Purpose. To evaluate the relative differences in surgical outcome of kyphoplasty (KP) versus vertebroplasty (VP) in the patients with single level refractory osteoporotic compression fractures (OCFs). Method. From August 2008 to May 2012, we intermittently treated 57 patients with single level OCF by PV and KP (Groups A and B, resp.). We used visual analogue scale (VAS) and short form 36 (SF36) questionnaire to measure functional recovery and followed them for six months. Independent samples t- and Kendall's tau-b tests were for statistics. Results. In terms of age, number, and bone mineral density of the patients, there were no significant differences between the two groups. In both groups, VAS and SF-36 scores improved significantly and remained relatively stable throughout the follow-up period. We had 9 and 6 asymptomatic cement extravasations and 5 and 8 new vertebral fractures in Group A and B, respectively. In comparing the two groups, the results indicated that KP almost failed to show any significant higher effect relative to VP during this period. Conclusions. In considering the high cost of KP relative to VP in the developing countries like Iran, there is no logical reason to use KP in a single level refractory OCF in these regions.
AIm: This study was conducted to evaluate the therapeutic effectiveness of surgical approaches in type II odontoid fracture. mATeRIAL and meTHods:In a retrospective study in Mashhad university, 15 patients with anterior screw fixation technique (ASF) and 31 patients with posterior approaches (PA) were reviewed. Patient demographics, clinical presentation, length of hospital stay, operation time, injury severity score (ISS), Preinjury Charlson comorbidity index, fusion rate and surgical complications were analyzed in these two groups.ResuLTs: Neck pain was the most common clinical presentation in these two groups (89.7%). There were no significant differences in ISS and mean length of hospital stay and Comorbidity index between the two groups. The operation time was different between these two groups (65 minutes in ASF versus118 minutes in PA, P < 0.05). Bone union was documented in 13 patients (87%) with ASF and 28 patients (90%) with PA. CoNCLusIoN:The outcome of surgery with anterior or posterior approach in the patients are potential candidates for surgery is good. In our patients, the operation time is different in the two groups but differences in fusion rate, length of hospital stay, comorbidity index and postsurgical complications are not considerable. KeywoRds:Type II odontoid fracture, Surgical management, Anterior approach, Posterior approach ÖZ AmAÇ: Bu çalışma tip II odontoid kırıklarda cerrahi yaklaşımın terapötik etkinliğini değerlendirmek için yapıldı. yÖNTem ve GeReÇLeR: Mashhad Üniversitesinde yapılan retrospektif bir çalışmada anterior vida fiksasyon tekniği (ASF) kullanılan 15 hasta ve posterior yaklaşımlar (PA) kullanılan 31 hasta gözden geçirildi. Bu iki grupta hasta demografik bilgileri, klinik sunum, hastanede kalma süresi, operasyon süresi, yaralanma şiddeti skoru (ISS), yaralanma öncesi Charlson Komorbidite İndeksi, füzyon oranı ve cerrahi komplikasyonlar analiz edildi.BuLGuLAR: Bu iki grupta en sık görülen klinik sunum boyun ağrısıydı (%89,7). İki grup arasında ISS ve ortalama hastanede kalma süresi ile komorbidite indeksi arasında önemli fark yoktu. Operasyon süresi bu iki grup arasında farklıydı (ASF grubunda 65 dakika ve PA grubunda 118 dakika, P < 0,05). Kemik birleşmesi ASF'li 13 hastada (%87) ve PA'lı 28 hastada (%90) görüldü. soNuÇ: Cerrahi için uygun olan hastalarda anterior veya posterior yaklaşımla cerrahi sonuçları iyidir. Hastalarımızda operasyon süresi iki grupta farklıydı ama füzyon oranı, hastanede kalma süresi, komorbidite indeksi ve cerrahi sonrası komplikasyonlar açısından önemli fark yoktu.
Management of the central nervous system malignancies are among the evolving areas of research and clinical practice requiring a well-coordinated interdisciplinary approach. The neuro-oncology scientific club (NOSC) has tried to cross the links between various disciplines' experts involved in brain tumor care in Iran since 2011. The NOSC's structured collaborative brain tumor registry (BTCR) and the support received from its steering committee and provincial boards have been the key elements for its success and growth so far. This scientific community not only has helped to optimize brain tumor care but provided interdisciplinary research opportunities to its members across Iran. Mashhad's NOSC has been the pioneer in the above. During the 3 rd Mashhad's NOSC meeting held in November 21 st 2013, the interim results from some important local neuro-oncology studies were presented. Some potential opportunities to improve the coordinated interdisciplinary brain tumor care within the province were discussed by neurosurgery, neuroradiology and radiation oncology faculty at this provincial NOSC meeting. Clinical outcome, survival data and prognostic factors in adult and pediatric gliomas over the past several years in Mashhad, the association between methyl guanine methyl transferase (MGMT) methylation status (determined by MSQP or methylation specific quantitative polymerase chain reaction) where among the main studies outlined during this event. We realize that optimized brain tumor management and productive research in neuro-oncology can only be achieved through an integrated approach and strong team work. This is what the NOSC pursues.
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