Fractures Of Thoracic Vertebrae Research Articles

Activity-restriction only as treatment yields positive outcomes in pediatric spinal compression fractures: a prospective study of 47 patients at medium-term follow-up.

We aimed to evaluate the clinical outcomes, radiographic results, and health-related quality of life in pediatric AO type A1 spinal compression fractures treated with activity-restriction only. All children between 2014 and 2020 with an AO type A1 spinal compression fracture treated with activity-restriction only identified from an institutional fracture registry were invited to a prospective outcomes study. Clinical findings and spinal radiographs were assessed at median 3 years, interquartile range (IQR) 1-4 follow-up from injury. Oswestry Disability Index, Pediatric Quality of Life Inventory Generic Core Scale (PedsQL), and PedsQL Pediatric Pain Questionnaire were compared with reference values. 63 children were identified, of whom 47 agreed to participate. 8 were polytrauma patients. Age at injury was median 11 (IQR 9-14) years. The number of injured vertebrae was median 2 (IQR 1-3). 82% (94 of 115) were thoracic vertebrae fractures and 70% (33 of 47) of the patients had thoracic vertebrae fractures only. At follow-up all but 2 fractures showed radiographic remodeling. There was no difference from the published reference values in the patient-reported outcome measures. A lower PedsQL physical functioning score was associated with higher patient-reported pain (P = 0.03). At follow-up 12 patients had hyperkyphosis (median difference from the reference values 4°, IQR 3-6, 95% confidence interval [CI] 3-6) and 5 hypolordosis (median difference from reference 8°, IQR 4-11, CI 4-14). None of the patients had surgery for deformity during follow-up. Clinical, radiographic, and health-related quality of life outcomes were good after activity-restriction treatment in pediatric A1 spinal compression fractures.

Case Report: Shewanella algae, a rare cause of osteosynthesis-associated infection

Shewanella is an emerging human pathogen. It mostly causes skin and soft tissue infections. Osteosynthesis-associated infection involving Shewanella are rare and in most cases are secondary to direct contamination following open fractures in aquatic environments. Here, we present a rare case of hematogenous osteosynthesis-associated infection involving Shewanella algae affecting an 18-year-old patient who was operated on for 12th thoracic vertebrae and 4th lumbar vertebrae fractures occurring in an aquatic environment. We performed surgical debridement with subsequent double course parenteral antibiotherapy that was then adapted to bacteria sensitivities for three weeks. After a follow-up of six months, the patient had no signs of recurrent infection. The presence of infected dermabrasions and the concordance between germs isolated in operative samples and in blood cultures presumes that the contamination was hematogenous.

Effectiveness of TiRobot-assisted and free-hand percutaneous kyphoplasty via pedicle of vertebra in treatment of osteoporotic vertebral compression fracture of thoracic vertebra

