RESUMO
BACKGROUND: Percutaneous vertebroplasty (PVP) is more commonly used for osteoporotic compression fractures (OCFs) and osteolytic vertebral body tumors. This study aimed to study the differences between OCFs and vertebral hemangiomas (VHs) treated with PVP. MATERIALS AND METHODS: Between September 2007 and January 2010, we prospectively treated 28 consecutive patients of OCFs (43 recently symptomatic OCFs) and 24 cases of VHs (26 VHs). We used visual analogue scale (VAS) pain and Oswestry Disability Index (ODI) to evaluate the patients. The followup period in group 1 and 2 were 25.1 months (range 12 - 31 months) and 21.3 months (range 14 - 28 months), respectively. Comparison of means was carried out with the Chi Square Tests, t-test, and N Par-Test for multiple comparisons, whenever appropriate. The level of statistical significance was set at P < 0.05. RESULTS: Following PVP the VAS score decreased to 4.57 and 4.17 in group 1 and 2, respectively. The ODI scores were 32.5% and 30%, respectively. This decrease in ODI scores lasted throughout the followup period. CONCLUSIONS: Although the preoperative scores were significantly different between group 1 and 2, there was no significant difference between two groups following the PVP.
RESUMO
BACKGROUND: Numerous techniques for determining the flexibility of the scoliotic cure have been invented. Our contribution includes combining traction and translation forces; we introduced a new radiographic technique that can be claimed to be capable of a far more precise prediction of the scoliotic curve flexibility. METHODS: In this study, we compared the flexibility rate obtained on standard fulcrum bending radiographs with modified ones in 50 consecutive patients with adolescent idiopathic scoliosis (78 curves) who had referred to our clinics from September 2009 to July 2012. In this new technique, we added traction force to the upside extremities. Then, flexibility rate of the two methods was compared statistically. RESULTS: The study included 50 cases (43 female and 7 male) aged 10-17 (14.5 ± 2.1 years) comprising 78 scoliotic curves. Curves magnitude varied from 25° to 135° (61.4° ± 21.3°). The mean flexibility rate with standard fulcrum bending radiograph was 38.8% ± 20%. This index increased to 58.3% ± 22.2% (which is statistically significant, p < 0.0005) as a result of implementing the modified fulcrum bending method. Excluding the proximal thoracic curves due to the limited number of the cases, the difference between flexibility rate with this new technique in main thoracic and thoracolumbar/lumbar curves is not statistically significant (p > 0.05). CONCLUSIONS: The modified fulcrum bending method we introduced has some inevitable disadvantages; however, in the era of modern and vigorous segmental spinal instrumentation, with combining traction and translation forces in their best biomechanical state, it can demonstrate the scoliotic curve flexibility much more efficiently.
RESUMO
BACKGROUND: Congenital muscular torticollis is the third most common congenital musculoskeletal anomaly after dislocation of the hip and clubfoot. When diagnosed early, it is obvious that it can be managed with good or excellent results. The aim of this prospective study was to determine the efficacy of surgery in neglected adult cases. METHODS: From January 2003 to June 2007, 18 adult skeletally matured patients were surgically treated for neglected congenital muscular torticollis and prospectively followed (at least one year). Bipolar release was performed in all patients. Radiography and the modified Lee's scoring system which included function and cosmesis, were used to measure the surgical results. Complications were also recorded. RESULTS: Four cases were lost during follow-up. Of the remaining 14 patients, 10 cases were males and 4 females. The age at operation ranged from 18 to 32 (average 21.9) years. The mean follow-up period was 2.5 years (range 1-5 years). Excellent results were noted in 7 patients, good in 5, and poor in 2 patients. Significant improvement (>10 degrees) of the cervico-thoracic scoliosis was noted only in 3 of 10 patients. CONCLUSION: Patients with congenital muscular torticollis can benefit from surgical treatment even in adulthood. Surgical bipolar sectioning of the sternocleidomastoid muscle should be considered even in adults with irreversible facial and skeletal deformities. The surgery restores the range of neck motion and resolves the head tilt; therefore it can improve the quality of life. This procedure is an effective and relatively complication-free method.
