scholarly journals Spine stabilization in patients with the thoracic and lumbar vertebrae fractures in reduced bone mineral density

2021 ◽  
pp. 31-39
Author(s):  
A. A. Afaunov ◽  
I. V. Basankin ◽  
K. K. Takhmazyan ◽  
M. L. Mukhanov ◽  
N. S. Chaikin
Keyword(s):  
Bone Mineral Density ◽  
Surgical Treatment ◽  
Bone Mineral ◽  
Lumbar Vertebrae ◽  
Clinical Effectiveness ◽  
Neurological Complications ◽  
Mineral Density ◽  
Transpedicular Fixation ◽  
Spine Stabilization ◽  
Group 2

Objective To compare the clinical effectiveness of various technical and tactical options for surgical treatment of patients with thoracic and lumbar vertebrae fractures with reduced bone mineral density.Material and Methods The study included 238 patients with the thoracic and lumbar vertebrae fractures with reduced bone mineral density (BMD). The patients were aged between 48 and 85 with T-score –1.5 to –3.5. The study did not include the patients with recurrent or multiple vertebral fractures, with absence of the clear date and fact of fracture in the case history, with neurological complications or polytrauma. The patients had fractures А1.2, А1.3, В1.2, В2.3 according to the classification of Magerl (1992). All patients underwent bisegmental transpedicular fixation (TPF). Group 1 included 68 patients who underwent non-cement augmented transpedicular screw fixation. Group 2 included 170 patients who underwent cement augmented transpedicular fixation. Both groups were divided into 2 subgroups. Subgroups 1.1 and 2.1 included patients operated in two stages. The first stage was TPF and the second stage was anterior corporodesis. Subgroups 1.2 и 2.2 included patients who underwent only TPF. Outcomes and complications were studied. The observation period lasted for not less than 2 years. Correlation analysis was performed between the technique of performing operations and surgical tactics in four subgroups and treatment outcomes.Conclusion 1. In the treatment of patients with fractures in the thoracic or lumbar spine with reduced BMD, isolated TPF with cemented screw implantation is clinically equivalent to two-stage surgical treatment - TPF with cementless or cemented implantation and anterior corprodesis of injured FPS. 2. In cementless TPF in patients with decreased BMD, anterior corprodesis of the injured VMS is necessary because its failure leads to the loss of anatomical relationship correction achieved during surgery, increase in local kyphosis, and functional maladaptation of patients.

scholarly journals The сhanges of bone mineral density on the risk of progression of osteoarthritis of the knee

2019 ◽  
Vol 91 (5) ◽  
pp. 61-67
Author(s):  
N G Kashevarova ◽  
E A Taskina ◽  
L I Alekseeva ◽  
N V Demin ◽  
A M Lila ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Statistical Significance ◽  
Lumbar Vertebrae ◽  
Axial Skeleton ◽  
Mineral Density ◽  
Knee Oa ◽  
Group 2 ◽  
Group 1

Aim. To find the relationship between bone mineral density (BMD) and risk of knee OA progression in a 5-year prospective study. Materials and methods. 110 females with knee OA were examined twice with 5-year interval. Examination included filling questionnaires, VAS pain assessment, plain knee radiography and axial skeleton densitometry. I stage knee OA was established in 33 (30%) patients, II stage - in 46 (41.8%), III stage - in 26 (23.6%), and IV - in 5 (4.5%). Normal lumbar vertebrae densitometry BMD values were found in 45 patients (40.9%), osteopenia - corresponding BMD values - in 33 (30.0%), and osteoporosis - in 32 (29.1%). Normal femoral neck BMD values were identified in 60 (54.5%) patients, osteopenia - level BMD - in 48 (43.7%), osteoporosis - in 2 (1.8%). In all premenopausal patients (n=15) axial skeleton BMD values were normal. Results. In 5-year interval radiographic progression was established in 40 patients (Group 2), while in 70 (Group 1) patients no progression occurred. Both groups were comparable in terms of age and disease duration, although, more patients from Group 2 tended to have normal baseline densitometry BMD values - both in lumbar vertebrae and femoral neck: 47.5% vs 37.1%, and 62.5% vs 44.3% as compared to Group 1 patients. Patients from Group 1 more often had BMD values corresponding to osteoporosis and osteopenia: 32.9% vs 22.5%, and 55.7% vs 37.5%, respectively, as compared to Group 2 patients, although not achieving statistical significance. These differences were still identifiable after 5-year interval. Absolute BMD values at the second examination in 5 years were indicative of statistically significant increase in femoral neck and total hip BMD in Group 2 patients with knee OA progression: 0.79±0.11 vs 0.73±0.16, р

scholarly journals Anterior stabilization of spine column in the staged surgical treatment of patients with fractures of thoracic and lumbar vertebrae with low bone mineral density