To compare the effectiveness of TiRobot-assisted and C-arm X-ray fluoroscopy assisted percutaneous kyphoplasty (PKP) via pedicle of vertebra in the treatment of osteoporotic vertebral compression fracture (OVCF) of thoracic vertebrae. The clinical data of 85 patients with OVCF of thoracic vertebrae who were admitted between January 2020 and March 2023 and met the selection criteria was retrospectively analyzed including 40 patients (50 vertebrae) undergoing PKP assisted by TiRobot (group A) and 45 patients (50 vertebrae) undergoing PKP assisted by C-arm X-ray fluoroscopy (group B). There was no significant difference in the comparison of baseline data such as gender, age, body mass index, bone mineral density T-value, fracture segment, trauma history, and preoperative numerical rating scale (NRS) score, Oswestry disability index (ODI), and Cobb angle of injured vertebra between the two groups ( P>0.05). The effectiveness evaluation indexes of the two groups, including the operation time, the volume of injected cement, the times of fluoroscopies, the length of hospital stay, and the occurrence of postoperative complications were collected and compared. Anteroposterior and lateral X-ray films and CT of the injured vertebra were reviewed at 1 day after operation to observe whether there was cement leakage and to evaluate the distribution of cement in the injured vertebra. Before and after operation, pain was assessed using the NRS score, dysfunction was assessed using the ODI, and vertebral height recovery was assessed by measuring the Cobb angle of the injured vertebrae by X-ray films. Both groups of patients successfully completed the operation, the operation time, the volume of injected cement, the times of fluoroscopies, and the length of hospital stay in group A were significantly less than those in group B ( P<0.05). The patients in two groups were followed up 4-12 months (mean, 9.6 months). Bone cement leakage occurred in 5 vertebrae in group A and 15 vertebrae in group B after operation, all of which leaked to the intervertebral space and around the vertebral body, and the patients had no obvious clinical symptoms. The difference of bone cement leakage between the two groups was significant ( P<0.05). No severe complication such as intraspinal leakage, infection, or vascular embolism was found in the two groups. At 1 day after operation, the distribution index of bone cement in group A was mostly grade Ⅴ, which was well dispersed; while in group B, it was mostly grade Ⅱ and grade Ⅴ; the difference of bone cement distribution index between the two groups was significant ( P<0.05). The NRS score, ODI, and Cobb angle of injured vertebra in both groups were significantly improved at 1 day after operation when compared with preoperative ones ( P<0.05). There was no significant difference in the difference of the above indexes between the two groups before and after operation ( P>0.05). TiRobot-assisted unilateral PKP in the treatment of OVCF of thoracic vertebrae is safe and effective, which can reduce the X-ray transmission times during operation, shorten the operation time, reduce the volume of bone cement injection, and thus decrease incidence of bone cement leakage.

Variations of azygos vein: a cadaveric study with clinical relevance.

The azygos vein can be formed as a single root, two roots, and three roots, namely lateral, intermediate and the medial roots respectively. The hemiazygos vein and the accessory hemiazygos vein are the tributaries of azygos vein rather than its left side equivalents. Its variations, especially in young persons without any relevant risk factors, may result in thromboembolic illness. This study aimed to describe the morphological and morphometric variations of azygos system of veins. The present study was conducted on thirty formalin fixed adult human cadavers by dissecting azygos vein from formation to termination and variations were noted. The azygos vein was formed by a single root in 56.7%, by two roots: the lateral root and intermediate root in 36.7% cases and by the lateral root and medial root in 6.6%. The vertebral level of termination of azygos vein was seen at the level of T4 vertebrae in 70% cases, at the level of T3 vertebrae in 20% of cases and at the level of T5 vertebrae in 10% cases. The course of azygos vein was varying in 13.3%. These morphological variations can be useful while performing mediastinal surgery, mediastinoscopy, surgery of the deformations of the vertebral column, neurovascular surgeries of the retroperitoneal organs, disc herniation and fracture of thoracic vertebrae.

The first case report of multiple thoracic vertebrae fractures caused by a low-voltage electric shock

BackgroundThis paper describes a unique case—the first case of multiple fractures of the thoracic vertebrae caused by a low-voltage electric shock.Case presentationA 22-year-old male patient was diagnosed with compression fractures of Th2–Th6 caused by a muscle spasm resulting from an electric shock. The patient was treated conservatively using a cervico-thoracic support corset. After rehabilitation, the patient has regained his physiological movement of the spine without any back pain.ConclusionsAlbeit vertebral fractures caused by electric shock injury are extremely rare, clinicians should always keep in mind this diagnosis, especially when clinical symptoms such as pain and limitation of movement are present.

A case of noteworthy findings similar to harlequin syndrome associated with fractures of thoracic vertebrae and upper dorsal ribs

A case of noteworthy findings similar to harlequin syndrome associated with fractures of thoracic vertebrae and upper dorsal ribs

Comparison of different pedicle screw fixation schemes in the treatment of neurosurgical spinal fractures: systematic review and meta-analysis.

