149 research outputs found
ΠΠΈΠ·Π½Π°ΡΠ΅Π½Π½Ρ Π²Π°Π»ΡΠΏΡΠΎΡΠ²ΠΎΡ ΠΊΠΈΡΠ»ΠΎΡΠΈ Ρ ΠΊΡΠΎΠ²Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΡΠ΅Π°ΠΊΡΡΠΉΠ½ΠΎΡ Π²ΠΈΡΠΎΠΊΠΎΠ΅ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡ ΡΡΠ΄ΠΈΠ½Π½ΠΎΡ Ρ ΡΠΎΠΌΠ°ΡΠΎΠ³ΡΠ°ΡΡΡ
ΠΠ΄ΡΠΉΡΠ½Π΅Π½Π° Π²Π·Π°ΡΠΌΠΎΠ΄ΡΡ Π²Π°Π»ΡΠΏΡΠΎΡΠ²ΠΎΡ ΠΊΠΈΡΠ»ΠΎΡΠΈ Π· 3-(2'-Π±ΡΠΎΠΌΠ°ΡΠ΅ΡΠΈΠ»)-7-ΠΌΠ΅ΡΠΎΠΊΡΠΈΠΊΡΠΌΠ°ΡΠΈΠ½ΠΎΠΌ Ρ ΡΠΎΠ·ΡΠΎΠ±Π»Π΅Π½ΠΎ ΡΡ Π²ΠΈΠ·Π½Π°ΡΠ΅Π½Π½Ρ Ρ ΠΊΡΠΎΠ²Ρ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΡΠ΅Π°ΠΊΡΡΠΉΠ½ΠΎΡ Π²ΠΈΡΠΎΠΊΠΎΠ΅ΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΡ ΡΡΠ΄ΠΈΠ½Π½ΠΎΡ Ρ
ΡΠΎΠΌΠ°ΡΠΎΠ³ΡΠ°ΡΡΡ. ΠΠΈΠ²ΡΠ΅Π½ΠΈΠΉ Π²ΠΏΠ»ΠΈΠ² ΡΡΠ·Π½ΠΈΡ
ΠΌΠ΅ΡΠΎΠ΄ΡΠ² Π΄Π΅ΠΏΡΠΎΡΠΎΡΠ½ΡΠ·Π°ΡΡΡ Π½Π° Π²ΠΈΠ²ΡΠ»ΡΠ½Π΅Π½Π½Ρ Π²Π°Π»ΡΠΏΡΠΎΡΠ²ΠΎΡ ΠΊΠΈΡΠ»ΠΎΡΠΈ ΡΠ° ΠΎΠΏΡΠΈΠΌΡΠ·ΠΎΠ²Π°Π½Ρ ΡΠΌΠΎΠ²ΠΈ ΠΏΡΠΎΠ±ΠΎΠΏΡΠ΄Π³ΠΎΡΠΎΠ²ΠΊΠΈ.ΠΡΡΡΠ΅ΡΡΠ²Π»Π΅Π½ΠΎ Π²Π·Π°ΠΈΠΌΠΎΠ΄Π΅ΠΉΡΡΠ²ΠΈΠ΅ Π²Π°Π»ΡΠΏΡΠΎΠ΅Π²ΠΎΠΉ ΠΊΠΈΡΠ»ΠΎΡΡ Ρ 3-(2'-Π±ΡΠΎΠΌΠ°ΡΠ΅ΡΠΈΠ»)-7-ΠΌΠ΅ΡΠΎΠΊΡΠΈΠΊΡΠΌΠ°ΡΠΈΠ½ΠΎΠΌ ΠΈ ΡΠ°Π·ΡΠ°Π±ΠΎΡΠ°Π½ΠΎ Π΅Π΅ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½ΠΈΠ΅ Π² ΠΊΡΠΎΠ²ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΡΠ΅Π°ΠΊΡΠΈΠΎΠ½Π½ΠΎΠΉ Π²ΡΡΠΎΠΊΠΎΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎΠΉ ΠΆΠΈΠ΄ΠΊΠΎΡΡΠ½ΠΎΠΉ Ρ
ΡΠΎΠΌΠ°ΡΠΎΠ³ΡΠ°ΡΠΈΠΈ. ΠΠ·ΡΡΠ΅Π½ΠΎ Π²Π»ΠΈΡΠ½ΠΈΠ΅ ΡΠ°Π·Π»ΠΈΡΠ½ΡΡ
ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π΄Π΅ΠΏΡΠΎΡΠ΅ΠΈΠ½ΠΈΠ·Π°ΡΠΈΠΈ Π½Π° Π²ΡΡ
ΠΎΠ΄Ρ Π²Π°Π»ΡΠΏΡΠΎΠ΅Π²ΠΎΠΉ ΠΊΠΈΡΠ»ΠΎΡΡ ΠΈ ΠΎΠΏΡΠΈΠΌΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Ρ ΡΡΠ»ΠΎΠ²ΠΈΡ ΠΏΡΠΎΠ±ΠΎΠΏΠΎΠ΄Π³ΠΎΡΠΎΠ²ΠΊΠΈ.The interaction of the valproic acid with 3-(2'-bromoacetyl)-7-methoxicoumarin has been carried out and its determination in blood by the reaction high performance liquid chromatography method has been developed. The influence of various methods of deproteinization on the yields of the valproic acid has been studied and the conditions of the sample preparing has been optimized
Π‘Ρ Π΅ΠΌΠΎΡΠ΅Ρ Π½ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΌΠΎΠ΄Π΅Π»ΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ ΠΈ ΡΠΈΠ½ΡΠ΅Π· Π°ΠΊΡΠΈΠ²Π½ΡΡ Π‘ΠΠ§-ΡΠΈΠ»ΡΡΡΠΎΠ² Π½Π° ΠΏΠΎΠ»Π΅Π²ΡΡ ΡΡΠ°Π½Π·ΠΈΡΡΠΎΡΠ°Ρ Π¨ΠΎΡΡΠΊΠΈ
