BACKGROUND:Percutaneous curved vertebroplasty has the advantages of minimal trauma and bone cement dispersion,but whether it is safe and effective for the treatment of compression fractures in the upper 1/3 of the vertebral body needs further study.OBJECTIVE:To investigate the clinical efficacy of percutaneous curved vertebroplasty in the treatment of the upper 1/3 compression fractures of the osteoporotic vertebrae.METHODS:Medical records of 66 patients with osteoporotic thoracolumbar upper 1/3 compression fracture admitted to Department of Orthopedics of PLA Rocket Force Characteristic Medical Center from January 2020 to June 2023 were retrospectively analyzed.Among them,32 cases were treated with percutaneous curved vertebroplasty(observation group)and 34 cases were treated with"noncoplanar bipedicular puncture"percutaneous vertebroplasty(control group).Pain visual analog scale score,Oswestry Disability Index,anterior edge height of injured vertebra,and Cobb angle of injured vertebra were compared and analyzed between the two groups before surgery,the first day after surgery,and the last follow-up.The operative time,bone cement leakage rate,bone cement injection volume,and bone cement dispersion score of the two groups were statistically analyzed.RESULTS AND CONCLUSION:(1)The operations were successfully completed in both groups of patients,and no complications such as bone cement allergy,bone cement embolism,nerve damage,or epidural hematoma occurred.(2)Pain visual analog scale score,Oswestry disability index,anterior edge height,and Cobb angle of injured vertebra of the two groups at the first day after surgery and the last follow-up were all better than those before surgery,with statistically significant difference(P＜0.05),but there was no statistical significance between the two groups(P＞0.05).The Oswestry disability index of the two groups at the last follow-up was better than that on the first day after surgery(P＜0.05).(3)The operation time and bone cement leakage rate of the observation group were lower than those of the control group,and the differences were statistically significant(P＜0.05).(4)There were no significant differences in bone cement injection volume and bone cement dispersion score between the two groups(P＞0.05).(5)The results show that percutaneous curved vertebroplasty in the treatment of osteoporotic vertebrae compression fractures in the upper 1/3 of the vertebral body can effectively relieve pain,maintain vertebral height,and reduce operative time and bone cement leakage rate.

OBJECTIVE: To compare the effectiveness of different puncture methods of the flexible bone cement delivery device in unilateral percutaneous curved vertebroplasty for osteoporotic vertebral upper 1/3 compression fractures. METHODS: A retrospective analysis was conducted on the clinical data of 67 patients with osteoporotic vertebral upper 1/3 compression fractures who were admitted and met the selection criteria between January 2023 and April 2024. The patients were divided into two groups based on the puncture method of the flexible bone cement delivery device: the oblique puncture group ( n=37) and the parallel puncture group ( n=30). There was no significant difference ( P>0.05) between the two groups in terms of gender, age, bone mineral density (T value), distribution of fractured vertebrae, time from injury to operation, and preoperative visual analogue scale (VAS) score for pain, Oswestry disability index (ODI), anterior vertebral height of the fractured vertebra, and Cobb angle of the fractured vertebra. The following parameters were compared between the two groups: operation time, incidence of secondary puncture, incidence of bone cement leakage, volume of injected bone cement, bone cement distribution score, as well as VAS score, ODI, anterior vertebral height of the fractured vertebra, and Cobb angle of the fractured vertebra at 1 day after operation and at last follow-up. RESULTS: Two cases in the oblique puncture group and 7 cases in the parallel puncture group underwent secondary puncture during operation, and the difference in the incidence of secondary puncture was significant ( P<0.05). No complications such as bone cement hypersensitivity, bone cement embolism, nerve injury, or epidural hematoma occurred in both groups. There was no significant difference in operation time, volume of injected bone cement, incidence of bone cement leakage, distribution score and rating of bone cement between the two groups ( P>0.05). All patients were followed up 6-18 months (mean, 12.0 months), and there was no significant difference in the follow-up time between the two groups ( P>0.05). No further fracture collapse or compression occurred in the fractured vertebra during follow-up. Both groups exhibited significant improvements in VAS score, ODI, anterior vertebral height, and Cobb angle of the fractured vertebra after operation compared to baseline ( P<0.05). There were also significant differences between the two time points after operation ( P<0.05). However, there was no significant difference in the above indicators between the two groups ( P>0.05). CONCLUSION For osteoporotic vertebral upper 1/3 compression fractures treated with unilateral percutaneous curved vertebroplasty, both oblique and parallel puncture methods of the flexible bone cement delivery device can effectively relieve pain, but the former is more conducive to reducing the incidence of secondary puncture.
