• MeSH
• chirurgie operační metody   MeSH
• fraktury páteře chirurgie   komplikace   patofyziologie   terapie   MeSH
• kosti a kostní tkáň patofyziologie   zranění   MeSH
• krční obratle patofyziologie   zranění   MeSH
• lidé MeSH
• ochrnutí hlasivek patofyziologie   terapie   MeSH
• ortopedické výkony metody   MeSH
• páteř patofyziologie   MeSH
• poranění krku chirurgie   patofyziologie   terapie   MeSH
• poranění nervového systému patofyziologie   terapie   MeSH
• vnitřní fixace fraktury metody   škodlivé účinky   MeSH
• Check Tag
• lidé MeSH

• MeSH
• bederní obratle * patofyziologie   zranění   MeSH
• cementování metody   škodlivé účinky   MeSH
• chirurgie operační metody   MeSH
• dospělí MeSH
• fraktury kostí chirurgie   komplikace   patofyziologie   terapie   MeSH
• fraktury páteře * chirurgie   komplikace   patofyziologie   terapie   MeSH
• hrudní obratle * patofyziologie   zranění   MeSH
• kosti a kostní tkáň patofyziologie   zranění   MeSH
• lidé MeSH
• ortopedické výkony metody   MeSH
• osteoporotické fraktury chirurgie   komplikace   patofyziologie   terapie   MeSH
• páteř patofyziologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

• MeSH
• fraktury kyčle epidemiologie   patofyziologie   MeSH
• fraktury páteře epidemiologie   patofyziologie   MeSH
• incidence MeSH
• komorbidita MeSH
• kostní denzita fyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• menopauza MeSH
• návaly epidemiologie   patofyziologie   MeSH
• pocení fyziologie   MeSH
• prospektivní studie MeSH
• senioři MeSH
• vazomotorický systém patofyziologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• souhrny MeSH
• Geografické názvy
• Spojené státy americké MeSH

PURPOSE OF THE STUDY The aim of the experiment was to compare the bending stiffness of an intact odontoid process with bending stiffness after its simulated type II fracture was fixed with a single lag screw. The experiment was done with a desire to answer the question of whether a single osteosynthetic screw is sufficient for good fixation of a type II odontoid fracture. MATERIAL AND METHODS The C2 vertebrae of six cadavers were used. With simultaneous measurement of odontoid bending stiffness, the occurrence of a fracture (type IIA, Grauer's modification of the Anderson- D'Alonzo classification) was simulated using action exerted by a tearing machine in the direction perpendicular to the odontoid axis. Each odontoid fracture was subsequently treated by direct osteosynthesis with a single lag screw inserted in the axial direction by a standard surgical procedure in order to provide conditions similar to those achieved by routine surgical management. The treated odontoid process was subsequently subjected to the same tearing machine loading as applied to it at the start of the experiment. The bending stiffness measured was then compared with that found before the fracture occurred. The results were statistically evaluated by the t-test for paired samples at the level of significance α = 0.05. RESULTS The average value of bending stiffness for odontoid processes of intact vertebrae at the moment of fracture occurrence was 318.3 N/mm. After single axial lag screw fixation of the fracture, the average bending stiffness for the odontoid processes treated was 331.3 N/mm. DISCUSSION Higher values of bending stiffness after screw fixation were found in all specimens and, in comparison with the values recorded before simulated fractures, the increase was statistically significant. CONCLUSIONS The results of our measurements suggest that the single lag screw fixation of a type IIA odontoid fracture will provide better stability for the fracture fragment-C2 body complex on antero-posterior perpendicular loading than can be found in intact C2 vertebrae. Key words: odontoid fracture, odontoid fixation, bending stiffness, lag screw.

• MeSH
• biomechanika fyziologie   MeSH
• dens axis zranění   chirurgie   MeSH
• fraktury páteře patofyziologie   chirurgie   MeSH
• kostní šrouby * MeSH
• lidé středního věku MeSH
• lidé MeSH
• mrtvola MeSH
• senioři MeSH
• vnitřní fixace fraktury přístrojové vybavení   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH

To compare the anchorage strength of Socon CS cannulated pedicle screws (B. Braun, Aesculap) with that of Socon screws in human cadaver vertebrae, using pull-out strength testing. MATERIAL Twelve samples involving T12 to L3 vertebrae were prepared and a total of 20 pedicle screws, 10 Socon CS and 10 Socon screws, were inserted in them. All screws were 55 mm in length and 6 mm in diameter. After placement, Socon CS pedicle screws were augmented with bone cement (Cimplant cement application kit, B. Braun, Aesculap). METHODS Both Socon CS and Socon screws were subjected to monotonous loading in the testing device ZWICK Z 020-TND with tensile stress applied in the screw axis. We evaluated the magnitude of strength resulting in screw loosening and the relationship between this strength and bone density of the sample. RESULTS Bone density of measured samples corresponded either to osteopenia, i.e. T-score range of -1 to -2.5 SD (standard deviation) or osteoporosis, i.e. T-score -2.5 SD. The average bone density of all samples corresponded to a T-score of -3.1 SD. Bone-screw linkage was found to be associated with both bone-cement and screw-cement interface. Pull-out strength was significantly higher for the Socon CS than the Socon screws (t-test, p<0.0005). In the Socon screws, the linear correlation between pull-out strength and bone density was significant at a 5% level of statistical significance (p=0.008) while, in the Socon CS screws, it was not significant (p=0.065). DISCUSSION The poor quality of osteoporotic bone is responsible for a higher frequency of implant failure due to loosening, particularly when implants developed for healthy bone are used. In this biomechanical study, we tested one of the possibilities of how to reduce the risk of implant failure by pedicle screw augmentation with bone cement. CONCLUSIONS The results of this study confirm the hypothesis that the anchorage of Socon CS cannulated pedicle screws with bone cement augmentation is disrupted by significantly higher pull-out strength than that of Socon screws, when subjected to monotonous loading. However, more clinical studies are needed to evaluate clinical outcomes

