Objective： To investigate prospectively the effectiveness ofkyphoplasty with SKY bone expander system in treatment of compression fracture of thoracic/ lumbar vertebrae and correction of the deformity. Methods： Twe...Objective： To investigate prospectively the effectiveness ofkyphoplasty with SKY bone expander system in treatment of compression fracture of thoracic/ lumbar vertebrae and correction of the deformity. Methods： Twenty-five patients with thoracic/lumbar vertebral osteoporotic compression fracture were admitted to our hospital between March 2007 and March 2008, and treated by kyphoplasty with SKY bone expander system. Patient＇s pain status was rated with Visual Analogue Scale （VAS） score system 1 day before and 1 hour, 48 hours, 6 months, 12 months after surgery. In addition, Rolland-Mor- ris and Oswestry disability questionnaires （RDQ and ODI） were used for survey 1 day before and 1, 6, 12 months after surgery. Pre- and post-operative vertebral heights and Cobb＇s angles were measured based on the X-ray films and statistically analyzed. Results： There were 27 fractured vertebrae in these 25 patients. After SKY kyphoplasty, the Cobb＇s angles （9.8°±9.76°） were significantly reduced compared with preoperative angles （17.18°±9.35°, P〈0.05）, and the average improve- ment rate was 39%. Patients＇ pain VAS scores were also greatly improved after operation （P〈0.05）. Moreover, postoperative RDQ and ODI scores were significantly smaller than preoperative values （P〈0.05）. Conclusions： Kyphoplasty with SKY bone expander system provides an effective method for treating thoracic/ lumbar vertebral osteoporotic compression fracture, with the advantages of small surgical wound and short duration. It can effectively recover the anterior and medial heights of fractured vertebrae （33% and 50%, respectively）, reduce the Cobb＇s angle, quickly alleviate pain and improve patients＇ quality of life in a relatively short time period.展开更多
BACKGROUND Percutaneous vertebroplasty(PVP)has been widely used in osteoporotic vertebral compression fracture(OVCF).Following surgery,the bone cement would be positioned permanently.However,in some cases of lumbar de...BACKGROUND Percutaneous vertebroplasty(PVP)has been widely used in osteoporotic vertebral compression fracture(OVCF).Following surgery,the bone cement would be positioned permanently.However,in some cases of lumbar degenerative disease,the cemented vertebrae needs to be fixed after decompression and fusion procedure.It is difficult to implant traditional pedicle screws into the cemented vertebrae because of the bone cement filling.At present,the main treatment strategy is to skip the cemented vertebra and conduct a long segment fixation.This article presents a cortical bone trajectory(CBT)fixation technique for cemented vertebrae.CASE SUMMARY PVP involving the L3 and L4 was performed in an 82-year-old man due to OVCF.During the surgery,bone cement leakage occurred,resulting in compression of the root of the right L3 nerve.We performed a partial facetectomy to retrieve the leaked bone cement and to relieve the patient’s neurological symptoms.After 3 mo,the patient developed lumbar disc herniation in L3/4,potentially due to instability caused by the previous surgery.Therefore,it was necessary to perform intervertebral fusion and fixation.It was difficult to implant traditional trajectory pedicle screws in L3 and L4 because of the bone cement filling.Hence,we implanted CBT screws in the L3 and L4 vertebrae.As a result,the patient’s symptoms resolved and he reported satisfaction with the surgery at follow-up after 8 mo.CONCLUSION It is feasible to utilize CBT in cemented vertebrae for the treatment of lumbar degenerative disease.展开更多
