Biomedical subjects

Chien-Lin Liu

Publications and source records attributed to Chien-Lin Liu.

At least 19 recordsLinked to original sources

PubMed2006

Optimization design of thumbspica splint using finite element method.

De Quervain's tenosynovitis is often observed on repetitive flexion of the thumb. In the clinical setting, the conservative treatment is usually an applied thumbspica splint to immobilize the thumb. However, the traditional thumbspica splint is bulky and heavy. Thus, this study used the finite element (FE) method to remove redundant material in order to reduce the splint's weight and increase ventilation. An FE model of a thumbspica splint was constructed using ANSYS9.0 software. A maximum lateral thumb pinch force of 98 N was used as the input loading condition for the FE model. This study implemented topology optimization and design optimization to seek the optimal thickness and shape of the splint. This new design was manufactured and compared with the traditional thumbspica splint. Ten thumbspica splints were tested in a materials testing system, and statistically analyzed using an independent t test. The optimal thickness of the thumbspica splint was 3.2 mm. The new design is not significantly different from the traditional splint in the immobilization effect. However, the volume of this new design has been reduced by about 35%. This study produced a new thumbspica splint shape with less volume, but had a similar immobilization effect compared to the traditional shape. In a clinical setting, this result can be used by the occupational therapist as a reference for manufacturing lighter thumbspica splints for patients with de Quervain's tenosynovitis.

De Quervain Disease↗

PubMed2006

Is fusion necessary for surgically treated burst fractures of the thoracolumbar and lumbar spine?: a prospective, randomized study.

STUDY DESIGN: A prospective clinical trial was conducted. OBJECTIVES: To compare the results of fusion versus nonfusion for surgically treated burst fractures of the thoracolumbar and lumbar spine. SUMMARY OF BACKGROUND DATA: The operative results of surgically treated burst fractures with short segmental fixation have been well documented. There is no report comparing the results of fusion and nonfusion. METHODS: Fifty-eight patients were included in this study, with the inclusion criteria as follows: neurologically intact spine with a kyphotic angle > or = 20 degrees, decreased vertebral body height > or = 50% or a canal compromise > or = 50%, incomplete neurologic deficit with a canal compromise 50%, complete neurologic deficit, and multilevel spinal injury or multiple traumas. All patients were randomly assigned to fusion or nonfusion groups, and operative treatment with posterior reduction and instrumentation was carried out. Posterior fusion with autogenous bone graft was performed for the fusion group (n = 30), and no fusion procedure was done for the nonfusion group (n = 28). The average follow-up period was 41 months (range, 24-71 months). RESULTS: The average loss of kyphotic angle was not statistically significant between these 2 groups. The radiographic parameters were statistically significantly better in the nonfusion group, including angular change in the flexion-extension lateral view (4.8 degrees vs. 1.0 degrees), lost correction of decreased vertebral body height (3.6% vs. 8.3%), intraoperative estimated blood loss (303 mL vs. 572 mL), and operative time (162 minutes vs. 224 minutes). The scores on the low back outcome scale were not statistically significant for these 2 groups. CONCLUSIONS: The short-term results of short segmental fixation without fusion for surgically treated burst fractures of the thoracolumbar spine were satisfactory. The advantages of instrumentation without fusion are the elimination of donor site complications, saving more motion segments, and reducing blood loss and operative time.

Adult↗

PubMed2006

Tuberculous spondylitis and pyogenic spondylitis: comparative magnetic resonance imaging features.

