PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Fractures, Compression”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMed2006

Interference screw technique for arthroscopic reduction and internal fixation of compression fractures of the tibial plateau.

Arthroscopic reduction and internal fixation (ARIF) is recommended as state-of-the-art treatment for patients with pure compression fracture of the tibial plateau. We describe a new technique for ARIF of pure compression tibial plateau fractures that uses a cannulated, bioabsorbable interference screw. After a guide pin is placed in the center of the compressed fragment and a tamp is used to elevate the fracture (with bone grafting as desired), the interference screw is advanced over the guide pin, resulting in both elevation and buttressing of the fracture. As compared with previously described techniques in which percutaneous buttress screws were used, ARIF attained with an interference screw via the tibial metaphyseal window allows substantially improved efficiency of surgical steps, improved preservation of the soft tissue envelope, definitive articular reduction under arthroscopic visualization, use of a bioabsorbable implant, and elimination of the need for fluoroscopy.

Arthroscopy↗
PubMed2004

Balloon kyphoplasty for vertebral compression fracture using a unilateral balloon tamp via a uni-pedicular approach: technical note.

OBJECTIVE: Percutaneous balloon kyphoplasty, like percutaneous vertebroplasty is a therapeutic intervention for painful osteoporotic vertebral body compression fracture. The procedure involves placement of bilateral inflatable balloon tamps in the fractured vertebral body via a bilateral transpedicular or bilateral extra-pedicular approach. We describe performance of balloon kyphoplasty using a unilateral, single, balloon tamp via a unilateral transpedicular approach. The advantages of a unilateral approach are reducing the risk, albeit low, of pedicle fracture, medial transgression of the pedicle and/or transgression into the spinal canal, nerve injury, cement extravasation along the cannula tract, and spinal epidural hematoma. Additionally, operative and anesthesia time is reduced, as well as the costs of balloon tamps, cannulas, and needles. CASE ILLUSTRATION: An 83-year-old woman with osteoporosis presented with severe lower thoracic back pain which occurred when she bent over to lift a heavy box. The pain was reproducible on palpation of the T-11 spinous process. A spine MRI with STIR (short tau inversion recovery) sequence demonstrated a subacute T-11 vertebral body compression fracture with associated edema. A T-11 balloon kyphoplasty was performed using a unilateral inflatable balloon tamp via a unilateral transpedicular approach. The patient reported immediate relief of pain and improvement of visual analog score (VAS) for pain from preoperative 10 to postoperative 2. She was able to ambulate postoperatively whereas preoperatively she was inhibited by pain. CONCLUSION: Balloon kyphoplasty can be performed using a unilateral balloon tamp via a unilateral pedicular approach. The key is a medial needle trajectory with a final balloon position in the midline of the vertebral body.

Journal Article↗
PubMed1991

Clinical profile of acute vertebral compression fractures in osteoporosis.

Thirty patients with acute, painful vertebral compression fracture were studied. Certain vertebrae, namely T8, T12, L1 and L4, were more likely to fracture. The majority occurred spontaneously (46%) or after trivial strain (36%). Of the former, 30% occurred whilst in bed. Radiation to the flanks and anteriorly was common (66%) but leg radiation was uncommon (6%). Associated symptoms noted were: nausea (26%), abdominal pain (20%), chest pain (13%). Straining exacerbated pain in only 60%. The position of comfort was lying flat (43%) or sitting (36%) but 16% found standing or walking most comfortable. The correct diagnosis was made at the first visit in only 43% of patients. In the remainder there was a mean delay of 4.5 days before diagnosis. This poor diagnostic rate may be improved if other clinical features of osteoporosis such as kyphosis and a previous history of wrist and hip fractures are recorded, particularly when acute back pain occurs in bed. Full thoracic and lumbar X-rays may be required because pain and site of pathology may not coincide. Bone scanning may be necessary if immediate X-rays are normal. In early management the position of most comfort may be preferable to complete bed rest.

Acute Disease↗
PubMed2005

Kyphoplasty for vertebral compression fracture via a uni-pedicular approach.

