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J Orthop Surg Res 2021 Jun 14;16(1):380. Epub 2021 Jun 14.

Department of Orthopedic Surgery, Spine Center, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, 1, Singil-ro, Yeongdeungpo-gu, Seoul, Republic of Korea, 07441.

Background: Lower lumbar osteoporotic vertebral compression fracture in extremely elderly patients can often lead to lumbosacral radiculopathy (LSR) due to delayed vertebral collapse (DVC). Surgical intervention requires posterior instrumented lumbar fusion as well as vertebral augmentation or anterior column reconstruction depending on the cleft formation and intravertebral instability. However, it is necessary to decide on surgery in consideration of the patient's frail status, surgical invasiveness, and rehabilitation. Read More

Int J Surg Case Rep 2021 Jun 9;84:106066. Epub 2021 Jun 9.

Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA; University of South Florida, Tampa, FL, USA.

Introduction And Importance: Low voltage electrical injuries (less than 1000 V) can produce enough tetany to cause fractures, usually of the upper extremities. Simultaneous bilateral fractures of the femoral neck are an extremely rare occurrence. It is even more uncommon for a young healthy male to suffer significant fractures from a low voltage injury. Read More

BMC Surg 2021 Jun 11;21(1):290. Epub 2021 Jun 11.

Department of Orthopaedics, Xijing Hospital, Air Force Medical University, 127 West Changle Road, Xi'an, 710032, China.

Background: To investigate the clinical efficacy and therapeutic value of posterior decompression reduction, bone grafting fusion, and internal fixation for treatment of symptomatic old thoracolumbar fractures.

Method: Retrospective analysis was conducted for 14 patients (9 men, 5 women; average age 40.1 years) with old thoracolumbar fractures who underwent posterior operation. Read More

Clin Orthop Surg 2021 Jun 17;13(2):207-215. Epub 2021 Mar 17.

Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center, Seoul, Korea.

Backgroud: The purpose of this study was to investigate the characteristics of osteoporotic vertebral compression fractures (OVCFs) in Korean postmenopausal women and the association between OVCFs and clinical factors such as age, bone mineral density (BMD), and quality of life.

Methods: According to the population distribution in four regions in Korea, 1,281 postmenopausal female patients were recruited from nationwide orthopedic outpatient clinics. Radiologic, asymptomatic, and within 3 months of OVCF groups were analyzed based on age, fracture location, and prevalence according to BMD. Read More

Medicine (Baltimore) 2021 Jun;100(22):e26174

Department of Orthopedic Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine.

Abstract: Percutaneous vertebroplasty (VP) and kyphoplasty (KP) are well-established minimally invasive surgical procedures for the treatment of osteoporotic vertebral compression fractures (OVCF). However, some drawbacks have been reported regarding these procedures, including height loss, cement leakage, and loss of the restored height after balloon deflation. We performed a novel VP technique to minimize these limitations of conventional procedures. Read More

Injury 2021 May 16. Epub 2021 May 16.

National and Kapodistrian University of Athens, Greece, Medical School, Orthopaedic Research and Education Center "Panayotis N. Soucacos" (OREC), 1st Orthopaedic Department, "ATTIKON" Hospital. Rimini 1, Dasos, Haidari, P.C. 12462, Greece.

Axial compressive/flexion moderate forces on the anterior spinal elements may cause vertebral compression fractures (VCF), compromising the anterior column of the spine, reducing vertebral body height and leading to characteristic wedge-shaped deformity. 60% to 75% of VCFs are located in the thoracolumbar junction (T12 - L2) due to mechanical forces upon the transition from the relatively fixed thoracic to the relatively mobile lumbar spine. Compression force spinal fractures vary in literature according to the classification system in use, resulting in controversial treatment options. Read More

Am J Case Rep 2021 May 28;22:e932002. Epub 2021 May 28.

Department of Oncology, University College London Hospital, London, United Kingdom.

BACKGROUND Papillary thyroid carcinoma is usually an indolent disease, with an almost 80% 5-year survival rate for metastatic disease. Conversely, anaplastic thyroid cancer is much more aggressive, with median overall survival rates of 4 months. CASE REPORT A 67-year-old woman presented with metastatic papillary thyroid cancer with bone metastasis, including an unstable L4 pathological fracture. Read More

Zhongguo Gu Shang 2021 May;34(5):458-61

Department of Orthopaedics, Ningbo Medical Treatment Centre Li Huili Hospital, Ningbo 315000, Zhejiang, China.

Objective: To explore diagnosis and surgical treatment of symptomatic lumbar spinal epidural lipoplasia.