STUDY DESIGN: We retrospectively compared magnetic resonance images (MRIs) of tuberculous (TB) spondylitis and pyogenic spondylitis. OBJECTIVE: To identify differences between the diseases. SUMMARY OF BACKGROUND DATA: Clinical and imaging findings of the 2 diseases are hard to distinguish. MRI may show important differences and aid in early diagnosis and treatment. METHODS: We compared 22 MRI parameters in 33 patients with TB spondylitis (average age, 66 years) and in 33 patients with pyogenic spondylitis (average age, 65 years). RESULTS: Seventeen parameters significantly differed between the groups. The most important were local and heterogeneous enhancement of the vertebral body in all patients with TB spondylitis, diffuse and homogeneous enhancement of the vertebral body in 94% of patients with pyogenic spondylitis, vertebral intraosseous abscess with rim enhancement (TB vs. pyogenic, 79% vs. 0%), disc abscess with rim enhancement (9% vs. 64%), and well-defined paraspinal abnormal signal intensity (82% vs. 18%). CONCLUSIONS: Most parameters occurred in both diseases. Distinctive findings were a pattern of bone destruction with relative disc preservation and heterogeneous enhancement for TB spondylitis and a diskitis pattern (disc destruction) with peridiscal bone destruction and homogeneous enhancement for pyogenic spondylitis. These MRI parameters may facilitate the differential diagnosis of these diseases.

Adult↗

PubMed2006

Comparison of two interbody fusion cages for posterior lumbar interbody fusion in a cadaveric model.

Although the Brantigan cage and Bagby and Kuslich (BAK) cage have different geometrical characteristics, clinical observations suggest that they are equally effective in restoring disc height and stability across the involved spinal segments. This study was designed to compare their performance as posterior lumbar interbody fusion devices at two levels in fresh ligamentous cadaver lumbar spines (L2-S1). After mounting in a testing frame, the three-dimensional load-displacement behaviour of each vertebra was quantified using the Selspot II Motion Measurement System for; the intact state, posterior decompression, and stabilisation, using a pair of Brantigan or BAK cages across L4-S1, additional stabilisation using Isola spinal instrumentation across L4-S1, and cyclic loading in flexion/extension. In the "cage-only" state, the Brantigan cage did not restore the stability in right axial rotation, whereas the BAK cage not only restored stability in all six directions but also improved lateral bending. After implanting the posterior instrumentation, both groups exhibited similar stability, and cyclic loading did not alter this. Although the Brantigan cage appears less effective than the BAK cage, implantation of posterior instrumentation significantly improves stability and reduces the differences between them. This underscores the need to use posterior instrumentation to achieve a higher initial stability.

Aged↗

PubMed2006

Posterolateral lumbar spinal fusion with autogenous bone chips from laminectomy extended with OsteoSet.

BACKGROUND: This study was conducted to evaluate posterolateral lumbar fusion with autogenous corticocancellous bone chips from the laminae and spinous processes extended with OsteoSet instead of cancellous bone from the iliac crest. METHODS: A total of 124 patients who underwent posterior decompression and posterolateral fusion with instrumentation between May 2001 and December 2003 were analyzed retrospectively. The study population comprised 49 males and 75 females with a mean age of 66 +/- 9.5 years. In all the patients, corticocancellous bone chips from laminectomy and OsteoSet were used as the graft material. There was no cancellous bone harvested from the iliac crest. The follow-up period was 28 +/- 7.1 months. RESULTS: The overall union rate was 91%, and the average union time was 3.9 months. There were 3 complications, including 2 patients with dura tear, and 1 with deep infection. At the final follow-up, the good and excellent results were up to 83.9%. CONCLUSION: Graft material from laminae and spinous processes extended with OsteoSet is reliable and effective enough to replace the graft from the posterior iliac crest.

Aged↗

PubMed2005

Can povidone-iodine solution be used safely in a spinal surgery?

