BackgroundUnilateral biportal endoscopic (UBE) spine surgery is a minimally invasive procedure for treating lumbar disorders. Hidden blood loss (HBL) is easily ignored by surgeons because blood loss is less visible. However, there are limited studies on HBL in UBE spine surgery. This study aimed to evaluate HBL and its possible risk factors in patients undergoing UBE spine surgery.MethodsPatients with lumbar disc herniation or lumbar spinal stenosis who underwent unilateral biportal endoscopic surgery between December 2020 and February 2022 at our hospital were retrospectively analyzed. Patient demographics, blood loss-related parameters, and surgical and radiological information were also collected. Pearson or Spearman correlation analysis was conducted to determine the association between clinical characteristics and HBL. Multivariate linear regression analysis was used to determine the independent risk factors for HBL.ResultsFifty-two patients (17 males and 35 females) were retrospectively enrolled in this study. The mean total blood loss (TBL) volume was 434 ± 212 ml, and the mean HBL volume was 361 ± 217 ml, accounting for 77.9% of the TBL in patients who underwent UBE surgery. Multivariate linear regression analysis revealed that HBL was positively associated with operation time (P = 0.040) and paraspinal muscle thickness at the target level (P = 0.033).ConclusionsThe amount of HBL in patients undergoing UBE surgery should not be neglected. Operation time and paraspinal muscle thickness at the target level may be independent risk factors for HBL.
ObjectivesTo validate and compare four tools, the Fracture Risk Assessment Tool (FRAX) without bone mineral density (BMD), Beijing Friendship Hospital Osteoporosis Screening Tool (BFH-OST), Osteoporosis Self-Assessment Tool for Asians (OSTA), and BMD, to identify painful new osteoporotic vertebral fractures (PNOVFs).MethodsA total of 2874 postmenopausal women treated from June 2013 to June 2022 were enrolled and divided into two groups: patients with PNOVFs who underwent percutaneous vertebroplasty (PNOVFs group, n = 644) and community-enrolled females (control group, n = 2230). Magnetic resonance and X-ray imaging were used to confirm the presence of PNOVFs. Dual-energy X-ray absorptiometry was performed to calculate the BMD T-scores. Osteoporosis was diagnosed according to WHO Health Organization criteria. Data on the clinical and demographic risk factors were self-reported using a questionnaire. The ability to identify PNOVFs using FRAX, BFH-OST, OSTA, and BMD scores was evaluated using receiver operating characteristic (ROC) curves. For this evaluation, we calculated the areas under the ROC curves (AUCs), sensitivity, specificity, and optimal cut-off points.ResultsThere were significant differences in FRAX (without BMD), BFH-OST, OSTA, and BMD T-scores (total hip, femoral neck, and lumbar spine) between the PNOVFs and control groups. Compared with BFH-OST, OSTA, and BMD, the FRAX score had the best identifying value for PNOVFs; the AUC of the FRAX score (optimal cutoff =3.6%) was 0.825, while the sensitivity and specificity were 82.92% and 67.09%, respectively.ConclusionFRAX may be the preferable tool for identifying PNOVFs in postmenopausal women, while BFH-OST and OSTA can be applied as more simple screening tools for PNOVFs.
Purpose This cross-sectional study estimated three clinical tools including the Osteoporosis Self-Assessment Tool for Asians (OSTA), Body Mass Index (BMI), and Beijing Friendship Hospital Osteoporosis Self-assessment Tool for Elderly Male (BFH-OSTM) for identifying primary osteoporosis and found optimal cut-off values in an elderly Han Beijing male population. Materials and Methods We conducted a cross-sectional study, enrolling 400 community-dwelling elderly Han Beijing males aged ≥50 from 8 medical institutions. Osteoporosis was diagnosed as a T-score of −2.5 standard deviations or lower than that of the average young adult in different diagnostic criteria [lumbar spine (L1-L4), femoral neck, total hip, WHO]. BFH-OSTM, OSTA, and BMI were assessed for predicting OP by receiver operating characteristic (ROC) curves. Sensitivity, specificity, and areas under the ROC curves (AUC) were determined. Ideal thresholds for the omission of screening BMD were proposed. Results The prevalence of osteoporosis ranged from 9.25% to 19.0% according to different diagnostic criteria. The present study indicated the highest discriminating ability was BFH-OSTM in different criteria. The AUCs of OSTA and BMI were 0.748 and 0.770 in WHO criteria, which suggested limiting predictive value for identifying OP in elderly Beijing males. The AUC of BFH-OSTM to predict OP based on WHO criteria was 0.827, yielding a sensitivity of 65.8% and specificity of 82.7%, respectively. With a cost of missing 6.5% of osteoporosis patients, BFH-OSTM could reduce 73.5% of participants in screening BMD tests. Conclusion BFH-OSTM may be a simple and effective tool for identifying OP in the elderly male population in Beijing to omit BMD screening reasonably.
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