Height Loss Rate Research Articles

Clinical efficacy of single-channel percutaneous endoscopic nucleotomy with annulus fibrosus suturing for lumbar disc herniation: A retrospective study.

This retrospective study aimed to investigate the clinical efficacy of single-channel percutaneous endoscopic nucleotomy combined with annulus fibrosus suturing for treating lumbar disc herniation (LDH). The study included 86 patients with LDH treated in our spinal department from August 2020 to January 2022. The suture group consisted of 26 males and 18 females, while the control group (nucleotomy alone) included 25 males and 17 females. All patients were followed for at least 1 year, with follow-up points at 3 days, 3 months, and 12 months postoperatively. Various clinical and radiological indicators were used to evaluate and compare the efficacy and safety of the 2 procedures. No statistically significant differences were observed in age, sex, BMI, surgical segments, degree of disc degeneration, or postoperative length of hospital stay. However, the suture group had a longer operative time (63.28 ± 4.17 minutes vs 54.71 ± 4.89 minutes, t = 8.759, P < .05). At 12 months postoperatively, neither group showed aggravated disc degeneration. There was also no significant difference in excellent rates between the 2 groups (95.45% vs 92.86%, X2=0.265, P = .607). However, the suture group had a lower intervertebral disc height loss rate compared to the control group (22.3% ± 4.6% vs 29.8% ± 6.2%, X2=6.390, P < .001). In conclusion, single-channel percutaneous endoscopic nucleotomy combined with annulus fibrosus suturing is a safe and reliable treatment for LDH. It effectively reduces the recurrence rate, slows disc degeneration and loss of disc height, and achieves excellent early outcomes.

Effect of printing parameters on extrudability and buildability of ultra-low carbon cementitious material

Cement-free cementitious materials are important for reducing the carbon footprint of 3D printing. However, for the ultra-low carbon cementitious material for 3D printing, the effect of printing parameters on its extrusion and stacking morphology has not been fully investigated. In this paper, an ultra-low carbon cement-free cementitious material (UCCCM) with ultra-fine slag and spherical fly ash as main components is developed. The influence of print head size (HS), print head height (HH), and printing speed (PS) on the extrudability and buildability are systematically investigated. Results showed that the HS had a clear influence on the extrudability, and a small print head size negatively affected the continuity of the extrudate. The HH had a greater influence on the buildability, and a low HH led to a height loss rate of more than 5 %. The PS had a greater influence on the buildability. When the PS was too slow, the mortar piled up and the printed specimens collapsed with a height loss rate of up to 35 %. When the PS was too fast, the strip cracked, and the height loss rate reached more than 10 %. The developed UCCCM for 3D printing presented optimal extrudability and buildability at a HS of 20 mm, a HH of 90 % and a PS of 20 mm/s.

Evaluation of the effectiveness of the short-segment thoracolumbar instrumentation

Aims: This prospective study aimed to compare the long-term follow-up findings of patients with short-segment thoracolumbar instrumentation with the long-term follow-up findings results of patients with long-segment thoracolumbar instrumentation. Merthods: Patients who underwent surgery for a thoracolumbar junction spine fracture were included in this study. The patient's age, gender, and neurological impairment, "AOSpine Classification Scale", "Visual Analog Scale (VAS)", "modified Japanese Orthopedic Association (mJOA)" and "Oswestry Disability Index (ODI)" scores, pedicle and/or pars interarticularis fractures, anterior, middle, and posterior height loss of the fractured vertebral body (mm), the height loss rate of the fractured vertebra, angulation degree, sagittal and axial spinal canal diameters (mm) and presence of bone fragment extending into the spinal canal on CT images were recorded at admission to the hospital, and the end of the sixth month after surgical intervention. Duration of anesthesia and surgery time, the amount of bleeding during the surgery, the radiation level (mGy) released by fluoroscopy, performing laminectomy, length of stay in the intensive care unit, and hospital were recorded. Additionally, the stability and integrity of the instrumentation were examined with dynamic X-ray images. Results: Preoperative fractured vertebra collapse rates (t=4.175, p=0.001) and surgery times (t=4.175, p=0.001) were different between groups In the long-segment group, preoperative VAS scores (Z=-2.687, p=0.007), mJOA scores (Z=-2.585, p=0.010), and ODI scores (t=53.253, p&lt;0.001) were different from postoperative long-term follow-up values. In addition, in the short segment group, preoperative VAS scores (Z=-2.214, p=0.027), mJOA scores (Z=-2.333, p=0.020), and ODI scores (t=48.338, p&lt;0.001) were different from the postoperative long-term follow-up values. ROC-curve analysis and Logistic Regression analysis results revealed that any study parameter could not predict the decision-making for inserting screws into the fractured vertebra, the need for laminectomy, the risk of developing postoperative instability, or the worse prognosis risk of mJOA. Conclusion: This study's results showed that short-segment instrumentation, which is performed by inserting a screw into the fractured vertebra, is as effective as long-segment instrumentation in providing both clinical and radiological improvement in patients. At the same time, it has advantages such as less operating time, less surgical bleeding, and short anesthesia time. However, it was determined that no parameter of the study could predict the placement of screws in the fractured spine, the need for laminectomy, the risk of postoperative instability, or the prognosis risk of mJOA. Therefore, it was concluded that conducting this study on a larger patient population would be appropriate.

