Subacute posttraumatic ascending myelopathy is a rare disorder, unrelated to syrinx formation or mechanical instability, which may gradually emerge within the first 1-2 weeks after a spinal cord injury and may lead to diagnostic and prognostic dilemmas. We present a case of 24-year-old female with unstable wedge compression fracture of L1 vertebrae with signal changes in the upper lumbar cord causing complete paraplegia below D9 with bladder and bowel involvement. In the subsequent week, she developed a delayed progressively increasing neurological deficit with cord signal abnormality on MRI extending cephalad from the injury site to the upper dorsal cord. The patient had no initial clinical improvement initially but showed a delayed recovery over months.
Adult ; Female ; Humans ; Spinal Cord Diseases ; etiology ; therapy ; Spinal Cord Injuries ; complications ; Spinal Fractures ; complications

OBJECTIVE: To investigate the incidence of lower extremity deep vein thrombosis (DVT) before surgery in patients with spinal fracture and analyze its risk factors. METHODS: The clinical data of 1 046 patients with spinal fracture who underwent surgery from October 2017 to December 2020 were retrospectively analyzed, including patient's age, gender, body mass index (BMI), smoking history, complications, the time from injury to diagnosis of DVT, blood index results on admission. The complications included hypertension, osteoporosis, diabetes, coronary heart disease, chronic obstructive pulmonary disease (COPD), anemia, obesity, hypokalemia, hyponatremia, hypoproteinemia, renal insufficiency, spinal cord injury;blood index results on admission included hematocrit (HCT), creatinine (Cre), triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein(LDL), D-dimer(D-D), fibrin/fibrinogen degradation products(FDP), and C-reactive protein(CRP). The patients were divided into group according to whether DVT was diagnosed by the lower extremity venous ultrasonography after admission to pre-operation. The patients with DVT were set as the DVT group, and the patients without DVT were set as the non-DVT group. First, the above-mentioned possible risk factors were analyzed by univariate analysis, and then the risk factors of DVT before spinal fracture surgery were analyzed by multivariate Logistic regression. RESULTS: Among 1 046 patients with spinal fracture, 137 had DVT before operation and 909 had no DVT. There were significant differences in age, the incidence of preoperative osteoporosis, diabetes, anemia, hypoalbuminemia, the levels of LDL, plasma D-D, FDP, and CRP between the two groups (P<0.05). Multivariate Logistic regression analysis showed that osteoporosis (OR=3.116, 95%CI:1.816-5.346, P<0.001), hypoproteinemia (OR=2.508, 95%CI:1.583-3.974, P<0.001), preoperative serum LDL>4.645 mmol/L(OR=2.586, 95%CI:1.394-4.798, P<0.001), plasma D-D>558.00 ng/ml (OR=23.916, 95%CI:15.108-37.860, P<0.001), FDP>13.81 µg/ml(OR=3.873, 95%CI:2.614-5.739, P<0.001) and age were independent risk factors for the occurrence of DVT before spinal fracture surgery, and the incidence of DVT in patients aged 36-50, 51-65 and over 65 years was 2.49, 2.59 and 4.02 times of those aged 18-35 years, respectively. CONCLUSION The incidence of preoperative DVT in patients with spinal fracture is 13.10%(137/1 046). Preoperative complicating osteoporosis, hypoalbuminemia, serum LDL>4.645 mmol/L, plasma D-D> 558.00 ng/ml, FDP> 13.81 µg/ml and age are risk factors for DVT. And the older the patient, the higher the risk of DVT.
Fractures, Bone/complications* ; Humans ; Hypoalbuminemia/complications* ; Incidence ; Osteoporosis/complications* ; Prevalence ; Retrospective Studies ; Risk Factors ; Spinal Fractures/surgery* ; Venous Thromboembolism

Adult ; Bartter Syndrome ; complications ; diagnosis ; Diagnosis, Differential ; Female ; Humans ; Osteoporotic Fractures ; etiology ; Spinal Fractures ; etiology

Adult ; Hematoma, Epidural, Spinal ; etiology ; Humans ; Male ; Spinal Fractures ; complications ; surgery ; Thoracic Vertebrae ; injuries ; surgery

OBJECTIVETo investigate the relationship between the risk of osteoporotic fracture in old people and the spinal morphology.

METHODSFrom June 2010 to January 2011, 107 old people's BMD of femoral neck were measured by Dual energy X-ray. A questionnaire survey on fracture risk factors of the 107 aged and data collection were adopted. Among the aged,41 were male and 66 were female,ranging in age from 48 to 82 years old,with an averaged of (67 +/- 6) years old. The fracture risk assessment tools (FRAX) recommended by WHO were adopted. A risk assessment on osteoporotic fracture in old people was done,followed with the calculation of the probability of the hip fracture and the main bone fractures (spine,hip,forearm or shoulder fractures) in ten years. The angles of spine vertebra, spine curvature in the upright positions of the old people were measured by using Spinalmouse. The correlation analysis along with curve fitting analysis between the probability of fracture risk and included angles of spine vertebra, spine curvature were done.

RESULTSThe probability of osteoporotic fracture had a positive relation with thoracic vertebra T7 and T8, thoracic spine curvature,lumbar curvature and incline angle in upright position (P < 0.05).

