No abstract

BackgroundPercutaneous kyphoplasty (PKP) is widely applied for the treatment of osteoporotic vertebral compression fractures (OVCFs) and has achieved satisfactory clinical results. With the accumulation of clinical cases and prolonged follow-up times, the inability to reconstruct vertebral height defects has attracted more and more attention. A comparison of clinical effects was retrospectively reviewed in 72 patients who underwent simple PKP or pedicle in vitro restorer (PIVR) combined with PKP to discuss the clinical application of self-developed PIVR used in PKP.MethodsFrom August 2013 to August 2016, 72 patients with OVCFs were treated surgically, with 30 patients undergoing PKP (group A) and 42 undergoing PIVR combined with PKP (group B). Operation-related situations, radiological data, and related scores were compared between the two groups by corresponding statistical methods.ResultsBone cement was successfully injected into 72 vertebral bodies. Sixty-three cases were followed up for an average of 14 months. There were significant differences between the two groups in the improvement of the height of the vertebral body, sagittal Cobb angle, and visual analogue scale (VAS) 1 week after the operation (P < 0.05), and the improvements of group B were better than those in group A. The cement leakage ratio was significantly different between the two groups (P < 0.05). The Oswestry Disability Index (ODI) at last follow-up was significantly different between the two groups (P < 0.05). There was no significant difference in the incidence of recurrent vertebral fractures between the two groups at the last follow-up (P > 0.05).ConclusionPIVR combined with PKP can overcome the limitations of PKP alone, that is, hardly restoring vertebral height and height being easily lost again with balloon removal. The combined method can also restore the vertebral fractures to a satisfactory height and effectively maintain the stability of the spine, which improves the long-term quality of life of patients. Thus, PIVR combined with PKP is a better choice for patients with OVCFs.

No abstract

In the present study, a novel subaxial cervical pedicle screw placement guide device was designed and developed. In cervical specimens (C3-C7), a pedicle screw was inserted into the left pedicle using the guide device with a keyhole partial laminectomy and tapping technique, and the right pedicle by drilling using the Abumi technique. After removing the pedicle screws, the channel wall of each pedicle screw was probed with a pedicle probe. The vertebral body was then dissociated for direct observation of the screw channel. Among the 10 specimens, 2 of the 50 pedicles (4%) in the guide device group were perforated. Screw placement failed in 8 of 50 pedicles (16%) in the Abumi technique group. Significant differences were observed in the outcomes for the guide device and Abumi technique groups. The subaxial cervical pedicle screw placement guide device developed in the present study decreased the failure rate of pedicle screw placement.