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Clinical Research of Pre-Hospital Emergency Care, Nursing, Infection Prevention and Control for Senile osteoporotic vertebral compression fracture during Epidemic Period

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Open Journal of Preventive Medicine 2022年第12期12卷 249-257页

作者： Ying Zhang Xinming Yang Yanlin Yin Peinan Zhang The First Affiliated Hospital of Heibei North University Zhangjiakou China

Background: Novel coronavirus pneumonia (NCP) and osteoporotic vertebral compression fractures (OVCF) are the high incidences of diseases in the elderly. During the epidemic period, if not treated in time, the complications are high and the mortality is high. If we do not pay attention to infection prevention and control in pre-hospital emergency care, it will lead to the first time infection of medical staff and in-hospital cross infection in emergency outpatient receiving area. The correct consideration of both and the establishment of perfect pre-hospital emergency treatment and infection prevention and control synchronous strategy is an important premise to ensure the stable, orderly and safe medical treatment. Objective: To explore the effect of synchronous implementation of pre-hospital emergency care, nursing and infection pre-vention and control for senile OVCF during the epidemic. In order to improve the efficiency of pre-hospital emergency care and prevent the spread of infection. Method: A total of 92 elderly patients with OVCF who received pre-hospital treatment in 18 hospitals in Zhangjiakou City during the epidemic prevention and control period from January 2020 to November 2022 and met the inclusion criteria were selected as research objects, including 24 males and 68 females, aged 65 - 82 (74.2 ± 2.2) years. All patients were associated with concomitant injuries and underlying diseases. All patients in this group underwent predictive pre-hospital rescue and infection prevention and control procedures. Results: All the 92 elderly patients with OVCF received timely pre-hospital treatment during the epidemic period, and no aggravation occurred of the 92 patients, 35 were in the high risk area, 10 were in the medium risk area, and 47 were in the low risk area. Exclude OVCF for NCP Patients were treated according to the conventional diagnosis and treatment principles. Suspected and confirmed cases are transferred to designated surgical hospitals for treatment. All patients were followed up 3 months, 6

关键词： Novel Coronavirus Pneumonia osteoporotic vertebral compression fracture Pre-Hospital First Aid On-Site Treatment Epidemic Risk Assessment Screening Process Infection Prevention and Control Synchronization

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The impact of endplate fracture on postoperative vertebral height loss and kyphotic deformity during treatment of osteoporotic vertebral compression fractures with balloon kyphoplasty

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The Journal of Biomedical Research 2016年第5期30卷 419-426页

作者： Qingqing Li Long Xiao Jianwei Zhang Jin Fan Wei Zhou Guoyong Yin Yongxin Ren Department of Orthopaedics The First Affiliated Hospital of Nanjing Medical University Department of Orthopaedics The Third Affiliated Hospital of Nanjing University of Chinese Medicine

This retrospective study investigated the impact of endplate fracture on postoperative vertebral height loss and kyphotic deformity in 144 patients with osteoporotic vertebral compression fracture （OVCF）, who received balloon kyphoplasty. Patients were divided into four groups： Group 1 had no superior endplate fracture, Group 2 had fractures on the anterior portion of the superior endplate, Group 3 had fractures on the posterior portion of the superior endplate, and Group 4 had complete superior endplate fractures. Anterior and middle vertebral body height, vertebral compression ratio, vertebral height loss rate, and kyphosis Cobb angle of each patient were measured and visual analogue scale （VAS） and Oswestry disability index （ODI） scores were recorded. The anterior vertebral height and kyphosis deformity of all groups significantly improved after the surgery, whereas substantial anterior vertebral height loss and increased Cobb angle were observed in all patients at the last follow-up. Although the vertebral height loss rate and the Cobb angle in Group 2, 3 and 4 were larger compared with Group 1 at the last follow-up, only the vertebral height loss rate in Group 4 and the increase in the Cobb angle in Group 2 and 4 were statistically different from those in Group 1. The VAS and ODI scores in all groups measured after the surgery and at the last follow-up were significantly lower compared with preoperative scores, but there was no significant difference among these groups. Balloon kyphoplasty significantly improved vertebral fracture height and kyphosis. vertebral height loss and increased kyphotic deformity were observed in OVCF patients with endplate fractures after the surgery. Postoperative aggravation of kyphosis was observed in Group 2. Furthermore, severe vertebral height loss and increased kyphotic deformity were confirmed in Group 4 after the surgery. Our results suggested that postoperative vertebral height loss and aggravation of kyphosis may be associated with biomechanical changes in the vertebral

