European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Despite potential advantages of three-dimensional fluoroscopy-based navigation, there still remain a lot of controversies about the indications of this technology, especially whether it is worthy of being used in placement of pedicle screws in lumbar spine. However, according to the inconsistent conclusions reported in the literature and our experiences, the traditional method relying on anatomical landmarks and fluoroscopic views to guide lumbar pedicle screw insertion is unable to meet the requirement of precise screw placement. Based on our observation, screw malposition seems to occur concomitant with vertebral axial rotation which is a ubiquitous phenomenon. ⋯ With degrees increasing, the accuracy declined. The accuracy of three-dimensional fluoroscopy-based navigation group was higher than traditional method group in vertebrae with axial rotation (P < 0.01). In qualitative evaluation, the accuracy of the two methods had statistical difference when the degree was 20°, and in quantitative evaluation, statistical difference existed in 5°, 10°, and 20° of vertebral axial rotation.
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Case Reports
Percutaneous anterolateral balloon kyphoplasty for metastatic lytic lesions of the cervical spine.
The purpose of our report is to describe a new application of kyphoplasty, the percutaneous anterolateral balloon kyphoplasty that we performed in two cases of metastatic osteolytic lesions in cervical spine. The first patient, aged 48 years, with primary malignancy in lungs had two metastatic lesions in C2 and C6 vertebrae. Patient's complaints were about pain and restriction of movements (due to the pain) in the cervical spine. ⋯ Karnofsky score showed also improvement from 40 and 30 preoperatively to 80 and 70, respectively, at the final follow-up (7 months after the procedure). Fluoroscopy-guided percutaneous anterolateral balloon kyphoplasty proved to be safe and effective minimally invasive procedure for metastatic osteolytic lesions of the cervical spine, reducing pain and avoiding vertebral collapse. Experience and attention are necessary in order to avoid complications.
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Women going through menopause experience bone loss and increased musculoskeletal pain, including low back pain. This study explored the relationships between bone mineral density (BMD) and body mass index (BMI), postmenopausal period and outcomes of treatment for low back pain in postmenopausal Korean women. On examining the medical records of 78 postmenopausal women hospitalized for low back pain, investigators found that women with low BMD were older and had been postmenopausal for longer periods than women with normal BMD. ⋯ In conclusion, age, postmenopausal length and BMI correlate with BMD in Korean women suffering from LBP. Larger studies investigating the associations between menopause, BMD, BMI and LBP seem desirable. Moreover, evidence-based therapeutic approaches should be explored for BMD and LBP management.