scholarly journals Odontoid balloon kyphoplasty associated with screw fixation for Type II fracture in 2 elderly patients

2015 ◽  
Vol 22 (3) ◽  
pp. 246-252 ◽  
Author(s):  
Luc Terreaux ◽  
Thomas Loubersac ◽  
Olivier Hamel ◽  
Eric Bord ◽  
Roger Robert ◽  
...  

Anterior screw fixation is a well-recognized technique that is used to stabilize Type IIB fractures of the odontoid process in the elderly. However, advanced age and osteoporosis are 2 risk factors for pseudarthrosis. Kyphoplasty has been described in the treatment of lytic lesions in C-2. The authors decided to combine these 2 techniques in the treatment of unstable fractures of the odontoid. Two approximately 90-year-old patients were treated for this type of fracture. Instability was demonstrated on dynamic radiography in one patient, and the fracture was seen on static radiography in the other. Clinical parameters, pain, range of motion, 36-Item Short Form Health Survey (SF-36) score (for the first patient), and radiological examinations (CT scans and dynamic radiographs) were studied both before and after surgery. After inflating the balloon both above and below the fracture line, the authors applied a high-viscosity polymethylmethacrylate cement. Some minor leakage of cement was noted in both cases but proved to be harmless. The screws were correctly positioned. The clinical result was excellent, both in terms of pain relief and in the fact that there was no reduction in the SF-36 score. The range of motion remained the same. A follow-up CT scan obtained 1 year later in one of the patients showed no evidence of change in the materials used, and the dynamic radiographs showed no instability. This combination of kyphoplasty and anterior screw fixation of the odontoid seems to be an interesting technique in osteoporotic Type IIB fractures of the odontoid process in the elderly, with good results both clinically and radiologically.

Spine ◽  
1989 ◽  
Vol 14 (10) ◽  
pp. 1065-1070 ◽  
Author(s):  
MAX AEBI ◽  
CHRISTIAN ETTER ◽  
MICHAEL COSCIA

2019 ◽  
Vol 41 (1) ◽  
pp. 69-78 ◽  
Author(s):  
Xi Liu ◽  
Jingjing An ◽  
Hui Zhang ◽  
Yaxing Li ◽  
Yu Chen ◽  
...  

Background: Posttraumatic arthritis of tibiotalar joints after AO/OTA type C3 pilon fractures, especially in young patients with a significant osteochondral defect in the tibial plafond joint surface, is a challenging situation. We report a joint-preserving technique using autologous osteochondral graft in combination with ankle distraction and supramalleolar osteotomy (SMOT), if necessary, to improve its outcome. Methods: Seventeen patients with an average age of 32.1 years with Takakura grade 1 to 3A posttraumatic arthritis of the tibiotalar joint after AO/OTA type C3 pilon fractures received osteochondral autograft transplantation, ankle distraction, and SMOT, when supramalleolar malalignment was present, between February 2010 and November 2015. The visual analog scale (VAS), Short-Form 36 (SF-36) score, American Orthopaedic Foot & Ankle Society (AOFAS) score, and ankle range of motion were used for outcome analysis. Radiographic assessment of any SMOT and the apparent joint space was performed. Fourteen patients were followed for an average of 18 months. Results: The VAS, SF-36, and AOFAS scores as well as the ankle range of motion all improved significantly at the last follow-up after the surgery ( P < .01). No deep surgical site infection, donor site complication, nonunion, osteochondral block loosening, or resorption was noted. No secondary arthrodesis was needed at the end of follow-up. Conclusion: Autologous osteochondral graft transplantation in combination with ankle distraction and SMOT was a promising joint-preserving technique for early posttraumatic arthritis of tibiotalar joint after severe pilon fractures in young patients. Level of Evidence: Level IV, case series.


2006 ◽  
Vol 6 (5) ◽  
pp. 94S
Author(s):  
Woo-Kie Min ◽  
Joo-Kyung Sung ◽  
In-Ho Jeon ◽  
Chang-Wug Oh ◽  
Shin-Yoon Kim ◽  
...  

2017 ◽  
Vol 41 (S1) ◽  
pp. S653-S653
Author(s):  
I. Feki ◽  
S. Hentati ◽  
R. Sallemi ◽  
M. Moala ◽  
J. Masmoudi

