Humans ; Osteoporosis ; drug therapy ; physiopathology ; surgery

OBJECTIVE: To review the research progress of Modic changes and its influence on lumbar interbody fusion. METHODS: The domestic and foreign literature related to Modic changes and its influence on lumbar interbody fusion was extensively reviewed. The etiology of Modic changes was summarized, and the treatment measures of Modic changes on lumbar interbody fusion were discussed. RESULTS: The etiology of Modic changes is not clear, which may be related to mechanical factors, autoimmune factors, low toxic infection factors, and genetic factors. Modic changes may lead to fusion failure and cage subsidence after lumbar interbody fusion. Preoperative evaluation of endplate sclerosis, reduction of iatrogenic endplate injury, fine operating of intervertebral space, management of osteoporosis, and selection of appropriate cage can prevent or reduce fusion failure or cage subsidence. CONCLUSION Modic changes may lead to fusion failure and cage subsidence after lumbar interbody fusion, and active perioperative intervention of Modic changes is helpful to improve the clinical prognosis.
Humans ; Lumbosacral Region/surgery* ; Osteoporosis ; Spinal Fusion ; Treatment Failure

The rate of rotator cuff injury repair and retear is high in elderly patients due to the combination of different degrees of osteoporosis. To solve this problem, many surgeons try to reduce retear rate of rotator cuff injuries in these patients by increasing the initial fixation strength of anchors and changing local bone conditions. The rapid advances of tissue engineering have made it possible to use growth factors as an aid. However, repair of rotator cuff injury with osteoporosis is still a great challenge for clinical workers. How to better increase anchor fixation strength, improve micro-environment of tendon and bone healing, reduce the rotator cuff retear rate have become the research focus in recent years. The paper reviewed literatures on the relationshipbetween osteoporosis and rotator cuff injury, effect of osteoporosis in rotator cuff tendon healing, methods of reducing osteoporosis on rotator cuff tendon healing, in order to guide clinical treatment, improve operative effect and postoperative satisfaction.
Aged ; Arthroplasty ; Humans ; Osteoporosis ; Rotator Cuff/surgery* ; Rotator Cuff Injuries/surgery* ; Tendons/surgery*

Aged ; Cervical Vertebrae ; surgery ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Middle Aged ; Osteoporosis ; surgery ; Spinal Fractures ; surgery ; Vertebroplasty

No abstract available.
Female ; Femoral Fractures/*surgery ; Fracture Fixation, Intramedullary/*methods ; Humans ; Male ; Osteoporosis, Postmenopausal/*pathology ; Osteoporotic Fractures/*surgery

Arthroplasty, Replacement, Hip ; Female ; Femoral Neck Fractures/surgery* ; Humans ; Osteoporosis/surgery* ; Pregnancy

Bisphosphonates are used effectively for many medical conditions, such as multiple myeloma, Paget's disease, osteoporosis, etc. However, recently, osteonecrosis of the jaw was observed in patients receiving long-term bisphosphonate therapy, including oral administration. This osteonecrosis is refractory, and complete recovery is not guaranteed despite a standard treatment protocol being established by many associations related to oral and maxillofacial surgery. The treatment outcome of oral bisphosphonate-related osteonecrosis of jaw (BRONJ) is reported with a review of the relevant literature.
Administration, Oral ; Clinical Protocols ; Diphosphonates ; Humans ; Jaw ; Multiple Myeloma ; Osteonecrosis ; Osteoporosis ; Surgery, Oral ; Treatment Outcome

OBJECTIVETo explore the clinical efficacy of the percutaneous kyphoplasty for the treatment of osteoporotic Kummell's disease.

METHODSFrom May 2010 to February 2012, 8 patients with osteoporotic Kummell's disease were treated with percutaneous balloon kyphoplasty. There were 2 males and 6 females, with a mean age of 73.4 years. All the patients suffered from lower back pain for 4.7 months, which affected seriously the patient's quality of life. The anterior vertebral height and Cobb angel was measured on standing lateral radiograph at pre- and post-operatively (2 days after operation) and during the final follow-up. Visual analog scale (VAS), Japanese Orthopedic Association (JOA) and Oswestry disability index (ODI) were used to evaluate pain and function.

