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Background: Osteoporosis, a skeletal disorder affecting nearly 20% of the global population, poses a significant health concern, with osteoporotic vertebral body fractures (VBF) representing a common clinical manifestation. The impact of osteoporotic sintering fractures in the thoracolumbar spine on the sagittal lumbar profile is incompletely understood and may lead to the onset of clinical symptoms in previously asymptomatic patients. Methods: This retrospective single-center study analyzed data from patients presenting with osteoporotic spine fractures between 2017 and 2022. Patient selection involved stringent inclusion and exclusion criteria, focusing on radiologically documented osteoporotic sintering fractures in the thoracolumbar junction (TH11-L2). Clinical parameters were recorded and analyzed, alongside lateral-view radiographic assessments utilizing the IDS 7-PACS®-System (Sectra, Linköping, Sweden). Measurements included total lumbar lordosis, lordosis caudal to the fracture, kyphosis of the fractured vertebra, and sacral slope. Statistical analysis was conducted using SPSS 27 (IBM, Armonk, USA). Results: Thirty patients (73.3% female, 26.7% male) met the inclusion criteria, with an average age of 82.4 years. Analysis revealed a significant increase in kyphosis of the fractured vertebra in the thoracolumbar spine (p < 0.0001) following further sintering of osteoporotic VBF with increased lordosis caudal to the fracture (p < 0.0001). Total lumbar lordosis remained unchanged, alongside sacral slope measurements (p = 0.612 and p = 0.863, respectively). Conclusion: Progressive sintering of osteoporotic fractures in the thoracolumbar junction accentuates lordosis in underlying segments, potentially exacerbating degenerative changes and symptomatic manifestations. Thus, prioritizing interventions aimed at preventing progressive sintering and restoring sagittal balance is paramount in optimizing treatment outcomes for affected individuals. [ABSTRACT FROM AUTHOR]

Study Design: Retrospective case-control study.Objectives: Proximal junctional kyphosis (PJK) is a postoperative complication involving the proximal segments which is commonly seen in patients with degenerative spine diseases (DSD). The purpose of the present study was to identify predictive factors for postoperative PJK in elderly patients with DSD.Methods: We reviewed elderly patients with DSD who underwent thoracolumbar fusion involving no less than 3 levels. Patients who developed PJK were propensity score-matched with patients with DSD who received the same procedure but did not develop PJK. Demographic characteristics, sagittal vertical axis (SVA), computed tomography (CT) value (Hounsfield unit), and paraspinal muscle parameters were compared between PJK and non-PJK groups.Results: Eighty-three PJK and non-PJK patients were selected by propensity score matching for age, sex, history of smoking, body mass index, number of fused segments, and upper instrumented vertebra (UIV) location. SVA showed no significant difference between the two groups. In PJK group, fatty infiltration (FI) in erector spinae and multifidus was significantly greater, while the relative cross-sectional area (rCSA) of erector spinae was significantly smaller than that in non-PJK group. CT value was significantly lower in PJK group. Lower erector spinae rCSA and CT value of the UIV, higher erector spinae FI and multifidus FI were identified as predictors of postoperative PJK.Conclusions: PJK is a common complication in older patients with DSD. Paraspinal muscle degeneration and low bone mineral density of the UIV are predictors of PJK. Protective measures targeting paraspinal muscles and the UIV may help prevent postoperative PJK. [ABSTRACT FROM AUTHOR]

Background: Spinal injection has been an accepted part of conservative therapy for degenerative diseases. The drugs used can cause side effects and severe complications. The aim of this study was to determine the occurrence of general side effects (GSE) and complications when performing consecutive different types of spinal injections and to evaluate pain reduction.Methods: Prospective data evaluation of patients with degenerative spine disease at hospital admission, discharge, and six and 12 weeks after discharge. All patients received a specific injection protocol depending on their symptoms and radiological findings. The injections performed were dorsal sacroiliac joint injections, perineural injections, epidural interlaminar and epidural periradicular injections, and facet joint injections. Potential complications were categorized and recorded as GSE and complications. In addition, the Numerical Analog Scale (NAS) for pain, the Oswestry Disability Index (ODI) were evaluated.Results: Forty-eight patients were enrolled. There were 282 spinal injections performed. A total of 131 common treatment-related events were recorded. Depending on the type of injection, transient pain at the injection site (32.4-73.5%), radiating pain (9.4-34.7%), and nerve root irritation (2-18.4%) were the most common. One complication with postpuncture syndrome occurred with epidural-interlaminar injection. No persistent neurologic deficits occurred. The highest rate of GSE was observed with periradicular injections (relative frequency (RF) = 0.8), followed by epidural-interlaminar injections (RF = 0.65), least frequently with FJ injections (RF = 0.32). From the time of admission to discharge, NAS scores were significantly decreased and ODI score significantly improved at discharge (p < 0.001), but relapse occurred at the 12-week follow-up.Conclusions: Various consecutive spinal injections for conservative treatment of degenerative spine diseases are safe and lead to a decrease in pain and improvement in quality of life. GSE are common, but not persistent. Although complications are rare, they can have serious consequences for the patient. [ABSTRACT FROM AUTHOR]

Background: Wound pain after surgery for lumbar spine disease may interfere with patients' recovery. Acupuncture is commonly used for pain management, but its efficacy for postoperative pain control is unclear. This study aimed to evaluate the effectiveness of acupuncture for adjuvant pain control after surgery for degenerative lumbar spine disease. Methods: We retrospectively reviewed the records of consecutive patients who received surgery for degenerative lumbar spine disease at our institution from 2013 to 2014. Surgical procedures included open laminectomy, discectomy, and trans-pedicle screw instrumentation with posterior-lateral fusion. Patients were grouped by pain control methods, including routine analgesia, patient-controlled analgesia (PCA), and acupuncture. The routine analgesia group received oral acetaminophen/non-steroidal anti-inflammatory drugs with meperidine as needed for immediate pain control. The PCA group received a basal dose of morphine and subsequent user-demand doses. The acupuncture group received acupuncture every other day after surgery. Results: Ninety-six patients were included, of whom 37 received acupuncture, 27 received PCA, and 32 received routine analgesics for pain control. Visual analog scale (VAS) pain scores in all 3 groups decreased significantly, and to the same degree, from the first postoperative day to the second day. No significant differences were found in VAS scores over the next 6 postoperative days; however, the scores of patients treated with PCA were slightly but still significantly higher (p = 0.026) on postoperative day 4 than scores of patients treated with acupuncture and traditional analgesia, a difference likely due to PCA being discontinued on postoperative day 3. No major complications were noted in the acupuncture group, but 2 patients dropped out because of fear of needle insertion. Conclusions: Acupuncture may be as effective as traditional analgesia and PCA for adjuvant pain control after surgery for degenerative lumbar spine disease. [ABSTRACT FROM AUTHOR]