UNLABELLED: Intra-operative incidental contamination of surgical wounds is not rare. Povidone-iodine solution can be used to disinfect surgical wounds. Although povidone-iodine is a good broad-spectrum disinfecting agent, it has occasionally been reported to have a negative effect on wound healing and bone union. Therefore, its safety in a spinal surgery is unclear. A prospective, single-blinded, randomized study was accordingly conducted to evaluate the safety of povidone-iodine solution in spinal surgeries. Ascertained herein was the effect of wound irrigation with diluted povidone-iodine solution on wound healing, infection rate, fusion status and clinical outcome of spinal surgeries. MATERIALS AND METHODS: From January 2002 to August 2003, 244 consecutive cases undergoing primary instrumented lumbosacral posterolateral fusion due to degenerative spinal disorder with segmental instability had been collected and randomly divided into two groups: the study group (120 cases, 212 fusion levels) and the control group (124 cases, 223 fusion levels). Excluded were those patients with a prior spinal surgery, spinal trauma, malignant tumor, infectious spondylitis, rheumatoid arthritis, ankylosing spondylitis, metabolic bone disease, skeletal immaturity or with an immunosuppressive treatment. In the former group, wounds were irrigated with 0.35% povidone-iodine solution followed by normal saline solution just before the bone-grafting and instrumentation procedure. However, only with normal saline solution in the latter. All the operations were done by the same surgeon with a standard technique. All the patients were treated in the same postoperative fashion as well. Later on, wound healing, infection rate, spinal bone fusion and clinical outcome were evaluated in both groups. RESULTS: A significant improvement of back and leg pain scores, modified Japanese Orthopedic Association function scores (JOA) and ambulatory capacity have been observed in both groups. One hundred and seven patients in the study group and one hundred and nine in the control group achieved solid union. There was no infection in the study group but six deep infections in the control group. Wound dehiscence was noted in one group 1 and two group 2 patients. A subsequent statistical analysis revealed higher infection rate in the control group (P<0.05), but no significant difference in fusion rate, wound healing, improvement of pain score, function score and ambulatory capacity between the two groups. CONCLUSION: Diluted povidone-iodine solution can be used safely in spinal surgeries, and it will not influence wound healing, bone union and clinical outcome.

Adult↗

PubMed2005

Efficacy of dilute betadine solution irrigation in the prevention of postoperative infection of spinal surgery.

STUDY DESIGN: Prospective, single-blinded, randomized study. OBJECTIVES: To evaluate the efficacy of dilute betadine irrigation of spinal surgical wounds in prevention of postoperative wound infection. SUMMARY AND BACKGROUND: Deep wound infection is a serious complication of spinal surgery that can jeopardize patient outcomes and increase costs. Povidoneiodine is a widely used antiseptic with bactericidal activity against a wide spectrum of pathogens, including methicillin-resistant Staphylococcus aureus. The aim of this study was to evaluate the efficacy of dilute betadine solution in the prevention of wound infection after spinal surgery. METHODS: Four hundred and fourteen patients undergoing spinal surgery were randomly assigned to two groups. In group 1 (208 patients), surgical wounds were irrigated with dilute betadine solution (3.5% betadine) before wound closure. Betadine irrigation was not used in group 2 (206 patients). Otherwise, perioperative management was the same for both groups. RESULTS: Mean length of follow-up was 15.5 months in both groups (range, 6-24 months). No wound infection occurred in group 1. One superficial infection (0.5%) and six deep infections (2.9%) occurred in group 2. The differences between the deep infection rate (P = 0.0146) and total infection rate (P = 0.0072) were significant between the two groups. CONCLUSIONS: Our report is the first prospective, single-blinded, randomized study to evaluate the clinical effectiveness of dilute betadine solution irrigation for prevention of wound infection following spinal surgery. We recommended this simple and inexpensive measure following spinal surgery, particularly in patients with accidental wound contamination, risk factors for wound infection, or undergoing surgery in the absence of routine ultraviolet light, laminar flow, and isolation suits.

Adult↗

PubMed2005

Posterior instrumentation reduces differences in spine stability as a result of different cage orientations: an in vitro study.

