TY - CASE A4 - Jenkins, K. A2 - Wake, P. J. DB - cin20 DO - 10.1046/j.1365-2044.2002.2575_20.x DP - EBSCOhost J2 - Anaesthesia KW - Arthroplasty, Replacement, Hip -- Adverse Effects Bone Cements -- Adverse Effects Embolism, Fat -- Etiology Heart Arrest -- Etiology Hypotension -- Etiology Aged Female Syndrome N1 - CINAHL (EbscoHost) literature search January 5, 2021 NV - Malden, Massachusetts PB - Wiley-Blackwell PY - 2002 SP - 416-416 ST - Cement implantation syndrome TI - Cement implantation syndrome UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104727922&site=ehost-live&scope=site VL - 57 ID - 830795 ER - TY - JOUR AN - 105866169. Language: English. Entry Date: 20080321. Revision Date: 20150711. Publication Type: Journal Article DB - cin20 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Hypotension -- Chemically Induced Pulmonary Embolism -- Chemically Induced Spinal Cord Compression -- Chemically Induced Spinal Fractures Intraoperative Monitoring Kyphoplasty Pain -- Therapy Tomography M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2007 SN - 1010-9609 SP - 12-13 ST - Complications with use of bone cement T2 - WHO Drug Information TI - Complications with use of bone cement UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105866169&site=ehost-live&scope=site VL - 21 ID - 830767 ER - TY - JOUR AB - OBJECTIVE OF ANALYSIS: The objective of this analysis is to examine the safety and effectiveness of percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures (VCFs) compared with conservative treatment. CLINICAL NEED AND TARGET POPULATION: Osteoporosis and associated fractures are important health issues in ageing populations. Vertebral compression fracture secondary to osteoporosis is a cause of morbidity in older adults. VCFs can affect both genders, but are more common among elderly females and can occur as a result of a fall or a minor trauma. The fracture may occur spontaneously during a simple activity such as picking up an object or rising up from a chair. Pain originating from the fracture site frequently increases with weight bearing. It is most severe during the first few weeks and decreases with rest and inactivity. Traditional treatment of painful VCFs includes bed rest, analgesic use, back bracing and muscle relaxants. The comorbidities associated with VCFs include deep venous thrombosis, acceleration of osteopenea, loss of height, respiratory problems and emotional problems due to chronic pain. Percutaneous vertebroplasty is a minimally invasive surgical procedure that has gained popularity as a new treatment option in the care for these patients. The technique of vertebroplasty was initially developed in France to treat osteolytic metastasis, myeloma, and hemangioma. The indications were further expanded to painful osteoporotic VCFs and subsequently to treatment of asymptomatic VCFs. The mechanism of pain relief, which occurs within minutes to hours after vertebroplasty, is still not known. Pain pathways in the surrounding tissue appear to be altered in response to mechanical, chemical, vascular, and thermal stimuli after the injection of the cement. It has been suggested that mechanisms other than mechanical stabilization of the fracture, such as thermal injury to the nerve endings, results in immediate pain relief. PERCUTANEOUS VERTEBROPLASTY: Percutaneous vertebroplasty is performed with the patient in prone position and under local or general anesthesia. The procedure involves fluoroscopic imaging to guide the injection of bone cement into the fractured vertebral body to support the fractured bone. After injection of the cement, the patient is placed in supine position for about 1 hour while the cement hardens. Cement leakage is the most frequent complication of vertebroplasty. The leakages may remain asymptomatic or cause symptoms of nerve irritation through compression of nerve roots. There are several reports of pulmonary cement embolism (PCE) following vertebroplasty. In some cases, the PCE may remain asymptomatic. Symptomatic PCE can be recognized by their clinical signs and symptoms such as chest pain, dyspnea, tachypnea, cyanosis, coughing, hemoptysis, dizziness, and sweating. LITERATURE SEARCH: A literature search was performed on Feb 9, 2010 using OVID MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, the Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Cochrane Library, and the International Agency for Health Technology Assessment (INAHTA) for studies published from January 1, 2005 to February 9, 2010. Studies were initially reviewed by titles and abstracts. For those studies meeting the eligibility criteria, full-text articles were obtained and reviewed. Reference lists were also examined for any additional relevant studies not identified through the search. Articles with an unknown eligibility were reviewed with a second clinical epidemiologist and then a group of epidemiologists until consensus was established. Data extraction was carried out by the author. STUDY DESIGN: Randomized controlled trials (RCTs) comparing vertebroplasty with a control group or other interventions STUDY POPULATION: Adult patients with osteoporotic vertebral fracturesSTUDY SAMPLE SIZE: Studies included 20 or more patientsEnglish language full-reportsPublished between Jan 1 2005 and Feb 9, 2010(eligible studies identified through the Auto Alert function of the search were also included) EXCLUSION CRITERIA: Non-randomized studiesStudies on conditions other than VCF (e.g. patients with multiple myeloma or metastatic tumors)Studies focused on surgical techniquesStudies lacking outcome measures RESULTS OF EVIDENCE-BASED ANALYSIS: A systematic search yielded 168 citations. The titles and the abstracts of the citations were reviewed and full text of the identified citations was retrieved for further consideration. Upon review of the full publications and applying the inclusion and exclusion criteria, 5 RCTs were identified. Of these, two compared vertebroplasty with sham procedure, two compared vertebroplasty with conservative treatment, and one compared vertebroplasty with balloon kyphoplasty. RANDOMIZED CONTROLLED TRIALS: Recently, the results of two blinded randomized placebo-controlled trials of percutaneous vertebroplasty were reported. These trials, providing the highest quality of evidence available to date, do not support the use of vertebroplasty in patients with painful osteoporotic vertebral compression fractures. Based on the results of these trials, vertebroplasty offer no additional benefit over usual care and is not risk free. In these trials the treatment allocation was blinded to the patients and outcome assessors. The control group received a sham procedure simulating vertebroplasty to minimize the effect of expectations and to reduce the potential for bias in self-reporting of outcomes. Both trials applied stringent exclusion criteria so that the results are generalizable to the patient populations that are candidates for vertebroplasty. In both trials vertebroplasty procedures were performed by highly skilled interventionists. Multiple valid outcome measures including pain, physical, mental, and social function were employed to test the between group differences in outcomes. Prior to these two trials, there were two open randomized trials in which vertebroplasty was compared with conservative medical treatment. In the first randomized trial, patients were allowed to cross over to the other arm and had to be stopped after two weeks due to the high numbers of patients crossing over. The other study did not allow cross over and recently published the results of 12 months follow-up. The following is the summary of the results of these 4 trials: Two blinded RCTs on vertebroplasty provide the highest level of evidence available to date. Results of these two trials are supported by findings of an open randomized trial with 12 months follow-up. Blinded RCTs showed: No significant differences in pain scores of patients who received vertebroplasty and patients who received a sham procedure as measured at 3 days, 2 weeks and 1 month in one study and at 1 week, 1 month, 3 months, and 6 months in the other.The observed differences in pain scores between the two groups were neither statistically significant nor clinically important at any time points.The above findings were consistent with the findings of an open RCT in which patients were followed for 12 months. This study showed that improvement in pain was similar between the two groups at 3 months and were sustained to 12 months.In the blinded RCTs, physical, mental, and social functioning were measured at the above time points using 4-5 of the following 7 instruments: RDQ, EQ-5D, SF-36 PCS, SF-36 MCS, AQoL, QUALEFFO, SOF-ADLThere were no significant differences in any of these measures between patients who received vertebroplasty and patients who received a sham procedure at any of the above time points (with a few exceptions in favour of control intervention).These findings were also consistent with the findings of an open RCT which demonstrated no significant between group differences in scores of ED-5Q, SF-36 PCS, SF 36 MCS, DPQ, Barthel, and MMSE which measure physical, mental, and social functioning (with a few exceptions in favour of control intervention).One small (n=34) open RCT with a two week follow-up detected a significantly higher improvement in pain scores at 1 day after the intervention in vertebroplasty group compared with conservative treatment group. However, at 2 weeks follow-up, this difference was smaller and was not statistically significant.Conservative treatment was associated with fewer clinically important complicationsRisk of new VCFs following vertebroplasty was higher than those in conservative treatment but it requires further investigation. AN - 23074396 C2 - Pmc3377535 DP - NLM ET - 2010/01/01 J2 - Ontario health technology assessment series LA - eng M1 - 19 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 1915-7398 (Print) 1915-7398 SP - 1-45 ST - Percutaneous vertebroplasty for treatment of painful osteoporotic vertebral compression fractures: an evidence-based analysis T2 - Ont Health Technol Assess Ser TI - Percutaneous vertebroplasty for treatment of painful osteoporotic vertebral compression fractures: an evidence-based analysis VL - 10 ID - 828863 ER - TY - CASE A4 - Cohen, J. A2 - Lane, T. A2 - Cohen, Jonathan A2 - Lane, Timothy DB - cin20 DO - 10.1016/j.amjmed.2010.01.037 DP - EBSCOhost J2 - American Journal of Medicine KW - Embolism -- Etiology Foreign Bodies -- Etiology Heart Atrium Heart Ventricle Polymethacrylic Acids Kyphoplasty -- Adverse Effects Aged Embolism -- Radiography Foreign Bodies -- Radiography Male N1 - CINAHL (EbscoHost) literature search January 5, 2021 PB - Excerpta Medica Publishing Group PY - 2010 SP - e5-6 ST - Right intra-atrial and ventricular polymethylmethacrylate embolus after balloon kyphoplasty TI - Right intra-atrial and ventricular polymethylmethacrylate embolus after balloon kyphoplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105112418&site=ehost-live&scope=site VL - 123 ID - 830702 ER - TY - CASE A4 - Abd El-Rahman, A. M. A2 - Lazzarotti, A. G. A2 - Cosottini, M. A2 - Puglioli, M. AB - Percutaneous vertebroplasty (PV) is considered a minimally invasive procedure, yet cement leakage into the circulation may result in serious complications. Here, we are reporting a case of pulmonary embolism following PV for treatment of osteoporotic compression vertebral fracture. AD - South Egypt Cancer Institute, Assiut, Egypt Unit of Interventional Radiology, Department of Neuroscience, Cisanello Hospital, Pisa University, Pisa, Italy Unit of Neuroradiology, Department of Neuroscience, Cisanello Hospital, Pisa University, Pisa, Italy DB - cin20 DO - 10.1177/197140091202500411 DP - EBSCOhost J2 - Neuroradiology Journal KW - Pulmonary Embolism -- Chemically Induced Orthopedic Surgery -- Adverse Effects Cementation -- Adverse Effects Postoperative Complications Case Management Female Aged Fractures, Compression -- Surgery Equipment and Supplies Echocardiography Blood Gas Analysis Radionuclide Imaging -- Utilization Tomography -- Utilization Minimally Invasive Procedures -- Adverse Effects Anticoagulants -- Therapeutic Use N1 - CINAHL (EbscoHost) literature search January 5, 2021 PB - Sage Publications, Ltd. PY - 2012 SP - 481-485 ST - Pulmonary Embolism Caused by Cement Leakage During Percutaneous Vertebroplasty: A Case Report of Successful Conservative Management TI - Pulmonary Embolism Caused by Cement Leakage During Percutaneous Vertebroplasty: A Case Report of Successful Conservative Management UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=83007050&site=ehost-live&scope=site VL - 25 ID - 830676 ER - TY - CASE A4 - Mattis, T. A2 - Knox, M. A2 - Mammen, L. A2 - Mattis, Tod A2 - Knox, Michael A2 - Mammen, Leena AD - Department of Diagnostic Radiology, Grand Rapids Medical Education Partners/Michigan State University, 1000 Monroe Ave. NE, Grand Rapids, MI 49503; Radiology Department, Spectrum Health, Grand Rapids, Michigan. DB - cin20 DO - 10.1016/j.jvir.2011.12.027 DP - EBSCOhost J2 - Journal of Vascular & Interventional Radiology KW - Bone Cements -- Adverse Effects Embolism -- Etiology Foreign-Body Migration -- Etiology Heart Injuries -- Etiology Methylmethacrylates -- Adverse Effects Pericarditis -- Etiology Kyphoplasty -- Adverse Effects Aged Embolism -- Radiography Embolism -- Therapy Foreign-Body Migration -- Radiography Foreign-Body Migration -- Therapy Heart Atrium -- Injuries Heart Injuries -- Radiography Heart Injuries -- Therapy Male Pericarditis -- Radiography Pericarditis -- Therapy Tomography, X-Ray Computed Treatment Outcomes N1 - CINAHL (EbscoHost) literature search January 5, 2021 NV - New York, New York PB - Elsevier B.V. PY - 2012 SP - 719-720 ST - Intracardiac methylmethacrylate embolism resulting in right atrial wall perforation and pericarditis following percutaneous vertebroplasty TI - Intracardiac methylmethacrylate embolism resulting in right atrial wall perforation and pericarditis following percutaneous vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104558400&site=ehost-live&scope=site VL - 23 ID - 830680 ER - TY - CASE A4 - Torres, Brian A. AB - The article presents a case study of a 64-year-old woman who underwent surgical revision of a prior right total hip arthroplasty due to ongoing pain. Preoperative differential diagnosis of the patient showed metal debris versus infection. It indicates that the patient was administered with 5- hydroxytryptamine3 (5-HT3) receptor antagonist after suspected bone cement implantation syndrome. AD - Goldfarb School of Nursing, Barnes-Jewish College DB - cin20 DP - EBSCOhost J2 - International Student Journal of Nurse Anesthesia KW - Bone Cements -- Adverse Effects Arthroplasty, Replacement, Hip Pulmonary Embolism -- Etiology Anesthesia Intraoperative Complications -- Prevention and Control Middle Age Female Reoperation Epidural Catheters Blood Loss, Surgical N1 - CINAHL (EbscoHost) literature search January 5, 2021 NV - Davidsonville, Maryland PB - R.L. Van Nest PY - 2013 SP - 18-22 ST - 5-HT3 Receptor Antagonism following Suspected Bone Cement Implantation Syndrome TI - 5-HT3 Receptor Antagonism following Suspected Bone Cement Implantation Syndrome UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=90157074&site=ehost-live&scope=site VL - 12 ID - 830653 ER - TY - JOUR AB - The proceedings contain 115 papers. The special focus in this conference is on Radiology. The topics include: Imaging approach and management of breast cysts; mammographic signs of systemic disease; diagnostic value of cardiac MRI in comparison to trans-thoracic echocardiography in detection and characterization of cardiac masses; the role of cardiac MRI in children’s congenital and acquired heart disease; pulmonary nodules CT scan; quantification of pulmonary thromboembolism in ct angiography reports and predicting right ventricular dysfunction and patient mortality; comparison of HRCT features of pneumocystis jiroveci pneumonia in patients with and without HIV; HRCT features of pulmonary aspergillosis in patients with solid organ transplant; diagnostic accuracy of HRCT for differentiation of NSIP, UIP and chronic hypersensitivity pneumonitis; malignant mesothelioma versus metastatic adenocarcinoma of pleura; anomalous retro aortic left brachiocephalic vein; ethical case studies in uroradiology; serial high-resolution ultrasound findings of acute nasal fracture; gastrointestinal imaging; the role of interventional radiology in diseases of the hepatobiliary system; usefulness of lung window in evaluating abdominal computed tomography of drug mules; differentiation between groin hernia with cross-sectional imaging; radiologic manifestations of chronic constipation in CT scan; sonoelastography of the liver; using optimal projections for reduction of radiation risks in some radiographies; accurate quantification of metabolite ratio in osteosarcoma employing clinical magnetic resonance spectroscopy at 3T; pharmacokinetic model and arterial input function selection in dynamic contrast enhanced-MRI in head and neck cancers; lumbar spinal stenosis; MR imaging of posterolateral corner injury of the knee; imaging presentations of spinal instability; QCT and diagnosis of osteoporosis; three dimensional transperineal ultrasonography of the pelvic floor; T1 quantification of the cortical bone employing short-TE MRI at 1.5 and 3 Tesla; value of sonographic examination of left wrist and hand in estimation of bone age in 0–6 years old children; true 3D weight bearing CT imaging for foot and ankle; differential X-ray diagnostics of aneurysmal and simple bone cyst; magnetic resonance imaging in the diagnosis of osteoarthritis of the knee; minimal invasive treatments; non-traumatic neurologic emergencies; pre and post operative imaging findings in tumoral lesions of temporal bone and base of skull; development of a low-cost phantom to assess absolute quantification in multi-voxel MR spectroscopy; vascular anatomy of the spinal cord; imaging of postoperative cranium; neonatal asphyxia, what a radiologist needs to know; the relationship between cognitive function and brain lesion volumes in multiple sclerosis patients; magnetic resonance spectroscopy in neurological disorders; patterns of brain injury in poisoning and intoxication; review on surgical and imaging anatomy of 7 segments of the internal carotid artery; approach to white matter lesions of brain; role of positron emission tomography– computed tomography in pulmonary neoplasms; imaging modalities in laryngeal tumors; diagnostic imaging of malignant cervical lymphadenopathy in staging and surgical planning; effectiveness of semi-quantitative multiphase dynamic contrast--enhanced MRI at 3 Tesla as a predictor of malignancy in adnexal masses; automatic bone segmentation in pelvis area with bone marrow metastases; applications in breast cancer treatment monitoring; a review study on the efficacy of quantitative DCE-MRI in adnexal lesion diagnosis; imaging workup of incidentally discovered adrenal masses in oncologic patients; imaging of congenital brain tumors; imaging of pediatric epilepsy; comparison of B-mode ultrasonography and CT-scan in diagnosis of children’s maxillary sinusitis; MRI Findings in Children Presenting with Epilepsy; Radiological Appearances of Fibrous dysplasia and its differential diagnosis; pitfalls and variants in brain sonography of pediatrics; p thologic findings in neonatal brain ultrasound; postmenopausal bleeding; urinary tract anomalies; sonographic measurement of the umbilical cord and its vessels and their relation with fetal anthropometric parameters; Doppler evaluation of uterine anomalies and masses in infertility; diffusion-weighted imaging of the normal placenta, correlation of ADC values with granuum classification; various types of niche imaging by sonohysterography; ultrasound in the diagnosis of endometriosis; imaging evaluation of recurrence in treated prostate cancer; conventional imaging of urinary system; role of acoustic value histogram of urinary stone on ultrasonography as predictor of amenability to extracorporeal shock wave lithotripsy; approach to renal incidentaloma; ultrasonographic evaluation of renal transplantation complications; percutaneous vertebroplasty and its short term clinical outcome; self-expandable metal stents in malignant biliary obstruction; intervention in benign biliary stricture and biliary leak; management of thyroid lesions; management of benign head and neck tumors; coil embolization of intracranial aneurysms; endovascular treatment of spinal arteriovenous malformations; endovenous laser for the treatment of saphenous reflux and varicose veins; safety and efficacy of intra-arterial chemotherapy in retinoblastoma; classification, imaging, and interventional procedures in peripheral congenital vascular anomalies; high frequency and noncontact low frequency ultrasound therapy for venous leg ulcer treatment; efficacy of radiologic percutaneous interventional treatments for biliary complications after liver complications after liver transplantation; biliary interventions and MR imaging protocol for pelvic genital organs. DB - Embase KW - metal radiology imaging human nuclear magnetic resonance imaging diagnosis male computer assisted tomography patient echography child nuclear magnetic resonance spectroscopy brain ultrasound cardiovascular magnetic resonance intoxication liver classification epilepsy skull pelvis knee cholestasis lung embolism diagnostic accuracy echocardiography diagnostic value Pneumocystis pneumonia inguinal hernia radiography lung aspergillosis solid transplantation prostate cancer allergic pneumonitis systemic disease hepatobiliary system nose fracture cognition mortality brain damage neurologic disease internal carotid artery interventional radiology diseases larynx tumor lung mule planning constipation cancer therapy monitoring radiation hazard maxilla sinusitis metabolite osteosarcoma urinary tract malformation pharmacokinetics model head and neck cancer lumbar spinal stenosis diffusion weighted imaging endometriosis injury osteoporosis histogram pelvis floor newborn hypoxia phantom lung nodule heart ventricle function heart disease invasive procedure osteoarthritis case study computed tomographic angiography congenital blood vessel malformation emergency temporal bone spinal cord brachiocephalic vein radiologist multiple sclerosis brain injury bone cyst white matter lesion positron emission tomography lung tumor pleura diagnostic imaging cervical lymphadenopathy staging X ray bone intracranial aneurysm bone marrow metastasis breast cancer ankle adenocarcinoma adrenal gland brain tumor fibrous dysplasia differential diagnosis pediatrics bleeding weight bearing mesothelioma umbilical cord anthropometric parameters uterus malformation infertility bone age placenta stent wrist kidney transplantation urinary tract urolithiasis extracorporeal shock wave lithotripsy examination incidentaloma cortical bone percutaneous vertebroplasty thyroid gland head and neck tumor coil embolization arteriovenous malformation laser varicosis safety intraarterial drug administration retinoblastoma procedures breast cyst ultrasound therapy leg ulcer liver transplantation genital system Human immunodeficiency virus LA - English M3 - Conference Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1735-1065 2008-2711 SP - S16 ST - 30th Iranian Congress of Radiology T2 - Iranian Journal of Radiology TI - 30th Iranian Congress of Radiology UR - https://www.embase.com/search/results?subaction=viewrecord&id=L75007248&from=export VL - 11 ID - 829418 ER - TY - JOUR AB - BACKGROUND: Recent literatures have showed that percutaneous kyphoplasty can effectively avoid nerve damage, pulmonary embolism, and insufficient vertebral height and other security risks when bone cement is infused into affected vertebrae in percutaneous vertebroplasty. OBJECTIVE: To compare the effect of percutaneous kyphoplasty and percutaneous vertebroplasty in repair of osteoporotic vertebral compression fractures. METHODS: A total of 106 patients with senile osteoporotic vertebral compression fractures were randomly divided into trial group and control group (n=53 per group). Patients in the trial group were treated with percutaneous kyphoplasty, and those in the control group treated with percutaneous vertebroplasty. All patients were followed up for 6 months after repair. The vertebral compression deformation, bone cement distribution, midline vertebral bone cement condition, vertebral height restoration, bone cement leakage, vertebral kyphosis, progressive spinal collapse, nerve damage, as well as visual analog scale scores and Oswestry disability index scores in these two groups were compared. RESULTS AND CONCLUSION: Compared with the control group, there was less bone cement leakage and vertebral compression deformation in the trial group. Moreouer, in the trial group, bone cement distributed uniformly, vertebral height restoration was good and effective, pain was obviously relieved, and the probability of vertebral kyphosis, progressive spine collapse and nerve damage was significantly reduced (all P < 0.05). These results suggest that percutaneous kyphoplasty can effectively relieve the pain of patients with osteoporotic vertebral compression fractures, restore vertebral body height and reduce the incidence of complications, which effectively guarantees the postoperative restoration of motor function. Copyright © 2016, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved. AN - CN-01414566 M1 - 4 N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2016 SP - 539‐543 ST - Percutaneous kyphoplasty versus percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a randomized comparison T2 - Chinese journal of tissue engineering research TI - Percutaneous kyphoplasty versus percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a randomized comparison UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01414566/full VL - 20 ID - 829988 ER - TY - CASE A4 - Hagen, Anita ten A2 - Doldersum, Pieter A2 - Raaij, Tom van AB - Background: Cemented total hip arthroplasty (THA) is a safe and common procedure. In rare cases life threatening bone cement implantation syndrome (BCIS) may occur, which is commonly caused by pulmonary embolism (PE). Case presentation: We describe the rare case of a 70-year old patient who underwent an elective total hip replacement. Before surgery he was diagnosed with underlying systemic indolent mastocytosis, a rare pathological disorder that may result in anaphylaxis after massive systemic mast cell activation. Triggers may be IgE-mediated, direct mast cell activation, or unclear. Some patients may be at risk for severe non IgE-mediated reactions, such as those experienced with nonsteroidal anti-inflammatory drugs, or with perioperative muscle relaxants. During cementing of the acetabular component, our patient developed acute hypotension (blood pressure dropped from 90/50 to 60/40 mmHg, and saturation dropped from 95 to 80%). The differential diagnosis of acute PE was excluded (no signs of breathing abnormalities during physical examination, normal arterial blood sample, and no electrocardiography or cardiac ultrasound abnormalities). The patient was diagnosed with acute anaphylactic shock, which was successfully managed by 100% oxygen administration, rapid fluid induction, and vasoconstrictive drug therapy. He recovered hemodynamically within 15 min, did not lose consciousness, and did not develop angioedema or an urticarial rash. Forty-five minutes after onset of the symptoms, the surgical procedure was completed after inserting a press fitted uncemented femoral stem component. The patient was transported to the Intensive Care Unit (ICU) for optimal monitoring. Our patient had an uneventful recovery. Within six hours after surgery he started to ambulate following our standard fast-track rehabilitation regime. Post-operative day one he was discharged to the specialized Orthopedic Department, and after five hospital days discharged to his home. Twelve months after THA surgery our patient was satisfied with an optimal functional status of his hip joint replacement. Conclusion: The differential diagnosis of anaphylactic shock must be taken into consideration in patients with acute hypotension during cementing of total hip arthroplasty components. Patients with underlying mastocytosis are at particular risk of this potential life-threatening intra-operative complication. This rare entity should be taken into consideration during the pre-operative risk stratification and shared decision-making process for elective cemented joint replacement. AD - Department of Anesthesiology, Martini Hospital Groningen, Van Swietenplein 1, 9728 NT Groningen, The Netherlands Department of Orthopaedic Surgery, Martini Hospital Groningen, van Swietenplein 1, 9728 NT Groningen, The Netherlands DB - cin20 DO - 10.1186/s13037-016-0113-x DP - EBSCOhost J2 - Patient Safety in Surgery N1 - CINAHL (EbscoHost) literature search January 5, 2021 PB - BioMed Central PY - 2016 SP - 1-4 ST - Anaphylactic shock during cement implantation of a total hip arthroplasty in a patient with underlying mastocytosis: case report of a rare intraoperative complication TI - Anaphylactic shock during cement implantation of a total hip arthroplasty in a patient with underlying mastocytosis: case report of a rare intraoperative complication UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=119929560&site=ehost-live&scope=site VL - 10 ID - 830582 ER - TY - JOUR AB - Objective; To evaluate the clinical effect of pereutaneous vertbroplasty (PVP) combined with implantation of iodine‐125 0"T) radioactive particle in the treatment of vertebral metastasis, and to provide basis for the treatment of vertebral metastasis. Methods: A total of 69 patients with vertebral metastasis were divided into test group (n=32) and control group (n=37); the patients in test group were treated with PVP comined with implantation l2;T radioactive particle and the patients in control group were treated with PVP only. The heights of anterior and posterior vertebral bodies of the patients before and after treatment were detected by X‐ray. The numerical rating scale (NRS) scores, pain relief rate and the incidence of surgical complications of the patients were recorded before operation and Id, 1 week, 1 month, 3 months, and 6 months after operation. Results: The operation was successfully performed in all the patients without local bleeding; there were no movement dysfunction and nerve compression phenomenon. There was no leakage of bone cement. All the 12 T radioactive particles located well and there was no particle obscission. The heights of vertebral bodies of the patients in two groups after operation were increased compared with before operation (P<0. 05). The NRS scores of the patients in two groups s at 1 d, 1 week, 1 month, 3 months, 6 months after operation were significantly decreased compared with before operation (P 0.05). The height of the anterior border of the vertebral body and the degree of kyphosis of the vertebral body were significantly increased after surgery (P < 0.05). At different time points after surgery, the height of the anterior border of the vertebral body and the degree of kyphosis of the vertebral body were more obviously increased in the experimental group than in the control group (P < 0.05). Bone cement leakage rate in the observation group was significantly lower than that in the control group (16.50% vs. 22.43%, P < 0.05). There were no serious complications, such as recurrent fracture of adjacent vertebral bodies and pulmonary embolism, during the follow up period. These results suggest that high‐ and low‐viscosity bone cement percutaneous vertebroplasty for treatment of thoracolumbar metastases can alleviate pain and improve quality of life with exact clinical efficacy and high safety. High‐viscosity bone cement percutaneous vertebroplasty better recovers the height of the anterior border of the vertebral body, reduces the Cobb angles of kyphosis of the vertebral body, and lowers the risk of bone cement leakage than low‐viscosity bone cement percutaneous vertesroplasty. AN - CN-02147679 DO - 10.3969/j.issn.2095-4344.1348 KW - *bone metastasis /diagnosis /surgery *percutaneous vertebroplasty *thoracolumbar metastasis /diagnosis /surgery Adult Aged Article Bone cement leakage /complication Clinical effectiveness Cobb angle Comparative study Controlled study Human Imaging Major clinical study Middle aged Quality of life Spine fracture Surgical risk Vertebra body Very elderly M1 - 26 M3 - Journal: Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2019 SP - 4129‐4135 ST - Percutaneous vertebroplasty with different viscosities of bone cement for treatment of thoracolumbar metastases T2 - Chinese journal of tissue engineering research TI - Percutaneous vertebroplasty with different viscosities of bone cement for treatment of thoracolumbar metastases UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02147679/full VL - 23 ID - 829983 ER - TY - JOUR AB - BACKGROUND: A large number of literatures have confirmed that the use of tranexamic acid in total knee arthroplasty can effectively reduce perioperative bleeding, but there is no consensus on which tranexamic acid is most used. Little is reported on the changes of related inflammatory factors in blood after tranexamic acid is given. OBJECTIVE: To investigate the effects of different tranexamic acid administration methods on perioperative blood loss and inflammatory response in total knee arthroplasty. METHODS: Ninety patients who underwent unilateral total knee arthroplasty due to knee osteoarthritis from June 2016 to June 2018 were included in this study. They were randomly divided into three groups, 30 in each group using the envelope lottery method. All of them received cemented posterior cruciate ligament‐retaining unilateral total knee arthroplasty. In group A, patients were treated by intravenous infusion of tranexamic acid. In group B, intraarticular injection of tranexamic acid was performed. In group C, both intravenous and intraarticular administration of tranexamic acid was used. Perioperative total blood loss and occult blood loss were calculated, and the number of patients receiving blood transfusion and the volume of blood transfused were recorded. Fibrinogen level, prothrombin time, activated partial thromboplastin time, and the levels of inflammatory factors C‐reactive protein and interleukin‐6 were measured before and 1, 3 and 7 days after surgery. Deep vein thrombosis was examined at 1 week after surgery. All patients were followed up for 6 months to determine the occurrence of deep vein thrombosis and pulmonary embolism. This study was approved by the Medical Ethics Committee of the Third People’s Hospital of Hainan Province, China. RESULTS AND CONCLUSION: (1) Total perioperative blood loss in groups A and B was significantly higher than that in group C (P < 0.05). There were no significant differences in occult blood loss and blood transfusion rate among the three groups (P > 0.05). (2) There were no significant differences in fibrinogen level, prothrombin time and activated partial thromboplastin time among three groups before surgery and at 1, 3 and 7 days after surgery (P > 0.05). (3) In each group, C‐reactive protein and interleukin‐6 levels at 1 and 3 days after surgery were significantly higher than those before surgery (P < 0.05), and there were no significant differences in C‐reactive protein and interleukin‐6 levels among three groups (P > 0.05). (4) At 7 days after surgery, the levels of C‐reactive protein and interleukin‐6 in each group decreased to the levels before surgery, and there were no significant differences among three groups (P > 0.05). Vascular ultrasound examination of the both lower limbs showed no deep vein thrombosis at 1 week after surgery. After 6 months of follow‐up, there were no cases of deep venous thrombosis and pulmonary embolism in the lower limbs. (5) The results suggest that compared with simple intravenous or intraarticular administration of tranexamic acid, combined intravenous and intraarticular administration of tranexamic acid can greatly reduce total perioperative blood loss and does not increase the risk of developing deep vein thrombosis after total knee arthroplasty. Different administration methods of tranexamic acid have no obvious effects on inflammatory response. AN - CN-02147717 DO - 10.3969/j.issn.2095-4344.1962 KW - *inflammation *operative blood loss *posterior cruciate ligament retaining total knee arthroplasty *total knee arthroplasty Activated partial thromboplastin time Article Blood transfusion Blood volume Deep vein thrombosis Human Knee osteoarthritis /surgery Lung embolism Major clinical study Prothrombin time M1 - 36 M3 - Journal: Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2019 SP - 5753‐5759 ST - Intravenous and intraarticular tranexamic acid can reduce blood loss and inflammatory response during cemented posterior cruciate ligament-retaining unilateral total knee arthroplasty T2 - Chinese journal of tissue engineering research TI - Intravenous and intraarticular tranexamic acid can reduce blood loss and inflammatory response during cemented posterior cruciate ligament-retaining unilateral total knee arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02147717/full VL - 23 ID - 830038 ER - TY - JOUR AB - Objectives:ADVOS multi is a recirculating albumin-based dialysis device that supports kidney, liver and lung function by eliminating CO2, water-soluble and protein-bound substances. In the present work in vitro data on the removal of these substances and CO2 are presented. Methods: An ex vivo model using porcine blood was established and applied in detoxification tests for water soluble and protein bound retention solutes. 3 x 3.3L of blood with high bilirubin (30 mg/dl) and lactate levels (>10 mmol/l) were treated with ADVOS multi for 4 hours each. This design, with 3 phases changing blood every 4 hours, led to high concentrations of both markers in blood during the 12 h test period. For CO2 removal tests, 5 liters of blood were used instead. In both cases, a continuous CO2 supply through an additional dialyzer was applied. Results: Bilirubin and lactate were efficiently removed during 12hrs of in vitro detoxification. Lactate removal rates were 90%, 86% and 84% for phase 1, 2 and 3, respectively. Bilirubin elimination rates were 66%, 62%, and 57%, resulting in a total elimination of 1150 mg in 12 hrs. Albumin binding capacity was determined to be >76% at the end of the treatment indicating that albumin was not denatured in the dialysate of the ADVOS system. CO2 removal with ADVOS multi depends on three variables: 1) The amount of supplied CO2 depends on concentrate flow affecting both, blood pCO2 and bicarbonate levels; 2) blood flow, and 3) dialysate pH and composition (i.e., carbonate concentration). A maximum CO2 removal of 142 ml/min was achieved with a carbonate-free dialysate at pH 10, a blood flow of 400 ml/min and a concentrate flow of 160 ml/min. Given that blood gases are maintained within physiological conditions, a CO2 removal rate of 61 ml/min can be achieved. During all the experiments blood pH was set to 7.35-7.45. Discussion:ADVOS multi is a device using albumin recirculation in its secondary circuit. Here, albumin binding capacity remains stable through a systematic modification of its tertiary structure through temperature and pH changes in the ADVOS multi circuit. This facilitates the release of toxins from albumin and allows for further binding. Moreover, presence of albumin, variable dialysate composition and the flexible dialysate pH might facilitate the treatment of patients with multiple organ failure. Objectives:Given the extent of bypass graft failure, the motivation behind this multidisciplinary project is to improve the patency of the current bypass grafts by developing a novel and optimised blood flow augmentation technique. Methods: One of the most significant contributions to the improvement of haemodynamics in grafts was based on a research which showed that the 'spiral flow' is a natural phenomenon in the whole arterial system and is induced by the twisting of the left ventricle during contraction and then accentuated upon entering the aortic arch. The benefit of this flow pattern lies in removing unfavourable haemodynamic environment such as turbulence, stagnation and oscillatory shear stress, which are believed to be the main causes of intimal hyperplasia at anastomotic configurations. Results:This multi-disciplinary engineering venture has resulted in a unique product which makes use of both non-planar helicity and an optimised internal ridge within the graft to achieve a significantly improved haemodynamic condition within the anastomosis (an anastomosis is a surgical connection between autologous/prosthetic grafts and veins/arteries inside the human body) Discussion:This truly multidisciplinary project has integrated fluid mechanics, biomechanics and biology with cardiovascular surgery to develop a novel biomedical device, inspired by the nuclear engineering sector. The novel spiral-inducing bypass graft, nominated for this award, is the best example of how engineering techniques, tools and designs can lead to life-saving innovations that could potentially save the lives of thousands of people and save millions of pounds for the healthcare systems across the world. Such successful engineering stories are what would encourage the next generation of engineers to go beyond the traditional boundaries of engineering disciplines to make a difference. Objectives:The goal of this work was to study methods that will allow increase in spatial freedom of couplers orientation in inductive powering unit for implantable medical devices. An inductive energy transfer system is considered, therefore the freedom of relative orientation of the transmitting and receiving coils must be optimized. Methods:The design procedure of inductive powering unit (IPU) consists of two main steps: design of the power amplifier and optimization of an inductive link. To account for the patient specifics, such as tissue thickness near the implantation site, a number of different couplers were simulated using finite element modeling. Effect of coils geometrical parameters on mutual inductance and inductive link efficiency was examined. Class E power amplifier was chosen as a driver for the transmitting coil. Capacitors in the amplifier loading network were tuned to achieve zero-voltage switching (ZVS). A patient's everyday activity, including walking and even breathing, leads to misalignment of the transmitting and receiving coils, and, as a result, detuning of the amplifier from ZVS and increased losses. Feedback schemes were studied to compensate the misalignments effect on the amplifier. Results:A self-oscillating IPU with class E amplifier was designed that provides stable output power about 0.5 W for the distance between the couplers in range 10-20 mm and the lateral distance up to 20 mm. The use of self-oscillating circuit in the transmitter increases spatial freedom of the transmitting and receiving coils corresponding to ZVS. Discussion: Inductive link geometrical parameters optimization and implementation of self-oscillating class E driver the IPU contributes to stable output power and efficiency of IPU. As a result, less intervention from the patient and physician is required, and patient quality of life is increased Precision medicine emerges from integration of a number of emerging technologies and the data they produce with modern data analytics. For precision diagnostics and for predicting drug responses new computational and in-vitro models are needed from gene regulation to cellular and organ functions. Human induced pluripotent stem cells (hIPSC) derived e.g., from patient blood cells provide means to produce most cell types and thus provide means to get patient specific in-vitro models. New technologies are needed to produce tissues from these cells and to assess the cell functions in-vitro. In addition, computational in-silico models can be used to augment our understanding of the diseases or drug effects. They also provide tools to translate the in-vitro findings to clinical settings and patient populations. We are in transition to turn our in-vitro cell culture models to body-on-chip platforms including environmental control and biophysical functional sensing. We have developed methods to assess the cellular functions based on electrophysiological sensing as well as 2D and 3D bioimaging. For example, we have developed imaging methods to assess functions of hIPSC cardiac cell with simultaneous assessment of electrophysiology such as Calcium and voltage transients as well as mechanobiology in vitro. Further, we have developed in-silico models of various cellular function including multi-cell-type neuronal networks and in-silico population models of the hIPSC cardiomyocytes. The later ones are providing us ionic machinery of hIPSC derived cardiomyocyte electrophysiology in various populations of patiets. We have shown that these computational models can represent pathological patient phenotype cells and populations of patients with specific mutations, e.g., long QT syndrome. We have also demonstrated the power of in-silico as possible pre-screening method for drug effects prior to in-vitro examinations. Moreover, our in-silico results highlight the need of careful consideration of use of HiPSC models before they can be turned from immature cell models to mature tissues in vitro. With integration of novel engineering expertise from multimodal sensing, imaging and computational modelling, we have shown their power on studying diseases and for pre-screening of compounds. Our results demonstrate the power of combined in-vitro and in-silco methods for future precision medicine. Objectives: We have developed in vivo tissue engineered autologous vascular grafts constructed in the subcutaneous of the recipient body. However, since the formation of the vascular grafts depends on the conditions of recipients including high risk or immature patients, immaturity in the fabricated tissues might be problematic for the severely diseased patients because of their suppressed regenerative activity. Therefore, possibility of the xenogeneic or the allogeneic implantation of the grafts should be evaluated. The objective of this study is to fabricate cardiovascular grafts using xenogeneic or allogeneic animals. Methods: Silicone rod molds were placed into subcutaneous pouches of beagle dogs, and after 4 weeks the implants with their surrounded connective tissues were harvested. Those were decellularized with detergents and stored at -20 degrees C for 1 week. Decellularized tubular connective tissues (internal diameter: 2 mm) were xeno-transplanted to abdominal aorta of the rats. Decellularized tubular connective tissues (internal diameter: 5 mm) were cut open and trimmed to elliptical sheets of 15 x 8 mm, they were allo-transplanted to carotid arteries of other beagle dogs as vascular patches. Results: Both xenogeneic vascular grafts and allogeneic patch grafts performed well after transplantation, and the luminal surfaces after resection were very smooth. Histological evaluation also showed host cells infiltration into the grafts. Discussion: Decellularized xenogeneic and allogeneic connective tissue membranes could be ideal vascular grafts. Objectives: This work aimed to print high-resolution, collagen-based, constructs via suspended 3D printing with load-bearing and compositions closer to native bone; for potential use as implant materials. Methods: Collagen type I (Col) and gelatin methacroylate (GelMA) blends were systematically investigated as bio-inks, probing their rheological properties and crosslinking efficiency for printing. An adapted 3D bioprinter (3DDiscovery, regenHU, Switzerland) based on an extrusion principle was used to print constructs. Calcification was investigated, in vitro, using a polymer-induced liquid precursor for the mineralization process. Results: Careful control over the formulation and processing resulted in refined construct properties such as: wall width (500um), lattice length (2cm) and shape (bone trabeculae). Once printed, the ability to cure the GelMA/Col blends was dependent on photo-polymerisation methodology, with enhanced curing and lower remaining soluble fractions (10% vs 40%) for visible light + Riboflavin/SPS in comparison to UV + Irgacure. Control over the construct structure allowed defined mineralisation, and subsequent material responses. Discussion: In recent years the development of 3D printing technologies has attempted to combat the growing need for bone repair solutions, although is limited by the number of bio-inks, and printable resolutions available. Suspended manufacture has sought to address this issue, using a fluid gel to support a secondary biologically relevant bio-ink whilst it undergoes a curing step, during or post-printing. To date, printing techniques have not been shown to provide fully resorbable and/or mechanically satisfactory bone implants. This research has shown promise as the first steps towards printing high resolution constructs with chemical compositions more closely matching that of natural bone. Further works involve deeper investigation of calcification and impact on implants mechanical properties and microstructure. Shifting from treating symptoms to curing chronic diseases by making the transformative promise of Advanced Therapies a reality for the benefit of patients and society and by making Europe a spearhead of Advanced Therapies in Science, Clinics and Biomedical Industry, that is the vision of the large-scale research initiative RESTORE - Health by Advanced Therapies. The increasing prevalence of chronic diseases and multi-morbidity due to demographic factors represents a high socio-economic burden for Europe. The direct health costs increased by 50% during the last decade and reached euro1.526bn in 2017, a staggering 9.6 % of Europe's GDP. As current therapies rarely cure, but merely fight symptoms, never-ending treatment is required, which means diminished quality-of-life, adverse effects and soaring cost for society. There is a high need to reach sustainable improvement for patients or even to cure them of chronic diseases - in other words, to disrupt the paradigm of "treating symptoms" with "restoring health". Advanced Therapies are the game changers that open up transforming therapeutic opportunities. For genetic diseases, immune diseases, cancer and tissue injury potential cures through Advanced Therapies exist - it is reality, not fiction. Some products are already on the market, mostly for rare diseases which means only a few thousand patients worldwide have benefitted from Advanced Therapies until now. At the advent of such a trailblazing change, obstacles and roadblocks abound. To make the disruptive promise of Advanced Therapies to cure chronic diseases a reality and to make Advanced Therapies accessible as standard-of-care for every European patient in need, RESTORE envisage to establish a sustainable pan-European ecosystem integrating transdisciplinary research, clinics, patients, and industry. Please join us for more details. RESTORE is funded by the EU for the preparatory phase of the large-scale research initiative (h2020, No 820292). Our main objective is to develop safe medical products for a minimally-invasive surgical intervention that fulfill all requirements by the new Medical Device Regulation (MDR). The secondary objective is to minimize the time to market by implementing standard conforming processes in a minimalistic way so they can be operated by only a handful of people. The twist in the story is that one of our products of our system will be individualized in the operating theater. While basically everybody is forced to operate in a "learning by doing" mode regarding MDR compliance, we do rely on external trainings provided by notified bodies and other sources like websites, webinars, and dedicated conferences to learn more about how to fulfil regulatory requirements. Additionally, we are partnering with our strategic investor (a manufacturer of class-III implantable active devices) to receive trainings and advice regarding regulatory affairs. However, it has to be stressed that one has to consider all parts of the MDR, especially the annexes and the applicable norms. Here we present our technical approach and our strategy on how we aim full MDR compliance. We established a completely digital workflow for all our documents, including cryptographic signatures, version history, reviews, mainly based on open source tools. This allows us to handle the document management very swiftly. We have one person dedicated to our quality management system. The risk management is integrated as a cross-cutting-concern into all the product development processes. The main challenge in the planning and founding phase of OtoJig GmbH was and still is to estimate what has to be done, which norms do apply, and how much effort (time and money) it is to perform the steps and create all the required documents. A difficulty is that contradicting statements between the MDR and other applicable norms are still under interpretation and public discussion. Objectives: The aim of this work is to study the influence of person physiology and anatomy, which include postoperative edema, movement and breathing of a patient, on the results of designing of inductive powering unit (IPU) for VAD and to propose design recommendations. Methods: A characteristic feature of the IPU is the misalignment of the coils. The stability of the VAD power supply (especially with continuous powering) is very important. Therefore, it is necessary to design an IPU tolerant to coil misalignment. The procedure of geometrical optimization for increasing the stability of energy transfer of IPU was performed for 3 axial distances between coils d (8, 10, 12 mm), which is a typical misalignment with a postoperative edema. The lateral misalignment of the coils reached the value of the outer radius of the receiving coil (35 mm), which characterizes the patient movement or breathing. The operating frequency was taken 1 MHz, and the output power of the system was 10 W. The power drop was within 10%. The results were verified by numerical simulation in MATLAB and PSpice. Results: It was found that with a decrease of d from 12 to 10 and 8 mm, the optimal outer radius of the transmitting coil increases from 53.9 to 54.6 and 55.7 mm. Turn pitch in the transmitting coil increases from 4.9 to 5.2 and 5.3 mm. For a receiving coil, turns pitch is increasing from 3 to 3.2 and 3.6, respectively. For all cases of d in each coil there are 11 turns (except for d = 8 mm, where there are 10 turns in the receiving coil). It is recommended to design coils with a slightly larger coils turns pitch and the outer radius of the transmitting coil because of disappearance of postoperative edema. Discussion: In this work, the influence of person physiology and anatomy on the design of IPU for VAD was investigated, and recommendations for designing were given. Objectives: Membrane oxygenators are an indispensable part of critical care medicine. Though necessary to supply sufficient gas exchange, the high intrinsic surface introduced by the hollow fiber packing has serious side effects on blood platelet parameters. To reduce these side effects the membrane surface must be minimized and gas exchange improved. Methods: Computational fluid dynamics (CFD) can support oxygenator optimization and supplement experimental data by delivering a spatial and temporal resolution of the gas exchange. While current research mostly focusses on the gas transport in the blood flow, this work presents a fully resolved CFD approach including transmembrane transport as well as convective and diffusive blood gas transport on shell- and lumen-side of the hollow fibers. Results: CO2 transport in a packing segment of a prototype hollow fiber module was fully resolved and simulated utilizing an inhouse solver membraneFoam based on the open source CFD code OpenFOAM (R). Simulation results show a CO2 partial pressure decline from 50 to 15 mmHg in the laminar boundary layer and an additional drop of 12 mmHg at the selective membrane surface. Boundary conditions for the gas transport simulations were computed by blood flow simulations of the whole module. Simulation results were compared to in vitro tests comprising measurements of CO2 exchange performance and blood side pressure drop of the prototype module. Discussion: Flow simulations predict the experimentally determined pressure drop of 68 mmHg at blood flow rates of 1280 mL/min accurately. The specific CO2 exchange rate of 220 mL STP/min/m2 is overpredicted due to the reduction of the whole packing to an idealized packing segment. Nevertheless, CFD allows for a structured optimization of membrane oxygenators as design changes can be efficiently investigated. Objectives: Anticoagulation therapy in LVAD patients is essential to reduce hemocompatibility related adverse events (HRAE). Phenprocoumon dose must be adapted and monitored by INR point-of-care-testing (POCT) in outpatients. The study aims to determine if the frequency of INR POCT in LVAD outpatients has an influence on the quality of anticoagulation therapy, HRAE and clinical outcomes. Methods: This retrospective, pseudo-randomized study included n=48 patients who received an LVAD implantation (HMII, HM3 and HVAD) between Jan. 2012 and Oct. 2016. Based on the frequency of weekly INR POCT, we compared a daily (n=36) and a 3x/week (n=12) group, specifically the 1-year anticoagulation quality (% of INR Tests in Range) as well as clinical outcomes, readmissions and HRAE using Kaplan-Meier curves. Readmission profiles and outcomes in three groups, based on the achieved quality of anticoagulation (% of INR Tests in Range) ranging from 0-60% (poor), 60-70% (acceptable), 70-100% (well controlled) were compared. Results: Daily and 3x/week groups were similar in demographic and pre-operative risk factors, INR target (2.0-3.0, p=0.27) and Aspirin daily doses (p=0.29). Freedom from any HRAE (38.9% vs. 25.0%, p=0.44), any readmission (72.2% vs. 75.0%, p=0.97) and 1-year survival (91.7% vs. 91.7%, p=0.98) were comparable in both groups. The % of INR Tests in Range was significantly higher with the daily self-assessments (73.5% vs. 68.4%, p=0.006). Freedom from any neurological event (91.7% vs. 75.0%, p=0.14) was n.s. higher in the daily POCT group. Well vs. poorly controlled INR POCT patients had a significant higher freedom from any neurological event (96.0 vs 69.2%, p=0.024) as well as hemorrhagic strokes (100% vs. 76.9%, p=0.011). Discussion: Well controlled anticoagulation of LVAD outpatients results in less neurological events including hemorrhagic stroke. Daily INR POCT and subsequent dose adjustment of vitamin-K antagonists result in a better quality of anticoagulation than 3x/week checks. Objectives: Spectroscopic method is widely used for non-invasive blood glucose (BG) measurement. Despite the progress in implementation of transmission NIR-spectroscopic method, applicable mostly for earlap measurements, research of non-transmission methods allows for the exapnsion of spectroscopy range of use. The aim of research is to estimate the penetration depth for 1600 nm radiation using reflection NIR-spectroscopy. Sufficiency of penetration depth on this wavelength would allow for the use of a mathematical model implemented in the transmission method. Methods: The developed experimental setup includes a semiconductor laser with wavelength of 1600 nm, two photodiodes, reflecting surface, control unit and power supply. For determining the position of optical elements a MATLAB program was developed, which calculated efficient detected radiation intensity depending on distances between the photodiode and the laser and between the laser and reflective surface. Scheme for measuring BG by reflection NIR-spectroscopy partially repeats the scheme used for transmission method. The main differences are in location of photodiodes on the same plane with the radiation source, while their optical axes are co-aligned and parallel to each other, and the reflecting surface tightly abuts the back wall of analytical cell with test solution. Results: The optimal distance between the photodiode and the laser is 5 mm, and between the laser and the reflective surface is 20 mm. This configuration allows intensity of the reflected radiation at about 20% of incident radiation to be obtained. Taking into account the permissible radiation density for skin, this value is enough for skin probing to a depth of 1.5 mm. Discussion: Reflection NIR-spectroscopy is promising method for non-invasive BG measurement. Research of transmission method has shown that the penetration depth of 1.5 mm is enough for receiving information about BG. Thereby mathematical apparatus applied for transmission NIR-spectroscopy can be used and similar error less than 20% can be expected. Objectives: Proper anatomical fitting of implants is crucial for a successful clinical outcome. However, every patient's anatomy is unique and there is a wide variety in the anatomical and morphological characteristics among individuals. Virtual fitting based on imaging data of a high number of patients has crucial benefits compared to conventional approaches during the design process. Methods: Population based engineering is a method that enables a virtual implantation combined with iterative design optimization based on 3D anatomical models created from imaging data of a high cohort of patients. This approach was successfully used during the design process of a novel inflow cannula for a Ventricular Assist Device and a Total Artificial Heart for maximizing the number of treatable patients. The objective was to create a design that contains all components, but which at the same time works for a wide variety of different body types and sizes. Results: The virtual studies have proven to give results that may not have been possible with conventional approaches. Compared with cadaver studies, this approach was a more accurate and economical way for determining the device fit and identifying areas for improvement. Clinical trials and in vivo studies of the devices have shown positive outcomes. Virtual fitting was able to reduce the risk of inflow obstruction, device-vessel misalignment, unexpected variabilities in the patient's anatomy and improper patient selection due to anatomical constraints. Discussion: Population based engineering is a cost-effective solution for including a large number of patients and anatomy variations in the design process. Additionally, this approach can be used for regulatory submission, e.g. to determine and justify anatomical and morphological eligibility or exclusion criteria for proper patient selection and/or the correct implant size. This is especially important in consideration of the future requirements of the Medical Device Regulation (MDR) for patient-specific implants. Objectives: None Alcoholic Fatty Liver disorders (NAFLD)is a complex systemic disorder becauseit is associated with clinical states such as obesity, insulin resistance, and type 2 diabetes thus involving both liver and pancreas. In particular, pathological pancreas (such as in diabetic patients, in non-alcoholic fatty pancreas disorders patients) led to mis control of insulin secretion (the insulin modulates the lipid accumulation in liver). Methods: Organ on chip approaches is one way to mimic human physiology. In this paper, we will present the development of a liver, pancreas and liver pancreas co-culture model to simulate the interaction between both organs. Results: The morphological analysis confirmed the rat hepatocytes and the rat Langehrans islets were cultivated successfully after the extraction for 7 days. The tissues functionality was confirmed by the production of albumin in the liver on chip models and by the insulin secretion in the pancreas biochips. The RTqPCR analysis confirmed that the pancreas on chip culture contribute to maintain high level mRNA of genes related to glucose insulin homeostasis when compared to Petri control. Then, the GLP1 drug contribute to increase the insulin metabolism in pancreas on chip. In liver pancreas co-culture, we found that the presence of pancreas islet contributed to modify the mRNA levels of glucose-insulin homeostasis related genes in the hepatocytes. It also contributed to increase the insulin production when compared to pancreas biochip control. Discussion: Those results demonstrated the potential of our liver pancreas model to be upgraded to a complex disease model. Objectives: We are developing a novel autologous tissue-engineered heart valve with a unique in-body tissue engineering. This is expected to be a viable bioprosthesis with better biocompatibility. In this study, we developed a conduit-type valve without any foreign materials and tested the feasibility and long-term availability in large animal experiments. Methods: We created plastic molds for Biovalves with a 3D printer easily and quickly considering the recipient character. We embedded them in the subcutaneous spaces of adult goats for about 2 months. After extracting the molds with the tissue en-block and removing the plastic molds only, Biovalves with tri-leaflets similar to those of the native valves were constituted from completely autologous connective tissues and fibroblasts. Total 21 conduit-type Biovalves were implanted in the apico-aortic bypass or the pulmonary artery of goats, (8 and 13, respectively). No anticoagurants were used after implantation. Results: The valves were successfully implanted and showed smooth movement of the leaflets with a little regurgitation in angiogram, and the maximum duration reached to 3 years 7 months. Histological examination of the Biovalves showed the autologous cells covering the laminar surface of the valve leaflets as the endothelium and also migrating into the leaflet body to construct characteristic tissues like native leaflets. Discussion: The valves have a potential to be used for viable bioprosthetic valves and to keep better function and biocompatibility longer than current ones. Objectives: The main purpose of this study is to analyze the correlation between different types of dnDSA and AMR after renal transplantation. Methods: We retrospectively analyzed the patients after renal transplantation from January 2002 to March 2017 in our Center. A total of 47 patients with positive PRA and confirmed as dnDSA were included, which were grouped according to the DSA binding to C1q, C3d and subtypes of IgG. Patients were divided into AMR and non-AMR groups according to the pathology of graft biopsy. Results: The pre-transplantation dialysis time of the non-AMR group was longer than that of the AMR group in 47 patients with dnDSA positive (35.4 +33.2 vs 9.8 +10.5, p=0.014). C1q-binding dnDSA had no significant effect on the graft survival after operation and biopsy. Among 47 patients with dnDSA positive, C3d-binding DSA group had lower graft survival time (p=0.009), higher HLA-DP mismatch (0.1 +/- 0.3, p=0.043) and higher percentage of pericapillary C4d deposition (p=0.042), with statistical significance. The graft survival rate of IgG3 subtype negative patients was higher than that of IgG3 subtype positive patients (p=0.003). Cox analysis found that the risk factors for graft survival included IgG3 (OR = 46.877, 95% CI = 4.211-521.830, P = 0.002), HLA-DR mismatch (OR = 0.103, 95% CI = 0.021-0.496, P = 0.005), proteinuriuria at biopsy (OR = 2.097, 95% CI = 1.184-3.713, p=0.024) and creatinine at biopsy (OR = 1.004, 95% CI = 1.001-1.007, P = 1.007) Discussion: Single-center study showed that there was no significant correlation between the incidence of AMR and different types of DSA. The accurate HLA-DR typing should be emphasized during transplantation. The monitoring of specific types of dnDSA will help us to take interventions and thus contribute to the survival of transplanted kidneys. Objectives: Rotary blood pumps (RBPs) are successfully used in high-risk treatments, but clot formation still threatens their long-term application. To reduce the risk of clot formation, in-vitro thrombogenicity testing could help to improve RBP design, as several studies have shown. Those studies were able to simulate in-vitro clot formation in RBPs, but they had limitations regarding a proper quantification of their thrombotic impact. In this study, we assessed if thromboelastometric analyses (TEM) are feasible to quantify the thrombotic impact of RBPs in-vitro. Methods: Five RBPs (n = 5) were placed into simple pump circuits that were built of silicone tubes and reservoirs. Each circuit was filled with 150 ml of slightly heparinized porcine blood (one donor pig per circuit) and the pumps were brought into operation. The pumps operated until a drastic drop in volume flow indicated thrombus formation. We carefully cleaned the RBPs from blood and documented any found thrombus. Prior to this, blood samples were taken at certain time points during pump operation. The blood samples were then analyzed by TEM. Results: TEM measurements showed a decrease in clotting time (CT) over the duration of the test, which indicates an ongoing increase in the activation of the coagulation system caused by the pump. Correspondingly, RBPs revealed visible blood clots at high-risk thrombus formation spots. Discussion: The decrease in CT over time corresponding to clot formation in the RBPs shows that TEM is able to detect and quantify the thrombotic impact of RBPs in-vitro. Thus, TEM could be used in future studies to compare the thrombogenicity of different RBPs by performing comparison tests similar to hemolysis testing. This could lead towards a standardization of in-vitro thrombogenicity testing of RBPs. Objectives: Cryopreservation of tissue-engineered constructs (TECs) is very important to provide such ready-to-use products for regenerative medicine and clinical application upon demand. Although cryopreservation of isolated cells seems to be well established, there are still a number of challenges associated with the cryopreservation of native and artificial tissues due to adherent cell state, limited heat and mass transfer as well as inadequate cryopreservation protocols. Here, we aim at developing an approach for efficient cryopreservation of electrospun TECs based on multipotent stromal cells (MSCs). Methods: Blend electrospun fibre mats (fibre diameter 0.8 +/- 0.2 mu m, thickness 100 +/- 10 mu m) were produced from polycaprolactone and polylactic acid (PCL-PLA, ratio 100:50) using electrospinning. The fibre mats (diameter 16 mm) were UV sterilised and seeded with MSCs (5x104 cells/cm2). The cells were cultivated on fibre mats for 7 days under static conditions and then frozen using 1 K/min cooling rate in a controlled rate freezer with different formulations of cryoprotective agents (CPAs), such as dimethyl sulfoxide (DMSO) and its combination with sucrose (with and without pre-culture with sucrose for 24 h). The viability of cells growing on fibre mats was monitored for 2 weeks after seeding and 24 h after thawing. Results: The results indicate that PCL-PLA fibre mats are biocompatible with MSCs (viability higher than 82%). Pre-culture with sucrose before freezing as well as its addition to DMSO-containing freezing medium significantly improved cell viability after thawing. Moreover, duration of equilibration of cell-seeded fibre mats with the CPAs before freezing affected cell viability post-thaw. Discussion: We showed that it is feasible to effectively cryopreserve electrospun TECs using controlled technological steps. This work could serve as a solid background for further development of efficient cryopreservation methods for biobanking of electrospun constructs for vascular or corneal tissue engineering. Objectives: There have been discussions on effects of pleural effusion on the breathing muscles dynamics. In particular, hemidiaphragm inversion influence on the pleural pressure (PPL) and ventilation parameters has not been precisely determined. The aim of this study was to analyze changes in PPL and ventilation parameters in patients undergoing therapeutic thoracentesis (TT). Particular attention has been paid to inversion of the hemidiaphragm caused by large one-sided pleural effusion. The analysis was based on virtual experiments performed on an artificial cardio-respiratory patient (AP). Methods: TT was simulated on AP, which consists of several cooperating models of the respiratory system mechanics, gas transport and exchange, and circulation. Three scenarios were considered: a) proper work of the diaphragm, b) flattening and fixation of the hemidiaphragm due to the large amount of fluid, c) paradoxical excursion of the inverted hemidiaphragm. Results: Simulations showed that during progressive pleural fluid withdrawal significant changes in the course of PPL were observed, particularly in scenarios b and c. Paradoxical excursion of the inverted hemidiaphragm significantly influenced the alveolar oxygen partial pressure (PAO2) due to a kind of pendelluft: e.g., air flows out from the corresponding lung during inspiration and thus it flows to the lung in the hemithorax without pleural effusion. Discussion: Flattening and inversion of the hemidiaphragm have an influence on several physiological factors of which PPL and PAO2 seem to be the most important. Hence, TT may improve pulmonary system function particularly in patients with inverted hemidiaphragm. Objectives: Bone loss at implantation sites on oral cavities is a major problem for dental surgeons; in order to combat this issue, we developed 3 types of colagen biomaterial blends: chondrohitin sulfate, carbon nanotubes, and electric stimulated. Methods: Bovine colagen type I was dissoluted at 4% in formic acid 0,1M (Synth - Brazil) and divided in 4 groups: A- with Chondroitin Sulphate (Sigma Aldrich); B - carbon nanotubes suspention (Sigma Aldrich); C- eletric field ; D - control group. All of the samples were crosslinked with NHS (N-hydroxysuccinimide esters) (Thermo Scientific-USA) and freeze dried at a LH2000 equipment (Terroni - Brazil). The samples were analized by: SEM; EDS; XPS; Bartha respirometry and FET. Results: All of the samples have the same macroscopic morphology. The SEM of the group submitted to electric field shows organization of the colagen fibers. The EDS shows atomic content of carbon, oxygen, and nitrogen with other substances Discussion: The absence of contaminants within the samples and the increase in stiffness exhibit the compatibility of this material for use in bone augmentation in implantology. The material is shown to be not toxic, however more tests should be conducted prior to human use. Objectives: The optimization of the long term storage of cells and tissues is a challenging process with many variables but one factor is often overlooked: the freezing device itself. There are freezing containers that have to be placed in a -80 degrees C freezer and the manufacturer promises a cooling rate of 1 K/min. On the other hand there are controlled rate freezers where cooling rates from 0.1 K/min up to 50 K/min are promised. In this study we compared two commercially available freezing containers and four controlled rate freezers with respect to their functioning principle. Furthermore, we investigated the accuracy of the adjusted cooling rate and the nucleation temperature of the samples. Methods: Seven 1.5 ml cryovials filled with 1 ml 0.9% (w/v) sodium chloride solution were dispersed evenly over the rack of each freezing device. Constantan thermocouples (type T) connected to a RedLab device were placed in the middle of the solution of each cryovial to record temperatures every second with the respective software. The cooling rates were calculated from the melting point (-0.6 degrees C) of the solution to -30 degrees C with n=3. For all freezing devices a cooling rate of 1 K/min was set according to the manufacturers guidelines. Results: The freezing containers had sample cooling rates between 0.5 and 0.8 K/min. All controlled rate freezers showed cooling rates similar to the programmed cooling rate of 1 K/min. Higher cooling rates resulted in increasing deviations between programmed and measured cooling rates. The nucleation temperatures of the samples in the freezing containers were mainly between 0 degrees C and -6 degrees C. However, the controlled rate freezers showed nucleation temperatures mainly in the range of -6 degrees C to -12 degrees C. Discussion: Varying definitions from each manufacturer resulted in the observed cooling rate differences of the freezing containers. Limited heat transfer accounted for the increased cooling rate deviation recorded in higher programmed cooling rates. Objectives: Patients using ventricular assist devices (VADs) still suffer from adverse events such as pump malfunctions or thromboembolic events. This can be caused by thrombi that have formed inside the pump (pump thrombus). Therefore, there is a great need to prevent such adverse events through engineering measures in the early development stage of blood pumps. Currently, a numerical model to predict thrombus sites inside VADs is still missing and the risk can only be assessed with in vitro experiments in the late development stage. A recently found model for thrombus formation at high shear rates that was derived from simple stenosis experiments promises great potential in the application in computational simulations (CFD) of VADs. Methods: In this study, advanced high resolution URANS simulations of rotational blood pumps were conducted with the flow solver of StarCCM+ (Siemens) at an operating point of 5L/min at 75 mmHg. A k- omega SST turbulence model and the sliding mesh method was applied. The existing model for predicting high shear thrombus formation was applied and compared with observations from explanted pumps. Based on these results a modification of that model is proposed that suggests a wall normal transport due to the change of shear rate in flow direction. This modification was realized in the CFD by applying a correlation between the computed direction of the pressure gradient and the flow direction. Results: The application of the model shows that thrombus sites are overpredicted in rotational blood pumps when compared with experimental results or observations from explanted pumps. However, with a modification of the model which proposes that the influence is a wall normal transport due to a change in shear rate, a good agreement was found. Discussion: Since there is little data available in the literature that shows the position of pump thrombi the validity of these models remains unclear and has to be experimentally evaluated further. Objectives: Cryptogenic stroke is the cause of 40% of ischaemic acute cerebrovascular events. Study aim was to evaluate the recurrence of ischaemic cerebrovascular events in patients successfully treated by percutaneous closure of patent foramen ovale (PFO). Methods: From February 2004 to January 2019, 314 symptomatic (243 stroke, 71 TIA) patients, (153 M 161 F; mean age 41 yrs, range 10-69) underwent percutaneous closure of PFO. 151 patients/314 (48%) had concomitant migraine, 90 (60%) with aura. 7 different occluder devices were implanted by transesophageal echocardiography, for a total of 317 implants. During follow-up all patients underwent clinical (Rankin modified scale) and quality of life (SF36) evaluations, transcranial Doppler (TCD), trans-thoracic echocardiography, and MRI. Cerebral and angio-MR assessed the degree of lesions by quantitative and qualitative comparative analysis performed before and after treatment. Sizes of lesions were measured by manual segmentation on the axial, coronal and sagittal images acquired. Results: Successful device deployment was achieved in 99% of pateints; patients were discharged home within 3 days. Follow-up was 100% complete (median 55.4, range 1-178 months). At 6 months, Rankin scale was 0 (p<0.0001) in 230 patients (95%) affected by stroke and 10 patients reached score 1. Quality of life improved significantly (P<0.0001). In 101/151 patients (67%) with migraine, intensity and frequency of attacks significantly decreased (P<0.0001). TCD showed residual microembolic signals in 10 patients, 3 patients required secondary successful treatment for an associate defect. TTE (after 1, 3, 6, 12 months and once a year for 5 years) showed optimal sealing of all devices without signs of erosion, incomplete closure and thrombus. In 265 patients cerebral MRI showed no new lesions at 2 years. Discussion: Our 15 year experience suggests that percutaneous treatment of PFO is safe and beneficial for secondary prevention of recurrence of acute cerebrovascular events irrespective of the device used. Objectives: Endovascular stent grafting is the standard treatment for patients with acute traumatic aortic rupture with extensive associated lesions. Very little long term information is available in large series. Methods: From March 1999 to September 2018, 83 patients (72 M and 11 F; mean age: 37.25 +/- 13.46;range 16 to 69) admitted with acute or chronic traumatic aortic lesions underwent endovascular repair. 60 cases had acute traumatic aortic rupture, due to road accidents in 69 patients and accidental falls in 3 patients. All procedures were carried out in the angiography suite. Left subclavian artery was always identified. Patients were followed-up in the out-patient clinic and by yearly angio CT-scan with regard to survival and complications. The follow-up was 100% complete. Results: Endovascular stent-graft treatment was successful in all cases of acute or chronic aortic injury. No post-operative paraplegia occurred. Control angiography showed optimal sealing and complete exclusion of the pseudo-aneurysm from blood flow with no primary endoleak. Patients underwent treatment of all associated lesions later on during hospital stay. Two patients died in the hospital: 1 patient of cerebral haemorrhage and 1 patient of sepsis. During the follow-up 5 patients died (survival: 91.4%) for causes unrelated to the aortic procedure. no cases of perigraft leakage or aortic disruption were detected. During follow-up 1 patient had a steal syndrome and 1 patient paraplegia due to the covering of the left subclavian artery by endovascular graft. 4 years after treatment 1 patient had inner thrombosis of the graft developing a gradient; a new endovascular stent graft was deployed successfully. Freedom from complications was 92.3%. Discussion: The outcomes over 20 years of follow-up proves that endovascular stent graft repair is the first choice treatment in patients with traumatic aortic injuries. Our experience demonstrates the feasibility and safety of endovascular treatment including patients with extensive associated injuries. Objectives: In vitro simulation of an in vivo environment for human stem cell research is crucial for any kind of biomedical purpose. While important factors like 3D-cultivation and physiological oxygen concentrations gain more attention in the scientific community, we still lack reliable methods to visualize the hypoxic response of cells in 2D and 3D in vitro systems. In this study we present human adipose-derived MSCs, modified with a genetically encoded hypoxia-sensor. Methods: We used a lentiviral system to stably integrate the genetic construct into the chromosomal DNA of mesenchymal stem cells. To investigate the features of this novel biosensor we cultivated our cells in a 2D- and 3D-environment under various oxygen levels and evaluated the outset of biosensor-fluorescence via microscopy and flow cytometry. Results: The hypoxia sensor was successfully integrated in mesenchymal stem cells and could easily be induced by cultivating the cells in a hypoxic condition. MSCs, modified with hypoxia biosensors could be cultivated up to passage 20. Trilineage differentiation of MSCs (adipogenous, osteogenous and chondrogenouse differentiation) was also preserved by the cells after transfection. Using these cells we could monitor which 3D-cultivation conditions lead to hypoxic response of MSCs. Discussion: Our findings can help to improve our understanding of the influence of cultivation conditions on in situ oxygen concentrations. Moreover, by choosing the right 3D cultivation system, MSC can be cultivated in vitro under physiological hypoxic conditions. Objectives: Heart failure with reduced Ejection Fraction (HFrEF) is a progressive disease with a low 5-year survival of <50%, which affects 23 million people worldwide. It is characterized by adverse remodeling of the left ventricle (dilated cardiomyopathy) due to an increase in filling pressures and myocardial wall stress. Pharmacological treatment and cardiac resynchronisation therapy have proven beneficial for survival. For patients with end-stage heart failure, a heart transplant or Left Ventricular Assist Device can be considered. A shortage of donors, patient selection and major downsides such as invasiveness and driveline infections limit the use of these treatments. Research has shown a 13% decrease in mortality for every 5% increase in left ventricular ejection fraction. Therefore, we developed a smart memory alloy configuration in order to increase the ejection fraction and obtain an increase of 3,5% in a bench model. To cope with ongoing left ventricular dilatation and rise in wall stress, this should be combined with adjustable and measurable ventricular restraint therapy. Our first aim is to measure local wall stress during a full cardiac cycle. Next, we aim to develop a mathematical model of the left ventricle to characterize the left ventricle in HFrEF patients. Methods: We will characterize in vivo wall stresses during the full cardiac cycle using Transesophageal Echocardiography and a left ventricular pressure catheter in 10 patients undergoing cardiac surgery for heart failure. With these parameters, we will develop a simplified mathematical model of the left ventricle and we will improve our bench model for experimental testing. Results: This research will provide a characterization of the weakened left ventricular wall and the determination of optimal smart material properties and configuration of the cardiac assist device. Discussion: With this information, a patient-specific HFrEF treatment device will be developed combining active cardiac support and restraint therapy. Objectives: Clinical data on the hemocompatibility of membranes used in double filtration lipoprotein apheresis (LP) is virtually unavailable. The present trial compared the hemocompatibility of a recently introduced polyethersulfone (PES) based plasma fractionator membrane, FractioPES (R) 200, to an ethylene-vinyl alcohol copolymer (EVAL) membrane during LP. Methods: In a prospective, randomized, controlled, crossover trial, eight patients on routine LP were subjected to one treatment with PES plasma (0.6 m(2), 3M PlasCure (R) 0.6) and fractionation (1.9 m(2), 3M SelectiCure (R) H19) membranes and one control treatment using a set of EVAL membranes (0.5 m(2), Asahi Plasmaflo OP-05W; 2.0 m(2), Asahi Cascadeflo EC-50W). Intraindividual treatment conditions were kept identical. At defined times, samples were drawn at different sites of the extracorporeal blood and plasma circuit to measure white blood cell (WBC) and platelet (PC) counts, complement factor C5a and thrombin-anti-thrombin III (ATIII). Results: With a nadir at 25 min, WBC in EVAL decreased to 34 % of baseline vs. 64 % at 20 min in PES (P<0.001). PC only marginally decreased over time with both membrane types. Maximum C5a in venous blood was 30.0 +/- 11.2 mu g/L at 30 min with EVAL and 14.0 +/- 12.8 mu g/L at 25 min with PES (P<0.001). Compared to PES (23.3 +/- 15.2 at 5 min and 16.9 +/- 12.3 at 20 min, resp.), highest C5a concentrations were found in plasma after the EVAL plasma (56.1 +/- 22.0 mu g/L at 10 min; P<0.001) and fractionation filters (50.6 +/- 19.4 mu g/L at 30 min; P<0.001). ATIII levels did not rise until the end of the treatment without differences between membranes. Regarding Lp(a), LDL and HDL removal, both membrane sets performed equally (PES, 69.8 +/- 5.7, 64.9 +/- 8.8, and 17.4 +/- 13.6 %, resp., vs. EVAL, 69.5 +/- 6.0, 65.2 +/- 6.9, and 18.2 +/- 7.3 %, resp.). Discussion: Compared to EVAL, PES membranes are more beneficial with respect to the classical hemocompatibility of extracorporeal treatment procedures, namely leukocyte and complement system activation. Objectives: Mechanical circulatory support (MCS) has become a standard therapy for adult end-stage heart failure patients. For pediatric patients, technological development lags behind with no currently approved implantable rotary blood pump. As an alternative, the HeartWare HVAD, originally designed for adults, is increasingly used in pediatric patients. The aim of this multicenter study was to assess in-silico, in-vitro and in-vivo the blood trauma potential of this pump in pediatric application. Methods: Blood trauma potential of the HVAD was investigated in-silico and in-vitro at an adult and pediatric operating point (5L/min and 2.5L/min at 2800rpm and 2200rpm, respectively). The flow was simulated by computational fluid dynamics and analyzed regarding flow structures, shear stresses and washout. Hemolysis was assessed with pumps circulating bovine blood in a temperate flow circuit. Clinical outcome and indicators for in-vivo blood trauma were investigated retrospectively in 14 pediatric HVAD patients (age 11.3 +/- 4.8years). Results: In the pediatric conditions, simulations predicted elevated mechanical stress profile below 50mPa, more stagnant flow field, with longer washout times within the pump. In-vitro measurements revealed an increased normalized index of hemolysis (NIH = 17.5 mg/100L vs. 8.2 mg/100L, (p=0.0021)). In the retrospective in vivo analysis, LDH and D-Dimer values were 1.5 and 3-fold elevated, respectively, compared to adult HVAD patients. Major bleedings were observed in 42.9%, suspected pump thrombosis and neurologic dysfunction in 14.3% of all patients. Discussion: The HVAD, operated at lower speeds and flows, induces elevated blood trauma. These results highlight the need for specifically adapted ventricular assist devices, optimized for the pediatric population. Further studies are required to assess the clinical implications of these findings. Objectives: Native arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis, but it still has high rate of failure due to stenosis formation. Convincing evidence supports a key role of local hemodynamics in vascular remodeling, suggesting that disturbed flow conditions may be related to stenosis development. The purpose of our investigation was to explore the feasibility of coupling non-contrast enhanced MRI and high-resolution computational fluid dynamics (HR-CFD) to relate morphological vessel changes to local hemodynamics in AVF over time. Methods: We acquired non-contrast enhanced 3D fast spin echo MRI (CUBE T1) at 1 and 6 weeks, 6 months and 1 year after radio-cephalic AVF creation in one patient. We generated 3D models and evaluated lumen cross-sectional area changes over time. We perfomed CFD simulations using pimpleFoam solver of OpenFoam, prescribing blood flow waveforms derived by Ultrasound examination. We computed the 2 components of the wall shear stress vector over time, namely WSSdir, the component in the mean direction of the WSS vector and WSStr, the transversal component. Results: We observed a dilatation of the vein until 6 months, with a more pronounced increase in the venous outflow as compared to the juxta-anastomotic vein (JAV). The increase in vein's diameter was then followed by a narrowing of JAV at 1 year after AVF surgery. We found high-frequency fluctuations both for WSSdir and WSStr components, in different locations of the vein, at 6 weeks and 6 months after AVF creation. Oscillations of both components damped at 1 year after AVF creation, as a result of vessel remodeling. Discussion: Optimized CUBE T1, coupled with HR-CFD, allowed a characterization of morphological and hemodynamic changes over time. Our MRI-to-CFD pipeline represents a promising approach to elucidate mechanisms of local vascular remodeling and can be used for clinical investigations aimed at identifying critical hemodynamic factors responsible for AVF failure. Objectives: For 30 years, the mortality rate of patients hospitalized in intensive care unit has been drastically reduced. But an increase in muscle dysfunctions at the end of intensive care stay, leading to long term functional disability was observed at the same time. The physiological mechanism remains poorly understood due to a lack of study tools. The objective of this work is therefore to create a new tool for the tissue construction of an in vitro skeletal muscle. This tool should allow a muscle construction which mimics physiological reality, in order to model the disease more accurately. Also, it should allow mechanical and electrical stimulation in order to simulate the resumption of muscle contraction of patients. Methods: Using sol-gel process, we synthesized a new biomaterial, based on an epoxy organic-inorganic hybrid precursor (g-glycidyloxypropyltrimethoxysilane). This biomaterial was deposited as a thin layer (spin-coating process) of 7 mu m thickness on a silicone membrane suitable to undergo mechanical stretching. The biomaterial was microstructured using the UV laser writing lithography to create a line network. This line network was revealed with a 2-minute isopropanol bath and we obtained lines of 8 mu m thickness spaced of 175 mu m. To ensure a biological environment and a strong adhesion of cells on microstructured silicone support during mechanical stretching, we grafted silylated bioactive peptides using dip-coating process. Results: Muscular stem cells which were isolated from patients' quadriceps biopsy were seemed and, by immunofluorescence staining, we observed a growth of muscle fibers along the lines, mimicking the physiological organization of a muscle. Discussion: We were able to model the first stages of a complex muscle organoid in vitro using a new tool manufactured by a fast, simple and reproducible process. With the mechanical and electrical stimulation of this muscle-on-a-chip, this work should allow us to better understand these muscle dysfunctions and find new treatments. Objectives: Cryopreservation of 'ready-to-use' tissue-engineered constructs (TECs) is a promising strategy which may facilitate their future clinical application. This is very challenging and ambitious task and therefore recent efforts have been focused on developing new cryopreservation strategies for long-term storage of TECs. This work covers some practical considerations for cryopreservation of cell-free and cell-seeded scaffolds vastly differing by structure and composition. Methods: The first test system includes 3D porous collagen-hydroxyapatite (HAP) scaffolds prepared by freeze-drying and coaxial alginate macrospheres prepared by electrospraying. Samples were frozen at 1 K/min either in a bulk DMSO solution (with and without sucrose) or after removal of residual solution. After thawing, we evaluated compression (collagen-HAP scaffolds) and rheological properties (coaxial alginate macrospheres) of cell-free systems. Viability of mesenchymal stromal cells (MSCs) within both types of scaffolds was evaluated 24-h post-thaw using live-dead assay. The second test system comprises flat fiber mats (produced from polycaprolactone/polylactic acid using electrospinning) seeded with CHO cells. This system intends to develop plate electrodes for electroporation of attached cells with non-permeable cryoprotective agents (CPAs) such as sugars for future cryopreservation applications. Results: All scaffolds were cytocompatible with corresponding cell types. Freezing after removal of residual solution was superior to conventional freezing. Addition of sucrose increased cell viability (both scaffold types) and improved viscoelastic properties of coaxial macrospheres. Constructed plate electrodes provided good compromise between high cell permeabilisation and viability after electroporation with sucrose at 1.7 kV/cm electric field. Discussion: The findings suggest that it is feasible to cryopreserve cell-free and cell-seeded scaffolds using DMSO and sucrose. As a step further, there are high expectations associated with using electroporation as a mean for intracellular delivery of non-toxic CPAs towards DMSO-free cryopreservation of TECs. Objectives: Tailored Forming is a new manufacturing technology to manufacture solid components out of two or more different metals. The components are joined to a hybrid semi-finished workpiece. Afterwards, a forming process is performed to improve the materials properties. This allows creating hybrid metallic parts that are adjusted to their specific loads and their field of application in comparison to parts made out of monomaterials. The potential use case of Tailored Forming-parts is still being researched. Biomedical implants are a potential field of application. In the presented study, the contact mechanics of two potential concepts for Tailored Forming hip implants were analysed. Methods: Both concepts consist of a magnesium component that should be resorbed in the human body and leads to a better bone growth. A second component in the implants is used to absorb loads. In a numerical analysis the two implants were compared to a conventional implant. For the potential evaluation two load cases "walking" and "walking upstairs" were considered. Results: While one concept leads to higher stresses in the implant, the other concept shows almost similar stress distributions as the conventional implant and has the additional advantage of the better bone growth due to the magnesium component. Discussion: Based on this work further research on different implant concepts has to be made to give a clear statement about the potential of Tailored Forming-Implants. Objectives: In consideration of the recently published implant files, testing of medical devices has gained signifigant importance. Many medical implants are subject to normative testing during their regulatory approval process, such as stents, heart valves and blood pumps. No testing norm or standard, however, exists for regulatory approval of left atrial appendage occlusion devices. Therefore, this study aimed to establish in-vitro bench tests for LAA occlusion (LAAo) devices and compares the clinically most widely used devices. Methods: Seven different LAA occlusion systems with device diameter ranging between 22 and 34 mm were tested regarding tug force and radial force resulting in a total of 24 devices. Radial force was assessed in a commercially available tester whereas tug force was evaluated in a novel in-vitro test setup consisting of bovine tissue. Results: Significant differences in the mechanical properties of the different devices were observed. Radial force ranged between 8.6 N at maximum compression for the LAmbre 2228 device and 0.1 N for the Occlutech 27 mm implant at minimum compression. A similar variability of mechanical properties was seen in the tug test results. Values ranged from 4.6 N to 0.4 N for the Wavecrest 22 mm and the Occlutech 24 mm device, respectively, at maximum and minimum compression. Discussion: Large variations in mechanical properties were seen between the different devices. The study showed that device stability is more dependent on anchoring structures, such as hooks and barbs, than on radial force. A strong positive correlation between the number of anchoring structures per millimeter circumference of an occluder and its tug force was found (r=0.87, p < 0.01). The large variations in mechanical properties aggravate comparison of current LAA occlusion devices which underlines the need for standardized preclinical testing to prompt clinical compatibility. Objectives: Pump thrombosis is a severe adverse event in ventricular assist devices. Current therapy often involves an exchange of the entire pump. Alternative solutions must be explored to reduce surgery numbers. A protocol for in vitro lysis of LVAD specific thrombus with alteplase was established in this study. Methods: A fluid chamber of silicone tubing was filled with isotonic sodium chloride solution. An artificial human thrombus was suspended within. Alteplase was added to the system according to the maximum dose for clinical use, 0.028 mg/ml. Five experiments each were conducted for stasis and fibrin thrombi respectively. Both types were lysis tested for four and 24 hours each. Fluid samples and photographs were taken for dissolution evaluation. Results: Visual inspection of the fibrin thrombus showed clear dissolution. For the stasis thrombus, the 24 h experiment produced no discernible dissolution of the thrombi, while the thrombi investigated over the 4 h period fragmented into small pieces which did not dissolve entirely. D-dimer levels in the fibrin thrombus tests rose steadily through the alteplase treatment for both test durations (short test 12800-25600 ng/ml, long test 25600-51200 ng/ml). For the short term stasis thrombus testing, D-dimer values rose similarly to the fibrin thrombus, but levels remained much lower (short test 1600-3200 ng/ml, long test >200 ng/ml). Long term stasis thrombus tests showed no significant rise in D-dimer levels. Discussion: Alteplase was successful in dissolving fibrin thrombi in our experimental setup. D-dimer analysis supported the visual impression. The fragmentation of stasis thrombi and D-dimer levels measured may be due to the drug's fibrinolytic effect. The amount of erythrocytes in a stasis thrombus may resist lysis and produce challenges in the clinical application of thrombus lysis treatment. With this setup we were able to examine the reaction of the LVAD thrombi to Alteplase. This information can be used to further optimise clinical lysis therapy. Objectives: Methylprednisolon pulse therapy was used in the initial phase of induction therapy in some patients. This study was conducted in order to examine the short and long term effect of methylprednisolone pulse therapy for the lupus nephritis treated with muti-target therapy. Methods: The retrospective st AN - WOS:000482237900001 DA - Aug DO - 10.1177/0391398819860985 J2 - Int. J. Artif. Organs KW - Engineering, Biomedical Transplantation LA - English M1 - 8 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 0391-3988 SP - 386-474 ST - 46th ESAO Congress 3-7 September 2019 Hannover, Germany Abstracts T2 - International Journal of Artificial Organs TI - 46th ESAO Congress 3-7 September 2019 Hannover, Germany Abstracts UR - ://WOS:000482237900001 VL - 42 ID - 830128 ER - TY - CASE A4 - Mercer, Joel A2 - Lam, Andrew C. L. A2 - Smith, Roger A2 - Fallah-Rad, Nazanin A2 - Kavanagh, John AB - A 69-year-old man developed pulmonary metastases following vertebroplasties for pathological fractures of vertebrae T12-L4. The fractures developed due to spinal metastases from castrate-resistant prostate cancer. A CT scan performed 1 month prior indicated no evidence of pulmonary malignancy. However, CT scans performed 2 months after the vertebroplasties demonstrated intravascular pulmonary metastases distributed similarly to embolized polymethylmethacrylate. Vertebroplasty is a well-established procedure for symptomatic management of vertebral compression fractures. However, studies have demonstrated an increase in circulating tumor cells following vertebroplasties, theoretically increasing the risk of distant metastases. In this case, the chronicity and radiological findings suggest that the pulmonary intravascular metastases may have resulted from the vertebroplasties. AD - Divisions of1Cardiothoracic Imaging and 2Department of Medicine, University of Toronto; and 3Neuroradiology, Toronto Joint Department of Medical Imaging, University Health Network 4Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada DB - cin20 DO - 10.3171/2019.9.SPINE19915 DP - EBSCOhost J2 - Journal of Neurosurgery: Spine N1 - CINAHL (EbscoHost) literature search January 5, 2021 NV - Rolling Meadows, Illinois PB - American Association of Neurological Surgeons & the Journal of Neurosurgical Publishing Group PY - 2019 SP - 1-4 ST - Development of pulmonary endovascular metastases following vertebroplasty: case report TI - Development of pulmonary endovascular metastases following vertebroplasty: case report UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=139937644&site=ehost-live&scope=site ID - 830518 ER - TY - JOUR AB - Owing to a Publisher error Declaration of Competing Interest statements were not included in the published versions of the following articles, that appeared in previous issues of Journal of Clinical Orthopaedics and Trauma. The appropriate “Declaration of Competing Interest statements”, provided by the Authors, are included below. 1. “Is It Necessary to Tie the Medial Row in Rotator Cuff Repair Double-Row Constructs when using Suture Tape?” (Journal of Clinical Orthopaedics and Trauma, 2020; 11: 378–382). https://10.1016/j.jcot.2020.02.007Declaration of Competing Interest: The Authors have no interests to declare. 2. “Bone block procedures for glenohumeral joint instability” (Journal of Clinical Orthopaedics and Trauma, 2019; 10: 231–235). https://10.1016/j.jcot.2018.10.002Declaration of Competing Interest: The Authors have no interests to declare. 3. “Axial giant cell tumor current standard of practice” (Journal of Clinical Orthopaedics and Trauma, 2019; 10: 1027–1032). https://10.1016/j.jcot.2019.09.025Declaration of Competing Interest: The Authors have no interests to declare. 4. “Working through the COVID-19 outbreak: Rapid review and recommendations for MSK and allied heath personnel” (Journal of Clinical Orthopaedics and Trauma, 2020; 11: 500–503). https://10.1016/j.jcot.2020.03.014Declaration of Competing Interest: The Authors have no interests to declare. 5. “Cementless jumbo cups for revision of failed Furlong prosthesis. A case series” (Journal of Clinical Orthopaedics and Trauma, 2020; 11: 56–61). https://10.1016/j.jcot.2018.08.009Declaration of Competing Interest: The Authors have no interests to declare. 6. “Effects of age and rate of twist on torsional fracture patterns in infant porcine femora” (Journal of Clinical Orthopaedics and Trauma, 2020; 11: 281–285). https://10.1016/j.jcot.2018.09.008Declaration of Competing Interest: The Authors have no interests to declare. 7. “Tibial-tubercle avulsion and patellar-tendon rupture in pre-pubertal child with osteogenesis imperfecta(OI): Case report and review of current treatment in OI” (Journal of Clinical Orthopaedics and Trauma, 2020; 11: 339–343). https://10.1016/j.jcot.2020.01.013Declaration of Competing Interest: The Authors have no interests to declare. 8. “Ultrasound-guided injections in musculo-skeletal system - An overview” (Journal of Clinical Orthopaedics and Trauma, 2019; 10: 669–673). https://10.1016/j.jcot.2019.05.013Declaration of Competing Interest: The Authors have no interests to declare. 9. “Can IL-6 predict the development of fat embolism in polytrauma? A rabbit model pilot experimental study” (Journal of Clinical Orthopaedics and Trauma, 2020; 11: 86–92). https://10.1016/j.jcot.2019.09.014Declaration of Competing Interest: The Authors have no interests to declare. 10. “Minimising aerosol generation during orthopaedic surgical procedures- Current practice to protect theatre staff during Covid-19 pandemic” (Journal of Clinical Orthopaedics and Trauma, 2020; 11: 506–507). https://10.1016/j.jcot.2020.04.024Declaration of Competing Interest: The Authors have no interests to declare. 11. “3D printing-creating a blueprint for the future of orthopedics: Current concept review and the road ahead!” (Journal of Clinical Orthopaedics and Trauma, 2018; 09: 207–212). https://10.1016/j.jcot.2018.07.007Declaration of Competing Interest: The Authors have no interests to declare. 12. “Rheumatoid subacromial-subdeltoid bursitis with rice bodies: A case report” (Journal of Clinical Orthopaedics and Trauma, 2019; 10: 514–517). https://10.1016/j.jcot.2018.09.014Declaration of Competing Interest: The Authors have no interests to declare. 13. “Impact of COVID 19 lockdown on orthopaedic surgeons in India: A survey” (Journal of Clinical Orthopaedics and Trauma, 2020; 11: 514–517). https://10.1016/j.jcot.2020.05.007Declaration of Competing Interest: The Authors have no interests to declare. 14. “Use of reverse stemless shoulder arthroplasty in a patient with multiple hereditary ex stosis” (Journal of Clinical Orthopaedics and Trauma, 2020; 11: 752–755). https://10.1016/j.jcot.2020.06.044Declaration of Competing Interest: The Authors have no interests to declare. 15. “Outcomes following fixation for proximal humeral fractures” (Journal of Clinical Orthopaedics and Trauma, 2019; 10: 468–473). https://10.1016/j.jcot.2019.01.029Declaration of Competing Interest: The Authors have no interests to declare. 16. “Demographics, mechanism of injury, and associated injuries of 25,615 patients with talus fractures in the National Trauma Data Bank” (Journal of Clinical Orthopaedics and Trauma, 2020; 11: 426–431). https://10.1016/j.jcot.2019.06.007Declaration of Competing Interest: The Authors have no interests to declare. 17. “6-Year clinical results and survival of Copeland Resurfacing hemiarthroplasty of the shoulder in a consecutive series of 279 cases” (Journal of Clinical Orthopaedics and Trauma, 2020; 11: 265–269). https://10.1016/j.jcot.2019.05.014Declaration of Competing Interest: The Authors have no interests to declare. 18. “Arthroscopic ankle fusion to manage sequel of loss of lateral malleoli in compound crushed ankle injury” (Journal of Clinical Orthopaedics and Trauma, 2019; 10: 231–233). https://10.1016/j.jcot.2018.12.001Declaration of Competing Interest: The Authors have no interests to declare. 19. “Modic changes - An evidence-based, narrative review on its patho-physiology, clinical significance and role in chronic low back pain” (Journal of Clinical Orthopaedics and Trauma, 2020; 11: 761–769). https://10.1016/j.jcot.2020.06.025Declaration of Competing Interest: The Authors have no interests to declare. 20. “Diagnosing posterior tibial tendon tear with dynamic ultrasound following tibial intramedullary nailing” (Journal of Clinical Orthopaedics and Trauma, 2019; 10: 666–668). https://10.1016/j.jcot.2018.08.015Declaration of Competing Interest: The Authors have no interests to declare. DB - Embase DO - 10.1016/j.jcot.2020.10.044 KW - erratum LA - English M1 - 6 M3 - Erratum N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 2213-3445 0976-5662 SP - 1172-1174 ST - Erratum regarding previously published articles (Journal of Clinical Orthopaedics and Trauma (2020) 11(S4) (S428–S430), (S0976566220302563), (10.1016/j.jcot.2020.06.023)) T2 - Journal of Clinical Orthopaedics and Trauma TI - Erratum regarding previously published articles (Journal of Clinical Orthopaedics and Trauma (2020) 11(S4) (S428–S430), (S0976566220302563), (10.1016/j.jcot.2020.06.023)) UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2008431756&from=export http://dx.doi.org/10.1016/j.jcot.2020.10.044 VL - 11 ID - 829047 ER - TY - JOUR AB - Background: Increase in intraosseous pressure and displacement of bone marrow contents leading to fat embolism and hypotension during cement injection in vertebroplasty (VP). We aimed to compare the effect of low and high viscosity cements during VP on pulmonary arterial pressure (PAP) with different cannula. Materials and Methods: Fifty‐two patients having multilevel VP due to osteoporotic vertebral compression fractures were randomly treated either by a high viscosity cement (group A, n = 27 patients) and 2.8 mm cannula or a low viscosity cement (group B, n = 25 patients) injected through 4.2 mm cannula. PAP was measured by standard echocardiography and blood d‐dimer values were recorded preoperatively, 24 h and third day after operation. Results: Mean age was 69 (62–87) years in group A and 70 (64–88) years in group B, and sex and comorbidities were similar. Average number of augmented levels was 5.4 in group A and 5.7 in group B. Preoperative mean PAP was 33 mm/Hg in group A, elevated to 41 mm/Hg on first day, and decreased to 36 mm/Hg on third day. The mean PAP in group B was 35 mm/Hg preoperatively, 51 mm/Hg on first day and 46 mm/Hg on third day (p < 0.05). The average blood d‐dimer values in group A increased from 2.1 µg/mL to 2.3 µg/mL and in group B from 2.2 µg/mL to 4.2 µg/mL. Conclusion: The finding of this study showed that high viscosity cement injected through a narrower cannula results in lesser PAP increase and d‐dimer levels when compared to low viscosity cement injected through a wider cannula. Higher PAP and d‐dimer level may show possible thromboembolism. This finding may give spine surgeons to reconsider their choice of cement type and cannula size. AN - CN-02136981 DO - 10.1177/2309499019897659 KW - *lung artery pressure *percutaneous vertebroplasty Adult Age Aged Article Clinical article Comorbidity Compression fracture /surgery Echocardiography Fat embolism Female Fragility fracture /surgery Gender Human Intermethod comparison Male Middle aged Preoperative evaluation Pulmonary fat embolism Spine fracture /surgery Surgical technique Thromboembolism Very elderly Viscosity M1 - 1 M3 - Journal: Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2020 ST - Effect of cementing on pulmonary arterial pressure in vertebroplasty: a comparison of two techniques T2 - Journal of orthopaedic surgery (Hong Kong) TI - Effect of cementing on pulmonary arterial pressure in vertebroplasty: a comparison of two techniques UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02136981/full VL - 28 ID - 830015 ER - TY - JOUR AB - Percutaneous vertebroplasty (PV) is considered a minimally invasive procedure, yet cement leakage into the circulation may result in serious complications. Here, we are reporting a case of pulmonary embolism following PV for treatment of osteoporotic compression vertebral fracture. AD - South Egypt Cancer Institute; Assiut, Egypt - ahmad23679@gmail.com. AN - 24029041 AU - Abd El-Rahman, A. M. AU - Lazzarotti, A. G. AU - Cosottini, M. AU - Puglioli, M. DA - Sep DO - 10.1177/197140091202500411 DP - NLM ET - 2013/09/14 J2 - The neuroradiology journal LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 1971-4009 (Print) 1971-4009 SP - 481-5 ST - Pulmonary embolism caused by cement leakage during percutaneous vertebroplasty. A case report of successful conservative management T2 - Neuroradiol J TI - Pulmonary embolism caused by cement leakage during percutaneous vertebroplasty. A case report of successful conservative management VL - 25 ID - 828709 ER - TY - JOUR AB - INTRODUCTION: Aneurysmal bone cyst is a benign, relatively uncommon lesion, representing 1.4 % of primary bone tumors. The vertebral column is involved in 3-30 % of cases. We present one rare case of ABC involving the thoracic spine in a young patient which was successfully treated with surgery. MATERIAL AND METHOD: A 17 year old boy presented with progressive bilateral lower limb weakness for 2 months, together with numbness and shooting pain radiating from hip to bilateral lower limb which aggravates more at night. Upon examination, there is tenderness at midthoracic spine. He has reduced power bilaterally and reduced sensations below T10 dermatome level. MRI of the thoracic spine revealed extramedullary extradural T4 vertebral mass involving vertebral body, pedicle and lamina. A computed tomography scan of the whole spine (Figure 1,2) demonstrated an irregular lytic lesion at left pedicle of T4 involving the vertebral body, lamina and tranverse process, eroding the bony cortex of T4 vertebrae. (Figure presented) An open biopsy was done subsequently. Intraoperatively, there is a highly vascularized mass at T4 which erodes and deformed the laminae. Histopathology showed proliferation of bland spindle shape cells with scattered, multinucleated, osteoclast-type giant cells with areas of hemorrhage, favouring aneurysmal bone cyst. We performed posterior spinal instrumentation of T2 to T6 and laminectomy of T4 with cage and bone cement insertion. The tumor was excised completely. RESULT: Postoperatively, he was immobilized in Jewett brace for 6 months. He recovered back his muscle power fully postoperatively and discharged home with wheelchair. At 6 month follow up, he was able to walk without any aids and denied any episodes of weakness or numbness. DISCUSSION: The optimal treatment of aneurysmal bone cysts of the spine remains controversial. Treatment options for aneurysmal bone cysts have included simple curettage with or without bone grafting, complete excision, embolisation, radiation therapy or a combination of these modalities. CONCLUSIONS: Early diagnosis and appropriate surgical treatment of aneurysmal bone cysts in the spine remain the key factors to successful management. AD - F. Abd Jabar, Orthopaedic Department, Hospital Kuala Lumpur, Malaysia AU - Abd Jabar, F. AU - Zainal Abidin, N. A. DB - Embase KW - bone cement adolescent aneurysmal bone cyst artificial embolization biopsy bleeding bone transplantation cancer radiotherapy case report cell proliferation clinical article computer assisted tomography conference abstract curettage dermatome early diagnosis excision follow up giant cell heel hip histopathology human human cell human tissue hypesthesia Jewett brace laminectomy male muscle strength night nuclear magnetic resonance imaging osteoclast pain radiotherapy surgery thoracic spine vertebra body weakness wheelchair LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1985-2533 ST - He came in wheels, walked out in heels T2 - Malaysian Orthopaedic Journal TI - He came in wheels, walked out in heels UR - https://www.embase.com/search/results?subaction=viewrecord&id=L622879505&from=export VL - 12 ID - 829213 ER - TY - JOUR AB - BACKGROUND CONTEXT: Cement augmentation techniques are standard treatments for osteoporotic vertebral fractures. Compared with vertebroplasty, kyphoplasty is associated with lower rates of cement leak and better deformity correction; however, posterior wall fractures are relative, but not absolute; contraindications for both techniques and hence treatment practices vary among spine centers. PURPOSE: The primary aim of this study was to assess our center's incidence of posterior cement leakage in osteoporotic vertebral fractures with posterior wall injury treated by balloon kyphoplasty (BKP). Secondarily, physiological results, pain relief, complication rates, and non-posterior cement leakage were also evaluated. STUDY DESIGN: This is a prospective cohort study done in a high-volume spine center in Germany. PATIENT SAMPLE: Eighty-two patients with 98 osteoporotic vertebral fractures with posterior wall cortical injury were studied from 2012 to 2016. OUTCOME MEASURES: The following were the outcome measures: (1) physiological measures: standing plain x-rays (anteroposterior and lateral views), with the following parameters evaluated: cement leak behind the posterior vertebral body border. Cobb angle for local sagittal deformity, vertebral wedge angle, and anterior vertebral height; (2) cement volume injected in each vertebra; and (3) self-report measures: visual analog scale (VAS). METHODS: All patients underwent BKP using a bipedicular approach. Preoperative clinical and neurologic evaluations were done. Radiological evaluations included plain X-ray images, computed tomography scans and magnetic resonance imaging. The average follow-up period was 18 months. RESULTS: No cement leakage into the spinal canal occurred in any of the patients. Asymptomatic leakage into other sites was seen in 22 vertebrae (22.45%). There was significant improvement in the Cobb angle, the vertebral wedge angle, and the anterior vertebral height in all cases. The mean preoperative VAS was 8.1, and this improved to 2.3 on the third postoperative day. CONCLUSION: Balloon kyphoplasty is a viable option for the treatment of osteoporotic vertebral fractures even with posterior wall involvement. (C) 2017 Elsevier Inc. All rights reserved. AD - [Abdelgawaad, Ahmed Shawky; Ezzati, Ali; Krajnovic, Branko] Helios Klinikum Erfurt, Spine Ctr, Nordhaeuser St 74, D-99089 Erfurt, Germany. [Abdelgawaad, Ahmed Shawky; Elnady, Belal; Said, Galal Zaki] Assiut Univ Hosp, Dept Orthoped & Traumatol, Assiut, Egypt. [Govindasamy, Ramachandran] PIMS Med Coll, Dept Orthoped, Pondicherry, India. Abdelgawaad, AS (corresponding author), Helios Klinikum Erfurt, Spine Ctr, Nordhaeuser St 74, D-99089 Erfurt, Germany. ahsh313@yahoo.com AN - WOS:000438471500006 AU - Abdelgawaad, A. S. AU - Ezzati, A. AU - Govindasamy, R. AU - Krajnovic, B. AU - Elnady, B. AU - Said, G. Z. DA - Jul DO - 10.1016/j.spinee.2017.11.001 J2 - Spine Journal KW - Cement augmentation Cement leakage Kyphoplasty Osteoporotic compression fractures Osteoporotic vertebral fractures Posterior wall defects QUALITY-OF-LIFE PERCUTANEOUS VERTEBROPLASTY COMPRESSION FRACTURES CEMENT LEAKAGE BALLOON KYPHOPLASTY RISK-FACTORS POLYMETHYLMETHACRYLATE COMPLICATIONS EMBOLISM WOMEN Clinical Neurology Orthopedics LA - English M1 - 7 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 1529-9430 SP - 1143-1148 ST - Kyphoplasty for osteoporotic vertebral fractures with posterior wall injury T2 - Spine Journal TI - Kyphoplasty for osteoporotic vertebral fractures with posterior wall injury UR - ://WOS:000438471500006 VL - 18 ID - 830164 ER - TY - JOUR AB - STUDY DESIGN: Literature review concerning pulmonary embolism of polymethylmethacrylate (PMMA) material following percutaneous vertebroplasty and a report on 2 new cases. OBJECTIVE: To inform clinicians about delayed clinical manifestation of pulmonary embolism of polymethylmethacrylate material after percutaneous vertebroplasty, pathophysiology, precautions, and therapeutic management of this complication. SUMMARY OF BACKGROUND DATA: Percutaneous vertebroplasty is a minimal invasive intervention used to treat vertebral fractures, which yields good therapeutic results and rarely produces complications. Nevertheless, serious complications may occur. Pulmonary PMMA embolism, which has been recently reported in some cases, is one of these. METHODS AND RESULTS: We report on 2 cases of pulmonary embolism of PMMA material after percutaneous vertebroplasty. In the case of a 45-year-old female patient, symptoms of pulmonary embolism arose with a delay of 3 days following percutaneous vertebroplasty. A therapy with low-molecular-weight heparin, Enoxaparin, enabled recovery from pulmonary failure. The second case occurred without detection of any cement leakage into the paravertebral venous system, neither intraoperatively nor perioperatively. The existence of PMMA in pulmonary vessels was detected 1 year later and remained asymptomatic. CONCLUSION: These 2 cases allow us to conclude that the risk of pulmonary embolism of PMMA might be underestimated. We propose routine chest radiograph following every vertebroplasty, in order to detect pulmonary PMMA embolism and thereby prevent serious delayed cardiopulmonary failures. AD - Department of Neurosurgery, Asklepios Klinik Schildautal Seesen, Germany. abdul-jalil@gmx.de AN - 17873801 AU - Abdul-Jalil, Y. AU - Bartels, J. AU - Alberti, O. AU - Becker, R. DA - Sep 15 DO - 10.1097/BRS.0b013e31814b84ba DP - NLM ET - 2007/09/18 J2 - Spine KW - Anticoagulants/therapeutic use Bone Cements/*adverse effects Enoxaparin/therapeutic use Female Fractures, Compression/diagnostic imaging/*surgery Humans Lumbar Vertebrae/diagnostic imaging/injuries/*surgery Middle Aged Orthopedic Procedures/*adverse effects Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/diagnostic imaging/drug therapy/*etiology Radiography Spinal Fractures/diagnostic imaging/*surgery Thoracic Vertebrae/diagnostic imaging/injuries/*surgery Time Factors Treatment Outcome LA - eng M1 - 20 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 0362-2436 SP - E589-93 ST - Delayed presentation of pulmonary polymethylmethacrylate emboli after percutaneous vertebroplasty T2 - Spine (Phila Pa 1976) TI - Delayed presentation of pulmonary polymethylmethacrylate emboli after percutaneous vertebroplasty VL - 32 ID - 828707 ER - TY - JOUR AB - Study Design: Literature review concerning pulmonary embolism of polymethylmethacrylate (PMMA) material following percutaneous vertebroplasty and a report on 2 new cases. Objective: To inform clinicians about delayed clinical manifestation of pulmonary embolism of polymethylmethacrylate material after percutaneous vertebroplasty, pathophysiology, precautions, and therapeutic management of this complication. Summary Of Background Data: Percutaneous vertebroplasty is a minimal invasive intervention used to treat vertebral fractures, which yields good therapeutic results and rarely produces complications. Nevertheless, serious complications may occur. Pulmonary PMMA embolism, which has been recently reported in some cases, is one of these. Methods and Results: We report on 2 cases of pulmonary embolism of PMMA material after percutaneous vertebroplasty. In the case of a 45-year-old female patient, symptoms of pulmonary embolism arose with a delay of 3 days following percutaneous vertebroplasty. A therapy with low-molecular-weight heparin, Enoxaparin, enabled recovery from pulmonary failure. The second case occurred without detection of any cement leakage into the paravertebral venous system, neither intraoperatively nor perioperatively. The existence of PMMA in pulmonary vessels was detected 1 year later and remained asymptomatic. Conclusion: These 2 cases allow us to conclude that the risk of pulmonary embolism of PMMA might be underestimated. We propose routine chest radiograph following every vertebroplasty, in order to detect pulmonary PMMA embolism and thereby prevent serious delayed cardiopulmonary failures. AD - Department of Neurosurgery, Asklepios Klinik Schildautal Seesen, Germany Department of Neurosurgery, Asklepios Klinik Schildautal Seesen, Germany. abdul-jalil@gmx.de AN - 105831284. Language: English. Entry Date: 20080307. Revision Date: 20200623. Publication Type: journal article AU - Abdul-Jalil, Y. AU - Bartels, J. AU - Alberti, O. AU - Becker, R. AU - Abdul-Jalil, Youssef AU - Bartels, Joerg AU - Alberti, Olaf AU - Becker, Ralf DB - cin20 DO - 10.1097/brs.0b013e31814b84ba DP - EBSCOhost KW - Bone Cements -- Adverse Effects Fractures, Compression -- Surgery Lumbar Vertebrae -- Surgery Methylmethacrylates -- Adverse Effects Orthopedic Surgery -- Adverse Effects Pulmonary Embolism -- Etiology Spinal Fractures -- Surgery Thoracic Vertebrae -- Surgery Anticoagulants -- Therapeutic Use Female Fractures, Compression -- Radiography Heparin, Low-Molecular-Weight -- Therapeutic Use Lumbar Vertebrae -- Injuries Lumbar Vertebrae -- Radiography Middle Age Pulmonary Embolism -- Drug Therapy Pulmonary Embolism -- Radiography Spinal Fractures -- Radiography Thoracic Vertebrae -- Injuries Thoracic Vertebrae -- Radiography Time Factors Treatment Outcomes M1 - 20 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2007 SN - 0362-2436 SP - E589-93 ST - Delayed presentation of pulmonary polymethylmethacrylate emboli after percutaneous vertebroplasty T2 - Spine (03622436) TI - Delayed presentation of pulmonary polymethylmethacrylate emboli after percutaneous vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105831284&site=ehost-live&scope=site VL - 32 ID - 830761 ER - TY - JOUR AB - Background:About 80-90% of patients with multiple myeloma (MM) will develop skeletal related complications, including diffuse osteopenia, focal lytic lesions, pathological fractures, and bone pain, mainly located in vertebrae and skull. The therapeutic intervention for bone disease is based on analgesic medications, byphosphonates, radiation therapy and in some cases percutaneous vertebroplasty (PV) or balloon kyphoplasty. PV was described by Galibert and colleagues in 1987 as a minimally invasive procedure involving the injection of polymethylmetacrilate (PMM) associated to a radiopaque substance within a collapsed vertebral body via a percutaneous approach, under fluoroscopic computed tomography (CT) image guidance. PV seems to have a satisfactory efficacy in almost all patients (90-100%) with an improvement of pain. All studies reported small volume, local intradiscal or paravertebral cement leaks, usually being asymptomatic. Severe life-threatening complications are very uncommon (<1%) and in some reports have been related to a cement volume of greater than 4 mL. Aims: To evaluate the efficacy and safety of percutaneous vertebroplasty (PV) in the treatment of spinal myeloma lesions (SML) refractory to analgesia, byphosphonates or radiation therapy. Methods: Forty-two patients with SML, from 2 centers were eligible. Vertebral fracture or collapse was confirmed by computed tomography or magnetic resonance imaging. PV of more than one vertebra was performed if feasible. Pain response was evaluated by a qualitative scale at 24 h, one and six months after PV. Complications appearing during the follow of 30 days were considered secondary to PV . Results: One hundred and ten PV were performed in 49 procedures. The number of vertebrae treated in each procedure was: 1 in 14 cases, 2 in 15 cases, 3 in 15 cases, 4 in 4 cases and 5 in 1 case, being the T12 the most frequent localization (16 cases). Cement leakage was observed in 46% of all patients. Six out of 42 patients (14%) experimented complications related to PV: two cases of psoas hematoma, one patient with pulmonary insufficiency, two patients suffered a pulmonary embolism (one died because of cement embolism) and one patient presented a subdural hematoma without neurological repercussion. Twenty-four hours after PV, 83% of patients referred a decrease in pain. The evaluation at 1 and 6 months later, showed an improvement of pain in 83% and 70%, respectively. Summary / Conclusion: PV is effective for pain control in 70-80% of myeloma patients with SML at short and long-term. However, some patients may experience life-threatening effects. Further studies with more patients and more follow-up are needed to confirm the efficacy and the incidence of adverse effects. AD - E. Abella, Hematology, Parc de Salut Mar, Barcelona, Spain AU - Abella, E. AU - Soler, J. AU - Angona, A. AU - Ares, J. AU - Zauner, M. AU - Solano, A. AU - Serra, J. AU - Besses, C. DB - Embase KW - cement analgesic agent percutaneous vertebroplasty patient human myeloma hematology safety pain vertebra procedures radiotherapy computer assisted tomography osteopenia drug therapy multiple myeloma nuclear magnetic resonance imaging bone disease iliopsoas hematoma lung insufficiency kyphoplasty skull spine fracture analgesia adverse drug reaction follow up bone pain pathologic fracture subdural hematoma embolism vertebra body lung embolism injection minimally invasive procedure L1 - www.haematologica.org/content/98/supplement_2/1.full-text.pdf+html LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0390-6078 SP - 603 ST - Efficacy and safety of percutaneous vertebroplasty in patients with spinal myeloma lesions T2 - Haematologica TI - Efficacy and safety of percutaneous vertebroplasty in patients with spinal myeloma lesions UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71697346&from=export VL - 98 ID - 829495 ER - TY - JOUR AB - Aim: To evaluate the efficacy and safety of percutaneous vertebroplasty (PV) in the treatment of spinal myeloma lesions (SML) refractory to analgesia, byphosphonates or radiation therapy. Methods:42 patients with SML, from 2 centers were eligible. Vertebral fracture or collapse was confirmed by computed tomography or magnetic resonance imaging. PV of more than one vertebra was performed if feasible. Pain re- sponse was evaluated by a qualitative scale at 24 h, one and six months after PV. Complications were considered secondary to PV during the following 30 days. Results:110 PV were performed in 49 procedures. The number of vertebrae treated in each procedure was: 1 in 14 cases, 2 in 15 cases, 3 in 15 cases, 4 in 4 cases and 5 in 1 case, being the T12 the most frequent localization (16 cases). Cement leakage was observed in 46%. Six out of 42 patients (14%) experimented complications related to PV: two cases of psoas hematoma, one patient with pulmonary insufficiency, two patients suffered a pulmonary embolism (one died because of cement embolism) and one patient presented a subdural hematoma without neurological repercussion. 24 hours after PV, 83% of patients referred a decrease in pain. The evaluation at 1 and 6 months later, showed an improvement of pain in 83% and 70% respectively. Conclusions: PV is effective for pain control in 70-80% of myeloma patients with SML at short and long-term. However, some patients may experience life-threatening effects. AD - E. Abella, Department of Hematology, Parc de Salut Mar, Barcelona, Spain AU - Abella, E. AU - Soler, J. A. AU - Angona, A. AU - Ares, J. AU - Zauner, M. AU - Solano, A. AU - Serra, J. AU - Besses, C. DB - Embase KW - cement myeloma percutaneous vertebroplasty patient human workshop safety pain vertebra procedures spine fracture subdural hematoma embolism nuclear magnetic resonance imaging lung embolism iliopsoas hematoma computer assisted tomography lung insufficiency radiotherapy analgesia LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 2152-2650 SP - S85-S86 ST - Efficacy and safety of percutaneous vertebroplasty in patients with spinal myeloma lesions T2 - Clinical Lymphoma, Myeloma and Leukemia TI - Efficacy and safety of percutaneous vertebroplasty in patients with spinal myeloma lesions UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71025910&from=export VL - 13 ID - 829503 ER - TY - JOUR AB - Introduction: Percutaneous vertebroplasty (PVP) is a common procedure that involves the percutaneous image guided injection of Polymethylmethacrylate (PMMA), commonly known as bone cement, into a fractured vertebral body. A well-known complication of this procedure is the extravasation of the bone cement into the surrounding vasculature resulting in pulmonary cement embolism (PCE). Estimates of the incidence of PCE vary between 2.1-26% as the majority of patients are asymptomatic. We present a unique case of PCE contributing to severe cardiopulmonary decompensation. Case Presentation: A 76-year-old male with a history of diastolic heart failure, coronary artery bypass, atrial fibrillation and L2 vertebroplasty four months prior presented with progressively worsening dyspnea on exertion and scant hemoptysis. He was emergently transferred to the intensive care unit after developing acute hypoxic respiratory failure requiring a nonrebreather. On arrival, patient was hypertensive and tachycardic. CT chest angiogram showed the presence of a calcium dense foreign body in the right upper and lower pulmonary arteries, which was consistent with PCE (Figure 1). Transthoracic echocardiogram showed a left ventricular ejection fraction of 45-50%, an enlarged right atrium, severely dilated right ventricle with moderately reduced systolic function, and right systolic ventricular pressure of 44mmHG. Left and right heart catheterization revealed a mean pulmonary artery pressure of 33mmHg, pulmonary capillary wedge pressure of 24mmHg, and severe native right coronary artery stenosis. Anticoagulation was initiated for the treatment for PCE. He underwent percutaneous coronary artery stenting to the right coronary artery. His course was complicated by the development of congestive heart failure and atrial fibrillation with rapid ventricular rate. After therapeutic diuresis patient was weaned off supplemental oxygen and discharged home on anticoagulation. Discussion: PCE is largely asymptomatic and thus underdiagnosed. While the emboli seem to be of little consequence in those with normal cardiopulmonary function, this case highlights their role as an exacerbating factor in those with cardiac disease. This patient had known left heart failure with coronary artery disease and the presence of the PCE likely contributed to his acute decline and severe right heart failure. There is no clear consensus on treatment of PCE. Review of the literature shows that anticoagulation and potential thrombectomy are recommended in symptomatic patients. This case emphasizes the need to diagnose PCE immediately after PVP and underscores the potential for acute life-threatening decompensation in those with underlying cardiopulmonary disease. AD - M. Abidali, Pulmonary and Critical Care, Banner University Medical Center - Phoenix, Phoenix, AZ, United States AU - Abidali, M. AU - Chopra, M. AU - GarciaOrr, R. DB - Embase KW - cement oxygen aged anticoagulation atrial fibrillation camel cardiopulmonary function case report clinical article conference abstract consensus cor pulmonale coronary artery bypass graft coronary artery disease coronary stenting diagnosis diastolic heart failure diuresis dyspnea foreign body heart catheterization heart left ventricle ejection fraction heart left ventricle failure heart right atrium heart right ventricle failure heart ventricle pressure hemoptysis human intensive care unit lung embolism male nonhuman percutaneous vertebroplasty pulmonary artery occlusion pressure respiratory failure right coronary artery stenosis tachycardia thorax thrombectomy transthoracic echocardiography LA - English M1 - MeetingAbstracts M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1535-4970 ST - The cement that broke the camel's back: A unique case of cement pulmonary embolism T2 - American Journal of Respiratory and Critical Care Medicine TI - The cement that broke the camel's back: A unique case of cement pulmonary embolism UR - https://www.embase.com/search/results?subaction=viewrecord&id=L622966443&from=export VL - 197 ID - 829215 ER - TY - JOUR AB - Conservative surgical strategies are appropriate for most symptomatic hemangiomas causing cord compression without instability or deformity. Even so, complete intralesional spondylectomy following embolization of aggressive vertebral hemangiomas with circumferential vertebral involvement can be safely accomplished. Such a spondylectomy can also prevent recurrence of hemangiomas. Transarterial embolization without decompression is an effective treatment for painful intraosseous hemangiomas. Vertebroplasty is useful for improving pain symptoms, especially when vertebral body compression fracture has occurred in patients without neurological deficit, but is less effective in providing long-term pain relief.Copyright © 2008 by Elsevier Inc. AD - Department of Neurological Surgery, University of California, San Francisco, R505 Parnassus Avenue, Room M-779, San Francisco, CA 94143-0112, USA. acostaf@post.harvard.edu AN - 105863287. Language: English. Entry Date: 20080314. Revision Date: 20150711. Publication Type: Journal Article. Journal Subset: Biomedical AU - Acosta, F. L., Jr. AU - Sanai, N. AU - Chi, J. H. AU - Dowd, C. F. AU - Chin, C. AU - Tihan, T. AU - Chou, D. AU - Weinstein, P. R. AU - Ames, C. P. DB - cin20 DP - EBSCOhost KW - Hemangioma -- Pathology Hemangioma -- Surgery Spinal Neoplasms -- Pathology Spinal Neoplasms -- Surgery Spine -- Pathology Spine -- Surgery Adult Aged Aged, 80 and Over Blood Vessels -- Pathology Blood Vessels -- Physiopathology Embolization, Therapeutic -- Methods Embolization, Therapeutic -- Standards Female Fractures, Compression -- Etiology Fractures, Compression -- Physiopathology Fractures, Compression -- Surgery Hemangioma -- Physiopathology Male Middle Age Neurosurgery -- Methods Neurosurgery -- Standards Spinal Cord Compression -- Etiology Spinal Cord Compression -- Physiopathology Spinal Cord Compression -- Surgery Spinal Neoplasms -- Physiopathology Spine -- Blood Supply Surgery, Cardiovascular -- Methods Surgery, Cardiovascular -- Standards M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2008 SN - 1042-3680 SP - 17-29 ST - Comprehensive management of symptomatic and aggressive vertebral hemangiomas T2 - Neurosurgery Clinics of North America TI - Comprehensive management of symptomatic and aggressive vertebral hemangiomas UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105863287&site=ehost-live&scope=site VL - 19 ID - 830758 ER - TY - JOUR AB - STUDY DESIGN: A retrospective review of consecutive series of Enneking stage 3 vertebral hemangiomas surgically treated at a major tertiary spine tumor center. OBJECTIVE: To determine the short-term recurrence rates, pain improvement, and operative morbidity of intralesional spondylectomy combined with preoperative embolization for Enneking stage 3 vertebral hemangiomas. SUMMARY OF BACKGROUND DATA: Aggressive vertebral hemangiomas (Enneking stage 3) often involve both the anterior and posterior columns with spinal canal and local soft tissue extension and may present with dramatic bony destruction, spinal instability, and pain accompanied with neurologic compromise. Although the current treatment paradigm for most vertebral hemangiomas is conservative management directed toward symptomatic relief, the subset of patients presenting with this rare variant requires more extensive surgical treatment. METHODS: A retrospective clinical review of patients diagnosed with Enneking stage 3 vertebral hemangiomas was conducted at the University of California at San Francisco. RESULTS: We identified 10 consecutive cases of Enneking stage 3 hemangiomas. Average follow-up was 2.42 years. The most common presentation was pain with or without myelopathy. Three of the 10 cases were recurrences after prior partial resection and reconstruction or cement augmentation. All patients underwent preoperative embolization. Average blood loss despite embolization was 2.1 L (range: 0.8 to 5 L). Average preoperative back pain visual analog scale was 7.2 and postoperative visual analog scale was 3.1 at 6 months. On postoperative imaging, all patients had gross total resection. Six patients had staged posterior/anterior transcavitary approach and 4 patients underwent single stage posterior transpedicular spondylectomy. To date, no patient has required adjuvant radiation therapy for tumor recurrence. CONCLUSIONS: Our results suggest that complete wide resection of aggressive Enneking stage 3 lesions can be safely accomplished with acceptable morbidity and blood loss and significant improvement in pain and neurological status. Partial resection of stage 3 lesions, even with stabilization or vertebroplasty, may lead to early recurrence. AD - Department of Neurological Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA. AN - 20844447 AU - Acosta, F. L., Jr. AU - Sanai, N. AU - Cloyd, J. AU - Deviren, V. AU - Chou, D. AU - Ames, C. P. DA - Jun DO - 10.1097/BSD.0b013e3181efe0a4 DP - NLM ET - 2010/09/17 J2 - Journal of spinal disorders & techniques KW - Adult Aged Female Follow-Up Studies Hemangioma/diagnostic imaging/*pathology/*surgery Humans Male Middle Aged Neoplasm Staging Radiography Retrospective Studies Spinal Neoplasms/diagnostic imaging/*pathology/*surgery Treatment Outcome LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2011 SN - 1536-0652 SP - 268-75 ST - Treatment of Enneking stage 3 aggressive vertebral hemangiomas with intralesional spondylectomy: report of 10 cases and review of the literature T2 - J Spinal Disord Tech TI - Treatment of Enneking stage 3 aggressive vertebral hemangiomas with intralesional spondylectomy: report of 10 cases and review of the literature VL - 24 ID - 828784 ER - TY - JOUR AB - STUDY DESIGN: A retrospective review of consecutive series of Enneking stage 3 vertebral hemangiomas surgically treated at a major tertiary spine tumor center. OBJECTIVE: To determine the short-term recurrence rates, pain improvement, and operative morbidity of intralesional spondylectomy combined with preoperative embolization for Enneking stage 3 vertebral hemangiomas. SUMMARY OF BACKGROUND DATA: Aggressive vertebral hemangiomas (Enneking stage 3) often involve both the anterior and posterior columns with spinal canal and local soft tissue extension and may present with dramatic bony destruction, spinal instability, and pain accompanied with neurologic compromise. Although the current treatment paradigm for most vertebral hemangiomas is conservative management directed toward symptomatic relief, the subset of patients presenting with this rare variant requires more extensive surgical treatment. METHODS: A retrospective clinical review of patients diagnosed with Enneking stage 3 vertebral hemangiomas was conducted at the University of California at San Francisco. RESULTS: We identified 10 consecutive cases of Enneking stage 3 hemangiomas. Average follow-up was 2.42 years. The most common presentation was pain with or without myelopathy. Three of the 10 cases were recurrences after prior partial resection and reconstruction or cement augmentation. All patients underwent preoperative embolization. Average blood loss despite embolization was 2.1 L (range: 0.8 to 5 L). Average preoperative back pain visual analog scale was 7.2 and postoperative visual analog scale was 3.1 at 6 months. On postoperative imaging, all patients had gross total resection. Six patients had staged posterior/anterior transcavitary approach and 4 patients underwent single stage posterior transpedicular spondylectomy. To date, no patient has required adjuvant radiation therapy for tumor recurrence. CONCLUSIONS: Our results suggest that complete wide resection of aggressive Enneking stage 3 lesions can be safely accomplished with acceptable morbidity and blood loss and significant improvement in pain and neurological status. Partial resection of stage 3 lesions, even with stabilization or vertebroplasty, may lead to early recurrence. Copyright © 2011 by Lippincott Williams &Wilkins. AD - C. P. Ames, Department of Neurological Surgery, University of California at San Francisco, Box 0112, 505 Parnassus Avenue, San Francisco, CA 94143-0112, United States AU - Acosta Jr, F. L. AU - Sanai, N. AU - Cloyd, J. AU - Deviren, V. AU - Chou, D. AU - Ames, C. P. DB - Embase Medline DO - 10.1097/BSD.0b013e3181efe0a4 KW - adult aged artificial embolization bleeding cancer recurrence cancer surgery clinical article enneking stage 3 vertebral hemangioma female follow up hemangioma human human tissue intralesional spondylectomy male morbidity nuclear magnetic resonance imaging outcome assessment pain priority journal review spinal cord disease spine surgery surgical approach visual analog scale LA - English M1 - 4 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 1536-0652 1539-2465 SP - 268-275 ST - Treatment of enneking stage 3 aggressive vertebral hemangiomas with intralesional spondylectomy: Report of 10 cases and review of the literature T2 - Journal of Spinal Disorders and Techniques TI - Treatment of enneking stage 3 aggressive vertebral hemangiomas with intralesional spondylectomy: Report of 10 cases and review of the literature UR - https://www.embase.com/search/results?subaction=viewrecord&id=L51077878&from=export http://dx.doi.org/10.1097/BSD.0b013e3181efe0a4 VL - 24 ID - 829614 ER - TY - JOUR AB - INTERVENTION: All participants are undergoing total knee replacement. Orthopaedic surgeons will complete each knee replacement, with training registrars operating under direct supervision. Each operation will last approximately 2 hours. The tourniquet will be used for the duration of the procedure and deflated immediately prior to wound closure. Participants in the tourniquet group will have a tourniquet applied during surgery. After exsanguination of the operated limb with a rubber tube exsanguinator, the tourniquet will be inflated to 100mmHg above systolic blood pressure or 250mmHg, whichever is higher. Adherence to the intervention protocol will be monitored by the principal investigator (orthopaedic surgeon) and research coordinator. CONDITION: Knee arthroplasty Knee osteoarthritis PRIMARY OUTCOME: Isometric quadriceps strength will be measured in Newtons and assessed by a trained research assistant using a fixed‐base electromechanical dynamometer (IsoForceControl EVO2 dynamometer) with the knee stabilised in 60 degrees of flexion. Patient will be seated in a customised chair with a frame to fix the dynamometer in position. Following 1‐2 practices, participants will extend their knee as forcefully as they can for 10 seconds. The maximum force from three consecutive attempts will be recorded. SECONDARY OUTCOME: Analgesic requirements will be determined from the patients hospital medication charts and the average morphine equivalent daily dose calculated (mg) Cement mantle quality according to the Knee Society total knee arthroplasty roentgenographic evaluation and scoring system Complications during inpatient stay as recorded in the patient's hospital medical record (deep vein thrombosis, pulmonary embolus) EQ‐5D‐5L (quality of life) Hospital length of stay according to the patient's hospital medical records Intra‐operative blood loss (ml) will be estimated visually by the treating surgeon. Isometric quadriceps strength will be measured in Newtons and assessed by a trained research assistant using a fixed‐base electromechanical dynamometer (IsoForceControl EVO2 dynamometer) with the knee stabilised in 60 degrees of flexion. Patient will be seated in a customised chair with a frame to fix the dynamometer in position. Following 1‐2 practices, participants will extend their knee as forcefully as they can for 10 seconds. The maximum force from three consecutive attempts will be recorded. Knee pain will be assessed using a 0‐10 Likert scale (0=no pain, 10=extreme pain) Operation and anaesthetic time as recorded in the patient's hospital medical record Oxford Knee Score (OKS) (Self‐reported pain & physical function) Patient satisfaction assessed with a 0‐10 visual analogue scale Revision surgery as recorded in the patient's hospital medical record Surgeon satisfaction with intra‐operative visual field, assessed using a 1‐10 Likert scale (1=completely unsatisfied, 10=completely satisfied) Tourniquet inflation time as recorded in the patient's hospital medical record Transfusions given (units) as recorded in the patient's hospital medical record WOMAC (Self‐reported pain & physical function) ; INCLUSION CRITERIA: 1. undergoing primary total knee replacement for primary osteoarthritis 2. > 18 years of age 3. Willing, able and mentally competent to provide informed consent AN - CN-01905348 AU - Actrn N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2018 ST - Evaluating the effects of tourniquet use in total knee arthroplasty T2 - http://www.who.int/trialsearch/Trial2.aspx?TrialID=ACTRN12618000425291 TI - Evaluating the effects of tourniquet use in total knee arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01905348/full ID - 830091 ER - TY - GEN AU - Adler, F. AU - Kim, Y. AU - Oh, S. AU - Kim, J. AU - Adler, Federico CY - Baltimore, Maryland DB - cin20 DP - EBSCOhost J2 - Journal of Bone & Joint Surgery, American Volume KW - Anoxemia -- Epidemiology Arthroplasty, Replacement, Hip -- Methods Bone Cements -- Therapeutic Use Embolism, Fat -- Epidemiology Mental Status N1 - CINAHL (EbscoHost) literature search January 5, 2021 PB - Lippincott Williams & Wilkins PY - 2003 SN - 0021-9355 SP - 569-569 ST - Fat embolism versus fat embolization following total hip arthroplasty...'Prevalence of fat embolism following bilateral simultaneous and unilateral total hip arthroplasty performed with or without cement. A prospective, randomized clinical study' (2002;84:1372-9), By Kim et al TI - Fat embolism versus fat embolization following total hip arthroplasty...'Prevalence of fat embolism following bilateral simultaneous and unilateral total hip arthroplasty performed with or without cement. A prospective, randomized clinical study' (2002;84:1372-9), By Kim et al UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106883295&site=ehost-live&scope=site VL - 85 ID - 830790 ER - TY - JOUR AD - Internal Medicine, HSHS Saint Mary's Hospital Medical Center, Green Bay, Wisconsin, USA. Internal Medicine, HSHS Saint Vincent Hospital, Green Bay, Wisconsin, USA. AN - 31311789 AU - Adu-Gyamfi, K. O. AU - Patri, S. C2 - Pmc6663223 DA - Jul 15 DO - 10.1136/bcr-2019-230603 DP - NLM ET - 2019/07/18 J2 - BMJ case reports KW - Aged, 80 and over Bone Cements/*adverse effects Dyspnea/etiology Echocardiography/methods Embolism/pathology Female Humans Pulmonary Embolism/*diagnostic imaging/therapy Tomography, X-Ray Computed/methods Treatment Outcome Vertebroplasty/*adverse effects/methods adult intensive care interventional radiology pulmonary embolism LA - eng M1 - 7 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 1757-790x ST - Symptomatic cardiopulmonary cement embolism following vertebroplasty T2 - BMJ Case Rep TI - Symptomatic cardiopulmonary cement embolism following vertebroplasty VL - 12 ID - 828650 ER - TY - JOUR AD - Department of Orthopaedic Surgery, Princess Alexandra Hospital, Ipswich Road, Woolloongabba Q 4102, Australia. AN - 106320337. Language: English. Entry Date: 20060818. Revision Date: 20200624. Publication Type: Journal Article AU - Aebli, N. AU - Schwenke, D. AU - Davis, G. AU - Hii, T. AU - Theis, J. AU - Krebs, J. DB - cin20 DO - 10.1080/17453670510045570 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Embolism, Fat -- Chemically Induced Hypertension, Pulmonary -- Chemically Induced Methylmethacrylates -- Adverse Effects Orthopedic Surgery -- Adverse Effects Spine -- Surgery Animal Studies Bone Cements -- Pharmacodynamics Comparative Studies Confidence Intervals Descriptive Statistics Hemodynamics -- Drug Effects Injections Methylmethacrylates -- Pharmacodynamics Paired T-Tests Post Hoc Analysis Regression Sheep Two-Way Analysis of Variance Unpaired T-Tests Waxes -- Adverse Effects Waxes -- Pharmacodynamics M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2005 SN - 1745-3674 SP - 904-911 ST - Polymethylmethacrylate causes prolonged pulmonary hypertension during fat embolism: a study in sheep T2 - Acta Orthopaedica TI - Polymethylmethacrylate causes prolonged pulmonary hypertension during fat embolism: a study in sheep UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106320337&site=ehost-live&scope=site VL - 76 ID - 830776 ER - TY - JOUR AB - Introduction: Since January 1st 2009 the Dynesys implant, amongst other posterior dynamic stabilization systems, is documented in the governmentally mandated SWISSspine registry in a prospective, observational mode; this in addition to disc arthroplasties and balloon kyphoplasty. The current study describes the early results of the patient cohort. Material/Methods: 76 female and 55 male patients with mean ages of 69.1 and 65.1 years are recorded with COMI back and EQ-5D as well as surgical and followup forms. 