BACKGROUND:Percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fracture have obtained good outcomes, because the traditional method is invalid, but there are a variety of choices in operation time, anesthesia, surgical approach and method, and each method has its advantages and disadvantages. OBJECTIVE:To investigate the effect and preponderance of the manual reduction combined with unilateral percutaneous vertebroplasty under general anesthesia in the treatment of osteoporotic vertebral compression fractures. METHODS:A total of 53 patients with single vertebral osteoporotic vertebral compression fractures, who were treated with percutaneous vertebroplasty, were retrospectively analyzed from July 2012 to December 2014. The new method group (32 cases) received manual reduction, underwent unilateral pedicle puncture and bone cement injection during unilateral percutaneous vertebroplasty under general anesthesia. The conventional method group (21 cases) received conventional percutaneous vertebroplasty. RESULTS AND CONCLUSION: There was an average of 6-month folow-up (3-14 months). Significant differences in visual analogue scale scores, vertebral compression ratio and kyphosis Cobb’s angle were detected in the new method and the conventional method groups at 3 days post surgery and during final folow-up compared with before surgery (P < 0.01). No significant difference in visual analogue scale scores was found between the two groups (P > 0.05). Compared with the conventional method group, postoperative vertebral compression ratio, kyphosis Cobb’s angle and bone cement leakage rate were significantly lower in the new method group (P < 0.01). Results verified that the new method combined with the advantages of percutaneous vertebroplasty and percutaneous kyphoplasty, the advantages of unilateral and bilateral puncture approach. The new method can correct kyphosis deformity, effectively recover the vertebral height and physiological curvature and the puncture is safe. Simultaneously, the leakage rate of bone cement is reduced, and the distribution of bone cement is ideal.

Objectlve To demonstrate the feasibility of three-dimensional(3D)spin-lattice relaxation time in the rotating frame(T1ρ)-weighted imaging of porcine patellar cartilage in vitro at 7.0 T and the measurement of T1ρ of agarose phantom and patellar cartilage.Methods All the MR Imaging experiments were performed on a 7.0 T Varian scanner using a 6.0-cm-diameter quadrature birdcage RF coil tuned to 300 MHz.A 3D spin-echo sequence with a self.compensating spin-lock pulse cluster was used to acquire 3D-T1ρ-weighted images.The time of spin-locking(TSL)was from 0 to 50 ms with an interval of 10 ms.Spin-lock power wag 440 Hz.3D-T1ρweighted imaging was done three times for 6 phantoms (concentration 1%t0 6%),as well as once for 8 porcine patellar cartilages in order to assess the reproducibility of this technique.Signal-to-noise ratio(SNR)was measured on the acquired images of both phantoms and patellar cartilages,which were tested for significance using Two-way ANOVA.The images were processed on Vnmr J workstation using home-built processing software to construct 3 D T1ρ maps.T1ρ values were calculated within manually drawn regions-of-interest(ROI),and differences between groups were tested for significance using analysis of variance(One-way ANOVA).Results T1ρ -weighted images with a shorter TSL had a higher SNR value,which measured between 48±8 and 95±8 in the global cartilage.Cartilage images had a higher SNR(TSL＜30 ms)compared to agarose phantoms and a lower SNR(TSL ＞30 ms)only compared to l%agarose phantorm T1ρ relaxation times in agarose phantoms increased as agarose concentrations decreased in global regions.The CV of T1ρ in agarose phantoms was less than 10%.Global and regional analyses of patellar cartilage T1ρ were 68.9±6.3 ms,80.7±12.8 ms,65.7±7.0 ms,82.4±7.7 ms,and 69.7±6.4 ms in the global cartilage,the superficial layer,the transitional layer,the deep layer,and the calcified layer,respectively.T1ρ in the superficial and deep layer was significantly higher than in the transitional,calcified layer and global cartilage(F=6.436,P＜0.05).Conclusions The present study demonstrates the feasibihty of 3D-T1ρ-weighted imaging of porcine patellar cartilage at 7.0 T with hish image quality.T1ρ maps can be used to quantify the laminar structures in 3D-T1ρ-weighted images of articular cartilage,which pave the way to evaluate early osteoarthritis and cartilage regeneration.

Many clinicians are very busy for clinical works to have no time taking into account scientific research, so that they are daunting the application of scientific research funds. However, when clinicians in the actual work can keep their strong curiosity for the unknown, not cling to the so-called classical point of view, develop a good habit of critical thinking, have the courage to question the unresolved clinical problems, as well as read the latest literature of their specialty regularly, they may find the breakthrough point of scientific research to carry out scientific research within our ability. The results obtained in the process of scientific research aim to provide new methods and new technologies to solve clinical problems. Therefore, we could get a better way to serve the patients through the integration of clinical practice and scientific research to improve the development of clinical medicine. This article will focus on the aspects of selecting scientific research topic, and raising, establishment and solution of scientific problems etc, so as to helping clinicians to successfully get the support of the scientific funds.