Π Π°Π·ΡΠ°Π±ΠΎΡΠ°Π½Ρ ΡΡ
Π΅ΠΌΡ Π°ΠΊΡΠΈΠ²Π½ΡΡ
Π‘ΠΠ§-ΡΠΈΠ»ΡΡΡΠΎΠ², ΠΏΡΠΈΠ³ΠΎΠ΄Π½ΡΡ
Π΄Π»Ρ ΠΈΡΠΏΠΎΠ»Π½Π΅Π½ΠΈΡ Π² Π²ΠΈΠ΄Π΅ Π³ΠΈΠ±ΡΠΈΠ΄Π½ΠΎΠΉ ΠΈΠ»ΠΈ ΠΏΠΎΠ»ΡΠΏΡΠΎΠ²ΠΎΠ΄Π½ΠΈΠΊΠΎΠ²ΠΎΠΉ ΠΌΠΈΠΊΡΠΎΡΡ
Π΅ΠΌΡ
ΠΡΠΎΠΌΠ°Π΄ΡΡΠΊΠ° ΡΠΎΠ±ΠΎΡΠ° ΡΠΊ ΡΠΈΠ½Π½ΠΈΠΊ ΠΏΠΎΠ²ΡΡΠΊΠ΄Π΅Π½Π½ΠΎΠ³ΠΎ ΠΆΠΈΡΡΡ Π²ΡΠΈΡΠ΅Π»Ρ
Treatment and reconstruction of large bone defects, delayed unions, and nonunions is challenging and has resulted in an ongoing search for novel tissue-engineered therapies. Bone morphogenetic protein-2 (BMP-2) gene therapy is a promising strategy to provide sustained production of BMP-2 locally. Alginate polymer-based nonviral gene therapy with BMP-2 plasmid DNA (pBMP-2) in constructs with multipotent mesenchymal stromal cells (MSCs) has resulted in prolonged gene expression and bone formation in vivo. To further translate this technology toward larger animal models, important issues remain to be investigated, such as the necessity of seeded cells as a target for gene therapy. For that purpose, a large animal-screening model in an orthotopic location, with fully separated chambers, was investigated. Four cylinder-shaped implants were placed in the iliac crests of ten goats. Polycaprolactone tubes around each implant allowed bone ingrowth from the underlying bone and bone marrow and ensured separation of the experimental conditions. An empty tube showed low levels of spontaneous bone ingrowth, and implantation of autologous bone indicated proper bone function with respect to remodeling and resorption. Control ceramic scaffolds were compared to scaffolds containing pBMP-2 either or not combined with seeded MSCs. Fluorochrome incorporation evaluated at 3, 6, and 9 weeks and histomorphometry at 12 weeks after implantation revealed clear differences between the groups, with pBMP-2 combined with MSCs being the most effective. The BMP-2 was demonstrated in a variety of bone-residing cells through