97.5% of patients were followed up for 3-6 months and 58% already for 1 year. 28 patients were treated on 2 levels, 3 patients on 3 levels. 6.7% of patients had a depression with pharmacological treatment. All but 8 patients were treated for symptomatic spinal stenosis (121 cases) and/or degenerative olisthesis up to grade 1 (107 cases), the others for discogenic back pain with degeneration of only 1-2 segments and no success after conservative therapy of 6 months. Results: 88% had a preoperative walking distance ≤1km, 67% had leg weakness and about 52% had a radiculopathy. VAS back was a mean of 6.5, VAS leg a mean of 7.2 (0-10). EQ-5D score was 0.23 points (-0.6 to 1). The most frequently applied decompression was a flavectomy (27%), followed by facet joint undercutting (26.3%) and laminotomy (25.2%). There were three intraoperative dural leaks and one peridural bleeding. One hematoma and one micro pulmonary embolism were documented as postoperative complications. The hematoma was surgically revised during the same hospital stay. There were three revisions after discharge, one with material removal and rigid stabilization and spondylodesis, and one with removal of spacers and cord and replacement with a dynamic pedicular system. In a third case a screw was exchanged. In two instances there were radiologically loose pedicle screws. At followup 83% of patients were able to walk more than 1km or unlimited, leg weakness was still present in 11.6% and radiculopathy had disappeared in 89.5% of cases. VAS back was 2.1 and leg 2 points. 81% had a minimum clinically relevant pain improvement of at least 2 points. EQ-5D was 0.82, 79% had a minimum clinically relevant quality of life improvement of at least 0.25 points. 94% of patients were somewhat or very satisfied with the treatment. Conclusion: short term results show a save therapy option with clearly improved walking distance, leg pain and radiculopathy. Pain alleviation was remarkable, also the percentage of patients with a clinically relevant pain improvement. Preoperative quality of life was very low, pre-to postoperative QoL improvements high and a relevant quality of life improvement happened in almost 8 out of 10 patients. Longer term results must prove the sustainability of clinical outcomes and survival of the implant. AD - E. Aghayev, Institute for Evaluative Research in Medicine, Evaluative Research, Bern, Switzerland AU - Aghayev, E. AU - Moulin, P. AU - Röder, C. DB - Embase DO - 10.1007/s00586-011-2033-x KW - spine society register patient human leg radiculopathy quality of life pain hematoma follow up implant walking weakness lung embolism bleeding kyphoplasty survival leg pain therapy decompression pedicle screw spondylodesis conservative treatment postoperative complication degeneration hospitalization backache vertebral canal stenosis male drug therapy female arthroplasty LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 0940-6719 SP - 2030 ST - Short-term results of dynamic stabilization from the SWISSspine registry T2 - European Spine Journal TI - Short-term results of dynamic stabilization from the SWISSspine registry UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71314012&from=export http://dx.doi.org/10.1007/s00586-011-2033-x VL - 20 ID - 829602 ER - TY - JOUR AB - INTRODUCTION: Vertebral augmentation through cement injection into the vertebral body (VB) has successfully stabilized vertebral compression fractures. Despite this, complications with these procedures include extravasation and poor osseointegration of the purely acrylic cements. Calcium phosphate (CaP) cements are bioactive; however lack the mechanical strength for these applications, and their use as fillers in acrylic cement has detrimental effects on the mechanical behavior and handling [1,2]. We have developed a premixed cement system that can incorporate CaP filler such as hydroxyapatite (HA) and Brushite with no deteriorating effects. The premixed system provides a versatile platform for tuning cement properties. Through the addition of CaP, cement bioactivity was introduced while the viscosity was tailored to decrease the risk of extravasation. The composite cement formulations synthesized using this system have been characterized using rheology, injectability, and mechanical tests. Physiologically relevant tests such as in vitro cell studies, and cadaver vertebroplasty models were performed to mimic the augmentation procedure and examine the stabilization and bioactivity of the cements. Methods: Cements were prepared as described in previous works. [3] Rheology and Injectability: Rheology was investigated for setting and non-setting cements to demonstrate viscosity changes and shear-thinning, respectively. A parallel plate configuration was used under constant angular frequency for the setting cements and a frequency sweep for the non-setting cements. A rod in barrel injection system was designed to track injection times of 5 niL of the cements. Mechanical Tests: ASTM standards [4,5] were followed to characterize cement compressive and flexural properties before and after immersion in Hank's salt solution (HSS). Fracture induction was also evaluated. Vertebroplasty Model: We examined the augmentation potential of the cements using 5 cadaver spines. The cadaver VBs (N=22) were fractured, augmented, and tested in fatigue mode. The VBs were sectioned to observe cement interdigitation. Mass-loss and Cell Studies: Cement pellets were immersed in HSS at 37°C and kept shaking in order to evaluate mass-loss due to CaP release. Micro-CT was used to analyze bulk porosity. The cements were tested for cytotoxicity and differentiation potential. Differentiation was assessed using an alkaline phosphatase (ALP) assay for direct contact between the cell and cement. Results: Characterization of physical properties demonstrated desirable cement shear-thinning, with high viscosities at low shear, which translates to ease of injectability and low risk of extravasation. Mechanical characterization found no detrimental effects of CaP filler introduction with an average compressive strength of 85 MPa and flexural strength of 65 MPa. The fractured cadaver VBs were successfully augmented using the composite cements. The sectioned VBs showed interdigitation of the cement through the cancellous network. The PMMA-Brushite cement showed a mass loss of 7% after 2 weeks of immersion with surface and bulk porosity generation. Cells studies demonstrated no cytotoxicity and desirable osteoblast differentiation with cement contact as ALP assays were positive. Discussion: The successful incorporation of fillers in the cement is due to the complete swelling achieved in the premixed system. This swelling creates homogenous cement with the filler completely dispersed within the acrylic matrix. Although used to introduce CaP fillers, the versatility of the premixed system can allow the introduction of drugs and biomolecules into the cements, ultimately tailoring the material for specific applications. After characterization and selection of the most suitable composite formulations, one PMMA-Brushite and one PMMA-HA, a simulated vertebroplasty demonstrated VB stabilization and height restoration after cement injection. The augmentation is attributed to the successful interdigitation of the cement within the trabecular structure, allowing for loa transfer through the cement. An endplate-to-endplate fill was achieved in the VB without any extravasation. The cell studies demonstrated positive results, with no toxic effects. The highly packed composite cements have a high powder-to-liquid ratio, lowering the concentration of toxic monomer. The ALP assay also demonstrated a positive interaction between the CaP fillers and the pre-osteoblast cells leading to differentiation. Despite this, differentiation was observed even in the absence of the CaP fillers; however it was enhanced when in contact with the composite cements. In conclusion, we have successfully designed a premixed cement system with the versatility to incorporate CaP fillers and be tailored for specific applications. These CaP containing cements exhibit a combination of high viscosity, pseudoplasticity, and high mechanical strength, and can provide the essential bioactivity factor for osseointegration without sacrificing load-bearing capability. Future animal studies will be conducted to visualize the bone growth through the cement while assessing the augmentative success of the cements. SIGNIFICANCE: Vertebral compression fractures are the most common effect of osteoporosis, with around 700,000 cases annually [6]. Acrylic cements have been successfully used in hip arthroplasties and other such applications; however there have been reported complications when using these acrylic cements in novel minimally invasive spine augmentation surgery. The acrylic cements fail Theologically when injected through small cannulas into VBs with the high injection pressures required possibly leading to cement leakage from the VB, which can form emboli in various parts of the body. The acrylic cements also lack the ability to incorporate fillers, as the cements mechanical properties are compromised upon addition. AD - S. Aghyarian, Biomaterials for Osseointegration and Novel Engineering Laboratory (BONE Lab), Department of Bioengineering, University of Texas at Dallas, Richardson, TX, United States AU - Aghyarian, S. AU - Jayaraman, V. AU - Kosmopoulos, V. AU - Lieberman, I. H. AU - Rodrigues, D. C. DB - Embase DO - 10.1002/jor.23247 KW - alkaline phosphatase bone cement calcium phosphate calcium phosphate dibasic endogenous compound hydroxyapatite monomer poly(methyl methacrylate) biological activity bone growth cadaver cannula compression fracture compressive strength cytotoxicity differentiation embolism extravasation fatigue flow kinetics height hip arthroplasty human immersion in vitro study injection major clinical study mechanical stimulus test micro-computed tomography osseointegration osteoblast osteoporosis percutaneous vertebroplasty porosity powder simulation surgery swelling vertebra body viscosity LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1554-527X ST - Novel pre-mixed PMMA-CaP composite bone cements for vertebroplasty T2 - Journal of Orthopaedic Research TI - Novel pre-mixed PMMA-CaP composite bone cements for vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L616819453&from=export http://dx.doi.org/10.1002/jor.23247 VL - 34 ID - 829346 ER - TY - JOUR AB - We report the case of a 51-year-old woman who underwent kyphoplasty with polymethylmethacrylate for painful compression fracture of the third lumbar vertebra. Infiltration of cement into the inferior vena cava, noted intraoperatively, was confirmed with postoperative CT scan. A Greenfield filter was placed to prevent cardiopulmonary embolization of the fragment. On follow-up x-rays, the cement fragment was found to have detached and embolized into the vena cava filter. Endovascular technique was used to retrieve it to the common femoral vein with subsequent successful removal of the crescent-like fragment with operative exploration. Patient was asymptomatic at four-week follow-up visit. AD - Department of Surgery, The University of Toledo Medical Center, Toledo, Ohio 43614, USA. ago77@hotmail.com AN - 19837540 AU - Agko, M. AU - Nazzal, M. AU - Jamil, T. AU - Castillo-Sang, M. AU - Clark, P. AU - Kasper, G. DA - Jan DO - 10.1016/j.jvs.2009.07.110 DP - NLM ET - 2009/10/20 J2 - Journal of vascular surgery KW - Bone Cements/*adverse effects Embolism/diagnostic imaging/etiology/*therapy Female Fractures, Compression/surgery Heart Diseases/etiology/*prevention & control Humans Lumbar Vertebrae/injuries/surgery Middle Aged Phlebography/methods Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/etiology/*prevention & control Spinal Fractures/surgery Tomography, X-Ray Computed Treatment Outcome *Vena Cava Filters *Vena Cava, Inferior/diagnostic imaging Vertebroplasty/*adverse effects/methods LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 0741-5214 SP - 210-3 ST - Prevention of cardiopulmonary embolization of polymethylmethacrylate cement fragment after kyphoplasty with insertion of inferior vena cava filter T2 - J Vasc Surg TI - Prevention of cardiopulmonary embolization of polymethylmethacrylate cement fragment after kyphoplasty with insertion of inferior vena cava filter VL - 51 ID - 828972 ER - TY - JOUR AB - The midterm results of 74 posterior stability total condylar prostheses were studied (average follow-up 3 1/2 years). The average age of the patients was 65 years with a predilection for females (73%). The most frequent diagnosis was osteoarthritis (70%) followed by rheumatoid arthritis (28%): in 20% of the cases previous operations had been performed. Most of the patients had severe deformity which was not susceptible to other surgical treatment. The most frequent deformity was varus (average 13 degrees), followed by valgus (average 25 degrees), and flexion contracture (average 37 degrees). Bone defect in the tibia requiring surgical treatment were present in 18% of the cases. The most frequent general complication was pulmonary embolism (5%), which was never fatal; minor complications related to wound healing were observed in 17.5% of the cases. The results, evaluated with a numerical recording form devised by the Hospital for Special Surgery (New York) were: excellent 72%, good 21%, fair 4%, poor 3%. Of the 4 fair results, one had lateral laxity following lysis for valgus knee, one had loosening of the tibial component, and one had painful patellar clicks. Painless, small patellar clicks were observed in 4 other patients. The two poor results were due to low-grade infection and detachment of both components. Seventy per cent of the knees had normal or almost normal function with maximum flexion averaging 100 degrees. In 78% of the cases a study of the cement-bone interface revealed either no radiotranslucent line or present in only one area of the tibia. Radiotranslucent lines around the femoral or patellar component was rare and of no clinical significance. AN - 3553067 AU - Aglietti, P. AU - Buzzi, R. AU - Pisaneschi, A. DA - Sep DP - NLM ET - 1986/09/01 J2 - Italian journal of orthopaedics and traumatology KW - Adult Aged Arthritis, Rheumatoid/surgery Bone Cements/administration & dosage Bone Transplantation Female Follow-Up Studies Humans *Knee Prosthesis Male Middle Aged Osteoarthritis/*surgery Postoperative Complications/*etiology Prosthesis Design Prosthesis Failure Wound Healing LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 1986 SN - 0390-5489 (Print) 0390-5489 SP - 275-88 ST - Total condylar knee prosthesis with posterior stability. A mid-term follow-up of 74 cases with severe deformity T2 - Ital J Orthop Traumatol TI - Total condylar knee prosthesis with posterior stability. A mid-term follow-up of 74 cases with severe deformity VL - 12 ID - 828901 ER - TY - JOUR AB - Methyl methacrylate (MMA) pulmonary embolism is a serious potential complication of percutaneous vertebroplasty. We present a case of a 28-year-old man who presented to an outside institution with pleuritic chest pain after MMA vertebroplasty of the T11 thoracic vertebra for chronic back ache secondary to a previous traumatic fracture. Multifocal MMA pulmonary embolism was identified on CT. The patient was referred to our institution following a wedge resection for pulmonary infarction. V/Q scintigraphy was performed and demonstrated normal ventilation with multiple mismatched perfusion defects bilaterally. Patient subsequently underwent central and bilateral segmental pulmonary embolectomies. AD - Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA. AN - 23242048 AU - Agrawal, G. AU - Wright, C. L. AU - Rhodes, N. G. AU - Sharma, A. DA - Jan DO - 10.1097/RLU.0b013e3182708548 DP - NLM ET - 2012/12/18 J2 - Clinical nuclear medicine KW - Adult Humans Image Processing, Computer-Assisted Lung/*blood supply/*pathology/physiopathology Male Methylmethacrylate/*adverse effects Perfusion Pulmonary Embolism/*chemically induced/diagnostic imaging/*physiopathology Tomography, X-Ray Computed Ventilation LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 0363-9762 SP - 50-2 ST - Mismatched perfusion defects secondary to recent methyl methacrylate embolization T2 - Clin Nucl Med TI - Mismatched perfusion defects secondary to recent methyl methacrylate embolization VL - 38 ID - 828803 ER - TY - JOUR AB - BACKGROUND CONTEXT: Vertebroplasty is commonly performed for management of pain associated with vertebral compression fractures. There have been two previous reports of fatal fat embolism following vertebroplasty. Here we describe a case of fat embolism syndrome following this procedure, and also provide fluoroscopic video evidence consistent with this occurrence. PURPOSE: The purpose of this study was to review the literature and report a case of fat embolism syndrome in a patient who underwent percutaneous vertebroplasty for compression fracture. STUDY DESIGN/SETTING: The study design for this manuscript was of a clinical case report. METHODS: A 68-year-old woman who developed sudden back pain with minimal trauma was found to have a T6 vertebral compression fracture on radiographs and bone scans. Percutaneous vertebroplasty of T5 and T6 was performed. RESULTS: Fluoroscopic imaging during the procedure demonstrated compression and rarefaction of the fractured vertebra associated with changes in intrathoracic pressure. Immediately after the procedure, the patient's back pain resolved and she was discharged home. Two days later, she developed increasing respiratory distress, confusion, and chest pain. A petechial rash on her upper arms also appeared. No evidence of bone cement leakage or pulmonary filling defects were seen on computed tomography-pulmonary angiography. Brain magnetic resonance imaging demonstrated hyperintensities in the periventricular and subcortical white matter on T2/fluid-attenuated inversion recovery sequences. A diagnosis of fat embolism syndrome was made, and the patient recovered with conservative management. CONCLUSIONS: Percutaneous vertebroplasty is a relatively safe and simple procedure, reducing pain and improving functional limitations in patients with vertebral fractures. This case demonstrates an uncommon yet serious complication of fat embolism syndrome. Clinicians must be aware of this complication when explaining the procedure to patients and provide prompt supportive care when it does occur. AD - Faculty of Medicine, University of New South Wales, Level 2, ASGM Building/Botany St, Sydney, New South Wales 2052, Australia; Department of Respiratory Medicine, St. George Hospital, Gray St, Kogarah, New South Wales 2217, Australia. Electronic address: h.ahmadzai@unsw.edu.au. Faculty of Medicine, University of New South Wales, Level 2, ASGM Building/Botany St, Sydney, New South Wales 2052, Australia; Department of Respiratory Medicine, St. George Hospital, Gray St, Kogarah, New South Wales 2217, Australia. Department of Radiology, St. George Private Hospital, 1 South St, Department of Radiology, Kogarah, New South Wales 2217, Australia. AN - 24314905 AU - Ahmadzai, H. AU - Campbell, S. AU - Archis, C. AU - Clark, W. A. DA - Apr DO - 10.1016/j.spinee.2013.09.021 DP - NLM ET - 2013/12/10 J2 - The spine journal : official journal of the North American Spine Society KW - Aged Embolism, Fat/diagnosis/*etiology Female Fluoroscopy Fractures, Compression/*surgery Humans Magnetic Resonance Imaging Postoperative Complications Spinal Fractures/*surgery Vertebroplasty/*adverse effects/methods Fat embolism Percutaneous vertebroplasty Polymethylmethacrylate Vertebral fracture LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1529-9430 SP - e1-5 ST - Fat embolism syndrome following percutaneous vertebroplasty: a case report T2 - Spine J TI - Fat embolism syndrome following percutaneous vertebroplasty: a case report VL - 14 ID - 828697 ER - TY - JOUR AB - STUDY DESIGN: Case report. OBJECTIVES: To report a case of lumbar hemangioma causing neurogenic claudication and early cauda equina, managed with hemostatic vertebroplasty and posterior decompression. SUMMARY OF BACKGROUND DATA: This is the first report to our knowledge of a lumbar hemangioma causing neurogenic claudication and early cauda equina syndrome. Most hemangiomas causing neurologic symptoms occur in thoracic spine and cause spinal cord compression. Vertebroplasty as a method of hemostasis and for providing mechanical stability in this situation has not been discussed previously in the literature. METHODS: L4 hemangioma was diagnosed in a 64-year-old woman with severe neurogenic claudication and early cauda equina syndrome. Preoperative angiograms showed no embolizable vessels. Posterior decompression was performed followed by bilateral transpedicular vertebroplasty. The patient received postoperative radiation to prevent recurrence. RESULTS: Complete relief of neurogenic claudication and cauda equina with less than 100 mL of blood loss. CONCLUSION: A lumbar hemangioma of the vertebral body, although rare, can cause neurogenic claudication and cauda equina syndrome. Intraoperative vertebroplasty can be an effective method of hemostasis and provide stability of the vertebra following posterior decompression. AD - The Sunnybrook & Women's College Health Sciences Centre, Toronto, Ontario, Canada. AN - 16261106 AU - Ahn, H. AU - Jhaveri, S. AU - Yee, A. AU - Finkelstein, J. DA - Nov 1 DO - 10.1097/01.brs.0000184560.78192.f6 DP - NLM ET - 2005/11/02 J2 - Spine KW - Decompression, Surgical Female Hemangioma/complications/*pathology/surgery Humans Intermittent Claudication/etiology/pathology Lumbar Vertebrae/diagnostic imaging/*pathology/surgery Magnetic Resonance Imaging Middle Aged Polyradiculopathy/etiology/*pathology/surgery Spinal Neoplasms/complications/*pathology/surgery Tomography, X-Ray Computed Treatment Outcome LA - eng M1 - 21 N1 - PubMed NLM literature search January 5, 2021 PY - 2005 SN - 0362-2436 SP - E662-4 ST - Lumbar vertebral hemangioma causing cauda equina syndrome: a case report T2 - Spine (Phila Pa 1976) TI - Lumbar vertebral hemangioma causing cauda equina syndrome: a case report VL - 30 ID - 828906 ER - TY - JOUR AB - Study Design. Case report. Objectives. To report a case of lumbar hemangioma causing neurogenic claudication and early cauda equina, managed with hemostatic vertebroplasty and posterior decompression. Summary of Background Data. This is the first report to our knowledge of a lumbar hemangioma causing neurogenic claudication and early cauda equina syndrome. Most hemangiomas causing neurologic symptoms occur in thoracic spine and cause spinal cord compression. Vertebroplasty as a method of hemostasis and for providing mechanical stability in this situation has not been discussed previously in the literature. Methods. L4 hemangioma was diagnosed in a 64-year- old woman with severe neurogenic claudication and early cauda equina syndrome. Preoperative angiograms showed no embolizable vessels. Posterior decompression was performed followed by bilateral transpedicular vertebroplasty. The patient received postoperative radiation to prevent recurrence. Results. Complete relief of neurogenic claudication and cauda equina with less than 100 mL of blood loss. Conclusion. A lumbar hemangioma of the vertebral body, although rare, can cause neurogenic claudication and cauda equina syndrome. Intraoperative vertebroplasty can be an effective method of hemostasis and provide stability of the vertebra following posterior decompression. AD - Sunnybrook & Womens Coll Hlth Sci Ctr, Toronto, ON M4N 3M5, Canada. Finkelstein, J (corresponding author), Sunnybrook & Womens Coll Hlth Sci Ctr, 2075 Bayview Ave,MG-361, Toronto, ON M4N 3M5, Canada. joel.finkelstein@swchsc.on.ca AN - WOS:000233016600029 AU - Ahn, H. AU - Jhaveri, S. AU - Yee, A. AU - Finkelstein, J. DA - Nov DO - 10.1097/01.brs.0000184560.78192.f6 J2 - Spine KW - hemangioma lumbar neurogenic claudication cauda equina vertebroplasty decompression SPINAL-CORD COMPRESSION Clinical Neurology Orthopedics LA - English M1 - 21 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2005 SN - 0362-2436 SP - E662-E664 ST - Lumbar vertebral hemangioma causing cauda equina syndrome - A case report T2 - Spine TI - Lumbar vertebral hemangioma causing cauda equina syndrome - A case report UR - ://WOS:000233016600029 VL - 30 ID - 830422 ER - TY - JOUR AB - Study Design: Case report.Objectives: To report a case of lumbar hemangioma causing neurogenic claudication and early cauda equina, managed with hemostatic vertebroplasty and posterior decompression.Summary Of Background Data: This is the first report to our knowledge of a lumbar hemangioma causing neurogenic claudication and early cauda equina syndrome. Most hemangiomas causing neurologic symptoms occur in thoracic spine and cause spinal cord compression. Vertebroplasty as a method of hemostasis and for providing mechanical stability in this situation has not been discussed previously in the literature.Methods: L4 hemangioma was diagnosed in a 64-year-old woman with severe neurogenic claudication and early cauda equina syndrome. Preoperative angiograms showed no embolizable vessels. Posterior decompression was performed followed by bilateral transpedicular vertebroplasty. The patient received postoperative radiation to prevent recurrence.Results: Complete relief of neurogenic claudication and cauda equina with less than 100 mL of blood loss.Conclusion: A lumbar hemangioma of the vertebral body, although rare, can cause neurogenic claudication and cauda equina syndrome. Intraoperative vertebroplasty can be an effective method of hemostasis and provide stability of the vertebra following posterior decompression. AD - The Sunnybrook & Women's College Health Sciences Centre, Toronto, Ontario, Canada Sunnybrook & Women's College Health Sciences Centre, Toronto, Ontario, Canada AN - 106383668. Language: English. Entry Date: 20060120. Revision Date: 20200708. Publication Type: journal article AU - Ahn, H. AU - Jhaveri, S. AU - Yee, A. AU - Finkelstein, J. AU - Ahn, Henry AU - Jhaveri, Subir AU - Yee, Albert AU - Finkelstein, Joel DB - cin20 DO - 10.1097/01.brs.0000184560.78192.f6 DP - EBSCOhost KW - Low Back Pain -- Etiology -- In Middle Age Intermittent Claudication -- Etiology -- In Middle Age Lumbar Vertebrae -- Pathology -- In Middle Age Hemangioma -- Diagnosis -- In Middle Age Spinal Nerve Roots -- Pathology -- In Middle Age Decompression, Surgical -- In Middle Age Orthopedic Surgery -- Methods -- In Middle Age Middle Age Female M1 - 21 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2005 SN - 0362-2436 SP - E662-4 ST - Lumbar vertebral hemangioma causing cauda equina syndrome: a case report T2 - Spine (03622436) TI - Lumbar vertebral hemangioma causing cauda equina syndrome: a case report UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106383668&site=ehost-live&scope=site VL - 30 ID - 830780 ER - TY - JOUR AD - Dr. Amr Mohammad Hassan Abdulrazaq Ajlan, Department of Radiology,, King Abdulaziz University,, Jeddah, 21411,, Saudi Arabia, T: 022-6408222 ext. 18163, amrajlan@yahoo.com, ORCiD id: http://orcid.org/0000-0001-8199-1915. AN - 27236397 AU - Ajlan, A. M. C2 - Pmc6074544 DA - May-Jun DO - 10.5144/0256-4947.2016.232 DP - NLM ET - 2016/05/30 J2 - Annals of Saudi medicine KW - Aged Bone Cements/*adverse effects Embolism/*diagnostic imaging/*etiology Humans Lumbar Vertebrae/surgery Male *Pulmonary Artery Radiography, Thoracic Vertebroplasty/*adverse effects LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 0256-4947 (Print) 0256-4947 SP - 232-3 ST - Pulmonary arterial cement embolization: arare complication of vertebroplasty T2 - Ann Saudi Med TI - Pulmonary arterial cement embolization: arare complication of vertebroplasty VL - 36 ID - 828705 ER - TY - JOUR AD - A.M.H.A. Ajlan, Department of Radiology, King Abdulaziz University, Jeddah, Saudi Arabia AU - Ajlan, A. M. H. A. DB - Embase Medline DO - 10.5144/0256-4947.2016.232 KW - aged artery embolism article case report computer assisted tomography dyspnea human male percutaneous vertebroplasty priority journal pulmonary arterial cement embolization pulmonary vascular disease thorax radiography LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 0975-4466 0256-4947 SP - 232-233 ST - Pulmonary arterial cement embolization: A rare complication of vertebroplasty T2 - Annals of Saudi Medicine TI - Pulmonary arterial cement embolization: A rare complication of vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L611643056&from=export http://dx.doi.org/10.5144/0256-4947.2016.232 VL - 36 ID - 829324 ER - TY - JOUR AD - Clinic of Hand Surgery, Baltalimani Training and Research Hospital, Turkey Department of Orthophaedic and Traumatology, Izmir Katip Qelebi University School of Medicine, Turkey Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland AN - 107866314. Language: English. Entry Date: 20140902. Revision Date: 20200708. Publication Type: Journal Article AU - Akcay, Serkan AU - Kazimoglu, Cemal AU - Yli-Kyyny, Teero DB - cin20 DO - 10.3109/17453674.2014.922738 DP - EBSCOhost KW - Femur Neck -- Injuries Femoral Fractures -- Surgery Hemiarthroplasty -- Methods Hemiarthroplasty -- Mortality Fat Embolism Syndrome Cementation -- Utilization Kidney Diseases M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2014 SN - 1745-3674 SP - 334-334 ST - Cemented or uncemented hemiarthroplasty for the treatment of femoral neck fractures?...Yli-Kyyny T, Sund R, Heinanen M, et al. Cemented or uncemented hemiarthroplasty for the treatment of femoral neck fractures? A Finnish database study of 25,174 patients. Acta Orthop 2014; 85: 49-53 T2 - Acta Orthopaedica TI - Cemented or uncemented hemiarthroplasty for the treatment of femoral neck fractures?...Yli-Kyyny T, Sund R, Heinanen M, et al. Cemented or uncemented hemiarthroplasty for the treatment of femoral neck fractures? A Finnish database study of 25,174 patients. Acta Orthop 2014; 85: 49-53 UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=107866314&site=ehost-live&scope=site VL - 85 ID - 830633 ER - TY - JOUR AB - Introduction: Vertebroplasty and kyphoplasty(VP/KP) are a successful treatment method for vertebral compression fractures( VCF) and improving pain. Although incidence of symptomatic complication for them is 1.6-3.8%, it has been reported to lead a range of 5-80% radiological complications. Material and Methods: Between June 2010 and December 2015, we performed VP/KP procedure for 52 cases who suffered from VCF and these cases retrospectively analyzed. Results: The group included 32 female (61.5%) and 20 male (38.5%), all of the patients were admitted with the complaint of severe pain and neurological examinations were intact in 48 (92.3%). The criterion for performing VP/KP was accepted as hyperintensity in T2 and/or STIR sequences in MRI. VP/KP was introduced to 71 VCF. Forty-two cases had a history of trauma, but initial diagnosis was tumor in 10 cases, inside whose 4 had weakness and/or numbness. Average of preoperative VAS were 8,09 points. All operations were performed under local anesthesia. KP was applied to 29(55.,8%) and VP 23(44.2%) patients, via bilateral transpedincular approach in 39 and unilateral in 13 cases. Average VAS was 2.3 (P ≤ .05). Postoperative CT scans showed no cement leakage in 27 (51,9%). Leakage was observed in 25(48.1%). Distribution of leakage according to region as follows; towards the intervertebral disk space in 12 (23.07%), epidural venous plexus in 11 (21.1%), paravertebral space in 6 (11.5%) and into spinal canal in 4 (7.6%) patients, while there was a reported pulmonary embolism in 1 (1.9%) case. The mean follow-up was 23.7 months. There was a reduction in segmental kyphotic angles from an average degree of 19.9 to 17.2 (P ≥ .05) which wasn't statistically significant. Conclusion: VP/KP treatments have low symptomatic complication rates, on the other hand cement leakage is higher than expected. Using local anesthesia in VP/KP procedures is helpful to make the surgeon more alert for these complications during both guide installment and cement placement; even if a cement leakage occurs. AD - R. Akdag, Bursa Specialization Education and Research Hospital, Neurosurgery, Bursa, Turkey AU - Akdag, R. AU - Dalgic, A. AU - Uckun, O. AU - Divanlioglu, D. AU - Karaoglu, D. AU - Isitan, E. AU - Belen, D. DB - Embase DO - 10.1177/2192568217708189 KW - cement complication compression fracture diagnosis female follow up human hypesthesia intervertebral disk kyphoplasty local anesthesia lung embolism major clinical study male neoplasm neurologic examination nuclear magnetic resonance imaging pain prevention surgeon surgery vein vertebral canal weakness x-ray computed tomography LA - English M1 - 2 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 2192-5690 SP - 362S ST - Vertebroplasty/kyphoplasty procedure under local anesthesia for prevention of their complications T2 - Global Spine Journal TI - Vertebroplasty/kyphoplasty procedure under local anesthesia for prevention of their complications UR - https://www.embase.com/search/results?subaction=viewrecord&id=L616656447&from=export http://dx.doi.org/10.1177/2192568217708189 VL - 7 ID - 829256 ER - TY - JOUR AB - Introduction: Vertebroplasty and kyphoplasty (VP/KP) are approved to be a successful treatment method for vertebral compression fractures (VCF) and numbers of publications were made for improving pain. Although incidence of symptomatic complication for them is 1, 6-3, 8 %, it has been reported to lead a range of 5-80 % radiological complications. We presented 52 patients underwent VP or KP procedure and evaluated their clinical and radiological assessment. Method: Between June 2010 and December 2015, we performed VP or KP procedure for 52 cases who suffered from VCF. We analyzed the demographic characteristics, clinical and radiological findings, complications and follow-up results of the patients. Results: The group included 32 female (61, 5 %) and 20 male (38, 5 %), all of the patients were admitted with the complaint of severe pain and neurological examinations were intact in 48 (92, 3 %). The criterion for performing VP or KP was accepted as hyperintensity in T2 and/or STIR sequences in MRI. VP or KP was introduced to 71 VCF in which distribution as follows; 16 in T12, 12 in L1, 11 in L2, 9 in L3, 8 in T11, 7 in L4, 2 in L5, 2 in T8 and 1 in T7. Forty-two cases had a history of trauma, but initial diagnosis was tumor in 10 cases, inside whose 4 had weakness and/or numbness. Average of preoperative pain scores (VAS) were 8, 09 points. All operations were performed under sedoanalgesia and local anesthesia. KP was applied to 29 (55, 8 %) while VP was applied to 23 (44, 2 %) of the patients, via bilateral transpedincular approach in 39 and unilateral in 13 cases. Single vertebral application in 41 of the cases, two vertebrae in 7 cases and more than two vertebrae in 4 cases were performed. No additional neurological symptom was observed postoperatively. Average VAS was 2, 3 (p≤0, 05). Postoperative CT scans were performed at the first day and showed no cement leakage in 27 (51, 9 %) cases. Cement leakage was observed in 25 (48, 1 %) cases. Distribution of leakage according to region as follows; towards the intervertebral disk space in 12 (23, 07 %), epidural venous plexus in 11 (21, 1 %), paravertebral space in 6 (11, 5 %) and into spinal canal in 4 (7, 6 %) patients, while there was a reported pulmonary embolism in 1 (1, 9 %) case. The mean follow-up was 23, 7 months free of additional neurological findings. There was a reduction in segmental kyphotic angles from an average degree of 19, 9 to 17, 2 (p≥0, 05) which wasn't statistically significant. Discussion: VP/KP treatments are very useful in pain relief with low symptomatic complication rates, but on the other hand cement leakage is higher than expected in radiological assessments. Using local anesthesia in VP/KP procedures is helpful to make the surgeon more alert for these complications during both guide installment and cement placement. Thus, clinically symptomatic complications can be prevented even if a cement leakage occurs. (Figure presented). AD - R. Akdag, Neurosurgery Clinic, Ankara Numune Research and Training Hospital, Ankara, Turkey AU - Akdag, R. AU - Dalgic, A. AU - Uckun, O. M. AU - Divanlioglu, D. AU - Alagoz, F. AU - Karaoglu, D. AU - Tunc, B. AU - Belen, D. DB - Embase DO - 10.1007/s00586-016-4723-x KW - cement analgesia compression fracture computer assisted tomography controlled study diagnosis female follow up human hypesthesia intervertebral disk kyphoplasty local anesthesia lung embolism major clinical study male neoplasm neurologic disease neurologic examination nuclear magnetic resonance imaging surgeon surgery vein vertebral canal weakness LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1432-0932 SP - S435 ST - Vertebroplasty/kyphoplasty procedure under local anesthesia and prevention of complications T2 - European Spine Journal TI - Vertebroplasty/kyphoplasty procedure under local anesthesia and prevention of complications UR - https://www.embase.com/search/results?subaction=viewrecord&id=L612138725&from=export http://dx.doi.org/10.1007/s00586-016-4723-x VL - 25 ID - 829305 ER - TY - JOUR AD - Department of Anesthesia, University of Iowa Hospitals & Clinics, Iowa City, Iowa AN - 107220615. Language: English. Entry Date: 19991101. Revision Date: 20150711. Publication Type: Journal Article AU - Aker, J. DB - cin20 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Cardiopulmonary Physiology -- Drug Effects Intraoperative Complications Arthroplasty, Replacement -- Adverse Effects Education, Continuing (Credit) Blood Coagulation Physiological Theory Syndrome Embolism, Air Embolism, Fat Bone Marrow Risk Factors M1 - 15 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 1998 SN - 0164-310X SP - 133-140 ST - A review of the etiology of cardiopulmonary reactions with methylmethacrylate cement T2 - Current Reviews for Nurse Anesthetists TI - A review of the etiology of cardiopulmonary reactions with methylmethacrylate cement UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=107220615&site=ehost-live&scope=site VL - 21 ID - 830802 ER - TY - JOUR AB - A 68-year-old man was admitted to the hospital with complaints of pain in the lumbar spine. He had L5 disc herniation, Spinal stenosis of the L5 root canal-S1 on the right in the past medical history. Percutaneous vertebroplasty at the level of L3 and Th8 vertebral bodies was performed six months ago due to painful vertebral hemangioma. The man is suffering from arterial hypertension, receives antihypertensive therapy. During routine transthoracic echocardiography, a hyperechoic structure with a size of 9.5 x 0.9 cm was found in the right atrium and right ventricle. Chest computed tomography with contrast enhancement revealed signs of bone cement in the right atrium and right ventricle, in the right upper lobe artery, in the branches of the upper lobe artery, in the paravertebral venous plexuses. Considering the duration of the disease, the stable condition, the absence of clinical manifestations and disorders of intracardiac hemodynamics, it was decided to refrain from surgical treatment. Antiplatelet therapy and dynamic observation were recommended. Conclusion: Percutaneous vertebroplasty is a modern minimally invasive surgical procedure for the treatment of degenerative-dystrophic diseases of the spine. However, the cement can penetrate into the paravertebral veins and migrate to the right chambers of the heart and the pulmonary artery. This clinical case demonstrates asymptomatic cement embolism of the right chambers of the heart and pulmonary artery after percutaneous vertebroplasty, detected incidentally during routine echocardiography. (Figure Presented). AD - S. Akhunova, Interregional Clinico-Diagnostic Center, Kazan, Russian Federation AU - Akhunova, S. AU - Khayrullin, R. AU - Stekolshchikova, N. AU - Samigullin, M. AU - Padiryakov, V. DB - Embase DO - 10.1093/ehjci/jez319.362 KW - antithrombocytic agent bone cement aged antihypertensive therapy case report clinical article complication computer assisted tomography conference abstract contrast enhancement embolism heart right atrium heart right ventricle hemodynamics human human cell hypertension intervertebral disk hernia low back pain male medical history minimally invasive surgery percutaneous vertebroplasty pulmonary artery surgery thorax tooth root canal transthoracic echocardiography vein vertebra body vertebra hemangioma vertebral canal stenosis LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 2047-2412 SP - i385 ST - Right atrial, right ventricular and pulmonary cement embolism: A rare complication of percutaneous vertebroplasty T2 - European Heart Journal Cardiovascular Imaging TI - Right atrial, right ventricular and pulmonary cement embolism: A rare complication of percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L631349782&from=export http://dx.doi.org/10.1093/ehjci/jez319.362 VL - 21 ID - 829097 ER - TY - JOUR AB - We present a case of pulmonary cement embolism during cement augmentation of pedicle screw fixation for severe degenerative scoliosis. During intra-operative C-arm fluoroscopy, a radio-opaque substance was incidentally noted to pulsate in synchrony with the patient's heartbeat. A diagnosis of pulmonary cement embolism was made. The patient was treated with coumarin for 6 months. He made a good recovery. AD - Department of Orthopaedics and Trauma, Norfolk and Norwich University Hospital, Norwich, United Kingdom. bolaakinola@googlemail.com AN - 21187553 AU - Akinola, B. AU - Lutchman, L. AU - Barker, P. AU - Rai, A. DA - Dec DO - 10.1177/230949901001800322 DP - NLM ET - 2010/12/29 J2 - Journal of orthopaedic surgery (Hong Kong) KW - Aged Bone Cements/*adverse effects *Bone Screws Humans Male Pulmonary Embolism/*diagnosis/*etiology/therapy Scoliosis/*surgery LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 1022-5536 SP - 364-6 ST - Pulmonary cement embolism during cement augmentation of pedicle screw fixation: a case report T2 - J Orthop Surg (Hong Kong) TI - Pulmonary cement embolism during cement augmentation of pedicle screw fixation: a case report VL - 18 ID - 828840 ER - TY - JOUR AB - Introduction: We present a case of cement embolism occurring during a procedure for correction of a severe degenerative scoliosis deformity. The complication was observed during intra-operative C-arm fluoroscopy when a radio-opaque substance was noted to pulsate in tandem with the patient\'s heartbeat. Real time fluoroscopy images of this phenomenon were obtained. A diagnosis of cement embolism was subsequently made, and patient was treated with coumarin for 6 months. He has made a good recovery. Methods: Case report Results: Full recovery Conclusion: The case highlights the need for constant communication between surgical and anaesthesia teams, and also to alert to the need for a viscous consistency of cement when undertaking the procedure in question. AD - B. Akinola, Department of Orthopaedics, Norfolk, Norwich University Hospital, United Kingdom AU - Akinola, B. AU - Lutchman, L. AU - Barker, P. AU - Rai, A. DB - Embase DO - 10.1007/s00586-010-1475-x KW - cement coumarin embolism pedicle screw lung embolism spine surgery biotechnology human patient fluoroscopy procedures diagnosis telecommunication arm deformity scoliosis case report anesthesia interpersonal communication LA - English M1 - 8 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0940-6719 SP - 1410 ST - Pulmonary cement embolism following cement augmentation of pedicle screw fixation T2 - European Spine Journal TI - Pulmonary cement embolism following cement augmentation of pedicle screw fixation UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71561985&from=export http://dx.doi.org/10.1007/s00586-010-1475-x VL - 19 ID - 829658 ER - TY - JOUR AB - We present a case of pulmonary cement embolism during cement augmentation of pedicle screw fixation for severe degenerative scoliosis. During intra-operative C-arm fluoroscopy, a radio-opaque substance was incidentally noted to pulsate in synchrony with the patient's heartbeat. A diagnosis of pulmonary cement embolism was made. The patient was treated with coumarin for 6 months. He made a good recovery. AD - Department of Orthopaedics and Trauma, Norfolk and Norwich University Hospital, Norwich, United Kingdom Department of Orthopaedics and Trauma, Norfolk and Norwich University Hospital, Norwich, United Kingdom. bolaakinola@googlemail.com AN - 105001639. Language: English. Entry Date: 20110708. Revision Date: 20200708. Publication Type: journal article AU - Akinola, B. AU - Lutchman, L. AU - Barker, P. AU - Rai, A. AU - Akinola, Bolarinwa AU - Lutchman, Lennel AU - Barker, Paul AU - Rai, Am DB - cin20 DO - 10.1177/230949901001800322 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Orthopedic Fixation Devices Pulmonary Embolism -- Diagnosis Pulmonary Embolism -- Etiology Scoliosis -- Surgery Aged Male Pulmonary Embolism -- Therapy M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2010 SN - 1022-5536 SP - 364-366 ST - Pulmonary cement embolism during cement augmentation of pedicle screw fixation: a case report T2 - Journal of Orthopaedic Surgery (10225536) TI - Pulmonary cement embolism during cement augmentation of pedicle screw fixation: a case report UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105001639&site=ehost-live&scope=site VL - 18 ID - 830697 ER - TY - JOUR AB - Background: Liposarcoma is a malignant tumor of soft tissue. Myxoid/round cell liposarcoma has a tendency to spread to extrapulmonary sites but the spine is an unusual location even for metastasis. Metastatic bone tumors in the spine are painful. The vertebral body augmentation procedures for treating painful metastatic spinal lesions are minimally invasive and are good alternatives to open surgery.Case Presentation: A 41-year-old Turkish man was treated with radiofrequency tumor ablation and percutaneous vertebral augmentation for spinal metastasis. Asymptomatic perivertebral and segmental veins' cement leakage was detected on perioperative X-ray radiograms; at the follow-up computed tomography scan, no further migration of any cement material was seen, and his postoperative course was uneventful.Conclusions: The risk of cement leakage and embolism is increased with the treatment of some malignant lesions. The frequency of local leakage of bone cement is relatively high. Patients undergoing percutaneous vertebral augmentation of malignant spinal metastases need close monitoring. There is no agreement on the treatment strategy. AD - Department of Neurosurgery, Adiyaman University Education and Research Hospital, Adiyaman, Turkey Department of Neurosurgery, School of Medicine, Adiyaman University, Adiyaman 02200, Turkey AN - 113284297. Language: English. Entry Date: 20161111. Revision Date: 20180817. Publication Type: journal article AU - Akpinar, Aykut AU - Ucler, Necati AU - Seyho Yucetas, Cem AU - Erdogan, Uzay AU - Davut Ucar, Mehmet AU - Yucetas, Cem Seyho AU - Ucar, Mehmet Davut DB - cin20 DO - 10.1186/s13256-016-0828-4 DP - EBSCOhost KW - Lumbar Vertebrae -- Surgery Soft Tissue Neoplasms -- Pathology Liposarcoma -- Surgery Bone Cements -- Adverse Effects Spinal Neoplasms -- Surgery Spinal Neoplasms Male Liposarcoma Catheter Ablation Adult N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2016 SN - 1752-1947 SP - 1-4 ST - Cement leakage and complication of liposarcoma spinal metastasis during vertebral augmentation procedure: a case report T2 - Journal of Medical Case Reports TI - Cement leakage and complication of liposarcoma spinal metastasis during vertebral augmentation procedure: a case report UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=113284297&site=ehost-live&scope=site VL - 10 ID - 830598 ER - TY - JOUR AB - BACKGROUND: Liposarcoma is a malignant tumor of soft tissue. Myxoid/round cell liposarcoma has a tendency to spread to extrapulmonary sites but the spine is an unusual location even for metastasis. Metastatic bone tumors in the spine are painful. The vertebral body augmentation procedures for treating painful metastatic spinal lesions are minimally invasive and are good alternatives to open surgery. CASE PRESENTATION: A 41-year-old Turkish man was treated with radiofrequency tumor ablation and percutaneous vertebral augmentation for spinal metastasis. Asymptomatic perivertebral and segmental veins' cement leakage was detected on perioperative X-ray radiograms; at the follow-up computed tomography scan, no further migration of any cement material was seen, and his postoperative course was uneventful. CONCLUSIONS: The risk of cement leakage and embolism is increased with the treatment of some malignant lesions. The frequency of local leakage of bone cement is relatively high. Patients undergoing percutaneous vertebral augmentation of malignant spinal metastases need close monitoring. There is no agreement on the treatment strategy. AD - Department of Neurosurgery, Adiyaman University Education and Research Hospital, Adiyaman, Turkey. Department of Neurosurgery, Adiyaman University Education and Research Hospital, Adiyaman, Turkey. necati_ucler@yahoo.com. Department of Neurosurgery, School of Medicine, Adiyaman University, Adiyaman, 02200, Turkey. necati_ucler@yahoo.com. AN - 26911878 AU - Akpinar, A. AU - Ucler, N. AU - Yucetas, C. S. AU - Erdogan, U. AU - Ucar, M. D. C2 - Pmc4765201 DA - Feb 24 DO - 10.1186/s13256-016-0828-4 DP - NLM ET - 2016/02/26 J2 - Journal of medical case reports KW - Adult Bone Cements/*adverse effects Catheter Ablation Humans Liposarcoma/secondary/*surgery Lumbar Vertebrae/*surgery Male Soft Tissue Neoplasms/*pathology Spinal Neoplasms/secondary/*surgery LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1752-1947 SP - 40 ST - Cement leakage and complication of liposarcoma spinal metastasis during vertebral augmentation procedure: a case report T2 - J Med Case Rep TI - Cement leakage and complication of liposarcoma spinal metastasis during vertebral augmentation procedure: a case report VL - 10 ID - 828653 ER - TY - JOUR AB - Hydrogen peroxide has a multitude of uses and its disinfectant properties have been utilised in the cleansing of surgical wounds for many years. It decomposes rapidly to water and oxygen following exposure to tissue catalase which manifests itself with the characteristic 'bubbling' seen on application to wounds as oxygen is released. 10 ml of 6% hydrogen peroxide releases 200 ml of free oxygen which can be potentially fatal when absorbed into the vasculature. Despite numerous case reports of oxygen emboli following the use of hydrogen peroxide during surgery, we describe the first case reported to the MHRA. Description A 63-year-old female was admitted electively for a revision of above knee stump under general anaesthesia. The induction and maintenance phase was uneventful until towards the end of the procedure. The wound was irrigated with 50 ml of 6% hydrogen peroxide, the stump was lifted and the surgeon proceeded to dress the wound and bandage the limb. At this stage a sudden drop in end-tidal CO2 was noted followed rapidly by ST segment changes and PEA arrest. ROSC followed 1 mg of adrenaline and one cycle of CPR. A 12 lead ECG and on-table echocardiogram showed acute right heart strain and a provisional diagnosis of pulmonary embolus was made. The patient was stabilised and transferred to the intensive care unit. A CTPA showed no sign of pulmonary emboli and a repeat ECG 4 h following the event showed normal sinus rhythm. The patient was successfully extubated with no evidence of neurological deficit. A repeat echocardiogram 24 h following the event was normal and the patient was discharged home 4 days later. Discussion The use of hydrogen peroxide is widespread worldwide and branches across different specialty groups. In 1920 The Lancet reported the use of intravenous hydrogen peroxide by British army doctors in India during an influenza epidemic [1]. They reported positive findings but were aware of the potential risk of oxygen emboli. There are multiple case reports of venous oxygen emboli described in the literature which include stroke and death reported as sequelae [2, 3]. Despite its regular use as a disinfectant there is no evidence that can be found to support this claim. The use of hydrogen peroxide in orthopaedic surgery is to clean and dry the bony bed before cementing joint prosthesis to increase bonecement strength. This theory has been tested and has not stood up to further scrutiny [4]. The hazards of using hydrogen peroxide are clear and well reported but the benefits are yet to be proven. As a consequence we believe its use during surgery should be reconsidered. AD - M. Akuji, Royal Bolton Hospital, United Kingdom AU - Akuji, M. DB - Embase DO - 10.1111/anae.12866 KW - hydrogen peroxide oxygen disinfectant agent catalase water epinephrine anesthesist human United Kingdom Ireland heart arrest embolism wound patient lung embolism surgery echocardiography case report surgeon procedures general anesthesia intensive care unit knee tissues female exposure cleaning electrocardiogram heart diagnosis joint prosthesis cerebrovascular accident venous oxygen tension sinus rhythm army physician India influenza ST segment risk limb epidemic death orthopedic surgery bandage hazard vascularization surgical wound return of spontaneous circulation LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 0003-2409 SP - 11 ST - Cardiac arrest following the use of hydrogen peroxide-time to reconsider its use T2 - Anaesthesia TI - Cardiac arrest following the use of hydrogen peroxide-time to reconsider its use UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71663820&from=export http://dx.doi.org/10.1111/anae.12866 VL - 69 ID - 829404 ER - TY - JOUR AB - A 70-year-old man underwent total hip replacement surgery under general anesthesia, endotracheal intubation, and controlled ventilation, with the patient in left lateral position. Intraoperatively, the patient was hemodynamically stable, with a normal range of pulse, ECG trace, oxygen saturation as measured by pulse oximetry (Spo2), and end-tidal CO2 (etco2). Five minutes after insertion of the hip prosthesis, his heart rate dropped to 30 beats/min, BP to 40/30 mm Hg, Spo2 to 70%, and etco2 to 10 mm Hg. AD - From the Department of Adult Critical Care Medicine, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia. Electronic address: icu_mariam@yahoo.com. From the Department of Adult Critical Care Medicine, King Khalid University Hospital, College of Medicine, King Saud University, Riyadh, Saudi Arabia. AN - 25367483 AU - Alansari, M. A. AU - Abdulmomen, A. A. DA - Nov DO - 10.1378/chest.14-0411 DP - NLM ET - 2014/11/05 J2 - Chest KW - Aged Arthroplasty, Replacement, Hip/*adverse effects Bone Cements/*adverse effects Diagnosis, Differential Echocardiography, Transesophageal Electrocardiography Embolism/*complications/diagnosis Fatal Outcome Heart Rate Humans Hypotension/diagnosis/*etiology Hypoxia/diagnosis/*etiology *Intraoperative Complications Male Oximetry Radiography, Thoracic Syndrome LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 0012-3692 SP - e160-e162 ST - A 70-year-old man with intraoperative hypoxia and hypotension during total hip replacement T2 - Chest TI - A 70-year-old man with intraoperative hypoxia and hypotension during total hip replacement VL - 146 ID - 828862 ER - TY - JOUR AB - Introduction. Metastatic bone disease represents a systemic pathology that heavily affects the quality of life of oncologic patients causing pain and functional disability. Methodology. We present the case of a patient with a history of renal cell cancer presenting pathologic fractures of both humeri and proximal right radius. Results. After a careful multidisciplinary approach, an adjuvant anticancer therapy and a photodynamic bone stabilization procedure were performed with a minimally invasive technique aiming to minimize pain and local disease progression, while restoring functional autonomy and improving the patient's quality of life. Electrochemotherapy was delivered on the lytic bone lesions with extraskeletal involvement of the proximal left humerus and the proximal right radius, and then polymeric bone stabilization was performed on both humeri. At two months of follow-up, the patient presented satisfactory functional scores (MSTS score: 12/30 bilaterally; DASH scores: 46.7/100 for the right side and 48.3/100 for the left one), and pain was well controlled with opioid analgesics. Radiographs showed good results in terms of ossification of lytic bone lesions and durability of polymeric stabilization. At four months of follow-up, the patient reported a stable clinical scenario. Six months after surgery, due to extremely poor prognosis after the progression of primary disease, the patient was referred to palliative care and died shortly thereafter. Conclusion. Over the last decade, the management of metastatic bone disease has changed. Low-toxicity and minimally invasive procedures such as electrochemotherapy and polymeric bone stabilization might be performed concomitantly in selected patients, as an alternative to radiation therapy and to more demanding surgical procedures such as plating and adjuvant cementing. AD - A. Conti, Oncologic Orthopaedic Division, Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Center, Città della Salute e della Scienza, Via Gianfranco Zuretti 29, Turin, Italy AU - Albertini, U. AU - Conti, A. AU - Ratto, N. AU - Pellegrino, P. AU - Boffano, M. AU - Piana, R. DB - Embase DO - 10.1155/2020/8408943 KW - arm sling balloon catheter Cliniporator VITAE technology polyethylene terephthalate guide wire IlluminOss intramedullary reamer needle electrode orthopedic fixation device pulse generator VGD-1830T16 electrodes analgesic agent anticoagulant agent bleomycin hemoglobin low molecular weight heparin monomer naloxone plus oxycodone pazopanib prescription drug abdominal radiography abduction adult analgesia anemia anticoagulant therapy arm pain arm swelling biomechanics blood transfusion bone atrophy bone metastasis bone pain bone radiography callus cancer adjuvant therapy cancer chemotherapy cancer fatigue cancer mortality cancer palliative therapy cancer prognosis cancer surgery case report clinical article clinical outcome closed reduction (procedure) computer assisted tomography daily life activity decreased appetite Disabilities of the Arm, Shoulder and Hand (score) disease exacerbation drug substitution drug withdrawal electrochemotherapy electroporation erythrocyte count female fluoroscopy follow up fracture healing functional status assessment general anesthesia heparinization human intramedullary nailing joint mobility Karnofsky Performance Status liver metastasis local therapy lung embolism lymph node metastasis middle aged minimally invasive surgery mobilization MSTS score multidisciplinary team muscle training musculoskeletal disease assessment numeric rating scale orthopedic surgery ossification parenteral nutrition passive movement pathologic fracture patient referral patient satisfaction photodynamic bone stabilization prescription proximal humerus fracture proximal radius fracture quality of life radical nephrectomy range of motion renal cell carcinoma response evaluation criteria in solid tumors review self report soft tissue metastasis systemic therapy thorax radiography thrombectomy treatment response tumor volume upper limb wound healing Dacron LA - English M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1687-9635 1687-9627 ST - Electrochemotherapy and Simultaneous Photodynamic Bone Stabilization of Upper Limbs in Metastatic Renal Cancer Disease: Case Report and Literature Review T2 - Case Reports in Medicine TI - Electrochemotherapy and Simultaneous Photodynamic Bone Stabilization of Upper Limbs in Metastatic Renal Cancer Disease: Case Report and Literature Review UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2008437516&from=export http://dx.doi.org/10.1155/2020/8408943 VL - 2020 ID - 829095 ER - TY - JOUR AB - A tourniquet is often used in total knee arthroplasty resulting in improved visualization of structures, reduced intraoperative bleeding and better cementation. The risks include deep vein thrombosis and pulmonary embolism. To quantify the case for or against tourniquet use, we carried out a systematic review and meta-analysis of selected randomized controlled trials. Ten studies were included in the meta-analysis. Of the 8 outcomes analyzed (surgery duration; total, intraoperative, and postoperative blood losses; deep vein thrombosis; pulmonary embolism; and minor/major complications), the total and intraoperative blood losses were less using a tourniquet. Minor complications were more common in the tourniquet group. The remaining Outcomes showed no difference between the groups. Using a tourniquet may be beneficial, but long-term studies of outcome are needed. AD - [Alcelik, Ilhan; Pollock, Raymond D.; Armstrong, Patrick M.; Eimer, Peter] W Cumberland Dist Gen Hosp, Dept Orthopaed, Whitehaven, England. [Sukeik, Mohammed] Univ Coll London Hosp, Dept Orthopaed, London, England. [Bettany-Saltikov, Josette] Univ Teesside, Sch Hlth & Social Care, Middlesbrough, Cleveland, England. Pollock, RD (corresponding author), W Cumberland Dist Gen Hosp, Dept Orthopaed, Whitehaven, England. AN - WOS:000301208500001 AU - Alcelik, I. AU - Pollock, R. D. AU - Sukeik, M. AU - Bettany-Saltikov, J. AU - Armstrong, P. M. AU - Eimer, P. DA - Mar DO - 10.1016/j.arth.2011.04.046 J2 - J. Arthroplast. KW - tourniquet total knee arthroplasty meta-analysis DEEP-VEIN THROMBOSIS BLOOD-LOSS THROMBOEMBOLISM REPLACEMENT QUALITY Orthopedics LA - English M1 - 3 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2012 SN - 0883-5403 SP - 331-340 ST - A Comparison of Outcomes With and Without a Tourniquet in Total Knee Arthroplasty A Systematic Review and Meta-analysis of Randomized Controlled Trials T2 - Journal of Arthroplasty TI - A Comparison of Outcomes With and Without a Tourniquet in Total Knee Arthroplasty A Systematic Review and Meta-analysis of Randomized Controlled Trials UR - ://WOS:000301208500001 VL - 27 ID - 830312 ER - TY - JOUR AB - A tourniquet is often used in total knee arthroplasty resulting in improved visualization of structures, reduced intraoperative bleeding and better cementation. The risks include deep vein thrombosis and pulmonary embolism. To quantify the case for or against tourniquet use, we carried out a systematic review and meta-analysis of selected randomized controlled trials. Ten studies were included in the meta-analysis. Of the 8 outcomes analyzed (surgery duration; total, intraoperative, and postoperative blood losses; deep vein thrombosis; pulmonary embolism; and minor/major complications), the total and intraoperative blood losses were less using a tourniquet. Minor complications were more common in the tourniquet group. The remaining outcomes showed no difference between the groups. Using a tourniquet may be beneficial, but long-term studies of outcome are needed. AD - Department of Orthopaedics, West Cumberland Hospital, Whitehaven, UK. AN - 21944371 AU - Alcelik, I. AU - Pollock, R. D. AU - Sukeik, M. AU - Bettany-Saltikov, J. AU - Armstrong, P. M. AU - Fismer, P. DA - Mar DO - 10.1016/j.arth.2011.04.046 DP - NLM ET - 2011/09/29 J2 - The Journal of arthroplasty KW - Arthroplasty, Replacement, Knee/*methods Humans Randomized Controlled Trials as Topic *Tourniquets Treatment Outcome LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0883-5403 SP - 331-40 ST - A comparison of outcomes with and without a tourniquet in total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials T2 - J Arthroplasty TI - A comparison of outcomes with and without a tourniquet in total knee arthroplasty: a systematic review and meta-analysis of randomized controlled trials VL - 27 ID - 829006 ER - TY - JOUR AN - 22112389 AU - Alcibar, J. AU - Blanco, R. AU - Garcia, K. AU - Peña, N. AU - Fernandez, L. AU - Arriola, J. DA - Jun DO - 10.1016/j.recesp.2011.07.019 DP - NLM ET - 2011/11/25 J2 - Revista espanola de cardiologia (English ed.) KW - Adenocarcinoma/secondary Aged Bone Cements/adverse effects Fatal Outcome Fractures, Compression/etiology/*therapy Humans Lumbar Vertebrae/*injuries Lung Neoplasms/complications Male Polymethyl Methacrylate/adverse effects Pulmonary Embolism/*etiology Spinal Fractures/etiology/*therapy Vertebroplasty/*adverse effects LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 1885-5857 SP - 571-2 ST - Multiple fatal pulmonary embolism during polymethyl-methacrylate vertebroplasty with successful percutaneous retrieval of a large cement fragment T2 - Rev Esp Cardiol (Engl Ed) TI - Multiple fatal pulmonary embolism during polymethyl-methacrylate vertebroplasty with successful percutaneous retrieval of a large cement fragment VL - 65 ID - 828879 ER - TY - JOUR AB - The article presents a clinical case of embolism with bone cement of the right ventricle of the heart and pulmonary artery after percutaneous vertebroplasty in a patient aged 63 years. According to the results of a comprehensive examination using ultrasound and x-ray methods, three foreign bodies were found: in the right ventricle cavity, in the trunk of the pulmonary artery, in the branches of the left pulmonary artery. Considering the stable condition, normal blood oxygen saturation, the lack of influence of formations on intracardiac hemodynamics, it was decided to refrain from surgery, since the risk of intervention exceeded the possible benefit. Conservative treatment tactics and dynamic observation were chosen. The literature data on the frequency of such events and tactics of management of these patients are presented. AD - Central Clinical Hospital of the Management Affair of President RF. Central Clinical Hospital of the Management Affair of President RF, Moscow. AN - 31002046 AU - Alekhin, M. N. AU - Ter-Akopian, A. V. AU - Abramov, A. S. AU - Skripnikova, A. V. DA - Apr 18 DO - 10.18087/cardio.2019.4.10255 DP - NLM ET - 2019/04/20 J2 - Kardiologiia KW - Bone Cements *Heart Diseases Humans Middle Aged Pulmonary Artery *Pulmonary Embolism *Vertebroplasty LA - rus M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 0022-9040 (Print) 0022-9040 SP - 92-96 ST - [Intracardiac and Pulmonary Cement Embolism after Percutaneous Vertebroplasty] T2 - Kardiologiia TI - [Intracardiac and Pulmonary Cement Embolism after Percutaneous Vertebroplasty] VL - 59 ID - 828587 ER - TY - JOUR AB - STUDY DESIGN: Case report. OBJECTIVE: The aim of this work is to describe a case of infected vertebroplasty due to uncommon bacteria solved surgically with 2 years of follow-up and to discuss 6 other cases found in literature. SUMMARY OF BACKGROUND DATA: Vertebroplasty is a well-known and useful technique for the treatment of painful osteoporotic vertebral fractures. Complications, such as cord or root compression or pulmonary embolisms, are infrequent and are mainly related with the frequent escape of cement throughout the vertebral veins. Infection is even more rare, but when it occurs is difficult to manage and can be a life-threatening complication. METHODS: A 63-year-old-man had a spondylitis of L2 after vertebroplasty. The patient was initially managed with antibiotics without clinical improvement. Surgical treatment by anterior debridement and anterior and posterior stabilization was done. The bacteria isolated from the intraoperative cultures were Serratia marcescens, Stenotrophomonas maltophilia, and Burkholderia cepacia. After surgery, the patient was treated with antibiotics for 3 month. RESULTS: After 2 years of follow-up, the patient was free of pain, without signs of infection, and a correct fusion was achieved. CONCLUSION: When facing an infected vertebroplasty, initial conservative treatment with needle biopsy culture and antibiotic administration are a rational option to start. If this treatment fails, surgical debridement is then indicated in order to remove the infected tissue and the acrylic cement and to stabilize the spine. Although this can be an effective treatment, it could be a difficult and hazardous surgical procedure. AD - Department of Orthopaedic Surgery, University Clinic of Navarra, Navarra, Spain. malfonsool@unav.es AN - 16985448 AU - Alfonso Olmos, M. AU - Silva González, A. AU - Duart Clemente, J. AU - Villas Tomé, C. DA - Sep 15 DO - 10.1097/01.brs.0000240202.91336.99 DP - NLM ET - 2006/09/21 J2 - Spine KW - Debridement/*methods Gram-Negative Bacterial Infections/etiology/*surgery Humans Lumbar Vertebrae/surgery Magnetic Resonance Imaging Male Middle Aged Postoperative Complications/microbiology/*surgery Spinal Fractures/microbiology/surgery Spinal Fusion/instrumentation/*methods Spondylitis/etiology/microbiology/*surgery Surgical Wound Infection/microbiology/*surgery Tomography, X-Ray Computed Treatment Outcome LA - eng M1 - 20 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0362-2436 SP - E770-3 ST - Infected vertebroplasty due to uncommon bacteria solved surgically: a rare and threatening life complication of a common procedure: report of a case and a review of the literature T2 - Spine (Phila Pa 1976) TI - Infected vertebroplasty due to uncommon bacteria solved surgically: a rare and threatening life complication of a common procedure: report of a case and a review of the literature VL - 31 ID - 828788 ER - TY - JOUR AB - Background: Vertebral hemangiomas are benign tumours and are rarely symptomatic. Aggressive forms represent less than 1% of all cases. Medical imaging allows both diagnosis and evaluation of their aggressivity. Objective: To assess the role of radiology, embolisation, percutaneous vertebroplasty, radiotherapy and surgery in the diagnosis and treatment of vertebral hemangiomas. Methods: We report our experience of five patients who had an average age of 20 years. They all presented with progressive medullary compression and were investigated with plain xrays, CT and MRI. Results: The vertebral hemangiomas were located in the cervical spine at C4 in one patient and between D3 and D9 in the other four. Plain xrays showed the classic vertical striations and MRI revealed a heterogeneous picture with attenuation of signal in some and hyper or iso intense signals on T1 and hyper intense T2 in the others. The epidural component presented the same imaging characteristics as the bony lesions. Two of our patients were embolised before surgery. Conclusion: Analysis of the radiological and imaging characteristics of these lesions make vertebral hemangiomas relatively easy to diagnosed. This analysis also enables an aggressivity score to be established that can help guide the therapeutic options. Our treatment strategy included preoperative embolisation vertebroplasty and surgery when the epidural space was invaded. AD - N. Allali, Service de Neuroradiologie, Rabat, Morocco AU - Allali, N. AU - Tizniti, S. AU - Rachid, M. AU - El Hassani, M. R. AU - El Quessar, A. AU - Chakir, N. AU - Jiddane, M. DB - Embase KW - adolescent adult article artificial embolization cervical spine clinical article computer assisted tomography disease course epidural space female hemangioma human image analysis imaging male nuclear magnetic resonance imaging patient percutaneous vertebroplasty spinal cord compression spine radiography spine tumor vertebra X ray analysis L1 - http://ajns.mine.nu/article.php?idcontenu=90&lang=EN LA - French M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2002 SN - 1015-8618 ST - Vertebral hemangiomas - Agressive forms T2 - African Journal of Neurological Sciences TI - Vertebral hemangiomas - Agressive forms UR - https://www.embase.com/search/results?subaction=viewrecord&id=L41289232&from=export VL - 21 ID - 829860 ER - TY - JOUR AB - Percutaneous vertebroplasty (VP) is a minimally invasive technique for the treatment of vertebral pathology providing early vertebral stabilization and pain relief. In cases of vertebral pathology complicated by spinal cord compression with associated neurological deficits, VP alone cannot be performed free of risks. We describe a combined approach in which decompressive laminectomy and intra-operative vertebroplasty (IVP) are performed during a single session. Among the 252 VP performed in our centre in the past three years, 12 patients (12 vertebral levels) with different pathologies (six symptomatic haemangiomas, two metastatic fractures, four osteoporotic fractures) were treated with an open procedure combined with surgery. All cases were treated with decompressive laminectomy and IVP (mono/bipeduncular or median-posterior trans-somatic access). Five patients with symptomatic haemangiomas were treated with endovascular embolization prior to the combined approach. A visual analogue scale (VAS) was applied to assess pain intensity before and after surgery. The neurological deficits were evaluated with an ASIA impairment scale. In all cases benefit from pain and neurological deficits was observed. The mean VAS score decreased from 7.8 to 2.5 after surgery. The ASIA score improved in all cases (five cases from D to E and five cases from C to D). No clinical complications were observed. In one case a CT scan performed after the procedure showed a foraminal accumulation of PMMA, but the patient referred no symptoms. IVP can be successfully applied in different pathologies affecting the vertebrae. In our limited series this approach proved safe and efficient to provide decompression of spinal cord and dural sac and vertebral body stabilization in a single session. AD - Department of Neuroradiology, San Martino Hospital; Genoa, Italy - pietro.fiaschi@me.com. Department of Neuroradiology, San Martino Hospital; Genoa, Italy. Department of Neurosurgery, San Martino Hospital; Genoa, Italy. AN - 25363261 AU - Allegretti, L. AU - Mavilio, N. AU - Fiaschi, P. AU - Bragazzi, R. AU - Pacetti, M. AU - Castelletti, L. AU - Saitta, L. AU - Castellan, L. C2 - Pmc4243228 DA - Oct 31 DO - 10.15274/inr-2014-10019 DP - NLM ET - 2014/11/05 J2 - Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences KW - Adult Aged Combined Modality Therapy Decompression, Surgical/*methods Embolization, Therapeutic Female Hemangioma/complications/surgery Humans Laminectomy Magnetic Resonance Imaging Male Middle Aged Nervous System Diseases/etiology Osteoporosis/complications Pain Measurement Spinal Cord Compression/diagnostic imaging/etiology/*surgery Spinal Fractures/diagnostic imaging/surgery Tomography, X-Ray Computed Vertebroplasty/*methods Pmma embolization fluoroscopy intra-operative vertebroplasty LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1591-0199 (Print) 1591-0199 SP - 583-90 ST - Intra-operative vertebroplasty combined with posterior cord decompression. A report of twelve cases T2 - Interv Neuroradiol TI - Intra-operative vertebroplasty combined with posterior cord decompression. A report of twelve cases VL - 20 ID - 828655 ER - TY - JOUR AB - Percutaneous vertebroplasty, among various other options, has become a mainstay in the management of osteoporotic and malignant vertebral fractures. The purpose of this article is to describe complications arising from the procedure, which can be classified as mild, which may include a temporary increase in pain and transient hypotension; moderate, including infection and extravasation of cement into the foraminal, epidural or dural space; and severe such as cement leakage in the paravertebral veins, leading to pulmonary embolism, cardiac perforation, cerebral embolism or even death. Vertebroplasty is not a procedure without complications. The article defines them and describes methods to minimize them. AD - Department of Radiology and Medical Imaging, College of Medicine, King Saud University, Riyadh, Saudi Arabia. AN - 104802952. Language: English. Entry Date: 20110930. Revision Date: 20200708. Publication Type: Journal Article AU - Al-Nakshabandi, N. A. DB - cin20 DO - 10.4103/0256-4947.81542 DP - EBSCOhost KW - Spinal Fractures -- Surgery Kyphoplasty -- Adverse Effects Osteoporosis -- Complications Severity of Illness Indices Spinal Fractures -- Etiology Spinal Neoplasms -- Complications Minimally Invasive Procedures -- Adverse Effects Minimally Invasive Procedures -- Methods Kyphoplasty -- Methods M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2011 SN - 0256-4947 SP - 294-297 ST - Percutaneous vertebroplasty complications T2 - Annals of Saudi Medicine TI - Percutaneous vertebroplasty complications UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104802952&site=ehost-live&scope=site VL - 31 ID - 830691 ER - TY - JOUR AB - Background: Vertebral hemangioma is the most common benign spinal tumor and is found in 11% of postmortem studies as a slow-growing benign vascular malformation. It usually involves the vertebral body and sometimes the posterior vertebral elements. When the posterior elements are involved, spinal cord compression with neurological symptoms are seen more often. Vertebral hemangiomas exist as a continuum of manifestations and lesions ranging from the common asymptomatic forms to the rare compression lesion. Extraosseous extension of vertebral hemangioma with cord compression and neurological symptoms is a rare condition and represents a treatment challenge. Surgical options are open resection, embolization or vertebroplasty. Clinical case: We report the case of an unusual size vertebral hemangioma with extraosseous extension to the spinal canal and osseous component in the posterior elements. This tumor caused neurological manifestations and was surgically treated with posterior decompression and stabilization with transpedicular screws and rods. Clinical outcome was good. Conclusions: Vertebral hemangioma is normally an asymptomatic benign lesion not requiring specific treatment. Only in a few cases is surgical treatment required. When neurological compromise is present, early treatment should be carried out before the onset of permanent paralysis. AD - [Alpizar-Aguirre, Armando; Zarate-Kalfopulos, Baron] Inst Nacl Rehabil & Ortoped, Serv Cirugia Columna Vertebral, Mexico City, DF, Mexico. [Miguel Rosales-Olivares, Luis] Inst Nacl Rehabil & Ortoped, Jefe Serv Cirugia Columna Vertebral, Mexico City, DF, Mexico. [del Carmen Baena-Ocampo, Leticia; Antonio Reyes-Sanchez, Alejandro] Inst Nacl Rehabil & Ortoped, Jefe Div Cirugia Especial, Mexico City, DF, Mexico. Inst Nacl Rehabil & Ortoped, Dept Anat Patol, Mexico City, DF, Mexico. Reyes-Sanchez, AA (corresponding author), Camino Santa Teresa 1055-950 Col Heroes Padierna, Mexico City 10700, DF, Mexico. alereyes@inr.gob.mx AN - WOS:000265638100009 AU - Alpizar-Aguirre, A. AU - Zarate-Kalfopulos, B. AU - Rosales-Olivares, L. M. AU - Baena-Ocampo, L. D. AU - Reyes-Sanchez, A. A. DA - Mar-Apr J2 - Cir. Cir. KW - hemangioma spine tumor vertebroplasty PERCUTANEOUS VERTEBROPLASTY CORD COMPRESSION NATURAL-HISTORY MANAGEMENT DIAGNOSIS Surgery LA - English M1 - 2 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2009 SN - 0009-7411 SP - 121-124 ST - Vertebral hemangioma of the posterior arch with subsequent extraosseous extension and neurological symptoms. Case report and literature review T2 - Cirugia Y Cirujanos TI - Vertebral hemangioma of the posterior arch with subsequent extraosseous extension and neurological symptoms. Case report and literature review UR - ://WOS:000265638100009 VL - 77 ID - 830359 ER - TY - JOUR AB - BACKGROUND: Vertebral hemangioma is the most common benign spinal tumor and is found in 11% of postmortem studies as a slow-growing benign vascular malformation. It usually involves the vertebral body and sometimes the posterior vertebral elements. When the posterior elements are involved, spinal cord compression with neurological symptoms are seen more often. Vertebral hemangiomas exist as a continuum of manifestations and lesions ranging from the common asymptomatic forms to the rare compression lesion. Extraosseous extension of vertebral hemangioma with cord compression and neurological symptoms is a rare condition and represents a treatment challenge. Surgical options are open resection, embolization or vertebroplasty. CLINICAL CASE: We report a case of a vertebral hemangioma with extraosseous extension to the spinal canal with an unusual size and osseous component in the posterior elements. This tumor caused neurological manifestations and was surgically treated with posterior decompression and stabilization with transpedicular screws and rods. Clinical outcome was good. CONCLUSIONS: Vertebral hemangioma is normally an asymptomatic benign lesion not requiring specific treatment. Only in a few cases is surgical treatment required. When neurological compromise is present, early treatment should be carried out before the presence of permanent paralysis. AD - Instituto Nacional de Rehabilitación y Ortopedia, México, D. F., Mexico. AN - 19534864 AU - Alpízar-Aguirre, A. AU - Zárate-Kalfópulos, B. AU - Rosales-Olivares, L. M. AU - Baena-Ocampo Ldel, C. AU - Reyes-Sánchez, A. A. DA - Mar-Apr DP - NLM ET - 2009/06/19 J2 - Cirugia y cirujanos KW - Adolescent Female Hemangioma/*complications/*pathology/surgery Humans Neoplasm Invasiveness Nerve Compression Syndromes/*etiology Spinal Cord Neoplasms/*complications/*pathology/surgery Spinal Neoplasms/*complications/*pathology/surgery LA - spa M1 - 2 N1 - PubMed NLM literature search January 5, 2021 OP - Hemangioma vertebral del arco posterior con extensión extraósea y sintomatología neurológica. Informe de un caso y revisión de la literatura. PY - 2009 SN - 0009-7411 SP - 127-30 ST - [Vertebral hemangioma of the posterior arch with subsequent extraosseous extension and neurological symptoms. Case report and literature review] T2 - Cir Cir TI - [Vertebral hemangioma of the posterior arch with subsequent extraosseous extension and neurological symptoms. Case report and literature review] VL - 77 ID - 828700 ER - TY - JOUR AB - Purpose Despite various postulated classifications attempting to simplify the complex angioarchitecture of the cervical spine, the nomenclature of spinal variants and lesions remains inconsistent. Knowledge of variations in the anatomy of the vertebral veins will assist in avoiding complications during neck surgery and procedures such as vertebroplasty. In addition, venous variants may act as a route for the spread of infection, emboli, or metastases. Therefore, we report a novel variant encountered at our institution in this case report. Methods We coincidentally discovered an original anatomical variant of the cervical venous plexus linking the transverse foramina in a Saudi man. Results We termed the variant "spinal anastomosed remnant imprints" (SARI), guided by the second edition ofTerminologia Embryologica, a project of the Federative International Programme for Anatomical Terminology. This variant anastomoses with the vertebral veins at the same level, forming segmented osseous impressions. It shares a topographical relationship with the embryonic anterior cardinal veins, which normally regress in the prenatal period. We hypothesize that these intersegmental anastomosing veins do not always regress and may persist into adulthood, with individualized variations of the venous circulation. Conclusion This report highlights an important finding of interpersonal anatomical variation of veins in the cervical spine, discovered with the aid of advanced imaging to distinguish it from pathological conditions. This will be of assistance to radiologists, anatomists, and clinicians in decision-making and to surgeons in planning for neck surgery. AD - [Al-Sharydah, Abdulaziz Mohammad; Al-Suhibani, Sari Saleh; Al-Abdulwahhab, Abdulrahman Hamad] Imam Abdulrahman Bin Faisal Univ, Diagnost & Intervent Radiol Dept, King Fahd Hosp Univ, POB 31952, Alkhobar City, Eastern Provinc, Saudi Arabia. [Al-Muhanna, Asma Fahd] Imam Abdulrahman Bin Faisal Univ, Dept Anat & Embryol, King Fahd Hosp Univ, Alkhobar City, Eastern Provinc, Saudi Arabia. Al-Abdulwahhab, AH (corresponding author), Imam Abdulrahman Bin Faisal Univ, Diagnost & Intervent Radiol Dept, King Fahd Hosp Univ, POB 31952, Alkhobar City, Eastern Provinc, Saudi Arabia. ahAbdulwahab@iau.edu.sa AN - WOS:000568194100001 AU - Al-Sharydah, A. M. AU - Al-Suhibani, S. S. AU - Al-Muhanna, A. F. AU - Al-Abdulwahhab, A. H. DO - 10.1007/s00276-020-02565-w J2 - Surg. Radiol. Anat. KW - Cervical veins Spinal angiography Transverse foramina Vascular impression Venous plexus HISTORY CORD Anatomy & Morphology Radiology, Nuclear Medicine & Medical Imaging Surgery LA - English M3 - Article; Early Access N1 - Web of Science Clarivate Analytics literature search January 5, 2021 SN - 0930-1038 SP - 7 ST - Spinal anastomosed remnant imprints of vertebral veins linking the transverse foramina: a case report of a novel anatomic variant of the cervical venous plexus T2 - Surgical and Radiologic Anatomy TI - Spinal anastomosed remnant imprints of vertebral veins linking the transverse foramina: a case report of a novel anatomic variant of the cervical venous plexus UR - ://WOS:000568194100001 ID - 830101 ER - TY - JOUR AB - PURPOSE: Despite various postulated classifications attempting to simplify the complex angioarchitecture of the cervical spine, the nomenclature of spinal variants and lesions remains inconsistent. Knowledge of variations in the anatomy of the vertebral veins will assist in avoiding complications during neck surgery and procedures such as vertebroplasty. In addition, venous variants may act as a route for the spread of infection, emboli, or metastases. Therefore, we report a novel variant encountered at our institution in this case report. METHODS: We coincidentally discovered an original anatomical variant of the cervical venous plexus linking the transverse foramina in a Saudi man. RESULTS: We termed the variant "spinal anastomosed remnant imprints" (SARI), guided by the second edition of Terminologia Embryologica, a project of the Federative International Programme for Anatomical Terminology. This variant anastomoses with the vertebral veins at the same level, forming segmented osseous impressions. It shares a topographical relationship with the embryonic anterior cardinal veins, which normally regress in the prenatal period. We hypothesize that these intersegmental anastomosing veins do not always regress and may persist into adulthood, with individualized variations of the venous circulation. CONCLUSION: This report highlights an important finding of interpersonal anatomical variation of veins in the cervical spine, discovered with the aid of advanced imaging to distinguish it from pathological conditions. This will be of assistance to radiologists, anatomists, and clinicians in decision-making and to surgeons in planning for neck surgery. AD - Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, P.O. Box: 31952, AlKhobar City, Eastern Province, Saudi Arabia. Anatomy and Embryology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, AlKhobar City, Eastern Province, Saudi Arabia. Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, P.O. Box: 31952, AlKhobar City, Eastern Province, Saudi Arabia. ahAbdulwahab@iau.edu.sa. AN - 32914224 AU - Al-Sharydah, A. M. AU - Al-Suhibani, S. S. AU - Al-Muhanna, A. F. AU - Al-Abdulwahhab, A. H. DA - Sep 10 DO - 10.1007/s00276-020-02565-w DP - NLM ET - 2020/09/12 J2 - Surgical and radiologic anatomy : SRA KW - Cervical veins Spinal angiography Transverse foramina Vascular impression Venous plexus LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 0930-1038 ST - Spinal anastomosed remnant imprints of vertebral veins linking the transverse foramina: a case report of a novel anatomic variant of the cervical venous plexus T2 - Surg Radiol Anat TI - Spinal anastomosed remnant imprints of vertebral veins linking the transverse foramina: a case report of a novel anatomic variant of the cervical venous plexus ID - 829003 ER - TY - JOUR AB - Objective: Percutaneous vertebroplasty (PVP) is the preferred treatment option for vertebral compression fractures (VCF). In this study, the efficacy and complications of PVP were investigated among 49 patients with VCF. Methods: Forty-nine patients with VCF due to osteoporosis, trauma, osteolytic bone tumors, metastases or leukemia who were admitted to our hospital between 2012 and 2015 and treated with PVP were included in the study. In patients’ preoperative and postoperative evaluation, a visual analogue scale (VAS) was used to assess back and leg pain, preoperative routine lumbar vertebral radiography was used for fracture morphology, lumbar magnetic resonance imaging was performed, and the segmental kyphotic angle, vertebral corpus compression rate, polymethylmethacrylate (PMMA) cement volume, and diffusion of PMMA were recorded. Results: Preoperative and postoperative VAS scores were 8.6±0.9 vs. 1.13±1.1 (p<0.01). The approximate compression rate was 24.72±13.99 %, the ratio of approximate restoration height was 3.47±5.36, and the mean kyphosis angle was 7.35±6.81 °. The mean pre- and postoperative values of vertebral height were 1.83±0.39 cm vs1.88±0.36 cm (P<.01). Conclusion: In this study, preoperative pain in patients with VCF prominently diminished in the postoperative early and late phase. After PVP, vertebral height showed a subtle increase. AD - F. Altinel, Baskent University, Zübeyde Hanim Teaching and Medical Research Center, Department of Neurosurgery, Izmir, Turkey AU - Altinel, F. AU - Soylev, G. O. AU - Tuncali, B. AU - Altinors, M. N. DB - Embase DO - 10.24165/jns.9873.16 KW - X ray film enoxaparin low molecular weight heparin poly(methyl methacrylate) aged article backache bone cement leakage bone tumor clinical article compression fracture female fluoroscopy follow up human injury kyphosis leg pain leukemia lumbar region lung embolism male metastasis nuclear magnetic resonance imaging osteolysis osteoporosis percutaneous vertebroplasty postoperative pain spine radiography traffic accident vertebra body visual analog scale LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1302-1664 1300-1817 SP - 222-230 ST - Vertebroplasty in vertebral compression fractures: Single institute experience with 49 cases T2 - Journal of Neurological Sciences TI - Vertebroplasty in vertebral compression fractures: Single institute experience with 49 cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L619157506&from=export http://dx.doi.org/10.24165/jns.9873.16 VL - 34 ID - 829285 ER - TY - JOUR AB - The cement-in-cement technique is useful in the setting of revision total hip arthroplasty (THA), especially to gain acetabular exposure, change a damaged or loose femoral component, or change the version, offset, or length of a fixed femoral component. The goal of this retrospective study was to assess the clinical and radiographic characteristics of revision THA using the cement-incement technique. Between 1971 and 2013, a total of 63 revision THAs used an Omnifit (Osteonics, Mahwah, New Jersey) or Exeter (Howmedica, Mahwah, New Jersey) stem and the cement-in-cement technique at the senior author's institution. Aseptic loosening (74%) was the predominant preoperative diagnosis followed by periprosthetic fracture (14%), instability (8%), and implant fracture (6%). Mean clinical follow-up was 5.5±3.8 years. The Harris Hip Score had a statistically significant increase of 18.5 points (P<.001) after revision THA using the cement-in-cement technique. There were 13 returns to the operating room, resulting in an overall failure rate of 21%. Eleven (18%) cases required revision THA, but only 1 (2%) revision THA was for aseptic removal of the femoral component. All other femoral implants had no evidence of component migration, cement mantel fracture, or circumferential lucent lines at final follow-up. The patients who underwent cement-in-cement revision THA at the senior author's institution had good restoration of function but a high complication rate. AD - R.T. Trousdale, Department of Orthopedic Surgery, Mayo Clinic, 200 First St SW, Rochester, MN, United States AU - Amanatullah, D. F. AU - Pallante, G. D. AU - Floccari, L. V. AU - Vasileiadis, G. I. AU - Trousdale, R. T. DB - Embase Medline DO - 10.3928/01477447-20161213-05 KW - total hip prosthesis aged article cement spacer cemented prosthesis controlled study deep vein thrombosis device removal female follow up Harris hip score human lung embolism major clinical study male open fracture reduction operation duration osteosynthesis periprosthetic fracture prosthesis loosening retrospective study revision arthroplasty sciatic nerve injury surgical infection surgical technique Exeter Omnifit LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1938-2367 0147-7447 SP - e348-e351 ST - Revision total hip arthroplasty using the cement-in-cement technique T2 - Orthopedics TI - Revision total hip arthroplasty using the cement-in-cement technique UR - https://www.embase.com/search/results?subaction=viewrecord&id=L615090132&from=export http://dx.doi.org/10.3928/01477447-20161213-05 VL - 40 ID - 829266 ER - TY - JOUR AB - A 66-year-old man presented with a 2-day history of acute onset vertigo followed by intractable nausea and vomiting. Magnetic resonance imaging (MRI) showed multiple strokes that explained his presenting symptom. It was later discovered that the underlying cause of his strokes was methamphetamine abuse. In addition, the patient received a chest x-ray to evaluate for a cough and bilateral rales in the setting of low-grade fevers. The radiograph showed a right upper lobe 9 mm nodule. Computer tomography (CT) of the chest with contrast was obtained to evaluate the nodule. It showed a “densely calcified nodular density in the medial right upper lobe corresponding to the radiographic abnormality. The linear and branching fingerlike projections suggest this may represent embolism of methylmethacrylate or bone cement.” Patient's surgical history included a right hip replacement performed in 2004. He suffered a broken femur as a result of a motorcycle accident. The embolus was asymptomatic and was not treated. The patient was discharged to a nursing facility. Bone cement embolism is an uncommon complication of orthopedic surgery that is most often seen following vetebroplasty. It can also be seen following hip replacement and less frequently following knee replacement surgery. Since 2000, 84 cases have been reported in the literature with an estimated incidence of bone cement embolism of 4.6 to 6.8 percent following vertebroplasty. One study cited an incidence of 16 cases in a series of 48 patients that had emboli 10 mm or larger that were diagnosed via transesophageal echocardiography. It is impossible to determine the age of this embolus just from radiography or to know if this was a complication that occurred during surgery or in the years after surgery. Bone cement emboli following intramedullary cementing of hip replacement is thought to be secondary to raised intramedullary pressures that develop during cementation and prosthesis insertion. That material is then forced into circulation creating emboli that end up in the pulmonary circulation. Treatment is indicated in patients with symptomatic emboli. Several studies cited patients that were treated effectively with anticoagulation (8 cases in the 84 vertebroplasty case series). 5 percent of those cases were treated with embolectomy. While there is no consensus on how to treat bone cement emboli, they remain a very real and significant complication of hip replacement and vertebroplasty that may present asymptomatically or with symptoms similar to pulmonary embolism. (Figure Presented). AD - A. Amaraneni, Western Michigan University, Homer Stryker M.D. School of Medicine, Kalamazoo, MI, United States AU - Amaraneni, A. AU - Malik, D. AU - Loehrke, M. DB - Embase KW - bone cement methamphetamine methacrylic acid methyl ester embolism patient human hip arthroplasty surgery American society lung nodule percutaneous vertebroplasty cerebrovascular accident thorax transesophageal echocardiography knee arthroplasty radiography abuse nuclear magnetic resonance imaging nursing traffic accident nausea and vomiting density computer assisted tomography vertigo femur male orthopedic surgery X ray film lung embolism fever crackle cementation prosthesis lung circulation consensus embolectomy case study anticoagulation coughing thorax radiography L1 - http://www.atsjournals.org/doi/pdf/10.1164/ajrccm-conference.2015.191.1_MeetingAbstracts.A3046 LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1073-449X ST - An unusually shaped lung nodule-a case of a bone cement embolus in a patient with a history of hip replacement surgery T2 - American Journal of Respiratory and Critical Care Medicine TI - An unusually shaped lung nodule-a case of a bone cement embolus in a patient with a history of hip replacement surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L72050874&from=export VL - 191 ID - 829359 ER - TY - JOUR AB - Background. In the wake of an upsurge in so-called microinvasive procedures, the stabilization of osteoporotic vertebral bodies by injection of bone cement has gained a certain level of importance. In this procedure the pedicle is punctured and low viscosity Palacos® is injected under high pressure. Material and methods. This article reports on the case of a 60-year-old man who was found dead in his vehicle with the engine running but there was no connection between the exhaust pipe and the vehicle interior. The autopsy revealed a posterior wall myocardial infarction which was no longer fresh with a heart weight of 840 g (body weight 128.5 kg) as the cause of death. Additionally, there were occlusions of the lumbar veins which extended to the inferior vena cava and consisted of a white, dense non-sliceable mass. Furthermore, this same material could be found in the hilar region of the right pulmonary artery in the form of a net-work-like collection of streak-like fragments measuring up to 2.5 cm in length and 2 mm in width. Preparation of the spinal column revealed an infiltration of the vertebral bod-ies L2 and L3 with a solid white material and a scar-like skin retraction was visible above the upper lumbar spine. The medical history documented that a vertebroplasty had been carried out for osteoporosis more than 1 year ago. Results. In the current case it was obvious that the injection into the spinal column resulted in embolization of the injected material via the inferior vena cava up to the hilus of the right lung, which had remained clinically unnoticed. A contribution to the mode of death would only be feasible as an additional cardiac load on top of substantial pre-exist-ing damage. Conclusion. The injection of low viscosity Palacos® under high pressure into richly vas-cularized areas therefore represents a substantial risk for embolic entrainment of the material. AD - B. Madea, Institut für Rechtsmedizin, Universität Bonn, Stiftsplatz 12, Bonn, Germany AU - Amberg, R. AU - Kernbach-Wighton, G. AU - Madea, B. DB - Embase DO - 10.1007/s00194-015-0009-6 KW - bone cement device palacos adult article artificial embolization autopsy case report cause of death clinical article foreign body heart weight human male medical history middle aged osteoporosis percutaneous vertebroplasty posterior myocardial infarction right pulmonary artery viscosity LA - German M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1434-5196 0937-9819 SP - 556-560 ST - Palacos® embolization following vertebroplasty T2 - Rechtsmedizin TI - Palacos® embolization following vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2002344473&from=export http://dx.doi.org/10.1007/s00194-015-0009-6 VL - 25 ID - 829351 ER - TY - JOUR AB - In the wake of an upsurge in so-called microinvasive procedures, the stabilization of osteoporotic vertebral bodies by injection of bone cement has gained a certain level of importance. In this procedure the pedicle is punctured and low viscosity Palacos(A (R)) is injected under high pressure. This article reports on the case of a 60-year-old man who was found dead in his vehicle with the engine running but there was no connection between the exhaust pipe and the vehicle interior. The autopsy revealed a posterior wall myocardial infarction which was no longer fresh with a heart weight of 840 g (body weight 128.5 kg) as the cause of death. Additionally, there were occlusions of the lumbar veins which extended to the inferior vena cava and consisted of a white, dense non-sliceable mass. Furthermore, this same material could be found in the hilar region of the right pulmonary artery in the form of a network-like collection of streak-like fragments measuring up to 2.5 cm in length and 2 mm in width. Preparation of the spinal column revealed an infiltration of the vertebral bodies L2 and L3 with a solid white material and a scar-like skin retraction was visible above the upper lumbar spine. The medical history documented that a vertebroplasty had been carried out for osteoporosis more than 1 year ago. In the current case it was obvious that the injection into the spinal column resulted in embolization of the injected material via the inferior vena cava up to the hilus of the right lung, which had remained clinically unnoticed. A contribution to the mode of death would only be feasible as an additional cardiac load on top of substantial pre-existing damage. The injection of low viscosity Palacos(A (R)) under high pressure into richly vascularized areas therefore represents a substantial risk for embolic entrainment of the material. AD - [Amberg, R.; Kernbach-Wighton, G.; Madea, B.] Univ Bonn, Inst Rechtsmed, D-53111 Bonn, Germany. [Amberg, R.] Facharztpraxis Rechtsmed, Freiburg, Germany. Madea, B (corresponding author), Univ Bonn, Inst Rechtsmed, Stiftspl 12, D-53111 Bonn, Germany. b.madea@uni-bonn.de AN - WOS:000365730100006 AU - Amberg, R. AU - Kernbach-Wighton, G. AU - Madea, B. DA - Dec DO - 10.1007/s00194-015-0009-6 J2 - Rechtsmedizin KW - Bone cements Foreign-body migration Myocardial infarction Pulmonary embolism Cause of death PERCUTANEOUS VERTEBROPLASTY FAT-EMBOLISM CEMENT LEAKAGE RANDOMIZED-TRIAL KYPHOPLASTY IDENTIFICATION COMPLICATIONS REMOVAL SAFETY Medicine, Legal LA - German M1 - 6 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2015 SN - 0937-9819 SP - 556-560 ST - Palacos(A (R)) embolization following vertebroplasty T2 - Rechtsmedizin TI - Palacos(A (R)) embolization following vertebroplasty UR - ://WOS:000365730100006 VL - 25 ID - 830229 ER - TY - JOUR AB - Cerebral embolism in patients undergoing total joint arthroplasty has an incidence rate of 0.5%. In those cases where cerebral emboli were confirmed, a venous-to-arterial circulation shunt, most commonly a patent foramen ovale, was identified. We report a case of severe cerebral fat emboli during cementless total hip arthroplasty in the absence of an intracardiac defect. AD - Department of Orthopaedic Surgery, University of Louisville, Louisville, Kentucky, USA. AN - 17400108 AU - Ammon, J. T. AU - Khalily, C. AU - Lester, D. K. DA - Apr DO - 10.1016/j.arth.2006.03.005 DP - NLM ET - 2007/04/03 J2 - The Journal of arthroplasty KW - Adult Arthroplasty, Replacement, Hip/*adverse effects Fatal Outcome Femoral Neck Fractures/surgery Humans Intracranial Embolism/diagnosis/*etiology Magnetic Resonance Imaging Male Reoperation LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 0883-5403 (Print) 0883-5403 SP - 477-9 ST - Fatal cerebral emboli in the absence of a cardiac arterial-venous shunt: case report T2 - J Arthroplasty TI - Fatal cerebral emboli in the absence of a cardiac arterial-venous shunt: case report VL - 22 ID - 828987 ER - TY - JOUR AB - Cerebral embolism in patients undergoing total joint arthroplasty has an incidence rate of 0.5%. In those cases where cerebral emboli were confirmed, a venous-to-arterial circulation shunt, most commonly a patent foramen ovale, was identified. We report a case of severe cerebral fat emboli during cementless total hip arthroplasty in the absence of an intracardiac defect. AD - Univ Louisville, Dept Orthopaed Surg, Louisville, KY 40202 USA. Louisville Bone & Joint Ctr, Louisville, KY USA. Univ Calif San Francisco, Sch Med, Fresno, CA USA. Ammon, JT (corresponding author), Univ Louisville, Dept Orthopaed Surg, 210 E Gray St,Suite 1003, Louisville, KY 40202 USA. AN - WOS:000246057500024 AU - Ammon, J. T. AU - Khalily, C. AU - Lester, D. K. DA - Apr DO - 10.1016/j.arth.2006.03.005 J2 - J. Arthroplast. KW - embolism arthroplasty TOTAL HIP-ARTHROPLASTY BONE CEMENT INTRAMEDULLARY PRESSURE REPLACEMENT SURGERY PULMONARY DOGS Orthopedics LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2007 SN - 0883-5403 SP - 477-479 ST - Fatal cerebral emboli in the absence of a cardiac arterial-venous shunt T2 - Journal of Arthroplasty TI - Fatal cerebral emboli in the absence of a cardiac arterial-venous shunt UR - ://WOS:000246057500024 VL - 22 ID - 830397 ER - TY - JOUR AB - An aortic embolus of cement occurred in a 72-year-old woman after lumbar percutaneous vertebroplasty for breast cancer metastasis. A CT scan during the procedure revealed cement migration into the aorta via the lumbar artery. The cement embolus in the aorta, along with the hook-shaped cement fragment in the lumbar artery, was asymptomatic. Thereafter, a CT scan 4 months later still showed the presence of cement in the aorta and the lumbar artery at the level of the vertebroplasty. The patient is free of complaints after 4 months without anticoagulant treatment. This rare complication occurred because the collateral arterial supplies to the breast metastasis and the retrograde migration of cement during the vertebroplasty were not recognized. Proper techniques can minimize the risk of arterial embolism caused by cement during the procedure. AD - Department of Radiology, Hôpital l'Archet, 06200 Nice Cedex 1, France. amorettinicolas@yahoo.fr AN - 17396256 AU - Amoretti, N. AU - Hovorka, I. AU - Marcy, P. Y. AU - Grimaud, A. AU - Brunner, P. AU - Bruneton, J. N. DA - Jul DO - 10.1007/s00256-006-0261-7 DP - NLM ET - 2007/03/31 J2 - Skeletal radiology KW - Aged Aortography/*methods Bone Cements/*adverse effects Breast Neoplasms/*pathology Embolism/*diagnosis/*etiology Female Follow-Up Studies Fractures, Compression/etiology/therapy Humans Lumbar Vertebrae/blood supply/diagnostic imaging Polymethyl Methacrylate/*adverse effects Postoperative Complications/diagnosis/etiology Rare Diseases Spinal Fractures/etiology/therapy Spinal Neoplasms/*secondary/therapy Tomography, X-Ray Computed/methods LA - eng M1 - 7 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 0364-2348 (Print) 0364-2348 SP - 685-7 ST - Aortic embolism of cement: a rare complication of lumbar percutaneous vertebroplasty T2 - Skeletal Radiol TI - Aortic embolism of cement: a rare complication of lumbar percutaneous vertebroplasty VL - 36 ID - 828875 ER - TY - JOUR AB - QUESTION: Is it possible to reduce the rate of thrombembolic events during total hip arthroplasty (THA) by the intraoperative use of a mechanical device for thrombembolic prophylaxis (A‐V Impulse System). METHOD: The efficacy of additional mechanical thrombembolic prophylaxis was investigated in a prospective randomised trial on 104 patients who underwent cementless THA. All patients received low dose heparin. In 52 patients the additional application of the A‐V Impulse System was introduced intraoperatively for the next 24 h. A perfusion scintigram of the lung was performed before and 7 days after the operation in both groups to detect embolic patterns. RESULTS: Perfusion deficits typical for thromboembolic events were detected postoperatively in 8 patients (15.4 %) of the controls and 5 patients (9.6 %) of the A‐V Impulse System group. CONCLUSIONS: With the perfusion lung scan we saw postoperatively a total of 13 patients (12.5 %, n=104) with an asymptomatic microthromboembolism of the lungs. Hence it is necessary to increase the protection against thromboembolism. Although statistically not significant (p=0.374), there is a tendency that the additional use of the mechanical thrombotic prophylaxis can reduce thromboembolic events in THA. The impact of the intraoperative introduction of the A‐V Impulse System is not really clear. However, for a higher velocity of blood flow during the operation it makes sense to start the procedure intraoperatively. AN - CN-00482163 AU - Anders, J. O. AU - Fuhrmann, R. AU - Roth, A. AU - Zenker, C. DO - 10.1055/s-2004-822665 KW - Aged Cementation Equipment Failure Analysis [*methods] Female Hip Prosthesis [*adverse effects] Humans Intraoperative Care [*instrumentation] Male Physical Therapy Modalities [*instrumentation] Prosthesis Failure Pulmonary Embolism [*diagnostic imaging, etiology, *prevention & control] Radiography Treatment Outcome M1 - 3 M3 - Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2004 SP - 328‐332 ST - Can the number of thromboembolisms incidents in total hips replacement be further reduced? T2 - Zeitschrift fur orthopadie und ihre grenzgebiete TI - Can the number of thromboembolisms incidents in total hips replacement be further reduced? UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00482163/full VL - 142 ID - 830024 ER - TY - JOUR AB - Question: Is it possible to reduce the rate of thrombembolic events during total hip arthroplasty (THA) by the intraoperative use of a mechanical device for thrombembolic prophylaxis (A‐V Impulse System). Method: The efficacy of additional mechanical thrombembolic prophylaxis was investigated in a prospective randomised trial on 104 patients who underwent cementless THA. All patients received low dose heparin. In 52 patients the additional application of the A‐V Impulse System was introduced intraoperatively for the next 24 h. A perfusion scintigram of the lung was performed before and 7 days after the operation in both groups to detect embolic patterns. Results: Perfusion deficits typical for thromboembolic events were detected postoperatively in 8 patients (15.4%) of the controls and 5 patients (9.6%) of the A‐V Impulse System group. Conclusions: With the perfusion lung scan we saw postoperatively a total of 13 patients (12.5%, n = 104) with an asymptomatic microthromboembolism of the lungs. Hence it is necessary to increase the protection against thromboembolism. Although statistically not significant (p = 0.374), there is a tendency that the additional use of the mechanical thrombotic prophylaxis can reduce thromboembolic events in THA. The impact of the intraoperative introduction of the A‐V Impulse System is not really clear. However, for a higher velocity of blood flow during the operation it makes sense to start the procedure intraoperatively. AN - CN-00516186 AU - Anders, J. O. AU - Fuhrmann, R. AU - Roth, A. AU - Zenker, C. DO - 10.1055/s-2004-822665 KW - *lung embolism/co [Complication] *lung embolism/di [Diagnosis] *lung embolism/dt [Drug Therapy] *lung embolism/pc [Prevention] *lung embolism/th [Therapy] *total hip prosthesis Article Clinical trial Controlled clinical trial Controlled study Diagnostic accuracy Human Incidence Lung scintiscanning Major clinical study Nadroparin/ct [Clinical Trial] Nadroparin/dt [Drug Therapy] Peroperative care Postoperative complication/co [Complication] Postoperative complication/di [Diagnosis] Postoperative complication/dt [Drug Therapy] Postoperative complication/pc [Prevention] Postoperative complication/th [Therapy] Randomized controlled trial Treatment outcome M1 - 3 M3 - Journal: Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2004 SP - 328‐332 ST - How can we deereose the number of thrombosis and pulmonary embolism in total hip replacement? T2 - Zeitschrift fur orthopadie und ihre grenzgebiete TI - How can we deereose the number of thrombosis and pulmonary embolism in total hip replacement? UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00516186/full VL - 142 ID - 830062 ER - TY - JOUR AB - In order to demonstrate the presence of air embolism during total hip replacement surgery six patients, chosen at random, were examined with an ultrasound probe placed over the right atrium. In five patients, the characteristic double cardiac sound coming from the ultrasound probe changed into an irregular rattling sound as the femoral cement started generating its maximum hardening heat. In two patients this change was also heard simultaneously with the insertion of the femoral prosthesis. In four patients in whom catheters were placed in the right atrium it was possible to aspirate a maximum of 3 ml air from the right atrium. During the cementation of acetabulum, no change in the signal, coming from the ultrasound probe, was registered. It is probable that air is formed in the venous system during the insertion and cementation of a femoral prosthesis. The resulting air embolism is presumed to be the cause of the massive, but generally very brief impairment of the central circulation and the lungs seen during a hip arthroplasty. In the case of patients undergoing anaesthesia with N2O, the N2O should be removed before the cementation, it is also recommended that the right atrium be catheterised, in order to reduce the risk of this complication. AN - 6660457 AU - Andersen, K. H. DA - Dec DO - 10.1111/j.1365-2044.1983.tb12520.x DP - NLM ET - 1983/12/01 J2 - Anaesthesia KW - Aged Embolism, Air/*diagnosis/therapy Female Heart Atria Heart Sounds *Hip Prosthesis Humans Intraoperative Complications/diagnosis Male Middle Aged Suction Time Factors Ultrasonography LA - eng M1 - 12 N1 - PubMed NLM literature search January 5, 2021 PY - 1983 SN - 0003-2409 (Print) 0003-2409 SP - 1175-8 ST - Air aspirated from the venous system during total hip replacement T2 - Anaesthesia TI - Air aspirated from the venous system during total hip replacement VL - 38 ID - 828941 ER - TY - JOUR AB - Total hip arthroplasty is associated with cardiopulmonary complications including cardiac arrest. We present one of four cases of cardiac arrest, two of the cases were fatal. The pathogenesis suggested to explain these complications is venous air embolism, generated by the methylmethacrylate bone cement polymerization causing thermal blood damage. To prevent this happening cortical bone allotransplantation around the prosthesis and bone cement with a low temperature of polymerization may be used. AD - H:S Bispebjerg Hospital, anaestesiologisk afdeling. AN - 9741263 AU - Andersen, K. H. AU - Nielsen, J. M. DA - Aug 17 DP - NLM ET - 1998/09/19 J2 - Ugeskrift for laeger KW - Aged Arthroplasty, Replacement, Hip/*adverse effects Bone Cements/*adverse effects/metabolism Embolism, Air/chemically induced/complications Fatal Outcome Heart Arrest/*etiology Humans Male Methylmethacrylates/*adverse effects/metabolism Polymers Postoperative Complications/diagnosis Temperature LA - dan M1 - 34 N1 - PubMed NLM literature search January 5, 2021 OP - Knoglecementens haerdningsvarme kan udløse hjertestop. PY - 1998 SN - 0041-5782 (Print) 0041-5782 SP - 4905-6 ST - [Heat of polymerization of bone cement can induce cardiac arrest] T2 - Ugeskr Laeger TI - [Heat of polymerization of bone cement can induce cardiac arrest] VL - 160 ID - 828545 ER - TY - JOUR AB - Vertebral fracture is a common complication of osteoporosis. In some patients such a fracture results in prolonged and intractable pain. Traditionally treatment has included bed rest, physiotherapy, pain management and in some cases bracing. During the last decade vertebroplasty has been developed as a treatment for these fractures. To evaluate the safety and the results of this procedure, we preformed a MEDLINE search in June 2002 using the terms »Vertebroplasty« and »Fracture«. The search revealed 15 clinical studies reporting pain 62% to 100% of the treated patients. Rare clinical complications relate to extravertebral leakage of cement, including local compression of the neural structures or cement emboli. Vertebroplasty seems to be a safe and effective treatment of painful osteoporotic compression fractures. Controlled trials are needed to determine the long-term safety of the procedure. AD - M.Ø. Andersen, Ortopædkirurgisk Afdeling O, Odense Universitetshospital, DK-5000 Odense, Denmark AU - Andersen, M. Ø AU - Thomsen, K. DB - Embase Medline KW - human intractable pain Medline nerve compression osteoporosis outcomes research percutaneous vertebroplasty postoperative complication review spine fracture LA - Danish M1 - 6 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2004 SN - 0041-5782 SP - 463-466 ST - Vertebroplasty: A new treatment for painful osteoporotic vertebral fractures? T2 - Ugeskrift for Laeger TI - Vertebroplasty: A new treatment for painful osteoporotic vertebral fractures? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L38325366&from=export VL - 166 ID - 829843 ER - TY - JOUR AB - This reports presents a case of a 62-year-old woman with hemorrhagic hypovolemic shock, respiratory distress, and pericardial effusion secondary to right atrial perforation caused by a cement embolus after dorsal spondylodesis. Despite optimal intensive care support for a supposed pulmonary embolism, the patient's condition markedly deteriorated. On delayed embolus recognition by contrast-enhanced computed tomography and transesophageal echocardiography, she had to undergo cardiac surgery. Cardiac involvement is a rare but important complication, with few cases described after vertebroplasty and none after spondylodesis. In our case, diagnosis before perforation would have allowed an endovascular approach, thereby avoiding open heart surgery. (C) 2017 by The Society of Thoracic Surgeons AD - Klagenfurt Clin, Dept Cardiothorac & Vasc Surg, Klagenfurt, Austria. Med Univ Graz, Dept Surg, Sect Surg Res, Graz, Austria. Univ Maribor, Fac Med, Maribor, Slovenia. Andra, M (corresponding author), Klinikum Klagenfurt Worthersee, Dept Cardiothorac & Vasc Surg, Feschnigstr 11, A-9020 Klagenfurt, Austria. michaela.andrae@kabeg.at AN - WOS:000414696900001 AU - Andra, M. AU - Baumer, H. AU - Mittergradnegger, F. AU - Laschitz, M. AU - Petek, T. AU - Wandschneider, W. DA - Nov DO - 10.1016/j.athoracsur.2017 J2 - Ann. Thorac. Surg. KW - PERCUTANEOUS VERTEBROPLASTY PULMONARY-EMBOLISM CEMENT KYPHOPLASTY Cardiac & Cardiovascular Systems Respiratory System Surgery LA - English M1 - 5 M3 - Editorial Material N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2017 SN - 0003-4975 SP - E355-E357 ST - Life-Threatening Cardiac Perforation After Posterior Spondylodesis T2 - Annals of Thoracic Surgery TI - Life-Threatening Cardiac Perforation After Posterior Spondylodesis UR - ://WOS:000414696900001 VL - 104 ID - 830186 ER - TY - JOUR AB - This reports presents a case of a 62-year-old woman with hemorrhagic hypovolemic shock, respiratory distress, and pericardial effusion secondary to right atrial perforation caused by a cement embolus after dorsal spondylodesis. Despite optimal intensive care support for a supposed pulmonary embolism, the patient's condition markedly deteriorated. On delayed embolus recognition by contrast-enhanced computed tomography and transesophageal echocardiography, she had to undergo cardiac surgery. Cardiac involvement is a rare but important complication, with few cases described after vertebroplasty and none after spondylodesis. In our case, diagnosis before perforation would have allowed an endovascular approach, thereby avoiding open heart surgery. AD - Department of Cardiothoracic and Vascular Surgery, Klagenfurt Clinic, Klagenfurt, Austria; Department of Surgery, Section for Surgical Research, Medical University Graz, Graz, Austria. Electronic address: michaela.andrae@kabeg.at. Department of Cardiothoracic and Vascular Surgery, Klagenfurt Clinic, Klagenfurt, Austria. Faculty of Medicine, University of Maribor, Maribor, Slovenia. AN - 29054227 AU - Andrä, M. AU - Baumer, H. AU - Mittergradnegger, F. AU - Laschitz, M. AU - Petek, T. AU - Wandschneider, W. DA - Nov DO - 10.1016/j.athoracsur.2017.06.021 DP - NLM ET - 2017/10/22 J2 - The Annals of thoracic surgery KW - Accidental Falls Bone Cements/*adverse effects Cardiac Surgical Procedures/*methods Critical Illness/therapy Echocardiography, Transesophageal/methods Female Follow-Up Studies Heart Atria/diagnostic imaging/injuries Heart Injuries/diagnostic imaging/*etiology/*surgery Humans Lumbar Vertebrae/*injuries/surgery Middle Aged Pericardial Effusion/diagnostic imaging/etiology/surgery Risk Assessment Spinal Fractures/diagnostic imaging/surgery Spinal Fusion/*adverse effects/methods Tomography, X-Ray Computed/methods Treatment Outcome LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 0003-4975 SP - e355-e357 ST - Life-Threatening Cardiac Perforation After Posterior Spondylodesis T2 - Ann Thorac Surg TI - Life-Threatening Cardiac Perforation After Posterior Spondylodesis VL - 104 ID - 828643 ER - TY - JOUR AB - Background. About 80-90% of patients with multiple myeloma will develop skeletal-related complications, including diffuse osteopenia, focal lytic lesions, pathological fractures and bone pain. The therapeutic intervention for spinal myeloma lesions (SML) is based on analgesic medications, biphosphonates, radiation therapy, and in some cases, percutaneous vertebroplasty (PV) and balloon kyphoplasty. PV consists in the injection of polymethylmethacrylate into the damaged vertebral body via a percutaneous approach under image guidance. While in patients with non myelomatous osteoporotic vertebral fractures, 2 randomized trials have shown no beneficial effect of PV compared with placebo or a simulated procedure without cement, no specific data in controlled trials are available for myeloma patients. Aims. To evaluate the efficacy and safety of PV in patients with SML. Methods. Patients with SML not responsive to medical treatment were eligible. A computed tomography and/or magnetic resonance were performed, previously to the procedure. The presence of pathological fractures was evaluated by a rheumatologist and/or radiologist specialist and performed by an interventionist radiologist with local anesthesia and light sedation. In some cases, more than one vertebra was treated in the same procedure. Pain response was evaluated by a qualitative scale at 24 hours, 1 and 6 months after PV. Results. Nineteen PV were performed in 15 patients (12 females and 3 males). Thirty-eight vertebras were treated (maximum 4 vertebras in the same procedure), being the most frequent localization L3. Medium age was 74.8 years (range, 39 to 88 years). The evaluation of pain at 24 hours, 1 and 6 months after PV, showed improvement in 79%, 47% and 37% of cases, respectively. Notably, most patients reported pain in other skeletal localization caused by disease progression, but unrelated to treated vertebra. The incidence of cement leakage was 47%. Four out of 15 patients developed severe complications: 1 psoas hematoma without hemoglobin decrease in the first 24 hours after PV with good outcome, 1 death by respiratory failure of unknown etiology 11 days after PV and 2 pulmonary embolism (the first one died in the first 24 hours after the third PV because of a cement pulmonary embolism; the second one was hospitalized one week after PV and treated successfully with heparin). Conclusions. PV is an easy technique for SML not responsive to medical treatment that results in immediate pain relief in 79% of patients. Severe clinical complications secondary to cement leakage can be observed in 26% (4 out of 15) of patients, with some being life-threatening. These results suggest that PV can be useful in acute SML treatment to improve pain related but further studies with more patients and more follow-up should be undertaken to confirm the efficacy and the incidence of adverse effects. AD - A. Angona, Hospital del Mar, Barcelona, Spain AU - Angona, A. AU - Abella, E. AU - Serra, J. AU - Solano, A. AU - Ares, J. AU - Ciria, M. AU - Saumell, S. AU - Gimeno, E. AU - Tena, J. AU - Alvarez-Larrán, A. AU - Pedro, C. AU - Jimenez, C. AU - Sanchez, B. AU - Salar, A. AU - Besses, C. DB - Embase KW - cement poly(methyl methacrylate) bisphosphonic acid derivative analgesic agent heparin placebo hemoglobin percutaneous vertebroplasty patient human myeloma hematology procedures vertebra pain lung embolism pathologic fracture radiologist therapy injection multiple myeloma kyphoplasty medical specialist nuclear magnetic resonance radiotherapy computer assisted tomography drug therapy safety controlled study rheumatology adverse drug reaction follow up bone pain local anesthesia sedation analgesia spine fracture etiology osteopenia respiratory failure death vertebra body iliopsoas hematoma disease course male female L1 - http://www.haematologica.org/content/96/supplement_2/1.full-text.pdf+html LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 0390-6078 SP - 536 ST - Percutaneous vertebroplasty in patients with spinal myeloma lesions T2 - Haematologica TI - Percutaneous vertebroplasty in patients with spinal myeloma lesions UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71699150&from=export VL - 96 ID - 829616 ER - TY - JOUR AB - Background: The therapeutic intervention for SML is based on analgesia, biphosphonates, radiation therapy, percutaneous vertebroplasty (PV) and balloon kyphoplasty. The aim of this study was to evaluate the efficacy and safety of PV in patients with SML. Patients and Methods: Patients with SML not responsive to medical treatment were eligible. The presence of fracture or vertebral collapse was evaluated by a rheumatologist and/or radiologist and performed by an interventionist radiologist. In some cases, more than one vertebra was treated in the same procedure. Pain response was evaluated by a qualitative scale at 24 hours, 1 and 6 months after PV. Results:Nineteen PV were performed in 15 patients. The most frequent localization of the 38 vertebras treated was L3. The evaluation of pain at 24 hours, 1 and 6 months after PV, showed improvement in 79%, 47% and 37% of cases, respectively. The incidence of cement leakage was 47%. Four out of 15 patients developed severe complications: 1 psoas hematoma, 1 death by respiratory failure of unknown etiology and 2 pulmonary embolism (one patient died because of a cement pulmonary embolism). Conclusions: PV is an easy technique for SML not responsive to medical treatment that results in immediate pain relief in 79% of patients. Severe clinical complications secondary to cement leakage can be observed in 4 out of 15 of patients, with some being life-threatening. These results suggest that PV can be useful in acute SML treatment but further studies should be undertaken to confirm the efficacy and the incidence of adverse effects. AD - A. Angona, Hematology. Parc De Salut Mar, Barcelona, Spain AU - Angona, A. AU - Abella, E. AU - Serra, J. AU - Solano, A. AU - Ares, J. AU - Gimeno, E. AU - Tena, J. AU - Pedro, C. AU - Alvarez-Larran, A. AU - Saumell, S. AU - Salar, A. AU - Jimenez, C. AU - Ciria, M. AU - Besses, C. DB - Embase KW - cement bisphosphonic acid derivative myeloma percutaneous vertebroplasty human patient workshop radiologist therapy lung embolism vertebra analgesia pain iliopsoas hematoma safety kyphoplasty procedures adverse drug reaction rheumatology fracture etiology respiratory failure death radiotherapy L1 - http://haematologica.org/content/96/supplement_1/S1.full-text.pdf+html LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 0390-6078 SP - S59-S60 ST - Percutaneous vertebroplasty in patients with spinal myeloma lesions (SML) T2 - Haematologica TI - Percutaneous vertebroplasty in patients with spinal myeloma lesions (SML) UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71694929&from=export VL - 96 ID - 829620 ER - TY - JOUR AB - Purpose Percutaneous vertebroplasty (PV) is a minimally invasive procedure involving the injection of bone cement within a collapsed vertebral body. Although this procedure was demonstrated to be effective in osteoporosis and metastases, few studies have been reported in cases of multiple myeloma (MM). We prospectively evaluated the safety and efficacy of PV in the treatment of vertebral compression fractures (VCFs) resulting from MM. Materials and Methods PV was performed in 106 consecutive MM patients who had back pain due to VCFs, the treatment of which had failed conservative therapies. Follow-up (28.2 +/- 12.1 months) was evaluated at 7 and 15 days as well as at 1, 3, 6, 12, 18, and every 6 months after PV. Visual analog scale (VAS) pain score, opioid use, external brace support, and Oswestry Disability Index (ODI) score were recorded. Results The median pretreatment VAS score of 9 (range 4-10) significantly (P < 0.001) decreased to 1 (range 0-9) after PV. Median pre-ODI values of 82% (range 36-89%) significantly improved to 7% (range 0-82%) (P < 0.001). Differences in pretreatment and posttreatment use of analgesic drug were statistically significant (P < 0.001). The majority of patients (70 of 81; 86%) did not use an external brace after PV (P < 0.001). Conclusion PV is a safe, effective, and long-lasting procedure for the treatment of vertebral compression pain resulting from MM. AD - [Anselmetti, Giovanni Carlo; Manca, Antonio; Chiara, Gabriele; Iussich, Gabriella] Inst Canc Res & Treatment, Intervent Radiol Unit, I-10060 Turin, Italy. [Hirsch, Joshua] Massachusetts Gen Hosp, Boston, MA 02114 USA. [Montemurro, Filippo; Grignani, Giovanni; Schianca, Fabrizio Carnevale; Capaldi, Antonio; Scalabrini, Delia Rota] Inst Canc Res & Treatment, Oncol Unit, I-10060 Turin, Italy. [Sardo, Elena; Debernardi, Felicino] Inst Canc Res & Treatment, Anesthesiol Unit, I-10060 Turin, Italy. [Regge, Daniele] Inst Canc Res & Treatment, Radiol Unit, I-10060 Turin, Italy. Anselmetti, GC (corresponding author), Inst Canc Res & Treatment, Intervent Radiol Unit, I-10060 Turin, Italy. giovanni.anselmetti@ircc.it; anto.manca@gmail.com; filippo.montemurro@ircc.it; jahirschmd@yahoo.com; chiaragabriele@gmail.com; giovanni.grignani@ircc.it; fabrizio.carnevale@ircc.it; antonio.capaldi@ircc.it; delia.rotascalabrini@ircc.it; elena.sardo@ircc.it; felicino.debernardi@ircc.it; gabriellaiussich@yahoo.com; daniele.regge@ircc.it AN - WOS:000304161900016 AU - Anselmetti, G. C. AU - Manca, A. AU - Montemurro, F. AU - Hirsch, J. AU - Chiara, G. AU - Grignani, G. AU - Schianca, F. C. AU - Capaldi, A. AU - Scalabrini, D. R. AU - Sardo, E. AU - Debernardi, F. AU - Iussich, G. AU - Regge, D. DA - Feb DO - 10.1007/s00270-011-0111-4 J2 - Cardiovasc. Interv. Radiol. KW - Vertebroplasty Myeloma Pain treatment Interventional radiology Quality of Life VERTEBRAL COMPRESSION FRACTURES ZOLEDRONIC ACID SKELETAL COMPLICATIONS FAT-EMBOLISM CHRONIC PAIN KYPHOPLASTY METASTASES EFFICACY THERAPY CANCER Cardiac & Cardiovascular Systems Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2012 SN - 0174-1551 SP - 139-145 ST - Percutaneous Vertebroplasty in Multiple Myeloma: Prospective Long-Term Follow-Up in 106 Consecutive Patients T2 - Cardiovascular and Interventional Radiology TI - Percutaneous Vertebroplasty in Multiple Myeloma: Prospective Long-Term Follow-Up in 106 Consecutive Patients UR - ://WOS:000304161900016 VL - 35 ID - 830313 ER - TY - JOUR AB - INTRODUCTION: Balloon kyphoplasty is a recently introduced procedure for the treatment of vertebral compression fractures, especially from osteoporosis, tumors and burst fractures. With the increase in frequency of procedures being performed more complications from kyphoplasty are seen. The risk of pulmonary embolism ranges from 3.5% to 23% for osteoporotic fractures. We report a case of an asymptomatic cement pulmonary embolism following a balloon kyphoplasty procedure. CASE PRESENTATION: An 82 year old woman was admitted for a dorsal spine wound infection and was found to have an abnormal chest x-ray. She has a past medical history of osteoporosis, hypertension, hypercholesterolemia and multiple vertebral compression fractures for which she had undergone a kyphoplasty of L3 and L4 8 weeks prior to admission. She had no respiratory complaints or weight loss. Oxygen saturation was 98% on room air. Her lung exam was clear to auscultation bilaterally. The only significant physical finding was related to her back where she had a foul smelling wound. Chest x-ray revealed multiple tubular filling defects in the right and left pulmonary arteries in comparison to her chest x -ray pre-kyphoplasty which was normal. Subsequently, a CT scan of her chest was performed which showed multiple filling defects with HU of 2600 consistent with pulmonary cement embolism. DISCUSSION: This case presents a case of post kyphoplasty pulmonary cement embolism. Although most leaks are asymptomatic there are case reports of fatalities. Cement leakage is the most frequent complication after percutaneous kyphoplasty. Due to the risk for radiation exposure, chest x-rays after kyphoplasty are not usually performed. In asymptomatic peripheral cement embolism the recommendation is to follow clinically and not anticoagulate. In cases of central or peripheral symptomatic cement embolism it is recommended to anticoagulate for 6 months. CONCLUSIONS: Physicians should be aware of the possibility of cement embolism following both kyphoplasty and vertebroplasty. A routine chest x-ray postprocedure may be of value in evaluating the incidence of pulmonary cement embolism. As with our patient, most cases are without respiratory complaints and there is no need to start anticoagulation for asymptomatic cement embolism when diagnosed on chest x-ray. However, the recommendation for treatment of symptomatic cement embolism is anticoagulation. Diagnosis of cement embolism on a routine post-kyphoplasty chest x-ray may initiate appropriate treatment earlier including close clinical follow up for incidental asymptomatic emboli. AD - G. Apergis, SUNY Downstate Medical Center, Brooklyn, NY, United States AU - Apergis, G. AU - Lagzdins, M. AU - Soueidan, A. DB - Embase DO - 10.1378/chest.1114492 KW - cement embolism kyphoplasty thorax radiography human procedures lung embolism compression fracture osteoporosis risk case report anticoagulation hypertension hypercholesterolemia body weight loss oxygen saturation ambient air auscultation smelling wound pulmonary artery computer assisted tomography fatality radiation exposure lung thorax percutaneous vertebroplasty patient diagnosis follow up neoplasm fracture fragility fracture female spine wound infection medical history physician L1 - http://chestjournal.chestpubs.org/cgi/content/meeting_abstract/140/4_MeetingAbstracts/8A?sid=1f672739-27e3-41bc-a5ce-9ba98a1c0c70 LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 0012-3692 ST - Asymptomatic pulmonary cement emboli T2 - Chest TI - Asymptomatic pulmonary cement emboli UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70634363&from=export http://dx.doi.org/10.1378/chest.1114492 VL - 140 ID - 829609 ER - TY - JOUR AB - Vertebral angioma is a common bone tumor. We report a case of L1 vertebral angioma revealed by type A3.2 traumatic pathological fracture of the same vertebra. Management comprised emergency percutaneous osteosynthesis and, after stabilization of the multiple trauma, arterial embolization and percutaneous kyphoplasty. AD - Neurosurgery Deptartment, Timone Hospital, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France. AN - 23453277 AU - Armaganian, G. AU - Adetchessi, T. AU - Pech-Gourg, G. AU - Blondel, B. AU - Dufour, H. AU - Fuentes, S. DA - Apr DO - 10.1016/j.otsr.2012.12.016 DP - NLM ET - 2013/03/05 J2 - Orthopaedics & traumatology, surgery & research : OTSR KW - Adult Combined Modality Therapy Embolization, Therapeutic Fracture Fixation, Internal Fractures, Spontaneous/*surgery Hemangioma/*complications/surgery Humans Kyphoplasty *Lumbar Vertebrae Male Multiple Trauma/*surgery Spinal Fractures/*complications/surgery Spinal Neoplasms/*complications/surgery Tomography, X-Ray Computed LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1877-0568 SP - 241-6 ST - L1 burst fracture with associated vertebral angioma T2 - Orthop Traumatol Surg Res TI - L1 burst fracture with associated vertebral angioma VL - 99 ID - 828874 ER - TY - JOUR AD - Cardiac Surgery Department, University Hospital of Salamanca, , Salamanca, Spain. AN - 24150665 AU - Arnáiz-García, M. E. AU - Dalmau-Sorlí, M. J. AU - González-Santos, J. M. DA - Apr DO - 10.1136/heartjnl-2013-304583 DP - NLM ET - 2013/10/24 J2 - Heart (British Cardiac Society) KW - Aged Bone Cements/*adverse effects Female Foreign-Body Migration/*etiology Humans Intraoperative Complications/*etiology Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/*etiology *Vertebroplasty/methods Cardiac Surgery LA - eng M1 - 7 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1355-6037 SP - 600 ST - Massive cement pulmonary embolism during percutaneous vertebroplasty T2 - Heart TI - Massive cement pulmonary embolism during percutaneous vertebroplasty VL - 100 ID - 828870 ER - TY - JOUR AB - Interventional radiology employs image-guided techniques to perform minimally invasive procedures for diagnosis and treatment. Interventional radiology is often used to place central venous catheters and subcutaneous ports, with some evidence of benefit over surgical placement. Arterial embolization procedures are used to manage many types of hemorrhage and are highly effective for severe postpartum hemorrhage. Vascular interventions, such as endovascular treatment of varicosities, acute limb ischemia, and pulmonary embolism, are superior to surgical interventions. For chronic limb ischemia and deep venous thrombosis, the choice of therapy is not as clear. Inferior vena cava filters can be placed and removed endovascularly, but there is a significant risk of complications that increases over time. Vascular interventions can be effective for scrotal varicocele and uterine fibroids, although fibroid treatment is limited by high recurrence rates. Image-guided percutaneous drainage and biopsy have become standard of care. Interventional approaches are being used in oncology for local diagnosis and treatment. Percutaneous ablation and targeted delivery of chemotherapy and radiation therapy are being developed as alternatives when surgery is not practical. Vertebroplasty and kyphoplasty provide significant pain and functional improvement in patients with spinal metastases. AD - Uniformed Services University of the Health Sciences, Bethesda, Maryland. Walter Reed National Military Medical Center, Bethesda, Maryland. AN - 135920727. Language: English. Entry Date: 20200306. Revision Date: 20200306. Publication Type: journal article AU - Arnold, Michael J. AU - Keung, Jonathan J. AU - McCarragher, Brent DB - cin20 DP - EBSCOhost KW - Radiography, Interventional -- Methods Specialties, Medical -- Methods Catheterization -- Methods Female Male Practice Guidelines Surgery, Cardiovascular -- Equipment and Supplies Embolization, Therapeutic -- Equipment and Supplies Neoplasms -- Radiotherapy Clinical Assessment Tools M1 - 9 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2019 SN - 0002-838X SP - 547-556 ST - Interventional Radiology: Indications and Best Practices T2 - American Family Physician TI - Interventional Radiology: Indications and Best Practices UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=135920727&site=ehost-live&scope=site VL - 99 ID - 830531 ER - TY - JOUR AB - Fat embolization syndrome is a well-known complication associated with total hip arthroplasty. It is believed to be caused by high intramedullary pressures that occur during cement pressurization and femoral stem placement. Fat embolization syndrome has also been reported with intramedullary reaming and placement of an intramedullary alignment guide during total knee arthroplasty. To our knowledge, there have not been previous reports of fatal fat emboli as a result of uncemented hip arthroplasty. The purpose of this case report is to describe a fatality due to fat embolization following a noncemented bipolar arthroplasty. AD - Creighton/Nebraska Health Foundation Orthopaedic Residency Program. AN - 7964778 AU - Arroyo, J. S. AU - Garvin, K. L. AU - McGuire, M. H. DA - Aug DO - 10.1016/0883-5403(94)90057-4 DP - NLM ET - 1994/08/01 J2 - The Journal of arthroplasty KW - Aged Aged, 80 and over Embolism, Fat/*etiology Fatal Outcome Femur Head/injuries Hip Fractures/surgery *Hip Prosthesis Humans Male Postoperative Complications/*etiology Prosthesis Design LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 1994 SN - 0883-5403 (Print) 0883-5403 SP - 449-52 ST - Fatal marrow embolization following a porous-coated bipolar hip endoprosthesis T2 - J Arthroplasty TI - Fatal marrow embolization following a porous-coated bipolar hip endoprosthesis VL - 9 ID - 828537 ER - TY - JOUR AB - Bone augmentation is a preventative osteoporosis intervention, comprising the injection of bone cement into an osteoporotic bone. As injection of excessive amounts of bone cement may result into thermal necrosis of bone tissue or even embolism, the minimum cement volume required to achieve a predefined level of augmentation must be sought. To this end, the present paper introduces a new evolutionary optimization method, applicable to any osteoporotic bone. The method was numerically evaluated through a typical case of femoral augmentation and compared to another powerful optimization method. The results demonstrate the efficiency and low computational cost of the proposed method. AD - [Artiles, Maria E. Santana; Venetsanos, Demetrios T.] Univ Kingston, Sch Mech & Automot Engn, London, England. Venetsanos, DT (corresponding author), Univ Kingston, Sch Mech & Automot Engn, London, England. D.Venetsanos@kingston.ac.uk AN - WOS:000399353100001 AU - Artiles, M. E. S. AU - Venetsanos, D. T. DO - 10.1080/10255842.2017.1291805 J2 - Comput. Methods Biomech. Biomed. Eng. KW - Bone augmentation femoroplasty osteoporosis optimization evolutionary method PROXIMAL FEMUR COMPRESSION FRACTURES PERCUTANEOUS VERTEBROPLASTY STRUCTURAL OPTIMIZATION MECHANICAL-BEHAVIOR CEMENT AUGMENTATION FEMOROPLASTY VERTEBRAE STRENGTH FAILURE Computer Science, Interdisciplinary Applications Engineering, Biomedical LA - English M1 - 7 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2017 SN - 1025-5842 SP - 691-700 ST - A new evolutionary optimization method for osteoporotic bone augmentation T2 - Computer Methods in Biomechanics and Biomedical Engineering TI - A new evolutionary optimization method for osteoporotic bone augmentation UR - ://WOS:000399353100001 VL - 20 ID - 830199 ER - TY - JOUR AB - INTRODUCTION: Knee-replacement surgery is frequently done and highly successful. It relieves pain and improves knee function in people with advanced arthritis of the joint. A rotating-hinge total knee prosthesis may be utilized for the treatment of global instability or severe bone loss around the knee. The outcome of primary total knee arthroplasty (TKA) using Endo-Modell 3(Link) rotating-hinge prosthesis was evaluated.1 CASE REPORT: We would like to present five patients that have undergone constraints TKA for severe osteoarthritis as primary fixation. Most of the patients had very bad deformity of the knee and had minimal extension capabilities. The prolonged lack of immobilization of their knees lead to osteoporosis. TKA was done using LINK Endo-Model and a total of four packets of cement was used for each case. Cement was used in view of osteoporotic bone. Four of the patients have acceptable range of movement and have started back their activity of daily living. Koss-Jr scoring was used to evaluate post operative outcome3 (Table Parsented) DISCUSSIONS: One of our patients developed bone cement implantation syndrome and we managed it with over-hydration and high FiO22. Subsequent patients were all managed with over-hydration preoperative and postoperative with close monitoring of fluid input and output. All other patients were free from bone cement implantation syndrome. CONCLUSION: TKA with a rotating-hinge total knee prosthesis provided substantial improvement in function and reduction in pain. The use of cement may lead to increase risk of fat and cement embolization and close monitoring or steps must me taken to reduce the risk of these complications2. We propose that a rotating-hinge total knee prosthesis may be utilized for the treatment of global instability or severe bone loss around the knee. AD - S.S. Arunjit, Mohan Department of Orthopedics, Hospital Taiping, Jalan Taming Sari, Taiping, Perak, Malaysia AU - Arunjit, S. S. DB - Embase KW - bone cement adult artificial embolization case report clinical article complication conference abstract daily life activity deformity female human hydration immobilization implantation male monitoring osteoarthritis osteolysis osteoporosis pain range of motion rotating hinge knee prosthesis surgery total knee arthroplasty LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1985-2533 ST - Primary constraint total knee arthroplasty as primary fixation for severely deformed knees T2 - Malaysian Orthopaedic Journal TI - Primary constraint total knee arthroplasty as primary fixation for severely deformed knees UR - https://www.embase.com/search/results?subaction=viewrecord&id=L623053300&from=export VL - 11 ID - 829289 ER - TY - JOUR AB - Nonthrombotic pulmonary embolism (NTPE) is a complete or partial occlusion of the pulmonary vasculature by various organic and inorganic materials. These materials include organic particulate matter (PM) such as adipocytes, tumor cells, bacteria, fungi, or gas and inorganic PM. Although NTPE due to organic PM has been extensively reported in the medical literature, there