BACKGROUND: Percutaneous kyphoplasty using a bone expander polymer device, such as percutaneous vertebroplasty and balloon kyphoplasty, is a therapeutic intervention for painful osteoporotic vertebral body compression fractures. Typically the procedure involves placement of bilateral Sky Bone Expanders in the fractured vertebral body via a transpedicular approach. We describe performance of "SKy"phoplasty using the Disc-O-Tech Sky Bone Expander (Disc-O-Tech Medical Technologies, Herzliya, Israel, and Monroe Township, New Jersey) via a unilateral transpedicular approach. The advantage of a unilateral approach is that it reduces the risks associated with large-bore needle placement. These risks include pedicle fracture, medial transgression of the pedicle or transgression into the spinal canal, nerve injury, cement leakage along the cannula tract, and spinal epidural hematoma. Additionally, using a unilateral approach reduces operative time and costs. CASE ILLUSTRATION: A 68-year-old man with osteoporosis presented with severe upper back pain which occurred following a fall. The pain was reproducible on palpation of the L1 spinous process. A lumbar spine magnetic resonance imaging (MRI) with STIR (short tau inversion recovery) sequence demonstrated an acute L1 vertebral body compression fracture. A L1 "SKy"phoplasty was performed using a single Sky Bone Expander polymer device via a unilateral transpedicular approach. The patient reported immediate relief of pain after the procedure. He denied any residual back pain at his follow-up visit. He was able to resume his normal activities including walking, which had been inhibited by pain prior to the procedure. CONCLUSION: "SKy"phoplasty can be performed using a single Sky Bone Expander via a unilateral pedicular approach. The key is a medial needle trajectory with a final Sky Bone Expander position in the midline of the vertebral body.

Journal Article↗
PubMed1988

Vertebral compression fracture as a presenting feature of acute lymphoblastic leukemia in children.

Twenty-four (1.6%) of 1466 children with acute lymphoblastic leukemia (ALL) treated at St. Jude Children's Research Hospital had vertebral compression fractures at diagnosis. When compared with patients without this complication, they were more likely to have good prognostic features, including a leukocyte count of greater than 25 X 10(9)/l, a leukemic cell DNA index of greater than 1.15, and hyperdiploidy (greater than 50 chromosomes). Complete remission of ALL was induced in all patients, and symptoms of vertebral compression fractures abated following antileukemia therapy. Although the diagnosis of ALL was delayed for some patients because this unusual presenting complication was not recognized as such, their treatment outcome was as good as that for other children with "standard-risk" ALL.

Adolescent↗
PubMed2002

Tuberculosis of the spine (Pott's disease) presenting as 'compression fractures'.

STUDY DESIGN: Case reports and survey of literature. OBJECTIVE: Case reports of two women with tuberculosis (TB) of the spine (Pott's disease) presenting with severe back pain and diagnosed as compression fracture are described. Physicians should include Pott's disease in the differential diagnosis when patients present with severe back pain and evidence of vertebral collapse. SETTING: Ohio, USA METHODS: A review of the literature on the pathogenesis, pathophysiology, clinical presentation, diagnostic methods, treatment and prognosis of spinal TB was conducted. RESULTS: After initial delay, proper diagnosis of spinal TB was made in our patients. Microbiologic diagnosis confirmed M. tuberculosis, and appropriate medical treatment was initiated. CONCLUSIONS: Although uncommon, spinal TB still occurs in patients from developed countries, such as the US and Europe. Back pain is an important symptom. Vertebral collapse from TB may be misinterpreted as 'compression fractures' especially in elderly women. Magnetic resonance imaging scan (MRI) is an excellent procedure for the diagnosis of TB spine. However, microbiologic diagnosis is essential. Mycobacterium tuberculosis may be cultured from other sites. Otherwise, biopsy of the spine lesion should be done for pathologic diagnosis, culture and stain for M. tuberculosis. Clinicians should consider Pott's disease in the differential diagnosis of patients with back pain and destructive vertebral lesions. Proper diagnosis and anti-tuberculosis treatment with or without surgery will result in cure.

Aged↗
PubMed2007

Percutaneous vertebroplasty and kyphoplasty for the stand-alone augmentation of osteoporosis-induced vertebral compression fractures: present status and future directions.

Enormous research efforts are being expended on two minimally invasive procedures: percutaneous vertebroplasty (VP) and kyphoplasty (KP). The present report, which is a detailed critical review of VP and KP that emphasizes their biomechanics aspects, is divided into six parts. In the first two parts, succinct descriptions are given of osteoporosis-induced vertebral body (VB) compression fractures as the underlying pathology to be treated with VP and KP, the theory of VP and KP, and the techniques used in performing these procedures. Concerns about VP and KP, such as the high radiation exposure burden that may be imposed on both patient and medical personnel and extravasation of the injectable bone cement, are discussed in the third part. Detailed discussions of fourteen issues/questions, such as the extent to which VP or KP affects various biomechanical measures of the augmented VB and those adjacent to it and the appropriate volume of the cement to use, are presented in the fourth part. Ideas for future research, such as development of a new generation of injectable bone cements and identification of an appropriate animal model, are covered in the fifth part. The final section contains a summary of the most salient points/observations made in the report.

Biomechanical Phenomena↗
PubMed2000

Estrogen and progesterone receptor-negative T11 vertebral hemangioma presenting as a postpartum compression fracture: case report and management.