Thoracolumbar fractures have the characteristics of acute onset, rapid change, and severe trauma. The best way to treat thoracolumbar fractures is through fracture reduction surgery. The surgical methods include percutaneous pedicle screw, posterior percutaneous pedicle screw internal fixation, and open pedicle screw internal fixation. We searched the PubMed, Embase, and Medline English database from April 1991 to April 2021, and the keywords included "percutaneous tablet screen", "posterior percutaneous tablet screen fixation", "open tablet screen fixation", "fracture of thoracic vertebrae", "thoracic fractures", "thoracic", and "vascular fracture". RevMan5.3 provided by Cochrane was used for meta-analysis. A total of 9 articles were included in this study. Percutaneous pedicle screw fixation and posterior percutaneous pedicle screw fixation were adopted as the surgical methods, and patients were enrolled into experimental and control groups. Open pedicle screw internal fixation was set as the control group. The mean difference (MD) of operation time, blood loss, pain score, postoperative complications, screw debris rate, and hospital stay were -0.73, -192.16, -0.70, 1.49, 0.32, and -1.26, respectively; 95% confidence intervals (CIs) were (-0.94, -0.51), (-213.23, -171.09), (-0.82, -0.57), (0.47, 4.79), (0.10, 0.99), and (-1.82, -0.71), respectively; Z values were 6.71, 17.87, 10.95, 0.67, 1.97, and 4.46, respectively; and P values were <0.00001, <0.00001, <0.00001, 0.50, 0.05, and <0.00001, respectively. A total of 9 articles were included in this meta-analysis. Compared with open surgery, the use of percutaneous pedicle screw and posterior percutaneous pedicle screw fixation had less blood loss, shorter operation time, shorter hospital stay, less pain, as well as lower screw dislocation and postoperative infection rates, indicating that the use of percutaneous pedicle screw and posterior percutaneous pedicle screw fixation is more effective than open surgery.

Spine stabilization in patients with the thoracic and lumbar vertebrae fractures in reduced bone mineral density

Objective To compare the clinical effectiveness of various technical and tactical options for surgical treatment of patients with thoracic and lumbar vertebrae fractures with reduced bone mineral density.Material and Methods The study included 238 patients with the thoracic and lumbar vertebrae fractures with reduced bone mineral density (BMD). The patients were aged between 48 and 85 with T-score –1.5 to –3.5. The study did not include the patients with recurrent or multiple vertebral fractures, with absence of the clear date and fact of fracture in the case history, with neurological complications or polytrauma. The patients had fractures А1.2, А1.3, В1.2, В2.3 according to the classification of Magerl (1992). All patients underwent bisegmental transpedicular fixation (TPF). Group 1 included 68 patients who underwent non-cement augmented transpedicular screw fixation. Group 2 included 170 patients who underwent cement augmented transpedicular fixation. Both groups were divided into 2 subgroups. Subgroups 1.1 and 2.1 included patients operated in two stages. The first stage was TPF and the second stage was anterior corporodesis. Subgroups 1.2 и 2.2 included patients who underwent only TPF. Outcomes and complications were studied. The observation period lasted for not less than 2 years. Correlation analysis was performed between the technique of performing operations and surgical tactics in four subgroups and treatment outcomes.Conclusion 1. In the treatment of patients with fractures in the thoracic or lumbar spine with reduced BMD, isolated TPF with cemented screw implantation is clinically equivalent to two-stage surgical treatment - TPF with cementless or cemented implantation and anterior corprodesis of injured FPS. 2. In cementless TPF in patients with decreased BMD, anterior corprodesis of the injured VMS is necessary because its failure leads to the loss of anatomical relationship correction achieved during surgery, increase in local kyphosis, and functional maladaptation of patients.

Multifactor Analysis of Costal Pain in Osteoporotic Fracture of Thoracic Vertebra

The costal pain is common in thoracic osteoporotic fracture patients. It is unclear why vertebral fracture patients without any specific nerve impingement on magnetic resonance imaging (MRI) present with costal pain. The aim of this study was to investigate the potential causes of costal pain in patients with osteoporotic fracture of thoracic vertebra. A retrospective study. Shandong province, China. In this retrospective study, 100 patients with thoracic osteoporotic fractures were collected and assigned into 2 groups on the basis of pain patterns noted during medical history and physical examination. Group A was comprised of 50 patients with costal pain. Group B was comprised of 50 patients without costal pain. The Visual Analog Scale and Oswestry Disability Index scores were recorded to assess the pattern and severity of pain. The gender, age, presence or absence of trauma, time of fracture, fracture segments, and analgesic application were recorded. Computed tomography data including changes in fracture vertebral body shape (height, width, and length), intervertebral foramen shape (height and width), wedge shape of fractured vertebral body, and local kyphosis angle were recorded. The fracture edema signal was determined by MRI. Multivariate analysis was performed for all the above parameters. There was a statistically significant difference in the vertebral body width between the 2 groups. The number of patients enrolled is not large enough. We also have limitations in interpreting all pains resulting from osteoporotic vertebral compression fractures, because all pain mechanisms are not fully understood. Further work is needed to improve the accuracy of locating pain sources and distinguishing pain patterns which may result from other spinal structures. The incidence of costal pain is significantly and positively associated with the width of the fractured vertebra in patients with osteoporotic thoracic vertebrae fracture.

