Spinal instrumentation is a common method for the treatment of spinal disorders, but it can lead to the changes of spine biomechanics. Because of the stress changes, accelerated degeneration of the adjacent segment may occur as time goes by, namely adjacent segment disease. The accelerated degeneration can lead to secondary spinal stenosis, articulated joint degeneration, acquired spondylolisthesis, and spine instability, and some patients may have to receive surgery again. In recent years, the researchers gradually recognized the importance of this disease, and began to investigate its pathogenesis and management.
Humans ; Joint Instability ; etiology ; prevention & control ; Postoperative Complications ; diagnosis ; prevention & control ; Spinal Diseases ; surgery ; Spinal Fusion ; adverse effects ; instrumentation ; Spinal Stenosis ; etiology ; prevention & control ; Spondylolisthesis ; etiology ; prevention & control

One hundred and five Labrador dogs were randomly divided into two groups to determine the number of animals that develop elbow dysplasia when treated with an oral supplement compared to untreated ones. Efficacy of the oral treatment was also evaluated once illness was diagnosed. The supplement (Hyaloral) contained hyaluronic acid, hydrolysed collagen, glucosamine, chondroitin sulphate, and gamma oryzanol. Clinical evaluation of the elbow joints was completed at months 3, 6, 12, and 20 by orthopaedic evaluations, radiography, serologic and blood analysis, and veterinarian evaluation of dysplasia symptoms. All side effects were recorded. In the control group, 33.3% of the dogs developed radiographic evidence of elbow dysplasia compared to 18.5% in the treated group. Symptoms of dysplasia at 12 months differed between the treated (12.5%) and control (61.5%) animals, and were significantly different at 20 months (p < 0.05). Differences in lameness along with movement and swelling of the elbows between groups were observed after 12 months. The treated group had improved significantly by the last visit (p < 0.05). No adverse side effects were reported. In conclusion, oral treatment with Hyaloral may have a potential cumulative action that provides protection against dysplasia and significantly improves symptoms of elbow dysplasia.
Administration, Oral ; Animals ; Collagen/*therapeutic use ; Dietary Supplements/analysis ; Dog Diseases/*prevention & control ; Dogs ; Drug Combinations ; Elbow Joint/*abnormalities ; Genetic Diseases, Inborn/prevention & control/*veterinary ; Hyaluronic Acid/*therapeutic use ; Joint Diseases/prevention & control/*veterinary ; Spain ; Species Specificity

OBJECTIVETo research the efficacy,security and necessity of combined therapy for preventing postsurgery stiffness after elbow fracture.

METHODSFrom May 2009 to April 2010, 60 patients with elbow fractures treated by operation were randomly divided into two groups: combined therapy group and past procedure group. Thirty patients in the combined therapy group,including 12 males and 18 females, ranging in age from 23 to 63 years, averaged (43.53 +/- 7.74) years old; 15 patients had two parts fractures, including humeral intercondylar fractures combined with olecroanon and (or) ulna coronoid process fractures in 8 cases, fractures of exterior and interior humeral condyle combined with capitulum radius in 3 cases, fractures of olecroanon and ulna coronoid process in 3 cases, fractures of olecroanon and capitulum radius in 1 case; other 15 patients had one part fractures, including fractures of exterior or interior humeral condyle in 8 cases,fractures of olecroanon or ulna coronoid process in 6 cases, fractures of capitulum radius in 1 patient. Thirty patients in the past procedure group,including 11 males and 19 females, ranging in age from 24 to 67 years, averaged (46.13 +/- 6.22) years; 15 patients had two parts fractures, including fractures of humeral intercondylar fracture combined with olecroanon and(or) ulna coronoid process in 7 cases, fractures of exterior and interior humeral condyle combined with capitulum radius in 2 cases,fractures of olecroanon and ulna coronoid process in 5 cases,fractures of humeral intercondylar fracture combined with capitulum radius in 1 patient; 15 pa- tients had one part fracture, including fractures of exterior or interior humeral condyle in 6 cases, fractures of olecroanon or ulna coronoid process in 8 cases, fractures of capitulum radius in 1 patient; the patients in the past procedure group were treated with past procedure methods. Mayo Elbow Performance Score (including gmotion of elbow joint) and security (using X-ray to recheck displacement fracture, internal fixation failure and heterotopic ossification) were evaluated at postoperative 6 months. From 2002 to 2006, 30 patients were reviewed as historical control group, including 17 males and 13 females, ranging in age from 27 to 62 years, averaged (47.17 +/- 7.83) years; 15 patients had two parts fractures, including fractures of humeral intercondylar combined with olecroanon and(or) ulna coronoid process in 7 cases, fractures of exterior and interior humeral condyle combined with capitulum radius in 1 case, fractures of olecroanon and ulna coronoid process in 6 cases, fractures of ulna coronoid process and capitulum radius in 1 case; 15 patients had one part fractures,including fractures of exterior or interior humeral condyle in 9 cases, fractures of olecroanon or ulna coronoid process in 5 cases,fractures of capitulum radius in 1 case. The Mayo Elbow Performance Score of the patients in historical control group was evaluated retrospectively at postoperative 6 months and the results were compared with that of past procedure group.

