Revista Espanola de Cirugia Ortopedica y Traumatologia最新文献

{"title":"[Translated article] Osteoporotic vertebral fractures: Natural history and impact","authors":"P. Checa-Betegón,&nbsp;R. Luque-Pérez,&nbsp;D. Oñate-Martínez-Olascoaga,&nbsp;J.L. Pérez-González,&nbsp;I. Domínguez-Esteban","doi":"10.1016/j.recot.2024.08.003","DOIUrl":"10.1016/j.recot.2024.08.003","url":null,"abstract":"<div><div>Osteoporosis, and the consequences derived from it, such as fragility fractures, constitute a growing public health problem. Suffering from a fracture of this nature is the main risk factor for suffering a new fracture.</div><div>It is documented that vertebral compression fractures lead to significant morbidity and mortality, in the short and long term, as well as other complications, such as sagittal imbalance and hyperkyphosis of the segment. However, we have not found documentation that analyzes the medium and long-term consequences of these injuries, assessing the type of treatment used, and the economic impact they represent.</div><div>The purpose of this review is to analyse the main recent literature on the subject and make a breakdown of the consequences of these fractures in various spheres, such as economic, quality of life, sagittal balance and radiographic parameters, pain or mortality; as well as a brief analysis of epidemiology and natural history.</div></div><div><h3>Conclusion</h3><div>Osteoporotic fractures constitute an emerging problem, both in the medical and economic fields. The consequences and sequelae on the patient are multiple and although surgical options offer good long-term results, it is necessary to properly select the patient, through multidisciplinary teams, to try to minimise potential complications.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages T587-T596"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnóstico radiográfico de pacientes con fracturas por compresión vertebral","authors":"E. Arana","doi":"10.1016/j.recot.2024.06.007","DOIUrl":"10.1016/j.recot.2024.06.007","url":null,"abstract":"<div><div>Vertebral compression fractures by osteoporosis (OVF) is usually a diagnostic problem and coincides on the age group of metastatic vertebral compression fractures (MVF). Although radiography is the first diagnostic technique, generally is not accurate for depicting demineralization and soft tissue lesions. Magnetic resonance (MRI) is the diagnostic choice. The most relevant signs are Intravertebral fluid collection or fluid signal, other vertebral deformities without edema and older age. Among the most relevant findings for diagnosis MVF are soft tissue mass and pedicle intensity signal asymmetries. However, reproducibility of these findings in clinical practice is moderate.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages 582-586"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estatus socioeconómico, osteoporosis y fracturas por fragilidad","authors":"G. Martínez-Díaz-Guerra,&nbsp;F. Hawkins Carranza,&nbsp;S. Librizzi","doi":"10.1016/j.recot.2024.06.010","DOIUrl":"10.1016/j.recot.2024.06.010","url":null,"abstract":"<div><div>Low socioeconomic status (SES) is associated with a higher risk of fragility fractures, as well as higher mortality in the first year post-fracture. The SES variables that have the greatest impact are educational level, income level, and cohabitation status. Significant disparities exist among racial and ethnic minorities in access to osteoporosis screening and treatment.</div><div>In Spain, a higher risk of fractures has been described in people with a low income level, residence in rural areas during childhood and low educational level. The Civil War cohort effect is a significant risk factor for hip fracture. There is significant geographic variability in hip fracture care, although the possible impact of socioeconomic factors has not been analyzed. It would be desirable to act on socioeconomic inequalities to improve the prevention and treatment of osteoporotic fractures.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages 539-546"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tips and tricks for using cement augmentation of pedicle screws and vertebral body replacements—A literature review supported by two case reports","authors":"V.J. Heck ,&nbsp;M. Rauschmann ,&nbsp;T. Prasse ,&nbsp;J.M. Vinas-Rios ,&nbsp;A. Slavici","doi":"10.1016/j.recot.2024.07.011","DOIUrl":"10.1016/j.recot.2024.07.011","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of osteoporosis is escalating alongside an aging global population, increasing the demand for spinal surgeries, including those necessitating cement augmentation for enhanced construct stability.</div></div><div><h3>Objective</h3><div>This article delves into the nuanced application of cement augmentation techniques for pedicle screws and vertebral body replacements (VBR), aimed at optimizing surgical outcomes in osteoporotic spines.</div></div><div><h3>Method</h3><div>Drawing from a comprehensive literature review according to important clinical and biomechanical studies and the authors’ clinical experiences, we elucidate strategies to mitigate complications and improve surgical efficacy.