Associations of Height Loss With Cognitive Decline and Incident Dementia in Adults Aged 50 Years and Older.

Associations of the rate of height loss (RHL) with cognitive decline and dementia in middle-aged and older adults have not been examined. This study included 3 610 participants aged 50 years and older from the English Longitudinal Study of Ageing. Standing height was measured with standardized protocols. RHL was estimated as an annualized percentage of height loss (% per year) during Waves 0-4, and was categorized into slow (<0.1%), medium (≥0.1% and <0.2%), and fast (≥0.2%). Associations between RHL and cognitive decline and incident dementia were analyzed using mixed-effects models and Cox regression models, respectively (Waves 5-9). There were 283 individuals identified with incident dementia over a mean follow-up of 7.21 years. Compared with participants in the slow group, those in the medium (coefficient [β] = -0.016, 95% confidence interval [CI] = -0.023 to -0.009) and fast groups (β = -0.030, 95% CI = -0.039 to -0.021) had faster declines in cognition. Faster height loss was also associated with increased risks of incident dementia (medium vs slow, hazard ratio [HR] = 1.37, 95% CI = 1.03-1.81; fast vs slow, HR = 1.75, 95% CI = 1.29-2.37). Besides, associations of RHL with cognitive decline were stronger in females than in males. Our findings indicated that rapid RHL was associated with faster declines in cognition and elevated risks of dementia. RHL may serve as an early marker of progressed neurodegeneration in middle-aged and older adults.

Comparison Clinical Outcomes of Posterior Short Segment Transpedicular Fixation with or without Injured Vertebra Fixation in Thoracolumbar Burst Fracture: A Retrospective Study.

To evaluate and compare clinical outcomes between the posterior short-segment pedicle fixation with injured vertebra fixation (PSPFI) and fixation without injured vertebra fixation (PSPF) for thoracolumbar burst fracture (TLBF). In this retrospective study, a total of 78 patients with TLBF were included and assigned to PSPFI (n=46) and PSPF (n=32) groups. The operative time, blood loss, perioperative complications, Oswestry disability index (ODI), and visual analog pain score (VAS) were examined immediately after surgery, 1 month, 3 months, and 1 year after surgery. Moreover, the postoperative vertebral height correction rate and postoperative Cobb angle correction rate were examined immediately and 1 year after surgery, as well as the corrected vertebral height loss rate and Cobb angle correction loss rate. No significant difference was identified in terms of operative time, blood loss, perioperative complications, ODI, and VAS after surgery (p > 0.05) between the PSPFI and PSPF groups. Moreover, the postoperative vertebral height correction rate and postoperative Cobb angle correction rate showed no difference between the groups as well. However, the PSPFI group had a significantly lower loss rate in terms of corrected vertebral height loss rate and Cobb angle correction loss rate than the PSPF group 1 year after surgery (p < 0.05). PSPFI and PSPF achieve similar clinical outcomes. However, posterior short-segment pedicle fixation with injured vertebra significantly maintains vertebral height correction rate and Cobb angle correction rate, which serve as a better choice for the treatment of TLBF.