RESULTSMayo score of combined therapy group was (91.00 +/- 7.81)surpassed to (76.83 +/- 10.71) of the past procedure group and (73.17 +/- 1.99) of historical control group (F = 24.98, P < 0.05). The range of motion of elbow was (102.40 +/- 9.16) degrees of combined therapy group surpassed to (83.57 +/- 6.21) degrees of the past procedure group (t = 9.325, P < 0.05). There were no internal fixation loose,obvious fracture displacement and heterotopic ossification in each X-ray examination of patients in the combined therapy group. The Mayo score of historical control group was (73.17 +/- 11.99), showing no significant differences when compared with (76.83 +/- 10.71) of the past procedure group (LSD, P = 0.172).

CONCLUSIONCombined therapy including different stage, different method combination and different subject to practice to prevent postsurgery stiffness after elbow fracture is effect, security and necessity.

Adult ; Aged ; Case-Control Studies ; Combined Modality Therapy ; Elbow Joint ; injuries ; surgery ; Female ; Fractures, Bone ; surgery ; Humans ; Joint Diseases ; physiopathology ; prevention & control ; Male ; Middle Aged ; Postoperative Complications ; prevention & control

Age Distribution ; Blood Coagulation Factors ; therapeutic use ; Child ; Child, Preschool ; Developed Countries ; Developing Countries ; Factor VIII ; therapeutic use ; Hemarthrosis ; epidemiology ; etiology ; prevention & control ; Hemophilia A ; complications ; drug therapy ; epidemiology ; Humans ; Intracranial Hemorrhages ; epidemiology ; etiology ; prevention & control ; Joint Diseases ; prevention & control ; Quality of Life ; Severity of Illness Index

PURPOSE: The comparative effects of alendronate and alfacalcidol on bone mineral density (BMD) and bone turnover have already been established in postmenopausal women with osteoporosis. An open-labeled prospective study was conducted to compare the treatment effects of alendronate and alfacalcidol on hip BMD and bone turnover in Japanese men with osteoporosis or osteopenia with clinical risk factors for fractures. MATERIALS AND METHODS: One hundred twelve men with osteoporosis or osteopenia with clinical risk factors for fractures (mean age: 71.4 years) were randomly divided into two groups of 56 patients each: the alendronate (5 mg daily) and alfacalcidol (1 microgram daily) groups. The BMD of the total hip, urinary level of cross-linked N-terminal telopeptides of type I collagen (NTX), and serum levels of bone-specific alkaline phosphatase (BSAP) were measured during the 12-month-treatment period. RESULTS: Forty-five patients in the alendronate group and 42 patients in the alfacalcidol group completed the trial. Alendronate increased BMD (+2.3% at 12 months) following reductions in the urinary level of NTX (-46.4% at 3 months) and serum level of BSAP (-34.1% at 12 months), while alfacalcidol sustained BMD (-1.9% at 12 months) as well as the urinary level of NTX (+13.2% at 3 months) and serum level of BSAP (+1.8% at 12 months). CONCLUSION: The present study confirmed that alendronate has better efficacy than alfacalcidol (active control) in increasing hip BMD and reducing bone turnover in Japanese men with osteoporosis or osteopenia with clinical risk factors for fractures.
Aged ; Aged, 80 and over ; Alendronate/pharmacology/therapeutic use ; Asian Continental Ancestry Group ; Bone Density/*drug effects ; *Bone Density Conservation Agents/pharmacology/therapeutic use ; Bone Diseases, Metabolic/*drug therapy ; Fractures, Bone/*prevention & control ; Hip Joint/*drug effects/pathology ; Humans ; *Hydroxycholecalciferols/pharmacology/therapeutic use ; Male ; Middle Aged ; Osteoporosis/*drug therapy ; Treatment Outcome

PURPOSE: The comparative effects of alendronate and alfacalcidol on bone mineral density (BMD) and bone turnover have already been established in postmenopausal women with osteoporosis. An open-labeled prospective study was conducted to compare the treatment effects of alendronate and alfacalcidol on hip BMD and bone turnover in Japanese men with osteoporosis or osteopenia with clinical risk factors for fractures. MATERIALS AND METHODS: One hundred twelve men with osteoporosis or osteopenia with clinical risk factors for fractures (mean age: 71.4 years) were randomly divided into two groups of 56 patients each: the alendronate (5 mg daily) and alfacalcidol (1 microgram daily) groups. The BMD of the total hip, urinary level of cross-linked N-terminal telopeptides of type I collagen (NTX), and serum levels of bone-specific alkaline phosphatase (BSAP) were measured during the 12-month-treatment period. RESULTS: Forty-five patients in the alendronate group and 42 patients in the alfacalcidol group completed the trial. Alendronate increased BMD (+2.3% at 12 months) following reductions in the urinary level of NTX (-46.4% at 3 months) and serum level of BSAP (-34.1% at 12 months), while alfacalcidol sustained BMD (-1.9% at 12 months) as well as the urinary level of NTX (+13.2% at 3 months) and serum level of BSAP (+1.8% at 12 months). CONCLUSION: The present study confirmed that alendronate has better efficacy than alfacalcidol (active control) in increasing hip BMD and reducing bone turnover in Japanese men with osteoporosis or osteopenia with clinical risk factors for fractures.
Aged ; Aged, 80 and over ; Alendronate/pharmacology/therapeutic use ; Asian Continental Ancestry Group ; Bone Density/*drug effects ; *Bone Density Conservation Agents/pharmacology/therapeutic use ; Bone Diseases, Metabolic/*drug therapy ; Fractures, Bone/*prevention & control ; Hip Joint/*drug effects/pathology ; Humans ; *Hydroxycholecalciferols/pharmacology/therapeutic use ; Male ; Middle Aged ; Osteoporosis/*drug therapy ; Treatment Outcome