Browsing by Publisher "ACTA MEDICA BELGICA"

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    Does timing matter in performing kyphoplasty ? Acute versus chronic compression fractures
    (ACTA MEDICA BELGICA) Erkan, S; Özalp, TR; Yercan, HS; Okcu, G
    The objective of this prospective consecutive cohort study was to compare the clinical outcomes, the radiographic outcomes and the complication rates of symptomatic acute (< 10 weeks) and chronic (> 16 weeks) osteoporotic vertebral compression fractures (VCFs) treated with kyphoplasty. Twenty-eight consecutive patients had 52 symptomatic osteoporotic VCFs treated with kyphoplasty; 5 of these patients were treated in two sessions. The Oswestry Disability Index (0131) for back pain, a Visual Analog Scale for pain assessment, a patients' satisfaction scale, and medication usage served to evaluate the clinical outcomes. All these variables improved significantly in both groups, and more so in the acute group, but the difference was most often not significant. Vertebral height, local kyphosis angle, global sagittal alignment and dynamic fracture mobility significantly improved in both groups (except global sagittal alignment), and again more so in the acute group (except global sagittal alignment); the difference between groups was significant regarding radiological variables, except global sagittal alignment. Timing of kyphoplasty certainly matters, as the clinical and radiological outcomes were mostly better in acute fractures than in chronic fractures, which somehow responded satisfactorily. Controlled studies (kyphoplasty versus natural history) are needed to establish the real value of the procedure.
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    The influence of sagittal cervical profile, gender and age on the thoracic kyphosis
    (ACTA MEDICA BELGICA) Erkan, S; Yercan, HS; Okcu, G; Özalp, RT
    The objective of this prospective consecutive cohort study was to investigate the effect of sagittal cervical profile, gender and age on the thoracic kyphosis in 228 subjects, mainly adults, free of spinal complaints and with a thoracic kyphosis of less than 50 degrees. The subjects, who were actually treated for lower extremity problems, were divided into two groups : the 68 subjects in group 1 (30%) had loss of cervical lordosis, while the 160 subjects in group 2 (70%) had a physiological cervical lordosis. In group 1 (loss of cervical lordosis) the mean angles of the upper (T1T6), lower (T7T12), and whole (T1T12) thoracic kyphosis were 8 degrees +/- 2 (range : 3-28 degrees), 15 degrees +/- 4 (range : 6-40 degrees), and 24 degrees +/- 6 (range : 10-46 degrees), respectively. In group 2 the normal cervical lordosis seemed to lead to a compensatory increase in these values : 13 degrees +/- 4 (range, 4-35 degrees) (p = 0.008), 21 degrees +/- 5 (range : 6-45 degrees) (p = 0.012), and 34 degrees +/- 8 (range : 12-50 degrees) (p = 0.007). In both groups gender had no significant effect on the values of the thoracic kyphosis (p > 0.05). Also age had no influence, neither in group 1 nor in group 2 as a whole, but in group 2 advanced age (>50 years) was correlated with a significant increase in the lower (T7T12) (p = 0.009) and whole (T1T12) thoracic kyphosis (p = 0.007). This study yields standards for reference for the normal curvatures of the spine in the sagittal plane. The literature is quite controversial on this matter.