immunohistochemistry. Further analysis indicated that multinucleated giant cells might have an important role in transgene expression. Taken together, this work introduces a large animal model for studying bone formation at multiple sites simultaneously in an orthotopic location. The model appeared robust, showed no neighboring effects, and demonstrated effectivity of combined cell and gene therapy
Π£ΡΠΎΠ²Π΅Π½Ρ ΠΏΡΠΎΠ²ΠΎΡΠΏΠ°Π»ΠΈΡΠ΅Π»ΡΠ½ΡΡ ΡΠΈΡΠΎΠΊΠΈΠ½ΠΎΠ² Π²Π½ΡΡΡΠΈΠΌΠ°ΡΠΎΡΠ½ΡΡ ΡΠΌΡΠ²ΠΎΠ² ΠΏΡΠΈ Π³ΠΈΠΏΠ΅ΡΠΏΠ»Π°Π·ΠΈΡΡ ΡΠ½Π΄ΠΎΠΌΠ΅ΡΡΠΈΡ
ΠΡΠΎΠ²Π΅Π΄Π΅Π½ΠΎ Π²ΠΈΠ²ΡΠ΅Π½Π½Ρ Π·ΠΌΡΠ½ ΡΡΠ²Π½Ρ ΠΏΡΠΎΠ·Π°ΠΏΠ°Π»ΡΠ½ΠΈΡ
ΡΠΈΡΠΎΠΊΡΠ½ΡΠ² ΠΠ -1Γ, ΠΠ -6 ΡΠ° Π€ΠΠ-Ξ± Π² ΠΌΠ°ΡΠΊΠΎΠ²ΠΈΡ
Π·ΠΌΠΈΠ²Π°Ρ
Ρ
ΠΆΡΠ½ΠΎΠΊ Π· ΡΡΠ·Π½ΠΈΠΌΠΈ Π²ΠΈΠ΄Π°ΠΌΠΈ Π³ΡΠΏΠ΅ΡΠΏΠ»Π°Π·ΡΠΉ Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΡΡ. ΠΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ΠΎ, ΡΠΎ ΡΠΎΡΠΌΡΠ²Π°Π½Π½Ρ Π³ΡΠΏΠ΅ΡΠΏΠ»Π°Π·ΡΡ Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΡΡ
ΡΡΠΏΡΠΎΠ²ΠΎΠ΄ΠΆΡΡΡΡΡΡ Π°ΠΊΡΠΈΠ²Π°ΡΡΡΡ ΠΏΡΠΎΠ·Π°ΠΏΠ°Π»ΡΠ½ΠΈΡ
ΡΠΈΡΠΎΠΊΡΠ½ΡΠ². ΠΠ°ΠΉΠ±ΡΠ»ΡΡ Π²ΠΈΡΠ°ΠΆΠ΅Π½Ρ Π·ΠΌΡΠ½ΠΈ Π²ΠΈΡΠ²Π»Π΅Π½Ρ ΠΏΡΠΈ ΠΊΠΎΠΌΠΏΠ»Π΅ΠΊΡΠ½ΡΠΉ
Π³ΡΠΏΠ΅ΡΠΏΠ»Π°Π·ΡΡ Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΡΡ. ΠΠ°ΠΏΠ°Π»ΡΠ½ΠΈΠΉ ΠΏΡΠΎΡΠ΅Ρ Π² ΡΡΠΎΠ³Π΅Π½ΡΡΠ°Π»ΡΠ½ΠΎΡ ΡΠΈΡΡΠ΅ΠΌΡ ΡΠΏΡΠΈΡΡ Π±ΡΠ»ΡΡ Π²ΠΈΡΠ°ΠΆΠ΅Π½ΠΎΠΌΡ Π·ΡΠΎΡΡΠ°Π½Π½Ρ ΡΡΠ²Π½Ρ
ΡΠΈΡΠΎΠΊΡΠ½ΡΠ² Π² ΠΌΠ°ΡΠΊΠΎΠ²ΠΈΡ
Π·ΠΌΠΈΠ²Π°Ρ
. ΠΡΡΠ½ΠΊΠ° Π²ΠΈΡΠ°ΠΆΠ΅Π½ΠΎΡΡΡ Π·ΠΌΡΠ½ Π² ΡΡΠ²Π½Ρ ΡΠΈΡΠΎΠΊΡΠ½ΡΠ² ΠΌΠ°ΡΠΊΠΎΠ²ΠΈΡ
Π·ΠΌΠΈΠ²ΡΠ² ΠΌΠΎΠΆΠ΅ Π²ΠΈΠΊΠΎΡΠΈΡΡΠΎΠ²ΡΠ²Π°ΡΠΈΡΡ
Π² ΡΠΊΠΎΡΡΡ Π΄ΠΎΠ΄Π°ΡΠΊΠΎΠ²ΠΎΠ³ΠΎ ΠΊΡΠΈΡΠ΅ΡΡΡ, ΡΠΎ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΠ·ΡΡ Π³ΡΠΏΠ΅ΡΠΏΠ»Π°Π·ΡΡ Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΡΡ, Π΄Π»Ρ ΠΎΡΡΠ½ΠΊΠΈ ΡΠΎΡΠΌΡΠ²Π°Π½Π½Ρ Π·Π°ΠΏΠ°Π»ΡΠ½ΠΈΡ
Π·ΠΌΡΠ½ Π² Π΅Π½Π΄ΠΎΠΌΠ΅ΡΡΡΡ ΠΏΡΠΈ ΠΉΠΎΠ³ΠΎ Π³ΡΠΏΠ΅ΡΠΏΠ»Π°Π·ΡΡ Ρ Π΄Π»Ρ ΠΎΡΡΠ½ΠΊΠΈ ΠΏΡΠΎΠ³Π½ΠΎΠ·Ρ ΠΏΠ΅ΡΠ΅Π±ΡΠ³Ρ Π³ΡΠΏΠ΅ΡΠΏΠ»Π°Π·ΡΠΉ.Levels of proinflammatory cytokines IL-1Γ, IL-6 and TNF-Ξ± in uterine lavage fluid of women with different
types of endometrial hyperplasia were studied. It is established that the formation of endometrial hyperplasia
