Acta Orthop Belg
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The objective of this manuscript is to show an effective, easier and cheaper way to reduce acute acromioclavicular (AC) dislocation type III and V (Rockwood classification). Numerous procedures have been described for surgical management of acromioclavicular joint disruption. Newest devices involve an arthroscopic technique that allows nonrigid anatomic fixation of the acromioclavicular joint. ⋯ It also allows reviewing glenohumeral associated lesions. This surgical technique requires no specific implants to achieve a correct AC reduction. Actually, economical advantages are very important factors to decide the use of determinate surgical techniques.
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Comparative Study
Growing rod instrumentation in the treatment of early onset scoliosis.
The goal of the treatment of early onset scoliosis (EOS) is correction of the deformity while still allowing for spinal growth. The aim of this study was to determine the safety and effectiveness of the single and dual growing rod techniques and which technique was the most effective in the management of EOS respectively. From 2003 to 2009, 23 patients underwent single (15) or dual (8) growing rod procedures using a pedicle screw construct and tandem connectors. ⋯ The mean Cobb angle before fusion was 58.7° (40°-75°). There were 0.9 complications per patient in all groups, 0.38 in the dual rod and 1.2 in the single rod group, respectively. Dual growing rods result in better deformity correction and stability of correction with an acceptable complication rate.
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Little data is available on the relationship between sagittal spinopelvic parameters and health related quality of life (HRQOL) in osteoporotic patients. The aim of this study was to identify relationships between spinopelvic parameters and HRQOL in osteoporosis. ⋯ Osteoporotic patients and controls were found to be significantly different in terms of sagittal spinopelvic parameters. Correlation analysis revealed significant relationships between radiographic parameters and clinical outcome variables. In particular, sagittal vertical axis, sacral slope, and FNBMD significantly predicted clinical outcomes in osteoporotic patients.
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Non-union of osteoporotic vertebra fractures are a seldom entity. However, when back pain persists in the course of conservatively treated osteoporotic vertebra fractures, a non-union should be considered. We thus sought to validate our diagnostic algorithm in patients with known osteoporotic vertebra fractures presenting persistent back pain and advert to the diagnosis and treatment of vertebral non-unions. ⋯ Non-union of osteoporotic vertebra fractures must be considered when symptoms outlast conservative treatment. In these cases, plain lateral fulcrum radiographs are a simple and effective adjunct to the conventional diagnostic methods. Surgical stabilization then proves to be the effective treatment of choice.
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Comparative Study Controlled Clinical Trial
Kyphoplasty versus vertebroplasty in the treatment of painful osteoporotic vertebral compression fractures: two-year follow-up in a prospective controlled study.
A total of 112 patients with a single-level osteoporotic vertebral compression fracture who did not respond to conservative therapy were included and allocated to either kyphoplasty or vertebroplasty treatment. The Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were used to assess back pain and disability. Anterior, midline, posterior vertebral body heights, and kyphotic angle at the fractured vertebra were measured for radiographic evaluation. ⋯ The incidence of asymptomatic cement leakage per treated vertebrae in the kyphoplasty group was 11.4% versus 31% in the vertebroplasty group (P < 0.001). Three adjacent level fractures in the kyphoplasty group and 2 in the vertebroplasty group occurred during 2-year follow-up, and no difference in patient satisfaction was detected between the 2 groups. Kyphoplasty and vertebroplasty achieved similar improvement of clinical outcomes and patient satisfaction at 2 years after surgery, albeit kyphoplasty had more ability to markedly reduce vertebral deformity and resulted in less cement leaks compared with vertebroplasty.