Is there a difference in the outcomes of anterior cervical discectomy and fusion among female patients with different menopausal statuses?

BackgroundThe surgical outcomes of anterior cervical discectomy and fusion (ACDF) in female patients according to menopausal status remain unclear. The objective of this study was to investigate the differences in these outcomes among female patients with different menopausal statuses.MethodsNinety-one patients undergoing single-level or consecutive two-level ACDF with a minimum 12-month postoperative follow-up were included in this study. There were 38 patients in the premenopausal group, 28 patients in the early postmenopausal group, and 25 patients in the late postmenopausal group. The clinical outcomes were evaluated by means of the neck disability index (NDI) scores, Japanese Orthopedic Association (JOA) scores, and visual analog scale (VAS) scores. Radiological parameters included cervical lordosis (CL), the functional spinal unit (FSU) angle, range of motion (ROM) of the total cervical spine, ROM of the FSU, anterior and posterior FSU height, implant subsidence, adjacent segment degeneration (ASD), and Hounsfield unit (HU) values.ResultsAll groups showed significant improvements in their JOA, VAS, and NDI scores (P < 0.05). The differences in preoperative and final follow-up CL, ROM of C2-7, FSU angle, and ROM of FSU were not statistically significant among the three groups (P > 0.05). The anterior FSU height loss rate showed a significant difference (P = 0.043), while there was no difference in the posterior FSU height loss rate (P = 0.072). The fusion rates in the early and late postmenopausal groups were consistently lower than those in the premenopausal group during the follow-up period. All patients had satisfactory outcomes at the final follow-up.ConclusionThere were no significant differences in clinical or other related outcomes of single-level or consecutive two-level ACDF in the long term among female patients with different menopausal statuses. However, the early bony fusion rates and anterior FSU height loss rates were poorer in late postmenopausal patients than in premenopausal or early postmenopausal patients. Hence, importance should be attached to the protection of late postmenopausal patients in the early postoperative period to guarantee solid bony fusion.

Clinical efficacy and therapeutic value of delayed surgery in patients with symptomatic old thoracolumbar fractures

BackgroundTo investigate the clinical efficacy and therapeutic value of posterior decompression reduction, bone grafting fusion, and internal fixation for treatment of symptomatic old thoracolumbar fractures.MethodRetrospective analysis was conducted for 14 patients (9 men, 5 women; average age 40.1 years) with old thoracolumbar fractures who underwent posterior operation. American Spinal Injury Association (ASIA) scores were used to evaluate neurologic function. Vertebral body height, Cobb angle in the sagittal plane, spinal canal volume ratio (%) and bone graft fusion were analyzed by radiography and computed tomography on different follow-up times.ResultsMean follow-up was 27.1 months (23–36 months). Of three patients with ASIA grade A, 2 had improved postoperative urination and defecation, although no classification change. Preoperative ASIA score for eight patients with incomplete injury was grade B; four patients recovered to grade C at final follow-up. Preoperative ASIA score was C in three patients, increased to D in two patients and returned to normal E in one patient. Preoperative results showed average injured vertebra height loss rate decreased from 50.4 to 8.9%; average Cobb angle on the sagittal plane recovered from 39.6 to 6.9°; and the average spinal canal volume ratio recovered from 33.8 to 5.9%. Bony fusion was achieved; local lumbago and leg pain were relieved to some extent. No patients exhibited loosening of the fracture treated by internal fixation, pseudoarthrosis, or other related serious complications.ConclusionTreatment of old thoracolumbar fractures by posterior decompression reduction, bone grafting fusion, and internal fixation can relieve spinal cord compression, improve neurologic function of some patients (ASIA grades B–C), effectively relieve pain, correct deformity, restore biomechanical stability, and significantly improve quality of life.

Traumatic compression fractures in thoracic-lumbar junction: vertebroplasty vs conservative management in a prospective controlled trial

BackgroundBoth surgery and conservative management are well established treatments for compression fractures of the thoraco-lumbar spine without neurological compromise. This article aims to compare the outcomes of conservative management to...