are no comprehensive reviews of inorganic material embolizing to the lungs. The purpose of this article is to examine the current literature describing NTPE resulting from inorganic PM and foreign bodies. Cases of NTPE are uncommon and often difficult to diagnose. The diagnosis is challenging due to its varied presentation, clinical features, and unusual radiologic features. In contrast to the “classic” pulmonary thromboembolism, the pathophysiologic effects of embolism by PM are not only mechanical but also a consequence of the nature of the offending material. NTPE caused by these substances can be relatively innocuous, life-threatening, or lead to chronic pulmonary disease, if left undetected. We hope that the heightened sense of awareness of this entity may allow earlier diagnosis and recognition of its complications. AD - A.C. Mehta, Department of Pulmonary Medicine, Respiratory Institute, Cleveland Clinic, Desk A90, 9500 Euclid Ave, Cleveland, OH, United States AU - Asah, D. AU - Raju, S. AU - Ghosh, S. AU - Mukhopadhyay, S. AU - Mehta, A. C. DB - Embase Medline DO - 10.1016/j.chest.2018.02.013 KW - central venous catheter guide wire silicone breast implant bone cement iodinated poppyseed oil fibrin iodine 125 poly(methyl methacrylate) silicone talc yttrium 90 artificial embolization chronic lung disease clinical feature computer assisted tomography early diagnosis foreign body granulomatosis human lung calcification lung embolism non invasive procedure nonthrombotic pulmonary embolism nuclear magnetic resonance imaging particulate matter pathophysiology priority journal prostate cancer pulmonary arteriovenous fistula radiodiagnosis review thorax radiography LA - English M1 - 5 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1931-3543 0012-3692 SP - 1249-1265 ST - Nonthrombotic Pulmonary Embolism From Inorganic Particulate Matter and Foreign Bodies T2 - Chest TI - Nonthrombotic Pulmonary Embolism From Inorganic Particulate Matter and Foreign Bodies UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2000683965&from=export http://dx.doi.org/10.1016/j.chest.2018.02.013 VL - 153 ID - 829195 ER - TY - JOUR AB - Background: Transcatheter coil embolization of collateral vessel such as aortopulmonary shunt (APS) and vena cava to pulmonary vein fistula is established procedure. However, it comes technically difficult when those vessels have a complex form. Also sometimes it requires many coils. As a result catheter intervention tend to be a time and money consuming procedure. N-butyl-2-cyanoacrylate (NBCA) is a monomeric acrylic glue that polymerizes rapidly when brought into contact with ionic media such as blood, and produces permanent occlusion. Utility of NBCA as an embolization material has already confirmed especially in nerouvascular area however, there are few published data that noted about its utility in congenital heart disease. Aim: To evaluate an utility of NBCA as an embolization material for collateral vessels in functional single ventricle patients. Case 1: Three year-old boy with Double outlet RV, MS and multiple VSD underwent TCPC at 29 months of age. We performed cardiac catheterization just before TCPC. Numerous APSs were detected by right IMA angiography. We embolized APSs with Target Coil. 360 Ultra 4mm × 6 cm was detained at distal side of right IMA. After coil detainment, we inserted microcatheter and infused 50% NBCA quickly. We confirmed complete right IMA occlusion. Case 2: Two-year-old girl with polysplenia, double outlet RV and multiple VSD. We underwent TCPS at 14 months of age. We performed cardiac catheterization just before TCPC operation. We confirmed SVC to pulmonary vein fistula. Eleven Coils were detained at distal of SVC-PV fistula. Then we inserted microcatheter to proximal side of fistula and inject NBCA quickly and fistula was completely collapsed. Arterial O2 saturation raise up from 82 to 86% Conclusions: We achieved complete embolization of collateral vessels with coils and emulsion of NBCA in functional single ventricle patients. Embolization with NBCA may be attractive, especially for complex and small caliber vessels. AD - K. Aso, St. Marianna University, School of Medicine, Pediatrics, Kawasaki, Japan AU - Aso, K. AU - Osada, Y. AU - Sakurai, K. AU - Mizuno, M. AU - Tsuzuki, Y. AU - Goto, K. DB - Embase DO - 10.1017/S104795111700110X KW - enbucrilate poly(methyl methacrylate) accessory spleen angiography aortopulmonary shunt arterial oxygen saturation artificial embolization case report child emulsion female fistula girl heart catheterization heart single ventricle human infant male microcatheter money polymerization preschool child pulmonary vein LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1467-1107 SP - S392 ST - Transcatheter embolization of collateral vessels using n butyl 2 cyanoacrylate in functional single ventricle patients T2 - Cardiology in the Young TI - Transcatheter embolization of collateral vessels using n butyl 2 cyanoacrylate in functional single ventricle patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L620076056&from=export http://dx.doi.org/10.1017/S104795111700110X VL - 27 ID - 829246 ER - TY - JOUR AB - Purpose: The purpose of this study is to analyze the results of intramedullary fixation of pathological humeral shaft fractures using an unreamed humeral nail (UHN). Patients & Methods: Twenty-one consecutive patients with 24 humeri fractured secondary to metastatic disease were retrospectively reviewed. The primary tumors included carcinomas of breast (11), kidney (2), multiple myeloma (2), colon (2), prostate (1), thyroid (1), lymphoma (1) and unknown origin (1). All fractures were stabilized with antegrade unreamed humeral nailing. Cemented technique was performed in 5 procedures. The mean age was 64 (range, 40-86), male to female ratio 6:15. Results: Blood loss was unremarkable in 19 patients (22 procedures). Two patients who underwent fixation of additional pathological fractures during the same operation were given a total of 3 units of PC perioperatively. Mean postoperative hospitalization period due to one UHN procedure alone was 3 days (range, 2-7 days). Two patients died of their disease within 3 weeks of surgery. The remaining 19 patients returned to nearly normal function within 6 weeks after nailing. One patient developed postoperative local wound cellulitis. Relief of pain was rated as good in all but one patient. Adjuvant therapy was given in 20 procedures. Bony union was achieved in 88% (15/17) of all the cases where the patient had survived a minimum of 3 months. Conclusion: Unreamed humeral nailing of the pathological humeral shaft fractures provides immediate stability and pain relief, minimum morbidity and early return of function to the extremity. AD - Hebrew Univ Jerusalem, Hadassah Med Ctr, Dept Orthopaed Surg, IL-91120 Jerusalem, Israel. Hebrew Univ Jerusalem, Hadassah Med Ctr, Dept Oncol, IL-91120 Jerusalem, Israel. Peyser, A (corresponding author), Hebrew Univ Jerusalem, Hadassah Med Ctr, Dept Orthopaed Surg, POB 12000, IL-91120 Jerusalem, Israel. peysera@hadassah.org.il AN - WOS:000245362300032 AU - Atesok, K. AU - Liebergall, M. AU - Sucher, E. AU - Temper, M. AU - Mosheiff, R. AU - Peyser, A. DA - Apr DO - 10.1245/s10434-006-9257-8 J2 - Ann. Surg. Oncol. KW - pathological humeral shaft fractures unreamed humeral nailing perioperative morbidity pain relief function METASTATIC BONE-DISEASE EMBOLIZATION MANAGEMENT Oncology Surgery LA - English M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2007 SN - 1068-9265 SP - 1493-1498 ST - Treatment of pathological humeral shaft fractures with unreamed humeral nail T2 - Annals of Surgical Oncology TI - Treatment of pathological humeral shaft fractures with unreamed humeral nail UR - ://WOS:000245362300032 VL - 14 ID - 830396 ER - TY - JOUR AB - Percutaneous vertebroplasty is an accepted treatment for painful vertebral compression fractures caused by osteoporosis and malignant disease. Venous leakage of cement and pulmonary cement embolism have been reported complications. We describe a paravertebral venous cement leak resulting in the deposition of a cement cast in the inferior vena cava and successful retrieval of the cement embolus. AD - Department of Radiology, St. Joseph's Healthcare, Hamilton, Ontario, Canada. sathreya@stjoes.ca AN - 19333651 AU - Athreya, S. AU - Mathias, N. AU - Rogers, P. AU - Edwards, R. DA - Jul DO - 10.1007/s00270-009-9550-6 DP - NLM ET - 2009/04/01 J2 - Cardiovascular and interventional radiology KW - Bone Cements/*adverse effects Extravasation of Diagnostic and Therapeutic Materials/diagnostic imaging/*therapy Female Fluoroscopy Humans Lumbar Vertebrae/*surgery Middle Aged Spinal Fractures/*surgery *Vena Cava Filters *Vena Cava, Inferior LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0174-1551 SP - 817-9 ST - Retrieval of cement embolus from inferior vena cava after percutaneous vertebroplasty T2 - Cardiovasc Intervent Radiol TI - Retrieval of cement embolus from inferior vena cava after percutaneous vertebroplasty VL - 32 ID - 828872 ER - TY - JOUR AB - Percutaneous vertebroplasty is an accepted treatment for painful vertebral compression fractures caused by osteoporosis and malignant disease. Venous leakage of cement and pulmonary cement embolism have been reported complications. We describe a paravertebral venous cement leak resulting in the deposition of a cement cast in the inferior vena cava and successful retrieval of the cement embolus. AD - Department of Radiology, St. Joseph's Healthcare, Hamilton, Ontario, Canada Department of Radiology, St. Joseph's Healthcare, Hamilton, Ontario, Canada. sathreya@stjoes.ca AN - 105221241. Language: English. Entry Date: 20100115. Revision Date: 20170802. Publication Type: journal article AU - Athreya, S. AU - Mathias, N. AU - Rogers, P. AU - Edwards, R. AU - Athreya, S. AU - Mathias, N. AU - Rogers, P. AU - Edwards, R. DB - cin20 DO - 10.1007/s00270-009-9550-6 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Extravasation of Diagnostic and Therapeutic Materials -- Therapy Lumbar Vertebrae -- Surgery Spinal Fractures -- Surgery Vena Cava Filters Vena Cava, Inferior Extravasation of Diagnostic and Therapeutic Materials -- Radiography Extravasation of Diagnostic and Therapeutic Materials -- Radiotherapy Female Fluoroscopy Middle Age M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0174-1551 SP - 817-819 ST - Retrieval of cement embolus from inferior vena cava after percutaneous vertebroplasty T2 - CardioVascular & Interventional Radiology TI - Retrieval of cement embolus from inferior vena cava after percutaneous vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105221241&site=ehost-live&scope=site VL - 32 ID - 830726 ER - TY - JOUR AB - Purpose: The acetabular reinforcement ring with a hook (ARRH) has been designed for acetabular total hip arthroplasty (THA) revision. Additionally, the ARRH offers several advantages when used as a primary implant especially in cases with altered acetabular morphology. The implant facilitates anatomic positioning by placing the hook around the teardrop and provides a homogenous base for cementing the polyethylene cup. Therefore, the implant has been widely used in primary total hip arthroplasty at our institution. The present study reports the long-term outcome of the ARRH after a minimum follow-up of 20 years. Methods: Two hundred and ten patients with 240 primary THAs performed between April 1987 and December 1991 using the ARRH were retrospectively reviewed after a minimum follow-up of 20 years. Twenty-three of 240 hips were lost to follow-up, 110 patients with 124 THAs had deceased without having a revision surgery performed. This left 93 hips for final evaluation. Of those, 75 hips were assessed clinically and radiographically after a mean follow-up of 23.1 years (range 21.1–26.1 years). In 18 cases, clinical and radiographic assessment was omitted because implant revision had been performed prior to the follow-up investigation. The primary endpoint was defined as revision for aseptic loosening. Results: Out of the 93 hips available for final evaluation, 14 hips were revised for aseptic loosening; another four were revised for other reasons (deep infection n = 2, recurrent dislocation n = 2). The survival probability of the cup was 0.96 (95% confidence interval 0.93–0.99) after 20 years with aseptic loosening as endpoint. Radiographic analysis of the surviving 75 hips showed at least one sign of radiographic loosening in 24 hips. The mean Merle d’Aubigne score increased from 8 points pre-operatively to 15 points at final follow-up (7.5 ± 1.8 vs 15.0 ± 2.3, p < 0.001). The mean HHS was 85 ± 14 at final follow-up. Radiographic loosening did not correlate with the clinical outcome. Conclusions: The long-term results of the ARRH in primary THA are comparable to results with standard cemented cups and modern cementless cups. We believe that the ARRH is a versatile implant for primary THA, especially in cases with limited acetabular coverage and altered acetabular bone stock where the ARRH provides sufficient structural support for a cemented cup. AD - F.M. Klenke, Department of Orthopaedic Surgery, Inselspital, Bern University Hospital, Switzerland, Freiburgstrasse 3, Bern, Switzerland AU - Attinger, M. C. AU - Haefeli, P. C. AU - Bäcker, H. C. AU - Flueckiger, R. AU - Ballmer, P. M. AU - Siebenrock, K. A. AU - Klenke, F. M. DB - Embase Medline DO - 10.1007/s00264-018-04284-9 KW - acetabular reinforcement ring with a hook acetabulum prosthesis polyethylene adult aged article avascular necrosis clinical outcome deep vein thrombosis female femoral neck fracture femur intertrochanteric osteotomy femur trochanteric fracture follow up Harris hip score hip dysplasia hip osteoarthritis hip osteotomy human lung embolism major clinical study male neuroma open reduction (procedure) osteosynthesis outcome assessment overall survival postoperative complication preoperative evaluation priority journal prosthesis loosening recurrent dislocation retrospective study revision arthroplasty rheumatoid arthritis survival rate survival time total hip replacement LA - English M1 - 12 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1432-5195 0341-2695 SP - 2697-2705 ST - The Ganz acetabular reinforcement ring shows excellent long-term results when used as a primary implant: a retrospective analysis of two hundred and forty primary total hip arthroplasties with a minimum follow-up of twenty years T2 - International Orthopaedics TI - The Ganz acetabular reinforcement ring shows excellent long-term results when used as a primary implant: a retrospective analysis of two hundred and forty primary total hip arthroplasties with a minimum follow-up of twenty years UR - https://www.embase.com/search/results?subaction=viewrecord&id=L626087329&from=export http://dx.doi.org/10.1007/s00264-018-04284-9 VL - 43 ID - 829101 ER - TY - JOUR AB - BACKGROUND: Intracardiac leakage of bone cement after kyphoplasty and vertebroplasty is a rare and life-threatening complication. Cortoss, which is an injectable, non-absorbable, polymer composite that is designed to mimic cortical bone, can be used instead of cement. Here, we present the case of a patient with right intra-cardiac Cortoss embolization. CASE REPORT: A 28-year-old man known to have ulcerative colitis since the age of 15 and treated with corticosteroids for more than 4 years and with anti-immune drugs presented to our hospital complaining of back pain and decreased body height due to osteomalacia with failed conservative treatment. Kyphoplasty and vertebroplasty of the thoracic 10-12 and first lumbar vertebrae were done with any complications. Three months later, the patient underwent kyphoplasty and vertebroplasty of lumbar 2-5 vertebrae by injecting Cortoss instead of cement, which was complicated with paravertebral intravascular leakage. We stopped surgery and transferred him to the recovery room, where he had slight chest pain that resolved spontaneously without neurological deficit. Two days later he developed severe chest pain and chest X-ray showed a large white shadow at the right side of the heart and another 2 small shadows just lateral to it. Sudden deterioration of patient status necessitated an emergency echocardiogram, which showed pericardial tamponade and a perforated right ventricle. Aspiration of pericardial blood and emergency open heart surgery were done. He was discharged 4 days later and was followed up at an outpatient clinic. CONCLUSIONS: Cardiac embolism is a serious condition that can complicate vertebral kyphoplasty; it requires a high level of suspicion and immediate action, and may need open heart surgery to save the patient's life. AD - Department of Orthopedic, King Abdullah University Hospital, Irbid, Jordan. Department of Neuroscience, King Fahd Medical City, Riyadh, Saudi Arabia. Department of Orthopedics, King Abdullah University Hospital, Irbid, Jordan. AN - 27173447 AU - Audat, Z. A. AU - Alfawareh, M. D. AU - Darwish, F. T. AU - Alomari, A. A. C2 - Pmc4917077 DA - May 13 DO - 10.12659/ajcr.897719 DP - NLM ET - 2016/05/14 J2 - The American journal of case reports KW - Adult Bisphenol A-Glycidyl Methacrylate Embolism/*etiology Foreign-Body Migration/*etiology Heart Diseases/*etiology Humans Intraoperative Complications Kyphoplasty/*adverse effects Male Vertebroplasty/*adverse effects LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1941-5923 SP - 326-30 ST - Intracardiac Leakage of Cement During Kyphoplasty and Vertebroplasty: A Case Report T2 - Am J Case Rep TI - Intracardiac Leakage of Cement During Kyphoplasty and Vertebroplasty: A Case Report VL - 17 ID - 828623 ER - TY - JOUR AB - We describe a female neonate with clinical features of neonatal suffering who underwent trans-fontanelle ultrasound scan. Ultrasound disclosed a hyperchoic expanding lesion, confirmed by subsequent MR scan which revealed large vascular structures and signs of bleeding within the lesion. Angiography was problematic given the weight of the neonate, the small vascular structures and the choice of angiographic materials. Three large vessels feeding the lesion were detected. Embolization was undertaken using acrylic glue to obtain rapid devascularization with a straightforward technique and minimum use of contrast medium and fluids in general. AD - S. Avignone, Neuroradiologia Diagnostica e Terap., I.R.C.C.S. Osp. Maggiore Policlinico, 20122 Milano, Italy AU - Avignone, S. AU - Cinnante, C. AU - Branca, V. DB - Embase KW - acrylic cement contrast medium glue angiography artificial embolization brain disease brain injury case report cavernous hemangioma clinical feature conference paper contrast enhancement devascularization echoencephalography female human interventional radiology newborn nuclear magnetic resonance imaging preoperative treatment LA - Italian M1 - 3 M3 - Conference Paper N1 - Embase Elsevier literature search January 5, 2021 PY - 2003 SN - 1120-9976 SP - 431-434 ST - Presurgical endovascular treatment of a neonatal cavernoma using acrylic glue: A case report T2 - Rivista di Neuroradiologia TI - Presurgical endovascular treatment of a neonatal cavernoma using acrylic glue: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L37237907&from=export VL - 16 ID - 829854 ER - TY - JOUR AB - SESSION TITLE: Monday Medical Student/Resident Case Report Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM INTRODUCTION: Pulmonary cement embolism (PCE) refers to embolization of polymethyl methacrylate into the lungs. Patients are most often asymptomatic, but reports have been made were patients present symptomatically after PCE. We report a case of a 61-year-old man who had a vertebral kyphoplasty and presented 2 days later with acute onset respiratory distress and found to have a fatal PCE in the setting of multiple comorbidities. CASE PRESENTATION: 61-year-old male with medical history of HIV, DM, HTN, ESRD on HD, presented with worsening back pain. The back pain started after a mechanical fall. Imaging revealed a T12 burst fracture.Patient underwent an uncomplicated kyphoplasty of T11, T12, L1 vertebrae, did well post-operatively and was discharged. Patient presented back to ED on same day of discharge with complaints of acute onset shortness of breath. On arrival, Patient appeared in severe respiratory distress. His physical examination was remarkable for decreased breath and crackles bilaterally. Due to increased work of breathing, he was intubated and placed on mechanical ventilation in the ED. Initial CXR showed increased hyperdense perihilar opacities. The clinical presentation was concerning for embolic vertebroplasty material (IMG1). This was confirmed with a CTA (IMG2) which reported extensive vertebroplasty cement embolism to the pulmonary arteries and enlargement of the pulmonary arteries. Patient was admitted to the ICU for mechanical ventilation and open cardiac surgery to remove cement from the lungs was considered, but patients status continued to deteriorate in the following 24 hours. He was hemodynamically unstable requiring large doses of vasopressors and requiring immediate hemodialysis. Patient had an episode of PEA arrest after which family decide to withdraw care. DISCUSSION: In this case, a Chest X ray showed pulmonary infiltrates and an increase in perihiliar opacities compatible with embolic vertebroplasty at the ER after 72 hours post procedure. Although most patients remain asymptomatic according to different authors, it has been reported cases in which patients develop symptoms months, and even until 10 years after procedure. PCE after kyphoplasty is a complication that happens according to different series as low as 3.5% up to high as 28.6%. Percutaneous kyphoplasty has been reported with less possibility to develop Pulmonary cement embolism than vertebroplasty. The presence of comorbidities in a patient of the older age increased the possibilities of fatal outcome in this patient. CONCLUSIONS: Percutaneous kyphoplasty one of the main complications of this procedure has been the development of PCE which if detected early with a high index of suspicion has an overall good prognosis. In those patients with serious co-morbidities and kyphoplasty, closer monitoring should be done in order to detect the onset of symptoms and to provide adequate treatment to avoid fatal outcomes. Reference #1: M.I. Syed, S. Jan, N.A. Patel, A. Shaikh, R.A. Marsh, R.V. Stewart. Fatal Fat Embolism after Vertebroplasty: Identification of the High-Risk Patient. American Journal of Neuroradiology Feb 2006, 27 (2) 343-345. Reference #2: Dash A, Brinster DR. Open heart surgery for removal of polymethylmethacrylate after percutaneous vertebroplasty. Annals of Thoracic Surgery. 2011;91(1):276–278 Reference #3: Nishant Sinha, Vivek Padegal, Satish Satyanarayana,and Hassan Krishnamurthy Santosh. Pulmonary cement embolization after vertebroplasty, an uncommon presentation of pulmonary embolism: A case report and literature review DISCLOSURES: No relevant relationships by Gustavo Avila, source=Web Response no disclosure on file for Yash Jobanputra; No relevant relationships by Purva Sharma, source=Web Response AU - Avila, G. AU - Sharma, P. AU - Jobanputra, Y. DB - Embase DO - 10.1016/j.chest.2019.08.727 KW - cement poly(methyl methacrylate) adult aged artificial ventilation backache case report clinical article comorbidity complication conference abstract crackle drug combination drug megadose drug withdrawal dyspnea end stage renal disease fat embolism fatality fracture hemodialysis high risk patient human Human immunodeficiency virus kyphoplasty lung embolism lung infiltrate male marsh medical history middle aged neuroradiology nonhuman open heart surgery outcome assessment physical examination prognosis pulmonary artery respiratory distress risk assessment surgery thorax radiography vertebra work of breathing LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1931-3543 0012-3692 SP - A754 ST - CAN CEMENT TAKE OUR BREATH AWAY? AN INTERESTING CASE OF PULMONARY EMBOLISM AFTER KYPHOPLASTY T2 - Chest TI - CAN CEMENT TAKE OUR BREATH AWAY? AN INTERESTING CASE OF PULMONARY EMBOLISM AFTER KYPHOPLASTY UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2002983424&from=export http://dx.doi.org/10.1016/j.chest.2019.08.727 VL - 156 ID - 829112 ER - TY - JOUR AD - Sir Peter Mansfield Imaging Centre (SPMIC), Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK; Radiology Department, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK. Department of Acute Medicine, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK. Electronic address: ivan.lejeune@nuh.nhs.uk. Radiology Department, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Derby Road, Nottingham NG7 2UH, UK. Trent Cardiac Centre, Department of Cardiology, Nottingham University Hospitals NHS Trust, City Campus, Nottingham NG5 1PB, UK. AN - 26871310 AU - Awwad, A. AU - Le Jeune, I. AU - Kumaran, M. AU - Sosin, M. D. DA - Apr 1 DO - 10.1016/j.ijcard.2016.01.176 DP - NLM ET - 2016/02/13 J2 - International journal of cardiology KW - Bone Cements/*adverse effects Female Humans Middle Aged Pulmonary Embolism/*chemically induced/*diagnostic imaging Vertebroplasty/*adverse effects Imaging/CT MRI etc. Pulmonary embolism Rare lung diseases LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 0167-5273 SP - 162-3 ST - A rock in a hard place: Cement pulmonary emboli after percutaneous vertebroplasty T2 - Int J Cardiol TI - A rock in a hard place: Cement pulmonary emboli after percutaneous vertebroplasty VL - 208 ID - 828842 ER - TY - JOUR AB - Study Design: Vertebroplasty was simulated on a pig model. Objective: To evaluate the risk of neoplastic tissue migration into lungs during vertebroplasty. Summary Of Background Data: The application of vertebroplasty in spinal metastasis is not well documented. The risk of neoplastic tissue migration into the lungs during vertebroplasty remains unknown. Methods: A cancer model was built in 11 Landrace pigs (50 kg) by injecting 99mTc-labeled albumin macroaggregates into the center of L5 and L6 prior to vertebroplasty. Continuous scintigraphic imaging was performed with 1-minute frames over the lungs and vertebrae before and after injection to ensure steady state and baseline. We surveyed free TcO4- in thyroid. Twenty minutes after the 99mTc injection, 2-level vertebroplasty was performed at L5 and L6 with 3 Jamshidi needles in each vertebra. Into each vertebra, on average, 2.8 ± 1.1 mL of poly(methyl methacrylate) cement (Depuy CMW, Blackpool, UK) was injected. Quantitative scintigrams were obtained within 90 minutes after vertebroplasty. X-rays and quantitative computed tomography scans quantified cement distribution. Means of 99mTc activity before and after vertebroplasty were compared in a paired t test. Results: In this cancer model, we found an 80% risk of tissue migration to the lungs when performing vertebroplasty. In average, the study showed a significant amount of macroaggregate migration of 1.87% total range from 0% to 8% (CI: 0.05%-0.37%) with P = 0.045. There was no free TcO4- in the thyroid. Despite the standardized procedure, we found a large interindividual variation of pulmonary embolism. Conclusion: It is demonstrated that there exists a significant risk of exporting neoplastic disease or fatty tissue to the lungs when performing vertebroplasty. A similar adverse effect can be expected with balloon kyphoplasty. In patients with metastatic disease, vertebroplasty should be limited to those with short life expectancy. AD - Department of Orthopedics E, Spine Section, Aarhus University Hospital, Aarhus, Denmark Department of Orthopedics E, Spine Section, Aarhus University Hospital, Aarhus, Denmark tDepartment of Nuclear Medicine, Aarhus University Hospital, Skejby, Denmark. AN - 108173740. Language: English. Entry Date: 20120810. Revision Date: 20200708. Publication Type: journal article AU - Axelsen, M. AU - Thomassen, L. D. AU - Bünger, C. AU - Bendtsen, M. AU - Zou, X. AU - Flo, C. AU - Wang, Y. AU - Rehling, M. AU - Axelsen, Martin AU - Thomassen, Line Dahl AU - Bünger, Cody AU - Bendtsen, Michael AU - Zou, Xuenong AU - Flo, Christian AU - Wang, Yu AU - Rehling, Michael DB - cin20 DO - 10.1097/BRS.0b013e31822e7a98 DP - EBSCOhost KW - Kyphoplasty -- Adverse Effects Neoplasm Invasiveness -- Prevention and Control Relative Risk Spinal Neoplasms -- Surgery Animal Studies Bone Cements -- Adverse Effects Neoplasm Invasiveness -- Radiography Spinal Fractures -- Radiography Spinal Fractures -- Surgery Spinal Neoplasms -- Radiography Swine M1 - 7 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2012 SN - 0362-2436 SP - 551-556 ST - Estimating risk of pulmonary neoplastic embolism during vertebroplasty T2 - Spine (03622436) TI - Estimating risk of pulmonary neoplastic embolism during vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=108173740&site=ehost-live&scope=site VL - 37 ID - 830684 ER - TY - JOUR AB - We treated two cases of bleeding by injecting bone cement into tumor-feeding vessels of metastatic hypervascular tumors during a percutaneous vertebroplasty (PV) procedure. When the inner needle was pulled out after puncture of the metastatic vertebral tumor, active arterial bleeding from the outer needle cannula was noticed. Bleeding was not stopped by injection of Gelfoam particles through the cannula. Thus, bone cement was injected, which filled the tumor-feeding vessels, and bleeding stopped. Skin rash and high fever occurred 2-3 hours after the PV procedure, probably due to allergic reaction and massive tumor necrosis. To decrease the risk of active bleeding during PV for hypervascular bone metastases, arterial embolization of the feeding arteries should be performed 1 or 2 days prior to PV. If active bleeding occurs through the outer needle when performing PV, injection of bone cement after confirmation of bleeding from the tumor feeding vessels by vertebrography is effective. AD - Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. AN - 17957519 AU - Baba, Y. AU - Hayashi, S. AU - Ueno, K. AU - Nakajo, M. DA - Nov DO - 10.1080/02841850701545789 DP - NLM ET - 2007/10/25 J2 - Acta radiologica (Stockholm, Sweden : 1987) KW - Bone Cements/*therapeutic use Contrast Media Embolization, Therapeutic/*methods Female Hemorrhage/*etiology/*therapy Humans Lumbar Vertebrae Male Middle Aged Neoplasm Invasiveness Punctures/adverse effects Radiography, Interventional Spinal Neoplasms/*complications/diagnostic imaging/secondary Tomography, X-Ray Computed LA - eng M1 - 9 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 0284-1851 SP - 1024-7 ST - Bone cement used as an embolic agent for active bleeding in vertebroplasty of metastatic lesions T2 - Acta Radiol TI - Bone cement used as an embolic agent for active bleeding in vertebroplasty of metastatic lesions VL - 48 ID - 828821 ER - TY - JOUR AB - Nonthrombotic pulmonary embolism is defined as embolization to the pulmonary circulation caused by a wide range of substances of endogenous and exogenous biological and nonbiological origin and foreign bodies. It is an underestimated cause of acute and chronic embolism. Symptoms cover the entire spectrum from asymptomatic patients to sudden death. In addition to obstruction of the pulmonary vasculature there may be an inflammatory cascade that deteriorates vascular, pulmonary and cardiac function. In most cases the patient history and radiological imaging reveals the true nature of the patient's condition. The purpose of this article is to give the reader a survey on pathophysiology, typical clinical and radiological findings in different forms of nonthrombotic pulmonary embolism. The spectrum of forms presented here includes pulmonary embolism with biological materials (amniotic fluid, trophoblast material, endogenous tissue like bone and brain, fat, Echinococcus granulosus, septic emboli and tumor cells); nonbiological materials (cement, gas, iodinated oil, glue, metallic mercury, radiotracer, silicone, talc, cotton, and hyaluronic acid); and foreign bodies (lost intravascular objects, bullets, catheter fragments, intraoperative material, radioactive seeds, and ventriculoperitoneal shunts). (c) 2012 Elsevier Ireland Ltd. All rights reserved. AD - [Bach, Andreas Gunter; Abbas, Jasmin; Behrmann, Curd; Spielmann, Rolf Peter; Surov, Alexey] Univ Halle Wittenberg, Dept Radiol, D-06108 Halle, Germany. [Restrepo, Carlos Santiago] Univ Texas Hlth Sci Ctr San Antonio, Dept Thorac Radiol, San Antonio, TX 78229 USA. [Villanueva, Alberto] Univ Navarra Clin, Dept Radiol, Pamplona, Spain. [Lorenzo Dus, Maria Jose] Univ & Polytech Hosp La Fe, Serv Pneumol, Valencia, Spain. [Schoepf, Reinhard] MRI Inst Landeck, Tyrol, Austria. [Imanaka, Hideaki] Tokushima Univ Hosp, Dept Emergency & Disaster Med, Kuramoto Tokushima, Japan. [Lehmkuhl, Lukas] Univ Leipzig, Dept Radiol, Herzzentrum Leipzig, D-04109 Leipzig, Germany. [Tsang, Flora Hau Fung] Univ Hong Kong, Dept Surg, Div Cardiothorac Surg, Hong Kong, Hong Kong, Peoples R China. [Saad, Fathinul Fikri Ahmad] Univ Putra Malaysia, Fac Med, Ctr Diagnost Nucl Imaging, Serdang, Malaysia. [Lau, Eddie] Peter Mac Callum Ctr, Melbourne, Vic, Australia. [Rubio Alvarez, Jose] Univ Hosp Santiago de Compostela, Dept Cardiac Surg, Santiago De Compostela, Spain. [Battal, Bilal] Gulhane Mil Med Acad, Dept Radiol, Ankara, Turkey. Bach, AG (corresponding author), Univ Halle Wittenberg, Dept Radiol, D-06108 Halle, Germany. mail@andreas-bach.de; srestrepouribe@hotmail.com; avillanueva@unav.es; mjdus@hotmail.com; dr.schoepf@roentgen-mrt-landeck.at; imanakah@clin.med.tokushima-u.ac.jp; lukas.lehmkuhl@med.uni-leipzig.de; floratsanghk@yahoo.com; ahmadsaadff@gmail.com; eddie.lau@petermac.org; framan1@hotmail.com; bilbat23@yahoo.com AN - WOS:000314899200004 AU - Bach, A. G. AU - Restrepo, C. S. AU - Abbas, J. AU - Villanueva, A. AU - Dus, M. J. L. AU - Schopf, R. AU - Imanaka, H. AU - Lehmkuhl, L. AU - Tsang, F. H. F. AU - Saad, F. F. A. AU - Lau, E. AU - Alvarez, J. R. AU - Battal, B. AU - Behrmann, C. AU - Spielmann, R. P. AU - Surov, A. DA - Mar DO - 10.1016/j.ejrad.2012.09.019 J2 - Eur. J. Radiol. KW - Nonthrombotic pulmonary embolism Amniotic fluid embolism Fat embolism Tumor embolism Cement embolism Gas embolism AMNIOTIC-FLUID EMBOLISM INTRAVASCULAR MIGRATION PERCUTANEOUS RETRIEVAL UNUSUAL COMPLICATION CEMENT EMBOLISM FAT-EMBOLISM OIL EMBOLISM EMBOLIZATION LUNG CT Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 3 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2013 SN - 0720-048X SP - E120-E141 ST - Imaging of nonthrombotic pulmonary embolism: Biological materials, nonbiological materials, and foreign bodies T2 - European Journal of Radiology TI - Imaging of nonthrombotic pulmonary embolism: Biological materials, nonbiological materials, and foreign bodies UR - ://WOS:000314899200004 VL - 82 ID - 830288 ER - TY - JOUR AB - Nonthrombotic pulmonary embolism is defined as embolization to the pulmonary circulation caused by a wide range of substances of endogenous and exogenous biological and nonbiological origin and foreign bodies. It is an underestimated cause of acute and chronic embolism. Symptoms cover the entire spectrum from asymptomatic patients to sudden death. In addition to obstruction of the pulmonary vasculature there may be an inflammatory cascade that deteriorates vascular, pulmonary and cardiac function. In most cases the patient history and radiological imaging reveals the true nature of the patient's condition. The purpose of this article is to give the reader a survey on pathophysiology, typical clinical and radiological findings in different forms of nonthrombotic pulmonary embolism. The spectrum of forms presented here includes pulmonary embolism with biological materials (amniotic fluid, trophoblast material, endogenous tissue like bone and brain, fat, Echinococcus granulosus, septic emboli and tumor cells); nonbiological materials (cement, gas, iodinated oil, glue, metallic mercury, radiotracer, silicone, talc, cotton, and hyaluronic acid); and foreign bodies (lost intravascular objects, bullets, catheter fragments, intraoperative material, radioactive seeds, and ventriculoperitoneal shunts). AD - Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany. mail@andreas-bach.de AN - 23102488 AU - Bach, A. G. AU - Restrepo, C. S. AU - Abbas, J. AU - Villanueva, A. AU - Lorenzo Dus, M. J. AU - Schöpf, R. AU - Imanaka, H. AU - Lehmkuhl, L. AU - Tsang, F. H. AU - Saad, F. F. AU - Lau, E. AU - Rubio Alvarez, J. AU - Battal, B. AU - Behrmann, C. AU - Spielmann, R. P. AU - Surov, A. DA - Mar DO - 10.1016/j.ejrad.2012.09.019 DP - NLM ET - 2012/10/30 J2 - European journal of radiology KW - Adult Female Foreign Bodies/*complications/*diagnostic imaging Humans Pulmonary Embolism/*diagnostic imaging/*etiology Radiographic Image Enhancement/*methods Radiography, Thoracic/*methods Thrombosis/diagnostic imaging LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 0720-048x SP - e120-41 ST - Imaging of nonthrombotic pulmonary embolism: biological materials, nonbiological materials, and foreign bodies T2 - Eur J Radiol TI - Imaging of nonthrombotic pulmonary embolism: biological materials, nonbiological materials, and foreign bodies VL - 82 ID - 828669 ER - TY - JOUR AB - Nonthrombotic pulmonary embolism is defined as embolization to the pulmonary circulation caused by a wide range of substances of endogenous and exogenous biological and nonbiological origin and foreign bodies. It is an underestimated cause of acute and chronic embolism. Symptoms cover the entire spectrum from asymptomatic patients to sudden death. In addition to obstruction of the pulmonary vasculature there may be an inflammatory cascade that deteriorates vascular, pulmonary and cardiac function. In most cases the patient history and radiological imaging reveals the true nature of the patient's condition. The purpose of this article is to give the reader a survey on pathophysiology, typical clinical and radiological findings in different forms of nonthrombotic pulmonary embolism. The spectrum of forms presented here includes pulmonary embolism with biological materials (amniotic fluid, trophoblast material, endogenous tissue like bone and brain, fat, Echinococcus granulosus, septic emboli and tumor cells); nonbiological materials (cement, gas, iodinated oil, glue, metallic mercury, radiotracer, silicone, talc, cotton, and hyaluronic acid); and foreign bodies (lost intravascular objects, bullets, catheter fragments, intraoperative material, radioactive seeds, and ventriculoperitoneal shunts). © 2012 Elsevier Ireland Ltd. AD - A.G. Bach, Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany AU - Bach, A. G. AU - Restrepo, C. S. AU - Abbas, J. AU - Villanueva, A. AU - Lorenzo Dus, M. J. AU - Schöpf, R. AU - Imanaka, H. AU - Lehmkuhl, L. AU - Tsang, F. H. F. AU - Saad, F. F. A. AU - Lau, E. AU - Alvarez, J. R. AU - Battal, B. AU - Behrmann, C. AU - Spielmann, R. P. AU - Surov, A. DB - Embase Medline DO - 10.1016/j.ejrad.2012.09.019 KW - biomaterial cement fat radioactive seed silicone amnion fluid article artificial ventilation blood vessel occlusion bone brain brain ventricle peritoneum shunt bullet disease severity Echinococcus granulosus foreign body gas embolism heart catheterization heart function hemodialysis human lung blood vessel lung embolism lung function nonthrombotic pulmonary embolism pathophysiology priority journal radiodiagnosis sudden death trophoblast tumor cell LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0720-048X 1872-7727 SP - e120-e141 ST - Imaging of nonthrombotic pulmonary embolism: Biological materials, nonbiological materials, and foreign bodies T2 - European Journal of Radiology TI - Imaging of nonthrombotic pulmonary embolism: Biological materials, nonbiological materials, and foreign bodies UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52269553&from=export http://dx.doi.org/10.1016/j.ejrad.2012.09.019 VL - 82 ID - 829509 ER - TY - JOUR AB - Nonthrombotic pulmonary embolism is defined as embolization to the pulmonary circulation caused by a wide range of substances of endogenous and exogenous biological and nonbiological origin and foreign bodies. It is an underestimated cause of acute and chronic embolism. Symptoms cover the entire spectrum from asymptomatic patients to sudden death. In addition to obstruction of the pulmonary vasculature there may be an inflammatory cascade that deteriorates vascular, pulmonary and cardiac function. In most cases the patient history and radiological imaging reveals the true nature of the patient's condition. The purpose of this article is to give the reader a survey on pathophysiology, typical clinical and radiological findings in different forms of nonthrombotic pulmonary embolism. The spectrum of forms presented here includes pulmonary embolism with biological materials (amniotic fluid, trophoblast material, endogenous tissue like bone and brain, fat, Echinococcus granulosus, septic emboli and tumor cells); nonbiological materials (cement, gas, iodinated oil, glue, metallic mercury, radiotracer, silicone, talc, cotton, and hyaluronic acid); and foreign bodies (lost intravascular objects, bullets, catheter fragments, intraoperative material, radioactive seeds, and ventriculoperitoneal shunts). AD - Department of Radiology, Martin-Luther-University Halle-Wittenberg, Halle, Germany. Electronic address: mail@andreas-bach.de. AN - 104317283. Language: English. Entry Date: 20130906. Revision Date: 20170411. Publication Type: journal article. Journal Subset: Biomedical AU - Bach, Andreas Gunter AU - Restrepo, Carlos Santiago AU - Abbas, Jasmin AU - Villanueva, Alberto AU - Lorenzo Dus, María José AU - Schöpf, Reinhard AU - Imanaka, Hideaki AU - Lehmkuhl, Lukas AU - Tsang, Flora Hau Fung AU - Saad, Fathinul Fikri Ahmad AU - Lau, Eddie AU - Alvarez, Jose Rubio AU - Battal, Bilal AU - Behrmann, Curd AU - Spielmann, Rolf Peter AU - Surov, Alexey AU - Rubio Alvarez, Jose DB - cin20 DO - 10.1016/j.ejrad.2012.09.019 DP - EBSCOhost KW - Foreign Bodies -- Complications Foreign Bodies -- Radiography Pulmonary Embolism -- Etiology Pulmonary Embolism -- Radiography Radiographic Image Enhancement -- Methods Radiography, Thoracic -- Methods Adult Female Thrombosis -- Radiography M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2013 SN - 0720-048X SP - e120-41 ST - Imaging of nonthrombotic pulmonary embolism: biological materials, nonbiological materials, and foreign bodies T2 - European Journal of Radiology TI - Imaging of nonthrombotic pulmonary embolism: biological materials, nonbiological materials, and foreign bodies UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104317283&site=ehost-live&scope=site VL - 82 ID - 830662 ER - TY - JOUR AD - Service de médecine interne, AP-HP, Hôpital Tenon, F-75020, Paris, France. claude.bachmeyer@tnn.aphp.fr AN - 19679429 AU - Bachmeyer, C. AU - Wislez, M. AU - Khalil, A. DA - Mar DO - 10.1016/j.lpm.2009.06.015 DP - NLM ET - 2009/08/15 J2 - Presse medicale (Paris, France : 1983) KW - Bone Cements/*adverse effects Foreign-Body Migration/*complications Humans Male Middle Aged Pulmonary Embolism/*etiology *Vertebroplasty LA - fre M1 - 3 N1 - PubMed NLM literature search January 5, 2021 OP - Embolies pulmonaires multiples au ciment après vertébroplastie. PY - 2010 SN - 0755-4982 SP - 406-7 ST - [Multiple pulmonary embolism of cement after vertebroplasty] T2 - Presse Med TI - [Multiple pulmonary embolism of cement after vertebroplasty] VL - 39 ID - 828963 ER - TY - JOUR AB - Objective: Posterior surgical approaches to the lumbar spine may cause vascular lesions, due to the proximity of large vessels. We report two cases with accidental intra-arterial application of bone cement and hemostatic agents during re-do spinal surgery. Methods: Case I: A 56 year-old women required surgical decompression at the level of L3/4. The patient was placed in prone position. After removal of an old screw massive bleeding occurred from the screw hole. The bleeding stopped after hemostatic agents were applied. The procedure was completed successfully and the patient placed in supine position. A livid, cold and pulseless right leg was noted. Computer tomography angiography (CTA) revealed an occlusion of the right common iliac artery with intra-arterial air. Prompt balloon-embolectomy from the groin restored the circulation to the leg. Foamy looking thrombus was successfully removed. Intraoperative angiography showed extensive embolization of small branches in the buttock, thigh and calf. The post operative course was uneventful. Without any cardiovascular risk factors the patient suffered severe claudication in the thigh and lower leg at one year. Results: Case II: A 72 year-old multimorbid women required extended re-decompression at the level of L3-S1 with spondylodesis and an sacral vertebroplasty in a prone position. Massive bleeding occurred after removal of the old screws. The hemodynamic relevant bleeding stopped after application of bone cement and hemostatic agents into the drill hole. Immediately after extubation the patient complained of uncontrollable pain in both legs and showed a complete sensomotoric loss. The CTA showed complete thrombosis of the infrarenal aorta and both iliac axes. Complex time-consuming revascularization of the abdominal, pelvic and lower limb arteries reestablished circulation to both legs. The patient died due to multi organ failure three days later. Conclusion: Vascular complications after posterior approaches to the lumbar spine are rare and potentially lethal. Early diagnosis and prompt revascularisation is crucial. AD - B. Bachofen, Bern, Switzerland AU - Bachofen, B. AU - Bühlmann, R. AU - Wyss, T. R. AU - Schmidli, J. AU - Makaloski, V. DB - Embase DO - 10.1024/0301-1526/a000722 KW - bone cement hemostatic agent adult adverse drug reaction aged aorta artificial embolization balloon embolectomy bleeding buttock calf (mammal) cardiovascular risk case report claudication clinical article cold stress complication computed tomographic angiography conference abstract decompression early diagnosis extubation female hemodynamics human iliac artery iliac bone inguinal region lower leg lumbar spine middle aged multiple organ failure nonhuman pain percutaneous vertebroplasty prone position revascularization risk assessment side effect spondylodesis supine position surgery thigh vascular lesion LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1664-2872 SP - 26 ST - Severe complications after intravascular application of bone cement and hemostatic agent during spinal surgery T2 - Vasa - European Journal of Vascular Medicine TI - Severe complications after intravascular application of bone cement and hemostatic agent during spinal surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L629826365&from=export http://dx.doi.org/10.1024/0301-1526/a000722 VL - 47 ID - 829176 ER - TY - JOUR AB - We report a case of three patients treated with pedicle subtraction osteotomy for post-vertebroplasty kyphosis. These patients were initially treated with a vertebroplasty for vertebral fracture (two cases) and spinal lymphoma (1 case). All of these patients worsened progressively on a clinical and radiographic level with progression of the spinal deformity in the form of kyphosis. The surgery consisted of transpedicular osteotomy instrumented at the level of the vertebra cemented with maximum removal of intra-corporeal cement. One of the three patients required a supplementary anterior approach to achieve good quality bone fusion. In all three cases the post-vertebroplasty kyphosis was able to be reduced by at least 50 % emphasizing the feasibility and relevance of the pedicle subtraction osteotomy in a context of cemented vertebra. (C) 2016 Elsevier Masson SAS. All rights reserved. AD - [Bachour, E.; Coloma, P.; Freitas, E.; Messerer, R.; Michel, F.; Barrey, C.] Univ Lyon 1, Hosp Civils Lyon, Hop Neurol & Neurochirurg P Wertheimer, Serv Neurochirurg C & Chirurg Rachis, F-69003 Lyon, France. Bachour, E (corresponding author), Hop Neurol & Neurochirurg P Wertheimer, Serv Neurochirurg C Chirurg Rachis, 59 Blvd Pinel, F-69394 Lyon, France. elias.bachour@yahoo.com; pierre.coloma@chu-lyon.fr; eurico.freitas@chu-lyon.fr; rostom.messerer@chu-lyon.fr; frederic.michel@chu-lyon.fr; cedric.barrey@chu-lyon.fr AN - WOS:000393256900007 AU - Bachour, E. AU - Coloma, P. AU - Freitas, E. AU - Messerer, R. AU - Michel, F. AU - Barrey, C. DA - Dec DO - 10.1016/j.neuchi.2016.07.006 J2 - Neurochirurgie KW - Pedicle subtraction Osteotomy Kyphosis Vertebroplasty PERCUTANEOUS VERTEBROPLASTY COMPRESSION FRACTURES SPINAL METASTASES BURST FRACTURES FOLLOW-UP CEMENT KYPHOPLASTY EMBOLISM OUTCOMES Clinical Neurology Surgery LA - French M1 - 6 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2016 SN - 0028-3770 SP - 321-326 ST - Surgical correction of post-vertebroplasty kyphosis by pedicle substruction osteotomy. Regarding three cases T2 - Neurochirurgie TI - Surgical correction of post-vertebroplasty kyphosis by pedicle substruction osteotomy. Regarding three cases UR - ://WOS:000393256900007 VL - 62 ID - 830202 ER - TY - JOUR AB - We reviewed a consecutive series of 153 uncemented Bi-Contact (Aesculap, Tuttlingen, Germany) total hip arthroplasties (THAs) in 138 patients who had been followed for at least 5 years (mean, 6.8 years; range, 5-9 years). The Bi-contact uncemented THA consists of a straight femoral stem made of titanium alloy. The proximal portion of the stem is titanium plasma-sprayed. The cup is press-fit with or without hydroxyapatite coating with a facility for anchoring screws with a snap-fit polyethylene liner. The mean age of the patients was 70.8 years (range, 41-94 years). The mean preoperative Harris hip score of 41 (range, 20-80) improved postoperatively to a mean of 92 (range, 56-96). Three acetabular cups were revised for aseptic loosening, and 1 cup was revised for recurrent dislocation. To date, none of the stems have been revised for aseptic loosening. Radiographic evaluation of the remaining 149 hips revealed that the acetabular cup was stable in 146 hips and possibly unstable in the remaining 3 cases with nonprogressive osteolysis behind the cup. None of the stems showed any evidence of instability. Using the recommendation of revision as the endpoint, the cumulative survival for the prosthesis was 97.3% at a mean follow-up of 6.8 years (95% confidence interval, 95.9-99.4), with stem survival of 100%. In the medium-term, these results are comparable to cemented primary THA and justify the continued use of this prosthesis. Copyright 2002, Elsevier Science (USA). All rights reserved. AD - N.P. Badhe, c/o Richard C. Quinnell, Derbyshire Royal Infirmary, London Road, Derby DE1 2QY, United Kingdom AU - Badhe, N. P. AU - Quinnell, R. C. AU - Howard, P. W. DB - Embase Medline DO - 10.1054/arth.2002.34523 KW - cefuroxime gentamicin hydroxyapatite polyethylene titanium warfarin adult aged article avascular necrosis controlled study coxitis deep vein thrombosis female follow up hip dysplasia human joint instability lung embolism major clinical study male metal implantation osteolysis Perthes disease postoperative infection prosthesis loosening retrospective study rheumatoid arthritis survival time total hip prosthesis ABG AML Bi-Contact CLS Harris Galante Harris Galante-I Karl Zweymuller PCA Taperloc LA - English M1 - 7 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2002 SN - 0883-5403 SP - 896-901 ST - The uncemented Bi-Contact total hip arthroplasty T2 - Journal of Arthroplasty TI - The uncemented Bi-Contact total hip arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L35121120&from=export http://dx.doi.org/10.1054/arth.2002.34523 VL - 17 ID - 829864 ER - TY - JOUR AB - STUDY DESIGN: Forty patients were enrolled in 2 FDA-approved pilot Investigational Device Exemption (IDE) studies using Cortoss for the treatment of vertebral compression fractures (VCF). Twenty patients were treated at 3 centers, using vertebroplasty (VP) and 20 patients were treated at 5 centers, using kyphoplasty (KP). OBJECTIVE: To assess the feasibility and clinical outcomes using Cortoss to treat osteoporotic VCF. SUMMARY OF BACKGROUND DATA: Cortoss is an injectable bioactive, self-setting, radiopaque composite shown to stabilize and provide immediate weight bearing support to fractured vertebrae. Cortoss is approved for use in Europe for both screw and vertebral augmentation. METHODS.: Patient assessments were conducted before surgery and after surgery through 24 months using Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and quality-of-life assessment (SF-12) questionnaires. Extravasations were evaluated using radiographs and CT scans. RESULTS: Immediate pain improvement was seen in VP patients with VAS scores decreasing from 75.7 before surgery to 35.9 at 72 hours. Continued improvement from baseline was seen out to 2 years (average VAS of 48.9). Disability improved with average ODI scores decreasing from 52.2% preoperative to 38.3% at 2 years for VP patients. Immediate pain improvement was also seen in KP patients with VAS scores decreasing from 78.1 before surgery to 42.7 at 72 hours. Continued improvement from baseline was seen out to 2 years (average VAS of 25.4). ODI scores improved from 60.5% preoperative to 34.5% at 2 years for KP patients. Average material volumes injected were 1.85 mL for VP and 4.13 mL for KP. Extravasations from both techniques were minor, anatomically close to the treated vertebrae and asymptomatic. No cardiac irregularities or pulmonary emboli were observed. CONCLUSION: These studies indicate Cortoss is safe and effective in treating osteoporotic VCF using vertebroplasty or kyphoplasty. Pain relief and restoration of function with Cortoss is comparable to results found in the literature for polymethylmethacrylate. AD - The Spine Institute, Santa Monica, CA, USA. hbae@laspineinstitute.com AN - 104924244. Language: English. Entry Date: 20110128. Revision Date: 20150711. Publication Type: Journal Article AU - Bae, H. AU - Shen, M. AU - Maurer, P. AU - Peppelman, W. AU - Beutler, W. AU - Linovitz, R. AU - Westerlund, E. AU - Peppers, T. AU - Lieberman, I. AU - Kim, C. AU - Girardi, F. DB - cin20 DO - 10.1097/BRS.0b013e3181dcda75 DP - EBSCOhost KW - Composite Resins -- Therapeutic Use Fractures, Compression -- Surgery Kyphoplasty -- Methods Spinal Fractures -- Surgery Aged Aged, 80 and Over Clinical Assessment Tools Composite Resins -- Adverse Effects Disability Evaluation Female Human Male Middle Age Pain Measurement Pilot Studies Prospective Studies Quality of Life Questionnaires Treatment Outcomes M1 - 20 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2010 SN - 0362-2436 SP - E1030-6 ST - Clinical experience using Cortoss for treating vertebral compression fractures with vertebroplasty and kyphoplasty: twenty four-month follow-up T2 - Spine (03622436) TI - Clinical experience using Cortoss for treating vertebral compression fractures with vertebroplasty and kyphoplasty: twenty four-month follow-up UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104924244&site=ehost-live&scope=site VL - 35 ID - 830704 ER - TY - JOUR AB - OBJECTIVE: To present the results of total knee replacement at the King Abdul-Aziz University Hospital in Jeddah, Kingdom of Saudi Arabia (KSA). METHODS: The medical records of 205 patients who received 309 prostheses was reviewed. The study took place at King Abdul-Aziz University Hospital, Jeddah, KSA between May 1989 and August 2005, where patients were either examined in the outpatient clinic or interviewed on the phone. Seventeen patients (22 prostheses) were lost for follow up. The scores were registered according to the Knee Society Clinical Rating System. RESULTS: There was a significant improvement in all-functional scores postoperatively in the first year, which continues without significant change throughout the follow up period. Symptomatic deep vein thrombosis was observed in 5 patients, 3 of them had pulmonary embolism, which was fatal in 2 cases. Early deep infection occurred in 3 cases. Superficial wound infection was seen in one patient. One patient suffered peroneal nerve palsy, while 4 patients had aseptic loosening of the femoral implant. One patient had rupture of the patellar tendon. Metal breakage was observed once and one patient is diagnosed to have polyethylene wear. In the early phase, when a prosthesis type without dislocation protection was used, 7 dislocations occurred. This type was not used anymore and no such complication was observed. CONCLUSION: Total knee replacement relieves pain and improves quality of life significantly. The observed complications compare well with the results reported in the literature. AD - Department of Surgery, King Abdul-Aziz University Hospital, PO Box 80215, Jeddah 21589, Kingdom of Saudi Arabia. drbakhsht@hotmail.com AN - 16680257 AU - Bakhsh, T. M. DA - May DP - NLM ET - 2006/05/09 J2 - Saudi medical journal KW - *Arthroplasty, Replacement, Knee/methods *Bone Cements Female Humans Knee Prosthesis Male Middle Aged *Prosthesis Failure *Prosthesis Implantation/adverse effects Pulmonary Embolism/etiology Saudi Arabia Surgical Wound Infection/etiology Venous Thrombosis/etiology LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0379-5284 (Print) 0379-5284 SP - 661-6 ST - Results of total knee replacement using a cemented stemmed prosthesis T2 - Saudi Med J TI - Results of total knee replacement using a cemented stemmed prosthesis VL - 27 ID - 828888 ER - TY - JOUR AB - Percutaneous vertebroplasty is a relatively safe, simple and commonly performed interventional procedure for the management of vertebral compression fractures. However, serious complications are rarely reported in the procedure. Those are pulmonary embolism, severe infection, paraplegia and an occurrence of a new fracture in an adjacent vertebra after vertebroplasty. Acute complications are generally associated with the procedure. We present the case of neuraxial anesthesia, developed after local anesthesia with 8 mL of 2% prilocaine, in a 68-year-old woman who underwent percutaneous vertebroplasty after an osteoporotic collapsed fracture in the L-1 vertebra due to trauma. To our knowledge, this is the first case in the literature. (C) 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. AD - [Balkarli, Huseyin] Akdeniz Univ, Fac Med Orthopaed & Traumatol, Antalya, Turkey. [Kilic, Mesut] Ondokuz Mayis Univ, Fac Med Orthopaed & Traumatol, Samsun, Turkey. [Ozturk, Ibrahim] Diskapi Yildirim Beyazit Educ & Res Hosp, Anesthesiol & Reanimat, Ancara, Turkey. Ozturk, I (corresponding author), Diskapi Yildirim Beyazit Educ & Res Hosp, Anesthesiol & Reanimat, Ancara, Turkey. drozturk28@gmail.com AN - WOS:000397558100013 AU - Balkarli, H. AU - Kilic, M. AU - Ozturk, I. DA - Mar-Apr DO - 10.1016/j.bjan.2016.08.004 J2 - Rev. Bras. Anestesiol. KW - Neuraxial anesthesia Percutaneous vertebroplasty Vertebra Fracture COMPRESSION FRACTURES METAANALYSIS Anesthesiology LA - Portuguese M1 - 2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2017 SN - 0034-7094 SP - 205-209 ST - Neuraxial anesthesia after local anesthesia for management of percutaneous vertebroplasty complication during vertebroplasty T2 - Revista Brasileira De Anestesiologia TI - Neuraxial anesthesia after local anesthesia for management of percutaneous vertebroplasty complication during vertebroplasty UR - ://WOS:000397558100013 VL - 67 ID - 830196 ER - TY - JOUR AB - Percutaneous vertebroplasty is a relatively safe, simple and commonly performed interventional procedure for the management of vertebral compression fractures. However, serious complications are rarely reported in the procedure. Those are pulmonary embolism, severe infection, paraplegia and an occurrence of a new fracture in an adjacent vertebra after vertebroplasty. Acute complications are generally associated with the procedure. We present the case of neuraxial anesthesia, developed after local anesthesia with 8mL of 2% prilocaine, in a 68-year-old woman who underwent percutaneous vertebroplasty after an osteoporotic collapsed fracture in the L(1) vertebra due to trauma. To our knowledge, this is the first case in the literature. AD - Akdeniz University Faculty of Medicine, Orthopaedics and Traumatology, Antalya, Turquia. Ondokuzmayıs University Faculty of Medicine, Orthopaedics and Traumatology, Samsun, Turquia. Dışkapı Yıldırım Beyazıt Education and Research Hospital, Anesthesiology and Reanimation, Ancara, Turquia. Electronic address: drozturk28@gmail.com. AN - 27637996 AU - Balkarlı, H. AU - Kılıç, M. AU - Öztürk, İ DA - Mar-Apr DO - 10.1016/j.bjan.2016.08.004 DP - NLM ET - 2016/09/18 J2 - Revista brasileira de anestesiologia KW - Aged *Anesthesia, Conduction *Anesthesia, Local Female Humans Intraoperative Complications/*etiology Lumbar Vertebrae/*injuries Osteoporotic Fractures/*surgery Spinal Fractures/*surgery Vertebroplasty/*adverse effects/methods Bloqueio neuraxial Fracture Fratura Neuraxial anesthesia Percutaneous vertebroplasty Vertebra Vertebroplastia percutânea Vértebra LA - por M1 - 2 N1 - PubMed NLM literature search January 5, 2021 OP - Bloqueio neuroaxial após anestesia local para manejo de complicação de vertebroplastia percutânea durante vertebroplastia. PY - 2017 SN - 0034-7094 SP - 205-209 ST - [Neuraxial anesthesia after local anesthesia for management of percutaneous vertebroplasty complication during vertebroplasty] T2 - Rev Bras Anestesiol TI - [Neuraxial anesthesia after local anesthesia for management of percutaneous vertebroplasty complication during vertebroplasty] VL - 67 ID - 828671 ER - TY - JOUR AB - BACKGROUND AND PURPOSE: Giant cell tumors (GCTs) of bone rarely affect the pelvis. We report on 20 cases that have been treated at our institution during the last 20 years. METHODS: 20 patients with histologically benign GCT of the pelvis were included in this study. 9 tumors were primarily located in the iliosacral area, 6 in the acetabular area, and 5 in the ischiopubic area. 8 patients were treated by intralesional curettage and 6 by intralesional resection with additional curettage of the margins. 3 patients with iliacal tumors were treated by wide resection. 2 patients were treated by a combination of external beam irradiation and surgery, and 1 patient solely by irradiation. In addition, 9 patients received selective arterial embolization one day before surgery. Of the 6 patients with acetabular tumors, 1 secondarily received an endoprosthesis and 1 was primarily treated by hip transposition. The patients were followed for a median time of 3 (1-11) years. RESULTS: 1 patient with a pubic tumor developed a local recurrence 1 year after intralesional resection and additional curettage of the margins. The recurrence presented as a small soft tissue mass within the scar tissue of the gluteal muscles and was treated by resection. No secondary sarcoma was detected and none of the patients developed pulmonary metastases or multicentricity. No major complication occurred during surgery. INTERPRETATION: We conclude that most GCTs of the pelvis can be treated by intralesional procedures. For tumors of the iliac wing, wide resection can be an alternative. Surgical treatment of tumors affecting the acetabular region often results in functional impairment. Pre-surgical selective arterial embolization appears to be a safe procedure that may reduce the risk of local recurrence. AD - Department of Orthopedic Surgery, University Hospital Muenster, Muenster, Germany. maurice.balke@ukmuenster.de AN - 19916695 AU - Balke, M. AU - Streitbuerger, A. AU - Budny, T. AU - Henrichs, M. AU - Gosheger, G. AU - Hardes, J. C2 - Pmc2823344 DA - Oct DO - 10.3109/17453670903350123 DP - NLM ET - 2009/11/18 J2 - Acta orthopaedica KW - Adult Aged Bone Cements Bone Neoplasms/radiotherapy/*surgery Bone Transplantation Curettage Embolization, Therapeutic/methods Female Follow-Up Studies Giant Cell Tumor of Bone/radiotherapy/*surgery Humans Ilium/pathology/surgery Male Middle Aged Neoplasm Recurrence, Local/prevention & control *Pelvic Bones/diagnostic imaging/surgery Radiography Radiotherapy, Adjuvant Retrospective Studies Treatment Outcome LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 1745-3674 (Print) 1745-3674 SP - 590-6 ST - Treatment and outcome of giant cell tumors of the pelvis T2 - Acta Orthop TI - Treatment and outcome of giant cell tumors of the pelvis VL - 80 ID - 828716 ER - TY - JOUR AB - OBJECTIVE: To review the evidence supporting use of percutaneous vertebroplasty for relief of pain and mechanical stability in patients with vertebral compression fractures unrelieved by conventional measures. QUALITY OF EVIDENCE: Ovid MEDLINE was searched from January 1966 to December2006 for all English-language papers on vertebroplasty. The quality of evidence in these papers was graded according to the 4-point classification system of evidence-based medicine. Level II evidence currently supports use of vertebroplasty. MAIN MESSAGE: Vertebroplasty alleviates pain from vertebral compression fractures that result from osteoporosis, hemangiomas, malignancies, and vertebral osteonecrosis. Vertebroplasty has provided substantial pain relief in 60% to 100% of patients; has decreasedanalgesic use in 34% to 91% of patients; and has improved physical mobility in 29% to 100% of patients. Contraindications to vertebroplasty include asymptomatic compression fractures of the vertebral body, vertebra plana, retropulsed bone fragments or tumours, active infection, uncorrectable coagulopathy, allergy to the bone cement or opacification agent, severe cardiopulmonary disease, pregnancy, and pre-existing radiculopathy. The short-term complication rate was found to be 0.5% to 54%. Rare but serious complications include compression of the spinal cord or nerve root, infection, cement embolization causing pulmonary infarct and clinical symptoms, paradoxical embolization of the cerebral artery, and severe hematomas. CONCLUSION: Vertebroplasty is a safe and effective treatment for vertebral fractures that cannot be treated using conservative measures. AD - Faculty of Medicine at the University of Ottawa in Ontario. sbane059@uottawa.ca AN - 105818318. Language: English. Entry Date: 20080307. Revision Date: 20150711. Publication Type: Journal Article AU - Banerjee, S. AU - Baerlocher, M. O. AU - Asch, M. R. DB - cin20 DP - EBSCOhost KW - Back Pain -- Therapy Lumbar Vertebrae -- Drug Effects Methylmethacrylates -- Pharmacodynamics Pain -- Therapy Back Pain -- Diagnosis Bone Cements Female Injections, Intraspinal Male Methylmethacrylates -- Therapeutic Use Pain Measurement Pain -- Diagnosis Patient Selection Prospective Studies Risk Assessment Severity of Illness Indices Treatment Outcomes Human M1 - 7 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2007 SN - 0008-350X SP - 1169-1175 ST - Back stab: percutaneous vertebroplasty for severe back pain T2 - Canadian Family Physician TI - Back stab: percutaneous vertebroplasty for severe back pain UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105818318&site=ehost-live&scope=site VL - 53 ID - 830762 ER - TY - JOUR AB - BACKGROUND: To reduce the risk of cerebrospinal fluid leak, clinicians utilize a filling material placed in the sella followed by floor reconstruction with various materials, including glue sealing. Cyano-acrylic glue Glubran®2 glue is commercially available and is generally used as embolizing agent and for the prevention of cerebrospinal fluid leakage. CASE DESCRIPTION: A 25-year-old woman underwent endoscopic endonasal transsphenoidal surgery for pituitary adenoma. After tumor resection, sellar floor reconstruction was performed by mucosal graft and Glubran®2 glue. The early post-operative period was uneventful. However, 2 months after surgery, the patient complained of headache, facial pain and greenish foul-smelling nasal discharge with solid particles dripping from the nose. Medical treatment was unsuccessful. Brain MRI showed inflammation and thickening of the sphenoidal and para-sphenoidal mucosa. The patient underwent endoscopic endonasal surgery and a solid glass-like mass surrounded by inflamed infected mucosa was seen in the inferior and lateral aspects of the sphenoid sinus. Efforts were made to erupt and de-crust the solid mass until total resection was achieved. Early post-operative period was uneventful, and a course of antibiotics was continued until total disappearance of the discharge. CONCLUSION: To the best of our knowledge, this is the first case reporting of acrylic glue (Glubran®2)-related sinusitis. Surgeon should be aware about similar side effects for the glue material that would complicate the surgery. AU - Bani-Ata, M. AU - Alzoubi, F. AU - Abuzayed, B. AU - Alhowary, A. A. A. AU - Aleshawi, A. J. DB - Medline DO - 10.1186/s12893-020-00866-w KW - adult article body weight brain cancer surgery case report chronic rhinosinusitis clinical article drug therapy endoscopic endonasal surgery female headache and facial pain human hypophysis adenoma mucosa nuclear magnetic resonance imaging postoperative period rhinorrhea side effect sphenoid sinus surgeon surgery transsphenoidal surgery antibiotic agent glass poly(methyl methacrylate) LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1471-2482 SP - 205 ST - Chronic rhinosinusitis due to cyano-acrylic glue after endoscopic transsphenoidal pituitary surgery T2 - BMC surgery TI - Chronic rhinosinusitis due to cyano-acrylic glue after endoscopic transsphenoidal pituitary surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L632896010&from=export http://dx.doi.org/10.1186/s12893-020-00866-w VL - 20 ID - 829056 ER - TY - JOUR AB - BACKGROUND CONTEXT: With more cement augmentation procedures done, the occurrence of serious complications is also expected to rise. Symptomatic central cement embolization is a rare but very serious complication. Moreover, the pathophysiology and treatment of intrathoracic cement embolism remain controversial. PURPOSE: In this case series, we are trying to identify various presentations and suggest our emergent management scheme for symptomatic central cement embolization. PATIENT SAMPLE: Retrospective case series of nine patients with symptomatic central cement embolism identified after vertebroplasty with 24 months of follow-up. Level IV. OUTCOME MEASURES: The degree of dyspnea measured by the New York Heart Association (NYHA) score and/or death related to cement embolism induced cardio/respiratory failure at the final follow-up at 24 months. METHODS: The nine patients, eight females, and one male had a mean age of 70.25 years (range 65-78 years) and were operated between January 2004 and December 2014. They had percutaneous vertebroplasty for osteoporotic non-traumatic and malignant vertebral collapse of dorsal and lumbar vertebrae. Post-vertebroplasty dyspnea and stitching chest pain were striking in the nine patients. After exclusion of cardiac ischemia and medical pulmonary causes for dyspnea, we identified radiopaque lesions on the chest X-ray. Further echocardiography and high-resolution chest CT were performed for optimal localization. Emergent heart surgery was performed in two patients: interventional therapy was conducted in one patient, while the remaining six patients were conservatively treated by anticoagulation. The management decision was taken in the setting of an interdisciplinary meeting depending on localization, fragmentation, and clinical status. RESULTS: All patients of this series showed gradual improvement and an uneventful hospital stay. During our 24-month follow-up phase, eight patients showed no subsequent cardiological and/or respiratory symptoms (NYHA I). However, one mortality due to advanced malignancy occurred. Preoperative anemia was the only common intersecting preoperative parameter among these nine patients. CONCLUSIONS: After cement augmentation, close clinical monitoring is mandatory. A chest CT is pivotal in determining the interdisciplinary management approach in view of the availability of necessary expertise, facilities and the location of the cement emboli whether accessible by cardiac or vascular surgical means. The clinical presentation and its timing may vary and the patient may be seen subsequently by other health care providers obligating a wide-spread awareness for this serious entity among health care providers for this age group as spine surgeons, family and emergency room doctors, and institutional or home-care nurses. Most symptomatic central cement emboli may be treated conservatively. AD - Department of Spinal Surgery, Zentralklinik Bad Berka, Wirbelsäulenchirurgie, Robert-Koch Allee 9, 99438, Bad Berka, Germany. ahmedsamir222222@live.com. Department of Orthopedics and Traumatology, Cairo University, Cairo, Egypt. ahmedsamir222222@live.com. Department of Cardiac Surgery, Zentralklinik Bad Berka, Bad Berka, Germany. Department of Cardiothoracic Surgery, Cairo University, Cairo, Egypt. Department of Spinal Surgery, Zentralklinik Bad Berka, Wirbelsäulenchirurgie, Robert-Koch Allee 9, 99438, Bad Berka, Germany. Department of Orthopedics and Spinal Surgery, Alexandria University Hospitals, Alexandria, Egypt. Department of Cardiology, Zentralklinik Bad Berka, Bad Berka, Germany. AN - 28821988 AU - Barakat, A. S. AU - Owais, T. AU - Alhashash, M. AU - Shousha, M. AU - El Saghir, H. AU - Lauer, B. AU - Boehm, H. DA - Oct DO - 10.1007/s00586-017-5267-4 DP - NLM ET - 2017/08/20 J2 - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society KW - Aged Bone Cements/*adverse effects *Embolism/chemically induced/diagnostic imaging Female Humans Male Radiography, Thoracic Retrospective Studies Tomography, X-Ray Computed Vertebroplasty/adverse effects *Conservative treatment *Open heart and minimally invasive heart surgery *Pulmonary cement emboli and central symptomatic bone embolization *Radiological interventionist *Vertebral cement leakage LA - eng M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 0940-6719 SP - 2584-2592 ST - Presentation and management of symptomatic central bone cement embolization T2 - Eur Spine J TI - Presentation and management of symptomatic central bone cement embolization VL - 27 ID - 828573 ER - TY - JOUR AB - Glubran2 is a cyanoacrylate-based synthetic glue modified by addition of a second monomer. Among its many advantages over traditional cyanoacrylate products, Glubran2 has a much lower thermal polymerization temperature than that of cyanoacrylates used for cutaneous application. For many years, the new glue has been widely used in neuroradiology endovascular treatments. Our study aimed to assess the use of Glubran2 to treat possible complications arising during the embolization of aneurysms or vascular malformations like AVM or fistulae. A complication encountered in some of these cases is rupture of the vessel wall by the microguide or perforation of the aneurysmal sac by the coils used for embolization. This complication could be overcome by injecting Glubran2 into the rupture point but this would put the glue directly in contact with the subarachnoid space and possibly reach adjacent brain tissue. The aim of this experimental study was to place the glue in direct contact with brain tissue to ascertain its immediate compatibility and tolerability in vivo and any ensuing tissue damage. Three swine underwent neurosurgical procedures and survived for different times after which they were slaughtered and their brains explanted and sent for macroscopic and microscopic investigation by the Pathological Anatomy Service. As a whole, Glubran2 was well tolerated in vivo and did not cause major damage in direct contact with brain tissue. AD - C. Barbara, Servizio di Neuroradiologia, Ospedale Bellaria, Bologna, Italy AU - Barbara, C. AU - Pozzati, E. AU - Marucci, G. AU - Joechler, M. AU - Pisoni, L. AU - Bellei, E. AU - Leonardi, M. AU - Masetti, L. DB - Embase DO - 10.1177/197140090501800503 KW - acrylic cement enbucrilate aneurysm animal experiment animal model animal tissue arteriovenous fistula arteriovenous malformation article artificial embolization blood vessel rupture congenital blood vessel malformation controlled study endovascular surgery neuroradiology nonhuman polymerization subarachnoid space pig Glubran 2 LA - English M1 - 5-6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2005 SN - 1120-9976 SP - 537-545 ST - Effects of Glubran2 acrylic glue on the subarachnoid surface in swine: Preliminary findings T2 - Rivista di Neuroradiologia TI - Effects of Glubran2 acrylic glue on the subarachnoid surface in swine: Preliminary findings UR - https://www.embase.com/search/results?subaction=viewrecord&id=L43132073&from=export http://dx.doi.org/10.1177/197140090501800503 VL - 18 ID - 829807 ER - TY - JOUR AB - Purpose: A hollow cementless femoral stem has been developed to reduce intramedullary pressure and fat embolism during implantation. Methods: In a prospective randomized clinical study, cementless hip stems (ALPHA‐FIT) were implanted in 42 patients (24 women, 18 men, mean age: 65.9 years). In Group I (n = 21) a solid standard stem was used. In Group II (n = 21) a modified hollow stem was implanted with vertical and longitudinal communicating drill holes opening at the implant surface. During surgery the intramedullary pressure was measured by a cannula fixed distally. Results: During stem insertion the mean pressure was 82 mmHg (minimum‐maximum, 12‐259 mmHg) for Group I and 27 mmHg (minimum‐maximum, 0‐48 mmHg) for Group II. This difference was statistically significant (t‐test, p < 0.00076). The pressure measured in Group II was similar to the base pressure before opening of the intramedullary canal (mean 35 mmHg; minimum‐maximum, 4‐72 mmHg). In both groups higher pressures were found for opening of the canal, drilling with the smallest drill size and rasping. Conclusion: Using the hollow prosthesis, the intramedullary pressure could be reduced significantly. The higher pressures during preparation of the femoral canal need further research. AN - CN-00516185 AU - Barden, B. AU - Seel, W. AU - Loer, F. AU - Konermann, H. DO - 10.1055/s-2004-822664 KW - *hip arthroplasty *hip prosthesis Aged Article Clinical article Clinical trial Controlled clinical trial Controlled study Female Femur shaft Human Male Pressure Randomized controlled trial Surgical technique M1 - 3 M3 - Journal: Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2004 SP - 298‐302 ST - The hollow prosthesis to reduce intramedullary pressure in cementless femoral hip arthroplasty T2 - Zeitschrift fur orthopadie und ihre grenzgebiete TI - The hollow prosthesis to reduce intramedullary pressure in cementless femoral hip arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00516185/full VL - 142 ID - 830061 ER - TY - JOUR AB - PURPOSE: A hollow cementless femoral stem has been developed to reduce intramedullary pressure and fat embolism during implantation. METHODS: In a prospective randomized clinical study, cementless hip stems (ALPHA‐FIT) were implanted in 42 patients (24 women, 18 men, mean age: 65.9 years). In Group I (n=21) a solid standard stem was used. In Group II (n=21) a modified hollow stem was implanted with vertical and longitudinal communicating drill holes opening at the implant surface. During surgery the intramedullary pressure was measured by a cannula fixed distally. RESULTS: During stem insertion the mean pressure was 82 mmHg (minimum‐maximum, 12‐259 mmHg) for Group I and 27 mmHg (minimum‐maximum, 0‐48 mmHg) for Group II. This difference was statistically significant (t‐test, p < 0.00076). The pressure measured in Group II was similar to the base pressure before opening of the intramedullary canal (mean 35 mmHg; minimum‐maximum, 4‐72 mmHg). In both groups higher pressures were found for opening of the canal, drilling with the smallest drill size and rasping. CONCLUSION: Using the hollow prosthesis, the intramedullary pressure could be reduced significantly. The higher pressures during preparation of the femoral canal need further research. AN - CN-00482164 AU - Barden, B. AU - Seel, W. AU - Löer, F. AU - Konermann, H. DO - 10.1055/s-2004-822664 KW - Adult Aged Aged, 80 and over Cementation Equipment Failure Analysis [*methods] Female Hip Joint [*physiopathology, *surgery] Hip Prosthesis Humans Male Middle Aged Postoperative Complications [*prevention & control] Pressure Treatment Outcome M1 - 3 M3 - Clinical Trial; Comparative Study; English Abstract; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2004 SP - 298‐302 ST - The cement free hollow hip prosthesis to reduce intramedullary pressure T2 - Zeitschrift fur orthopadie und ihre grenzgebiete TI - The cement free hollow hip prosthesis to reduce intramedullary pressure UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00482164/full VL - 142 ID - 830025 ER - TY - JOUR AB - Study Design. Experimental study using a laboratory leakage model. Objective. To examine the working hypothesis that high-viscosity cements will spread uniformly, thus significantly reducing the risk of leakage. Summary of Background Data. In vertebroplasty, forces that govern the flow of bone cement in the trabecular bone skeleton are an essential determinant of the uniformity of cement filling. Extraosseous cement leakage has been reported to be a major complication of this procedure. Leakage occurs due to the presence of a path of least resistance caused by irregularities in the trabecular bone or shell structure. Ideally, cement uniformly infiltrates the trabecular bone skeleton and does not favor specific paths. Cement viscosity is believed to affect the infiltration forces and flow during the procedure. Clinically, altering the time between cement mixing and delivery modifies the viscosity of bone cement. Methods. An experimental model of the leakage phenomenon of vertebroplasty was developed. A path, simulating a blood vessel, was created in the model to perturb the forces underlying cement flow and to favor leakage. Cement of varying viscosities was injected in the model, and, thereafter, the filling pattern, cement mass that has leaked, time at which leakage occurred, and injection pressure were measured. Results. A strong relationship was found between the uniformity of the filling pattern and the elapsed time from cement mixing and viscosity, respectively. Specifically, 3 distinct cement leakage patterns were observed: immediate leakage was observed when cement was injected 5 - 7 minutes following mixing. The cement was of a low viscosity and more than 50% of the total cement injected leaked. Moderate leakage was observed when injection occurred 7 - 10 minutes following mixing. Less than 10% of the cement leaked, and the viscosity was at a transient state between the low viscosity of immediate leakage and a higher viscosity, doughy cement. Cement leakage ceased completely when cement was delivered after 10 minutes. The viscosity of the cement in this case was high, and the cement was of a dough-like consistency. Conclusions. High-viscosity cement seems to stabilize cement flow. However, the forces required for the delivery of high-viscosity cement may approach or exceed the human physical limit of injection forces. Although the working time of the cement is about 17 minutes, it may not be manually injectable with a standard syringe and cannula after 10 minutes, at which time cement leakage ceased completely. AD - Univ Sherbrooke, Dept Mech Engn, Canada Res Chair Skeletal Reconstruct, Biomech Lab, Sherbrooke, PQ J1K 2R1, Canada. Dr Robert Mathys Fdn, Bettlach, Switzerland. Baroud, G (corresponding author), Univ Sherbrooke, Dept Mech Engn, Canada Res Chair Skeletal Reconstruct, Biomech Lab, 2500 Boul Univ, Sherbrooke, PQ J1K 2R1, Canada. Gamal.Baroud@Usherbrooke.ca AN - WOS:000241519200009 AU - Baroud, G. AU - Crookshank, M. AU - Bohner, M. DA - Oct DO - 10.1097/01.brs.0000240695.58651.62 J2 - Spine KW - vertebroplasty extraosseous leakage cement extravasation filling pattern cement viscosity PERCUTANEOUS VERTEBROPLASTY BONE-CEMENT INTRAMEDULLARY PRESSURE RHEOLOGICAL PROPERTIES PULMONARY-EMBOLISM FAT-EMBOLISM FRACTURES INJECTION BIOMECHANICS SUSPENSIONS Clinical Neurology Orthopedics LA - English M1 - 22 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2006 SN - 0362-2436 SP - 2562-2568 ST - High-viscosity cement significantly enhances uniformity of cement filling in vertebroplasty: An experimental model and study on cement leakage T2 - Spine TI - High-viscosity cement significantly enhances uniformity of cement filling in vertebroplasty: An experimental model and study on cement leakage UR - ://WOS:000241519200009 VL - 31 ID - 830405 ER - TY - JOUR AB - Neural injuries that occur after total hip arthroplasty (THA) can be classified as involving either the central nervous system or peripheral nerves. Central nervous system changes after THA may be attributed to increased appreciation of fat embolism syndrome associated with THA. Certain maneuvers such as impacting the acetabulum, femoral reaming, and cement pressurization can force marrow fat into the venous system. When there is an associated right to left shunt, paradoxical embolization can occur, which may account for previously unexplained cases of confusion and mental status changes after surgery. Peripheral nerve injuries are rare and can involve either distant sites or nerves in the immediate vicinity of the hip joint. Upper extremity nerve injuries are usually associated with patient positioning. Sciatic nerve injury is the most common nerve injury following THA. In comparison, femoral nerve injury is much less common and is associated with an anterior approach. Diagnosis is often delayed, and the prognosis is generally better than with sciatic nerve injury. The superior gluteal nerve is at risk during the direct lateral approach. Obturator nerve injury is the least common type of injury and has the least functional consequence. It can present as groin or inguinal pain. Vascular injuries are less common but more immediately life threatening. The mechanisms of vascular injury include occlusion associated with preexisting peripheral vascular disease and vascular injury during removal of cement during screw fixation of acetabular components, cages, or structural grafts. Perioperative assessment should include vascular evaluation of patients with absent pulses, previous vascular bypass surgery, or dysvascular limbs. A CT scan should be considered when cement or components extend medially into the pelvis. AD - Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA. AN - 12690854 AU - Barrack, R. L. AU - Butler, R. A. DP - NLM ET - 2003/04/15 J2 - Instructional course lectures KW - *Arthroplasty, Replacement, Hip Humans Perioperative Care Postoperative Complications/etiology/*prevention & control Trauma, Nervous System/etiology/*prevention & control Vascular Diseases/etiology/*prevention & control LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2003 SN - 0065-6895 (Print) 0065-6895 SP - 267-74 ST - Avoidance and management of neurovascular injuries in total hip arthroplasty T2 - Instr Course Lect TI - Avoidance and management of neurovascular injuries in total hip arthroplasty VL - 52 ID - 829026 ER - TY - JOUR AB - All intramedullary femoral surgery entails embolic phenomena which explain peroperative collapses formally known as bone cement implantation syndrome, as well as perioperative fat embolism syndromes. Locally, the bigger the cavity is, the higher the number of accidents: 2.5-5 per cent for GUEPAR hinged-knee prosthesis, 1.75 per cent for total hip arthroplasty with long stem, and 0.1 per cent during classic THA with cement limited to the metaphysis. Anomalies in bone vascularization also increase risk: 10.5-13 per cent during prophylactic nailing for shaft metastases, 1-11.5 per cent during hemiarthroplasty cemented in osteoporotic bone of femoral neck fractures, and only 0.1 per cent during THA implanted because of arthrosis. Not only cement, but also rods, reamers, nails, implants, ultrasonic tool for cement extraction, increase the pressure inside the cavity. Methylmethacrylate is no longer the only incriminated factor, even if it is responsible for a major part of the compressive load. The intensity and duration of the pressure are correlated with the number of embolic phenomena and with measured cardiopulmonary parameters. The intracavity fat content is expelled (an empty cavity, as in THA revision, does not lead to embolic phenomena). Then filters through the intraosseous veins whose diameter limit the size of the extruded embolic phenomena. The ultrasonography of the inferior vena cava shows innumerable fine particles and thrombi which are already organized under the influence of procoagulant factors released from the operative shield and which remain crumbly. These emboli cross the cardiac cavities. Transesophageal echocardiography (TEE), of recent use, does quantify the amount of right atrial filling, duration of echogenesis and size of particles: the result is higher in patients who underwent cemented versus noncemented THA: however the embolism score is no an indicator of seriousness because it is not correlated with cardiorespiratory manifestations; TEE shows only one fourth of the patent foramen ovale, whereas the atrial septal defect is surely one of the most efficient systemic invasion mechanisms to produce perioperative fat embolism. Lung response is most often asymptomatic, even if all patients undergoing intramedullary surgery display an increase in pulmonary vascular resistance which is managed by the right heart only, as well as pulmonary (and sometimes systemic) microvascular fat obstruction. Common operating room monitoring procedures do not detect successive embolic phenomena before they cause pulmonary arterial hypertension which then has repercussions on the left heart and in turn causes peroperative hemodynamic accidents. Only pulmonary arterial pressure measurement with a Swan-Ganz catheter gives early and durable signs of an intolerance to embolic load. Preventive treatment is surgical as there is an inverse relation between embolic marrow and marrow eliminated by large volume washes (which is often more effective than draining). Cement indications in older patients as well as the choice of fixation techniques in femoral fractures must take into account the cardio-pulmonary condition of the patient. Resuscitation procedures dealing with these complications end in the patient's death in half of the cases. AD - Département d'Anesthésie-Réanimation, CHU Reims, Hôpital Maison Blanche, Reims. AN - 9161544 AU - Barre, J. AU - Lepouse, C. AU - Segal, P. DP - NLM ET - 1997/01/01 J2 - Revue de chirurgie orthopedique et reparatrice de l'appareil moteur KW - Animals Bone Cements/adverse effects Embolism, Fat/*etiology/physiopathology/therapy Femoral Neoplasms/surgery Fracture Fixation, Intramedullary/*adverse effects/methods Hip Prosthesis/*adverse effects/methods Knee Prosthesis/*adverse effects/methods LA - fre M1 - 1 N1 - PubMed NLM literature search January 5, 2021 OP - Embolies et chirurgie fémorale intra-médullaire. PY - 1997 SN - 0035-1040 (Print) 0035-1040 SP - 9-21 ST - [Embolism and intramedullary femoral surgery] T2 - Rev Chir Orthop Reparatrice Appar Mot TI - [Embolism and intramedullary femoral surgery] VL - 83 ID - 828798 ER - TY - JOUR AB - BACKGROUND: Cancer patients experience pathological fractures and the typical poor bone quality frequently complicates stabilization. Methods for overcoming screw failure include utilization of fenestrated screws that permit the injection of bone cement into the vertebral body to augment fixation. OBJECTIVE: To evaluate the safety and efficacy of cement augmentation via fenestrated screws. METHODS: A retrospective chart review of patients with neoplastic spinal instability who underwent percutaneous instrumented stabilization with cement augmentation using fenestrated pedicle screws. Patient demographic and treatment data and intraoperative and postoperative complications were evaluated by chart review and radiographic evaluation. Prospectively collected patient reported outcomes (PRO) were evaluated at short (2- <6 mo) and long term (6-12 mo). RESULTS: Cement augmentation was performed in 216 fenestrated pedicle screws in 53 patients. Three patients required reoperation. One patient had an asymptomatic screw fracture at 6 mo postoperatively that did not require intervention. No cases of lucency around the pedicle screws, rod fractures, or cement extravasation into the spinal canal were observed. Eight cases of asymptomatic, radiographically-detected venous extravasation were found. Systemic complications included a pulmonary cement embolism, a lower extremity deep vein thrombosis, and a postoperative mortality secondary to pulmonary failure from widespread metastatic pulmonary infiltration. Significant improvement in PRO measures was found in short- and long-term analysis. CONCLUSION: Cement augmentation of pedicle screws is an effective method to enhance the durability of spinal constructs in the cancer population. Risks include cement extravasation into draining blood vessels, but risk of clinically significant extravasation appears to be exceedingly low. AD - Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, New York. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York. Department of Neurological Surgery, Weill Cornell Medical College, New York, New York. AN - 30508168 AU - Barzilai, O. AU - McLaughlin, L. AU - Lis, E. AU - Reiner, A. S. AU - Bilsky, M. H. AU - Laufer, I. C2 - Pmc7311793 DA - May 1 DO - 10.1093/ons/opy186 DP - NLM ET - 2018/12/07 J2 - Operative neurosurgery (Hagerstown, Md.) KW - Adult Aged Aged, 80 and over *Bone Cements Female Humans Joint Instability/diagnostic imaging/*surgery Kyphoplasty/adverse effects/instrumentation/methods Lumbar Vertebrae/diagnostic imaging/surgery Male Middle Aged *Pedicle Screws Postoperative Complications/diagnostic imaging/surgery Prospective Studies Retrospective Studies Spinal Fusion/adverse effects/instrumentation/*methods Spinal Neoplasms/diagnostic imaging/*surgery Thoracic Vertebrae/diagnostic imaging Young Adult *Cancer *Fenestrated screws *Instability *PMMA bone cement *Spinal instability *Spine *Stabilization *Tumor LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 2332-4252 (Print) 2332-4252 SP - 593-599 ST - Utility of Cement Augmentation via Percutaneous Fenestrated Pedicle Screws for Stabilization of Cancer-Related Spinal Instability T2 - Oper Neurosurg (Hagerstown) TI - Utility of Cement Augmentation via Percutaneous Fenestrated Pedicle Screws for Stabilization of Cancer-Related Spinal Instability VL - 16 ID - 828555 ER - TY - JOUR AB - History and clinical findings Emergency admission of a 66-years-old man with right-sided and partly breath-dependent chest pain in the interdisciplinary emergency room. The complaints existed for several days and had a progressive character. Purulent expectoration and fever were negated. There was a history of COPD with occasional pulmonary exacerbations. Several weeks before the current event, community- acquired pneumonia had been treated with antibiotics. Moreover, the patient reported on multiple spine surgery procedures performed in recent months. Investigations and diagnosis In transthoracic echocardiography (TTE), detection of a foreign body (Palacos) in the right ventricle, which was confirmed to be a toothpick-like structure in the supplementary CT scan of the thorax and the transoesophageal echocardiography (TOE). Treatment and course Foreign body extraction using right anterior mini thoracotomy. Subsequently, iatrogenic pneumothorax with bilateral nosocomial pneumonia and drainage. After short-term convalescence, renewed admission with bilateral pulmonary infiltrates. Under invasive ventilation, new left-sided pneumothorax was diagnosed, which was supplied with a Bulau drainage. Due to the detection of positive blood cultures, re-conducting of a TOE examination. Now first diagnosis of tricuspid valve endocarditis. Despite successful surgical biologic tricuspid valve replacement with an epicardial pacemaker electrode placement, the patient died approximately three quarters of a year after he became an emergency patient due to dyspnoea. Discussion The present case shows that a typical clinical symptom, associated with a previously known chronic illness, has to be reminded again and again of other and less common diseases. Even everyday diagnostic and therapeutic procedures are associated with a residual risk of possible complications. AD - [Bauer, Marcus; Kroeger, Ulrike; Lenga, Peter] St Vincenz Krankenhaus Datteln, Med Klin 2, Rottstr 11, D-45711 Datteln, Germany. Bauer, M (corresponding author), St Vincenz Krankenhaus Datteln, Med Klin 2, Rottstr 11, D-45711 Datteln, Germany. m.bauer@vincenz-datteln.de AN - WOS:000477660800014 AU - Bauer, M. AU - Kroger, U. AU - Lenga, P. DA - Aug DO - 10.1055/a-0825-4939 J2 - Dtsch. Med. Wochenschr. KW - dyspnea percutaneous vertebroplasty palacos embolism tricuspid valve endocarditis CARDIAC PERFORATION PULMONARY-EMBOLISM CEMENT COMPLICATION Medicine, General & Internal LA - German M1 - 15 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 0012-0472 SP - 1069-1073 ST - Dyspnoea Due to Foreign Embolism after Percutaneous Vertebroplasty T2 - Deutsche Medizinische Wochenschrift TI - Dyspnoea Due to Foreign Embolism after Percutaneous Vertebroplasty UR - ://WOS:000477660800014 VL - 144 ID - 830129 ER - TY - JOUR AB - History and clinical findings Emergency admission of a 66-years-old man with right-sided and partly breath-dependent chest pain in the interdisciplinary emergency room. The complaints existed for several days and had a progressive character. Purulent expectoration and fever were negated. There was a history of COPD with occasional pulmonary exacerbations. Several weeks before the current event, community-acquired pneumonia had been treated with antibiotics. Moreover, the patient reported on multiple spine surgery procedures performed in recent months. Investigations and diagnosis In transthoracic echocardiography (TTE), detection of a foreign body (Palacos) in the right ventricle, which was confirmed to be a toothpick-like structure in the supplementary CT scan of the thorax and the transoesophageal echocardiography (TOE). Treatment and course Foreign body extraction using right anterior mini thoracotomy. Subsequently, iatrogenic pneumothorax with bilateral nosocomial pneumonia and drainage. After short-term convalescence, renewed admission with bilateral pulmonary infiltrates. Under invasive ventilation, new left-sided pneumothorax was diagnosed, which was supplied with a Bulau drainage. Due to the detection of positive blood cultures, re-conducting of a TOE examination. Now first diagnosis of tricuspid valve endocarditis. Despite successful surgical biologic tricuspid valve replacement with an epicardial pacemaker electrode placement, the patient died approximately three quarters of a year after he became an emergency patient due to dyspnoea. Discussion The present case shows that a typical clinical symptom, associated with a previously known chronic illness, has to be reminded again and again of other and less common diseases. Even everyday diagnostic and therapeutic procedures are associated with a residual risk of possible complications. AD - [Bauer, M.; Kroeger, U.; Lenga, P.] St Vincenz Krankenhaus Datteln, Med Klin 2, Rottstr 11, D-45711 Datteln, Germany. Bauer, M (corresponding author), St Vincenz Krankenhaus Datteln, Med Klin 2, Rottstr 11, D-45711 Datteln, Germany. m.bauer@vincenz-datteln.de AN - WOS:000579052400015 AU - Bauer, M. AU - Kroger, U. AU - Lenga, P. DA - Oct DO - 10.1055/a-1148-8733 J2 - Pneumologie KW - CARDIAC PERFORATION PULMONARY-EMBOLISM CEMENT COMPLICATION Respiratory System LA - German M1 - 10 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2020 SN - 0934-8387 SP - 665-669 ST - Dyspnoea Due to Foreign Embolism after Percutaneous Vertebroplasty T2 - Pneumologie TI - Dyspnoea Due to Foreign Embolism after Percutaneous Vertebroplasty UR - ://WOS:000579052400015 VL - 74 ID - 830098 ER - TY - JOUR AB - HISTORY AND CLINICAL FINDINGS: Emergency admission of a 66-years-old man with right-sided and partly breath-dependent chest pain in the interdisciplinary emergency room. The complaints existed for several days and had a progressive character. Purulent expectoration and fever were negated. There was a history of COPD with occasional pulmonary exacerbations. Several weeks before the current event, community-acquired pneumonia had been treated with antibiotics. Moreover, the patient reported on multiple spine surgery procedures performed in recent months. INVESTIGATIONS AND DIAGNOSIS: In transthoracic echocardiography (TTE), detection of a foreign body (Palacos) in the right ventricle, which was confirmed to be a toothpick-like structure in the supplementary CT scan of the thorax and the transoesophageal echocardiography (TOE). TREATMENT AND COURSE: Foreign body extraction using right anterior mini thoracotomy. Subsequently, iatrogenic pneumothorax with bilateral nosocomial pneumonia and drainage. After short-term convalescence, renewed admission with bilateral pulmonary infiltrates. Under invasive ventilation, new left-sided pneumothorax was diagnosed, which was supplied with a Bülau drainage. Due to the detection of positive blood cultures, re-conducting of a TOE examination. Now first diagnosis of tricuspid valve endocarditis. Despite successful surgical biologic tricuspid valve replacement with an epicardial pacemaker electrode placement, the patient died approximately three quarters of a year after he became an emergency patient due to dyspnoea. DISCUSSION: The present case shows that a typical clinical symptom, associated with a previously known chronic illness, has to be reminded again and again of other and less common diseases. Even everyday diagnostic and therapeutic procedures are associated with a residual risk of possible complications. AD - Medizinische Klinik II, St. Vincenz-Krankenhaus Datteln, Datteln, Germany. AN - 31350751 AU - Bauer, M. AU - Kröger, U. AU - Lenga, P. DA - Aug DO - 10.1055/a-0825-4939 DP - NLM ET - 2019/07/28 J2 - Deutsche medizinische Wochenschrift (1946) KW - Aged Bone Cements/adverse effects *Dyspnea/diagnosis/etiology *Foreign Bodies *Heart Ventricles/diagnostic imaging/pathology Humans Male Polymethyl Methacrylate/adverse effects *Postoperative Complications Thoracotomy Tomography, X-Ray Computed Vertebroplasty/*adverse effects LA - ger M1 - 15 N1 - PubMed NLM literature search January 5, 2021 OP - Dyspnoe aufgrund eines Fremdkörper-Embolisats nach perkutaner Vertebroplastie. PY - 2019 SN - 0012-0472 SP - 1069-1073 ST - [Dyspnoea Due to Foreign Embolism after Percutaneous Vertebroplasty] T2 - Dtsch Med Wochenschr TI - [Dyspnoea Due to Foreign Embolism after Percutaneous Vertebroplasty] VL - 144 ID - 828596 ER - TY - JOUR AB - HISTORY AND CLINICAL FINDINGS:  Emergency admission of a 66-years-old man with right-sided and partly breath-dependent chest pain in the interdisciplinary emergency room. The complaints existed for several days and had a progressive character. Purulent expectoration and fever were negated. There was a history of COPD with occasional pulmonary exacerbations. Several weeks before the current event, community-acquired pneumonia had been treated with antibiotics. Moreover, the patient reported on multiple spine surgery procedures performed in recent months. INVESTIGATIONS AND DIAGNOSIS:  In transthoracic echocardiography (TTE), detection of a foreign body (Palacos) in the right ventricle, which was confirmed to be a toothpick-like structure in the supplementary CT scan of the thorax and the transoesophageal echocardiography (TOE). TREATMENT AND COURSE:  Foreign body extraction using right anterior mini thoracotomy. Subsequently, iatrogenic pneumothorax with bilateral nosocomial pneumonia and drainage. After short-term convalescence, renewed admission with bilateral pulmonary infiltrates. Under invasive ventilation, new left-sided pneumothorax was diagnosed, which was supplied with a Bülau drainage. Due to the detection of positive blood cultures, re-conducting of a TOE examination. Now first diagnosis of tricuspid valve endocarditis. Despite successful surgical biologic tricuspid valve replacement with an epicardial pacemaker electrode placement, the patient died approximately three quarters of a year after he became an emergency patient due to dyspnoea. DISCUSSION:  The present case shows that a typical clinical symptom, associated with a previously known chronic illness, has to be reminded again and again of other and less common diseases. Even everyday diagnostic and therapeutic procedures are associated with a residual risk of possible complications. AD - Medizinische Klinik II, St. Vincenz-Krankenhaus Datteln, Datteln, Deutschland. AN - 33059372 AU - Bauer, M. AU - Kröger, U. AU - Lenga, P. DA - Oct DO - 10.1055/a-1148-8733 DP - NLM ET - 2020/10/16 J2 - Pneumologie (Stuttgart, Germany) KW - Aged Dyspnea/*etiology/mortality Echocardiography Endocarditis/diagnosis/*surgery Fatal Outcome Foreign Bodies/*diagnostic imaging Humans Male Postoperative Complications Pulmonary Embolism/diagnosis/*surgery Thoracotomy/*adverse effects Tricuspid Valve/microbiology/surgery Vertebroplasty/*adverse effects LA - ger M1 - 10 N1 - PubMed NLM literature search January 5, 2021 OP - Dyspnoe aufgrund eines Fremdkörper-Embolisats nach perkutaner Vertebroplastie. PY - 2020 SN - 0934-8387 SP - 665-669 ST - [Dyspnoea Due to Foreign Embolism after Percutaneous Vertebroplasty] T2 - Pneumologie TI - [Dyspnoea Due to Foreign Embolism after Percutaneous Vertebroplasty] VL - 74 ID - 828607 ER - TY - JOUR AB - PURPOSE: To report interdisciplinary management in a case of cement embolization into the inferior vena cava and peripheral pulmonary arteries after percutaneous vertebroplasty. CASE REPORT: A 50-year-old female patient with an osteoporotic compression fracture of the second lumbar vertebra underwent percutaneous vertebroplasty with polymethylmetaacrylate. Thereafter, CT scanning revealed small asymptomatic cement emboli in peripheral pulmonary arteries, along with a hook-shaped cement fragment in the inferior vena cava. Due to the risk that the large cement fragment could migrate to the pulmonary arteries and cause serious complications, they were retrieved from the inferior vena cava by an endovascular technique and extracted through a surgical groin incision. The patient received anticoagulant treatment for 3 months and is free of complaints after 1 year. CONCLUSION: This case shows that this rare complication following vertebroplasty can be successfully managed with an interdisciplinary approach. AD - Department of Vascular Surgery, University Hospital Graz, Graz, Austria. anneliese.baumann@meduni-graz.at AN - 16376118 AU - Baumann, A. AU - Tauss, J. AU - Baumann, G. AU - Tomka, M. AU - Hessinger, M. AU - Tiesenhausen, K. DA - May DO - 10.1016/j.ejvs.2005.11.008 DP - NLM ET - 2005/12/27 J2 - European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery KW - *Bone Cements Embolism/diagnosis/*etiology/*therapy Female Humans Lumbar Vertebrae/injuries Middle Aged *Polymethyl Methacrylate *Postoperative Complications Spinal Fractures/surgery *Vena Cava, Inferior LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 1078-5884 (Print) 1078-5884 SP - 558-61 ST - Cement embolization into the vena cava and pulmonal arteries after vertebroplasty: interdisciplinary management T2 - Eur J Vasc Endovasc Surg TI - Cement embolization into the vena cava and pulmonal arteries after vertebroplasty: interdisciplinary management VL - 31 ID - 828795 ER - TY - JOUR AB - The increase of intramedullary femoral pressure can lead to the intravasation of bone marrow and fat cells into the blood stream of the femoral vein and consequently into the pulmonary circulation. This effect is the same in intramedullary nailing and in the implantation of femoral stem prostheses. In a prospective study we evaluated the intraoperative, intramedullary pressure in the distal femur during the implantation of femoral stem prostheses with two different designs. In eight patients we implanted Müller straight stems and in another eight we implanted stem type Option 3000. Intramedullary pressure was recorded continuously by the implantation of a microtip pressure probe (piezoresistive principle, 50 Hz) in the distal femur. We found markedly higher pressure in Müller straight stem prostheses: range: 590-2,570 mmHg (median = 1,293, SD = 627 mmHg). Intramedullary pressure in stem prosthesis type Option 3000 was much lower: range: 59-574 mmHg (median = 289, SD = 219 mmHg). The differences were statistically significant (p = 0.0008). By changing the designs of femoral stem prostheses, the intramedullary pressure can be markedly reduced. In the case of elderly patients or those with pulmonary illness we recommend femoral stem prosthesis designs, which induce little increase in the intramedullary pressure, in order to reduce cardiopulmonary complications. AD - Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Ulm, Steinhövelstrasse 9, 89075 Ulm. alexander.beck@medizin.uni-ulm.de AN - 11803720 AU - Beck, A. AU - Strecker, W. AU - Gebhard, F. AU - Arand, M. AU - Krischak, G. AU - Kinzl, L. DA - Dec DO - 10.1007/s001130170005 DP - NLM ET - 2002/01/24 J2 - Der Unfallchirurg KW - Bone Cements Bone Marrow/*physiopathology Bone Screws Embolism, Fat/*physiopathology/prevention & control *Hip Prosthesis Humans Hydrostatic Pressure Intraoperative Complications/*physiopathology/prevention & control Microcomputers Monitoring, Intraoperative/instrumentation Prospective Studies Prosthesis Design Pulmonary Embolism/*physiopathology/prevention & control Risk Factors Signal Processing, Computer-Assisted/*instrumentation Software LA - ger M1 - 12 N1 - PubMed NLM literature search January 5, 2021 OP - Einfluss des Prothesendesigns auf die intramedulläre Druckentwicklung bei der Femurschaftimplantation von zementierten Hüftendoprothesen. PY - 2001 SN - 0177-5537 (Print) 0177-5537 SP - 1140-4 ST - [Influence of prosthesis design on intramedullary pressure formation in femur shaft implants of cemented hip endoprostheses] T2 - Unfallchirurg TI - [Influence of prosthesis design on intramedullary pressure formation in femur shaft implants of cemented hip endoprostheses] VL - 104 ID - 828856 ER - TY - JOUR AB - Vertebroplasty is a minimally invasive technique for the treatment of osteoporotic fractures. Within its complications is pulmonary embolism, which can be asymptomatic or with respiratory distress and may be notes by radiography or computed tomography. At present there is no guide to indicate the routine performance of imaging techniques after treatment, and all agreed on the need to start anticoagulant therapy for 3 months or so with coumarin in symptomatic or asymptomatic central emboli. AN - 24646932 AU - Bedini, M. P. AU - Albertini, R. A. AU - Orozco, S. DP - NLM ET - 2013/01/01 J2 - Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) KW - Anticoagulants/therapeutic use Bone Cements/adverse effects Female Humans Middle Aged Osteoporosis/complications Pulmonary Embolism/*diagnostic imaging/drug therapy/etiology Radiography Vertebroplasty/*adverse effects LA - spa M1 - 3 N1 - PubMed NLM literature search January 5, 2021 OP - Embolismo pulmonar de cemento posterior a vertebroplastia percutanea. PY - 2013 SN - 0014-6722 SP - 163-6 ST - [Pulmonary embolism following percutaneous vertebroplasty] T2 - Rev Fac Cien Med Univ Nac Cordoba TI - [Pulmonary embolism following percutaneous vertebroplasty] VL - 70 ID - 828820 ER - TY - JOUR AB - Background The ideal fixation for modern tibial components in total knee arthroplasty (TKA) remains controversial with uncertainty on whether cementless implants can yield equivalent outcomes to cemented fixation in early follow-up. Methods A series of 70 consecutive cases with reverse hybrid cementless fixation were matched to 70 cemented cases from 2008 to 2015 based on implant design and patient demographics. Results Cementless TKA demonstrated greater aseptic loosening (7 vs 0, P = .013) and revision surgery (10 vs 0, P = .001) than cemented fixation within 5 years of follow-up, but with no clinically significant differences in outcome scores. Conclusion It remains unclear whether early aseptic loosening in cementless TKA can be reduced with enhanced adjunct fixation and what proportion of early failure justifies the potential lifelong fixation through biologic ingrowth of cementless tibial components. AD - B.R. Levine, Department of Orthopaedics, Rush University Medical Center, 1611 W. Harrison St, Suite 300, Chicago, IL, United States AU - Behery, O. A. AU - Kearns, S. M. AU - Rabinowitz, J. M. AU - Levine, B. R. DB - Embase Medline DO - 10.1016/j.arth.2016.12.023 KW - cemented prosthesis cementless prosthesis adult aged article bone regeneration cemented tibial fixation cementless tibial fixation clinical outcome cohort analysis controlled study deep vein thrombosis device failure female fracture fixation human implant migration intermethod comparison lung embolism major clinical study male medical device complication outcome assessment pain patient satisfaction pes anserine bursitis postoperative complication prosthesis infection prosthesis loosening range of motion reoperation retrospective study total knee arthroplasty LA - English M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1532-8406 0883-5403 SP - 1510-1515 ST - Cementless vs Cemented Tibial Fixation in Primary Total Knee Arthroplasty T2 - Journal of Arthroplasty TI - Cementless vs Cemented Tibial Fixation in Primary Total Knee Arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L614065356&from=export http://dx.doi.org/10.1016/j.arth.2016.12.023 VL - 32 ID - 829252 ER - TY - JOUR AB - Introduction: Intra-cardiac embolism secondary to cement leakage during vertebroplasty for vertebral body fracture could be an incidental finding that may appear anytime during and after procedure, we report a case of chronic neglected intracardiac cement emboli detected 4 years after procedure. Case Report: A 68-year-old woman was admitted to our cardiology department due to progressive dyspnea and peripheral edema during last few months. She had a previous history of systemic hypertension and chronic AF rhythm taking oral anticoagulant with warfarin . She had undergone coronary angiography 8 yrs ago that showed ectatic coronary arteries with no significant stenosis. She had a traumatic fracture of multiple vertebral bodies 4 yrs ago that had prolonged hospitalization and surgical spinal fixation and instrumentation. ECG showed AF rhythm with nonspecific ST-T changes. Transthoracic echocardiography (TTE) showed normal LV size with reduced systolic function and EF = 20%, no RWMA , mild MR, severe RV enlargement and severe systolic RV dysfunction ,severe low pressure TR with pulmonary arterial pressure (PAP = 35-40 mmHg) and a linear, smooth, elongated thick wire-like echo-density in right atrium (RA) with proximal end free floating in RA chamber and prolapsing across tricuspid valve . Transesophageal echocardiography (TEE) showed that distal end of this echodensity entrapped in ostium of coronary sinus and there was no PFO. Reviewing her chest X-ray and chest Computed Tomography (CT) scan showed a large intracardiac radio-density in right heart along with right AV groove .After reviewing her past medical history in her previous remote hospitalization due to traumatic vertebral body fracture , she had combined bone cement augmentation procedure injecting polymethylmethacrylate (PMMA) cement into fractured vertebral body and surgical spinal fusion with instrument. Regarding her history and imaging data diagnosis of intracardiac cement emboli was confirmed. Fluoroscopy showed the presence of mobile radio-dense oyster-shell like foreign material in RA and one attempt to remove it by snare during intervention was unsuccessful due to rigid fixation of distal end in coronary sinus . As the patient stabilized with heart failure treatment and she had high operative risk due to low EF ,severe RV dysfunction and comorbidity , she was not candidate for surgical removal of intracardiac cement material and was discharged with oral therapeutic anticoagulation.In 6-month follow-up she is asymptomatic with no new event. Discussion: We experienced a case of accidental finding of chronic intra cardic embolism caused by cement leakage with an unsuccessful attempt to remove it from the RA. Transthoracic echocardiography is an inexpensive and non-invasive examination that should be always performed after these procedures to early identify cement cardiac embolization which may be associated with catastrophic complications. (Figure Presented). AD - N.E.D.A. Behzadnia, Shahid Beheshti Medical University, National Research Institute of Tuberculosis and Lung Disease, Tehran, Iran AU - Behzadnia, N. E. D. A. AU - Ahmadi, Z. H. AU - Naghashzadeh, F. A. R. A. H. AU - Serati, A. DB - Embase DO - 10.1093/ehjci/jey261 KW - bone cement warfarin adverse drug reaction aged animal shell anticoagulation artificial embolization cardiology case report clinical article comorbidity complication computer assisted tomography conference abstract coronary angiography coronary artery coronary sinus dyspnea electrocardiogram female fluoroscopy follow up foreign body fracture heart failure heart right atrium hospitalization human hypertension hypobarism incidental finding lung artery pressure medical history percutaneous vertebroplasty peripheral edema rhythm side effect spine fusion stenosis surgical risk thorax radiography transesophageal echocardiography transthoracic echocardiography tricuspid valve vertebra body LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 2047-2412 SP - i553 ST - Stone heart T2 - European Heart Journal Cardiovascular Imaging TI - Stone heart UR - https://www.embase.com/search/results?subaction=viewrecord&id=L630843487&from=export http://dx.doi.org/10.1093/ehjci/jey261 VL - 20 ID - 829169 ER - TY - JOUR AB - Introduction: In oncological patients, life quality can be greatly impaired by the presence of painful bone metastases, as standard forms of treatment often achieve inadequate palliation. The aim of our study was to evaluate the clinical efficacy of radiofrequency ablation (RFA) with respect to pain relief in patients with refractory bone metastases or who are ineligible to conventional treatments. Methods: 12 patients with 13 painful osteolytic skeletal metastases, and who were unresponsive to analgesic drug therapy, underwent one (seven lesions) or two (five lesions) RFA sessions under computed tomography (CT) guidance. The RFA procedure was completed in all patients without complications. One patient also received cementoplasty after the RFA procedure. To obtain semiquantitative pain scores, the brief pain inventory (BPI) was administered before treatment and during follow-up. The local effects of RFA were monitored for at least one year in eight of 12 patients with CT and/or magnetic resonance imaging. Results: Immediate pain relief after treatment was experienced by nine of 12 patients, but in two cases, pain recurred within the first week. Long-lasting palliation was obtained in seven of 12 patients. BPI mean scores for worst and average daily pain decreased from 7.7 and 5.0, respectively, at baseline, to 3.1 and 1.8, respectively, at one year. Imaging follow-up showed large areas of necrosis in nine of 12 lesions. Conclusion: In our preliminary experience, RFA showed good and long-lasting efficacy for pain control in bone metastases. A possible role of RFA as a coadjuvant palliative treatment in these cases is suggested. AD - [Belfiore, G.; Tedeschi, E.; Belfiore, M. P.] S Anna S Sebastiano Hosp, Dept Diagnost Imaging, I-81100 Caserta, Italy. [Della, Volpe T.] S Anna S Sebastiano Hosp, Dept Anesthesiol, I-81100 Caserta, Italy. [Zeppetella, G.] S Anna S Sebastiano Hosp, Dept Oncol & Palliat Care, I-81100 Caserta, Italy. [Ronza, F. M.; Rotondo, A.] Univ Naples 2, Dept Radiol, I-80138 Naples, Italy. Belfiore, G (corresponding author), S Anna S Sebastiano Hosp, Dept Diagnost Imaging, Via F Palasciano, I-81100 Caserta, Italy. radospce@libero.it AN - WOS:000258828300010 AU - Belfiore, G. AU - Tedeschi, E. AU - Ronza, F. M. AU - Belfiore, M. P. AU - Della, V. T. AU - Zeppetella, G. AU - Rotondo, A. DA - Jul J2 - Singap. Med. J. KW - bone metastases imaging-guided intervention pain palliation radiofrequency ablation thermoablation THERMAL ABLATION ORTHOPEDIC ONCOLOGY TUMORS CEMENTOPLASTY EMBOLIZATION EXPERIENCE Medicine, General & Internal LA - English M1 - 7 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2008 SN - 0037-5675 SP - 565-570 ST - Radiofrequency ablation of bone metastases induces long-lasting palliation in patients with untreatable cancer T2 - Singapore Medical Journal TI - Radiofrequency ablation of bone metastases induces long-lasting palliation in patients with untreatable cancer UR - ://WOS:000258828300010 VL - 49 ID - 830378 ER - TY - JOUR AB - This case report demonstrates too cases of embolization (Bone Cement Implantation Syndrome - BCIS) of echogenic material detected by transoesophageal echocardiography (TEE) during a cemented and cementless total hip arthroplasty. This case report is in line with other studies which show a haemodynamic impact of TEE detected emboli during total hip replacement. The stronger the embolic events, the heavier the cardiopulmonary complications. No chances were observed in plasma concentrations of natriuretic peptides and D-dimer. So far, further studies are required to determine therapeutic strategies in case of BCIS. AU - Belitova, M. AU - Karadimov, D. AU - Tivchev, P. AU - Zlatareva, N. AU - Kostadinova, R. DB - Embase KW - bone cement D dimer natriuretic factor adult article case report disease severity hemodynamic monitoring human image analysis lung embolism peroperative complication protein blood level total hip prosthesis transesophageal echocardiography LA - Bulgarian M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2007 SN - 1310-4284 SP - 42-47 ST - Pulmonary embolism detected by intraoperative transoesophageal echocardiography during total hip replacement T2 - Anaesthesiology and Intensive Care TI - Pulmonary embolism detected by intraoperative transoesophageal echocardiography during total hip replacement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L352530504&from=export VL - 34 ID - 829756 ER - TY - JOUR AB - We performed a case-control study to compare the rates of further surgery, revision and complications, operating time and survival in patients who were treated with either an uncemented hydroxyapatite-coated Corail bipolar femoral stem or a cemented Exeter stem for a displaced intracapsular fracture of the hip. The mean age of the patients in the uncemented group was 82.5 years (53 to 97) and in the cemented group was 82.7 years (51 to 99) We used propensity score matching, adjusting for age, gender and the presence or absence of dementia and comorbidities, to produce a matched cohort receiving an Exeter stem (n = 69) with which to compare the outcome of patients receiving a Corail stem (n = 69). The Corail had a significantly lower all-cause rate of further surgery (p = 0.016; odds ratio (OR) 0.18, 95% CI 0.04 to 0.84) and number of hips undergoing major further surgery (p = 0.029; OR 0.13, 95% CI 0.01 to 1.09). The mean operating time was significantly less for the Corail group than for the cemented Exeter group (59 min [12 to 136] vs 70 min [40 to 175], p = 0.001). The Corail group also had a lower risk of a peri-prosthetic fracture (p = 0.042; OR 0.19, 95% CI 0.01 to 1.42) . There was no difference in the mortality rate between the groups. There were significantly fewer complications in the uncemented group, suggesting that the use of this stem would result in a decreased rate of morbidity in these frail patients. Whether this relates to an improved functional outcome remains unknown. © 2014 The British Editorial Society of Bone & Joint Surgery. AD - P.J. Jenkins, Department of Orthopaedic Surgery, Royal Infirmary of Edinburgh, Old Dalkeith Road, Edinburgh, EH16 4SA, United Kingdom AU - Bell, K. R. AU - Clement, N. D. AU - Jenkins, P. J. AU - Keating, J. F. DB - Embase Medline DO - 10.1302/0301-620X.96B3 KW - hydroxyapatite adult aged article case control study cemented prosthesis cementless prosthesis deep vein thrombosis female femoral neck fracture fracture fixation fracture treatment hematoma hip prosthesis hip surgery human intermethod comparison Kaplan Meier method lung embolism major clinical study male morbidity operation duration postoperative complication priority journal randomized controlled trial (topic) reoperation respiratory tract infection survival rate treatment outcome very elderly wound hemorrhage wound infection cemented Exeter bipolar hemiarthroplasty uncemented collared hydroxyapatite coated Corail femoral stem LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 2049-4408 SP - 299-305 ST - A comparison of the use of uncemented hydroxyapatite-coated bipolar and cemented femoral stems in the treatment of femoral neck fractures: A case-control study T2 - Bone and Joint Journal TI - A comparison of the use of uncemented hydroxyapatite-coated bipolar and cemented femoral stems in the treatment of femoral neck fractures: A case-control study UR - https://www.embase.com/search/results?subaction=viewrecord&id=L372543587&from=export http://dx.doi.org/10.1302/0301-620X.96B3 VL - 96 B ID - 829434 ER - TY - JOUR AB - STUDY DESIGN: In vitro testing of vertebroplasty techniques including pulsed jet-lavage for fat and marrow removal in human cadaveric lumbar and thoracic vertebrae. OBJECTIVE: To develop jet-lavage techniques for vertebroplasty and investigate their effect on cement distribution, injection forces, and fat embolism. SUMMARY OF BACKGROUND DATA: The main complications of cement vertebroplasty are cement leakage and pulmonary fat embolism, which can have fatal consequences and are difficult to prevent reliably by current vertebroplasty techniques. METHODS: Twenty-four vertebrae (Th8-L04) from 5 osteoporotic cadaver spines were grouped in triplets depending on bone mineral density (BMD). Before polymethylmethacrylate (PMMA) vertebroplasty, a pulsatile jet-lavage for removal of intertrabecular fat and bone marrow was performed in 2 groups with 8 specimens each, performing radial and axial irrigation from the biopsy needles. One hundred mL of Ringer solution were injected through 1 pedicle and regained by low vacuum via the contralateral pedicle. Eight control vertebrae were not irrigated. All specimens underwent standardized PMMA cement augmentation injecting 20% of the vertebral volume. Injection forces, cement distribution, and extravasations were quantified. RESULTS: All irrigation solution could be retrieved with the vacuum applied. A Kruskal-Wallis test revealed significantly higher injection forces of the control group as compared with the irrigated groups (P = 0.021). Dilatation of the syringe at forces above 300 N occurred in 75% of the untreated compared with 12.5% of the lavaged specimens. CT distribution analysis showed more homogenous cement distribution of the cement and significantly less extravasation in the irrigated specimens. CONCLUSION: The developed lavage technique for vertebroplasty showed to be feasible and reproducible. The reduction of injection forces would allow the use of more viscous PMMA cement lowering the risk for cement embolization and results in a safer procedure. The wash-out of bone marrow and the possible reduction of pulmonary fat embolism have to be verified with in vivo models. AD - Inselspital, Department of Orthopaedic Surgery, University of Berne, Berne, Switzerland. lorin.benneker@insel.ch AN - 105607337. Language: English. Entry Date: 20090313. Revision Date: 20150711. Publication Type: Journal Article AU - Benneker, L. M. AU - Heini, P. F. AU - Suhm, N. AU - Gisep, A. DB - cin20 DP - EBSCOhost KW - Bone Cements Embolism, Fat -- Etiology Kyphoplasty -- Methods Methylmethacrylates -- Administration and Dosage Postoperative Complications Bone Cements -- Adverse Effects Bone Density Bone Diseases, Metabolic -- Metabolism Bone Diseases, Metabolic -- Surgery Cadaver Comparative Studies Data Analysis Software Kruskal-Wallis Test Kyphoplasty -- Adverse Effects Lumbar Vertebrae -- Surgery Mann-Whitney U Test Methylmethacrylates -- Adverse Effects Pressure Thoracic Vertebrae -- Surgery Human M1 - 23 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2008 SN - 0362-2436 SP - E906-10 ST - The effect of pulsed jet lavage in vertebroplasty on injection forces of polymethylmethacrylate bone cement, material distribution, and potential fat embolism: a cadaver study T2 - Spine (03622436) TI - The effect of pulsed jet lavage in vertebroplasty on injection forces of polymethylmethacrylate bone cement, material distribution, and potential fat embolism: a cadaver study UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105607337&site=ehost-live&scope=site VL - 33 ID - 830745 ER - TY - JOUR AD - Department of Orthopedic Surgery, Inselspital, University of Bern, Bern, Switzerland. AN - 104940465. Language: English. Entry Date: 20110401. Revision Date: 20200708. Publication Type: Journal Article AU - Benneker, L. M. AU - Krebs, J. AU - Boner, V. AU - Boger, A. AU - Hoerstrup, S. AU - Heini, P. F. AU - Gisep, A. DB - cin20 DO - 10.1007/s00586-010-1555-y DP - EBSCOhost KW - Blood Component Removal -- Methods Blood Pressure -- Physiology Bone Cements Cardiac Output -- Physiology Kyphoplasty -- Methods Methylmethacrylates -- Administration and Dosage Animal Studies Embolism, Fat -- Prevention and Control Female Injections Therapeutic Irrigation Models, Biological Pulmonary Embolism -- Prevention and Control Sheep M1 - 11 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2010 SN - 0940-6719 SP - 1913-1920 ST - Cardiovascular changes after PMMA vertebroplasty in sheep: the effect of bone marrow removal using pulsed jet-lavage T2 - European Spine Journal TI - Cardiovascular changes after PMMA vertebroplasty in sheep: the effect of bone marrow removal using pulsed jet-lavage UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104940465&site=ehost-live&scope=site VL - 19 ID - 830700 ER - TY - JOUR AD - Department of Rheumatology and Clinical Immunology/Allergology, University Hospital, CH-3010 Berne, Switzerland. AN - 12480681 AU - Bernhard, J. AU - Heini, P. F. AU - Villiger, P. M. C2 - Pmc1754288 DA - Jan DO - 10.1136/ard.62.1.85 DP - NLM ET - 2002/12/14 J2 - Annals of the rheumatic diseases KW - Aged Bone Cements/*adverse effects Humans Injections, Spinal Male Polymethyl Methacrylate/administration & dosage/*adverse effects Pulmonary Embolism/diagnostic imaging/*etiology Radiography Spinal Fractures/therapy Viscosity LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2003 SN - 0003-4967 (Print) 0003-4967 SP - 85-6 ST - Asymptomatic diffuse pulmonary embolism caused by acrylic cement: an unusual complication of percutaneous vertebroplasty T2 - Ann Rheum Dis TI - Asymptomatic diffuse pulmonary embolism caused by acrylic cement: an unusual complication of percutaneous vertebroplasty VL - 62 ID - 828936 ER - TY - JOUR AD - P.M. Villiger, Department of Rheumatology, University Hospital, CH-3010 Berne, Switzerland AU - Bernhard, J. AU - Heini, P. F. AU - Villiger, P. M. DB - Embase Medline DO - 10.1136/ard.62.1.85 KW - bone cement poly(methyl methacrylate) aged case report computer assisted tomography embolism human letter lung embolism male nuclear magnetic resonance imaging osteoporosis percutaneous vertebroplasty priority journal thorax radiography vertebra body spine fracture LA - English M1 - 1 M3 - Letter N1 - Embase Elsevier literature search January 5, 2021 PY - 2003 SN - 0003-4967 SP - 85-86 ST - Asymptomatic diffuse pulmonary embolism caused by acrylic cement: An unusual complication of percutaneous vertebroplasty [4] T2 - Annals of the Rheumatic Diseases TI - Asymptomatic diffuse pulmonary embolism caused by acrylic cement: An unusual complication of percutaneous vertebroplasty [4] UR - https://www.embase.com/search/results?subaction=viewrecord&id=L36005806&from=export http://dx.doi.org/10.1136/ard.62.1.85 VL - 62 ID - 829857 ER - TY - JOUR AB - Patients who undergo vertebroplasties to repair fractures may develop complications postoperatively. If proper work-up is completed, cement emboli may be uncovered. Based on a literature review, 0.4-0.9% of patients who undergo vertebroplasties and are found to have cement emboli present with symptoms such as that of dyspnea, tachycardia, and/or tachypnea. In this case report, a 76-year-old female who underwent a vertebroplasty due to an L1 vertebral fracture secondary to a mechanical fall, developed increased oxygen demand along with increased respiratory and heart rates. Plain films demonstrated bilateral pleural effusion and incidentally appreciated cement emboli. A thoracentesis was performed and resulted in a significant number of red blood cells correlating with a hemothorax. This was suspected as a possible complication of vetebroplasty. Based on the limited amount of cases reported, treatment of cement emboli includes anticoagulation. There is no gold standard agent, however, it has been reported that Warfarin or Enoxaparin for approximately 3 months can help prevent thrombosis around cement. In this case, the patient was not placed on any means of anticoagulation due to the rare complication of hemothorax secondary to cement emboli. Instead, her symptoms were relieved after a chest tube was placed. Up until this point, hemothorax has not been a reported outcome of cement emboli. Increased awareness of this complication may have helped guide treatment and shorten the length of hospitalization for this patient. AD - M. Bernshteyn, SUNY Upstate Medical University, Syracuse, NY, United States AU - Bernshteyn, M. AU - Cortese, A. AU - Nat, A. DB - Embase KW - cement enoxaparin oxygen warfarin aged anticoagulation artificial ventilation awareness breathing rate case report chest tube clinical article complication conference abstract dyspnea embolism erythrocyte female gold standard heart rate hematothorax hospitalization human human cell percutaneous vertebroplasty pleura effusion prevention spine fracture tachycardia tachypnea thoracocentesis thrombosis LA - English M1 - 9 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1535-4970 ST - Cement emboli and subsequent traumatic hemothorax as a rare complication of vertebroplasty T2 - American Journal of Respiratory and Critical Care Medicine TI - Cement emboli and subsequent traumatic hemothorax as a rare complication of vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L630355068&from=export VL - 199 ID - 829141 ER - TY - JOUR AB - Introduction: Spinal Hemangiomas usually show a benign behavior, found to be 2 - 3% of all spine tumors. Within autopsy or using MRI, they can be found in up to 10 % of all spine tumors. These tumors consist of blood vessels, may result in excavation of the vertebral body and result in fractures or spinal cord compression. Preoperative embolization seems to be a useful tool to reduce blood loss under surgery and is - combination with irradiation or vertebroplasty and posterior fixation - a possible treatment (Fig-1). We saw, however, following this treatment, a relevant number of local recurrency. Here, we present our experiences with recurrened hemangiomas as well as initially aggressive hemangiomas with extensive growth, narrowing the spinal canal causing neurological symptoms. Materials/Methods: Data presented here are extracted from the register of a large spine center in Germany. Search paradigm was “hemangioma”. Time of data acquisition: 1/ 1997-6/2017. We present demographic data, clinical symptoms, localization of the tumor, kind of surgery, which was performed first and the definitive operative treatment. Results: 24 Patients, mean age 55±17years, 1 FU 1 month - 19 years.14 F, 10 M. 75% of the patients with local pain, 25% with neurological symptoms. Main localization (62%) was the thoracic spine, the vertebral body was always affected and there was always an epidural invasion. 33% of patients had received a pretreatment, (3 with vertebroplasty, 5 with decompression of the spinal canal, followed by posterior instrumentation). Preoperative embolization in 19 cases. In 83% final treatment with a vertebral - body -en-bloc resection and fixation (Fig-2). Intracavitary spongiosaplasty and incomplete vertebral body resection in each 8% of patients. Up to now no recurrence. Conclusion: Although spinal hemangiomas usually grow within the vertebral body without spinal canal invasion, there are others with more aggressive behavior- both initially or seen as recurrence. In those cases the hemangiomas invade the spinal canal, resulting in severe neuro deficits. We feel that simple decompression with instrumentation or vertebroplasty is not sufficient to prevent further growth in these cases. Thus, radical resection and an intense FU are necessary both in recurrence and in initially aggressive tumors, too. Moreover, a preoperative embolization to prevent intraoperative bleeding seems to make sense. (Figure Presented). AD - J. Drumm, SRH Klinikum, Zentrum für Wirbelsäulenchirurgie, Karlsbad, Germany AU - Berthold, C. AU - Drumm, J. AU - Pöckler-Schöniger, C. AU - Pitzen, T. AU - Ruf, M. DB - Embase DO - 10.1007/s00586-017-5336-8 KW - adult aggression artificial embolization clinical article decompression demography female Germany hemangioma human information processing irradiation male middle aged neurologic disease operative blood loss pain percutaneous vertebroplasty prevention radical resection relapse surgery thoracic spine vertebra body vertebral canal LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1432-0932 SP - 2999 ST - Treatment strategy for hemangiomas with aggressive behaviour or recurrence T2 - European Spine Journal TI - Treatment strategy for hemangiomas with aggressive behaviour or recurrence UR - https://www.embase.com/search/results?subaction=viewrecord&id=L619390836&from=export http://dx.doi.org/10.1007/s00586-017-5336-8 VL - 26 ID - 829233 ER - TY - JOUR AD - Department of Cardiology, Centre Hospitalier Universitaire de Grenoble, BP 217, Grenoble Cedex 09 38043, France. Department of Cardiology, Centre Hospitalier Universitaire de Grenoble, BP 217, Grenoble Cedex 09 38043, France Department of Radiology, Groupe Hospitalier Mutualiste de Grenoble, France. Department of Cardiology, Centre Hospitalier Universitaire de Grenoble, BP 217, Grenoble Cedex 09 38043, France ennezat@yahoo.com. AN - 24497331 AU - Berthoud, B. AU - Sarre, G. AU - Chaix, D. AU - Ennezat, P. V. DA - Sep 7 DO - 10.1093/eurheartj/ehu013 DP - NLM ET - 2014/02/06 J2 - European heart journal KW - Adult Bone Cements/*adverse effects Cardiac Tamponade/*chemically induced Female Foreign-Body Migration/complications Humans Kyphoplasty/adverse effects Lumbar Vertebrae/surgery Pericardial Effusion/chemically induced Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/*chemically induced Spinal Neoplasms/secondary/surgery LA - eng M1 - 34 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 0195-668x SP - 2333 ST - Cardiac tamponnade, cement right atrial mass, and pulmonary embolism complicating percutaneous plasty of osteolytic metastases T2 - Eur Heart J TI - Cardiac tamponnade, cement right atrial mass, and pulmonary embolism complicating percutaneous plasty of osteolytic metastases VL - 35 ID - 828895 ER - TY - JOUR AB - STUDY DESIGN: Prospective case series. OBJECTIVES: To determine the safety and feasibility of routine preinjection of gelfoam embolization during percutaneous vertebroplasty. SUMMARY OF BACKGROUND DATA: Percutaneous vertebroplasty has been used effectively in pain relief for vertebral fractures resulting from malignancy and osteoporosis. However, cement extrusion is a common problem and can lead to complications. Gelfoam embolization of venous channels before cement injection has not been widely used as a technique to prevent leakage. METHODS: Thirty-one patients who met the inclusion-exclusion criteria for the study underwent percutaneous vertebroplasty. Venography was first performed to determine the flow pattern in the vertebrae and confirm needle placement. Next, routine gelfoam embolization of venous channels was performed. This was followed by low-pressure, minimal-volume cement injection. The outcome measure of cement leakage was assessed after surgery using radiographs and CT scans. RESULTS: There were no complications. In the 31 patients, 61 levels of vertebroplasty were performed. Overall, there were 16 leaks out of 61 levels in 12 patients (26.2%). In osteoporotic fractures, there were 11 leaks in 49 levels, giving a leakage rate of 22.5%. There was only 1 epidural leak in this group (2%), and this was asymptomatic. Seven leakages were into the adjacent disc, 2 into the body, and 1 into the paravertebral tissues. In malignant fractures, there were 5 leakages out of 12 levels (41.7%). Of these, 2 were epidural leaks (16.7%), which were asymptomatic. CONCLUSIONS: Complications resulting from leakage are the most feared side effect of the procedure. This has resulted in only limited application of vertebroplasty in the United Kingdom. Routine gelfoam embolization together with careful technique has been shown to be a safe and feasible method during vertebroplasty. AD - Department of Orthopaedics, University Hospital of North Tees, Hardwick, Stockton on Tees, UK. AN - 16622381 AU - Bhatia, C. AU - Barzilay, Y. AU - Krishna, M. AU - Friesem, T. AU - Pollock, R. DA - Apr 15 DO - 10.1097/01.brs.0000209307.03930.38 DP - NLM ET - 2006/04/20 J2 - Spine KW - Aged Aged, 80 and over *Bone Cements *Embolization, Therapeutic *Extravasation of Diagnostic and Therapeutic Materials/epidemiology Female Gelatin Sponge, Absorbable/*administration & dosage Humans Injections, Spinal Male Middle Aged Prospective Studies Spinal Fractures/epidemiology/surgery/*therapy Spinal Fusion/*methods LA - eng M1 - 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0362-2436 SP - 915-9 ST - Cement leakage in percutaneous vertebroplasty: effect of preinjection gelfoam embolization T2 - Spine (Phila Pa 1976) TI - Cement leakage in percutaneous vertebroplasty: effect of preinjection gelfoam embolization VL - 31 ID - 828755 ER - TY - JOUR AB - Study Design. Prospective case series. Objectives. To determine the safety and feasibility of routine preinjection of gelfoam embolization during percutaneous vertebroplasty. Summary of Background Data. Percutaneous vertebroplasty has been used effectively in pain relief for vertebral fractures resulting from malignancy and osteoporosis. However, cement extrusion is a common problem and can lead to complications. Gelfoam embolization of venous channels before cement injection has not been widely used as a technique to prevent leakage. Methods. Thirty-one patients who met the inclusionexclusion criteria for the study underwent percutaneous vertebroplasty. Venography was first performed to determine the flow pattern in the vertebrae and confirm needle placement. Next, routine gelfoam embolization of venous channels was performed. This was followed by low-pressure, minimal-volume cement injection. The outcome measure of cement leakage was assessed after surgery using radiographs and CT scans. Results. There were no complications. In the 31 patients, 61 levels of vertebroplasty were performed. Overall, there were 16 leaks out of 61 levels in 12 patients (26.2%). In osteoporotic fractures, there were 11 leaks in 49 levels, giving a leakage rate of 22.5%. There was only 1 epidural leak in this group (2%), and this was asymptomatic. Seven leakages were into the adjacent disc, 2 into the body, and 1 into the paravertebral tissues. In malignant fractures, there were 5 leakages out of 12 levels (41.7%). Of these, 2 were epidural leaks (16.7%), which were asymptomatic. Conclusions. Complications resulting from leakage are the most feared side effect of the procedure. This has resulted in only limited application of vertebroplasty in the United Kingdom. Routine gelfoam embolization together with careful technique has been shown to be a safe and feasible method during vertebroplasty. AD - Univ Hosp N Tees, Dept Orthopaed, Stockton On Tees TS19 8PE, England. Pollock, R (corresponding author), Univ Hosp N Tees, Dept Orthopaed, Stockton On Tees TS19 8PE, England. raymond.pollock@nth.nhs.uk AN - WOS:000236922700012 AU - Bhatia, C. AU - Barzilay, Y. AU - Krishna, M. AU - Friesem, T. AU - Pollock, R. DA - Apr DO - 10.1097/01.brs.0000209307.03930.38 J2 - Spine KW - vertebroplasty cement leakage vertebral fracture gelfoam embolization VERTEBRAL COMPRESSION FRACTURES TRANSPEDICULAR VERTEBROPLASTY METHACRYLATE VERTEBROPLASTY METHYL-METHACRYLATE POLYMETHYLMETHACRYLATE METASTASES INJECTION VOLUME Clinical Neurology Orthopedics LA - English M1 - 8 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2006 SN - 0362-2436 SP - 915-919 ST - Cement leakage in percutaneous vertebroplasty - Effect of preinjection gelfoam embolization T2 - Spine TI - Cement leakage in percutaneous vertebroplasty - Effect of preinjection gelfoam embolization UR - ://WOS:000236922700012 VL - 31 ID - 830410 ER - TY - JOUR AB - STUDY DESIGN: Case report. OBJECTIVE: To report a case of injury to a segmental branch of the L4 lumbar artery following kyphoplasty. SUMMARY OF BACKGROUND DATA: To our knowledge, arterial injury following vertebral augmentation has not been described. The complications that have been reported rarely require additional intervention. The caliber of the fourth lumbar artery is such that injury to it, or to its more proximal branches, may cause significant morbidity. METHODS: An 84-year-old female who presents 10 days after surgery from L5 kyphoplasty with pulsatile bleeding from the kyphoplasty site. An angiogram revealed an injury to a segmental branch of L4 lumbar artery. RESULTS: A superselective angiogram was performed, followed by embolization of a branch of the L4 lumbar artery. This procedure successfully controlled the bleeding. CONCLUSION: Surgeons performing percutaneous procedures for the augmentation of vertebral compression fractures are not able to visualize the arterial channels on the posterior aspect of the vertebral column. Although injury to these structures may be difficult to prevent, awareness of this complication will improve our response and decrease associated morbidity. AD - Department of Orthopaedic Surgery, University of Illinois Medical Center, Chicago, USA. AN - 16449893 AU - Biafora, S. J. AU - Mardjetko, S. M. AU - Butler, J. P. AU - McCarthy, P. L. AU - Gleason, T. F. DA - Feb 1 DO - 10.1097/01.brs.0000197596.88416.02 DP - NLM ET - 2006/02/02 J2 - Spine KW - Aged, 80 and over Female Fracture Fixation, Internal/*adverse effects Fractures, Compression/diagnostic imaging/surgery Humans Lumbar Vertebrae/diagnostic imaging/*surgery Orthopedic Procedures/adverse effects Radiography Spinal Fractures/diagnostic imaging/surgery Vertebral Artery/*diagnostic imaging/*injuries LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0362-2436 SP - E84-7 ST - Arterial injury following percutaneous vertebral augmentation: a case report T2 - Spine (Phila Pa 1976) TI - Arterial injury following percutaneous vertebral augmentation: a case report VL - 31 ID - 828919 ER - TY - JOUR AB - Study Design. Case report. Objective. To report a case of injury to a segmental branch of the L4 lumbar artery following kyphoplasty. Summary of Background Data. To our knowledge, arterial injury following vertebral augmentation has not been described. The complications that have been reported rarely require additional intervention. The caliber of the fourth lumbar artery is such that injury to it, or to its more proximal branches, may cause significant morbidity. Methods. An 84-year-old female who presents 10 days after surgery from L5 kyphoplasty with pulsatile bleeding from the kyphoplasty site. An angiogram revealed an injury to a segmental branch of L4 lumbar artery. Results. A superselective angiogram was performed, followed by embolization of a branch of the L4 lumbar artery. This procedure successfully controlled the bleeding. Conclusion. Surgeons performing percutaneous procedures for the augmentation of vertebral compression fractures are not able to visualize the arterial channels on the posterior aspect of the vertebral column. Although injury to these structures may be difficult to prevent, awareness of this complication will improve our response and decrease associated morbidity. AD - Univ Illinois, Dept Orthopaed Surg, Med Ctr, Chicago, IL USA. Illinois Bone & Joint Inst, Rush Dept Orthopaed Surg, Morton Grove, IL USA. Adv Radiol Consultants, Park Ridge, IL USA. Gleason, TF (corresponding author), 734 Raleigh Rd, Glenview, IL 60053 USA. ibji@mindspring.com AN - WOS:000235011800024 AU - Biafora, S. J. AU - Mardjetko, S. M. AU - Butler, J. P. AU - McCarthy, P. L. AU - Gleason, T. F. DA - Feb DO - 10.1097/01.brs.0000197596.88416.02 J2 - Spine KW - kyphoplasty vascular injury lumbar artery embolization COMPRESSION FRACTURES BALLOON KYPHOPLASTY OUTCOMES BODY Clinical Neurology Orthopedics LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2006 SN - 0362-2436 SP - E84-E87 ST - Arterial injury following percutaneous vertebral augmentation - A case report T2 - Spine TI - Arterial injury following percutaneous vertebral augmentation - A case report UR - ://WOS:000235011800024 VL - 31 ID - 830414 ER - TY - JOUR AB - Study Design: Case report. Objective: To report a case of injury to a segmental branch of the L4 lumbar artery following kyphoplasty. Summary Of Background Data: To our knowledge, arterial injury following vertebral augmentation has not been described. The complications that have been reported rarely require additional intervention. The caliber of the fourth lumbar artery is such that injury to it, or to its more proximal branches, may cause significant morbidity. Methods: An 84-year-old female who presents 10 days after surgery from L5 kyphoplasty with pulsatile bleeding from the kyphoplasty site. An angiogram revealed an injury to a segmental branch of L4 lumbar artery. Results: A superselective angiogram was performed, followed by embolization of a branch of the L4 lumbar artery. This procedure successfully controlled the bleeding. Conclusion: Surgeons performing percutaneous procedures for the augmentation of vertebral compression fractures are not able to visualize the arterial channels on the posterior aspect of the vertebral column. Although injury to these structures may be difficult to prevent, awareness of this complication will improve our response and decrease associated morbidity. AD - Department of Orthopaedic Surgery, University of Illinois Medical Center, Chicago, USA Department of Orthopaedic Surgery, University of Illinois Medical Center, Chicago AN - 106433050. Language: English. Entry Date: 20060428. Revision Date: 20200708. Publication Type: journal article AU - Biafora, S. J. AU - Mardjetko, S. M. AU - Butler, J. P. AU - McCarthy, P. L. AU - Gleason, T. F. AU - Biafora, Sam J. AU - Mardjetko, Steven M. AU - Butler, Jesse P. AU - McCarthy, Patrick L. AU - Gleason, Thomas F. DB - cin20 DO - 10.1097/01.brs.0000197596.88416.02 DP - EBSCOhost KW - Embolization, Therapeutic -- In Old Age Hemorrhage -- Etiology -- In Old Age Kyphoplasty -- In Old Age Lumbar Vertebrae -- Pathology -- In Old Age Postoperative Complications -- In Old Age Vertebral Artery -- Injuries -- In Old Age Aged, 80 and Over Female M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2006 SN - 0362-2436 SP - E84-7 ST - Arterial injury following percutaneous vertebral augmentation: a case report T2 - Spine (03622436) TI - Arterial injury following percutaneous vertebral augmentation: a case report UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106433050&site=ehost-live&scope=site VL - 31 ID - 830774 ER - TY - JOUR AD - C.J. Lettieri, Pulmonary and Critical Care Medicine, Walter Reed Army Medical Center, Washington, DC, United States AU - Biega, T. J. AU - Lettieri, C. J. AU - Levy, L. M. AU - Venbrux, A. C. DB - Embase Medline DO - 10.1159/000092955 KW - bone cement poly(methyl methacrylate) abdominal pain aged article case report common bile duct stone compression fracture dyspnea exercise tolerance female human lung embolism percutaneous vertebroplasty priority journal thorax radiography X ray film LA - English M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 0025-7931 SP - 705-707 ST - Linear pulmonary opacities in an asymptomatic patient T2 - Respiration TI - Linear pulmonary opacities in an asymptomatic patient UR - https://www.embase.com/search/results?subaction=viewrecord&id=L44481492&from=export http://dx.doi.org/10.1159/000092955 VL - 73 ID - 829787 ER - TY - JOUR AB - INTRODUCTION: We present the case of a patient with exertional fat embolism on isolated exercise of his right leg two and four months after right total hip joint replacement. His immediate post-operative period had also been complicated by an acute episode of chest pain and hypotension, treated as acute coronary syndrome. To the best of our knowledge, this is the first reported case of exertional fat embolism following orthopedic surgery. CASE PRESENTATION: A 71-year-old Caucasian man underwent elective cementless total right hip joint replacement. His acute post-operative period was complicated by an episode of chest pain and hypotension. This was treated as acute coronary syndrome. Two months later, a routine stress echocardiography demonstrated a shower of small, echodense bubbles in his right heart, reproduced on exercise of his right leg but not his left. Computed tomography pulmonary angiography excluded pulmonary thromboemboli. A technetium-99m colloid scan confirmed pulmonary fat emboli. Similar findings occurred again four months after the operation but had resolved at six months. CONCLUSIONS: Fat embolism is a well-described phenomenon in the acute setting after long-bone trauma or intramedullary manipulation, and the rare fat embolism syndrome can be fatal. Exertional fat embolism months after joint replacement, however, is an undescribed phenomenon that may have implications in the sub-acute post-operative phase. This may be of particular interest to those involved in orthopedics, cardiology and rehabilitation, but the large volume of patients undergoing joint replacements may broaden the clinical scope of this unusual presentation far beyond these specialties. AD - Cardiology Department, Level 3 West, Concord Repatriation General Hospital, Hospital Road, Concord, NSW 2139, Australia. john.yiannikas@sydney.edu.au. AN - 25495955 AU - Bing, R. AU - Yiannikas, J. C2 - Pmc4301799 DA - Dec 15 DO - 10.1186/1752-1947-8-426 DP - NLM ET - 2014/12/17 J2 - Journal of medical case reports KW - Acute Coronary Syndrome/*diagnosis/physiopathology Aged Arthroplasty, Replacement, Hip/*adverse effects Embolism, Fat/*diagnosis/*etiology/physiopathology *Exercise Humans Male Postoperative Complications/*diagnosis/physiopathology Treatment Outcome LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1752-1947 SP - 426 ST - Exertional fat embolism after hip joint replacement: a case report T2 - J Med Case Rep TI - Exertional fat embolism after hip joint replacement: a case report VL - 8 ID - 828781 ER - TY - JOUR AB - Study Design. Retrospective review. Objective. To describe an accurate method of intraoperative localization of thoracic spine levels with percutaneously placed radiopaque markers at the pedicle of the level of interest. Summary of Background Data. Intraoperative localization of thoracic spine levels can be difficult in cases without obvious vertebral body deformation (compression fracture, tumor), such as thoracic discectomy, as well as in surgery of the midthoracic spine and in the morbidly obese. Intraoperative fluoroscopy or plain radiographs are useful but can often be difficult to interpret in these cases. Methods. Fourteen patients requiring anterior thoracic spine surgery for thoracic disc herniations underwent preoperative localization and placement of radiopaque marker. Using standard percutaneous techniques, the radiopaque markers were placed using biplanar fluoroscopy at the pedicle at the level of interest. Eight patients subsequently underwent thoracoscopic discectomy and fusion, and 6 patients underwent mini-open thoracotomy for discectomy and fusion. Results. Placement of radiopaque markers was successfully completed without complications in all 14 patients. Intraoperatively, the markers were easy to identify and assisted in identification of the correct surgical level in all cases. Conclusion. Preoperative placement of radiopaque markers at the level of interest before surgery of the thoracic spine is a safe and effective technique for avoiding wrong-level surgery in cases in which standard localization techniques may be difficult. AD - [Binning, Mandy J.; Schmidt, Meic H.] Univ Utah, Dept Neurosurg, Salt Lake City, UT 84132 USA. Schmidt, MH (corresponding author), Univ Utah, Dept Neurosurg, 175 N Med Dr E, Salt Lake City, UT 84132 USA. neuropub@hsc.utah.edu AN - WOS:000281656400015 AU - Binning, M. J. AU - Schmidt, M. H. DA - Sep DO - 10.1097/BRS.0b013e3181c90bdf J2 - Spine KW - thoracic spine localization radiopaque markers PULMONARY-EMBOLISM INTRADURAL LESIONS ACRYLIC CEMENT VERTEBROPLASTY POLYMETHYLMETHACRYLATE Clinical Neurology Orthopedics LA - English M1 - 19 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2010 SN - 0362-2436 SP - 1821-1825 ST - Percutaneous Placement of Radiopaque Markers at the Pedicle of Interest for Preoperative Localization of Thoracic Spine Level T2 - Spine TI - Percutaneous Placement of Radiopaque Markers at the Pedicle of Interest for Preoperative Localization of Thoracic Spine Level UR - ://WOS:000281656400015 VL - 35 ID - 830336 ER - TY - JOUR AB - The underlying case report describes the successful endovascular prevention of an aortic injury by a bone cement skid after kyphoplasty. The intervention was performed in order to prohibit fatal aortic rupture or embolisation and underlines the role of vascular surgery techniques in interdisciplinary clinical networks. AD - [Bischoff, M. S.; Meisenbacher, K.; Hyhlik-Durr, A.; Boeckler, D.] Univ Klinikum Heidelberg, Klin Gefasschirurg & Endovaskulare Chirurg, Neuenheimer Feld 110, D-69120 Heidelberg, Germany. [Schmack, B.] Univ Klinikum Heidelberg, Klin Herzchirurg, Heidelberg, Germany. [Tanner, M.] Univ Klinikum Heidelberg, Klin Orthopad & Unfallchirurg, Heidelberg, Germany. [Goldschmidt, H.] Univ Klinikum Heidelberg, Klin Innere Med 5, Heidelberg, Germany. [Kasperk, C.] Univ Klinikum Heidelberg, Klin Innere Med 1, Heidelberg, Germany. Bischoff, MS (corresponding author), Univ Klinikum Heidelberg, Klin Gefasschirurg & Endovaskulare Chirurg, Neuenheimer Feld 110, D-69120 Heidelberg, Germany. moritz.bischoff@med.uni-heidelberg.de AN - WOS:000387309400009 AU - Bischoff, M. S. AU - Meisenbacher, K. AU - Schmack, B. AU - Tanner, M. AU - Goldschmidt, H. AU - Kasperk, C. AU - Hyhlik-Durr, A. AU - Bockler, D. DA - Nov DO - 10.1007/s00132-016-3342-x J2 - Orthopade KW - Aortic diseases Balloon vertebroplasty Endovascular techniques Grafts Stents PERCUTANEOUS VERTEBROPLASTY INJURY Orthopedics LA - German M1 - 11 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2016 SN - 0085-4530 SP - 994-997 ST - Prevention of aortic erosion by a bone cement skid. Thoracic endovascular aortic repair following kyphoplasty T2 - Orthopade TI - Prevention of aortic erosion by a bone cement skid. Thoracic endovascular aortic repair following kyphoplasty UR - ://WOS:000387309400009 VL - 45 ID - 830206 ER - TY - JOUR AB - The underlying case report describes the successful endovascular prevention of an aortic injury by a bone cement skid after kyphoplasty. The intervention was performed in order to prohibit fatal aortic rupture or embolisation and underlines the role of vascular surgery techniques in interdisciplinary clinical networks. AD - Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland. moritz.bischoff@med.uni-heidelberg.de. Klinik für Gefäßchirurgie und Endovaskuläre Chirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland. Klinik für Herzchirurgie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland. Klinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland. Klinik für Innere Medizin V, Universitätsklinikum Heidelberg, Heidelberg, Deutschland. Klinik für Innere Medizin I, Universitätsklinikum Heidelberg, Heidelberg, Deutschland. AN - 27709244 AU - Bischoff, M. S. AU - Meisenbacher, K. AU - Schmack, B. AU - Tanner, M. AU - Goldschmidt, H. AU - Kasperk, C. AU - Hyhlik-Dürr, A. AU - Böckler, D. DA - Nov DO - 10.1007/s00132-016-3342-x DP - NLM ET - 2016/10/28 J2 - Der Orthopade KW - Aged Aorta, Thoracic/*injuries/*surgery *Blood Vessel Prosthesis Combined Modality Therapy Endovascular Procedures/*instrumentation/methods Female Humans Kyphoplasty Treatment Outcome Vascular System Injuries/diagnostic imaging/*surgery Wounds, Penetrating/diagnostic imaging/*surgery Aortic diseases Balloon vertebroplasty Endovascular techniques Grafts Stents LA - ger M1 - 11 N1 - PubMed NLM literature search January 5, 2021 OP - Pelottierung der A. thoracica descendens durch einen Zementsporn : Endovaskuläre Behandlung nach Kyphoplastie. PY - 2016 SN - 0085-4530 SP - 994-997 ST - [Prevention of aortic erosion by a bone cement skid : Thoracic endovascular aortic repair following kyphoplasty] T2 - Orthopade TI - [Prevention of aortic erosion by a bone cement skid : Thoracic endovascular aortic repair following kyphoplasty] VL - 45 ID - 828509 ER - TY - JOUR AB - OBJECTIVES: Intravasation of bone marrow contents into venous circulation and pulmonary embolization after intramedullary nailing may be coupled with the activation of coagulation and fibrinolytic cascades. The objective of this study was to assess hemostatic response to pulmonary extravasated marrow contents. We hypothesize that activation of platelet activity and the coagulation cascade may occur after embolization of marrow contents in an experimental animal model of intramedullary nailing. METHODS: Fifteen New Zealand white male rabbits were randomly assigned to control or fat embolism (FE) groups. In the FE group (n = 8), femurs were surgically instrumented with retrograde intramedullary nails and pressurized with bone cement. In the control group (n = 7), a sham knee incision was made that was immediately closed without drilling, reaming, or pressurization. Fibrinogen, D-dimer latex screen assay, 1 stage prothrombin time, and activated partial thromboplastin time were analyzed. RESULTS: As the main platelet activation indicators, the marker Annexin-V percent binding increased in the FE group at 2 hours (P = 0.04) and 4 hours (P = 0.04), and the marker CD62P percent expression increased in the FE group at 2 hours (P = 0.04). CONCLUSIONS: This preliminary study showed that pressurization of marrow and intravasation of fat and marrow products cause activation of platelets and the coagulation cascade, with or without tissue trauma. This may be relevant to the treatment of multiply injured patients with prior respiratory and coagulation abnormalities. A future larger study may be needed. AD - Martin Orthopaedic Biomechanics Laboratory, St Michael's Hospital, Toronto, Ontario, Canada. AN - 108083542. Language: English. Entry Date: 20130426. Revision Date: 20150712. Publication Type: Journal Article AU - Blankstein, M. AU - Byrick, R. J. AU - Nakane, M. AU - Bang, A. K. AU - Freedman, J. AU - Garvey, M. B. AU - Zdero, R. AU - Schemitsch, E. H. DB - cin20 DO - 10.1097/BOT.0b013e3182410560 DP - EBSCOhost KW - Blood Platelets -- Immunology Bone Marrow -- Immunology Embolism, Fat -- Etiology Embolism, Fat -- Immunology Embolization, Therapeutic -- Adverse Effects Fracture Fixation -- Adverse Effects Platelet Activation -- Immunology Animal Studies Male Pilot Studies Rabbits M1 - 11 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2012 SN - 0890-5339 SP - e214-20 ST - A preliminary study of platelet activation after embolization of marrow contents T2 - Journal of Orthopaedic Trauma TI - A preliminary study of platelet activation after embolization of marrow contents UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=108083542&site=ehost-live&scope=site VL - 26 ID - 830667 ER - TY - JOUR AB - Background: The objective of this study was to assess the role of pulmonary fat embolism caused by intramedullary pressurization of the femoral canal in the development of acute lung injury in the setting of acute hemorrhagic shock and resuscitation.Methods: Thirty New Zealand White rabbits were randomly assigned to one of four groups: (1) nine animals in which hemorrhagic shock was induced by carotid bleeding, resuscitation was performed, and the femoral canal was reamed and pressurized with bone cement to induce fat embolism (hemorrhagic shock and resuscitation/fat embolism [HR/FE] group); (2) six animals in which shock was induced by carotid bleeding, resuscitation was performed, and a sham knee incision was made and closed without drilling, reaming, or pressurization (hemorrhagic shock and resuscitation [HR] group); (3) eight animals in which no hemorrhage or shock was induced but the femoral canal was reamed and pressurized with bone cement to induce fat embolism (fat embolism [FE] group); and (4) seven animals that had a three-hour ventilation period followed by a sham knee incision (control group). The animals were ventilated for four hours following closure. Flow cytometry with use of antibodies against CD45 and CD11b was performed to test neutrophil activation in whole blood. Histological examination of lung specimens was also performed. Plasma and bronchoalveolar lavage fluid were analyzed for monocyte chemotactic peptide-1 and interleukin-8 levels with use of the ELISA (enzyme-linked immunosorbent assay) method.Results: Three animals in the HR/FE group died immediately after canal pressurization and were excluded. CD11b mean channel fluorescence was significantly elevated, as compared with baseline, only in the HR/FE group at two hours (p = 0.025) and four hours (p = 0.024) after knee closure. Histological analysis showed that only the HR/FE (p < 0.001) and HR (p = 0.010) groups had significantly greater infiltration of alveoli by polymorphonuclear leukocytes as compared with that in the controls. No significant differences in plasma cytokine levels were found between the groups. Only the HR/FE group had significantly higher interleukin-8 (p = 0.020) and monocyte chemotactic peptide-1 (p = 0.004) levels in the bronchoalveolar lavage fluid as compared with those in the controls.Conclusions: Fat embolism from canal pressurization alone did not activate a pulmonary inflammatory response. The combination of hemorrhagic shock, resuscitation, and fat embolism elicited neutrophil activation, infiltration of alveoli by polymorphonuclear leukocytes, and inflammatory cytokine expression in bronchoalveolar lavage fluid. AD - St. Michael's Hospital, 55 Queen Street East, Suite 800, Toronto, M5C 1R6 ON, Canada AN - 105285111. Language: English. Entry Date: 20100129. Revision Date: 20200708. Publication Type: journal article AU - Blankstein, M. AU - Byrick, R. J. AU - Nakane, M. AU - Bang, K. W. AU - Freedman, J. AU - Richards, R. R. AU - Kajikawa, O. AU - Zdero, R. AU - Bell, D. AU - Schemitsch, E. H. AU - Blankstein, Michael AU - Byrick, Robert J. AU - Nakane, Masaki AU - Bang, K. W. Annie AU - Freedman, John AU - Richards, Robin R. AU - Kajikawa, Osamu AU - Zdero, Rad AU - Bell, David AU - Schemitsch, Emil H. DB - cin20 DO - 10.2106/JBJS.H.01141 DP - EBSCOhost KW - Acute Lung Injury -- Physiopathology Embolism, Fat -- Physiopathology Pulmonary Embolism -- Physiopathology Shock, Hemorrhagic -- Physiopathology Systemic Inflammatory Response Syndrome -- Physiopathology Acute Lung Injury -- Etiology Animal Studies Embolism, Fat -- Complications Male Models, Biological Pulmonary Embolism -- Complications Rabbits Shock, Hemorrhagic -- Complications Shock, Hemorrhagic -- Therapy Systemic Inflammatory Response Syndrome -- Etiology M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2010 SN - 0021-9355 SP - 149-161 ST - Amplified inflammatory response to sequential hemorrhage, resuscitation, and pulmonary fat embolism: an animal study T2 - Journal of Bone & Joint Surgery, American Volume TI - Amplified inflammatory response to sequential hemorrhage, resuscitation, and pulmonary fat embolism: an animal study UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105285111&site=ehost-live&scope=site VL - 92 ID - 830715 ER - TY - JOUR AB - OBJECTIVES: : The objective of this study was to assess the effects of fat embolism on rabbit physiology. METHODS: : After anesthetic administration, both femoral condyles of the right knee only of 23 New Zealand white rabbits were exposed through a medial parapatellar approach to the knee. In the pulmonary fat embolism group (n = 15), the femoral canal was drilled in a retrograde fashion and then reamed and pressurized with a 1- to 1.5-mL cement injection. In the no-pressurization group (n = 4), after reaming, no cement was injected. In the control group (n = 4), the knee incision was immediately closed. Animals were then observed for 5 hours. Hemodynamics and blood gases were recorded at standard intervals. Postmortem, the lungs were removed en bloc and fixed for histologic assessment and quantitative histomorphometry. RESULTS: : Four intraoperative deaths occurred in the pulmonary fat embolism group immediately after pressurization and may have been associated with hypotension and cardiac arrest. In the pulmonary fat embolism group, pulmonary artery pressure increased, and both mean arterial pressure and PaO2 decreased after pressurization. Approximately 2% of lung volume was occupied by intravascular fat and there were no signs of perivascular inflammation. Control and no-pressurization animals remained stable throughout the experiment. CONCLUSIONS: : This model simulates pulmonary fat embolism after long-bone fractures. Despite cardiorespiratory dysfunction, there was no evidence of fat initiating pulmonary inflammation based on histologic data within the timeframe of the investigation. AD - From the *Faculty of Medicine, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; tDepartment of Anesthesia, St Michael's Hospital, Toronto, Ontario, Canada; tDepartment of Pathology, Mount Sinai Hospital, Toronto, Ontario, Canada; §Martin Orthopaedic Biomechanics Laboratory, St Michael's Hospital, Toronto, Ontario, Canada; and Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, Ontario, Canada. AN - 108197843. Language: English. Entry Date: 20120323. Revision Date: 20150712. Publication Type: Journal Article AU - Blankstein, M. AU - Byrick, R. J. AU - Richards, R. R. AU - Mullen, J. B. AU - Zdero, R. AU - Schemitsch, E. H. DB - cin20 DP - EBSCOhost KW - Models, Biological Embolism, Fat -- Physiopathology Pulmonary Embolism -- Physiopathology Rabbits Animals Blood Gas Analysis Blood Pressure Embolism, Fat -- Etiology Embolism, Fat -- Pathology Hemodynamics Longevity Lung -- Pathology Lung -- Physiopathology Male Oxygen -- Blood Pulmonary Artery -- Physiopathology Pulmonary Embolism -- Etiology Pulmonary Embolism -- Pathology Pulmonary Gas Exchange Lower Extremity -- Physiopathology Lower Extremity -- Surgery M1 - 11 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2011 SN - 0890-5339 SP - 674-680 ST - Pathophysiology of fat embolism: a rabbit model T2 - Journal of Orthopaedic Trauma TI - Pathophysiology of fat embolism: a rabbit model UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=108197843&site=ehost-live&scope=site VL - 25 ID - 830688 ER - TY - JOUR AB - STUDY DESIGN: A prospective randomized controlled clinical study. OBJECTIVE: To investigate the feasibility of a calcium phosphate cement (CaP) in balloon kyphoplasty if compared to polymethylmethacrylate (PMMA). SUMMARY OF BACKGROUND DATA: In kyphoplasty and vertebroplasty, PMMA currently represents the standard in augmentation materials. It is characterized, however, by a lack of osseointegration and limited biocompatibility. Consequently, CaP is currently being investigated as an alternative material for vertebral augmentation. METHODS: Inclusion criteria were 1 or 2 adjacent osteoporotic fractures of vertebral bodies in the thoracolumbar spine, patient age > or =65 years, and fracture age < or =4 months. Exclusion criteria were tumor lesions and additional posterior instrumentation. RESULTS: A total of 60 osteoporotic vertebral body fractures in 56 patients were included. CaP and PMMA were randomly applied in 30 vertebrae each with 2-fracture-patients receiving only 1 type of cement for both vertebrae. All 60 fractures were classified compression fractures (type A). Of these, 27 were classified burst fractures (type A3). 52/56 patients experienced statistically significant pain relief (7.9 +/- 1.9 to 1.8 +/- 2.1 on a Visual Analog Scale from 0 "best" to 10 "worst"). Bisegmental endplate angles were restored by 6.2 degrees +/- 5.9 degrees on average. Complications that turned out to be cement-specific were: vascular embolism (n = 2) for PMMA; subtotal cement washout (n = 1); and radiographic loss of correction (n = 9) due to cement failure in burst fractures for CaP. There was no case of cement failure, when PMMA had been used. CONCLUSION: The routine use of the CaP tested is not currently recommended for kyphoplasty. Because of its low resistance against flexural, tractive, and shear forces compared to PMMA, in certain constellations (burst fractures), there is a higher risk of cement failure and subsequent loss of correction. AD - Clinic for Trauma, Reconstructive & Plastic Surgery, University Hospital, Leipzig, Germany. thomas.blattert@medizin.uni-leipzig.de AN - 19139662 AU - Blattert, T. R. AU - Jestaedt, L. AU - Weckbach, A. DA - Jan 15 DO - 10.1097/BRS.0b013e31818f8bc1 DP - NLM ET - 2009/01/14 J2 - Spine KW - Aged Aged, 80 and over Bone Cements/adverse effects/chemistry/*therapeutic use Calcium Phosphates/adverse effects/*therapeutic use Embolism/chemically induced/physiopathology Humans Osteoporosis/complications Polymethyl Methacrylate/adverse effects/*therapeutic use Postoperative Complications/etiology/physiopathology Prospective Studies Radiography Spinal Fractures/pathology/physiopathology/*surgery Spine/diagnostic imaging/pathology/*surgery Stress, Mechanical Treatment Outcome Vertebroplasty/instrumentation/*methods LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0362-2436 SP - 108-14 ST - Suitability of a calcium phosphate cement in osteoporotic vertebral body fracture augmentation: a controlled, randomized, clinical trial of balloon kyphoplasty comparing calcium phosphate versus polymethylmethacrylate T2 - Spine (Phila Pa 1976) TI - Suitability of a calcium phosphate cement in osteoporotic vertebral body fracture augmentation: a controlled, randomized, clinical trial of balloon kyphoplasty comparing calcium phosphate versus polymethylmethacrylate VL - 34 ID - 828729 ER - TY - JOUR AB - Study Design: A prospective randomized controlled clinical study. Objective: To investigate the feasibility of a calcium phosphate cement (CaP) in balloon kyphoplasty if compared to polymethylmethacrylate (PMMA). Summary Of Background Data: In kyphoplasty and vertebroplasty, PMMA currently represents the standard in augmentation materials. It is characterized, however, by a lack of osseointegration and limited biocompatibility. Consequently, CaP is currently being investigated as an alternative material for vertebral augmentation. Methods: Inclusion criteria were 1 or 2 adjacent osteoporotic fractures of vertebral bodies in the thoracolumbar spine, patient age > or =65 years, and fracture age < or =4 months. Exclusion criteria were tumor lesions and additional posterior instrumentation. Results: A total of 60 osteoporotic vertebral body fractures in 56 patients were included. CaP and PMMA were randomly applied in 30 vertebrae each with 2-fracture-patients receiving only 1 type of cement for both vertebrae. All 60 fractures were classified compression fractures (type A). Of these, 27 were classified burst fractures (type A3). 52/56 patients experienced statistically significant pain relief (7.9 +/- 1.9 to 1.8 +/- 2.1 on a Visual Analog Scale from 0 "best" to 10 "worst"). Bisegmental endplate angles were restored by 6.2 degrees +/- 5.9 degrees on average. Complications that turned out to be cement-specific were: vascular embolism (n = 2) for PMMA; subtotal cement washout (n = 1); and radiographic loss of correction (n = 9) due to cement failure in burst fractures for CaP. There was no case of cement failure, when PMMA had been used. Conclusion: The routine use of the CaP tested is not currently recommended for kyphoplasty. Because of its low resistance against flexural, tractive, and shear forces compared to PMMA, in certain constellations (burst fractures), there is a higher risk of cement failure and subsequent loss of correction. AD - Clinic for Trauma, Reconstructive & Plastic Surgery, University Hospital, Leipzig, Germany Clinic for Trauma, Reconstructive & Plastic Surgery, University Hospital, Leipzig, Germany. thomas.blattert@medizin.uni-leipzig.de AN - 105632005. Language: English. Entry Date: 20090508. Revision Date: 20170411. Publication Type: journal article AU - Blattert, T. R. AU - Jestaedt, L. AU - Weckbach, A. AU - Blattert, Thomas R. AU - Jestaedt, Leonie AU - Weckbach, Arnulf DB - cin20 DO - 10.1097/BRS.0b013e31818f8bc1 DP - EBSCOhost KW - Bone Cements -- Therapeutic Use Kyphoplasty -- Methods Methylmethacrylates -- Therapeutic Use Phosphates -- Therapeutic Use Spinal Fractures -- Surgery Spine -- Surgery Aged Aged, 80 and Over Bone Cements Bone Cements -- Adverse Effects Embolism -- Chemically Induced Embolism -- Physiopathology Kyphoplasty -- Equipment and Supplies Methylmethacrylates -- Adverse Effects Osteoporosis -- Complications Phosphates -- Adverse Effects Postoperative Complications -- Etiology Postoperative Complications -- Physiopathology Prospective Studies Spinal Fractures -- Pathology Spinal Fractures -- Physiopathology Spine -- Pathology Spine -- Radiography Stress, Mechanical Treatment Outcomes Human M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0362-2436 SP - 108-114 ST - Suitability of a calcium phosphate cement in osteoporotic vertebral body fracture augmentation: a controlled, randomized, clinical trial of balloon kyphoplasty comparing calcium phosphate versus polymethylmethacrylate T2 - Spine (03622436) TI - Suitability of a calcium phosphate cement in osteoporotic vertebral body fracture augmentation: a controlled, randomized, clinical trial of balloon kyphoplasty comparing calcium phosphate versus polymethylmethacrylate UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105632005&site=ehost-live&scope=site VL - 34 ID - 830739 ER - TY - JOUR AD - Y. Mirovsky, Spine Unit, Department of Orthopedics, Assaf Harofeh Medical Center, Zerifin 70300, Israel AU - Blecher, R. AU - Smorgick, Y. AU - Mirovsky, Y. DB - Embase Medline KW - anticoagulant agent low molecular weight heparin abdominal pain adult article bone biopsy case report cesarean section computed tomographic angiography computer assisted tomography deep vein thrombosis female human immobilization laminectomy low back pain lung embolism neurologic examination nuclear magnetic resonance imaging patient referral percutaneous vertebroplasty physical examination pregnancy premature fetus membrane rupture spinal cord decompression spine hemangioma spine radiography spine tumor treatment outcome vena cava filter LA - English M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 1565-1088 SP - 311-313 ST - Symptomatic spinal hemangioma in pregnancy T2 - Israel Medical Association Journal TI - Symptomatic spinal hemangioma in pregnancy UR - https://www.embase.com/search/results?subaction=viewrecord&id=L359000994&from=export VL - 12 ID - 829682 ER - TY - JOUR AD - Department of Trauma, Hand and Reconstructive Surgery, University Hospital Giessen and Marburg, Location Marburg, Germany. bliemel@med.uni-marburg.de AN - 109863532. Language: English. Entry Date: 20150724. Revision Date: 20150923. Publication Type: Journal Article AU - Bliemel, Christopher AU - Buecking, Benjamin AU - Struewer, Johannes AU - Piechowiak, Eike Immo AU - Ruchholtz, Steffen AU - Krueger, Antonio DB - cin20 DP - EBSCOhost KW - Bone Cements Kyphoplasty -- Adverse Effects Pulmonary Embolism -- Etiology Pulmonary Embolism -- Radiography Aged Aged, 80 and Over Algorithms Female Human Male Middle Age Pain Measurement Prospective Studies M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2013 SN - 0001-6462 SP - 444-450 ST - Detection of pulmonary cement embolism after balloon kyphoplasty : should conventional radiographs become routine? T2 - Acta Orthopaedica Belgica TI - Detection of pulmonary cement embolism after balloon kyphoplasty : should conventional radiographs become routine? UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=109863532&site=ehost-live&scope=site VL - 79 ID - 830652 ER - TY - JOUR AB - Introduction: The incidence for pulmonary cement embolism following percutaneous vertebroplasty is reported in the literature between 3,5 - 6,8%. Studies with standardised postoperative radiological examination of the chest organs document this. Concerning the incidence for pulmonary cement embolism following percutaneous kyphoplasty no studies exist so far. Therefore uncertainty concerning the incidence still remains. Material/Method: From the beginning of the year 2009 the incidence for pulmonary cement embolism following percutaneous kyphoplasty is analysed by a prospective study in our hospital. From the beginning of the study until June 2010, 57 patients could be included (39 women; 18 men; mean age 77 years; range of age 54-98 years). In these 57 patients 79 vertebrae were treated in 58 surgical interventions (one patient had two surgical treatments) by percutaneous kyphoplasty. Postoperative a standardised radiological examination of the chest organs was performed in all patients to search for therapy relevant pulmonary cement embolism. This happened according to a decision tree for the management of pulmonary cement embolism as applied in our institution. A viscous toothpaste like consistence of the injected PMMA cement, which is achieved 8-9 minutes after mixing the cement, is the main condition for the avoidance of pulmonary cement embolism. Results: No pulmonary cement embolism was detected by the postoperative performed x-ray examination of the chest organs in two planes. Additionally all patients were clinically asymptomatic during their stay in our hospital as well as in the aftercare periode. Conclusion: According to our results it is presumed, that a chest x-ray in two planes without pathological findings leads to no further complaints in the post-treatment periode. Indeed pulmonary cement embolism can only be detected by performing a computed tomography, nevertheless as a suitable postoperative screening method for uncomplicated cases a x-ray examination of the chest organs in two planes is indicated. Following a critical indication percutaneous kyphoplasty is a secure surgical procedure for the treatment of osteoporotic vertebral fractures. Anyhow clinical follow up examinations, a standardised postoperative x-ray examination of the chest organs in two planes and if there is justified suspicion, a computed tomography for the early proof of a pulmonary cement embolism are necessary. AD - C. Bliemel, Universitätsklinikum Marburg, Unfallchirurgie, Marburg, Germany AU - Bliemel, C. AU - Krueger, A. AU - Oberkircher, L. AU - Ruchholtz, S. DB - Embase DO - 10.1007/s00586-010-1601-9 KW - cement toothpaste spine embolism kyphoplasty society human thorax patient radiodiagnosis examination computer assisted tomography hospital surgery decision tree percutaneous vertebroplasty follow up vertebra therapy spine fracture surgical technique male female screening aftercare prospective study thorax radiography LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0940-6719 SP - 2018 ST - Incidence for pulmonary cement embolism following percutaneous kyphoplasty. Clinical results after 1,5 years T2 - European Spine Journal TI - Incidence for pulmonary cement embolism following percutaneous kyphoplasty. Clinical results after 1,5 years UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71557972&from=export http://dx.doi.org/10.1007/s00586-010-1601-9 VL - 19 ID - 829640 ER - TY - JOUR AB - Introduction: The majority of osteoporotic, spinal cord compressive, vertebral fractures occurs at the thoracolumbar junction level. When responsible for neurological impairment, these rare lesions require a decompression procedure. We present the results of a new option to treat these lesions: an open balloon kyphoplasty associated with a short-segment posterior internal fixation. Materials and methods: Twelve patients, aged a mean 72.3 years, were included in this prospective series; all of them presented osteoporotic burst fractures located between T11 and L2 associated with neurological impairment. The surgical procedure first consisted of a laminectomy, for decompression, followed by an open balloon kyphoplasty. A short-segment posterior internal fixation was subsequently put into place when the local kyphosis was considered severe. A CAT scan study evaluated local vertebral body's height restoration using two pre- and postoperative radiological indices. Results: All of the patients in the series were followed up for a mean 14 months. Local kyphosis improved a mean 10.8 (p < 0.001). Vertebral body height was also substantially restored, with a mean gain of 26% according to the anterior height/adjacent height ratio and 28% according to the Beck Index (p < 0.001). Two cases of cement leakage were recorded, with no adverse clinical side effect. Complete neurological recovery was observed in 10 patients; two retained a minimal neurological deficit but kept a walking capacity. Discussion: The results presented in this study confirm the data reported in the literature in terms of local kyphosis correction and vertebral body height restoration. The combination of this technique with laminectomy plus osteosynthesis allowed us to effectively treat burst fractures of the thoracolumbar junction and led to stable results 1 year after surgery. This can be advantageous in a population often carrying multiple co-morbidities. With a single operation, we can achieve neurological decompression and spinal column stability in a minimally invasive way; this avoids more substantial surgery in these fragile patients. Level of evidence: Level IV. Therapeutic prospective study. © 2009 Elsevier Masson SAS. All rights reserved. AD - B. Blondel, Department of Neurosurgery, Timone Teaching Hospital, 249, rue Saint-Pierre, 13005 Marseille, France AU - Blondel, B. AU - Fuentes, S. AU - Metellus, P. AU - Adetchessi, T. AU - Pech-Gourg, G. AU - Dufour, H. DB - Embase Medline DO - 10.1016/j.otsr.2009.06.001 KW - antibiotic agent adult aged article body height clinical article computer assisted tomography disease association female follow up fracture fixation fragility fracture human kyphoplasty laminectomy lung embolism male neurologic disease osteosynthesis priority journal surgical technique thoracolumbar spine urinary tract infection wound infection LA - English M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 1877-0568 SP - 359-364 ST - Severe thoracolumbar osteoporotic burst fractures: Treatment combining open kyphoplasty and short-segment fixation T2 - Orthopaedics and Traumatology: Surgery and Research TI - Severe thoracolumbar osteoporotic burst fractures: Treatment combining open kyphoplasty and short-segment fixation UR - https://www.embase.com/search/results?subaction=viewrecord&id=L50593226&from=export http://dx.doi.org/10.1016/j.otsr.2009.06.001 VL - 95 ID - 829699 ER - TY - JOUR AB - Introduction: The moderately cross-linked Depuy Marathon™ cemented acetabular component was introduced into the UK in 2007. Wear rates and follow up has been studied for the Marathon™ uncemented component but not as yet for the cemented version. We present the medium term results of the Marathon™ cemented prosthesis used in primary total hip arthroplasty. Methods: All Marathon™ cemented acetabular components implanted between July 2008 and July 2009 were identified from our institutions electronic implant register. All patients' case notes were reviewed and follow up post-operative radiographs were examined by a single investigator. The uni-radiographic technique was applied using the CAD™ software to measure linear wear and wear rate. Results: Two hundred and sixty five Marathon™ cemented acetabular component implants were identified. Mean age was 67 years (range 26-90). Of the two hundred and sixty five patients, data was unavailable for twenty two. Six patients had died during the study period, and sixteen were lost to follow up. Mean follow-up was 55 months (range 50-61). Mean radiological followup was 46 months (range 24-57). The mean overall wear was 0.37 mm (range 0.04 mm-0.78 mm). The wear rate was calculated as 0.03 mm/year (95% CI 0.02-0.06). Five patients were diagnosed with post-operative deep vein thrombosis (2.05%) and there were no cases of pulmonary embolus. There were 2 post-op dislocations (0.8%). There were no revisions for failure of the Marathon™ cemented acetabular component. Discussion: The wear rates for the Marathon™ uncemented acetabular component have been reported to be range from 0.06 to 0.01 mm/year. We report the mean wear rate of cemented Marathon cups to be 0.03 mm/yr. (95% CI 0.02-0.06). The Marathon™ cemented acetabular component is safe and reliable for use in primary hip arthroplasty. Post-operative surgical and medical complications are low. Medium term survivorship at a mean of 56 months is excellent. AD - T. Board, Centre for Hip Surgery, Wrightington Hospital, Wrightington, United Kingdom AU - Board, T. AU - Siney, P. AU - Barkatali, B. AU - Jones, H. W. AU - Gambhir, A. AU - Porter, M. DB - Embase DO - 10.5301/hipint.5000334 KW - polyethylene neutrophil cytoplasmic antibody survival prosthesis hip society follow up human patient implant United Kingdom cemented prosthesis total hip prosthesis lung embolism register hip arthroplasty X ray film software deep vein thrombosis L1 - http://www.hip-int.com/Attach/3fd3478c-a11d-462c-883f-b672128a7ff9/5deedb29-a7c4-4612-adb4-d35bb3765fd9 LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1120-7000 SP - S86 ST - Wear rate and medium-term survival of a cemented, moderately cross linked polyethylene acetabular prosthesis T2 - HIP International TI - Wear rate and medium-term survival of a cemented, moderately cross linked polyethylene acetabular prosthesis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L72166560&from=export http://dx.doi.org/10.5301/hipint.5000334 VL - 25 ID - 829356 ER - TY - JOUR AD - M. Boattini, Unidade de Urgência Médica, Hospital São José, Centro Hospitalar Lisboa Central, Portugal AU - Boattini, M. AU - Francisco, A. R. AU - Cavaco, R. AU - Rodrigues, J. AU - Bento, L. DB - Embase Medline DO - 10.1016/j.medin.2014.06.011 KW - C reactive protein hypertensive factor lactate dehydrogenase poly(methyl methacrylate) acidemia adult adult respiratory distress syndrome blood gas analysis blood pressure measurement case report computed tomographic angiography continuous renal replacement therapy coughing cyanosis dyspnea electrocardiography fever Glasgow coma scale human hyperbilirubinemia hyperkalemia hypotension hypovolemia kidney failure laboratory test letter lung edema lung embolism lung infiltrate male male to female transgender medical history multiple organ failure normochromic normocytic anemia oxygen therapy respiratory failure shock sinus tachycardia sweating tachycardia tachypnea thorax radiography transthoracic echocardiography vasoplegia LA - English M1 - 4 M3 - Letter N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1578-6749 0210-5691 SP - 256-257 ST - Shock following subcutaneous injections of polymethylmethacrylate T2 - Medicina Intensiva TI - Shock following subcutaneous injections of polymethylmethacrylate UR - https://www.embase.com/search/results?subaction=viewrecord&id=L603953578&from=export http://dx.doi.org/10.1016/j.medin.2014.06.011 VL - 39 ID - 829375 ER - TY - JOUR AN - 105257737. Language: English. Entry Date: 20100723. Revision Date: 20200708. Publication Type: Journal Article AU - Boger, A. AU - Benneker, L. M. AU - Krebs, J. AU - Boner, V. AU - Heini, P. F. AU - Gisep, A. DB - cin20 DO - 10.1007/s00586-009-1079-5 DP - EBSCOhost KW - Bone Cements -- Standards Foreign-Body Migration -- Prevention and Control Therapeutic Irrigation -- Methods Kyphoplasty -- Equipment and Supplies Kyphoplasty -- Methods Methylmethacrylates -- Standards Animal Studies Biomechanics -- Physiology Bone Cements Bone Cements -- Adverse Effects Cardiovascular Diseases -- Chemically Induced Cardiovascular Diseases -- Physiopathology Embolism, Fat -- Etiology Embolism, Fat -- Physiopathology Embolism, Fat -- Prevention and Control Female Foreign-Body Migration -- Etiology Foreign-Body Migration -- Physiopathology Injections -- Equipment and Supplies Injections -- Methods Therapeutic Irrigation -- Equipment and Supplies Kyphoplasty -- Adverse Effects Methylmethacrylates Methylmethacrylates -- Adverse Effects Models, Biological Osteoporosis -- Complications Osteoporosis -- Physiopathology Postoperative Complications -- Etiology Postoperative Complications -- Physiopathology Postoperative Complications -- Prevention and Control Pressure -- Adverse Effects Sheep Viscosity M1 - 12 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0940-6719 SP - 1957-1962 ST - The effect of pulsed jet lavage in vertebroplasty on injection forces of PMMA bone cement: an animal study T2 - European Spine Journal TI - The effect of pulsed jet lavage in vertebroplasty on injection forces of PMMA bone cement: an animal study UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105257737&site=ehost-live&scope=site VL - 18 ID - 830716 ER - TY - JOUR AN - 105227423. Language: English. Entry Date: 20100115. Revision Date: 20150711. Publication Type: Journal Article. Journal Subset: Biomedical AU - Boger, A. AU - Wheeler, K. D. AU - Schenk, B. AU - Heini, P. F. DB - cin20 DO - 10.1007/s00586-009-1037-2 DP - EBSCOhost KW - Bone Cements Methylmethacrylates Postoperative Complications -- Prevention and Control Spinal Fractures -- Surgery Kyphoplasty -- Methods Aged Aged, 80 and Over Bone Cements -- Therapeutic Use Female Injections -- Equipment and Supplies Injections -- Methods Male Polymers Polymers -- Therapeutic Use Methylmethacrylates -- Therapeutic Use Postoperative Complications -- Etiology Postoperative Complications -- Physiopathology Pulmonary Embolism -- Etiology Pulmonary Embolism -- Physiopathology Pulmonary Embolism -- Prevention and Control Time Factors Viscosity M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0940-6719 SP - 1272-1278 ST - Clinical investigations of polymethylmethacrylate cement viscosity during vertebroplasty and related in vitro measurements T2 - European Spine Journal TI - Clinical investigations of polymethylmethacrylate cement viscosity during vertebroplasty and related in vitro measurements UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105227423&site=ehost-live&scope=site VL - 18 ID - 830724 ER - TY - JOUR AD - Oakwood Heritage Hospital, Berkley, MI, United States. AN - 27672866 AU - Boji, B. M. AU - Ho, J. DA - Sep DO - 10.1016/j.pmrj.2016.07.141 DP - NLM ET - 2016/09/28 J2 - PM & R : the journal of injury, function, and rehabilitation LA - eng M1 - 9s N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1934-1482 SP - S193 ST - Poster 98 Cerebral Infarction Secondary to Cement Embolism Through a Patent Foramen Ovale After Percutaneous Kyphoplasty: A Case Report T2 - Pm r TI - Poster 98 Cerebral Infarction Secondary to Cement Embolism Through a Patent Foramen Ovale After Percutaneous Kyphoplasty: A Case Report VL - 8 ID - 828998 ER - TY - JOUR AB - Case/Program Description: This patient presented to the hospital with low back pain one week after sustaining a ground-level fall at home. MRI of the lumbar spine revealed an acute L3 compression fracture. She underwent percutaneous kyphoplasty with polymethylmethacrylate cement three days later. The following day, she developed right hemiplegia, expressive aphasia, and dysphagia. A noncontrast CT of the head demonstrated left temporoparietal lobe densities suggestive of foreign material. MRI of the brain confirmed the infarcts. CT angiography of the brain revealed poor circulation in the left MCA. A transesophageal echocardiogram demonstrated a patent foramen ovale (PFO). She was transferred to the inpatient rehabilitation unit after medical stability. Setting: Inpatient Rehabilitation Unit. Results: The patient participated thoroughly in the rehabilitation program. On day 6, her Functional Independence Measure (FIM) score was 68 and by day 11, it was 92. Prior to discharge, she as able to ambulate at modified independent level with a standard walker. She went home two days later. Discussion: There are rare case reports of cerebral infarction due to cement crossing the PFO after percutaneous kyphoplasty. In our patient, despite the foreign etiology of her stroke, she made great strides in her recovery. She did not experience any seizure activity during her rehabilitation course. Conclusions: It is possible for extravasated cement from percutaneous kyphoplasty to travel through Batson's venous plexus to the azygous system, and gain access to the arterial system via the PFO. AD - B.M. Boji, Oakwood Heritage Hospital, Berkley, MI, United States AU - Boji, B. M. AU - Ho, J. DB - Embase KW - cement artery ataxic aphasia brain infarction case report cerebrovascular accident compression fracture computed tomographic angiography dysphagia echocardiography embolism female foreign body Functional Independence Measure head hemiplegia hospital patient human kyphoplasty low back pain nuclear magnetic resonance imaging patent foramen ovale rehabilitation travel vein walker LA - English M1 - 9 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1934-1482 SP - S193 ST - Cerebral infarction secondary to cement embolism through a patent foramen ovale after percutaneous kyphoplasty: A case report T2 - PM and R TI - Cerebral infarction secondary to cement embolism through a patent foramen ovale after percutaneous kyphoplasty: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L612984319&from=export VL - 8 ID - 829306 ER - TY - JOUR AB - Percutaneous vertebroplasty consists of injection of acrylic cement - polymethylmethacrylate - into a vertebral body to obtain pain relief and increase its mechanical stability. The procedure is indicated for painful hemangiomas and for painful vertebral compression fractures due to osteoporosis or malignancy. Although vertebroplasty is an efficient treatment, it is not free of complications. We present the case of a patient with pulmonary cement embolism after percutaneous vertebroplasty. Because such patients may be completely asymptomatic, but may also present with acute and severe, cardiovascular instability, clinicians and nuclear physicians should be aware that pulmonary embolism of polymethylmethacrylate may occur after percutaneous vertebroplasty. AD - Nuclear Medicine Department, HIA Val de Grâce, Paris, France. gerald.bonardel@free.fr AN - 17667431 AU - Bonardel, G. AU - Pouit, B. AU - Gontier, E. AU - Dutertre, G. AU - Mantzarides, M. AU - Goasguen, O. AU - Foehrenbach, H. DA - Aug DO - 10.1097/RLU.0b013e3180a1ad5a DP - NLM ET - 2007/08/02 J2 - Clinical nuclear medicine KW - Bone Cements/*adverse effects Extravasation of Diagnostic and Therapeutic Materials/*complications/*diagnosis Humans Male Methylmethacrylates/*adverse effects Middle Aged Pulmonary Embolism/*chemically induced/*diagnosis Thrombosis/complications LA - eng M1 - 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 0363-9762 (Print) 0363-9762 SP - 603-6 ST - Pulmonary cement embolism after percutaneous vertebroplasty: a rare and nonthrombotic cause of pulmonary embolism T2 - Clin Nucl Med TI - Pulmonary cement embolism after percutaneous vertebroplasty: a rare and nonthrombotic cause of pulmonary embolism VL - 32 ID - 828796 ER - TY - JOUR AB - Percutaneous vertebroplasty consists of injection of acrylic cement-polymethylmethacrylate-into a vertebral body to obtain pain relief and increase its mechanical stability. The procedure is indicated for painful hemangiomas and for painful vertebral compression fractures due to osteoporosis or malignancy. Although vertebroplasty is an efficient treatment, it is not free of complications. We present the case of a patient with pulmonary cement embolism after percutaneous vertebroplasty. Because such patients may be completely asymptomatic, but may also present with acute and severe, cardiovascular instability, clinicians and nuclear physicians should be aware that pulmonary embolism of polymethylmethacrylate may occur after percutaneous vertebroplasty. AD - Nucl Med Serv, Dept Nucl Med, HIA Val Grace, F-75230 Paris 05, France. Dept Neurosurg, HIA Val Grace, Paris, France. Bonardel, G (corresponding author), Nucl Med Serv, Dept Nucl Med, HIA Val Grace, 74 Bd Port Royal, F-75230 Paris 05, France. geraid.bonardel@free.fr AN - WOS:000248382000003 AU - Bonardel, G. AU - Pouit, B. AU - Gontier, E. AU - Dutertre, G. AU - Mantzarides, M. AU - Goasguen, O. AU - Foehrenbach, H. DA - Aug DO - 10.1097/RLU.0b013e3180a1ad5a J2 - Clin. Nucl. Med. KW - pulmonary embolism vertebroplasty lung scan SPECT ACRYLIC CEMENT POLYMETHYL METHACRYLATE POLYMETHYLMETHACRYLATE COMPLICATION MANAGEMENT Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 8 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2007 SN - 0363-9762 SP - 603-606 ST - Pulmonary cement embolism after percutaneous vertebroplasty - A rare and nonthrombotic cause of pulmonary embolism T2 - Clinical Nuclear Medicine TI - Pulmonary cement embolism after percutaneous vertebroplasty - A rare and nonthrombotic cause of pulmonary embolism UR - ://WOS:000248382000003 VL - 32 ID - 830392 ER - TY - JOUR AB - INTRODUCTION: Long bone metastasis to the tibia is somewhat rare and has only been studied in a few publications with a limited number of cases. This led us to carry out a large multicenter, observational, retrospective study to 1) evaluate the clinical and radiological outcomes of surgical treatment at this location and 2) highlight the specific risks associated with this condition. HYPOTHESIS: We hypothesized that the clinical outcomes and survivorship were comparable to those reported in the literature. MATERIAL AND METHODS: The case series included 15 men and 10 women with a mean age of 66±11.7 years. The most common primary cancers were kidney (10 patients) and lung (4 patients). Thirteen patients had a concurrent visceral metastasis and sixteen had metastasis in another bone. The tibial metastasis was the initial sign of cancer in seven patients. The surgical procedure was done to prevent an impending fracture in 19 patients and to treat a pathological fracture in 6 patients (initial sign of cancer in 4 patients). Osteolysis occurred in the proximal epiphysis/metaphysis in 12 patients, diaphysis in 9 patients and distal epiphysis/metaphysis in 4 patients. We performed fixation with a lateral cortex plate and cementoplasty in 14 patients, locked intramedullary nailing in 8 patients, cementoplasty only in 2 patients and knee arthroplasty in 1 patient. RESULTS: Three surgical site infections, one pulmonary embolism and one cardiac rhythm disturbance occurred. Four patients died before the 3(rd) month postoperative. At their best clinical status, 2 patients had not resumed walking, 10 could walk short distances with two canes or a walker, 3 had altered gait but could walk without aids and 6 could walk normally. The mean survival was 14±11.7 months (95% CI: 8.1-19.8) for all patients, 4±4 months (95% CI: 3-14) for those with a lung primary and 32±14 months (95% CI: 20-47) for those with a kidney primary. The survival was 15 months (95% CI: 4-29) after preventative treatment and 5 months (95% CI: 4-26) after fracture treatment. CONCLUSION: Our clinical outcomes are comparable overall to the three main published articles on this topic. The risk of infection and benefits of preventative fixation were apparent in our cohort. LEVEL OF EVIDENCE: IV, retrospective study. AD - Département d'Orthopédie Traumatologie, Hôpital Pierre-Paul Riquet, Place Baylac-Toulouse, 31052 Toulouse cedex, France. Electronic address: ventre.s@chu-toulouse.fr. Service d'Orthopédie Traumatologie, Hôpital Cochin, 27, rue du Faubourg St Jacques, 75014 Paris, France. Service hospitalo-universitaire d'Orthopédie Traumatologie, Hôpital Hautepierre, 1, avenue Molière, 67200 Strasbourg, France. Service hospitalo-universitaire d'Orthopédie Traumatologie, Hôpital Nord, chemin des Bourrely, 13015 Marseille, France. Département d'Orthopédie Traumatologie, Hôpital Pierre-Paul Riquet, Place Baylac-Toulouse, 31052 Toulouse cedex, France. Service hospitalo-universitaire d'Orthopédie Traumatologie, Hôpital Pellegrin, place Amelie-Raba, 33000 Bordeaux, France. 56, rue Boissonade, 75014 Paris, France. AN - 31624032 AU - Bonnevialle, P. AU - Descamps, J. AU - Niglis, L. AU - Lebaron, M. AU - Falguieres, J. AU - Mericq, O. AU - Fabre, T. AU - Reina, N. AU - Sailhan, F. DA - Oct DO - 10.1016/j.otsr.2019.07.017 DP - NLM ET - 2019/10/19 J2 - Orthopaedics & traumatology, surgery & research : OTSR KW - Bone metastasis Locked nailing Pathological fracture Tibia metastasis LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 1877-0568 SP - 1039-1045 ST - Surgical treatment of tibial metastases: Retrospective, multicenter, observational study of 25 patients T2 - Orthop Traumatol Surg Res TI - Surgical treatment of tibial metastases: Retrospective, multicenter, observational study of 25 patients VL - 106 ID - 828572 ER - TY - JOUR AB - Introduction: Long bone metastasis to the tibia is somewhat rare and has only been studied in a few publications with a limited number of cases. This led us to carry out a large multicenter, observational, retrospective study to 1) evaluate the clinical and radiological outcomes of surgical treatment at this location and 2) highlight the specific risks associated with this condition. Hypothesis: We hypothesized that the clinical outcomes and survivorship were comparable to those reported in the literature. Material and methods: The case series included 15 men and 10 women with a mean age of 66 +/- 11.7 years. The most common primary cancers were kidney (10 patients) and lung (4 patients). Thirteen patients had a concurrent visceral metastasis and sixteen had metastasis in another bone. The tibial metastasis was the initial sign of cancer in seven patients. The surgical procedure was done to prevent an impending fracture in 19 patients and to treat a pathological fracture in 6 patients (initial sign of cancer in 4 patients). Osteolysis occurred in the proximal epiphysis/metaphysic in 12 patients, diaphysis in 9 patients and distal epiphysis/metaphysic in 4 patients. We performed fixation with a lateral cortex plate and cementoplasty in 14 patients, locked intramedullary nailing in 8 patients, cementoplasty only in 2 patients and knee arthroplasty in 1 patient. Results: Three surgical site infections, one pulmonary embolism and one cardiac rhythm disturbance occurred. Four patients died before the 3rd month postoperative. At their best clinical status, 2 patients had not resumed walking, 10 could walk short distances with two canes or a walker, 3 had altered gait but could walk without aids and 6 could walk normally. The mean survival was 14 +/- 11.7 months (95% CI: 8.1-19.8) for all patients, 4 +/- 4 months (95% CI: 3-14) for those with a lung primary and 32 +/- 14 months (95% CI: 20-47) for those with a kidney primary. The survival was 15 months (95% CI: 4-29) after preventative treatment and 5 months (95% CI: 4-26) after fracture treatment. Conclusion: Our clinical outcomes are comparable overall to the three main published articles on this topic. The risk of infection and benefits of preventative fixation were apparent in our cohort. (C) 2019 Published by Elsevier Masson SAS. AD - [Bonnevialle, Paul; Mericq, Olivier; Reina, Nicolas] Hop Pierre Paul Riquet, Dept Orthoped Traumatol, Pl Baylac Toulouse, F-31052 Toulouse, France. [Descamps, Jules; Sailhan, Frederic] Hop Cochin, Serv Orthoped Traumatol, 27 Rue Faubourg St Jacques, F-75014 Paris, France. [Niglis, Lucas] Hop Hautepierre, Serv Hosp Univ Orthoped Traumatol, 1 Ave Moliere, F-67200 Strasbourg, France. [Lebaron, Marie; Falguieres, Julie] Hop Nord Marseille, Serv Hosp Univ Orthoped Traumatol, Chemin Bourrely, F-13015 Marseille, France. [Fabre, Thierry] Hop Pellegrin, Serv Hosp Univ Orthoped Traumatol, Pl Amelie Raba, F-33000 Bordeaux, France. [SoFCOT] 56 Rue Boissonade, F-75014 Paris, France. Bonnevialle, P (corresponding author), Hop Pierre Paul Riquet, Dept Orthoped Traumatol, Pl Baylac Toulouse, F-31052 Toulouse, France. ventre.s@chu-toulouse.fr AN - WOS:000577437900007 AU - Bonnevialle, P. AU - Descamps, J. AU - Niglis, L. AU - Lebaron, M. AU - Falguieres, J. AU - Mericq, O. AU - Fabre, T. AU - Reina, N. AU - Sailhan, F. AU - SoFcot DA - Oct DO - 10.1016/j.otsr.2019.07.017 J2 - Orthop. Traumatol.-Surg. Res. KW - Bone metastasis Pathological fracture Tibia metastasis Locked nailing LONG-BONE METASTASES PATHOLOGICAL FRACTURES SKELETAL METASTASES PROGNOSTIC-FACTORS JOINT REPLACEMENT RIGIDITY ANALYSIS SCORING SYSTEM SURVIVAL MANAGEMENT DISEASE Orthopedics Surgery LA - English M1 - 6 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2020 SN - 1877-0568 SP - 1039-1045 ST - Surgical treatment of tibial metastases: Retrospective, multicenter, observational study of 25 patients T2 - Orthopaedics & Traumatology-Surgery & Research TI - Surgical treatment of tibial metastases: Retrospective, multicenter, observational study of 25 patients UR - ://WOS:000577437900007 VL - 106 ID - 830099 ER - TY - JOUR AB - Background: Development of post-traumatic osteoarthritis after acetabulum fractures can occur even after anatomical reconstruction of the hip joint. The postarthroplasty outcome of these injuries has not been well reported in the literature. Aim: To measure the outcome of patients requiring total hip replacement (THR) following acetabular fracture. Methods: Between August 1995 and November 2008, all patients who had THR, having sustained acetabular fractures previously were included. Demographic details, mechanism of original injury, fracture classification (Letournel & Judet), post-fracture/THR complications, type of THR, and pre/post-operative Charnley's modified D'Aubigné & Postel hip score were recorded. Mean followup time was 4.5 years (1-12). Results: Out of 520 patients treated in our institution, 31 (5.9%) (11 female) patients met the inclusion criteria. Average age at injury was 43.5 years (18-80 years). Average age at THR was 53 years (28-80). 7 patients sustained both column fractures; 8 posterior columns posterior wall; 8 posterior wall, 7 transverse posterior wall and 1 anterior column. 15 patients sustained dislocation of their native hip. All fractures (except 3 patients) underwent surgical reconstruction. Post-fracture fixation complications included proximal deep venous thrombosis (3), pulmonary embolism (1), residual lower limb neuropraxia from injury (4), severe heterotopic ossification (3) and AVN (6). All patients received cemented THR apart from 1 case of hip resurfacing. The mean time between acetabular injury and THR was 9.85 years (1 to 40 years). There were 3 early dislocations (within 1 year of THR) and 1 late dislocation. 2 patients developed deep infections. In total 5 patients have undergone revision surgery. The patient's Charnley's modified hip score showed 63% Charnley Activity Grade A, 85% “Very Good Satisfaction”, 67% “No Pain” and 44% “Normal” Function. Conclusion: THR after acetabulum fracture remains a challenging procedure. Vigilance is required for the avoidance of complications, good functional outcome and to optimise the longevity of the hip joint. AD - H. Boon Tan, Academic Department of Trauma and Orthopaedics, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom AU - Boon Tan, H. AU - MacDonald, D. A. AU - Bobak, P. AU - Giannoudis, P. V. DB - Embase KW - total hip prosthesis acetabulum fracture arthroplasty European hip society human patient injury fracture surgery osteoarthritis lung embolism deep vein thrombosis fracture fixation follow up classification alertness procedures satisfaction infection heterotopic ossification leg pain longevity female L1 - http://www.hip-int.com/article/abstracts-from-the-9th-domestic-meeting-of-the-european-hip-society-art006629 LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 1120-7000 SP - 396-397 ST - Total hip arthroplasty following acetabular fracture: A review of post-arthroplasty outcome T2 - HIP International TI - Total hip arthroplasty following acetabular fracture: A review of post-arthroplasty outcome UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71960533&from=export VL - 20 ID - 829663 ER - TY - JOUR AB - Vertebral compression fractures (VCFs) are the most prevalent fractures in osteoporotic patients. The classical conservative management of these fractures is through rest, pain medication, bracing and muscle relaxants. The aim of this paper is to review prospective controlled studies comparing the efficacy and safety of minimally invasive techniques for vertebral augmentation, vertebroplasty (VP) and balloon kyphoplasty (BKP), versus non-surgical management (NSM). The Fracture Working Group of the International Osteoporosis Foundation conducted a literature search and developed a review paper on VP and BKP. The results presented for the direct management of osteoporotic VCFs focused on clinical outcomes of these three different procedures, including reduction in pain, improvement of function and mobility, vertebral height restoration and decrease in spinal curvature (kyphosis). Overall, VP and BKP are generally safe procedures that provide quicker pain relief, mobility recovery and in some cases vertebral height restoration than conventional conservative medical treatment, at least in the short term. However, the long-term benefits and safety in terms of risk of subsequent vertebral fractures have not been clearly demonstrated and further prospective randomized studies are needed with standards for reporting. Referral physicians should be aware of VP/BKP and their potential to reduce the health impairment of patients with VCFs. However, VP and BKP are not substitutes for appropriate evaluation and treatment of osteoporosis to reduce the risk of future fractures. © 2011 International Osteoporosis Foundation and National Osteoporosis Foundation. AD - K. Åkesson, Department of Orthopedics, Skåne University Hospital Malmö, Lund University, Malmö, Sweden AU - Boonen, S. AU - Wahl, D. A. AU - Nauroy, L. AU - Brandi, M. L. AU - Bouxsein, M. L. AU - Goldhahn, J. AU - Lewiecki, E. M. AU - Lyritis, G. P. AU - Marsh, D. AU - Obrant, K. AU - Silverman, S. AU - Siris, E. AU - Åkesson, K. DB - Embase Medline DO - 10.1007/s00198-011-1639-5 KW - bone cement opiate analgesia body height cement leakage clinical effectiveness conservative treatment cost effectiveness analysis disease severity epidural space follow up health care cost human intermethod comparison kyphoplasty kyphosis lung embolism meta analysis (topic) minimally invasive procedure pain assessment percutaneous vertebroplasty physician self-referral postoperative complication postoperative period priority journal prospective study quality of life randomized controlled trial (topic) review risk reduction spine mobility spine surgery treatment outcome vertebra body vertebra compression spine fracture LA - English M1 - 12 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 0937-941X 1433-2965 SP - 2915-2934 ST - Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures T2 - Osteoporosis International TI - Balloon kyphoplasty and vertebroplasty in the management of vertebral compression fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L51540942&from=export http://dx.doi.org/10.1007/s00198-011-1639-5 VL - 22 ID - 829597 ER - TY - GEN AB - The article offers information on therapeutic strategies of Aneurysmal bone cyst (ABC),a benign bone tumor. Topics discussed include therapeutic proposals such as local injection of ethanol, acrylic glue, Poly(methyl methacrylate) (PMMA); Selective arterial embolization (SAE) to reduce the intraoperative blood loss in order to perform complete excision, to reduce the local recurrence rate; and reports on surgical technique requiring a complex reconstruction. AD - GSpine4 Unit, IRCCS Galeazzi Orthopedic Institute, 20161, Milan, Italy AU - Boriani, Stefano CY -, DB - cin20 DO - 10.1007/s00586-018-5608-y DP - EBSCOhost J2 - European Spine Journal N1 - CINAHL (EbscoHost) literature search January 5, 2021 PB - Springer Nature PY - 2019 SN - 0940-6719 SP - 279-283 ST - Expert's comment concerning Grand Rounds case entitled "Aneurysmal bone cyst of C2 treated with novel anterior reconstruction and stabilization" by S. Rajasekaran et al. (Eur Spine J; 2016: DOI 10.1007/s00586-016-4518-0) TI - Expert's comment concerning Grand Rounds case entitled "Aneurysmal bone cyst of C2 treated with novel anterior reconstruction and stabilization" by S. Rajasekaran et al. (Eur Spine J; 2016: DOI 10.1007/s00586-016-4518-0) UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=134806561&site=ehost-live&scope=site VL - 28 ID - 830538 ER - TY - JOUR AB - Background and Goal of Study: Tranexamic acid (TA) reduces blood loss and blood transfusions in hip arthroplasty. However an optimal dose of tranexamic acid has not been determined yet. The goal of our study was to compare effects of repeated i.v. bolus of TA vs single bolus of TA on postoperative blood loss in hip arthroplasty. Materials and Methods: In a randomized controlled study, 90 patients underwent primary cementless total hip arthroplasty. Preoperatively, all patients received TA bolus (1 gm i.v.). All patients had drains and received transfusion of unwashed filtered shed blood (UFSB) if drain blood loss was >200 ml within the first 6 hrs postoperatively. All patients were randomized to three groups: single preoperative TA bolus (PREOP, n=30), repeated bolus of TA (1 gm) 3 hrs later (group POST3, n=30) and repeated bolus of TA 6 hrs postoperatively in case drain blood loss >200 ml (group POST6, n=30). The primary endpoints were postoperative drain blood loss within first 18 hrs and perioperative blood loss within first 48 hrs (calculated from the change of level Hb). Data were analyzed by one-way ANOVA followed by Tukey's post hoc test and χ2-test accordingly. Results and Discussion: All groups were similar with regard to demographic variables. Data are shown as mean±SD. The main results are summarized in the table. (Table presented) Allogeneic blood transfusion was given to one patient of the POST3 group at postoperative day 7. No patient in any group had manifesting deep venous thrombosis or pulmonary embolism during hospitalization. Conclusion(s): In primary cementless total hip arthroplasty, repeated i.v. bolus of TA does not result in further reduce in the postoperative blood loss compared with single preoperative bolus. AD - D. Borisov, Northern Medical Clinical Center, Department of Anaesthesiology and Intensive Care, Arkhangelsk, Russian Federation AU - Borisov, D. AU - Yudin, S. AU - Krylov, O. AU - Markov, B. AU - Istomina, N. DB - Embase KW - tranexamic acid hip arthroplasty anesthesiology dose response human patient bleeding postoperative hemorrhage total hip prosthesis blood transfusion deep vein thrombosis lung embolism hospitalization optimal drug dose controlled study transfusion blood post hoc analysis analysis of variance LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 0265-0215 SP - 88 ST - Tranexamic acid in hip arthroplasty: A dose-response study T2 - European Journal of Anaesthesiology TI - Tranexamic acid in hip arthroplasty: A dose-response study UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70681247&from=export VL - 28 ID - 829615 ER - TY - JOUR AB - Case Presentation: A 53-year-old female presented to the orthopedic clinic with complaints of left hip pain, back pain, and motor and sensory deficits. Imaging demonstrated multiple lytic bone metastasis and thoracic spinal cord compression. She was emergently admitted for decompression and fixation of the spine. Cement was used for vertebroplasty and stabilization of spinal fusion with the aide of intraoperative computerized tomography (CT). After an apparently uncomplicated operation, a radiologist reviewed the intra-operative CT images and found multiple high-density opacities in the thoracic vasculature. A noncontrasted CT of the chest confirmed opacities extending from the para-spinal region into the azygos vein and superior vena cava with emboli in the bilateral pulmonary arteries consistent with extensive cement emboli (Fig. 1). The patient remained unchanged both symptomatically and clinically and was safely discharged home. A repeat chest radiograph 4 months later demonstrated persistent highdensity opacities in the lung parenchyma as expected. Discussion: Acrylic bone cement (polymethyl methacrylate {PMMA}) is used in a variety of procedures for diseases such as osteoporotic collapse, osteolytic metastasis, and multiple myeloma. Although the incidence of complications when using PMMA is low at 1-10%, the most serious complication is pulmonary embolism caused by cement. Vascular invasion and other extra-vertebral extravasations can occur when using PMMA, especially when working with highly vascular tumors. The true incidence of pulmonary cement embolism is unknown, with mostly case reports cited in the literature. Reported incidence ranges from 4.6 to 6.8%, with the vast majority being asymptomatic. Diagnosis is typically made via radiographs. Chest radiographs can typically detect the high-density cement particles (Figure presented) compared with lung parenchyma; however, CT is a more sensitive study. Theoretical concerns exist regarding the risk of intravascular thrombus formation adjacent to cement deposits, as the foreign material may act as a nidus for thrombosis. Although there is no study to suggest systemic anticoagulation is beneficial in these patients, some authors recommend anticoagulation therapy for symptomatic patients. Conclusions: Hospitalists commonly comanage perioperative orthopedic patients, making it imperative to be aware of the diagnosis of cement embolism. Although the true incidence, outcomes, and treatment of this complication are not yet defined, keeping a high level of suspicion in patients undergoing procedures utilizing PMMA may help to cement the diagnosis. AD - R. Borne, University of Colorado Hospital, Denver, CO, United States AU - Borne, R. AU - Wolfe, B. AU - Sturges, R. DB - Embase DO - 10.1002/jhm.1927 KW - cement acrylic cement poly(methyl methacrylate) diagnosis hospital society human patient embolism thorax radiography lung parenchyma density backache case report procedures lung embolism extravasation vascular tumor X ray film risk blood clotting thrombosis anticoagulation anticoagulant therapy medical staff female hip pain imaging bone metastasis thoracic spinal cord spinal cord compression decompression spine foreign body computer assisted tomography percutaneous vertebroplasty radiologist vascularization thorax azygos vein superior cava vein pulmonary artery diseases metastasis multiple myeloma spine fusion LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1553-5592 SP - S291 ST - Cementing the diagnosis T2 - Journal of Hospital Medicine TI - Cementing the diagnosis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70698461&from=export http://dx.doi.org/10.1002/jhm.1927 VL - 7 ID - 829580 ER - TY - JOUR AB - Objective: Review a case of a 41 year old female who underwent bilateral uterine artery embolization for management of pelvic pain and severe urinary symptoms secondary to large uterine fibroid tumor burden. Background: A 41 year old female presented for management of pelvic discomfort/pressure, urinary incontinence, and dysuria, who initially underwent uterine artery embolization for management of numerous large fibroids (largest: 8 cm x 10 cm x 10 cm). The patient underwent a bilateral uterine artery embolization via the left common femoral artery, with 2 vials of 500–700 micron embospheres, 2 vials of 700–900 micron embospheres, and 3 vials of 900–1200 micron embospheres injected bilaterally. She subsequently saw a small decrease in each fibroid size of appx 1–2 cm diameter. However, after the initial decrease in size within the first 6 months, no further decrease in size was noted at 1- and 2-year time intervals, at which point a robotic myomectomy was performed. At time of myomectomy, embospheres were noted at time of dissection, and were demonstrated to be relatively free flowing, with no signs of cementation of the beads together, as may be expected. Discussion: No previous study has been performed examining long-term effects of embosphere spillage in the abdomen. Furthermore, the current assumption is that embolization media would deteriorate over time and that the beads would be unlikely to spill into the abdominal cavity over a period of years. This directly contradicts the video evidence presented. Conclusion: The relative free-flowing nature of the embospheres during myomectomy following a 2 year timespan after embolization demonstrates that the embospheres do not undergo a coagulation effect as would be expected. Instead, the embospheres remain free-flowing and dispersed widely outside of the fibroid site at time of resection. AD - O. Borodulin, University of Arizona, Phoenix, AZ, United States AU - Borodulin, O. AU - Mourad, J. DB - Embase DO - 10.1016/j.jmig.2018.09.632 KW - abdominal cavity adult case report cementation clinical article conference abstract dissection dysuria embolic particle female femoral artery human myomectomy pelvic pain spillage tumor volume urine incontinence uterine artery embolization uterus myoma videorecording LA - English M1 - 7 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1553-4669 1553-4650 SP - S214 ST - A Case of Uterine Fibroids: Embolization Beads & Subsequent Robotic Resection T2 - Journal of Minimally Invasive Gynecology TI - A Case of Uterine Fibroids: Embolization Beads & Subsequent Robotic Resection UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2001201720&from=export http://dx.doi.org/10.1016/j.jmig.2018.09.632 VL - 25 ID - 829173 ER - TY - JOUR AB - Learning Objectives: To describe the techniques employed at our institution in some cases of symptomatic vertebral hemangiomas and to comment on the results obtained. Background: Hemangiomas of the vertebrae are common lesions seen in 11% of autopsies, most frequent in the thoracic spine. The majority are asymptomatic and require no treatment. Less than 1% of them produce symptoms owing to collapse or cord compression. The latter is more likely with lesions that extend into the pedicles and laminae of thoracic vertebrae where the cord occupies most of the volume of the spinal canal. The current treatment of vertebral hemangiomas is varied. We employ transarterial embolization, sometimes prior to surgery to decrease intraoperative blood loss, intralesional injection of ethanol as a sclerosing agent to rapidly obliterate and shrink the malformation (a critical requirement in the presence of progressive cord compression), and percutaneous vertebroplasty in cases of vertebral collapse. Clinical Findings/Procedure Details: We treated three patients with vertebral hemangiomas that caused cord compression with percutaneous intralesional injection of ethanol (volume not exceeding 15 ml) and using CT guidance. All of them had relief of the symptoms and the lesions were obliterated completely at follow-up imaging. The seven patients with vertebral body collapse treated with percutaneous vertebroplasty also experienced pain relief. Embolization reduced blood loss in patients who underwent subsequent surgery. No procedure-related complications were found. Conclusion: When precise indications are followed, any technique for treatment of symptomatic vertebral hemangioma is safe and effective, with good immediate and long term results, in terms of clinical outcome and follow-up imaging. AD - A.M. Boronat, Radiology, Hospital Universitario Doctor Peset, Valencia, Spain AU - Boronat, A. M. AU - Lonjedo, E. AU - Cabrera, G. AU - Ruiz, A. AU - Magan, A. AU - Martinez, J. J. DB - Embase DO - 10.1007/s00270-010-9954-3 KW - alcohol sclerosing agent hemangioma Europe society compression patient percutaneous vertebroplasty follow up imaging vertebra artificial embolization surgery bleeding intralesional drug administration thoracic spine autopsy vertebral canal learning vertebra body analgesia congenital malformation LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0174-1551 SP - 218 ST - Symptomatic vertebral hemangiomas: Treatment techniques T2 - CardioVascular and Interventional Radiology TI - Symptomatic vertebral hemangiomas: Treatment techniques UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70288964&from=export http://dx.doi.org/10.1007/s00270-010-9954-3 VL - 33 ID - 829652 ER - TY - JOUR AB - BACKGROUND: An osteogenic sarcoma of the skull is rare, particularly as a primary tumor. The incidence of primary osteogenic sarcomas of the skull is about 1 to 2% of all skull tumors. CASE DESCRIPTION: A 21-year-old male was initially evaluated because of a large mass that had been growing for 7 months. The patient had been experiencing frequent headaches and tenderness at the site of the lump for about a month before being seen by the neurosurgeon. A computed tomography scan revealed a large mass, 12 cm x 7 cm, involving the scalp extending from the right temporal region to the vertex. A magnetic resonance imaging (MRI) scan showed a large mass arising from the posterolateral aspect that was 90% extracranial and 10% intracranial on the right side of the skull. The MRI showed marked vascularity and neovascularity of the tumor. An angiogram was performed, which demonstrated that the mass was fed by the branches from the right external carotid artery. The patient subsequently underwent surgery for embolization of the right occipital and superficial temporal arteries and removal of the mass. Pathology evaluation of a specimen revealed a high-grade osteoblastic osteosarcoma. CONCLUSION: We review the literature of reported cases of primary osteogenic sarcomas of the skull to discuss the common clinical presentation, evaluation methods, and recommended treatment plans. AD - Department of Neurosurgery, Christiana Care Health Care System, Newark, Delaware, USA. AN - 12480227 AU - Bose, B. DA - Sep-Oct DO - 10.1016/s0090-3019(02)00864-9 DP - NLM ET - 2002/12/14 J2 - Surgical neurology KW - Adult Antineoplastic Combined Chemotherapy Protocols/adverse effects/therapeutic use Bone Cements Chemotherapy, Adjuvant Combined Modality Therapy Humans Magnetic Resonance Imaging Male Neoplasm Recurrence, Local/diagnosis/drug therapy/surgery Neovascularization, Pathologic/diagnosis Osteosarcoma/diagnosis/drug therapy/*surgery Parietal Bone/pathology/*surgery Prosthesis Implantation Skull Neoplasms/diagnosis/drug therapy/*surgery Tomography, X-Ray Computed LA - eng M1 - 3-4 N1 - PubMed NLM literature search January 5, 2021 PY - 2002 SN - 0090-3019 (Print) 0090-3019 SP - 234-9; discussion 239-40 ST - Primary osteogenic sarcoma of the skull T2 - Surg Neurol TI - Primary osteogenic sarcoma of the skull VL - 58 ID - 828946 ER - TY - JOUR AB - Vertebroplasty cement embolization into the venous system has long been recognized as a potential complication, but the true incidence of systemic embolization is unknown. Clinical presentations range from patients who are asymptomatic or have incidental findings on imaging to massive pulmonary embolism resulting in death. Optimal treatment is controversial and the natural history is unknown. We present the case of an 85-year-old female undergoing combined laminectomy and vertebroplasty with subsequent pulmonary embolism of the cement which was successfully retrieved from a percutaneous approach. AD - Department of Medicine, Division of Cardiology, Baylor Heart and Vascular Hospital, Baylor University Medical Center, 621 N. Hall, Dallas, TX 75226, USA. AN - 20665860 AU - Bose, R. AU - Choi, J. W. DA - Aug 1 DO - 10.1002/ccd.22496 DP - NLM ET - 2010/07/29 J2 - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions KW - Aged, 80 and over Bone Cements/*adverse effects *Catheterization, Swan-Ganz Female Foreign-Body Migration/diagnostic imaging/etiology/*therapy Humans Laminectomy/*adverse effects Methylmethacrylate/*adverse effects Pulmonary Embolism/diagnostic imaging/etiology/*therapy Radiography, Interventional Treatment Outcome Vertebroplasty/*adverse effects LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 1522-1946 SP - 198-201 ST - Successful percutaneous retrieval of methyl methacrylate orthopedic cement embolism from the pulmonary artery T2 - Catheter Cardiovasc Interv TI - Successful percutaneous retrieval of methyl methacrylate orthopedic cement embolism from the pulmonary artery VL - 76 ID - 828807 ER - TY - JOUR AD - Radiology Department, Hospital General Universitario Morales Meseguer, Murcia, Spain. Electronic address: carmenbotiaglez@gmail.com. Radiology Department, Hospital General Universitario Morales Meseguer, Murcia, Spain. AN - 28502344 AU - Botía González, C. M. AU - Hernández Sánchez, L. AU - Plasencia Martínez, J. M. DA - May DO - 10.1016/j.amjms.2016.07.015 DP - NLM ET - 2017/05/16 J2 - The American journal of the medical sciences KW - Aged Angiography Anticoagulants/therapeutic use Bone Cements/*adverse effects Dyspnea/diagnostic imaging Female Humans Pulmonary Artery/diagnostic imaging Pulmonary Embolism/*diagnostic imaging/pathology Radiography, Thoracic Reperfusion Tomography, X-Ray Computed LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 0002-9629 SP - 507 ST - Cement Pulmonary Embolism T2 - Am J Med Sci TI - Cement Pulmonary Embolism VL - 353 ID - 828582 ER - TY - JOUR AU - Botía González, C. M. AU - Plasencia Martínez, J. M. AU - Solano Romero, A. P. AU - Gayán Belmonte, M. J. DB - Embase KW - bone cement device bone cement aged arthrodesis article bone cement leakage case report clinical article dyspnea human lung embolism male multiple bilateral pulmonary cement emboli thorax radiography very elderly LA - English M1 - 11 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1879-2898 0160-9963 SP - 34-35 ST - Multiple bilateral pulmonary cement emboli T2 - Applied Radiology TI - Multiple bilateral pulmonary cement emboli UR - https://www.embase.com/search/results?subaction=viewrecord&id=L625194932&from=export VL - 47 ID - 829174 ER - TY - JOUR AD - Department of Anesthesia, Ghent University Hospital, Ghent, Belgium. Department of Anesthesia, Ghent University Hospital, Ghent, Belgium. Electronic address: Eckhard.Mauermann@usb.ch. Department of Cardiac Surgery, Ghent University Hospital, Ghent, Belgium. AN - 28526207 AU - Bouchez, S. AU - Mauermann, E. AU - Philipsen, T. AU - Wouters, P. DA - Dec DO - 10.1053/j.jvca.2017.02.053 DP - NLM ET - 2017/05/21 J2 - Journal of cardiothoracic and vascular anesthesia KW - Echocardiography, Three-Dimensional/*methods/trends Embolism/diagnostic imaging/etiology Foreign Bodies/*diagnostic imaging/etiology Heart Ventricles/*diagnostic imaging/*injuries Humans Male Middle Aged Polymethyl Methacrylate/administration & dosage/*adverse effects Vertebroplasty/*adverse effects/trends *3-D transesophageal echocardiography *cement emboli *cement rods *complications *methyl methacrylate *right ventricle perforation LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 1053-0770 SP - 2123-2126 ST - 3D Echocardiographic Diagnosis of Right Ventricular Perforation With Polymethylmethacrylate Particles After Vertebroplasty T2 - J Cardiothorac Vasc Anesth TI - 3D Echocardiographic Diagnosis of Right Ventricular Perforation With Polymethylmethacrylate Particles After Vertebroplasty VL - 31 ID - 828506 ER - TY - JOUR AB - Percutaneous vertebral augmentation/consolidation techniques are varied. These are vertebroplasty, kyphoplasty, and several methods with percutaneous introduction of an implant (associated or not with cement injection). They are proposed in painful osteoporotic vertebral fractures and traumatic fractures. The objectives are to consolidate the fracture and, if possible, to restore the height of the vertebral body to reduce vertebral and regional kyphosis. Stabilization of the fracture leads to a reduction in pain and thus restores the spinal support function as quickly as possible, which is particularly important in the elderly. The effectiveness of these interventions on fracture pain was challenged once by two randomized trials comparing vertebroplasty to a sham intervention. Since then, many other randomized studies in support of vertebroplasty efficacy have been published. International recommendations reserve vertebroplasty for medical treatment failures on pain, but earlier positioning may be debatable if the objective is to limit kyphotic deformity or even reexpand the vertebral body. Recent data suggest that in osteoporotic fracture, the degree of kyphosis reduction achieved by kyphoplasty and percutaneous implant techniques, compared with vertebroplasty, is not sufficient to justify the additional cost and the use of a somewhat longer and traumatic procedure. In young patients with acute traumatic fractures and a significant kyphotic angle, kyphoplasty and percutaneous implant techniques are preferred to vertebroplasty, as in these cases a deformity reduction has a significant positive impact on the clinical outcome. AD - V. Bousson, Service de Radiologie Ostéoarticulaire, Viscérale et Vasculaire, Hôpital Lariboisière, APHP, Université Paris-Diderot, 2 rue Ambroise Paré, Paris, France AU - Bousson, V. AU - Hamze, B. AU - Odri, G. AU - Funck-Brentano, T. AU - Orcel, P. AU - Laredo, J. D. DB - Embase DO - 10.1055/s-0038-1673639 KW - article clinical outcome compression fracture fragility fracture human kyphoplasty kyphosis microembolism percutaneous vertebroplasty priority journal spine fracture treatment failure treatment indication vertebra body LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1098-8963 0739-9529 SP - 309-323 ST - Percutaneous Vertebral Augmentation Techniques in Osteoporotic and Traumatic Fractures T2 - Seminars in Interventional Radiology TI - Percutaneous Vertebral Augmentation Techniques in Osteoporotic and Traumatic Fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L624768665&from=export http://dx.doi.org/10.1055/s-0038-1673639 VL - 35 ID - 829222 ER - TY - JOUR AB - Learning Objectives: The objective is to create a timeline that demonstrates the evolution of minimally invasive treatments of metastatic disease to the spine. We plan to outline the history of the development of each procedure as well as its indications, advantages, techniques, and potential adverse events of using the different currently available interventions. Background: Spinal metastases are a common and morbid condition in America. Of the 1.6 million new cases of cancer estimated to be diagnosed in the United States in 2015, approximately 5-10% will develop spinal metastases (80,000 160,000). This number is expected to increase as the life expectancy of patients with cancer increases. Patients with osteolytic spinal metastases experience severe and often debilitating pain, which significantly reduces quality of life. The advent and evolution of percutaneous treatments of spinal metastases has shown progressive success in reducing pain, improving neurologic function, and providing mechanical stability of compressed vertebrae. Clinical Findings/Procedure Details: We will review the historical significance, indications, advantages, and techniques of the various currently available interventions. Specifically, we will review vertebroplasty, vertebral augmentation, ie, balloon kyphoplasty, KIVA implant, etc., and coblation and radiofrequency ablation systems. For more complex or advanced spinal metastases, we will review combined treatments including vertebral augmentation in conjunction with radiofrequency ablation, external beam radiation, and the novel treatment of intraoperative radiotherapy. Finally, we will discuss potential complications for each modality, including cement leakage and pulmonary embolization. Conclusions: The advent and evolution of percutaneous treatments of spinal metastases has shown progressive success in reducing pain and providing mechanical stability of compressed vertebrae. Vertebral augmentation is becoming a first-line treatment for management of painful malignant vertebral compression fractures. Understanding the indications, technique, safety profile and potential adverse events is crucial for the appropriate clinical utilization of percutaneous minimally invasive spine techniques. AD - M. Bozza, Loyola University Medical Center, Maywood, IL, United States AU - Bozza, M. AU - Glaenzer, B. AU - Malamis, A. DB - Embase KW - cement spinal cord metastasis society interventional radiology minimally invasive procedure pain spine human patient vertebra neoplasm implant kyphoplasty Western Hemisphere percutaneous vertebroplasty procedures lung embolism compression fracture radiofrequency ablation device quality of life intraoperative radiotherapy life expectancy external beam radiotherapy radiofrequency ablation United States safety metastasis learning LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1051-0443 SP - S295 ST - Percutaneous minimally invasive techniques in the treatment of spinal metastases T2 - Journal of Vascular and Interventional Radiology TI - Percutaneous minimally invasive techniques in the treatment of spinal metastases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L72230040&from=export VL - 27 ID - 829328 ER - TY - JOUR AB - Background: Pseudoaneuryms of the MMA are rare lesions, accounting for less than 1% of all intracranial aneurysms. Case Description: We report a case of a spontaneous intracerebral hematoma that DSA revealed as ispilateral traumatic PMMA. The lesion was managed through an endovascular approach, and definitive embolization of pseudoaneurysm and parent vessel with histoacryl injection was carried out. Recovery and follow-up were uneventful. We discuss the management of those lesions, emphasizing the current neuroendovascular tools and techniques. Conclusion: Pseudoaneurysm of the MMA is uncommon but has a potential aggressive natural history. As it can occur with different patterns of intracranial hemorrhage, the external carotid arteries have to be included in hemorrhagic investigational DSA. Once diagnosed, it must be treated. The minimally invasive endovascular approach and definitive embolization of pseudoaneurysm and parent vessel with histoacryl injection are safe and effective. (c) 2006 Published by Elsevier Inc. AD - Univ Fed Pernambuco, Hosp Restauracao, BR-52071000 Recife, PE, Brazil. Bozzetto-Ambrosi, P (corresponding author), Univ Fed Pernambuco, Hosp Restauracao, BR-52071000 Recife, PE, Brazil. patri_boz@yahoo.fr AN - WOS:000242182100006 AU - Bozzetto-Ambrosi, P. AU - Andrade, G. AU - Azevedo, H. DO - 10.1016/j.surneu.2006.08.048 J2 - Surg. Neurol. KW - intraparenchymal hematoma middle meningeal artery aneurysm pseudoaneurysm endovascular therapy ebolization INTRACEREBRAL HEMATOMA ANEURYSMS Clinical Neurology Surgery LA - English M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2006 SN - 0090-3019 SP - S29-S32 ST - Traumatic pseudoaneurysm of the middle meningeal artery and cerebral intraparenchymal hematoma: case report T2 - Surgical Neurology TI - Traumatic pseudoaneurysm of the middle meningeal artery and cerebral intraparenchymal hematoma: case report UR - ://WOS:000242182100006 VL - 66 ID - 830419 ER - TY - JOUR AB - BACKGROUND: Pseudoaneuryms of the MMA are rare lesions, accounting for less than 1% of all intracranial aneurysms. CASE DESCRIPTION: We report a case of a spontaneous intracerebral hematoma that DSA revealed as ispilateral traumatic PMMA. The lesion was managed through an endovascular approach, and definitive embolization of pseudoaneurysm and parent vessel with histoacryl injection was carried out. Recovery and follow-up were uneventful. We discuss the management of those lesions, emphasizing the current neuroendovascular tools and techniques. CONCLUSION: Pseudoaneurysm of the MMA is uncommon but has a potential aggressive natural history. As it can occur with different patterns of intracranial hemorrhage, the external carotid arteries have to be included in hemorrhagic investigational DSA. Once diagnosed, it must be treated. The minimally invasive endovascular approach and definitive embolization of pseudoaneurysm and parent vessel with histoacryl injection are safe and effective. AD - Hospital da Restauração, University of Pernambuco, Recife 52071-000, Brazil. patri_boz@yahoo.fr AN - 17081850 AU - Bozzetto-Ambrosi, P. AU - Andrade, G. AU - Azevedo-Filho, H. DO - 10.1016/j.surneu.2006.08.048 DP - NLM ET - 2006/11/04 J2 - Surgical neurology KW - Adult Aneurysm, False/complications/*diagnostic imaging/*therapy Angiography, Digital Subtraction Humans Intracranial Hemorrhage, Traumatic/complications/*diagnostic imaging/*therapy Male *Meningeal Arteries LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0090-3019 (Print) 0090-3019 SP - S29-31 ST - Traumatic pseudoaneurysm of the middle meningeal artery and cerebral intraparenchymal hematoma: case report T2 - Surg Neurol TI - Traumatic pseudoaneurysm of the middle meningeal artery and cerebral intraparenchymal hematoma: case report VL - 66 Suppl 3 ID - 828861 ER - TY - JOUR AD - fbraiteh@mdanderson.org AN - 19176564 AU - Braiteh, F. AU - Row, M. DA - Feb DO - 10.1136/hrt.2008.158790 DP - NLM ET - 2009/01/30 J2 - Heart (British Cardiac Society) KW - Embolism/diagnostic imaging/*etiology Female Foreign Bodies/*complications/diagnostic imaging Heart Diseases/diagnostic imaging/*etiology Humans Middle Aged *Polymethyl Methacrylate Postoperative Complications/diagnostic imaging/*etiology Radiography Spinal Fractures/diagnostic imaging/*surgery Vertebroplasty/adverse effects LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 1355-6037 SP - 275 ST - Right ventricular acrylic cement embolism: late complication of percutaneous vertebroplasty T2 - Heart TI - Right ventricular acrylic cement embolism: late complication of percutaneous vertebroplasty VL - 95 ID - 828983 ER - TY - JOUR AN - 105636841. Language: English. Entry Date: 20090403. Revision Date: 20170411. Publication Type: journal article AU - Braiteh, F. AU - Row, M. AU - Braiteh, F. AU - Row, M. DB - cin20 DO - 10.1136/hrt.2008.158790 DP - EBSCOhost KW - Embolism -- Etiology Foreign Bodies -- Complications Heart Diseases -- Etiology Methylmethacrylates Postoperative Complications -- Etiology Spinal Fractures -- Surgery Embolism -- Radiography Female Foreign Bodies -- Radiography Heart Diseases -- Radiography Kyphoplasty -- Adverse Effects Middle Age Postoperative Complications -- Radiography Spinal Fractures -- Radiography M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 1355-6037 SP - 275-275 ST - Right ventricular acrylic cement embolism: late complication of percutaneous vertebroplasty T2 - Heart TI - Right ventricular acrylic cement embolism: late complication of percutaneous vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105636841&site=ehost-live&scope=site VL - 95 ID - 830736 ER - TY - JOUR AB - The insertion of an intramedullary cement restrictor can lead to the same pathophysiologic reactions that are well described as fat embolism syndrome after cement and stem implantation. Fat and marrow are forced into the draining veins of the femur. In this study, we compared the extrusion of intramedullary contents produced by the insertion of a commonly used gelatin (Biostop G/IMSET) and a new expandable cement restrictor (REX Cement Stop) in 7 paired, fresh-frozen femora. A further 9 pairs were used to evaluate the function of a custom-made application instrument, which allowed for suction during plug (Biostop G/IMSET) insertion. The oversized restrictor produced, on average, twice as much fat as the expandable restrictor (P = 0.0156). The gelatin plug with additional suction was not associated with reduced fat extrusion, because the suction device in its current design failed because of obstruction in most cases. The expandable restrictor showed favorable characteristics and has the potential to reduce the risk of fat embolism. AD - University of Edinburgh, Department of Orthopaedics, New Royal Infirmary, Scotland. AN - 15343534 AU - Breusch, S. J. AU - Heisel, C. DA - Sep DO - 10.1016/j.arth.2004.01.012 DP - NLM ET - 2004/09/03 J2 - The Journal of arthroplasty KW - Arthroplasty, Replacement, Hip/adverse effects/*instrumentation Biomechanical Phenomena *Bone Cements Cementation Embolism, Fat/etiology/*prevention & control *Femur Gelatin Humans Polymethyl Methacrylate Statistics, Nonparametric LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2004 SN - 0883-5403 (Print) 0883-5403 SP - 739-44 ST - Insertion of an expandable cement restrictor reduces intramedullary fat displacement T2 - J Arthroplasty TI - Insertion of an expandable cement restrictor reduces intramedullary fat displacement VL - 19 ID - 828789 ER - TY - JOUR AB - Intraoperative fat embolism associated with cemented total hip arthroplasty is a well recognized complication. In a new sheep model allowing for standardized bilateral, simultaneous cement pressurization we studied the effectiveness of both pulsatile and syringe lavage of equal volume with regard to their cleansing capabilities as measured by fat and bone marrow intravasation. The operative procedure involved bilateral placement of intravenous catheters into the external lilac veins via retroperitoneal approach. After femoral neck osteotomies both femoral cavities were prepared for retrograde cement application. After randomization one side was lavaged with 250 ml irrigation using a bladder syringe, the contralateral femur with the identical volume but using a pulsatile lavage. A specially designed apparatus was used to allow for bilateral simultaneous cement pressurization. Venous blood from both lilac catheters was then collected, anticoagulated and a quantitative and qualitative fat analysis was performed. Despite equal volume manual lavage produced significantly higher fat and bone marrow intravasation (P < 0.001) than pulsatile lavage thus suggesting that not only the volume but also the quality of bone lavage is an essential factor influencing the risk of fat embolism and adverse cardiorespiratory effects. Our findings further emphasize the important role of pulsatile lavage in preventing fat and bone marrow embolisation during cemented total hip arthroplasty. AN - CN-01756990 AU - Breusch, S. J. AU - Reitzel, T. AU - Schneider, U. AU - Volkmann, M. AU - Ewerbeck, V. AU - Lukoschek, M. DO - 10.1007/s001320050496 KW - *total hip prosthesis Anticoagulation Article Clinical trial Controlled clinical trial Controlled study Fat embolism /complication /diagnosis /prevention Human Human tissue Postoperative complication Pulsatile flow Randomized controlled trial Surgical technique M1 - 6 M3 - Journal: Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2000 SP - 578‐586 ST - Pulsatile lavage reduces the risk of fat embolism in cemented total hip arthroplasty T2 - Der Orthopade TI - Pulsatile lavage reduces the risk of fat embolism in cemented total hip arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01756990/full VL - 29 ID - 830066 ER - TY - JOUR AB - AIM: The purpose of this study was to determine the efficacy of pulsatile jet lavage and manual syringe lavage with regard to their cleansing capabilities as measured by cement penetration into cancellous bone both in vivo and in vitro. METHODS: Three separate experiments were performed. Study A: In a cadaver study 36 left human cadaver femora were used for implantation of cemented femoral components. Conventional broaches were used for femoral preparation. Bone lavage was carried out either using jet lavage or manual syringe lavage of equal volume. The allocation to two different lavage groups was randomised. In both groups high‐pressurising cementing techniques were implemented with the use of a proximal seal and additional finger packing. Study B: To guarantee standardised cement pressurisation and equal bone quality, the influence of jet lavage (1000 ml) versus syringe lavage (1000 ml) was studied in 11 paired human cadaver femora in an additional study without prosthesis implantation. The specimens were imbedded in specially designed pots. Bone cement was applied in a retrograde manner and subjected to a standard pressure protocol with a constant force of 3000 N. Study C: To directly compare the effectiveness of both pulsatile jet and syringe lavage with regard to cement penetration in vivo, a new sheep model allowing for standardised bilateral, simultaneous cement pressurisation was used. After femoral neck osteotomies both femoral cavities of 10 sheep were prepared for retrograde cement application. After randomisation one side was lavaged with 250 ml irrigation using a bladder syringe, the contralateral femur with the identical volume but using a pulsatile lavage. A specially designed apparatus was used to allow for bilateral simultaneous cement pressurisation. Analysis: In all studies horizontal sections were obtained from the femoral specimens at predefined levels using a diamond saw. Microradiographs were taken and analysed using image analysis to assess cement penetration into cancellous bone. RESULTS: Study A: Compared with syringe lavage the use of jet lavage significantly improved the penetration of cement into cancellous bone (p = 0.027). In the presence of strong, dense cancellous bone the findings were more pronounced. Study B: Our results show that in equal quality bone, the use of jet lavage yields significantly (p < 0.001) improved cement penetration compared to syringe lavage specimens. Study C: The results of the in vivo study confirmed the superiority of jet lavage bone surface preparation (p = 0.002). CONCLUSIONS: The use of jet lavage yields significantly improved interdigitation between cancellous bone and cement both in vitro and in vivo and should be regarded as mandatory in cemented total hip arthroplasty. High pressurising techniques are effective means to improve cement penetration, but should only be administered with jet lavage to reduce the risk of fat embolism. AN - CN-00327089 AU - Breusch, S. J. AU - Schneider, U. AU - Reitzel, T. AU - Kreutzer, J. AU - Ewerbeck, V. AU - Lukoschek, M. DO - 10.1055/s-2001-11871 KW - Animals Arthroplasty, Replacement, Hip Bone Cements Equipment Failure Analysis Femur [pathology] Humans Hydrostatic Pressure Polymethyl Methacrylate [*administration & dosage] Sheep Therapeutic Irrigation M1 - 1 M3 - Clinical Trial; Comparative Study; English Abstract; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2001 SP - 52‐63 ST - Significance of jet lavage for in vitro and in vivo cement penetration T2 - Zeitschrift fur orthopadie und ihre grenzgebiete TI - Significance of jet lavage for in vitro and in vivo cement penetration UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00327089/full VL - 139 ID - 829998 ER - TY - JOUR AB - Study shows no complications from infection, bleeding, pulmonary embolism, or cardiac arrest. AN - 105610029. Language: English. Entry Date: 20090213. Revision Date: 20150711. Publication Type: Journal Article. Journal Subset: Biomedical AU - Brockenbrough, G. DB - cin20 DP - EBSCOhost KW - Kyphoplasty Osteolysis -- Therapy Spinal Fractures -- Therapy Minimally Invasive Procedures -- Methods Orthopedics Pain -- Therapy M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0279-5647 SP - 38-38 ST - Balloon kyphoplasty may be effective in cases of osteolytic vertebral fractures T2 - Orthopedics Today TI - Balloon kyphoplasty may be effective in cases of osteolytic vertebral fractures UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105610029&site=ehost-live&scope=site VL - 29 ID - 830743 ER - TY - JOUR AB - Bone metastases are the most common tumours affecting the musculoskeletal system. The most frequently affected area of the skeleton is the spine. The vertebral bodies are reached largely via the bloodstream and neoplastic substitution of the bone tissue causes progressive structural destruction leading to loss of stability and compression of the intracanal nerve structures. The treatment of bone metastases in the spine is different and controversial, mostly because of the wide spectrum of clinical and radiographic pattern of the local and systemic disease. Percutaneous vertebroplasty is emerging as one of the most promising new interventional procedures for relieving (or reducing) pain and improve stability. In this article we review indications, contraindications, technique, and complications of percutaneous vertebroplasty in spine metastases. AD - Osped Maggiore CA Pizzardi, Chirurgia Rachide, Unita Operat Ortopedia & Traumatol, Bologna, Italy. Brodano, GB (corresponding author), Osped Maggiore CA Pizzardi, Chirurgia Rachide, Unita Operat Ortopedia & Traumatol, Bologna, Italy. AN - WOS:000251054800002 AU - Brodano, G. B. AU - Cappuccio, M. AU - Gasbarrini, A. AU - Bandiera, S. AU - De Salvo, F. AU - Cosco, F. AU - Boriani, S. DA - Mar-Apr J2 - Eur. Rev. Med. Pharmacol. Sci. KW - vertebroplasty metastases complications PERCUTANEOUS VERTEBROPLASTY PULMONARY-EMBOLISM RADIOFREQUENCY ABLATION SURGICAL-MANAGEMENT ACRYLIC CEMENT COMPLICATIONS POLYMETHYLMETHACRYLATE Pharmacology & Pharmacy LA - English M1 - 2 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2007 SN - 1128-3602 SP - 91-100 ST - Vertebroplasty in the treatment of vertebral metastases: clinical cases and review of the literature T2 - European Review for Medical and Pharmacological Sciences TI - Vertebroplasty in the treatment of vertebral metastases: clinical cases and review of the literature UR - ://WOS:000251054800002 VL - 11 ID - 830400 ER - TY - JOUR AB - Timely interventional cancer pain therapies complement conventional pain management by reducing the need for high-dose opioid therapy and its associated toxicity. All patients with upper abdominal visceral pain should be considered for celiac plexus neurolysis soon after diagnosis. Intrathecal therapy should be considered in any patient with moderate-to-severe pain despite a reasonable therapeutic trial of opioid pharmacotherapy or in any patient intolerant of opioid therapy. Specific interventions for vertebral metastases and other sites of metastatic bone pain, including vertebroplasty, kyphoplasty, and image-guided tumor ablation, should be understood and considered. A collaborative model of care, including pain medicine specialists with expertise in interventional therapies, should be standard in all oncologic practices in order to optimize outcomes for patients with cancer throughout the course of their treatment. © 2010 Elsevier Inc. AD - S. Brogan, Department of Anesthesiology, University of Utah, 30 North 1900 East, Salt Lake City, UT 84132, United States AU - Brogan, S. AU - Junkins, S. C1 - prialt DB - Embase Medline KW - antibiotic agent baclofen bisphosphonic acid derivative bupivacaine clonidine corticosteroid droperidol fentanyl hydromorphone ketamine ketorolac lidocaine methadone midazolam morphine morphine sulfate neostigmine nonsteroid antiinflammatory agent omega conotoxin MVIIA opiate oxycodone paracetamol pethidine placebo sufentanil absence of side effects add on therapy adult agitation anxiety artificial embolization ataxia bladder dysfunction bone metastasis cancer pain case report catheter celiac plexus clinical practice clinical trial cognitive defect constipation continuous infusion controlled clinical trial cost effectiveness analysis creatine kinase blood level delusion diarrhea drug activation drug delivery system drug dose titration lack of drug effect drug withdrawal epigastric pain external beam radiotherapy extrapyramidal symptom follow up hematoma hot flush human hypotension implantable port system intestinal dysmotility kyphoplasty lethargy lung embolism male meningitis mental disease motor dysfunction nausea nausea and vomiting nerve block neurolysis neurolytic celiac plexus blockade neuropathic pain outcome assessment pain assessment pancreas adenocarcinoma paraplegia parasympathetic tone patient controlled analgesia percutaneous vertebroplasty postdural puncture headache pruritus quality of life radiofrequency ablation randomized controlled trial respiration depression review sedation sensory dysfunction seroma side effect simple percutaneous intrathecal catheter skin infection spinal cord injury spinal cord lesion spine metastasis superior hypogastric plexus block treatment contraindication treatment indication tumor ablation tunneled intrathecal catheter urine retention vagus tone spine fracture visceral pain visual analog scale prialt Patient Therapy Manager L1 - http://www.supportiveoncology.net/journal/articles/0802052.pdf LA - English M1 - 2 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 1544-6794 SP - 52-58 ST - Interventional therapies for the management of cancer pain T2 - Journal of Supportive Oncology TI - Interventional therapies for the management of cancer pain UR - https://www.embase.com/search/results?subaction=viewrecord&id=L358999747&from=export VL - 8 ID - 829678 ER - TY - JOUR AB - The case report describes fat pulmonary embolism during a cemented hip arthroplasty procedure. A 70-year-old woman required a cemented hemiarthroplasty for hip fracture. Her medical history consisted of non-Q myocardial infarction two years ago. Current medications were ACE inhibitor and nitrates. Low molecular weight heparin was given night before the surgery. During the cementing of the canal and insertion of the femoral prosthesis a ventricular arrhythmia occurred, blood pressure declined to 80/60 mmHg and patient's oxyhemoglobin saturation decreased to 92%. The patient underwent a successful intraoperative resuscitation and was transferred to the intensive care unit. In the postoperative course she developed acute coronary syndrome and non-Q myocardial infarction, acute renal and respiratory failure. On the fourth day after the surgery she suffered fatal cardiac arrest. The autopsy findings revealed multiple fat vacuoles in the pulmonary vasculature and confirmed the cause of death as fat embolism. AD - Univ Hosp Tumours, Zagreb 10000, Croatia. Osijek Univ Hosp, Osijek, Croatia. Brozovic, G (corresponding author), Univ Hosp Tumours, Ilica 197, Zagreb 10000, Croatia. gordana.brozovic@kzt.hr AN - WOS:000248274400008 AU - Brozovic, G. AU - Kvolik, S. AU - Nagy, A. AU - Dumencic, B. AU - Marjanovic, K. AU - Rakipovic-Stojanovic, A. J2 - Neurol. Croat. KW - fat embolism respiratory failure HIP-ARTHROPLASTY CARDIAC-ARREST Clinical Neurology LA - English M3 - Article; Proceedings Paper N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2005 SN - 0353-8842 SP - 49-54 ST - Fat embolism as the cause of respiratory failure T2 - Neurologia Croatica TI - Fat embolism as the cause of respiratory failure UR - ://WOS:000248274400008 VL - 54 ID - 830430 ER - TY - JOUR AB - While vertebroplasty enjoys continued use in some settings, there is now high‐moderate quality evidence based on systematic review that includes five placebo‐controlled trials that it provides no benefits over placebo and these results do not differ according to pain duration (≤6 vs >6 weeks). A clinically important increased risk of incident symptomatic vertebral fractures or other serious adverse events cannot be excluded due to small event numbers. Serious harms including cord compression, ventricular perforation, pulmonary embolism, infection and death have been reported. This unfavourable risk–benefit ratio should be convincing doctors and patients to stop the use of vertebroplasty. At the very least, clinicians should fully inform their patients about the evidence including the likelihood of improving without vertebroplasty and the potential harms, so that patients can make evidence‐informed decisions about their treatment. They should also warn patients about the pitfalls of relying on information sourced from the internet or from 'awareness raising' campaigns. AD - Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne Victoria, Australia Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne Victoria, Australia Biostatistics Consulting Platform, Research Methodology Division, School of Public Health and Preventive Medicine, Melbourne Victoria, Australia AN - 139622972. Language: English. Entry Date: 20191118. Revision Date: 20201102. Publication Type: Article AU - Buchbinder, Rachelle AU - Busija, Lucy DB - cin20 DO - 10.1111/imj.14628 DP - EBSCOhost KW - Vertebroplasty -- Adverse Effects Osteoporotic Fractures -- Risk Factors Spinal Fractures -- Risk Factors Risk Assessment Treatment Termination Pain Measurement Spinal Cord Compression -- Risk Factors Heart Rupture -- Risk Factors Pulmonary Embolism -- Risk Factors Infection -- Risk Factors Physician-Patient Relations Decision Making, Clinical Internet Health Knowledge Health Promotion M1 - 11 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2019 SN - 1444-0903 SP - 1367-1371 ST - Why we should stop performing vertebroplasties for osteoporotic spinal fractures T2 - Internal Medicine Journal TI - Why we should stop performing vertebroplasties for osteoporotic spinal fractures UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=139622972&site=ehost-live&scope=site VL - 49 ID - 830520 ER - TY - JOUR AB - BACKGROUND: Considering the demographic changes in the populations of Germany and Europe as a whole, the field of geriatric traumatology is gaining more and more importance within the specialty of orthopedic and trauma surgery. The high prevalence of osteoporosis in this specific group of patients poses a special challenge, with vertebral compression fractures being the by far most common osteoporosis-related fractures. These fractures present with acute as well as chronic back pain leading to severe consequences for the affected patients. Mobility and quality of life are often heavily impaired. Furthermore, higher morbidity and mortality as well as higher risk for further fractures have been proven in these patients. METHOD: Balloon kyphoplasty has become a more frequently used therapy and is now offered broadly. This treatment addresses stable fractures not involving the posterior margin of the vertebrae. With increasing application of this surgical procedure the number of complication reports is also rising. The following article gives an overview of the technique, indications and the possible complications by giving several examples from the daily practice and reviewing the relevant literature. RESULTS: Cement leakage of the treated vertebrae is the most common complication associated with balloon kyphoplasty. In almost all cases this occurs due to too early application of the cement, not having reached its optimum in viscosity. Literature research shows a percentage rate of about 9% for cement leakage. Thus, balloon kyphoplasty provides more safety for the patient than vertebroplasty, for which cement leakage rates of up to 41% are reported. Other studies report cement leakage ratios of 4-10% for kyphoplasty versus 20-70% for vertebroplasty. Overall the percentage of cement leakage is clearly increased in osteoporotic fractures compared to non-osteoporotic fractures, with the cement leaking mainly into the spinal disc space. So far, valid data in order to further explore the consequences of intradiscal cements are lacking. Most relevant for everyday practice are cement leakages that have become symptomatic. Depending on the localisation they present with dysaesthesia culminating in radicular pain or even paraplegia. Cement leakage into vessels can, depending on the amount of cement, lead to embolism of pulmonary arteries. Complications due to the surgical technique, postoperative infections, bleeding or cardiovascular complications are rare with less than 1%. The probability for symptomatic cement leakage averages about 1.3% for balloon kyphoplasty. Another discussion, for which at present there is no evidence-based verification, is concerned with the higher risk for adjacent vertebral fractures after cement augmentation of an osteoporotic vertebral compression fracture. At present the degree of osteoporosis and more important the number of osteoporosis-related fractures must be the relevant predictor for adjacent fractures of neighbouring vertebrae. CONCLUSION: Balloon kyphoplasty is a highly standardised and widely used minimally invasive procedure for stabilising and augmenting painful osteoporotic fractures of the vertebral body. When surgery is indicated carefully and is carried out subtly, the risk of complications is reasonable and the outcome is promising. Viscosity of the used cement has to be adequate and it must not be inserted with too high a pressure. A causal connection between cement viscosity and risk of cement leakage has been proven in experimental studies. During application of PMMA cement a thorough fluoroscopic monitoring must take place in order to detect cement leakage at an early stage and if necessary stop application. These procedures should be reserved for clinical centres and surgeons who are able to surgically handle possible complications such as compression of the spinal cord. On the basis of our own experience we also recommend treatment in a hospital with an integrated osteoporosis centre and consecutive treatment in specialised outpatient care. Standards in primary care as well as after treatment can be introduced thereby. Also communication with practitioner concerned with outpatient care is simplified, which leads to enduring therapeutic outcome. AD - Klinik für Unfall-, Wiederherstellungs- und Handchirurgie, Städtisches Klinikum Dresden-Friedrichstadt, Dresden. bula-ph@khdf.de AN - 21080313 AU - Bula, P. AU - Lein, T. AU - Strassberger, C. AU - Bonnaire, F. DA - Dec DO - 10.1055/s-0030-1250379 DP - NLM ET - 2010/11/17 J2 - Zeitschrift fur Orthopadie und Unfallchirurgie KW - Female Humans Kyphoplasty/*adverse effects Male Osteoporotic Fractures/*surgery Postoperative Complications/*etiology Reproducibility of Results Risk Assessment Risk Factors Sensitivity and Specificity Spinal Fractures/*surgery Treatment Outcome LA - ger M1 - 6 N1 - PubMed NLM literature search January 5, 2021 OP - Ballonkyphoplastie zur Behandlung osteoporotischer Wirbelfrakturen: Indikationen - Behandlungsstrategie - Komplikationen. PY - 2010 SN - 1864-6697 SP - 646-56 ST - [Balloon kyphoplasty in the treatment of osteoporotic vertebral fractures: indications - treatment strategy - complications] T2 - Z Orthop Unfall TI - [Balloon kyphoplasty in the treatment of osteoporotic vertebral fractures: indications - treatment strategy - complications] VL - 148 ID - 828847 ER - TY - JOUR AB - INTRODUCTION: Acrylic kyphoplasty involves percutaneous reduction of a vertebral body fracture with balloon compression followed by injection of polymethylmethacrylate (PMMA) cement (1). Intravascular embolization of PMMA cement is a known complication (2). Prior case reports suggest surgical thrombectomy in symptomatic patients with central pulmonary embolisms (3). We report an alternative approach using a fluoroscopy guided snare to remove a central pulmonary embolism percutaneously. CASE PRESENTATION: A 41 year old male with a prior un-witnessed seizure complicated by endplate vertebral fractures was admitted for kyphoplasty. During injection of PMMA cement under fluoroscopy, a larger than usual amount of cement was observed to migrate out of the T7 vertebral body via an emissary vein and into the pulmonary vasculature. Computed tomography confirmed PMMA embolism within the truncus anterior. An echocardiogram showed no evidence of right heart strain. The patient remained hemodynamically stable. Post-procedure, the patient reported shortness of breath with movement. His oxygen saturation on room air was 88%. Full dose anticoagulation was initiated and IR guided embolectomy was attempted. Using femoral venous access, a catheter was placed proximal to the filling defect. A 20mm loop snare was then used to retrieve the cement embolism. The patient's exercise tolerance gradually improved and he was discharged home off anticoagulation. DISCUSSION: PMMA leakage after acrylic kyphoplasty is a common complication that can occur if the PMMA is too liquid or if too much pressure is applied during injection (2). Intravascular embolization is a known risk, although pulmonary embolism occurs less frequently, with an incidence ranging from 3.5-23% (2). Prior literature suggests surgical thrombectomy in symptomatic patients with central embolisms (3) and anticoagulation in any symptomatic embolism (2). To our knowledge, this is the first reported percutaneous removal of a symptomatic central embolism that lead to resolution of symptoms and successful discharge off anticoagulation. We recommend consideration of this approach in all patients with central symptomatic emboli following vertebral kyphoplasty. CONCLUSIONS: Fluoroscopy guided percutaneous removal of PMMA cement pulmonary embolisms should be considered as alternative to surgical thrombectomy in symptomatic patients. AD - D. Burke, NYU Langone Medical Center, New York, NY, United States AU - Burke, D. AU - Rudym, D. AU - Lubinksy, A. DB - Embase DO - 10.1378/chest.2251529 KW - cement poly(methyl methacrylate) fluoroscopy kyphoplasty lung embolism human patient embolism anticoagulation injection surgical thrombectomy artificial embolization vertebra body ambient air oxygen saturation male dyspnea procedures case report echocardiography trunk computer assisted tomography lung blood vessel compression vein spine fracture fracture heart nerve ending exercise tolerance catheter embolectomy seizure liquid risk L1 - http://journal.publications.chestnet.org/article.aspx?articleID=2456427 LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 0012-3692 ST - Percutaneous fluoroscopy guided retrieval of a kyphoplasty cement pulmonary embolism T2 - Chest TI - Percutaneous fluoroscopy guided retrieval of a kyphoplasty cement pulmonary embolism UR - https://www.embase.com/search/results?subaction=viewrecord&id=L72132787&from=export http://dx.doi.org/10.1378/chest.2251529 VL - 148 ID - 829362 ER - TY - JOUR AB - Objective. To describe vertebroplasty and kyphoplasty, which are relatively new techniques used to treat painful vertebral compression fractures. Design Setting Patients. This article briefly reviews the procedural indications, technical aspects of the procedure, and strategies for complication avoidance. Results. Percutaneous vertebroplasty is the injection of a vertebral body with bone cement, generally polymethylmethacrylate. Kyphoplasty is the placement of balloons (called "tamps") into the vertebral body with an inflation/deflation sequence to create a cavity prior to the cement injection. These procedures are most often performed in a percutaneous fashion on an outpatient (or short stay) basis. The mechanism of action is unknown, but it is postulated that stabilization of the fracture leads to analgesia. The procedure is indicated for painful vertebral compression fractures due to osteoporosis or malignancy, and painful hemangiomas. The procedure has efficacy in painful vertebral metastasis and traumatic compression fractures. Much evidence favors the use of this procedure for pain associated with these disorders. The overall risks of the procedure are low but serious complications can occur. The serious complications include spinal cord compression, nerve root compression, venous embolism, pulmonary embolism including cardiovascular collapse, and others. With good patient selection and careful technique, these complications are avoidable, making the risk-to-benefit ratio highly favorable. Conclusions. Vertebroplasty and kyphoplasty are effective and safe techniques used to treat painful spinal fractures. © 2008 by American Academy of Pain Medicine. AD - A.W. Burton, Department of Anesthesiology, UT MD Anderson Cancer Center, 1400 Holcombe Blvd.-409, Houston, TX 77030, United States AU - Burton, A. W. DB - Embase DO - 10.1111/j.1526-4637.2008.00440.x KW - hydromorphone oxycodone poly(methyl methacrylate) tramadol adult article bone marrow transplantation cancer regression case report compression fracture disease severity exercise falling human kyphoplasty low back pain male multiple myeloma nuclear magnetic resonance imaging pain assessment percutaneous vertebroplasty thoracolumbar spine spine fracture LA - English M1 - SUPPL. 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2008 SN - 1526-2375 1526-4637 SP - S58-S64 ST - Vertebroplasty and Kyphoplasty: Case presentation, complications, and their prevention T2 - Pain Medicine TI - Vertebroplasty and Kyphoplasty: Case presentation, complications, and their prevention UR - https://www.embase.com/search/results?subaction=viewrecord&id=L351736835&from=export http://dx.doi.org/10.1111/j.1526-4637.2008.00440.x VL - 9 ID - 829747 ER - TY - JOUR AN - 29169440 AU - Butscheidt, S. AU - Ritter, J. AU - Püschel, K. C2 - Pmc5719242 DA - Nov 3 DO - 10.3238/arztebl.2017.0756 DP - NLM ET - 2017/11/25 J2 - Deutsches Arzteblatt international KW - Aged Bone Cements/*adverse effects Fatal Outcome Female Humans Kyphoplasty/*adverse effects Pulmonary Embolism/*etiology Tomography, X-Ray Computed LA - eng M1 - 44 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 1866-0452 SP - 756 ST - Multiple Pulmonary Emboli of Bone Cement after Kyphoplasty T2 - Dtsch Arztebl Int TI - Multiple Pulmonary Emboli of Bone Cement after Kyphoplasty VL - 114 ID - 828696 ER - TY - JOUR AB - Purpose Complications of cement-augmented interventions (e.g., kyphoplasty) in the spine include local cement leakage and pulmonary cement embolisms (PCE). This study was conducted to determine their extent in a unique post-mortem cohort. Methods Retrospective analysis of post-mortem whole-body CT scans and review of autopsy results in 29 consecutive cases with cement-augmented interventions in the spine. PCE findings were graded based on cement deposits: grade 0 (no PCE), grade 1 (1-3 PCE), grade 2 (4-6 PCE), and grade 3 (> 6 or branch-shaped PCE). Bone and lung tissue specimens were obtained in representative cases to confirm the findings histologically. Results Local cement leakage was detected in 69%: intravenous (34%), intervertebral (31%), intraspinal (14%), and retrograde (17%). Lung sections showed PCE in 52%: grade 0 (48%), grade 1 (31%), grade 2 (10%), and grade 3 (10%). Matching with autopsy findings revealed that none of the cases died due to the impact of PCE. Conclusions The presented data reveal a high frequency of PCE making it a notable finding especially since not only single but also branch-like embolisms were detected. Thus, it is of great importance that none of the causes of death were related to the impact of PCE. Nevertheless, it is crucial to consider the underlying diseases for increased PCE risk and to apply latest surgical techniques and preventive measures. AD - [Butscheidt, Sebastian; Rolvien, Tim; Amling, Michael] Univ Med Ctr Hamburg Eppendorf, Dept Osteol & Biomech, Lottestr 59, D-22529 Hamburg, Germany. [Ritter, Jakob; Heinemann, Axel; Vogel, Hermann; Pueschel, Klaus] Univ Med Ctr Hamburg Eppendorf, Dept Legal Med, Butenfeld 34, D-22529 Hamburg, Germany. Puschel, K (corresponding author), Univ Med Ctr Hamburg Eppendorf, Dept Legal Med, Butenfeld 34, D-22529 Hamburg, Germany. pueschel@uke.de AN - WOS:000447507500021 AU - Butscheidt, S. AU - Rolvien, T. AU - Ritter, J. AU - Heinemann, A. AU - Vogel, H. AU - Amling, M. AU - Puschel, K. DA - Oct DO - 10.1007/s00586-018-5581-5 J2 - Eur. Spine J. KW - Pulmonary cement embolism PMMA Vertebroplasty Kyphoplasty Cause of death Histology VERTEBRAL COMPRESSION FRACTURES PERCUTANEOUS VERTEBROPLASTY BONE-CEMENT RISK-FACTORS KYPHOPLASTY LEAKAGE CT METHACRYLATE COMPLICATION Clinical Neurology Orthopedics LA - English M1 - 10 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 0940-6719 SP - 2593-2601 ST - Pulmonary cement embolism is not associated with the cause of death in a post-mortem cohort of cement-augmented interventions in the spine T2 - European Spine Journal TI - Pulmonary cement embolism is not associated with the cause of death in a post-mortem cohort of cement-augmented interventions in the spine UR - ://WOS:000447507500021 VL - 27 ID - 830157 ER - TY - JOUR AB - PURPOSE: Complications of cement-augmented interventions (e.g., kyphoplasty) in the spine include local cement leakage and pulmonary cement embolisms (PCE). This study was conducted to determine their extent in a unique post-mortem cohort. METHODS: Retrospective analysis of post-mortem whole-body CT scans and review of autopsy results in 29 consecutive cases with cement-augmented interventions in the spine. PCE findings were graded based on cement deposits: grade 0 (no PCE), grade 1 (1-3 PCE), grade 2 (4-6 PCE), and grade 3 (> 6 or branch-shaped PCE). Bone and lung tissue specimens were obtained in representative cases to confirm the findings histologically. RESULTS: Local cement leakage was detected in 69%: intravenous (34%), intervertebral (31%), intraspinal (14%), and retrograde (17%). Lung sections showed PCE in 52%: grade 0 (48%), grade 1 (31%), grade 2 (10%), and grade 3 (10%). Matching with autopsy findings revealed that none of the cases died due to the impact of PCE. CONCLUSIONS: The presented data reveal a high frequency of PCE making it a notable finding-especially since not only single but also branch-like embolisms were detected. Thus, it is of great importance that none of the causes of death were related to the impact of PCE. Nevertheless, it is crucial to consider the underlying diseases for increased PCE risk and to apply latest surgical techniques and preventive measures. These slides can be retrieved under Electronic Supplementary material. AD - Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Lottestr. 59, 22529, Hamburg, Germany. Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529, Hamburg, Germany. Department of Legal Medicine, University Medical Center Hamburg-Eppendorf, Butenfeld 34, 22529, Hamburg, Germany. pueschel@uke.de. AN - 29667142 AU - Butscheidt, S. AU - Rolvien, T. AU - Ritter, J. AU - Heinemann, A. AU - Vogel, H. AU - Amling, M. AU - Püschel, K. DA - Oct DO - 10.1007/s00586-018-5581-5 DP - NLM ET - 2018/04/19 J2 - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society KW - Bone Cements/*adverse effects *Cementoplasty/adverse effects/mortality Humans *Pulmonary Embolism/chemically induced/mortality Retrospective Studies Spinal Diseases/surgery Spine/*surgery Tomography, X-Ray Computed *Cause of death *Histology *Kyphoplasty *Pmma *Pulmonary cement embolism *Vertebroplasty LA - eng M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 0940-6719 SP - 2593-2601 ST - Pulmonary cement embolism is not associated with the cause of death in a post-mortem cohort of cement-augmented interventions in the spine T2 - Eur Spine J TI - Pulmonary cement embolism is not associated with the cause of death in a post-mortem cohort of cement-augmented interventions in the spine VL - 27 ID - 828590 ER - TY - JOUR AB - A 55-year-old patient presented with a massive renal cancer metastasis of the acetabulum. After transarterial embolization, four sessions of cementoplasty and percutaneous screw fixation to fuse the cement blocks, in association with antiangiogenics, the patient was able to run. AD - X. Buy, Department of Radiology, Institut Bergonié, Bordeaux, France AU - Buy, X. AU - Catena, V. AU - Gross-Goupil, M. AU - Palussière, J. DB - Embase DO - 10.1007/s00270-016-1405-3 KW - cement acetabulum adult artificial embolization case report cementoplasty destruction human kidney cancer metastasis middle aged LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1432-086X SP - S208 ST - Combination of embolization, cementoplasty, and percutaneous screw fixation for major acetabular destruction due to kidney cancer metastasis: Mid-term outcome T2 - CardioVascular and Interventional Radiology TI - Combination of embolization, cementoplasty, and percutaneous screw fixation for major acetabular destruction due to kidney cancer metastasis: Mid-term outcome UR - https://www.embase.com/search/results?subaction=viewrecord&id=L613933601&from=export http://dx.doi.org/10.1007/s00270-016-1405-3 VL - 39 ID - 829345 ER - TY - JOUR AB - Learning Objectives 1. To report the most appropriate indications for bone tumour ablation and embolisation 2. To learn how to manage and avoid complications 3. To report and illustrate various ablation techniques Bone metastases are the most common cause of chronic pain in cancer patients. Treatment strategy for patients with bone tumors requires consideration of many factors: a) histology of the tumor, with differentiation of benign and malignant tumors; b) careful evaluation of the patient's general condition and understanding of the disease process; c) definition of the therapeutic goal: curative or palliative; and d) potential need for mechanical stabilization when treating weight-bearing bones. Interventional radiology offers various techniques for the management of bone tumors: consolidation with cementoplasty or percutaneous screw fixation, tumor ablation with radiofrequency, microwave or cryoablation, and embolization. All these techniques should be proposed in a multidisciplinary approach that involves oncologists, orthopedic surgeons, and radiotherapist. Bone tumor embolization is indicated for different clinical situations: a) before surgery to reduce perioperative blood loss; b) for palliative local tumor control or tumor debulking, particularly for hypervascular painful metastases - in such cases, other interventional radiology techniques such as cementoplasty and thermal ablation may also be considered as alternative or combined methods; and c) for a curative local control in benign tumors such as hemangiomas or aneurysmal bone cysts or for malignant oligometastates. Complications due to bone tumor embolization remain rare. Nontargeted embolization can occur; therefore, spinal tumors close to the radiculo-medullary artery are contraindicated. Post-embolization skin necrosis is exceptional. Secondary fracture is the most common delayed complication; thus, additional consolidation technique should always be considered when embolizing a weight-bearing bone. Conclusion: bone tumor embolization before surgery remains a major technique to reduce perioperative blood loss. For palliative or curative treatment of non-surgical bone tumors, thermal ablation techniques such as radiofrequency or cryoablation are generally preferred as they induce an effective controllable and reproducible tumor necrosis. However, for tumors where thermal ablation cannot be proposed (very large tumor or tumors in contact with vulnerable organs that cannot be displaced), bone embolization should be considered as an alternative. Embolization is also particularly useful to treat large hypervascular bone tumors where thermal ablation alone may be ineffective due to major thermal sink effect. For selected non-surgical oligometastatic patients in whom optimal local tumor control is required, bone embolization in combination with intraarterial perfusion of targeted chemotherapy may offer new perspectives. AD - X. Buy, Department of Radiology, Institut Bergonié, Bordeaux, France AU - Buy, X. AU - Cazzato, R. L. AU - Gangi, A. AU - Palussière, J. DB - Embase KW - society Europe artificial embolization bone tumor human neoplasm bone patient cancer control tumor ablation interventional radiology ablation therapy cementoplasty radiofrequency bleeding weight bearing surgery cryoablation orthopedic surgeon oncologist histology tumor necrosis perfusion fracture skin necrosis microwave radiation bone metastasis spinal cord tumor cancer patient aneurysmal bone cyst hemangioma chronic pain artery benign neoplasm metastasis general condition malignant neoplasm intraarterial drug administration chemotherapy learning LA - English M1 - 2 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 0174-1551 SP - S106-S107 ST - Ablation and embolisation T2 - CardioVascular and Interventional Radiology TI - Ablation and embolisation UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71617754&from=export VL - 37 ID - 829412 ER - TY - JOUR AB - Learning Objectives 1. To become familiar with the most common cement types 2. To know about technical considerations for the use of different cements 3. To know about literature evidence Polymethylmethacrylate (PMMA) was the first cement used in orthopedic surgery in 1950. By mixing a radio-opacifier with PMMA, Deramond was the first to perform a percutaneous vertebroplasty in 1987, to treat an aggressive vertebral hemangioma. Since then, consolidation of osteoporotic compression fractures and stabilization of painful metastases or myeloma have become the major indications of percutaneous vertebroplasty. PMMA has many advantages: mechanically efficient, easy to inject, stability over time and low cost. The radio-opacity of the cement can be adapted by adding a contrast dye. However, few drawbacks still persist: exothermic reaction during polymerization, absence of bone integration and excessive stiffness. Indeed, the Yong's modulus of PMMA is about 5 to 8 times more than the one of cancellous bone. This excessive stiffness may lead to an increase rate of subsequent vertebral fractures in osteoporotic patients. However, this point remains controversial, as many authors consider that occurrence of new fractures is related to the natural course of osteoporosis. To overcome the drawbacks of PMMA, alternative cements have been developed. Ceramic cements have shown similar clinical results and adverse events rates, compared to PMMA. Silicone cements are less stiff, but series report a high rate of venous leakage and lung embolism due to a long setting time and a lower radio-opacity. Calcium-phosphate cements have a lower Young's modulus, low exothermic reaction and their partial resorption allows some osteo-integration. However, they are difficult to inject without prior cavity, due to poor viscosity. Their lower resistance also raises concerns about the risk of delayed cement failure. Composite cements mixing PMMA and calcium-phosphate cement have been developed to reduce stiffness and to achieve a better bone integration. Thus, they may show a possible benefit in osteoporosis, to reduce the risk of subsequent fractures. In oncology, several research projects are ongoing, trying to promote cement as a potential therapeutic vector. Animal studies report the use of chemotherapy- and radionuclide-loaded cements, but major concerns remain unsolved: only drugs not modified by exothermic reaction can be loaded; the amount of drug that is released from the cement is poorly controlled; finally, in case of cement leakage, vulnerable structures may be inadvertently exposed to the drug. In conclusion, PMMA is still the most commonly used cement. It is cheap and easy to handle. Moreover, its mechanical properties and its stability over time allow its use in various clinical indications, particularly osteoporosis and oncology. AD - X. Buy, Interventional Radiology, Institut Bergonie, Bordeaux, France AU - Buy, X. AU - Palussière, J. AU - Catena, V. DB - Embase DO - 10.1007/s00270-019-02282-x KW - calcium phosphate cement contrast medium poly(methyl methacrylate) radioisotope silicone adult cancer patient ceramics chemotherapy compression fracture conference abstract human learning lung embolism metastasis myeloma osteoporosis percutaneous vertebroplasty polymerization rigidity spine fracture trabecular bone vertebra hemangioma viscosity LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1432-086X SP - S81 ST - Cements in the spine: Percutaneous polymethylmethacrylate and beyond T2 - CardioVascular and Interventional Radiology TI - Cements in the spine: Percutaneous polymethylmethacrylate and beyond UR - https://www.embase.com/search/results?subaction=viewrecord&id=L629259087&from=export http://dx.doi.org/10.1007/s00270-019-02282-x VL - 42 ID - 829123 ER - TY - JOUR AN - 3740513 AU - Byrick, R. J. AU - Forbes, D. AU - Waddell, J. P. DA - Aug DO - 10.1097/00000542-198608000-00016 DP - NLM ET - 1986/08/01 J2 - Anesthesiology KW - Aged Blood Gas Analysis Blood Pressure Bone Marrow Embolism/*complications Embolism, Fat/*complications Female Heart Arrest/*etiology Humans *Intraoperative Complications *Knee Prosthesis Tidal Volume Time Factors LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 1986 SN - 0003-3022 (Print) 0003-3022 SP - 213-6 ST - A monitored cardiovascular collapse during cemented total knee replacement T2 - Anesthesiology TI - A monitored cardiovascular collapse during cemented total knee replacement VL - 65 ID - 828536 ER - TY - JOUR AB - Percutaneous vertebroplasty (PVP) is a therapeutic, interventional radiological procedure involving bone cement injection into a vertebral body. Although PVP is considered a minimally invasive procedure, cement leakage into the perivertebral venous system can occur with its migration towards the right heart and the pulmonary circulation. We report a case of accidental finding of asymptomatic cardiac and pulmonary embolism caused by cement leakage after PVP. AD - Department of Cardiovascular and Neurological Sciences, University of Cagliari, Monserrato 09042, Italy. cadedduc@unica.it AN - 19329500 AU - Cadeddu, C. AU - Nocco, S. AU - Secci, E. AU - Deidda, M. AU - Pirisi, R. AU - Mercuro, G. DA - Jun DO - 10.1093/ejechocard/jep030 DP - NLM ET - 2009/03/31 J2 - European journal of echocardiography : the journal of the Working Group on Echocardiography of the European Society of Cardiology KW - Aged *Bone Cements Cardiac Catheterization Echocardiography, Doppler, Color Embolism/*diagnostic imaging/etiology Female Heart Diseases/*diagnostic imaging/etiology Heart Ventricles/diagnostic imaging Humans Incidental Findings *Methylmethacrylate Postoperative Complications/*diagnostic imaging Pulmonary Embolism/*diagnostic imaging/etiology Tomography, X-Ray Computed Vertebroplasty/*adverse effects LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 1532-2114 SP - 590-2 ST - Echocardiographic accidental finding of asymptomatic cardiac and pulmonary embolism caused by cement leakage after percutaneous vertebroplasty T2 - Eur J Echocardiogr TI - Echocardiographic accidental finding of asymptomatic cardiac and pulmonary embolism caused by cement leakage after percutaneous vertebroplasty VL - 10 ID - 828893 ER - TY - JOUR AB - Osteoporotic vertebral fracture is becoming increasingly risk factor of the aging population. Percutaneous vertebroplasty is a widely used treatment for the vertebral fracture. However this procedure may carry complication about cement leakage. Here we report a case of a 66-year-old woman who had developed the inferior vena cava and pulmonary embolism after PVP with bone cement leakage. This patient subsequently underwent a combination surgery to remove the embolus. This case discussed the therapeutic methods to treat pulmonary cement embolism. AD - X.-P. Chai, Department of Emergency, The 2nd Xiang-ya Hospital of Central South University, No. 139 Renmin Road, Changsha, China AU - Cai, Y. Z. AU - Peng, W. AU - Chai, X. P. DB - Embase KW - D dimer aged article bone cement leakage case report computer assisted tomography dyspnea embolism female human inferior vena cava embolism laparotomy lung embolism percutaneous vertebroplasty risk factor spine fracture sternotomy thorax pain LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1940-5901 SP - 4847-4850 ST - Surgical retrieval pulmonary and inferior vena cava embolism caused by cement leakage after percutaneous vertebroplasty: Case report and literature review T2 - International Journal of Clinical and Experimental Medicine TI - Surgical retrieval pulmonary and inferior vena cava embolism caused by cement leakage after percutaneous vertebroplasty: Case report and literature review UR - https://www.embase.com/search/results?subaction=viewrecord&id=L609237951&from=export VL - 9 ID - 829330 ER - TY - JOUR AB - PURPOSE: To determine the analgesic efficacy of percutaneous vertebroplasty in treating osteoblastic and mixed spinal metastases. MATERIALS AND METHODS: Fifty-two patients underwent 59 vertebroplasty procedures for 103 painful vertebral metastases, among which 53 were pure osteoblastic and 50 were mixed (blastic and lytic). Analgesic efficacy was classified as "excellent," "good," "fair," and "poor." The patients were followed up at 1 month, 6 months, 12 months, 2 years, and 5 years. The mean follow-up period was 17 months. RESULTS: The analgesic efficacy rate was 86% at 1 month and 92% at 6 months (among which 71% of patients had "excellent" results and 21% had with "good" results). In most cases, it was stable. It was correlated with vertebral filling quality (Fisher test, P = .0932 at 1 month follow-up) but neither with filling volume (Mann-Whitney test, P = .143 at 1 month) nor with the vertebral structure, pure blastic or mixed (Fisher test, P = .784 at 1 month). There were 5 filling failures (4.7%) whose occurrence was correlated with the pure blastic structure of the vertebra (Mann-Whitney test, P = .033). Local clinical complications were observed in 5 cases (8.5%): 1 transitory radiculalgia (1.7%), 2 durable radiculalgias (3.4%), 1 cauda equina syndrome (1.7%), and 1 hemothorax (1.7%). General clinical complications were 2 pulmonary embolisms (3.4%). No patients died. The occurrence of clinical complications was not correlated with the vertebral structure (Fisher test, P = .279). CONCLUSION: Vertebroplasty for osteoblastic and mixed metastases allows, with a well-trained operator, a satisfactory anesthesia with acceptable clinical complication rates. AD - Grp Hosp Pitie Salpetriere, Dept Neuroradiol, F-75651 Paris 13, France. Calmels, V (corresponding author), Grp Hosp Pitie Salpetriere, Dept Neuroradiol, 47,Bd Hop, F-75651 Paris 13, France. valerie_calmels@yahoo.fr AN - WOS:000245160100042 AU - Calmels, V. AU - Vallee, J. N. AU - Rose, M. AU - Chiras, J. DA - Mar J2 - Am. J. Neuroradiol. KW - PULMONARY-EMBOLISM COMPRESSION FRACTURES CEMENT METHACRYLATE Clinical Neurology Neuroimaging Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2007 SN - 0195-6108 SP - 570-574 ST - Osteoblastic and mixed spinal metastases: Evaluation of the analgesic efficacy of percutaneous vertebroplasty T2 - American Journal of Neuroradiology TI - Osteoblastic and mixed spinal metastases: Evaluation of the analgesic efficacy of percutaneous vertebroplasty UR - ://WOS:000245160100042 VL - 28 ID - 830399 ER - TY - JOUR AB - PURPOSE: To determine the analgesic efficacy of percutaneous vertebroplasty in treating osteoblastic and mixed spinal metastases. MATERIALS AND METHODS: Fifty-two patients underwent 59 vertebroplasty procedures for 103 painful vertebral metastases, among which 53 were pure osteoblastic and 50 were mixed (blastic and lytic). Analgesic efficacy was classified as "excellent," "good," "fair," and "poor." The patients were followed up at 1 month, 6 months, 12 months, 2 years, and 5 years. The mean follow-up period was 17 months. RESULTS: The analgesic efficacy rate was 86% at 1 month and 92% at 6 months (among which 71% of patients had "excellent" results and 21% had with "good" results). In most cases, it was stable. It was correlated with vertebral filling quality (Fisher test, P = .0932 at 1 month follow-up) but neither with filling volume (Mann-Whitney test, P = .143 at 1 month) nor with the vertebral structure, pure blastic or mixed (Fisher test, P = .784 at 1 month). There were 5 filling failures (4.7%) whose occurrence was correlated with the pure blastic structure of the vertebra (Mann-Whitney test, P = .033). Local clinical complications were observed in 5 cases (8.5%): 1 transitory radiculalgia (1.7%), 2 durable radiculalgias (3.4%), 1 cauda equina syndrome (1.7%), and 1 hemothorax (1.7%). General clinical complications were 2 pulmonary embolisms (3.4%). No patients died. The occurrence of clinical complications was not correlated with the vertebral structure (Fisher test, P = .279). CONCLUSION: Vertebroplasty for osteoblastic and mixed metastases allows, with a well-trained operator, a satisfactory anesthesia with acceptable clinical complication rates. AD - Department of Neuroradiology, Groupe Hospitalier Pitié-Salpêtrière, Paris, France. valerie_calmels@yahoo.fr AN - 17353339 AU - Calmels, V. AU - Vallée, J. N. AU - Rose, M. AU - Chiras, J. DA - Mar DP - NLM ET - 2007/03/14 J2 - AJNR. American journal of neuroradiology KW - Adult Aged Aged, 80 and over Analgesia/adverse effects/*methods Bone Cements/adverse effects/therapeutic use Breast Neoplasms/pathology Female Follow-Up Studies Humans Lung Neoplasms/pathology Male Middle Aged *Orthopedic Procedures/adverse effects Osteoblasts/*pathology *Pain Management Prostatic Neoplasms/pathology Spinal Neoplasms/diagnostic imaging/*secondary/*therapy Tomography, X-Ray Computed LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 0195-6108 (Print) 0195-6108 SP - 570-4 ST - Osteoblastic and mixed spinal metastases: evaluation of the analgesic efficacy of percutaneous vertebroplasty T2 - AJNR Am J Neuroradiol TI - Osteoblastic and mixed spinal metastases: evaluation of the analgesic efficacy of percutaneous vertebroplasty VL - 28 ID - 828751 ER - TY - JOUR AB - The perioperative morbidity of one-stage bilateral total hip arthroplasty is no greater than that of unilateral total hip arthroplasty with regard to pulmonary function, cardiac function, and overall clinical outcome. In total hip arthroplasty, specific intraoperative events (reaming and cementing) did not cause precipitous declines in PaO2 levels that would explain the postoperative hypoxemia seen. Postoperative respiratory depression occurs frequently in both bilateral (35 per cent) and unilateral (33 per cent) total hip arthroplasties. These patients should be identified early and considered at risk for respiratory and cardiac complications. Preoperative PaO2, preoperative serum triglyceride level, and the last intraoperative PaO2 values were significantly related to postoperative mean 12-hour PaO2 levels. These factors can be used to generate predictive equations for severity of postoperative changes in both unilateral and bilateral total hip arthroplasties. The classic concepts of the fat embolism syndrome are misleading and represent an advanced stage of respiratory distress which is often irreversible. The term should therefore be abandoned in favor of the term adult respiratory distress syndrome to describe the frequently occurring spectrum of hypoxemia which occurs following musculoskeletal trauma. We conclude that in selected cases with proper monitoring, single-stage bilateral total hip arthroplasty can be a safe procedure, and, as previously reported by Salvati et al., may offer significant advantages over staged bilateral total hip arthroplasties with regard to length of both hospitalization and rehabilitation. AD - Hip Office, The Hospital for Special Surgery, New York, NY 10021 AU - Cammisa Jr, F. P. AU - O'Brien, S. J. AU - Salvati, E. A. AU - Sculco, T. P. AU - Wilson Jr, P. D. AU - Ranawat, C. S. AU - Pellicci, P. M. AU - Inglis, A. E. DB - Embase Medline KW - bone cement complication human major clinical study methodology morbidity total hip prosthesis LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1988 SN - 0030-5898 SP - 657-668 ST - One-stage bilateral total hip arthroplasty. A prospective study of perioperative morbidity T2 - Orthopedic Clinics of North America TI - One-stage bilateral total hip arthroplasty. A prospective study of perioperative morbidity UR - https://www.embase.com/search/results?subaction=viewrecord&id=L18177688&from=export VL - 19 ID - 829954 ER - TY - JOUR AB - BACKGROUND: The systemic consequences of esthetic filler injections are poorly understood. CASE PRESENTATION: We report a patient with a past history of subcutaneous injection of aesthetic filler material in the lower legs, who presented with post-infectious glomerulonephritis following necrotic leg ulcers at the injection site. Kidney biopsy revealed the presence of translucent, non-birefringent microspherical bodies compatible with polymethylmetacrylate (PMMA) microspheres in some capillary lumens. This had not previously been described. PMMA is a biphasic aesthetical filler composed of polymethylmetacrylate microspheres suspended in a biodegradable bovine collagen carrier. The solid phase (PMMA microspheres) persists in tissues for years. Although PMMA was thought to not disseminate systemically, tissue necrosis may have favored systemic dissemination of the microspheres, although entry in the circulation and microembolization at the time of administration cannot be ruled out. CONCLUSIONS: In conclusion, aesthetic filler implants may cause microembolization into small vessels. Recognition of the characteristic morphology may expedite diagnosis and avoid unnecessary further testing. AD - Pathology, IIS-Fundacion Jimenez Diaz, School of Medicine, UAM, Madrid, Spain. Nephrology and REDINREN, IIS-Fundacion Jimenez Diaz, School of Medicine, UAM, Madrid, Spain. Pathology, 12 Octubre Hospital, Madrid, Spain. Dermatology, IIS-Fundacion Jimenez Diaz, School of Medicine, UAM, Madrid, Spain. Nephrology and REDINREN, IIS-Fundacion Jimenez Diaz, School of Medicine, UAM, Madrid, Spain. aortiz@fjd.es. IRSIN, Madrid, Spain. aortiz@fjd.es. Laboratory of Nephrology, IIS-Fundacion Jimenez Diaz, Avda Reyes Catolicos 2, 28040, Madrid, Spain. aortiz@fjd.es. AN - 26746693 AU - Cannata-Ortiz, P. AU - Gracia, C. AU - Aouad, Y. AU - Barat, A. AU - Martinez-Gonzalez, M. A. AU - Rossello, G. AU - Martin-Cleary, C. AU - Fernández-Fernández, B. AU - Requena, L. AU - Ortiz, A. C2 - Pmc4706724 DA - Jan 8 DO - 10.1186/s13000-016-0453-y DP - NLM ET - 2016/01/10 J2 - Diagnostic pathology KW - Acute Disease *Biocompatible Materials Biopsy Cosmetic Techniques/*adverse effects Dermal Fillers/administration & dosage/*adverse effects Embolism/*chemically induced/diagnosis/therapy Female Fluorescent Antibody Technique Foreign-Body Migration/diagnosis/*etiology/therapy Glomerulonephritis/*chemically induced/diagnosis/therapy Humans Injections, Subcutaneous Microspheres Middle Aged Polymethyl Methacrylate/administration & dosage/*adverse effects Predictive Value of Tests Streptococcal Infections/complications LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1746-1596 SP - 2 ST - Small vessel microembolization and acute glomerulonephritis following infection of aesthetic filler implants T2 - Diagn Pathol TI - Small vessel microembolization and acute glomerulonephritis following infection of aesthetic filler implants VL - 11 ID - 828499 ER - TY - JOUR AB - Objective. - Although kyphoplasty is widely used to repair osteoporotic and pathologic vertebral fractures, balloon kyphoplasty and vertebral body stenting are new treatment options in cases of traumatic spinal injury. To our knowledge, there are no literature data on the incidence of cement leakage whereas these two percutaneous techniques are commonly used to repair non-pathologic fractures. The aim of this study was to evaluate and compare the clinical characteristics and the incidence of cement leakage associated with balloon kyphoplasty and vertebral body stenting in the percutaneous treatment of traumatic spinal injury. Methods. - A series of 76 consecutive kyphoplasties (50 with vertebral body stenting and 26 balloon kyphoplasties) were retrospectively reviewed. Preoperative and postoperative computed tomography scans were analyzed in order to detect cement leakage and grade it as minor, moderate or major. Results. - The overall leakage rate was 50%. None of the leakages gave rise to clinical symptoms. Although balloon kyphoplasty and vertebral body stenting did not differ in terms of the leakage rate, the latter technique was associated with a lower leakage volume. The Magerl type, fracture level and use of concomitant osteosynthesis did not appear to significantly influence the leakage rate. Conclusion. - Vertebral body stenting can reduce the amount of cement leakage due to a better cohesion of the bone fragments after kyphosis correction and maintenance. (C) 2014 Published by Elsevier Masson SAS. AD - [Capel, C.; Fichten, A.; Nicot, B.; Lefranc, M.; Toussaint, P.; Desenclos, C.; Peltier, J.] CHU Amiens, Serv Neurochirurg, F-80054 Amiens 1, France. [Deramond, H.; Le Gars, D.] CHU Amiens, Serv Radiol, F-80054 Amiens 1, France. Capel, C (corresponding author), CHU Amiens, Serv Neurochirurg, Pl Victor Pauchet, F-80054 Amiens 1, France. cyrille.capel@neurochirurgie.fr AN - WOS:000348245800005 AU - Capel, C. AU - Fichten, A. AU - Nicot, B. AU - Lefranc, M. AU - Toussaint, P. AU - Desenclos, C. AU - Deramond, H. AU - Le Gars, D. AU - Peltier, J. DA - Dec DO - 10.1016/j.neuchi.2014.05.004 J2 - Neurochirurgie KW - Adverse effects Bone cement Kyphoplasty Spinal fracture Leakage VERTEBRAL COMPRESSION FRACTURES BALLOON KYPHOPLASTY RARE COMPLICATION VERTEBROPLASTY EMBOLIZATION DEFORMITY EFFICACY RISK Clinical Neurology Surgery LA - English M1 - 6 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2014 SN - 0028-3770 SP - 293-298 ST - Should we fear cement leakage during kyphoplasty in percutaneous traumatic spine surgery? A single experience with 76 consecutive cases T2 - Neurochirurgie TI - Should we fear cement leakage during kyphoplasty in percutaneous traumatic spine surgery? A single experience with 76 consecutive cases UR - ://WOS:000348245800005 VL - 60 ID - 830251 ER - TY - JOUR AB - BACKGROUND: We developed a total hip system using osseointegration guidelines, a metaphyseal‐loading proximal femoral replacement in the retained neck and a dual‐geometry titanium shell in the acetabulum. PATIENTS AND METHODS: A randomized controlled clinical trial was undertaken in 52 patients (53 hips), using the cemented Spectron stem and cementless Harris‐Galante II cup as control implants (24 patients in experimental group, 29 control patients). Clinical measures of Harris Hip Score (HHS), pain score and radiostereometric analysis (RSA) at regular intervals for up to three years were used to monitor progress. RESULTS: No statistically significant differences were found in HHS and pain score; the stability of the cementless experimental implant was also comparable to that of the cemented controls by RSA. 3 revisions were required for migration in the experimental group and 1 was required for component dislocation in the control group. INTERPRETATION: Our findings indicate the practicality of osseointegration of titanium implants, but suggest that current performance is inadequate for clinical introduction. However, the stable fixation achieved in the retained neck in the majority of patients is indicative of osseointegration. This finding will encourage technical and design improvements for enhancement of clinical osseointegration and should also encourage further study. Periprosthetic osteolysis might be avoided by the establishment and maintenance of direct implant‐bone connection: "osseointegration". AN - CN-00567552 AU - Carlsson, L. V. AU - Albrektsson, B. E. AU - Albrektsson, B. G. AU - Albrektsson, T. O. AU - Jacobsson, C. M. AU - Macdonald, W. AU - Regnér, L. AU - Röstlund, T. AU - Weidenhielm, L. R. DO - 10.1080/17453670610012601 KW - *bone regeneration *hip osteoarthritis/su [Surgery] *titanium *total hip prosthesis Acetabulum Acetabulum [surgery] Adult Aged Arthroplasty, Replacement, Hip [instrumentation, *methods] Article Bone cement Cementation Clinical article Clinical trial Controlled clinical trial Controlled study Deep vein thrombosis/co [Complication] Female Femur Femur [surgery] Follow up Follow‐Up Studies Harris hip score Hip Prosthesis Human Humans Lung embolism/co [Complication] Male Metaphysis Middle Aged Multicenter study Osseointegration Osteoarthritis, Hip [surgery] Osteolysis Pain assessment Pelvis radiography Peroperative complication/co [Complication] Photogrammetry Prosthesis Design Prosthesis Failure Prosthesis loosening/co [Complication] Radiostereometry Randomized controlled trial Stereometry Surgical technique Titanium Treatment Outcome Wound infection/co [Complication] M1 - 4 M3 - Comparative Study; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2006 SP - 549‐558 ST - Stepwise introduction of a bone-conserving osseointegrated hip arthroplasty using RSA and a randomized study: i. Preliminary investigations--52 patients followed for 3 years T2 - Acta orthopaedica TI - Stepwise introduction of a bone-conserving osseointegrated hip arthroplasty using RSA and a randomized study: i. Preliminary investigations--52 patients followed for 3 years UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00567552/full VL - 77 ID - 829999 ER - TY - JOUR AB - BACKGROUND: We have developed a bone‐conserving commercially pure titanium hip replacement system using osseointegration principles: a metaphyseal loading proximal femoral component affixing into the retained neck and metaphysis only, leaving the femoral canal untouched. The acetabular cup closely fits a dual‐geometry cavity, avoiding stress protection at the dome. PATIENTS AND METHODS: After extensive laboratory and clinical pilot trial investigations, the surface‐engineered implants were submitted to a prospective randomized controlled clinical trial involving 40 patients (40 hips), in which they were compared to the cemented Spectron femoral component and cementless Trilogy cup as control implant. The following clinical measures were used to monitor progress at regular intervals for the first 2 postoperative years: radiostereometric analysis (RSA), Harris Hip Score, pain score, WOMAC, and SF‐36. RESULTS: After 2 years of follow‐up, no statistically significant differences were seen between the groups concerning rotation or translation along the cardinal axes. The patients receiving the Gothenburg osseointegrated titanium (GOT) system had significantly higher Harris Hip Score at 6 months, suggesting more rapid recovery. WOMAC, SF‐36 and pain analysis were similar for the first 2 postoperative years. INTERPRETATION: Our RSA data suggest that osseointegration was achieved for all patients receiving the GOT hip system. This bone‐conserving prosthesis may provide a good alternative, especially for young and active patients. AN - CN-00567553 AU - Carlsson, L. V. AU - Albrektsson, T. AU - Albrektsson, B. E. AU - Jacobsson, C. M. AU - Macdonald, W. AU - Regnér, L. AU - Weidenhielm, L. R. DO - 10.1080/17453670610012610 KW - *bone regeneration *hip osteoarthritis/su [Surgery] *titanium *total hip prosthesis Acetabulum Acetabulum [surgery] Adult Aged Arthroplasty, Replacement, Hip [instrumentation, *methods] Article Cementation Clinical article Clinical trial Controlled clinical trial Controlled study Deep vein thrombosis/co [Complication] Female Femur Femur [surgery] Follow up Follow‐Up Studies Harris hip score Hip radiography Human Humans Lung embolism/co [Complication] Male Metaphysis Middle Aged Osseointegration Osteoarthritis, Hip [surgery] Pain assessment Photogrammetry Postoperative complication/co [Complication] Prospective study Prosthesis Design Prosthesis Failure Prosthesis loosening/co [Complication] Radiostereometry Randomized controlled trial Short Form 36 Stereometry Tantalum Titanium Treatment Outcome Visual analog scale M1 - 4 M3 - Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2006 SP - 559‐566 ST - Stepwise introduction of a bone-conserving osseointegrated hip arthroplasty using RSA and a randomized study: iI. Clinical proof of concept--40 patients followed for 2 years T2 - Acta orthopaedica TI - Stepwise introduction of a bone-conserving osseointegrated hip arthroplasty using RSA and a randomized study: iI. Clinical proof of concept--40 patients followed for 2 years UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00567553/full VL - 77 ID - 830026 ER - TY - JOUR AB - Introduction: Vertebral compression fractures of the thoracic and lumbar column caused by osteoporosis, metastasis or trauma may have a relevant socio-economic impact because of high incidence of relevant complications and deaths. Percutaneous kyphoplasty is a minivasive surgical procedure that relieve the pain not responding to conservative treatment, restore the height of the fractured vertebral body, reduce the segmental kyphosis and stabilize the fracture with polymethylmethacrylate bone cement (PMMA). Materials and Methods: The analisys was conducted on 500 patients operated on at our Institution between 2007 and 2017 for Magerl A1.1.and A1.2 compression fracture after failure of conservative treatment. Clinical (VAS for vertebral pain) and radiological (plain RX films in AP and LL projections for evaluation of kyphosis at 1,2,3 and six months) follow-up range from six months to ten years. Before surgery all patients experienced a cycle of conservative treatment with a mean duration of 3-4 weeks. Exclusions criteria adopted: vertebra plana (vertebral body height reduction > 90%); burst fractures; posterior wall of the vertebral body involvement with a reduction of spinal canal diameters > 20%; vertebral instability; A3 fractures; neoplastic epidural invasion from tumour; local infections; haemorragic syndromes; cardiorespiratory insufficiences. We always performed local anesthetic infiltration of skin, fascia, muscles and vertebral bone, transpedicluar approach with fluoroscopic AP and LL check of procedural steps. Results: We performed 500 percutaneous kyphoplasties on 460 patients (348 F and 112M-75,65% and 24,35%), with a median age of 72,3 years (range 16-93 years). The procedure was performed in two months on 80% of patients, in six months on 10% and in 1 yera on 10%. We performed: 410 biportal procedures and 90 monoportal procedures. We collected: 310 osteoporotic fractures, 185 post-traumaticfractures and 5 metastatic fractures. 122 vertebral fractures were involved the thoracic spine and 378 the lumbar spine. One level was fractured in 340 patients, two levels in 158 and three levels in 2 cases. The execution time of surgical procedure range from 20 to 45 minutes. Surgical complications involved 4 patients: intradiscal injection of PMMA without clinical sequelae. We don't experienced PMMA extravasation in the spinal canal, hypotension, embolic events, infections of the surgical site, adjacent vertebral fractures or pseudarthrosis in any case. All patients reported absence of pain at 72h from surgical treatment and at three months all occupied patients returned to their job. In 80% of cases we registered a vertebral body augmentation > 40%. Conclusion: The percutaneous transpedicular kyphoplasty is a minivasive surgical procedure, with low cost, of brief duration, easy to perform, useful for thoracic and lumbar compression (not burst or instable) fractures that provide a rapid pain relief and prevent the vertebral body collapse and the pseudoarthrosis with consequential spinal kyphosis. AD - G. Carrabs, Neurosurgery, Avellino, Italy AU - Carrabs, G. AU - Sessa, G. DB - Embase DO - 10.1177/2192568218771072 KW - bone cement local anesthetic agent poly(methyl methacrylate) adolescent adult aged analgesia body height collapse complication compression fracture conference abstract conservative treatment embolism extravasation fascia female follow up fragility fracture human hypotension intradiscal drug administration kyphoplasty lumbar region lumbar spine major clinical study male muscle neoplasm peroperative complication prevention pseudarthrosis Scheuermann disease skin spinal pain surgery surgical infection surgical technique thoracic spine treatment failure vertebra body vertebral canal LA - English M1 - 1 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 2192-5690 SP - 360S ST - Percutaneous transpedicular kyphoplasty with ppma for treatment of vertebral body compression fractures: Clinical and radiological results on 500 cases T2 - Global Spine Journal TI - Percutaneous transpedicular kyphoplasty with ppma for treatment of vertebral body compression fractures: Clinical and radiological results on 500 cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L622331729&from=export http://dx.doi.org/10.1177/2192568218771072 VL - 8 ID - 829197 ER - TY - JOUR AB - Vertebral hemangiomas can cause acute spinal cord compression either after a minor trauma or during the last 3 months of pregnancy. Failure to recognize the lesion can lead to potentially serious treatment delays. An emergency MRI scan usually establishes the diagnosis of vertebral hemangioma responsible for spinal cord compression requiring laminectomy. We report two cases showing that posterior fixation should be considered: in our experience it prevents vertebral collapse during the interval preceding secondary vertebroplasty, which, if performed, provides highly significant pain relief. AD - CHU Pitie Salpetriere, Dept Orthoped & Trauma Surg, F-75013 Paris, France. CHU Pitie Salpetriere, Dept Neuroradiol, F-75013 Paris, France. Saillant, G (corresponding author), CHU Pitie Salpetriere, Dept Orthoped & Trauma Surg, 47-83 Bd Hop, F-75013 Paris, France. AN - WOS:000082283900016 AU - Castel, E. AU - Lazennec, J. Y. AU - Chiras, J. AU - Enkaoua, E. AU - Saillant, G. DA - Jun DO - 10.1007/s005860050167 J2 - Eur. Spine J. KW - spine cord compression vertebral hemangioma pregnancy vertebroplasty METHYL-METHACRYLATE NEUROLOGICAL SIGNS PREGNANCY EMBOLIZATION VERTEBROPLASTY RADIOTHERAPY FEATURES Clinical Neurology Orthopedics LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1999 SN - 0940-6719 SP - 244-248 ST - Acute spinal cord compression due to intraspinal bleeding from a vertebral hemangioma: two case-reports T2 - European Spine Journal TI - Acute spinal cord compression due to intraspinal bleeding from a vertebral hemangioma: two case-reports UR - ://WOS:000082283900016 VL - 8 ID - 830468 ER - TY - JOUR AD - A. Castillo, Serv. de Anestesiologia/Reanimacion, Hospital Virgen de la Victoria, Malaga, Spain AU - Castillo, A. AU - Marchal, J. M. DB - Embase Medline KW - epinephrine atropine bicarbonate isoprenaline adult case report collapse female human hypotension hypoxemia intravenous drug administration letter lung embolism total hip prosthesis LA - Spanish M1 - 4 M3 - Letter N1 - Embase Elsevier literature search January 5, 2021 PY - 1994 SN - 0034-9356 SP - 246-247 ST - Irreversible cardiovascular collapse after cementing of total hip prosthesis [2] T2 - Revista Espanola de Anestesiologia y Reanimacion TI - Irreversible cardiovascular collapse after cementing of total hip prosthesis [2] UR - https://www.embase.com/search/results?subaction=viewrecord&id=L24257316&from=export VL - 41 ID - 829937 ER - TY - JOUR AB - Objective: To report a case of incidental damage of a lumbar artery, after a percutaneous vertebroplastic performed with extrapedicular approach. Case report: We present a case of a 63-year-old male who underwent a procedure of vertebroplastic to treat a compression vertebral body fracture of L1. The procedure was performed in theatre with fluoroscopic guidance. Initially, the vertebral body was approached from the left side but this attempt failed because of the impossibility to place the needle correctly. Then a transpedicular right sided procedure was accomplished successfully. During the first post-operative period the patient went through a progressive decrease of hemoglobin level. A CT was performed after 24 h from the intervention, the imaging showed a conspicuous hematoma in the left paralumbar fossa. The CT examination didn't show an active bleeding but puncture sites and bone tracks of the needles were identified. The leftsided track was demonstrated to follow an extrapedicular pathway. An early angiography wasn't able to identify an active bleeding. However the next angiographic procedure, performed because of clinical evidence of bleeding, identified a lesion of a lumbar arterial branch which was immediately and successfully embolized with microcoils. Although the patient became haemodynamically stable after the embolization, the occurence of new complications led to the patient's death. Discussion: This case, investigated with CT and angiographic examinations, show the risks of a paravertebral interventional approach in a vertebroplastic procedure. AD - M.C. Castoldi, Ospedale Traumatologico Ortopedico, Milano, Italy AU - Castoldi, M. C. AU - Mezzadra, A. AU - Corso, R. AU - D'Andrea, G. DB - Embase DO - 10.1007/s00586-010-1375-0 KW - acrylic cement human case report spine society procedures patient bleeding examination needle vertebra body angiography bone puncture hematoma compression imaging hemoglobin blood level male fracture risk artificial embolization death lumbar artery LA - English M1 - 5 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0940-6719 SP - 842 ST - Case report: Vascular complication after percutaneous vertebroplastic performed with extrapedicular approach T2 - European Spine Journal TI - Case report: Vascular complication after percutaneous vertebroplastic performed with extrapedicular approach UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71562055&from=export http://dx.doi.org/10.1007/s00586-010-1375-0 VL - 19 ID - 829670 ER - TY - JOUR AB - PURPOSE OF THE STUDY: Insertion of cement plugs into the femoral shaft has become an essential part of total hip arthroplasty procedures. The goal is to achieve secure cementing of the femoral component, but the pressure induced can cause serious problems. The purpose of this study was to determine the effect of a flexible bioabsorbable cement restrictor with decompression valves on cementing efficacy and to determine the effect of inserting the restrictor then the cement plug into the femoral shaft on respiratory functions. MATERIAL AND METHODS: The restrictor was implanted in 108 patients undergoing first‐intention total hip arthroplasty. The canal was prepared and calibrated before inserting the restrictor at a depth estimated at preoperative planning to be 10 to 20 mm below the tip of the femoral stem. The efficacy of the restrictor was assessed using radiographic criteria for the quality of the cement sheath and its position relative to the femoral stem. Oxygen saturation of arterial blood and end‐expiration PCO2 were measured at first incision, at insertion of the restrictor, at insertion of the cement plug, and at insertion of the femoral stem. RESULTS: The relative position of the restrictor was measured on postoperative x‐rays at less than 20 mm in 75% of the patients, at 20‐40 mm in 13% and at more than 40 mm in 12%. No cement leakage through the restrictor was identified on postoperative x‐rays. The quality of the cement sheath was satisfactory in 71% of the patients (77 procedures), fair in 20% (22 procedures) and poor in 8% (9 procedures). For a first group of patients operated on under spinal anesthesia and optional oxygen delivered with a face mask, there was no significant difference in arterial blood oxygen saturation before the procedure and during the four explored operative times. Conversely, in a second group of patients who had general anesthesia without oxygen enrichment of the initial oxygen‐nitrogen protoxide gas mixture, arterial blood oxygen saturation during the four operative times was statistically different from the preoperative value. The same observation was made for end‐expiratory PCO2. DISCUSSION: The retrictor's decompression valves did not allow cement leakage beyond the restrictor. The risk of restrictor migration after insertion and after the increased pressure due to cement plug insertion was not increased and was found to be less than rates reported in the literature. In the patients who had general anesthesia, blood gases showed a minimal, but significant, decrease during the operative times susceptible to induce increased intramedullary pressure. In patients who had a non‐cemented acetabular insert, use of the pressure‐valve cement restrictor appeared to stabilize these parameters. AN - CN-00412447 AU - Caton, J. AU - Prudhon, J. L. AU - Aslanian, T. AU - Lifante, J. C. AU - Ritz, B. KW - Absorbable Implants [*adverse effects, *standards] Adolescent Adult Aged Aged, 80 and over Air Arthroplasty, Replacement, Hip [*instrumentation] Blood Gas Analysis Bone Cements [*therapeutic use] Cementation [*instrumentation] Echocardiography, Transesophageal [methods] Embolism [blood, classification, etiology, *prevention & control] Female Femur [*surgery] Humans Intraoperative Complications [blood, classification, etiology, *prevention & control] Male Middle Aged Monitoring, Intraoperative [methods] Permeability Severity of Illness Index M1 - 8 M3 - Clinical Trial; Controlled Clinical Trial; English Abstract; Journal Article; Multicenter Study N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2002 SP - 767‐776 ST - Air permeable diaphyseal obturators: efficacity of femoral cementing and prevention of associated cardiovascular disorders T2 - Revue de chirurgie orthopedique ET reparatrice de l'appareil moteur TI - Air permeable diaphyseal obturators: efficacity of femoral cementing and prevention of associated cardiovascular disorders UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00412447/full VL - 88 ID - 830080 ER - TY - JOUR AB - Purpose. This study was performed to evaluate the results and complications of percutaneous vertebroplasty (PVP) performed under CT guidance. Materials and methods. We treated 106 patients (182 PVP): 67 for osteoporotic vertebral compression fracture, and 39 for osteolytic metastases. The first 78 patients were treated using computed tomography (CT) combined with conventional fluoroscopy as an imaging guide (135 PVP). In 28 patients, the procedure was performed with multislice CT fluoroscopy (47 PVP). Results. Partial or complete pain relief was obtained in 98% of patients within 24 h from the treatment; significant results were also obtained with regard to improvement in functional mobility and reduction of analgesic use. CT allowed the detection of cement leakage in 43.9%. Severe complications were one case of pneumothorax and two cases of symptomatic cement leakage. Mild complications included two cases of cement pulmonary embolism. During the follow-up, eight osteoporotic patients presented a new vertebral fracture, and new vertebral metastases appeared in two oncological patients. Conclusions. Our personal experience confirms the efficacy of PVP treatment for both osteoporotic and oncological patients. The use of CT guidance reduces the risk of complications in comparison with conventional fluoroscopy alone, as well as facilitates the detection of small cement leakages. © 2008 Springer-Verlag. AD - R. Caudana, Unità Operative di Diagnostica Per Immagini, Azienda Ospedaliera Carlo Poma, Mantova 46100, Italy AU - Caudana, R. AU - Brivio, L. R. AU - Ventura, L. AU - Aitini, E. AU - Rozzanigo, U. AU - Barai, G. C1 - magnevist(Schering,Germany) DB - Embase Medline DO - 10.1007/s11547-008-0230-1 KW - analgesic agent gadolinium pentetate adult aged analgesia article compression fracture computer assisted tomography controlled study female fluoroscopy follow up fragility fracture human lung embolism major clinical study male osteolysis outcome assessment percutaneous vertebroplasty pneumothorax spine metastasis spine fracture visual analog scale magnevist LA - Italian English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2008 SN - 0033-8362 SP - 114-133 ST - CT-guided percutaneous vertebroplasty: Personal experience in the treatment of osteoporotic fractures and dorsolumbar metastases T2 - Radiologia Medica TI - CT-guided percutaneous vertebroplasty: Personal experience in the treatment of osteoporotic fractures and dorsolumbar metastases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L351387213&from=export http://dx.doi.org/10.1007/s11547-008-0230-1 VL - 113 ID - 829751 ER - TY - JOUR AB - PURPOSE: This study was performed to evaluate the results and complications of percutaneous vertebroplasty (PVP) performed under CT guidance. MATERIALS AND METHODS: We treated 106 patients (182 PVP): 67 for osteoporotic vertebral compression fracture, and 39 for osteolytic metastases. The first 78 patients were treated using computed tomography (CT) combined with conventional fluoroscopy as an imaging guide (135 PVP). In 28 patients, the procedure was performed with multislice CT fluoroscopy (47 PVP). RESULTS: Partial or complete pain relief was obtained in 98% of patients within 24 h from the treatment; significant results were also obtained with regard to improvement in functional mobility and reduction of analgesic use. CT allowed the detection of cement leakage in 43.9%. Severe complications were one case of pneumothorax and two cases of symptomatic cement leakage. Mild complications included two cases of cement pulmonary embolism. During the follow-up, eight osteoporotic patients presented a new vertebral fracture, and new vertebral metastases appeared in two oncological patients. CONCLUSIONS: Our personal experience confirms the efficacy of PVP treatment for both osteoporotic and oncological patients. The use of CT guidance reduces the risk of complications in comparison with conventional fluoroscopy alone, as well as facilitates the detection of small cement leakages. AD - Unità Operative di Diagnostica per Immagini, Azienda Ospedaliera Carlo Poma, Viale Albertoni 1, 46100 Mantova, Italy. roberto.caudana@ospedalimantova.it AN - 18338132 AU - Caudana, R. AU - Renzi Brivio, L. AU - Ventura, L. AU - Aitini, E. AU - Rozzanigo, U. AU - Barai, G. DA - Feb DO - 10.1007/s11547-008-0230-1 DP - NLM ET - 2008/03/14 J2 - La Radiologia medica KW - Adult Aged Aged, 80 and over Analgesics/therapeutic use Bone Cements/adverse effects Female Fluoroscopy/methods Follow-Up Studies Fractures, Compression/surgery Humans Image Processing, Computer-Assisted/methods Lumbar Vertebrae/injuries/*surgery Male Middle Aged Osteolysis/surgery Osteoporosis/*surgery Pain Measurement Postoperative Complications Pulmonary Embolism/etiology Radiography, Interventional/*methods Range of Motion, Articular/physiology Retrospective Studies Spinal Fractures/*surgery Spinal Neoplasms/*secondary/surgery Tomography, X-Ray Computed/*methods Treatment Outcome Vertebroplasty/*methods LA - eng ita M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 0033-8362 (Print) 0033-8362 SP - 114-33 ST - CT-guided percutaneous vertebroplasty: personal experience in the treatment of osteoporotic fractures and dorsolumbar metastases T2 - Radiol Med TI - CT-guided percutaneous vertebroplasty: personal experience in the treatment of osteoporotic fractures and dorsolumbar metastases VL - 113 ID - 828719 ER - TY - JOUR AB - Percutaneous vertebroplasty is a useful and safe therapeutic intervention to stabilize vertebral fractures. Rarely, cement leakage into the paravertebral venous system may result in embolization of its particles into the right cardiac chambers and pulmonary artery. We experienced a case of a 64-year-old woman who was diagnosed through echocardiography as having cardiac tamponade. Previously, the patient was treated for pulmonary cement embolization after percutaneous vertebroplasty. Prompt diagnosis and urgent surgery, in which a few linear cement particles of 1-cm to 2-cm long were discovered within the pericardial space, which resulted in a favorable outcome. AD - Department of Cardiovascular Surgery and Radiology, Florence Nightingale Hospital, Istanbul Bilim University, Istanbul, Turkey. AN - 19101319 AU - Caynak, B. AU - Onan, B. AU - Sagbas, E. AU - Duran, C. AU - Akpinar, B. DA - Jan DO - 10.1016/j.athoracsur.2008.05.074 DP - NLM ET - 2008/12/23 J2 - The Annals of thoracic surgery KW - Cardiac Tamponade/diagnostic imaging/*etiology/surgery Chest Pain/diagnosis/etiology Emergency Treatment/methods Female Follow-Up Studies Humans Middle Aged Pericardiocentesis/methods Pulmonary Embolism/diagnostic imaging/drug therapy/*etiology Radiography Rare Diseases Risk Assessment Spinal Fractures/diagnostic imaging/*therapy Thoracic Vertebrae/*injuries Thoracotomy/methods Thrombolytic Therapy/methods Treatment Outcome Vertebroplasty/*adverse effects/methods LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0003-4975 SP - 299-301 ST - Cardiac tamponade and pulmonary embolism as a complication of percutaneous vertebroplasty T2 - Ann Thorac Surg TI - Cardiac tamponade and pulmonary embolism as a complication of percutaneous vertebroplasty VL - 87 ID - 828748 ER - TY - JOUR AB - The metastatic disease from thyroid cancer represents a complex clinical scenario, which mandates a case-based multi-disciplinary approach in tertiary referral centers. Direct localised treatments such as minimally invasive interventional radiology procedures can play a vital role in providing a timely palliative or curative treatment in accordance with the patients' clinical status. In this narrative review, we present the current status of interventional radiology treatments for the management of thyroid cancer distant metastases. AD - Department of Interventional Radiology, Hôpitaux Universitaires de Strasbourg, place de l'Hopital, Strasbourg, France. Department of Interventional Radiology, Royal Devon and Exeter Hospital, NHS Trust, Exeter, UK. Department of Interventional Radiology, Institut Bergonié, Bordeaux, France. AN - 29770304 AU - Cazzato, R. L. AU - Garnon, J. AU - Koch, G. AU - Shaygi, B. AU - Tsoumakidou, G. AU - Caudrelier, J. AU - Boatta, E. AU - Buy, X. AU - Palussiere, J. AU - Gangi, A. C2 - Pmc5938279 DA - Apr DO - 10.21037/gs.2017.12.08 DP - NLM ET - 2018/05/18 J2 - Gland surgery KW - Thyroid cancer bone metastases cementoplasty cryosurgery embolization osteosynthesis thermal ablation LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 2227-684X (Print) 2227-684x SP - 80-88 ST - Current role of interventional radiology in the management of visceral and bone metastases from thyroid cancer T2 - Gland Surg TI - Current role of interventional radiology in the management of visceral and bone metastases from thyroid cancer VL - 7 ID - 829035 ER - TY - JOUR AB - Giant cell tumor is colonized by aneurismal bone cyst in only 15% of cases and cervical localisation accounts for less than 1% of giant cell tumors. We are reporting a rare case of a C2 hypervascularized giant cell tumor colonized by an aneurismal bone cyst treated with an effective preoperative Onyx embolization followed by a full tumor resection. The patient experienced a moderate cervical spine injury 2 months prior admission followed by a progressive stiff neck and cervicalgia. CT and MRI identified a lytic lesion of the body and lateral masses of the C2 with encasement of both vertebral arteries. The angiography showed a hypervascularization of the lesion from the vertebral and external carotid arteries as well as a thrombosis of the V3 segment of the right vertebral artery at the C1 level. A posterior occipito-C3/C4 fixation and a tumor biopsy were performed. Histopathological examination concluded to a giant cell tumor colonized by an aneurismal bone cyst. Three weeks later, the patient developed a right upper extremity deficit. The MRI showed an increased C1-C2 stenosis and an increase of the hypervascularization. Three sessions of embolization by the onyx were performed. During surgery a near total tumor devascularisation was observed and a complete resection of the tumor was achieved through an anterolateral approach. Reconstruction consisted of a cementoplasty of the C2 body and odontoïd process with an anterior C3-prosthesis plate. The postoperative course was uneventful. AD - Service de neurochirurgie, hôpital de Hautepierre - hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France. AN - 22695034 AU - Cebula, H. AU - Boujan, F. AU - Beaujeux, R. AU - Boyer, P. AU - Froelich, S. DA - Dec DO - 10.1016/j.neuchi.2012.03.008 DP - NLM ET - 2012/06/15 J2 - Neuro-Chirurgie KW - Accidents, Home Adult Bone Cysts, Aneurysmal/*complications/diagnostic imaging/pathology/surgery Bone Density Conservation Agents/therapeutic use Bone Plates Cervical Vertebrae/diagnostic imaging/injuries/*pathology/surgery Diphosphonates/therapeutic use Embolization, Therapeutic Fracture Fixation, Internal Fractures, Spontaneous/*etiology/surgery Giant Cell Tumors/blood supply/*complications/diagnostic imaging/pathology/surgery Humans Imidazoles/therapeutic use Ligation Magnetic Resonance Imaging Male Odontoid Process/*injuries/surgery Spinal Cord Compression/etiology Spinal Fractures/*etiology/surgery Spinal Neoplasms/blood supply/*complications/diagnostic imaging/pathology/surgery Spinal Stenosis/etiology Tomography, X-Ray Computed Torticollis/etiology Vertebral Artery/pathology/surgery Zoledronic Acid LA - fre M1 - 6 N1 - PubMed NLM literature search January 5, 2021 OP - Tumeur à cellules géantes de C2 colonisée par un kyste anévrismal. À propos d'un cas. PY - 2012 SN - 0028-3770 SP - 376-81 ST - [Giant cell tumor of the C2 colonized by an aneurismal bone cyst. Report of case] T2 - Neurochirurgie TI - [Giant cell tumor of the C2 colonized by an aneurismal bone cyst. Report of case] VL - 58 ID - 828834 ER - TY - JOUR AB - Pulmonary embolism due to cementum (CPS) is a potentially fatal complication. The migration of the cementing material into the pulmonary circulation can occur by extravasation of the same to the vertebral venous plexus, which is connected to the azygos system, thereby reaching the vena cava and pulmonary circulation. The therapeutic strategy depends on the clinical symptomatology and the location of the emboli: observation, anticoagulation or surgical embolectomy. We present the case of a 64-year-old woman who underwent an instrumented L2-S1 posterolateral arthrodesis with cannulated screws for cementation. In the thoracic CT performed later, multiple images of metallic density were identified inside the pulmonary arteries. AD - J. de Miguel-Díez, Servicio de Neumología, Hospital General Universitario Gregorio Marañón, Spain AU - Cerezo Lajas, A. AU - Masiá Borrell, C. E. AU - de Miguel-Díez, J. DB - Embase KW - bone cement adult arthrodesis bone screw case report computer assisted tomography female foreign body human lung artery lung embolism middle aged note LA - English Spanish M1 - 1 M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 2173-920X 1576-9895 SP - 30-32 ST - Pulmonary embolization of the vertebral cementing material T2 - Revista de Patologia Respiratoria TI - Pulmonary embolization of the vertebral cementing material UR - https://www.embase.com/search/results?subaction=viewrecord&id=L617607962&from=export VL - 20 ID - 829278 ER - TY - JOUR AD - UT MD Anderson Cancer Center, Pain Medicine, 1400 Holcombe Blvd, Unit 409, Houston, TX 77030(∗). Electronic address: tchai@mdanderson.org. UT MD Anderson Cancer Center, Diagnostic Radiology, Houston, TX(†). AN - 26724427 AU - Chai, T. AU - Shroff, G. S. DA - May DO - 10.1016/j.pmrj.2015.12.003 DP - NLM ET - 2016/01/03 J2 - PM & R : the journal of injury, function, and rehabilitation KW - Bone Cements/*adverse effects Breast Neoplasms/*complications/diagnosis/secondary Female Fractures, Spontaneous/*complications/diagnosis/surgery Humans Lumbar Vertebrae/diagnostic imaging/*injuries/surgery Middle Aged Pulmonary Embolism/diagnosis/*etiology Spinal Fractures/diagnosis/etiology/*surgery Tomography, X-Ray Computed Vertebroplasty/*adverse effects LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1934-1482 SP - 488-90 ST - Cement Pulmonary Embolism After Percutaneous Vertebral Augmentation in a Patient With Pathologic Lumbar Fracture From Metastatic Breast Cancer T2 - Pm r TI - Cement Pulmonary Embolism After Percutaneous Vertebral Augmentation in a Patient With Pathologic Lumbar Fracture From Metastatic Breast Cancer VL - 8 ID - 828867 ER - TY - JOUR AB - Case Description: A 60-year-old woman with history of metastatic breast cancer to bone and pathologic thoracic vertebral compression fracture at T7.Program Description: The patient underwent T7 vertebroplasty under computed-tomography guidance for pathologic T7 vertebral compression fracture with associated intractable back pain. 5 days later, the patient was hospitalized at an outside facility for fever. Workup revealed an infected Port-a- Cath and bacteremia. During hospitalization, the patient developed increasing back pain, bilateral lower limb pain, numbness, and weakness. A magnetic resonance imaging study of the thoracic spine revealed a thoracic spinal epidural abscess extending from T4 to T9, with spinal cord compression. The patient subsequently underwent emergent thoracic laminectomy from T6 to T9 for decompression and abscess drainage. Setting: Tertiary Cancer Center Results or Clinical Course: The patient underwent inpatient physical therapy after decompressive surgery for thoracic spinal epidural abscess, with improvement in lower limb motor strength and functional capacity. Discussion: Vertebral augmentation is generally considered a safe and effective minimally-invasive procedure for the management of pain due to vertebral compression fracture. The cancer patient population, however, is known to be at higher risk for post-procedure complications. Complications related to vertebroplasty include extravertebral extravasation of cement, which may result in pulmonary cement emboli or spinal canal stenosis, although usually clinically asymptomatic. Infection after vertebral augmentation is a rare but serious complication, as osteomyelitis and epidural abscess may require aggressive treatment, to include neurosurgical intervention. In our patient's case, the spinal epidural abscess appears to be due to hematogenous dissemination secondary to bacteremia. Conclusions: Patient characteristics and current oncologic treatment are important factors, among others, to consider during evaluation for vertebral augmentation in the cancer patient with pathologic vertebral compression fracture. AD - T. Chai, UT MD Anderson Cancer Center, Houston, TX, United States AU - Chai, T. AU - Viswanathan, A. AU - Driver, L. C. DB - Embase DO - 10.1016/j.pmrj.2013.08.564 KW - cement human cancer patient percutaneous vertebroplasty epidural abscess rehabilitation case report physical medicine compression paraplegia patient compression fracture leg bacteremia backache metastatic breast cancer functional status physiotherapy fever population computer assisted tomography female disease course abscess drainage laminectomy spinal cord compression thoracic spine nuclear magnetic resonance imaging decompression weakness cancer center paresthesia hospital patient osteomyelitis decompression surgery limb pain minimally invasive procedure pain vertebral canal stenosis embolism bone hospitalization extravasation procedures risk infection LA - English M1 - 9 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1934-1482 SP - S308 ST - Paraplegia due to cord compression in a cancer patient with epidural abscess after vertebroplasty: A case report T2 - PM and R TI - Paraplegia due to cord compression in a cancer patient with epidural abscess after vertebroplasty: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71206158&from=export http://dx.doi.org/10.1016/j.pmrj.2013.08.564 VL - 5 ID - 829483 ER - TY - JOUR AB - OBJECTIVE: To compare the difference of anterior knee pain after total knee arthroplasty (TKA) between the ways using periosteal dissector and electric scalpel to release medial collateral ligament and pes anserinus. METHODS: From September 2009 to September 2012, 220 patients with unilateral osteoarthritis were treated with primary TKA in hospital 301. All the patients were randomly divided into periosteal dissector group (110 cases) or electric scalpel group (110 cases). In the periosteal dissector group, there were 47 males and 63 females,with an average age of (58.8 +/- 17.2) years old; the degree of genuavarus was (14.0 +/- 3.5) degrees; the weight was (65.6 +/- 12.8) kg; the body mass index (BMI) was (26.6 +/- 3.6) kg/m2. In the electric scalpel group,there were 49 males and 61 females,with an average age of (59.6 +/- 16.7) years old;the degree of genuavarus was (15.0 +/- 4.7) degrees; the weight was (66.4 +/- 13.4) kg; the BMI was (27.4 +/- 4.1) kg/m2. The mean follow-up period was 24.6 months. The AKS, VAS and HSS were used to evaluate clinical results. RESULTS: All incisions healed at the first stage;no deep vein thrombosis of lower limbs or pulmonary embolism occurred. Knee infection occurred in 3 cases (1 in the periosteal dissector group and 2 in the electric scalpel group), and the 3 patients received stage 2 total knee revision using antibiotic bone cement and TC3 prosthesis. No recurrence of infection occurred during follow-up. Among the 20 patients who had anterior knee pain, 16 patients were in the periosteal dissector group and 4 patients were in the electric scalpel group. The occurrence rate of anterior knee pain in the electric scalpel group was lower than that in the periosteal dissector group. The AKS knee score and HSS score after total knee arthroplasty in the electric scalpel group were all higher than those in the periosteal dissector group, and the VAS in electric scalpel group was lower than that of periosteal dossector group. CONCLUSION: Compared with using electric scalpel,using periosteal dissector used to release medial collateral ligament and pes anserinus may cause more anterior knee pain after total knee arthroplasty. AN - 25029830 AU - Chai, W. AU - Sun, C. J. AU - Ni, M. AU - Zhang, G. Q. AU - Zhang, Q. AU - Shen, Y. AU - Zhou, Y. G. AU - Chen, J. Y. AU - Wang, Y. DA - Apr DP - NLM ET - 2014/07/18 J2 - Zhongguo gu shang = China journal of orthopaedics and traumatology KW - Adult Aged Arthroplasty, Replacement, Knee/*adverse effects Case-Control Studies Female Humans Knee Joint/*surgery Male Middle Aged Pain, Postoperative/*etiology Tibia/*pathology Treatment Outcome Young Adult LA - chi M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1003-0034 (Print) 1003-0034 SP - 269-73 ST - [Case-control study on earlier medial tibial pain after total knee arthroplasty] T2 - Zhongguo Gu Shang TI - [Case-control study on earlier medial tibial pain after total knee arthroplasty] VL - 27 ID - 828793 ER - TY - JOUR AB - Acute severe hypoxia is a relatively common anaesthetic emergency. There is a wide differential diagnosis, but in the trauma patient, there are additional causes to consider. Description We present the case of a 65-year-old woman who was booked for emergency repair of a distal femoral fracture sustained following a mechanical fall. Medical history was notable for learning disability, epilepsy and obesity. The patient lived alone in supported accommodation, where she was relatively independent, selfcaring, and mobilising with a stick or frame. She was admitted to hospital immediately after the fall, but surgery was delayed whilst a specific orthopaedic implant was sourced. Surgery was performed on day 7 post-fall. Anaesthetic history (general anaesthesia for brain tumour resection) was unremarkable, and airway examination was not concerning. Anaesthesia was induced with fentanyl and propofol, and an i-gel airway was inserted, after which a fascia iliaca block was performed. Anaesthesia was maintained with sevoflurane in oxygen and air, with morphine for analgesia. An hour into the operation, there was a sudden drop in oxygen saturation, expired carbon dioxide and blood pressure, which persisted despite 100% oxygen and vasopressors. Arterial-blood gas showed hypoxia, hypercapnia and acidosis. A diagnosis of pulmonary embolism (PE) was made, a senior anaesthetic help was sought, endotracheal tube, arterial and central lines were inserted, and inotropic support was initiated. Surgery was rapidly concluded, and the patient transferred to the intensive care unit, but despite maximal inotropic support, she sadly died within a few hours. Discussion There are many causes of acute severe intra-operative hypoxia, but a number are specific to trauma surgery. The sudden combination of hypoxia, tachypnoea, hypotension and tachycardia, with a raised oxygen and carbon dioxide gradient between expired gases and blood gases is suspicious for PE. In this case, in addition to embolised clot, we considered the possibility of embolised air, fat, marrow and bone cement. Blood gases can support the diagnosis. Whatever the cause of PE, treatment is generally supportive, following an ABC (airway, breathing, circulation) approach. We considered thrombolysis but opted against it given the risk of bleeding so soon postoperatively. The case was discussed with the coroner, who did not order a post-mortem and recorded PE as the primary cause of death. AD - C. Chan, Hospital Bedford AU - Chan, C. AU - Menon, A. AU - Mawondo, K. AU - McCretton, D. AU - Sharif, R. AU - McNamara, J. DB - Embase DO - 10.1111/anae.14740 KW - bone cement carbon dioxide fentanyl morphine oxygen propofol sevoflurane acidosis aged airway analgesia arterial gas bleeding blood clot lysis blood oxygenation bone marrow brain tumor breathing cancer surgery case report cause of death central venous catheter clinical article conference abstract coroner diagnosis distal femur fracture endotracheal tube epilepsy fascia female general anesthesia human hypercapnia hypotension hypoxia inotropism intensive care unit learning disorder lung embolism medical history obesity orthopedic implant oxygen saturation surgery tachycardia tachypnea traumatology LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1365-2044 SP - 26 ST - Acute severe intra-operative hypoxia in trauma surgery T2 - Anaesthesia TI - Acute severe intra-operative hypoxia in trauma surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L628859262&from=export http://dx.doi.org/10.1111/anae.14740 VL - 74 ID - 829130 ER - TY - JOUR AB - Hydrogen peroxide (H2O2) is a commonly used chemical agent in orthopaedic practice for antisepsis, haemostasis and preparation of bone bed for cementation. However, the associated risks of H2O2 usage are not widely known. We report a case of suspected air embolism after use of H2O2 during drainage of a septic arthritis of the shoulder. Upon our literature review, we were able to demonstrate H2O2 to be beneficial in antisepsis and care of chronic wounds. However, it has not been proven to be superior to other antiseptics commonly used in orthopaedic surgery. Regarding its use in cementation, there is evidence to show it is more effective than saline however, the use of pulsatile lavage appears to be the most important factor affecting the quality of cementation. H2O2 has not been shown to be helpful with haemostasis. Prior to the use of H2O2, one should be cautious and understand its associated risks and precautions. AD - M.M. Chan, Department of Orthopaedics and Traumatology, Tuen Mun Hospital, Hong Kong AU - Chan, M. M. AU - Tse, T. S. T. AU - Wan, Y. C. S. AU - Wah Hung, Y. AU - Fan, J. C. H. DB - Embase DO - 10.1177/2210491720925089 KW - adverse drug reaction air embolism antisepsis article bacterial arthritis case report cementation chronic wound clinical article complication gas embolism hemostasis human lavage orthopedic surgery shoulder side effect hydrogen peroxide oxygen sodium chloride LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 2210-4925 2210-4917 SP - 247-251 ST - A rare and uncommon complication after use of hydrogen peroxide (H2O2): A review of use of H2O2 in orthopaedics T2 - Journal of Orthopaedics, Trauma and Rehabilitation TI - A rare and uncommon complication after use of hydrogen peroxide (H2O2): A review of use of H2O2 in orthopaedics UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2007494052&from=export http://dx.doi.org/10.1177/2210491720925089 VL - 27 ID - 829043 ER - TY - JOUR AB - We report the clinical and radiological outcomes of a series of contemporary cementless ceramic-on-ceramic total hip replacements (THRs) at ten years in patients aged ≤ 55 years of age. Pre- and post-operative activity levels are described. A total of 120 consecutive ceramic cementless THRs were performed at a single centre in 110 patients from 1997 to 1999. The mean age of the patients at operation was 45 years (20 to 55). At ten years, four patients had died and six were lost to follow-up, comprising ten hips. The mean post-operative Harris hip score was 94.7 (55 to 100). Radiological analysis was undertaken in 90 available THRs of the surviving 106 hips at final review: all had evidence of stable bony ingrowth, with no cases of osteolysis. Wear was undetectable. There were four revisions. The survival for both components with revision for any cause as an endpoint was 96.5% (95% confidence interval 94.5 to 98.7). The mean modified University of California, Los Angeles activity level rose from a mean of 6.4 (4 to 10) pre-operatively to 9.0 (6 to 10) at the ten-year post-operative period. Alumina ceramic-on-ceramic bearings in cementless primary THR in this series have resulted in good clinical and radiological outcomes with undetectable rates of wear and excellent function in the demanding younger patient group at ten years. ©2013 The British Editorial Society of Bone & Joint Surgery. AD - R. Chana, Specialist Orthopaedic Group, Mater Hospital, 3-9 Gillies Street, Sydney, NSW 2065, Australia AU - Chana, R. AU - Facek, M. AU - Tilley, S. AU - Walter, W. K. AU - Zicat, B. AU - Walter, W. L. DB - Embase Medline DO - 10.1302/0301-620X.95B12.30917 KW - aluminum oxide hydrocortisone local anesthetic agent acetabulum prosthesis adult article avascular necrosis bone atrophy bone growth cementless prosthesis ceramic prosthesis endoprosthesis loosening female follow up Harris hip score hip osteoarthritis hip radiography human juvenile rheumatoid arthritis lung embolism major clinical study male middle aged modified University of California Los Angeles score outcome assessment periprosthetic fracture postoperative period preoperative period priority journal proximal femur prosthesis reoperation sciatic nerve injury scoring system slipped capital femoral epiphysis survival tendinitis total hip prosthesis University of California Los Angeles score young adult Osteonics ABC acetabular component S-ROM stem Secur-Fit femoral component Secur-Fit Plus femoral component LA - English M1 - 12 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 2049-4408 SP - 1603-1609 ST - Ceramic-on-ceramic bearings in young patients: Outcomes and activity levels at minimum ten-year follow-up T2 - Bone and Joint Journal TI - Ceramic-on-ceramic bearings in young patients: Outcomes and activity levels at minimum ten-year follow-up UR - https://www.embase.com/search/results?subaction=viewrecord&id=L372137967&from=export http://dx.doi.org/10.1302/0301-620X.95B12.30917 VL - 95 B ID - 829514 ER - TY - JOUR AB - INTRODUCTION: Polymethyl-methacrylate (PMMA) is a synthetic thermoplastic polymer with multiple uses including orthopedic and cosmetic surgeries. We present a case that involves subcutaneous injections of PMMA for cosmetic enhancement resulting in pulmonary microemboli. CASE PRESENTATION: A 51 year-old woman with no significant medical history presented to the emergency room with severe shortness of breath, tachypnea, and hypoxemia. Four days prior to her presentation she had undergone cosmetic buttock enhancement in Mexico. She reported having a substance injected into her buttocks to increase their size. Immediately after the injection, she experienced sudden shortness of breath, pleuritic chest pain, and lightheadedness. She returned to the United States and sought further medical attention. Upon presentation to our emergency room, her oxygen saturation was 78% on room air with a rise to 98% on 100% nonrebreather mask. She was tachycardic to 110bpm with a blood pressure of 90/60, and was tachypneic to 33 bpm. Her lungs were clear to auscultation. Her cardiac exam was notable for tachycardia. The remainder of her exam was unremarkable. She also complained of blurry vision. Formal ophthomologic exam revealed flame hemorrhages and cotton wool spots. She was admitted to the ICU. CT pulmonary angiogram revealed bibasilar dependent atelectasis and no evidence of thromboembolic disease. Doppler ultrasound of the lower extremities was negative for deep venous thrombosis. Laboratory values revealed normal chemistries, renal function, and liver function. Her WBC count was mildly elevated at 16,000 with neutrophilic predominance. While in the ICU, she was treated empirically with ceftriaxone and axithromycin for community-acquired pneumonia. She remained hypoxic with minimal improvement in her symptoms. Echocardiogram confirmed normal systolic function with an ejection fraction of 55-60%. There was no interatrial shunt with injection of contrast and her PA pressures were elevated at 42 mmHg. Given the continued suspicion for thromboembolic disease, a V/Q scan was requested. The results showed multiple mismatched peripheral subsegmental defects in both lungs suggestive of peripheral microemboli. She was managed conservatively and ultimately discharged with home oxygen. DISCUSSIONS: Polymethyl-methacrylate is a synthetic polymer primarily used as a cement in reconstructive orthopedic surgeries (eg: vertebroplasty). There are multiple suspensions. The common suspension used for cosmetic alterations is microscopic polymer beads in a bovine collagen or chemical colloid vehicle. PMMA, a biologically inert substance, is not reabsorbed by the body, thus providing permanent results after implantation. The procedure known as bioplasty was originally developed for use in HIV patients with lipodystophy, however is also utilized in many other cosmetic alterations (i.e. smoothing of facial wrinkles, buttock augmentation, lip enhancement). There have been multiple case reports of pulmonary microemboli resulting from PMMA in the setting of percutaneous vertebroplasty, however very few of these result from subcutaneous injections. There is also some debate as to the long term treatment of these patients. Since PMMA is not reabsorbed,the particles will remain in the vascular system indefinitely. There is also some evidence to suggest that the substance may actually cause a hypercoagulable state and that anticoagulation may play a role in long term therapy. To our knowledge, this is the first reported case of pulmonary micoemboli resulting from subcutaneous PMMA injection for cosmetic purposes. CONCLUSION: Subcutaneous injections for cosmetic augmentation may lead to devastating outcomes from vascular embolic phenomena. Patients and physicians must be aware of these potentially harmful complications. Further evaluation of PMMA is needed to better assess the possible thrombogenic properties of the substance for clarification on the role of anticoagulation in treatment of microemboli. AD - B.B. Chandrasoma, Cedars-Sinai Medical Center, Los Angeles, CA, United States AU - Chandrasoma, B. B. AU - Kamangar, N. AU - Bierer, G. B. DB - Embase KW - cosmetic polymer poly(methyl methacrylate) collagen ceftriaxone oxygen cement physician thorax college injection buttock patient subcutaneous drug administration dyspnea thromboembolism percutaneous vertebroplasty lung long term care anticoagulation emergency ward suspension colloid implantation wrinkle lip case report cardiovascular system female medical history tachypnea hypoxemia Mexico thorax pain dizziness United States ambient air blood pressure auscultation tachycardia bleeding cotton Human immunodeficiency virus oxygen saturation wool atelectasis Doppler flowmetry leg deep vein thrombosis laboratory kidney function liver function leukocyte count community acquired pneumonia echocardiography heart ejection fraction orthopedic surgery esthetic surgery L1 - http://meeting.chestpubs.org/cgi/content/abstract/136/4/41S-e LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 0012-3692 ST - Pulmonary microemboli as a result of cosmetic enhancement T2 - Chest TI - Pulmonary microemboli as a result of cosmetic enhancement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70203722&from=export VL - 136 ID - 829696 ER - TY - JOUR AD - Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan. AN - 27852957 AU - Chang, C. H. AU - Keng, L. T. AU - Ko, J. C. DA - Aug DO - 10.1136/thoraxjnl-2016-209475 DP - NLM ET - 2016/11/18 J2 - Thorax KW - Aged, 80 and over Bone Cements/*adverse effects Foreign Bodies/diagnostic imaging/*etiology Humans Lumbar Vertebrae Male Postoperative Complications/diagnostic imaging/*etiology Pulmonary Embolism/diagnostic imaging/*etiology Spinal Fractures/*surgery Tomography, X-Ray Computed Vertebroplasty/*adverse effects *Pulmonary Embolism LA - eng M1 - 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 0040-6376 SP - 766 ST - Cementing an unwanted relationship T2 - Thorax TI - Cementing an unwanted relationship VL - 72 ID - 828496 ER - TY - JOUR AB - Gastric variceal bleeding is a serious complication of liver cirrhosis. A recent consensus suggested that endoscopic injection of tissue glue for gastric variceal obliteration (GVO) should be the first choice for treatment of acute gastric variceal bleeding. Following the widespread use of GVO, more severe complications such as needle cementation, fistula formation, embolic sequels, recurrent septicemia, etc., have been reported. We present the first case of GVO-complicated pyogenic portosplenic vein thrombosis which led to persistent Klebsiella pneumoniae septicemia. The foreign body of a glue plug offers an ideal surface for bacterial colonization which becomes a reservoir for continuous bacterial dissemination. The mechanism was proven by ribotyping of the microorganism and postmortem pathology. AD - Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. AN - 19023208 AU - Chang, C. J. AU - Shiau, Y. T. AU - Chen, T. L. AU - Hou, M. C. AU - Sun, C. H. AU - Liao, W. C. AU - Lin, H. C. AU - Lee, S. D. DO - 10.1159/000175360 DP - NLM ET - 2008/11/22 J2 - Digestion KW - Cyanoacrylates/administration & dosage/*adverse effects Esophageal and Gastric Varices/complications/*therapy Gastrointestinal Hemorrhage/*drug therapy/etiology Humans Male Middle Aged *Portal Vein Sepsis/*etiology Tissue Adhesives/administration & dosage/*adverse effects Venous Thrombosis/*etiology LA - eng M1 - 2-3 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 0012-2823 SP - 139-43 ST - Pyogenic portal vein thrombosis as a reservoir of persistent septicemia after cyanoacrylate injection for bleeding gastric varices T2 - Digestion TI - Pyogenic portal vein thrombosis as a reservoir of persistent septicemia after cyanoacrylate injection for bleeding gastric varices VL - 78 ID - 828954 ER - TY - JOUR AD - Internal Medicine Department, Kaohsiung Armed Forces General Hospital, Lingya District, Kaohsiung City, Taiwan (R.O.C.) alpha1320@gmail.com. Internal Medicine Department, Kaohsiung Armed Forces General Hospital, Lingya District, Kaohsiung City, Taiwan (R.O.C.). AN - 28396332 AU - Chang, C. Y. AU - Huang, S. F. C2 - Pmc5386849 DA - Apr 10 DO - 10.1503/cmaj.160579 DP - NLM ET - 2017/04/12 J2 - CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne KW - Asymptomatic Diseases Bone Cements/*adverse effects Humans Male Middle Aged Pulmonary Embolism/*diagnostic imaging/etiology Radiography, Thoracic Spondylolisthesis/surgery Tomography, X-Ray Computed Vertebroplasty/*adverse effects LA - eng M1 - 14 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 0820-3946 (Print) 0820-3946 SP - E543 ST - Asymptomatic pulmonary cement embolism T2 - Cmaj TI - Asymptomatic pulmonary cement embolism VL - 189 ID - 828561 ER - TY - JOUR AB - Background: Severe developmental dysplasia of the hip is a surgical challenge. The purpose of this study is to describe the cementless arthroplasty with a distal femoral shortening osteotomy for Crowe type IV developmental hip dysplasia and to report the results of this technique. Materials and Methods: 12 patients (2 male and 10 female) of Crowe type IV developmental hip dysplasia operated between January 2005 and December 2010 were included in the study. All had undergone cementless arthroplasty with a distal femoral shortening osteotomy. Acetabular cup was placed at the level of the anatomical position in all the hips. The clinical outcomes were assessed and radiographs were reviewed to evaluate treatment effects. Results: The mean followup for the 12 hips was 52 months (range 36-82 months). The mean Harris hip score improved from 41 points (range 28-54) preoperatively to 85 points (range 79-92) at the final followup. The mean length of bone removed was 30 mm (range 25-40 mm). All the osteotomies healed in a mean time of 13 weeks (range 10-16 weeks). There were no neurovascular injuries, pulmonary embolism or no infections. Conclusion: Our study suggests that cementless arthroplasty with a distal femoral shortening is a safe and effective procedure for severe developmental dysplasia of the hip. AD - Department of Orthopaedics, The Affiliated Southeast Hospital of Xiamen University, Orthopaedic Center of the People’s Liberation Army, Zhangzhou 363000, China AN - 109816791. Language: English. Entry Date: 20150709. Revision Date: 20200708. Publication Type: Journal Article AU - Chang‑Yong, Guo AU - Mo, Sha AU - Liang‑Qi, Kang AU - Jiang‑Ze, Wang AU - Zhen‑Qi, Ding DB - cin20 DO - 10.4103/0019-5413.159652 DP - EBSCOhost KW - Arthroplasty -- Classification Hip Dislocation, Congenital Osteotomy Human Male Female Time Factors Clinical Assessment Tools Adult Middle Age Aged M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2015 SN - 0019-5413 SP - 442-446 ST - Cementless arthroplasty with a distal femoral shortening for the treatment of Crowe type IV developmental hip dysplasia T2 - Indian Journal of Orthopaedics TI - Cementless arthroplasty with a distal femoral shortening for the treatment of Crowe type IV developmental hip dysplasia UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=109816791&site=ehost-live&scope=site VL - 49 ID - 830614 ER - TY - JOUR AB - BACKGROUND: Symptomatic bilateral hip osteoarthritis can be treated surgically with either staged or single-anaesthetic bilateral total hip replacement (BTHR). Today the typical candidate for BTHR is more likely to receive cementless implants. We present the experience of BTHR at our institution using cemented stems combined with cemented and uncemented sockets and, to our knowledge, the largest prospective single-centre series. PATIENTS AND METHODS: This cohort study reviews all patients (319 patients: 638 hips) having BTHR at our institution between December 1977 and December 2015. No case was lost to follow-up. Data were collected prospectively but reviewed retrospectively. Length of stay and complication rates were included, and data were compared with Hospital Episode Statistics figures for operations carried out between March 2005 and June 2014 to confirm local database validity. Patient experience and Oxford Hip Scores were obtained for a subgroup of this cohort, comparing them with patients who underwent bilateral staged operations performed within 1 year. RESULTS: The rates for mortality, deep vein thrombosis, non-fatal myocardial infarction within 6 months were each 0.3% (1 episode) and non-fatal pulmonary embolism 0.6% (2 episodes). There were no intraoperative periprosthetic fractures or readmissions within 30 days. CONCLUSIONS: Our study shows a low risk of complications when using cemented and hybrid BTHRs for selected patients and the risk of complications compares favourably with published results. Available functional scores compared favourably to a comparison group of patients undergoing bilateral staged procedures, and a positive impression on treatment experience from a subgroup of interviewed BTHR patients was noticeable. AD - Princess Elizabeth Orthopaedic Centre, Exeter, UK. AN - 30450975 AU - Charity, J. AU - Wyatt, M. C. AU - Jameson, S. AU - Whitehouse, S. L. AU - Wilson, M. J. AU - Gie, G. A. DA - Sep DO - 10.1177/1120700018813280 DP - NLM ET - 2018/11/20 J2 - Hip international : the journal of clinical and experimental research on hip pathology and therapy KW - Aged Aged, 80 and over Anesthetics *Arthroplasty, Replacement, Hip/methods *Bone Cements Cohort Studies Female Hip/surgery *Hip Prosthesis Humans Male Middle Aged Osteoarthritis, Hip/surgery Periprosthetic Fractures/etiology Prospective Studies Retrospective Studies Treatment Outcome Bilateral cemented stems hip replacement safety LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 1120-7000 SP - 468-474 ST - Is single-anaesthetic bilateral total hip replacement using cemented stems safe and appropriate? A review of four decades of practice T2 - Hip Int TI - Is single-anaesthetic bilateral total hip replacement using cemented stems safe and appropriate? A review of four decades of practice VL - 29 ID - 828613 ER - TY - JOUR AB - Introduction Periacetabular bone metastasis present with severe pain and functional loss leading to a poor quality of life. Surgical treatment remains challenging. Material and methods We reviewed all cases operated at our institution. We analyzed pain scores and functional status as well as complications and their risk factors. Results Thirty-five patients underwent curettage and cemented reconstruction. Mean surgical time was 168 min. Mean surgical blood losses were 3150 ml. Major complications were encountered in 23% and minor complications in 29% of cases. We found a significant pain relief (p < 0.0001) and improvement in functional status in the postoperative period (p < 0.0001). A Harrington grade 4 lesion was correlated with a higher complication rate (p-value = 0.002). Conclusions In this series we were able to show that surgical management is an effective option in the treatment of metastatic bone disease to the pelvis. However, this treatment is very complex and associated with very high complication rates. Therefore, adequate patient selection and preoperative management is advocated. AD - M. Gebhart, Department of Orthopedic Surgery, Institut Jules Bordet, Université libre de Bruxelles, Belgium AU - Charles, T. AU - Ameye, L. AU - Gebhart, M. DB - Embase Medline DO - 10.1016/j.ejso.2017.03.018 KW - catheter acetabulum adult aged analgesia article atelectasis bone metastasis bone screw breast carcinoma cancer growth cancer prognosis catheter infection clinical article crutch curettage deep vein thrombosis device failure external beam radiotherapy female femur head necrosis follow up functional status hemangiopericytoma heterotopic ossification hip dislocation hip surgery human immobility limited mobility liver cancer lung cancer lung embolism male metastasis resection multiple myeloma operative blood loss pain assessment pathologic fracture pelvis cancer pelvis surgery pneumonia postoperative complication postoperative period preoperative evaluation preoperative radiotherapy primary tumor priority journal prostate cancer quality of life radiotherapy dosage renal cell carcinoma retrospective study sepsis surgical technique survival rate thyroid cancer thyroid carcinoma total hip prosthesis transitional cell carcinoma uterine cervix carcinoma visceral metastasis wound dehiscence wound infection LA - English M1 - 9 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1532-2157 0748-7983 SP - 1727-1732 ST - Surgical treatment for periacetabular metastatic lesions T2 - European Journal of Surgical Oncology TI - Surgical treatment for periacetabular metastatic lesions UR - https://www.embase.com/search/results?subaction=viewrecord&id=L615985115&from=export http://dx.doi.org/10.1016/j.ejso.2017.03.018 VL - 43 ID - 829239 ER - TY - JOUR AB - Background: Use of the direct anterior approach (DAA) for total hip arthroplasty (THA) has increased over the last decade. We sought to investigate whether (1) a difference exists in dislocation risk for DAA compared with posterior THA, (2) a difference exists in risk for specific revision reasons, and (3) the likelihood of adverse 90-day postoperative events differs.Methods: We conducted a cohort study using data from Kaiser Permanente's Total Joint Replacement Registry. Patients aged ≥18 years who underwent primary cementless THA for osteoarthritis with a highly cross-linked polyethylene liner were included (2009-2017). Multivariable Cox proportional hazards regression was used to evaluate dislocation and cause-specific revision risks, and multivariable logistic regression was used to evaluate 90-day emergency department visits, 90-day unplanned readmissions, and 90-day complications (including deep infection, deep vein thrombosis, and pulmonary embolism).Results: Of 38,399 primary THA, 6428 (16.7%) were DAA. All-cause revision at 2-years follow-up was 1.78% (95% confidence interval [CI] = 1.46-2.17) for DAA and 2.28% (95% CI = 2.11-2.45) for posterior. After adjusting for covariates, DAA had a lower risk of dislocation (hazard ratio [HR] = 0.39, 95% CI = 0.29-0.53), revision for instability (HR = 0.33, 95% CI = 0.18-0.58), revision for periprosthetic fracture (HR = 0.57, 95% CI = 0.34-0.96), and readmission (odds ratio = 0.82, 95% CI = 0.67-0.99) compared with posterior approach but a higher risk of revision for aseptic loosening (HR = 2.26, 95% CI = 1.35-3.79).Conclusion: While the DAA associated with lower risks of dislocation and revision for instability and periprosthetic fracture, it is associated with a higher revision risk for aseptic loosening. Surgeons should discuss these risks with their patients. AD - Department of Orthopaedic Surgery, The Permanente Medical Group, Vallejo, CA Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, CA Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Harbor City, CA Department of Orthopaedic Surgery, The Permanente Medical Group, San Leandro, CA Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Irvine, CA AN - 143363370. Language: English. Entry Date: In Process. Revision Date: 20200526. Publication Type: journal article. Journal Subset: Biomedical AU - Charney, Mark AU - Paxton, Elizabeth W. AU - Stradiotto, Ronald AU - Lee, John J. AU - Hinman, Adrian D. AU - Sheth, Dhiren S. AU - Prentice, Heather A. DB - cin20 DO - 10.1016/j.arth.2020.01.033 DP - EBSCOhost M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2020 SN - 0883-5403 SP - 1651-1657 ST - A Comparison of Risk of Dislocation and Cause-Specific Revision Between Direct Anterior and Posterior Approach Following Elective Cementless Total Hip Arthroplasty T2 - Journal of Arthroplasty TI - A Comparison of Risk of Dislocation and Cause-Specific Revision Between Direct Anterior and Posterior Approach Following Elective Cementless Total Hip Arthroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=143363370&site=ehost-live&scope=site VL - 35 ID - 830509 ER - TY - JOUR AB - BACKGROUND AND OBJECTIVES: As part of the Thai Anesthesia Incidents Study of anesthetic adverse outcomes, we evaluated the incidence and factors related to cardiac arrest during spinal anesthesia. METHODS: During a 12-mo period (March 1, 2003, to February 28, 2004), a prospective, multicenter registry of patients receiving anesthesia was initiated in 20 hospitals (7 university, 5 tertiary, 4 general, and 4 district hospitals) across Thailand. Anesthesia personnel reported patient-, surgery-, and anesthetic-related variables and adverse outcomes, including cardiac arrest during spinal anesthesia (defined as the time period from induction of spinal anesthesia until the end of operation). Adverse event specific forms were recorded within 24 h of an anesthetic procedure whenever a specific adverse event occurred. Univariate and multivariate analysis were used to identify factors related to cardiac arrest during spinal anesthesia. A P value <0.05 was considered significant. RESULTS: In the registry of 40,271 cases of spinal anesthesia, there were 11 cardiac arrests, corresponding to an incidence of 2.73 (95% CI: 1.12-4.34) per 10,000 anesthetics. The mortality rate was 90.9% among patients who arrested. Among 11 patients who arrested, there were 5 cases of cesarean delivery and 6 cases of extremity surgery, including hip surgery. In 4 patients (36.3%), the anesthetic contributed directly to the arrest (high sympathetectomy, local anesthetic overdose, or lack of electrocardiography monitoring), whereas some arrests were associated with specific events (cementing of prosthesis, massive bleeding, suspected pulmonary embolism, and suspected myocardial infarction). From multivariate analysis, the risks of cardiac arrest during anesthesia were shorter stature (odds ratio 0.944 [95% CI: 0.938-0.951], P < 0.001), longer duration of surgery (odds ratio 1.003 [95% CI: 1.001-1.005], P = 0.002), and spinal anesthesia administered by the surgeon (odd ratio 23.508 [95% CI: 6.112-90.415], P < 0.001), respectively. CONCLUSION: The incidence of cardiac arrest during spinal anesthesia was infrequent, but was associated with a high mortality rate. If the surgeon performed the spinal anesthetic, this was a significant factor associated with cardiac arrest. Increasing the number of anesthesiologists, improving monitoring guidelines for spinal anesthesia and improving the nurse-anesthetist training program may decrease the frequency of arrest and/or improve patient outcome. AD - Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Rama IV Rd., Pathumwan, Bangkok 10330, Thailand. somratcu@hotmail.com AN - 18931240 AU - Charuluxananan, S. AU - Thienthong, S. AU - Rungreungvanich, M. AU - Chanchayanon, T. AU - Chinachoti, T. AU - Kyokong, O. AU - Punjasawadwong, Y. DA - Nov DO - 10.1213/ane.0b013e31817bd143 DP - NLM ET - 2008/10/22 J2 - Anesthesia and analgesia KW - Adult Aged Anesthesia, Spinal/*adverse effects/*standards Cesarean Section/adverse effects Female Heart Arrest/chemically induced/*epidemiology/mortality Humans Intraoperative Care/standards Male Middle Aged Monitoring, Physiologic/standards Pregnancy Registries/statistics & numerical data Safety Survival Analysis Survivors Thailand LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 0003-2999 SP - 1735-41 ST - Cardiac arrest after spinal anesthesia in Thailand: a prospective multicenter registry of 40,271 anesthetics T2 - Anesth Analg TI - Cardiac arrest after spinal anesthesia in Thailand: a prospective multicenter registry of 40,271 anesthetics VL - 107 ID - 828829 ER - TY - JOUR AB - A 62-year-old woman with severe osteoporosis experienced pulmonary embolism by polymethylmethacrylate after percutaneous vertebroplasty. The patient immediately developed respiratory and cardiac distress, and a computed tomographic scan revealed the presence of cement in the pulmonary circulation. Proper techniques can minimize the risk of pulmonary embolism during percutaneous vertebroplasty: adequate preparation of cement and fluoroscopy during the procedure are recommended. AD - Département d'anesthésie-réanimation, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex, France. audecharvet@wanadoo.fr 0.05). The results show that minimally invasive THA has the advantages of less complication, shorter hospital stay, slighter pain and faster function recovery compared to routine THA. AD - G. Chen, Department of Bone and Joint Surgery, Hospital of Luzhou Medical College, Luzhou 646000 Sichuan Province, China AU - Chen, G. AU - Zhang, Z. J. AU - Ge, J. H. AU - Ye, L. Z. DB - Embase KW - adult aged arthralgia article controlled study female femur head necrosis femoral neck fracture follow up Harris hip score hemarthrosis hip osteoarthritis human intermethod comparison joint function length of stay major clinical study male minimally invasive surgery outcome assessment peroperative complication skin incision surgical technique total hip prosthesis vein embolism LA - Chinese M1 - 48 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2008 SN - 1673-8225 SP - 9537-9540 ST - Minimally invasive total hip arthroplasty in 47 cases T2 - Journal of Clinical Rehabilitative Tissue Engineering Research TI - Minimally invasive total hip arthroplasty in 47 cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L354160888&from=export VL - 12 ID - 829730 ER - TY - JOUR AB - Vertebral hemangiomas are common entities that rarely present with neurological deficits. The authors report the unusual case of a large L-3 vertebral hemangioma with epidural extension in a 27-year-old woman who presented with hip flexor and quadriceps weakness, foot drop, and leg pain. The characteristics of the mass on magnetic resonance imaging suggested an aggressive, hypervascular lesion. The patient underwent embolization of the lesion followed by direct intralesional injection of ethanol. Significant resolution of clinical symptoms was observed immediately after the procedure and at her follow-up visits. Follow-up imaging studies obtained 9 months after the procedure also documented a considerable reduction in the size of the hemangioma with minimal loss of vertebral height and a mild kyphosis at the affected level. On repeated imaging studies obtained 21 months postoperatively, the size of the hemangioma and the degree of vertebral body compression were stable. As demonstrated in this case, patients with vertebral hemangiomas can present with acute nerve root compression and signs and symptoms similar to those of disc herniation. Vertebral hemangiomas can be treated effectively with interventional techniques such as embolization and ethanol injection. AD - Univ Penn, Sch Med, Dept Neurosurg, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Div Intervent Neuroradiol, Philadelphia, PA 19104 USA. Specialists PC, Orthopaed & Neurosurg, Stamford, CT USA. Grady, MS (corresponding author), Univ Penn, Sch Med, Dept Neurosurg, 3400 Spruce St, Philadelphia, PA 19104 USA. gradys@uphs.upenn.edu AN - WOS:000247800500013 AU - Chen, H. I. AU - Heuer, G. G. AU - Zaghloul, K. AU - Simon, S. L. AU - Weigele, J. B. AU - Grady, M. S. DA - Jul DO - 10.3171/spi-07/07/080 J2 - J. Neurosurg.-Spine KW - embolization ethanol injection hemangioma lumbar spine radiculopathy SPINAL-CORD COMPRESSION PERCUTANEOUS VERTEBROPLASTY INTRALESIONAL INJECTION METHYL-METHACRYLATE NATURAL-HISTORY MANAGEMENT PREGNANCY ETHANOL ALCOHOL EXTENSION Clinical Neurology Surgery LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2007 SN - 1547-5654 SP - 80-85 ST - Lumbar vertebral hemangioma presenting with the acute onset of neurological symptoms - Case report T2 - Journal of Neurosurgery-Spine TI - Lumbar vertebral hemangioma presenting with the acute onset of neurological symptoms - Case report UR - ://WOS:000247800500013 VL - 7 ID - 830394 ER - TY - JOUR AB - This case report describes a fatal cardiac arrest during percutaneous vertebroplasty. This serves to remind us that life threatening intraoperative pulmonary embolism may occur in this minimal invasive procedure. Surgical precautions and invasive cardiovascular monitoring may be required in high-risk patients. AD - Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan. AN - 12351294 AU - Chen, H. L. AU - Wong, C. S. AU - Ho, S. T. AU - Chang, F. L. AU - Hsu, C. H. AU - Wu, C. T. DA - Oct DO - 10.1097/00000539-200210000-00049 DP - NLM ET - 2002/09/28 J2 - Anesthesia and analgesia KW - Aged Bone Cements/*adverse effects Echocardiography, Transesophageal Fatal Outcome Female Humans Orthopedic Procedures/*adverse effects Osteoporosis/complications Pulmonary Embolism/diagnostic imaging/*etiology Spinal Cord Compression/complications/surgery Spine/*surgery LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2002 SN - 0003-2999 (Print) 0003-2999 SP - 1060-2, table of contents ST - A lethal pulmonary embolism during percutaneous vertebroplasty T2 - Anesth Analg TI - A lethal pulmonary embolism during percutaneous vertebroplasty VL - 95 ID - 828960 ER - TY - JOUR AB - From January 2006 to April 2008, 84 total hip arthroplasty recipients, including 48 males and 36 females, aged 25-82 years, were enrolled from Department of Orthopaedics in Ganzhou Municipal People's Hospital and were retrospectively analyzed. Hydroxyapatite-coated metal prosthesis with non-bone cement handle was purchased from Taiwan Union Company. Out of 12 cases who developed early complications postoperatively with an average age of 62 years, 1 case was respiratory failure, 4 cases were pulmonary infection, 1 case was wound infection, 2 cases were electrolyte disturbances, 1 cases was stress ulcer, 1 case was post-dislocation, 1 case was injury of sciatic nerve, and 1 case was pulmonary embolism. Only 1 case with pulmonary embolism died of acute respiratory failure, while other patients were well recovered. There was no complications such as prosthetic loosening, disrupt or submerge. The thoroughly preoperative management, careful operation and positive precaution are important to avoid postoperative early complication. AD - J.-P. Chen, Department of Orthopaedics, Ganzhou Municipal People's Hospital, Ganzhou 341000 Jiangxi Province, China AU - Chen, J. P. AU - Chen, R. C. AU - Zeng, W. C. AU - You, H. AU - Zhu, D. X. AU - Cai, X. J. AU - Yang, Y. B. AU - Zhong, H. F. AU - Chen, Q. AU - Guo, L. Z. DB - Embase KW - hydroxyapatite acute respiratory failure adult aged article electrolyte disturbance female hip dislocation human lung embolism lung infection major clinical study male peripheral nerve injury postoperative complication preoperative care prosthesis loosening recipient respiratory failure retrospective study sciatic nerve stress ulcer total hip prosthesis wound infection LA - Chinese M1 - 39 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2008 SN - 1673-8225 SP - 7685-7687 ST - Postoperative early complications of total hip arthroplasty in 84 cases T2 - Journal of Clinical Rehabilitative Tissue Engineering Research TI - Postoperative early complications of total hip arthroplasty in 84 cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L352728370&from=export VL - 12 ID - 829735 ER - TY - JOUR AB - Large parasagittal meningioma is rare in pregnant women. In this paper, we report the successful treatment of a pregnant woman with a large parasagittal meningioma. A 35-year-old woman in her 37th week of pregnancy presented with acute consciousness disturbances after experiencing headache and nausea for 2 weeks. We performed a successful cesarean delivery under general anesthesia, and immediately after the delivery, brain computed tomography was performed. The scan revealed a large tumor (8.3 × 6.8 × 7.1 cm3) in the left frontal region, thickening of the adjacent skull base, and perifocal edema. Twenty-four hours after the delivery, the patient underwent imaging studies, namely, magnetic resonance imaging and angiography. The parasagittal meningioma was removed through craniotomy, and the surgical outcome was highly satisfactory. Although meningioma is benign, the tumor mass can expand rapidly during pregnancy. In our patient, an early cesarean section was first performed for a successful delivery, and imaging studies and transarterial embolization of the tumor blood supply were performed prior to the second operation for craniotomy and total tumor excision. A multidisciplinary team was critical for successfully treating this patient. AD - K.-F. Huang, Division of Neurosurgery, Department of Surgery, Taipei Tzu-Chi Hospital, Buddhist Tzu-Chi Medical Foundation, 289 Jianguo Road, Xindian Section, New Taipei City, Taiwan AU - Chen, K. H. AU - Chang, Y. K. AU - Hsu, H. T. AU - Huang, K. F. C1 - decadron DB - Embase DO - 10.1016/j.fjs.2015.08.004 KW - bone cement dexamethasone mannitol adult angiography article brain edema case report cesarean section computer assisted tomography consciousness disorder craniotomy female headache human human tissue intracranial hypertension meningioma nuclear magnetic resonance imaging parasagittal meningioma pregnant woman priority journal treatment outcome tumor volume decadron LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 2213-5413 1682-606X SP - 218-221 ST - Large parasagittal meningioma in a pregnant woman T2 - Formosan Journal of Surgery TI - Large parasagittal meningioma in a pregnant woman UR - https://www.embase.com/search/results?subaction=viewrecord&id=L607756070&from=export http://dx.doi.org/10.1016/j.fjs.2015.08.004 VL - 48 ID - 829352 ER - TY - JOUR AB - OBJECTIVE: To comparatively study the efficacy and safety of unilateral and bilateral balloon kyphoplasty in the treatment of painful multi-vertebral osteoporotic compression fractures. METHODS: From May 2002 to June 2007, 41 consecutive patients with painful multi-vertebral osteoporotic compression fractures underwent unilateral or bilateral kyphoplasty. The unilateral group included 3 male and 14 female with an average age of 70.4 (range 52 to 91 years old). The bilateral group included 4 men and 20 women with an average age of 72.4 (range 61 to 87 years old). Each procedure included insertion of inflatable balloon, fracture reduction and cement filling under "C"-arm monitoring. Preoperative and postoperative pain level, SF-36 score, radiographs and complications were recorded and analyzed. RESULTS: All 41 patients tolerated the operation well. The mean operation time were (86 +/- 32) min and (120 +/- 26) min for unilateral and bilateral groups respectively; the mean volume of cement injected into one level were (3.9 +/- 1.6) ml and (5.4 +/- 2.1) ml for unilateral and bilateral groups respectively. The mean follow-up were (32.5 +/- 17.2) months and (30.7 +/- 14.3) months for unilateral and bilateral groups respectively. The mean VAS pain score of unilateral group decreased significantly from 7.4 +/- 2.1 preoperatively to 2.7 +/- 1.9 postoperatively (t = 2.50, P < 0.05) and 3.1 +/- 2.2 at final follow-up, the mean VAS pain score of bilateral group decreased significantly from 7.9 +/- 2.1 preoperatively to 2.3 +/- 2.5 postoperatively (t = 2.41, P < 0.05) and 2.7 +/- 2.2 at final follow-up, no significant difference was found between two groups. Significant increase of the mean height of anterior and medial vertebral body were recorded after the operation and maintained at final follow-up. The mean correction of local kyphosis was 7.2 degrees +/- 4.9 degrees for unilateral group and 7.3 degrees +/- 5.9 degrees for bilateral group, no significant difference was found between two groups. Postoperatively, 6 of 8 subscales measured by SF-36 were significantly improved for both groups. Complications were found in 7 patients including 6 cases of cement leakage and 1 case of pulmonary embolization. CONCLUSION: As a minimally invasive procedure, unilateral or bilateral kyphoplasty is effective and relatively safe for multi-vertebral osteoporotic compression fracture. AD - Department of Orthopaedic Surgery, Suzhou University, Suzhou 215006, China. AN - 20137400 AU - Chen, L. AU - Yang, H. L. AU - Tang, T. S. DA - Nov 1 DP - NLM ET - 2010/02/09 J2 - Zhonghua wai ke za zhi [Chinese journal of surgery] KW - Aged Aged, 80 and over Female Follow-Up Studies Fractures, Compression/etiology/*surgery Humans Male Middle Aged Osteoporosis/complications Spinal Fractures/etiology/*surgery Treatment Outcome Vertebroplasty/*methods LA - chi M1 - 21 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0529-5815 (Print) 0529-5815 SP - 1642-6 ST - [Unilateral versus bilateral balloon kyphoplasty in the treatment of multi-vertebral osteoporotic compression fractures] T2 - Zhonghua Wai Ke Za Zhi TI - [Unilateral versus bilateral balloon kyphoplasty in the treatment of multi-vertebral osteoporotic compression fractures] VL - 47 ID - 828780 ER - TY - JOUR AB - The association between osteoporosis and cardiovascular diseases has been demonstrated. Higher cardiovascular risk has also been correlated with vertebral fractures. However, the association between osteoporotic vertebral fracture and the possibly higher risk of stroke remains uncertain. This study aimed to evaluate the incidence, risk, and type of stroke in patients with osteoporotic vertebral fracture. Patients with osteoporotic vertebral fracture were identified (n=380) and 10 age- and sex-matched controls per case (comparison group, n=3795) were chosen from a nationwide representative cohort of 999,997 people from 1998 to 2005. Both groups were followed-up for stroke events for 3 years, matched by propensity scores with adjustments for covariates such as comorbidities (ie, hypertension, diabetes, arrhythmia, or coronary heart diseases) and exposure to medications (ie, aspirin, lipid lowering drug, or nitrates), and assessed by Kaplan-Meier and Cox regression analyses. The incidence rate of stroke in the osteoporotic vertebral fracture group (37.5 per 1000 person-years; 95% confidence interval [CI], 27.551.2) was significantly higher than in the comparison group (14.0 per 1000 person-years; 95% CI, 12.016.4, p<0.001). Stroke was more likely to occur in the osteoporotic vertebral fracture patients than in the normal controls (crude hazard ratio [HR] 2.68, 95% CI 1.893.79, p<0.001; adjusted HR 2.71, 95% CI 1.903.86, p<0.001). In conclusion, patients with osteoporotic vertebral fracture have a higher risk of stroke (ie, both ischemic and hemorrhagic) and require stroke prevention strategies. (c) 2013 American Society for Bone and Mineral Research. AD - [Chen, Yu-Chun] Natl Yang Ming Univ Hosp, Dept Med Res & Educ, Ilan, Taiwan. [Chen, Yu-Chun; Chen, Tzeng-Ji] Natl Yang Ming Univ, Inst Hosp & Hlth Care Adm, Taipei 112, Taiwan. [Wu, Jau-Ching; Cheng, Henrich] Natl Yang Ming Univ, Inst Pharmacol, Taipei 112, Taiwan. [Wu, Jau-Ching; Huang, Wen-Cheng; Cheng, Henrich] Natl Yang Ming Univ, Sch Med, Taipei 112, Taiwan. [Wu, Jau-Ching; Huang, Wen-Cheng; Cheng, Henrich] Taipei Vet Gen Hosp, Dept Neurosurg, Neurol Inst, Taipei 11217, Taiwan. [Liu, Laura] Chang Gung Mem Hosp, Dept Ophthalmol, Tao Yuan, Taiwan. [Liu, Laura] Chang Gung Univ, Coll Med, Tao Yuan, Taiwan. [Thien, Peck-Foong] Natl Yang Ming Univ Hosp, Dept Pediat, Ilan, Taiwan. [Lo, Su-Shun] Natl Yang Ming Univ, Sch Med, Dept Surg, Taipei 112, Taiwan. Wu, JC (corresponding author), Taipei Vet Gen Hosp, Dept Neurosurg, Neurol Inst, Room 509,17F,201 Shih Pai Rd,Sec 2, Taipei 11217, Taiwan. jauching@gmail.com AN - WOS:000315106300012 AU - Chen, Y. C. AU - Wu, J. C. AU - Liu, L. AU - Huang, W. C. AU - Cheng, H. AU - Chen, T. J. AU - Thien, P. F. AU - Lo, S. S. DA - Mar DO - 10.1002/jbmr.1722 J2 - J. Bone Miner. Res. KW - INCIDENCE ISCHEMIC HEMORRHAGIC OSTEOPOROTIC VERTEBRAL FRACTURE STROKE RANDOMIZED CLINICAL-TRIAL PULMONARY CEMENT EMBOLISM ACUTE ISCHEMIC-STROKE BONE-MINERAL DENSITY POSTMENOPAUSAL WOMEN PHYSICAL-ACTIVITY CARDIOVASCULAR-DISEASE LEISURE-TIME OLDER WOMEN MORTALITY Endocrinology & Metabolism LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2013 SN - 0884-0431 SP - 516-523 ST - Hospitalized osteoporotic vertebral fracture increases the risk of stroke: A population-based cohort study T2 - Journal of Bone and Mineral Research TI - Hospitalized osteoporotic vertebral fracture increases the risk of stroke: A population-based cohort study UR - ://WOS:000315106300012 VL - 28 ID - 830289 ER - TY - JOUR AB - In this article we describe the treatment of compressive vertebral hemangioma. Our case series comprised three patients with aggressive hemangioma. We performed a combination of posterior decompression and vertebroplasty for the two patients with a sacral hemangioma and a thoracic hemangioma, and en bloc resection for the third patient, who also had a thoracic lesion. Surgical intervention is indicated in cases of rapidly progressive tumors or severe myelopathy. All three patients had good clinical results. The follow-up period ranged from 8 to 56 months. The mean blood loss was around 700 ml, and mean surgical time was 2.1 h. Blood loss for the en bloc procedure was around 1,200 ml, and surgical time was 2.3 h. A combination of posterior decompression, vertebroplasty, and posterior fixation for aggressive hemangioma can reduce blood loss during surgery. For patients with hemangioma and with incomplete paralysis, total en bloc spondylectomy should be considered. Adjuvant radiotherapy can reduce the recurrence of cavernous vertebral hemangiomas. AD - [Chen, Yun-lin; Hu, Xu-dong; Xu, Nan-jian; Jiang, Wei-yu; Ma, Wei-hu] Ningbo 6 Hosp, Dept Spine Surg, 1059 Zhongshan East Rd, Ningbo, Zhejiang, Peoples R China. Ma, WH (corresponding author), Ningbo 6 Hosp, Dept Spine Surg, 1059 Zhongshan East Rd, Ningbo, Zhejiang, Peoples R China. 21318465@zju.edu.cn AN - WOS:000427583500006 AU - Chen, Y. L. AU - Hu, X. D. AU - Xu, N. J. AU - Jiang, W. Y. AU - Ma, W. H. DA - Mar DO - 10.1007/s00132-017-3503-6 J2 - Orthopade KW - Spinal cord compression Spinal neoplasms Cavernous hemangioma Vertebroplasty Surgery VERTEBRAL HEMANGIOMAS CORD COMPRESSION NATURAL-HISTORY EMBOLIZATION MANAGEMENT DIAGNOSIS Orthopedics LA - English M1 - 3 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 0085-4530 SP - 221-227 ST - Surgical treatment of compressive spinal hemangioma A case series of three patients and literature review T2 - Orthopade TI - Surgical treatment of compressive spinal hemangioma A case series of three patients and literature review UR - ://WOS:000427583500006 VL - 47 ID - 830176 ER - TY - JOUR AB - INTERVENTION: Single:Single PVP;double:double PVP; CONDITION: single phase osteoporosis vertebral compression fractures PRIMARY OUTCOME: Operation time;amount of bone cement injection;bone cement leakage;venous thrombosis;pulmonary embolism;the adjacent vertebral body fracture surgery for 12 months;ODI;VAS;Cobb's Angle; INCLUSION CRITERIA: 1. Diagnostic criteria: the X‐ray and MRI suggests thoracic lumbar vertebral compression fractures in patients with single section; 2. symptoms and signs and imaging anastomosis; 3. thoracic lumbar vertebral body positive side of the bone mineral density prompt T ‐ Score of 2.5 or less SD; 4. physical condition that can tolerate surgery; 5. To be able to complete the 12 months duration of follow‐up. AN - CN-01870285 AU - Chi, Ctr Ior N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2014 ST - Single and double side by pedicle in the PVP treatment of single phase osteoporosis vertebral compression fractures: a randomized controlled trial T2 - http://www.who.int/trialsearch/Trial2.aspx?TrialID=ChiCTR-IOR-14005526 TI - Single and double side by pedicle in the PVP treatment of single phase osteoporosis vertebral compression fractures: a randomized controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01870285/full ID - 830005 ER - TY - JOUR AD - Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. jchick@partners.org AN - 23011486 AU - Chick, J. F. AU - Chauhan, N. R. AU - Mullen, K. M. AU - Bair, R. J. AU - Khurana, B. DA - Dec DO - 10.1007/s11739-012-0847-0 DP - NLM ET - 2012/09/27 J2 - Internal and emergency medicine KW - Adult Anticoagulants/therapeutic use Bone Cements/*adverse effects Breast Neoplasms/pathology Education, Medical, Continuing Enoxaparin/therapeutic use Female Foreign-Body Migration/diagnostic imaging/drug therapy Humans Kyphoplasty/*adverse effects Pulmonary Embolism/*etiology Radiography Treatment Outcome LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 1828-0447 SP - 569-71 ST - Pulmonary cement emboli after kyphoplasty T2 - Intern Emerg Med TI - Pulmonary cement emboli after kyphoplasty VL - 7 ID - 828523 ER - TY - JOUR AD - Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, USA, jchick@partners.org. AN - 104129772. Language: English. Entry Date: 20140103. Revision Date: 20200708. Publication Type: journal article AU - Chick, J. F. AU - Chauhan, N. R. AU - Mullen, K. M. AU - Bair, R. J. AU - Khurana, B. AU - Chick, Jeffrey Forris Beecham AU - Chauhan, Nikunj Rashmikant AU - Mullen, Katherine Marie AU - Bair, Ryan James AU - Khurana, Bharti DB - cin20 DO - 10.1007/s11739-012-0847-0 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Kyphoplasty -- Adverse Effects Pulmonary Embolism -- Etiology Adult Anticoagulants -- Therapeutic Use Breast Neoplasms -- Pathology Education, Medical, Continuing Heparin, Low-Molecular-Weight -- Therapeutic Use Female Foreign-Body Migration -- Drug Therapy Foreign-Body Migration -- Radiography Treatment Outcomes M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2012 SN - 1828-0447 SP - 569-571 ST - Pulmonary cement emboli after kyphoplasty T2 - Internal & Emergency Medicine TI - Pulmonary cement emboli after kyphoplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104129772&site=ehost-live&scope=site VL - 7 ID - 830666 ER - TY - JOUR AD - J. F. B. Chick, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 02115, United States AU - Chick, J. F. B. AU - Chauhan, N. R. AU - Mullen, K. M. AU - Bair, R. J. AU - Khurana, B. DB - Medline DO - 10.1007/s11739-012-0847-0 KW - anticoagulant agent bone cement enoxaparin adult breast tumor case report editorial female foreign body human kyphoplasty lung embolism medical education pathology radiography treatment outcome LA - English M1 - 6 M3 - Editorial N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1828-0447 1970-9366 SP - 569-571 ST - Pulmonary cement emboli after kyphoplasty T2 - Internal and Emergency Medicine TI - Pulmonary cement emboli after kyphoplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52226872&from=export http://dx.doi.org/10.1007/s11739-012-0847-0 VL - 7 ID - 829525 ER - TY - JOUR AB - Percutaneous vertebroplasty is an interventional radiology technique where pathological vertebral bodies are filled with acrylic cement. This method is used to strengthen the vertebral body and reduce pain in certain diseases involving the vertebrae. The main indications are spinal angioma, metastasis and osteoporosis. Vertebroplasty is performed under neuroleptanalgesia for the cervical spine. A lateral approach is used. For thoracic or lumbar vertebrae, the transpedicular approach is usually used. If this approach is not possible, e.g. osteolysis of the pedicle, surgical osteosynthesis, a posterolateral approach may be used. Technical incidents are not rare but usually asymptomatic. Venous filling is not uncommon, both intraspinal (vertebral plexus) and paraspinal veins may be involved, but despite this frequency, pulmonary embolism in direct relation with vertebroplasty has not been reported. Extravasation into an intervertebral disk or soft tissue may also occur. This type of incident may be related to the position of the needle or to cortical rupture. Local complications are uncommon: the rate of neurological deficit or infection is below 0.5%. Radicular pain is observed in 3.7% of cases. It appears to be more frequent in metastatic disease (5%) than in case of osteoporotic fracture (0.5%) or spinal angioma (1%). These complications are closely related to the radiological aspect of the vertebra: disruption of the cortical, heterogeneous lysis of the vertebral body. Indications concern lesions involving the vertebral body: symptomatic spinal angiomas, painful osteoporotic fractures after medical treatment or in patients with a high risk of decubitus complications, metastatic disease, consolidation of the vertebral body to relieve pain. Vertebroplasty may be helpful in case of recurrent pain after chemotherapy and/or radiotherapy and also in unstable vertebrae to obtain stabilization before radiotherapy or chemotherapy given alone or in combination with surgical osteosynthesis. AD - J. Chiras, Service de Neuroradiologie Charcot, Hopital de La Salpetriere, 75013 Paris, France AU - Chiras, J. DB - Embase KW - article human interventional radiology osteoporosis spinal cord metastasis spine tumor surgical technique treatment indication vertebra body LA - French M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2000 SN - 0181-9801 SP - 58-68 ST - Percutaneous vertebroplasties: Technique, indications, results T2 - Feuillets de Radiologie TI - Percutaneous vertebroplasties: Technique, indications, results UR - https://www.embase.com/search/results?subaction=viewrecord&id=L30139714&from=export VL - 40 ID - 829892 ER - TY - JOUR AB - Interventional radiology can be very helpful in some aspects of spine involvement by multiple myeloma: embolization can be helpful to facilitate surgical resection in case of tumoral compression. Percutaneous vertebroplasty can give consolidation of vertebral fractures in relation with post-therapeutic osteopenia. In most cases, the antalgic effect is very important and can helpfully improve the quality of life of these patients. AD - J. Chiras, Hopital Pitie-Salpetriere, Service de Neuroradiologie Charcot, 47, boulevard de l'Hôpital, F-75651 Paris Cedex 13, France AU - Chiras, J. AU - Cormier, E. AU - Vallee, J. N. AU - Rose, M. DB - Embase KW - artificial embolization France human image analysis interventional radiology multiple myeloma percutaneous vertebroplasty short survey spine disease treatment indication LA - French M1 - 2 M3 - Short Survey N1 - Embase Elsevier literature search January 5, 2021 PY - 2002 SN - 1292-3818 SP - 127-129 ST - Interventional radiology in multiple myeloma T2 - Oncologie TI - Interventional radiology in multiple myeloma UR - https://www.embase.com/search/results?subaction=viewrecord&id=L34453337&from=export VL - 4 ID - 829871 ER - TY - JOUR AB - Percutaneous vertebroplasty is a technique of interventional radiology, which allows to fullfill pathologic vertebral body with acrylic cement. This method is used to strengthen the vertebral body and reduce pain in some diseases involving the vertebra. Main indications are spine angiomas, metastases and osteoporosis. The vertebroplasty is realised under neuroleptanalgesia for cervical spine antero lateral way is used. For thoracic or lumbar vertebra, the way of approach is usually transpedicular; but in some cases, this approach is not possible : osteolysis of the pedicle, surgical osteosynthesis; in such cases, a postero lateral approach is realized. Technical incidents are not rare, but are usually asymptomatic. More frequent are venous filling with cement; the veins involved can be intra spinal (vertebral plexus) or paraspinal. Instead of this frequency pulmonary embolism in direct relation with the vertebroplasty where not reported. Extravasation in intervertebral disk or softissue can also be observed. This last incident can be in relation with the way of the needle or with a cortical rupture. Local complications are rare: rate of neurological deficit or infection is under 0.5%. Radicular pain is observed in 3.7% of cases. These complications are in close relation with the radiological involvement of the vertebra: cortical disruption, heterogeneous Lysis of the vertebral body. The frequency of complications is 1.3% in osteoporosis, 2.5% in spine angiomas and 10% in metastatic disease. Indications concern lesion involving the vertebral body : symptomatic spine angiomas; painful osteoporotic fractures after medical treatment or in patients with a high risk of decubitus complications; in metastatic disease, vertebroplasty is a way to consolidate the vertebral body and release pain. It can be upfull in recurrent pain after chemotherapy and/or radiotherapy, and also in unstable vertebra to obtain a stabilization before radiotherapic or chemotherapic treatment isolately or in combination with surgical osteosynthesis. AD - HOP NORD AMIENS, SERV RADIOL A, AMIENS, FRANCE. Chiras, J (corresponding author), HOP LA PITIE SALPETRIERE, SERV NEURORADIOL CHARCOT, PARIS, FRANCE. AN - WOS:A1997XK25600008 AU - Chiras, J. AU - Depriester, C. AU - Weill, A. AU - SolaMartinez, M. T. AU - Deramond, H. DA - Jun J2 - J. Neuroradiol. KW - percutaneous vertebroplasty interventional radiology spine metastase osteoporosis spine angioma ACRYLIC BONE-CEMENT INJECTION REPLACEMENT SPINE Clinical Neurology Neuroimaging Radiology, Nuclear Medicine & Medical Imaging LA - French M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1997 SN - 0150-9861 SP - 45-59 ST - Percutaneous vertebroplasties. Technique and indications T2 - Journal of Neuroradiology TI - Percutaneous vertebroplasties. Technique and indications UR - ://WOS:A1997XK25600008 VL - 24 ID - 830481 ER - TY - JOUR AB - Percutaneous vertebroplasty is a technique of interventional radiology, which allows to fulfill pathologic vertebral body with acrylic cement. This method is used to strengthen the vertebral body and reduce pain in some diseases involving the vertebra. Main indications are spine angiomas, metastases and osteoporosis. The vertebroplasty is realised under neuroleptanalgesia for cervical spine antero lateral way is used. For thoracic or lumbar vertebra, the way of approach is usually transpedicular; but in some cases, this approach is not possible: osteolysis of the pedicle, surgical osteosynthesis; in such cases, a postero lateral approach is realized. Technical incidents are not rare, but are usually asymptomatic. More frequent are venous filling with cement; the veins involved can be intra spinal (vertebral plexus) or paraspinal. Instead of this frequency pulmonary embolism in direct relation with the vertebroplasty where not reported. Extravasation in intervertebral disk or soft tissue can also be observed. This last incident can be in relation with the way of the needle or with a cortical rupture. Local complications are rare: rate of neurological deficit or infection is under 0.5%. Radicular pain is observed in 3.7% of cases. These complications are in close relation with the radiological involvement of the vertebra: cortical disruption, heterogeneous Lysis of the vertebral body. The frequency of complications is 1.3% in osteoporosis, 2.5% in spine angiomas and 10% in metastatic disease. Indications concern lesion involving the vertebral body: symptomatic spine angiomas; painful osteoporotic fractures after medical treatment or in patients with a high risk of decubitus complications; in metastatic disease, vertebroplasty is a way to consolidate the vertebral body and release pain. It can be usefull in recurrent pain after chemotherapy and/or radiotherapy, and also in unstable vertebra to obtain a stabilization before radiotherapic or chemotherapic treatment isolated or in combination with surgical osteosynthesis. AD - Service de Neuroradiologie Charcot, Hôpital de La Salpêtrière, Paris. AN - 9303944 AU - Chiras, J. AU - Depriester, C. AU - Weill, A. AU - Sola-Martinez, M. T. AU - Deramond, H. DA - Jun DP - NLM ET - 1997/06/01 J2 - Journal of neuroradiology = Journal de neuroradiologie KW - *Acrylic Resins Aged *Bone Cements Extravasation of Diagnostic and Therapeutic Materials Female Fracture Fixation, Internal/methods Fractures, Spontaneous/diagnostic imaging/surgery Humans Intervertebral Disc/injuries Intraoperative Complications Male Middle Aged Neuroleptanalgesia Osteolysis/diagnostic imaging/surgery Osteoporosis/diagnostic imaging/surgery Pain/surgery *Prostheses and Implants Pulmonary Embolism/etiology Radiculopathy/etiology Radiography, Interventional Spinal Diseases/diagnostic imaging/*surgery Spinal Fractures/diagnostic imaging/surgery Spinal Injuries/etiology Spinal Neoplasms/diagnostic imaging/secondary/surgery Spine/blood supply/diagnostic imaging/surgery Veins/injuries LA - fre M1 - 1 N1 - PubMed NLM literature search January 5, 2021 OP - Vertébroplasties percutanées. Technique et indications. PY - 1997 SN - 0150-9861 (Print) 0150-9861 SP - 45-59 ST - [Percutaneous vertebral surgery. Technics and indications] T2 - J Neuroradiol TI - [Percutaneous vertebral surgery. Technics and indications] VL - 24 ID - 828762 ER - TY - JOUR AB - Percutaneous vertebroplasty is a technique of interventional radiology, which alows to fullfill pathologic vertebral body with acrylic cement. This method is used to strengthen the vertebral body and reduce pain in some diseases involving the vertebra. Main indications are spine angiomas, metastases and osteoporosis. The vertebroplasty is realised under neuroleptanalgesia for cervical spine antero lateral way is used. For thoracic or lumbar vertebra, the way of approach is usually transpedicular; but in some cases, this approach is not possible: osteolysis of the pedicle, surgical osteosynthesis; in such cases, a postero lateral approach is realized. Technical incidents are not rare, but are usually asymptomatic. More frequent are venous filling with cement; the veins involved can be intra spinal (vertebral plexus) or paraspinal. Instead of this frequency pulmonary embolism in direct relation with the vertebroplasty where not reported. Extravasation in intervertebral disk or softissue can also be observed. This last incident can be in relation with the way of the needle or with a cortical rupture. Local complications are rare: rate of neurological deficit or infection is under 0.5%. Radicular pain is observed in 3.7% of cases. These complications are in close relation with the radiological involment of the vertebra: cortical disruption, heterogeneous Lysis of the vertebral body. The frequency of complications is 1.3% in osteoporosis, 2.5% in spine angiomas and 10% in metasiatic disease. Indications concern lesion involving the vertebral body: symptomatic spine angiomas; painfull osteoporotic fractures after medical treatment or in patients with a high risk of decubitus complications; in metastatic disease, vertebroplasty is a way to consolidate the vertebral body and release pain. It can be upfull in recurrent pain after chemotherapy and/or radiotherapy, and also in unstable vertebra to obtain a stabilization before radiotherapic or chemotherapic treatment isolately or in combination with surgical osteosynthesis. AD - J. Chiras, Service de Neuroradiologie Charcot, Hopital de La Salpetriere, Paris, France AU - Chiras, J. AU - Depriester, C. AU - Weill, A. AU - Sola-Martinez, M. T. AU - Deramond, H. DB - Embase Medline KW - adult article clinical article decubitus female human interventional radiology intervertebral disk hernia male osteoporosis percutaneous transluminal angioplasty radicular pain spine fracture spine metastasis treatment indication vertebra body LA - French M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1997 SN - 0150-9861 SP - 45-59 ST - Percutaneuos vertebroplasties. Technique and indications T2 - Journal of Neuroradiology TI - Percutaneuos vertebroplasties. Technique and indications UR - https://www.embase.com/search/results?subaction=viewrecord&id=L27292806&from=export VL - 24 ID - 829915 ER - TY - JOUR AB - Interventional radiology plays a significant role in the treatment of bone metastases by various techniques, percutaneous or endovascular. Vertebroplasty is the most well-studied technique for stabilisation of spine metastases as it induces satisfactory stabilisation of the vertebra and offers clear improvement of the quality of life. Due to the success of this technique cementoplasty of other bones, mainly pelvic girdle, has been largely developed. The development of reinforced cementoplasty allows treatment of pre-fractural osteolysis of some long bones. The heat due to the polymerisation of the cement induces carcinolytic effect but this effect is not as important as that which results from radiofrequency destruction. This last technique appears currently as the most important development to definitively destroy bone metastases and is progressively replacing percutaneous alcoholic destruction of such lesions. Angiographic techniques, such as endovascular embolisation, can also be very useful to reduce the risk of surgical treatment of hyper vascular metastases. Chemoembolisation is currently developed to associate pain relief induced by Endovascular embolisation and the carcinolytic effect obtained by local endovascular chemotherapy. All these techniques should develop largely during the next years. AD - Department of Interventional Neuroradiology, Pitié ‐ Salpêtrière Hospital, Paris France Paris VI University, Pierre et Marie Curie, Paris France AN - 126068703. Language: English. Entry Date: 20171111. Revision Date: 20191111. Publication Type: Article AU - Chiras, J. AU - Shotar, E. AU - Cormier, E. AU - Clarençon, F. DB - cin20 DO - 10.1111/ecc.12741 DP - EBSCOhost KW - Bone Metastases -- Therapy Cementoplasty Vertebroplasty Catheter Ablation Embolization, Therapeutic Breast Neoplasms Thyroid Neoplasms Kidney Neoplasms M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 0961-5423 SP - n/a-N.PAG ST - Interventional radiology in bone metastases T2 - European Journal of Cancer Care TI - Interventional radiology in bone metastases UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=126068703&site=ehost-live&scope=site VL - 26 ID - 830562 ER - TY - JOUR AB - Learning Objectives: Interventional radiological procedures offer minimally invasive, safe and effective diagnostic/therapeutic options to patients. These procedures include CT-guided biopsy, radiofrequency ablation, sclerotherapy, embolisation, vertebral body augmentation (vertebroplasty/kyphoplasty), etc. Background: Pre-operative assessment of vertebral lesion is done with CT scan or MRI along with blood investigations. Most of these procedures are done under local anesthesia. Radiofrequency ablation, trans-oral and -nasal approach for biopsy, and vertebroplasty require general anesthesia. CT or fluoroscopic guidance is used. Commonly used hardware are biopsy needles, RFA electrode, sclerosant (sodium tetradecyl sulphate (STD), polidocanol, or ethyl alcohol), embolization particles (polyvinyl alcohol, n-acetyl butyl cyanoacrylate glue, etc.), bone cement (polymethyl methacrylate), etc. Clinical Findings/Procedure: Most common procedure done is biopsy using Murphy's bone biopsy and Ackerman needle. Lesions in clivus, 1st and 2nd cervical vertebrae through trans-nasal and trans-oral approach have been targeted. Radiofrequency ablation of osteoblastoma was performed with technical success and good clinical outcome. Epidural air and dextrose insufflation was done to create barrier between spinal cord and RFA electrode. Preoperative embolization of vertebral metastases as well as primary therapeutic embolization of sacral giant cell tumors and hemangiomas are commonly done. Sclerotherapy for vertebral hemangioma is been performed. Vertebroplasty for patients with collapse of vertebral body in cases of myeloma, metastases, and even traumatic fractures have been effectively treated. Vertebroplasty of clivus and 2nd cervical vertebra is also performed. Conclusion: Vertebral interventional procedures offer minimally invasive, safe, and effective diagnostic and therapeutic options and have resulted in significant reduction in morbidity. AD - R.S. Chivate, Interventional Radiology, Tata Memorial Hospital, Mumbai, India AU - Chivate, R. S. AU - Kulkarni, S. S. AU - Shetty, N. S. AU - Polnaya, A. M. AU - Gala, K. B. AU - Panbude, S. DB - Embase DO - 10.1007/s00270-016-1405-3 KW - alcohol bone cement glucose polidocanol poly(methyl methacrylate) polyvinyl alcohol aeration artificial embolization biopsy needle blood bone biopsy cervical vertebra clinical outcome clinical study clivus collapse computer assisted tomography diagnosis electrode fracture general anesthesia giant cell tumor human human tissue kyphoplasty learning local anesthesia morbidity myeloma nuclear magnetic resonance imaging osteoblastoma preoperative evaluation radiofrequency ablation radiological procedures sacral spinal cord sclerotherapy spine metastasis vertebra body vertebra hemangioma LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1432-086X SP - S207-S208 ST - To review different vertebral interventional techniques T2 - CardioVascular and Interventional Radiology TI - To review different vertebral interventional techniques UR - https://www.embase.com/search/results?subaction=viewrecord&id=L613933567&from=export http://dx.doi.org/10.1007/s00270-016-1405-3 VL - 39 ID - 829344 ER - TY - JOUR AB - Ischemic optic neuropathy due to hemorrhaging remote from visual pathway can occur after surgery. This complication is usually associated with a chronic bleeding disorder, such as gastrointestinal hemorrhage, diabetes, arteriosclerosis, and/or metal poisoning. There are many complications related to cemented hemiarthroplasty in patients who have a femoral neck fracture, such as dislocation, infection, leg length discrepancy, peroneal nerve palsy, and embolism. However, visual loss after this procedure has not previously been reported. In the case reported here, the operation time was short, and there was no massive hemorrhaging. Unilateral visual loss occurred within 3 days of an apparently safe and simple unilateral hemiarthroplasty of the hip. AD - Department of Orthopedic Surgery, Chonbuk National University Hospital, Research Institute of Clinical Medicine, Jeonju, South Korea. AN - 19473808 AU - Cho, H. M. AU - Park, M. S. AU - Kim, K. B. AU - Cho, N. C. DA - Dec DO - 10.1016/j.arth.2009.04.014 DP - NLM ET - 2009/05/29 J2 - The Journal of arthroplasty KW - Accidental Falls Aged Arthroplasty, Replacement, Hip/*adverse effects Blindness/*etiology Female Femoral Neck Fractures/*surgery Humans Optic Neuropathy, Ischemic/*etiology Risk Factors LA - eng M1 - 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0883-5403 SP - 1292.e11-4 ST - Ischemic optic neuropathy after hemiarthroplasty for femoral neck fracture T2 - J Arthroplasty TI - Ischemic optic neuropathy after hemiarthroplasty for femoral neck fracture VL - 24 ID - 828978 ER - TY - JOUR AB - Percutaneous vertebroplasty consists of the percutaneous injection of polymethylmethacrylate (PMMA) cement into a collapsed vertebral body in order to obtain pain relief and mechanically strengthen the vertebral body. This procedure is now extensively used in treating osteoporotic vertebral compression fracture. It is an efficient treatment, but it is not free of complications. Most complications after vertebroplasty are associated with PMMA leakage. Pulmonary embolism of PMMA is rare, but this can occur when there is a failure to recognize venous migration of cement early during the procedure. We encountered a case of a patient with asymptomatic pulmonary embolism because of PMMA after percutaneous vertebroplasty. Chest X-ray and CT scanning revealed numerous tubular branching opacities that corresponded to the pulmonary vessels at the segmental and subsegmental levels. AD - J.J. Ahn, Department of Internal Medicine, Ulsan University Hospital, Ulsan University College of Medicine, 290-3, Jeonha-dong, Dong-ku, Ulsan 682-714, South Korea AU - Cho, J. H. AU - Jung, J. P. AU - Eum, J. B. AU - Seo, K. W. AU - Jegal, Y. J. AU - Choi, S. H. AU - Ahn, J. J. DB - Embase DO - 10.4046/trd.2006.61.2.184 KW - bone cement poly(methyl methacrylate) article computer assisted tomography human lung embolism osteoporosis percutaneous vertebroplasty spinal cord compression thorax radiography LA - Korean M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 1738-3536 SP - 184-188 ST - Numerous bilateral radiographically dense branching opacities after vertebroplasty with polymethylmethacrylate T2 - Tuberculosis and Respiratory Diseases TI - Numerous bilateral radiographically dense branching opacities after vertebroplasty with polymethylmethacrylate UR - https://www.embase.com/search/results?subaction=viewrecord&id=L44831554&from=export http://dx.doi.org/10.4046/trd.2006.61.2.184 VL - 61 ID - 829789 ER - TY - JOUR AB - OBJECTIVE: The purpose of this study was to determine the frequency, radiographic findings, and clinical significance of a pulmonary embolism of cement occurring during percutaneous vertebroplasty or kyphoplasty as detected on conventional chest radiography. MATERIALS AND METHODS: Chest radiographs were obtained after 69 percutaneous vertebroplasty procedures in 64 patients. Chest radiographs were reviewed retrospectively for the presence of pulmonary emboli of cement, and findings were assessed. The frequency was calculated from the cases treated. Medical records were reviewed for procedure-related complications. RESULTS: The emboli of cement were noted radiographically in three (4.6%) of 65 procedures performed in our institution. All patients with cement emboli had multiple myeloma. The chest radiographic findings were multiple radiographically dense opacities with a tubular and branching shape that were scattered sporadically or distributed diffusely throughout the lungs. All patients with cement pulmonary embolism remained asymptomatic. A correlation of embolism of cement to lungs was found with paravertebral venous cement leak (p < 0.001) but not with the number of vertebral bodies treated (p = 0.185) or with the type of procedure performed-kyphoplasty versus vertebroplasty (p = 0.98). CONCLUSION: Pulmonary embolism of cement is seen in 4.6% of patients after percutaneous vertebroplasty or kyphoplasty. The characteristic radiographic findings should be recognized by radiologists. AD - Department of Radiology, Box 57, Division of Diagnostic Imaging, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA. AN - 15385313 AU - Choe, D. H. AU - Marom, E. M. AU - Ahrar, K. AU - Truong, M. T. AU - Madewell, J. E. DA - Oct DO - 10.2214/ajr.183.4.1831097 DP - NLM ET - 2004/09/24 J2 - AJR. American journal of roentgenology KW - Bone Cements/*adverse effects/therapeutic use Extravasation of Diagnostic and Therapeutic Materials/*complications/*diagnostic imaging Female Humans Kyphosis/*surgery Male Middle Aged Pulmonary Embolism/*diagnostic imaging/*etiology *Radiography, Thoracic Retrospective Studies Spine/*surgery Statistics, Nonparametric LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2004 SN - 0361-803X (Print) 0361-803x SP - 1097-102 ST - Pulmonary embolism of polymethyl methacrylate during percutaneous vertebroplasty and kyphoplasty T2 - AJR Am J Roentgenol TI - Pulmonary embolism of polymethyl methacrylate during percutaneous vertebroplasty and kyphoplasty VL - 183 ID - 828667 ER - TY - JOUR AN - 19797786 AU - Choi, S. Y. AU - Goo, J. M. AU - Chun, H. J. AU - Han, D. H. DA - Jan DO - 10.3174/ajnr.A1886 DP - NLM ET - 2009/10/03 J2 - AJNR. American journal of neuroradiology KW - Bone Cements/*adverse effects Carcinoma, Hepatocellular/*secondary/*surgery Contrast Media/*adverse effects Diagnosis, Differential Embolism/*chemically induced/*diagnosis Humans Iodized Oil/*adverse effects Liver Neoplasms/*pathology Male Middle Aged Spinal Neoplasms/*secondary/*surgery Vertebroplasty/*adverse effects LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 0195-6108 SP - E2-3 ST - Lipiodol can simulate cement embolism in patients having undergone vertebroplasty due to metastasis from hepatocellular carcinoma T2 - AJNR Am J Neuroradiol TI - Lipiodol can simulate cement embolism in patients having undergone vertebroplasty due to metastasis from hepatocellular carcinoma VL - 31 ID - 828976 ER - TY - JOUR AB - An 80-year-old female with a history of osteoporosis was evaluated for sudden onset axial low back pain with bilateral lower extremity weakness, hyperreflexia, pain, urinary retention, and decreased rectal tone. Computed tomography of the lumbar spine revealed L1 compression fracture, retropulsion of bone causing spinal canal compromise with associated severe central canal stenosis. Following cement kyphoplasty of L1 with polymethyl methacrylate, the patient developed tachycardia and dyspnea. Chest radiograph and computed tomographic pulmonary angiogram revealed a large collection of hyperdense material within the right lower lobe pulmonary artery, consistent with pulmonary cement emboli. Management and imaging are discussed. AD - Division of Physical Medicine and Rehabilitation, Stanford University School of Medicine, Palo Alto, California, U.S.A. AN - 21435160 AU - Chong, T. AU - Lieu, J. AU - Alamin, T. AU - Mitra, R. DA - Nov-Dec DO - 10.1111/j.1533-2500.2011.00446.x DP - NLM ET - 2011/03/26 J2 - Pain practice : the official journal of World Institute of Pain KW - Aged, 80 and over Back Pain/diagnostic imaging/etiology/*surgery Bone Cements/*therapeutic use Female Humans Kyphoplasty/*methods Lumbar Vertebrae/diagnostic imaging/surgery Osteoporosis/complications Pulmonary Embolism/complications/etiology/*surgery Tomography, X-Ray Computed Vertebroplasty LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2011 SN - 1530-7085 SP - 570-3 ST - Pulmonary cement embolism after kyphoplasty T2 - Pain Pract TI - Pulmonary cement embolism after kyphoplasty VL - 11 ID - 828808 ER - TY - JOUR AB - Introduction: Traumatic displaced femoral neck fractures in the elderly can be treated with cemented or uncemented hemiarthroplasty with good outcomes. Earlier studies reported a higher incidence of deep vein thrombosis (DVT) associated with cemented prostheses in elective total hip or knee arthroplasty. In addition, the hypercoagulable state after a traumatic femoral neck fracture and possible thrombogenic properties of bone cement could put these patients at greater risk for thromboembolism. We aimed to compare the incidence of DVT and progression to pulmonary embolism (PE) or mortality in cemented and uncemented hemiarthroplasty.Methods: The data of 271 patients treated with cemented or uncemented hemiarthroplasty after a traumatic displaced femoral neck fracture was retrospectively analysed for the incidence of DVT. The level of thrombosis, progression to PE and mortality were compared.Results: There were 133 (49.1%) patients with cemented hemiarthroplasty, while 138 (50.9%) had uncemented hemiarthroplasty. The patients had an average age of 76.6 (range 53-99) years and 11 (4.1%) patients had DVT. There were no significant differences in development of DVT, level of thrombosis, PE and mortality regardless of whether a cemented or an uncemented prosthesis was used.Conclusion: Cemented hemiarthroplasty is not associated with higher risks of DVT, PE or mortality in patients with traumatic displaced femoral neck fracture. Cemented prostheses can be safely used for this group of patients. AD - Department of Orthopaedic Surgery, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore AN - 113422324. Language: English. Entry Date: 20170129. Revision Date: 20180619. Publication Type: journal article AU - Choon Chiet, Hong AU - Nazrul, Nashi AU - Milindu Chanaka, Makandura AU - Lingaraj, Krishna AU - Hong, Choon Chiet AU - Nashi, Nazrul AU - Makandura, Milindu Chanaka AU - Krishna, Lingaraj DB - cin20 DO - 10.11622/smedj.2016030 DP - EBSCOhost KW - Hemiarthroplasty -- Adverse Effects Postoperative Complications Bone Cements Hip Fractures -- Surgery Venous Thrombosis -- Etiology Hip Fractures -- Complications Middle Age Male Risk Management Aged, 80 and Over Aged Singapore Incidence Retrospective Design Female Venous Thrombosis -- Epidemiology Human M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2016 SN - 0037-5675 SP - 69-72 ST - Cemented hemiarthroplasty in traumatic displaced femoral neck fractures and deep vein thrombosis: is there really a link? T2 - Singapore Medical Journal TI - Cemented hemiarthroplasty in traumatic displaced femoral neck fractures and deep vein thrombosis: is there really a link? UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=113422324&site=ehost-live&scope=site VL - 57 ID - 830599 ER - TY - JOUR AB - BACKGROUND: Vertebroplasty is one of the minimally invasive surgery that benefit in pain relief from the osteoporotic or malignancy related vertebral compression fractures. However, many literatures reported both asymptomatic and serious complications. The aim of the present study was to summarize, collect data and report the complication ofvertebroplastyfrom our experience at a single institute. MATERIAL AND METHOD: Three hundred and twenty five vertebroplasty procedures from 236 patients performed in our institute were retrospectively reviewed. Data of diagnosis, age at the time of procedure were collected. All complications found were reviewed in detail. RESULTS: Commonly performed procedures were at thoracolumbar junction (51.4%). Osteoporosis was the most common cause of fracture. The present study found 88 (27%) complications with 26 (8%) symptomatic patients. Most common complication was cement leakage, which intervertebral disc was the most common site (42.9). Spinal canal leakage was found in 14 cases (20%). Four out of 14 cases had neurological complications and need further managements. Two cases had neurologic complications from needle injury.Adjacent level collapse found in 13 patients (4%) and remote segment collapse occurred in 5 patients (1.5%). Three had progressive kyphosis required later surgical treatment. One asymptomatic cement pulmonary embolism was found in the present study. CONCLUSION: The complications of vertebroplasty were mostly asymptomatic, but serious complication such as neurologic injury could occur. Vertebroplasty could be considered a quite safe treatment for osteoporotic vertebral fracture. Meticulous technique should be executed during the procedure to avoid the leakage complication. AD - Department of Orthopaedics Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand. siact@mahidol.ac.th AN - 23326986 AU - Chotivichit, A. AU - Korwutthikulrangsri, E. AU - Churojana, A. AU - Songsaeng, D. DA - Sep DP - NLM ET - 2013/01/19 J2 - Journal of the Medical Association of Thailand = Chotmaihet thangphaet KW - Adult Aged Aged, 80 and over Female Fractures, Compression/*therapy Humans Male Middle Aged Osteoporotic Fractures/*therapy Vertebroplasty/*adverse effects LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0125-2208 (Print) 0125-2208 SP - S75-81 ST - Complications in vertebroplasty T2 - J Med Assoc Thai TI - Complications in vertebroplasty VL - 95 Suppl 9 ID - 828638 ER - TY - JOUR AD - Division of Haematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. AN - 23530982 AU - Chou, C. W. AU - Teng, C. L. AU - Hwang, W. L. DA - May DO - 10.1111/bjh.12305 DP - NLM ET - 2013/03/28 J2 - British journal of haematology KW - Bone Cements/*adverse effects Fatal Outcome Female Humans Middle Aged Multiple Myeloma/*complications Pulmonary Embolism/*chemically induced/*diagnostic imaging Radiography LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 0007-1048 SP - 459 ST - Bone cement-induced pulmonary embolism in a myeloma patient T2 - Br J Haematol TI - Bone cement-induced pulmonary embolism in a myeloma patient VL - 161 ID - 828904 ER - TY - JOUR AD - W.-L. Hwang, Division of Haematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan AU - Chou, C. W. AU - Teng, C. L. J. AU - Hwang, W. L. DB - Embase Medline DO - 10.1111/bjh.12305 KW - anticoagulant agent bone cement hemoglobin immunoglobulin kappa chain adult bone lesion bone pain cancer staging cardiopulmonary insufficiency case report clinical feature compression fracture computed tomographic angiography disease exacerbation drug effect dyspnea echocardiography female heart catheterization hemoglobin blood level human low back pain lung embolism multiple myeloma note oxygen supply percutaneous vertebroplasty priority journal pulmonary hypertension respiratory distress syndrome systolic blood pressure thorax radiography thrombectomy tricuspid valve regurgitation LA - English M1 - 4 M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0007-1048 1365-2141 SP - 459 ST - Bone cement-induced pulmonary embolism in a myeloma patient T2 - British Journal of Haematology TI - Bone cement-induced pulmonary embolism in a myeloma patient UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52515634&from=export http://dx.doi.org/10.1111/bjh.12305 VL - 161 ID - 829499 ER - TY - JOUR AB - Severe thoracic kyphosis caused by pathologic fractures often needs to be corrected by resection of the collapsed vertebral body, reconstruction of the anterior spinal column, and correction of the kyphosis with long-segment fixation. The resection of this pathologic bone functions essentially as a vertebral column resection. With the advent of minimally invasive technology, the powerful corrective forces afforded in open cases can be applied using a less invasive approach. In this article, we describe a mini-open posterior technique for thoracic kyphosis via a vertebrectomy and cantilever technique. Two patients underwent kyphosis correction via mini-open vertebrectomy. One patient was corrected from 92 degrees to 65 degrees, and the second patient was corrected from 70 degrees to 53 degrees. Both patients underwent a mini-open approach. Cantilever correction was accomplished over an expandable cage with a minimally invasive pedicle screw system. We describe our technique of mini-open vertebral column resection and kyphosis correction in the thoracic spine. © 2013 Elsevier Ltd. All rights reserved. AD - D. Chou, Department of Neurological Surgery, University of California, San Francisco, Box 0112 505 Parnassus Avenue, San Francisco, CA 94143, United States AU - Chou, D. AU - Lau, D. AU - Roy, E. DB - Embase Medline DO - 10.1016/j.jocn.2013.10.001 KW - anticoagulant agent poly(methyl methacrylate) adult aged allograft anticoagulant therapy arthrodesis article artificial embolization cantilever technique case report compression fracture death disease severity epidural drug administration female follow up fracture fixation human bone marrow biopsy needle Kirschner wire kyphoplasty kyphoscoliosis kyphosis lung embolism metastasis mini open vertebral column resection mini open vertebrectomy nuclear magnetic resonance imaging outcome assessment pathologic fracture pedicle screw pedicle screw fixation postoperative complication priority journal radiculopathy spinal cord disease spine surgery surgical equipment surgical technique thoracic kyphosis thoracic spine thorax radiography walking difficulty LA - English M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1532-2653 0967-5868 SP - 841-845 ST - Feasibility of the mini-open vertebral column resection for severe thoracic kyphosis T2 - Journal of Clinical Neuroscience TI - Feasibility of the mini-open vertebral column resection for severe thoracic kyphosis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52905289&from=export http://dx.doi.org/10.1016/j.jocn.2013.10.001 VL - 21 ID - 829447 ER - TY - JOUR AB - We performed transoesophageal echocardiography on 20 patients with femoral neck fractures randomly treated with an uncemented Austin‐Moore or cemented Hastings hemiarthroplasty. Cemented arthroplasty caused greater and more prolonged embolic cascades than did uncemented arthroplasty. Some emboli were more than 3 cm in length. In some patients the cascades were associated with pulmonary hypertension, diminished oxygen tension and saturation, and the presence of fat and marrow in aspirates from the right atrium. AN - CN-00101091 AU - Christie, J. AU - Burnett, R. AU - Potts, H. R. AU - Pell, A. C. KW - Arthroplasty [*adverse effects] Bone Cements [*adverse effects] Echocardiography, Transesophageal Embolism [*diagnostic imaging, etiology] Femoral Neck Fractures [surgery] Heart Atria Heart Diseases [*diagnostic imaging, etiology] Humans Hypertension, Pulmonary [etiology] Intraoperative Complications [*diagnostic imaging] M1 - 3 M3 - Clinical Trial; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1994 SP - 409‐412 ST - Echocardiography of transatrial embolism during cemented and uncemented hemiarthroplasty of the hip T2 - Journal of bone and joint surgery. British volume TI - Echocardiography of transatrial embolism during cemented and uncemented hemiarthroplasty of the hip UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00101091/full VL - 76 ID - 830055 ER - TY - JOUR AB - We randomised 24 patients before they had a cemented hemiarthroplasty for hip fracture to receive either thorough or minimal saline lavage of the femoral canal. We then determined the effect in each group on the thromboembolic and cardiopulmonary responses to the pressurised insertion of cement, using transoesophageal echocardiography to show the echogenic embolic response. We found a statistically significant reduction in both the duration of the response and the number of large emboli in patients who had had thorough lavage as compared with the control group with minimal lavage. There was also less disturbance of pulmonary function, as assessed by the change in end‐tidal CO2 levels and oxygen saturation, in patients who had thorough lavage. Three patients had a significant fall in blood pressure during cement insertion; all had only minimal lavage. We consider that thorough lavage should be an essential part of the preparation of the proximal femur before cement insertion. AN - CN-00113886 AU - Christie, J. AU - Robinson, C. M. AU - Singer, B. AU - Ray, D. C. KW - Aged Aged, 80 and over Bone Marrow [surgery] Cementation Embolism [*prevention & control] Female Femoral Neck Fractures [*surgery] Hip Prosthesis [*adverse effects] Humans Male Therapeutic Irrigation Treatment Outcome M1 - 3 M3 - Clinical Trial; Controlled Clinical Trial; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1995 SP - 456‐459 ST - Medullary lavage reduces embolic phenomena and cardiopulmonary changes during cemented hemiarthroplasty T2 - Journal of bone and joint surgery. British volume TI - Medullary lavage reduces embolic phenomena and cardiopulmonary changes during cemented hemiarthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00113886/full VL - 77 ID - 830063 ER - TY - JOUR AD - Institute of Biomedical Engineering, National Yang Ming University, Taipei, Taiwan, ROC; Department of Orthopedics, Cheng Hsin General Hospital, Taipei, Taiwan, ROC. AN - 104072926. Language: English. Entry Date: 20140124. Revision Date: 20200708. Publication Type: Journal Article AU - Chu, William AU - Tsuei, Yu-Chuan AU - Liao, Pei-Hung AU - Lin, Jiun-Hung AU - Chou, Wen-Hsiang AU - Chu, Woei-Chyn AU - Young, Shuenn-Tsong DB - cin20 DO - 10.1016/j.injury.2012.10.017 DP - EBSCOhost KW - Fractures, Compression -- Surgery Kyphoplasty -- Adverse Effects Kyphoplasty -- Methods Osteoporosis -- Surgery Postoperative Complications -- Surgery Spinal Fractures -- Surgery Aged Aged, 80 and Over Bone Cements -- Adverse Effects Decompression, Surgical Extravasation of Diagnostic and Therapeutic Materials -- Complications Female Human Male Middle Age Osteoporosis -- Complications Postoperative Complications -- Etiology Prospective Studies Pulmonary Embolism -- Etiology Pulmonary Embolism -- Prevention and Control Spinal Cord Compression -- Etiology Spinal Cord Compression -- Prevention and Control Taiwan Treatment Outcomes M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2013 SN - 0020-1383 SP - 813-818 ST - Decompressed percutaneous vertebroplasty: A secured bone cement delivery procedure for vertebral augmentation in osteoporotic compression fractures T2 - Injury TI - Decompressed percutaneous vertebroplasty: A secured bone cement delivery procedure for vertebral augmentation in osteoporotic compression fractures UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104072926&site=ehost-live&scope=site VL - 44 ID - 830657 ER - TY - JOUR AB - Percutaneous vertebroplasty (PVP) is an effective treatment for lesions of the vertebral body that involves a percutaneous injection of polymethylmethacrylate (PMMA). Although PVP is considered to be minimally invasive, complications can occur during the procedure. We encountered a renal embolism of PMMA in a 57-year-old man that occurred during PVP. This rare case of PMMA leakage occurred outside of the anterior cortical fracture site of the L1 vertebral body, and multiple tubular bone cements migrated to the course of the renal vessels via the valveless collateral venous network surrounding the L1 body. Although the authors could not explain the exact cause of the renal cement embolism, we believe that physicians should be aware of the fracture pattern, anatomy of the vertebral venous system, and careful fluoroscopic monitoring to minimize the risks during the PVP. AD - Department of Diagnostic Radiology, Wooridul Spine Hospital, Seoul, Republic of Korea. eunrad@dreamwiz.com AN - 16362386 AU - Chung, S. E. AU - Lee, S. H. AU - Kim, T. H. AU - Yoo, K. H. AU - Jo, B. J. C2 - Pmc1602188 DA - Oct DO - 10.1007/s00586-005-0037-0 DP - NLM ET - 2005/12/20 J2 - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society KW - Bone Cements/*adverse effects/therapeutic use Embolism/diagnosis/*etiology Foreign-Body Migration/*complications/etiology Fractures, Bone/diagnosis/therapy Humans Kidney Diseases/diagnosis/*etiology Lumbar Vertebrae/injuries Magnetic Resonance Imaging Male Middle Aged Polymethyl Methacrylate/*adverse effects/therapeutic use Tomography, X-Ray Computed Ultrasonography Vertebroplasty/*adverse effects LA - eng M1 - Suppl 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0940-6719 (Print) 0940-6719 SP - 590-4 ST - Renal cement embolism during percutaneous vertebroplasty T2 - Eur Spine J TI - Renal cement embolism during percutaneous vertebroplasty VL - 15 Suppl 5 ID - 828777 ER - TY - JOUR AB - A case study of 59-year-old man is presented with abnormal chest radiograph, and history of compression fracture and traumatic spondylolisthesis because of a car accident. Treatment included percutaneous vertebroplasty and pedicle screw augmentation. Examination showed multiple linear hyperdense foreign bodies at the pulmonary arteries bilaterally and vertebroplasty with cement migration. He was suggested for patient anticoagulation treatment. AD - Internal Medicine Department, Kaohsiung Armed Forces General Hospital, Lingya District, Kaohsiung City, Taiwan (R.O.C.) AN - 122416486. Language: English. Entry Date: 20170421. Revision Date: 20171023. Publication Type: journal article AU - Chun-Yung, Chang AU - Shu-Fang, Huang AU - Chang, Chun-Yung AU - Huang, Shu-Fang DB - cin20 DO - 10.1503/cmaj.160579 DP - EBSCOhost KW - Pulmonary Embolism Vertebroplasty -- Adverse Effects Bone Cements -- Adverse Effects Male Pulmonary Embolism -- Etiology Radiography, Thoracic Middle Age Spondylolisthesis -- Surgery Disease Attributes Tomography, X-Ray Computed M1 - 14 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 0820-3946 SP - E543-E543 ST - Asymptomatic pulmonary cement embolism T2 - CMAJ: Canadian Medical Association Journal TI - Asymptomatic pulmonary cement embolism UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=122416486&site=ehost-live&scope=site VL - 189 ID - 830569 ER - TY - JOUR AB - This case describes a complication of bone cement use. A 65-year-old male patient with back spine trauma caused by a fall, underwent a percutaneous vertebroplasty. Five years later, he consulted for palpitations, and the electrocardiogram showed supraventricular arrhythmia. A transthoracic two-dimensional echocardiography showed a hyperechogenic linear structure of 7 cm length, running from the lateral wall of the right ventricle to the right atrium through the tricuspid valve. This foreign body, which was suspicious for bone cement embolism, appeared rigid and was attached at the lateral wall of the right ventricle, with its proximal end free in the right atrium. The tip of the cement embolus was inside the myocardium of the lateral wall of the right ventricle, with risk of cardiac perforation. A fluoroscopy was performed, which confirmed the presence of cement within the right heart, with great mobility in each cardiac cycle. Chest computed tomography (CT) and multidetector CT three-dimensional reconstruction confirmed the presence of cement within the right heart. Chest CT showed two pulmonary embolisms, one in the right upper lobe and one in the left lower pulmonary lobe. This case emphasizes the risk of late clinical manifestations of cardiac and pulmonary embolism of methylmethacrylate after percutaneous vertebroplasty, suggesting that the risk of such embolism might be underestimated. We propose routine chest radiography, two-dimensional echocardiography, and chest CT after every percutaneous vertebroplasty, to detect asymptomatic cardiac and pulmonary embolism and thereby prevent serious delayed cardiopulmonary failures. AD - Department of Cardiology, Hospital of the Government of the City of Buenos Aires "Dr. Cosme Argerich", Capital Federal, Buenos Aires, Argentina. Researcher of the Ministry of Health, Government of the City of Buenos Aires, Buenos Aires, Argentina. AN - 28573824 AU - Cianciulli, T. F. AU - Mc Loughlin, D. E. AU - Morita, L. A. AU - Saccheri, M. C. AU - Lax, J. A. DA - Aug DO - 10.1111/echo.13580 DP - NLM ET - 2017/06/03 J2 - Echocardiography (Mount Kisco, N.Y.) KW - Aged Bone Cements/*adverse effects Diagnosis, Differential Echocardiography Fluoroscopy Foreign-Body Migration/*complications/diagnosis Heart Diseases/diagnosis/*etiology Humans Imaging, Three-Dimensional Male Multidetector Computed Tomography *Postoperative Complications Pulmonary Embolism/diagnosis/*etiology Vertebroplasty/*adverse effects bone embolism cardiac and pulmonary embolism percutaneous vertebroplasty LA - eng M1 - 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 0742-2822 SP - 1239-1241 ST - Bone cement cardiac and pulmonary embolism T2 - Echocardiography TI - Bone cement cardiac and pulmonary embolism VL - 34 ID - 828588 ER - TY - JOUR AB - This report describes a case of successful percutaneous direct-puncture ethanol embolization, followed by vertebroplasty, of an aggressive vertebral hemangioma (VH) involving two adjacent thoracic vertebral levels. In this case, the 78-year-old male patient presented with a 6-month history of progressive paraparesis due to spinal cord compression by a T8-T9 VH with an extensive epidural component. Follow-up demonstrated epidural component shrinkage with complete regression of symptoms at 3 months. This case suggests that exclusive percutaneous treatment may be considered for symptomatic VH even when two adjacent vertebral levels are affected. AD - Department of Neuroradiology, Medical University of South Carolina, 169, Ashley Avenue, Charleston, SC 29425, USA; Department of Neuroradiology, Neurocenter of Italian Switzerland, Lugano, Switzerland. Electronic address: cianfoni@musc.edu. Department of Neuroradiology, Medical University of South Carolina, 169, Ashley Avenue, Charleston, SC 29425, USA. Electronic address: massarimd@gmail.com. Department of Neuroradiology, Medical University of South Carolina, 169, Ashley Avenue, Charleston, SC 29425, USA. Electronic address: gdani@gmail.com. Department of Neurological Surgery, Medical University of South Carolina, 169, Ashley Avenue, Charleston, SC 29425, USA. Electronic address: jrlena@gmail.com. Department of Neuroradiology, Medical University of South Carolina, 169, Ashley Avenue, Charleston, SC 29425, USA. Electronic address: rumbolz@musc.edu. Department of Neurological Surgery, Medical University of South Carolina, 169, Ashley Avenue, Charleston, SC 29425, USA. Electronic address: wavandergrift@gmail.com. Neuroradiology Unit, Ospedali Riuniti di Bergamo, Bergamo, Italy. Electronic address: mail@bonaldi.org. AN - 23419714 AU - Cianfoni, A. AU - Massari, F. AU - Dani, G. AU - Lena, J. R. AU - Rumboldt, Z. AU - Vandergrift, W. A. AU - Bonaldi, G. DA - Oct DO - 10.1016/j.neurad.2012.10.003 DP - NLM ET - 2013/02/20 J2 - Journal of neuroradiology = Journal de neuroradiologie KW - Aged Bone Cements/*therapeutic use Combined Modality Therapy/methods Embolization, Therapeutic/*methods Ethanol/*therapeutic use Hemangioma/diagnosis/*therapy Humans Male Spinal Neoplasms/diagnosis/*therapy *Thoracic Vertebrae Treatment Outcome Vertebroplasty/*methods Ethanol embolization Spine Vertebral hemangiomas Vertebroplasty LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 0150-9861 (Print) 0150-9861 SP - 269-74 ST - Percutaneous ethanol embolization and cement augmentation of aggressive vertebral hemangiomas at two adjacent vertebral levels T2 - J Neuroradiol TI - Percutaneous ethanol embolization and cement augmentation of aggressive vertebral hemangiomas at two adjacent vertebral levels VL - 41 ID - 828876 ER - TY - JOUR AB - This report describes a case of successful percutaneous direct-puncture ethanolembolization, followed by vertebroplasty, of an aggressive vertebral hemangioma (VH) involvingtwo adjacent thoracic vertebral levels. In this case, the 78-year-old male patient presented witha 6-month history of progressive paraparesis due to spinal cord compression by a T8-T9 VH withan extensive epidural component. Follow-up demonstrated epidural component shrinkage withcomplete regression of symptoms at 3 months. This case suggests that exclusive percutaneoustreatment may be considered for symptomatic VH even when two adjacent vertebral levels areaffected. AD - F. Massari, Department of Neuroradiology, Medical University of South Carolina, 169, Ashley Avenue, Charleston, SC, United States AU - Cianfoni, A. AU - Massari, F. AU - Lena, G. D. AU - Rumboldt, Z. AU - Bonaldi, W. A. DB - Embase Medline DO - 10.1016/j.neurad.2012.10.003 KW - alcohol cement poly(methyl methacrylate) aged article artificial embolization bone necrosis brain biopsy case report clinical feature compression fracture computer assisted tomography core biopsy needle diagnostic imaging differential diagnosis disease association disease course follow up human human tissue image analysis male medical history nuclear magnetic resonance imaging outcome assessment patient assessment percutaneous vertebroplasty recurrent disease spinal hematoma LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1773-0406 0150-9861 SP - 269-274 ST - Percutaneous ethanol embolization and cementaugmentation of aggressive vertebral hemangiomasat two adjacent vertebral levels T2 - Journal of Neuroradiology TI - Percutaneous ethanol embolization and cementaugmentation of aggressive vertebral hemangiomasat two adjacent vertebral levels UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52445997&from=export http://dx.doi.org/10.1016/j.neurad.2012.10.003 VL - 41 ID - 829444 ER - TY - JOUR AB - The hypothetical basis of this trial specifies that hemiarthroplasty applications without cement will prove to be superior to applications with cement in terms of survival, complications, clinical and radiological improvements in the early stages of femoral neck fracture cases, which belongs to the Society of Anesthesiologists (ASA) class III group. Society of Anesthesiologists (ASA) class III elderly patients (minimum 70 years of age), who had undergone surgical interventions for femoral neck fractures were classified into two groups as those undergoing the intervention without cement (Group A) and those undergoing the procedure with cement (Group B), and these were retrospectively evaluated. The patients were followed up for a mean duration of 47.4 and 44.8 months, respectively. Survival in the early stage, duration of stay in the intensive care, intraoperative cardiac indexes, complications, clinical and radiological parameters were the main factors used in the evaluation and comparisons. The mean duration of operation in Group B cases was determined to be statistically significantly longer than that of Group A (p < 0.001). The postoperative stay at the intensive care unit in both groups and the rate of mortality for 6 months in Group B were determined to be statistically significantly high (p < 0.05). In group B, significant depressive findings were determined in the comparison of the intra-operative pre-and post-cement cardiac indexes. In the clinical assessment, no statistically significant results were obtained, although higher final Harris scores were determined in Group A cases (p = 0.581). In the treatment of femoral neck fractures, bipolar hemiarthroplasty applications without cement provide favourable early and short-term results, which are at least as effective as the applications with cement. AD - F. Seyfettinoglu, Adana Numune Training and Research Hospital, Orthopaedi and Traumatology Department, Adana, Turkey AU - Cicek, H. AU - Seyfettinoglu, F. AU - Kilicarslan, K. AU - Ogur, H. U. AU - Öztürk, L. AU - Inkaya, E. DB - Embase Medline DO - 10.1016/j.injury.2015.05.019 KW - cemented prosthesis cementless prosthesis aged article cardiovascular disease chronic kidney failure controlled study diabetic nephropathy embolism fatality female femoral neck fracture follow up heart failure cardiac index heterotopic ossification hip arthroplasty human intensive care kidney carcinoma length of stay lung embolism major clinical study male operation duration periprosthetic fracture postoperative complication priority journal prosthesis infection prosthesis loosening radiological parameters reoperation retrospective study surgical infection surgical mortality Corin MetaFix Corin TapeFit LA - English M1 - 8 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1879-0267 0020-1383 SP - 1567-1570 ST - What should be the preferred choice of hemiarthroplasty technique in American Society of Anesthesiologists (ASA) class III patients with femoral neck fractures? Cemented or cementless T2 - Injury TI - What should be the preferred choice of hemiarthroplasty technique in American Society of Anesthesiologists (ASA) class III patients with femoral neck fractures? Cemented or cementless UR - https://www.embase.com/search/results?subaction=viewrecord&id=L604478271&from=export http://dx.doi.org/10.1016/j.injury.2015.05.019 VL - 46 ID - 829367 ER - TY - JOUR AB - Intraosseous mandibular arteriovenous malformations (AVMs) are congenital vascular lesions that may present with life threatening hemorrhage. We describe a case of mandibular AVM emergently treated by molar extraction and direct hydroxyapatite cement infusion into the mandibular cavity. AD - C. Cinar, Radiology, Ege University, Faculty of Medicine, Izmir, Turkey AU - Cinar, C. AU - Bozkaya, H. AU - Oran, I. AU - Parildar, M. DB - Embase KW - hydroxyapatite cement arteriovenous malformation injection society Europe artificial embolization vascular lesion bleeding infusion tooth extraction LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0174-1551 SP - S274 ST - Embolization of a mandibular arteriovenous malformation through a direct hydroxyapatite cement injection into the molar cavity T2 - CardioVascular and Interventional Radiology TI - Embolization of a mandibular arteriovenous malformation through a direct hydroxyapatite cement injection into the molar cavity UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71323453&from=export VL - 36 ID - 829486 ER - TY - JOUR AB - Presurgical devascularization of hypervascular spinal metastases has been shown to be effective in preventing major blood loss during open surgery. Most often, embolization can be performed using polyvinyl alcohol (PVA) microparticles. However, in some cases, the close relationship between the feeders of the metastases and the feeders of the anterior spinal artery (ASA) poses a risk of spinal cord ischemia when PVA microparticle embolization is performed. The authors present their early experience in the treatment of spinal metastases close to the ASA; in 2 cases they injected Onyx-18, by direct puncture, into hypervascular posterior arch spinal metastases situated close to the ASA. Two women, one 36 and the other 55 years of age, who presented with spinal lesions (at the posterior arch of C-4 and T-6, respectively) from thyroid and a kidney tumors, were sent to the authors' department to undergo presurgical embolization. After having performed a complete spinal digital subtraction angiography study, a regular angiography catheter was positioned at the ostium of the artery that mainly supplied the lesion. Then, with the patient in the left lateral decubitus position, direct puncture with 18-gauge needles of the lesion was performed using roadmap guidance. Onyx-18 was injected through the needles under biplanar fluoroscopy. Satisfactory devascularization of the lesions was obtained; the ASA remained patent in both cases. The metastases were surgically removed in both cases within the 48 hours after the embolization and major blood loss did not occur. Presurgical devascularization of hypervascular spinal metastases close the ASA by direct puncture with Onyx- 18 seems to be an effective technique and appears to be safe in terms of the preserving the ASA's patency. © 2013 AANS. AD - F. Clarençon, Department of Neuroradiology, Pitié-Salpêtrière Hospital, 47, Boulevard de l'Hôpital, 75013 Paris, France AU - Clarençon, F. AU - Di Maria, F. AU - Cormier, E. AU - Sourour, N. A. AU - Enkaoua, E. AU - Sailhan, F. AU - Iosif, C. AU - Le Jean, L. AU - Chiras, C. C1 - kefandol(Lilly) DB - Embase Medline DO - 10.3171/2013.3.SPINE12832 KW - cefamandole contrast medium methylprednisolone onyx copolymer adult anterior spinal artery anticoagulant therapy article artificial embolization case report computer assisted tomography deterioration devascularization digital subtraction angiography drug distribution female fluoroscopy follow up human job experience kidney cancer laminectomy motor performance nuclear magnetic resonance imaging patient safety percutaneous vertebroplasty peroperative care recurrent disease spinal cord compression spinal cord decompression spinal cord ischemia spine metastasis thyroid cancer vascular patency vertebral artery kefandol L1 - http://thejns.org/doi/pdf/10.3171/2013.3.SPINE12832 LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1547-5654 1547-5646 SP - 606-610 ST - Onyx injection by direct puncture for the treatment of hypervascular spinal metastases close to the anterior spinal artery: Initial experience T2 - Journal of Neurosurgery: Spine TI - Onyx injection by direct puncture for the treatment of hypervascular spinal metastases close to the anterior spinal artery: Initial experience UR - https://www.embase.com/search/results?subaction=viewrecord&id=L369049460&from=export http://dx.doi.org/10.3171/2013.3.SPINE12832 VL - 18 ID - 829489 ER - TY - JOUR AB - Purpose To evaluate the safety and clinical effectiveness of percutaneous vertebroplasty (PVP) in patients aged 80 and over. One hundred and seventy-three patients (127 women, 46 men; mean age = 84.2y) underwent 201 PVP procedures (391 vertebrae) in our institution from June 2008 to March 2012. One hundred and twenty-six patients (73 %) had osteoporotic vertebral compression fractures (VCF), 36 (20.5 %) were treated for tumour lesions, and the remaining 11 (6.5 %) for lesions from another cause. Comorbidities and American Society of Anesthesiologists (ASA) scores were assessed before treatment. Periprocedural and delayed complications were systematically recorded. A qualitative scale was used to evaluate pain relief at 1-month follow-up, ranging from significant pain worsening to marked improvement or disappearance. New fracture occurrence was assessed on follow-up imaging. Forty-five percent of patients had pretreatment ASA class scores a parts per thousand yen3. No major complication occurred. Pain was unchanged in 16.9 % of cases, mildly improved in 31.5 %, and disappeared in 47.8 %. We identified 27 (11 %) symptomatic new VCFs in patients with osteoporosis on follow-up imaging. The mean delay in diagnosis of new fractures was 5 +/- 8.7 months. Even in the elderly, PVP remains a safe and effective technique for pain relief, independently of the underlying disease. aEuro cent Post-PVP pain improvement was observed in 79.3 % of elderly patients. aEuro cent PVP remains a safe technique in elderly patients. aEuro cent No decompensation of comorbidity was observed in our series. AD - [Clarencon, Frederic; Fahed, Robert; Gabrieli, Joseph; Cormier, Evelyne; Molet-Benhamou, Luc; Chiras, Jacques] Hop La Pitie Salpetriere, Dept Intervent Neuroradiol, Paris, France. [Clarencon, Frederic; Gabrieli, Joseph; Dadoun, Sabrina; Chiras, Jacques] Univ Paris 06, Paris, France. [Guermazi, Yessine] Sfax Univ Hosp, Dept Radiol, Sfax, Tunisia. [Jean, Betty] Clermont Ferrand Univ Hosp, Dept Neuroradiol, Clermont Ferrand, France. [Dadoun, Sabrina] Hop La Pitie Salpetriere, Dept Rheumatol, Paris, France. [Rose, Michele; Le Jean, Lise] Hop La Pitie Salpetriere, Dept Anaesthesiol, Paris, France. Clarencon, F (corresponding author), Hop La Pitie Salpetriere, Dept Intervent Neuroradiol, Paris, France.; Clarencon, F (corresponding author), Univ Paris 06, Paris, France. fredclare5@msn.com AN - WOS:000377996200042 AU - Clarencon, F. AU - Fahed, R. AU - Gabrieli, J. AU - Guermazi, Y. AU - Cormier, E. AU - Molet-Benhamou, L. AU - Jean, B. AU - Dadoun, S. AU - Rose, M. AU - Le Jean, L. AU - Chiras, J. DA - Jul DO - 10.1007/s00330-015-4035-2 J2 - Eur. Radiol. KW - Percutaneous vertebroplasty Elderly Pain relief Vertebral fracture Imaging modality VERTEBRAL COMPRESSION FRACTURES PULMONARY CEMENT EMBOLISM TERM-FOLLOW-UP SPINAL METASTASES CANCER-PATIENTS EXPERIENCE DISEASE Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 7 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2016 SN - 0938-7994 SP - 2352-2358 ST - Safety and Clinical Effectiveness of Percutaneous Vertebroplasty in the Elderly (>= 80 years) T2 - European Radiology TI - Safety and Clinical Effectiveness of Percutaneous Vertebroplasty in the Elderly (>= 80 years) UR - ://WOS:000377996200042 VL - 26 ID - 830212 ER - TY - JOUR AB - Purpose: To evaluate the safety and clinical effectiveness of percutaneous vertebroplasty (PVP) in patients aged 80 and over. Methods: One hundred and seventy-three patients (127 women, 46 men; mean age = 84.2y) underwent 201 PVP procedures (391 vertebrae) in our institution from June 2008 to March 2012. One hundred and twenty-six patients (73 %) had osteoporotic vertebral compression fractures (VCF), 36 (20.5 %) were treated for tumour lesions, and the remaining 11 (6.5 %) for lesions from another cause. Comorbidities and American Society of Anesthesiologists (ASA) scores were assessed before treatment. Periprocedural and delayed complications were systematically recorded. A qualitative scale was used to evaluate pain relief at 1-month follow-up, ranging from significant pain worsening to marked improvement or disappearance. New fracture occurrence was assessed on follow-up imaging. Results: Forty-five percent of patients had pretreatment ASA class scores ≥3. No major complication occurred. Pain was unchanged in 16.9 % of cases, mildly improved in 31.5 %, and disappeared in 47.8 %. We identified 27 (11 %) symptomatic new VCFs in patients with osteoporosis on follow-up imaging. The mean delay in diagnosis of new fractures was 5 ± 8.7 months. Conclusions: Even in the elderly, PVP remains a safe and effective technique for pain relief, independently of the underlying disease. Key Points: • Post-PVP pain improvement was observed in 79.3 % of elderly patients. • PVP remains a safe technique in elderly patients. • No decompensation of comorbidity was observed in our series. AD - F. Clarençon, Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France AU - Clarençon, F. AU - Fahed, R. AU - Gabrieli, J. AU - Guermazi, Y. AU - Cormier, E. AU - Molet-Benhamou, L. AU - Jean, B. AU - Dadoun, S. AU - Rose, M. AU - Le Jean, L. AU - Chiras, J. C1 - aspirin DB - Embase Medline DO - 10.1007/s00330-015-4035-2 KW - bone cement device acetylsalicylic acid angiogenesis inhibitor anticoagulant agent antithrombocytic agent antivitamin K cefazolin low molecular weight heparin narcotic analgesic agent poly(methyl methacrylate) aged aging allergy American Society of Anesthesiologist score analgesia anticoagulant therapy article bone cement leakage chronic atrial fibrillation clinical assessment clinical effectiveness comorbidity compression fracture controlled study diagnostic imaging female follow up fragility fracture hematologic disease hematoma human lung embolism major clinical study male patient safety percutaneous vertebroplasty perioperative period postoperative pain priority journal rating scale scoring system spinal cord compression spine fracture spine metastasis surgical patient symptom vertebral compression fracture very elderly aspirin Biomet V Cement LA - English M1 - 7 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1432-1084 0938-7994 SP - 2352-2358 ST - Safety and Clinical Effectiveness of Percutaneous Vertebroplasty in the Elderly (≥80 years) T2 - European Radiology TI - Safety and Clinical Effectiveness of Percutaneous Vertebroplasty in the Elderly (≥80 years) UR - https://www.embase.com/search/results?subaction=viewrecord&id=L606537567&from=export http://dx.doi.org/10.1007/s00330-015-4035-2 VL - 26 ID - 829311 ER - TY - JOUR AB - In a prospective, controlled study, we measured the effect on cardiac output of the introduction of methylmethacrylate during hemiarthroplasty for displaced fractures of the femoral neck. We treated 20 elderly patients who were similar in age, height, weight and preoperative left ventricular function with either cemented or uncemented hemiarthroplasty. Using a transoesophageal Doppler probe, we measured cardiac output before incision and at six stages of the procedure: during the surgical approach, reaming and lavage of the femoral canal, the introduction of cement, the insertion of the prosthesis, and in reduction and closure. We found that before the cement was introduced, there was no difference in stroke volume or cardiac output (p > 0.25). Cementation produced a transient but significant reduction in cardiac output of 33% (p < 0.01) and a reduction in stroke volume of 44% (p < 0.02). The introduction of cement did not affect the heart rate or mean arterial pressure. There was no significant difference in cardiac function on insertion of the prosthesis. Standard non‐invasive haemodynamic monitoring did not detect the cardiovascular changes which may account for the sudden deaths that sometimes occur during cemented hemiarthroplasty. The fall in stroke volume and cardiac output may be caused by embolism occurring during cementation, but there was no similar fall during reaming or insertion of the prosthesis. AN - CN-00354901 AU - Clark, D. I. AU - Ahmed, A. B. AU - Baxendale, B. R. AU - Moran, C. G. DO - 10.1302/0301-620x.83b3.11477 KW - Aged Arthroplasty, Replacement, Hip [*adverse effects] Bone Cements [*adverse effects] Cardiac Output [*physiology] Echocardiography, Transesophageal Femoral Neck Fractures [surgery] Hip Prosthesis Humans Methylmethacrylate Middle Aged Prospective Studies Prosthesis Design Stroke Volume [physiology] M1 - 3 M3 - Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2001 SP - 414‐418 ST - Cardiac output during hemiarthroplasty of the hip. A prospective, controlled trial of cemented and uncemented prostheses T2 - Journal of bone and joint surgery. British volume TI - Cardiac output during hemiarthroplasty of the hip. A prospective, controlled trial of cemented and uncemented prostheses UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00354901/full VL - 83 ID - 830033 ER - TY - JOUR AB - Aims Cementless primary total hip arthroplasty (THA) is associated with risks of bleeding and thromboembolism. Anticoagulants are effective as venous thromboprophylaxis, but with an increased risk of bleeding. Tranexamic acid (TXA) is an efficient antifibrinolytic agent, but the mode and timing of its administration remain controversial. This study aimed to determine whether two intravenous (IV) TXA regimens (a three‐hour two‐dose (short‐TXA) and 11‐hour four‐dose (long‐TXA)) were more effective than placebo in reducing perioperative real blood loss (RBL, between baseline and day 3 postoperatively) in patients undergoing THA who receive rivaroxaban as thromboprophylaxis. The secondary aim was to assess the non‐inferiority of the reduction of blood loss of the short protocol versus the long protocol. Patients and Methods A multicentre, prospective, randomized, double‐blind, placebo‐controlled trial was undertaken involving 229 patients undergoing primary cementless THA using a posterior approach, whose extended rivaroxaban thromboprophylaxis started on the day of surgery. There were 98 male and 131 female patients, with a mean age of 65.5 years (32 to 91). The primary outcome, perioperative RBL, was evaluated at 72 hours postoperatively. The efficacy of short‐ and long‐TXA protocols in the reduction of perioperative RBL was compared with a placebo group. Results TXA significantly reduced perioperative blood loss compared with placebo (p < 0.001); the mean differences were 525.3 ml (short‐TXA vs placebo) and 550.1 ml (long‐TXA vs placebo). No venous or arterial thromboembolic complications were reported. The upper boundary of the 95% confidence interval, when comparing short and long protocols, was below the pre‐specified margin of non‐inferiority (p = 0.027). Conclusion In patients undergoing primary cementless THA, using a posterior approach, who are treated with rivaroxaban for thromboembolic prophylaxis, short‐ and long‐TXA IV protocols are significantly more effective than placebo in reducing perioperative RBL, without any thromboembolic complications. Non‐inferiority of a short‐ versus a long‐TXA protocol in reducing perioperative RBL was supported in a secondary analysis. AN - CN-02052785 AU - Clave, A. AU - Gerard, R. AU - Lacroix, J. AU - Baynat, C. AU - Danguy des Deserts, M. AU - Gatineau, F. AU - Mottier, D. DO - 10.1302/0301-620X.101B2.BJJ-2018-0898.R1 KW - *operative blood loss *total hip replacement Aged Ambulatory surgery Article Complication Controlled study Double blind procedure Drug combination Drug therapy Female Human Major clinical study Male Multicenter study Outcome assessment Prophylaxis Prospective study Randomized controlled trial Secondary analysis Surgery Vein embolism M1 - 2 M3 - Journal: Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2019 SP - 207‐212 ST - A randomized, double-blind, placebo-controlled trial on the efficacy of tranexamic acid combined with rivaroxaban thromboprophylaxis in reducing blood loss after primary cementless total hip arthroplasty T2 - Bone and joint journal TI - A randomized, double-blind, placebo-controlled trial on the efficacy of tranexamic acid combined with rivaroxaban thromboprophylaxis in reducing blood loss after primary cementless total hip arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02052785/full VL - 101‐B ID - 830082 ER - TY - JOUR AD - Department of Medical Imaging, Cliniques Universitaires St-Luc, Brussels, Belgium. AN - 17555080 AU - Coche, E. DA - Mar-Apr DP - NLM ET - 2007/06/09 J2 - JBR-BTR : organe de la Societe royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR) KW - Aged Bone Cements/*adverse effects Extravasation of Diagnostic and Therapeutic Materials/*diagnostic imaging Humans Male Pulmonary Embolism/*diagnostic imaging/*etiology Spinal Fractures/*surgery Tomography, X-Ray Computed LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 0302-7430 (Print) 0302-7430 SP - 138 ST - Cement pulmonary embolism after percutaneous vertebroplasty T2 - Jbr-btr TI - Cement pulmonary embolism after percutaneous vertebroplasty VL - 90 ID - 828961 ER - TY - JOUR AN - 5098710 AU - Cohen, C. A. AU - Smith, T. C. DA - Nov DO - 10.1097/00000542-197111000-00020 DP - NLM ET - 1971/11/01 J2 - Anesthesiology KW - Acrylic Resins/*adverse effects Atropine/administration & dosage Autopsy Bone Cements/*adverse effects Diazepam/administration & dosage Electrocardiography Female Femur/surgery Fentanyl/administration & dosage Heart Arrest/etiology Humans Injections, Intravenous Intubation, Intratracheal Lung/pathology Middle Aged Oxygen Prostheses and Implants Pulmonary Edema/etiology Pulmonary Embolism/chemically induced/pathology Tetracaine/administration & dosage LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 1971 SN - 0003-3022 (Print) 0003-3022 SP - 547-9 ST - The intraoperative hazard of acrylic bone cement: report of a case T2 - Anesthesiology TI - The intraoperative hazard of acrylic bone cement: report of a case VL - 35 ID - 828966 ER - TY - JOUR AN - 20920681 AU - Cohen, J. AU - Lane, T. DA - Oct DO - 10.1016/j.amjmed.2010.01.037 DP - NLM ET - 2010/10/06 J2 - The American journal of medicine KW - Aged Embolism/diagnostic imaging/*etiology Foreign Bodies/diagnostic imaging/*etiology *Heart Atria *Heart Ventricles Humans Male *Polymethacrylic Acids Radiography Vertebroplasty/*adverse effects LA - eng M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 0002-9343 SP - e5-6 ST - Right intra-atrial and ventricular polymethylmethacrylate embolus after balloon kyphoplasty T2 - Am J Med TI - Right intra-atrial and ventricular polymethylmethacrylate embolus after balloon kyphoplasty VL - 123 ID - 828542 ER - TY - JOUR AD - Department of Anesthesiology, Moffitt Cancer Center, Tampa, FL, USA. AN - 22388069 AU - Cohen, J. B. DA - Aug DO - 10.1097/ALN.0b013e31824de99a DP - NLM ET - 2012/03/06 J2 - Anesthesiology KW - Aged Bone Cements/*adverse effects Diagnosis, Differential Female Foreign Bodies/diagnostic imaging/surgery Heart Ventricles/diagnostic imaging/surgery Humans Hypotension/etiology Hypoxia/etiology Methylmethacrylate/adverse effects Pulmonary Embolism/diagnosis/*etiology/surgery Radiography Syndrome Tachycardia, Ventricular/etiology Thoracic Vertebrae Treatment Outcome Ultrasonography LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0003-3022 SP - 407 ST - Bone cement embolism T2 - Anesthesiology TI - Bone cement embolism VL - 117 ID - 828743 ER - TY - JOUR AD - Department of Anesthesiology, Moffitt Cancer Center, Tampa, FL, USA Department of Anesthesiology, Moffitt Cancer Center, Tampa, Florida, and Department of Interdisciplinary Oncology, University of South Florida, Tampa, Florida. jonathan.cohen@moffitt.org. AN - 108138189. Language: English. Entry Date: 20121026. Revision Date: 20170406. Publication Type: journal article AU - Cohen, J. B. AU - Cohen, Jonathan B. DB - cin20 DO - 10.1097/ALN.0b013e31824de99a DP - EBSCOhost KW - Bone Cements -- Adverse Effects Pulmonary Embolism -- Etiology Aged Anoxia -- Etiology Diagnosis, Differential Female Foreign Bodies -- Radiography Foreign Bodies -- Surgery Foreign Bodies -- Ultrasonography Heart Ventricle -- Radiography Heart Ventricle -- Surgery Heart Ventricle -- Ultrasonography Hypotension -- Etiology Methylmethacrylates -- Adverse Effects Pulmonary Embolism -- Diagnosis Pulmonary Embolism -- Surgery Syndrome Tachycardia, Ventricular -- Etiology Thoracic Vertebrae Treatment Outcomes M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2012 SN - 0003-3022 SP - 407-407 ST - Bone cement embolism T2 - Anesthesiology TI - Bone cement embolism UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=108138189&site=ehost-live&scope=site VL - 117 ID - 830674 ER - TY - JOUR AB - Melanoma metastatic to bone carries a poor prognosis with overall median survival in the 4-6 months range. Others have published data that suggest resection of isolated visceral organ metastases improves survival. We conducted a retrospective analysis of 130 cases of stage IV melanoma with pathologically confirmed bony disease. We used Cox regression survival analysis to compare a group of patients who underwent wide resection of metastases with those who received other surgery or were treated nonoperatively. We also compared the three groups against matched historical stage IV melanoma controls to determine differences between expected and observed 1-year overall survival. Median overall survival for the nonoperative (N=80), intralesional (N=32), and resection (N=18) groups was 4.8, 5.1, and 11.8 months, respectively. Cox regression survival analysis confirmed the overall survival benefit resulting from wide resection (hazard ratio 0.53) after correcting for independent predictors of worse survival, such as pathologic spinal compression fracture (hazard ratio 1.68). The observed 1-year overall survival rate in the resection group was nearly double that of matched historical controls (50.0 vs. 24.8%). We present the largest known series of bony melanoma, along with data which suggest that overall survival may be improved in carefully selected patients where all known macroscopic disease can be resected. Level of evidence: level III. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. AD - M.W. Colman, Department of Orthopedic Surgery, Division of Musculoskeletal Oncology, University of Pittsburgh Medical Center, 1395 East Claybourne Avenue, Salt Lake City, UT 84106, United States AU - Colman, M. W. AU - Kirkwood, J. M. AU - Schott, T. AU - Goodman, M. A. AU - McGough Iii, R. L. DB - Embase Medline DO - 10.1097/CMR.0000000000000076 KW - adjacent segment collapse article bone metastasis cancer control cancer growth cancer radiotherapy cancer recurrence cancer staging cause of death conservative treatment controlled study deep vein thrombosis female human kyphoplasty liquorrhea lung embolism lung metastasis major clinical study male medical record review melanoma metastasis resection multiple organ failure overall survival pathologic fracture postoperative complication postoperative period priority journal reoperation spinal compression fracture surgical infection wide excision LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1473-5636 0960-8931 SP - 354-359 ST - Does metastasectomy improve survival in skeletal melanoma? T2 - Melanoma Research TI - Does metastasectomy improve survival in skeletal melanoma? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L53121139&from=export http://dx.doi.org/10.1097/CMR.0000000000000076 VL - 24 ID - 829449 ER - TY - JOUR AB - BACKGROUND: Developmental dysplasia of the hip (DDH) is a common cause of secondary osteoarthritis (OA) in younger patients, and when end-stage OA develops, a THA can provide a solution. Different options have been developed to reconstruct these defects, one of which is impaction bone grafting combined with a cemented cup. To determine the true value of a specific technique, it is important to evaluate patients at a long-term followup. As there are no long-term studies, to our knowledge, on THA in patients with DDH using impaction bone grafting with a cemented cup, we present the results of this technique at a mean of 15 years in patients with previous DDH. QUESTIONS/PURPOSES: We wished to determine (1) the long-term probability of cup revision at a minimum followup of 15 years for cemented acetabular impaction bone grafting in patients with DDH; (2) the radiographic appearance of the bone graft and radiographic signs of implant loosening; and (3) the complications and pre- and postoperative Harris hip scores with cemented THA combined with impaction bone grafting in patients with previous DDH. METHODS: Between January 1984 and December 1995 we performed 28 acetabular impaction bone grafting procedures for secondary OA believed to be caused by DDH in 22 patients; four patients died before 15 years, leaving 24 hips in 18 patients for retrospective analysis at a minimum of 15 years (mean, 20 years; range, 16-29 years). The diagnosis of DDH was made according to preoperative radiographs and intraoperative findings. All grades of dysplasia were included; five patients had Crowe Group I, eight had Group II, nine had Group III, and two had Group IV DDH. No patients were lost to followup. In all cases the acetabular defects were combined cavitary and segmental. Owing to the high number of deaths, we performed a competing-risk analysis to determine the probability of cup revision surgery. RESULTS: The competing-risk analysis showed cumulative incidences at 15 and 20 years, with endpoint revision for any reason of 7% (95% CI, 0%-17%), whereas this was 4% (95% CI, 0%-11%) with endpoint revision of the cup for aseptic loosening. Three revision surgeries were performed. Two cup revisions were performed for aseptic loosening at 12 and 26 years. Another cup revision was performed owing to sciatic nerve problems at 2 years. A stable radiographic appearance of the graft was seen in 19 of the 25 unrevised hips. Four hips showed acetabular radiolucent lines and two showed acetabular osteolysis. None of the unrevised cups showed migration or radiographic failure. Postoperative complications included a pulmonary embolus and a superficial wound infection. The Harris hip score improved from 37 (range, 9-72) preoperatively to 83 (range, 42-99) at latest followup. CONCLUSIONS: Cemented primary THA with the use of impaction bone grafting shows satisfying long-term results in patients with previous DDH. For future research it is important to evaluate this technique in a larger cohort with a long-term followup. Other techniques also should be evaluated at long-term followup to be able to compare different techniques in this important and specific patient group. LEVEL OF EVIDENCE: Level IV, therapeutic study. AD - Department of Orthopaedic Surgery, Radboud University Medical Center, Nijmegen, Netherlands. Department of Orthopaedic Surgery, Radboud University Medical Center, Nijmegen, Netherlands. Wim.Schreurs@radboudumc.nl. Department of Orthopaedic Surgery 611, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, Netherlands. Wim.Schreurs@radboudumc.nl. AN - 27492686 AU - Colo, E. AU - Rijnen, W. H. AU - Gardeniers, J. W. AU - van Kampen, A. AU - Schreurs, B. W. C2 - Pmc5052201 DA - Nov DO - 10.1007/s11999-016-4998-6 DP - NLM ET - 2016/08/06 J2 - Clinical orthopaedics and related research KW - Adult Aged *Arthroplasty, Replacement, Hip/adverse effects/instrumentation Biomechanical Phenomena *Bone Transplantation/adverse effects Female Follow-Up Studies Hip Dislocation, Congenital/complications/diagnostic imaging/physiopathology/*surgery Hip Joint/abnormalities/diagnostic imaging/physiopathology/*surgery Hip Prosthesis Humans Male Middle Aged Osteoarthritis, Hip/diagnostic imaging/etiology/physiopathology/*surgery Prosthesis Failure Reoperation Retrospective Studies Risk Assessment Risk Factors Time Factors Treatment Outcome LA - eng M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 0009-921X (Print) 0009-921x SP - 2462-2468 ST - Satisfying Results of Primary Hip Arthroplasty in Patients With Hip Dysplasia at a Mean Followup of 20 Years T2 - Clin Orthop Relat Res TI - Satisfying Results of Primary Hip Arthroplasty in Patients With Hip Dysplasia at a Mean Followup of 20 Years VL - 474 ID - 829018 ER - TY - JOUR AB - Background: Developmental dysplasia of the hip (DDH) is a common cause of secondary osteoarthritis (OA) in younger patients, and when end-stage OA develops, a THA can provide a solution. Different options have been developed to reconstruct these defects, one of which is impaction bone grafting combined with a cemented cup. To determine the true value of a specific technique, it is important to evaluate patients at a long-term followup. As there are no long-term studies, to our knowledge, on THA in patients with DDH using impaction bone grafting with a cemented cup, we present the results of this technique at a mean of 15 years in patients with previous DDH. Questions/purposes: We wished to determine (1) the long-term probability of cup revision at a minimum followup of 15 years for cemented acetabular impaction bone grafting in patients with DDH; (2) the radiographic appearance of the bone graft and radiographic signs of implant loosening; and (3) the complications and pre- and postoperative Harris hip scores with cemented THA combined with impaction bone grafting in patients with previous DDH. Methods: Between January 1984 and December 1995 we performed 28 acetabular impaction bone grafting procedures for secondary OA believed to be caused by DDH in 22 patients; four patients died before 15 years, leaving 24 hips in 18 patients for retrospective analysis at a minimum of 15 years (mean, 20 years; range, 16–29 years). The diagnosis of DDH was made according to preoperative radiographs and intraoperative findings. All grades of dysplasia were included; five patients had Crowe Group I, eight had Group II, nine had Group III, and two had Group IV DDH. No patients were lost to followup. In all cases the acetabular defects were combined cavitary and segmental. Owing to the high number of deaths, we performed a competing-risk analysis to determine the probability of cup revision surgery. Results: The competing-risk analysis showed cumulative incidences at 15 and 20 years, with endpoint revision for any reason of 7% (95% CI, 0%–17%), whereas this was 4% (95% CI, 0%–11%) with endpoint revision of the cup for aseptic loosening. Three revision surgeries were performed. Two cup revisions were performed for aseptic loosening at 12 and 26 years. Another cup revision was performed owing to sciatic nerve problems at 2 years. A stable radiographic appearance of the graft was seen in 19 of the 25 unrevised hips. Four hips showed acetabular radiolucent lines and two showed acetabular osteolysis. None of the unrevised cups showed migration or radiographic failure. Postoperative complications included a pulmonary embolus and a superficial wound infection. The Harris hip score improved from 37 (range, 9–72) preoperatively to 83 (range, 42–99) at latest followup. Conclusions: Cemented primary THA with the use of impaction bone grafting shows satisfying long-term results in patients with previous DDH. For future research it is important to evaluate this technique in a larger cohort with a long-term followup. Other techniques also should be evaluated at long-term followup to be able to compare different techniques in this important and specific patient group. Level of Evidence: Level IV, therapeutic study. AD - B.W. Schreurs, Department of Orthopaedic Surgery 611, Radboud University Medical Center, PO Box 9101, Nijmegen, Netherlands AU - Colo, E. AU - Rijnen, W. H. C. AU - Gardeniers, J. W. M. AU - van Kampen, A. AU - Schreurs, B. W. DB - Embase Medline DO - 10.1007/s11999-016-4998-6 KW - hip prosthesis adult aged article bone transplantation cemented acetabular impaction bone grafting clinical article female follow up Harris hip score hip arthroplasty hip dysplasia hip radiography human lung embolism male nerve paralysis osteoarthritis osteolysis patient satisfaction priority journal prosthesis loosening reoperation retrospective study sciatic nerve surgical infection LA - English M1 - 11 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1528-1132 0009-921X SP - 2462-2468 ST - Satisfying Results of Primary Hip Arthroplasty in Patients With Hip Dysplasia at a Mean Followup of 20 Years T2 - Clinical Orthopaedics and Related Research TI - Satisfying Results of Primary Hip Arthroplasty in Patients With Hip Dysplasia at a Mean Followup of 20 Years UR - https://www.embase.com/search/results?subaction=viewrecord&id=L611592271&from=export http://dx.doi.org/10.1007/s11999-016-4998-6 VL - 474 ID - 829298 ER - TY - JOUR AB - Most percutaneous vertebroplasty procedures are being performed in order to relieve pain in patients with severe osteoporosis and associated stable fractures of one or more vertebral bodies. In addition, vertebroplasty is also recommended for patients suffering from post-traumatic symptoms associated with vertebral fractures, patients with large angiomas positioned inside the vertebral body, with an increased risk for collapse fracture and also patients presenting with pain associated with vertebral body metastatic disease. On another aspect, it is possible that in isolated cases, an orthopedic surgeon confronted with a vertebra plana presentation will recommend bone cement injection into the vertebral bodies adjacent to the fractured one, in order to have a better and more robust substrate for placement of screws or other fixation devices. The aim of our study is to compare results attained by the Department of Interventional Radiology, in performing this procedure, with results attained by following the classical orthopedic treatment procedure, involving non-operative treatment, using medication and bracing varying from simple extension orthoses in order to limit spinal flexion, light bracing for contiguous fractures, presenting either angulation or compression, and for severe cases standard thoracolumbosacral orthoses (TLSOs). AD - [Constantin, Cristian; Albulescu, Dana-Maria] Univ Med & Pharm Craiova, Dept Radiol & Med Imaging, 2 Petru Rares St, Craiova 200349, Romania. [Dita, Daniel-Razvan] Univ Med & Pharm Craiova, Dept Orthoped Surg, Craiova, Romania. [Georgescu, Claudia-Valentina] Univ Med & Pharm Craiova, Dept Pathol, Craiova, Romania. [Deaconu, Andrei-Constantin] Emergency Cty Hosp, Dept Radiol & Med Imaging, Craiova, Romania. Albulescu, DM (corresponding author), Univ Med & Pharm Craiova, Dept Radiol & Med Imaging, 2 Petru Rares St, Craiova 200349, Romania. med73danam@yahoo.com AN - WOS:000438117200019 AU - Constantin, C. AU - Albulescu, D. M. AU - Dita, D. R. AU - Georgescu, C. V. AU - Deaconu, A. C. J2 - Rom. J. Morphol. Embryol. KW - vertebral fracture vertebroplasty minimally invasive THORACOLUMBAR BURST FRACTURES COMPRESSION FRACTURES EMBOLISM RISK Developmental Biology LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 1220-0522 SP - 159-164 ST - Vertebral body clinico-morphological features following percutaneous vertebroplasty versus the conservatory approach T2 - Romanian Journal of Morphology and Embryology TI - Vertebral body clinico-morphological features following percutaneous vertebroplasty versus the conservatory approach UR - ://WOS:000438117200019 VL - 59 ID - 830179 ER - TY - JOUR AB - STUDY DESIGN: Retrospective assessment of risk factors using univariate and multivariate analyses. OBJECTIVE: To evaluate risk factors retrospectively for cement leakage (CL), including vascular cement leakage (vCL) and cortical cement leakage (cCL), in percutaneous vertebroplasty of spinal metastasis. SUMMARY OF BACKGROUND DATA: Complications of vertebroplasty for spine metastasis are rare but related to extravertebral cement leakage that is pulmonary embolism and medullary compression. Better understanding of the risk factors for vascular and cortical types of cement leakage is necessary to prevent these complications. METHODS: Fifty-six cancer patients (30 females, 26 males; age, 56 ± 12 yr) (81 vertebrae) were treated in 58 sessions under fluoroscopy or computed tomography-fluoroscopy guidance. Leakage rates were reported. The following items were assessed for occurrence of CL, vCL, and cCL: primary tumor site, prior radiotherapy or local tumor ablation or embolization, appearance on computed tomography, cortical osteolytic destruction, vertebral collapse, operator's experience, guidance modality, and cement filling. RESULTS: CL, vCL, and cCL rates were 53%, 25%, and 32%. History of prior treatment correlated with a decrease in CL (P = 0.018). vCL decreased when lung was the primary tumor site (P = 0.036), in osteolytic vertebrae (P = 0.033) or when there was a vertebral collapse (P = 0.037). cCL correlated with operator's experience (P = 0.021) and vertebral collapse (P < 0.001). Superior discal cCL correlated with superior endplate cortical destruction (P = 0.012). Although history of prior treatment seemed to be an independent protective factor (odds ratio = 0.24; 95% confidence interval, 0.087-0.7; P = 0.001), vertebral collapse was isolated as a risk factor for cCL (odds ratio = 32; 95% confidence interval, 6.7-161; P = 0.001). CONCLUSION: Risk factors for cCL and vCL are distinct. Vertebral collapse and cortical destruction are risk factors for cCL. History of prior treatment is a protective factor for CL.Level of Evidence: 4. AD - Departments of *Interventional Radiology and tBiostatistics, Institut Gustave Roussy, Villejuif, France. AN - 107790193. Language: English. Entry Date: 20150116. Revision Date: 20150712. Publication Type: Journal Article AU - Corcos, Gabriel AU - Dbjay, Jonathan AU - Mastier, Charles AU - Leon, Sandrine AU - Auperin, Anne AU - De Baere, Thierry AU - Deschamps, Frédéric DB - cin20 DO - 10.1097/BRS.0000000000000134 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Extravasation of Diagnostic and Therapeutic Materials -- Etiology Spinal Neoplasms -- Surgery Vertebroplasty -- Methods Adult Aged Female Human Logistic Regression Lung Neoplasms -- Pathology Lung Neoplasms -- Therapy Male Middle Age Multivariate Analysis Neoplasms -- Pathology Neoplasms -- Therapy Postoperative Complications -- Etiology Retrospective Design Risk Assessment -- Methods Risk Assessment -- Statistics and Numerical Data Risk Factors Spinal Neoplasms Vertebroplasty -- Adverse Effects M1 - 5 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2014 SN - 0362-2436 SP - E332-8 ST - Cement leakage in percutaneous vertebroplasty for spinal metastases: a retrospective evaluation of incidence and risk factors T2 - Spine (03622436) TI - Cement leakage in percutaneous vertebroplasty for spinal metastases: a retrospective evaluation of incidence and risk factors UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=107790193&site=ehost-live&scope=site VL - 39 ID - 830642 ER - TY - JOUR AD - Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Sevilla, España. Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Sevilla, España. Electronic address: ialfageme@separ.es. AN - 24125825 AU - Cordova, A. AU - Alfageme, I. DA - Mar DO - 10.1016/j.arbres.2013.08.003 DP - NLM ET - 2013/10/16 J2 - Archivos de bronconeumologia KW - Bone Cements/*adverse effects Delayed Diagnosis Dyspnea/etiology Female Foreign-Body Migration/*complications/diagnostic imaging Humans Iliac Vein Lumbar Vertebrae/surgery Middle Aged Postoperative Complications/diagnostic imaging/*etiology Pulmonary Embolism/diagnostic imaging/*etiology Radiography *Vertebroplasty LA - eng spa M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 0300-2896 SP - 123 ST - Foreign-body pulmonary embolism T2 - Arch Bronconeumol TI - Foreign-body pulmonary embolism VL - 50 ID - 828505 ER - TY - JOUR AB - INTRODUCTION: Percutaneous vertebroplasty and kyphoplasty are both techniques used to treat vertebral fractures and consist in the application of polimethilmethacrilate (PMMA) into the vertebral body, working as cement. One of the complications is pulmonary embolism (PE) of PMMA due to leakage of cement into the perivertebral veins. We report one case of a patient with cement PE seen in our practice. CASE PRESENTATION: A 50 year-old-woman, non-smoker, with history of vertebroplasty of L5 four years before, referred to our consult because of an abnormal chest radiograph. The patient reported that in the last four years had noticed effort dyspnea, chest pain and palpitation episodes. Physical examination was normal. Chest X-ray revealed a hyperdense foreign body in the left pulmonary artery and similar lineal images in contralateral hemithorax. Thorax/abdomen computer tomography (CT) scan confirmed the presence of a calcium-density foreign body in left pulmonary artery and in multiple peripheral arteries of right lung. In addition, at L5 level, there was a lineal hyperdensity, that started from the cement of the L5 vertebral body and extended into the left common iliac vein. The diagnosis was cement pulmonary embolism, secondary to vertebroplasty intervention. Treatment was not given, observation follow-ups for the next three years were made, and the patient did not present clinical or radiology changes. DISCUSSION: Cement PE due to vertebroplasty frequency reported in case series has a range between 3.4% and 23%, and in most of the cases curses asymptomatic, probably making this complication under-diagnosed. Even though there are case reports, case series and reviews in the literature, the quality of these studies is not enough to determine a clear treatment strategy. Treatment is based on the presence or absence of symptoms and emboli location. Observation is recommended in case of asymptomatic patient, 3 to 6-month-anticoagulation in symptomatic or in patients with central emboli, or surgery in severe cases. CONCLUSIONS: The incidence of cement pulmonary embolism is probably underestimated due to asymptomatic cases. Chest X-ray after the intervention is recommended. Further and better studies are needed to clear up treatment strategies; meanwhile recommendations made from the available literature should be followed. AD - A. Córdova, HU Virgen de Valme, Sevilla, Spain AU - Córdova, A. AU - Alfageme, I. DB - Embase DO - 10.1378/chest.1822247 KW - cement calcium lung embolism human patient percutaneous vertebroplasty thorax radiography embolism case study pulmonary artery foreign body vertebra body anticoagulation case report radiology female iliac vein lung density vein spine fracture computer assisted tomography physical examination heart palpitation artery thorax pain diagnosis dyspnea smoking surgery kyphoplasty L1 - http://journal.publications.chestnet.org/article.aspx?articleID=1837312 LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 0012-3692 ST - Cement pulmonary embolism T2 - Chest TI - Cement pulmonary embolism UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71429070&from=export http://dx.doi.org/10.1378/chest.1822247 VL - 145 ID - 829425 ER - TY - JOUR AB - Purpose: Vertebral hemangiomas (VH) account for 2–3% of all spinal tumors. The majority is incidentally found on radiographic studies: 1% present with pain and/or neurologic deficits. We report our experience with the multidisciplinary management of aggressive symptomatic thoracic VH by concomitant intraoperative sclerotization with sodium tetradecyl sulfate (STS), vertebroplasty, posterior decompression (with/without fusion) and surgical resection in a hybrid operating room (HR) equipped with a rotational scanner and a radiolucent operating table. Methods: Patients admitted with aggressive spinal VH between 2007 and 2018 were included. Data regarding demographics, presenting symptoms, location of the lesion, preoperative embolization, length of the surgery, estimated blood loss (EBL) as well as follow-up (FU) were retrieved. Results: Five patients were included (three females, mean age 65 years; range 59–75). Three patients presented with a myelopathy and two mechanical thoracic pain. All patients underwent a single-stage percutaneous sclerotization and vertebroplasty followed by a surgical decompression associated with epidural intralesional injection of STS and subtotal resection of the epidural lesion. Two patients had preoperative embolization. Mean procedural duration was 338 min (range 210–480 min). Four patients had marginal EBL, one patient had 500 ml EBL. Patients had no evidence of lesion recurrence or progression at the end of the follow-up. Conclusions: The single-stage multimodal management of aggressive symptomatic VH is safe and effective. It allows for a direct intraoperative sclerotherapy combined with maximal tumor resection, resulting in reduced blood loss. The use of STS as a direct intraoperative sclerotizing agent is safe and reliable. AD - M.V. Corniola, Spine Unit, Département Des Neurosciences Cliniques, Service de Neurochirurgie, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, Geneva, Switzerland AU - Corniola, M. V. AU - Schonauer, C. AU - Bernava, G. AU - Machi, P. AU - Yilmaz, H. AU - Lemée, J. M. AU - Tessitore, E. DB - Embase Medline DO - 10.1007/s00586-020-06404-9 KW - aged article artificial embolization bleeding cancer surgery case report clinical article decompression demography drug therapy female follow up human intralesional drug administration operating table percutaneous vertebroplasty preoperative evaluation sclerotherapy spinal cord disease surgery thorax pain vertebra hemangioma tetradecyl sulfate sodium LA - English M3 - Article in Press N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1432-0932 0940-6719 ST - Thoracic aggressive vertebral hemangiomas: multidisciplinary management in a hybrid room T2 - European Spine Journal TI - Thoracic aggressive vertebral hemangiomas: multidisciplinary management in a hybrid room UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2004613002&from=export http://dx.doi.org/10.1007/s00586-020-06404-9 ID - 829084 ER - TY - JOUR AB - Vertebral hemangiomas can cause difficult-to-treat neurological complications. We report our experience with three such cases. Patients n degrees 1 and 2 were females aged 64 and 71 years, respectively; patient n degrees 1 had a two-year history of weakness in the lower limbs and patient n degrees 2 had a five-month history of back pain. Both these patients had a pyramidal syndrome in the lower limbs. Patient n degrees 3 was a 61 year old male with a one-year history of left sciatica. Roentgenograms were suggestive of a hemangioma occupying the entire T8 (cases 1 and 2) or L5 (case 3) vertebra. Computed tomography and magnetic resonance imaging confirmed this diagnosis and showed that patients 1 and 2 had an anterior epidural hemangioma opposite T8 impinging on the spinal cord. In patients 1 and 2, treatment consisted in embolization of T8 followed by transpedicular injection of 6 cc of methylmethacrylate into the body of T8. One cubic centimeter of histoacryl was also injected in each lamina. The third patient had a similar vertebroplasty procedure without prior embolization since he had no epidural hemangioma. One patient (n degrees I) developed intercostal neuralgia of several hours duration after the procedure. Ail three patients subsequently underwent laminectomy (T7-T8 with removal of the epidural hemangioma in cases 1 and 2, L5 in case 3). The pyramidal syndrome resolved within 15 days in patients 1 and 2; the nerve root pain resolved within 48 hours in patient 3. Six months after treatment, patients 1 and 3 were free of symptoms and patient 2 reported mechanical low back pain; neurological findings were normal in all three cases. In our opinion, this multidisciplinary therapeutic approach is effective and safe. Vertebroplasty strengthens the vertebra, allowing to perform only limited surgery. Injection of histoacryl in the laminae improves the safety of laminectomy. AD - CHRU LILLE,HOP B,SERV RHUMATOL,LILLE,FRANCE. CHRU LILLE,HOP B,SERV RADIOL GEN,LILLE,FRANCE. CHRU,HOP B,SERV NEURORADIOL,LILLE,FRANCE. CHRU LILLE,HOP B,SERV NEUROCHIRURG,LILLE,FRANCE. CHRU AMIENS,HOP NORD,SERV RADIOL A,AMIENS,FRANCE. AN - WOS:A1994MV60100004 AU - Cortet, B. AU - Cotten, A. AU - Deprez, A. AU - Deramond, H. AU - Lejeune, J. P. AU - Leclerc, X. AU - Chastanet, P. AU - Duquesnoy, B. AU - Delcambre, B. DA - Jan J2 - Rev. Rhum. KW - VERTEBRA HEMANGIOMA VERTEBROPLASTY COMPRESSION MYELOPATHY PREOPERATIVE EMBOLIZATION NEUROLOGIC SYMPTOMS RESECTION Rheumatology LA - French M1 - 1 M3 - Note N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1994 SN - 1169-8446 SP - 16-22 ST - VERTEBROPLASTY WITH SURGICAL DECOMPRESSION FOR THE TREATMENT OF AGGRESSIVE VERTEBRAL HEMANGIOMAS - A REPORT OF 3 CASES T2 - Revue Du Rhumatisme TI - VERTEBROPLASTY WITH SURGICAL DECOMPRESSION FOR THE TREATMENT OF AGGRESSIVE VERTEBRAL HEMANGIOMAS - A REPORT OF 3 CASES UR - ://WOS:A1994MV60100004 VL - 61 ID - 830492 ER - TY - JOUR AB - Vertebral hemangiomas can cause difficult-to-treat neurological complications. We report our experience with three such cases. Patients no. 1 and 2 were females aged 64 and 71 years, respectively; patient no. 1 had a two-year history of weakness in the lower limbs and patient no. 2 had a five-month history of back pain. Both these patients had a pyramidal syndrome in the lower limbs. Patient no. 3 was a 61 year old male with a one-year history of left sciatica. Roentgenograms were suggestive of a hemangioma occupying the entire T8 (cases 1 and 2) or L5 (case 3) vertebra. Computed tomography and magnetic resonance imaging confirmed this diagnosis and showed that patients 1 and 2 had an anterior epidural hemangioma opposite T8 impinging on the spinal cord. In patients 1 and 2, treatment consisted in embolization of T8 followed by transpedicular injection of 6 cc of methylmethacrylate into the body of T8. One cubic centimeter of histoacryl was also injected in each lamina. The third patient had a similar vertebroplasty procedure without prior embolization since he had no epidural hemangioma. One patient (no. 1) developed intercostal neuralgia of several hours duration after the procedure. All three patients subsequently underwent laminectomy (T7-T8 with removal of the epidural hemangioma in cases 1 and 2, L5 in case 3). The pyramidal syndrome resolved within 15 days in patients 1 and 2; the nerve root pain resolved within 48 hours in patient 3.(ABSTRACT TRUNCATED AT 250 WORDS) AD - Service de Rhumatologie, CHRU de Lille. AN - 8000396 AU - Cortet, B. AU - Cotten, A. AU - Deprez, X. AU - Deramond, H. AU - Lejeune, J. P. AU - Leclerc, X. AU - Chastanet, P. AU - Duquesnoy, B. AU - Delcambre, B. DA - Jan DP - NLM ET - 1994/01/01 J2 - Revue du rhumatisme (Ed. francaise : 1993) KW - Aged Combined Modality Therapy Embolization, Therapeutic Enbucrilate/administration & dosage/analogs & derivatives Epidural Neoplasms/therapy Female Hemangioma/surgery/*therapy Humans Injections, Spinal *Lumbar Vertebrae Male Methylmethacrylates/*administration & dosage Middle Aged Spinal Cord Compression/etiology/therapy *Spinal Fusion Spinal Neoplasms/surgery/*therapy *Thoracic Vertebrae Tissue Adhesives LA - fre M1 - 1 N1 - PubMed NLM literature search January 5, 2021 OP - Intérêt de la vertébroplastie couplée à une décompression chirurgicale dans le traitement des angiomes vertébraux agressifs. A propos de trois cas. PY - 1994 SN - 1169-8330 (Print) 1169-8330 SP - 16-22 ST - [Value of vertebroplasty combined with surgical decompression in the treatment of aggressive spinal angioma. Apropos of 3 cases] T2 - Rev Rhum Ed Fr TI - [Value of vertebroplasty combined with surgical decompression in the treatment of aggressive spinal angioma. Apropos of 3 cases] VL - 61 ID - 828995 ER - TY - JOUR AB - Vertebral hemangiomas can cause difficult-to-treat neurological complications. We report our experience with three such cases. Patients 1 and 2 were females aged 64 and 71 years, respectively; patient 1 had a two-year history of weakness in the lower limbs and patient 2 had a five-month history of back pain. Both these patients had a pyramidal syndrome in the lower limbs. Patient 3 was a 61 year old male with a one-year history of left sciatica. Roentgenograms were suggestive of a hemangioma occupying the entire T8 (cases 1 and 2) or L5 (case 3) vertebra. Computed tomography and magnetic resonance imaging confirmed this diagnosis and showed that patients 1 and 2 had an anterior epidural hemangioma opposite T8 impinging on the spinal cord. In patients 1 and 2, treatment consisted in embolization of T8 followed by transpedicular injection of 6 cc of methylmethacrylate into the body of T8. One cubic centimeter of histoacryl was also injected in each lamina. The third patient had a similar vertebroplasty procedure without prior embolization since he had no epidural hemangioma. One patient (patient 1) developed intercostal neuralgia of several hours duration after the procedure. All three patients subsequently underwent laminectomy (T7-T8 with removal of the epidural hemangioma in cases 1 and 2, L5 in case 3). The pyramidal syndrome resolved within 15 days in patients 1 and 2; the nerve root pain resolved within 48 hours in patient 3. Six months after treatment, patients 1 and 3 were free of symptoms and patient 2 reported mechanical low back pain; neurological findings were normal in all three cases. In our opinion, this multidisciplinary therapeutic approach is effective and safe. Vertebroplasty strengthens the vertebra, allowing to perform only limited surgery. Injection of histoacryl in the laminae improves the safety of laminectomy. AD - B. Cortet, Service de Rhumatologie, Centre A. Verhaeghe, 59037 Lille Cedex, France AU - Cortet, B. AU - Cotten, A. AU - Deprez, X. AU - Deramond, H. AU - Lejeune, J. P. AU - Leclerc, X. AU - Chastanet, P. AU - Duquesnoy, B. AU - Delcambre, B. DB - Embase KW - methacrylic acid methyl ester adult aged article artificial embolization case report computer assisted tomography female hemangioma human intrathecal drug administration male nuclear magnetic resonance imaging spinal cord compression spine tumor LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1994 SN - 1169-8446 SP - 14-20 ST - Vertebroplasty with surgical decompression for the treatment of aggressive vertebral hemangiomas. A report of three cases T2 - Revue du Rhumatisme (English Edition) TI - Vertebroplasty with surgical decompression for the treatment of aggressive vertebral hemangiomas. A report of three cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L24059972&from=export VL - 61 ID - 829938 ER - TY - JOUR AB - OBJECT: Vertebroplasty is a well-known technique used to treat pain associated with vertebral compression fractures. Despite a success rate of up to 90% in different series, the procedure is often associated with major complications such as cord and root compression, epidural and subdural hematomas (SDHs), and pulmonary emboli, as well as other minor complications. In this study, the authors discuss the major complications of transpedicular vertebroplasty and their clinical implications during the postoperative course. METHODS: Vertebroplasty was performed in 12 vertebrae of 7 patients. Five patients had osteoporotic compression fractures, 1 had tumoral compression fractures, and 1 had a traumatic fracture. Two patients had foraminal leakage, 1 had epidural leakage, 1 had subdural cement leakage, 2 had a spinal SDH, and the last had a split fracture after the procedure. RESULTS: Three patients had paraparesis (2 had SDHs and 1 had epidural cement leakage), 3 had root symptoms, and 1 had lower back pain. Two of the 3 patients with paraparesis recovered after evacuation of the SDH and subdural cement; however, 1 patient with paraparesis did not recover after epidural cement leakage, despite cement evacuation. Two patients with foraminal leakage and 1 with subdural cement leakage had root symptoms and recovered after evacuation and conservative treatment. The patient with the split fracture had no neurological symptoms and recovered with conservative treatment. CONCLUSIONS: Transpedicular vertebroplasty may have major complications, such as a spinal SDH and/or cement leakage into the epidural and subdural spaces, even when performed by experienced spinal surgeons. Early diagnosis with CT and intervention may prevent worsening of these complications. AD - Department of Neurosurgery, Faculty of Medicine, Canakkale 18 March University, Canakkale, Turkey. drcosar@hotmail.com AN - 19929366 AU - Cosar, M. AU - Sasani, M. AU - Oktenoglu, T. AU - Kaner, T. AU - Ercelen, O. AU - Kose, K. C. AU - Ozer, A. F. DA - Nov DO - 10.3171/2009.4.spine08466 DP - NLM ET - 2009/11/26 J2 - Journal of neurosurgery. Spine KW - Adolescent Aged Aged, 80 and over Female Fractures, Compression/diagnostic imaging/*surgery Humans Male Middle Aged Osteoporosis/diagnostic imaging/*surgery *Postoperative Complications Radiography Spinal Fractures/diagnostic imaging/*surgery Vertebroplasty/*adverse effects LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 1547-5646 SP - 607-13 ST - The major complications of transpedicular vertebroplasty T2 - J Neurosurg Spine TI - The major complications of transpedicular vertebroplasty VL - 11 ID - 828694 ER - TY - JOUR AB - Object: Vertebroplasty is a well-known technique used to treat pain associated with vertebral compression fractures. Despite a success rate of up to 90% in different series, the procedure is often associated with major complications such as cord and root compression, epidural and subdural hematomas (SDHs), and pulmonary emboli, as well as other minor complications. In this study, the authors discuss the major complications of transpedicular vertebroplasty and their clinical implications during the postoperative course. Methods: Vertebroplasty was performed in 12 vertebrae of 7 patients. Five patients had osteoporotic compression fractures, 1 had tumoral compression fractures, and 1 had a traumatic fracture. Two patients had foraminal leakage, 1 had epidural leakage, 1 had subdural cement leakage, 2 had a spinal SDH, and the last had a split fracture after the procedure. Results: Three patients had paraparesis (2 had SDHs and 1 had epidural cement leakage), 3 had root symptoms, and 1 had lower back pain. Two of the 3 patients with paraparesis recovered after evacuation of the SDH and subdural cement; however, 1 patient with paraparesis did not recover after epidural cement leakage, despite cement evacuation. Two patients with foraminal leakage and 1 with subdural cement leakage had root symptoms and recovered after evacuation and conservative treatment. The patient with the split fracture had no neurological symptoms and recovered with conservative treatment. Conclusions: Transpedicular vertebroplasty may have major complications, such as a spinal SDH and/or cement leakage into the epidural and subdural spaces, even when performed by experienced spinal surgeons. Early diagnosis with CT and intervention may prevent worsening of these complications. AD - Department of Neurosurgery, Faculty of Medicine, Canakkale 18 March University, Canakkale, Turkey Department of Neurosurgery, Faculty of Medicine, Canakkale 18 March University, Canakkale, Turkey. drcosar@hotmail.com AN - 105251496. Language: English. Entry Date: 20100115. Revision Date: 20170411. Publication Type: journal article AU - Cosar, M. AU - Sasani, M. AU - Oktenoglu, T. AU - Kaner, T. AU - Ercelen, O. AU - Kose, K. C. AU - Ozer, A. F. AU - Cosar, Murat AU - Sasani, Mehdi AU - Oktenoglu, Tunc AU - Kaner, Tuncay AU - Ercelen, Omur AU - Kose, K. Cagri AU - Ozer, A. Fahir DB - cin20 DO - 10.3171/2009.4.SPINE08466 DP - EBSCOhost KW - Fractures, Compression -- Surgery Osteoporosis -- Surgery Postoperative Complications Spinal Fractures -- Surgery Kyphoplasty -- Adverse Effects Adolescence Aged Aged, 80 and Over Female Fractures, Compression -- Radiography Human Male Middle Age Osteoporosis -- Radiography Spinal Fractures -- Radiography M1 - 5 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 1547-5654 SP - 607-613 ST - The major complications of transpedicular vertebroplasty T2 - Journal of Neurosurgery: Spine TI - The major complications of transpedicular vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105251496&site=ehost-live&scope=site VL - 11 ID - 830719 ER - TY - JOUR AB - AIM: The aim of this paper was to assess the efficacy of a minimally invasive treatment with percutaneous vertebroplasty and kyphoplasty for traumatic fracture of thoracolumbar junction. Treatment of stable traumatic vertebral fractures of the thoracolumbar junction without neurological deficit is still controversy. Conservative treatment, characterized by discomfort and limitation in patient mobility, was progressively replaced by minimally invasive techniques such as percutaneous vertebroplasty and kyphoplasty. METHODS: Between January 2003 and August 2005, 34 patients suffering from 42 thoracolumbar fractures were treated at Neurosurgical Department of Istituto Galeazzi (Milan). The treatment selected (vertebroplasty versus kyphoplasty), depended on age of patients, timing and type of fracture. Results were clinically assessed by Visual Analogue Score (VAS) and Oswestry Disability Index. RESULTS: Mean preoperative VAS was 8.32 (range 5-10). Percutaneous vertebroplasty was performed in 25 cases (73.5%); while 9 patients were treated by kyphoplasty (27.5%); 27 patients showed a single level and 7 multilevel of the fractures. No complications occurred (infection, neurological deficit, embolic events) after treatment. At the early follow-up 91.7% of the patients achieved a good pain control already after 24 hours. Pain relief and disability, analyzed by VAS and Oswestry Disability Index, showed a good results at late follow-up time. CONCLUSIONS: Percutaneous vertebroplasty and kyphoplasty are two safe and effective techniques for treatment of thoracolumbar traumatic fractures and allow a good pain-control and return to normal working activity and social life. AD - Operative Unit of Neurosurgery, IRCCS Galeazzi Institute, Milan, Italy. f.costa@fastwebmail.it AN - 19322131 AU - Costa, F. AU - Ortolina, A. AU - Cardia, A. AU - Sassi, M. AU - De Santis, A. AU - Borroni, M. AU - Savoia, G. AU - Fornari, M. DA - Mar DP - NLM ET - 2009/03/27 J2 - Journal of neurosurgical sciences KW - Female Follow-Up Studies Fractures, Bone/pathology/*surgery Humans Lumbar Vertebrae/*injuries/pathology/*surgery Magnetic Resonance Imaging Male Middle Aged Minimally Invasive Surgical Procedures Neuropsychological Tests Thoracic Vertebrae/*injuries/pathology/*surgery Treatment Outcome Vertebroplasty/adverse effects/*methods LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0390-5616 (Print) 0390-5616 SP - 13-7 ST - Efficacy of treatment with percutaneous vertebroplasty and kyphoplasty for traumatic fracture of thoracolumbar junction T2 - J Neurosurg Sci TI - Efficacy of treatment with percutaneous vertebroplasty and kyphoplasty for traumatic fracture of thoracolumbar junction VL - 53 ID - 828710 ER - TY - JOUR AB - The first records of pulmonary embolism by polymethyl methacrylate have been recently published (2003) with no more than 15 cases reported. The current case report describes a young patient who underwent percutaneous vertebroplasty with polymethyl methacrylate two months before consultation. The patient complaint of symptoms suggestive of pleural compromise; the chest X-ray showed multiple radiopaque images in both pulmonary fields. Pulmonary embolism by polymethyl mehtacrylate is an infrequent complication related to the procedure; however, it should be ruled out in patients with a history of vertebroplasty who present chest pain or dyspnea. AD - Y.C. Costa, Clínica Santa Isabel, Unidad Coronaria, Directorio 2037 - 6 Piso, Buenos Aires, Argentina AU - Costa, Y. C. AU - Aurelio, M. G. AU - Santa María, H. G. AU - Mauro, V. AU - Barrero, C. DB - Embase KW - contrast medium heparin poly(methyl methacrylate) adult anamnesis angioma article case report consultation electrocardiogram human lung embolism male percutaneous vertebroplasty physical examination thorax pain thorax radiography tomography L1 - http://www.scielo.org.ar/pdf/rac/v77n2/v77n2a11.pdf LA - Spanish M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 0034-7000 1850-3748 SP - 129-130 ST - Pulmonary embolism by polymethyl methacrylate T2 - Revista Argentina de Cardiologia TI - Pulmonary embolism by polymethyl methacrylate UR - https://www.embase.com/search/results?subaction=viewrecord&id=L355274863&from=export VL - 77 ID - 829717 ER - TY - JOUR AB - Methods We analyzed approximately 25,000 hemiarthroplasty cases from the AOA National Joint Replacement Registry. Deaths at 1 day, 1 week, 1 month, and 1 year were compared for all patients and among subgroups based on implant type. Results Patients treated with cemented monoblock hemiarthroplasty had a 1.7-times higher day-1 mortality compared to uncemented monoblock components (p < 0.001). This finding was reversed by 1 week, 1 month, and 1 year after surgery (p < 0.001). Modular hemiarthroplasties did not reveal a difference in mortality between fixation methods at any time point. Interpretation This study shows lower (or similar) overall mortality with cemented hemiarthroplasty of the hip. AD - [Costain, Darren J.; Whitehouse, Sarah L.; Crawford, Ross W.] Queensland Univ Technol, Inst Hlth & Biomed Innovat, Brisbane, Qld 4001, Australia. [Costain, Darren J.; Whitehouse, Sarah L.; Crawford, Ross W.] Prince Charles Hosp, Orthopaed Res Unit, Brisbane, Qld, Australia. [Pratt, Nicole L.; Ryan, Philip] Univ Adelaide, Data Management & Anal Ctr, Discipline Publ Hlth, Adelaide, SA, Australia. [Graves, Stephen E.] Australian Orthopaed Assoc Natl Joint Replacement, Adelaide, SA, Australia. Crawford, RW (corresponding author), Queensland Univ Technol, Inst Hlth & Biomed Innovat, Brisbane, Qld 4001, Australia. r.crawford@qut.edu.au AN - WOS:000291060000004 AU - Costain, D. J. AU - Whitehouse, S. L. AU - Pratt, N. L. AU - Graves, S. E. AU - Ryan, P. AU - Crawford, R. W. DA - May DO - 10.3109/17453674.2011.584208 J2 - Acta Orthop. KW - TOTAL HIP-ARTHROPLASTY UNCEMENTED HEMIARTHROPLASTY BIPOLAR HEMIARTHROPLASTY FAT-EMBOLISM FEMORAL-NECK RISK-FACTORS MARROW EMBOLIZATION CEMENTED THOMPSON 30-DAY MORTALITY BONE-CEMENT Orthopedics LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2011 SN - 1745-3674 SP - 275-281 ST - Perioperative mortality after hemiarthroplasty related to fixation method T2 - Acta Orthopaedica TI - Perioperative mortality after hemiarthroplasty related to fixation method UR - ://WOS:000291060000004 VL - 82 ID - 830325 ER - TY - JOUR AB - Introduction: Posterior lumbar interbody fusion is the main repair method for senile degenerative lumbar spondylolisthesis. Although it is relatively safe, complications have been reported over time. Among those complications, cement pulmonary embolism [PCE] is considered a rare complication. Case presentation: A 71-year-old woman was referred to the neurosurgeon because of increased lumbar pain. Her medical history consisted of depression, osteoporosis and chronic low back pain after failed back surgery 7 years earlier. Imaging of the lumbar spine revealed instability in lumbar vertebrae L2 and L3. She underwent a posterior lumbar interbody arthrodesis of L2-L3, with bone-cement-injectable cannulated pedicle screw fixations. During the procedure, some cement leaked into the paravertebral space. After surgery, she suddenly suffered from respiratory distress, being hypoxemic with oxygen saturation of 60%, and was transferred to Intensive Care, where supportive care was initiated. A chest radiography showed a sausage-shaped radio-opaque opacity at the right hilus (Figure 1). Computer tomography (CT) without IV contrast showed a foreign body at the level of the right hilus in the lower lobe branch of the pulmonary artery (Figure 2). This was confirmed by a CT angiography. Leakage of the cement was still visible on X-ray and CT of lumbar column (Figure 3(a,b)). Upon the diagnosis of a pulmonary embolism, full anticoagulation therapy was started. The further course was uneventful. Conclusion/discussion: Pulmonary cement embolism (PCE) is a rare but potentially serious complication of posterior lumbar interbody fusion procedure. Most patients with PCE are asymptomatic or only develop transient symptoms, but a few may exhibit more symptomatic cardiorespiratory manifestations, occasionally being fatal. If, after such a procedure, the patient has chest pain or respiratory difficulty, chest radiography and possibly advanced chest imaging studies should be performed immediately. IV contrast should be avoided because it may mask the foreign body. Management depends on the location and size of the emboli as well as the patients symptomatology. A management guideline is available in case of (a)symptomatic peripheral or central pulmonary embolism (Krueger-Eur Spine J. 2009;18:1257-1265). However, since PCE is rather a mechanical occlusion than a clot, therapeutic anticoagulation beyond the acute phase is sometimes deferred. Finally, the occurrence of leakage should always be reported in the operation report. AD - C. Cottignie, AZ Nikolaas, Sint-Niklaas, Belgium AU - Cottignie, C. AU - Stolte, C. AU - Ryckaert, R. AU - Jackers, J. AU - Van De Kelft, E. AU - Deblonde, S. AU - De Meester, J. DB - Embase DO - 10.1080/17843286.2018.1542267 KW - bone cement aged anticoagulant therapy building material case report clinical article complication computed tomographic angiography conference abstract diagnosis failed back surgery syndrome female foreign body human intensive care low back pain lumbar vertebra lung embolism meat medical history neurosurgeon occlusion osteoporosis oxygen saturation pedicle screw posterior lumbar interbody fusion practice guideline pulmonary artery respiratory distress surgery thorax pain thorax radiography X ray LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 2295-3337 SP - 19-20 ST - Losing your building material isn't without complications T2 - Acta Clinica Belgica: International Journal of Clinical and Laboratory Medicine TI - Losing your building material isn't without complications UR - https://www.embase.com/search/results?subaction=viewrecord&id=L625817209&from=export http://dx.doi.org/10.1080/17843286.2018.1542267 VL - 73 ID - 829223 ER - TY - JOUR AN - 6529647 AU - Couderc, E. AU - Desmonts, J. M. AU - Caramella, J. P. AU - Bilaine, J. AU - Berger, J. L. AU - Diakite, B. AU - Armand, C. DA - Mar DP - NLM ET - 1984/03/01 J2 - Cahiers d'anesthesiologie KW - Aged Bone Cements/*adverse effects Embolism, Fat/*etiology Female Humans Knee Prosthesis/*adverse effects/methods Risk Tourniquets LA - fre M1 - 2 N1 - PubMed NLM literature search January 5, 2021 OP - Le scellement des prothèses à charnière du genou: un risque vital important. PY - 1984 SN - 0007-9685 (Print) 0007-9685 SP - 139-42 ST - [Sealing of hinged prostheses of the knee: an important vital risk] T2 - Cah Anesthesiol TI - [Sealing of hinged prostheses of the knee: an important vital risk] VL - 32 ID - 828549 ER - TY - JOUR AB - Introduction. Percutaneous vertebroplasty (PVP) is a therapeutic, interventional radiological procedure involving bone cement injection into a fractured vertebral body in order to obtain pain relief and mechanical stability of the vertebral body. Complications are uncommon, and among them is the bone cement leakage into the spinal canal, the paravertebral tissues, or the perivertebral venous system and right heart/pulmonary embolism. Case report. A 68 year-old woman with a history of diabetes mellitus type 1, neuropathy, arterial hypertension, hypercholesterolemia, surgery for right knee and left hip prosthesis and several PVP procedures two year earlier, came to our attention for echocardiographic evaluation of her arterial hypertension and for a suspected amyloidosis. So, she underwent a transthoracic echocardiogram, by which we excluded cardiac amyloidosis, but we found, in the apical four-chamber view, a hyperechogenic linear image in the right ventricle (RV), going from the apical portion of RV to the right atrium. The patient was asymptomatic. After diagnostic confirmation at transoesophageal echocardiography and chest computed tomography (CT), the patient was sent to the cath lab to perform an attempt of removal via right cardiac catheterism, that was unsuccessful, with the breaking of the material in two parts, one of those migrated to the left pulmonary vein; a chest CT showed it in the laterobasal segment of the left inferior lung. A surgical attempt of removal was judged inopportune, due to a low risk/benefit ratio. Conclusions. Although PVP is considered a minimally invasive procedure, it may result in cardiovascular complications, which are infrequent and consist in bleeding at the puncture site, local infection, cement leakage into the spinal canal, the paravertebral tissues or the perivertebral venous system, and several instances of pulmonary embolism. Although the surface of fresh or aged bone cement is not thrombogenic in vitro, its presence into the could be capable of causing cardiac perforations. According to our experience, we think that Transthoracic echocardiography is an easily available examination that should be always performed after PVP to easily identify cement cardiac embolization. AD - L. Craba, Dipartimento Di Scienze Mediche E Sanità Pubblica, Università Degli Studi Di Cagliari, Italy AU - Craba, L. AU - Centorbi, C. AU - Zanda, G. AU - Agus, E. AU - Aneris, F. AU - Dessalvi, C. C. AU - Deidda, M. AU - Secci, E. AU - Mercuro, G. DB - Embase KW - bone cement aged attention bleeding computer assisted tomography conference abstract female heart amyloidosis heart perforation heart right atrium heart right ventricle hip prosthesis human human tissue hypercholesterolemia hypertension in vitro study insulin dependent diabetes mellitus knee lung embolism minimally invasive procedure neuropathy percutaneous vertebroplasty pulmonary vein puncture surgery thorax transesophageal echocardiography transthoracic echocardiography venous circulation vertebral canal LA - English M1 - 12 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1972-6481 SP - 128S-129S ST - Echocardiographic accidental finding of asymptomatic cardiac and pulmonary embolism due to cemental leakeage after percutaneous vertebroplasty T2 - Giornale Italiano di Cardiologia TI - Echocardiographic accidental finding of asymptomatic cardiac and pulmonary embolism due to cemental leakeage after percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L631055431&from=export VL - 20 ID - 829102 ER - TY - JOUR AB - STUDY DESIGN. Prospective, nonrandomized consecutive single surgeon series. OBJECTIVE. To compare the clinical and radiographic outcomes in degenerative lumbar scoliosis (DLS) patients treated with posterior instrumented correction and fusion with additional anterior lumbar interbody fusion (ALIF) versus transforaminal lumbar interbody fusion (TLIF) to help define whether anterior surgery should be routinely required in treating DLS. SUMMARY OF BACKGROUND DATA. The benefits of interbody support in promoting postoperative stability and arthrodesis are well established. Whether the interbody fusion is better performed from an anterior or posterior approach has not been studied for patients undergoing surgical correction for DLS. METHODS. Forty consecutive patients with DLS, stenosis, and olisthesis underwent posterior instrumented reduction/arthrodesis at average 7 levels (range: 4-9 levels). Additional ALIF was performed in 20 patients, TLIF in the other 20. Follow-up averaged 38 months (24-68 months). Oswestry Disability Index (ODI), visual analog pain scores (VAS) were evaluated preoperative, 1 and 2 years postoperative. Radiograph measurements included the scoliosis, T12 to S1 lordosis, coronal and sagittal balance, and pelvic incidence. CT evaluation of the fusion integrity was performed after 1 year. RESULTS. The ALIF group complications included 4 nonunions, 5 adjacent level fractures, 5 adjacent degeneration, 3 infections, and 1 footdrop. Revision surgery was performed in 8 of 20. Medical complications included 2 nonfatal pulmonary embolus, 1 ileus requiring colostomy, and 1 stroke. TLIF group complications included 3 adjacent segment degeneration, 2 adjacent fractures, 2 nonunions, and 1 infection and transient footdrop. Two of 20 required revision surgery. VAS and ODI improvements for both groups showed significant improvement frompreoperative (P < 0.0019) but were not different. Deformity correction was also similar (70%) between ALIF and TLIF groups. CONCLUSION. With current deformity correction techniques, both ALIF and TLIF are effective in DLS surgery. Anterior surgery is not routinely required to treat all cases of DLS. © 2009 Lippincott Williams & Wilkins, Inc. AD - D. G. Crandall, 1432 South Dobson Rd, Mesa, AZ 85202, United States AU - Crandall, D. G. AU - Revella, J. DB - Embase Medline DO - 10.1097/BRS.0b013e3181b612db KW - adult aged arthrodesis article cervical spine radiography clinical article colostomy computer assisted tomography controlled study debridement female follow up fracture nonunion human ileus infection intermethod comparison kyphoplasty lung embolism male pain pain assessment postoperative period preoperative period priority journal pseudarthrosis scoliosis scoring system spine fracture spine fusion stenosis cerebrovascular accident treatment outcome visual analog scale wound irrigation LA - English M1 - 20 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 0362-2436 1528-1159 SP - 2126-2133 ST - Transforaminal lumbar interbody fusion versus anterior lumbar interbody fusion as an adjunct to posterior instrumented correction of degenerative lumbar scoliosis: Three year clinical and radiographic outcomes T2 - Spine TI - Transforaminal lumbar interbody fusion versus anterior lumbar interbody fusion as an adjunct to posterior instrumented correction of degenerative lumbar scoliosis: Three year clinical and radiographic outcomes UR - https://www.embase.com/search/results?subaction=viewrecord&id=L355384587&from=export http://dx.doi.org/10.1097/BRS.0b013e3181b612db VL - 34 ID - 829698 ER - TY - JOUR AB - We prospectively reviewed 1000 consecutive patients who underwent a cementless, hydroxyapatite-coated, stemless, total knee replacement over a period of nine years. Regular post-operative clinical follow-up was performed using the Knee Society score. The mean pre-operative score was 96, improving to 182 and 180 at five and ten years, respectively. To date, there have been seven (0.5%) cases which required revision, primarily for septic loosening (four cases), with low rates of other post-operative complications. The cumulative survival at ten years with revision as the end-point, was 99.14% (95% confidence interval 92.5 to 99.8). These results support the use of hydroxyapatite in a cementless total knee replacement since it can give reliable fixation with an excellent clinical and functional outcome. © 2005 British Editorial Society of Bone and Joint Surgery. AD - M.J. Cross, Australian Institute of Musculo-Skeletal Research, Sydney, NSW, Australia AU - Cross, M. J. AU - Parish, E. N. DB - Embase Medline DO - 10.1302/0301-620X.87B8.15772 KW - chromium cobalt hydroxyapatite adult aged article confidence interval controlled study deep vein thrombosis endoprosthesis loosening female femur fracture follow up heart arrhythmia heart infarction human lung embolism major clinical study male coating (procedure) outcomes research postoperative care preoperative evaluation priority journal prospective study prosthesis fixation reliability reoperation scoring system sepsis surgical mortality survival rate survival time total knee arthroplasty Active uncemented TKR system LA - English M1 - 8 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2005 SN - 0301-620X SP - 1073-1076 ST - A hydroxyapatite-coated total knee replacement. Prospective analysis of 1000 patients T2 - Journal of Bone and Joint Surgery - Series B TI - A hydroxyapatite-coated total knee replacement. Prospective analysis of 1000 patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L41135803&from=export http://dx.doi.org/10.1302/0301-620X.87B8.15772 VL - 87 ID - 829812 ER - TY - JOUR AB - INTERVENTION: Intervention1: Computer assisted navigation total knee replacement surgery: Both femoral and tibial bone cuts are computer assisted and femoral and tibial intramedullary canal not breached during total knee replacement. Hence it is hypothesised that it will not produce fat emboli. Control Intervention1: Standard conventional total knee replacement surgery: Conventional total knee replacement using intramedullary femoral jig and extramedullary tibial jig to make femoral and tibial bone cuts. Intramedullary femoral canal is breached in this technique which is hypothesised to produce fat emboli. CONDITION: Patients undergoing total knee replacement PRIMARY OUTCOME: 1. Embolus burden quantified by TEE at time of intramedullary rod insertion and after tourniquet release ; 2. Relation of embolic showers with pulmonary artery wedge pressure ; 3. Bone marrow/ fat/ thrombus/ air/ cement components in blood samples ; 4. Measured and hidden Blood loss ; 5. Operating time ; ‐‐‐‐‐‐Timepoint: 1. At baseline ; 2. After bone cuts ; 3. After trial ; 4. After cementing ; 5. After tourniquet release SECONDARY OUTCOME: 1. Relation of embolic showers with pulmonary artery wedge pressure ; 2. Bone marrow/ fat/ thrombus/ air/ cement components in blood samples ; 3. Measured and hidden Blood loss ; 4. Operating time ; ‐‐‐‐‐‐Timepoint: At baseline ; 2. After bone cuts ; 3. After trial ; 4. After cementing ; 5. After tourniquet release INCLUSION CRITERIA: Adult patient with sufficient knee pathology to be appropriate candidate for Total knee replacement falling in ASA 1 and 2 groups. AN - CN-01845403 AU - Ctri N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2014 ST - TO COMPARE TWO TECHNIQUES OF TOTAL KNEE REPLACEMENT WITH RESPECT TO AFFECT ON HEART AND LUNGS T2 - http://www.who.int/trialsearch/Trial2.aspx?TrialID=CTRI/2014/01/004291 TI - TO COMPARE TWO TECHNIQUES OF TOTAL KNEE REPLACEMENT WITH RESPECT TO AFFECT ON HEART AND LUNGS UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01845403/full ID - 830088 ER - TY - JOUR AB - Introduction. Balloon kyphoplasty provides symptomatic relief of vertebral compression fractures in elderly patients. Peri-operative complications are rare; however, they can potentially be devastating. To the best of our knowledge, complications during balloon kyphoplasty have not been described previously in published case reports. Case presentation. A 66-year-old man who was a farmer of Caucasian origin presented with a 6-month history of back pain after a fall. We discovered a significant T12 wedge compression fracture, so we performed a T12 balloon kyphoplasty. Approximately 2 weeks after being discharged from our hospital, the patient presented with increasing back pain. He presented for a second time with excruciating pain on the left side of his thoracolumbar region, so he was admitted to our ward. X-rays did not show any further fractures or compromise, but magnetic resonance imaging showed extensive edema in the T11 and L1 vertebral bodies as well as fluid tracking from the T11-T12 disc into the vertebral body. Nine days after being discharged, the patient presented to the outpatient clinic with severe back pain. Magnetic resonance imaging at that visit showed edema at the levels above and below the T11/T12 disc. He was put into a brace and given 300mg of morphine, which did not provide any pain resolution. Posterior instrumentation from T9 to L2 (pedicle fixation of T9-T10 as well as L1-L2, rods in between and a crosslink above T11-T12) was performed as the final treatment, and the patient was discharged uneventfully. Conclusion: Patients presenting with residual pain over a previous balloon kyphoplasty level should raise high suspicion for a fracture or complication involving the levels above and/or below the balloon kyphoplasty. The best way to treat fractures that develop after a failed balloon kyphoplasty is to instrument and fuse posteriorly. Our present case report shows that a high level of suspicion for possible new fractures should be maintained for all similar cases. © 2014 Cumming et al.; licensee BioMed Central Ltd. AD - T. Pagonis, Trauma and Orthopaedic Department, Spinal Unit, Ipswich Hospital, Heath Road, Ipswich IP4 5PD, United Kingdom AU - Cumming, D. AU - Pagonis, T. AU - Wood, R. DB - Embase Medline DO - 10.1186/1752-1947-8-189 KW - C reactive protein morphine paracetamol thyroxine adult aged article asthma backache blood cell count bone biopsy case report clinical examination compression fracture deep vein thrombosis diabetes mellitus edema emergency ward emphysema fracture fixation pollen allergy heart infarction human human tissue kyphoplasty lung embolism male medical history nuclear magnetic resonance imaging osteoporosis outpatient department posterior instrumentation priority journal thoracolumbar junction thoracolumbar spine vertebra body X ray film LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1752-1947 ST - Posterior instrumentation after a failed balloon kyphoplasty in the thoracolumbar junction: A case report T2 - Journal of Medical Case Reports TI - Posterior instrumentation after a failed balloon kyphoplasty in the thoracolumbar junction: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L53195360&from=export http://dx.doi.org/10.1186/1752-1947-8-189 VL - 8 ID - 829417 ER - TY - JOUR AB - Introduction: Pulmonary cement embolization is a rare, typically asymptomatic, and potentially lethal complication of orthopedic spine surgery. Polymethyl methacrylate (PMMA), commonly known as bone cement, is a widely used polymer that creates a tight space to mechanically interlock bone surface with prosthesis. The reported incidence of pulmonary cement embolism following augmentation of the vertebral body is 1-2%, although this is considered a substantial underestimation given that most patients do not experience symptoms. Presentation: A 75-year old man with a history of diabetes presented with one month of acute on chronic low back pain and three days of urinary retention and bilateral lower extremity weakness with decreased sensation. The patient was febrile on arrival and physical exam was notable for complete paralysis below the L1 level and positive Babinski sign bilaterally. Labs revealed white blood cell count of 19.3, C-reactive protein of 18.6, and ESR 84. Magnetic resonance imaging of the spine demonstrated discitis, osteomyelitis and epidural abscess at the T11-12 level causing compression and edema of the spinal cord. He underwent corpectomy, laminectomy, and spinal fusion with PMMA cementation of pedicle screws into vertebral bodies and cement augmentation of balloon kyphoplasty under fluoroscopic guidance. The patient had mild hypoxia postoperatively and a radiograph and subsequent computed tomography of the chest demonstrated embolized radiopaque bone cement in multiple bilateral lobar, segmental, and sub-segmental pulmonary arteries. In addition, imaging demonstrated adherent thrombus formation adjacent to the cement, presumably in situ thrombus rather than embolic. Pulmonary function studies were notable for moderate restriction and mild diffusion limitation (FVC 49%, FEV1 62%, FEV1/FVC 125%, TLC 67%, DLCO 65% of predicted). The patient was treated with therapeutic anticoagulation. He recovered and outpatient follow-up with pulmonology was arranged. Discussion: Embolization of PMMA cement to the pulmonary arteries is a potential complication of percutaneous vertebroplasty and balloon kyphoplasty. The incompletely polymerized PMMA leaks into the vertebral veins with subsequent travel via the vena cava to the pulmonary vasculature where it ultimately hardens. The total volume and viscosity of the injected PMMA are factors affecting the risk of cement embolization. This case highlights such an occurrence despite the recommended use of real-time fluoroscopic monitoring during cement injection. Cases of large cement embolism requiring urgent surgical removal and causing death have been reported. Most patients do not experience symptoms and are treated with observation and therapeutic anticoagulation for at least 6 months to prevent further in situ thrombus formation. (Figure Presented) . AD - A. Cypro, Internal Medicine, UCSD, San Diego, CA, United States AU - Cypro, A. AU - Montgrain, P. R. DB - Embase KW - bone cement C reactive protein endogenous compound poly(methyl methacrylate) aged anticoagulation artificial embolization Babinski reflex blood clotting case report cava vein cementation clinical article complication compression computer assisted tomography conference abstract diabetes mellitus diskitis drug combination drug fatality edema epidural abscess follow up forced expiratory volume forced vital capacity human hypesthesia hypoxia kyphoplasty laminectomy leukocyte count low back pain lower limb lung blood vessel lung diffusion capacity male nuclear magnetic resonance imaging osteomyelitis outpatient paralysis pedicle screw physical examination polymerization pulmonary artery pulmonology spinal cord spine fusion surgery thorax travel urine retention vertebra body viscosity weakness X ray film LA - English M1 - 9 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1535-4970 ST - An under-recognized and potentially fatal complication of orthopedic procedures utilizing bone cement: A case report T2 - American Journal of Respiratory and Critical Care Medicine TI - An under-recognized and potentially fatal complication of orthopedic procedures utilizing bone cement: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L630355505&from=export VL - 199 ID - 829144 ER - TY - JOUR AB - We report the case of a 62-year-old woman who initially presented with symptoms suggesting acute type A aortic dissection. Imaging studies revealed hemorrhagic pericardial fluid without the evidence of dissection. Foreign body material was noted floating in the inferior vena cava (IVC) and also piercing the right ventricular wall. Upon surgical exploration, the extracted material could be identified to be acrylic bone cement (palacos). The patient had reported a history of kyphoplasty in 2008. © 2012 Georg Thieme Verlag KG Stuttgart · New York. AD - M. Czesla, Sana Herzchirurgie Stuttgart, GmbH, Herdweg 2, Stuttgart 70174, Germany AU - Czesla, M. AU - Karnari, O. AU - Götte, J. AU - Schulte, B. AU - Pfeilsticker, U. AU - Narr, A. AU - Doll, N. DB - Embase Medline DO - 10.1055/s-0031-1295580 KW - bone cement palacos adult aortic dissection article backache case report female foreign body heart right ventricle human imaging inferior cava vein kyphoplasty lung embolism pericardial effusion priority journal LA - English M1 - SUPPL. 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 0946-4778 SP - e28-e30 ST - Unusual cause of acute back pain mimicking aortic dissection: A case report T2 - Thoracic and Cardiovascular Surgeon, Supplement TI - Unusual cause of acute back pain mimicking aortic dissection: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52513812&from=export http://dx.doi.org/10.1055/s-0031-1295580 VL - 60 ID - 829526 ER - TY - JOUR AB - Introduction: Realisation of a big operation with tumours / metastases in the backbone is in many cases not possibly above all with older multimorbid patients with higher OP risks. So it is important to go forward here so minimally invasive as possible, but at most actually to reduce the patient above all pains and other fracture and deformation danger and to improve thereby quality of life clearly. The modern method of the percutaneous Coblation-Cavity by plasma field is known since shorter time and is used by us for 5 years successfully. The aim of this work is to present the specific features of the methodology, problems, OP technology, results of the treatment of more than 200 patients with spine tumours/metastases. Material/methods: The Cavity SpineWand (Fa. ArthroCare) provides a place in the tumour by patented plasma field-highfrequency technology (Coblation-controlled Ablation, based on plasma-provided high-frequency energy) and can be used with additional procedures as for example cement injection for whirl stabilisation - Vertebroplastie. Access to the backbone occurs perkutan and transpedikulär, in some cases extrapedikulär. By the removal of tumour fabric one reaches not only place for the cement replenishment, but also complete destruction / vaporisation of the tumour cells. Recurrencerisk, fracture danger and compression of the neural structures is thereby clearly reduced. Results: Within 61 Mon. (03/2008-05/2013) became 200 patients (133-w., 67-m., age 31-92 y.) with spinal tumours and backbone metastases with this method treats. In 49 cases it was carried out, in addition, dorsal percutan Instrumentation and erection with (Fixateur interne Longitude / Fa. Medtronic). Results became clinical and radiological in 2.14 days, 3,6,12,24,36 and 48 months (yet does not control with all patients on account of the shorter method application time) postal-surgically. It showed to itself clear pain reduction and with it satisfaction and quality of life improvement with all patients. In several cases treatment was combined with chemotherapy or radiatio by which also tumour cell growth orrecurrencecould be clearly diminished. Patients could be mobilisedquickly after surgery, blood loss was minimum, Nextoncologytreatmentcould be initiated immediately. Especially by Hemangioma in one or several floors with massive bleeding inclination and cement embolism danger these both risk factors were clearly minimised by Ablation and coagulating the tumour vessels. Complications: in 19 cases with especially big osteolythischen defects to occurred cement escapes paravertebral (forwards, lateral and in the intervertebral disc field), without clinical relevance, check was not necessary. 53 patients are dead by the tumor intoxication. Conclusion: The perkutane Cavity Coblation method of the treatment of the tumours metastases in the spineshows a sure minimum-invasive procedure for patients what was booked by short-term and long-term results. By perkutanen minimally invasive access are the OP risks, v. a. blood loss and OP times clearly low and shorter. This new method becomes still only in few medical centres and centres in Germany as well as in other countries at the moment successfully is used and from our point of view for the future is promising. AD - D. Dabravolski, Donau-Ries-Klinik Donauwörth, Wirbelsäulenchirurgie, Donauwörth, Germany AU - Dabravolski, D. DB - Embase DO - 10.1007/s00586-013-3050-8 KW - cement metastasis plasma diathermy devices invasive procedure patient human neoplasm bleeding tumor cell fracture quality of life pain technology risk longitude compression Germany intoxication intervertebral disk injection embolism procedures hemangioma spine surgery cell growth risk factor chemotherapy satisfaction methodology LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0940-6719 SP - 2636-2637 ST - Minimum-invasive treatment of the tumours and metastases in the spineby plasma field-high-frequency therapy (Cavity Coblation method) with and without additional dorsal perkutane minimum-invasive instrumentation T2 - European Spine Journal TI - Minimum-invasive treatment of the tumours and metastases in the spineby plasma field-high-frequency therapy (Cavity Coblation method) with and without additional dorsal perkutane minimum-invasive instrumentation UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71283690&from=export http://dx.doi.org/10.1007/s00586-013-3050-8 VL - 22 ID - 829470 ER - TY - JOUR AB - Introduction/ Aim: Realisation of a big operation with tumours / metastases in the backbone is in many cases not possibly above all with older multi-morbid patients with higher OP risks. So it is important to go forward here as minimally invasive as possible, but at most actually to reduce the patient above all pains and other fracture and deformation danger and to improve thereby quality of life clearly. The modern method of the percutaneous Coblation/Cavity by plasma field is known since shorter time and is used by us for 6 years successfully. The aim of this work is to present the specific features of the methodology, problems, surgical technique, results of the treatment of 302 patients with spine tumours / metastases. Material / methods: Patients of all ages with destruction of the spine caused by tumors / metastases were treated. Diagnostics before OP: clinically and radiologically. The spine wand provides a place in the tumour (resection - Cavity) by plasma field (Coblation-controlled Ablation, based on plasma-provided high-frequency energy) and is used with kypho- /vertebroplasty. Access to the backbone occurs percutan and trans-/extrapediculeosly: removal of tumour tissue, deformation correction, stability. Recurrence risk, fracture danger and compression of the neural structures is thereby clearly reduced. After the OP: locally radiotherapy and chemotherapy. Follow up was clinical and radiological in 2.14 days,3,6,12,24,36,48 and 60 months postoperatively. Results: Within 7 years (04/2008-04/2015) became 302 patients (188-w., 114-m., age 31-92 y., average age - 65.4 years) with total 987 from tumors or spinal metastases affected vertebral bodies treated with destruction / osteolysis and fractures with this method treats. In 62 cases it was carried out, in addition, dorsal percutan Instrumentation and erection. It showed significant reduction of pain, satisfaction and quality of life improvement by all patients. In several cases treatment (by all metastases) was combined with chemotherapy and local radiotherapyby which also tumor cell growth or recurrence rate could be significantly reduced. Patients could be mobilised quickly after surgery, blood loss was minimum, nextoncologytreatment could be initiated immediately. Especially by Hemangiomas with massive bleeding inclination and cement embolism danger these both risk factors were clearly minimised by ablation and coagulating the tumour vessels. Complications: in 40 (by 40 vertebral bodies from 987 - only in 4,1 %) cases, where large vertebral damage was present, small cement leakage laterally or in the intervertebral disc space were detected without clinical relevance. 232 patients (139 women, 93 men) have died as a result of tumour manifestations of the metastasis in the internal organs. Discussion / Conclusion: Percutaneous Cavity/Coblation method with the plasma field energy for the treatment of spine tumors / metastases spine provides for patients is a sure minimally invasive procedure, what was booked by short-term and longterm results. OP risks, blood loss, surgical time are considerably lower and shorter. This new method becomes still only in few medical centres and centres in Germany as well as in other countries at the moment successfully is used and from our point of view for the future is very promising. Important: correct indication, treatment strategy adapted individually, assess prognosis, precise surgical technique. (Figure Presented). AD - D. Dabravolski, Klinikum Fichtelgebirge, Klinik für Wirbelsäulenchirurgie, Selb, Germany AU - Dabravolski, D. AU - Eßer, J. AU - Lahm, A. AU - Merk, H. DB - Embase DO - 10.1007/s00586-017-5336-8 KW - cement adult bleeding bone atrophy cancer recurrence cancer surgery chemotherapy clinical assessment complication compression destruction dorsal region drug combination embolism female follow up fracture Germany hemangioma human human tissue intervertebral disk major clinical study male minimally invasive procedure nervous system pain percutaneous vertebroplasty plasma prognosis quality of life radiotherapy recurrence risk risk factor satisfaction spine metastasis surgery surgical technique tumor growth vertebra body LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1432-0932 SP - 3012 ST - Minimally invasive surgical treatment of tumors and metastases in the spine with osteolytic lesions or fractures T2 - European Spine Journal TI - Minimally invasive surgical treatment of tumors and metastases in the spine with osteolytic lesions or fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L619390643&from=export http://dx.doi.org/10.1007/s00586-017-5336-8 VL - 26 ID - 829232 ER - TY - JOUR AB - BACKGROUND: Realisation of a major operation of tumours/metastases in the backbone is in many cases not possible, above all in older multimorbid patients with higher OP risks. So it is important to proceed here so minimally invasive as possible, but at least actually to reduce above all pain for the patient and the danger of other fractures and deformations and to improve thereby the quality of life. The modern method of the percutaneous cavity coblation by plasma field has been known for a short time and has been used by us for 5.5 years successfully. The aim of this work is to present the specific features of the methodology, problems, OP technology, results of the treatment of more than 218 patients with spine tumours/metastases. PATIENTS/MATERIAL AND METHODS: Old and young patients with spinal tumours (painful large haemangiomas) and metastases were treated. The Cavity SpineWand device (ArthroCare) provides a space in the tumour by patented coblation technology (coblation = controlled ablation, based on plasma-provided high-frequency energy) and can be used with additional procedures such as, for example, cement injection for vertebral stabilisation - kypho-/vertebroplasty. Access to the backbone occurs percutaneously and transpedicularly, in some cases extrapedicularly. By the removal of tumour tissue not only space for the cement replenishment is achieved, but also complete destruction/vaporisation of the tumour cells. Recurrence risk, fracture danger and compression of the neural structures are clearly reduced thereby. RESULTS: Within the 5.5 years (03/2008-09/2013) we treated 218 patients (144 f., 74 m., age 31-92 years) with spinal tumours and backbone metastases with this method. In 59 cases it was carried out in addition to dorsal percutaneous instrumentation and erection. RESULTS of clinical and radiological evaluations were assessed at 2 and 14 days as well as at 3, 6, 12, 24, 36, 48 and 60 months post-surgery (but not for control with all patients on account of the shorter method application time). A clear pain reduction and with it satisfaction and quality of life improvement were seen for all patients. In several cases treatment was combined with chemotherapy or radiotherapy by which also tumour cell growth or recurrence could be clearly diminished. Patients could be mobilised quickly after surgery, blood loss was minimal, further oncological treatment could be initiated immediately. Especially for haemangiomas in one or several levels with massive bleeding tendency and danger of cement embolism, these risk factors were clearly minimised by ablation and coagulating the tumour vessels. COMPLICATIONS: in 29 cases with especially large osteolytic defects slight cement escape was observed paravertebrally (forwards, lateral and in the intervertebral disc field), without clinical relevance, an intervention was not necessary. 65 patients (43 f., 22 m.) died due to tumour intoxication. CONCLUSION: The percutaneous cavity coblation method for the treatment of tumours and metastases in the spine represents a sure, minimally invasive procedure for patients as demonstrated by short-term and long-term results. Due to the percutaneous, minimally invasive access, the OP risks, especially blood loss and OP times are clearly low and shorter. This new method is as yet only available in a few medical centres in Germany as well as in other countries but at the moment it is being used successfully and from our point of view has a promising future. AD - Wirbelsäulenchirurgie, Donau-Ries-Klinik Donauwörth; Klinik für Orthopädie und orthopädische Chirurgie, Ernst-Moritz-Arndt-Universität Greifswald Klinik für Orthopädie und orthopädische Chirurgie, Ernst-Moritz-Arndt-Universität Greifswald; Krebszentrum Kliniken Maria Hilf GmbH, Mönchengladbach. Klinik für Orthopädie und orthopädische Chirurgie, Ernst-Moritz-Arndt-Universität Greifswald. AN - 25347550 AU - Dabravolski, D. AU - Lahm, A. AU - Kasch, R. AU - Merk, H. DA - Oct DO - 10.1055/s-0034-1382936 DP - NLM ET - 2014/10/28 J2 - Zeitschrift fur Orthopadie und Unfallchirurgie KW - Adult Aged Aged, 80 and over Catheter Ablation/*methods Combined Modality Therapy/methods Humans *Internal Fixators Kyphoplasty/*methods Middle Aged Minimally Invasive Surgical Procedures Plasma Gases Spinal Fusion/*instrumentation/*methods Spinal Neoplasms/diagnosis/*secondary/*surgery LA - ger M1 - 5 N1 - PubMed NLM literature search January 5, 2021 OP - Minimalinvasive Therapie der Tumoren und Metastasen der Wirbelsäule durch Plasmafeldtherapie (Cavity Coblation) und Vertebro-/Kyphoplastie mit und ohne zusätzliche dorsale perkutane Instrumentation. PY - 2014 SN - 1864-6697 SP - 489-97 ST - [Minimally invasive treatment of tumours and metastases in the spine by plasma field therapy (cavity coblation) and vertebro-/kyphoplasty with and without additional dorsal percutaneous instrumentation] T2 - Z Orthop Unfall TI - [Minimally invasive treatment of tumours and metastases in the spine by plasma field therapy (cavity coblation) and vertebro-/kyphoplasty with and without additional dorsal percutaneous instrumentation] VL - 152 ID - 828778 ER - TY - JOUR AB - The standard treatment of zygomatic bone fractures is fixation by microplates or miniplates and screws today. It is very difficult to place plates and screws into thin bones or small bone fragments especially in the facial bones and bones adjacent to important structures. Cyanoacrylate is used as a hemostatic agent, an embolic agent, in retinal tears, in corneal ulcers, in fixation of mandibular osteotomies and in craniofacial surgery. N-2-Butyl cyanoacrylate is a form of cyanoacrylate which is bioabsorbable and biocompatible. It is easily applied to the tissues. We aimed to determine the effect of N-2-butyl cyanoacrylate in the fixation of displaced zygomatic bone fractures. We examined the histotoxicity and the effects on healing and foreign body reaction of N-2-butyl cyanoacrylate. Eight New Zealand white rabbits underwent zygomatic osteotomies bilaterally. The fractures on left sides of the rabbits were determined as study site and right sides as control site. Knight and North classification of zygomatic bone fractures were used and group 4 fractures were made bilaterally. Open reduction of fractures was performed bilaterally and N-2-butyl cyanoacrylate was applied only on left sides. No fixation was made on right sides representing the control group. Postoperatively in the first, second, third and fourth weeks, two rabbits were sacrificed and the fracture sites were examined macroscopically and histopathologically. In the glued study group, fixation was obtained in all cases whereas in the control group, all the fractures were seen to be displaced. Tissue reaction was similar in the study and the control groups. AD - Department of Otorhinolaryngology and Head and Neck Surgery, Sişli Etfal Teaching and Research Hospital, Fatih, Istanbul, Turkey. bdadas@yahoo.com AN - 17203306 AU - Dadaş, B. AU - Alkan, S. AU - Cifci, M. AU - Başak, T. DA - May DO - 10.1007/s00405-006-0227-3 DP - NLM ET - 2007/01/05 J2 - European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery KW - Animals Bone Cements/pharmacology/*therapeutic use Enbucrilate/pharmacology/*therapeutic use Fracture Fixation/*methods Fracture Fixation, Internal Granulation Tissue/*drug effects Hemostatics/pharmacology/*therapeutic use Rabbits Zygomatic Fractures/pathology/*therapy LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 0937-4477 (Print) 0937-4477 SP - 539-44 ST - Treatment of tripod fracture of zygomatic bone by N-2-butyl cyanoacrylate glue fixation, and its effects on the tissues T2 - Eur Arch Otorhinolaryngol TI - Treatment of tripod fracture of zygomatic bone by N-2-butyl cyanoacrylate glue fixation, and its effects on the tissues VL - 264 ID - 828740 ER - TY - JOUR AB - Hip arthroplasty (hip replacement) surgery is a very common procedure and is particularly common in elderly individuals, where it is typically performed following traumatic hip fracture. As with any surgical procedure, hip arthroplasties are associated with a certain degree of morbidity and mortality, with many deaths occurring in the post-operative period. As most of these cases result from trauma (fractured hips), they are typically referred for medicolegal death investigation. Occasionally, sudden cardiorespiratory collapse and death occurs during hip arthroplasty surgery. In certain medicolegal jurisdictions, all intra-operative deaths must be investigated. Although many post-operative arthroplasty-related deaths might not require autopsy, those that occur intra-operatively may require autopsy. While clinical decision-making during recent years has resulted in fewer arthroplasty-related deaths, intraoperative deaths may still occur. In this review, the authors present their experience with three intra-operative arthroplasty-related deaths, followed by a discussion related to possible mechanisms involved in the deaths. AD - J.A. Prahlow, Western Michigan University Homer Stryker MD School of Medicine, 300 Portage St, Kalamazoo, MI, United States AU - Dalavayi, S. AU - Prahlow, J. A. DB - Embase Medline DO - 10.1016/j.jflm.2019.06.010 KW - orthopedic prosthesis bone cement fat droplet hemosiderin methacrylic acid methyl ester aged Alzheimer disease article atrial fibrillation autopsy brain atrophy cardiopulmonary arrest case report chronic obstructive lung disease clinical article congestive cardiomyopathy coronary artery atherosclerosis fat embolism female femoral neck fracture forensic pathology heart atrioventricular node heart calcification heart hypertrophy heart muscle fibrosis hip arthroplasty human hydrocephalus hypertension hypotension insulin dependent diabetes mellitus lung embolism lung emphysema lung hemorrhage pleura effusion resuscitation sinus node sudden death very elderly LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1878-7487 1752-928X SP - 138-143 ST - Sudden death during hip replacement surgery: A case series T2 - Journal of Forensic and Legal Medicine TI - Sudden death during hip replacement surgery: A case series UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2002257953&from=export http://dx.doi.org/10.1016/j.jflm.2019.06.010 VL - 66 ID - 829121 ER - TY - JOUR AB - Holter monitoring during cementation of a hip prosthesis showed sudden R-wave loss. At post mortem, demonstration of a large intracardiac air embolus may explain the ECG changes. AD - Department of Anaesthesia, Aarhus Amtssygehus, Aarhus University Hospital, Denmark. AN - 11354577 AU - Dalsgaard, J. AU - Sand, N. P. AU - Felsby, S. AU - Juelsgaard, P. AU - Thygesen, K. DA - Feb DO - 10.1080/140174301750101582 DP - NLM ET - 2001/05/17 J2 - Scandinavian cardiovascular journal : SCJ KW - Aged Aged, 80 and over Arthroplasty, Replacement, Hip/*adverse effects/*mortality *Bone Cements Electrocardiography, Ambulatory Embolism, Air/*etiology/*mortality/physiopathology Fatal Outcome Female Humans Intraoperative Complications Ventricular Dysfunction, Right/*etiology/*mortality/physiopathology LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2001 SN - 1401-7431 (Print) 1401-7431 SP - 61-4 ST - R-wave changes in fatal air embolism during bone cementation T2 - Scand Cardiovasc J TI - R-wave changes in fatal air embolism during bone cementation VL - 35 ID - 828550 ER - TY - JOUR AB - Holter monitoring during cementation of a hip prosthesis showed sudden R wave loss. At post mortem, demonstration of a large intracardiac air embolus may explain the ECG changes. AD - J. Dalsgaard, Aarhus University Hospital, Sjællandsgade 75, DK-8000 Aarhus C, Denmark AU - Dalsgaard, J. AU - Sand, N. P. R. AU - Felsby, S. AU - Juelsgaard, F. AU - Thygesen, K. DB - Embase Medline DO - 10.1080/140174301750101582 KW - bone cement aged air embolism article autopsy case report electrocardiogram female hip prosthesis Holter monitoring human lethality orthopedic surgery priority journal R wave LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2001 SN - 1401-7431 SP - 61-64 ST - R-wave changes in fatal air embolism during bone cementation T2 - Scandinavian Cardiovascular Journal TI - R-wave changes in fatal air embolism during bone cementation UR - https://www.embase.com/search/results?subaction=viewrecord&id=L32318470&from=export http://dx.doi.org/10.1080/140174301750101582 VL - 35 ID - 829882 ER - TY - JOUR AB - Intra-cranial and spinal foreign body reactions represent potential complications of medical procedures. Their diagnosis may be challenging as they frequently show an insidious clinical presentation and can mimic other life-threatening conditions. Their pathophysiological mechanism is represented by a local inflammatory response due to retained or migrated surgical elements. Cranial interventions may be responsible for the presence of retained foreign objects represented by surgical materials (such as sponges, bone wax, and Teflon). Spinal diagnostic and therapeutic procedures, including myelography, chordotomy, vertebroplasty, and device implantation, are another potential source of foreign bodies. These reactions can also follow material migration or embolization, for example in the case of Lipiodol, Teflon, and cement vertebroplasty. Imaging exams, especially CT and MRI, have a central role in the differential diagnosis of these conditions together with patient history. Neuroradiological findings are dependent on the type of material that has been left in or migrated from the surgical area. Knowledge of these entities is relevant for clinical practice as the correct identification of foreign bodies and related inflammatory reactions, material embolisms, or migrations can be difficult. This pictorial review reports neuroradiological semeiotics and differential diagnosis of foreign body-related imaging abnormalities in the brain and spine. AD - Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy. Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy. renato.cuocolo@unina.it. AN - 31853666 AU - D'Amico, A. AU - Perillo, T. AU - Ugga, L. AU - Cuocolo, R. AU - Brunetti, A. C2 - Pmc6920316 DA - Dec 18 DO - 10.1186/s13244-019-0817-4 DP - NLM ET - 2019/12/20 J2 - Insights into imaging KW - Brain Computed tomography Foreign bodies Magnetic resonance imaging Spine LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 1869-4101 (Print) 1869-4101 SP - 124 ST - Intruding implements: a pictorial review of retained surgical foreign objects in neuroradiology T2 - Insights Imaging TI - Intruding implements: a pictorial review of retained surgical foreign objects in neuroradiology VL - 10 ID - 828997 ER - TY - JOUR AB - Arteriovenous dysplasia is rather uncommon disease, quite often leading to severe complications even in young age. Involvement of the osseous apparatus into the pathological process is frequently associated with the problem of amputation of the affected limb. Therefore, salvage of the extremity while removing arteriovenous shunt and trophic impairments is an extremely important clinical task. In the presented herein clinical case report, a female patient with arteriovenous angiodysplasia of the lower limb with the tibial bone involved into the pathological process underwent repeated stagewise embolisations, failing however to achieve complete liquidation of the arteriovenous reflux. In this connection, after removal of angiomatous tissues, requiring also excochleation of the damaged portions of the bone, in order to reinforce the axis of the tibial bone the intramedullary canal of the latter was filled with polymethylmethacrylate (PMMA). Expansion of the spectrum of auxiliary methods, besides the most frequently performed in such patients embolisations of afferent arteries and removal of angiomatous tissues would make it possible to increase radical nature of interventions with salvage of the supporting function of limbs. AD - Institute of Surgery named after A.V. Vishnevsky under the RF Ministry of Public Health, Moscow, Russia. AN - 26355937 AU - Dan, V. N. AU - Akhmedov, B. G. AU - Krupochkin, S. N. AU - Sapelkin, S. V. AU - Tsygankov, V. N. AU - Varava, A. B. AU - Yashina, N. I. AU - Kadyrova, M. V. DP - NLM ET - 2015/09/12 J2 - Angiologiia i sosudistaia khirurgiia = Angiology and vascular surgery KW - Adult Angiodysplasia/etiology/*surgery Angiography *Arteriovenous Malformations/complications/physiopathology/surgery Bone Cements/therapeutic use *Bone Diseases/diagnostic imaging/etiology/surgery Cementoplasty/*methods Embolization, Therapeutic/*methods Female Humans Leg/blood supply/diagnostic imaging/surgery Limb Salvage/methods Polymethyl Methacrylate/therapeutic use Tibia/blood supply/diagnostic imaging/surgery *Tibial Arteries/abnormalities/surgery Tomography, X-Ray Computed Treatment Outcome LA - eng rus M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 1027-6661 (Print) 1027-6661 SP - 153-8 ST - Use of polymethylmethacrylate in treatment of arteriovenous angiodysplasia with bone lesions T2 - Angiol Sosud Khir TI - Use of polymethylmethacrylate in treatment of arteriovenous angiodysplasia with bone lesions VL - 21 ID - 828517 ER - TY - JOUR AB - PURPOSE: Vertebral hemangioma (VH) is virtually vascular malformation, which is usually asymptomatic. Only 3.7 % of VH may become active and symptomatic, and 1 % may invade the spinal canal and/or paravertebral space. Treatment protocols for active or aggressive VHs are still in controversy. Reported treatments include radiotherapy, vertebroplasty, direct alcohol injection, embolization, surgery and a combination of these modalities. METHODS: A 41-year-old lady was presented with 18 month history of intermittent back pain. CT revealed T5 osteolytic lesion with epidural and paravertebral extension. The first CT guided biopsy yielded little information. RESULTS: Histopathological diagnosis of the second biopsy was VH. Vertebroplasty, posterior decompression and fixation were performed followed by postoperative radiotherapy. Her symptoms were resolved immediately after the operation. At 12 months follow-up, no recurrence was detected by CT with contrast enhancement. CONCLUSION: Surgical decompression, vertebroplasty and fixation are safe and effective for aggressive VH. More attention is needed in determining the algorithm for the diagnosis and treatment of aggressive VH. AD - Orthopaedic Department, Peking University Third Hospital, No 49 North Garden Road, HaiDian District, Beijing, China. danglei_2000@yahoo.com AN - 22732826 AU - Dang, L. AU - Liu, C. AU - Yang, S. M. AU - Jiang, L. AU - Liu, Z. J. AU - Liu, X. G. AU - Yuan, H. S. AU - Wei, F. AU - Yu, M. C2 - Pmc3463694 DA - Oct DO - 10.1007/s00586-012-2349-1 DP - NLM ET - 2012/06/27 J2 - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society KW - Adult Female Humans Radiography Radiotherapy, Adjuvant Skull/abnormalities/diagnostic imaging/surgery Spinal Fusion Spine/abnormalities/diagnostic imaging/surgery Vascular Malformations/*diagnostic imaging/*radiotherapy/*surgery LA - eng M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0940-6719 (Print) 0940-6719 SP - 1994-9 ST - Aggressive vertebral hemangioma of the thoracic spine without typical radiological appearance T2 - Eur Spine J TI - Aggressive vertebral hemangioma of the thoracic spine without typical radiological appearance VL - 21 ID - 829023 ER - TY - JOUR AB - Purpose: Vertebral hemangioma (VH) is virtually vascular malformation, which is usually asymptomatic. Only 3.7 % of VH may become active and symptomatic, and 1 % may invade the spinal canal and/or paravertebral space. Treatment protocols for active or aggressive VHs are still in controversy. Reported treatments include radiotherapy, vertebroplasty, direct alcohol injection, embolization, surgery and a combination of these modalities. Methods: A 41-year-old lady was presented with 18 month history of intermittent back pain. CT revealed T5 osteolytic lesion with epidural and paravertebral extension. The first CT guided biopsy yielded little information. Results: Histopathological diagnosis of the second biopsy was VH. Vertebroplasty, posterior decompression and fixation were performed followed by postoperative radiotherapy. Her symptoms were resolved immediately after the operation. At 12 months follow-up, no recurrence was detected by CT with contrast enhancement. Conclusion: Surgical decompression, vertebroplasty and fixation are safe and effective for aggressive VH. More attention is needed in determining the algorithm for the diagnosis and treatment of aggressive VH. AD - Orthopaedic Department, Peking University Third Hospital, No 49 North Garden Road, HaiDian District, Beijing, China Orthopaedic Department, Peking University Third Hospital, No 49, North Garden Road, HaiDian District, 100191, Beijing, China, danglei_2000@yahoo.com. AN - 104373265. Language: English. Entry Date: 20130621. Revision Date: 20200708. Publication Type: journal article AU - Dang, L. AU - Liu, C. AU - Yang, S. M. AU - Jiang, L. AU - Liu, Z. J. AU - Liu, X. G. AU - Yuan, H. S. AU - Wei, F. AU - Yu, M. AU - Dang, Lei AU - Liu, Chen AU - Yang, Shao Min AU - Jiang, Liang AU - Liu, Zhong Jun AU - Liu, Xiao Guang AU - Yuan, Hui Shu AU - Wei, Feng AU - Yu, Miao DB - cin20 DO - 10.1007/s00586-012-2349-1 DP - EBSCOhost KW - Cardiovascular Abnormalities -- Radiography Cardiovascular Abnormalities -- Radiotherapy Cardiovascular Abnormalities -- Surgery Adult Female Human Radiotherapy, Adjuvant Skull -- Abnormalities Skull -- Radiography Skull -- Surgery Spinal Fusion Spine -- Abnormalities Spine -- Radiography Spine -- Surgery M1 - 10 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2012 SN - 0940-6719 SP - 1994-1999 ST - Aggressive vertebral hemangioma of the thoracic spine without typical radiological appearance T2 - European Spine Journal TI - Aggressive vertebral hemangioma of the thoracic spine without typical radiological appearance UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104373265&site=ehost-live&scope=site VL - 21 ID - 830669 ER - TY - JOUR AB - We describe a 73-year-old woman who had a right atrial-inferior vena caval thrombus and pulmonary thromboembolism develop after percutaneous vertebroplasty with methylmethacrylate. Our patient subsequently underwent open-heart surgery to effectively remove the bulk of the foreign material. This case illustrates the need for close monitoring of patients undergoing percutaneous vertebroplasty and emphasizes the importance of prompt diagnosis and treatment. AD - Division of General Surgery, Hershey Medical Center, Hershey, Pennsylvania, USA. AN - 21172531 AU - Dash, A. AU - Brinster, D. R. DA - Jan DO - 10.1016/j.athoracsur.2010.06.106 DP - NLM ET - 2010/12/22 J2 - The Annals of thoracic surgery KW - Aged Bone Cements/*adverse effects Female Humans Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/diagnosis/etiology/*surgery *Vena Cava, Inferior Venous Thrombosis/diagnosis/etiology/*surgery Vertebroplasty/*adverse effects LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2011 SN - 0003-4975 SP - 276-8 ST - Open heart surgery for removal of polymethylmethacrylate after percutaneous vertebroplasty T2 - Ann Thorac Surg TI - Open heart surgery for removal of polymethylmethacrylate after percutaneous vertebroplasty VL - 91 ID - 828527 ER - TY - JOUR AB - Case Presentation: Mr. J. is a 79-year-old man with a history of pulmonary embolism (PE)/deep vein thrombosis (DVT), coronary artery disease status post coronary artery bypass graft with ICM ejection fraction (EF) of 36% in 2007, AS, 2 cerebrovascular accidents, hypertension, HL, and osteoporosis with multiple vertebral compression fractures status post L4/L5 percutaneous vertebroplasty (PVP) admitted with weakness and acute worsening of his chronic shortness of breath, which started 3 days prior to admission when walking up the stairs to his room with his cane. He called the heart failure clinic, and they recommended a dose of Lasix 20 mg. He did so with good response (>700 cc urine output), but did not feel better and thus came to the emergency department (ED). In the ED his SaO2 was 93% on room air, and he appeared comfortable. He felt better with oxygen. He underwent electrocardiography and blood work. He was admitted for further evaluation with a pending pulmonary embolism (PE) CT. PE CT showed interval development of numerous pulmonary cement emboli (PCE). High-density cement was seen in the L4-L5 region; there was also a strand of high-attenuation material extending into the inferior vena cava (IVC). He also underwent transthoracic echocardiography (TTE), which indicated moderate to severe aortic stenosis (AS) and left ventricular hypertrophy with mildly decreased left ventricular systolic function (EF, 46%). Although systolic function was stable if not improved (prior EF, 36%), the AS was increased from prior TTE done 2 years ago. As the worsened AS was likely subacute in nature, there was concern that the cement emboli were the cause of the patient's acute symptoms. Pulmonary was consulted regarding the need for anticoagulation (recommended treatment with heparin transitioned to 6 months of warfarin), and interventional radiology (IR) was consulted for IVC filter placement given cement extending into the IVC. The patient declined anticoagulation. He was, however, amenable to IVC filter placement. IR placed a bird's nest filter, which would be most likely to catch a dislodged particulate cement fragment. The patient was discharged to subacute rehabilitation. Discussion: PV P and balloon kyphoplasty (BKP) are relatively new orthopedic procedures shown to be of benefit in pain management, especially with osteoporotic fractures. Transvertebral leakage of cement into surrounding soft tissues and extension into the veins is common: up to 90% in PVP and up to 37.5% in BKP. The incidence of cement emboli is estimated to be from 3.5% to 23% for osteoporotic fractures. There are no clear guidelines for workup or management of PCE. A review of the literature indicates that asymptomatic PCE do not need to be treated. Symptomatic PCE, however, should likely be treated according to guidelines for thrombotic PEs to avoid further thrombosis from the cement. By completion of the 6 months, the thrombus should be endothelialized. Surgical embolectomy should only be considered in particular cases (e.g., perforated right ventricle). Conclusions: The incidence of both cement extravasation and PCE is underestimated following PVP and BKP. Hospitalists should consider PCE in a patient with a history of these procedures presenting with acute onset of dyspnea. Management should be based on the degree of symptomaticity. AD - J. Dastidar, University of Michigan, Ann Arbor, MI, United States AU - Dastidar, J. DB - Embase DO - 10.1002/jhm.920 KW - cement povidone heparin warfarin furosemide oxygen percutaneous vertebroplasty dyspnea hospital patient embolism filter anticoagulation fragility fracture lung embolism blood density attenuation inferior cava vein transthoracic echocardiography aortic stenosis heart left ventricle hypertrophy male deep vein thrombosis coronary artery disease heart ejection fraction cerebrovascular accident hypertension osteoporosis medical staff interventional radiology bird rehabilitation kyphoplasty orthopedic surgery pain soft tissue vein thrombosis embolectomy heart right ventricle extravasation coronary artery thrombosis compression fracture coronary artery bypass graft weakness walking heart failure urine volume emergency ward ambient air electrocardiography thrombus L1 - http://onlinelibrary.wiley.com/doi/10.1002/jhm.920/pdf LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 1553-5592 SP - S170 ST - History of PE/DVT + vertebroplasty + dyspnea = ? T2 - Journal of Hospital Medicine TI - History of PE/DVT + vertebroplasty + dyspnea = ? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70423450&from=export http://dx.doi.org/10.1002/jhm.920 VL - 6 ID - 829621 ER - TY - JOUR AD - GRP HOSP COCHIN,SERV ANAT PATHOL & CYTOL PATHOL,PARIS,FRANCE. SALPETRIERE,SERV NEUROCHIRURG,PARIS,FRANCE. DAUMASDUPORT, C (corresponding author), HOP ST ANNE,ANAT PATHOL LAB,F-75674 PARIS 14,FRANCE. AN - WOS:A1977EJ35000006 AU - Daumasduport, C. AU - Hanau, J. AU - Abelanet, R. KW - Anatomy & Morphology Pathology LA - French M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1977 SN - 0003-3871 SP - 269-278 ST - CEREBRAL FAT EMBOLI - ONE CASE OF PER-OPERATIVE COMPLICATIONS ASSOCIATED WITH USE OF A BONE CEMENT IN ORTHOPEDIC SURGERY T2 - Annales D Anatomie Pathologique TI - CEREBRAL FAT EMBOLI - ONE CASE OF PER-OPERATIVE COMPLICATIONS ASSOCIATED WITH USE OF A BONE CEMENT IN ORTHOPEDIC SURGERY UR - ://WOS:A1977EJ35000006 VL - 22 ID - 830499 ER - TY - JOUR AB - A case of a per-operative complication associated with the use of a bone cement in orthopaedic surgery is reported. Pathological study revealed the presence of massive fat emboli : pulmonary and cerebral. There were recent infarcts throughout the cerebral cortex, unrelated to arterial topography. The physiopathology of these unusual cerebral lesions ;n association with fat emboli is discussed. They would appear to be related to the particularly abundant and voluminous nature of the fat emboli. AN - 612239 AU - Daumas-Duport, C. AU - Hanau, J. AU - Abelanet, R. DP - NLM ET - 1977/01/01 J2 - Annales d'anatomie pathologique KW - Bone Cements/*adverse effects Embolism, Fat/*etiology Hip Joint/surgery Intracranial Embolism and Thrombosis/*etiology Joint Prosthesis/adverse effects Pulmonary Embolism/*etiology LA - fre M1 - 3 N1 - PubMed NLM literature search January 5, 2021 OP - Embolies graisseuses cérébrales. A propos d'un cas d'accident per-opératoire, lors de l'utilisation d'un ciment pour os en chirurgie orthopédique. PY - 1977 SN - 0003-3871 (Print) 0003-3871 SP - 269-78 ST - [Cerebral fat emboli. Apropos of a case of a peroperative complication associated with the use of a bone cement in orthopedic surgery] T2 - Ann Anat Pathol (Paris) TI - [Cerebral fat emboli. Apropos of a case of a peroperative complication associated with the use of a bone cement in orthopedic surgery] VL - 22 ID - 828982 ER - TY - JOUR AB - A case of a peroperative complication associated with the use of a bone cement in orthopaedic surgery is reported. Pathological study revealed the presence of massive fat emboli: pulmonary and cerebral. There were recent infarcts throughout the cerebral cortex, unrelated to arterial topography. The physiopathology of these unusual cerebral lesions in association with fat emboli is discussed. They would appear to be related to the particularly abundant and voluminous nature of the fat emboli. AD - Lab. Anat. Pathol., Hop. Ste-Anne, Paris AU - Daumas-Duport, C. AU - Hanau, J. AU - Abelanet, R. DB - Embase Medline KW - bone cement poly(methyl methacrylate) adverse drug reaction autopsy brain embolism case report drug administration embolism fat embolism histology lung embolism orthopedic surgery therapy total hip prosthesis LA - French M1 - 3 N1 - Embase Elsevier literature search January 5, 2021 PY - 1977 SP - 269-278 ST - Cerebral fat emboli. One case of per-operative complications associated with the use of a bone cement in orthopaedic surgery T2 - Annales d'Anatomie Pathologique TI - Cerebral fat emboli. One case of per-operative complications associated with the use of a bone cement in orthopaedic surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L8260960&from=export VL - 22 ID - 829972 ER - TY - JOUR AB - Aims: Vertebral compression is frequently seen in elderly patients due to various causes like osteoporosis and bone marrow disorders (malignancy). We analysed our cases who had undergone percutaneous vertebroplasty for complications and to highlight the pitfalls. Methods: Thirty nine patients operated at SSHRI in last 5 years. All these patients had undergone percutaneous vertebroplasty with biopsy for fragility fracture with normal neurology, following conservative treatment for 4 to 6 weeks with analgesics and anti-osteoporotic drugs. Results: Three patients were found to have abnormal biopsy report. Two had infection and one had myeloma. In five patients the cement leaked per-operatively. But none had adverse systemic effect or neurological consequences. Adjacent near or distal fracture occurred in one patient who was noncompliant for medical management of osteoporosis. One patient had symptomatic pulmonary embolism with uneventful further outcome. All patients at 1 year follow up also never achieved the prefracture functional status. Conclusion: Rapid and substantial relief of pain and improvement in the quality of life are observed following percutaneous vertebroplasty, with few technical pitfalls. But, usually the patients never return back to their previous functional level and the fragility fracture is the beginning of gradual deteriorating ordeal of age. Biopsy is always mandatory. Adjacent level fracture not observed. Medical treatment is no substitute. AD - B. Dave, Stavya Spine Hospital, Ahemdabad, India AU - Dave, B. DB - Embase DO - 10.1007/s00198-011-1717-8 KW - cement analgesic agent percutaneous vertebroplasty Asia osteoporosis bone human patient biopsy fracture fragility fracture diseases myeloma bone marrow pain infection follow up conservative treatment lung embolism neurology functional status disease management quality of life therapy aged compression LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 0937-941X SP - S614 ST - Percutaneous vertebroplasty: Is ita cake walk? Lessons learnt T2 - Osteoporosis International TI - Percutaneous vertebroplasty: Is ita cake walk? Lessons learnt UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70806939&from=export http://dx.doi.org/10.1007/s00198-011-1717-8 VL - 22 ID - 829612 ER - TY - JOUR AB - A wide range of interventional radiology methods is currently available for the management of bone metastasis disease. Indications should be discussed in pluridisciplinary staff, depending of therapeutic intent (curative or palliative), risk of fracture, and general status of the patient. The aim of this article is to present these techniques. Cementoplasty, defined by percutaneous injection of polymethylmethacrylate into bone metastases, is used to relieve pain and prevent pathological fractures. Thermal ablation techniques are applied to achieve partial or complete destruction of bone lesions, by increasing (radiofrequency and micro-waves) or decreasing (cryoablation) intratumoral temperature. Arterial embolization and chemoembolization are used to reduce blood supply of bone tumors, in order to manage pain or before orthopedic surgery of hypervascular lesions. For the most complexes cases, combined treatment can be proposed. AD - A. David, Imagerie médicale, radiologie interventionnelle, centre René-Gauducheau, institut de cancérologie de l'Ouest, boulevard Jacques-Monod, Saint-Herblain cedex, France AU - David, A. AU - Liberge, R. AU - Labbe, C. AU - Perret, C. AU - Douane, F. DB - Embase DO - 10.1016/j.mednuc.2017.06.002 KW - poly(methyl methacrylate) ablation therapy arterial embolization bone lesion bone metastasis bone tumor cementoplasty chemoembolization cryoablation human interventional radiology orthopedic surgery pain pathologic fracture short survey vascularization LA - English French M1 - 4 M3 - Short Survey N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1878-6820 0928-1258 SP - 273-279 ST - Therapeutic strategies of bone metastases management in interventional radiology T2 - Medecine Nucleaire TI - Therapeutic strategies of bone metastases management in interventional radiology UR - https://www.embase.com/search/results?subaction=viewrecord&id=L617324476&from=export http://dx.doi.org/10.1016/j.mednuc.2017.06.002 VL - 41 ID - 829245 ER - TY - JOUR AU - David, S. AU - Kleber, F. X. DB - Medline DO - 10.1007/s00113-020-00920-5 KW - adult article case report clinical article computer assisted tomography embolism female fracture human inferior cava vein kyphoplasty middle aged neurologic disease pedicle screw vertebra body cement LA - German M3 - Article in Press N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1433-044X ST - Cement embolism in the vena cava after pedicle screw augmentation T2 - Der Unfallchirurg TI - Cement embolism in the vena cava after pedicle screw augmentation UR - https://www.embase.com/search/results?subaction=viewrecord&id=L633445530&from=export http://dx.doi.org/10.1007/s00113-020-00920-5 ID - 829046 ER - TY - JOUR AB - Limb-salvage surgery for malignant tumors frequently involves reconstruction with an endoprosthesis anchored to bone by using third-generation cementing techniques. A 10-year-old boy with osteosarcoma had a pulmonary embolus caused by polymethylmethacrylate after having limb-salvage surgery that used high-pressure cementing techniques. He experienced transient postoperative chest pain, and a new wedge-shaped radiodense pulmonary lesion appeared on a computed tomography scan of the chest. A thoracotomy for resection of suspected metastatic osteosarcoma revealed a pulmonary infarct caused by cement embolization. Awareness of this potential complication should prompt investigation of possible pulmonary embolism and may prevent unnecessary thoracotomy. AN - 105952952. Language: English. Entry Date: 20080201. Revision Date: 20150711. Publication Type: Journal Article AU - Daw, N. C. AU - Jenkins, J. J. AU - McCarville, M. B. AU - Rao, B. N. DB - cin20 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Femoral Neoplasms -- Surgery Limb Salvage -- Adverse Effects Methylmethacrylates -- Adverse Effects Osteosarcoma -- Surgery Pulmonary Embolism -- Chemically Induced Biopsy Bone Cements -- Therapeutic Use Child Diagnosis, Differential Fatal Outcome Femoral Neoplasms -- Diagnosis Limb Salvage -- Methods Male Methylmethacrylates -- Therapeutic Use Osteosarcoma -- Diagnosis Pulmonary Embolism -- Diagnosis Tomography, X-Ray Computed M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2006 SN - 0009-921X SP - 252-256 ST - Case reports: polymethylmethacrylate lung embolus after limb-salvage surgery of the distal femur T2 - Clinical Orthopaedics & Related Research TI - Case reports: polymethylmethacrylate lung embolus after limb-salvage surgery of the distal femur UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105952952&site=ehost-live&scope=site VL - 448 ID - 830770 ER - TY - JOUR AB - Limb-salvage surgery for malignant tumors frequently involves reconstruction with an endoprosthesis anchored to bone by using third-generation cementing techniques. A 10-year-old boy with osteosarcoma had a pulmonary embolus caused by polymethylmethacrylate after having limb-salvage surgery that used high-pressure cementing techniques. He experienced transient postoperative chest pain, and a new wedge-shaped radiodense pulmonary lesion appeared on a computed tomography scan of the chest. A thoracotomy for resection of suspected metastatic osteosarcoma revealed a pulmonary infarct caused by cement embolization. Awareness of this potential complication should prompt investigation of possible pulmonary embolism and may prevent unnecessary thoracotomy. AD - Department of Hematology-Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA. najat.daw@stjude.org AN - 16826124 AU - Daw, N. C. AU - Jenkins, J. J. AU - McCarville, M. B. AU - Rao, B. N. AU - Neel, M. N. DA - Jul DO - 10.1097/01.blo.0000223973.68218.10 DP - NLM ET - 2006/07/11 J2 - Clinical orthopaedics and related research KW - Biopsy Bone Cements/*adverse effects/therapeutic use Child Diagnosis, Differential Fatal Outcome Femoral Neoplasms/diagnosis/*surgery Humans Limb Salvage/*adverse effects/methods Male Osteosarcoma/diagnosis/*surgery Polymethyl Methacrylate/*adverse effects/therapeutic use Pulmonary Embolism/*chemically induced/diagnosis Tomography, X-Ray Computed LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0009-921X (Print) 0009-921x SP - 252-6 ST - Case reports: polymethylmethacrylate lung embolus after limb-salvage surgery of the distal femur T2 - Clin Orthop Relat Res TI - Case reports: polymethylmethacrylate lung embolus after limb-salvage surgery of the distal femur VL - 448 ID - 828909 ER - TY - JOUR AB - Limb-salvage surgery for malignant tumors frequently involves reconstruction with an endoprosthesis anchored to bone by using third-generation cementing techniques. A 10-year-old boy with osteosarcoma had a pulmonary embolus caused by polymethylmethacrylate after having limb-salvage surgery that used high-pressure cementing techniques. He experienced transient postoperative chest pain, and a new wedge-shaped radiodense pulmonary lesion appeared on a computed tomography scan of the chest. A thoracotomy for resection of suspected metastatic osteosarcoma revealed a pulmonary infarct caused by cement embolization. Awareness of this potential complication should prompt investigation of possible pulmonary embolism and may prevent unnecessary thoracotomy. © 2006 Lippincott Williams & Wilkins. AD - N.C. Daw, Department of Hematology-Oncology, MS 260, St. Jude Children's Research Hospital, 332 N. Lauderdale, Memphis, TN 38105-2794, United States AU - Daw, N. C. AU - Jenkins, J. J. AU - McCarville, M. B. AU - Rao, B. N. AU - Neel, M. N. DB - Embase Medline DO - 10.1097/01.blo.0000223973.68218.10 KW - antibiotic agent carboplatin doxorubicin ifosfamide medronate technetium tc 99m narcotic agent poly(methyl methacrylate) analytic method anamnesis article case report computer assisted tomography endoprosthesis femur Histoplasma capsulatum human limb salvage lung embolism lung infarction male nuclear magnetic resonance imaging osteosarcoma pain postoperative complication postoperative period priority journal school child skin test thoracotomy thorax pain tumor volume urinalysis X ray film LA - English M1 - 448 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 1528-1132 0009-921X SP - 252-256 ST - Polymethylmethacrylate lung embolus after limb-salvage surgery of the distal femur T2 - Clinical Orthopaedics and Related Research TI - Polymethylmethacrylate lung embolus after limb-salvage surgery of the distal femur UR - https://www.embase.com/search/results?subaction=viewrecord&id=L44324877&from=export http://dx.doi.org/10.1097/01.blo.0000223973.68218.10 ID - 829805 ER - TY - JOUR AU - De Castro, A. C. B. AU - Collares, M. V. M. AU - Portinho, C. P. AU - Dias, P. C. AU - Pinto, R. D. A. DB - Embase Medline DO - 10.1016/s1808-8694(15)31184-8 KW - cosmetic poly(methyl methacrylate) aged artery embolism article case report cyanosis emergency ward face edema face pain facial necrosis heparinization hospital admission hospitalization human necrosis plastic surgery private hospital tissue necrosis vascular surgery wound dressing LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2007 SN - 1808-8686 1808-8694 SP - 850 ST - Extensive facial necrosis after infiltration of polymethylmethacrylate T2 - Brazilian Journal of Otorhinolaryngology TI - Extensive facial necrosis after infiltration of polymethylmethacrylate UR - https://www.embase.com/search/results?subaction=viewrecord&id=L352816941&from=export http://dx.doi.org/10.1016/s1808-8694(15)31184-8 VL - 73 ID - 829778 ER - TY - JOUR AB - Several mechanisms have been postulated as potentially involved in life-threatening complications during cemented surgery. In this study, we evaluated the role of anaphylaxis and pulmonary fat embolism in the pathophysiology of bone cement implantation syndrome in a series of fatal cases that underwent medicolegal investigations. Postmortem findings in these cases were compared with those obtained from individuals who died after other injuries and/or interventions and in which activated mast cells and pulmonary fat embolism were involved in the pathogenesis of death. Fifty subjects were selected including 6 individuals who had undergone cemented total hip arthroplasty and died intraoperatively, 32 subjects who died shortly after being involved in traffic accidents, 8 individuals who died shortly after the injection of contrast material, and 4 subjects who had undergone orthopedic surgery and died postoperatively. Massive pulmonary fat embolism was determined to be the cause of death in all the 6 subjects who died intraoperatively as well as the main cause of death in traffic-road victims with rapid respiratory function deterioration. Mast cell activation was identified exclusively in the group of subjects who died shortly after contrast material administration. Massive pulmonary fat embolism appears to be the most important factor responsible for severe cardiorespiratory function deterioration during cemented arthroplasty. Cardiac comorbidities can also significantly influence the severity of intraoperative complications, thus corroborating the hypothesis of a multifactorial model in the pathogenesis of bone cement implantation syndrome. AD - From the *University Center of Legal Medicine, Lausanne University Hospital, Lausanne, Switzerland; and †Department of Diagnostic Services, Pathology and Legal Medicine, Section of Pathology, University of Modena and Reggio Emilia, Modena, Italy. AN - 25072810 AU - de Froidmont, S. AU - Bonetti, L. R. AU - Villaverde, R. V. AU - del Mar Lesta, M. AU - Palmiere, C. DA - Sep DO - 10.1097/paf.0000000000000110 DP - NLM ET - 2014/07/30 J2 - The American journal of forensic medicine and pathology KW - Accidents, Traffic Anaphylaxis/chemically induced/pathology Arthroplasty, Replacement, Hip/adverse effects Bone Cements/*adverse effects Contrast Media/adverse effects Embolism, Fat/*pathology Female Fractures, Bone/surgery Humans Laminectomy/adverse effects Male Mast Cells/enzymology Middle Aged Postoperative Complications Pulmonary Embolism/*pathology Tryptases/metabolism LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 0195-7910 SP - 206-11 ST - Postmortem findings in bone cement implantation syndrome-related deaths T2 - Am J Forensic Med Pathol TI - Postmortem findings in bone cement implantation syndrome-related deaths VL - 35 ID - 828663 ER - TY - JOUR AB - Several mechanisms have been postulated as potentially involved in life-threatening complications during cemented surgery. In this study, we evaluated the role of anaphylaxis and pulmonary fat embolism in the pathophysiology of bone cement implantation syndrome in a series of fatal cases that underwent medicolegal investigations. Postmortem findings in these cases were compared with those obtained from individuals who died after other injuries and/or interventions and in which activated mast cells and pulmonary fat embolism were involved in the pathogenesis of death. Fifty subjects were selected including 6 individuals who had undergone cemented total hip arthroplasty and died intraoperatively, 32 subjects who died shortly after being involved in traffic accidents, 8 individuals who died shortly after the injection of contrast material, and 4 subjects who had undergone orthopedic surgery and died postoperatively. Massive pulmonary fat embolism was determined to be the cause of death in all the 6 subjects who died intraoperatively as well as the main cause of death in traffic-road victims with rapid respiratory function deterioration. Mast cell activation was identified exclusively in the group of subjects who died shortly after contrast material administration. Massive pulmonary fat embolism appears to be the most important factor responsible for severe cardiorespiratory function deterioration during cemented arthroplasty. Cardiac. comorbidities can also significantly influence the severity of intraoperative complications, thus corroborating the hypothesis of a multifactorial model in the pathogenesis of bone cement implantation syndrome. AD - [de Froidmont, Sebastien; Villaverde, Raquel Vilarino; Lesta, Maria del Mar; Palmiere, Cristian] Univ Lausanne Hosp, Univ Ctr Legal Med, Lausanne, Switzerland. [Bonetti, Luca Reggiani] Univ Modena & Reggio Emilia, Sect Pathol, Dept Diagnost Serv Pathol & Legal Med, Modena, Italy. Palmiere, C (corresponding author), Ctr Univ Romand Med Legale, 21 Rue Bugnon, CH-1011 Lausanne, Switzerland. cristian.palmiere@chuv.ch AN - WOS:000341169500013 AU - de Froidmont, S. AU - Bonetti, L. R. AU - Villaverde, R. V. AU - Lesta, M. D. AU - Palmiere, C. DA - Sep DO - 10.1097/paf.0000000000000110 J2 - Am. J. Forensic Med. Pathol. KW - cemented arthroplasty bone cement implantation syndrome forensic pathology postmortem biochemistry autopsy fat embolism TOTAL KNEE ARTHROPLASTY TOTAL HIP-ARTHROPLASTY PATENT FORAMEN OVALE FAT-EMBOLISM TRANSESOPHAGEAL ECHOCARDIOGRAPHY CARDIOVASCULAR COLLAPSE CARDIAC-ARREST HEMIARTHROPLASTY HEMODYNAMICS HISTAMINE Medicine, Legal Pathology LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2014 SN - 0195-7910 SP - 206-211 ST - Postmortem Findings in Bone Cement Implantation Syndrome-Related Deaths T2 - American Journal of Forensic Medicine and Pathology TI - Postmortem Findings in Bone Cement Implantation Syndrome-Related Deaths UR - ://WOS:000341169500013 VL - 35 ID - 830259 ER - TY - JOUR AB - STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To investigate the effect of timing of initiation of prophylactic anticoagulation (AC) on the incidence of venous thromboembolism (VTE) after surgery for metastatic tumors of the spine. SUMMARY OF BACKGROUND DATA: VTE is a known complication in patients undergoing surgery for metastatic spine disease. However, there is limited data on the use of prophylactic AC in this population and its impact on the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE), as well as the risk of epidural hematoma. METHODS: A retrospective review of our institutional neurosurgical spine database for the years 2012 through 2018 was performed. Patients who underwent surgery for metastatic tumors were identified. The development of VTE within 30 days was examined, as well as the occurrence of epidural hematoma. The incidence of VTE was compared between patients receiving "early" (within postoperative days 1-3) and "delayed" prophylactic AC (on or after postoperative day 4). RESULTS: Sixty-five consecutive patients were identified (mean age 57, 62% male). The overall rate of VTE was 16.9%-all of whom had DVTs with a 3.1% rate of nonfatal PE (two patients also developed PE). From the overall cohort, 36 of 65 (56%) received prophylactic AC in addition to mechanical prophylaxis-22 in the early group (61.1%) and 14 in the delayed group (38.9%). The risk of VTE was 9.1% in the early group and 35.7% in the delayed group (26.6% absolute risk reduction; P = 0.049); there was one case of epidural hematoma (1.5%). On multivariate analysis, delayed prophylactic AC was found to significantly increase the odds of VTE development (OR 6.43; 95% CI, 1.01-41.2; P = 0.049). CONCLUSION: The findings of this study suggest that administration of prophylactic AC between days 1 and 3 after surgery for metastatic tumors of the spine may significantly reduce the risk of postoperative thromboembolic events. LEVEL OF EVIDENCE: 4. AD - Spine Research Group, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY. Department of Neurological Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY. AN - 30475345 AU - De la Garza Ramos, R. AU - Longo, M. AU - Gelfand, Y. AU - Echt, M. AU - Kinon, M. D. AU - Yassari, R. DA - Jun 1 DO - 10.1097/brs.0000000000002944 DP - NLM ET - 2018/11/27 J2 - Spine KW - Adult Aged Anticoagulants/*administration & dosage Cohort Studies Female Humans Kyphoplasty/adverse effects/trends Male Middle Aged Post-Exposure Prophylaxis/*methods/trends Postoperative Complications/diagnosis/etiology/prevention & control Prosthesis Implantation/adverse effects/trends Pulmonary Embolism/diagnosis/etiology/prevention & control Retrospective Studies Risk Factors Spinal Neoplasms/diagnosis/*drug therapy/*surgery Thromboembolism/diagnosis/etiology/*prevention & control Time Factors Venous Thromboembolism/diagnosis/etiology/prevention & control Venous Thrombosis/diagnosis/etiology/prevention & control LA - eng M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 0362-2436 SP - E650-e655 ST - Timing of Prophylactic Anticoagulation and Its Effect on Thromboembolic Events After Surgery for Metastatic Tumors of the Spine T2 - Spine (Phila Pa 1976) TI - Timing of Prophylactic Anticoagulation and Its Effect on Thromboembolic Events After Surgery for Metastatic Tumors of the Spine VL - 44 ID - 828574 ER - TY - JOUR AB - Background Vertebroplasty (VP) and kyphoplasty (KP) are two minimally invasive techniques used to relieve pain and restore stability in metastatic spinal disease. However, most of these procedures are performed in the thoracolumbar spine, and there is limited data on outcomes after VP/KP for cervical metastases. The purpose of this article is to evaluate the safety and efficacy of VP and KP for treating pain in patients with cervical spine metastases. Methods A systematic review of the literature was conducted using the PubMed and Medline databases. Only studies that reported five or more patients treated with VP/KP in the cervical spine were included. Levels of evidence and grades of recommendation were established based on the Oxford Centre for Evidence-Based Medicine guidelines. Data was pooled to perform a meta-analysis for pain relief and complication rates. Results Six studies (all level 4 studies) met the inclusion criteria, representing 120 patients undergoing VP/KP at 135 vertebrae; the most common addressed level was C2 in 83 cases. The average volume of injected cement was 2.5 ± 0.5 milliliters at each vertebra. There were 22 asymptomatic cement leaks (16%; 95% CI, 9.8% - 22.2%) most commonly occurring in the paraspinal soft tissue. There were 5 complications (4%; 95% CI, 0.5% - 7.5%): 3 cases of mild odynophagia, 1 case of occipital neuralgia secondary to leak, and 1 case of stroke secondary to cement embolism. Pain relief was achieved in 89% of cases (range: 80 - 100%). The calculated average pain score decreased significantly from 7.6 ± 0.9 before surgery to 1.9 ± 0.8 at last evaluation (p=0.006). Conclusion Although the calculated complication rate after VP/KP in the cervical spine is low (4%) and the reported pain relief rate is approximately 89%, there is lack of high-quality evidence supporting this. Future randomized controlled trials are needed. AD - E. Caro-Osorio, Institute of Neurology and Neurosurgery, Hospital Zambrano Hellion Tecnológico de Monterrey, Batallón de San Patricio #112, 8th Floor, Monterrey, Mexico AU - De la Garza-Ramos, R. AU - Benvenutti-Regato, M. AU - Caro-Osorio, E. DB - Embase DO - 10.14444/3007 KW - bone cement analgesia article bone cement leakage cement embolism cerebrovascular accident cervical spine embolism human kyphoplasty meta analysis neuralgia odynophagia pain pain assessment percutaneous vertebroplasty priority journal spine metastasis systematic review LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 2211-4599 ST - Vertebroplasty and kyphoplasty for cervical spine metastases: A systematic review and meta-analysis T2 - International Journal of Spine Surgery TI - Vertebroplasty and kyphoplasty for cervical spine metastases: A systematic review and meta-analysis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L610958255&from=export http://dx.doi.org/10.14444/3007 VL - 10 ID - 829399 ER - TY - JOUR AB - BACKGROUND: Vertebroplasty (VP) and kyphoplasty (KP) are two minimally invasive techniques used to relieve pain and restore stability in metastatic spinal disease. However, most of these procedures are performed in the thoracolumbar spine, and there is limited data on outcomes after VP/KP for cervical metastases. The purpose of this article is to evaluate the safety and efficacy of VP and KP for treating pain in patients with cervical spine metastases. METHODS: A systematic review of the literature was conducted using the PubMed and Medline databases. Only studies that reported five or more patients treated with VP/KP in the cervical spine were included. Levels of evidence and grades of recommendation were established based on the Oxford Centre for Evidence-Based Medicine guidelines. Data was pooled to perform a meta-analysis for pain relief and complication rates. RESULTS: Six studies (all level 4 studies) met the inclusion criteria, representing 120 patients undergoing VP/KP at 135 vertebrae; the most common addressed level was C2 in 83 cases. The average volume of injected cement was 2.5 ± 0.5 milliliters at each vertebra. There were 22 asymptomatic cement leaks (16%; 95% CI, 9.8% - 22.2%) most commonly occurring in the paraspinal soft tissue. There were 5 complications (4%; 95% CI, 0.5% - 7.5%): 3 cases of mild odynophagia, 1 case of occipital neuralgia secondary to leak, and 1 case of stroke secondary to cement embolism. Pain relief was achieved in 89% of cases (range: 80 - 100%). The calculated average pain score decreased significantly from 7.6 ± 0.9 before surgery to 1.9 ± 0.8 at last evaluation (p=0.006). CONCLUSION: Although the calculated complication rate after VP/KP in the cervical spine is low (4%) and the reported pain relief rate is approximately 89%, there is lack of high-quality evidence supporting this. Future randomized controlled trials are needed. AD - Tecnológico de Monterrey, School of Medicine and Health Sciences, Monterrey, México; Institute of Neurology and Neurosurgery, Hospital Zambrano Hellion Tecnológico de Monterrey, Monterrey, México. Tecnológico de Monterrey, School of Medicine and Health Sciences, Monterrey, México; Institute of Neurology and Neurosurgery, Hospital Zambrano Hellion Tecnológico de Monterrey, Monterrey, México; Department of Neurosurgery, Universidad Autónoma de Nuevo León, Monterrey, México. AN - 26913227 AU - De la Garza-Ramos, R. AU - Benvenutti-Regato, M. AU - Caro-Osorio, E. C2 - Pmc4752017 DO - 10.14444/3007 DP - NLM ET - 2016/02/26 J2 - International journal of spine surgery KW - cervical metastases kyphoplasty spinal metastases systematic review vertebroplasty LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 2211-4599 (Print) 2211-4599 SP - 7 ST - Vertebroplasty and kyphoplasty for cervical spine metastases: a systematic review and meta-analysis T2 - Int J Spine Surg TI - Vertebroplasty and kyphoplasty for cervical spine metastases: a systematic review and meta-analysis VL - 10 ID - 828999 ER - TY - JOUR AB - Introduction: Bronchopleural fistulas (BPF) are associated with significant morbidity and mortality. Although surgery remains the cornerstone of care, no standard therapeutic approach to the management of BPFs has been established. The variability in BPF features and patient co-morbidities often mandate conservative strategies. We describe the use of a customized silicone Y-stent and an Amplatzer device to treat a patient with post-pneumonectomy BPF. Case presentation: A 65-year-old man with a history of complicated cavitary Aspergillus pneumonia and persistent Mycobacterium szulgai infection who underwent left-sided pneumonectomy presented with severe dyspnea and productive cough eleven weeks postoperatively. Flexible bronchoscopy revealed a 4mm fistula on the left-sided bronchial stump. Communication with the pleural cavity was evident with purulent secretions coming from the BPF, which resulted in soiling of the contralateral lung. Therapeutic management included antibiotics, pleural space debridement and Kerlix packing, and eventually Eloesser flap creation. Despite this, aspiration of purulent secretions from the left pleural cavity into the right-sided airways impeded the patient's clinical recovery. Thus, a customized silicone Y-stent was placed by rigid bronchoscopy. The stent was manually modified in the operating room by cutting the left limb at 10 mm from the carina and invaginating the distal end. Stapling and circumferential mattress sutures were used to tie in the distal left limb (Figure 1). Dermabond (2-Octyl cyanoacrylate) was instilled within the stent to seal any remaining spaces along the suture line. Four months later, bronchoscopic evaluation demonstrated a persistent 4mm BPF, covered by the silicone Y-stent. After multidisciplinary discussion, the decision was made to attempt to close the BPF, which if successful, would permit surgical closure of the thoracotomy window. Thus, an Amplatzer device was placed in the left mainstem bronchus proximal to the BPF and secured in place with fibrin glue delivered through a modified CRE balloon catheter. The silicone Y-stent was subsequently removed, and the patient is currently awaiting surgical closure of the Eloesser flap. Conclusion: Different stent designs to support BPF epithelialization have been proven useful, but these may not always be readily available. For BPF cases which demand immediate sealing, the use of customizable silicone stents and Amplatzer devices are valuable alternative treatments. The Amplatzer device can be cemented in place by injecting fibrin glue or Onyx-34 liquid embolic system based on previous reports. These highly technical procedures necessitate multidisciplinary teamwork for success. AD - A. De Lima, Division of Thoracic Surgery and Interventional Pulmonology, Beth Israel Deaconess Medical Center, Boston, MA, United States AU - De Lima, A. AU - Gesthalter, Y. B. AU - Barry, M. AU - Wilson, J. L. AU - Kent, M. S. AU - Majid, A. AU - Holden, V. K. AU - Chee, A. C. DB - Embase KW - antibiotic agent cyanoacrylic acid octyl ester fibrin glue onyx copolymer silicone aged airway Aspergillus aspiration bronchopleural fistula bronchus case report clinical article conference abstract coughing debridement dilatation catheter drug therapy dyspnea epithelization fiberoptic bronchoscopy gauze dressing human limb lung resection male Mycobacterium szulgai nonhuman operating room pleura cavity pneumonia remission sizing balloon catheter stent suppuration surgery suture teamwork thoracotomy LA - English M1 - MeetingAbstracts M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1535-4970 ST - Treatment of persistent bronchopleural fistula with manually modified endobronchial stent and amplatzer device T2 - American Journal of Respiratory and Critical Care Medicine TI - Treatment of persistent bronchopleural fistula with manually modified endobronchial stent and amplatzer device UR - https://www.embase.com/search/results?subaction=viewrecord&id=L622965469&from=export VL - 197 ID - 829214 ER - TY - JOUR AB - Hybrid metal-on-metal surface arthroplasty of the hip has recently been introduced, with a vast number of implants used in European countries including Belgium. This article presents results in 252 hips with a mean follow-up of 2.8 years. Using a tight press-fit with minimal cement mantle as the technique of femoral fixation, there have been only three failures. The main complications have been avascular necrosis of the femoral head and femoral neck fracture. In most cases, patients returned to a high functional level with no restrictions in their physical activity and were highly satisfied. Future refinements in surgical technique and instruments will make this procedure more accessible and reproducible for the surgeon. © 2005 Elsevier Inc. All rights reserved. AD - K.A. De Smet, Anca Clinic, Kalverbosstraat 31 A, B-9070 Heusden, Belgium AU - De Smet, K. A. DB - Embase Medline DO - 10.1016/j.ocl.2005.01.004 KW - adolescent adult aged article avascular necrosis Belgium bone radiography clinical trial congenital hip dislocation controlled clinical trial controlled study deep vein thrombosis female femur follow up heterotopic ossification hip arthroplasty hip dislocation hip dysplasia hip injury hip osteoarthritis hip prosthesis hip resurfacing arthroplasty human lung embolism major clinical study male nerve paralysis orthopedics ossification osteolysis peroneus nerve paralysis postoperative complication postoperative infection postoperative period priority journal rheumatic disease sciatic nerve surgical technique treatment outcome LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2005 SN - 0030-5898 SP - 203-213 ST - Belgium experience with metal-on-metal surface arthroplasty T2 - Orthopedic Clinics of North America TI - Belgium experience with metal-on-metal surface arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L40503998&from=export http://dx.doi.org/10.1016/j.ocl.2005.01.004 VL - 36 ID - 829820 ER - TY - JOUR AB - Treatment with injectable tissue fillers for aesthetic purposes is increasingly popular. In parallel with this success, questions related to the safety of these treatments and the products involved are being raised more prominently. To gain insight in the safety aspects of injectable tissue fillers, we performed a literature review to collect studies reporting clinical data of injectable tissue fillers. We found several case reports where serious complications after more than three years are described. However, there are only a limited number of well-defined prospective clinical studies available with follow-up periods longer than three years. Furthermore, causes of complications, that is, treatment or product related, are often not specified in literature. Considering the intended functional period of fillers in combination with the known occurrence of long-term complications, there is a need for well-defined prospective clinical studies. In order to be able to discriminate between product failure (a product safety issue) or application methodology (a physician expertise or training issue), better identification of observed complications and whether they are product or treatment related, is needed. For the safe use of the fillers it is important that treatment with injectable tissue fillers is performed by a trained physician, who knows the product specifications and its applications. © 2013 Informa UK Ltd. AD - C.G.J.C.A. De Vries, Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, NL-3720 BA Bilthoven, Netherlands AU - De Vries, C. G. J. C. A. AU - Geertsma, R. E. DB - Embase Medline DO - 10.1586/17434440.2013.839211 KW - 2 hydroxyethyl methacrylate carboxymethylcellulose collagen hyaluronic acid hydroxyapatite poly(methyl methacrylate) polyacrylamide polylactic acid application site erythema application site papule artery embolism case report clinical study cyst delayed hypersensitivity ecchymosis edema erythema esthetics faintness follow up foreign body granuloma granulomatous inflammation hematoma human hyperpigmentation hypersensitivity infection inflammation injectable tissue filler injection site cellulitis injection site contusion injection site nodule injection site reaction injection site swelling keratoacanthoma lumpy skin disease medical device medical device complication necrosis pain paresthesia physician postoperative pain product safety pruritus rash review safety scleromyxedema skin contusion skin discoloration skin induration skin nodule skin tingling skin ulcer suppuration swelling wrinkle LA - English M1 - 6 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1743-4440 1745-2422 SP - 835-853 ST - Clinical data on injectable tissue fillers: A review T2 - Expert Review of Medical Devices TI - Clinical data on injectable tissue fillers: A review UR - https://www.embase.com/search/results?subaction=viewrecord&id=L370277372&from=export http://dx.doi.org/10.1586/17434440.2013.839211 VL - 10 ID - 829467 ER - TY - JOUR AB - Case presentation: The 62 year old female with a medical history of hypertension and type 2 diabetes mellitus underwent vertebroplasty to the T12 and L3 vertebrae which took approximately 85 min from intubation to extubation. The trochar was inserted under fluroscopic guidance and kyphon cement was injected into both vertebral bodies with no reported orthopedic complications. On recovery from anaesthesia the patient complained of pleuritic type chest discomfort and respiratory compromise was apparent. Examination and investigations: Initial assessment established that the patient was hypoxaemic, PaO2 9.52 FiO2 .66 with no apparent haemodynamic compromise. Clinical examination and chest x-ray failed to identify the cause of the hypoxaemia initially however an enhanced and unenhanced computed tomography scan, that was performed 6 h post operation, identified moderately sized bilateral pneumothoraces and evidence of cement embolisation within the pulmonary vasculature. Management: Management was supportive with oxygen therapy via facemask and no invasive interventions were used during the patients 4 day hospital stay, which ended with the patient returning home. Discussion: The presenting complaints and the timing of their detection are of particular interest in this case given that they appear to present sometime after the likely insult occurred. The degree to which either the pneumothoraces or cement emboli contributed to the hypoxaemia is unclear although it appears that the change from positive pressure to physiological ventilation 'unmasked' the underlying insults. The anaesthetic team must remain alert to the broad range of potential causes of hypoxaemia in surgical interventions of this nature. AD - J. Dean, Ipswich Hospital NHS Trust, United Kingdom AU - Dean, J. AU - Nadarajan, S. DB - Embase KW - cement adult anesthesia artificial embolization case report clinical article clinical assessment clinical examination complication computer assisted tomography conference abstract extubation face mask female hemodynamics human hypertension hypoxemia intubation kyphoplasty system lung blood vessel medical history middle aged non insulin dependent diabetes mellitus outpatient department oxygen therapy percutaneous vertebroplasty pneumothorax remission surgery thorax pain thorax radiography vertebra body LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1399-6576 SP - 19 ST - A case of hypoxaemia post extubation following vertebroplasty T2 - Acta Anaesthesiologica Scandinavica TI - A case of hypoxaemia post extubation following vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L623414836&from=export VL - 59 ID - 829373 ER - TY - JOUR AB - INTRODUCTION: Vertebral hemangiomas (VH) represent the most common primary bone tumor of the spine and are rarely symptomatic. Currently, there is no consensus for treatment and many therapeutic options are available, alone or in combination including cementoplasty, sclerotherapy, surgery, embolization and/or radiotherapy. OBJECTIVE: To evaluate the clinical and radiological outcome of a multimodal management for symptomatic VH. METHODS: A consecutive prospective and retrospective multicenter study was conducted to review cases of symptomatic VHs between 2005 and 2015. Clinical and radiological aspects, treatment modalities and complications were evaluated preoperatively; postoperatively and at last follow-up. We also reviewed the literature of studies concerning case series of VH, published after 1990 and involving more than 10 patients. RESULTS: Twenty-seven VHs were included in our series (mean age at diagnosis: 47.9 years), out of which 26 were symptomatic. Ten presented with neurologic deficit (37%). An epidural extension was noted in 13 patients (48%). Eleven patients (41%) underwent multimodal treatments. In the multimodal group, eradication was observed in 6 patients (54%), stable residue in 5 cases (46%) with no recurrence versus 3 eradication (23%), 9 stable residue (69%) and no recurrence in the monomodal group, (P>0.05). The literature comprised 14 studies including 458 patients. Only 4 studies were focused on multimodal treatments. CONCLUSION: Based on this study, the multimodal management of symptomatic VHs appeared safe and effective. Finally, we propose an algorithm for symptomatic VHS management based on the severity of epidural extension and fracture risk. AD - Service de neuro chirurgie C, chirurgie du rachis, hôpital P.-Wertheimer, hospices civils de Lyon, université Claude-Bernard Lyon, boulevard Pinel, 69003 Lyon, France. Service de neurochirurgie, hôpital Erasme, route de Lennik, 808, 1070 Bruxelles, Belgique. Service de neurochirurgie, CHRU de Lille, rue E. Laine, 59037 Lille, France. Université d'Aix-Marseille, 13284 Marseille, France; Service de neurochirurgie, hôpital Timone, AP-HM, 13005 Marseille, France. Service de neuroradiologie interventionnelle, P.-Wertheimer, hospices civils de Lyon, université Claude-Bernard Lyon 1, 59, boulevard Pinel, 69003 Lyon, France. Service de neuro chirurgie C, chirurgie du rachis, hôpital P.-Wertheimer, hospices civils de Lyon, université Claude-Bernard Lyon, boulevard Pinel, 69003 Lyon, France; Laboratoire de biomécanique, arts et metiers Paris-Tech, ENSAM, boulevard de l'Hôpital, 75013 Paris, France. Electronic address: c.barrey@wanadoo.fr. AN - 29122304 AU - Delabar, V. AU - Bruneau, M. AU - Beuriat, P. A. AU - Zairi, F. AU - Fuentes, S. AU - Riva, R. AU - Gory, B. AU - Barrey, C. DA - Dec DO - 10.1016/j.neuchi.2017.08.001 DP - NLM ET - 2017/11/11 J2 - Neuro-Chirurgie KW - Algorithms Combined Modality Therapy Hemangioma/*therapy Humans Middle Aged Prospective Studies Retrospective Studies Spinal Neoplasms/*therapy Aggressive hemangioma Hémangiome agressif Hémangiome vertébral Multimodal treatment Primary bone tumor Spine tumor Traitement multimodal Tumeur du rachis Tumeur osseuse primitive Vertebral hemangioma Vertebroplasty Vertébroplastie LA - fre M1 - 6 N1 - PubMed NLM literature search January 5, 2021 OP - Intérêt d’une prise en charge multimodale des hémangiomes vertébraux symptomatiques : à propos de 27 cas et revue de la littérature. PY - 2017 SN - 0028-3770 SP - 458-467 ST - [The efficacy of multimodal treatment for symptomatic vertebral hemangiomas: A report of 27 cases and a review of the literature] T2 - Neurochirurgie TI - [The efficacy of multimodal treatment for symptomatic vertebral hemangiomas: A report of 27 cases and a review of the literature] VL - 63 ID - 828683 ER - TY - JOUR AB - Background: The effect of hydroxyapatite (HA) coating on the fixation of a cementless femoral stem is discussed, in particular in cases of primary fixation with geometrically stable components. Therefore, we performed a comparative retrospective study of a series of Alloclassic-SL™ stems to: 1) present the long-term results and 2) evaluate the contribution, if any, of proximal HA coating. Hypotheses: Long-term cementless press-fit ("flat wedge-shaped") fixationis reliable and HA coating only improves the radiological results of the proximal bone-prosthesis interface. Materials and Methods: One hundred and ninety-eight Alloclassic total hip arthroplasties were performed in 179 patients, mean age 66years old (22-85), including 105 with proximal HA coating and 93 with the original grit-blast coating. One hundred and ninety-three hips were analyzed after a mean follow-up of 9.8years (1-24years). Results: Results were excellent or good in 184hips (95%) with no significant difference between the 2groups (Merle d'Aubigné. ≥. 16 for 89/92 (98%) without HA compared to 95/101 (94%) with HA P= 0.59). Radiographic signs of stable osseointegration were observed in 173hips (90% of the cases). HA coating significantly improved the radiographic results of the proximal bone-implant interface: (42/92 (46%) of the stems without HA had proximal radiolucencies in zones1 and 7 compared to 4/101 (4%) with HA (P= 0.0001)). Polyethylene wear. >. 0.1mm/year was observed in 6hips (3%) including 1/101 (1%) in the group with HA versus 5/92 (5.4%) without HA (P= 0.17). One intra-operative femoral fracture occurred and there were 9dislocations in the first 3postoperative months (4.5%). The main cause of revision surgery was recurrent dislocation (11/17cases). The "revision per-100 observed-femoral component years" was 0.10 in both groups and survival for aseptic loosening of the stem was 100% (95% CI. = 73.2% to 100%) at 20years. Conclusion: This study shows that secondary fixation by osseointegration of a straight standard grit-blasted titanium alloy non-anatomical implant is reliable. Possible proximal fibrous encapsulation, which is reduced by HA coating, but especially conventional polyethylene wear, were the main limitations of this system. Level of evidence: III retrospective case-control study. AD - C. Delaunay, Clinique de l'Yvette, 67-71, route de Corbeil, Longjumeau, France AU - Delaunay, C. DB - Embase Medline DO - 10.1016/j.otsr.2014.07.010 KW - cementless prosthesis total hip prosthesis hydroxyapatite polyethylene titanium adult aged article bone atrophy bone regeneration case control study comparative study female femur fracture follow up hip radiography human lung embolism major clinical study male ossification osteolysis osteopenia periprosthetic fracture phlebitis postoperative complication prosthesis loosening recurrent dislocation reliability retrospective study Alloclassic-SL LA - English M1 - 7 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1877-0568 SP - 739-744 ST - Effect of hydroxyapatite coating on the radio-clinical results of a grit-blasted titanium alloy femoral taper. A case-control study of 198 cementless primary total hip arthroplasty with the Alloclassic™ system T2 - Orthopaedics and Traumatology: Surgery and Research TI - Effect of hydroxyapatite coating on the radio-clinical results of a grit-blasted titanium alloy femoral taper. A case-control study of 198 cementless primary total hip arthroplasty with the Alloclassic™ system UR - https://www.embase.com/search/results?subaction=viewrecord&id=L600425546&from=export http://dx.doi.org/10.1016/j.otsr.2014.07.010 VL - 100 ID - 829454 ER - TY - JOUR AB - Cementless acetabular components gained popularity because of the increased rate of loosening associated with cemented cups after intermediate and long-term follow-up. There are few long-term follow-up studies of cementless acetabular components. This study aims to evaluate the clinical and radiological long-term results of the press-fit standard Wagner Cup. Between January 1, 1994 and June 30, 1994, 118 implantations of a standard Wagner Cup were performed, and 102 implants were clinically and radiographically followed-up after a mean of 12.0 years. The Merle d'Aubigné score improved from a preoperative mean of 9.5 to 17.2 at latest follow-up. Early postoperative complications included two deep haematomata requiring needle aspiration, two deep vein thromboses, one pulmonary embolism, two temporary lesions of the sciatic nerve, one single event of THR dislocation and one recurrent dislocation. Two isolated cup revisions and five more complete total hip replacements were performed for aseptic loosening. The overall survival rate at 12 years was 93.1% (95/102). The standard Wagner cup yields very good long-term results. AD - Department of Pediatric Orthopedics, Orthopedic Clinic Wichernhaus, 90592 Schwarzenbruck, Germany Department of Pediatric Orthopedics, Orthopedic Clinic Wichernhaus, 90592 Schwarzenbruck, Germany. AN - 105285088. Language: English. Entry Date: 20100409. Revision Date: 20170411. Publication Type: journal article AU - Demmelmeyer, U. AU - Schraml, A. AU - Hönle, W. AU - Schuh, A. AU - Demmelmeyer, Uwe AU - Schraml, Annemarie AU - Hönle, Wolfgang AU - Schuh, Alexander DB - cin20 DO - 10.1007/s00264-009-0766-5 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Adverse Effects Arthroplasty, Replacement, Hip -- Equipment and Supplies Joint Prosthesis Joint Diseases -- Surgery Postoperative Complications -- Etiology Prosthesis Design Acetabulum -- Surgery Adult Aged Arthroplasty, Replacement, Hip -- Methods Cementation Female Hip Joint -- Physiopathology Hip Joint -- Radiography Hip Joint -- Surgery Human Joint Diseases -- Physiopathology Male Middle Age Postoperative Complications -- Surgery Prosthesis Failure Reoperation Treatment Outcomes M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2010 SN - 0341-2695 SP - 33-37 ST - Long-term results of the standard Wagner cup T2 - International Orthopaedics TI - Long-term results of the standard Wagner cup UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105285088&site=ehost-live&scope=site VL - 34 ID - 830714 ER - TY - JOUR AB - One hundred twenty consecutive total knee arthroplasties were performed to compare the accuracy of intramedullary versus extramedullary tibial resection guides. An intramedullary guide (group 1) was used in 60 cases and an extramedullary guide (group 2) was used in another 60 cases. In group 2, the distal portion of the extramedullary guide was shifted 3 mm medial to the midpoint of the ankle in order to position it over the center of the talus. Postoperative tibial component alignment angles were similar in both groups (group 1, 0.43 degrees varus; group 2, 0.36 degrees valgus). However, 88% of tibial components in group 2 were aligned within 2 degrees of the 90 degrees goal versus only 72% of tibial components in group 1. Satisfactory alignment can be obtained with either intramedullary or extramedullary resection guides, although a wider range of error was encountered with intramedullary guide use. Distal positioning of the extramedullary guide over the center of the talus rather than the midpoint of the ankle is important to avoid varus tibial resection. Extramedullary guides avoid the potential complications of intramedullary guide use, including fat embolization and hypoxia, intraoperative fracture, loss of polymethyl methacrylate pressurization, and inability of intramedullary rod passage due to deformity, retained hardware, or pathologic bone disease. AD - Denver Orthopedic Clinic, Research Department, CO 80205. AN - 8436988 AU - Dennis, D. A. AU - Channer, M. AU - Susman, M. H. AU - Stringer, E. A. DA - Feb DO - 10.1016/s0883-5403(06)80106-3 DP - NLM ET - 1993/02/01 J2 - The Journal of arthroplasty KW - Aged Arthritis, Rheumatoid/surgery Female Humans Intraoperative Care/instrumentation *Knee Prosthesis Male Orthopedic Equipment Osteoarthritis/surgery Prosthesis Failure Tibia/anatomy & histology/*surgery LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 1993 SN - 0883-5403 (Print) 0883-5403 SP - 43-7 ST - Intramedullary versus extramedullary tibial alignment systems in total knee arthroplasty T2 - J Arthroplasty TI - Intramedullary versus extramedullary tibial alignment systems in total knee arthroplasty VL - 8 ID - 829040 ER - TY - JOUR AB - Thyroid cancer rarely metastasizes to the pelvis. We report a case where the metastasis was found two years before the thyroid cancer. Treatment included initial surgery with resection of the metastatic tumor and reconstruction of the acetabulum with bone cement, and secondly total thyroidectomy, node dissection and I131. Surgical treatment of locoregional recurrence had no influence on the clinical course leading to the patient's death. Early diagnosis of unique metastasis of a thyroid cancer is important in terms of prognosis and quality of life. This case is exceptional due to the unique bone metastasis and treatment options for acetabular metastases. Therapeutic options should be adapted according to algorithms reported in the literature. AD - Département de Chirurgie, Institut Jules Bordet, rue Héger Bordet 1, 1000 Bruxelles, France. AN - 11845027 AU - Dequanter, D. AU - Abdoulaye, D. AU - Lothaire, P. AU - Gebhart, M. AU - Andry, G. DA - Dec DP - NLM ET - 2002/02/15 J2 - Annales d'endocrinologie KW - Acetabulum/pathology/surgery Adenocarcinoma, Follicular/pathology/radiotherapy/*secondary/surgery Aged Bone Neoplasms/radiotherapy/*secondary/surgery Carcinoma/pathology/radiotherapy/*secondary Combined Modality Therapy Diagnostic Errors Disease Progression Fatal Outcome Female Humans Ileum/*pathology Iodine Radioisotopes/therapeutic use Osteoarthritis, Hip/diagnosis Postoperative Complications/etiology Pulmonary Embolism/etiology Thyroid Neoplasms/diagnosis/*pathology/radiotherapy/surgery Thyroidectomy LA - fre M1 - 6 N1 - PubMed NLM literature search January 5, 2021 OP - Métastase pelvienne isolée d'un cancer de la thyroïde. PY - 2001 SN - 0003-4266 (Print) 0003-4266 SP - 521-4 ST - [Isolated pelvic metastasis of thyroid cancer] T2 - Ann Endocrinol (Paris) TI - [Isolated pelvic metastasis of thyroid cancer] VL - 62 ID - 828947 ER - TY - JOUR AB - Percutaneous vertebroplasty consists of percutaneous injection of polymethylmethacrylate (PMMA) via a transpedicular approach for the treatment of collapsed osteoporotic or metastatic vertebrae. Even if percutaneous vertebroplasty is considered to be minimally invasive, threatening complications can occur. Cement leakage is the most common complication of percutaneous vertebroplasty. Rigorous patient selection and individual therapeutic strategy may reduce the occurrence of leakage, in particular the risk of cement entry into the venous system and the spinal canal is the potent major hazard of this technique. Cement pulmonary and cardiac embolism are reported in literature as a cause of unexpected death after percutaneous vertebroplasty. Authors report a fatal case of pulmonary cement embolization occurred after vertebroplasty with haemopericardium, due to the perforation of the right atrium wall from a cement solidified fragment. A complete post mortem examination documented the presence of multiple cement fragments in the pulmonary arteries and transmural perforation of the wall of the right atrium by a whitish needle-like foreign body. Pulmonary microembolization was observed under polarized light. AD - Department of Legal Medicine, Azienda USL Toscana Nordovest, Lucca, Italy. Electronic address: stefano.derrico@uslnordovest.toscana.it. Department of Legal Medicine, Azienda USL Toscana Nordovest, Lucca, Italy. AN - 30861473 AU - D'Errico, S. AU - Niballi, S. AU - Bonuccelli, D. DA - Apr DO - 10.1016/j.jflm.2019.03.004 DP - NLM ET - 2019/03/13 J2 - Journal of forensic and legal medicine KW - Aged Bone Cements/*adverse effects Death, Sudden/*etiology Extravasation of Diagnostic and Therapeutic Materials/*complications Female Foreign Bodies/pathology Forensic Pathology Fractures, Compression/surgery Heart Atria/*injuries/pathology Humans Osteoporotic Fractures/surgery Polymethyl Methacrylate/adverse effects Pulmonary Embolism/*pathology Spinal Fractures/surgery Vertebroplasty/*adverse effects Cardiac perforation Cement leakage Percutaneous vertebroplasty LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 1752-928x SP - 48-51 ST - Fatal cardiac perforation and pulmonary embolism of leaked cement after percutaneous vertebroplasty T2 - J Forensic Leg Med TI - Fatal cardiac perforation and pulmonary embolism of leaked cement after percutaneous vertebroplasty VL - 63 ID - 828566 ER - TY - JOUR AB - A report is presented of five serious accidents that occurred during or immediately after operations for the reconstruction of the hip or the knee. The only element which these cases had in common was that acrylic cement was used in all of them. In three patients subjected to operation of the hip, cardiocirculatory arrest occurred suddenly during the minute following the femoral sealing. A number of predisposing factors may be considered such as the patients' bad general condition, hypoxia, hypovolemia and the monomer of methylmetacrylate. The complications in the two patients subjected to operation for total prosthesis of the knee were diagnosed immediately after the operation. The anatomical and clinical aspects observed were compatible with the hypothesis of fat embolism. (42 references.) AD - Dept. Anesthesiol., Hop. Bichat, Paris AU - Desmonts, J. M. AU - Mauge, F. AU - Klein, J. P. DB - Embase KW - bone cement methacrylic acid methyl ester adverse drug reaction bradycardia embolism fat embolism heart arrest hypotension knee prosthesis lung embolism major clinical study total hip prosthesis total knee arthroplasty LA - French M1 - 7 N1 - Embase Elsevier literature search January 5, 2021 PY - 1974 SN - 0007-9685 SP - 693-706 ST - Complications consequent on sealing of hip and knee prosthesis with methylmethacrylate T2 - Cahiers d'Anesthesiologie TI - Complications consequent on sealing of hip and knee prosthesis with methylmethacrylate UR - https://www.embase.com/search/results?subaction=viewrecord&id=L5180708&from=export VL - 22 ID - 829977 ER - TY - JOUR AB - Background The Exeter cemented femoral stem has demonstrated excellent clinical and radiographic outcomes as well as long-term survivorship free from aseptic loosening. A shorter revision stem (125 mm) with a 44 offset became available for the purpose of cement-in-cement revision situations. In certain cases, this shorter revision stem may be used for various primary total hip arthroplasties (THAs) where the standard length stem would require distally reaming the femoral canal. We sought to report on the early to midterm results of this specific stem when used for primary THA regarding (1) clinical and radiographic outcomes, (2) complications, and (3) survivorship. Methods Twenty-nine patients (33 hips) underwent a hybrid THA using the smaller revision Exeter cemented femoral stem. Twenty-five patients (28 hips) had at least 2 years of follow-up and were assessed for clinical and radiographic outcomes. All 33 hips were included in the analysis of complications and survivorship. The Kaplan-Meier survivorship was performed using revision for all causes and for aseptic loosening as the end points. Results The average clinical follow-up was 4 years (range, 2-7). Harris Hip Scores improved from a mean preoperative value of 56 (range, 23-96) to 90 (range, 51-100) at the latest follow-up. All patients demonstrated superior cement mantles with no signs of loosening. One patient suffered a B2 periprosthetic fracture and 1 patient experienced 2 episodes of instability. The 5-year Kaplan-Meier survivorship was 96.7% for all causes of revision and was 100% using aseptic loosening as the end point. Conclusion The shorter Exeter revision cemented femoral stem has favorable early to midterm clinical and radiographic outcomes when used for primary THA with a low complication rate and is a viable option in patients with narrow femoral canals where uncemented stem fixation is not desired. AD - R.J. Sierra, Department of Orthopedic Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, United States AU - Desy, N. M. AU - Johnson, J. D. AU - Sierra, R. J. DB - Embase Medline DO - 10.1016/j.arth.2016.07.051 KW - cemented prosthesis femur prosthesis total hip prosthesis adult aged article brace cerclage clinical article closed luxation reduction controlled study fat embolism female follow up Harris hip score hip dislocation human male open fracture reduction periprosthetic fracture preoperative period prosthesis loosening proximal femur fracture reoperation retrospective study survival rate treatment outcome Exeter LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1532-8406 0883-5403 SP - 494-498 ST - Satisfactory Results of the Exeter Revision Femoral Stem Used for Primary Total Hip Arthroplasty T2 - Journal of Arthroplasty TI - Satisfactory Results of the Exeter Revision Femoral Stem Used for Primary Total Hip Arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L613206579&from=export http://dx.doi.org/10.1016/j.arth.2016.07.051 VL - 32 ID - 829270 ER - TY - JOUR AB - Percutaneous vertebroplasty and kyphoplasty are two procedures which have revolutionised spine care in the last decade or so. Vertebroplasty is basically a procedure in which acrylic bone cement is injected into the vertebral body. Kyphoplasty is a similar cementing procedure but in this technique a special balloon is inserted into the vertebral body which inflates thereby increasing the height of the body. Vertebroplasty was first described by Galibert P etal1 in 1987 to treat a case of angioma in France. Since then many centres have carried out these procedures all over the world. These two procedures were originally described for osteoporotic spinal collapse, but later have found use in many other indications such as malignancy. AD - M.S. Dhillon, Department of Orthopaedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India AU - Dhatt, S. S. AU - Kang, M. AU - Dhillon, M. S. DB - Embase KW - fentanyl midazolam allergy analgesia blood clotting disorder cement leakage compression fracture computer assisted tomography conscious sedation epidural leak fluoroscopy follow up fragility fracture hemangioma human infection kyphoplasty liquorrhea lung embolism myeloma neuralgia osteoporosis percutaneous vertebroplasty postoperative complication quality of life review spinal cord disease spine fracture spine metastasis systematic review thecal sac perforation thoracolumbar fracture treatment contraindication treatment indication vertebra body LA - English M1 - 2 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 0302-2404 SP - 63-68 ST - Vertebroplasty and kyphoplasty T2 - Bulletin, Postgraduate Institute of Medical Education and Research, Chandigarh TI - Vertebroplasty and kyphoplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L362968198&from=export VL - 43 ID - 829686 ER - TY - JOUR AB - Cardiac and pulmonary artery emboli are lethal complications following vertebroplasty. Clinicians should recognise these fatal complications immediately and surgical extraction is mandatory and provides the best outcome. AD - Department of Cardiothoracic Surgery, St. George's Hospital, London SW17 0QT, UK. Department of Cardiothoracic Surgery, Speciality Hospital, Amman, Jordan. AN - 27293775 AU - Diab, M. S. AU - Diab, A. AU - Dihmis, W. AU - Diab, S. C2 - Pmc4900300 DA - Jun DO - 10.1177/2054270416643891 DP - NLM ET - 2016/06/14 J2 - JRSM open KW - Pulmonary embolism thoracic surgery LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 2054-2704 (Print) 2054-2704 SP - 2054270416643891 ST - Acute right atrial and pulmonary artery bone cement mass emboli following vertebroplasty T2 - JRSM Open TI - Acute right atrial and pulmonary artery bone cement mass emboli following vertebroplasty VL - 7 ID - 828730 ER - TY - JOUR AB - PURPOSE: This particular complication of vertebroplasty calls for better awareness and care against such complication. METHODS: A 28-year male with 4-year history of ulcerative colitis was maintained on prednisolone, mesalazine and infiximab. He underwent cement vertebroplasty for severe lumbar spine osteoporosis, 24 hours after which he developed right pleuritic pain and dyspnea. Chest X-ray,Echocardiogram, Chest CT-Angiogram and Lab tests were performed. RESULTS: Lab tests: pO2 75mmHg & pCO2 25mmHg, pH 7.48, D-Dimer 5763 elevated (N ∼500). Echocardiogram revealed pericardial effusion & echogenic mass in right atrium.Chest X-ray showed high density mass at the right atrium. CT-Angiogram showed high density masses in right atrium & pulmonary artery branches with a pericardial effusion Cardiac temponade necessitated ultrasound guided pericardial drainage and pulsating bloody fluid issued. Emergency cardiac surgery was performed. Cement masses were removed from both right atrium and right pulmonary branches. Tears in tricuspid valve and right atrial wall were repaired. The patient was discharged after one week and at 4-month follow up, he was still in excellent condition. CONCLUSIONS: Cement emboli following vertebroplasty has been reported in 6.8%. However, our case exemplifies dramatic event with right atrial and pulmonary artery involvement, which has not been previously described. AD - S. Diab, Specialty Hospital, Amman, Jordan AU - Diab, S. AU - Diab, M. DB - Embase DO - 10.1378/chest.1388796 KW - cement prednisolone mesalazine D dimer artificial embolization pulmonary artery percutaneous vertebroplasty heart right atrium echocardiography pericardial effusion density thorax ulcerative colitis X ray liquid lacrimal fluid lumbar spine osteoporosis thorax radiography dyspnea pH embolism pain follow up ultrasound emergency heart surgery tricuspid valve patient human male L1 - http://journal.publications.chestnet.org/article.aspx?articleid=1376365 LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 0012-3692 ST - Cement embolization to right atrium and pulmonary artery after percutaneous vertebroplasty T2 - Chest TI - Cement embolization to right atrium and pulmonary artery after percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71073176&from=export http://dx.doi.org/10.1378/chest.1388796 VL - 142 ID - 829541 ER - TY - JOUR AB - Learning Objectives: The purpose of this poster is to share some of our experience in the management of high-flow arteriovenous malformations (AVMs) based on problem cases. Background: High-flow AVMs are rare and complex lesions that may involve any part of the body. They often represent a therapeutic challenge because of their complex anatomy and behavior. The type of embolic agent and access may be determined by the anatomy of the lesion, localization, size, operator's experience, etc. Clinical Findings/Procedure: We selected the following problem cases: 1. Direct alcohol injection into the nidus of a foot AVM. 2. Use of the Amplatzer plug in a renal AVM. 3. Histoacryl and lipiodol embolization of a uterine AVM. 4. Alcohol and cement injection into an osseous AVM. Conclusion: Each AVM poses a therapeutic challenge. It is important to be familiar with the different embolic agents, their indications, and routes of administration. AD - M.L. Diaz, Interventional and Vascular Radiology, Hospital General, Universitario Miguel Servet, Zaragoza, Spain AU - Diaz, M. L. AU - Simmons, M. AU - Urtasun, F. DB - Embase DO - 10.1007/s00270-015-1173-5 KW - alcohol enbucrilate cement iodinated poppyseed oil arteriovenous malformation society Europe injection uterus artificial embolization learning LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 0174-1551 SP - S293-S294 ST - High-flow arteriovenous malformations: Lessons learned from challenging cases T2 - CardioVascular and Interventional Radiology TI - High-flow arteriovenous malformations: Lessons learned from challenging cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L72060126&from=export http://dx.doi.org/10.1007/s00270-015-1173-5 VL - 38 ID - 829364 ER - TY - JOUR AB - A 37-year-old woman presented an acute respiratory distress syndrome six days after a post-traumatic vertebral osteosynthesis. First, a pulmonary embolism was suspected, and a thrombolysis realised. This diagnosis was secondary excluded, and the diagnosis of probable fatty embolism was established by the bronchoalveolar lavage. So, this case shows a delayed presentation of fatty embolism and permits a discussion about clinical presentation, and diagnosis methods of such pathology. (c) 2006 Elsevier SAS. Tous droits reserves. AD - CHU St Etienne, Serv Reanimat, Hop Bellevue, F-42100 St Etienne, France. CHU St Etienne, Dept Anesthesie Reanimat, Hop Bellevue, F-42100 St Etienne, France. Diconne, E (corresponding author), CHU St Etienne, Serv Reanimat, Hop Bellevue, 25 Blvd Pasteur, F-42100 St Etienne, France. ericdiconne@yahoo.fr AN - WOS:000236684400011 AU - Diconne, E. AU - Abdellaoui, L. AU - Lutz, M. F. AU - Molliex, S. AU - Zeni, F. DA - Mar DO - 10.1016/j.annfar.2005.10.029 J2 - Ann. Fr. Anest. Reanim. KW - delayed fat embolism vertebral osteosynthesis bronchoalveolar lavage PULMONARY-EMBOLISM VERTEBROPLASTY DIAGNOSIS Anesthesiology LA - French M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2006 SN - 0750-7658 SP - 306-308 ST - A case of delayed fat embolism after a vertebral osteosynthesis T2 - Annales Francaises D Anesthesie Et De Reanimation TI - A case of delayed fat embolism after a vertebral osteosynthesis UR - ://WOS:000236684400011 VL - 25 ID - 830411 ER - TY - JOUR AB - INTRODUCTION: Vertebroplasty (VP) is a cost-efficient alternative to kyphoplasty; however, regarding safety and vertebral body (VB) height restoration, it is considered inferior. We assessed the safety and efficacy of VP in alleviating pain, improving quality of life (QoL) and restoring alignment. METHODS: In a prospective monocenter case series from May 2007 until July 2008, there were 1,408 vertebroplasties performed during 319 interventions in 306 patients with traumatic, lytic and osteoporotic fractures. The 249 interventions in 233 patients performed because of osteoporotic vertebral fractures were analyzed regarding demographics, treatment and radiographic details, pain alleviation (VAS), QoL improvement (NASS and EQ-5D), complications and predictors for new fractures requiring a reoperation. RESULTS: The osteoporotic patient sample consisted of 76.7% (179) females with a median age of 80 years. A total of 54 males had a median age of 77 years. On average, there were 1.8 VBs fractured and 5 VBs treated. The preoperative pain was assessed by the visual analog scale (VAS) and decreased from 54.9 to 40.4 pts after 2 months and 31.2 pts after 6 months. Accordingly, the QoL on the EQ-5D measure (-0.6 to 1) improved from 0.35 pts before surgery to 0.56 pts after 2 and to 0.68 pts after 6 months. The preoperative Beck Index (anterior height/posterior height) improved from a mean of 0.64 preoperative to 0.76 postoperative, remained stable at 2 months and slightly deteriorated to 0.72 at 6 months postoperatively. There were cement leakages in 26% of the fractured VBs and in 1.4% of the prophylactically cemented VBs; there were symptoms in 4.3%, and most of them were temporary hypotension and one pulmonary cement embolism that remained asymptomatic. The univariate regression model revealed a tendency for a reduced risk for new or refractures on radiographs (OR = 2.61, 95% CI 0.92-7.38, p = 0.12) and reoperations (OR = 2.9, 95% CI 0.94-8.949, p = 0.1) when prophylactic augmentation was performed. The final multivariate regression model revealed male patients to have an about three times higher refracture risk (radiographic) (OR = 2.78, p = 0.02) at 6 months after surgery. Patients with a lumbar index fracture had an about three to five times higher refracture/reoperation risk than patients with a thoracic (OR = 0.33/0.35, p = 0.009/0.01) or thoracolumbar (OR = 0.32/0.22, p = 0.099/0.01) index fracture. CONCLUSION: If routinely used, VP is a safe and efficacious treatment option for osteoporotic vertebral fractures with regard to pain relief and improvement of the QoL. Even segmental realignment can be partially achieved with proper patient positioning. Certain patient or fracture characteristics increase the risk for early radiographic refractures or new fractures, or a reoperation; a consequent prophylactic augmentation showed protective tendencies, but the study was underpowered for a final conclusion. AD - Spine Service Inselspital, University Hospital, University of Bern, Bern, Switzerland. AN - 21877131 AU - Diel, P. AU - Freiburghaus, L. AU - Röder, C. AU - Benneker, L. M. AU - Popp, A. AU - Perler, G. AU - Heini, P. F. C2 - Pmc3535211 DA - Aug DO - 10.1007/s00586-011-1989-x DP - NLM ET - 2011/08/31 J2 - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society KW - Adult Aged Aged, 80 and over Back Pain/epidemiology/*prevention & control Female Humans Incidence Male Middle Aged Osteoporotic Fractures/diagnostic imaging/*surgery Predictive Value of Tests Prospective Studies Quality of Life Radiography Reoperation Retrospective Studies Risk Factors Spinal Fractures/diagnostic imaging/*surgery Treatment Outcome Vertebroplasty/*adverse effects/*methods LA - eng M1 - Suppl 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0940-6719 (Print) 0940-6719 SP - S792-9 ST - Safety, effectiveness and predictors for early reoperation in therapeutic and prophylactic vertebroplasty: short-term results of a prospective case series of patients with osteoporotic vertebral fractures T2 - Eur Spine J TI - Safety, effectiveness and predictors for early reoperation in therapeutic and prophylactic vertebroplasty: short-term results of a prospective case series of patients with osteoporotic vertebral fractures VL - 21 Suppl 6 ID - 828830 ER - TY - JOUR AB - Background: Vertebroplasty (VP) is a cost-efficient alternative to kyphoplasty. However, it is considered inferior when it comes to maintaining safety and in vertebral body (VB) height restoration. We assess the safety and efficacy of VP in alleviating pain, improving quality of life (QoL), and restoring alignment. Materials and Methods: In a prospective monocenter case series, from April 2007 until July 2008, 1,422 vertebroplasties were performed, during 307 interventions, in 279 patients with traumatic, lytic, and osteoporotic fractures with 28 repeat interventions, for new fractures after the primary surgery, in 28 patients. The 226 interventions (n=203 patients) done for osteoporotic fractures were analyzed for demographics, treatment and radiographic details, pain alleviation, QoL improvement [NASS and Euroqol (EQ-5D)] and complications. Results: Osteoporotic patient sample consisted of 77.8 (n=158) females with a median age of 78 years and 45 males who had the same median age. Around 69 of these patients were ASA (American Society of Anesthesiologists) grade 3 and above. On an average there were 1.8 VBs fractured and five VBs treated,whereas the most frequently performed cementations were in six (35.6, n=80) or five (19.6, n=44) levels. About 36.5, (n=414) of the interventions were localized at the thoraco-lumbar junction (Th12-L2). On applying the Genant classification, there was a slight height reduction in 13.1 (n=29), a medium loss in 34.3 (n=78), and a severe loss of height in 52.6 (n=119). The pre-operative pain was assessed by the visual analog scale (VAS) and decreased from 56.7 to 41.4 pts after two months. Accordingly, the QoL on the EQ-5D measure (0.6 to 1) improved from 0.32 pts before surgery to 0.58 pts after two months. The pre-operative Beck index (anterior height/posterior height) improved from a mean of 0.66 preoperative to 0.80 post-operative and remained stable at two months post-operatively. There were cement leakages in 33 of the fractured VBs and in 0.8 of the prophylactically cemented VBs; there were symptoms in 7.1, and most of them were temporary hypotension and one pulmonary cement embolism that remained asymptomatic. Conclusion: If routinely used, VP is a safe and efficient treatment option for osteoporotic vertebral fractures with regard to pain relief and improvement of the QoL. Even segmental re-alignment can be achieved to a certain extent with proper patient positioning. AD - [Diel, Peter; Merky, Dominique; Roeder, Christoph; Heini, Paul Ferdinand] Inselspital Bern, Spine Serv, CH-3010 Bern, Switzerland. [Popp, Albrecht] Univ Bern, Univ Hosp, Osteoporosis Policlin, Bern, Switzerland. [Diel, Peter; Roeder, Christoph; Perler, Malgorzata] Univ Bern, Inst Evaluat Res Orthoped Surg, Bern, Switzerland. Roder, C (corresponding author), Inselspital Bern, Spine Serv, Freiburgstr, CH-3010 Bern, Switzerland. christoph.roeder@insel.ch AN - WOS:000270729800003 AU - Diel, P. AU - Merky, D. AU - Roder, C. AU - Popp, A. AU - Perler, M. AU - Heini, P. F. DA - Apr-Jun DO - 10.4103/0019-5413.53452 J2 - Indian J. Orthop. KW - Osteoporosis percutaneous vertebroplasty vertebral fractures VERTEBRAL COMPRESSION FRACTURES PERCUTANEOUS VERTEBROPLASTY PAIN RELIEF KYPHOPLASTY SPINE RISK TECHNOLOGIES MORTALITY OUTCOMES SWEDEN Orthopedics LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2009 SN - 0019-5413 SP - 228-233 ST - Safety and efficacy of vertebroplasty: Early results of a prospective one-year case series of osteoporosis patients in an academic high-volume center T2 - Indian Journal of Orthopaedics TI - Safety and efficacy of vertebroplasty: Early results of a prospective one-year case series of osteoporosis patients in an academic high-volume center UR - ://WOS:000270729800003 VL - 43 ID - 830357 ER - TY - JOUR AB - BACKGROUND: Vertebroplasty (VP) is a cost-efficient alternative to kyphoplasty. However, it is considered inferior when it comes to maintaining safety and in vertebral body (VB) height restoration. We assess the safety and efficacy of VP in alleviating pain, improving quality of life (QoL), and restoring alignment. MATERIALS AND METHODS: In a prospective monocenter case series, from April 2007 until July 2008, 1,422 vertebroplasties were performed, during 307 interventions, in 279 patients with traumatic, lytic, and osteoporotic fractures with 28 repeat interventions, for new fractures after the primary surgery, in 28 patients. The 226 interventions (n=203 patients) done for osteoporotic fractures were analyzed for demographics, treatment and radiographic details, pain alleviation, QoL improvement [NASS and Euroqol (EQ-5D)] and complications. RESULTS: Osteoporotic patient sample consisted of 77.8% (n=158) females with a median age of 78 years and 45 males who had the same median age. Around 69% of these patients were ASA (American Society of Anesthesiologists) grade 3 and above. On an average there were 1.8 VBs fractured and five VBs treated,whereas the most frequently performed cementations were in six (35.6%, n=80) or five (19.6%, n=44) levels. About 36.5%, (n=414) of the interventions were localized at the thoraco-lumbar junction (Th12-L2). On applying the Genant classification, there was a slight height reduction in 13.1% (n=29), a medium loss in 34.3% (n=78), and a severe loss of height in 52.6% (n=119). The pre-operative pain was assessed by the visual analog scale (VAS) and decreased from 56.7 to 41.4 pts after two months. Accordingly, the QoL on the EQ-5D measure (0.6 to 1) improved from 0.32 pts before surgery to 0.58 pts after two months. The pre-operative Beck index (anterior height/posterior height) improved from a mean of 0.66 preoperative to 0.80 post-operative and remained stable at two months post-operatively. There were cement leakages in 33% of the fractured VBs and in 0.8% of the prophylactically cemented VBs; there were symptoms in 7.1%, and most of them were temporary hypotension and one pulmonary cement embolism that remained asymptomatic. CONCLUSION: If routinely used, VP is a safe and efficient treatment option for osteoporotic vertebral fractures with regard to pain relief and improvement of the QoL. Even segmental re-alignment can be achieved to a certain extent with proper patient positioning. AD - Spine Service, Inselspital Bern, Switzerland. AN - 19838343 AU - Diel, P. AU - Merky, D. AU - Röder, C. AU - Popp, A. AU - Perler, M. AU - Heini, P. F. C2 - Pmc2762175 DA - Jul DO - 10.4103/0019-5413.53452 DP - NLM ET - 2009/10/20 J2 - Indian journal of orthopaedics KW - Osteoporosis percutaneous vertebroplasty vertebral fractures LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0019-5413 (Print) 0019-5413 SP - 228-33 ST - Safety and efficacy of vertebroplasty: Early results of a prospective one-year case series of osteoporosis patients in an academic high-volume center T2 - Indian J Orthop TI - Safety and efficacy of vertebroplasty: Early results of a prospective one-year case series of osteoporosis patients in an academic high-volume center VL - 43 ID - 828725 ER - TY - JOUR AB - INTRODUCTION: Femoral neck fractures in the elderly comprise a significant number of orthopedic surgical cases at a major trauma center. These patients are immediately incapacitated, and surgical fixation can help increase mobility, restore independence, and reduce morbidity and mortality. However, operative treatment carries its own inherent risks including infections, deep vein thromboses, and intraoperative cardiovascular collapse. Cerebrovascular stroke is a relatively uncommon occurrence after hip fractures. METHODS: We present 2 cases with unusual postoperative medical complication after cemented hip hemiarthroplasty for femoral neck fracture that will serve to illustrate an infrequent but very serious complication. RESULTS: Case 1 was a 73-year-old man with a Garden IV femoral neck fracture who underwent a right hip unipolar cemented hemiarthroplasty under general anesthesia. After uneventful surgery, he developed neurological deficits, and a postoperative noncontrast head computed tomography showed a right medial thalamic infarct. Case 2 was an 82-year-old man with a Garden IV femoral neck fracture who underwent a right hip unipolar cemented hemiarthroplasty under general anesthesia. After uneventful surgery, the patient became hemodynamically unstable. A postoperative noncontrast head computed tomography showed a large evolving left middle cerebral artery stroke. CONCLUSIONS: General anesthesia in the setting of decreased cardiac function (decreased ejection fraction and output) carries the risk for ischemic injury to the brain from decreased cerebral perfusion. Risk factors including advanced age, history of coronary artery disease, atherosclerotic disease, and atrial fibrillation increase the risk for perioperative stroke. Furthermore, it is known that during the cementing of implants, microemboli can be released, which must be considered in patients with preoperative heart disease. As a result, consideration of using a noncemented implant or cementing without pressurizing in this clinical scenario should be an important aspect of the preoperative plan in an at-risk patient. Further studies are needed that can elucidate a causal relationship. AD - From the *Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York; and †Department of Neurology, NYU School of Medicine, New York, New York. AN - 24618641 AU - Ding, D. Y. AU - Christoforou, D. AU - Turner, G. AU - Tejwani, N. C. DA - Jun DO - 10.1097/pts.0000000000000063 DP - NLM ET - 2014/03/13 J2 - Journal of patient safety KW - Aged Aged, 80 and over Anesthesia, General/*adverse effects *Arthroplasty, Replacement, Hip/methods Embolism/etiology Femoral Neck Fractures/*surgery *Hemiarthroplasty/methods Humans Male Postoperative Complications/*etiology Risk Factors Stroke/*etiology Thalamic Diseases/etiology LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1549-8417 SP - 117-20 ST - Postoperative stroke after hemiarthroplasty for femoral neck fracture: a report of 2 cases and review of literature T2 - J Patient Saf TI - Postoperative stroke after hemiarthroplasty for femoral neck fracture: a report of 2 cases and review of literature VL - 10 ID - 828790 ER - TY - JOUR AB - We present the case of a serious complication related to the invasive treatment of multiple vertebral fractures due to multiple myeloma by percutaneous vertebroplasty. It concerns a cerebral fat embolism and pulmonary cement secondary to an undiagnosed permeable foramen ovale. After a literature review of the published works on this technique, it is evident that it is widely accepted despite the numerous studies in which there is doubt about its effectiveness in the short and long term, as well as the existence of multiple complications, some of which can be very serious. All this makes the correct management of pain in a conservative and multidisciplinary way essential and, in the case of performing a percutaneous vertebroplasty, be aware of the existence of such complications and try to detect them through proper monitoring. AD - M. Dinu, Clínica del Dolor Servicio de Anestesiología Reanimación y Terapéutica del Dolor Hospital, Universitario Germans Trias i Pujol Badalona, Barcelona, Spain AU - Dinu, M. AU - De Paz, S. AU - Beleta Benedicto, N. AU - Dexeus Llopis, C. AU - Frutos Saumell, V. DB - Embase KW - article brain embolism case report clinical article clinical effectiveness conservative treatment fat embolism heart foramen ovale human lung embolism multiple myeloma pain assessment paradoxical embolism patient monitoring percutaneous vertebroplasty spine fracture LA - Spanish M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 0214-0659 SP - 64-67 ST - Paradoxical embolism after analgesic percutaneous vertebroplasty in a patient with multiple myeloma: A case report T2 - DOLOR TI - Paradoxical embolism after analgesic percutaneous vertebroplasty in a patient with multiple myeloma: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L623813384&from=export VL - 33 ID - 829201 ER - TY - JOUR AD - A. Dogan, Istanbul Yeni Yuzyil University, Faculty of Medicine, Gaziosmanpasa Hospital, Cardiology Department, Gaziosmanpasa, Istanbul, Turkey AU - Dogan, A. AU - Baki, H. AU - Ozdemir, E. AU - Kurtoglu, N. DB - Embase Medline KW - bone cement device bone cement poly(methyl methacrylate) aged bone cement leakage case report clinical article clinical feature compression fracture coronary angiography coronary artery disease daily life activity diabetes mellitus dyspnea female human hypertension lung artery pressure lung embolism medical history note percutaneous vertebroplasty pulmonary cement embolism pulmonary hypertension pulmonology systolic blood pressure transthoracic echocardiography tricuspid valve regurgitation LA - English M1 - 2 M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1557-2501 1042-3931 SP - E43 ST - Late manifestation of pulmonary cement embolism visualized by coronary angiography T2 - Journal of Invasive Cardiology TI - Late manifestation of pulmonary cement embolism visualized by coronary angiography UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2005253826&from=export VL - 33 ID - 829089 ER - TY - JOUR AB - We present a case of selective bilateral renal artery embolization with acrylic microsphere particles, which is an alternative to surgery in a young patient with end-stage kidney failure and resistant proteinuria secondary to primary focal segmental glomerulosclerosis. AD - N. Dogan, Radiology Clinic, Private Bahar Hospital, Bursa, Turkey AU - Dogan, N. AU - Nas, O. F. AU - Canver, B. AU - Ozturk, K. AU - Gokalp, G. DB - Embase DO - 10.1007/s00270-016-1405-3 KW - microsphere poly(methyl methacrylate) case report end stage renal disease focal glomerulosclerosis human kidney artery embolization proteinuria surgery LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1432-086X SP - S322 ST - Selective bilateral renal artery embolization with acrylic microsphere particles in focal segmental glomerulosclerosis T2 - CardioVascular and Interventional Radiology TI - Selective bilateral renal artery embolization with acrylic microsphere particles in focal segmental glomerulosclerosis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L613933210&from=export http://dx.doi.org/10.1007/s00270-016-1405-3 VL - 39 ID - 829341 ER - TY - JOUR AB - BACKGROUND AND PURPOSE: Several trials have compared vertebral augmentation with nonsurgical treatment for vertebral compression fractures. This trial compares the efficacy and safety of balloon kyphoplasty and vertebroplasty. MATERIALS AND METHODS: Patients with osteoporosis with 1‐3 acute fractures (T5‐L5) were randomized and treated with kyphoplasty (n =191) or vertebroplasty (n = 190) and were not blinded to the treatment assignment. Twelve‐ and 24‐month subsequent radiographic fracture incidence was the primary end point. Due to low enrollment and early withdrawals, the study was terminated with 404/1234 (32.7%) patients enrolled. RESULTS: The average age of patients was 75.6 years (77.4% female). Mean procedure duration was longer for kyphoplasty (40.0 versus 31.8 minutes, P < .001). At 12 months, 7.8% fewer patients with kyphoplasty (50/140 versus 57/131) had subsequent radiographic fracture, and there were 8.6% fewer at 24 months (54/110 versus 64/111). The results were not statistically significant (P>.21). When we used time to event for new clinical fractures, kyphoplasty approached statistical significance in longer fracture‐free survival (Wilcoxon, P‐.0596). Similar pain and function improvements were observed. CT demonstrated lower cement extravasation for kyphoplasty (157/214 versus 164/201 levels treated, P = .047). For kyphoplasty versus vertebroplasty, common adverse events within 30 postoperative days were procedural pain (12/191, 9/190), back pain (14/191, 28/190), and new vertebral fractures (9/191, 17/190); similar 2‐year occurrence of device‐related cement embolism (1/191, 1/190), procedural pain (3/191, 3/190), back pain (2/191, 3/190), and new vertebral fracture (2/191, 2/190) was observed. CONCLUSIONS: Kyphoplasty and vertebroplasty had similar long‐term improvement in pain and disability with similar safety profiles and few device‐related complications. Procedure duration was shorter with vertebroplasty. Kyphoplasty had fewer cement leakages and a trend toward longer fracture‐free survival. AN - CN-01040596 AU - Dohm, M. AU - Black, C. M. AU - Dacre, A. AU - Tillman, J. B. AU - Fueredi, G. DO - 10.3174/ajnr.A4127 KW - *compression fracture/su [Surgery] *kyphoplasty *osteoporosis *percutaneous vertebroplasty *spine fracture/co [Complication] *spine fracture/su [Surgery] *vertebral compression fracture/su [Surgery] Adult Aged Aged, 80 and over Article Backache/co [Complication] Bone Cements [therapeutic use] Clinical observation Controlled study Disability Embolism/co [Complication] Female Fractures, Compression [*surgery] Human Humans Kyphoplasty [*methods] Major clinical study Male Medical device complication/co [Complication] Middle Aged Operative Time Osteoporotic Fractures [*surgery] Pain assessment Patient safety Postoperative pain/co [Complication] Quality of life Randomized controlled trial Spinal Fractures [*surgery] Spine radiography Spine stabilization Survival rate Therapy effect Treatment Outcome Vertebroplasty [*methods] M1 - 12 M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2014 SP - 2227‐2236 ST - A randomized trial comparing balloon kyphoplasty and vertebroplasty for vertebral compression fractures due to osteoporosis T2 - AJNR. American journal of neuroradiology TI - A randomized trial comparing balloon kyphoplasty and vertebroplasty for vertebral compression fractures due to osteoporosis UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01040596/full VL - 35 ID - 830016 ER - TY - JOUR AB - Bone cement implantation syndrome (BCIS) is poorly understood. It is an important cause of intraoperative mortality and morbidity in patients undergoing cemented hip arthroplasty and may also be seen in the postoperative period in a milder form causing hypoxia and confusion. Hip arthroplasty is becoming more common in an ageing population. The older patient may have co-existing pathologies which can increase the likelihood of developing BCIS. This article reviews the definition, incidence, clinical features, risk factors, aetiology, pathophysiology, risk reduction, and management of BCIS. It is possible to identify high risk groups of patients in which avoidable morbidity and mortality may be minimized by surgical selection for uncemented arthroplasty. Invasive anaesthetic monitoring should be considered during cemented arthroplasty in high risk patients. AD - Department of Anaesthesia, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK Department of Anaesthesia, University Hospital of South Manchester, Southmoor Road, Manchester M23 9LT, UK. AN - 105626302. Language: English. Entry Date: 20090130. Revision Date: 20200708. Publication Type: journal article AU - Donaldson, A. J. AU - Thomson, H. E. AU - Harper, N. J. AU - Kenny, N. W. AU - Donaldson, A. J. AU - Thomson, H. E. AU - Harper, N. J. AU - Kenny, N. W. DB - cin20 DO - 10.1093/bja/aen328 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Adverse Effects Bone Cements -- Adverse Effects Cementation -- Adverse Effects Intraoperative Complications -- Prevention and Control Anoxia -- Etiology Arthroplasty, Replacement, Hip -- Methods Embolism -- Etiology Hypotension -- Etiology Risk Factors Syndrome M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0007-0912 SP - 12-22 ST - Bone cement implantation syndrome T2 - BJA: The British Journal of Anaesthesia TI - Bone cement implantation syndrome UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105626302&site=ehost-live&scope=site VL - 102 ID - 830740 ER - TY - JOUR AB - The mechanism of pain induced by IR procedures is mainly nociceptive (Bone, visceral, inflammatory). Pain varies greatly according to the procedures: Moderate pain: Liver tumor embolisation, UFE embolisation, coeliac plexus block, cementoplasty, lung R.F., gastrostomy. Intense pain: Radio frequency ablation, bone RF, biliary drainage, dialysis fistula, digestive stenting. A pre- interventional visit, 48 h before procedure (unless emergency), is essential to determine the choice of analgesia (sedation or general anaesthesia) according to pain intensity and physical patient status (chronic obstructive pulmonary disease, obesity, chronic renal failure, coronary artery disease or psychological disorder). Information is given to the patient and consent is obtained. Premedication is prescribed: (Hydroxyzine: 1 mg/kg, application of Emla® cream on the site of puncture). Sedation combines PCA opioids (Morphine: bolus 3 mg, interval: 3 min or Oxycodone: bolus 1.5 mg interval: 3 min), midazolam: titration: 0.03 mg/Kg), inhalation of mixed equimolecular oxygen/ nitrous oxide). Low doses of ketamine (0.2 mg/Kg) I.V. have antihyperalgesic effects in association with opioids. The patient is monitored by NIBP, EKG, oxymetry, adequate training personnel with no other responsibilities in IR room maintains verbal contact with the patient. Patient controlled administration of propofol is border to general anaesthesia. Bispectral index monitoring may increase safety if frontal brain activity is preserved above 85/100. However, an anaesthesiologist may be ready for rescue in case hemodynamic or ventilation failure. Hypnosis has been shown to be effective in reducing pain and anxiety during IR procedures but needs a psychologist sitting next the patient and addition of sedative drugs. Loco-regional anaesthesia (Troncular, plexic) may be used for upper or lower limbs interventions (RF, cementoplasty, dialysis fistula), using ropivacaïne 0.2 or 0.75% (max dose: 150 mg) but must be performed by an anaesthesiologist as epidural analgesia for pelvic procedures. General anaesthesia is required in case of important pain, no possibility of prone position in conscious patient, unstable status patient (hemodynamic, respiratory, metabolic) and high risk of vital function decompensation (lung R.F, vascular endoprothesis). In post interventional period after sedation or general anaesthesia, the patient is transferred in recovery room. Antalgia is multimodal: acetaminophen: 1000 mg x 4; nefopam: 120 mg /24 h, NSAIDs, ketoprofen 100 mg x 3 (except usual contra-indications: renal or cardiac impairment, risk of gastric bleeding). Opioids are administered with PCA device (morphine or oxycodone). In case of chronic opioid administration before intervention, a continuous rate of infusion is prescribed, associated with opioid PCA. Switch to oral route is made as soon as possible. AD - S. Donnadieu, Service Anesthesie-reanimation, Hopital Europeen Georges-Pompidou, Paris, France AU - Donnadieu, S. DB - Embase KW - morphine oxycodone opiate sedative agent paracetamol nefopam ketoprofen hydroxyzine midazolam nitrous oxide ketamine propofol pain Europe society patient general anesthesia sedation artificial embolization fistula lung risk bone dialysis safety frontal cortex electroencephalogram air conditioning hypnosis anxiety psychologist sitting regional anesthesia leg epidural anesthesia pelvis body position endoprosthesis devices infusion recovery room liver pain liver tumor celiac plexus gastrostomy radiofrequency ablation biliary tract drainage stent emergency analgesia chronic obstructive lung disease chronic kidney failure coronary artery disease stomach hemorrhage premedication puncture obesity titrimetry inhalation low drug dose oximetry personnel responsibility bispectral index monitoring mental disease LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 0174-1551 SP - 203-204 ST - Basics of pain management for IR procedures T2 - CardioVascular and Interventional Radiology TI - Basics of pain management for IR procedures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70339177&from=export VL - 32 ID - 829702 ER - TY - JOUR AB - Introduction: Bone implantation syndrome is poorly understood and clinical features may vary from transient hypoxia, hypotension, cardiac arrhythmias to cardiac arrest. It is an important cause of intraoperative morbidity and mortality. Clinical presentation can be at any time from cementation to deflation of the tourniquet. The underlying pathophysiology is poorly understood and the proposed aetiology includes a monomer mediated model or the embolus mediated model. Case description: This case describes an 88 year old lady undergoing a hip revision under spinal anaesthetic. Patient was given 2.5 mls of bupivacaine 0.5 % with fentanyl 25 mcg. Patient had arterial line inserted prior to spinal and was haemodynamically stable during the procedure initially and with O2 saturations >98 %. Shortly after cementation patient underwent cardiac arrest and was resuscitated with CPR and IV adrenaline 1 mg before being started on an IV adrenaline infusion. Patient was intubated and subsequently transferred to ICU where the patient passed away. This was an important case to highlight the sudden presentation of severe bone implantation syndrome resulting in cardiovascular collapse and the mortality of a patient. It is significant as we increase the number of hip arthroplasties in the elderly population that we can identify higher risk patient to try and minimize this occurrence. AD - K. Doody, Department of Anaesthesia, University Hospital Limerick, Ireland AU - Doody, K. AU - Moore, S. AU - Mahdy, S. DB - Embase DO - 10.1007/s11845-015-1396-0 KW - bone cement epinephrine monomer fentanyl bupivacaine implantation anesthesia human patient bone cementation heart arrest mortality model heart arrhythmia hypotension tourniquet hypoxia infusion pathophysiology etiology population embolism arterial line morbidity clinical feature procedures spinal anesthesia hip shock hip arthroplasty aged high risk patient LA - English M1 - 2 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1863-4362 SP - S133-S134 ST - Bone cement implantation syndrome-its implications in anaesthesia T2 - Irish Journal of Medical Science TI - Bone cement implantation syndrome-its implications in anaesthesia UR - https://www.embase.com/search/results?subaction=viewrecord&id=L72312878&from=export http://dx.doi.org/10.1007/s11845-015-1396-0 VL - 185 ID - 829329 ER - TY - JOUR AB - Performing a skull reconstruction for a long-term existing large cranium defect usually needs either skin enhancement or skin flaps and cranioplasty. This procedure can be accompanied with aesthetic and functional complications. The presented case describes a 27-year-old man in need of a cranial reconstruction following decompressive craniectomy as treatment for severe traumatic brain injury. Autologous cranioplasty after decompressive craniectomy failed due to bone flap infection. Because of cognitive behavioral problems, a protective helmet needed to be worn in awaiting cranioplasty. The final titanium cranioplasty was placed subsequent to scalp expansion. The expansion was realized by placing a temporary and custom-made polymethylmethacrylate (PMMA) plate over the defect with a tissue expander on top of it, using the existing scar and skull defect. Our reported technique avoids additional skin flap creation and accompanied complications such as additional scalp and bone damage. In cognitive damaged patients who need to wear a helmet constantly, this simple method provides, concurrently, protection of the brain and tissue expansion. We demonstrate a successful novel technical manner to provide scalp enhancement by positioning a temporary PMMA graft over the skull defect and placing the tissue expander on top of it. AD - E.J. Dos Santos Rubio, Department of Neurosurgery, Erasmus Medical Center, Gravendijkwal 230, P.O. Box 2040, Rotterdam, Netherlands AU - Dos Santos Rubio, E. J. AU - Bos, E. M. AU - Dammers, R. AU - Koudstaal, M. J. AU - Dumans, A. G. DB - Embase DO - 10.1055/s-0035-1549011 KW - anticoagulant agent barbituric acid derivative low molecular weight heparin poly(methyl methacrylate) silicone titanium adult aggression article bone graft bone plate brain contusion brain protection case report cognitive defect cognitive rehabilitation computer assisted tomography contrast enhancement cranioplasty decompressive craniectomy deep vein thrombosis epidural hematoma Glasgow coma scale graft infection head protection human intensive care unit intracranial hypertension intracranial pressure lung embolism male parietal bone priority journal problem behavior scar skull defect skull fracture subarachnoid hemorrhage subdural hematoma tissue expander tissue expansion traffic accident traumatic brain injury treatment failure wound closure LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1943-3883 1943-3875 SP - 355-360 ST - Two-Stage Cranioplasty: Tissue Expansion Directly over the Craniectomy Defect Prior to Cranioplasty T2 - Craniomaxillofacial Trauma and Reconstruction TI - Two-Stage Cranioplasty: Tissue Expansion Directly over the Craniectomy Defect Prior to Cranioplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L603557496&from=export http://dx.doi.org/10.1055/s-0035-1549011 VL - 9 ID - 829296 ER - TY - JOUR AB - INTRODUCTION: Bone Cement Implantation Syndrome (BCIS) is a lethal condition with complex physiological changes after the insertion of Methyl Methacrylate (MMA) cement during intraoperative arthroplasty. Despite the etiology and the pathophysiology of BCIS has not been fully understood, several mechanisms have been discovered. Some clinical manifestations of BCIS are hypotension, hypoxemia, a decrease of consciousness, arrhythmia, pulmonary hypertension, and cardiac arrest. PRESENTATION OF CASE: A 67 years old woman underwent cemented hemiarthroplasty operation due to intertrochanteric fracture in her right femur. The hemodynamic was stable before and during operation, but suddenly the patient went into cardiac arrest as the cement inserted. Immediate resuscitation was performed successfully and stable hemodynamic was achieved. DISCUSSION: Several risk factors including underlying cardiovascular disease, advanced age, osteoporosis (enlarged porous cavities increase the risk of emboli generation), fracture type, metastatic bone disease, femoral canal diameter of more than 21 mm, previously non-instrumented femoral canal, and patent foramen ovale (paradoxical embolus). Some studies have shown usage of H1 and H2 antagonists, methylprednisolone, inotropes, vasopressor, and some alterations in surgical technique, can prevent the progression of the BCIS. Communication between the orthopaedic surgeon and anesthesiologist and high-quality cardiopulmonary resuscitation (CPR) will become a good basis in treating BCIS. CONCLUSION: Preoperative optimization by increasing oxygen inspiration concentration, usage of inotropes and vasopressor, and avoiding intravascular volume depletion during operation is essential in cemented arthroplasty procedure. Both orthopaedic surgeon and anesthesiologist should recognize the clinical presentation of BCIS and well-prepared for the management of BCIS including any supportive measures. AD - Orthopaedics and Traumatology Department, Faculty of Medicine, Universitas Brawijaya-Saiful Anwar General Hospital, Malang, East Java, Indonesia. Electronic address: respatisdradjat@ub.ac.id. Orthopaedics and Traumatology Department, Faculty of Medicine, Universitas Brawijaya-Saiful Anwar General Hospital, Malang, East Java, Indonesia. Electronic address: satyapradana88@gmail.com. Orthopaedics and Traumatology Department, Faculty of Medicine, Universitas Brawijaya-Saiful Anwar General Hospital, Malang, East Java, Indonesia. Electronic address: domypradanaputra@gmail.com. Orthopaedics and Traumatology Department, Faculty of Medicine, Universitas Brawijaya-Saiful Anwar General Hospital, Malang, East Java, Indonesia. Electronic address: ray.asaf@gmail.com. Orthopaedics and Traumatology Department, Faculty of Medicine, Universitas Brawijaya-Saiful Anwar General Hospital, Malang, East Java, Indonesia. Electronic address: md.felix.c@gmail.com. Orthopaedics and Traumatology Department, Faculty of Medicine, Universitas Brawijaya-Saiful Anwar General Hospital, Malang, East Java, Indonesia. Electronic address: edimustamsir@ub.ac.id. AN - 33388512 AU - Dradjat, R. S. AU - Pradana, A. S. AU - Putra, D. P. AU - Hexa Pandiangan, R. A. AU - Cendikiawan, F. AU - Mustamsir, E. DA - Dec 28 DO - 10.1016/j.ijscr.2020.12.076 DP - NLM ET - 2021/01/04 J2 - International journal of surgery case reports KW - Bone cement implantation syndrome (BCIS) Cardiac arrest Cemented arthroplasty LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 2210-2612 (Print) 2210-2612 SP - 331-335 ST - Successful management of severe manifestation bone cemented implantation syndrome during hemiarthroplasty surgery in patient with multiple comorbidities: A case report T2 - Int J Surg Case Rep TI - Successful management of severe manifestation bone cemented implantation syndrome during hemiarthroplasty surgery in patient with multiple comorbidities: A case report VL - 78 ID - 828682 ER - TY - JOUR AD - H. Dreger, Department of Cardiology and Angiology, Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany AU - Dreger, H. AU - Treskatsch, S. AU - Lembcke, A. AU - Grubitzsch, H. AU - Knebel, F. AU - Laule, M. DB - Embase Medline DO - 10.1093/eurheartj/ehs410 KW - anticoagulant agent gentamicin bone cement adult anticoagulant therapy cardiopulmonary bypass cardiovascular magnetic resonance case report computer assisted tomography dyspnea echocardiography female fragility fracture heart atrium thrombosis heart ventricle perforation human kyphoplasty lung embolism note pericardial effusion priority journal thorax pain thorax radiography LA - English M1 - 16 M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0195-668X 1522-9645 SP - 1203 ST - Perforation of the right ventricle by bone cement: A rare complication of kyphoplasty T2 - European Heart Journal TI - Perforation of the right ventricle by bone cement: A rare complication of kyphoplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L368888256&from=export http://dx.doi.org/10.1093/eurheartj/ehs410 VL - 34 ID - 829500 ER - TY - JOUR AB - Background: In order to reduce the occurrence of bone cement leakage, bone filling mesh container technique can be a prior choice for the treatment of vertebral metastases with damaged posterior margin of the thoracolumbar vertebral body. Objectives: The purpose of this retrospective study was to compare the efficacy and safety of percutaneous balloon kyphoplasty (PKP) and bone filling mesh containers (BFMCS) in the treatment of vertebral metastases with posterior vertebral body damage. Patients and Methods: This is a retrospective study. From October 2016 to January 2018, 40 cases (72 vertebral bodies) of thoracolumbar osteolytic metastases were treated with vertebroplasty. Among them, 20 cases (37 vertebral bodies) were treated with PKP (PKP group), and 20 cases (35 vertebral bodies) were treated with BFMCS (BFMCS group). The operation time of the two groups was recorded, and visual analog scale (VAS), Oswestry disability index (ODI), intraoperative bone cement leakage and complications were observed before operation and 1 day, 1 month and 6 months after operation. Results: All patients underwent successful operation. The operation time of the PKP group was 42.65 ± 7.84 minutes, and 42.95±8.48 minutes in the BFMCS group (P = 0.91). Both groups differed significantly when the results were compared with those measured before treatment. VAS dropped from 7.50 ± 0.95 points before operation to 1.20 ± 0.41 points at 6 months follow up in PKP group (P < 0.001), in the BFMCS group VAS dropped from 7.50 ± 0.94 points before operation to 1.45 ± 0.51 points at 6 months after operation (P < 0.001). The ODI of the PKP group dropped from 75.80±4.76 before operation to 12.05 ± 1.47, 6 months after operation (P < 0.001), ODI dropped from 75.00 ± 4.34 before operation to 11.60 ± 1.39 at 6 months follow up in the BFMCS group (P < 0.001). In the PKP group, 15 vertebral bodies (40.5%, 15/37) occurred bone cement leakage, but the patients had no clinical symptoms of bone cement leakage. Cement leakage occurred in one case in the BFMCS group. There were no complications such as pulmonary embolism, paraplegia or perioperative death. Conclusion: The application of bone-filling mesh container for treating patients with thoracolumbar osseointegrated metastases could significantly reduce the leakage rate of bone cement, and is similar to traditional PKP in pain relief and activity improvement. AD - C.-J. He, Department of Pain, People’s Hospital of Guizhou Province, Guiyang, China AU - Duan, Z. K. AU - Kang, X. G. AU - Zou, J. F. AU - Ye, S. L. AU - He, C. J. DB - Embase DO - 10.5812/iranjradiol.86417 KW - bone filling mesh container surgical mesh bone cement adult aged article biopsy bone cement leakage case report clinical article computer assisted tomography female fluoroscopy follow up human intraoperative period kyphoplasty limb pain lung cancer male nuclear magnetic resonance imaging operation duration Oswestry Disability Index postoperative period preoperative period retrospective study sexual behavior sleep social behavior spine injury spine metastasis thoracolumbar spine vertebra body very elderly visual analog scale walking weight lifting whole body scintiscanning LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 2008-2711 1735-1065 ST - Therapeutic effect of bone-filling mesh container in treating vertebral metastases with vertebral body posterior marginal damage T2 - Iranian Journal of Radiology TI - Therapeutic effect of bone-filling mesh container in treating vertebral metastases with vertebral body posterior marginal damage UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2002864131&from=export http://dx.doi.org/10.5812/iranjradiol.86417 VL - 16 ID - 829109 ER - TY - JOUR AB - Kümmell's disease (eponymous name for osteonecrosis and collapse of a vertebral body due to ischemia and non‐union of anterior vertebral body wedge fractures after major trauma) cannot heal spontaneously. Bone‐filling mesh container (BFMC) can significantly relieve pain, help the correction of kyphosis, and may prevent cement leakage. This pilot study may provide the basis for the design of future studies. PURPOSE: To compare the effectiveness and safety of BFMC and percutaneous kyphoplasty (PKP) for treatment of Kümmell's disease. METHODS: From August 2016 to May 2018, 40 patients with Kümmell's disease were admitted to Guizhou Provincial People's Hospital. Among them, 20 patients (20 vertebral bodies) received PKP (PKP group) and the other 20 received BFMC (BFMC group). Operation time, Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Cobb's angle changes, and related complications were recorded. RESULTS: All patients underwent operations successfully. VAS scores and ODI of both groups at each postoperative time point were lower than preoperatively, with statistically significant difference (p < 0.05). Postoperative Cobb's angle of both groups postoperatively was lower than preoperatively (p < 0.05). Cement leakage occurred in eight vertebrae (8/20) in the PKP group and in one vertebra (1/20) in the BFMC group. No complications such as pulmonary embolism, paraplegia, or perioperative death occurred during operation in both groups. Adjacent vertebral refractures occurred in five patients (5/20) in the PKP group and in four patients (4/20) in the BFMC group, with no significant difference in the incidence rate of refractures in both groups but the material is too small to verify statistically. CONCLUSIONS: Both PKP and BFMC technologies can significantly relieve pain and help the correction of kyphosis while treating Kümmell's disease. Moreover, the BMFC may prevent cement leakage. AN - CN-02102770 AU - Duan, Z. K. AU - Zou, J. F. AU - He, X. L. AU - Huang, C. D. AU - He, C. J. DO - 10.1007/s11657-019-0656-4 KW - Aged Back Pain [surgery] Bone Cements [adverse effects, therapeutic use] Bone Substitutes [therapeutic use] Extravasation of Diagnostic and Therapeutic Materials [etiology] Female Fractures, Compression [*surgery] Humans Kyphoplasty [adverse effects, *methods] Kyphosis [*surgery] Male Middle Aged Osteonecrosis [surgery] Pain Measurement [methods] Pilot Projects Postoperative Complications [etiology] Prostheses and Implants [adverse effects] Spinal Fractures [*surgery] Surgical Mesh Treatment Outcome M1 - 1 M3 - Comparative Study; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2019 SP - 109 ST - Bone-filling mesh container versus percutaneous kyphoplasty in treating Kümmell's disease T2 - Archives of osteoporosis TI - Bone-filling mesh container versus percutaneous kyphoplasty in treating Kümmell's disease UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02102770/full VL - 14 ID - 830064 ER - TY - JOUR AN - 17223885 AU - Duffau, P. AU - Beylot-Barry, M. AU - Palussiere, J. AU - Ly, S. AU - Cogrel, O. AU - Doutre, M. S. DA - Feb DO - 10.1111/j.1365-2133.2006.07625.x DP - NLM ET - 2007/01/17 J2 - The British journal of dermatology KW - Adult Bone Cements/*adverse effects Breast Neoplasms Embolism/*etiology Female Foot/blood supply Foot Dermatoses/*etiology Humans Lumbar Vertebrae/injuries Necrosis Polymethyl Methacrylate/*adverse effects Skin Diseases, Vascular/*etiology Spinal Fractures/therapy Spinal Neoplasms/*secondary/therapy LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 0007-0963 (Print) 0007-0963 SP - 382-3 ST - Necrotic livedo after vertebroplasty T2 - Br J Dermatol TI - Necrotic livedo after vertebroplasty VL - 156 ID - 828512 ER - TY - JOUR AB - Bone cement leakage is a common complication after percutaneous kyphoplasty. In rare cases, leakage into the venous system occurs, which can be life-threatening, especially when it embolizes the heart. Here, we present a case of cement embolization of the right ventricle with tricuspid valve involvement. A 69-year-old woman with an asymptomatic severe tricuspid valve regurgitation was referred to our department. She had a history of balloon kyphoplasty because of osteoporotic collapsed vertebrae in 2010. Echocardiography showed a foreign body attached to the right ventricle, prolapsing into the right atrium and causing a severe tricuspid valve regurgitation. The foreign body was surgically removed, and the tricuspid valve was replaced with a biological valve. The foreign body was analysed by scanning electron microscopy and element analysis. Zirconium was identified within the foreign body, which is an additive in bone cement used in orthopaedic surgery. Intracardiac cement embolism following percutaneous kyphoplasty is a rare but life-threatening complication. Here, we present a case of tricuspid valve destruction caused by the long-term presence of an intracardiac foreign body, specifically a cement embolus. AD - Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, Netherlands. AN - 29955843 AU - Duijvelshoff, R. AU - Anthonissen, N. F. M. AU - Morshuis, W. J. AU - Van Garsse, L. DA - Feb 1 DO - 10.1093/ejcts/ezy233 DP - NLM ET - 2018/06/30 J2 - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery KW - Aged Bone Cements/*adverse effects Female *Foreign Bodies/diagnostic imaging/etiology/surgery Heart Ventricles/diagnostic imaging/surgery Humans Kyphoplasty/*adverse effects Polymethyl Methacrylate *Tricuspid Valve Insufficiency/diagnostic imaging/etiology/surgery LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 1010-7940 SP - 366-368 ST - Intracardiac cement embolism resulting in tricuspid regurgitation T2 - Eur J Cardiothorac Surg TI - Intracardiac cement embolism resulting in tricuspid regurgitation VL - 55 ID - 828493 ER - TY - JOUR AB - STUDY DESIGN: This is a case report. OBJECTIVE: Describe the occurrence of cardiac emboli recorded on transesophageal echocardiogram (TEE) after the injection of a topical hemostatic agent into a vertebra prior to performing a pedicle subtraction osteotomy (PSO). SUMMARY OF BACKGROUND DATA: Hemostasis during spinal surgery is critical for adequate visualization and to reduce the risk of perioperative complications. Adult spinal deformity surgery can involve performing PSOs which are useful in cases of fixed spinal deformities and are associated with increased blood loss secondary to epidural and cancellous bleeding. Prior to performing a PSO, a topical hemostatic agent can be injected into the vertebra through the pedicle screw pilot holes in an attempt to decrease cancellous bleeding. Injected hemostatic agents can pressurize the vertebral body similar to cementation in vertebroplasty and during fracture reaming and prosthetic implantation in the femur. Patients with cardiac defects such as patent foramen ovale or atrial septal defect may be more prone to systemic embolic events resulting in morbidity or mortality. METHODS: We injected a topical hemostatic matrix agent through the pedicle screw pilot holes into the L1 vertebral body prior to performing a PSO while simultaneously recording with TEE. RESULTS: The TEE recorded large visible emboli traveling through the heart into the pulmonary vasculature. The patient remained stable throughout the remainder of the case and a postoperative spiral computed tomography (CT) scan was negative for filling defects. The patient had an uneventful hospital course. CONCLUSION: Questions remain about the exact consistency of these emboli, when they are most likely to occur, how much cardiopulmonary insult can be tolerated without resulting in complications, or how to prevent their occurrence. Patients undergoing spinal surgery with the plan to inject hemostatic matrix agents into the vertebral body may benefit from a preoperative TEE to reduce the risk of complications associated with embolic events, especially in patients with undiagnosed patent foramen ovale or atrial septal defect. LEVEL OF EVIDENCE: 5. AD - *Department of Orthopedic Surgery †Department of Anesthesiology, Ochsner Clinic Foundation, New Orleans, LA ‡Spine & Scoliosis Specialists, Tampa, FL. AN - 27128259 AU - Duplantier, N. L. AU - Couch, M. AU - Emory, L. AU - Zavatsky, J. M. DA - May DO - 10.1097/brs.0000000000001307 DP - NLM ET - 2016/04/30 J2 - Spine KW - Administration, Topical Aged *Echocardiography, Transesophageal/methods Embolism/chemically induced/*diagnostic imaging Heart Diseases/chemically induced/*diagnostic imaging Hemostatics/*administration & dosage/adverse effects Humans Male *Monitoring, Intraoperative/methods Osteotomy/*methods LA - eng M1 - 9 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 0362-2436 SP - E556-60 ST - Cardiac Emboli Documented by Intraoperative Transesophageal Echocardiogram During Administration of a Topical Hemostatic Agent Prior to Pedicle Subtraction Osteotomy T2 - Spine (Phila Pa 1976) TI - Cardiac Emboli Documented by Intraoperative Transesophageal Echocardiogram During Administration of a Topical Hemostatic Agent Prior to Pedicle Subtraction Osteotomy VL - 41 ID - 828732 ER - TY - JOUR AB - Background: Percutaneous vertebroplasty (PV) has recently become a very common procedure for vertebral compression fractures. Extravasation of cement, a common event associated with vertebroplasty, may lead to cement emboli in the lungs. Purpose: To determine the frequency of pulmonary cement embolism after percutaneous vertebroplasty. Material and Methods: Between 2002 and 2006, 128 percutaneous vertebroplasties were performed in 73 patients (56 women and 17 men) in our institution. Postprocedural chest radiographs were obtained for all patients and assessed for the presence of pulmonary cement emboli. Results: Pulmonary cement embolism was detected on chest radiographs and confirmed with chest computed tomography (CT) in four patients treated with percutaneous vertebroplasty for osteoporotic collapse and one patient treated for multiple myeloma. The imaging finding of pulmonary cement embolism was solitary or multiple fine radiodense lines with occasional branching patterns. The frequency of pulmonary cement embolism was 6.8%. Conclusion: An incidence of pulmonary cement embolism of 6.8% during PV was found. Close clinical follow-up, postprocedural chest radiographs, and chest CT scans, if necessary, are important for the detection of pulmonary cement embolism at an early stage. AD - Florence Nightingale Hastanesi, Radyoloji Bolumu, Abidei Hurriyet cad. No: 290, 34381 Caglayan, Sisli, Istanbul, Turkey AN - 26951838. Language: English. Entry Date: In Process. Revision Date: 20170413. Publication Type: journal article. Journal Subset: Biomedical AU - Duran, C. AU - Sirvanci, M. AU - Aydoğan, M. AU - Ozturk, E. AU - Ozturk, C. AU - Akman, C. AU - Aydoğan, M. DB - cin20 DO - 10.1080/02841850701422153 DP - EBSCOhost KW - Thoracic Vertebrae -- Surgery Lumbar Vertebrae -- Surgery Pulmonary Embolism -- Etiology Vertebroplasty -- Adverse Effects Spinal Diseases -- Surgery Bone Cements -- Adverse Effects Osteoporosis -- Surgery Methylmethacrylates Aged Aged, 80 and Over Middle Age Spinal Diseases -- Complications Retrospective Design Adult Female Male Pulmonary Embolism Tomography, X-Ray Computed Multiple Sclerosis -- Complications Scales M1 - 8 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2007 SN - 0284-1851 SP - 854-859 ST - Pulmonary cement embolism: a complication of percutaneous vertebroplasty T2 - Acta Radiologica TI - Pulmonary cement embolism: a complication of percutaneous vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=26951838&site=ehost-live&scope=site VL - 48 ID - 830760 ER - TY - JOUR AB - An 84-year-old woman with previous spinal operations including vertebroplasty and lumbar decompressions was admitted electively under the spinal team for right-sided L4/5 decompression for worsening back pain which she undergoes using a posterior approach. Postoperatively, she develops stabbing upper central chest pain and given unremarkable chest X-ray, ECG and cardiac troponin, she undergoes a CT pulmonary angiogram which shows a fracture of the upper part of sternum but no pulmonary embolism. There is no history of recent trauma and this is deemed to be secondary to prolonged spinal surgery in the prone position in a patient with osteopenic bones. To date, we have not come across a case of spontaneous sternal fracture as a complication of spinal surgery at our regional spinal unit. Most cases of sternal fractures are secondary to blunt anterior chest wall trauma with spontaneous fractures and stress fractures being rare. AD - Health Care for Older People, Nottingham University Hospitals NHS Trust, Nottingham, UK. AN - 30217798 AU - Dwivedi, R. C2 - Pmc6144172 DA - Sep 14 DO - 10.1136/bcr-2018-225293 DP - NLM ET - 2018/09/16 J2 - BMJ case reports KW - Aftercare Aged, 80 and over Chest Pain/*diagnosis/etiology Decompression, Surgical/*adverse effects/methods Female Humans Lumbar Vertebrae/*surgery Osteoporosis/complications/diagnostic imaging Postoperative Period Prone Position/physiology Sternum/diagnostic imaging/*injuries/pathology Treatment Outcome osteoporosis pain spinal cord LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 1757-790x ST - Uncommon cause of chest pain in a postoperative spinal patient T2 - BMJ Case Rep TI - Uncommon cause of chest pain in a postoperative spinal patient VL - 2018 ID - 828734 ER - TY - JOUR AB - Background: Perioperative pulmonary embolism (PE) is a rare but life-threatening complication. The diagnosis remains challenging due to non-specific clinical presentations, which may vary from asymptomatic to cardiovascular collapse. Objective: To describe the clinical presentation, diagnosis, and outcomes of the patients after suspected PE as well as to investigate the cause among Thai surgical population. Materials and Methods: The authors conducted an observational study by retrospective analysis of the data from the Perioperative and Anesthetic Adverse Events in Thailand (PAAd Thai) study. All surgical patients under anesthesia in 22 participating hospitals between January 1 and December 31, 2015, were included. The incident reports of suspected PE were reviewed independently by three anesthesiologists. Data regarding patient characteristics, clinical manifestation, and other details were obtained from the standardized incident report forms. Descriptive statistics was used. Results: Of the 2,000 incident reports, 16 patients were diagnosed with suspected PE. Cardiac arrest occurred in 11 cases (68.7%) and the overall mortality rate was 37.5% (6 of 16 patients). Most incidents were reported in orthopedic patients (10 cases, 62.5%) and caused by thrombosis (13 cases, 81.2%). Most of the incidents occurred intraoperatively (10 cases, 62.5%). The confirmatory imaging studies were investigated in eight cases (50%). To minimize the adverse outcomes, having more experience along with the help from experienced assistants and improved multidisciplinary support, were predominantly recommended. In addition, the most frequent suggested corrective strategies were implementation of appropriate clinical practice guideline and quality assurance activity. Conclusion: Perioperative PE causes significant morbidity and mortality. The diagnosis remains difficult but early detection of suspicious clinical presentation and optimization of the treatment are crucial. Identification of high-risk patients, intraoperative vigilance, and effective interdepartmental communication should be considered to improve patient outcomes. AD - A. Vimuktanandana, Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand AU - Earsakul, A. AU - Vimuktanandana, A. AU - Pongruekdee, S. AU - Tanyong, A. AU - Lapisatepun, W. AU - Nimmaanrat, S. DB - Embase DO - 10.35755/jmedassocthai.2020.09.11509 KW - bone cement adult adverse event aged article autopsy brain artery aneurysm brain ischemia computer assisted tomography consciousness depression dyspnea echocardiography elective surgery end tidal carbon dioxide tension esophagus intubation female heart arrest hemodynamics human hypoxemia hypoxia intensive care unit lung embolism lung ventilation perfusion ratio major clinical study male observational study outcome assessment oxygen desaturation petechia pulmonary aspiration pulse oximetry quality control resuscitation retrospective study tachypnea transesophageal echocardiography venous thromboembolism LA - English M1 - 9 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 0125-2208 SP - 869-877 ST - Suspected pulmonary embolism in the first 2,000 incidents reports of perioperative and anesthetic adverse events in Thailand (PAAd Thai) study T2 - Journal of the Medical Association of Thailand TI - Suspected pulmonary embolism in the first 2,000 incidents reports of perioperative and anesthetic adverse events in Thailand (PAAd Thai) study UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2007864365&from=export http://dx.doi.org/10.35755/jmedassocthai.2020.09.11509 VL - 103 ID - 829059 ER - TY - JOUR AB - BACKGROUND CONTEXT: Previous investigators have reported on benefits and risks associated with vertebroplasty and kyphoplasty, but there are limited comparison data available. Additionally, much of the data is from retrospective studies and case series. PURPOSE: The purpose of this study is to review the literature and perform a meta-analysis of pain relief and risk of complications associated with vertebroplasty versus kyphoplasty. STUDY DESIGN: A meta-analysis of the literature on effectiveness of pain control and risk of complications after vertebroplasty versus balloon kyphoplasty. Outcomes measures include visual analog scale and complications. METHODS: A comprehensive review of the literature was performed. All studies providing information on pain relief and complications were included. Preoperative, postoperative, and change in visual analog scale (VAS) scores were tabulated. Data were analyzed to identify if a significant improvement in the VAS score occurred. Changes in the VAS scores were compared for vertebroplasty and kyphoplasty to determine if there was a significant difference. RESULTS: A total of 1,036 abstracts were identified. Of these, 168 studies met the inclusion criteria. Mean pre- and postoperative VAS scores for vertebroplasty were 8.36 and 2.68, respectively, with a mean change of 5.68 (p<.001). The mean pre- and postoperative VAS scores for kyphoplasty were 8.06 and 3.46, respectively, with a mean change of 4.60 (p<.001). There was statistically greater improvement found with vertebroplasty versus kyphoplasty (p<.001). The risk of new fracture was 17.9% with vertebroplasty versus 14.1% with kyphoplasty (p<.01). The risk of cement leak was 19.7% with vertebroplasty versus 7.0% with kyphoplasty (p<.001). CONCLUSIONS: Both vertebroplasty and kyphoplasty provided significant improvement in VAS pain scores. Vertebroplasty had a significantly greater improvement in pain scores but also had statistically greater risk of cement leakage and new fracture. (C) 2008 Elsevier Inc. All rights reserved. AD - [Eck, Jason C.; Nachtigall, Dean] Mem Hosp, Dept Orthopaed Surg, York, PA 17403 USA. [Humphreys, S. Craig; Hodges, Scott D.] Ctr Sports Med & Orthopaed, Chattanooga, TN 37404 USA. Eck, JC (corresponding author), Mem Hosp, Dept Orthopaed Surg, 325 Belmont Ave,Box 129, York, PA 17403 USA. Jason-laurie@comcast.net AN - WOS:000256181300010 AU - Eck, J. C. AU - Nachtigall, D. AU - Humphreys, S. C. AU - Hodges, S. D. DA - May-Jun DO - 10.1016/j.spinee.2007.04.004 J2 - Spine Journal KW - CALCIUM-PHOSPHATE CEMENT PERCUTANEOUS POLYMETHYLMETHACRYLATE VERTEBROPLASTY SPONDYLITIS FOLLOWING VERTEBROPLASTY CLINICAL FOLLOW-UP QUALITY-OF-LIFE PULMONARY-EMBOLISM ACRYLIC CEMENT INITIAL-EXPERIENCE INTRAVERTEBRAL CLEFTS HEIGHT RESTORATION Clinical Neurology Orthopedics LA - English M1 - 3 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2008 SN - 1529-9430 SP - 488-497 ST - Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature T2 - Spine Journal TI - Comparison of vertebroplasty and balloon kyphoplasty for treatment of vertebral compression fractures: a meta-analysis of the literature UR - ://WOS:000256181300010 VL - 8 ID - 830382 ER - TY - JOUR AB - A case of intraoperative death because of right heart failure due to extensive pulmonary fat and bone marrow embolism in an 85 year old woman during cemented total hip replacement under spinal analgesia is reported. AD - Institut für Anästhesie der Technischen Universität München. AN - 2729535 AU - Egbert, R. AU - von Hundelshausen, B. AU - Gradinger, R. AU - Hipp, E. AU - Kolb, E. DA - Apr DP - NLM ET - 1989/04/01 J2 - Anasthesie, Intensivtherapie, Notfallmedizin KW - Aged Aged, 80 and over *Anesthesia, Spinal Breast Neoplasms/*surgery Female Femoral Neck Fractures/*surgery Femoral Neoplasms/*secondary/surgery Heart Arrest/*mortality *Hip Prosthesis Humans Intraoperative Complications/*mortality Pulmonary Embolism/mortality Risk Factors LA - ger M1 - 2 N1 - PubMed NLM literature search January 5, 2021 OP - Herzstillstand bei Implantation einer zementierten Hüftgelenkstotalendoprothese unter Spinalanästhesie--Fallbericht. PY - 1989 SN - 0174-1837 (Print) 0174-1837 SP - 118-20 ST - [Heart arrest in implantation of a cemented total hip joint endoprosthesis under spinal anesthesia--a case report] T2 - Anasth Intensivther Notfallmed TI - [Heart arrest in implantation of a cemented total hip joint endoprosthesis under spinal anesthesia--a case report] VL - 24 ID - 828535 ER - TY - JOUR AB - The article presents a case study of a 77-year-old woman with persistent chest pain after having complication-free hip replacement surgery with a cemented prosthesis. She had a computed tomography scan and an echocardiogram which revealed the hyperechogenic rod-like structure perforating the wall of the right atrium. The patient undergone an open heart surgery, foreign object at the right auricle was removed and defected wall was repaired. AD - Department of Cardiology,University Hospital of Northern Norway, Tromsø Department of Thoracic Surgerym University Hospital of Northern Norway, Tromsø Department of Pathology, University Hospital of Northern Norway, Tromsø From Departments of Cardiology (E.T.S., O.D.-E., P.I.L.), Thoracic Surgery (T.S.), and Pathology (L.U.-H.), University Hospital of Northern Norway, Tromsø AN - 109448637. Language: English. Entry Date: 20160214. Revision Date: 20191106. Publication Type: journal article AU - Ek Skjølsvik, Eystein Theodor AU - Steensrud, Tor AU - Dahl-Eriksen, Øystein AU - Uhlin-Hansen, Lars AU - Lunde, Per Ivar AU - Skjølsvik, Eystein Theodor Ek DB - cin20 DO - 10.1161/CIRCULATIONAHA.115.017141 DP - EBSCOhost KW - Wounds, Penetrating -- Etiology Arthroplasty, Replacement, Hip -- Equipment and Supplies Foreign-Body Migration -- Complications Embolism -- Complications Bone Cements -- Adverse Effects Heart Injuries -- Etiology Tomography, X-Ray Computed Arthroplasty, Replacement, Hip -- Adverse Effects Joint Prosthesis Aged Wounds, Penetrating -- Radiography Treatment Outcomes Female Heart Injuries -- Radiography Heart Surgery M1 - 11 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2015 SN - 0009-7322 SP - 1047-1048 ST - Cardiac Perforation Caused by Cement Embolus After Total Hip Replacement T2 - Circulation TI - Cardiac Perforation Caused by Cement Embolus After Total Hip Replacement UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=109448637&site=ehost-live&scope=site VL - 132 ID - 830607 ER - TY - JOUR AB - Background and purpose — Implant survival of cemented total hip arthroplasty (THA) in elderly patients is higher than that of uncemented THA. However, a higher mortality rate in patients undergoing cemented THA compared with uncemented or hybrid THA has been reported. We assessed whether cemented fixation increases peri- or early postoperative mortality compared with uncemented and hybrid THA. Patients and methods — Patients with osteoarthritis who received a primary THA in Finland between 1998 and 2013 were identified from the PERFECT database of the National Institute for Health and Welfare in Finland. Definitive data on fixation method and comorbidities were available for 62,221 THAs. Mortality adjusted for fixation method, sex, age group, and comorbidities among the cemented, uncemented, and hybrid THA was examined using logistic regression analysis. Reasons for cardiovascular death within 90 days since the index procedure were extracted from the national Causes of Death Statistics and assessed separately. Results — 1- to 2-day adjusted mortality after cemented THA was comparable to that of the uncemented THA group (OR 1.2; 95% CI 0.24-6.5). 3- to 10-day mortality in the cemented THA group was comparable to that in the uncemented THA group (OR 0.54; CI 0.26-1.1), and in the hybrid THA group (OR 0.64, CI 0.25-1.6). Pulmonary embolism or cardiovascular reasons as a cause of death were not over-represented in the cemented THA group. Interpretation — Early peri- and postoperative mortality in the cemented THA group was similar compared with that of the hybrid and uncemented groups. AD - Department of Orthopaedics and Traumatology, Turku University Hospital, Turku, Finland National Institute for Health and Welfare, Helsinki, Finland AN - 134473053. Language: English. Entry Date: 20190207. Revision Date: 20190306. Publication Type: Article AU - Ekman, Elina AU - Palomäki, Antton AU - Laaksonen, Inari AU - Peltola, Mikko AU - Häkkinen, Unto AU - Mäkelä, Keijo DB - cin20 DO - 10.1080/17453674.2018.1558500 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Methods -- Finland Cementation Postoperative Period Arthroplasty, Replacement, Hip -- Mortality -- Finland Human Osteoarthritis, Hip -- Surgery Logistic Regression Odds Ratio Confidence Intervals Finland M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2019 SN - 1745-3674 SP - 6-10 ST - Early postoperative mortality similar between cemented and uncemented hip arthroplasty: a register study based on Finnish national data T2 - Acta Orthopaedica TI - Early postoperative mortality similar between cemented and uncemented hip arthroplasty: a register study based on Finnish national data UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=134473053&site=ehost-live&scope=site VL - 90 ID - 830536 ER - TY - JOUR AB - Background: Within the last two decades the use of polymethylmethacrylate (PMMA) in the treatment of osteoporotic vertebral fractures has been established widely. Several techniques of cement application in spinal surgery have been described. Besides classical vertebroplasty, kyphoplasty and related techniques that reinforce stability of the fractured vertebral body itself, augmentation of pedicle screws became an issue in the past 10 years. Aim of this technique is strengthening of the implant-bone-interface and the prevention of loosening and failure of posterior instrumentation in limited bone quality due to osteoporosis. PMMA use in spinal surgery always bears the risk of cement leakage and cement embolism. There are only few publications dealing with cement leakage in pedicle screw augmentation. We examined our cohort concerning incidence and type of leakage in comparison to the literature. In particular, we evaluated a possible role of intrathoracic pressure during cementation procedure. Patients and methods: In this retrospective study 42 patients were included. Mean age was 74 (57-89) years. 311 fenestrated, augmented screws were analyzed postoperatively concerning leakage and subsequent pulmonary embolism of cement particles. Overall, there was a leakage rate of 38.3 %, and 28.6 % of patients showed pulmonary embolism of PMMA. During surgery, patients were in part ventilated with a positive end-expiratory pressure (PEEP) of 15 cmHO during cement injection. These individuals showed significantly less leakage locally as well as less PMMA-emboli in the pulmonary circulation in contrast to patients ventilated without increased PEEP. Conclusion: PEEP elevation during administration of PMMA via fenestrated pedicle screws is reducing the leakage rate in spinal surgery. These beneficial effects warrant further evaluation in prospective studies. AD - Department of Trauma, Hand, and Reconstructive Surgery, University Hospital of the Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7 60590 Frankfurt/Main Germany Department of Diagnostic and Interventional Radiology, University Hospital of the Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7 60590 Frankfurt/Main Germany AN - 104234948. Language: English. Entry Date: 20131010. Revision Date: 20200708. Publication Type: Journal Article AU - El Saman, A. AU - Kelm, A. AU - Meier, S. AU - Sander, A. AU - Eichler, K. AU - Marzi, I. AU - Laurer, H. DB - cin20 DO - 10.1007/s00068-013-0319-x DP - EBSCOhost KW - Spinal Fractures -- Surgery Fracture Fixation -- Methods Orthopedic Fixation Devices Bone Cements Fractures, Vertebral Compression -- Surgery Human Osteoporosis -- Complications Retrospective Design Data Analysis Software Logistic Regression Male Female Middle Age Aged Aged, 80 and Over Descriptive Statistics M1 - 5 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2013 SN - 1863-9933 SP - 461-468 ST - Intraoperative PEEP-ventilation during PMMA-injection for augmented pedicle screws: improvement of leakage rate in spinal surgery T2 - European Journal of Trauma & Emergency Surgery TI - Intraoperative PEEP-ventilation during PMMA-injection for augmented pedicle screws: improvement of leakage rate in spinal surgery UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104234948&site=ehost-live&scope=site VL - 39 ID - 830650 ER - TY - JOUR AB - We report the case of a 61-year-old woman with acute decompensated heart failure secondary to acute traumatic mitral regurgitation, resulting from polymethylmethacrylate cement found in the left ventricle less than 24 hours after fluoroscopic percutaneous vertebroplasty. The patient had a history of ovarian cancer and had undergone treatment for symptomatic osteoporotic compression fractures of the vertebrae (T11, L1, and L3). The patient underwent a successful emergency open-heart operation, mitral valve replacement, closure of an atrial septal defect, and video-assisted removal of the cement foreign body from the left ventricle. The patient was later discharged with a good outcome. AD - Department of Surgical Critical Care, Allegheny General Hospital, Pittsburgh, Pennsylvania. Pulmonary Department, Allegheny General Hospital, Pittsburgh, Pennsylvania. Department of Cardiothoracic and Vascular Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania. Department of Interventional Cardiology, Allegheny General Hospital, Pittsburgh, Pennsylvania. Department of General Cardiology and Echocardiography, Allegheny General Hospital, Pittsburgh, Pennsylvania. Department of Cardiothoracic and Vascular Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania. Electronic address: sbailey2@wpahs.org. AN - 26897199 AU - Elapavaluru, S. AU - Alhassan, S. AU - Khan, F. AU - Khalil, R. AU - Schuett, A. AU - Bailey, S. DA - Mar DO - 10.1016/j.athoracsur.2015.04.115 DP - NLM ET - 2016/02/22 J2 - The Annals of thoracic surgery KW - Acute Disease Cardiac Catheterization/methods Cardiopulmonary Bypass/methods Echocardiography, Transesophageal/methods Emergency Treatment Female Follow-Up Studies Foreign Bodies/*complications Heart Valve Prosthesis Implantation/methods Humans Middle Aged Mitral Valve Insufficiency/diagnostic imaging/*etiology/surgery Osteoporosis, Postmenopausal/complications/diagnostic imaging Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/diagnostic imaging/*etiology/therapy Radiography Severity of Illness Index Shock, Cardiogenic/diagnostic imaging/*etiology/therapy Spinal Fractures/diagnostic imaging/etiology/surgery Treatment Outcome Vertebroplasty/*adverse effects/methods LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 0003-4975 SP - 1169-71 ST - Severe Acute Traumatic Mitral Regurgitation, Cardiogenic Shock Secondary to Embolized Polymethylmethracrylate Cement Foreign Body After a Percutaneous Vertebroplasty T2 - Ann Thorac Surg TI - Severe Acute Traumatic Mitral Regurgitation, Cardiogenic Shock Secondary to Embolized Polymethylmethracrylate Cement Foreign Body After a Percutaneous Vertebroplasty VL - 101 ID - 828782 ER - TY - JOUR AB - Study Design: This is a prospective cohort study. Purpose: This study discusses a new technique for injecting cement in the affected vertebrae. Overview of Literature: Since introduction of vertebroplasty to clinical practice, the cement leak is considered the most frequent and hazardous complication. In literature, the cement extravasation occurred in 26%-97% of the cases. Methods: A hundred and twenty-three patients underwent vertebroplasty using the serial injection technique. The package of the cement powder and the solvent was divided into five equal parts. Each part of the powder and the solvent was mixed as a single dose and injected to the affected vertebra. The duration between subsequent injections was 10 minutes. Each injection consisted of 1-1.5 mL of cement. Results: This new technique gives the surgeon enough time to make multiple separate injections using the same package. The time interval between injections hardens the cement just enough so that it does not get displaced by the next cement injection. This technique gives time to the preceding injected cement to seal off the cracks and cavities in the vertebra, and subsequently leads to a significant decrease in cement leak (p<0.001), as compared to literature. Conclusions: This study demonstrates a previously unreported technique for vertebroplasty that adds more safety to the procedure by significantly decreasing cement leak. It also makes the surgeon more relaxed due to time intervals, giving him more self-confidence whilst performing the procedure. AD - [Elnoamany, Hossam] Menoufia Univ Hosp, Fac Med, Dept Neurosurg, 64 Gamal Abdel Nasser St, Shibin Al Kawm, Egypt. Elnoamany, H (corresponding author), Menoufia Univ Hosp, Fac Med, Dept Neurosurg, 64 Gamal Abdel Nasser St, Shibin Al Kawm, Egypt. hae1967@gmail.com AN - WOS:000420356300004 AU - Elnoamany, H. DA - Dec DO - 10.4184/asj.2015.9.6.855 J2 - Asian Spine J. KW - Osteoporotic spinal fractures Traumatic non osteoporotic vertebral fractures Percutaneous vertebroplasty Serial cement injection technique Cement leak OSTEOPOROTIC VERTEBRAL FRACTURES POLYMETHYLMETHACRYLATE VERTEBROPLASTY COMPRESSION FRACTURES PULMONARY-EMBOLISM PAIN RELIEF COMPLICATION KYPHOPLASTY Orthopedics LA - English M1 - 6 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2015 SN - 1976-1902 SP - 855-862 ST - Percutaneous Vertebroplasty: A New Serial Injection Technique to Minimize Cement Leak T2 - Asian Spine Journal TI - Percutaneous Vertebroplasty: A New Serial Injection Technique to Minimize Cement Leak UR - ://WOS:000420356300004 VL - 9 ID - 830230 ER - TY - JOUR AB - Vertebroplasty and kyphoplasty are procedures that are increasingly being used in patients with osteoporosis and metastatic cancer to provide pain relief from compression fractures. Cement pulmonary emboli can occur following these procedures. We desribe a case to demonstrate the clinical presentation, radiographic findings, and management of this complication. AD - A. Elshinawy, Mem. Sloan Kettering Cancer Center, New York, NY, United States AU - Elshinawy, A. AU - Boland, P. AU - White, D. A. DB - Embase KW - adult analgesia article bone metastasis bone pain case report cement pulmonary embolus human kyphoplasty lung embolism male osteoporosis percutaneous vertebroplasty treatment indication spine fracture LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2005 SN - 0194-259X SP - 23-24 ST - A patient with cement pulmonary embolus following kyphoplasty T2 - Journal of Respiratory Diseases TI - A patient with cement pulmonary embolus following kyphoplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L40543201&from=export VL - 26 ID - 829824 ER - TY - JOUR AD - Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA. AN - WOS:000186070400650 AU - Elshinawy, A. A. AU - White, D. A. AU - Stover, D. E. DA - Oct DO - 10.1378/chest.124.4_MeetingAbstracts.304S-a J2 - Chest KW - PULMONARY-EMBOLISM PERCUTANEOUS VERTEBROPLASTY ACRYLIC CEMENT Critical Care Medicine Respiratory System LA - English M1 - 4 M3 - Meeting Abstract N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2003 SN - 0012-3692 SP - 304S-305S ST - Hard rock arteries: A case of a post-operative complication T2 - Chest TI - Hard rock arteries: A case of a post-operative complication UR - ://WOS:000186070400650 VL - 124 ID - 830444 ER - TY - JOUR AB - The management of giant cell tumor of the proximal humerus that extends to the joint is challenging. Here, we report a case of proximal humerus giant cell tumor with cortical bone destruction extending to the shoulder joint. Pre-operative selective arterial embolization induced peripheral tumor ossification. Subsequently, the lesion was removed by intralesional curettage, and the cavity was filled with cement. Macroscopically, the inner wall of the cavity was found to be lined with a thick fibrous membrane. Histologically, massive fibrosis and resultant remodeling of the destroyed cortical bone were induced, which was consistent with the peripheral ossification on the plain radiograph. We believe that selective arterial embolization can be an effective neoadjuvant therapy for giant cell tumors of the extremities, especially for tumors with large cortical defects or joint involvement. AD - Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, West 16, South 1, Sapporo 060-8543, Japan. emrmkt@yahoo.co.jp AN - 22689917 AU - Emori, M. AU - Kaya, M. AU - Sasaki, M. AU - Wada, T. AU - Yamaguchi, T. AU - Yamashita, T. DA - Sep DO - 10.1093/jjco/hys090 DP - NLM ET - 2012/06/13 J2 - Japanese journal of clinical oncology KW - Bone Cements/therapeutic use *Bone Neoplasms/diagnostic imaging/pathology/therapy *Chemoembolization, Therapeutic Curettage *Giant Cell Tumor of Bone/diagnostic imaging/pathology/therapy Humans *Humerus/pathology Male Neoadjuvant Therapy/*methods *Shoulder Joint/diagnostic imaging/pathology/surgery Tomography, X-Ray Computed Young Adult LA - eng M1 - 9 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0368-2811 SP - 851-5 ST - Pre-operative selective arterial embolization as a neoadjuvant therapy for proximal humerus giant cell tumor of bone: radiological and histological evaluation T2 - Jpn J Clin Oncol TI - Pre-operative selective arterial embolization as a neoadjuvant therapy for proximal humerus giant cell tumor of bone: radiological and histological evaluation VL - 42 ID - 828934 ER - TY - JOUR AB - Vertebroplasty is a minimally invasive procedure that may be performed under either local or general anesthesia. In this study, we aimed at assessing the outcomes of the vertebroplasty performed under local anesthesia in patients at high risk of general anesthesia. Vertebroplasty was performed under local anesthesia in the treatment of a total of 62 patients (68 vertebrae in total) with osteoporotic vertebral fractures between 2011 and 2013. None of the patients had a history of trauma. Patients who were classified as ASA III during the preoperative examinations were included in the study. VAS scores were evaluated before the surgery, on the first postoperative day, and in week 1 and in month 1 after the surgery. The average age was 77.5 years (age range 53-102). An average of 2 cc of cement was injected to 22 patients (35.5 %), and an average of 3 cc of cement was injected to 40 patients (64.5 %). The mean VAS scores were 7.52 (6-9) before the procedure, 3.55 (2-5) on the first day, 2.03 (0-4) in week 1 and 0.87 (0-2) in month 1 postoperatively. Asymptomatic cement embolism was detected in one patient. No other complications were observed in the study group. Vertebroplasty performed under local anesthesia is an effective and safe procedure in terms of pain control and early ambulation and is bereft of the complications associated with general anesthesia. AD - Orthopaedia and Traumatology Department, Memorial Hizmet Hospital, Halkalı Caddesi Yeşilköy Toplu Konut Sitesi A 31, Yeşilköy Istanbul Turkey Orthopaedia and Traumatology Department, Florence Nightingale Bilim Üniversitesi, Istanbul Turkey Orthopaedia and Traumatology Department, Ankara Military Hospital, Ankara Turkey Physical Medicine and Rehabilitation Department, Medicine Hospital, Istanbul Turkey Orthopaedia and Traumatology Department, Istanbul Florence Nightingale İstanbul Omurga Center, Istanbul Turkey AN - 112155779. Language: English. Entry Date: 20160208. Revision Date: 20190723. Publication Type: Article AU - Emre, Tuluhan AU - Gökcen, H. AU - Atbaşı, Zafer AU - Kavadar, Gülis AU - Enercan, Meriç AU - Ozturk, Cagatay DB - cin20 DO - 10.1007/s00590-015-1700-8 DP - EBSCOhost KW - Anesthesiologists -- Organizations -- United States Health Status Indicators Osteoporosis -- Complications -- In Old Age Spinal Fractures -- Surgery Vertebroplasty -- Methods Anesthesia, Local Outcome Assessment Human United States Middle Age Aged Aged, 80 and Over Minimally Invasive Procedures Scales Length of Stay Patient Safety Descriptive Statistics Data Analysis Software T-Tests Visual Analog Scaling Pearson's Correlation Coefficient Female Male Quality of Life M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2016 SN - 1633-8065 SP - 47-52 ST - ASA III osteoporotic fracture in 62 patients treated with vertebroplasty under local anesthesia T2 - European Journal of Orthopaedic Surgery & Traumatology TI - ASA III osteoporotic fracture in 62 patients treated with vertebroplasty under local anesthesia UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=112155779&site=ehost-live&scope=site VL - 26 ID - 830600 ER - TY - JOUR AB - Purpose: Determining whether implantation of an expandable titanium mesh cage (Osseofix® system) is a successful and safe minimally invasive therapy for osteoporotic and tumorous vertebral compression fractures (VCFs). Materials and Methods: 32 patients (25 women, 7 men, mean age 71) with 46 osteoporotic or tumorous VCFs (T6 to L4) from June 2010 to January 2012 were included. All of them were stabilized with the Osseofix® system. Preinterventionally we performed X-ray, MRI, and bone density measurements (DXA). The clinical and radiological results were evaluated preop, postop and 12 months postop based on the visual analog scale (VAS) and the Oswestry Disability Index (ODI), X-ray (Beck Index, Cobb angle) and CT. Results: There was a significant improvement in pain intensity (VAS) (7.8 to 1.6) as well as a significant reduction in the mean ODI (71.36% to 30.4%) after 12 months. The mean kyphotic angle according to Cobb showed significant improvements (12.3° to 10.8°) after 12 months. Postinterventional imaging showed one case of loss of height in a stabilized lumbar vertebral body (2.2%) in osteoporosis and one case with adjacent fracture (2.2%) in osteoporosis. We saw no changes in the posterior vertebral wall. Except for one pronounced postoperative hematoma, we saw no surgical complications including no cement leakage. Conclusion: The clinical mid-term results are good at a low complication rate. The stabilization of symptomatic osteoporotic and tumorous VCFs with the Osseofix® system is a safe and effective procedure, even in fractures with posterior wall involvement. The Osseofix® system is an interesting alternative to the established procedures of cement augmentation. © Georg Thieme Verlag KG Stuttgart New York. AD - S.A. Ender, Klinik für Orthopädie und Orthopädische Chirurgie, Universitätsmedizin Greifswald, F.