2020 ◽  
Vol 27 (3) ◽  
pp. 5-15
Author(s):  
Asker A. Afaunov ◽  
Igor V. Basankin ◽  
Karapet K. Takhmazyan ◽  
Abram A. Giulzatyan ◽  
Mikhail L. Mukhanov ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Surgical Treatment ◽  
Bone Mineral ◽  
Cement Augmentation ◽  
Mineral Density ◽  
Spinal Motion ◽  
Second Stage ◽  
Thoracic And Lumbar Spine ◽  
Group 2 ◽  
Spinal Motion Segment

Aim. To determine the clinical effectiveness of anterior stabilization in the surgical treatment of patients with traumatic injuries of the thoracic and lumbar spine with reduced bone mineral density. Materials and methods. The study included 238 patients with thoracic and lumbar vertebral fractures with reduced bone mineral density (BMD). The age of patients is from 48 to 85 years. There are following types of fractures according to F. Magerl (1992): A1.2, A1.3, B1.2, B2.3. BMD of the vertebrae was decreased (T-score from 1.5 to 3.5). Results. All patients underwent short segment transpedicular fixation (TPF) with four-screw systems. In group 1 were included 68 patients who underwent TPF without cemented augmentation of screws. Group 2 included 170 patients who underwent TPF reinforced with a cement. Both groups were divided into 2 subgroups. Subgroup 1.1 included patients, which were operated on in two stages. The first stage is TPF. The second stage is the anterior stabilization. Subgroup 1.2 included patients who underwent only TPF. Patients in group 2 were divided into two subgroups in a similar way. The results and complications according to clinical and spondylometric criteria were studied. Correlation analysis was performed between surgical technique, surgical tactics and the treatment results in the four selected subgroups. The observation period is at least 2 years. Conclusion. 1. When using TPF with cement augmentation for the treatment of patients with fractures of the thoracic and lumbar spine with reduced BMD, the anterior stabilization of injured spinal motion segment as a second stage of surgical treatment does not provide clinical advantages compared to the use of only TPF with cement augmentation. 2. In case of cementless TPF in patients with reduced BMD, anterior stabilization of the injured spinal motion segment is necessary. Only when anterior stabilization is performed, the stability of fixation is ensured. It is sufficient to preserve the anatomical relationships restored during the operation and functional adaptation of patients in the long-term period after surgery.

scholarly journals AB0910 SARCOPENIA AND BONE MINERAL DENSITY IN MEN WITH CORONARY HEART DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1757.2-1757
Author(s):  
T. Raskina ◽  
I. Grigoreva ◽  
J. Averkieva ◽  
A. Kokov ◽  
V. Masenko
Keyword(s):  
Bone Mineral Density ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Muscle Mass ◽  
Bone Mineral ◽  
Mineral Density ◽  
Group 3 ◽  
Group 2