Comparative analysis of binding multi-fold rib graft, iliac bone graft and titanium mesh graft during surgery of tuberculosis of thoracic vertebra

To compare the clinical effects of three different methods of binding multi-fold rib graft, iliac bone graft and titanium mesh graft in tuberculosis of thoracic vertebra by approach of transverse rib process. A hundred and seven patients with tuberculosis of thoracic vertebra received surgical treatment from January 2010 to December 2016 were retrospectively analyzed. The patients were divided into three groups according different methods of bone graft. The surgical approach of the transverse rib process was used in all 107 patients, after thoroughly remove the necrotic tissue of tuberculosis, three different bone grafts were used respectively including iliac bone graft (36 cases, group A), binding multi-fold rib graft (35 cases, group B), titanium mesh bone graft (36 cases, group C). Perioperative indexes, the time required for bone graft during operation, intraoperation blood loss, the loss rate of the anterior edge of the lesion, Cobb angle, postoperative bone graft fusion time, spinal nerve recovery and Oswestry Disability Index were compared among three groups. All the patients were followed up for 13 to 24 months, and the operation time required for bone graft was (23.2±4.1) min in group A, (23.8± 4.4)min in group B, and (25.5±4.2) min in group C, with no statistically significant difference among three groups (P>0.05). Intraoperative blood loss was (541.6±35.3) ml in group A, (546.8±27.8) ml in group B, and (540.1±34.5) ml in group C, withno statistically significant difference among three groups(P>0.05). Preoperative anterior vertebral height loss rate was (46.0± 3.1)% in group A, (46.4±3.3)% in group B, and (45.3±3.6)% in group B;at the final follow up, the loss rate of anterior vertebral height among three groups was (8.6±5.0)%, (8.1±4.2)%, (9.4±4.3)%, respectively. There were no statistically significant differences before operation and final follow-up among three groups (P>0.05). Preoperative Cobb angle was (35.1±4.8)° in group A, (35.2±4.5)° in group B and (35.2±4.5)° in group C, with no statistically significant difference among three groups (P>0.05);postoperative at 3 days, Cobb angle in three groups was (15.1±3.6)°, (15.3±3.1)° and (15.2±3.4)°, respectively, there was no statistically significant difference among three groups (P>0.05);at the final follow-up, the Cobb angle among three groups was (17.7±3.3)°, (17.9±3.9)°, (18.6±3.6)°, respectively, with no statistically significant difference among three groups (P>0.05). The time of bone graft fusion was (5.6±0.5) months in group A, (5.6±0.6) months in group B and (5.8±0.6)months in group C, with no statistically significant difference among three groups (P>0.05). Frankel classification at the final follow up, 4 cases were grade B, 7 cases were grade C, 10 cases were grade D, and 86 cases were grade E. Spinal nerve function in all three groups recovered to a certain extent after treatment, with no statistically significant difference among three groups (P> 0.05). Oswestry Disability Index at the final follow-up showed no statistically significant difference among three groups (P> 0.05). The approach of transverse rib process for debridement of lesions can effectively treat tuberculosis of thoracic vertebra by binding multi-fold rib graft, iliac bone graft and titanium mesh graft, but binding multi-fold rib graft can effectively avoid iliac bone donor complications, and is an effective alternative to iliac bone graft, which is worth popularizing.

The effect of pre-existing structures on the Moosfluh landslide and its lateral propagation (Great Aletsch Glacier, Switzerland)

The retreat of the Great Aletsch Glacier is accompanied by a series of slope failures in solid bedrock, which are heavily influenced by the presence of pre-existing deformation structures. Since the 1880's, the Great Aletsch Glacier has shortened by more than 3 km and decreased about 400 m in thickness. As a reaction to the loss of the stabilizing effect of the ice, one of the largest active deep-seated landslides in the European Alps with an affected surface area of about 1.5 km2, called Moosfluh landslide, is evolving. In this study, a multimethod approach combining field work, remote sensing techniques and microseismic monitoring is used to assess the effect of pre-existing structures on the landslide deformation processes.The landslide evolution from 2008 to 2018 could be reconstructed with high spatial resolution. Surface deformation analysis reveals the concentration of high deformation in narrow zones, allowing to directly link pre-existing tectonic and exhumation structures with landslide deformation processes. Toppling as the main gravity-driven process is enabled by reactivation of NE-SW striking, steeply SE dipping Alpine Handegg phase shear zones. Differences in the lateral detachment processes are attributed to shear zone bridges in the NE as well as fractures and shear zones similarly oriented to Alpine Oberaarb phase shear zones in the SW. At the landslide toe, a transition from toppling to sliding mechanism due to the formation of a continuous basal detachment surface can be observed, which is favored by the presence of exfoliation joints. The dramatic acceleration of the Moosfluh landslide in autumn 2016 is directly related to an increase in glacier height loss rate, which implies that glacier retreat is the main trigger of the landslide. A temporal stabilization of the landslide is recorded after 2017, most probably caused by the self-stabilizing properties of flexural toppling. However, microseismic data records a lateral propagation of the landslide, following the retreating Great Aletsch Glacier.