Humans ; Bone Cements/therapeutic use* ; Fractures, Compression/surgery* ; Retrospective Studies ; Vertebroplasty/instrumentation* ; Osteoporotic Fractures/surgery* ; Spinal Fractures/surgery* ; Female ; Male ; Aged ; Middle Aged ; Treatment Outcome ; Punctures/methods* ; Aged, 80 and over

BACKGROUND:The effect of protective agent penetration is crucial in organ cryopreservation.Quantitative analysis of the effect of cryoprotectant dimethyl sulfoxide introduction can provide a theoretical basis for the successful cryopreservation of organs.OBJECTIVE:To study the effect of dimethyl sulfoxide penetration on the cryopreservation of rabbits'severed hindlimb.METHODS:Fifty New Zealand white rabbits were randomly divided into group A1(n=8),group A2(n=8),group B1(n=8),group B2(n=8),group C1(n=6),group C2(n=6),and group C3(n=6)by random number table method.The severed hind limb cryoprotectant perfusion model was established in all groups.Groups A1 and A2 were perfused with 10％and 20％dimethyl sulfoxide solution through the femoral artery for 50 minutes,respectively.The concentration of dimethyl sulfoxide in muscle tissue was detected by microdialysis-freezing osmometer.Group B1 and group B2 were perfused with 10％and 20％dimethyl sulfoxide solution through the femoral artery for 30 and 20 minutes,respectively.The concentration of dimethyl sulfoxide in perivascular,muscle and subcutaneous tissue was detected by nuclear magnetic resonance spectroscopy.Group C1,group C2,and group C3 were immersed in 50％,35％,and 20％dimethyl sulfoxide solution for 30 minutes,respectively.Nuclear magnetic resonance spectroscopy was used to detect the concentration of dimethyl sulfoxide in perivascular,muscle and subcutaneous tissues.RESULTS AND CONCLUSION:(1)The concentration of dimethyl sulfoxide in the muscle tissue of groups A1 and A2 increased with the extension of perfusion time.The concentration of group A1 stabilized at about 5％after 30 minutes of perfusion,and the concentration of group A2 stabilized at about 12％after 20 minutes of perfusion.The concentration of dimethyl sulfoxide in the muscle tissue of group A2 at each perfusion time point was higher than that of group A1(P＜0.05).(2)The concentrations of dimethyl sulfoxide in the muscle,perivascular and subcutaneous tissue of group B2 were 12％,20％,and 8.6％,respectively.The concentrations of dimethyl sulfoxide in the perivascular,muscle tissue and subcutaneous tissue of group B1 were 10.9％,6.9％,and 1％,respectively.There were significant differences in the concentrations of dimethyl sulfoxide in the same tissues between the two groups(P＜0.05).(3)The presence of dimethyl sulfoxide was not detected in the muscle and perivascular tissue of groups C1,C2,and C3.The concentrations of dimethyl sulfoxide in the subcutaneous tissue of groups C1,C2,and C3 were 6.5％,2.3％,and 1.85％,respectively,and the difference between the groups was significant(P＜0.05).(4)These results suggest that for the rabbits'severed hindlimb model,the dimethyl sulfoxide penetration is ineffective by traditional immersion method,while 20％dimethyl sulfoxide can reach or approach effective vitrification concentration in most tissues after being introduced into the model through arterial perfusion.