Anterior stabilization of spine column in the staged surgical treatment of patients with fractures of thoracic and lumbar vertebrae with low bone mineral density

Aim. To determine the clinical effectiveness of anterior stabilization in the surgical treatment of patients with traumatic injuries of the thoracic and lumbar spine with reduced bone mineral density.&#x0D; Materials and methods. The study included 238 patients with thoracic and lumbar vertebral fractures with reduced bone mineral density (BMD). The age of patients is from 48 to 85 years. There are following types of fractures according to F. Magerl (1992): A1.2, A1.3, B1.2, B2.3. BMD of the vertebrae was decreased (T-score from 1.5 to 3.5).&#x0D; Results. All patients underwent short segment transpedicular fixation (TPF) with four-screw systems. In group 1 were included 68 patients who underwent TPF without cemented augmentation of screws. Group 2 included 170 patients who underwent TPF reinforced with a cement. Both groups were divided into 2 subgroups. Subgroup 1.1 included patients, which were operated on in two stages. The first stage is TPF. The second stage is the anterior stabilization. Subgroup 1.2 included patients who underwent only TPF. Patients in group 2 were divided into two subgroups in a similar way. The results and complications according to clinical and spondylometric criteria were studied. Correlation analysis was performed between surgical technique, surgical tactics and the treatment results in the four selected subgroups. The observation period is at least 2 years.&#x0D; Conclusion. 1. When using TPF with cement augmentation for the treatment of patients with fractures of the thoracic and lumbar spine with reduced BMD, the anterior stabilization of injured spinal motion segment as a second stage of surgical treatment does not provide clinical advantages compared to the use of only TPF with cement augmentation. 2. In case of cementless TPF in patients with reduced BMD, anterior stabilization of the injured spinal motion segment is necessary. Only when anterior stabilization is performed, the stability of fixation is ensured. It is sufficient to preserve the anatomical relationships restored during the operation and functional adaptation of patients in the long-term period after surgery.

Exploring thoracic kyphosis and incident fracture from vertebral morphology with high-intensity exercise in middle-aged and older men with osteopenia and osteoporosis: a secondary analysis of the LIFTMOR-M trial