Analysis of hidden blood loss and its risk factors in the treatment of osteoporotic vertebral compression fractures with PVP

To investigate the influencing factors of hidden blood loss (HBL) during the treatment of percutaneous vertebroplasty (PVP). The clinical data of 125 patients with osteoporotic vertebral compression fractures (OVCFs) treated with percutaneous vertebroplasty from March 2016 to December 2017 were retrospectively analyzed. All patients underwent X rays of the AP and lateral lumbar spine, double oblique, and dynamic positions. Lumbar spine CT, MRI, and dual energy X ray bone densitometer (DXA) were used to confirm the diagnosis. There were 55 males and 70 females, 10 cases of thoracic vertebrae, 89 cases of thoracolumbar vertebrae, 26 cases of lumbar vertebrae, 87 cases with single segment, 29 cases with double segment,and 9 cases with 3 segments. The vertebral compression height ratios of 67 patients were less than 1 / 3, and the ratios for 41 patients were from 1 / 3 to 2 / 3,for 17 patients were more than 2 / 3. Blood routine examination were performed before and 3 days after surgery to analyze hidden blood loss and to explore its risk factors. The average hidden blood loss was (317±156) ml in 125 patients. Multiple linear regression analysis revealed a history of diabetes(P=0.011),surgical segments(P=0.036),number of segments (P<0.001),vertebral height loss rate (P=0.002),vertebral height recovery rate (P<0.001) and bone cement leakage rate (P=0.003) were positively correlated with hidden blood loss. Moreover,it was found that the blood loss was higher in those with higher vertebral height loss rate than in those with lower vertebral height loss rate, and the blood loss was higher in those with good vertebral height recovery than those with poor vertebral height recovery. Additionally,the cement leakage was also an important factor in increasing hidden blood loss. However,there was no significant correlation between bone mineral density(P=0.814) or history of hypertension(P=0.055) and hidden blood loss. Patients with OVCFs have a large amount of hidden blood loss after PVP treatment, which needs attention. At the same time, the history of diabetes, surgical segments, number of segments, bone cement leakage rate, vertebral height loss rate and vertebral height recovery rate are the risk factors for hidden blood loss.

Can Unilateral Kyphoplasty Replace Bilateral Kyphoplasty in Treatment of Osteoporotic Vertebral Compression Fractures? A Systematic Review and Meta-analysis

