Reconstruction of vertebral body in thoracolumbar AO type A post-traumatic fractures by balloon kyphoplasty: a series of 85 patients with a long follow-up and review of the literature.

BACKGROUND: Traumatic fractures of the thoracolumbar spine are common injuries, accounting for approximately 90% of all spinal traumas. Optimal management of these fractures still gives rises to much debate in the literature. Currently, one of the treatment options in young patients with stable traumatic vertebral fractures is conservative treatment using braces. Kyphoplasty as a minimally invasive procedure has been shown to be effective in stabilizing vertebral body fractures, resulting in immediate pain relief and improving physical function with early return to work activity. The aim of our study was to report VAS, ODI scores, and kyphosis correction following treatment. METHODS: This is a retrospective study to investigate the clinical and radiological results 10 years after percutaneous balloon kyphoplasty followed by cement augmentation with polymethylmethacrylate (PMMA) or calcium phosphate cements (CPC), according to age, in 85 consecutive patients affected by 91 AO spine type A traumatic fractures of the thoracolumbar spine (A1, A2, and A3). Clinical follow-up was performed with the Visual Analogic Scale (VAS) at the preoperative visit and in the postoperative follow-up after 1 week, 1, 6, 12 months, and each year up to 10 years. Additionally, the Oswestry Disability Index (ODI) improvement was calculated as the difference between the ODI scores at the preoperative visit and at final follow-up. Finally, the Cobb angle from this cohort was assessed before surgery, immediately postoperatively, and at the end of follow-up. RESULTS: Kyphoplasty markedly improved pain and resulted in statistically significant vertebral height restoration and normalization of morphologic shape indexes that remained stable for at least 10 years following treatment. CONCLUSIONS: The present study showed that kyphoplasty and cement augmentation are an effective method of treatment for selected type A fractures.

Variation of POP concentrations in fresh-fallen snow and air on an Alpine glacier (Monte Rosa).

To understand better the mechanisms ruling the fate of POPs (persistent organic pollutants) in cold environments, a field campaign sampling fresh-fallen snow and air on an Alpine glacier was carried out during Summer 2003. The concentrations of all analyzed chemicals in fresh-fallen snow show a sharp decrease over time, particularly for the more volatile POPs, confirming the rather limited literature evidence of a rapid decline of such substances from the snowpack and/or ice. Even if the results presented here are preliminary and should be confirmed by further studies, some evidence of the influence of a night/day cycle of temperature on POP deposition and revolatilization mechanisms has been highlighted. Finally, the role of cold condensation and long-range atmospheric transport in the contamination of higher altitudes in this Alpine system has been substantiated, particularly for OC pesticides.