STUDY DESIGN: A multisegmental cadaveric spine model was used to quantify the load-displacement behavior of intact spine specimens, specimens injured and stabilized using Bagby and Kuslich (BAK) cages as lumbar interbody fusion devices with or without posterior instrumentation across two levels. OBJECTIVES: To compare the stabilities imparted by the cages placed using an oblique and conventional posterior approaches and to determine the effects of supplementary posterior instrumentation. SUMMARY OF BACKGROUND DATA: The BAK cage as posterior lumbar interbody fusion (PLIF) has been used to restore disc height, reduce morbidity, provide immediate stability to the patients, and enhance fusion rates. The obliquely inserted BAK cage has the advantages of reducing exposure and precise implantation. The biomechanical efficacy of this procedure is sparse, especially in comparison to the PLIF with and without posterior instrumentation. METHODS: Nine fresh human ligamentous spines (L2-S1) were affixed within a testing frame for determining their load-displacement behaviors. Load testing in clinically relevant modes was performed sequentially for the intact and the following procedures across the L4-S1 segment: posterior destabilization, stabilization using two parallel BAK cages (CBAK group) or one oblique BAK cage (OBAK group), further stabilization with posterior instrumentation, and finally cyclic loading in flexion-extension. Spatial positions of the LEDs attached to vertebral bodies were recorded using a three-dimensional motion measurement system. RESULTS: When used alone to restore stability, the orientation of the cage affected the outcome. In flexion OBAK orientation and in extension CBAK orientation provided better stability (decrease in motion with respect to intact case), compared with the other orientation. In lateral bending, CBAK orientation was found to be better than OBAK. In axial mode, CBAK orientation was effective in both directions while OBAK was effective only in right axial rotation. With the supplementary posterior fixation, the differences in stability resulting from the orientations were not noticeable at all, both before and after cyclic tests. CONCLUSIONS: Owing to the differences in the surgical approach and the amount of dissection, the stability for the cages when used alone as a function of cage orientation was different. These subtle differences were reduced by the use of posterior fixation device, underscoring the importance of using instrumentation when cages are used as PLIFs. However, the oblique insertion may be more favorable since it requires less exposure, enables precise implantation, and is less expensive, especially when used with supplementary instrumentation.

Aged↗

PubMed2005

Operative treatment of intra-articular distal radius fractures using the small AO external fixation device.

BACKGROUND: A retrospective group study was done to evaluate the effect of the small AO external fixator in the management of acute intra-articular fractures of the distal radius. METHODS: Between January 1995 and December 1996, 70 consecutive patients with articular fractures of the distal radius were treated by closed reduction and external fixation with small AO external fixators. The mean age at the time of surgery was 58.9 years (range, 14-87 years). There were 58 Colles' Barton's fractures and 12 Smith's Barton's fractures. The follow-up period was 104 months (range, 92-118 months). RESULTS: All fractures united in a mean of 5.8 weeks (range, 4-10 weeks). At the final follow-up, the average range of motion was 56.3 +/- 11.6 degrees in flexion, 58.6 +/- 10.7 degrees in extension, 21.5 +/- 4.2 degrees in ulnar deviation, 9.1 +/- 2.9 degrees in radial deviation, 71.5 +/- 8.5 degrees in pronation, and 67.3 +/- 9.2 degrees in supination. Compared with the normal side, the average grip force was 87 +/- 6%. The overall clinical and functional outcomes, according to the scoring system of Gartland and Werley, showed that 22 patients (31.4%) had excellent results, 36 (51.4%) had good results, 9 (12.9%) had fair results, and 3 (4.3%) had poor results. CONCLUSION: Closed reduction and external fixation with the small AO external fixator is useful and effective in the management of displaced comminuted articular fractures of the distal radius.

Adolescent↗

PubMed2005

Allograft arthrodesis of the knee in high-grade osteosarcoma.

