Unilateral percutaneous vertebroplasty in osteoporotic vertebral compression fractures: A clinical efficacy evaluation.

Osteoporotic vertebral compression fractures, often resulting from low-energy trauma, markedly impair the quality of life of elderly individuals. The present retrospective study focused on the clinical efficacy of unilateral percutaneous vertebroplasty (PVP) in the treatment of osteoporotic compression fractures. A total of 68 patients, representing 92 vertebral bodies, who underwent the unilateral PVP technique from March 2020 to January 2023 were evaluated. Key parameters such as visual analogue scale (VAS) values, Oswestry disability index (ODI) scores, Cobb angle measurements, and anterior vertebral height (AVH) were documented pre- and post-surgery. The mean follow-up period was 15.41±3.74 months. The mean pre-operative VAS score was 8.08±0.79, which was significantly reduced to 2.25±0.71 by 24 h post-surgery and stabilized at 1.58±0.51 by the final follow-up. The ODI showed a significant improvement from a pre-operative average of 67.75±7.91 to 19.74±2.90 post-surgery, and was maintained at a low level of 28.00±4.89 at the last assessment. Radiological evaluations revealed significant alterations in Cobb angle and AVH post-operation. Notably, during the follow-up, eight patients developed new compression fractures in different vertebral segments. In conclusion, the unilateral PVP method is safe and efficient for the management of osteoporotic vertebral compression fractures.

TREATMENT OF THORACOLUMBAR FRACTURES BY CLOSED REDUCTION VIA A PERCUTANEOUS SOLID PEDICLE SCREW.

Objectives: Investigate the effect of closed reduction and per- cutaneous pedicle screw fixation in treating thoracolumbar fractures. Methods: This retrospective study analyzed 12 cases of single-segment thoracolumbar spine fractures without spinal cord and nerve injury at our department from March 2016 to September 2017. Patients were treated with closed reduction, percutaneous reduction, and internal fixation with solid pedicle screws. The operation time, intraoperative blood loss, anterior vertebral body height ratio (AVHR), Cobb angle (CA) of sagittal kyphosis, and VAS of back pain were determined and statistically compared. Results: The average operation time was 147.2 ± 45.6 min, and the average intraoperative bleeding was 67.8 ± 34.2 mL. All fractured vertebrae were completely reduced, their height was restored, and kyphosis was corrected. The average follow-up period was 10.6 ± 2.7 months, with significant improvements seen in the AVHR, CA of sagittal kyphosis, and VAS score (P < 0.01). One case had a broken rod after three months, and another had a postoperative infection. All the patients achieved bony healing. Conclusion: The treatment of thoracolumbar fractures by closed reduction and internal fixation with a percutaneous solid pedicle screw is simple, effective, and economical. Level of Evidence VI; Therapeutic Study, Case Series .

Objetivo: Investigar o efeito da redução incruenta e da fixação com parafuso de pedículo percutâneo no tratamento das fraturas toraco- lombares. Métodos: Este estudo retrospectivo analisou 12 casos de fraturas toracolombares com segmento único sem lesão medular ou neural, encontrados no departamento dentro do período de março de 2016 a setembro de 2017. Os pacientes foram tratados com redução fechada e fixação interna com parafusos de pedículo percutâneo. O tempo de operação, a perda sanguínea intra-operatória, a relação da altura do corpo vertebral anterior (AVHR), o ângulo de Cobb (CA) da cifose sagital e a EVA relativa à dor nas costas foram determinados e comparados estatisticamente. Resultados: O tempo médio da operação foi de 147,2±45,6 min, com sangramento intraoperatório médio de 67,8±34,2 mL. Todas as vértebras fraturadas foram com- pletamente reduzidas, suas alturas foram restauradas e a cifose foi corrigida. O período médio de acompanhamento foi de 10,6±2,7 meses, apresentando melhorias significativas observadas no AVHR, CA da cifose sagital e pontuação VAS (P <0,01). Um caso teve uma haste quebrada após 3 meses, e outro paciente apresentou uma infecção pós-operatória. Todos os pacientes alcançaram a recuperação óssea. Conclusão: O tratamento das fraturas toracolombares por redução fechada com fixação interna pelo parafuso de pedículo percutâneo é simples, eficaz e econômico. Nível de Evidência IV; Estudos Terapêuticos, Série de Casos.