is associated with activation of proinflammatory cytokines. The most intensive changes were found in complex
endometrial hyperplasia. Inflammation in the urogenital system leads to more intensive increase of cytokines
level in the uterine washout. Investigation of changes in cytokines levels in uterine lavage fluid can be used as an
additional criterion for characteristics of endometrial hyperplasia, to assess the formation of inflammatory changes
in the endometrium and for prognosis of hyperplasia
Reliability and Validity of the German Version of the AO Spine Patient Reported Outcome Spine Trauma Questionnaire.
STUDY DESIGN
A single-center validation study.
OBJECTIVE
To translate and cross-culturally adapt the AO Spine PROST (Patient Reported Outcome Spine Trauma) into German, and to test its psychometric properties among German-speaking Swiss spine trauma patients.
METHODS
Patients were recruited from a level-1 Swiss trauma center. Next to the AO Spine PROST, the EQ-5D-3L questionnaire was used for concurrent validity. Questionnaires were filled out at two-time points for test-retest reliability. Patient characteristics were analyzed using descriptive statistics. For content validity, floor, and ceiling effects, as well as any irrelevant and missing questions were analyzed. Construct validity of the AO Spine PROST questionnaire to the EQ-5D-3L was tested using Spearman correlation tests.
RESULTS
The AOSpine PROST was translated and adapted into German using established guidelines. We included 179 patients. The floor effect for all items was well within the optimal range (below 15%), while the ceiling effect of seven items was within the optimal range. None of the items displayed a problematic floor or ceiling effect. The overall test-retest reliability of the total PROST score was excellent, with an ICC of .83 (95% CI .69-.91). The Spearman correlation coefficient between the total PROST summary score and EQ-5D-3Β L was Ο = .63.