CONCLUSIONThe old people's morphological characteristics of spine have the ability to reflect the risk level o osteoporotic fracture.

Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Osteoporotic Fractures ; etiology ; Risk ; Spinal Curvatures ; complications ; Spinal Fractures ; etiology

Objective To investigate the effect of sarcopenia on the efficacy of percutaneous kyphoplasty(PKP)in the treatment of osteoporotic spinal compression fracture(OSCF)in elderly patients. Methods From February 2017 to June 2018,a total of 77 elderly patients who met the inclusion and exclusion criteria were included in this study.Grip strength of dominant hand was measured by an electronic grip dynamometer with cut-off values of 27 kg for males and 16 kg for females.The cross-sectional area of the pedicle level muscle of the 12th thoracic vertebra(T12)was measured by chest CT.The skeletal muscle index(SMI)was calculated by dividing the T12 pedicle level muscle cross-sectional area by the square of body height.The SMI cut-off value used to diagnose sarcopenia was 42.6 cm
Aged ; Female ; Fractures, Compression/surgery* ; Humans ; Kyphoplasty ; Male ; Osteoporotic Fractures/surgery* ; Retrospective Studies ; Sarcopenia/complications* ; Spinal Fractures ; Treatment Outcome

Humans ; Spinal Fractures/etiology* ; Fractures, Compression/etiology* ; Osteoporotic Fractures/complications* ; Vertebroplasty/adverse effects* ; Bone Diseases, Metabolic/complications* ; Punctures/adverse effects* ; Treatment Outcome ; Bone Cements ; Retrospective Studies

OBJECTIVETo evaluate the clinical outcome of percutaneous kyphoplasty in treating vertebral compression fractures.

METHODSFrom October 2008 to May 2010,41 patients with osteoporotic vertebral compression fractures were treated with percutaneous kyphoplasty. There were 10 males and 31 females, ranging in age from 61 to 83 years, with an average of 67.5 years. Fracture site was from T9 to L4 including 65 vertebral bodies. Clinical symptom was lumbar and back pain to affect orthobiosis. The pain, height of vertebral body, Cobb angle, function of daily activities were analyzed by VAS sore, imaging data, Oswestry score before and after operation.

RESULTSAll operations were successful and no severe complications were found. Bone cement leakage occurred in 7 vertebrae, but no clinical sympton. All lumbago obtained obviously anesis after operation. All patients were followed up from 7 to 26 months with an average of 14 months. Preoperative, postoperative and at final follow-up, VAS score was 8.38 +/- 0.60, 2.45 +/- 0.38, 2.53 +/- 0.36, respectively; Oswestry score was 40.00 +/- 1.16, 17.00 +/- 2.11, 15.00 +/- 1.41, respectively; height of vertebral body was (14.64 +/- 1.30), (25.11 +/- 1.12), (23.16 +/- 1.14) mm, respectively; Cobb angle was (30.17 +/- 1.45) degrees, (12.10 +/- 1.37) degrees, (14.31 +/- 0.51) degrees, respectively. There was significant difference between postoperative and preoperative, and between at final follow-up and preoperative (P<0.05). There was no significant difference between final follow-up and postoperative (P>0.05).

CONCLUSIONPercutaneous kyphoplasty is effective for treatment of senile osteoporotic vertebral compression fractures, which can expeditiously relieve pain and effectively recover height of vertebral body and kyphosis Cobb angle, has advantages of minimal trauma and good security.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Fractures, Compression ; complications ; surgery ; Humans ; Kyphoplasty ; methods ; Male ; Middle Aged ; Osteoporosis ; complications ; Skin ; Spinal Fractures ; complications ; surgery

Adult ; Cervical Vertebrae ; injuries ; Female ; Fractures, Spontaneous ; etiology ; Histiocytosis, Langerhans-Cell ; complications ; Humans ; Paralysis ; etiology ; Spinal Fractures ; etiology

OBJECTIVETo study therapeutic effects of Sky-bone expander for the treatment of osteoporotic vertebral compressed fractures.

METHODSFifteen patients (18 vertebrae) suffering from vertebral compression fractures were treated with Sky bone expander system which expanded and reconstructed the vertebral body with PMMA cement. The clinical effect was evaluated by observing the changing of visual analogue scale (VAS). The preoperative and postoperative mean VAS scores were compared by paired-sample t test. All the patients were followed up by telephone or clinic consulting after being discharged from our hospital.

RESULTSThe procedure was performed successfully in 15 patients. The operation time ranged from 45 to 110 minutes (65 minutes per vertebra on average). The patients were followed up and the duration ranged from 6 to 12 months (8 months on average). The mean VAS score of the patients were improved significantly at the third postoperative day compared with those before the operation (2.5 +/- 1.3, vs 7.7 +/- 1.1, all P < 0.05). The mean VAS score at the end of the follow-up was 2.2 +/- 1.2.

CONCLUSIONSky bone expander system provides significant pain relief effect in the cases of osteoporotic vertebral compression fractures, shortens the duration of lying in bed, and its procedure is convenient with few complications.

Aged ; Female ; Fractures, Compression ; surgery ; Humans ; Male ; Middle Aged ; Osteoporosis ; complications ; Pain Measurement ; Spinal Fractures ; surgery ; Vertebroplasty