Characteristic changes in spinopelvic parameters identified in patients with lumbar degenerative disc disease were a reduction in pelvic incidence, sacral slope and lumbar lordosis, with an increased pelvic tilt. These were found to correlate with MRI changes in surgically treated patients.
Increased age, extracapsular fractures and delayed surgery have worse outcomes. Regarding gender, even if not significant at the 0.05 level, probability of survival for females is higher for all time intervals. Updated, regional studies could be used in patient management to improve outcomes whilst decreasing costs.
Haemophilia is a hereditary disease due to a defect of the X chromosome, which determines a faulty production of coagulation factor VIII in haemophilia A (85% of cases) and factor IX in haemophilia B. Three degrees of severity can be distinguished: low, with a deficient factor concentration greater than 5% of normal values, medium, with a concentration between 1 and 5%, and severe, comprising more than half of haemophilia cases, with a concentration of factor VIII or factor IX under 1% of normal. The evolution of haemophilic arthropathy is almost always from haemarthrosis to chronic synovitis and extended erosions of the articular surface, culminating in the final stage of articular destruction-chronic haemophilic arthropathy. This paper analyses the results of the treatment applied to a lot of one hundred and ten patients operated inside the our country's sole Compartment of Osteo-Articular Surgery of haemophiliac patients within the Clinic No. 2 of Orthopaedics and Traumatology between 2001 and 2013. This compartment was founded in 2001, being included in the Romanian Health Ministry's programme for financing the treatment for haemophilia. Within the aforementioned time period, a total of 158 patients from the entire country were consulted. From these, 110 patients underwent a series of surgical procedures, 112 in total. The age interval of the studied lot was between 9 and 45 years, with a maximum between 11 and 20 years. With replacement therapy and correct surgical indication, osteoarticular surgery in haemophiliacs, performed in a specialized centre by a multidisciplinary team, can give good results with acceptable risks.
In our study on OVF, vertebroplasty delivered superior clinical and radiological outcomes over the first year from intervention when compared to conservative treatment of patients with osteoporotic compression fractures without neurological deficit. We believe that the possibility of evolution towards progressive kyphosis is sufficient to justify prophylactic and therapeutic intervention such as vertebroplasty, a minor gesture compared with extensive correction surgery and stabilization.
The main cause of mechanical complications was insufficient sagittal correction. To limit the risk of mechanical complications and to achieve a good sagittal balance, PSO must be associated with additional SPOs or a second corrective surgery to obtain a solid anterior fusion.
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