CONCLUSIONS
The German version of the AO Spine PROST questionnaire demonstrated very good validity and reliability results
ΠΠΎΡΡΠ΅ΠΊΡΠΈΡ ΡΠΎΡΡΠΎΡΠ½ΠΈΡ ΠΈΠΌΠΌΡΠ½Π½ΠΎΠΉ ΡΠΈΡΡΠ΅ΠΌΡ ΠΊΡΡΡ Ρ Π°Π΄ΡΡΠ²Π°Π½ΡΠ½ΡΠΌ Π°ΡΡΡΠΈΡΠΎΠΌ Π²Π²Π΅Π΄Π΅Π½ΠΈΠ΅ΠΌ Π»ΠΈΠΏΠΈΠ΄Π½ΠΎΠΉ ΡΡΠ°ΠΊΡΠΈΠΈ ΠΏΠ»Π°ΡΠ΅Π½ΡΡ
ΠΠ²Π΅Π΄Π΅Π½Π½Ρ Π»ΡΠΏΡΠ΄Π½ΠΎΡ ΡΡΠ°ΠΊΡΡΡ ΠΏΠ»Π°ΡΠ΅Π½ΡΠΈ, ΠΎΡΡΠΈΠΌΠ°Π½ΠΎΡ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΊΡΡΠΎΠ³Π΅Π½Π½ΠΎΠ³ΠΎ ΠΌΠΎΠ»Π΅ΠΊΡΠ»ΡΡΠ½ΠΎΠ³ΠΎ ΡΡΠ°ΠΊΡΡΠΎΠ½ΡΠ²Π°Π½Π½Ρ, Π½Π° ΡΠΎΠ½Ρ ΡΠΎΠ·Π²ΠΈΡΠΊΡ Π°Π΄βΡΠ²Π°Π½ΡΠ½ΠΎΠ³ΠΎ Π°ΡΡΡΠΈΡΡ ΠΎΠΊΠ°Π·ΡΡ ΠΊΠΎΡΠ΅Π³ΡΡΡΠΈΠΉ Π²ΠΏΠ»ΠΈΠ² Ρ Π²ΡΠ΄Π½ΠΎΡΠ΅Π½Π½Ρ ΡΠΊ Π²ΠΌΡΡΡΡ, ΡΠ°ΠΊ Ρ ΡΡΠ½ΠΊΡΡΠΎΠ½Π°Π»ΡΠ½ΠΎΡ Π°ΠΊΡΠΈΠ²Π½ΠΎΡΡΡ ΡΠ΅Π³ΡΠ»ΡΡΠΎΡΠ½ΠΈΡ
Π’-ΠΊΠ»ΡΡΠΈΠ½ ΡΠ΅Π³ΡΠΎΠ½Π°Π»ΡΠ½ΠΈΡ
Π»ΡΠΌΡΠΎΠ²ΡΠ·Π»ΡΠ², ΡΠΎ ΠΏΡΠΈΠ·Π²ΠΎΠ΄ΠΈΡΡ Π΄ΠΎ Π·Π½ΠΈΠΆΠ΅Π½Π½Ρ ΡΠ½ΡΠ΅Π½ΡΠΈΠ²Π½ΠΎΡΡΡ ΠΊΠ»ΡΠ½ΡΡΠ½ΠΈΡ
ΠΎΠ·Π½Π°ΠΊ Π·Π°Ρ
Π²ΠΎΡΡΠ²Π°Π½Π½Ρ.Injection of placental lipid fraction obtained by cryogenic molecular fractionation method on the background of adjuvant arthritis development has a correcting influence in relation to both content and functional activity of regulatory T-cells of regional lymph nodes which leads to a decrease in intensity of clinical signs of the disease
Injuries related to bicycle accidents: an epidemiological study in The Netherlands
Background: This study aims to analyze the incidence and outcomes of bicycle-related injuries in hospitalized patients in The Netherlands. Methods: Bicycle accidents resulting in hospitalization in a level-I trauma center in The Netherlands between 2007 and 2017 were retrospectively identified. We subcategorized data of patients involved in a regular bicycle, race bike, off-road bike or e-bike accident. The primary outcomes were mortality rate and incidence of multitrauma. Secondary outcomes were differences between bicycle subcategories. Independent risk factors were identified using multivariable logistic regression. All variables with a p value < 0.20 in univariable analysis were entered in multivariable analysis. Results: We identified 1986 patients. The mortality rate after emergency room admission was 5.7%, and 41.0% were multitraumas. A higher age, multitrauma and cerebral haemorrhages were independent risk factors for in hospital mortality. Independent risk factors found for multitrauma were a higher age, two-sided trauma, e-bike accidents and cerebral haemorrhage. Conclusion: Bicycle accidents resulting in hospitalization have a high mortality rate. Furthermore, a high incidence of multitrauma, fractures and cerebral haemorrhages were found. Considering the increasing incidence of bicycle accident victims needing hospital admission, new and more efficient prevention strategies are essential
Clinical, radiological, and patient-reported outcomes 13Β years after pedicle screw fixation with balloon-assisted endplate reduction and cement injection
Purpose: In management of traumatic thoracolumbar burst fractures, short-segment pedicle screw fixation with balloon-assisted endplate reduction (BAER) and cement injection is a safe, feasible, and effective technique to maintain radiological alignment with minimum spinal segments involved. However, 20% of patients report daily discomfort despite good spinal alignment and fusion after this technique. This study provides clinical, radiological, and patient-reported outcomes after a minimum 13Β years of follow-up. Methods: Eighteen patients were invited at the outpatient clinic for clinical/radiological examinations. The cohort (originally 20 patients) was treated 13β14Β years earlier with pedicle screw fixation, BAER, and cement injection for traumatic thoracolumbar burst fractures. Patient-reported outcome measures were obtained at time of examinations. Current data were compared with data obtained at 6Β years of follow-up. Results: Seventeen patients (median age 50; range 32β80) cooperated. No/minimal back pain was reported by 15 patients, and 12 patients returned to their previous heavy labor work. Median visual analog score of health (80%; 50β100%) was similar to results at 6Β years (80%; 60β100% p = 0.259). An Oswestry Disability Index score of less