Methods: A retrospective analysis of 19 patients with symptomatic lumbar spinal epidural hyperplasia treated with hemilaminectomy and interbody fusion and internal fixation from February 2012 to November 2018 were performed, including 7 males and 12 females, aged from 48 to 72 years old with an average of (57.6±1. Read More

BMC Musculoskelet Disord 2021 May 24;22(1):476. Epub 2021 May 24.

Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China.

Background: Vertebral compression fractures (VCFs) are the most common among all osteoporotic fractures. The body may compensate to the kyphosis from vertebral compression fractures with lordosis of the adjacent spinal segments, rotation of the pelvis, knee flexion and ankle dorsiflexion. However, the detailed degree of body compensation, especially the lower limb, remains uncertain. Read More

Am J Transl Res 2021 15;13(4):2939-2946. Epub 2021 Apr 15.

Department of Nephrology, Affiliated Hospital of Jiangnan University Wuxi 214125, Jiangsu Province, China.

Objective: To determine the effect of comfort nursing in elderly patients with lumbar vertebral compression fractures (LVCFs).

Methods: A total of 194 elderly patients with LVCFs were enrolled, and assigned to two groups based on different nursing intervention methods. Among them, 93 patients were given routine nursing intervention as a control group (CON group), while the rest 101 patients were given comfort nursing as an intervention group (INT group). Read More

J Gastrointest Oncol 2021 Apr;12(2):455-463

Division of Cancer Medicine, Banner MD Anderson Cancer Center, Gilbert, AZ, USA.

Background: Skeletal metastases (SM) in advanced pancreatic ductal adenocarcinoma (PDAC) is an infrequent occurrence that has been previously reported in literature to occur in less than 2.5% of the cases. Complications such as pathological fractures can result in intractable pain, immobilization and a significant deterioration in quality of life. Read More

Medicine (Baltimore) 2021 May;100(20):e25705

Working Group Exercise Oncology, Department of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg University Hospital.

Rationale: One repetition maximum (1-RM) testing is a standard strength assessment procedure in clinical exercise intervention trials. Because no adverse events (AEs) are published, expert panels usually consider it safe for patient populations. However, we here report a vertebral fracture during 1-RM testing. Read More

Int J Radiat Oncol Biol Phys 2021 May 11. Epub 2021 May 11.

Johns Hopkins University School of Medicine, Department of Neurosurgery, Baltimore, MD, USA. Electronic address:

Purpose: Vertebral compression fracture (VCF) is a common complication of spinal stereotactic body radiation therapy. Development of an in vivo model is crucial to fully understand how focal radiation treatment affects vertebral integrity and biology at various dose fractionation regimens. We present a clinically-relevant animal model to analyze the effects of localized, high-dose radiation on vertebral microstructure and mechanical integrity. Read More

Pain Physician 2021 May;24(3):E349-E356

Department of Spinal Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China.

Background: In clinical practice, we have found that the pain caused by thoracolumbar osteoporotic vertebral compression fracture (OVCF) is sometimes not limited to the level of the fractured vertebrae but instead occurs in areas far away from the injured vertebrae, such as the lower back, area surrounding the iliac crest, or buttocks, and this type of pain is known as distant lumbosacral pain. The pathogenesis of pain in distant regions caused by thoracolumbar OVCF remains unclear.

Objectives: To compare the clinical efficacy and imaging outcomes of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of distant lumbosacral pain accompanied by thoracolumbar OVCF and to explore the possible pathogenesis of distant lumbosacral pain caused by thoracolumbar OVCF. Read More

J Orthop Surg Res 2021 May 13;16(1):312. Epub 2021 May 13.

Department of Spine Surgery, Zibo Central Hospital, Zibo, No. 54 Gongqingtuan Road, Zhangdian District, Zibo City, Shandong Province, Zibo, 255036, Shandong, China.

Objective: The purpose of this research is to evaluate the risk factors and incidence of pulmonary cement embolism (PCE) during percutaneous vertebroplasty (PVP) or kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCFs) based on postoperative computed tomography (CT).

Methods: A total of 2344 patients who underwent PVP or PKP due to OVCFs in our spine center were analyzed retrospectively. According to the detection of postoperative pulmonary CT, the patients were divided into two groups: pulmonary cement embolism group (PCE group) and non-pulmonary cement embolism group (NPCE group). Read More

Cureus 2021 Apr 9;13(4):e14388. Epub 2021 Apr 9.

Orthopaedic Surgery, Putrajaya Hospital, Putrajaya, MYS.