Background: Kyphoplasty has been proven to be an efficient method to relieve patient suffering from osteoporotic vertebral compression fractures (OVCFs). Because of its technological superiority, unilateral kyphoplasty consumes less operative time and bone cement than traditional bilateral kyphoplasty. However, there is controversy about which method is most efficient in the treatment of OVCFs. Thus, an overall analysis should be performed to shed light on the facts corroborating both procedures. Objective: To evaluate the safety and efficacy of unipedicular kyphoplasty versus bipedicular kyphoplasty in treating OVCFs. Study Design: Inclusion criteria were randomized controlled trials focusing on comparing unilateral versus bilateral balloon kyphoplasty in treatment of OVCFs. The exclusion criteria contained infection, neoplastic etiology, traumatic fracture, neural compression, neurological deficit, spinal stenosis, previous surgery at the involved vertebral body, long-term use of steroids, and kyphoplasty with other invasive or semi-invasive intervention treatment. Retrospective studies, reviews, technology introductions, and biochemical trials were also excluded. Settings: The PubMed MEDLINE, Cochrane Library, Web of Science, and EMBASE were systematic searched. Only randomized controlled trials published up to June 2015 comparing unilateral kyphoplasty with bilateral kyphoplasty in treatment of OVCFs were identified. Methods: Two researchers independently screeded the works for inclusion and data extraction. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used to assess the methodological quality and evidence synthesis. Results: Six articles with 563 patients were enrolled in this study. Results showed that the unilateral approach required less surgical time (MD, -23.19; 95% CI, [-27.08, -19.31]; P &lt; 0.00001) and cement consumption (MD, -2.07; 95% CI, [-2.23, -1.91]; P &lt; 0.00001), as well as a reduced cement leakage ratio (RR, 0.59; 95% CI, [0.35, 0.99]; P &lt; 0.05) and improved short-term general health (MD, 1.48; 95% CI, [0.02, 2.93], P &lt; 0.05). No significant difference was found in the visual analog scale score (short-term and long-term), Oswestry Disability Index score (mid-term and long-term) kyphotic angle reduction, restoration rate of anterior vertebral height, vertebral height loss rate, postoperative adjacent-level fractures, or in other assessments of 36-Item Short Form Health Survey parameters (short-term and long-term). Limitations: Only 6 studies were included, so that the sample size was still relatively small and publication bias could not be revealed in this study. Observation time of some data was inconsistent. All of these problems could influence the reliability of the results. Conclusion: Both unilateral kyphoplasty and bilateral kyphoplasty are safe and effective treatments for OVCFs. However, when operative time, cement volume, cement leakage, short-term general health, radiation dose, and hospitalization costs are taken into consideration, unilateral kyphoplasty may be the better choice. Yet, more high-quality RCTs with long-term follow-up are still required to make the final conclusion. Key words: Kyphoplasty, unilateral approach, bilateral approach, osteoporotic vertebral compression fractures, meta-analysis

Clinical efficacy of improved percutaneous kyphoplasty in treatment of osteoporotic vertebral compression fracture

Objective To compare the curative effect of improved percutaneous kyphoplasty (IPKP) with conventional PKP in the treatment of osteoporotic vertebral compression fracture (OVCF). Methods A retrospective analysis was made on 103 senile patients with OVCF undergone IPKP (57 cases, 72 vertebras) or PKP (46 cases, 58 vertebras) between September 2009 and September 2014. Preoperative vertebral compression, vertebral height restoration, height loss, bone cement leakage and adjacent vertebral refracture were compared between the two groups. Curative effect was evaluated using the visual analogue score (VAS) and Oswestry disability index (ODI). Results Duration of follow-up was 6-38 months (mean, 16 months). Between-group differences were insignificant with respect to the rate of preoperative vertebral compression, rate of postoperative height restoration and height loss rate at the final follow-up (P>0.05). PKP versus IPKP was associated with a higher rate of cement leakage (14% vs. 8%) (P>0.05) and refracture (20% vs. 5%) (P 0.05). VAS and ODI within the group showed significant differences after operation and at the final follow-up compared to these before operation (P 0.05). Conclusions Both procedures can restore vertebral height, alleviate pain and improve mobility. By contrast, IPKP provides long-term benefits in vertebral height loss and refracture rate. Key words: Vertebroplasty; Thoracic vertebrae; Lumbar vertebrae; Osteoporotic fractures

The impact of endplate fracture on postoperative vertebral height loss and kyphotic deformity during treatment of osteoporotic vertebral compression fractures with balloon kyphoplasty.

This retrospective study investigated the impact of endplate fracture on postoperative vertebral height loss and kyphotic deformity in 144 patients with osteoporotic vertebral compression fracture (OVCF), who received balloon kyphoplasty. Patients were divided into four groups: Group 1 had no superior endplate fracture, Group 2 had fractures on the anterior portion of the superior endplate, Group 3 had fractures on the posterior portion of the superior endplate, and Group 4 had complete superior endplate fractures. Anterior and middle vertebral body height, vertebral compression ratio, vertebral height loss rate, and kyphosis Cobb angle of each patient were measured and visual analogue scale (VAS) and Oswestry disability index (ODI) scores were recorded. The anterior vertebral height and kyphosis deformity of all groups significantly improved after the surgery, whereas substantial anterior vertebral height loss and increased Cobb angle were observed in all patients at the last follow-up. Although the vertebral height loss rate and the Cobb angle in Group 2, 3 and 4 were larger compared with Group 1 at the last follow-up, only the vertebral height loss rate in Group 4 and the increase in the Cobb angle in Group 2 and 4 were statistically different from those in Group 1. The VAS and ODI scores in all groups measured after the surgery and at the last follow-up were significantly lower compared with preoperative scores, but there was no significant difference among these groups. Balloon kyphoplasty significantly improved vertebral fracture height and kyphosis. Vertebral height loss and increased kyphotic deformity were observed in OVCF patients with endplate fractures after the surgery. Postoperative aggravation of kyphosis was observed in Group 2. Furthermore, severe vertebral height loss and increased kyphotic deformity were confirmed in Group 4 after the surgery. Our results suggested that postoperative vertebral height loss and aggravation of kyphosis may be associated with biomechanical changes in the vertebral body caused by endplate fracture. Therefore, surgery should not only restore compressed vertebral body height and correct kyphosis, but also correct the deformity of endplate to achieve an effective treatment of OVCF patients with endplate fracture.

Height loss with advancing age in a hospitalized population of Polish men and women: magnitude, pattern and associations with mortality

The connection between the rate of height loss in older people and their general health status has been well documented in the medical literature. Our study was aimed at furthering the characterization of this interrelationship in the context of health indices and mortality in a hospitalized population of Polish adults. Data were collated from a literature review and from a longitudinal study of aging carried out in the Polish population which followed 142 physically healthy inmates, including 68 men and 74 women, for at least 25 years from the age of 45 onwards. Moreover, cross-sectional data were available from 225 inmates, including 113 men and 112 women. These subjects were confined at the same hospital. ANOVA, t-test, and regression analysis were employed. The results indicate that the onset of height loss emerges in the fourth and five decade of life and there is a gradual acceleration of reduction of height at later stages of ontogeny in both sexes. Postmenopausal women experience a more rapid loss of height compared with men. The individuals who had higher rate of loss of height (≥3 cm/decade) tend to be at greater risk of cardiovascular events and all-cause mortality. In conclusion, our findings suggest that a systematic assessment of the rate of loss of height can be useful for clinicians caring for elderly people because of its prognostic value in terms of morbidity and mortality.

Height loss rate as a marker of vitamin D deficiency in men with osteoporosis

Height loss rate as a marker of vitamin D deficiency in men with osteoporosis

Height loss, forearm bone density and bone loss in menopausal women: a 15-year prospective study. The Nord-Trøndelag Health Study, Norway

In a population-based cohort of 1,421 women 45-60 years old followed for 15.5 years, 71% of the women had lost height. Height loss was associated with low forearm bone density and increased bone loss, but high body weight and oestrogen therapy were protective factors. Increased height loss indicates a generalized state of bone loss. The degree of height loss and its association to forearm bone mineral density (BMD) and bone loss was investigated in a population-based cohort of middle-aged women followed for more than 15 years. Among 8,856 women aged 45-60 years attending the first HUNT Study, Norway (1984-86), a 35% random sample was invited to forearm densitometry 11.3 years later (HUNT 2, 1995-97), and 2,188 attended (78.3%). In 2001, 15.5 years since baseline, all were invited to follow-up densitometry and height measurement. A total of 71.2% and 17.4% of the 1,421 women attending had lost >1 cm and >3 cm of height since baseline, respectively. Women aged >or= 64 years at HUNT 2 had a relative risk (RR) for height loss >3 cm of 3.1 (95% CI 2.2, 4.3) compared to women <64 years. A strong and negative association was found between height loss and forearm BMD, adjusted for time since menopause. A high rate of height loss was associated to increased forearm bone loss. High body weight, oestrogen treatment and good self-rated health were protective against height loss. Height loss is frequent in middle-aged women, and increased height loss indicates a generalized state of bone loss.