关键词： osteoporotic vertebral compression fracture balloon kyphoplasty endplate fracture height loss kyphosis

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Effect of osteoporotic vertebral compression fracture on Adjacent Intervertebral Disc Degeneration

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Journal of Clinical and Nursing Research 2020年第6期4卷 71-74页

作者： Tuanmao Guo Yanli Xing Zhongning Chen Haiyun Zhu Department of Othopedics Xianyang Central HospitalXianyang 712000China Department of Plarmacy Xianyang Central HospitalXianyang 712000China

Objective:The influence of vertebral compression fracture on the degeneration of adjacent disc was analyzed.Methods:88 patients with osteoporotic vertebral compression fractures admitted to the orthopedic pain department from July 2014 to July 2019 were selected as the research objects.According to the previous MRI and the improved MRI results of admission,the patients were converted into old fractures after conservative treatment.They were followed up in 3,6 and 12 months after discharge,and the VAS score at each time point(visual acuity score)was calculated We collected and analyzed the classifcation of intervertebral disc degeneration and MRI index.Results:The follow-up rate was 659%(58/88);There were 42 cases(72.4%)of degenerative disc adjacent to the diseased vertebra,and 16 cases(27.5%)of adjacent intervertebral disc did not degenerate;VAS scores were 1ower at 14 days,3 months,6 months and 12 months after admission;The number of grade 1 of disc degeneration was lower in 6 months and 12 months than that in admission(P0.05);MRI index at 6 and 12 months follow-up was lower than that at admission(Posteoporotic vertebral compression fracture will have a corresponding impact on the adjacent intervertebral disc,which can make the adjacent intervertebral disc degenerate.

关键词： osteoporotic vertebral compression fracture Adjacent to intervertebral disc Degeneration Influence

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Sequential therapy with zoledronic acid and teriparatide for osteoporotic vertebral compression fracture:case report and review of literature

Sequential therapy with zoledronic acid and teriparatide for...

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2016年浙江省骨科学学术年会

作者：徐三中张益均余列道沈淼达林向进浙江大学医学院附属第一医院骨科

Despite the existence of numerous case series,no evidenced-based medical management for osteoporotic vertebral compression fracture has been established.We report the outcome of zoledronic acid administration followed by teriparatide in an elder woman with painful osteoporotic vertebral compression fracture.Twelve months later,the patient experienced complete pain relief and function improvement.Bone mineral density testing revealed increase of 33.3%at the lumbar spine.Plain radiographs of the thoracolumbar spine revealed fracture totally healing with vertebral body of T12 in high density.During the therapy,the βisomer of C-terminal telopeptide of type I collagen decreased significantly with zoledronic acid injection while the N-terminal propeptide of typelcollagen increased significantly after 6 months of teriparatide administration.Our case indicated that sequential therapy with teriparatide following zoledronic acid in cases of osteoporotic vertebral compression fracture might be a rational treatment option.

关键词： sequential therapy osteoporotic vertebral compression fracture zoledronic acid teriparatide

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Full-endoscopic spine surgery treatment of lumbar foraminal stenosis after osteoporotic vertebral compression fractures:A case report

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World Journal of Clinical Cases 2022年第2期10卷 656-662页

作者： Quan-Lai Zhao Kun-Peng Hou Zhong-Xuan Wu Liang Xiao Hong-Guang Xu Department of Spine Surgery Wannan Medical CollegeWuhu 241001Anhui ProvinceChina

BACKGROUND Few reports have described lumbar foraminal stenosis-induced radiculopathy after treatment by full-endoscopic spine surgery(FESS)combined with percutaneous vertebroplasty(PVP)in patients with vertebral compression fractures.We herein report such a case,including the patient’s treatment process and doctor’s surgical experience.CASE SUMMARY A 79-year-old man presented with symptoms of radiculopathy after sustaining L4 vertebral compression fractures.Imaging and physical examination revealed L4 vertebral compression fractures combined with L3/4 Lumbar foraminal stenosis(LFS).The patient’s symptoms were low back pain with pain in the lateral left leg.Although many reports have described radiculopathy induced by osteoporotic vertebral compression fractures,the use of FESS combined with PVP has rarely been reported.This case report indicates that the combination of FESS and PVP is a safe and effective approach for the treatment of LFS-induced radiculopathy after vertebral compression fractures.This minimally invasive technique has great potential to replace traditional lumbar fixation and decompression surgery.Thus,we suggest the continued accumulation of similar cases to discuss the wider application of FESS.CONCLUSION For patients with osteoporotic vertebral compression fracture(OVCF)and LFS,PVP and FESS can be used to restore the vertebral height and reduce the pressure around the intervertebral foramen.Additionally,the combination of FESS and PVP can treat the pain or numbness of the low back and lower limbs and allow for recovery in a short time with excellent postoperative effects.In general,FESS is a good treatment for radiculopathy caused by foraminal stenosis after OVCF.

