Burtonhahn8888
The patients with chronic back pain along with marked symptoms variability need consideration of Fibromyalgia for possible diagnosis especially in the absence of secondary cause for these symptoms. ACR 2010 diagnostic criteria seem compelling and effective for the diagnosis of fibromyalgia among patients with chronic back pain.
The patients with chronic back pain along with marked symptoms variability need consideration of Fibromyalgia for possible diagnosis especially in the absence of secondary cause for these symptoms. ACR 2010 diagnostic criteria seem compelling and effective for the diagnosis of fibromyalgia among patients with chronic back pain.
Lumbar disc herniation (LDH) can cause lumbar nerve root compression, which can lead to denervated atrophy of paraspinal muscles theoretically, however, the conclusions of morphological alteration in multifidus with LDH remain controversial. Transforming growth factor-beta 1 (TGF-β1) plays an essential role in the development of tissue fibrosis and is a molecular marker in the study of muscle fibrosis, but no relevant studies on TGF-β1 expression in multifidus have been reported so far. This study is to observe altered morphology of multifidus in patients with LDH, and to explore the correlation between multifidus fibrosis and TGF-β1 expression.
46 LDH patients with low back pain combined with unilateral leg radiation pain and/or numbness were selected. Patients were divided into four groups according to their medical histories. Group 1 medical history less than 6months (15 cases); group 2 a medical history of 6-12months (10 cases); group 3 a medical history of 12-24months (13 cases); and group 4 medical ically significant difference in TGF-β1 expression in both sides. In the remaining three groups, TGF-β1 expression in the involved sides was higher than were found in the uninvolved sides.
Nerve root compression by LDH leads to multifidus atrophy, fibrosis, and increased TGF-β1 expression, which might promote multifidus fibrosis.
All Clinical Trials done in India should preferably be registered with the Clinical Trials Registry of India, set up by the Indian Council of Medical Research (website http//ctri.nic.in). Authors should provide the CTRI number along with the manuscript.
Nerve root compression by LDH leads to multifidus atrophy, fibrosis, and increased TGF-β1 expression, which might promote multifidus fibrosis.Trials registration All Clinical Trials done in India should preferably be registered with the Clinical Trials Registry of India, set up by the Indian Council of Medical Research (website http//ctri.nic.in). Authors should provide the CTRI number along with the manuscript.
We hypothesized that an entire pedicle screw tract cement augmentation has greater strength than traditional techniques.
Twenty-four fresh frozen calf lumbar spines were randomized into three study groups, each having eight vertebrae (1) screw cemented after vertebroplasty; (2) fenestrated cemented screw; and (3) cementation of the entire pedicle screw tract. For the right side screws, two pedicle screws were inserted in each vertebra with the standard position in the sagittal plane, whereas the left side screws were placed at a 30° angle craniocaudal plane. From the recorded force-displacement curves, the maximum peak load (failure load) of each screw was determined. The mode of failure was screw stripping at all levels tested.
The pull-out strength for standard screw replacement at the sagittal plane was 1843.3N, 1707.45N, and 5365.1N consecutively. The failure load value in the standard position in the sagittal plane in the cementation of the entire pedicle screw tract group was significantly higher than that in the fenestrated cemented screw group and screw cemented after vertebroplasty (
< 0.001 and
< 0.001, respectively). The standard pedicle screw position in the sagittal plane showed a significant pull-out strength than the others (
< 0.001).
The pull-out strength of the cementation of the entire pedicle screw tract was 2.5 times higher than the others. The pull-out strength of the pedicle screws in malposition obtained the same strength to the standard positions after the augmentation procedure in our study.
The pull-out strength of the cementation of the entire pedicle screw tract was 2.5 times higher than the others. The pull-out strength of the pedicle screws in malposition obtained the same strength to the standard positions after the augmentation procedure in our study.
Randomized controlled trial.
To study the magnitude of bone loss at forearm in persons with acute spinal cord injury (SCI) & the effect of early administration of Zoledronic acid on its' prevention.
Sawai Man Singh Medical College,Jaipur, India.
Sixty patients with acute SCI were randomized either to receive standard medical and nursing care or Zoledronic acid infusion in combination with standard medical and nursing care. Areal bone mineral density (aBMD) was measured at the forearm (radius + ulna) once patientswere medically stable using Dual Energy X-Ray Absorptiometry (DXA) at baseline and at 3, 6 and 12 months.
Significant differences in aBMD was found between the control & Zoledronic acid group at 1/3 forearm (- 0.064; 95% CI - 0.092 to - 0.036,
= 0.001), mid forearm (- 0.059; 95% CI - 0.084 to - 0.034,
= 0.001), UD forearm (- 0.048; 95% CI - 0.097 to 0.001,
= 0.016) and total forearm (- 0.048; 95% CI - 0.088 to - 0.008,
= 0.021) at 1 year in the paraplegic patients with SCI. months following acute spinal cord injury.
Single dose of 5mg intravenous Zoledronic acid is an effective treatment in preventing bone loss at the forearm for 12 months following acute spinal cord injury.
