Influence of bone cement distribution on outcomes following percutaneous vertebroplasty: a retrospective matched-cohort study.

OBJECTIVE: To evaluate the influence of insufficient bone cement distribution on outcomes following percutaneous vertebroplasty (PVP). METHODS: This retrospective matched-cohort study included patients 50-90 years of age who had undergone PVP for single level vertebral compression fractures (VCFs) from February 2015 to December 2018. Insufficient (Group A)/sufficient (Group B) distribution of bone cement in the fracture area was assessed from pre- and post-operative computed tomography (CT) images. Assessments were before, 3-days post-procedure, and at the last follow-up visit (≥12 months). RESULT: Of the 270 eligible patients, there were 54 matched pairs. On post-operative day 3 and at the last follow-up visit, significantly greater visual analogue scale (VAS) pain scores and Oswestry Disability Index (ODI) scores were obtained in Group B over Group A, while kyphotic angles (KAs) and vertebral height (VH) loss were significantly larger in Group A compared with Group B. Incidence of asymptomatic cement leakage and re-collapse of cemented vertebrae were also greater in Group A compared with Group B. CONCLUSIONS: Insufficient cement distribution may relate to less pain relief and result in progressive vertebral collapse and kyphotic deformity post-PVP.

Bilobed mucosal flap for correction of secondary lip deformities following cleft lip surgery.

BACKGROUND: Upper lip whistling deformities, asymmetric upper lip thickness and insufficient vermilion tubercle often occur simultaneously in an affected individual. Unfortunately, these deformities cannot be corrected by a single conventional method. Here, we describe a new technique, using a vermilion-bilobed flap, to address the triplex of deformities simultaneously. METHODS: A total of 30 A Thirty patients were included in this study. Their ages ranged from 10 to 35 years. The flap consisted of two lobes: one lobe of the flap was located at the oral mucosa of the prolabium, which allowed for correction of the whistle deformity as well as augmentation of the vermilion tubercle; the other was located at the vermilion mucosa on the lateral side of the cleft, which effectively repaired oral mucosal defects. Quantitative measurements of the vermilion shape were performed before surgery and 6 months postoperatively. RESULTS: All patients healed well with no complications of the flaps.The gross appearance of the vermilion was significantly improved. Normal tubercles were restored and symmetric profiles of vermilion were achieved. All the patients were satisfied with their final appearance. CONCLUSIONS: The bilobed vermilion mucosal flap is a safe technique, easy to perform and effectively corrects the combined secondary deformities associated with cleft lip surgery.

[Experimental study on the toxic effects of hydrophilic polyacrylamide gel].

OBJECTIVE: To study the safety of Hydrophilic polyacrylamide gel (HPAG) through an animal experiment. METHODS: After HPAG was injected underneath the skin of SD rats, tissue specimens were taken for general and histological examinations. The cytotoxicity was evaluated by agar coverage and MTT method. RESULTS: It was determined that the cytotoxicity was over level-two. The toxicity to kidney was obvious. The local histological reaction was slight and a thin fibrous membrane was formed around HPAG, which became stiff gradually. The shape and location of the injected HPAG was not stable. The HPAG could not be drawn out completely. CONCLUSION: HPAG has obvious cytotoxicity and is not a suitable material as soft tissue implant for the bad shape and texture.

[Clinically analyzing the possible side-effects after injecting hydrophilic polyacrylamide gel as a soft-tissue filler].

OBJECTIVE: To evaluate the possible side-effects after injecting hydrophilic polyacrylamide gel for augmentation of the soft-tissue. METHODS: Fifteen patients with some side-effects after injecting the hydrophilic polyacrylamide gel had been undergoing for the treatment in our unit from 2000 to 2001. Their symptoms were analyzed and the specimen of the tissue was also removed for pathologic examination. RESULTS: The major complaints of the patients after injecting hydrophilic polyacrylamide gel were feeling pain(60.00%), uncomfortable (13.33%), no cosmetic improvement results (33.33%), secondary deformity (20.00%), long-lasting swelling (6.67%), and nodules (80.00%). The pathologic examination was showing the capsule formation (53.33%), macrophagocyte infiltration (60.00%) and granuloma producing (20.00%). CONCLUSION: Clinical application of the hydrophilic polyacrylamide gel may result in some serious side-effects. It should be cautious to the physicians who may apply the product for clinic use.