关键词： osteoporotic vertebral compression fracture Lumbar foraminal stenosis Percutaneous vertebroplasty Full-endoscopic spine surgery Radiculopathy Case report

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Comparative Analysis and Exploration of Clinical Value of Kyphoplasty and Conservative Treatment for osteoporotic vertebral compression fractures

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Journal of Clinical and Nursing Research 2022年第1期6卷 96-100页

作者： Feiyu Yin Shenggen Wang Xinrui Hospital(Wuxi Branch of Ruijin Hospital) Wuxi 214000Jiangsu ProvinceChina

Objective:To explore the clinical value of kyphoplasty and conservative treatment for osteoporotic vertebral compression fractures.Methods:40 patients with osteoporotic vertebral compression fracture from May 2019 to November 2021 were selected.The control group was treated with conservative treatment and the experimental group was treated with kyphoplasty.Results:Compared with the control group,the experimental group had higher total effective rate(95.00%),better recovery of Cobb Angle and vertebral height,and higher quality of life score.The data was more meaningful(Posteoporotic vertebral compression fractures,the application of kyphoplasty can improve the treatment effect,accelerate the recovery of vertebral body function and enhance the quality of life,which is worthy of popularization.

关键词： osteoporotic vertebral compression fracture Kyphoplasty Conservative treatment Value

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Total spinal anesthesia caused by lidocaine during unilateral percutaneous vertebroplasty performed under local anesthesia:A case report

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World Journal of Clinical Cases 2022年第25期10卷 9050-9056页

作者： Yu-Fei Wang Zhao-Yue Bian Xin-Xian Li Yun-Xiang Hu Lin Jiang Department of Anesthesiology Taizhou People’s HospitalTaizhou 225300Jiangsu ProvinceChina Department of Spine Surgery The People’s Hospital of Liuyang CityLiuyang 410300Hunan ProvinceChina Department of Orthopedics Dalian Municipal Central Hospital Affiliated of Dalian Medical UniversityDalian 116021Liaoning ProvinceChina School of Graduates Dalian Medical UniversityWest SectionNo.8 South Lvshun RoadLvshun DistrictDalian 116000Liaoning ProvinceChina

BACKGROUND Intradural anesthesia caused by anesthetic drug leakage during percutaneous vertebroplasty(PVP)has rarely been reported.We here report a 71-year-old woman who suffered this rare and life-threatening complication during PVP.CASE SUMMARY A 71-year-old woman,who suffered from 2 wk of severe back pain with a visual analog score of 8,came to our outpatient clinic.She was later diagnosed with a newly compressed L1 fracture and was then admitted in our department.PVP was initially attempted again under local anesthesia.However,serendipitous intradural anesthesia leading to total spinal anesthesia happened.Fortunately,after successful resuscitation of the patient,PVP was safely and smoothly performed.Great pain relief was achieved postoperatively,and she was safely discharged on postoperative day 4.The patient recovered normally at 3-mo follow-up.CONCLUSION Total spinal anesthesia secondary to PVP by anesthetic drug leakage rarely occurs.In cases of inadvertent wrong puncture leading to drug leakage when performing it under local anesthesia,surgeons should be highly vigilant during the whole procedure.Electrocardiogram monitoring,oxygen inhalation,intravenous cannula set prior to surgery,regular checking of motor activity and a meticulous imaging monitoring with slower pushing of anesthetic drugs,etc.should be highly recommended.