Bone fractures can be detected by analyzing vibration signals following bone stimulation. This method can also be applied to detect stress fractures, such as spondylolysis. The aim of this study was to investigate whe...Bone fractures can be detected by analyzing vibration signals following bone stimulation. This method can also be applied to detect stress fractures, such as spondylolysis. The aim of this study was to investigate whether vibration signal analysis can be used to detect lumbar spondylolysis in synthetic bone. Four synthetic spondylolysis models of the fifth lumbar vertebra (Sawbones, product No. SAW1352-10: Malmö, Sweden) were prepared, with the following conditions: intact, unilateral defect, and bilateral defect. Unilateral defects were created by making an incision of either half the diameter (50% incision) or the entire diameter (100% incision) in length through the pars interarticularis or pedicle. Bilateral defects were created by making an additional incision of half the diameter in length on the opposite side of the defected pars interarticularis or pedicle (50% + 100% incision). Hammering was performed five times on each spinous process of the fixed synthetic bones and vibration signals were measured using an accelerometer attached to the contralateral side of the hammer. Signals were analyzed using fast Fourier transform. The parameters analyzed included the mean power frequency, first power minimum frequency (the minimum value between the first and second peaks), spectral areas of low and high frequency bands, and the relative ratio between the spectral areas of low and high frequency bands. The relative ratio was significantly lower in the 50%, 100%, and 50% + 100% incision conditions compared to the intact condition (p < 0.01), suggesting the potential utility of vibration signal analysis in diagnosing lumbar spondylolysis.展开更多
目的:基于MRI定量非对称回波最小二乘估算水脂分离(iterative decomposition of water and fat with echo asymmetry and least-squares estimation image quantitation,IDEAL-IQ)技术探讨成年人腰椎不同节段骨髓脂肪与年龄和性别的关...目的:基于MRI定量非对称回波最小二乘估算水脂分离(iterative decomposition of water and fat with echo asymmetry and least-squares estimation image quantitation,IDEAL-IQ)技术探讨成年人腰椎不同节段骨髓脂肪与年龄和性别的关系。方法:收集298例受检者的MRI IDEAL-IQ脂肪分数图像,其中男性138例,女性160例,年龄20~69岁。将所有患者按照每10岁为一个年龄段分为5组:20~29岁(20~组),男24例,女20例;30~39岁(30~组),男47例,女39例;40~49岁(40~组),男36例,女47例;50~59岁(50~组),男20例,女37例;60~69岁(60~组),男11例,女17例。使用脂肪分数图在GE ADW4.6工作站测量L1~L5的骨髓质子密度脂肪分数(proton density fat fraction,PDFF)。结果:同一年龄组、不同性别间PDFF存在差异,20~、30~、40~组人群中,男性L1~L5椎体PDFF均高于女性(P<0.05);50~组人群中男性L1~L5椎体PDFF与女性的差异无统计学意义(P>0.05);60~组人群,男性L1~L5椎体PDFF均低于女性(P<0.05)。腰椎椎体PDFF与年龄呈正相关,女性(r=0.72,P<0.05)相关性高于男性(r=0.32,P<0.05)。从20~69岁,男性L4 PDFF增长率最大(21.08%),女性L1 PDFF增长率最大(65.68%);男性各椎体PDFF增长主要集中在30~及50~组,其中L1、L4、L5椎体PDFF在50~组增长率最大,L2、L3椎体PDFF在30~岁组增长率最大;女性各椎体PDFF在30~组呈轻微下降趋势,此后各椎体PDFF逐渐升高,增长主要集中在40~、50~、60~三个年龄组,其中50~组增长率最大。结论:成人不同年龄组男女性各椎体脂肪分布存在差异,椎体PDFF增长率也有所不同;腰椎不同节段椎体PDFF均与年龄呈正相关。展开更多
文摘Objective： To investigate prospectively the effectiveness ofkyphoplasty with SKY bone expander system in treatment of compression fracture of thoracic/ lumbar vertebrae and correction of the deformity. Methods： Twenty-five patients with thoracic/lumbar vertebral osteoporotic compression fracture were admitted to our hospital between March 2007 and March 2008, and treated by kyphoplasty with SKY bone expander system. Patient＇s pain status was rated with Visual Analogue Scale （VAS） score system 1 day before and 1 hour, 48 hours, 6 months, 12 months after surgery. In addition, Rolland-Mor- ris and Oswestry disability questionnaires （RDQ and ODI） were used for survey 1 day before and 1, 6, 12 months after surgery. Pre- and post-operative vertebral heights and Cobb＇s angles were measured based on the X-ray films and statistically analyzed. Results： There were 27 fractured vertebrae in these 25 patients. After SKY kyphoplasty, the Cobb＇s angles （9.8°±9.76°） were significantly reduced compared with preoperative angles （17.18°±9.35°, P〈0.05）, and the average improve- ment rate was 39%. Patients＇ pain VAS scores were also greatly improved after operation （P〈0.05）. Moreover, postoperative RDQ and ODI scores were significantly smaller than preoperative values （P〈0.05）. Conclusions： Kyphoplasty with SKY bone expander system provides an effective method for treating thoracic/ lumbar vertebral osteoporotic compression fracture, with the advantages of small surgical wound and short duration. It can effectively recover the anterior and medial heights of fractured vertebrae （33% and 50%, respectively）, reduce the Cobb＇s angle, quickly alleviate pain and improve patients＇ quality of life in a relatively short time period.
