Vertebral compression fractures can affect both sexes and constitute a major health care problem, due to negative impact on the patient’s function, quality of life and the costs to the health care system. Patients can be treated conservatively or by conventional fluoroscopic assisted vertebroplasty – injection of polymethylmethacrylate PMMA into the fractured vertebral body. Conventional vertebroplasty imposes technical challenges with possible complications including cement extravasations, nerve root compression, the possibility of breaching the walls of the pedicle by the osteoplasty needle and prolonged fluoroscopic radiation exposure of the surgeon and the medical team at large. We present here a comparative study of 20 cases of thoraco-lumbar vertebral compression fracture, treated with robotic assisted vertebroplasty (research group) versus 30 cases of fractures treated by conventional fluoroscopic vertebroplasty (compared group). All patients were diagnosed as suffering from acute vertebral compression fractures (up to 3 weeks from the traumatic event) and were scored 7 and above in the VAS. The mean overall operation time of the fluoroscopic assisted vertebroplasty was 35 minutes compared to a mean operation time of 45 minutes at the robotic assisted vertebroplasty. There was a significant difference in the fluoroscopic time and subsequent exposure time to radiation between the groups: in the research group we used only an average of 3 seconds of fluoroscopic exposure (an average of 5 fluoroscopic images) compared to an average of 7 seconds of exposure (an average of 12 fluoroscopic images). No difference was found between the groups in regard with overall admission time or with the time between the operation and physiotherapy.
Anterior decompression and adequate spine fixation in patients with cervical radiculopathy and myelopathy are essential for functional restoration of cervical spine. In this study, we performed evaluation and comparative radiological assessment of several types of spinal implants in terms of bone block formation, sagittal alignment and effectiveness as a structural support.
Group1. Autograft – 91 patients Group 2. TiNi alloy cages – 74 patients. Group 3. Varilift expandable cages without plate fixation – 22 patients Group 4. Verilift cages with plate fixation – 8 patients Group 5. Bone substitute spacer and plate fixation – 3 patients.
Nuclear magnetic resonance imaging (MRI) was used to study the normal knee. As well as revealing bone quality, MRI provided useful information on intra-articular and extra-articular soft tissues. Midsagittal views gave clear images of the cruciate ligaments, and of the patellar and quadriceps tendons. Parasagittal views were the best for delineating the menisci which, like ligaments and tendons, are of low intensity; the semimembranosus tendon and its insertion to the proximal tibia were also seen clearly in these views. The cruciate ligaments and menisci, though visible in the coronal view also, were better seen in the sagittal view. Axial views provided information on the structure of the patella, its cartilage, the patellofemoral joint and posterior soft-tissue structures.