Treatment of thoracolumbar fractures by closed reduction via a percutaneous solid pedicle screw / Tratamento de fraturas toracolombares por redução fechada com parafuso de pedículo percutâneo

ABSTRACT Objectives: Investigate the effect of closed reduction and per- cutaneous pedicle screw fixation in treating thoracolumbar fractures. Methods: This retrospective study analyzed 12 cases of single-segment thoracolumbar spine fractures without spinal cord and nerve injury at our department from March 2016 to September 2017. Patients were treated with closed reduction, percutaneous reduction, and internal fixation with solid pedicle screws. The operation time, intraoperative blood loss, anterior vertebral body height ratio (AVHR), Cobb angle (CA) of sagittal kyphosis, and VAS of back pain were determined and statistically compared. Results: The average operation time was 147.2 ± 45.6 min, and the average intraoperative bleeding was 67.8 ± 34.2 mL. All fractured vertebrae were completely reduced, their height was restored, and kyphosis was corrected. The average follow-up period was 10.6 ± 2.7 months, with significant improvements seen in the AVHR, CA of sagittal kyphosis, and VAS score (P < 0.01). One case had a broken rod after three months, and another had a postoperative infection. All the patients achieved bony healing. Conclusion: The treatment of thoracolumbar fractures by closed reduction and internal fixation with a percutaneous solid pedicle screw is simple, effective, and economical. Level of Evidence VI; Therapeutic Study, Case Series.

RESUMO Objetivo: Investigar o efeito da redução incruenta e da fixação com parafuso de pedículo percutâneo no tratamento das fraturas toraco- lombares. Métodos: Este estudo retrospectivo analisou 12 casos de fraturas toracolombares com segmento único sem lesão medular ou neural, encontrados no departamento dentro do período de março de 2016 a setembro de 2017. Os pacientes foram tratados com redução fechada e fixação interna com parafusos de pedículo percutâneo. O tempo de operação, a perda sanguínea intra-operatória, a relação da altura do corpo vertebral anterior (AVHR), o ângulo de Cobb (CA) da cifose sagital e a EVA relativa à dor nas costas foram determinados e comparados estatisticamente. Resultados: O tempo médio da operação foi de 147,2±45,6 min, com sangramento intraoperatório médio de 67,8±34,2 mL. Todas as vértebras fraturadas foram com- pletamente reduzidas, suas alturas foram restauradas e a cifose foi corrigida. O período médio de acompanhamento foi de 10,6±2,7 meses, apresentando melhorias significativas observadas no AVHR, CA da cifose sagital e pontuação VAS (P <0,01). Um caso teve uma haste quebrada após 3 meses, e outro paciente apresentou uma infecção pós-operatória. Todos os pacientes alcançaram a recuperação óssea. Conclusão: O tratamento das fraturas toracolombares por redução fechada com fixação interna pelo parafuso de pedículo percutâneo é simples, eficaz e econômico. Nível de Evidência IV; Estudos Terapêuticos, Série de Casos

A retrospective cross-sectional survey of non-specific lower back pain among a cohort of Chinese army soldiers.

RESEARCH BACKGROUND: Nonspecific lower back pain (LBP) has been a major public health problem in western countries since the second half of the 20 t h century. The trend has expanded to non-western countries, and LBP is currently a significant cause of disability in the working population. OBJECTIVE: To investigate the prevalence of nonspecific lower back pain (LBP) and its risk factors among soldiers in the Chinese army. METHODS: A total of 2876 Chinese army soldiers were requested to complete a self-administered questionnaire on demographic, anthropometric factors, and their non-specific LBP symptoms. The LBP evaluation and risk factor analysis were based on the self-questionnaire survey. RESULTS: The prevalence of non-specific LBP with physical state, one-child family, educational status, resident location and ethnicity were not associated (P > 0.05); while smoking, LBP history, LBP family history, nightmare frequency, sleep quality, and self-perceived fitness had significant effects on LBP (P < 0.05, Table 2). Multivariate logistic regression analysis showed that smoking (OR = 2.153,95% CI = 1.045-4.433), History of LBP (OR = 2.503,95% CI = 1.580-3.966), LBP family history (OR = 1.615,95%CI = 1.015-2.572), nightmare frequency (OR = 3.386, 95% CI = 2.047-5.603), sleep quality (OR = 2.391, 95% CI = 1.085-5.269) and self-perceived fitness (OR = 1.93,95%CI = 1.045-3.765) had significant effects on LBP (P < 0.05)) (Table 3). CONCLUSIONS: Smoking, history of LBP, LBP family history, nightmare frequency, sleep quality, self-perceived fitness were important factors in the occurrence and persistence of LBP.

Anterior cervical distraction and screw elevating-pulling reduction for traumatic cervical spine fractures and dislocations: A retrospective analysis of 86 cases.