than 20% (reflecting minimal disability) was reported by 14 patients, compared with 15 patients at 6Β years of follow-up. No significant differences were found in wedge or Cobb angle between the time points. Intravertebral cement resorption was not observed. Conclusion: Results from this study suggest that, 13Β years after pedicle screw fixation with BAER and cement injection for traumatic thoracolumbar burst fractures, functional performance, pain and radiological outcomes of the current cohort were stable or had slightly improved. Graphic abstract: These slides can be retrieved under Electronic Supplementary Material.[Figure not available: see fulltext.]
Sacral Fractures and Associated Injuries.
STUDY DESIGN: Literature review.
OBJECTIVE: The aim of this review is to describe the injuries associated with sacral fractures and to analyze their impact on patient outcome.
METHODS: A comprehensive narrative review of the literature was performed to identify the injuries associated with sacral fractures.
RESULTS: Sacral fractures are uncommon injuries that result from high-energy trauma, and that, due to their rarity, are frequently underdiagnosed and mistreated. Only 5% of sacral fractures occur in isolation. Injuries most often associated with sacral fractures include neurologic injuries (present in up to 50% of sacral fractures), pelvic ring disruptions, hip and lumbar spine fractures, active pelvic/ abdominal bleeding and the presence of an open fracture or significant soft tissue injury. Diagnosis of pelvic ring fractures and fractures extending to the lumbar spine are key factors for the appropriate management of sacral fractures. Importantly, associated systemic (cranial, thoracic, and abdominopelvic) or musculoskeletal injuries should be promptly assessed and addressed. These associated injuries often dictate the management and eventual outcome of sacral fractures and, therefore, any treatment algorithm should take them into consideration.
CONCLUSIONS: Sacral fractures are complex in nature and often associated with other often-missed injuries. This review summarizes the most relevant associated injuries in sacral fractures and discusses on their appropriate management
Surgical treatment of traumatic fractures of the thoracic and lumbar spine: A systematic review
Introduction: The treatment of traumatic thoracic and lumbar spine fractures remains controversial. To date no consensus exists on the correct choice of surgical approach and technique. Research question: to provide a comprehensive up-to-date overview of the available different surgical methods and their quantified outcomes. Methods: PubMed and EMBASE were searched between 2001 and 2020 using the term βspinal fracturesβ. Inclusion criteria were: adults, β₯10 cases, β₯12 months follow-up, thoracic or lumbar fractures, and surgery <3 weeks of trauma. Studies were categorized per surgical technique: Posterior open (PO), posterior percutaneous (PP), stand-alone vertebral body augmentation (SA), anterior scopic (AS), anterior open (AO), posterior percutaneous and anterior open (PPAO), posterior percutaneous and anterior scopic (PPAS), posterior open and anterior open (POAO) and posterior open and anterior scopic (POAS). The PO group was used as a reference group. Results: After duplicate removal 6042 articles were identified. A total of 102 articles were Included, in which 137 separate surgical technique cohorts were described: PO (n = 75), PP, (n = 39), SA (n = 12), AO (n = 5), PPAO (n = 1), PPAS (n = 1), POAO (n = 2) and POAS (n = 2). Discussion and conclusion: For type A3/A4 burst fractures, without severe neurological deficit, posterior percutaneous (PP) technique seems the safest and most feasible option in the past two decades. If needed, PP can be combined with anterior augmentation to prevent secondary kyphosis. Furthermore, posterior open (PO) technique is feasible in almost all types of fractures. Also, this technique can provide for an additional posterior decompression or fusion. Overall, no neurologic deterioration was reported following surgical intervention
- β¦