OBJECTIVE: To explore the clinical efficacy of percutaneous pedicle screw short segment internal fixation with or without the intermediate screw in the treatment of Magerl A3 thoracolumbar fractures with low bone mineral density. METHODS: Patients with Magerl A3 thoracolumbar fracture underwent percutaneous pedicle screw short segment internal fixation from January 2017 to July 2020 were retrospectively analyzed, 93 cases met the diagnosis and inclusion criteria, 9 cases were excluded according to the exclusion criteria, and the remaining 84 cases obtained complete imaging follow-up data. There were 38 males and 46 females, the age ranged from 56 to 73 years old with an average of (64.78±7.12) years old, bone mineral density (BMD) ranged from 0.61 to 0.89 g/cm³ with an average of (0.73±0.14) g/cm³, the follow-up time was 11 to 25 months with an average of (17.58±6.12) months. There were 45 cases in group A with intermediate screw and 39 cases in group B without intermediate screw. The operation time and intraoperative blood loss were recorded, Oswestry Disability Index (ODI) and visual analogue scale (VAS) were used for clinical evaluation. The Cobb angle, vertebral wedge angle (VWA) and anterior vertebral body height (AVBH) were measured by X-ray after the operation. The corrected loss of the above parameters was calculated. RESULTS: There were 5 cases of screw loosening in 84 patients (2 cases in group A and 3 cases in group B, P>0.05). There were significant differences in operation time and intraoperative blood loss between two groups(P<0.01). Clinical effects of two groups were good, postoperative VAS and ODI after operation obviously improved, there was no significant difference between two groups during all follow-up periods (3 days, 1 month after operation and the final follow-up) (P>0.05). Three days after the operation, the image evaluations (Cobb angle, VWA and AVBH) were significantly improved (P<0.05), but significant reduction loss was observed in both groups at 1 month after the operation and at the final follow-up (P<0.05). At the final follow-up, the loss of Cobb angle, VWA and AVBH in group A were (5.26±4.18) °, (4.63±3.80) ° and (9.54±8.71)%, respectively;group B was (6.01±4.34) °, (6.55±6.21) ° and (11.67± 9.95)%, respectively;however, there was no significant difference in reduction loss between the two groups(P>0.05). CONCLUSION Although the curative effect of the patients is satisfactory, the stability of the patients can not be improved by increasing the middle injured vertebra screw placement, the two groups of percutaneous short segment internal fixation can not resist the reduction loss of Magerl-A3 thoracolumbar fracture with low bone mineral density. Because the injured vertebra screw increases the operation time and intraoperative blood loss, it is not significant to use the intermediate screw for the elderly Magerl A3 thoracolumbar fractures with low bone mineral density.
Aged ; Blood Loss, Surgical ; Bone Diseases, Metabolic ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; Humans ; Lumbar Vertebrae/surgery* ; Male ; Middle Aged ; Pedicle Screws ; Retrospective Studies ; Spinal Fractures/surgery* ; Thoracic Vertebrae/surgery* ; Treatment Outcome

PURPOSE: The aim of this study was to evaluate the clinical characteristics of children diagnosed as cryopyrin-associated periodic syndrome (CAPS) in Korea. METHODS: Diagnosis was made based on clinical features and confirmed by a mutation in the cold-induced autoinflammatory syndrome 1 (CIAS1) gene. Especially, osteocartilaginous overgrowth in the patella or distal femur was so characteristic that its presence warranted a diagnosis of chronic infantile neurologic cutaneous and articular/NOMID. RESULTS: We observed the clinical features of 9 Korean CAPS patients. All the patients suffered from an urticarial rash with recurrent fever. Among the 9 patients, 6 presented with rash and 4 with fever on the 1st or 2nd days of birth. Eight patients showed myalgia, and 7 patients showed arthralgia in the joints, and 6 patients showed radiologic findings of arthropathy including cupping of the metaphysis, excessive growth of the epiphysis, osteopenia or overgrowth of the cartilage. Four patients showed brain atrophy, enlarged ventricles or leptomeningeal enhancement on magnetic resonance imaging. Intellectual disability was observed in 1 patient. Five patients had eye involvement as conjunctivitis, uveitis, chorioretinitis, avascular area or papillary edema, and 3 patients showed progressive hearing loss. All 9 patients showed increased C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). CONCLUSIONS: All the patients carried a mutation on exon 3 of the CIAS1 gene. After the anakinra (interleukin-1 receptor antagonist) therapy, the fever and rash immediately disappeared, and CRP and ESR were improved.
Arthralgia ; Atrophy ; Blood Sedimentation ; Bone Diseases, Metabolic ; Brain ; C-Reactive Protein ; Cartilage ; Child ; Chorioretinitis ; Conjunctivitis ; Cryopyrin-Associated Periodic Syndromes ; Diagnosis ; Edema ; Epiphyses ; Exanthema ; Exons ; Femur ; Fever ; Hearing Loss ; Humans ; Intellectual Disability ; Interleukin 1 Receptor Antagonist Protein ; Joints ; Korea ; Magnetic Resonance Imaging ; Myalgia ; Parturition ; Patella ; Uveitis