• MeSH
• bederní obratle chirurgie   patofyziologie   zranění   MeSH
• biomechanika MeSH
• fraktury páteře chirurgie   patofyziologie   MeSH
• hrudní obratle chirurgie   patofyziologie   zranění   MeSH
• kostní denzita MeSH
• kostní šrouby MeSH
• lidé MeSH
• mrtvola MeSH
• osteoporotické fraktury chirurgie   patofyziologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• techniky in vitro MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Publikační typ
• srovnávací studie MeSH

INTRODUCTION: Vertebroplasty and balloon kyphoplasty have shown to improve pain and functional outcome in cases with symptomatic vertebral fractures. Although restoration of the vertebral body height and kyphosis seemed to be easier with balloon kyphoplasty, it became clear that some of the correction achieved by the balloon is lost once it was deflated. Vertebral body stent was developed to eliminate this phenomenon. To our knowledge this is the first study in describing this technique in clinical settings. MATERIALS AND METHODS: Seventeen patients with 20 fractured vertebral bodies were included. All fractures were Type A1.3 or A3.1 (incomplete burst). Information about pain (visual analogue scale-VAS) and function (Oswestry disability index-ODI) and vertebral body deformity (vertebral angle-VA) was recorded in a prospective way at regular intervals. Patients were classified into osteoporotic group (7 patients) and traumatic groups (10 patients, younger than 60 years). RESULTS: There were 6 male and 11 female patients with mean age of 58.1 years (31-88 years). Mean follow up was 12 months. The preoperative pain level showed a mean VAS score of 8.9 in osteoporotic group and 9.7 in traumatic group. Postoperatively, in osteoporotic group, mean VAS was 4.8 at 6 weeks, 4.0 at 6 months and 2.5 at 12 months compared with traumatic fracture group where it was 2.7 at 6 weeks, 2.2 at 6 months and 1.6 at 12 months. Mean ODI in osteoporotic group was 41.7% (14-58%) and in traumatic group it was 20.4% (6-33%). Mean vertebral body angle prior to surgery in osteoporotic group was 9.7 whilst postoperatively it was 5.2°; so the mean correction achieved was 4.5°. In traumatic group preoperative VA was 13° whilst postoperatively it was 5.7°; therefore the mean correction achieved was 7.3°. None of the patients lost reduction at their last follow up. CONCLUSION: Vertebral body stenting leads to satisfactory improvement in pain, function and kyphosis correction in the treatment of osteoporotic and traumatic fractures. Anterior spinal column, especially the fragmented superior endplate is nicely reconstructed by the stent provided it is inserted accurately. With addition of posterior transpedicular instrumentation, indications for this technique may be wider covering some Type B and C fractures with similar vertebral body damage.

• MeSH
• bederní obratle zranění   chirurgie   MeSH
• bolest prevence a kontrola   MeSH
• dospělí MeSH
• fraktury páteře patofyziologie   chirurgie   MeSH
• hrudní obratle zranění   chirurgie   MeSH
• kostní cementy terapeutické užití   MeSH
• kyfoplastika metody   MeSH
• kyfóza chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• měření bolesti MeSH
• osteoporotické fraktury patofyziologie   chirurgie   MeSH
• polymethylmethakrylát terapeutické užití   MeSH
• posuzování pracovní neschopnosti MeSH
• prospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• stenty MeSH
• vertebroplastika metody   MeSH
• vnitřní fixace fraktury přístrojové vybavení   metody   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Skeletal fractures are common in hemodialysis (HD) patients. However, consensus regarding technique and site of bone examination has not been reached in HD patients. Seventy-two patients (44% females) aged 65 (1.4) years, treated with HD for 43 (4.6) months were examined with quantitative computed tomography and 53 of them re-examined after 1 year. Bone mineral density (BMD) of lumbar spine was established separately for cortical and trabecular bone, prevalent vertebral fractures were determined. Data are given as mean (standard error). At least one vertebral fracture was discovered in 15 (21%) patients. In a logistic regression model, fractures were best predicted by cortical BMD: OR 0.96 (CI 0.94, 0.99), p < 0.005. With a multiple regression analysis, time on dialysis was found to be independently correlated to cortical BMD (R = 0.35, p < 0.005). On follow-up, a decrease of BMD was detected, which occurred only in the cortical region and was significantly greater in females than in males: -7% (1.7) versus 1.2% (1.9), p < 0.005. A time-dependent loss of vertebral cortical bone occurs in HD patients, especially in females. This decrement may impose an increased risk of fractures on long-term dialysis patients.

• MeSH
• alkalická fosfatasa metabolismus   MeSH
• bederní obratle patofyziologie   MeSH
• časové faktory MeSH
• demografie MeSH
• dialýza ledvin škodlivé účinky   MeSH
• financování organizované MeSH
• fraktury páteře epidemiologie   etiologie   komplikace   patofyziologie   MeSH
• kostní denzita MeSH
• lidé MeSH
• následné studie MeSH
• prevalence MeSH
• prospektivní studie MeSH
• průřezové studie MeSH
• resorpce kosti epidemiologie   etiologie   komplikace   patofyziologie   MeSH
• rizikové faktory MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH