Effect of Anterior Thoracoscopic Release Combined with the Posterior Correction Operation on the Pulmonary Function of Patients with Idiopathic Scoliosis.

BACKGROUND: Anterior thoracoscopic release combined with posterior correction is a common surgery to treat idiopathic scoliosis (IS). However, whether it has detrimental effects on pulmonary function is still unknown. AIM: The aim of the study is to evaluate the effect of anterior thoracoscopic release combined with posterior correction on the pulmonary function. Materials and Methods A retrospective study of 28 (12 male, 16 female) patients with IS undergoing anterior thoracoscopic release combined with posterior correction from 2009 to 2011 was performed. The radiographic and pulmonary function evaluations were performed preoperatively and at 24 months postoperatively. RESULTS: The average coronal Cobb angle was corrected from 88.36 ± 25.6 degrees to 49.8 ± 11.8 degrees, and average sagittal Cobb angle was corrected from 57.5 ± 17.2 degrees to 26.3 ± 4.7 degrees. The measured forced vital capacity (FVC) and total lung capacity (TLC) were significantly increased at 2 years postoperatively (3.21 ± 1.18 versus 2.47 ± 0.33; 4.32 ± 1.41 versus 3.68 ± 0.36; p < 0.01). However, no significant difference in the FVC% and TLC% was observed. The functional residual capacity percentage was 109.87 ± 14.87 preoperatively and increased to 118.56 ± 34.34 at 2 years postoperatively (p < 0.05). Both the measured residual volume (RV) and RV% were reduced postoperatively (p < 0.05). The maximum ventilatory volume percentage improved significantly (107.38 ± 39.22 versus 77.46 ± 12.37, p < 0.05). In addition, total airway resistance, inhaled airway resistance, and exhaled airway resistance were all decreased significantly. CONCLUSION: Anterior thoracoscopic release combined with posterior correction has proved to be a safe surgical technique that results in minor pulmonary function impairment.

[Analysis of hidden blood loss after percutaneous kyphoplasty for osteoporotic vertebral compression fracture and its influencing factors].

OBJECTIVE: To investigate the hidden blood loss and related risk factors of osteoporotic vertebral compression fractures after percutaneous kyphoplasty. METHODS: The clinical data of 153 patients with osteoporotic vertebral compression fractures who underwent percutaneous kyphoplasty from March 2015 to December 2017 were retrospectively analyzed, including 55 males and 98 females, aged 68 to 87(78.6±11.4) years old. Erythrocyte specific volume was collected before and after operation to calculate the hidden blood loss. The influence of sex, age, body mass index, bone mineral density, diabetes mellitus and hypertension, operation mode (unilateral or bilateral), operation time, operative segment and number, loss height of vertebral body and recovery height ratio on hidden blood loss was analyzed by multiple linear regression model. RESULTS: Postoperative hidden blood loss was (287.7±68.5) ml. Multivariate linear regression analysis showed that the history of diabetes mellitus (ß=2.405, P=0.012), the mode of operation(ß=3.042, P<0.001), the time of operation (ß=2.043, P=0.038), the operative segment (ß=1.993, P=0.043), the number (ß=0.374, P<0.001), the loss of vertebral height (ß=2.785, P=0.003) and the recovery ratio(ß=7.301, P<0.001) were correlated with occult hemorrhage. CONCLUSIONS: There is a certain degree of occult hemorrhage in kyphoplasty for osteoporotic vertebral compression fractures. The risk factors of hidden hemorrhage are diabetes history, operation method, operation time, operative segment and number, loss of vertebral height and recovery ratio.

The Effect of the Modified Eighth Section of Eight-Section Brocade on Osteoporosis in Postmenopausal Women: A Prospective Randomized Trial.

Osteoporosis and related fragility fractures represent a serious and global public health problem. To evaluate whether the modified eighth section of Eight-section Brocade (MESE) exercise could improve the symptom and indexes associated with osteoporosis in postmenopausal women. Guangzhou and Liuzhou hospital of traditional Chinese medicine in China. Women (n = 198) aged 50 to 75 years were randomized into Control, Ca, MESE, and MESE + Ca. Subjects in Ca and MESE groups were separately asked to consume thrice daily Calcium Carbonate Chewable D3 tablet and to perform thrice daily MESE exercise by 7 repetitions per time for 12 months. Subjects in MESE + Ca group performed such the combined treatment project for 12 months. Body height and Hospital for Special Surgery (HSS) scores of both knees, chronic back pain visual analogue scale scores (VAS), bone mineral density (BMD) at L2 to L4 and the left femoral neck, 3-feet Up and Go Test (3') and one-leg Stance (OLS). In our study, the improvement in chronic back pain of the patients in Ca, MESE, and MESE + Ca group was better than that in control group. There was 1.9% and 1.7%, 2.3%, and 2.1% net profit in left femoral neck and lumbar BMD after the treatment for 12 months in MESE and MESE + Ca groups. For the balance capacity, the subjects in MESE and MESE + Ca groups secured much better performance than those in Ca and control group after the treatment for 12 months (P < 0.001, P < 0.001). The treatment of MESE exercise is the most effective for the improvement of the symptom and indexes in postmenopausal women. Importantly, the low attrition and the high exercise compliance indicate that MESE exercise is safe, feasible, and well tolerated by postmenopausal women.

Comparison of the sagittal profiles among thoracic idiopathic scoliosis patients with different Cobb angles and growth potentials.

BACKGROUND: Previous studies have demonstrated that pelvic incidence and sacral slope are significantly greater in idiopathic scoliosis patients compared with normal adolescents. However, whether these sagittal parameters are related to the progression of scoliosis remain unknown. The present was designed to determine the differences in the sagittal profiles among thoracic idiopathic scoliosis patients with different potentials for curve progression. METHODS: Ninety-seven outpatient idiopathic scoliosis patients enrolled from June 2008 to June 2011 were divided to three groups according to different Cobb angles and growth potentials: (1) non-progression of thoracic curve group, Risser sign of 5 and Cobb's angle < 40°; (2) moderate progression of thoracic curve group, Risser sign of 5 and Cobb's angle ≥ 40°; and (3) severe progression of thoracic curve group, Risser sign ≤ 3 and Cobb's angle ≥ 40°. All patients underwent whole spinal anteroposterior and lateral X-ray in standing position, and the sagittal parameters were measured, including thoracic kyphosis, lumbar lordosis, sacral slope, pelvic incidence, and pelvic tilt. RESULTS: The average thoracic scoliosis Cobb's angle in the non-progression group was significantly less than that in the moderate progression group (P < 0.01) and severe progression group (P < 0.01), but there was no statistical difference in the average thoracic scoliosis Cobb's angle between the severe progression group and moderate progression group. The average thoracic kyphosis angle in the severe progression group (9° ± 4°) was significantly smaller than that in the non-progression group (18° ± 6°, P < 0.01) and moderate progression group (14° ± 5°, P < 0.05). No statistical differences were present in the average lumbar lordosis, sacral slope, pelvic incidence, and pelvic tilt among the three groups. CONCLUSIONS: Thoracic hypokyphosis is strongly related with the curve progression in thoracic idiopathic scoliosis patients, but not pelvic sagittal profiles.