Managing the osteoporotic patient today

Patients with osteoporosis need a safe and effective treatment that reduces the risk of vertebral and hip fractures, leading to clinical benefits such as reduced pain and disability. The unique mechanism of action of strontium ranelate corrects bone turnover so that it is rebalanced in favor of bone formation. Double-blind, placebo-controlled studies in postmenopausal osteoporosis show it to be effective in reducing vertebral and hip fracture risks. Treatment efficacy has been documented across a wide range of patient profiles and appears to be independent of all the major determinants of fracture risk, including the severity of the disease at baseline, the number of prevalent fractures, and the age of the patient. This antifracture efficacy translates into clinical benefits, including a reduction in the rate of height loss and an increase in the number of patients free of back pain. Strontium ranelate is also one of the few antiosteoporotic drugs with data to demonstrate an improvement in quality of life indices. The rates of compliance with treatment were over 80% in phase 3 studies, reflecting the tolerability and safety profile and the ease of administration of this agent. Strontium ranelate thus offers significant clinical benefits in terms of efficacy, tolerability, and ease of administration in the treatment of postmenopausal women with osteoporosis fractures.

Addressing and meeting the needs of osteoporotic patients with strontium ranelate: a review

Patients with osteoporosis need a safe and effective treatment that reduces the risk of vertebral and non-vertebral fractures, leading to clinical benefits such as reduced back pain and height loss. Strontium ranelate corrects bone turnover, producing a more physiological state. Double-blind, placebo-controlled studies in postmenopausal osteoporosis show it to be effective in reducing vertebral and non-vertebral fracture risks. Treatment efficacy has been documented across a wide range of patient profiles, and appears to be independent of all the major determinants of fracture risk, including the severity of the disease at baseline, the number of prevalent fractures, and the age of the patient. This antifracture efficacy translates into clinical benefits, such as a 20% reduction in the rate of height loss and a 29% increase in the number of patients free of back pain. The effect of treatment with strontium ranelate on well-being has been assessed using the Quality-of-Life Questionnaire in Osteoporosis, which is a supplement to the 36-question Short-Form Health Survey. Treatment with strontium ranelate had a significant beneficial effect on the emotional, physical, and global Quality-of-Life Questionnaire in Osteoporosis scores compared with placebo. The rates of compliance with treatment were over 80% in phase III studies, reflecting the tolerability and safety profile and the ease of administration of this agent. Together with the antifracture data, the clinical benefits and quality of life data endorse the treatment of postmenopausal osteoporosis with strontium ranelate.

Effects of hormone replacement therapy on clinical fractures and height loss: the heart and estrogen/progestin replacement study (HERS)

Purpose: To determine if estrogen plus progestin reduces the incidence of fractures or height loss in postmenopausal women with coronary disease. Subjects and methods: We enrolled 2,763 postmenopausal women with coronary disease and with an intact uterus into the Heart Estrogen/progestin Replacement Study, a randomized double-blind, placebo-controlled secondary prevention trial of cardiovascular disease. Radiographically documented clinical fractures were a prespecified secondary endpoint. Height loss was used as a surrogate for vertebral fractures. The average age of the women was 66.7 ± 6.7 years, and fewer than 15% of the women had osteoporosis based on their bone density. Women were randomly assigned to either 0.625 mg of conjugated equine estrogens plus 2.5 mg of medroxyprogesterone acetate in 1 tablet daily (n = 1,380) or placebo (n = 1,383). Follow-up averaged 4.1 years; 82% of those assigned to hormone treatment were taking it at the end of 1 year, and 64% at the end of the study. Results: During 10,554 person years of follow-up, 286 women experienced a fracture: 138 in the treatment group (26.3 per 1,000 person years) and 148 in the placebo group (28.0 per 1,000 person years); relative hazard, 0.94; 95% confidence interval 0.8 to 1.2, P = 0.61). These included 58 wrist fractures (1.01; 0.6 to 1.7); 27 hip fractures (1.09; 0.5 to 2.3); 32 spine fractures (0.69; 0.3 to 1.4), and 192 other fractures (0.91; 0.7 to 1.2). There was no difference in average height loss between the treatment and placebo groups or in the percent of women who lost more than 2 cm in height: 10.6% in the treatment group and 12.1% in the placebo group. Conclusions: There was no evidence of a reduction in the incidence of fractures or rate of height loss in older women not selected for osteoporosis. Randomized studies are needed to clarify the effect of hormone replacement therapy on fracture risk among women with and without osteoporosis.