BACKGROUND: A retrospective cohort study was conducted to evaluate the outcomes of massive allograft arthrodesis in the management of high-grade osteosarcoma around the knee. METHODS: The results of 19 patients with high-grade osteosarcoma around the knee, which was treated by wide resection and reconstruction using allograft arthrodesis, were evaluated for a mean length of 7.3 years (range, 3-13 years). The mean age at the time of surgery was 13.3 years (range, 6-27 years). According to the Musculoskeletal Tumor Society staging system, 17 patients were stage IIB and 2 were stage IIIB at presentation. Evaluations were based on the oncologic results, non-oncologic results and complications. Functional evaluation was performed with the Enneking functional evaluation form. RESULTS: Four patients (21.1%) died of their disease; 3 (15.8%) are alive with disease; and 12 (63.2%) are free of disease. Four patients (21.1%) had local recurrence of their tumor at a mean of 23 months postoperatively (range, 9-44 months). The mean time to union of the metaphyseal junction was 24.7 weeks (range, 16-30 weeks) and the diaphyseal junction was 47 weeks (range, 24-78 weeks). The overall complication rate was 31.6%, including 2 (10.5%) infections, 3 (15.8%) allograft fractures, and 1 (5.3%) nonunion. Our mean final functional result was 65%. CONCLUSION: Due to the high rate of complications in this study, we conclude that allograft arthrodesis should be left as a salvage or "back-up" reconstructive procedure after resection of osteosarcoma around the knee, unless there are special indications for this procedure. We found allograft fracture to be the most common complication.

Adolescent↗

PubMed2005

Biomechanical analysis of the disc adjacent to posterolateral fusion with laminectomy in lumbar spine.

OBJECTIVES: After posterolateral fusion with laminectomy for the degenerative lumbar spine, accelerated degeneration of the disc adjacent to the fusion mass has been clinically observed. Previous studies used a finite element model (FEM) to calculate the stress of the adjacent disc in the fused lumbar spine with spinal fixator and bone graft. However, little emphasis was placed on the simultaneous spinal fusion and decompression procedure. To investigate if the spinal decompression procedure in posterolateral fusion would increase stress significantly, the FEM was employed to estimate the stress concentration of the disc above the fusion mass in posterolateral fusion with laminectomy and hemilaminectomy. METHODS: Three FEMs of the lumbar spine were established: intact spine, posterolateral fusion with total laminectomy, and posterolateral fusion with hemilaminectomy (preserved partial lamina, spinous process, and supraspinous and interspinous ligaments). The posterolateral fusion added spinal fixator and bone graft between the transverse process. The L1 vertebral body was subjected to 10-Nm flexion, extension, torsion, and lateral bending. The bottom of the L5 vertebral body was fixed. RESULTS: In flexion, the stress on the adjacent disc in posterolateral fusion with laminectomy and hemilaminectomy respectively increased 90% and 21% over that of the intact spine. In posterolateral fusion with hemilaminectomy, the supraspinous and interspinous ligaments shared some external forces to alleviate the stress concentration of the adjacent disc. However, in extension, torsion, and lateral bending, these two fusion models had almost no change in range of motion and stress of adjacent disc. CONCLUSION: Posterolateral fusion with hemilaminectomy (preserved partial lamina, spinous process, and supraspinous and interspinous ligaments) was able to alleviate the stress concentration of the disc above the fusion mass in flexion.

Biomechanical Phenomena↗

PubMed2004

Acute noncontiguous multiple-level thoracic disc herniations with myelopathy: a case report.

STUDY DESIGN: The case report of a 38-year-old man with a unique acute, triple-level, noncontiguous thoracic disc herniation (T6, T9-T10, and T11-T12), delayed onset of lower limb weakness, paresthesias below the T10 dermatome, and urinary dysfunction following minor trauma resulting from a motorcycle accident. OBJECTIVES: To present an unusual case of herniation that could involve ambiguous test results (imaging findings not necessarily correlated with severity of clinical manifestations). SUMMARY OF BACKGROUND DATA: Multiple-level symptomatic disc herniations of the thoracic spine are rare, and the reported cases are mostly of contiguous, two-level lesions with chronic clinical presentation. No case of acute three-level noncontiguous ruptured thoracic disc herniations with myelopathy has been reported. METHODS: Through the left transthoracic approach, partial corpectomy, complete discectomy, and interbody fusion of the T9-T10 vertebrae were performed. The less prominent lesions of the T6 and T12-L1 vertebrae were left untreated. RESULTS: Remarkable improvement of neurologic symptoms, including motor weakness and bladder dysfunction, was observed 1 week after operation. At 1-year follow-up, he could walk without aid and with a somewhat spastic gait. However, paresthesias below dermatome T12 persisted. The patient refused to accept the recommendation of further surgical decompression of the nerves at the T6 and T12-L1 vertebral lesions. CONCLUSION: Since the presentation of thoracic disc herniation is variable and difficult to correlate with imaging findings, decompression at all lesion levels in a patient with symptomatic multiple-level ruptured thoracic disc herniations may be necessary to achieve complete symptom relief and satisfactory results.

