Treatment of pathologic spinal fractures with combined radiofrequency ablation and balloon kyphoplasty

<p>Abstract</p> <p>Background</p> <p>In oncologic patients with metastatic spinal disease, the ideal treatment should be well tolerated, relieve the pain, and preserve or restore the neurological function.</p> <p>The combination of fluoroscopic guided radiofrequency ablation (RFA) and kyphoplasty may fulfill these criteria.</p> <p>Methods</p> <p>We describe three pathological vertebral fractures treated with a combination of fluoroscopic guided RFA and kyphoplasty in one session: a 62-year-old man suffering from a painful L4 pathological fracture due to a plasmocytoma, a 68-year-old man with a T12 pathological fracture from metastatic hepatocellular carcinoma, and a 71-year-old man with a Th12 and L1 pathological fracture from multiple myeloma.</p> <p>Results</p> <p>The choice of patients was carried out according to the classification of Tomita. Visual analog score (VAS) and Oswestry disability index (ODI) were used for the evaluation of the functional outcomes. The treatment was successful in all patients and no complications were reported. The mean follow-up was 6 months. Marked pain relief and functional restoration was observed.</p> <p>Conclusion</p> <p>In our experience the treatment of pathologic spinal fractures with combined radiofrequency ablation and balloon kyphoplasty is safe and effective for immediate pain relief in painful spinal lesions in neurologically intact patients.</p

Acromioclavicular joint acceleration-deceleration injury as a cause of persistent shoulder pain : outcome after arthroscopic resection

Background: Shoulder pain in general and acromioclavicular joint (ACJ) pain specifically is common after acceleration-deceleration injury following road traffic accident (RTA). The outcome of surgical treatment in this condition is not described in the literature. The aim of the present study was to report the outcome of arthroscopic resection of the ACJ in these cases. Materials and Methods: Nine patients with localized ACJ pain, resistant to nonoperative treatment were referred on an average 18 months after the injury. There were 3 male and 6 females. The right shoulder was involved in seven patients and the left in two. The average age was 38.9 years (range 29-46 years). All presented with normal X-rays but with torn acromioclavicular joint disc and effusion on magnetic resonance imaging (MRI). Arthroscopic ACJ excision arthroplasty was performed in all patients. Results: At a mean followup of 18 month, all patients had marked improvement. The Constant score improved from 36 to 81, the pain score from 3/15 to 10/15 and the patient satisfaction improved from 3.5/10 to 9.3/10. Conclusion: Arthroscopic ACJ excision arthroplasty, gives good outcomes in patients not responding to conservative management in ACJ acceleration-deceleration injury

Persistent sciatica induced by quadratus femoris muscle tear and treated by surgical decompression: a case report

<p>Abstract</p> <p>Introduction</p> <p>Quadratus femoris tear is an uncommon injury, which is only rarely reported in the literature. In the majority of cases the correct diagnosis is delayed due to non-specific symptoms and signs. A magnetic resonance imaging scan is crucial in the differential diagnosis since injuries to contiguous soft tissues may present with similar symptoms. Presentation with sciatica is not reported in the few cases existing in the English literature and the reported treatment has always been conservative.</p> <p>Case presentation</p> <p>We report here on a case of quadratus femoris tear in a 22-year-old Greek woman who presented with persistent sciatica. She was unresponsive to conservative measures and so was treated with surgical decompression.</p> <p>Conclusion</p> <p>The correct diagnosis of quadratus muscle tear is a challenge for physicians. The treatment is usually conservative, but in cases of persistent sciatica surgical decompression is an alternative option.</p

Thoracolumbar Burst Fractures: A Systematic Review of Management

The management of thoracolumbar burst fractures remains challenging Ideally, it should effectively correct the deformity induce neurological recovery, allow early mobilization and return to work and be associated with minimal risk of complication. This article reviews the related studies reporting their clinical data for the management of thoracolumbar burst fractures, discusses the most suitable approach in cases such as these, highlights specific treatment recommendations, and proposes a treatment algorithm. Using PubMed and Scopus databases to search the term thoracolumbar burst fractures, abstracts and original articles in English investigating the treatment of thoracolumbar burst fractures were searched and analyzed