ABSTRACT
Osteoporotic vertebral compression fractures have become common in aging societies and can lead to a decreased quality of life with severe back pain and neurological deficits. Traditional direct decompression and stabilization surgeries can produce sufficient decompression and provide good results. However, after surgical treatment, some elderly patients with numerous chronic diseases often experience severe postoperative complications owing to the long surgery duration and massive bleeding. Therefore, to prevent perioperative morbidity, other surgical methods that simplify the surgical process and reduce the operation time are required. Herein, we describe a case of indirect decompression using ligamentotaxis and sequential anabolic agents. To examine their effectiveness during surgery, we monitored intraoperative motor-evoked potentials. The patient's neurological symptoms improved postoperatively. After the operation, the anabolic agent "romosozumab" was injected monthly to treat osteoporosis, prevent additional fractures, and accelerate posterolateral fusion. On serial follow-up, the anterior body height of the fractured vertebra improved significantly, demonstrating the importance of osteoporosis treatment using anabolic agents. Indirect decompression surgery may have early effects, whereas sequential anabolic agent use may consolidate the long-term effects of surgical treatment.
ABSTRACT
Estimulação magnética transcraniana (EMT) é uma técnica capaz de induzir correntes elétricas em regiões corticais de forma não invasiva que apresenta um grande potencial tanto como uma ferramenta diagnóstica quanto terapêutica nos transtornos neuropsiquiátricos, como na depressão, esquizofrenia e neurológicos como no AVC e epilepsia. Este artigo aborda sinteticamente a EMT: fundamentos, tipos, aplicações, efeitos adversos e medidas de segurança...
Transcranial magnetic stimulation (TMS) is a non-invasive technique that can induce electrical currents in cortical areas, having thus a significant potential both as an investigational and as a therapeutic tool in neuropsychiatric disorders, such as depression and schizophrenia, and neurological, such as stroke and epilepsy. This article synthetically summarizes the applications of transcranial magnetic stimulation: fundamentals, type of stimulation, applications, adverse effects e safety...
Subject(s)
Humans , Electroencephalography , Transcranial Magnetic Stimulation/methods , Electric Stimulation Therapy/methods , Depression/therapy , Parkinson Disease/therapy , Epilepsy/therapy , Schizophrenia/therapyABSTRACT
Objective To investigate the effects of paravertebral injection of different concentrations of adriamycin on motor conduction function in rats. Methods Eighty healthy male Wistar rats weighing 250-300 gwere randomly divided into 4 groups (n = 20 each): 3 adriamycin groups receiving paravertebral injection of 0.3%, 0.5% and 1.0% adriamycin 10 μl respectively (group A1, A2, A3) and control group (group C)receiving equal volume of normal saline (NS) instead of adriamycin. The animals were anesthetized with intraperitoneal 3% pentobarbital 40 mg/kg. A right paramedian incision was made in the back from L3 to S1.L4,5,5,6 intervertebral foramina were exposed. 0.3%, 0.5% and 1.0% adriamycin and NS 10 pl were injected into the intervertebral foramina in group A1, A2, A3 and C respectively. Spinal motor evoked pontential (SMEP)was measured at 1, 2, 4 and 8 weeks (T1-4)after paravertebral injection. Results The latent period of SMEP was significantly prolonged and the amplitude decreased at T1-4 in group A3 as compared with group A1, A2 and C.Conclusion Paravertebral injection of 1.0% adriamycin can significantly depress motor conduction function.
