Changes of Serum Alkaline Phosphatase and Osteocalcin during Fracture Healing / 대한정형외과학회잡지

PURPOSE: To investigate changes of serum osteoblastic marker during fracture healing. MATERIALS AND METHODS: The study included 22 patients with fresh fractures. Serum alkaline phosphatase (ALP), bone specific alkaline phosphatase and osteocalcin were analyzed on the first day and 1, 2, 4 and 8 weeks after injury. The bone specific-ALP was quantified by electrophoresis. Osteocalcin was quantified by enzyme linked immunosorbent assay (ELISA). RESULTS: One, 2, 4 and 8 weeks after injury, mean values of serum ALP increased 1.26, 1.45, 1.63, and 1.2 times that on the first day after injury, respectively. Similarly, during the same period, bone specific ALP increased 1.38, 1.33, 1.73 and 1.25 times, and serum osteocalcins increased 1.32, 1.2, 1.64 and 2.09 times. CONCLUSION: Serum ALP increased during the early soft callus phase. However, serum osteocalcins increased during the late hard callus phase. Serum alkaline phosphatase and osteocalcin warrant further study as useful prognostic indicators of fracture healing.

Pyogenic L4-5 Spondylitis Managed with Percutaneous Drainage Followed by Posterior Lumbar Interbody Fusion: A Case Report / 대한척추외과학회지

STUDY DESIGN: A case report and review of literature OBJECTIVE: Mostly operative treatment for pyogenic spondylits has been performed via anterior approach, which is often followed by greater morbidity and late sequelae. Efficacy of percutaneous drainage and posterior lumbar interbody fusion (PLIF), which are increasingly applied with favorable results, as an alternative of anterior surgery was investigated. MATERIAL AND METHOD: A case of pyogenic L4-5 spondylitis with psoas abscess but without neurologic deficit in a 66-year old lady was reviewed. Percutaneous drainage under fluoroscopic guide was performed. 7 weeks later, curettage of disc space and posterior lumbar interbody fusion using autogeous graft was performed to get rid of dead space and achieve stability. Administration of antimicrobial agents followed. RESULTS: Infection was controlled successfully. Clinical features including ambulatory function improved. Solid fusion was achieved. SUMMARY: In treating pyogenic spondylitis with moderate abscess, percutaneous drainage and posterior lumbar interbody fusion seemed to be one of alternatives of anterior surgery.