Background:The osteoporotic vertebral compression fractures (OVCF) have attracted more and more attention due to increase in life span globally and aging population. Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) have been popularized rapidly by virtue of their unique advantage in minimal invasiveness. We analysed our results in osteoporotic thoracolumbar fractures using percutaneous kyphoplasty and posterior screw rod system. To investigate the possibility of treatment of rupture of the posterior vertebral osteoporotic fractures by means of kyphoplasty combined with the posterior screw-rod system.Materials and Methods:Twenty six patients (65 years of age or older) with the single spine fractures included in study. The preoperative bone mineral density was measured by dual-energy X-ray. The PKP was done in all the cases. Decompression was done if neurological symptoms were present.Results:The results demonstrated osteoporosis with BMD T value ≤ −2.5; injured posterior vertebral body (3 cases) had shown the whole damage accompanied by neurological symptoms through X-ray or CT. After 2 days, the remaining patients of back pain symptoms were relieved or disappeared except for three cases of patients with decompression incision. VAS score and Cobb angle changed from preoperative 8.23 ± 0.17 and 28.7 ± 0.33° respectively to postoperative 3.77 ± 0.44 and 3.8 ± 0.2° respectively.Conclusion:Treatment of rupture of the posterior vertebral osteoporotic thoracolumbar fractures by means of kyphoplasty combined with posterior screw-rod system is a safe, effective procedure.

ObjectiveThis study aims to explore the efficacy and safety of posterior vertebral column resection (PVCR) in treating thoracolumbar spinal tuberculous angular kyphosis (TSTAK).MethodsFrom January 2008 to January 2012, 17 TSTAK patients were treated surgically, including five males and 12 females, with an average age of 23.6 years, among five cases who had the kyphotic apical vertebrae located at the thoracic vertebrae, ten cases were located at the thoracolumbar segment, and two cases were located at the lumbar vertebrae. The kyphotic Cobb angle was measured in the preoperative, postoperative, and final follow-up, respectively, and the nerve function ASIA classification was assessed.ResultsThe mean operative time was 364 min; the average intraoperative blood loss was 2,218 ml; and the average intraoperative blood transfusion was 1,863 ml. Among the five patients with the preoperative nerve function as grade D, four of them recovered to grade E. The preoperative average Cobb angle was 81.3° ± 12.8°, while the postoperative average Cobb average was 17.3° ± 3.6°; while it was significantly improved than the preoperative (P < 0.01), the average kyphosis correction rate was 68.7% ± 6.5%; the postoperative average follow-up was 18.7 months, with an average correction loss as 3.3°.ConclusionPVCR could be safely and effectively used in TSTAK.

Avascular necrosis of the lunate bone (Kienböck disease) is caused by loss of blood supply of the bone. This study aimed to evaluate the efficacy and safety of a novel nickel–titanium (Ni–Ti) memory alloy arthrodesis concentrator in the treatment of this disease.A consecutive 24 patients with stage IIIb aseptic lunate necrosis were treated with scapho-trapezio-trapezoeid (STT) arthrodesis using a Ni–Ti arthrodesis concentrator from August 2008 to December 2012. Wrist pain, grip strength, carpal height, and scapholunate angle were measured and compared before and after the surgery. The wrist functions were evaluated using the Mayo scale.Patients were followed up for a mean of 12 months (range, 6–24 months). Grip strength of the affected side was significantly improved after the surgery (18 ± 4.74 kg vs. 30.21 ± 7.14 kg, P < 0.0001). Wrist pain score was significantly decreased from 5.88 ± 0.9 to 0.5 ± 0.51 (P < 0.0001). Carpal height and Mayo score were also significantly increased after the surgery (P < 0.0001). Scapholunate angle was significantly decreased after the surgery (68.38 ± 7.28° vs. 49.91 ± 4.28°, P < 0.0001). No implant breakage, loose implant, wound infection, or nonunion occurred.STT arthrodesis is effective for the treatment of stage IIIb lunate necrosis. The Ni–Ti memory alloy arthrodesis concentrator is a convenient tool for STT arthrodesis with excellent and reliable results.

To investigate the mechanical and biomechanical properties of nickel-titanium (Ni-Ti) shape memory alloy scaphoid arc nail (NT-SAN) fixator as well as study the surgical method of treating carpal scaphoid fractures and evaluate its clinical efficacy. (1) Static and dynamic bending tests with embedded axial bending fixture were conducted to study the mechanical properties. (2) To evaluate biomechanical strength and fatigue, 32 scaphoid samples were classified into four groups to perform the fixation rigidity test: intramedullary Kirschner fixation (group A), Kirschner straddle nail fixation (group B), screw nail fixation (group C), and NT-SAN fixation (group D). Next, 24 scaphoid waist fracture models were classified to conduct fatigue experiments as follows: Kirschner straddle nail fixation (group E), screw nail fixation (group F), and NT-SAN fixation (group G). (3) The Krimmer score chart was used for clinical evaluations.(1) NT-SAN showed excellent mechanical performance and a long lifespan.(2) NT-SAN was fixated with a strong intensity and an anti-fatigue outcome.(3) Ninety-eight interviewed patients were satisfied with the therapeutic effects of the arc nail (satisfaction rate: 95.92%). The designed strength and hardness of NT-SAN corresponded with the anatomical characteristics of the scaphoid, and the designed mechanical properties met the biomechanical requirements of a scaphoid fracture. The fatigue strength can meet the requirements of bone healing after the scaphoid fracture. Clinical trials on NT-SAN scaphoid fracture treatment have shown that the surgery is simple and the clinical results are satisfactory. The therapeutic level of NT-SAN is III; thus, it is worth promoting.