Introduction: The optimal management of thoracolumbar spine fractures remains a matter of controversy. The current literature implies that the use of short-segment pedicle screw fixation may be inappropriate because of its high reported failure rate. The purpose of this study is to report the short-term results of thoracolumbar burst and compression fractures treated with short-segment pedicle instrumentation. Materials and Methods: From 2002 to 2007, 19 patients with thoracolumbar acute traumatic fractures were instrumented with posterior short-segment pedicle screws. The patients’ case notes, operation records, preoperative and postoperative radiographs (sagittal index, anterior body compression and regional kyphosis), computed tomography scans, neurological findings (Frankel functional classification), and follow-up records up to 18 months were reviewed. Results: A statistically significant difference was found between the patients’ preoperative, postoperative and follow-up sagittal index, anterior body compression and regional kyphosis measurement. One case resulted in screw pedicle screw pullout and subsequently, kyphotic deformity. The patient underwent revision surgery to long-segment posterior instrumentation and fusion. None of the patients showed an increase in neurological defi cit. Conclusion: In conclusion, the short-term follow-up results suggest a favourable outcome for short-segment instrumentation. Load shearing classification is essential for the selection of patient for short-segment instrumentation. However, the long-term follow-up evaluation will be needed to verify our findings. Key words: Kyphoytic angle, Radiological outcome, Short segment posterior fixation, Thoracolumbar spine fractures
IntroductionWorldwide estimates are that 9.6% of men and 18.0% of women aged over 60 years have symptomatic osteoarthritis. The current treatment options vary from conservative to joint replacement. Recently, debridement of the joint has become an option for symptomatic relief. We evaluated the outcome of arthroscopic debridement with autologous conditioned plasma. The latter helps to promote cellular repair. We have evaluated our results over a two year period.Materials and MethodsWe retrospectively analyzed a cohort of 52 patients who underwent arthroscopic knee debridement with autologous conditioned plasma in 2011. The patients were followed up in clinic till discharge. The case notes were reviewed and baseline demographic data obtained. This included age, medical history, occupation, range of movement, BMI measurements, duration of operation and radiographic scores. We analyzed the outcomes against those factors.ResultsOf the 52 patients in our study, 16 were female and 36 were male. The mean follow-up period in the clinic was 6.5 months. The Kellgren-Lawrence score was 21.2% Grade 1, 13.5% Grade 2, 51.9% Grade 3 and 13.5% Grade 4. Improvement in range of movement was seen in 32.7% of patients.ConclusionsThis study shows that arthroscopic debridement with autologous conditioned plasma (ACP) has a role to play in the treatment of osteoarthritis. In view of these findings, we recommend that surgeons should consider arthroscopic debridement with autologous conditioned plasma as part of their treatment armamentarium.
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