Accidents, Traffic↗

PubMed2004

Idiopathic spinal epidural lipomatosis.

Spinal epidural lipomatosis is a rare disorder characterized by the pathological overgrowth of epidural fat and often causes extradural compression which may mimic other spinal disorders. Steroid administration is a well-documented etiology. We report a case of spinal epidural lipomastosis without history of steroid administration. The initial manifestation was bizarre and was misdiagnosed as a degenerative vertebral or disc disease for long. Posterior decompression with debulking of the extradural fat successfully and thoroughly relieved his symptoms. We emphasize the importance of taking this disease into consideration for a markedly obese patient with persisting back pain or symptoms suggesting spinal cord or other spinal neural elements compression.

Aged↗

PubMed2004

Postoperative spinal deep wound infection: a six-year review of 3230 selective procedures.

BACKGROUND: Postoperative wound infection remains a troublesome but common complication after spinal surgery. This study presents the 6-year experience of our surgical team with post-operative deep wound infection in Taipei Veterans General Hospital. METHODS: Of 3230 selected operations, 72 cases of wound infection were identified. Thirty patients with deep wound infection were reviewed, including 17 men and 13 women at a mean age of 32 years. The pre-operative diagnoses included spondylolisthesis, scoliosis, spinal stenosis, herniated inter-vertebral disc, spinal fracture and adjacent syndrome. RESULTS: In this report, different deep wound infection rates were compared between different operative procedures including (1) posterior decompression with fixation and fusion, 1.15%. (2) simple decompression (laminectomy) and disectomy, 0.37%, (3) revision fixation with decompression, 4.4%, and (4) removal of implant. 0.33%. The onset of infection sign was divided into 3 groups: (1) acute (< 2 weeks), 43.3%, (2) subacute (2-4 weeks), 40%, and (3) chronic (> 4 weeks), 16.6%. In 11 patients with deep wound infection, no bacteria was cultured, while 14 patients had Methicillin-resistant Staphylococcus aureus and another 3 patients had lower-grade toxic Staphylococcus aureus. All patients received debridement followed by delayed wound closure with effective antibiotics. Instruments were removed in only 8 patients. Twenty seven cases were cured after treatment but 3 patients expired in poor condition. CONCLUSIONS: In this series, total deep wound infection was 0.9% in our 6-year experience. The incidence of postoperative spinal infection increased with the complexity of the procedure. Most patients got completely disease free with antibiotics and surgical treatment.

Aged↗

PubMed2003

Flexion-distraction injury of the thoracolumbar spine.

Flexion-distraction injury of the thoracolumbar spine results from a failure of both the posterior and middle columns under tension, and this injury is uncommon. Progressive kyphotic deformity frequently develops after conservative treatments. We report our 10 years' experience with the surgical treatment of flexion-distraction injuries. From January 1991 to December 2000, 30 flexion-distraction thoracolumbar spinal injuries were treated at our hospital. We included 23 patients in this study, and seven patients were excluded. The mean age of the patients was 37.2 years. Six were female and 17 were male. All patients received open reduction, posterior instrumentation, and posterior fusion at the level of injury. Post-operatively, patients were all placed in total contact orthoses for 3 months. Ambulation was allowed immediately after brace application.The mean follow-up period was 84.7 months follow-up. The final average follow-up kyphotic angulation was 5.4 degrees, which is an average improvement of 9.5 degrees. Post-operative back pain ratings indicated that result of surgery was mostly good, and the neurological evaluation was almost normal after long-term follow-up. A satisfactory reduction and good stabilisation with solid fusion was achieved in all cases, without any significant loss of reduction. Surgical treatment of reduction and stabilisation with posterior instrumentation and fusion is suggested in patients with flexion-distraction injury of the thoracolumbar spine.