</div></div><div><h3>Results</h3><div>Cement augmentation has shown promise in managing vertebral fractures and in securing pedicle screws within osteoporotic vertebrae, with the advent of polymethylmethacrylate (PMMA) bone cement marking a pivotal advancement in spinal surgery. We highlight intraoperative measures like the choice between pre-injecting cement and utilizing cannulated or fenestrated screws, emphasizing the importance of controlling cement viscosity to prevent leakage and embolism. Through two case reports, we demonstrate the practical application of endplate cementation following VBR.</div></div><div><h3>Conclusion</h3><div>While the use of cement augmentation poses certain risks, its judicious application—supported by evidence-based guidelines and surgical expertise—can substantially enhance the stability of spinal constructs in osteoporotic patients. This allows a reduction in instrumentation length by enhancing biomechanical stability concerning pullout, bending, and rotational forces. Furthermore, the incidence of endplate sintering following VBF can be significantly reduced. Future research, particularly on antibiotic-loaded PMMA, may further expand its utility and optimize its safety profile.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages 607-614"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141724667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manejo de la deformidad espinal en el contexto de fracturas por compresión vertebral osteoporóticas","authors":"C. Mengis ,&nbsp;N. Plais ,&nbsp;F. Moreno ,&nbsp;G. Cózar ,&nbsp;F. Tomé-Bermejo ,&nbsp;L. Álvarez-Galovich","doi":"10.1016/j.recot.2024.08.009","DOIUrl":"10.1016/j.recot.2024.08.009","url":null,"abstract":"<div><div>Osteoporosis and fragility play a significant role in the treatment and planning of patients with deformity secondary to osteoporotic vertebral fracture (OVF). The resulting deformity can present significant challenges for its management, both from a medical and surgical perspective. The need for a specific classification for these deformities, including the potential for the development of artificial intelligence and machine learning in predictive analysis, is emerging as a key point in the coming years. Relevant aspects in preoperative optimization and management of these patients are addressed. A classification with therapeutic guidance for the management of spinal deformity secondary to OVF is developed, emphasizing the importance of personalized treatment. Flexibility and sagittal balance are considered key aspects. On the other hand, we recommend, especially with these fragile patients, management with minimally invasive techniques to promote rapid recovery and reduce the number of complications.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages 615-623"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Artículo traducido] Consejos y trucos para el uso de cemento óseo en tornillos pediculares y en reemplazos de cuerpos vertebrales: una revisión de la literatura respaldada por dos informes de casos","authors":"V.J. Heck ,&nbsp;M. Rauschmann ,&nbsp;T. Prasse ,&nbsp;J.M. Vinas-Rios ,&nbsp;A. Slavici","doi":"10.1016/j.recot.2024.09.009","DOIUrl":"10.1016/j.recot.2024.09.009","url":null,"abstract":"<div><h3>Background</h3><div>The prevalence of osteoporosis is escalating alongside an aging global population, increasing the demand for spinal surgeries, including those necessitating cement augmentation for enhanced construct stability.</div></div><div><h3>Objective</h3><div>This article delves into the nuanced application of cement augmentation techniques for pedicle screws and vertebral body replacements (VBR), aimed at optimizing surgical outcomes in osteoporotic spines.</div></div><div><h3>Method</h3><div>Drawing from a comprehensive literature review according to important clinical and biomechanical studies and the authors’ clinical experiences, we elucidate strategies to mitigate complications and improve surgical efficacy.</div></div><div><h3>Results</h3><div>Cement augmentation has shown promise in managing vertebral fractures and in securing pedicle screws within osteoporotic vertebrae, with the advent of polymethylmethacrylate (PMMA) bone cement marking a pivotal advancement in spinal surgery. We highlight intraoperative measures like the choice between pre-injecting cement and utilizing cannulated or fenestrated screws, emphasizing the importance of controlling cement viscosity to prevent leakage and embolism. Through two case reports, we demonstrate the practical application of endplate cementation following VBR.</div></div><div><h3>Conclusion</h3><div>While the use of cement augmentation poses certain risks, its judicious application—supported by evidence-based guidelines and surgical expertise—can substantially enhance the stability of spinal constructs in osteoporotic patients. This allows a reduction in instrumentation length by enhancing biomechanical stability concerning pullout, bending, and rotational forces. Furthermore, the incidence of endplate sintering following VBF can be significantly reduced. Future research, particularly on antibiotic-loaded PMMA, may further expand its utility and optimize its safety profile.