tailieunhanh - báo cáo hóa học:" Kyphoplasty in osteoporotic vertebral compression fractures - Guidelines and technical considerations"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học quốc tế đề tài : Kyphoplasty in osteoporotic vertebral compression fractures - Guidelines and technical considerations | Robinson et al. Journal of Orthopaedic Surgery and Research 2011 6 43 http content 6 1 43 JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH REVIEW Open Access Kyphoplasty in osteoporotic vertebral compression fractures - Guidelines and technical considerations Yohan Robinson1 Christoph E Heyde2 Peter Forsth1 and Claes Olerud1 Abstract Osteoporotic vertebral compression fractures are a menace to the elderly generation causing diminished quality of life due to pain and deformity. At first conservative treatment still is the method of choice. In case of resulting deformity sintering and persistent pain vertebral cement augmentation techniques today are widely used. Open correction of resulting deformity by different types of osteotomies addresses sagittal balance but has comparably high morbidity. Besides conventional vertebral cement augmentation techniques balloon kyphoplasty has become a popular tool to address painful thoracic and lumbar compression fractures. It showed improved pain reduction and lower complication rates compared to standard vertebroplasty. Interestingly the results of two placebo-controlled vertebroplasty studies question the value of cement augmentation if compared to a sham operation. Even though there exists now favourable data for kyphoplasty from one randomised controlled trial the absence of a sham group leaves the placebo effect unaddressed. Technically kyphoplasty can be performed with a transpedicular or extrapedicular access. Polymethyl methacrylate PMMA -cement should be favoured since calcium phosphate cement showed inferior biomechanical properties and less effect on pain reduction especially in less stable burst fractures. Common complications of kyphoplasty are cement leakage and adjacent segment fractures. Rare complications are toxic PMMA-monomer reactions cement embolisation and infection. Keywords Kyphoplasty vertebroplasty osteoporosis spinal fractures Introduction Osteoporosis and pathological osteoporotic .

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