关键词： Percutaneous vertebroplasty Intradural anesthesia Total spinal anesthesia Minimally invasive surgery osteoporotic vertebral compression fracture fracture Spinal anesthesia Case report

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Predictive risk factors for recollapse of cemented vertebrae after percutaneous vertebroplasty: A meta-analysis

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World Journal of Clinical Cases 2021年第12期9卷 2778-2790页

作者： Yi-Hang Ma Zhi-Sen Tian Hao-Chuan Liu Bo-Yin Zhang Yu-Hang Zhu Chun-Yang Meng Xiang-Ji Liu Qing-San Zhu Department of Spine Surgery China-Japan Union Hospital of Jilin UniversityChangchun 130033Jilin ProvinceChina

BACKGROUND As one of the most common complications of osteoporosis,osteoporotic vertebral compression fracture(OVCF)increases the risk of disability and mortality in elderly patients.Percutaneous vertebroplasty(PVP)is considered to be an effective,safe,and minimally invasive treatment for OVCFs.The recollapse of cemented vertebrae is one of the serious complications of PVP.However,the risk factors associated with recollapse after PVP remain controversial.AIM To identify risk factors for the recollapse of cemented vertebrae after PVP in patients with OVCFs.METHODS A systematic search in EMBASE,MEDLINE,the Cochrane Library,and PubMed was conducted for relevant studies from inception until March 2020.Studies investigating risk factors for the recollapse of cemented vertebrae after PVP without additional trauma were selected for analysis.Odds ratios(ORs)or standardized mean differences with 95%confidence interval(CI)were calculated and heterogeneity was assessed by both the chi-squared test and the I-squared test.The methodological quality of the included studies was assessed according to the Newcastle-Ottawa Scale.RESULTS A total of nine case-control studies were included in our meta-analysis comprising 300 cases and 2674 controls.The significant risk factors for the recollapse of cemented vertebrae after PVP in OVCF patients were fractures located at the thoracolumbar junction(OR=2.09;95%CI:1.30 to 3.38;P=0.002),preoperative intravertebral cleft(OR=2.97;95%CI:1.93 to 4.57;Pvertebral height restoration could increase the risk forcemented vertebra recollapse after PVP in OVCFs.CONCLUSIONThis meta-analysis suggests that thoracolumbar junction fractures, preoperativeintravertebral cleft, and solid lump cement distribution pattern are associatedwith

关键词： Vertebroplasty osteoporotic vertebral compression fracture Risk factors Recollapse Cemented vertebrae Meta-analysis

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Cement distribution patterns are associated with recompression in cemented vertebrae after percutaneous vertebroplasty:a retrospective analysis

Cement distribution patterns are associated with recompressi...

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2016年浙江省骨科学学术年会

作者： Chao Lou Weiyang Yu Zhenzhong Chen Kejun Zhu Feijun Liu Dengwei He 丽水市中心医院

Purpose The purpose of this study was to develop the traditional classical two cement distribution patterns to four with the aim of revaluating the cement distribution patterns and further comprehensively investigate associations between cement distribution patterns and the occurrence rates of recompression in cemented vertebrae after percutaneous vertebroplasty(PVP).Methods A retrospective study of 224 patients(age range 66-89 years) treated with PVP for a single-level thoracolumbar osteoporotic compression fractures were conducted with a mean follow-up of 21.3 months(13-37 months) from June 2012 to July 2014.Patients were divided into those without recompression(maintained group,n = 192) and those with recompression(recompressed group,n = 32).Another,patients were divided into four groups according to the cement distribution patterns evaluated on radiography and/or computed tomography:interlocked solid pattern group(group LS,n = 19) and uninterlocked solid pattern group(group ULS,n = 62),compact and solid cement filling pattern but interlocked or uninterlocked with surrounding cancellous bone in vertebrae;contiguous trabecular pattern group(group CT,n = 102) and discontiguous trabecular pattern group(group DCT,n = 41),sponge-like but contiguous or discontiguous cement internal filling pattern.The filled type of responsible area was divided into sufficient filling pattern(SF,n = 184) and insufficient filling pattern(ISF,n= 40).Differences in treatment efficacy and the occurrence rates of recompression in cemented vertebrae were examined and compared for both groups using the Mann-Whitney U test and chi-square test.Results Recompression in cemented vertebrae was significantly more frequent in solid pattern group than in trabecular pattern group(Pcompression rate in group ULS and group DCT was statistical higher than that in group LS and group CT(Pcompression(P<0.05) than the group LS.A significan

关键词： Cement distribution Vertebroplasty osteoporotic vertebral compression fracture Recompression

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