Objective: To analyze the clinical significance of postoperative back muscle exercises after percutaneous vertebroplasty for spinal osteoporotic compression fracture patients. Design: Clinical randomized controlled trials of parallel group nonpharmacologic study. Setting: Patients practised back muscle exercises in the spinal surgery department, rehabilitation department and at their residences. Subjects: Osteoporotic compression fracture patients who had undergone percutaneous vertebroplasty and processed sufficient muscle strength to participate in the training were studied. Interventions: Patients were randomized into two groups, which were titled A and B. General postoperation therapy, including antiosteoporotic medications and education, was offered to all patients. Group B patients received additional systematic back muscle exercise. Main measures: Both Oswestry Disability Index (ODI) and visual analogue scale (VAS) were recorded preoperatively and postoperatively at three-day, one-month, six-month, one-year and two-year follow-up. Results: From January 2006 to January 2009, a total of 82 patients were assessed for eligibility, 60 patients were enrolled and randomized into two groups. Forty-two (70%) patients (20 of 30 in Group A and 22 of 30 in Group B) were successfully followed-up for two years. Systematic back muscle exercises resulted in a significant advantage in both measurements. The ODI of Group B was significantly better than Group A at the six-month, one-year and two-year follow-ups (P < 0.05). The pain level of Group B was significantly lower than in Group A at the one-and two-year follow-ups (P < 0.05). At the end of our study, the mean (SD) of the ODI in Groups A and B were 39.1 (9.14) and 23.4 (5.62); the mean (SD) of the VAS in Groups A and B were 3.4 (1.15) and 2.1 (0.84), respectively. Conclusions: Our findings suggest that the benefit of the exercises required at least six months to be observed; however, the favourable effects could last for two years. Therefore, systematic back muscle exercise should be recommended as one of the treatment guidelines for postpercutaneous vertebroplasty patients.
BackgroundThis study investigated the outcomes of preoperative HGT as an adjunct treatment for severe thoracic kyphoscoliosis, its role in radiographic correction, and pulmonary function improvement, together with nursing strategy and incidence of complications.Material/MethodsEleven patients with a mean age of 18.8 years were retrospectively reviewed. Inclusion criteria were: patients with severe kyphoscoliosis (coronal Cobb angle and kyphosis angle ≥80°); duration of HGT ≥8 weeks; patients undergoing HGT for at least 12 h per day; traction weight no less than 40% of body weight; and patients not receiving physical therapies. All patients underwent respiratory training.ResultsThe major coronal curve scoliosis averaged 114.00±24.43° and was reduced to 80.55±17.98° after HGT. The major kyphosis was 103.91±18.95° and was reduced to 80.55±17.98°. Significantly improved percent-predicted values for FVC was found after HGT (p=0.014), and significantly increased forced expiratory volume in 1 s (FEV1%) was also observed (p<0.001), with significantly improved percent-predicted values for PEF (p=0.003) after HGT.ConclusionsOur data reveal that preoperative HGT can be performed safely, and can help achieve excellent curve correction in both the coronal and sagittal planes, together with improved respiratory function and no severe complications in patients with severe thoracic kyphoscoliosis.
Wadding corticocancellous bone and increasing screw length failed to provide sufficient anchoring strength for a loosened iliac screw; however, both traditional and boring PMMA-augmented techniques could effectively increase the fixation strength. On the basis of the viewpoint of minimal invasion, the boring PMMA augmentation may serve as a suitable salvage technique for iliac screw loosening.
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