Objectives:To examine bone mineral density (BMD) in men with coronary heart disease (CHD), depending on the state of the muscle mass, strength and function.Methods:79 men aged over 50 years with verified CHD were examined (mean age 63 (57; 66) years).The BMD and T-criterion (standart deviation, SD) of the femoral neck and lumbar spine (L1-L4) were evaluated using dual-energy x-ray absorptiometry (DXA) on the Lunar Prodigy Primo bone densitometer (USA). The following reference intervals were used: normal BMD values (T-criterion ≥-1), osteopenia (OPe) (T-criterion from -1 to -2.5), and osteoporosis (OP) (T-criterion <-2.5).To assess muscle mass, the total area (cm2) of the lumbar muscles of the axial section at the level of the 3rd lumbar vertebra (L3) was determined using multispiral computed tomography on a 64-slice computer tomograph “Somatom Sensation 64” (Siemens AG Medical Solution, Germany). The ratio of the obtained index of the area of skeletal muscle to the square of the patient’s growth index determined the “ skeletalmuscular index L3” (SMI). The media considered the threshold value to be 52.4 cm2/m2.Results:The femoral neck BMD in the examined patients was 0.96 (0.89; 1.03) g/cm2, which corresponds to -0.50 (-1.00; 0) SD according to the T-criterion, in the lumbar spine -1.23 (1.11; 1.32) g/cm2and 0.4 (-0.50; 1.20) SD according to the T-criterion.In accordance with the recommendations of the European working group on sarcopenia in Older people (EWGSOP, 2010, 2018), the patients were divided into 3 groups: 31 patients without sarcopenia (group 1), 21 patients with isolated muscle loss (presarcopenia) (group 2) and 27 patients with sarcopenia (group 3).BMD in the femoral neck in the group of patients without sarcopenia was 0.96 (0.72; 1.26) g/cm2, which corresponds to -0.50 (-0.8; 0.2) SD according to the T-criterion, in the lumbar spine – 1.19 (1.10; 1.275) g/cm2and 0.1 (-0.6; 0.8) SD according to the T-criterion. BMD in the femoral neck in the group of patients with presarcopenia (group 2) – 0.995 (0.94; 1.04) g/cm2and -0.3 (-0.70; 0) SD according to the T-criterion, in the lumbar spine – 1.32 (1.24; 1.40) g/cm2and 1.20 (0.50; 1.90) SD according to the T-criterion. In patients with established sarcopenia (group 3), the following indicators of BMD and T-criterion were recorded: 0.95 (0.845; 0.98) g/cm2and -0.60 (-1.40; -0.40) SD and 1.23 (0.085; 1.31) g/cm2and 0.4 (-0.8; 1.1) SD in the femoral neck and lumbar spine, respectively.A comparative analysis of the results of the DXA found that patients with sarcopenia had a significant decrease in the BMD and T-criterion in the femoral neck compared to patients with presarcopenia (p=0.039 and p=0.040, respectively). There were no differences between the groups of patients without sarcopenia and with sarcopenia and presarcopenia (p>0.05).It was found that patients with sarcopenia had significantly lower BMD and T-criterion in the lumbar spine compared to patients with presarcopenia (p=0.017 and p=0.0165, respectively). The values of the BMD and T-criterion in the groups of patients without sarcopenia and with presarcopenia and sarcopenia in the lumbar spine were comparable (p>0.05).Conclusion:The presence of sarcopenia is associated with loss of BMD in the femoral neck and in the lumbar spine. The results obtained confirm the high probability of common pathogenetic links between OP and sarcopenia.Disclosure of Interests:None declared

Analysis of the Increase in Bone Mineral Density After Surgical Treatment of Primary Hyperparathyroidism

2019 ◽  
Vol 22 (2) ◽  
pp. 171-178 ◽  
Author(s):  
Fernando Mendoza-Moreno ◽  
Manuel Díez-Alonso ◽  
Enrique Ovejero-Merino ◽  
Ana Sánchez-Gollarte ◽  
Ricardo Alvarado-Hurtado ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Surgical Treatment ◽  
Primary Hyperparathyroidism ◽  
Bone Mineral ◽  
Mineral Density

scholarly journals AGE AND SEX-RELATED STRUCTURAL AND FUNCTIONAL CHANGES OF BONE REMODELING DURING SIMULTATE ABDOMEN CT-SCANNING

2020 ◽  
Vol 73 (1) ◽  
pp. 91-94
Author(s):  
Nazar M. Kostyshyn ◽  
Liubov P. Kostyshyn ◽  
Mechyslav R. Gzhegotskyi
Keyword(s):  
Computed Tomography ◽  
Bone Mineral Density ◽  
Bone Mass ◽  
Old Age ◽  
Bone Mineral ◽  
Lumbar Vertebrae ◽  
Middle Adulthood ◽  
Mineral Density ◽  
Functional Changes ◽  
Early Old Age

The aim of investigation was to study the structural and functional conditions of cortical and trabecular layers of lumbar vertebrae L1-L5 in different age groups. Materials and methods: In order to assess BMD of the lumbar vertebrae 102 people18 to 75 years old was examined. Study of bone mineral density cortical and trabecular layer of lumbar vertebrae (L1-L5) performed by computed tomography in Hounsfield Units (HU) in terms of standard deviation (SD). Results: The results of computed tomography showed a direct relationship of bone mineral density of lumbar vertebrae with age of examined persons. Osteoporosis and osteopenia was registered in 15% of men and 30% women in middle adulthood, in late adulthood – 35% and 50% respectively. During early old age osteopenia and osteoporosis are observed in 37,5% and 25% of men and 26% and 64% women. Osteoporosis in the middle old age has been reported in 50% of men and 75% of women Conclusions: Results of the study showed a direct link between mineral density, age and gender. The middle adulthood age period was characterized by the highest mineral mass compared with the other age periods. Then there is a loss of bone mass throughout life, and with the onset of aging osteopenia and osteoporosis are recorded. It was investigated that in the early old age, loss of bone mass is mainly observed in female.

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