BackgroundMost elderly patients, with cancer are cared for, by a family member who may be affected by various stressors that can influence their health and quality of life (QOL).ObjectivesTo explore depression, quality of life and its related factors among caregivers of elderly patients with cancer.MethodologyThis is a descriptive and analytical cross-sectional study including 40 primary caregivers of old patients aged 65 or older, with cancer in oncologic radiotherapy service in university hospital Habib Bourguibain Sfax, Tunisia. The short form health survey (SF-36) and Beck inventory (13 items) were used to assess respectively QOL and depression.ResultsThe average age of caregivers was 44.62 years. The sex ratio (M/F) was 0.9. Most of caregivers (75%) had impaired QOL (score ˂ 66.7). The two main components of SF-36 were altered with a standard score of 45 for the physical component and 41.1 for mental component. According to Beck inventory, Depression was present in 67.6% of cases. Impaired QOL of life was significantly correlated with somatic illnesses in the caregiver (P = 0.016), advanced stage of cancer (P = 0.01), financial difficulties (P = 0.04), the non-cohabitation with the patient before the disease (P = 0.031) and depression (P = 0.00).ConclusionAccording to our study, caregiving can have a negative effect on the caregiver's mental and physical health. Assistance and information from healthcare professionals are the key to improving the ability of caregivers to cope with caring for older patients with cancer.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shoichiro Ohyama ◽  
Masatoshi Hoshino ◽  
Shinji Takahashi ◽  
Yusuke Hori ◽  
Hiroyuki Yasuda ◽  
...  

AbstractSarcopenia has been associated with poor clinical outcomes in several diseases. Herein, the clinical results of balloon kyphoplasty (BKP) for acute osteoporotic vertebral fracture (OVF) treatment were assessed and compared between sarcopenia and non-sarcopenia patients. Sixty patients who underwent BKP for treatment of acute OVF with poor prognostic factors between April 2016 and September 2017 and were assessed for sarcopenia were enrolled. Clinical results (back pain on visual analogue scale [VAS]; short-form [SF] 36; vertebral deformity; activities of daily living levels; and incidence of adjacent vertebral fractures) were compared between the two groups at 6 months post-BKP. Data analysis revealed that back pain on VAS, SF-36 scores, and vertebral deformity improved from baseline to 6 months after BKP. Thirty-nine patients (65.0%) were diagnosed with sarcopenia and demonstrated a lower body mass index (21.2 vs. 23.3 kg/m2, p = 0.02), skeletal muscle mass index (5.32 vs. 6.55 kg/m2, p < 0.01), hand-grip strength (14.7 vs. 19.2 kg, p = 0.01), and bone mineral density of the femoral neck (0.57 vs. 0.76 g/cm2, p < 0.01) than those of patients without sarcopenia. However, no significant differences were observed in the clinical results between these groups. Therefore, BKP’s clinical results for the treatment of acute OVF are not associated with sarcopenia.


2017 ◽  
Vol 16 (3) ◽  
pp. 236-239 ◽  
Author(s):  
SERGIO SORIANO-SOLÍS ◽  
JAVIER QUILLO-OLVERA ◽  
MANUEL RODRÍGUEZ-GARCÍA ◽  
HÉCTOR ANTONIO SORIANO SOLÍS ◽  
JOSÉ-ANTONIO SORIANO-SÁNCHEZ

ABSTRACT Objective: To report two cases of multilevel cervical spondylotic myelopathy with monosegmental instability, in which we performed a minimally invasive microsurgical transmuscular approach with tubular retractors to create a single-door plate laminoplasty combined with fixation of the unstable segment with lateral mass screws. Methods: The surgical procedures were performed by the senior author. In both patients, the follow-up was performed using the Oswestry Disability Index (ODI), the Visual Analogue Scale for neck and radicular pain (radVAS, neckVAS), the Neck Disability Index (NDI) and the Short Form 36 (SF-36), in the preoperative (preop) and postoperative (postop) periods, and at 1, 3, 6, 12, 18 and 24 months. A radiological evaluation also was performed, which included AP, lateral and flexion-extension films at 6, 12 and 24 months and CT-scan at 12 months. Results: Case 1 - preop ODI: 40%, 24 months postop ODI: 4%; preop radVAS: 7, 24 months radVAS: 0; preop neckVAS: 8, postop 24 months neckVAS: 0; preopNDI: 43%, 24 months PostopNDI: 8%; SF-36 - preop Physical Functioning (PF): 40, preop Vitality (VT): 40, preop Emotional role functioning (RE): 33.3, Bodily pain (BP): 51, General Health (GH): 57, Social Functioning (SF): 75; postop PF: 95, VT: 95, RE: 100, BP: 74, GH: 87, SF: 100. Case 2 - preopODI: 46%, 24 months postopODI: 10%; preop radVAS: 7, 24m radVAS: 0; preop neckVAS: 9, postop 24 months neckVAS: 0; preopNDI: 56%, 24 months PostopNDI: 15%; SF-36 - preop PF: 39, VT: 45, RE: 33.3, BP: 50, GH: 49, SF: 70; postop PF: 90, VT: 100, RE: 100, BP: 82, GH: 87, SF: 100. No complications, cervical instability or signs of failed surgery were found trough and at final follow-up at 24 months. We found significant clinical improvement in both patients. Conclusions: Minimally invasive cervical laminoplasty combined with lateral mass screw fixation for the unstable segment is a useful technique in cases with multilevel cervical spondylotic myelopathy associated with monosegmental instability. Additional comparative studies are needed to establish its efficacy.


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