Accidental Falls↗

PubMed2003

Calcium pyrophosphate dihydrate crystal deposition disease in cervical radiculomyelopathy.

One patient had cervical spinal canal stenosis with radiculomyelopathy due to deposition of calcium pyrophosphate dihydrate within the ligamentum flavum. The MRI of cervical spine showed a calcified nodule over C5-6 level ligamentum flavum with obvious cord compression. After posterior decompressive laminectomy with removal of the calcified nodule, the symptom and sign relieved remarkedly and the pathology showed calcium pyrophosphate dihydrate deposition within the ligamentum flavum. We presented this case and reviewed the literature to acknowledge so-call "pseudogout syndrome."

Aged↗

PubMed2003

One-stage posterior surgery for treatment of advanced spinal tuberculosis.

BACKGROUND: It is not uncommon that some patients in poor general condition and advanced spinal tuberculosis cannot proceed with the staged anterior spinal surgery after posterior instrumentation. We demonstrated a group of patients with advanced spinal tuberculosis that were treated posterior procedure alone. METHODS: From January 1993 to January 2001, 12 patients in our hospital in poor general condition and advanced spinal tuberculosis-marked abscess with angular deformity more than 25 degrees and/or spinal canal compromised more than 30%, were treated in our hospital with posterior instrumentation and chemotherapy only. All patients were immobilized postoperatively with orthosis until solid fusion was noted on bony graft. The chemotherapy persisted for at least 12 months in all patients. RESULTS: Spontaneous bony fusion of vertebrae at 1-year follow-up averaged 75%. Solid union on posterior or posterolateral fusion was about 91.7%. Implant loosening and deep wound infection were noted in 2 of the patients respectively. We assessed the functional results with the postoperative activity condition, symptom relief and medication dependence in the 6th month after the spinal surgery. Seven cases of the 12 patients (58.3%) had good to excellent results in this series. CONCLUSIONS: The one-stage posterior surgery adjunct with chemotherapy is a considerable and alternative treatment for patients with advanced spinal tuberculosis and in poor general condition.

Adult↗

PubMed2003

Kyphosis correction and height restoration effects of percutaneous vertebroplasty.

BACKGROUND AND PURPOSE: Percutaneous vertebroplasty is known for its pain-relieving effect. Our purpose was to evaluate its effect on the kyphosis angle, wedge angle, and height of the fractured vertebral body. METHODS: We reviewed digital radiographs of 73 vertebral bodies in 53 patients before and after vertebroplasty. We measured the spinal kyphosis angle and the wedge angle of the fractured vertebral body. Ratios of the height of the anterior border, center, and posterior borders of the collapsed vertebra to the height at the posterior border of an adjacent normal vertebral body were measured. Gain from vertebroplasty and the restoration percentage (gain divided by loss) were calculated for each parameter. RESULTS: The kyphosis angle, wedge angle, anterior height, center height, and posterior height significantly improved after vertebroplasty. The mean reduction in the kyphosis angle was 4.3 degrees, and the wedge-angle reduction was 7.4 degrees. The mean wedge-angle reduction in fractured vertebral bodies containing gas was 10.2 degrees. Restoration percentages for the kyphosis angle and wedge angle were 19% and 44%, respectively. Gain in the height of the fractured vertebral bodies was 16.7% for the anterior border, 14% for the center, and 7% for the posterior border. Restoration percentages for the height of the vertebral body were 29% for the anterior border and 27% for the center. CONCLUSION: Vertebroplasty increases the height of the fractured vertebra and reduces the wedge and kyphosis angles. These effects are most remarkable in fractured vertebra containing gas.

Aged↗