OBJECTIVE AND IMPORTANCE: Pregnancy-related vertebral hemangioma compressive myelopathy is a rare occurrence that tends to arise in the upper thoracic and lower cervical spine, peaks during the third trimester, and remits after parturition. Whether corticosteroid receptors play a role in the pathogenesis of these lesions is unknown. Most of these lesions have been managed with posterior decompression. CLINICAL PRESENTATION: A 29-year-old woman presented with acute-onset lower-extremity weakness and sensory loss immediately after parturition. INTERVENTION: We used a retropleural approach for anterior decompression and fusion, followed by radiation therapy. Immunohistochemical analysis of estrogen and progesterone receptor expression was performed. CONCLUSION: We report an unusual case of lower thoracic postpartum vertebral hemangioma compressive myelopathy caused by a parturition-related compression fracture. Results of tests for corticosteroid receptors were negative, which implicated a hemodynamic rather than hormonal cause for disease progression.

Adult↗
PubMedDate not supplied

Lumbar compression fractures secondary to lap-belt use in children.

The correlation between flexion-distraction injuries and lap-belt use has been well documented. Over a 10-year period, we identified seven children admitted to Children's National Medical Center, Washington, DC, with compression fractures of the lumbar spine secondary to lap-belt use. Four were rear seat passengers, and three were in the front seat. The average age was 7 years. Four of the seven (57%) suffered associated abdominal injuries. One died of an associated head injury. We hypothesize that the mechanism of injury in these cases was similar to that in flexion-distraction injuries. The increased elasticity in the posterior ligamentous complex in children may be responsible for the occurrence of these compression fractures rather than the expected flexion-distraction-type injuries.

Abdominal Injuries↗
PubMed2006

Persistent notochordal canal mimicking compression fracture: a case report.

A persistent notochordal canal is a rare anomaly that is generally discovered by chance. The radiographic appearance of this entity is characteristic and usually does not require further investigation. However, in some cases plain films may fail to depict this appearance, and computed tomography or magnetic resonance imaging (MRI) is required for final diagnosis. We report the MRI findings of a young woman with persistent notochordal canal who, based on plain radiographs, had first been misdiagnosed as having a compression fracture.

Adult↗
PubMed2001

Comparison of the biomechanics of hydroxyapatite and polymethylmethacrylate vertebroplasty in a cadaveric spinal compression fracture model.

OBJECT: Polymethylmethacrylate (PMMA) has long been used in the stabilization and reconstruction of traumatic and pathological fractures of the spine. Recently, hydroxyapatite (HA), an osteoconductive, biocompatible cement, has been used as an alternative to PMMA. In this study the authors compare the stabilizing effects of the HA product, BoneSource, with PMMA in an experimental compression fracture of L-1. METHODS: Twenty T9-L3 cadaveric spine specimens were mounted individually on a testing frame. Light-emitting diodes were placed on the neural arches as well as the base. Motion was tracked by two video cameras in response to applied loads of 0 to 6 Nm. The weight-drop technique was used to induce a reproducible compression fracture of T-11 after partially coring out the vertebra. Load testing was performed on the intact spine. postfracture, after unilateral transpedicular vertebroplasty with 7 to 10 ml of PMMA or HA, and after flexion-extension fatiguing to 5000 cycles at +/- 3 Nm. No significant difference between the HA- and PMMA cemented-fixated spines was demonstrated in flexion, extension, left lateral bending, or right and left axial rotation. The only difference between the two cements was encountered before and after fatiguing in right lateral bending (p < or = 0.05). CONCLUSIONS: The results of this study suggest that the same angular rigidity can be achieved using either HA or PMMA. This is of particular interest because HA is osteoconductive, undergoes remodeling, and is not exothermic.

Biocompatible Materials↗
PubMed2006

Bone density comparison of selected carpal and tarsal bones: validation for their use in compression fracture fixation studies of scaphoid screws.

INTRODUCTION: To determine if trabecular, total and cortical bone densities of the capitate, navicular, cuboid, and first cuneiform were equivalent to those of the scaphoid, such that these bones could be used in place of the scaphoid in evaluating new headless scaphoid compression screws. METHODS: Fifty scaphoids, capitates, naviculars, cuboids, and first cuneiforms were harvested from fresh frozen cadavers. The trabecular, total and cortical bone densities were measured using pQCT technology and statistically compared. RESULTS: A paired t comparison between paired scaphoids and capitates showed no difference between the trabecular bone densities. However, their total bone and cortical densities were found to be different. An independent measures ANOVA comparison of the five bones, showed no significant difference in mean trabecular density between the capitates, naviculars and first cuneiforms when compared to the scaphoids. However, the mean total and cortical densities of the first cuneiforms were less than the scaphoids and the mean trabecular, total and cortical bone densities of the cuboids were all less than the scaphoids. DISCUSSION: Compression fracture fixation studies of headless compression screws could be conducted using the capitate, navicular, and first cuneiform as models of the scaphoid when the supply of scaphoids is limited.