Lower back pain is a common presentation in clinical practice. Although most are musculoskeletal in nature, occult spine infection such as spondylodiscitis is commonly missed due to its insidious onset and non-specific symptoms. We report a case of a 63-year-old diabetic woman who presented to our institution's emergency department with altered mental status, nausea, and vomiting. Read More

World J Clin Cases 2021 Apr;9(12):2778-2790

Department of Spine Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China.

Background: As one of the most common complications of osteoporosis, osteoporotic vertebral compression fracture (OVCF) increases the risk of disability and mortality in elderly patients. Percutaneous vertebroplasty (PVP) is considered to be an effective, safe, and minimally invasive treatment for OVCFs. The recollapse of cemented vertebrae is one of the serious complications of PVP. Read More

J Orthop Sci 2021 May 4. Epub 2021 May 4.

Center for Medical Sciences, Ibaraki Prefectural University of Health Sciences, Ami, Ibaraki 300-0394, Japan; Department of Orthopaedic Surgery, Ibaraki Prefectural University of Health Sciences Hospital, Ami, Ibaraki 300-0394, Japan.

Background: Focusing on compression fractures of bone by finite elements, we evaluated bone strength based on the computed tomography-based finite element method. However, the exposure dose is an issue. We aimed to investigate the quantity of reduction of the radiation dose with respect to the reference dose by comparing the calculation results of compression fractures of the vertebral body using experimental data obtained from the spine of a pig. Read More

Neurosurg Focus 2021 May;50(5):E11

1Department of Neurological Surgery, Memorial Sloan Kettering Cancer Center; and.

Objective: High-grade metastatic epidural spinal cord compression from radioresistant tumor histologies is often treated with separation surgery and adjuvant stereotactic body radiation therapy. Historically, long-segment fixation is performed during separation surgery with posterior transpedicular fixation of a minimum of 2 spinal levels superior and inferior to the decompression. Previous experience with minimal access surgery techniques and percutaneous stabilization have highlighted reduced morbidity as an advantage to the use of shorter fixation constructs. Read More

J Orthop Surg Res 2021 Apr 29;16(1):284. Epub 2021 Apr 29.

Shanxi Bethune Hospital, Shanxi Academy of Medical Science, No. 99, Longcheng Street, Taiyuan, 030032, Shanxi Province, China.

Background: To evaluate the effect of postoperative BP treatment on improving the fusion rate after lumbar spinal fusion surgery by performing a meta-analysis of randomized controlled trials (RCTs) and other comparative cohort studies.

Methods: A comprehensive search of PubMed, EMBASE, the Web of Science, and the Cochrane Central Register of Controlled Trials was performed for RCTs and other comparative cohort studies on the effect of BP treatment on improving the fusion rate after lumbar spinal fusion surgery. The primary outcome measures were the number of patients with bone formation grades A, B, and C at 12 months of follow-up; fusion rates at 12 and 24 months of follow-up; vertebral compression fracture (VCF) at 12 and 24 months of follow-up; pedicle screw loosening at 24 months of follow-up; and cage subsidence, the Oswestry disability index (ODI), and the visual analogue score (VAS) at 12 months of follow-up. Read More

Int J Spine Surg 2021 Apr 1;15(2):353-358. Epub 2021 Apr 1.

Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

Background: Percutaneous balloon kyphoplasty (BK) is widely accepted as both a safe and effective method for the treatment of symptomatic benign vertebral compression fractures (VCFs) of the thoracic and lumbar spines. A disruption in the posterior wall of the affected vertebra is often considered to be a relative or an absolute contraindication to BK. This study was performed to determine the safety as well as the efficacy of BK for vertebral body compression fractures associated with posterior wall disruption. Read More

Int J Spine Surg 2021 Feb 29;14(s4):S16-S20. Epub 2020 Dec 29.

Neurosurgery Department, Complejo Hospitalario Universitario de Cáceres, Spain.

Background: Ankylosing spondylitis (AS) is associated with high rates of severe thoracolumbar fractures, in many cases with neurological deficits. It is currently a point of debate as to whether the optimal surgical treatment is posterior fixation and fusion or combined approaches. Vascular injuries in this kind of fracture are a challenging issue to solve in the management of these patients. Read More

BMC Musculoskelet Disord 2021 Apr 22;22(1):377. Epub 2021 Apr 22.

Department of Orthopaedic Surgery, Hokkaido Spinal Cord Injury Center, Higashi-4, Minami-1, 3-1, Bibai, Hokkaido, 072-0015, Japan.