文摘BACKGROUND Percutaneous vertebroplasty(PVP)has been widely used in osteoporotic vertebral compression fracture(OVCF).Following surgery,the bone cement would be positioned permanently.However,in some cases of lumbar degenerative disease,the cemented vertebrae needs to be fixed after decompression and fusion procedure.It is difficult to implant traditional pedicle screws into the cemented vertebrae because of the bone cement filling.At present,the main treatment strategy is to skip the cemented vertebra and conduct a long segment fixation.This article presents a cortical bone trajectory(CBT)fixation technique for cemented vertebrae.CASE SUMMARY PVP involving the L3 and L4 was performed in an 82-year-old man due to OVCF.During the surgery,bone cement leakage occurred,resulting in compression of the root of the right L3 nerve.We performed a partial facetectomy to retrieve the leaked bone cement and to relieve the patient’s neurological symptoms.After 3 mo,the patient developed lumbar disc herniation in L3/4,potentially due to instability caused by the previous surgery.Therefore,it was necessary to perform intervertebral fusion and fixation.It was difficult to implant traditional trajectory pedicle screws in L3 and L4 because of the bone cement filling.Hence,we implanted CBT screws in the L3 and L4 vertebrae.As a result,the patient’s symptoms resolved and he reported satisfaction with the surgery at follow-up after 8 mo.CONCLUSION It is feasible to utilize CBT in cemented vertebrae for the treatment of lumbar degenerative disease.
文摘Bone fractures can be detected by analyzing vibration signals following bone stimulation. This method can also be applied to detect stress fractures, such as spondylolysis. The aim of this study was to investigate whether vibration signal analysis can be used to detect lumbar spondylolysis in synthetic bone. Four synthetic spondylolysis models of the fifth lumbar vertebra (Sawbones, product No. SAW1352-10: Malmö, Sweden) were prepared, with the following conditions: intact, unilateral defect, and bilateral defect. Unilateral defects were created by making an incision of either half the diameter (50% incision) or the entire diameter (100% incision) in length through the pars interarticularis or pedicle. Bilateral defects were created by making an additional incision of half the diameter in length on the opposite side of the defected pars interarticularis or pedicle (50% + 100% incision). Hammering was performed five times on each spinous process of the fixed synthetic bones and vibration signals were measured using an accelerometer attached to the contralateral side of the hammer. Signals were analyzed using fast Fourier transform. The parameters analyzed included the mean power frequency, first power minimum frequency (the minimum value between the first and second peaks), spectral areas of low and high frequency bands, and the relative ratio between the spectral areas of low and high frequency bands. The relative ratio was significantly lower in the 50%, 100%, and 50% + 100% incision conditions compared to the intact condition (p < 0.01), suggesting the potential utility of vibration signal analysis in diagnosing lumbar spondylolysis.
文摘目的:基于MRI定量非对称回波最小二乘估算水脂分离(iterative decomposition of water and fat with echo asymmetry and least-squares estimation image quantitation,IDEAL-IQ)技术探讨成年人腰椎不同节段骨髓脂肪与年龄和性别的关系。方法:收集298例受检者的MRI IDEAL-IQ脂肪分数图像,其中男性138例,女性160例,年龄20~69岁。将所有患者按照每10岁为一个年龄段分为5组:20~29岁(20~组),男24例,女20例;30~39岁(30~组),男47例,女39例;40~49岁(40~组),男36例,女47例;50~59岁(50~组),男20例,女37例;60~69岁(60~组),男11例,女17例。使用脂肪分数图在GE ADW4.6工作站测量L1~L5的骨髓质子密度脂肪分数(proton density fat fraction,PDFF)。结果:同一年龄组、不同性别间PDFF存在差异,20~、30~、40~组人群中,男性L1~L5椎体PDFF均高于女性(P<0.05);50~组人群中男性L1~L5椎体PDFF与女性的差异无统计学意义(P>0.05);60~组人群,男性L1~L5椎体PDFF均低于女性(P<0.05)。腰椎椎体PDFF与年龄呈正相关,女性(r=0.72,P<0.05)相关性高于男性(r=0.32,P<0.05)。从20~69岁,男性L4 PDFF增长率最大(21.08%),女性L1 PDFF增长率最大(65.68%);男性各椎体PDFF增长主要集中在30~及50~组,其中L1、L4、L5椎体PDFF在50~组增长率最大,L2、L3椎体PDFF在30~岁组增长率最大;女性各椎体PDFF在30~组呈轻微下降趋势,此后各椎体PDFF逐渐升高,增长主要集中在40~、50~、60~三个年龄组,其中50~组增长率最大。结论:成人不同年龄组男女性各椎体脂肪分布存在差异,椎体PDFF增长率也有所不同;腰椎不同节段椎体PDFF均与年龄呈正相关。