Treatment of cervical fracture and dislocation by improving the anterior cervical technique.Anterior cervical approach has been extensively used in treating cervical spine fractures and dislocations. However, when this approach is used in the treatment of locked facet joints, an unsatisfactory intraoperative reduction and prying reduction increases the risk of secondary spinal cord injury. Thus, herein, the cervical anterior approach was improved. With distractor and screw elevation therapy during surgery, the restoration rate is increased, and secondary injury to the spinal cord is avoided.To discuss the feasibility of the surgical method of treating traumatic cervical spine fractures and dislocations and the clinical application.This retrospective study included the duration of patients' hospitalization from January 2005 to June 2015. The potential risks of surgery (including death and other surgical complications) were explained clearly, and written consents were obtained from all patients before surgery.The study was conducted on 86 patients (54 males and 32 females, average age of 40.1 ±â€Š5.6 years) with traumatic cervical spine fractures and dislocations, who underwent one-stage anterior approach treatment. The effective methods were evaluated by postoperative follow-up.The healing of the surgical incision was monitored in 86 patients. The follow-up duration was 18 to 36 (average 26.4 ±â€Š7.1) months. The patients achieved bones grafted fusion and restored spine stability in 3 to 9 (average 6) months after the surgery. Statistically, significant improvement was observed by Frankel score, visual analog scale score, Japanese Orthopedic Association score, and correction rate of the cervical spine dislocation pre- and postoperative (P < .01).The modified anterior cervical approach is simple with a low risk but a good effect in reduction. In addition, it can reduce the risk of iatrogenic secondary spinal cord injury and maintain optimal cervical spine stability as observed during follow-ups. Therefore, it is suitable for clinical promotion and application.

Comparison of the technique of anterior cervical distraction and screw elevating-pulling reduction and conventional anterior cervical reduction technique for traumatic cervical spine fractures and dislocations.

INTRODUCTION: To analyze and confirm the advantages of anterior cervical distraction and screw elevating-pulling reduction which are absent in conventional anterior cervical reduction for traumatic cervical spine fractures and dislocations. MATERIALS AND METHODS: A retrospective study was conducted on 86 patients with traumatic cervical spine fractures and dislocations who received one-stage anterior approach treatment for a distraction-flexion injury with bilateral locked facet joints between January 2010 and June 2015. They were 54 males and 32 females with an age ranging from 20 to 73 years (average age, 40.1 ± 5.6 years). These patients were distributed into group A and group B in the sequence of visits, with 44 cases of conventional anterior cervical reduction (group A) and 42 cases of anterior cervical distraction and screw elevating-pulling reduction (group B). Comparison of intraoperative blood loss, operation duration and vertebral reduction rate was made between the two groups. The follow-up time was 12-18 months, and the clinical outcomes of surgery were evaluated according to ASIA score, VAS score and JOA score. RESULTS: Statistically significant difference was revealed between group A and group B in the surgical time and the correction rate of cervical spine dislocation (p < 0.05), with the results of group B better than those of group A. For the two groups, statistically significant difference was shown between the ASIA score, VAS score and JOA score before and after operation (p < 0.05), with the results better after operation, while no statistically significant difference was revealed in such scores between the two groups (p > 0.05), with the therapeutic effect of group A the same with that of group B. CONCLUSIONS: Anterior cervical distraction and screw elevating-pulling reduction is simple with low risk, short operation duration, good effect of intraoperative vertebral reduction and well-recovered function after the operation. Meanwhile, as a safe and effective operation method for cervical spine fractures and dislocations, it can reduce postoperative complications and the risk of the iatrogenic cervical spinal cord injury caused by prying or facet joint springing during conventional reduction, having more obvious advantages compared to the conventional surgical reduction adopted by group A, with good cervical spine stability as shown in long-term follow-up. Therefore, it is suitable for clinical promotion and application.

[The causes of death and risk factors in patients of war wound and trauma of extremities by logistic regression model].

OBJECTIVE: To explore the causes of death and risk factors in patients of war wound and trauma of extremities. METHODS: This retrospective study involved 352 patients of war wound and trauma of extremities admitted to 303rd Hospital of People's Liberation Army during the period between 1968 to 2002. All the data were reviewed and the causes of death of 15 patients were analyzed by autopsy, and a computer's logistic regression model analysis was performed to approach the risk factors of death. RESULTS: Fifteen of the three hundred and fifty-two patients were died (4.3 %). The causes of death included acute renal failure (ARF) (46.7%, 7/15), lung embolism (20.0%, 3/15), clostridial myonecrosis (20.0%, 3/15) and multiple organ system failure (MOSF) (13.3%, 2/15). In the univariate analysis, the risk of death increased by shock, time admitted to hospital, amputation, time of tourniquet, associated injury of head, thoracic region, abdomen or blood vessel (P < 0. 05). In the logistic regression model analysis, shock and amputation were the two factors most strongly associated with the death of patients of war wound and trauma. (P < 0. 05). CONCLUSION: Acute renal failure (ARF) was the main cause of death of patients of war wound and trauma of extremities. Its should be helpful for minimize the mortality of patients of war wound and trauma to manage the shock in time and have a correct choice of amputation promptly.