RESULTSIncision of all patients healed normally without infection. The level of back pain decreased remarkably after surgery. The mean time of ambulation was 4.3 days (ranged, 1 to 10 days). Cement leakage occurred in 1 case with no symptom. The anterior vertebral height and Cobb angel of the fractured vertebra recovered respectively from preoperative (30.4 +/- 7.4)% and (31.3 +/- 9.9) degree to (70.3 +/- 3.3)% and (9.1 +/- 3.0) degree at the 2nd day after operation. VAS and JOA scores, ODI improved from preoperative 8.7 +/- 1.2, 12.3 +/- 1.7 and (93.3 +/- 4.6)% to 3.1 +/- 1.1, 24.9 +/- 1.6 and (32.2 +/- 5.4)% respectively at the 2nd day after operation. All the patients were followed up, and the duration ranged from 3 to 24 months, with a mean of 4.7 months. At the latest follow-up, the anterior vertebral height and Cobb angel of the fractured vertebra were (69.9 +/- 3.2)% and (10.9 +/- 2.4) degree; the VAS and JOA scores and ODI were 2.2 +/- 1.0, 26.4 +/- 1.4 and (29.2 +/- 4.5)% respectively, which had no obvious difference compared to those results at the 2nd day after operation.

CONCLUSIONBalloon kyphoplasty is safe and effective treatment for osteoporotic Kummell's disease.

Aged ; Aged, 80 and over ; Female ; Humans ; Kyphoplasty ; methods ; Male ; Osteoporosis ; surgery ; Treatment Outcome

Degenerative scoliosis is one of the important reasons of low back pain in middle-aged and elderly. The surgical treatment has been gradually paid more attention to in recent years. Pain and the quality of life are the key points of the surgical treatment. In addition to neurogenic compression,clinical symptoms and health-related quality of life are also closely related to the three-dimensional deformity of spine. Researchers try to employ different classifications of degenerative scoliosis to guide personalizedly surgical treatment. In the future,osteoporosis and complications may be the research highlights in the surgical treatment of degenerative scoliosis.
Aged ; Humans ; Low Back Pain ; etiology ; Middle Aged ; Osteoporosis ; etiology ; Quality of Life ; Scoliosis ; complications ; surgery ; Spine

BACKGROUNDPrevious studies have suggested that percutaneous vertebroplasty might alter vertebral stress transfer, leading to adjacent vertebral failure. However, no three-dimensional finite element study so far accounted for the stress distributions on different cement volumes. The purpose of this study was to evaluate the stress distributions on the endplate under different loading conditions after augmentation with various volumes of bone cement.

METHODSL2-L3 motion segment data were obtained from CT scans of the lumbar spine from a cadaver of a young man who had no abnormal findings on roentgenograms. Three-dimensional model of L2-L3 was established using Mimics software, and finite element model of L2-L3 functional spinal unit (FSU) was established using Ansys10.0 software. For simulating percutaneous vertebral augmentation, polymethylmethacrylate (PMMA) was deposited into the bipedicle of the L2 vertebra. The percentage of PMMA volume varied between 15% and 30%. The stress distributions on the endplate of the augmented vertebral body were calculated under three different loading conditions.

RESULTSIn general, the stress level monotonically increased with bone cement volume. Under each loading condition, the stress change on the L2 superior and inferior endplates in three kinds of finite element models shows monotonic increase. Compared with the stress-increasing region of the endplate, the central part of the L2 endplate was subject to the greatest stress under three kinds of loading conditions, especially on the superior endplate and under flexion.

CONCLUSIONSThe finite element models of FSU are useful to optimize the planning for vertebroplasty. The bone cement volume might have an influence on the endplate of the augmentation, especially the superior endplate. It should be noted that the optimization of bone cement volume is patient specific; the volume of the bone cement should be based on the size, body mineral density, and stiffness of the vertebrae of individual patients.

Bone Cements ; therapeutic use ; Finite Element Analysis ; Humans ; Osteoporosis ; Spinal Fractures ; surgery ; Stress, Mechanical ; Vertebroplasty ; methods