The Lifting Intervention For Training Muscle and Osteoporosis Rehabilitation for Men (LIFTMOR-M) trial examined efficacy and safety of an eight-month, supervised, high-intensity progressive resistance and impact training (HiRIT) program compared with machine-based isometric axial compression (IAC) training in middle-aged and older men with low areal bone mineral density (aBMD). The primary purpose of the current work was to explore change in thoracic kyphosis and incident fracture from vertebral morphology following eight-months of HiRIT or IAC training. The secondary purpose was to explore change in clinical kyphosis measures for HiRIT, IAC and a non-randomized, matched control group. Men (≥ 45yrs), with low aBMD, were recruited and randomized to HiRIT or IAC, or designated control. Clinical measures of thoracic kyphosis with inclinometry were determined. Cobb angle of kyphosis and vertebral fracture assessment using the Genant semi-quantitative method were determined from lateral thoracolumbar DXA (Medix DR, Medilink, France). Per-protocol (n = 40) and intention-to-treat (n = 93) analyses were conducted. Forty participants (HiRIT n = 20, IAC n = 20; 66.1 ± 7.8yrs.; lumbar spine T-score - 0.1 ± 0.8; femoral neck T-score - 1.5 ± 0.5) underwent clinical kyphosis measures and thoracolumbar DXA at baseline and follow-up. No between-group differences were detected in kyphosis change, however, within-group improvements in neutral (HiRIT - 2.3 ± 0.8°; IAC - 2.5 ± 0.8°) and 'standing tall' (HiRIT - 2.4 ± 0.8°; IAC - 2.0 ± 0.8°) postures were observed (p < 0.05). HiRIT improved Cobb angle (- 3.5 ± 1.5°, p = 0.027) from baseline. Over the 8months, no incident vertebral fractures nor progression of prevalent vertebral fractures occurred for HiRIT participants. Five incident fractures of thoracic vertebrae occurred for IAC and one wedge fracture progressed. Ninety-three participants underwent clinical kyphosis measures at both time-points (HiRIT n = 34, IAC n = 33, control n = 26). HiRIT exhibited a reduction in 'standing tall' kyphosis compared to control (- 2.3 ± 0.6° versus 1.4 ± 0.7°, p < 0.05), but no other between-group differences were detected. Although there was no difference in change between intervention groups, thoracic kyphosis appeared to improve in both HiRIT and IAC with exercise exposure. HiRIT improved 'standing tall' posture in comparison to usual activities. HiRIT was not associated with vertebral fracture progression or incident vertebral fracture, but for some IAC participants there was evidence of progression of vertebral fracture severity and incident vertebral fractures, in our small sample. Larger trials are required to confirm the observations of the current work, which was exploratory in nature.

Thoracic vertebrae fracture: Is it an indicator of abdominal injury?

Traumatic vertebral fracture accounts for 10-15% of trauma related admissions. While the correlation between lumbar vertebral fractures and abdominal injuries is well established, the relationship between thoracic vertebral fractures (TVF) and abdominal injuries is comparatively less well elucidated. Using a large national trauma database, we aimed to examine the incidence and severity of associated abdominal injuries in blunt trauma patients suffering from TVF. A retrospective cohort study using the Israeli National Trauma Registry was conducted. Patients with thoracic vertebrae spine fractures following blunt mechanisms of trauma between 1997 and 2018 were examined, comparing the incidence and severity of associated intraabdominal organs injuries with and without TVF. Demographics and outcomes between the two cohorts were compared. From 362,924 blunt trauma patients, 4967 (1.37%) had isolated TVF. Mean age was 49.8years and 61.9% were males. The most common mechanism of injury was fall following by MVC. The patients with TVF had significantly higher rates of increased ISS score (ISS>16, 28.45% vs. 10.42%, p<0.001) and higher mortality rate (3.5% vs. 2%, p<0.0001). Patients with TVF had 2-3 times more intraabdominal organ injuries (p<0.001). The most commonly injured organ was spleen (3.28%); followed by liver (2.64%) and kidney (1.47%). An analysis of non-isolated thoracic spine fractures showed same distribution in age, ISS, mechanisms, patterns of intra-abdominal injury, mortality rate and laparotomy rate. Clinicians should have an elevated suspicion for intra-abdominal injuries when a thoracic spine fracture is identified, which may necessitate further evaluation.

Unusual Foreign Bodies of Surgical Discovery on a Traumatic Spine

Introduction: Para-spinal non-metallic foreign bodies (fabrics or plastics) are rare and poorly documented. They are often unknown and discovered at the stage of infectious complications and present big therapeutic challenges. We report a rare case of three para-spinal foreign bodies (fabric, plastic and postoperative gauze) discovered during surgery of a traumatic thoracic spine. Case report: A 32-year-old man admitted for a polytrauma (collision motorcycle-cart). The admission examination noted closed trauma of the thoracic spine, an ASIA score of A, dyspnea, a penetrating wound of the left side of the chest. The CT scan showed a compressive left pleural effusion, multiple ribs fractures, pulmonary contusion, unstable fracture of fifth and sixth thoracic vertebrae associated with posterior epidural hematoma responsible for medullar compression. There was a rounded, para-spinal image, dotted with small areas of low density, air bubbles. We lifted the vital emergency by draining the left pleural effusion, debriding the penetrating chest wound, and administering broad-spectrum antibiotic therapy. Fourteen days later, we decided to stabilize the spine. After a posterior approach, we discovered free pus and para-vertebral three foreign bodies. Enterobacter spp.was isolated in pus susceptible to imipenem. The immediate operative follow-up was simple. Conclusion: The best treatment remains preventive by simple measures, exploration of penetrating wounds, repeated count and careful verification of gauze, because the infectious complications that they generate are source of mortality and serious medico-legal implications.