The study aimed to evaluate the agreement between the radiographic union scale (RUST) and modified RUST (mRUST) in humeral shaft fractures treated with different techniques, and the effect of surgeons' experience and thresholds for determining bone union.
A total of 20 orthopedic surgeons reviewed and scored radiographs of 30 patients with humeral shaft fractures treated by external fixation, intramedullary nailing, and plating using the RUST and mRUST on the 0day, 6weeks, 12weeks and 24weeks follow-up radiographs. Bone healing, interrater agreement between RUST and mRUST scores, and the threshold for radiographic union were evaluated.
The intraclass correlation coefficient (ICC) was slightly higher for the mRUST score than the RUST score (0.71 versus [vs.] 0.67). There was substantial agreement between the mRUST and RUST scores for external fixation (0.75 and 0.69, respectively) and intramedullary nailing (0.79 and 0.71); there was moderate agreement between them for plating (0.59 and 0.55). Surgeons with varying experience had a similar agreement for both scores and scores for each humeral cortex. The external fixation and intramedullary nailing group had higher RUST and mRUST scores than the plating group. The ICC for union was substantial (0.64; external fixation 0.68, intramedullary nailing 0.64, and plating 0.61). More than 90% of the reviewers recorded scores of 10/12 for RUST and 13/16 for mRUST at the time of union.
RUST and mRUST scores can be used reliably for the evaluation of bony union in humeral fractures treated with an external fixator and intramedullary nailing. In cases of humeral plating, a more sensitive tool for evaluation of fracture union is needed.
RUST and mRUST scores can be used reliably for the evaluation of bony union in humeral fractures treated with an external fixator and intramedullary nailing. In cases of humeral plating, a more sensitive tool for evaluation of fracture union is needed.
The location of bisphosphonate-related atypical femoral fractures (AFFs) is related to the femoral bow. Other factors that might also be related to the distribution of AFFs are not well studied. In this study, we attempt to define the demographic factors that influence the distribution AFFs in our local population.
The medical records of all the patients diagnosed with AFFs treated in our institution between 2008 and 2017 were retrospectively reviewed and divided based on fracture location into subtrochanteric and mid-shaft groups. Demographic data were collected and compared between the two groups. Independent factors affecting the location of AFFs were identified via multivariate analysis.
Seventy-nine AFFs in 71 patients were included. Thirty-two fractures occurred at the subtrochanteric region and 47 occurred at the mid-shaft. Age, bone density, anterior femoral bow and lateral femoral bow were significantly different between the two groups, whereas height, weight, body mass index, presence of prodromal symptoms, type and duration of bisphosphonates were not significantly different. Multivariate analysis showed anterior femoral bow was the only independent factor associated with the location of AFFs.
Anterior femoral bow is the only factor that can predict the location of AFFs. In our population, other demographic factors were not found to be predictive.
Anterior femoral bow is the only factor that can predict the location of AFFs. In our population, other demographic factors were not found to be predictive.
Growth factors are considered to play an important role in the process of bone healing. This study assessed serum levels of transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor (VEGF) in patients undergoing intramedullary nailing for isolated fracture of femur shaft operated at various time lag from injury.
All patients between 18 and 60years of age group operated for isolated femoral shaft fractures (AO/OTA32 A, B, C) were included. The serum levels of VEGF and TGF-β1 were compared at various intervals amongst the study group divided into two groups based on the time lag between injury and surgery along with a health control cohort.
31 patients were operated within the first 48h while 28 patients were operated within 2-12days after injury. Highest VEGF levels were observed on postop day 3, followed by a subsequent decline thereafter. TGF-β1 level also showed increasing trend after surgery, but the levels reached dual peaks after 2weeks and 12weeks after surgery. Both groups revealed similar trends of temporal expression of serum VEGF and TGF-β1. There was no statistical difference between the two groups at any point of time during the observation period. There was also no statistical difference in clinico-radiological healing of fractures among the groups.
There is a definite and specific trend of serum levels of growth factors in the fracture healing process. There is no effect of time lag from injury to surgery on the healing outcome of isolated femoral shaft fractures both at the molecular level and also at the clinical level.
There is a definite and specific trend of serum levels of growth factors in the fracture healing process. There is no effect of time lag from injury to surgery on the healing outcome of isolated femoral shaft fractures both at the molecular level and also at the clinical level.
This study aimed to investigate the incidences of pre- and post-operative lower extremity deep venous thrombosis (DVT) in hospitalized patients with intertrochanteric fractures and to analyze the relevant risk factors.
A retrospective study was conducted between July 2014 and October 2016 in 218 intertrochanteric fracture patients who presented at Xi'an Honghui Hospital and underwent Doppler ultrasonography for DVT diagnosis. IOX2 modulator We divided DVT into distal, proximal, and mixed thrombosis. Patients were divided into either the thrombosis or no thrombosis group according to preoperative and postoperative ultrasonography results. All patients were evaluated for the risk factors associated with thrombosis.
A total of 37.61% of preoperative patients had DVT, and the postoperative incidence increased to 58.72%. The days between fracture and hospitalization and the days between fracture and surgery were independent risk factors for preoperative DVT. The days between fracture and hospitalization and d-dimer levels at postoperative 1day were independent risk factors of postoperative DVT.