BACKGROUND:Percutaneous curved vertebroplasty has the advantages of minimal trauma and bone cement dispersion,but whether it is safe and effective for the treatment of compression fractures in the upper 1/3 of the vertebral body needs further study.OBJECTIVE:To investigate the clinical efficacy of percutaneous curved vertebroplasty in the treatment of the upper 1/3 compression fractures of the osteoporotic vertebrae.METHODS:Medical records of 66 patients with osteoporotic thoracolumbar upper 1/3 compression fracture admitted to Department of Orthopedics of PLA Rocket Force Characteristic Medical Center from January 2020 to June 2023 were retrospectively analyzed.Among them,32 cases were treated with percutaneous curved vertebroplasty(observation group)and 34 cases were treated with"noncoplanar bipedicular puncture"percutaneous vertebroplasty(control group).Pain visual analog scale score,Oswestry Disability Index,anterior edge height of injured vertebra,and Cobb angle of injured vertebra were compared and analyzed between the two groups before surgery,the first day after surgery,and the last follow-up.The operative time,bone cement leakage rate,bone cement injection volume,and bone cement dispersion score of the two groups were statistically analyzed.RESULTS AND CONCLUSION:(1)The operations were successfully completed in both groups of patients,and no complications such as bone cement allergy,bone cement embolism,nerve damage,or epidural hematoma occurred.(2)Pain visual analog scale score,Oswestry disability index,anterior edge height,and Cobb angle of injured vertebra of the two groups at the first day after surgery and the last follow-up were all better than those before surgery,with statistically significant difference(P＜0.05),but there was no statistical significance between the two groups(P＞0.05).The Oswestry disability index of the two groups at the last follow-up was better than that on the first day after surgery(P＜0.05).(3)The operation time and bone cement leakage rate of the observation group were lower than those of the control group,and the differences were statistically significant(P＜0.05).(4)There were no significant differences in bone cement injection volume and bone cement dispersion score between the two groups(P＞0.05).(5)The results show that percutaneous curved vertebroplasty in the treatment of osteoporotic vertebrae compression fractures in the upper 1/3 of the vertebral body can effectively relieve pain,maintain vertebral height,and reduce operative time and bone cement leakage rate.

BACKGROUND:The effect of protective agent penetration is crucial in organ cryopreservation.Quantitative analysis of the effect of cryoprotectant dimethyl sulfoxide introduction can provide a theoretical basis for the successful cryopreservation of organs.OBJECTIVE:To study the effect of dimethyl sulfoxide penetration on the cryopreservation of rabbits'severed hindlimb.METHODS:Fifty New Zealand white rabbits were randomly divided into group A1(n=8),group A2(n=8),group B1(n=8),group B2(n=8),group C1(n=6),group C2(n=6),and group C3(n=6)by random number table method.The severed hind limb cryoprotectant perfusion model was established in all groups.Groups A1 and A2 were perfused with 10％and 20％dimethyl sulfoxide solution through the femoral artery for 50 minutes,respectively.The concentration of dimethyl sulfoxide in muscle tissue was detected by microdialysis-freezing osmometer.Group B1 and group B2 were perfused with 10％and 20％dimethyl sulfoxide solution through the femoral artery for 30 and 20 minutes,respectively.The concentration of dimethyl sulfoxide in perivascular,muscle and subcutaneous tissue was detected by nuclear magnetic resonance spectroscopy.Group C1,group C2,and group C3 were immersed in 50％,35％,and 20％dimethyl sulfoxide solution for 30 minutes,respectively.Nuclear magnetic resonance spectroscopy was used to detect the concentration of dimethyl sulfoxide in perivascular,muscle and subcutaneous tissues.RESULTS AND CONCLUSION:(1)The concentration of dimethyl sulfoxide in the muscle tissue of groups A1 and A2 increased with the extension of perfusion time.The concentration of group A1 stabilized at about 5％after 30 minutes of perfusion,and the concentration of group A2 stabilized at about 12％after 20 minutes of perfusion.The concentration of dimethyl sulfoxide in the muscle tissue of group A2 at each perfusion time point was higher than that of group A1(P＜0.05).(2)The concentrations of dimethyl sulfoxide in the muscle,perivascular and subcutaneous tissue of group B2 were 12％,20％,and 8.6％,respectively.The concentrations of dimethyl sulfoxide in the perivascular,muscle tissue and subcutaneous tissue of group B1 were 10.9％,6.9％,and 1％,respectively.There were significant differences in the concentrations of dimethyl sulfoxide in the same tissues between the two groups(P＜0.05).(3)The presence of dimethyl sulfoxide was not detected in the muscle and perivascular tissue of groups C1,C2,and C3.The concentrations of dimethyl sulfoxide in the subcutaneous tissue of groups C1,C2,and C3 were 6.5％,2.3％,and 1.85％,respectively,and the difference between the groups was significant(P＜0.05).(4)These results suggest that for the rabbits'severed hindlimb model,the dimethyl sulfoxide penetration is ineffective by traditional immersion method,while 20％dimethyl sulfoxide can reach or approach effective vitrification concentration in most tissues after being introduced into the model through arterial perfusion.