Closing the Brief Case: Bacteremia and Vertebral Osteomyelitis Due to Staphylococcus schleiferi.

A 60-year-old female was admitted to a hospital in Missouri with back pain and pathological fractures of multiple thoracic vertebrae. Four months prior to presentation, the patient began experiencing low back pain without inciting trauma. Over the next 2 months, the pain continued to worsen and she

The effect of screw tunnels on the biomechanical stability of vertebral body after pedicle screws removal: a finite element analysis

Posterior reduction and pedicle screw fixation is a widely used procedure for thoracic and lumbar vertebrae fractures. Usually, the pedicle screws would be removed after the fracture healing and screw tunnels would be left. The aim of this study is to evaluate the effect of screw tunnels on the biomechanical stability of the lumbar vertebral body after pedicle screws removal by finite element analysis (FEA). First, the CT values of the screw tunnels wall in the fractured vertebral bodies were measured in patients whose pedicle screws were removed, and they were then compared with the values of vertebral cortical bone. Second, an adult patient was included and the CT images of the lumbar spine were harvested. Three dimensional finite element models of the L1 vertebra with unilateral or bilateral screw tunnels were created based on the CT images. Different compressive loads were vertically acted on the models. The maximum loads which the models sustained and the distribution of the force in the different parts of the models were recorded and compared with each other. The CT values of the tunnels wall and vertebral cortical bone were 387.126±62.342 and 399.204±53.612, which were not statistically different (P=0.149). The models of three dimensional tetrahedral mesh finite element of normal lumbar 1 vertebra were established with good geometric similarity and realistic appearance. After given the compressive loads, the cortical bone was the first one to reach its ultimate stress. The maximum loads which the bilateral screw tunnels model, unilateral screw tunnel model, and normal vertebral model can sustain were 3.97 Mpa, 3.83 Mpa, and 3.78 Mpa, respectively. For the diameter of the screw tunnels, the model with a diameter of 6.5 mm could sustain the largest load. In addition, the stress distributing on the outside of the cortical bone gradually decreased as the thickness of the tunnel wall increased. Based on the FEA, pedicle screw tunnels would not decrease the biomechanical stability and strength of the vertebral body. A large diameter of screw tunnel and thick tunnel wall were helpful for the biomechanical stability of the vertebral body.

Comparison of intraoperative O-arm- and conventional fluoroscopy (C-arm)-assisted insertion of pedicle screws in the treatment of fracture of thoracic vertebrae

Purpose:To introduce the intraoperative O-arm-assisted pedicle screw insertion without any navigation system in the treatment of thoracic vertebrae fracture and compare it to conventional fluoroscopy (C-arm)-assisted pedicle screw insertion technique.Methods:About 156 pedicle screws were inserted in 23 patients (C-arm group), and 208 pedicle screws were inserted in 30 patients (O-arm group). The postoperative computed tomography images were analyzed for pedicle violation based on Gertzbein classification. The total surgery time, the average time required for inserting a screw, the mean action times of adjusting guide probe and pedicle screw, and the hospitalization time were compared in both groups, respectively. The American Spinal Injury Association (ASIA) was used for evaluating the health outcomes pre- and postoperatively.Results:There are the higher accuracy rate of satisfactory pedicle screw placement (grades 0 and 1) and the less incidence of medial perforation in the O-arm group compared to the C-arm group ( p &lt; 0.05). The average time required for inserting a screw, the action times of adjusting the guide probe and pedicle screw, and the hospitalization time in the O-arm group are less than the respective ones in the C-arm group ( p &lt; 0.05). There was no significant difference for the total surgery time between both groups. No further damage of the nerve function postoperatively is found according to the ASIA grade.Conclusion:The O-arm-assisted pedicle screw insertion without navigation we described provides higher accuracy of pedicle screw placement and better clinical efficacy compared to conventional fluoroscopy (C-arm) technique.