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages T607-T614"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142356016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manejo rehabilitador y ortopédico de las fracturas por compresión vertebral osteoporótica","authors":"A. Teixeira Taborda ,&nbsp;C. De Miguel Benadiva ,&nbsp;P. Sánchez Tarifa","doi":"10.1016/j.recot.2024.10.003","DOIUrl":"10.1016/j.recot.2024.10.003","url":null,"abstract":"<div><div>Osteoporosis represents a public health problem that can be prevented and treated early through health education. Over time, screening techniques, diagnosis and treatments even conservative and surgical, have improved.</div><div>Through this publication we want to highlight the importance of the medical and orthopedic management of these fractures, describing the benefit of diet and physical exercise as the protagonists of conservative treatment but above all its indications and contraindications, emphasizing the limitations of exercise in a vertebral osteoporotic fracture. The different orthoses prescriptions are also highlighted.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages 624-628"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Verdades y mentiras de las técnicas de cementación en el tratamiento de las fracturas por fragilidad","authors":"S. Santiago Maniega ,&nbsp;J. Crespo Sanjuán ,&nbsp;F. Ardura Aragón ,&nbsp;R. Hernández Ramajo ,&nbsp;G.J. Labrador Hernández ,&nbsp;M. Bragado González ,&nbsp;D.C. Noriega González","doi":"10.1016/j.recot.2024.04.007","DOIUrl":"10.1016/j.recot.2024.04.007","url":null,"abstract":"<div><div>The main event of osteoporosis is fragility fractures. Vertebral compression fractures are the most commonly fragility fracture related to osteoporosis.</div><div>Our goal is to review the available literature to confirm or deny concepts learned about spinal cementation and adapt our clinical practice according to scientific evidence.</div><div>In the complex world of spine surgery, constant innovations seek to improve the quality of life of patients. Among these, vertebral augmentation has emerged as an increasingly popular technique, but often shrouded in myths and misunderstandings. In this systematic review, we will thoroughly explore the truths behind vertebral augmentation, unraveling common myths and providing a clear insight into this technique. As specialists in the field, it is crucial to understand the reality surrounding these interventions to offer our patients the best possible information and make informed decisions.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages 597-606"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140756533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Diagnostic imaging in patients with vertebral compression fractures","authors":"E. Arana","doi":"10.1016/j.recot.2024.08.006","DOIUrl":"10.1016/j.recot.2024.08.006","url":null,"abstract":"<div><div>Vertebral compression fractures by osteoporosis (OVF) is usually a diagnostic problem and coincides on the age group of metastatic vertebral compression fractures (MVF). Although radiography is the first diagnostic technique, generally is not accurate for depicting demineralization and soft tissue lesions. Magnetic resonance (MRI) is the diagnostic choice. The most relevant signs are intravertebral fluid collection or fluid signal, other vertebral deformities without oedema and older age. Among the most relevant findings for diagnosis MVF are soft tissue mass and pedicle intensity signal asymmetries. However, reproducibility of these findings in clinical practice is moderate.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages T582-T586"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Translated article] Anatomical and biomechanical factors of osteoporotic vertebral fracture and the occurrence of cascade fractures","authors":"F. Tomé-Bermejo ,&nbsp;J.F. Bartolomé Gómez","doi":"10.1016/j.recot.2024.09.004","DOIUrl":"10.1016/j.recot.2024.09.004","url":null,"abstract":"<div><div>Osteoporosis weakens the structural strength of bone to such an extent that normal daily activity may exceed the capacity of the vertebra to bear this load. Vertebral fracture and deformity is a hallmark of osteoporosis. The detriment of trabecular bone properties alone cannot explain the occurrence of osteoporotic vertebral fracture. The ability of the spine to bear and resist loads depends on the structural capacity of the vertebrae, but also on loading conditions arising from activities of daily living or low-energy trauma. This review describes the mechanical properties of the vertebral bone, the structural load-bearing capacity of the various elements forming the spine, the neuromuscular control of the trunk, as well as the biomechanics of the loads to which the spine is subjected in relation to the presence of osteoporosis and the risk of vertebral fracture. A better understanding of biomechanical factors may help to explain both the high incidence of osteoporotic vertebral fractures and their mechanism of production. Consideration of these issues may be important in the development of prevention and management strategies.</div></div>","PeriodicalId":39664,"journal":{"name":"Revista Espanola de Cirugia Ortopedica y Traumatologia","volume":"68 6","pages":"Pages T562-T571"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}