Bleeding disorders, including hemophilia, can be seen in every ethnic population in the world. Among various bleeding disorders, reduced bone density has been addressed in hemophilia A. In recent years, there has been an increasing interest in addressing osteopenia and osteoporosis in hemophilia A. There is little or no study about the possible susceptibility of other individuals with bleeding disorders to reduced bone density. Questions have been raised about the role of blood coagulation factors in bone mineralization. This review provides new insight and ideas for further survey in the field of bleeding disorders and reduced bone density.
Blood Coagulation Factors ; Bone Density* ; Bone Diseases, Metabolic ; Calcification, Physiologic ; Hemophilia A ; Hemophilia B ; Hemorrhage* ; Osteoporosis ; von Willebrand Diseases

Osteoporosis is a major health problem that can lead to mortality. This study was conducted to estimate the prevalence of osteopenia and osteoporosis separately and to assess the risk factors associated with osteopenia/osteoporosis in Korean men aged 50 years and over. A total of 1,136 subjects were analyzed among the participants of the Korea National Health and Nutrition Examination Survey (KNHANES) 2010~2011 by using SPSS statistics complex samples (windows ver. 23.0). The prevalence rates of osteopenia and osteoporosis were 46.3% and 7.3%, respectively, and the mean ages of both osteopenia and osteoporosis risk groups were significantly higher than that of the normal group. The mean values for lifetime tallest height and bone mineral density in whole body, total femur, femoral neck, and lumbar spine were significantly lower in the risk group (osteopenia/osteoporosis) than in the normal group, whereas the mean values for height, body weight, BMI, waist circumference, alkaline phosphatase, parathyroid hormone, fasting blood glucose, total cholesterol, HDL-cholesterol, LDL-cholesterol, and triglycerides of the two groups showed no significant differences. The intakes of energy and carbohydrates were significantly higher in the risk group than in the normal group. The results of multiple logistic regression showed that being underweight and having hypercholesterolemia were significantly related with the prevalence of osteopenia/osteoporosis, whereas health habits such as smoking and exercise, chronic diseases such as obesity and hypertension, and nutrient intakes were not. These findings suggest the need for further studies to examine osteopenia/osteoporosis risk factors and outcomes specificly focused on Korean men.
Alkaline Phosphatase ; Blood Glucose ; Body Height ; Bone Density ; Bone Diseases, Metabolic ; Carbohydrates ; Cholesterol ; Chronic Disease ; Fasting ; Femur ; Femur Neck ; Humans ; Hypercholesterolemia ; Hypertension ; Korea* ; Logistic Models ; Male ; Mortality ; Nutrition Surveys* ; Obesity ; Osteoporosis ; Parathyroid Hormone ; Prevalence* ; Risk Factors* ; Smoke ; Smoking ; Spine ; Thinness ; Triglycerides ; Waist Circumference

BACKGROUND/AIMS: Although trials have suggested an association between osteoporosis and cardiovascular disease (CVD), the relationship between fracture risk and cardiovascular disease is not well defined. Here, we examined whether subjects with a higher risk of fracture also share an increased likelihood of developing CVD. METHODS: This study included 477 subjects; patients with a history of diabetes, chronic hepatopathy, nephritic syndrome, or any cardiovascular diseases were excluded. We used dual energy X-ray absorptiometry to assess the bone mineral density (BMD) of the lumbar spine and femur, and calculated fracture risk based on the Fracture Risk Assessment (FRAX) score. The Framingham risk score (FRS) was used to estimate cardiovascular risk. RESULTS: Of the 477 subjects, 222 had osteopenia and 150 had osteoporosis; the remaining 105 had a normal BMD. In men, no significant differences were observed in systolic blood pressure (SBP), diastolic blood pressure, low-density lipoprotein, high-density lipoprotein (HDL), and triglyceride (TG) between groups. Men with osteoporosis were generally older, and had significantly higher total cholesterol (TC). In women, age and FRS were significantly higher in the osteoporosis group. In the multivariate analysis, age, SBP, TC, HDL, TG, and FRAX were all significantly associated with FRS. CONCLUSIONS: These data suggest that patients with a higher risk of fracture are also at greater risk of developing CVD, indicating a possible mechanistic link between CVD and osteoporosis.
Absorptiometry, Photon ; Blood Pressure ; Bone Density ; Bone Diseases, Metabolic ; Cardiovascular Diseases ; Cholesterol ; Female ; Femur ; Humans ; Lipoproteins ; Male ; Multivariate Analysis ; Osteoporosis ; Risk Assessment* ; Spine ; Triglycerides

Vitamin D deficiency is common and may contribute to osteopenia, osteoporosis and falls risk in the elderly. Screening for vitamin D deficiency is important in high-risk patients, especially for patients who suffered minimal trauma fractures. Vitamin D deficiency should be treated according to the severity of the deficiency. In high-risk adults, follow-up serum 25-hydroxyvitamin D concentration should be measured 3-4 months after initiating maintenance therapy to confirm that the target level has been achieved. All patients should maintain a calcium intake of at least 1,000 mg for women aged ≤ 50 years and men ≤ 70 years, and 1,300 mg for women > 50 years and men > 70 years.
Aged ; Bone Density ; Bone Diseases, Metabolic ; prevention & control ; Calcium, Dietary ; therapeutic use ; Cholecalciferol ; administration & dosage ; Female ; Hip Fractures ; complications ; epidemiology ; Humans ; Male ; Middle Aged ; Osteoporosis ; prevention & control ; Practice Guidelines as Topic ; Prevalence ; Primary Health Care ; methods ; Risk Factors ; Vitamin D ; analogs & derivatives ; blood ; Vitamin D Deficiency ; diagnosis ; epidemiology

OBJECTIVES: This study was carried out to investigate bone mineral density (BMD), blood pressure, age and biochemical index and nutrient intakes, and to analyze the relationship between BMD, blood pressure, biochemical index, nutrient intakes of Korean women. METHODS: The study subjects were 499 women with a age range of 30-79 years living in Seoul and Kyunggi area who participated in 2011 KNHANES. The study subjects were divided into 5 age groups: 30 years (145), 40 years (110), 50 years (102), 60 years (85) and 70 years (57), and 3 BMD groups: normal 258 (50.4%), osteopenia 163 (32.9%) and osteoporosis 78 (16.7%). RESULTS: The average waist circumference, BMI and body fat increased with age, but fat free mass decreased with age. Average BMD and T-score was decreased from 0.84, 0.74 g/cm2 in 30 years to 0.05, -1.05 g/cm2 in 70 years. The rates of osteopenia and osteoporosis increased significantly 22% in 30~40 years, 47% in 50 years and 56% in 60~70 years. Systolic blood pressure and cholesterol were significantly increased with age. The rates of hypertension was significantly increased 2.1% in 30 years, 30.4% in 50 years 89.5% in 70 years. Average nutrient intakes such as protein, calcium, iron, vitamin A and C were significantly decreased with age. There were significant negative correlations between age and calcium, systolic blood pressure, triglyceride. CONCLUSIONS: In this study, we found the risk of osteoporosis and hypertension were significantly increase with over 50 years age. Calcium and protein intake decreased with age. Therefore, in order to prevent osteoporosis and hypertension, adult women need to be educated regarding the importance of protein, calcium and other nutrients in their diet.
Adipose Tissue ; Adult ; Blood Pressure ; Bone Density* ; Bone Diseases, Metabolic ; Calcium ; Cholesterol ; Diet ; Female ; Gyeonggi-do ; Humans ; Hypertension ; Iron ; Osteoporosis ; Seoul ; Triglycerides ; Vitamin A ; Waist Circumference

This study was carried out to investigate bone mineral density (BMD), blood pressure, calcium, sodium intake and related biochemical variables, and to analyze the relationship between BMD, and blood pressure, physical characteristics, nutrient intakes of Korean adult women. The study subjects were 30~80years old, 513 women living in Seoul and Kyunggi area who participated in 2011 KNHANES. The study subjects were divided into three BMD groups; normal, n = 259 (50.4%), osteopenia, n = 169 (32.9%), and osteoporosis, n = 85 (16.7%). Average height and weight and fat free mass decreased with a decrease in BMD. Average BMD of normal, osteopenia, osteoporosis were 0.87, 0.79, 0.70 g/cm2, and T-score were 0.42, -0.66, -1.62, respectively. Higher systolic blood pressure, alkaline phosphatase, and triglyceride were significantly associated with a decrease in the BMD. The rates of hypertension were significantly increased from normal to osteoporosis. i.e. 18.5% in normal, 34.3% in osteopenia and 63.5% in osteoporosis. Average nutrientintakes such as protein, fat, calcium, phosphorus, iron, sodium, potassium, vitamin A, vitamin B, vitamin B2, and vitamin C were significantly lower in subjects with lower BMD.n. Average calcium intake of normal, osteopernia and osteoporosis were 528.50, 416.96, 389.56 mg, respectively. There were significant negative correlations between calcium, phosphorus and age, systolic blood pressure, triglyceride. Also, there were negative correlation systolic blood pressure (incomplete sentence). In this study, we found low BMD according to low calcium intake increase the risk of osteoporosis and hypertension rather than sodium intake, also calcium intake decreased with increase age. Therefore, in order to prevent osteoporosis and hypertension, subjects need to be educated regarding the importance of calcium nutrients in diet.
Adult ; Alkaline Phosphatase ; Ascorbic Acid ; Blood Pressure ; Bone Density ; Bone Diseases, Metabolic ; Calcium ; Diet ; Female ; Humans ; Hypertension ; Iron ; Osteoporosis ; Phosphorus ; Potassium ; Riboflavin ; Sodium ; Vitamin A ; Vitamins

The risk of osteoporosis or osteopenia is known to increase after childhood cancer treatment. The purpose of this study was to evaluate patterns of bone mineral density (BMD) and to identify factors related to the decreased BMD in childhood cancer survivors. We studied 78 patients (34 boys, 44 girls) treated for childhood cancer. Twenty (25.7%) patients had lumbar BMD (LBMD) standard deviation score (SDS) lower than -2. Nineteen (24.4%) patients had femur neck BMD (FNBMD) SDS lower than -2. The patients treated with hematopoietic stem cell transplantation had lower LBMD SDS (-1.17 +/- 1.39 vs -0.43 +/- 1.33, P = 0.025). The risk of having LBMD SDS < -2 was higher in the patients treated with glucocorticoid (GC) for graft-versus-host disease (GVHD) (36.6% vs 13.5%; odds ratio [OR], 3.7; P = 0.020). In multivariate logistic regression analysis, longer duration of GC treatment for GVHD (OR, 1.12; 95% confidence interval [CI], 1.05-1.20) and lower body mass index (BMI) SDS (OR, 0.59; 95% CI, 0.36-0.95) were associated with decreased LBMD SDS. These findings suggest that prolonged GC use and reduction in BMI are risk factors for decreased BMD in childhood cancer survivors. Anticipatory follow-up and appropriate treatment are necessary, especially for the patients with risk factors.
Adolescent ; Body Mass Index ; Bone Density/*drug effects ; Bone Diseases, Metabolic/*chemically induced ; Child ; Female ; Glucocorticoids/*adverse effects/*therapeutic use ; Graft vs Host Disease/drug therapy ; Hematopoietic Stem Cell Transplantation/adverse effects ; Hormones/blood ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology ; Leukemia, Myeloid, Acute/pathology ; Male ; Osteoporosis/*chemically induced ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/pathology ; Risk Factors ; Survivors

OBJECTIVETo study whether effect of aspirin plus low-dose diethylstilbestrol is more effective and safer than high diethylstilbestrol dose alone on prevention of ovariectomy-induced osteopenia and dyslipidemia.

METHODSThirty-eight 4-month-old female SD rats were divided into baseline (BAS) group (n=6), sham operation group (n=8) and ovariectomy (OVX) group (n=24). The OVX group was further divided into vehicle treatment group (n=8), diethylstilbestrol (30 μg/kg•d) treatment group (OVX+D30 group, n=8), and aspirin (9 mg/kg•d) plus diethylstilbestrol (10 μg/kg•d) treatment group (OVX+A-D10 group, n=8). Their left tibiae were collected for the bone histomorphometric analysis in undecalcified sections. Left femurs were collected for the bone mineral density measurement.

RESULTSThe body weight and serum cholesterol were increased, while uterine weight and cancellous bone mass were decreased in OVX rats compared with the SHAM group. Cancellous bone mass was significantly increased, while body weight and bone resorption parameters were decreased in both A-D10 and D30 treatment group compared with OVX group. The rats treated with A-D10 showed significantly increased in bone formation parameters and decreased in serum triglyceride compared with the D30-treated rats.

CONCLUSIONAspirin plus low-dose diethylstilbestrol can effectively prevent osteopenia by reducing bone resorption, and is thus a better treatment modality for preventing dyslipidemia than high-dose diethylstilbestrol alone.

Animals ; Anti-Inflammatory Agents, Non-Steroidal ; pharmacology ; therapeutic use ; Aspirin ; pharmacology ; therapeutic use ; Biomarkers ; blood ; Body Weight ; drug effects ; Bone Density ; Bone Diseases, Metabolic ; blood ; prevention & control ; Bone and Bones ; drug effects ; Diethylstilbestrol ; pharmacology ; therapeutic use ; Drug Evaluation, Preclinical ; Drug Therapy, Combination ; Dyslipidemias ; blood ; prevention & control ; Estrogens, Non-Steroidal ; pharmacology ; therapeutic use ; Female ; Organ Size ; drug effects ; Ovariectomy ; Rats ; Uterus ; drug effects