Influencing factors of recurrence of fracture after percutaneous vertebral augmentation

Objective To evaluate the influencing factors of recurrence of fracture after percutaneous vertebral augmentation. Methods From January 2007 to December 2013, 256 cases patients with percutaneous vertebral augmentation in treatment of osteoporotic vertebral compression fractures in the Central Hospital of Chaoyang were retrospectively reviewed.After operation, the patients were divided into recurrent fracture group(59 cases) and no recurrence group(197 cases) according to whether postoperative recurrence of vertebral fracture.The age, sex, body mass index(BMI), bone mineral density, operation mode, bone cement injection volume, the existence of bone cement leakage and vertebral body height recovery rate were compared between the two groups respectively.Multi factor Logistic regression analysis was performed to analyze the correlation between the factors and the recurrence of vertebral body fractures. Results The age((75.9±4.6) years old vs. (69.9±5.0) years old), BMI((23.5±0.6) kg/m2 vs. (25.4±0.7) kg/m2), bone mineral density((-3.67±0.68) vs. (-2.75 ±0.98)), the existence of bone cement leakage rate(22.0% vs. 5.1%) and vertebral body height recovery rate((24.1±2.9)% vs. (14.9±3.0)%) between recurrent fracture group and no recurrence group had statistically significant differences(P=0.046, 0.047, 0.046, 0.026, 0.023). Multi factor Logistic regression analysis showed that age, BMI were not related to postoperative recurrence of fracture(P=0.140, 0.137), and bone density, bone cement leakage and vertebral body height recovery rate were related to recurrence of fracture(P=0.018, 0.000, 0.000). Conclusion Low bone mineral density, existence of bone cement leakage and high body height recovery rate are the risk factors of recurrence of fracture after percutaneous vertebral augmentation. Key words: Thoracic and lumbar vertebrae fracture; Percutaneous vertebral angioplasty; Percutaneous kypho-plasty; Recurrence of vertebral fracture; Bone mineral density; Bone cement leakage; Vertebral body height recovery rate

Clinical Efficacy of Minimally Invasive Transpedicular Stabilization for Thoracic and Lumbar Vertebrae Fractures

Clinical Efficacy of Minimally Invasive Transpedicular Stabilization for Thoracic and Lumbar Vertebrae Fractures

Clinical Efficacy of Minimally Invasive Transpedicular Stabilization for Thoracic and Lumbar Vertebrae Fractures

Clinical efficacy of percutaneous transpedicular stabilization for the treatment of patients with A2 and A3 traumatic compression thoracic and lumbar fractures was performed. The study included 25 patients with mean age 34 (29-42) years. The male-female ratio was 2:1. Severity of pain syndrome by analog visual scale (VAS), quality of life by Oswestry Disability Index (ODI), duration of surgery and blood loss, patient outcome satisfaction by MacNab's criteria and rate of complications were assessed. Mean duration of surgery made up 120 (90-140) min, median blood loss - 50 (30-80) ml. Marked postoperative reduction of pain syndrome (p

Fractures of thoracic vertebrae in patients with locally advanced non-small cell lung carcinoma treated with intensity modulated radiotherapy

PurposeTo report on the incidence of vertebral fractures in patients treated with Intensity Modulated Radiotherapy (IMRT) for locally advanced non-small cell lung carcinoma (NSCLC) and to analyse the association with clinical and dosimetric parameters. Patients and methodsBetween 2007 and 2012, 524 patients treated with ⩾51Gy were retrospectively analysed for the incidence of vertebral fractures (VF). Clinical parameters were assessed. In addition, a case control study in 50 patients was performed to study the association between the radiotherapy dose and fractured vertebrae. ResultsThree hundred and thirty-six patients were eligible for analyses. Twenty-eight patients (8%) were observed with VF at a median follow up of 12months. Age was significantly higher in the group with VF (p<0.01). After balancing age, the mean vertebrae dose was most significantly associated with fractures of the vertebrae (p<0.01). ConclusionVF was observed in 8% of the patients with locally advanced NSCLC. RT dose was associated with the occurrence of thoracic vertebral fractures.