ABSTRACT
CASE: We present a case of progressive paraplegia because of extramedullary hematopoiesis and pathological vertebral fracture in thalassemia patient. The various surgical techniques including larger pedicle screws, bicortical fixation, and convergent direction to improve pullout strength had been used secondary to osteoporotic bone and kyphotic deformity. CONCLUSION: Prompt diagnosis and awareness of the compromised bone quality of the thalassemic patient is essential to guide the proper management and produce the desire outcomes.
ABSTRACT
OBJECTIVE: To evaluate the effectiveness of the In- space (Synthes, Umkirch, Germany) and the correlation between radiographic parameters and clinical outcome in patients with lumbar spinal canal stenosis (LSS). METHODS: Between June 2009 and May 2013, 56 patients with LSS underwent In-space by one senior surgeon. All of the patients were evaluated both clinically and radiographic measurements before the procedure and each visit at the postoperative follow-up. Preoperative and postoperative X-ray imaging was performed before the procedure and at follow-up to assess the correlation with the clinical outcome. Radiological measurements and clinical outcomes were recorded to establish a relationship between the radiographic parameters and clinical outcome of this procedure. All patients had at least 2 years of follow-up. RESULTS: The mean VAS score of back pain decreased significantly (p < 0.05). CONCLUSIONS: Our data suggest that percutaneous interspinous devices are a good alternative to treat LSS. The device offers significant decrease in back pain, leg pain and ODI score with 2-year lasting relief from symptoms. The increased intervertebral foramenal space explains the improvement of leg pain, but the mechanism of back pain relief remains unclear. A very weak correlation between the radiographic changes and improvement of pain was found.
ABSTRACT
Anthropometric data on the distal femoral condyle and the proximal tibia of 200 knees in 200 Thai subjects were measured using magnetic resonance imaging (MRI). The data including the resected femoral anterior-posterior (AP) length, the resected femoral medial-lateral (ML) width, the resected tibial AP length and the resected tibial ML width were measured. A characterization of the aspect ratio (the ML to AP dimensions) was made for the distal part of the femur and the aspect ratio (the AP to ML dimensions) was made for the proximal part of the tibia. All parameters were compared to the size of the total knee prosthesis with four prosthetic systems which currently used in Thailand: NexGen (Zimmer), P.F.C. Sigma (Depuy-Johnson & Johnson), Genesis II (Smith & nephew), and Scorpio (Stryker). The results of this study could provide fundamental data for the design of knee prostheses suitable for the Thai population.
