Riverstranberg2019

The surgical group had a significantly higher incidence of posttreatment complications than the non-surgical group (18.8% vs 2.4%, P = .015). During the mean follow-up of 5.7 years, AAC recurred in 4 (9.8%) patients in the non-surgical group. Three patients underwent cholecystectomy, 1 was treated with antibiotics, and no recurrence-related death occurred. The recurrence rate of AAC was not different between PC and antibiotics only groups (14.3% vs 7.4%, P = .596).Recurrence was observed in 9.8% of AAC patients treated non-surgically and the outcome in the non-surgical group was not inferior to that in the surgical group.It is well known that the main segments of spinal fracture is thoracolumbar (T11-L11). Therefore, in addition to the lumbar, the lower thoracic vertebra (T9-T12) often has the clinical needs of implantation of cortical bone trajectory (CBT) screws. However, the anatomic parameters of the lower thoracic vertebrae are quite different from those of the lumbar vertebrae, which means that if CBT screws are to be implanted in the lower thoracic vertebrae, the selection of the screw entry point, the length, diameter, angle and path of the screws in each segment need to be redefined. Methods In this part, 3-dimensional finite element model was established to analyze the stress and fixation efficiency of CBT screws in thoracic vertebrae after 5000 times of fatigue loading of normal model and osteoporosis model. Discussion If the outcomes indicate the trial is feasible and there is evidence to provide some basic anatomical parameters for CBT screw implantation in the lower thoracic spine, so that the ideal insertion point, length, diameter, and angle of CBT screw in different segments of the lower thoracic spine were determined.Trial Registration Chinese Clinical Trial Registry, ChiCTR1900026915.Registered on September 26, 2019.BACKGROUND This meta-analysis was conducted to compare the effects and safety of teriparatide with risedronate in the treatment of osteoporosis. MATERIAL AND METHODS PubMed, Embase, Web of Science and Cochrane library database were systematically reviewed for studies published up to February 24, 2019. Eligible studies that compared the effects of teriparatide with risedronate in osteoporosis were included in this meta-analysis. The outcomes included percentage change in bone mineral density (BMD) of lumbar spine, femoral neck, and total hip, the incidence of clinical fractures, serum bone markers, and adverse events. A random-effects or fixed-effects model was used to pool the estimate, according to the heterogeneity among the included studies. RESULTS Seven studies were included in this meta-analysis. Compared with risedronate, teriparatide was associated with a significant increase in lumbar spine BMD [weight mean difference (WMD)=4.24, 95%CI 3.11, 5.36; P  less then  .001], femoral neck BMD (WMD=2.28, 95%Cebral fracture and non-vertebral fracture. There was no significant difference in incidence of adverse events between the 2 drugs. Considering the potential limitations in the present study, further large-scale, well-performed randomized trials are needed to verify our findings.In this retrospective observational study, I aimed to report long-term follow-up results of femoral varus osteotomy in the treatment of Perthes disease patients who were between 6 and 8 years old at the onset of the disease with Herring B and C hip involvement. I also aimed to compare 2 different osteotomy techniques open-wedge and closed-wedge femoral varus osteotomies.Patients with Perthes disease treated with femoral varus osteotomies were invited for final examination. Twenty two hips of 19 patients were evaluated. Mean follow-up period was 15.2 years. Patients were divided into 2 homogenous groups according to femoral osteotomy technique. In Group A (12 hips) open-wedge osteotomy, and in Group B (10 hips) closed-wedge osteotomy was performed.There were 15 male (78.9%) and 4 female (21.1%) patients. The median age at the onset of the disease was 7 years in Group A and B. The mean follow-up period was 16.2 years in Group A, and 11.4 years in Group B. According to Stulberg classification 5 hips (22.7%) wereorable center-edge angle results.RATIONALE We present a rare case of a traumatic intradural ruptured disc associated with a mild vertebral body compression fracture along with a review of the relevant medical literature. An intradural ruptured disc often occurs due to chronic degenerative diseases and is rarely due to trauma. It can cause irreversible neurological complications if the appropriate treatment is not planned. PATIENT CONCERNS A 32-year-old male presented with motor paraparesis (grade 3/5), right ankle dorsiflexion, and great toe dorsiflexion (grade 1/5), along with radiating pain at his right L4 and L5 sensory dermatome following a fall. DIAGNOSES Computed tomography revealed a compression fracture of the L2 body. Lumbar magnetic resonance imaging showed an intradural mass-like lesion on the ventral side of his spinal cord and an epidural mass-like lesion on the dorsal side of his spinal cord, indicating a hematoma. INTERVENTIONS An emergency L2 laminectomy was performed to remove the space-occupying lesions and to decompress the cauda equina and nerve root. The mass-like lesion was removed. No other lesions were found in the spinal canal. OUTCOMES Pathologic examination of the intradural mass lesion revealed fibrocartilage similar to that found in disc material. The patient still continued to experience motor weakness at the 1-year follow-up examination. LESSONS We report a rare case of a traumatic lumbar disc rupture into the dural sac associated with a mild vertebral body compression fracture. Early diagnosis and prompt surgical intervention are essential, as is performing a magnetic resonance imaging or computed tomography myelogram promptly to evaluate the spinal canal when there are unexplained neurologic symptoms. selleck compound An intraspinal canal evaluation should be completed before the postural reduction of the vertebral body fracture to prevent any neurological complications.RATIONALE Intradural disc herniation has been documented rarely and the pathogenesis remains unclear. The region most frequently affected by intradural lumbar disc herniations is L4-5 level, and the average age of intradural disc herniations is between 50 and 60 years. Although magnetic resonance imaging is a valuable tool in the diagnosis of this disease, it is still difficult to make a definite diagnosis preoperatively. PATIENT CONCERNS In this report, we described a 58-year-old male patient who presented with intermittent pain of low back and radiating pain of the both lower extremities for 2 years as well as decreased muscle strength of the both legs and dysfunction of urinary and defecation for 1 month. DIAGNOSIS Lumbar disc herniation was diagnosed during the first clinical examination in the local hospital. Magnetic resonance imaging revealed a mass disc filling almost the entire spinal canal at the L4/5 level and a stalk connecting the mass to the intervertebral disc was detected in the sagittal T2-weighted image.