Background: Osteoporotic vertebral compression fractures (VCFs) are commonly observed in elderly people and can be treated by conservatively with minimal risk of complications in most cases. However, utilization of direct oral anticoagulants (DOACs) increases the risks of secondary hematoma even after insignificant trauma. The use of DOACs increased over the past decade because of their approval and recommendation for both stroke prevention in non-valvular atrial fibrillation and treatment of venous thromboembolism. Read More

Anesth Pain Med (Seoul) 2021 Apr 19;16(2):177-183. Epub 2021 Apr 19.

Department of Anesthesiology, Yale New Haven Hospital, New Haven, CT, USA.

Background: Lumbar spinal stenosis is a condition of progressive neurogenic claudication that can be managed with lumbar decompression surgery or less invasive interspinous process devices after failed conservative therapy. Popular interspinous process spacers include X-Stop, Vertiflex and Coflex, with X-Stop being taken off market due to its adverse events profile.

Methods: A disproportionality analysis was conducted to determine whether a statistically significant signal exists in the three interspinous spacers and the reported adverse events using the Manufacturer and User Facility Device Experience (MAUDE) database maintained by the US Food and Drug Administration. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Apr;35(4):471-476

Department of Orthopedics, SSL Central Hospital of Dongguan City, Affiliated Shilong People's Hospital of Southern Medical University, Dongguan Guangdong, 523326, P.R.China.

Objective: To investigate the feasibility and mechanical properties of polymethyl methacrylate (PMMA) bone cement and allogeneic bone mixture to strengthen sheep vertebrae with osteoporotic compression fracture.

Methods: A total of 75 lumbar vertebrae (L -L ) of adult goats was harvested to prepare the osteoporotic vertebral body model by decalcification. The volume of vertebral body and the weight and bone density before and after decalcification were measured. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Apr;35(4):464-470

Department of Orthopedics, the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan Shandong, 250001, P.R.China.

Objective: To report an improved classification system of Kümmell's disease and its clinical application.

Methods: Based on CT and MRI, an improved classification system of Kümmell's disease was proposed in terms of the integrity of sagittal endplate, the integrity of posterior wall of vertebral body, and the degree of vertebral compression. Between January 2011 and March 2018, the improved classification system was used to evaluate and guide the treatment of 78 patients with Kümmell's disease. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2021 Apr;35(4):458-463

Department of Spine Surgery, Luohe Central Hospital, Luohe Henan, 462000, P.R.China.

Objective: To investigate the efficacy and safety of over-bending rod reduction and fixation technique via posterior approach in the treatment of unstable fresh thoracolumbar burst fracture.

Methods: A clinical data of 27 patients with unstable fresh thoracolumbar burst fracture, who were met the inclusive criteria and admitted between January 2018 and October 2019, was retrospectively analyzed. There were 15 males and 12 females with an average age of 41. Read More

Am J Transl Res 2021 15;13(3):1726-1733. Epub 2021 Mar 15.

Department of Rehabilitation Orthopedics, Affiliated Hospital of Gansu University of Traditional Chinese Medicine Lanzhou 730020, Gansu Province, China.

Objective: To investigate the effect of rehabilitation nursing combined with conservative therapy on patients undergoing compression fracture surgery.

Methods: 86 patients with compression fractures admitted to our hospital for rehabilitation from November 2018 to November 2019 were recruited as the study cohort. The patients were provided with conservative traditional Chinese medicine treatment along with rehabilitation methods such as rehabilitation nursing, lumbar pillows, and the prevention and cure of complications. Read More

J Pediatr Endocrinol Metab 2021 May 12;34(5):573-581. Epub 2021 Apr 12.

Pediatric Neurology Unit, Department of Pediatrics,APC, PGIMER, Chandigarh, India.

Objectives: Boys with Duchenne Muscular Dystrophy (DMD) are at increased risk for compromised bone health, manifesting as low-impact trauma long bone fractures and vertebral compression fractures.

Methods: In a prospective observational study, we studied bone health parameters in North Indian boys with DMD. We consecutively enrolled ambulatory boys with DMD on glucocorticoid therapy. Read More

J Am Acad Orthop Surg 2021 Apr 7. Epub 2021 Apr 7.

From the Department of Orthopaedics, University of California, Davis, Sacramento, CA.

Introduction: Despite guidelines recommending postfracture bone health workup, multiple studies have shown that evaluation and treatment of osteoporosis has not been consistently implemented after fragility fractures. The primary aim of this study was to evaluate rates of osteoporosis evaluation and treatment in adult patients after low-energy thoracolumbar vertebral compression fractures (VCFs).

Methods: We retrospectively reviewed all patients ≥60 years old presenting to a single academic trauma center with acute thoracolumbar VCFs after a ground-level fall from 2016 to 2020 . Read More