Aged↗
PubMed2000

Is there a need for lumbar orthosis in mild compression fractures of the thoracolumbar spine?: A retrospective study comparing the radiographic results between early ambulation with and without lumbar orthosis.

Compression fractures of the thoracolumbar spine are common in spinal trauma. Most patients are treated with early ambulation. Bracing is an option not always recommended by the treating team. There are no definite recommendations so far regarding the need for lumbar orthosis in this type of injury. The authors retrospectively compared two methods for treating patients with compression as great as 30%: early ambulation with and without lumbar orthosis. The results show that although demographic variables, type of injury, and cause of injury were similar between the groups, neither treatment emerged as superior. Thoracolumbar fractures with compression as much as 30% can be treated with early ambulation and no external support. Close clinical and radiographic follow-up is essential.

Adult↗
PubMed2006

Changes in vertebral wedging rate between supine and standing position and its association with back pain: a prospective study in patients with osteoporotic vertebral compression fractures.

STUDY DESIGN: Prospective consecutive series. OBJECTIVE: To analyze supine and standing radiographs and the association of back pain using subjective pain criteria. SUMMARY OF BACKGROUND DATA: It has been considered that there is little correlation between the degree of collapse of the vertebral body and the level of pain. In previous studies, however, measurements have only been based on supine radiographs. Although there were 2 authors who reported the results of supine lateral and standing lateral radiographs in patients with thoracolumbar vertebral fractures, as far as we know, there has not been any detailed report concerning the correlation between radiologic findings using supine and standing lateral radiographs and back pain. METHODS: We examined 100 consecutively treated patients, prospectively. Back pain and the supine and standing radiographs were assessed 1 month after injury. Changes in vertebral wedging rate (WR) from supine to standing position (Delta WR) was reported by the following equation: Delta WR = WR(standing)-WR(supine). RESULTS: The median age of the cohort was 75 years (range, 60-89 years). The median VAS of back pain at supine position, at standing position, and when standing erect was 13, 33, and 41, respectively. The median wedging rate on the supine and standing radiographs were 28% and 37%, respectively (P < 0.001). There was a significant correlation between Delta WR and back pain when standing erect (r = 0.79, P < 0.001). CONCLUSION: Changes in vertebral wedging rate between supine and standing position and its association with back pain may give a clue to the pathogenesis of pain from osteoporotic thoracolumbar vertebral compression fractures.

Aged↗
PubMedDate not supplied

Metastasis in vertebra mimicking acute compression fractures in a patient with osteoporosis: MRI findings.

Elderly patients who have osteoporosis and a cancer history with backache and vertebral fractures are diagnostic challenges. We present a case of an 87-year-old man who complained of severe low-back pain with radiation to the lower limbs and weakness of the lower limbs. The patient had had a fall on a bus 1 month before admission. The patient also had a history of colon cancer and had received a colostomy 9 years before. In this admission, lumbar spine radiographs showed compressive fractures of vertebral bodies at L1 and L3. Magnetic resonance imaging (MRI) showed hyperemic change of the L3 marrow with osteonecrosis (fluid sign). The ventral thecal sac was slightly compressed due to retropulsion of L3. The L1 marrow was normal. Bone densitometry of the calcaneous revealed osteoporosis. The patient was then treated by vertebroplasty and bilateral foraminotomy of L3 after a diagnosis of acute compressive fracture. On histology, there was a metastatic adenocarcinoma arranged in glands and nests in the bone and paraspinal soft tissue. On retrospective viewing, an axial gadolinium-enhanced MRI revealed paraspinal extension of soft tissue at L3, which is highly suggestive of metastasis in a vertebra.

Adenocarcinoma↗
PubMed1991

[Dorso-lumbar spinal compression fractures in the child. Follow-up at the termination of development].

Between 1970 and 1985, we count 32 children with compressive fractures of the vertebral column. None of them undergo a surgical procedure. We examine 24 of these 32 children with a mean delay of 10.5 years. Most of the fractures were referring to sporting activities and home games. The main localization was dorsal (T6) and upper-lumbar (12). The mean reduced height of the ventral portion of the vertebra was 27%. Some 10 years later, two third of the patients have some persistent pains and half of them daily. Most of the aches concerned children of more than 12 years when trauma occurred and those who developed a scoliosis during evolution. Wonder the global static of the rachis is little concerned in most of these children. Therefore compressive vertebral fracture of the youngster should be reduced and fixed by a corset. But the immobilization shouldn't be longer than 2 months, accompanied by appropriate gymnastics and followed by a quick renewal of the sporting activities.

Adolescent↗