-Sauerbruch-Straße, 17475 Greifswald, Germany AU - Ender, S. A. AU - Gradl, G. AU - Ender, M. AU - Langner, S. AU - Merk, H. R. AU - Kayser, R. DB - Embase Medline DO - 10.1055/s-0033-1355504 KW - adult aged article body height bone density clinical article Cobb angle compression fracture device safety female fragility fracture hematoma human infection lung embolism male middle aged minimally invasive procedure neurological complication nuclear magnetic resonance imaging Oswestry Disability Index peroperative complication postoperative complication postoperative hemorrhage postoperative infection priority journal prospective study spine fracture spine stabilization titanium cage very elderly visual analog scale wound healing impairment X ray Osseofix LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1438-9010 1438-9029 SP - 380-387 ST - Osseofix® system for percutaneous stabilization of osteoporotic and tumorous vertebral compression fractures - Clinical and radiological results after 12 months T2 - RoFo Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren TI - Osseofix® system for percutaneous stabilization of osteoporotic and tumorous vertebral compression fractures - Clinical and radiological results after 12 months UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52820265&from=export http://dx.doi.org/10.1055/s-0033-1355504 VL - 186 ID - 829446 ER - TY - JOUR AB - Sudden cardiac arrest, a rare and often fatal complication of total joint replacement, usually occurs during the insertion of polymethyl methacrylate cement and a prosthesis. We describe a cardiac arrest during insertion of a customized long-stem prosthesis (without the use of a tourniquet) for revision of an earlier total knee replacement. We attribute this complication to the "fat embolism syndrome" (FES)--hypoxemia from an acute pulmonary embolism composed of fat and marrow elements extruded into the venous circulation--coupled with systemic hypotension from absorption of the cement monomer. The syndrome appears to be more common when long-stem prostheses are used. Hypoxemia also correlates with the release of tissue-thromboplastic products as well as the bone marrow elements. Phase 1 of the syndrome consists of particulate obstruction of the pulmonary circulation that causes cor pulmonale and bradycardia or other dysrhythmia. Phase 2 is characterized by respiratory and neurologic manifestations associated with the classic conception of the syndrome. Intraoperative increases in pulmonary artery and pulmonary artery occlusion pressures and pulmonary vascular resistance during unexplained hypoxemia should alert the clinician to the possibility of FES. Proper diagnosis relies on recognizing the three most common clinical manifestations: hypoxemia, neurologic derangements, and fever. Other manifestations of FES are petechiae, thrombocytopenia, anemia, lipuria, changes on ECG, tachycardia, and dyspnea. AD - Department of Anesthesiology, University of Florida College of Medicine, Gainesville 32610-0254, USA. AN - 7669319 AU - Enneking, F. K. DA - May DO - 10.1016/0952-8180(94)00043-4 DP - NLM ET - 1995/05/01 J2 - Journal of clinical anesthesia KW - Aged Critical Care Heart Arrest/*etiology Humans Knee Prosthesis/*adverse effects/instrumentation Male Methylmethacrylates/adverse effects Prosthesis Design LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 1995 SN - 0952-8180 (Print) 0952-8180 SP - 253-63 ST - Cardiac arrest during total knee replacement using a long-stem prosthesis T2 - J Clin Anesth TI - Cardiac arrest during total knee replacement using a long-stem prosthesis VL - 7 ID - 828939 ER - TY - JOUR AB - Sudden cardiac arrest, a rare and often fatal complication of total joint replacement, usually occurs during the insertion of polymethyl methacrylate cement and a prosthesis. We describe a cardiac arrest during insertion of a customized long stem pros thesis (without the use of a tourniquet) for revision of an earlier total knee replacement. We attribute this complication to the 'fat embolism syndrome' (FES)-hypoxemia from an acute pulmonary embolism composed of fat and marrow elements extruded into the venous circulation-coupled with systemic hypotension from absorption of the cement monomer. The syndrome appears to be more common when long-stem prostheses are used. Hypoxemia also correlates with the release of tissue-thromboplastic products as well as the bone marrow elements. Phase 1 of the syndrome consists of particulate obstruction of the pulmonary circulation that causes cor pulmonale and bradycardia or other dysrhythmia. Phase 2 is characterized by respiratory and neurologic manifestations associated with the classic conception of the syndrome. Intraoperative increases in pulmonary artery and pulmonary artery occlusion pressures and pulmonary vascular resistance during unexplained hypoxemia should alert the clinician to the possibility of FES. Proper diagnosis relies on recognizing the three most common clinical manifestations: hypoxemia, neurologic derangements, and fever. Other manifestations of FES are petechiae, thrombocytopenia, anemia, lipuria, changes on EGG, tachycardia, and dyspnea. AD - F.K. Enneking, Editorial Office, Department of Anesthesiology, Univ. of Florida College of Medicine, Gainesville, FL 32610-0254, United States AU - Enneking, F. K. AU - Malawer, M. M. DB - Embase Medline DO - 10.1016/0952-8180(94)00043-4 KW - epinephrine atropine doxorubicin ephedrine indometacin isoflurane lidocaine nitrous oxide poly(methyl methacrylate) suxamethonium thiopental aged bradycardia case report clinical feature conference paper cor pulmonale dose response fat embolism heart arrest heart arrhythmia human hypotension hypoxemia intravenous drug administration knee prosthesis lung circulation male osteosarcoma priority journal total knee arthroplasty LA - English M1 - 3 M3 - Conference Paper N1 - Embase Elsevier literature search January 5, 2021 PY - 1995 SN - 0952-8180 SP - 253-263 ST - Cardiac arrest during total knee replacement using a long-stem prosthesis T2 - Journal of Clinical Anesthesia TI - Cardiac arrest during total knee replacement using a long-stem prosthesis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L25171591&from=export http://dx.doi.org/10.1016/0952-8180(94)00043-4 VL - 7 ID - 829929 ER - TY - JOUR AB - Percutaneous vertebroplasty (PV) is considered a very safe and effective procedure to treat painful compression fractures, and this procedure rarely results in complications. To our knowledge, there is only one case report of the complications associated with cerebral infarction after PV. Here, we report a rare case of postoperative acute cerebellar infarction that was caused by vertebral artery occlusion. We present a rare case of left acute cerebellar infarction that developed approximately 6 h after PV in an 82-year-old woman. Brain magnetic resonance (MR) angiography showed complete occlusion of the left vertebral artery. The patient was treated conservatively. To the best of our knowledge, acute cerebellar infarction after PV has yet not been reported. Although we cannot rule out the possibility of embolism because the patient was in the prone position with her head rotated during the operation, there are no specific links between acute arterial infarction and PV. Thus, this complication may be incidental rather than causal. Nevertheless, special attention should be paid to the postoperative variable changes in aged patients. AD - K. S. Eom, Wonkwang Univeristy School of Medicine, Neurosurgery, Iksan, South Korea AU - Eom, K. S. AU - Na, K. J. AU - Young, K. T. DB - Embase KW - bone cement acute cerebellar infarction acute disease aged article body position bone density brain artery brain embolism brain hemorrhage case report cerebellum infarction compression fracture conservative treatment disease duration disease severity dizziness female frontal lobe head movement hemiparesis human low back pain magnetic resonance angiography motor performance nausea neuroimaging nuclear magnetic resonance imaging osteoporosis percutaneous vertebroplasty posterior inferior cerebellar artery postoperative complication postoperative period spine radiography superior cerebellar artery vertebra body spine fracture vertebral artery stenosis visual analog scale LA - English Turkish M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1302-1664 1300-1817 SP - 368-372 ST - Acute cerebellar infarction after percutaneous vertebroplasty T2 - Journal of Neurological Sciences TI - Acute cerebellar infarction after percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L365013507&from=export VL - 29 ID - 829588 ER - TY - JOUR AB - Background Context: The application of pedicle screws with cement to strengthen the fixation of the osteoporotic spine has increasingly gained popularity. However, the technique has also led to an increase in cement-related complications.Purpose: The aim of the present study was to compare the clinical and radiological results of the patients with degenerative spinal pathologies who were treated with pedicle screws and cement injections on all segments versus those who were treated with cement injections only on the strategic vertebrae selected.Study Design: A retrospective clinical study.Patient Sample: The sample consists of 31 patients who underwent spinal surgery due to degenerative spinal pathologies.Outcome Measures: Patients were assessed for the adequate spinal fusion and cement-related complication parameters.Methods: Thirty-one patients with a minimum follow-up period of 2 years were divided into two groups and evaluated. Group A consisted of 17 patients (14 females, 3 males; mean age: 68.1 years) with cemented pedicle screws and Group B consisted of 14 patients (12 females, 2 males; mean age: 67.2 years) with cemented screws on selected vertebrae alone. Selection of the strategic vertebrae was made by taking the most stressed regions in the fusion site into account. Prophylactic vertebroplasty was performed in all patients in Group A and on strategic segments in Group B to avoid an adjacent segment fracture. Early- and late-term complications during the follow-up period were recorded.Results: Mean follow-up period was 51.8 (range: 31 to 80) months in Group A and 41.2 (range: 26 to 61) months in Group B. Cemented pedicle screws were bilaterally placed on 94 vertebrae in Group A. In Group B, cement was applied on 28 of 80 vertebrae. Including the prophylactic vertebroplasties, a total of 111 cement applications were performed in Group A and 38 in Group B. Cement embolism, symptomatic chest discomfort, and duration of surgery were significantly higher in Group A (p<.05). No adjacent segment fracture in the proximal or distal vertebra, implant failure, or loss of correction was seen throughout the follow-up period.Conclusions: The application of cemented pedicle screws on all segments of the osteoporotic spine increases the cement volume and rate of cement-related complications. Cementing the strategic vertebrae alone will enhance the fixation strength and endurance and decrease the complications caused by cement application. AD - Department of Orthopaedics and Traumatology, Hisar Intercontinental Hospital, Site Yolu Cad. No:7 34768, Umraniye, Istanbul, Turkey Department of Orthopaedics and Traumatology, Fatih Sultan Mehmet Education and Research Hospital, E5 Karayolu 34752, Icerenkoy, Atasehir, Istanbul, Turkey Department of Orthopaedics and Traumatology, Memorial Hospital, Piyalepasa Bulvarı 34385, Sisli, Istanbul, Turkey Bosphorus Spine Center, Yesil Cimen Sokak No:9, Besiktas, Istanbul, Turkey AN - 121244788. Language: English. Entry Date: 20170730. Revision Date: 20191029. Publication Type: journal article AU - Erdem, Mehmet Nuri AU - Karaca, Sinan AU - Sarı, Seckin AU - Yumrukcal, Feridun AU - Tanli, Ruhat AU - Aydogan, Mehmet DB - cin20 DO - 10.1016/j.spinee.2016.10.001 DP - EBSCOhost KW - Pedicle Screws Spinal Fusion -- Methods Spinal Diseases -- Surgery Methylmethacrylates -- Therapeutic Use Osteoporosis -- Surgery Bone Cements -- Therapeutic Use Bone Cements -- Adverse Effects Retrospective Design Methylmethacrylates -- Adverse Effects Osteoporosis Aged Spinal Diseases Vertebroplasty -- Methods Equipment Failure Spinal Fusion -- Equipment and Supplies Male Female Vertebroplasty -- Equipment and Supplies Radiography Human M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 1529-9430 SP - 328-337 ST - Application of cement on strategic vertebrae in the treatment of the osteoporotic spine T2 - Spine Journal TI - Application of cement on strategic vertebrae in the treatment of the osteoporotic spine UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=121244788&site=ehost-live&scope=site VL - 17 ID - 830571 ER - TY - JOUR AB - INTRODUCTION: Current treatment strategies for osteoporotic vertebral compression fractures (VCFs) focus on cement-associated solutions. Complications associated with cement application are leakage, embolism, adjacent fractures, and compromise in bony healing. This study comprises a validated VCF model in osteoporotic sheep in order to (1) evaluate a new cementless fracture fixation technique using titanium mesh implants (TMIs) and (2) demonstrate the healing capabilities in osteoporotic VCFs. METHODS: Twelve 5-year-old Merino sheep received ovariectomy, corticosteroid injections, and a calcium/phosphorus/vitamin D-deficient diet for osteoporosis induction. Standardized VCFs (type AO A3.1) were created, reduced, and fixed using intravertebral TMIs. Randomly additional autologous spongiosa grafting (G1) or no augmentation was performed (G2, n = 6 each). Two months postoperatively, macroscopic, micro-CT and biomechanical evaluation assessed bony consolidation. RESULTS: Fracture reduction succeeded in all cases without intraoperative complications. Bony consolidation was proven for all cases with increased amounts of callus development for G2 (58.3%). Micro-CT revealed cage integration. Neither group showed improved results with biomechanical testing. CONCLUSIONS: Fracture reduction/fixation using TMIs without cement in osteoporotic sheep lumbar VCF resulted in bony fracture healing. Intravertebral application of autologous spongiosa showed no beneficial effects. The technique is now available for clinical use; thus, it offers an opportunity to abandon cement-associated complications. AD - Department of Trauma, Hand and Reconstructive Surgery, University of Rostock, Medical Center, Schillingallee 35, 18057 Rostock, Germany. Clinic for Anesthesiology and Critical Care Medicine, University of Rostock, Medical Center, Schillingallee 35, 18059 Rostock, Germany. Institute for Biomedical Engineering, University of Rostock, F. Barnewitz-Straße 4, 18119 Rostock, Germany. Faculty of Mechanical Engineering and Marine Technology, Chair of Mechanical Engineering Design/Lightweight Design, University of Rostock, Albert-Einstein-Straße 2, 18059 Rostock, Germany. Rudolf-Zenker Institute for Experimental Surgery, University of Rostock, Medical Center, Schillingallee 69a, 18057 Rostock, Germany. Department of Trauma, Orthopedic and Reconstructive Surgery, Munich Municipal Hospital Group, Clinic Harlaching, Sanatoriumsplatz 2, 81545 Munich, Germany. AN - 27019848 AU - Eschler, A. AU - Roepenack, P. AU - Roesner, J. AU - Herlyn, P. K. AU - Martin, H. AU - Reichel, M. AU - Rotter, R. AU - Vollmar, B. AU - Mittlmeier, T. AU - Gradl, G. C2 - Pmc4785241 DO - 10.1155/2016/4094161 DP - NLM ET - 2016/03/29 J2 - BioMed research international KW - Animals Disease Models, Animal *Fracture Healing *Internal Fixators Lumbar Vertebrae/*surgery Sheep Spinal Fractures/*surgery *Surgical Mesh *Titanium LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 2314-6133 (Print) SP - 4094161 ST - Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model T2 - Biomed Res Int TI - Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model VL - 2016 ID - 828642 ER - TY - JOUR AB - Introduction. Current treatment strategies for osteoporotic vertebral compression fractures (VCFs) focus on cement-associated solutions. Complications associated with cement application are leakage, embolism, adjacent fractures, and compromise in bony healing. This study comprises a validated VCF model in osteoporotic sheep in order to (1) evaluate a new cementless fracture fixation technique using titanium mesh implants (TMIs) and (2) demonstrate the healing capabilities in osteoporotic VCFs. Methods. Twelve 5-year-old Merino sheep received ovariectomy, corticosteroid injections, and a calcium/phosphorus/vitamin D-deficient diet for osteoporosis induction. Standardized VCFs (type AO A3.1) were created, reduced, and fixed using intravertebral TMIs. Randomly additional autologous spongiosa grafting (G1) or no augmentation was performed (G2, n = 6 each). Two months postoperatively, macroscopic, micro-CT and biomechanical evaluation assessed bony consolidation. Results. Fracture reduction succeeded in all cases without intraoperative complications. Bony consolidation was proven for all cases with increased amounts of callus development for G2 (58.3%). Micro-CT revealed cage integration. Neither group showed improved results with biomechanical testing. Conclusions. Fracture reduction/fixation using TMIs without cement in osteoporotic sheep lumbar VCF resulted in bony fracture healing. Intravertebral application of autologous spongiosa showed no beneficial effects. The technique is now available for clinical use; thus, it offers an opportunity to abandon cement-associated complications. AD - A. Eschler, Department of Trauma, Hand and Reconstructive Surgery, University of Rostock, Medical Center, Schillingallee 35, Rostock, Germany AU - Eschler, A. AU - Roepenack, P. AU - Roesner, J. AU - Herlyn, P. K. E. AU - Martin, H. AU - Reichel, M. AU - Rotter, R. AU - Vollmar, B. AU - Mittlmeier, T. AU - Gradl, G. DB - Embase Medline DO - 10.1155/2016/4094161 KW - animal experiment animal model article bone graft bone structure cementless prosthesis comparative study compression fracture controlled study experimental sheep female fracture fixation fracture healing fracture reduction fragility fracture image reconstruction micro-computed tomography nonhuman ovariectomy-induced osteoporosis postoperative period surgical mesh three-dimensional imaging titanium mesh implant LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 2314-6141 2314-6133 ST - Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model T2 - BioMed Research International TI - Cementless Titanium Mesh Fixation of Osteoporotic Burst Fractures of the Lumbar Spine Leads to Bony Healing: Results of an Experimental Sheep Model UR - https://www.embase.com/search/results?subaction=viewrecord&id=L608950250&from=export http://dx.doi.org/10.1155/2016/4094161 VL - 2016 ID - 829336 ER - TY - JOUR AB - INTRODUCTION: Vertebral compression fractures (VCFs) are one of the most common injuries in the aging population presenting with an annual incidence of 1.4 million new cases in Europe. Current treatment strategies focus on cement-associated solutions (kyphoplasty/vertebroplasty techniques). Specific cement-associated problems as leakage, embolism and the adjacent fracture disease are reported adding to open questions like general fracture healing properties of the osteoporotic spine. In order to analyze those queries animal models are of great interest; however, both technical difficulties in the induction of experimental osteoporosis in animal as well as the lack of a standardized fracture model impede current and future in vivo studies. This study introduces a standardized animal model of an osteoporotic VCF type A3.1 that may enable further in-depth analysis of the afore mentioned topics. MATERIAL AND METHODS: Twenty-four 5-year-old female Merino sheep (mean body weight: 67 kg; range 57-79) were ovariectomized (OP1) and underwent 5.5 months of weekly corticosteroid injections (dexamethasone and dexamethasone-sodium-phosphate), adding to a calcium/phosphorus/vitamin D-deficient diet. Osteoporosis induction was documented by pQCT and micro-CT BMD (bone mineral density) as well as 3D histomorphometric analysis postoperatively of the sheep distal radius and spine. Non osteoporotic sheep served as controls. Induction of a VCF of the second lumbar vertebra was performed via a mini-lumbotomy surgical approach with a standardized manual compression mode (OP2). RESULTS: PQCT analysis revealed osteoporosis of the distal radius with significantly reduced BMD values (0.19 g/cm(3), range 0.13-0.22 vs. 0.27 g/cm(3), range 0.23-0.32). Micro-CT documented significant lowering of BMD values for the second lumbar vertebrae (0.11 g/cm(3), range 0.10-0.12) in comparison to the control group (0.14 g/cm(3), range 0.12-0.17). An incomplete burst fracture type A3.1 was achieved in all cases and resulted in a significant decrease in body angle and vertebral height (KA 4.9°, range: 2-12; SI 4.5%, range: 2-12). With OP1, one minor complication (lesion of small bowel) occurred, while no complications occurred with OP2. CONCLUSIONS: A suitable spinal fracture model for creation of VCFs in osteoporotic sheep was developed. The technique may promote the development of improved surgical solutions for VCF treatment in the experimental and clinical setting. AD - Dept. of Trauma, Hand and Reconstructive Surgery, University of Rostock, Medical Center, Germany. Electronic address: anica.eschler@med.uni-rostock.de. Dept. of Trauma, Hand and Reconstructive Surgery, University of Rostock, Medical Center, Germany. Clinic for Anesthesiology and Critical Care Medicine, University of Rostock, Medical Center, Germany. Chair of Nutrition Physiology and Animal Nutrition, Faculty of Agricultural and Environmental Sciences, University of Rostock, Germany. Rudolf-Zenker Institute for Experimental Surgery, University of Rostock, Medical Center, Germany. Dept. of Trauma, Orthopedic and Reconstructive Surgery, Munich Municipal Hospital Group, Clinic Harlaching, Germany. AN - 26542861 AU - Eschler, A. AU - Röpenack, P. AU - Herlyn, P. K. AU - Roesner, J. AU - Pille, K. AU - Büsing, K. AU - Vollmar, B. AU - Mittlmeier, T. AU - Gradl, G. DA - Oct DO - 10.1016/s0020-1383(15)30014-0 DP - NLM ET - 2015/11/07 J2 - Injury KW - Animals Biomechanical Phenomena Bone Density Calcium/deficiency Diet Disease Models, Animal Female Fracture Fixation/*methods Fractures, Compression/etiology/*pathology/surgery Lumbar Vertebrae/*pathology Osteoporosis/complications/etiology/*pathology Ovariectomy Phosphorus/deficiency Sheep, Domestic Vitamin D Deficiency Vcf calcium/phosphorus deficient diet glucocorticoids osteoporosis pQCT sheep model spine Micro CT vertebral compression fractures μCγ LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 0020-1383 SP - S17-23 ST - The standardized creation of a lumbar spine vertebral compression fracture in a sheep osteoporosis model induced by ovariectomy, corticosteroid therapy and calcium/phosphorus/vitamin D-deficient diet T2 - Injury TI - The standardized creation of a lumbar spine vertebral compression fracture in a sheep osteoporosis model induced by ovariectomy, corticosteroid therapy and calcium/phosphorus/vitamin D-deficient diet VL - 46 Suppl 4 ID - 828741 ER - TY - JOUR AB - Introduction: Vertebral compression fractures (VCFs) are one of the most common injuries in the aging population presenting with an annual incidence of 1.4 million new cases in Europe. Current treatment strategies focus on cement-associated solutions (kyphoplasty/ vertebroplasty techniques). Specific cement-associated problems as leakage, embolism and the adjacent fracture disease are reported adding to open questions like general fracture healing properties of the osteoporotic spine. In order to analyze those queries animal models are of great interest; however, both technical difficulties in the induction of experimental osteoporosis in animal as well as the lack of a standardized fracture model impede current and future in vivo studies. This study introduces a standardized animal model of an osteoporotic VCF type A3.1 that may enable further in-depth analysis of the afore mentioned topics. Material and Methods: Twenty-four 5-year-old female Merino sheep (mean body weight: 67 kg; range 57-79) were ovariectomized (OP1) and underwent 5.5 months of weekly corticosteroid injections (dexamethasone and dexamethasone-sodium-phosphate), adding to a calcium/phosphorus/vitamin D-deficient diet. Osteoporosis induction was documented by pQCT and micro-CT BMD (bone mineral density) as well as 3D histomorphometric analysis postoperatively of the sheep distal radius and spine. Non osteoporotic sheep served as controls. Induction of a VCF of the second lumbar vertebra was performed via a mini-lumbotomy surgical approach with a standardized manual compression mode (OP2). Results: PQCT analysis revealed osteoporosis of the distal radius with significantly reduced BMD values (0.19 g/cm(3), range 0.13-0.22 vs. 0.27 g/cm(3), range 0.23-0.32). Micro-CT documented significant lowering of BMD values for the second lumbar vertebrae (0.11 g/cm(3), range 0.10-0.12) in comparison to the control group (0.14 g/cm(3), range 0.12-0.17). An incomplete burst fracture type A3.1 was achieved in all cases and resulted in a significant decrease in body angle and vertebral height (KA 4.9 degrees, range: 2-12; SI 4.5%, range: 2-12). With OP1, one minor complication (lesion of small bowel) occurred, while no complications occurred with OP2. Conclusions: A suitable spinal fracture model for creation of VCFs in osteoporotic sheep was developed. The technique may promote the development of improved surgical solutions for VCF treatment in the experimental and clinical setting. (C) 2015 Elsevier Ltd. All rights reserved. AD - [Eschler, Anica; Roepenack, Paula; Herlyn, Philipp K. E.; Pille, Kristin; Mittlmeier, Thomas] Univ Rostock, Dept Trauma Hand & Reconstruct Surg, Med Ctr, D-18057 Rostock, Germany. [Roesner, Jan] Univ Rostock, Clin Anesthesiol & Crit Care Med, Med Ctr, D-18057 Rostock, Germany. [Pille, Kristin] Univ Rostock, Fac Agr & Environm Sci, Chair Nutr Physiol & Anim Nutr, D-18057 Rostock, Germany. [Vollmar, Brigitte] Univ Rostock, Rudolf Zenker Inst Expt Surg, Med Ctr, D-18057 Rostock, Germany. [Gradl, Georg] Munich Municipal Hosp Grp, Dept Trauma Orthoped & Reconstruct Surg, Clin Harlaching, Munich, Germany. Eschler, A (corresponding author), Univ Rostock, Dept Trauma Hand & Reconstruct Surg, Med Ctr, Schillingallee 35, D-18057 Rostock, Germany. anica.eschler@med.uni-rostock.de AN - WOS:000363905200004 AU - Eschler, A. AU - Ropenack, P. AU - Herlyn, P. K. E. AU - Roesner, J. AU - Pille, K. AU - Busing, K. AU - Vollmar, B. AU - Mittlmeier, T. AU - Gradl, G. DA - Oct DO - 10.1016/s0020-1383(15)30014-0 J2 - Injury-Int. J. Care Inj. KW - vertebral compression fractures VCF sheep model osteoporosis glucocorticoids calcium/phosphorus deficient diet spine Micro CT mu CT pQCT HYPOTHALAMIC-PITUITARY DISCONNECTION LOW TURNOVER OSTEOPOROSIS BONE-MINERAL DENSITY BALLOON KYPHOPLASTY CANCELLOUS BONE TRABECULAR BONE VERTEBROPLASTY INHIBITION STRATEGY EWES Critical Care Medicine Emergency Medicine Orthopedics Surgery LA - English M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2015 SN - 0020-1383 SP - S17-S23 ST - The standardized creation of a lumbar spine vertebral compression fracture in a sheep osteoporosis model induced by ovariectomy, corticosteroid therapy and calcium/phosphorus/vitamin D-deficient diet T2 - Injury-International Journal of the Care of the Injured TI - The standardized creation of a lumbar spine vertebral compression fracture in a sheep osteoporosis model induced by ovariectomy, corticosteroid therapy and calcium/phosphorus/vitamin D-deficient diet UR - ://WOS:000363905200004 VL - 46 ID - 830234 ER - TY - JOUR AB - Introduction: Vertebral compression fractures (VCFs) are one of the most common injuries in the aging population presenting with an annual incidence of 1.4 million new cases in Europe. Current treatment strategies focus on cement-associated solutions (kyphoplasty/vertebroplasty techniques). Specific cement-associated problems as leakage, embolism and the adjacent fracture disease are reported adding to open questions like general fracture healing properties of the osteoporotic spine. In order to analyze those queries animal models are of great interest; however, both technical difficulties in the induction of experimental osteoporosis in animal as well as the lack of a standardized fracture model impede current and future in vivo studies. This study introduces a standardized animal model of an osteoporotic VCF type A3.1 that may enable further in-depth analysis of the afore mentioned topics. Material and Methods: Twenty-four 5-year-old female Merino sheep (mean body weight: 67 kg; range 57–79) were ovariectomized (OP1) and underwent 5.5 months of weekly corticosteroid injections (dexamethasone and dexamethasone-sodium-phosphate), adding to a calcium/phosphorus/vitamin D-deficient diet. Osteoporosis induction was documented by pQCT and micro-CT BMD (bone mineral density) as well as 3D histomorphometric analysis postoperatively of the sheep distal radius and spine. Non osteoporotic sheep served as controls. Induction of a VCF of the second lumbar vertebra was performed via a mini-lumbotomy surgical approach with a standardized manual compression mode (OP2). Results: PQCT analysis revealed osteoporosis of the distal radius with significantly reduced BMD values (0.19 g/cm3, range 0.13–0.22 vs. 0.27 g/cm3, range 0.23–0.32). Micro-CT documented significant lowering of BMD values for the second lumbar vertebrae (0.11 g/cm3, range 0.10–0.12) in comparison to the control group (0.14 g/cm3, range 0.12–0.17). An incomplete burst fracture type A3.1 was achieved in all cases and resulted in a significant decrease in body angle and vertebral height (KA 4.9°, range: 2–12; SI 4.5%, range: 2–12). With OP1, one minor complication (lesion of small bowel) occurred, while no complications occurred with OP2. Conclusions: A suitable spinal fracture model for creation of VCFs in osteoporotic sheep was developed. The technique may promote the development of improved surgical solutions for VCF treatment in the experimental and clinical setting. AD - A. Eschler, Hand and Reconstructive Surgery, University of Rostock, Medical Center, Schillingallee 35, Tel.: +49 176 3281 8627, Rostock, Germany AU - Eschler, A. AU - Röpenack, P. AU - Herlyn, P. K. E. AU - Roesner, J. AU - Pille, K. AU - Büsing, K. AU - Vollmar, B. AU - Mittlmeier, T. AU - Gradl, G. DB - Embase Medline DO - 10.1016/S0020-1383(15)30014-0 KW - adult animal experiment animal model article body weight bone density complication compression fracture corticosteroid therapy distal radius experimental osteoporosis female fracture treatment human in vivo study Merino sheep micro-computed tomography nonhuman nutritional deficiency ovariectomy ovine model second lumbar vertebra small intestine surgical approach vertebral height calcium dexamethasone dexamethasone sodium phosphate phosphorus vitamin D LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1879-0267 0020-1383 SP - S17-S23 ST - The standardized creation of a lumbar spine vertebral compression fracture in a sheep osteoporosis model induced by ovariectomy, corticosteroid therapy and calcium/phosphorus/vitamin D-deficient diet T2 - Injury TI - The standardized creation of a lumbar spine vertebral compression fracture in a sheep osteoporosis model induced by ovariectomy, corticosteroid therapy and calcium/phosphorus/vitamin D-deficient diet UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2010084368&from=export http://dx.doi.org/10.1016/S0020-1383(15)30014-0 VL - 46 ID - 829358 ER - TY - JOUR AB - We evaluated in this study indications, surgical technique, and results of wedge plates for fixation in proximal tibia medial opening wedge osteotomy. Fifty-eight knees in 56 consecutive patients (9 men, 47 women; mean age 52 years; ranging between 36 and 66 years) with medial compartment osteoarthrosis were treated with proximal tibia medial open-wedge osteotomy. For fixation, plates which were designed by the first author and which support the osteotomy surface with wedge-shaped projections were used. The plates were either rectangular in shape with two or four holes or had an inverse "L" shape with four holes, and had bearing metal wedges of varying heights from 5 to 15 mm. Tricortical (n=8) and bicortical (n=43) iliac bone autografts and allografts (n=7) were used. The average follow-up time was 21 months (ranging between 6 and 44 months). The mean preoperative tibiofemoral angle was 4.6 degrees varus (0 degrees-11 degrees) while it was 5.6 degrees valgus (2 degrees-11 degrees) postoperatively. The mean preoperative HSS score was 58 (range 51-75) and it was found 89 (range 79-96) postoperatively. As complications, lateral tibial plateau fracture in 5 knees (8.6%) and lateral cortex fracture in 15 knees (25.8%) were encountered during surgery. Deep vein thrombosis in two cases (3.4%) and nonfatal pulmonary embolism in one case (1.7%), delayed wound healing in two knees (3.4%), and delayed union as well as breakdown of a distal screw in one knee (1.7%) were encountered postoperatively. In conclusion, using wedge plates for fixation of proximal tibia medial opening wedge osteotomy in the treatment of medial osteoarthritis with unicompartmental involvement of the knee, provides adequate stabilization to allow early movement for functional rehabilitation and keeps the obtained correction level. AD - Inonu Univ, Dept Orthopaed & Traumatol, Sch Med, TR-44065 Malatya, Turkey. Esenkaya, I (corresponding author), Inonu Univ, Dept Orthopaed & Traumatol, Sch Med, TR-44065 Malatya, Turkey. nelmali@hotmail.com AN - WOS:000240913000008 AU - Esenkaya, I. AU - Elmali, N. DA - Oct DO - 10.1007/s00167-006-0075-0 J2 - Knee Surg. Sports Traumatol. Arthrosc. KW - knee joint/surgery/radiography osteoarthritis/surgery proximal tibial osteotomy high tibial osteotomy osteotomy/methods/instrumentation FOLLOW-UP UNICOMPARTMENTAL OSTEOARTHRITIS COMPARTMENT OSTEOARTHRITIS VALGUS OSTEOTOMY KNEE HEMICALLOTASIS TOMOFIX CEMENT Orthopedics Sport Sciences Surgery LA - English M1 - 10 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2006 SN - 0942-2056 SP - 955-961 ST - Proximal tibia medial open-wedge osteotomy using plates with wedges: early results in 58 cases T2 - Knee Surgery Sports Traumatology Arthroscopy TI - Proximal tibia medial open-wedge osteotomy using plates with wedges: early results in 58 cases UR - ://WOS:000240913000008 VL - 14 ID - 830406 ER - TY - JOUR AD - Dept. of Radiol. and Neurol. Surgery AU - Eskridge, J. AU - Britz, G. W. DB - Embase KW - erratum error LA - English M1 - 3 M3 - Erratum N1 - Embase Elsevier literature search January 5, 2021 PY - 2004 SN - 0195-6108 SP - B1 ST - Erratum: (Retracted article) Paradoxical cerebral arterial embolization of cement during intraoperative vertebroplasty: Case report (American Journal of Neuroradiology (May 2002) 23 (868-870)) T2 - American Journal of Neuroradiology TI - Erratum: (Retracted article) Paradoxical cerebral arterial embolization of cement during intraoperative vertebroplasty: Case report (American Journal of Neuroradiology (May 2002) 23 (868-870)) UR - https://www.embase.com/search/results?subaction=viewrecord&id=L38374944&from=export VL - 25 ID - 829842 ER - TY - JOUR AN - WOS:000220321500037 AU - Eskridge, J. AU - Britz, G. W. DA - Mar J2 - Am. J. Neuroradiol. KW - Clinical Neurology Neuroimaging Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 3 M3 - Correction N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2004 SN - 0195-6108 SP - B1-B1 ST - Paradoxical cerebral arterial embolization of cement during intraoperative vertebroplasty: Case report (Retraction of AJNR, vol 23, pg 868, 2002) T2 - American Journal of Neuroradiology TI - Paradoxical cerebral arterial embolization of cement during intraoperative vertebroplasty: Case report (Retraction of AJNR, vol 23, pg 868, 2002) UR - ://WOS:000220321500037 VL - 25 ID - 830440 ER - TY - JOUR AB - The occurrence of a fat embolism syndrome (FES) can be explained by two hypothetic mechanisms. In the mechanical hypothesis, bone marrow enters into the cardiovascular system during an intramedullary peak pressure. This peak could occur during either long bone fracture and/or intramedullary nailing or cemented or noncemented arthroplasty. According to the biochemical hypothesis, the FES could occur in nontraumatic conditions such as lipid emulsion infusion or sickle cell disease. The C-reactive protein is a possible factor for destabilizing plasma fat (chylomicrons or Intralipid(R) liposomes). Treatment with heparin has been reported to interfere with lipid metabolism through a << creaming >> phenomenon. Plasma fatty acids increase lipid peroxidation, with potential severe oxidative stress of lung. Vascular lung injury is increased by granulocytes and the clotting cascade is activated by neutral fat. After a symptom-free period, the full clinical picture is characterized by pulmonary insufficiency with hypoxaemia, neurological impairment, pyrexia and petechial haemorrhages. The accurate incidence cannot be assessed as many subclinical forms remain unrecognized. Transoesophageal echocardiography with color-flow Doppler allows considerable insight into the sequence of embolic events and patent foramen ovale (PFO). A PFO induces an increase in right-to-left shunt in case of an elevated intrapulmonary pressure. PFO might elicit systemic manifestations of the FES, particularly with neurological impairment. Carotid ultrasonography helps to visualize embolism. Magnetic resonance imaging of cerebral fat emboli is a better diagnostic tool for detecting brain embolism than computerized tomography. Quantification of cells containing fat droplets in bronchoalveolar lavage material could also be helpful. Pulmonary microvascular cytology analysis of capillary blood samples obtained through a pulmonary artery catheter in combination with blood gas changes are of value for earlier stage FES. Prophylactic and therapeutic measures are aimed to counteract the various mechanisms leading to FES. The decrease in time delay of fracture management is probably the most effective prophylactic means. A reaming procedure can be noxious, particularly in a patient with a severe thoracic trauma. The insertion without reaming of a small diameter nail, plating or external fixation have several advantages. Albumin infusion is recommended for restoration of blood volume and binding of fatty acids. Among pharmacologic measures, only corticosteroids have a proven benefit, not only for prophylaxis but also for therapy. Aprotinin and heparin are beneficial in counteracting blood cell aggregation. A prophylactic use of vena cava filters has been advocated. Prevention or early treatment of hypovolaemia and hypoxaemia are essential. AD - Estebe, JP (corresponding author), CTR HOSP REG & UNIV RENNES,SERV ANESTHESIE REANIMAT CHIRURG 2,RUE HENRI LE GUILLOU,F-35033 RENNES 9,FRANCE. AN - WOS:A1997WP34400007 AU - Estebe, J. P. DO - 10.1016/s0750-7658(97)87195-x J2 - Ann. Fr. Anest. Reanim. KW - fat embolism TOTAL KNEE ARTHROPLASTY PATENT FORAMEN OVALE PULMONARY MICROVASCULAR CYTOLOGY SICKLE-CELL-ANEMIA BRONCHOALVEOLAR LAVAGE CEMENTED ARTHROPLASTY TOURNIQUET DEFLATION ARTERY CATHETER EARLY DIAGNOSIS TRAUMA PATIENTS Anesthesiology LA - French M1 - 2 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1997 SN - 0750-7658 SP - 138-151 ST - From fat embolus to fat embolism syndrome T2 - Annales Francaises D Anesthesie Et De Reanimation TI - From fat embolus to fat embolism syndrome UR - ://WOS:A1997WP34400007 VL - 16 ID - 830485 ER - TY - JOUR AB - The occurrence of a fat embolism syndrome (FES) can be explained by two hypothetic mechanisms. In the mechanical hypothesis, bone marrow enters into the cardiovascular system during an intramedullary peak pressure. This peak could occur during either long bone fracture and/or intramedullary nailing or cemented or noncemented arthroplasty. According to the biochemical hypothesis, the FES could occur in nontraumatic conditions such as lipid emulsion infusion or sickle cell disease. The C-reactive protein is a possible factor for destabilizing plasma fat (chylomicrons or Intralipid liposomes). Treatment with heparin has been reported to interfere with lipid metabolism through a "creaming" phenomenon. Plasma fatty acids increase lipid peroxidation, with potential severe oxidative stress of lung. Vascular lung injury is increased by granulocytes and the clotting cascade is activated by neutral fat. After a symptom-free period, the full clinical picture is characterized by pulmonary insufficiency with hypoxaemia, neurological impairment, pyrexia and petechial haemorrhages. The accurate incidence cannot be assessed as many subclinical forms remain unrecognized. Transoesophageal echocardiography with color-flow Doppler allows considerable insight into the sequence of embolic events and patent foramen ovale (PFO). A PFO induces an increase in right-to-left shunt in case of an elevated intrapulmonary pressure. PFO might elicit systemic manifestations of the FES, particularly with neurological impairment. Carotid ultrasonography helps to visualize embolism. Magnetic resonance imaging of cerebral fat emboli is a better diagnostic tool for detecting brain embolism than computerized tomography. Quantification of cells containing fat droplets in bronchoalveolar lavage material could also be helpful. Pulmonary microvascular cytology analysis of capillary blood samples obtained through a pulmonary artery catheter in combination with blood gas changes are of value for earlier stage FES. Prophylactic and therapeutic measures are aimed to counteract the various mechanisms leading to FES. The decrease in time delay of fracture management is probably the most effective prophylactic means. A reaming procedure can be noxious, particularly in a patient with a severe thoracic trauma. The insertion without reaming of a small diameter nail, plating or external fixation have several advantages. Albumin infusion is recommended for restoration of blood volume and binding of fatty acids. Among pharmacologic measures, only corticosteroids have a proven benefit, not only for prophylaxis but also for therapy. Aprotinin and heparin are beneficial in counteracting blood cell aggregation. A prophylactic use of vena cava filters has been advocated. Prevention or early treatment of hypovolaemia and hypoxaemia are essential. AD - Service d'anesthésie-réanimation chirurgicale II, centre hospitalier régional et universitaire de Rennes, France. AN - 9686075 AU - Estèbe, J. P. DO - 10.1016/s0750-7658(97)87195-x DP - NLM ET - 1997/01/01 J2 - Annales francaises d'anesthesie et de reanimation KW - *Embolism, Fat/complications/diagnosis/physiopathology/therapy Humans Syndrome LA - fre M1 - 2 N1 - PubMed NLM literature search January 5, 2021 OP - Des emboles de graisse au syndrome d'embolie graisseuse. PY - 1997 SN - 0750-7658 (Print) 0750-7658 SP - 138-51 ST - [From fat emboli to fat embolism syndrome] T2 - Ann Fr Anesth Reanim TI - [From fat emboli to fat embolism syndrome] VL - 16 ID - 828692 ER - TY - JOUR AB - The occurrence of a fat embolism syndrome (FES) can be explained by two hypothetic mechanisms. In the mechanical hypothesis, bone marrow enters into the cardiovascular system during an intramedullary peak pressure. This peak could occur during either long bone fracture and/or intramedullary nailing or cemented or noncemented arthroplasty. According to the biochemical hypothesis, the FES could occur in nontraumatic conditions such as lipid emulsion infusion or sickle cell disease. The C-reactive protein is a possible factor for destabilizing plasma fat (chylomicrons or Intralipid® liposomes). Treatment with heparin has been reported to interfere with lipid metabolism through a 'creaming' phenomenon. Plasma fatty acids increase lipid peroxidation, with potential severe oxidative stress of lung. Vascular lung injury is increased by granulocytes and the clotting cascade is activated by neutral fat. After a symptom-free period, the full clinical picture is characterized by pulmonary insufficiency with hypoxaemia, neurological impairment, pyrexia and petechial haemorrhages. The accurate incidence cannot be assessed as many subclinical forms remain unrecognized. Transoesophageal echocardiography with color-flow Doppler allows considerable insight into the sequence of embolic events and patent foramen ovale (PFO). A PFO induces an increase in right-to-left shunt in case of an elevated intrapulmonary pressure. PFO might elicit systemic manifestations of the FES, particularly with neurological impairment. Carotid ultrasonography helps to visualize embolism. Magnetic resonance imaging of cerebral fat emboli is a better diagnostic tool for detecting brain embolism than computerized tomography. Quantification of cells containing fat droplets in bronchoalveolar lavage material could also be helpful. Pulmonary microvascular cytology analysis of capillary blood samples obtained through a pulmonary artery catheter in combination with blood gas changes are of value for earlier stage FES. Prophylactic and therapeutic measures are aimed to counteract the various mechanisms leading to FES. The decrease in time delay of fracture management is probably the most effective prophylactic means. A reaming procedure can be noxious, particularly in a patient with a severe thoracic trauma. The insertion without reaming of a small diameter nail, plating or external fixation have several advantages. Albumin infusion is recommended for restoration of blood volume and binding of fatty acids. Among pharmacologic measures, only corticosteroids have a proven benefit, not only for prophylaxis but also for therapy. A protinin and heparin are beneficial in counteracting blood cell aggregation. A prophylactic use of vena cava filters has been advocated. Prevention or early treatment of hypovolaemia and hypoxaemia are essential. AD - J.P. Estebe, Serv. d'Anesth.-Rean. Chirurg. II, Centre Hospitalier Regional, Rue Henri Le-Guillou, 35033 Rennes Cedex 9, France AU - Estèbe, J. P. DB - Embase Medline DO - 10.1016/S0750-7658(97)87195-X KW - albumin aprotinin corticosteroid heparin cytology fat embolism human hypovolemia hypoxemia lipid metabolism nuclear magnetic resonance imaging pathophysiology review transesophageal echocardiography LA - French M1 - 2 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 1997 SN - 0750-7658 SP - 138-151 ST - From fat embolus to fat embolism syndrome T2 - Annales Francaises d'Anesthesie et de Reanimation TI - From fat embolus to fat embolism syndrome UR - https://www.embase.com/search/results?subaction=viewrecord&id=L27143789&from=export http://dx.doi.org/10.1016/S0750-7658(97)87195-X VL - 16 ID - 829916 ER - TY - JOUR AB - Introduction: In revision total hip arthroplasty (RTHA), reconstruction of acetabular component challenges the surgeons and requires a metal ring cage to support the acetabular sides in most of the cases. Objectives: To investigate the outcomes of our experience with Gap II (Graft Augmentation Prosthesis) implant for acetabular component reconstruction Methods: Between 2010 and 2013, 24 patients (19 males and 5 females) aged 49.5 ± 26.2 years underwent RTHA utilising Gap II prosthesis. Structural allograft (bulk), morselised allograft and TMT augment were used in 2, 8 and 1 hip, respectively. A cemented polyethylene cup implanted with cement in Gap II implant. Patients were examined clinically and radiographically before and after the operation. Gross classification was used to classify the bone defects. Preand post operation, modified Harris Hip Score was completed for all patients. The cup stability was assessed using plain x-rays of the hip. Patients were followed for 15.7 ± 9.3 months. Results: We found no patient with infection, deep venous thrombosis, pulmonary thromboembolic disease and dislocation. Modified HHS increased significantly from 53 ± 13.6 before the surgery to 85±15.5 after the operation (p<0.001). Conclusions: Reconstruction of the acetabulum in RTHA has 2 major steps including reconstructing the bone defects using grafts and supporting the graft and acetabular sides with a metal cage. Gap II has a hook which implanted in obturator foramina and facilitates the anatomic acetabular component positioning. In addition, extension plates supply more stability for implant through multiple screws in iliac bone. AD - H. Ettehad, Department of Orthopedics, Guillan University of Medical Sciences, Rasht, Iran AU - Ettehad, H. AU - Taheriazam, A. AU - Safdari, F. DB - Embase DO - 10.5301/hipint.5000188 KW - metal cement polyethylene total hip prosthesis European hip society human patient implant allograft prosthesis bone defect Harris hip score male female obturator lung embolism classification surgery iliac bone surgeon infection deep vein thrombosis acetabulum X ray L1 - http://www.hip-int.com/article/abstracts-from-the-11th-congress-of-the-european-hip-society LA - English M1 - 5 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1120-7000 SP - 510 ST - Acetabular reconstruction cage in revision total hip arthroplasty T2 - HIP International TI - Acetabular reconstruction cage in revision total hip arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71959885&from=export http://dx.doi.org/10.5301/hipint.5000188 VL - 24 ID - 829414 ER - TY - JOUR AB - INTERVENTION: Trade Name: Cyklokapron Product Name: Cyklokapron Product Code: NA Pharmaceutical Form: Injection* Pharmaceutical form of the placebo: Intravenous infusion Route of administration of the placebo: Local use (Noncurrent) CONDITION: In this study Tranexamic acid efficacy in reducing blood loss will be investigated in total knee replacement.Tranexamic acid will be applied topically to the exposed tissue around the knee joint prior to the wound closure and tourniquet release. It is anticipated that this method of administration will be quicker, easier and have less systemic side effect. ; MedDRA version: 9.1 Level: LLT Classification code 10023227 Term: Joint replacement PRIMARY OUTCOME: Main Objective: To find out whether Tranexamic acid can reduce blood loss significantly after total knee replacement when applied topically.; Primary end point(s): •Drain blood loss (First 48 hour). ; Total knee replacement is performed in bloodless field. The blood is exsangunated from the limb and tourniquet applied higher up to keep the limb bloodless. After suturing the skin and applying the pressure dressing, the tourniquet is released allowing the blood to flow into the limb. Any bleeding will be sucked out by the vacuum drain. Hence drain blood loss is good reflection of total blood loss after total knee replacement. The outcome is a continuous variable, measured in millilitre (ml) and will be analysed by two sample t‐tests. Fifty percent reduction in mean drain blood loss will be considered significant.; Secondary Objective: •Blood loss in recovery room.; •Blood transfusion required and volume of blood transfused (until discharge).*; •Haemoglobin and Haematocrit drops ( On day 2 postoperatively); •General quality of life measure (EUROQOL) preoperative and at 3 months postoperative.; •Oxford knee score preoperative and at 3 months postoperative.; •Length of stay.; •Complications:; 1. Wound infection. (Clinical and / or microbiological diagnosis).; 2. Deep venous thrombosis (confirmed radiologically).; 3. Pulmonary embolism (confirmed radiologically).; 4. Myocardial infarction. (Confirmed by ECG or cardiac enzymes).; 5. Cerebrovascular accident.(Confirmed by CT scan).; 6. Death until discharge.; ; •Cost effectiveness analysis.; Cost analysis reflecting changes in resources utilisation (length of stay, blood transfusion, and complications treatment costs).; INCLUSION CRITERIA: Undergoing unilateral primary cemented total knee replacement. Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18‐64 years) yes F.1.2.1 Number of subjects for this age range F.1.3 Elderly (>=65 years) yes F.1.3.1 Number of subjects for this age range AN - CN-01798210 AU - Euctr, G. B. N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2008 ST - Randomised Controlled Trial of the Use of Topical Application of Tranexamic Acid in Primary Cemented Total Knee Replacement (TRANX-K). - TRANX-K T2 - http://www.who.int/trialsearch/Trial2.aspx?TrialID=EUCTR2007-007813-35-GB TI - Randomised Controlled Trial of the Use of Topical Application of Tranexamic Acid in Primary Cemented Total Knee Replacement (TRANX-K). - TRANX-K UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01798210/full ID - 830035 ER - TY - JOUR AB - The frequency of air embolism was studied in 21 patients during total hip replacement. Two groups were examined, one having femoral shaft cement insertion by hand, the other by Exeter cement gun. Venous air embolism was common throughout the hip surgery, but was especially so during prosthesis positioning in the femoral shaft. There were fewer air emboli and cardiovascular sequelae detected in the gun‐inserted cement group, and the only patients to show clinically significant cardiovascular abnormalities during insertion of cement and prosthesis were those having cement insertion by hand. We conclude that the incidence of air embolism and associated cardiovascular changes during total hip replacement may be expected to be reduced in those patients in whom a cement gun is used to place the cement. AN - CN-00059028 AU - Evans, R. D. AU - Palazzo, M. G. AU - Ackers, J. W. DO - 10.1093/bja/62.3.243 KW - Aged Clinical Trials as Topic Double‐Blind Method Embolism, Air [*etiology, physiopathology] Female Hemodynamics Hip Prosthesis Humans Male Methylmethacrylates [*administration & dosage] Postoperative Complications [*etiology] Surgical Instruments [*adverse effects] M1 - 3 M3 - Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1989 SP - 243‐247 ST - Air embolism during total hip replacement: comparison of two surgical techniques T2 - British journal of anaesthesia TI - Air embolism during total hip replacement: comparison of two surgical techniques UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00059028/full VL - 62 ID - 830058 ER - TY - JOUR AB - Purpose: To report and describe an urgent therapeutic endovascular maneuver performed to treat pulmonary cement embolism (PCM) during percutaneous vertebroplasty procedures (PVP). Material and Methods: From September 1997 to December 2012, 613 PVP were performed during 379 sessions in 312 patients. Three (0.4%) PCM events were observed during PVP performed under fluoroscopic guidance. In these cases, injection of polymethylmethacrylate (PMMA) was immediately stopped, patients were moved to the supine position, the right inguinal area was draped, and the femoral vein was punctured. A 5Fr pigtail and snare catheters were used for removing the PMMA fragment or cement fragments were pushed distally in the pulmonary artery with the pigtail catheter in case of unsuccessful retrieval. Results: Mean follow-up period was 17 months. In 3 patients, it was not possible to snare the cement fragment, mainly because of fragment shape and/or breakage. Therefore, to decrease the possible hemodynamic response, all cement fragments were pushed distally in the pulmonary artery. All patients remained asymptomatic immediately after the procedure and during follow-up. Venous cement leakage immediately after PVP was observed on CT in all 3 patients. No patient showed reactive pulmonary parenchymal changes associated with CM at the end of the follow-up period. Conclusion: Pulmonary embolism caused by PMMA migration during PVP may be asymptomatic, but fatal cardiopulmonary infarction, hypercapnia, and cardiac arrest have been reported. This reported endovascular maneuver seems to be useful and effective for urgent treatment of this serious and possibly fatal complication. AD - E.P. Eyheremendy, Radiology, Hospital Alemán, Buenos Aires, Argentina AU - Eyheremendy, E. P. AU - Sierre, S. AU - Mendez, P. AU - Jakubowicz, M. DB - Embase KW - cement povidone poly(methyl methacrylate) lung embolism percutaneous vertebroplasty society Europe patient human follow up catheter procedures pulmonary artery femoral vein inguinal region supine position injection heart arrest hypercapnia infarction embolism hemodynamics LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0174-1551 SP - S269 ST - Endovascular treatment of cement pulmonary embolism during percutaneous vertebroplasty T2 - CardioVascular and Interventional Radiology TI - Endovascular treatment of cement pulmonary embolism during percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71323434&from=export VL - 36 ID - 829484 ER - TY - JOUR AB - Main circulatory (heart frequency, HF, intra-artery pressure, AP ECG) and respiratory (arterial oxyhemoglobin saturation SaO2, end-tidal CO2) arterial gas-analysis (HGA) parameters were recorded continually during cemented hip arthroplasty in 70 consecutive non-selected patients. The use of cement did not cause any change in the parameters obtained in 21 of the cases, reduction in arterial oxygen pressure (PaO2) ranging from 11% to 38% was observed in 44 cases, associated with simultaneous reduction in ETCO2 in 11 cases. The reduction in ETCO2 was an isolated finding in 5 of the patients. AP decreased by more than 10% in only 2 cases and there was arrhythmia in another 2 cases. These findings are strongly suggestive of pulmonary embolism encouraging the hypothesis of gas embolism previously suggested by other authors. In patients with little coronary or pulmonary reserve use of cement means an increased risk of severe hemodynamic complications. AD - II Servizio di Anestesia e Rianimazione, Istituti Ortopedici Rizzoli, Bologna. AN - 9147925 AU - Fabbri, G. AU - Perin, S. AU - Colì, A. AU - Lari, S. DA - Sep-Dec DP - NLM ET - 1996/09/01 J2 - La Chirurgia degli organi di movimento KW - Aged Aged, 80 and over *Bone Cements/adverse effects Carbon Dioxide/blood Embolism, Air/blood/etiology Female Hemodynamics *Hip Prosthesis Humans Male Middle Aged Oxygen/blood Pulmonary Embolism/blood/*etiology Risk Factors LA - eng ita M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 1996 SN - 0009-4749 (Print) 0009-4749 SP - 347-9 ST - Pulmonary embolism associated with use of bone cement during hip arthroplasty T2 - Chir Organi Mov TI - Pulmonary embolism associated with use of bone cement during hip arthroplasty VL - 81 ID - 828898 ER - TY - JOUR AB - OBJECTIVE: To evaluate the incidence and risk factors for ICE during a PV. MATERIALS AND METHODS: Single-center retrospective analysis of 1512 consecutive patients who underwent 1854 PV procedures for osteoporotic (34 %), malignant (39.9 %) or other cause (26.1 %) of vertebral compression fractures (VCFs)/spine tumor lesions. Only thoracic or lumbar PVs were included. PVs were performed with polymethylmethacrylate (PMMA) low-viscosity bone cement under fluoroscopic guidance. Chest imaging (X-ray or CT) was performed the same day after PV in patients with high clinical suspicion of ICE. All post-procedural chest-imaging examinations were reviewed, and all ICEs were agreed upon in consensus by two radiologists. RESULTS: ICEs were detected in 72 patients (92 cement embolisms). In 86.1 % of the cases, concomitant pulmonary artery cement leakage was detected. Symptomatic ICEs were observed in six cases (8.3% of all ICEs; 0.32% of all PV procedures). No ICE led to death or permanent sequelae. Multiple levels treated during the same PV session were associated with a higher ICE rate [OR: 3.59, 95% CI: (1.98-6.51); p < 0.001]; the use of flat panel technology with a lower ICE occurrence [OR: 0.51, 95% CI: (0.32-0.83); p = 0.007]. CONCLUSION: Intracardiac cement embolism after PV has a low incidence (3.9 % in our study). Symptomatic complications related to ICE are rare (0.3%); none was responsible for clinical sequelae in our series. KEY POINTS: • The incidence of intracardiac cement embolism (ICE) during PVP is low (3.9%). • Having a high number of treated vertebrae during the same session is a significant risk factor for ICE. • Symptomatic intracardiac cement embolisms have a low incidence (8.3% of patients with ICE). AD - Department of Neuroradiology, Pitié-Salpêtrière Hospital, APHP, 47, Bd de l'Hôpital, 75013, Paris, France. Paris VI University, Pierre et Marie Curie, Paris, France. Department of Anesthesiology, Pitié-Salpêtrière Hospital, Paris, France. Department of Oncoly, Pitié-Salpêtrière Hospital, Paris, France. Department of Rheumatology, Pitié-Salpêtrière Hospital, Paris, France. Department of Cardiology, Pitié-Salpêtrière Hospital, Paris, France. Department of Neuroradiology, Pitié-Salpêtrière Hospital, APHP, 47, Bd de l'Hôpital, 75013, Paris, France. fredclare5@msn.com. Paris VI University, Pierre et Marie Curie, Paris, France. fredclare5@msn.com. AN - 30054794 AU - Fadili Hassani, S. AU - Cormier, E. AU - Shotar, E. AU - Drir, M. AU - Spano, J. P. AU - Morardet, L. AU - Collet, J. P. AU - Chiras, J. AU - Clarençon, F. DA - Feb DO - 10.1007/s00330-018-5647-0 DP - NLM ET - 2018/07/29 J2 - European radiology KW - Adolescent Adult Aged Aged, 80 and over Bone Cements/*adverse effects Embolism/diagnostic imaging/*etiology Extravasation of Diagnostic and Therapeutic Materials/diagnostic imaging Female Fluoroscopy Fractures, Compression/*surgery Heart Diseases/diagnostic imaging/*etiology Humans Incidence Male Middle Aged Polymethyl Methacrylate/adverse effects Postoperative Complications/diagnostic imaging Pulmonary Embolism/diagnostic imaging/etiology Radiography Radiography, Interventional Retrospective Studies Risk Factors Spinal Fractures/diagnostic imaging/*surgery Vertebroplasty/*adverse effects/methods Young Adult Cardiac Cement Complication Embolism Leakage Percutaneous vertebroplasty LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 0938-7994 SP - 663-673 ST - Intracardiac cement embolism during percutaneous vertebroplasty: incidence, risk factors and clinical management T2 - Eur Radiol TI - Intracardiac cement embolism during percutaneous vertebroplasty: incidence, risk factors and clinical management VL - 29 ID - 828565 ER - TY - JOUR AB - Objective: To evaluate the incidence and risk factors for ICE during a PV.Materials and Methods: Single-center retrospective analysis of 1512 consecutive patients who underwent 1854 PV procedures for osteoporotic (34 %), malignant (39.9 %) or other cause (26.1 %) of vertebral compression fractures (VCFs)/spine tumor lesions. Only thoracic or lumbar PVs were included. PVs were performed with polymethylmethacrylate (PMMA) low-viscosity bone cement under fluoroscopic guidance. Chest imaging (X-ray or CT) was performed the same day after PV in patients with high clinical suspicion of ICE. All post-procedural chest-imaging examinations were reviewed, and all ICEs were agreed upon in consensus by two radiologists.Results: ICEs were detected in 72 patients (92 cement embolisms). In 86.1 % of the cases, concomitant pulmonary artery cement leakage was detected. Symptomatic ICEs were observed in six cases (8.3% of all ICEs; 0.32% of all PV procedures). No ICE led to death or permanent sequelae. Multiple levels treated during the same PV session were associated with a higher ICE rate [OR: 3.59, 95% CI: (1.98-6.51); p < 0.001]; the use of flat panel technology with a lower ICE occurrence [OR: 0.51, 95% CI: (0.32-0.83); p = 0.007].Conclusion: Intracardiac cement embolism after PV has a low incidence (3.9 % in our study). Symptomatic complications related to ICE are rare (0.3%); none was responsible for clinical sequelae in our series.Key Points: • The incidence of intracardiac cement embolism (ICE) during PVP is low (3.9%). • Having a high number of treated vertebrae during the same session is a significant risk factor for ICE. • Symptomatic intracardiac cement embolisms have a low incidence (8.3% of patients with ICE). AD - Department of Neuroradiology, Pitié-Salpêtrière Hospital, APHP, 47, Bd de l'Hôpital, 75013, Paris, France Paris VI University, Pierre et Marie Curie, Paris, France Department of Anesthesiology, Pitié-Salpêtrière Hospital, Paris, France Department of Oncoly, Pitié-Salpêtrière Hospital, Paris, France Department of Rheumatology, Pitié-Salpêtrière Hospital, Paris, France Department of Cardiology, Pitié-Salpêtrière Hospital, Paris, France AN - 133695340. Language: English. Entry Date: In Process. Revision Date: 20200402. Publication Type: journal article. Journal Subset: Biomedical AU - Fadili Hassani, Sarah AU - Cormier, Evelyne AU - Shotar, Eimad AU - Drir, Mehdi AU - Spano, Jean-Philippe AU - Morardet, Laetitia AU - Collet, Jean-Philippe AU - Chiras, Jacques AU - Clarençon, Frédéric DB - cin20 DO - 10.1007/s00330-018-5647-0 DP - EBSCOhost KW - Vertebroplasty -- Adverse Effects Embolism -- Etiology Bone Cements -- Adverse Effects Spinal Fractures -- Surgery Fractures, Compression -- Surgery Heart Diseases -- Etiology Radiography Heart Diseases Middle Age Radiography, Interventional Aged, 80 and Over Adolescence Retrospective Design Pulmonary Embolism Female Pulmonary Embolism -- Etiology Methylmethacrylates -- Adverse Effects Postoperative Complications Spinal Fractures Extravasation of Diagnostic and Therapeutic Materials Vertebroplasty -- Methods Risk Factors Adult Fluoroscopy Embolism Young Adult Aged Male Incidence Scales M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2019 SN - 0938-7994 SP - 663-673 ST - Intracardiac cement embolism during percutaneous vertebroplasty: incidence, risk factors and clinical management T2 - European Radiology TI - Intracardiac cement embolism during percutaneous vertebroplasty: incidence, risk factors and clinical management UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=133695340&site=ehost-live&scope=site VL - 29 ID - 830537 ER - TY - JOUR AB - OBJECTIVE: To evaluate the incidence of intracardiac cement embolism during percutaneous vertebroplasty (PV). MATERIALS AND METHODS: Single-center retrospective analysis of 1512 consecutive patients (996 females, 516 males; mean age = 68 y) who underwent 1855 PV with PMMA cement for thoracic and/or lumbar vertebral compression fracture (VCF) (tumor lesion: 45.5%, osteoporosis: 33.7%, trauma: 10%, other: 10.8%). A chest imaging (plain X-ray and/or CT-scan) was performed when a venous leakage was suspected by the operator during the procedure. The rate of cement cardiac migration (CCM) was evaluated. Age, sex, operator's experience, lesion type (tumor, osteoporosis, trauma), sub-type of tumor lesions (blastic, osteolytic or mixed) were evaluated as risk factors for CCM. Clinical consequences of CCM were evaluated in post-procedure and at 1-month follow-up. RESULTS: In 65.4 % post-PV chest imaging was available. Seventy-one patients (4.7%) had CCM during the 1855 procedures. These CCMs were isolated in 14% of the cases and associated with lung cement embolism in 86% of the cases. The rate of CCM was independent from age, sex, operator's experience, lesion type, tumor lesions' sub-type. Five patients (7%) with CCM had symptoms potentially related to this complication: one cardio-respiratory arrest, that immediately recovered and without any clinical consequence, one pericardial effusion, and 3 cases of transitory dyspnea without further consequence. All these patients had an associated lung cement migration. CONCLUSION: CCM during PMMA PV are not exceptional (4.7% the cases) but are asymptomatic in most cases (93%). AD - S. Fadili, Pitié-Salpêtrière Hospital Interventional, Neuroradiology, France AU - Fadili, S. AU - Clarencon, F. AU - Cormier, E. AU - Le Jean, L. AU - Chiras, J. DB - Embase KW - cement intracardiac drug administration percutaneous vertebroplasty risk factor human neoplasm patient procedures embolism osteoporosis imaging thorax lung injury compression fracture male pericardial effusion respiratory arrest follow up computer assisted tomography X ray dyspnea female LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 0028-3940 SP - 198 ST - Intracardiac cement migration after percutaneous vertebroplasty incidence and risk factors T2 - Neuroradiology TI - Intracardiac cement migration after percutaneous vertebroplasty incidence and risk factors UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71812665&from=export VL - 56 ID - 829413 ER - TY - JOUR AB - Background Acetabular impaction bone grafting aims to restore anatomy in hip revision surgery. This is an effective but expensive and time-consuming technique. Usually, the articular cartilage is removed from the femoral head allograft. We aimed to reproduce the same results retaining the cartilage of the allograft. Methods Eighty acetabular revisions using impacted morselized bone graft retaining the articular cartilage and a cemented cup were studied retrospectively. Six were lost during follow-up. The mean follow-up was 6.5 years (range 1-13). Clinical and radiological assessment was made using the Oxford Hip Score, Hodgkinson's criteria for socket loosening, and the Gie classification for evaluation of allograft incorporation. Results Sixty-three sockets (85.1%) were considered radiologically stable (type 0, 1, and 2 demarcations), 8 (10.8%) were radiologically loose (type 3), and 3 (4.1%) presented with migration. Fifty-one (68.9%) cases showed good trabecular remodeling (grade 3), 20 (27%) showed trabecular incorporation (grade 2), and 3 (4.1%) showed poor allograft incorporation. Mean preoperative hip score was 43 and postoperative score was 28. Six (8.1%) cases presented heterotopic ossification around the revised implants, 2 patients (2.7%) had periprosthetic fractures, and 4 (5.4%) had dislocations. The Kaplan-Meier survivorship at a mean of 6.5 years with revision of the cup for any reason was 95.9% (95% confidence interval 5.6-7.5). Conclusion The mid-term results of our technique are promising. Particularly when the supply of fresh-frozen allografts and surgical time is limited, using whole femoral head with articular cartilage is both safe and effective. AD - A. Fadulelmola, Center for Hip Surgery, Department Of Orthopaedics, Wrightington Hospital, Hall Lane, Wigan, Lancashire, United Kingdom AU - Fadulelmola, A. AU - Drampalos, E. AU - Hodgkinson, J. AU - Hemmady, M. DB - Embase Medline DO - 10.1016/j.arth.2017.01.021 KW - ciprofloxacin low molecular weight heparin teicoplanin adult aged article articular cartilage clinical protocol cohort analysis controlled study deep vein thrombosis disease classification dislocation female fracture fracture nonunion Gie classification heterotopic ossification hip arthroplasty Hodgkinson criteria human impaction grafting technique lung embolism major clinical study male osteotomy outcome assessment Oxford Hip Score periprosthetic fracture retrospective study survival rate tendon graft tissue transplantation trochanteric osteotomy venous thromboembolism whole femoral head allograft wound infection LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1532-8406 0883-5403 SP - 1970-1975 ST - Survivorship Analysis of Eighty Revised Hip Arthroplasties With the Impaction Grafting Technique Using Whole Femoral Head Allografts With the Articular Cartilage T2 - Journal of Arthroplasty TI - Survivorship Analysis of Eighty Revised Hip Arthroplasties With the Impaction Grafting Technique Using Whole Femoral Head Allografts With the Articular Cartilage UR - https://www.embase.com/search/results?subaction=viewrecord&id=L614393520&from=export http://dx.doi.org/10.1016/j.arth.2017.01.021 VL - 32 ID - 829248 ER - TY - JOUR AB - Vertebroplasty is a new minimal-invasive procedure for the treatment of painful vertebral fractures. The risk of a pulmonary embolism ranges from 3.5 to 23% for osteoporotic fractures. However, data about the incidence and treatment strategies of pulmonary cement embolisms (PCE) are limited. We report a case of a patient with symptomatic pulmonary cement embolism after the vertebroplasty. The diagnosis was confirmed by means of CT- scan. In cases of asymptomatic patients with peripheral PCE we recommend no treatment besides clinical follow-up. In our case of symptomatic embolisms, we recommend to proceed according to the guidelines regarding the treatment of thrombotic pulmonary embolisms, which includes initial heparinization and a following 6-month coumarin therapy. AD - [Falkenstern-Ge, Roger Fei; Husemann, Kim; Kohlhaufl, Martin] Univ Tubingen, Teaching Hosp, Ctr Pulmonol & Thorac Surg, Div Pulmonol,Klin Schillerhoehe, D-70839 Stuttgart, Germany. Falkenstern-Ge, RF (corresponding author), Univ Tubingen, Teaching Hosp, Ctr Pulmonol & Thorac Surg, Div Pulmonol,Klin Schillerhoehe, Solitude Str 18, D-70839 Stuttgart, Germany. Roger-Fei.Falkenstern-Ge@rbk.de AN - WOS:000324555900022 AU - Falkenstern-Ge, R. F. AU - Husemann, K. AU - Kohlhaufl, M. DA - Oct DO - 10.2478/s11536-013-0207-0 J2 - Cent. Eur. J. Med. KW - Vertebroplasty Kyphoplasty Complication Cement leakage PCE (Pulmonary cement embolism) Polymethylmethacrylate (PMMA) PERCUTANEOUS VERTEBROPLASTY ACRYLIC CEMENT COMPLICATION FRACTURES Medicine, General & Internal LA - English M1 - 5 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2013 SN - 1895-1058 SP - 662-664 ST - Late onset of pulmonary cement embolism after a regular vertebroplasy. A clinical documentation T2 - Central European Journal of Medicine TI - Late onset of pulmonary cement embolism after a regular vertebroplasy. A clinical documentation UR - ://WOS:000324555900022 VL - 8 ID - 830279 ER - TY - JOUR AB - Vertebroplasty is a new minimal-invasive procedure for the treatment of painful vertebral fractures. The risk of a pulmonary embolism ranges from 3.5 to 23% for osteoporotic fractures. However, data about the incidence and treatment strategies of pulmonary cement embolisms (PCE) are limited. We report a case of a patient with symptomatic pulmonary cement embolism after the vertebroplasty. The diagnosis was confirmed by means of CT- scan. In cases of asymptomatic patients with peripheral PCE we recommend no treatment besides clinical follow-up. In our case of symptomatic embolisms, we recommend to proceed according to the guidelines regarding the treatment of thrombotic pulmonary embolisms, which includes initial heparinization and a following 6-month coumarin therapy. © 2013 Versita Warsaw and Springer-Verlag Berlin Heidelberg. AD - R.F. Falkenstern-Ge, Division of Pulmonology, Center for Pulmonology and Thoracic Surgery, Teaching Hospital of the University of Tuebingen, Solitude Str. 18, 70839 Stuttgart-Gerlingen, Germany AU - Falkenstern-Ge, R. F. AU - Husemann, K. AU - Kohlhäufl, M. DB - Embase DO - 10.2478/s11536-013-0207-0 KW - coumarin ozone aged arterial oxygen tension article case report computer assisted tomography contrast enhancement disease course disease severity dyspnea female follow up forced expiratory volume forced vital capacity heparinization human hypoxemia laminectomy lung artery pressure lung embolism medical documentation osteoporosis oxygen therapy percutaneous vertebroplasty practice guideline priority journal spinal cord compression spine fracture spirometry transthoracic echocardiography treatment duration treatment outcome LA - English M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1895-1058 1644-3640 SP - 662-664 ST - Late onset of pulmonary cement embolism after a regular vertebroplasy. A clinical documentation T2 - Central European Journal of Medicine TI - Late onset of pulmonary cement embolism after a regular vertebroplasy. A clinical documentation UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52711109&from=export http://dx.doi.org/10.2478/s11536-013-0207-0 VL - 8 ID - 829477 ER - TY - JOUR AB - PURPOSE: This case report describes a cardiac arrest during a cemented hip arthroplasty procedure. Hemodynamic instability during methylmethacrylate use in arthroplasty surgery can be explained by fat embolization rather than the inherent toxicity of the monomer. CLINICAL FEATURES: A 78-yr-old woman required a cemented hemiarthroplasty for a pathologic left subcapital fracture. The patient's past medical history included stable angina, diet-controlled type II diabetes and metastatic breast cancer. During the cementing of the canal and insertion of the femoral prosthesis, desaturation, hypotension and cardiac arrest occurred. The patient underwent a successful intraoperative resuscitation and was transferred to the intensive care unit where she subsequently developed disseminated intravascular coagulopathy. The patient died 24 hr later and autopsy confirmed the cause of death as fat embolization. CONCLUSION: The deleterious cardiovascular effects of methylmethacrylate have been discussed in the literature. However, clinical evidence supports fat embolization during arthroplasty surgery as a greater determinant of hemodynamic compromise. Surgical precautions are paramount in minimizing the sequelae of Bone Implantation Syndrome and anesthetic treatment consists of supportive care. AD - Department of Anesthesia, St. Joseph's Health Care, London, Ontario, Canada. AN - 11495867 AU - Fallon, K. M. AU - Fuller, J. G. AU - Morley-Forster, P. DA - Jul-Aug DO - 10.1007/bf03016194 DP - NLM ET - 2001/08/10 J2 - Canadian journal of anaesthesia = Journal canadien d'anesthesie KW - Aged *Arthroplasty, Replacement, Hip Bone Cements/*adverse effects Electrocardiography Embolism, Fat/*etiology/pathology Fatal Outcome Female Heart Arrest/*etiology/pathology Humans Methylmethacrylate/*adverse effects LA - eng M1 - 7 N1 - PubMed NLM literature search January 5, 2021 PY - 2001 SN - 0832-610X (Print) 0832-610x SP - 626-9 ST - Fat embolization and fatal cardiac arrest during hip arthroplasty with methylmethacrylate T2 - Can J Anaesth TI - Fat embolization and fatal cardiac arrest during hip arthroplasty with methylmethacrylate VL - 48 ID - 828920 ER - TY - JOUR AB - Orthopedic implants have become essential components of modern medicine. The risk of infection of total hip arthroplasty (THA) is 1.5%-2%. Are the C-reactive protein (CRP), the erythrocyte sedimentation rate (ESR), and procalcitonin (PCT) good markers for THA infection screenings? From February 2009 to December 2012 at our Department of Orthopedics and Traumatology, 1248 patients were treated with THA. No prosthesis was cemented. All patients received antibiotic prophylaxis. All patients were discharged approximately 7.4 days after surgery with this clinical and radiographic follow-up program at 15 days and 1, 3, 6, 12, 24, and 36 months after surgery. Blood samples to determine ESR, CRP, and PCT values were taken at 1 hour before surgery and 15 days and 1, 3, 6, 12, 24, and 36 months after surgery. During follow-ups there were 22 cases of THA infections; according the Widmer classification, infections are hematogenous ones in 16 cases, late chronic ones in 5 cases, and early postoperative ones in 1 case. In all cases the three markers were considered positive; in 6 cases there were no radiological signs of septic loosening. ESR, CRP, and PCT proved to have a greater diagnostic accuracy than X-rays in predicting late chronic and early postoperative infections. These markers are valuable support for the surgeon in monitoring the prosthetic implant lifespan. AD - L. Meccariello, Division of Orthopedics and Trauma Surgery, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy AU - Falzarano, G. AU - Piscopo, A. AU - Grubor, P. AU - Rollo, G. AU - Medici, A. AU - Pipola, V. AU - Bisaccia, M. AU - Caraffa, A. AU - Barron, E. M. AU - Nobile, F. AU - Cioffi, R. AU - Meccariello, L. DB - Embase DO - 10.1155/2017/9679470 KW - C reactive protein procalcitonin adult aged antibiotic prophylaxis article blood sampling cerebrovascular accident chest infection coxitis deep vein thrombosis diagnostic accuracy erythrocyte sedimentation rate female follow up gastrointestinal hemorrhage heart failure heart infarction hospital discharge human lung embolism major clinical study male peroperative complication postoperative infection prosthesis infection total hip prosthesis urinary tract infection LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 2090-3472 2090-3464 ST - Use of Common Inflammatory Markers in the Long-Term Screening of Total Hip Arthroprosthesis Infections: Our Experience T2 - Advances in Orthopedics TI - Use of Common Inflammatory Markers in the Long-Term Screening of Total Hip Arthroprosthesis Infections: Our Experience UR - https://www.embase.com/search/results?subaction=viewrecord&id=L618228461&from=export http://dx.doi.org/10.1155/2017/9679470 VL - 2017 ID - 829282 ER - TY - JOUR AB - In recent years, deep venous thrombosis (DVT) after spine surgery has received extensive attention, but perioperative prevalence of DVT in patients undergoing percutaneous kyphoplasty (PKP) is lacking.To assess the perioperative prevalence of deep vein thrombosis (DVT) in patients undergoing PKP with routinely applied ultrasonography.We reviewed 1113 consecutive patients undergoing PKP from January 2014 to August 2017. The surgical procedure was bilateral PKP. All patients were routinely examined with ultrasonography when admitted to the hospital and on the first post-operative day. Clinical signs of DVT were checked and recorded before examination.Forty (3.6%) out of 1113 patients were diagnosed with DVT by ultrasonography. Of the 40 detected cases of DVT, only six (0.54%) patients presented with clinical signs of DVT, demonstrating that there were 34 (3.05%) asymptomatic cases. No patient presenting with clinically suspected pulmonary embolism (PE) was observed. Gender, body mass index (BMI), operative time, hypertension, diabetes, heart disease, and lower limb fracture were not significant risk factors for DVT (P > .05). In contrast, patient age, oncologic conditions, DVT history, and paraplegia appeared to be significant risk factors for DVT (P < .01). There was no significant difference in the incidence of DVT found between the three PKP surgical levels (P > .05).The total incidence of perioperative DVT diagnosed with ultrasonography in patients undergoing PKP was 3.6%, of which only 0.54% was symptomatic cases. It is necessary to assess DVT using ultrasonography during the perioperative procedure of PKP, especially for high-risk patients.Level of evidence: Level IV. AD - Department of Orthopaedic Surgery, Daqing Oilfield General Hospital, Heilongjiang 163001. Department of Nephrology, Affiliated Hospital of Nanjing Medical University, North District of Suzhou Municipal Hospital, Suzhou. Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, Shizi Road, Suzhou 215006. Department of Orthopaedic Surgery, Shengzhou People's Hospital, The First Affiliated Hospital of Zhejiang University Shengzhou Branch, Zhejiang, China. AN - 32150087 AU - Fan, W. AU - Qiao, T. AU - You, Y. AU - Zhang, J. AU - Gao, J. C2 - Pmc7478572 DA - Mar DO - 10.1097/md.0000000000019402 DP - NLM ET - 2020/03/10 J2 - Medicine KW - Adult Aged China Female Humans Kyphoplasty/*adverse effects/methods Male Middle Aged *Perioperative Period Postoperative Complications/epidemiology/etiology/physiopathology Prevalence Retrospective Studies Risk Factors Ultrasonography/statistics & numerical data Venous Thrombosis/epidemiology/*etiology/physiopathology LA - eng M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 0025-7974 (Print) 0025-7974 SP - e19402 ST - Perioperative prevalence of deep vein thrombosis in patients with percutaneous kyphoplasty: A retrospective study with routine ultrasonography T2 - Medicine (Baltimore) TI - Perioperative prevalence of deep vein thrombosis in patients with percutaneous kyphoplasty: A retrospective study with routine ultrasonography VL - 99 ID - 828500 ER - TY - JOUR AD - Department of Radiology, Ninth People's Hospital, Shanghai Second Medical University, Shanghai, People's Republic of China. fanxindong@yahoo.com.cn AN - 18083429 AU - Fan, X. AU - Zhu, L. AU - Zhang, C. DA - Jan DO - 10.1016/j.joms.2006.06.259 DP - NLM ET - 2007/12/18 J2 - Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons KW - Adolescent Adult Angiography/methods Arteriovenous Malformations/diagnostic imaging/*therapy Bone Cements/therapeutic use Carotid Artery, External/*abnormalities Child Embolization, Therapeutic/adverse effects/instrumentation/*methods Enbucrilate/analogs & derivatives/therapeutic use Female Humans Male Mandible/*blood supply Postoperative Hemorrhage/etiology Treatment Outcome LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 0278-2391 SP - 139-43 ST - Treatment of mandibular arteriovenous malformation by transvenous embolization through the mental foramen T2 - J Oral Maxillofac Surg TI - Treatment of mandibular arteriovenous malformation by transvenous embolization through the mental foramen VL - 66 ID - 828531 ER - TY - JOUR AB - The authors report the case of a 74-year-old woman who underwent an L-2 vertebral kyphoplasty. The patient experienced delayed postoperative hemodynamic deterioration that may have been caused by embolization of polymethylmethacrylate (PMMA) cement through the right cardiac ventricular wall. Cardiac and pulmonary embolization of bone cement can develop as a complication of vertebral kyphoplasty. Surgeons should be alert to this potentially life-threatening condition when performing this increasingly popular form of spine procedure. AD - Department of Neurological Surgery, University of Rochester Medical Center, Rochester, New York 14642, USA. arash_farahvar@urmc.rochester.edu AN - 19929347 AU - Farahvar, A. AU - Dubensky, D. AU - Bakos, R. DA - Oct DO - 10.3171/2009.5.spine08517 DP - NLM ET - 2009/11/26 J2 - Journal of neurosurgery. Spine KW - Aged Bone Cements/*adverse effects Echocardiography, Transesophageal Female Fractures, Compression/surgery Heart Injuries/diagnostic imaging/*etiology Humans Lumbar Vertebrae/*surgery Minimally Invasive Surgical Procedures/adverse effects Polymethyl Methacrylate/*adverse effects Spinal Fractures/*surgery Vertebroplasty/*adverse effects/methods LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 1547-5646 SP - 487-91 ST - Perforation of the right cardiac ventricular wall by polymethylmethacrylate after lumbar kyphoplasty T2 - J Neurosurg Spine TI - Perforation of the right cardiac ventricular wall by polymethylmethacrylate after lumbar kyphoplasty VL - 11 ID - 828929 ER - TY - JOUR AB - The authors report the case of a 74-year-old woman who underwent an L-2 vertebral kyphoplasty. The patient experienced delayed postoperative hemodynamic deterioration that may have been caused by embolization of polymethylmethacrylate (PMMA) cement through the right cardiac ventricular wall. Cardiac and pulmonary embolization of bone cement can develop as a complication of vertebral kyphoplasty. Surgeons should be alert to this potentially life-threatening condition when performing this increasingly popular form of spine procedure. AD - A. Farahvar, Department of Neurological Surgery, University of Rochester Medical Center, 601 Elmwood Avenue, Box 670, Rochester, NY 14642, United States AU - Farahvar, A. AU - Dubensky, D. AU - Bakos, R. DB - Embase Medline DO - 10.3171/2009.5.SPINE08517 KW - poly(methyl methacrylate) troponin aged anamnesis article blood chemistry case report female heart disease heart ventricle wall heart ventricular wall perforation human kyphoplasty lung embolism postoperative complication postoperative period spinal cord compression spine radiography L1 - http://thejns.org/doi/pdf/10.3171/2009.5.SPINE08517 LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 1547-5654 1547-5646 SP - 487-491 ST - Perforation of the right cardiac ventricular wall by polymethylmethacrylate after lumbar kyphoplasty: Case report T2 - Journal of Neurosurgery: Spine TI - Perforation of the right cardiac ventricular wall by polymethylmethacrylate after lumbar kyphoplasty: Case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L355369711&from=export http://dx.doi.org/10.3171/2009.5.SPINE08517 VL - 11 ID - 829694 ER - TY - JOUR AB - The authors report the case of a 74-year-old woman who underwent an L-2 vertebral kyphoplasty. The patient experienced delayed postoperative hemodynamic deterioration that may have been caused by embolization of polymethylmethacrylate (PMMA) cement through the right cardiac ventricular wall. Cardiac and pulmonary embolization of bone cement can develop as a complication of vertebral kyphoplasty. Surgeons should be alert to this potentially life-threatening condition when performing this increasingly popular form of spine procedure. AD - Department of Neurological Surgery, University of Rochester Medical Center, Rochester, New York 14642, USA Department of Neurological Surgery, University of Rochester Medical Center, Rochester, New York 14642, USA. arash_farahvar@urmc.rochester.edu AN - 105251475. Language: English. Entry Date: 20100115. Revision Date: 20170411. Publication Type: journal article AU - Farahvar, A. AU - Dubensky, D. AU - Bakos, R. AU - Farahvar, Arash AU - Dubensky, Deborah AU - Bakos, Robert DB - cin20 DO - 10.3171/2009.5.SPINE08517 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Heart Injuries -- Etiology Lumbar Vertebrae -- Surgery Methylmethacrylates -- Adverse Effects Spinal Fractures -- Surgery Kyphoplasty -- Adverse Effects Aged Echocardiography, Transesophageal Female Fractures, Compression -- Surgery Heart Injuries -- Ultrasonography Minimally Invasive Procedures -- Adverse Effects Kyphoplasty -- Methods M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 1547-5654 SP - 487-491 ST - Perforation of the right cardiac ventricular wall by polymethylmethacrylate after lumbar kyphoplasty T2 - Journal of Neurosurgery: Spine TI - Perforation of the right cardiac ventricular wall by polymethylmethacrylate after lumbar kyphoplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105251475&site=ehost-live&scope=site VL - 11 ID - 830722 ER - TY - JOUR AB - BACKGROUND: Metastatic spinal tumors are common and major causes of pathological spinal fractures that result in severe pain, weakness, and progressive neurological deficits. This study aims to evaluate the efficacy of percutaneous vertebroplasty (PVP) in pain-relief in patients with spinal fractures due to metastatic spinal tumors. METHODS: We evaluated 25 documented cases of metastatic spinal tumors with pathologic vertebral fractures who were suffering from severe pain and underwent vertebroplasty. Degree of pain was measured by visual analog scale (VAS). The symptoms were evaluated 24 hours and 2 months after vertebroplasty regarding the degree of pain relief.Complications such as leakage, embolism and infection were assessed. RESULTS: MeanVAS score was 8.23 before therapy in the patients that was reduced to 2.12 and 1 in the patients 24 hours and 2 months after vertebroplasty, respectively. The most common complication was cement leakage (44%) and there was no embolism or infection. Data was analyzed by SPSS version 18 software through ANOVA test with Greenhouse-Geisser correction and P-value of 0.00 was obtained in the patients 24 hours and 1 month after surgery. CONCLUSION: Considering significant decrease in the mean pain severity degree after the treatment, veretebroplasty seems to be significantly effective in pain relief in metastatic spinal tumors. AD - Associate Professor of Neurosurgery, Shiraz Neurosciences Research Center, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran. AN - 23115714 AU - Farrokhi, M. AU - Nouraei, H. AU - Kiani, A. C2 - Pmc3482324 DA - Sep DP - NLM ET - 2012/11/02 J2 - Iranian Red Crescent medical journal KW - Pain Polymethylmethacrylate (PMMA) Spinal metastasis Spine Tumors Vertebroplasty LA - eng M1 - 9 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 2074-1804 (Print) 2074-1804 SP - 523-30 ST - The Efficacy of Percutaneous Vertebroplasty in Pain Relief in Patients with Pathological Vertebral Fractures due to Metastatic Spinal Tumors T2 - Iran Red Crescent Med J TI - The Efficacy of Percutaneous Vertebroplasty in Pain Relief in Patients with Pathological Vertebral Fractures due to Metastatic Spinal Tumors VL - 14 ID - 828746 ER - TY - JOUR AB - Background: Metastatic spinal tumors are common and major causes of pathological spinal fractures that result in severe pain, weakness, and progressive neurological deficits. This study aims to evaluate the efficacy of percutaneous vertebroplasty (PVP) in pain-relief in patients with spinal fractures due to metastatic spinal tumors. Methods: We evaluated 25 documented cases of metastatic spinal tumors with pathologic vertebral fractures who were suffering from severe pain and underwent vertebroplasty. Degree of pain was measured by visual analog scale (VAS). The symptoms were evaluated 24 hours and 2 months after vertebroplasty regarding the degree of pain relief.Complications such as leakage, embolism and infection were assessed. Results: MeanVAS score was 8.23 before therapy in the patients that was reduced to 2.12 and 1 in the patients 24 hours and 2 months after vertebroplasty, respectively. The most common complication was cement leakage (44%) and there was no embolism or infection. Data was analyzed by SPSS version 18 software through ANOVA test with Greenhouse-Geisser correction and P-value of 0.00 was obtained in the patients 24 hours and 1 month after surgery. Conclusion: Considering significant decrease in the mean pain severity degree after the treatment, veretebroplasty seems to be significantly effective in pain relief in metastatic spinal tumors. AD - M. R. Farrokhi, Shiraz Neurosciences Research Center, Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran AU - Farrokhi, M. R. AU - Nouraei, H. AU - Kiani, A. DB - Embase KW - cement adult aged analgesia article clinical article clinical effectiveness cohort analysis female human male metastatic spinal tumor pain assessment palliative therapy percutaneous vertebroplasty postoperative complication prospective study spinal cord tumor spine fracture visual analog scale LA - English M1 - 9 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 2074-1804 ST - The efficacy of percutaneous vertebroplasty in pain relief in patients with pathological vertebral fractures due to metastatic spinal tumors T2 - Iranian Red Crescent Medical Journal TI - The efficacy of percutaneous vertebroplasty in pain relief in patients with pathological vertebral fractures due to metastatic spinal tumors UR - https://www.embase.com/search/results?subaction=viewrecord&id=L365666898&from=export VL - 14 ID - 829589 ER - TY - JOUR AB - INTRODUCTION: Percutaneous vertebroplasty is becoming the standard of care to relieve pain and augment vertebral bone strength in symptomatic osteoporotic collapse, osteolytic metastasis, and myeloma. Polymethyl methacrylate (PMMA), a rapidly setting bone cement, is injected under fluoroscopic or CT guidance. This technique has gained popularity with marked pain relief achieved in over 90% of patients obviating the need for surgery. Previous case series have described pulmonary vascular embolism of PMMA as incidental findings. CASE PRESENTATION: 63 year old with untreated Multiple Myeloma presented with a one day history of sudden onset dyspnea and left-sided pleuritic chest pain unrelated to exertion, two weeks after undergoing vertebroplasty. Chest radiographs revealed cement material in vertebrae and in the left pulmonary vascular tree, but clear lung fields. A CT angiogram of the chest revealed cement material embolization (noted on prior chest radiograph) without associated thrombus. On examination, patient’s pulse was 120 bpm at rest; pulse oximetry at 93% room air. Dyspnea improved with supplemental oxygen. Labs were unremarkable. DISCUSSION: Case series have shown the that PMMA embolization has an incidence of 4.6%. Most patients with this condition are asymptomatic, however this patient developed symptoms later suggesting an in situ thombosis at the site of prior embolus. The prompt relief of symptoms with oxygen supplementation and anticoagulation therapy was consistent with a clinical diagnosis of pulmonary embolism. The patient was discharged on enoxaparin. The need for anticoagulation in this setting is not well defined in patients without a history of malignancy. The risk of in situ thrombosis at the sites of PMMA embolization is unknown. CONCLUSIONS: PMMA embolization to the pulmonary vasculature is relatively common following vertebroplasty. Most instances are asymptomatic, but symptoms can develop weeks after the embolization, likely as a result of in situ thombosis. An index of suspicion and exclusion of alternative causes of dyspnea is imperative. Treatment with anticoagulation should be individualized based on the specific risk profile, since the long term impact of in situ pulmonary vascular thrombosis associated with these PMMA embolizations are unknown. AD - A. Faruki, University of Texas, Health Science Center at Houston, Houston, TX, United States AU - Faruki, A. AU - Eapen, G. DB - Embase DO - 10.1378/chest.1390258 KW - poly(methyl methacrylate) cement oxygen bone cement enoxaparin lung embolism kyphoplasty human patient artificial embolization percutaneous vertebroplasty dyspnea thorax radiography lung blood vessel embolism anticoagulation risk case study thrombosis thorax vertebra myeloma thorax pain metastasis multiple myeloma exercise bone strength lung incidental finding pain health care quality diagnosis anticoagulant therapy supplementation ambient air pulse oximetry surgery pulse rate examination thrombus analgesia L1 - http://journal.publications.chestnet.org/article.aspx?articleid=1376728 LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 0012-3692 ST - Symptomatic polymethyl methacrylate-induced cement pulmonary embolism after kyphoplasty T2 - Chest TI - Symptomatic polymethyl methacrylate-induced cement pulmonary embolism after kyphoplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71072897&from=export http://dx.doi.org/10.1378/chest.1390258 VL - 142 ID - 829540 ER - TY - JOUR AB - Introduction Symptomatic complications can occur after intravascular injection of cyanoacrylate glue. We report a case of pulmonary embolism following embolisation of an arteriovenous malformation (AVM). Casereport A 46-year-old woman was found to have an internal iliac AVM which was obliterated using N-butyl-2 cyanoacrylate (NBCA) mixed with lipiodol. The early clinical course was uneventful. On the third post-operative day she complained of sudden, transient chest tightness. On admission one hour later the chest pain had disappeared. Physical examination was normal. A chest roentgenogram showed multiple, dense, branched opacities scattered throughout both lung fields which were confirmed on HRCT, suggesting diffuse scattered embolism of iodine-labelled NBCA. The radiological signs persisted 6 months later. Conclusion Endovascular treatment of arteriovenous malformations with NBCA can be responsible for symptomatic pulmonary embolism. This is not detectable radiologically in the absence of contrast medium. Radiologists should be aware of these often asymptomatic, but sometimes fatal, embolic complications. AD - [Favrolt, N.; Bonniaud, P.; Foucher, P.; Camus, C.; Camus, P.] Hop Bocage, CHU Dijon, Serv Pneumol & Reanimat Resp, F-21079 Dijon, France. [Cercueil, J. -P.] CHU Dijon, Dept Radiol & Imagerie Diagnost & Therapeut, Dijon, France. [Logerot, S.] CHU Dijon, Serv Materiovigilance, Dijon, France. Favrolt, N (corresponding author), Hop Bocage, CHU Dijon, Serv Pneumol & Reanimat Resp, 2 Blvd Marechal Lattre Tassigny,BP 77908, F-21079 Dijon, France. nicolas.favrolt@chu-dijon.fr AN - WOS:000263555000011 AU - Favrolt, N. AU - Bonniaud, P. AU - Cercueil, J. P. AU - Logerot, S. AU - Foucher, P. AU - Camus, C. AU - Camus, P. DA - Jan DO - 10.1016/s0761-8425(09)70138-x J2 - Rev. Mal. Respir. KW - N-butyl-2 cyanoacrylate Embolization Arteriovenous malformation Side effects Pulmonary embolism PERCUTANEOUS VERTEBROPLASTY Respiratory System LA - French M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2009 SN - 0761-8425 SP - 74-77 ST - Pulmonary embolism by cyanoacrylate following embolisation of an arteriovenous malformation T2 - Revue Des Maladies Respiratoires TI - Pulmonary embolism by cyanoacrylate following embolisation of an arteriovenous malformation UR - ://WOS:000263555000011 VL - 26 ID - 830365 ER - TY - JOUR AB - BACKGROUND: Wire cerclage closure of sternotomy is the standard of care despite evidence of pathologic sternal displacement (> 2 mm) during physiologic distracting forces (coughing). Postoperative functional recovery, respiration, pain, sternal dehiscence, and infection are influenced by early bone stability. This translational research report provides proof-of-concept (part A) and first-in-man clinical data (part B) with use of a triglyceride-based porous adhesive to rapidly enhance the stability of conventional sternal closure. METHODS: In part A, fresh human cadaver blocks were subjected to midline sternotomy and either conventional wire closure or modified adhesive closure. After 24 hours at 37 degrees C, using a biomechanical test apparatus, a step-wise increase in lateral distracting force simulated physiologic stress. Sternal displacement was measured by microdisplacement sensors. In part B, a selected clinical case series was performed and sternal perfusion assessed by serial single photon emission computed tomography imaging. RESULTS: Wire closure resulted in measurable bony displacement with increasing load. Pathologic displacement (> or = 2 mm) was observed in all regional segments at loads 400 newton (N) or greater. In contrast, adhesive closure completely eliminated pathologic displacement at forces 600 N or less (p < 0.001). In patients, adhesive closure was not associated with adverse events such as adhesive migration, embolization, or infection. There was excellent qualitative correlation between cadaver and clinical computed tomographic images. Sternal perfusion was not compromised by adhesive closure. CONCLUSIONS: This first-in-man series provides proof-of-concept indicating that a novel biologic bone adhesive is capable of rapid sternal fixation and complete elimination of pathologic sternal displacement under physiologic loading conditions. A randomized clinical trial is warranted to further define the potential risks and benefits of this innovative technique. AD - Department of Cardiac Sciences, Division of Cardiac Surgery, Libin Cardiovascular Institute of Alberta, Calgary, Alberta, Canada. paul.fedak@gmail.com AN - 20732527 AU - Fedak, P. W. AU - Kolb, E. AU - Borsato, G. AU - Frohlich, D. E. AU - Kasatkin, A. AU - Narine, K. AU - Akkarapaka, N. AU - King, K. M. DA - Sep DO - 10.1016/j.athoracsur.2010.05.009 DP - NLM ET - 2010/08/25 J2 - The Annals of thoracic surgery KW - *Bone Cements *Bone Wires Cadaver *Castor Oil Humans *Polymers Postoperative Complications/prevention & control Sternum/*surgery Thoracic Surgical Procedures/methods LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 0003-4975 SP - 979-85 ST - Kryptonite bone cement prevents pathologic sternal displacement T2 - Ann Thorac Surg TI - Kryptonite bone cement prevents pathologic sternal displacement VL - 90 ID - 828766 ER - TY - JOUR AB - Background: Wire cerclage closure of sternotomy is the standard of care despite evidence of pathologic sternal displacement (>2 mm) during physiologic distracting forces (coughing). Postoperative functional recovery, respiration, pain, sternal dehiscence, and infection are influenced by early bone stability. This translational research report provides proof-of-concept (part A) and first-in-man clinical data (part B) with use of a triglyceride-based porous adhesive to rapidly enhance the stability of conventional sternal closure. Methods: In part A, fresh human cadaver blocks were subjected to midline sternotomy and either conventional wire closure or modified adhesive closure. After 24 hours at 37°C, using a biomechanical test apparatus, a step-wise increase in lateral distracting force simulated physiologic stress. Sternal displacement was measured by microdisplacement sensors. In part B, a selected clinical case series was performed and sternal perfusion assessed by serial single photon emission computed tomography imaging. Results: Wire closure resulted in measurable bony displacement with increasing load. Pathologic displacement (<2 mm) was observed in all regional segments at loads 400 newton (N) or greater. In contrast, adhesive closure completely eliminated pathologic displacement at forces 600 N or less (p < 0.001). In patients, adhesive closure was not associated with adverse events such as adhesive migration, embolization, or infection. There was excellent qualitative correlation between cadaver and clinical computed tomographic images. Sternal perfusion was not compromised by adhesive closure. Conclusions: This first-in-man series provides proof-of-concept indicating that a novel biologic bone adhesive is capable of rapid sternal fixation and complete elimination of pathologic sternal displacement under physiologic loading conditions. A randomized clinical trial is warranted to further define the potential risks and benefits of this innovative technique. © 2010 The Society of Thoracic Surgeons. AD - P. W. M. Fedak, 1403-29 St NW, Calgary, AB T2N 2T9, Canada AU - Fedak, P. W. M. AU - Kolb, E. AU - Borsato, G. AU - Frohlich, D. E. C. AU - Kasatkin, A. AU - Narine, K. AU - Akkarapaka, N. AU - King, K. M. DB - Embase Medline DO - 10.1016/j.athoracsur.2010.05.009 KW - adhesive agent bone cement kryptonite medronate technetium tc 99m unclassified drug devices article artificial embolization biomechanics breathing cadaver case study cerclage clinical article clinical assessment clinical feature clinical study compressive strength contrast convalescence coughing human human tissue imaging infection migration perfusion physiological stress priority journal qualitative analysis risk benefit analysis sensor single photon emission computed tomography sternotomy sternum sternum displacement temperature wire fixation wound closure LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0003-4975 SP - 979-985 ST - Kryptonite bone cement prevents pathologic sternal displacement T2 - Annals of Thoracic Surgery TI - Kryptonite bone cement prevents pathologic sternal displacement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L359448318&from=export http://dx.doi.org/10.1016/j.athoracsur.2010.05.009 VL - 90 ID - 829683 ER - TY - JOUR AB - Background: The spine, pelvis, skull, and femur are the most common sites of bone metastases, and pain is the main symptom of metastatic tumors. Percutaneous femoroplasty (PFP) is becoming increasingly popular for treating proximal femoral metastases.Objectives: To assess the clinical value and feasibility of PFP performed under the guidance of computed tomography (CT).Study Design: A retrospective clinical review comparing pain intensity and the ability to perform activities of daily living before and after treatment with PFP.Setting: Single academic medical center.Methods: Sixteen patients with proximal femoral metastasis were treated with PFP under CT guidance and followed up for 6 - 12 months. Pain intensity was evaluated using the visual analog scale (VAS) and patients' quality of life was evaluated using the Barthel Index of Activities of Daily Living (BIADL) preoperatively and at both 7 days and 6 months after PFP.Results: The mean VAS score decreased from 7.44 ± 0.81 preoperatively to 2.69 ± 0.79 at 7 days postoperatively and 1.25 ± 0.93 at 6 months postoperatively. The BIADL score increased from 44.06 ± 9.53 preoperatively to 69.06 ± 8.61 at 7 days postoperatively and 83.13 ± 6.55 at 6 months postoperatively. No patients suffered from pulmonary embolism or complications such as pathologic fracture of the proximal femur. The median overall survival was 12 months. One patient experienced cement leakage into the hip, and the injection was immediately stopped. Then dexamethasone was injected intravenously to prevent potential pulmonary fat embolism caused by localized high pressure.Limitations: The study evaluated a single group of patients before and after CT-guided PFP and did not include a comparison with conventional fluoroscopic approaches in a large patient sample.Conclusion: Use of CT-guided PFP was associated with a low risk of complications and improvement in patients' quality of life. CT guidance made the operation easy and safe, and thus, this approach represents a potential treatment option for proximal femoral metastases if indications are observed closely. AD - Department of Orthopedics, The Fourth Hospital of Hebei Medical University, China Department of Orthopedics, The Third Hospital of Hebei Medical University, China AN - 120950149. Language: English. Entry Date: 20170228. Revision Date: 20191029. Publication Type: journal article AU - Feng, Helin AU - Wang, Jin AU - Guo, Peng AU - Xu, Jianfa AU - Chen, Wei AU - Zhang, Yingze DB - cin20 DP - EBSCOhost KW - Outcome Assessment Orthopedic Surgery -- Methods Bone Neoplasms -- Surgery Femur -- Surgery Surgery, Computer-Assisted -- Methods Bone Cements -- Therapeutic Use Male Neoplasm Metastasis Retrospective Design Middle Age Aged, 80 and Over Orthopedic Surgery -- Adverse Effects Female Aged Adult Tomography, X-Ray Computed Human Scales M1 - 5 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2016 SN - 1533-3159 SP - E767-E773 ST - CT-Guided Percutaneous Femoroplasty (PFP) for the Treatment of Proximal Femoral Metastases T2 - Pain Physician TI - CT-Guided Percutaneous Femoroplasty (PFP) for the Treatment of Proximal Femoral Metastases UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=120950149&site=ehost-live&scope=site VL - 19 ID - 830588 ER - TY - JOUR AB - BACKGROUND: Vertebroplasty and kyphoplasty have been widely applied in the treatment of osteoporotic thoracolumbar compression fracture. However, cement leakage is a major problem in the application of this technology, especially for the vertebral posterior wall ruptured patients. OBJECTIVE: To investigate the therapeutic efficacy of high viscosity bone cement and vertebroplasty in the treatment of osteoporotic thoracolumbar compression fracture. METHODS: A retrospective study was conducted in 20 cases receiving high viscosity bone cement and vertebroplasty surgery for osteoporotic thoracolumbar compression fracture. Clinical outcomes were evaluated mainly with use of Visual Analog Scale for lower back pain. Function of lower back pain was assessed using Oswestry Disability Index questionnaire. Quality of life was evaluated using 36-Item Short Form Health Survey and Frankel score was applied to evaluate neurological function. The anterior vertebral height of the fractured vertebrae was assessed with X-ray. The bone cement leakage, pulmonary embolism, incidence of nearby vertebral fractures and other complications were evaluated during follow-up. RESULTS AND CONCLUSION: All patients were followed up for 12-18 months. The anterior vertebral height of the fractured vertebrae, the lower back pain and function, and quality of life were improved significantly after treatment (P < 0. 05). All patients got the same neurological symptoms before surgery. The bone cement dispersion was good after treatment, detected by X-ray and CT scan, only two cases appeared with bone cement leakage, but no clinical symptoms were found. There was no cement toxicity or allergic complications, pulmonary embolism, infection, nerve injury or new fractures. The high viscosity bone cement used in the treatment of osteoporotic thoracolumbar vertebral compression fractures can significantly relieve thoracic back pain, improve lower back function and quality of life, and greatly reduce the risk of bone cement leakage. AD - L. Zhang, Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu Province, China AU - Feng, X. M. AU - Wang, J. C. AU - Zhang, L. AU - Tao, Y. P. AU - Yang, J. D. AU - Cai, J. AU - Zhang, S. F. AU - Huang, J. J. DB - Embase DO - 10.3969/j.issn.2095-4344.2014.30.001 KW - bone cement article bone cement leakage clinical article compression fracture computer assisted tomography dispersion echography follow up fragility fracture functional status human low back pain neurologic disease osteoporotic thoracolumbar compression fracture percutaneous vertebroplasty quality of life retrospective study thoracolumbar spine treatment outcome viscosity LA - Chinese M1 - 30 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1673-8225 SP - 4757-4763 ST - Application of high viscosity bone cement in thoracolumbar osteoporotic compression fractures T2 - Chinese Journal of Tissue Engineering Research TI - Application of high viscosity bone cement in thoracolumbar osteoporotic compression fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L606126947&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.2014.30.001 VL - 18 ID - 829416 ER - TY - JOUR AB - Background: Percutaneous vertebroplasty (PV) is largely employed in vertebral body compression fractures (VCF). Purpose: To evaluate the efficacy of PV on pain relief and functional status, and its complications rate. Materials and methods: A prospective observational study was conducted by the Division of Internal Medicine of St. Croce and Carle Hospital. Inclusion criteria: Diagnosis of osteoporosis, intense back pain, unresponsive to conservative treatment, associated with radiological evidence of recent VCF. Pain control and functional improvement were respectively assessed using Visual Analogue Scale (VAS) and Activity of Daily Living scale (ADL) on admission, 24 h after PV and at follow-up. PV complications were detected by an immediate computed tomography (CT) scan on the vertebra treated as well as the vertebrae above and below the treated level(s) and by CT chest scan to exclude pulmonary emboli. A magnetic resonance imaging (MRI) follow-up at 6 or 12 months was performed. Results: Fifty-two (46 with primary osteoporosis) patients were enrolled (mean age 73.18 yr, range 44-92). Median follow-up was 20.4 months (range 6-24). Treated vertebrae were 124. VAS, mean value was 9.05 (range 6-10) before treatment, 5.95 (range 2-8) at 24 h after PV and 4.94 (range 2-9) at follow-up (p<0.001). Before PV, 18 patients (34.6%) were functionally impaired vs 8 patients (15.3%) at follow-up (p<0.003). Control MRI evidenced 9 (17.3%) new VCF adjacent and 13 (25%) non-adjacent to treated vertebras. There was one case of discitis. Seven cases (13%) of cement leakage in para-vertebral space were observed. Conclusion: PV is safe and effective in immediate pain reduction and functional improvement and at a median term follow-up. AD - [Fenoglio, L.; Cena, P.; Migliore, E.; Bracco, C.; Ferrigno, D.; Silvestri, A.; Golle, G.; Brignone, C.; Serraino, C.; Pomero, F.] St Croce & Carle Hosp, Dept Internal Med, Cuneo, Italy. [Lingua, G.; Gallarato, G.; Grosso, M.] St Croce & Carle Hosp, Dept Radiol, Cuneo, Italy. Fenoglio, L (corresponding author), St Croce Hosp, Dept Internal Med, Via Michele Coppino 26, I-12100 Cuneo, Italy. medicina.interna@ospedale.cuneo.it AN - WOS:000261148400010 AU - Fenoglio, L. AU - Cena, P. AU - Migliore, E. AU - Bracco, C. AU - Ferrigno, D. AU - Silvestri, A. AU - Lingua, G. AU - Golle, G. AU - Brignone, C. AU - Serraino, C. AU - Gallarato, G. AU - Pomero, F. AU - Grosso, M. DA - Sep DO - 10.1007/bf03349260 J2 - J. Endocrinol. Invest. KW - Functional status osteoporosis outcome analysis vertebral body fracture vertebroplasty QUALITY-OF-LIFE PERCUTANEOUS VERTEBROPLASTY COMPRESSION FRACTURES FOLLOW-UP CEMENT PAIN Endocrinology & Metabolism LA - English M1 - 9 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2008 SN - 0391-4097 SP - 795-798 ST - Vertebroplasty in the treatment of osteoporosis vertebral fractures: Report on 52 cases T2 - Journal of Endocrinological Investigation TI - Vertebroplasty in the treatment of osteoporosis vertebral fractures: Report on 52 cases UR - ://WOS:000261148400010 VL - 31 ID - 830373 ER - TY - JOUR AB - BACKGROUND: Percutaneous vertebroplasty (PV) is largely employed in vertebral body compression fractures (VCF). PURPOSE: To evaluate the efficacy of PV on pain relief and functional status, and its complications rate. MATERIALS AND METHODS: A prospective observational study was conducted by the Division of Internal Medicine of St. Croce and Carle Hospital. INCLUSION CRITERIA: Diagnosis of osteoporosis, intense back pain, unresponsive to conservative treatment, associated with radiological evidence of recent VCF. Pain control and functional improvement were respectively assessed using Visual Analogue Scale (VAS) and Activity of Daily Living scale (ADL) on admission, 24 h after PV and at follow-up. PV complications were detected by an immediate computed tomography (CT) scan on the vertebra treated as well as the vertebrae above and below the treated level(s) and by CT chest scan to exclude pulmonary emboli. A magnetic resonance imaging (MRI) follow-up at 6 or 12 months was performed. RESULTS: Fifty-two (46 with primary osteoporosis) patients were enrolled (mean age 73.18 yr, range 44-92). Median follow-up was 20.4 months (range 6-24). Treated vertebrae were 124. VAS, mean value was 9.05 (range 6-10) before treatment, 5.95 (range 2-8) at 24 h after PV and 4.94 (range 2-9) at follow-up (p<0.001). Before PV, 18 patients (34.6%) were functionally impaired vs 8 patients (15.3%) at follow-up (p<0.003). Control MRI evidenced 9 (17.3%) new VCF adjacent and 13 (25%) non-adjacent to treated vertebras. There was one case of discitis. Seven cases (13%) of cement leakage in para-vertebral space were observed. CONCLUSION: PV is safe and effective in immediate pain reduction and functional improvement and at a median term follow-up. AD - Department of Internal Medicine, St. Croce Hospital, Cuneo, Italy. medicina.interna@ospedale.cuneo.it AN - 18997492 AU - Fenoglio, L. AU - Cena, P. AU - Migliore, E. AU - Bracco, C. AU - Ferrigno, D. AU - Silvestri, A. AU - Lingua, G. AU - Gollè, G. AU - Brignone, C. AU - Serraino, C. AU - Gallarato, G. AU - Pomero, F. AU - Grosso, M. DA - Sep DO - 10.1007/bf03349260 DP - NLM ET - 2008/11/11 J2 - Journal of endocrinological investigation KW - Adult Aged Aged, 80 and over Back Pain/prevention & control Chi-Square Distribution Fractures, Compression/*surgery Humans Magnetic Resonance Imaging Middle Aged Osteoporosis/*surgery Prospective Studies Quality of Life Spinal Fractures/*surgery Vertebroplasty/*methods LA - eng M1 - 9 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 0391-4097 SP - 795-8 ST - Vertebroplasty in the treatment of osteoporosis vertebral fractures: report on 52 cases T2 - J Endocrinol Invest TI - Vertebroplasty in the treatment of osteoporosis vertebral fractures: report on 52 cases VL - 31 ID - 828672 ER - TY - JOUR AB - The histological findings seen in a total hip joint endoprosthesis pseudocapsule are presented. The patient underwent reoperation after total hip replacement performed 18 years previously. Abundant fibrosis with a necrotic area, sheets of histiocytes, and numerous multinucleated foreign body-type giant cells with hone cement particles phagocytized in their cytoplasms were observed. Multiple fatty bone marrow microemboli occluding the microvessels, a feature yet undescribed in pseudocapsule morphology was seen. This feature should be considered being responsible for the pathogenesis of the necrotic area in the endoprosthesis pseudocapsule. AD - Z. Ferencic, Department of Clinical Pathology, Sestre Milosrdnice Univ. Hospital, Zagreb, Croatia AU - Ferencic, Z. AU - Matejcic, A. DB - Embase KW - aged article bone marrow case report embolism endoprosthesis loosening female fibrosis granulation tissue histology human joint prosthesis pathogenesis total hip prosthesis LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1995 SN - 0353-9466 SP - 31-35 ST - Fatty bone marrow microemboli in the joint pseudocapsule after implantation of total hip joint endoprosthesis T2 - Acta Clinica Croatica TI - Fatty bone marrow microemboli in the joint pseudocapsule after implantation of total hip joint endoprosthesis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L25269646&from=export VL - 34 ID - 829927 ER - TY - JOUR AB - We report a case of cryptococcal sinusitis, a rare presentation of Cryptococcus neoformans infection in a patient with multiple myeloma. The objective of this case report is to highlight the utility of structural and functional imaging modalities in the differential diagnosis of sinonasal soft tissue masses in the immunocompromised patient population. PET-CT was the first imaging modality in this patient, who presented for routine follow-up staging of multiple myeloma, and was asymptomatic at the time of his presentation. PET-CT findings prompted further evaluation with MRI, to aid in the differential diagnosis with respect to a neoplastic versus infectious etiology. Ultimately, surgical excision with histopathology was required to provide definitive diagnosis. Final histopathology displayed yeast-organism staining consistent with Cryptococcus neoformans/gatti. The patient subsequently underwent treatment for this infection, along continued treatment for multiple myeloma. To our knowledge this is the first known case of cryptococcal sinusitis in a patient with neoplastic disease. Imaging represents an important tool to differentiate fungal infection from neoplasm in the immunocompromised patient population. As the population of immunocompromised patients continues to grow, the relevance of this diagnosis as well as the use of alternative imaging modalities is becoming more important in clinical practice. AD - R.A. Ferraro, Department of Radiology, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, United States AU - Ferraro, R. A. AU - Ivanidze, J. AU - Margolskee, E. AU - Tsang, H. AU - Sconomiglio, T. AU - Jhanwar, Y. S. DB - Embase Medline DO - 10.1016/j.clinimag.2016.10.010 KW - amphotericin B bortezomib dexamethasone flucytosine immunoglobulin G lenalidomide piperacillin plus tazobactam warfarin adult article asymptomatic infection case report computer assisted emission tomography controlled study cryptococcosis Cryptococcus neoformans differential diagnosis ethmoidectomy follow up histopathology human human tissue immunocompromised patient immunoglobulin blood level invasive granulomatous cryptococcal sinusitis kyphoplasty lung embolism male medical history middle aged multiple myeloma nuclear magnetic resonance imaging outcome assessment paraproteinemia priority journal rare disease sinusitis LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1873-4499 0899-7071 SP - 65-68 ST - Invasive granulomatous cryptococcal sinusitis in an adult with multiple myeloma T2 - Clinical Imaging TI - Invasive granulomatous cryptococcal sinusitis in an adult with multiple myeloma UR - https://www.embase.com/search/results?subaction=viewrecord&id=L612945623&from=export http://dx.doi.org/10.1016/j.clinimag.2016.10.010 VL - 41 ID - 829273 ER - TY - JOUR AN - 9005508 AU - Figueira, A. AU - Núñez, M. AU - Regueijo, C. AU - Carregal, A. AU - Rey, M. AU - González, G. DA - Nov DP - NLM ET - 1996/11/01 J2 - Revista espanola de anestesiologia y reanimacion KW - Aged Aged, 80 and over Bone Cements/*adverse effects Embolism, Fat/*complications Fatal Outcome Female *Hip Prosthesis Humans Shock, Cardiogenic/etiology Shock, Surgical/*etiology LA - spa M1 - 9 N1 - PubMed NLM literature search January 5, 2021 OP - Colapso cardiovascular tras prótesis cementada: cemento óseo o embolismo masivo? PY - 1996 SN - 0034-9356 (Print) 0034-9356 SP - 339-40 ST - [Cardiovascular collapse after cemented prosthesis: bone cement or a massive embolism?] T2 - Rev Esp Anestesiol Reanim TI - [Cardiovascular collapse after cemented prosthesis: bone cement or a massive embolism?] VL - 43 ID - 828986 ER - TY - JOUR AB - BACKGROUND CONTEXT: Percutaneous vertebral augmentation procedures, also called percutaneous osteoplasties (PO), can include percutaneous vertebroplasty (PV) and baloon kyphoplasty (KP). Both are minimally invasive techniques that involve injection of polymethyl methacrylate (PMMA) cement under radiologic control, helping to stabilize a malignant involvement of the spinal column, hemangioma and mainly osteoporotic fractured vertebrae, which afflicts millions of people worldwideCement leakage during vertebroplasty is a common occurrence, and occurs with a frequency of 11-73% for OVF, being the majority asymptomatic. The risk of cement leakage is a major concern with the use of percutaneous vertebroplasty. Its occurrence is affected by the viscosity of the cement, the anatomic peculiarities at the injection site, and the cannula placement. With the traditional front-opening cannula (FOC) the cement flow is directed anteriorly, toward the periphery of the vertebral body, increasing the risk of cement leakage into adjacent veins and subsequent embolization. Directing the cement flow medially with the use of a new side-opening cannula (SOC), as described by Heini and Allred in 2002, and confirmed by the author's publication in 2009, this new cannula may reduce the likelihood of this problem and contribute to the safety of the technique. Baloon kyphoplasty(KP), involves inflation of a ballon within the collapsed body of a vertebra, before stabilization with PMMA. The risk of cement extravasation seems to be reduced due to injection of high-viscosity cement into a previously formed cavity. Both PV and KP provide pain relieve and can reinforce the structure of a vertebral body. PURPOSE: The aim of this article was to study the results of two different types of percutaneous vertebroplasty and kyphoplasty to osteoporotic vertebral fractures, focusing at the risk of cement extrusion. STUDY DESIGN/SETTING: It was prospectively analyzed a series of PVs (percutaneous vertebroplasty) from January 2003 to February 2008, and a consecutive series KPs (kyphoplasties) from March 2008 to November 2010, performed for patients with painful osteoporotic vertebral fractures (OVFs). PVs were performed using the frontal-opening cannula (FOC) and using the new side-opening cannula (SOC), randomly distributed in the PV group. PATIENT SAMPLE: 68 PVs were studied in 43 patients with OVFs. A total of 47 PVs in 30 patients were included, between 2003 and 2008, following the specific protocol for this study. Twenty eight of the patients were female and 3 were males, with ages varying from 48 to 91 years (median age was 77 years). A prospective, controlled and randomizedstudy was performed comparing the PVs, beeing randomly distributed 22 PVs to the experimental group, using the SOC, and 25 PVs to the control group, using the FOC (Table 1). 41 KPs performed in 24 patients with OVFs were studied prospectively, and the results were compared with the PV group. Fifteen of the patients were female and eight were males, with ages varying from 16 to 87 years. Informed consent was obtained from all patients before they participated in the study, and they were distributed in randomized manner. Institutional and National review board approval was also previously obtained. All selected patients had painful OVF from T4 to L5, who did not responded to the clinical therapy for at least one month, and had the proper radiologic assessment, including magnetic resonance imaging (MRI). The experimental device for PV is not approved in the United States. OUTCOME MEASURES: The authors obtained and analized sociodemographic, radiologic, procedural, and clinical data on all patients. The clinical result of the procedure was measured using the visual analog scale (VAS) for pain. Independent radiologist from the radiologic unit performed evaluation of the postoperative films. Based on postoperative x-ray and CT scan, they could decide whether or not the patient had cement leakage, and they could also locate it. The authors also reviewed the films searching to any cement ext usion. The incidence of cement leakage and the clinical outcome of each group was recorded and analyzed using the appropriate tests. A difference of p<.05 was considered to be statistically significant, using statistical tests and c2 (PHStat®, R® and S-Plus®). METHODS: They were submitted to the PV and KP by the same team, at the Hemodinamic Unit (LACIC - Jardim Cuiaba Hospital, Cuiab®a, MT, Brazil), under local anesthesia and conscious sedation. The patients were in prone position, in slight hyperextension with pillows inserted under the chest and pelvis to achieve some fracture redution, using the standard transpedicular technique, as reported previously, guided by fluoroscopy, uni or bipedicularlly, according to the distribution of cement for PV and bipedicularlly for KP. A postprocedural radiography (including chest and spine X-ray), and computed tomography (CT) of the treated level was performed in all cases to scan for the presence or not of cement leaks. Two kinds of disposable 11 or 13-gauge, 10 or 15 cm long bone marrow needles were used randomly for the PV, the FOC and the SOC. Standard cannulas were manually modified to create the side-opening, by sealing the frontopening in the distal end. The authors routinely used the larger cannulas for lumbar and thoracolumbar PVs, and the smaller ones for thoracic PV. The size of the ballons for KP used were number 10/3, 15/3 or 20/3, according to the vertebrae level and size. RESULTS: The FOC was used in 25 PVs, resulting in cement leaks in 68 % (17) of the procedures. The SOC was used in 22 PVs, resulting in 27.3% (6) of cement extrusion (Table 1). The difference between both groups was statistically significant (p<.01). Among the 23 cases of cement leakage with PV, there were some procedures in which there were more than one leakage, distributed as follows: four cases into the disk with the SOC and six with the FOC; three with the SOC and ten with the FOC to the para-vertebral space; two cases of epidural cement extrusion with the FOC and none with the SOC; one case of lung cement embolism with the FOC and none with the SOC. Among the 6 cases of cement leakage with KV: four cases occurred into the para-vertebral space; one to the disk and one to the epidural space. The average number of injections for PV was higher in the control group (1.75) in comparison with the experimental group (1.53), but with no statistical significant difference (pO.05). The patients submitted to KP received bilateral injections of bone cement. The volume of injected cement for PV was reduced from 6.3 ml to 5.5 ml (pO.05) using the FOC and SOC, respectively. The average volume of cement for KP was 2.87 ml. There was a proportional reduction of cost with materials during the procedure with the FOC, compared to the new SOC, because of the reduced number of bilateral injections with the experimental cannula, without a significant difference (pO.05). The cost of KP was significantly superior to PV because the material used was much more expensive (p<.05). The VAS score was analised for all the patients submitted to the osteoplasties until January 2010, to be able to compare the initial and 6 months VAS score. The VAS was similar in all the three groups before the OP, 8.04 (ranging from 7.59 to 8.49) with the SOC, 7.92 (7.47 to 8.37) with the FOC and 7.67 (0.73 to 8.27) with KP. At 1 month follow-up, the mean pain score were also similar, 1.14 (0.69 to 1.59) with the SOC, 1.44 (0.99 to 1.89) with the FOC and 2.33 (1.69 to 2.98) with KP, without significant differences (pO.05). There were a similar pain improvement for all the three groups, for the SOC group, 1.05 (0.60 to 1.50) for the SOC, 1.36 (0.91 to 1.81) for the FOC (p<.05) and 1.11 (0.52 to 1.70) with KP. There were no clinical relevant complications neither in PV nor KP group, but there were two cases of bending at the tip of the SOC during PV, one of those broke and the tip was left inside the vertebral body with the bone cement, with no detrimental consequences. After that, the modified cannula was improved by making it sharper. CONC USIONS: The pain control was similar for all groups (pO.05), with good improvement of pain in most of the patients, and there were no clinical relevant complications. The cement leakage was significantly reduced with the KP (14.6%) and the SOC (27,3%) for PV, in comparison with the FOC (68,0%). The cement extrusion was lower with KP (p<.05), comparing with SOC, increasing the safety of the procedure using both the KP and this new SOC. AD - N. Figueiredo, Federal University of MT, University of Cuiaba, Cuiaba, Brazil AU - Figueiredo, N. AU - Gonsales, D. AU - Casulari, L. DB - Embase DO - 10.1016/j.spinee.2011.08.096 KW - cement bone cement poly(methyl methacrylate) cannula spine percutaneous vertebroplasty spine fracture kyphoplasty society human patient pain injection risk vertebra vertebra body thorax X ray safety female viscosity male control group computer assisted tomography bone remodeling lung hemangioma injection site artificial embolization vein extravasation minimally invasive procedure epidural space follow up informed consent therapy nuclear magnetic resonance imaging devices United States clinical study visual analog scale radiologist hospital Brazil local anesthesia dental anesthesia conscious sedation body position pelvis fracture radiography bone marrow long bone epidural drug administration needle embolism fluoroscopy LA - English M1 - 10 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 1529-9430 SP - 35S-36S ST - Kyphoplasty versus percutaneous vertebroplasty using the traditional and the new side-opening cannula for osteoporotic vertebral fracture T2 - Spine Journal TI - Kyphoplasty versus percutaneous vertebroplasty using the traditional and the new side-opening cannula for osteoporotic vertebral fracture UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70558161&from=export http://dx.doi.org/10.1016/j.spinee.2011.08.096 VL - 11 ID - 829607 ER - TY - JOUR AB - Fat embolism syndrome is the presence of a fatty embolus in the circulatory system that can manifest itself in multiple ways, ranging from asymptomatic presentation to respiratory failure, neurocognitive deficits, and death. It is a relatively common complication after procedures or conditions such as orthopaedic surgery, severe burns, liver injury, closed-chest cardiac massage, and liposuction. This pathology is relatively common in the field of orthopaedics, especially in long bone fractures and procedures such as total hip replacements. It is typically an exclusion diagnosis, and the management is supportive care. In this report, we present a case of a 63-year-old patient who, during a cemented total knee replacement, presented with fat embolism syndrome with neurological and pulmonary manifestations, and subsequently made a complete recovery at discharge. AD - Departamento de Traumatología, Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. Facultad de Medicina, Clínica Alemana Universidad del Desarrollo, Santiago, Chile. Estudiante de la Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. AN - 31886385 AU - Figueroa, D. AU - Figueroa, F. AU - Calvo Mena, R. AU - Figueroa, M. C2 - Pmc6920724 DA - Dec DO - 10.1016/j.artd.2019.09.004 DP - NLM ET - 2019/12/31 J2 - Arthroplasty today KW - Arthroplasty Fat embolism Total knee replacement LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 2352-3441 (Print) 2352-3441 SP - 431-434 ST - Cerebral and pulmonary fat embolism after unilateral total knee arthroplasty T2 - Arthroplast Today TI - Cerebral and pulmonary fat embolism after unilateral total knee arthroplasty VL - 5 ID - 828634 ER - TY - JOUR AB - Introduction: Dose Reference Levels (DRLs) are a useful tool for controlling patient radiation dose. The purpose of this study was to assess local DRLs in Interventional Radiology (IR) by using a dose tracking software. Materials and Methods: The IR Section within the Department of Neuroradiology at Parma Hospital is equipped with two dedicated Philips angiographic facilities. We retrospectively evaluated, for 6 procedures, 4 different dose parameters: Fluoroscopy Time, Total Dose Area Product (DAP_t), Fluoro DAP (DAP_f) and Reference Point Dose (RPD). Data were automatically collected by the commercially available software Radimetrics (Bayer). Over a period of 3 months, patients (121) underwent to the following IR treatments: Cerebral Embolization (56), Vertebroplasty (27), Biliary Drainage (6), Internal Venous Cavography (IVC) with filter placement (14), PTA of Arteriovenous fistulas (8) and Varicocele (10). Results: DRLs were automatically obtained for each procedure as mean value and 75th percentile of dosimetrics parameters distributions. We verified that our data are generally in agreement with the published literature. DAP_t values were compared to the dose threshold for skin injuries. About 7% of cases (Cerebral Embolizations) exceeded dose threshold. The peak skin dose in the worst case was 4700 mGy. The ratio DAP_t/DAP_f was significantly different from 1 and for 3 procedures it ranged between 5 and 10. Conclusions: Radimetrics allows a fast and effective analysis of dosimetric data enabling the definition of the local DRLs for IR. Peak skin dose calculation is a suitable trigger to recognize patients who are likely to show skin injures. Fluoroscopy time is not a reliable dosimetric index because DAP_t may be much higher than DAP_f due to a massive use of fluorography. The impact of all this information on the daily practice needs to be evaluated. AU - Filice, S. AU - Ghetti, C. AU - Sireus, M. AU - Bruni, S. AU - Crisi, G. DB - Embase DO - 10.1016/j.ejmp.2016.01.268 KW - adult arteriovenous fistula biliary tract drainage brain embolism cavography conference abstract controlled study dose calculation filter fluorography fluoroscopy human interventional radiology male neuroradiology percutaneous vertebroplasty preliminary data retrospective study skin injury software varicocele LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1724-191X 1120-1797 SP - 78 ST - Local reference levels for interventional radiology using a dose tracking application: Preliminary results T2 - Physica Medica TI - Local reference levels for interventional radiology using a dose tracking application: Preliminary results UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2007639417&from=export http://dx.doi.org/10.1016/j.ejmp.2016.01.268 VL - 32 ID - 829332 ER - TY - JOUR AB - Skeletal-related events in patients with metastatic bone disease include intractable severe pain, pathologic fracture, spinal cord and nerve compression, hypercalcemia and bone marrow aplasia. In patients with breast cancer, the skeleton is the most frequent site for metastases. Treatment options for metastatic bone disease in these patients include bisphosphonates, chemotherapeutic agents, opioids, hormonal therapy, minimally invasive/interventional and surgical techniques. Interventional oncology techniques for breast cancer patients with bone metastases include diagnostic (biopsy) and therapeutic (palliative and curative) approaches. In the latter, percutaneous ablation, augmentation and stabilization are included. The purpose of this article is to describe the basic concepts of biopsy, ablation, embolization and peripheral skeleton augmentation techniques in patients with metastatic bone disease from breast carcinoma. The necessity for a tailored approach applying different techniques for different cases and locations will be addressed. AD - D. Filippiadis, Second Department of Radiology, National and Kapodistrian University of Athens, School of Medicine, Attikon University General Hospital, 41 Ventouri Street, Holargos, Athens, Greece AU - Filippiadis, D. AU - Mavrogenis, A. F. AU - Mazioti, A. AU - Palialexis, K. AU - Megaloikonomos, P. D. AU - Papagelopoulos, P. J. AU - Kelekis, A. DB - Embase Medline DO - 10.1007/s00590-017-1986-9 KW - arterial embolization bone augmentation bone biopsy bone metastasis breast carcinoma human metastatic breast cancer minimally invasive procedure orthopedic surgery percutaneous vertebroplasty priority journal review tumor ablation tumor biopsy LA - English M1 - 6 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1432-1068 1633-8065 SP - 729-736 ST - Metastatic bone disease from breast cancer: a review of minimally invasive techniques for diagnosis and treatment T2 - European Journal of Orthopaedic Surgery and Traumatology TI - Metastatic bone disease from breast cancer: a review of minimally invasive techniques for diagnosis and treatment UR - https://www.embase.com/search/results?subaction=viewrecord&id=L616740170&from=export http://dx.doi.org/10.1007/s00590-017-1986-9 VL - 27 ID - 829243 ER - TY - JOUR AB - Objective: To illustrate different Interventional Radiology techniques for pain palliationTo learn about proper patient selection and therapeutic algorithmsTo learn about protective techniques which increase safety of palliative therapies Methods: Pain pathophysiology in metastatic bone disease includes tumor driven osteolysis and microfractures, chronic neuronal stimulation with altered neurotransmitter express and neuropathic pain. Therapeutic armamentarium includes conservative medical therapy, surgical options, radiation therapy, Interventional radiology techniques such as neurolysis, embolization, ablation and bone augmentation. Results: Percutaneous neurolysis can be either chemical (by means of phenol or alcohol) or thermal (using radiofrequency or cryoablation). Bone augmentation techniques apply in the spine or peripheral skeleton and include injection of PMMA either solely performed or combined to introduction of implants (screws, metallic mesh of microwires/needles, peek cages, stents etc). Bone ablation provides simultaneous treatment of both the source and sensation of pain as well as tumor decompression and inhibition of osteoclast activity. Conclusions: Pain is a common symptom in metastatic bone disease not adequately treated in the majority of cases. Interventional Radiology techniques with proper patient selection provide attractive, efficient and safe alternatives for pain palliation in oncologic patients. AD - D. Filippiadis, 2nd Department of Radiology, University General Hospital ATTIKON, Athens, Greece AU - Filippiadis, D. AU - Mazioti, A. AU - Spiliopoulos, S. AU - Kostantos, C. AU - Brountzos, E. AU - Kelekis, N. AU - Kelekis, A. DB - Embase DO - 10.1016/j.jvir.2016.04.006 KW - alcohol analgesic agent neurotransmitter phenol artificial embolization bone metastasis clinical study decompression human interventional radiology microfracture minimally invasive procedure needle neurolysis neuropathic pain nociception osteoclast activity osteolysis palliative therapy patient selection pharmacokinetics radiofrequency radiotherapy safety spine stent surgery symptom LA - English M1 - 6 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1535-7732 SP - e64 ST - Minimally invasive techniques for pain palliation in metastatic bone disease: An extra step in the analgesic ladder T2 - Journal of Vascular and Interventional Radiology TI - Minimally invasive techniques for pain palliation in metastatic bone disease: An extra step in the analgesic ladder UR - https://www.embase.com/search/results?subaction=viewrecord&id=L614675537&from=export http://dx.doi.org/10.1016/j.jvir.2016.04.006 VL - 27 ID - 829317 ER - TY - JOUR AB - Cancer patients quite commonly will report different types of pain associated with the disease substrate. Systemic analgesia and radiotherapy provide only partial pain relief in the majority of these patients. Interventional Oncology techniques for pain management and mobility improvement in cancer patients include percutaneous techniques such as neurolysis, ablation and augmentation (both in the spine and peripheral skeleton) as well as trans-arterial embolization. Percutaneous neurolysis acts indirectly providing regional anesthesia whilst the rest of the aforementioned techniques act directly upon the tumor either by inhibiting local growth or by providing stability and skeletal augmentation. Whenever possible, techniques such as ablation and trans-arterial embolization apart from pure palliation may add to the principle of local tumor control. The aim of this review is to provide details concerning the Interventional Oncology techniques used for cancer pain management and to address the necessity for a tailored-based approach applying different techniques or combinations of them in different cases and locations. AD - 2(nd) Radiology Department, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 1 Rimini str, 12462 Haidari/Athens, Greece. Electronic address: dfilippiadis@yahoo.gr. AP-HP, Sorbonne université, Hôpital Tenon, department of radiology, interventional radiology/interventional oncology, 4, rue de la Chine, 75020 Paris, France. 2(nd) Radiology Department, University General Hospital "ATTIKON", Medical School, National and Kapodistrian University of Athens, 1 Rimini str, 12462 Haidari/Athens, Greece. AN - 31447338 AU - Filippiadis, D. K. AU - Cornelis, F. H. AU - Kelekis, A. DA - Jul-Aug DO - 10.1016/j.lpm.2019.06.006 DP - NLM ET - 2019/08/27 J2 - Presse medicale (Paris, France : 1983) KW - Anesthesia, Conduction Bone and Bones/surgery Cancer Pain/*therapy Catheter Ablation/methods Embolization, Therapeutic/methods Humans Medical Oncology/*methods/trends Neoplasms/complications/*therapy Nerve Block/methods Pain Management/*methods Palliative Care/*methods/trends Spine/pathology/surgery Vertebroplasty/methods LA - eng M1 - 7-8 Pt 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 0755-4982 SP - e251-e256 ST - Interventional oncologic procedures for pain palliation T2 - Presse Med TI - Interventional oncologic procedures for pain palliation VL - 48 ID - 828556 ER - TY - JOUR AB - A 78-year-old woman with multiple vertebral body compression fractures underwent intraoperative vertebroplasty and posterior fixation from T4-T12. Polymethylmethacrylate and sterile barium mixture were used within multiple vertebral bodies for both vertebroplasty and fixation. A postoperative chest radiograph showed diffuse bilateral punctate densities within the lungs. Chest CT showed scattered intravascular high attenuation material. What is your diagnosis? AD - E.J. Stern, Harborview Medical Center, Box 359728, 325 Ninth Avenue, Seattle, WA 98104, United States AU - Finch, L. AU - Cheng, S. G. AU - Steinberg, K. P. AU - Stern, E. J. DB - Embase DO - 10.1097/00045413-200203000-00013 KW - poly(methyl methacrylate) aged article case report clinical feature computer assisted tomography echocardiography female human lung embolism percutaneous vertebroplasty LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2002 SN - 1068-0640 SP - 133-134 ST - Polymethylmethacrylate pulmonary emboli T2 - Clinical Pulmonary Medicine TI - Polymethylmethacrylate pulmonary emboli UR - https://www.embase.com/search/results?subaction=viewrecord&id=L34252264&from=export http://dx.doi.org/10.1097/00045413-200203000-00013 VL - 9 ID - 829872 ER - TY - JOUR AD - Department of Orthopedic Surgery, Hutzel Hospital, Wayne State University, Detroit, Michigan 48201, USA. AN - 7639384 AU - Fitzgerald, R. AU - Mason, L. AU - Kanumilli, V. AU - Kleinhomer, K. AU - Sakamoto, A. AU - Johnson, C. DA - Aug DO - 10.1213/00000539-199408000-00033 DP - NLM ET - 1994/08/01 J2 - Anesthesia and analgesia KW - Bone Cements *Echocardiography, Transesophageal Embolism/complications/*diagnostic imaging/etiology Heart Arrest/*diagnostic imaging/etiology Hip Prosthesis/*adverse effects/methods Humans Male Middle Aged Monitoring, Intraoperative LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 1994 SN - 0003-2999 (Print) 0003-2999 SP - 382-5 ST - Transient cardiac standstill associated with embolic phenomena diagnosed by intraoperative transesophageal echocardiography during cemented total hip arthroplasty T2 - Anesth Analg TI - Transient cardiac standstill associated with embolic phenomena diagnosed by intraoperative transesophageal echocardiography during cemented total hip arthroplasty VL - 79 ID - 828548 ER - TY - JOUR AB - BACKGROUND CONTEXT: Metastatic osteolytic involvement of the second cervical vertebra (C2) is rare, but usually very painful. Percutaneous vertebroplasty has shown to be effective regarding pain control, but carries the risk of cement leakage. PURPOSE: To describe an alternative microsurgical procedure suitable for patients suffering from C2 osteolysis who are considered to be high risk with respect to cement leakage. STUDY DESIGN: A technical report. PATIENT SAMPLE: It included seven patients. OUTCOME MEASURES: They include the assessment of clinical safety regarding approach-and procedure-related morbidity and radiologic safety regarding extravertebral cement leakage and the assessment of clinical efficacy by monitoring the pain activity using the visual analog scale (VAS). MATERIALS AND METHODS: Seven patients (five men, two women; mean age 70 years) presented with an acute onset of excruciating neck pain (VAS>6) due to osteolytic destruction of the axis vertebra. There was no neurologic deficit and no compression of the spinal cord preoperatively requiring surgical decompression or stabilization in any of the cases. An open treatment strategy via an anterolateral microsurgical approach was performed. Under biplanar fluoroscopic control, the soft tumor tissue was resected out of the vertebral body through a drilled entry in the anterior wall. After the excavation procedure, the resection cavity was filled with minimal pressure with polymethylmethacrylate bone cement. RESULTS: All patients suffered from severe spontaneous neck pain (mean VAS 8.1, range 6-9), with head motion-dependent pain exacerbation despite high dose of opiates and fixation of the head with a brace. Mean duration of the operative procedure was 51 minutes. Histologic analysis revealed a diagnosis of cancer metastasis in all cases. On average, 1.9 mL cement was placed within the vertebral body, and no cement leakage was observed in postoperative computed tomography and X-ray controls. All patients experienced immediate pain relief at Day 1 after the procedure (mean VAS 4.0, range 2-6), and a further decrease of pain levels was observed at Week 6 after the completion of radiation therapy (mean VAS 2.0, range 0-5). CONCLUSIONS: In cases of metastatic C2 destruction, tumor excavation via an anterolateral approach and subsequent filling of the resection cavity with bone cement offers a safe and effective alternative to percutaneous approaches. (C) 2014 Elsevier Inc. All rights reserved. AD - [Floeth, Frank W.; Herdmann, Joerg; Steiger, Hans-Jakob] Univ Dusseldorf, Fac Med, Dept Neurosurg, Dusseldorf, Germany. [Floeth, Frank W.; Herdmann, Joerg; Rhee, Sascha] St Vinzenz Hosp, Dept Spine & Pain, Dusseldorf, Germany. [Turowski, Bernd] Univ Dusseldorf, Fac Med, Dept Neuroradiol, Dusseldorf, Germany. [Krajewski, Kara; Eicker, Sven O.] Univ Hamburg, Fac Med, Dept Neurosurg, Hamburg, Germany. Eicker, SO (corresponding author), Univ Hamburg Eppendorf, Dept Neurosurg, Martinistr 52, D-20246 Hamburg, Germany. s.eicker@uke.de AN - WOS:000345429500037 AU - Floeth, F. W. AU - Herdmann, J. AU - Rhee, S. AU - Turowski, B. AU - Krajewski, K. AU - Steiger, H. J. AU - Eicker, S. O. DA - Dec DO - 10.1016/j.spinee.2014.09.018 J2 - Spine Journal KW - Axis C2 Pain Osteolysis Metastasis Tumor resection Vertebroplasty ANEURYSMAL BONE-CYST FATAL ETHIBLOC EMBOLIZATION PERCUTANEOUS VERTEBROPLASTY TRANSORAL APPROACH MECHANICAL-BEHAVIOR MULTIPLE-MYELOMA C2 AXIS INJECTION SPINE Clinical Neurology Orthopedics LA - English M1 - 12 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2014 SN - 1529-9430 SP - 3030-3037 ST - Open microsurgical tumor excavation and vertebroplasty for metastatic destruction of the second cervical vertebra-outcome in seven cases T2 - Spine Journal TI - Open microsurgical tumor excavation and vertebroplasty for metastatic destruction of the second cervical vertebra-outcome in seven cases UR - ://WOS:000345429500037 VL - 14 ID - 830252 ER - TY - JOUR AB - Object Frequent complications of posterolateral instrumented fusion have been reported after treatment of degenerative scoliosis in elderly patients. Considering that in some cases, most of the symptomatology of adult degenerative scoliosis (ADS) is a consequence of the segmental instability at the dislocated level, the use of minimally invasive anterior lumbar interbody fusion (ALIF) to manage symptoms can be advocated to reduce surgical morbidity. The purpose of this study was to evaluate the midterm outcomes of 1-or 2-level minimally invasive ALIFs in ADS patients with 1-or 2-level dislocations. Methods?A total of 47 patients (average age 64 years; range 43-80 years) with 1-or 2-level ALIF performed for ADS (64 levels) in a single institution were included in the study. An independent spine surgeon retrospectively reviewed all the patients' medical records and radiographs to assess operative data and surgery-related complications. Clinical outcome was reported using the Oswestry Disability Index (ODI) and the visual analog scale (VAS) for lumbar and leg pain. Intraoperative data and complications were collected. Fusion and risk for adjacent-level degeneration were assessed. Results?The mean follow-up duration was 3 years (range 1-10 years). ODI, and back and leg pain VAS scores were significantly improved at last follow-up. A majority of patients (74%) had a statistically significant improvement in their ODI score of more than 20 points at latest follow-up and 1 had a worsening of his disability. The mean operating time was 166 minutes (range 70-355 minutes). The mean estimated blood loss was 410 ml (range 50-1700 ml). Six (5 major and 1 minor) surgical complications (12.7% of patients) and 13 (2 major and 11 minor) medical complications (27.7% of patients) occurred without death or wound infection. Fusion was achieved in 46 of 47 patients. Surgery resulted in a slight but significant decrease of the Cobb angle, and improved the pelvic parameters and lumbar lordosis, but had no effect on the global sagittal balance. At latest follow-up, 9 patients (19.1%) developed adjacent-segment disease at a mean of 2 years' delay from the index surgery; 4 were symptomatic but treated medically, and none required iterative surgery. Conclusions?Single-or 2-level minimally invasive fusion through a minimally invasive anterior approach in some selected cases of ADS produced a good functional outcome with a high fusion rate. They were associated with a significantly lower rate of complications in this study than the historical control. AD - C.-H. Flouzat-Lachaniette, Hôpital Henri Mondor, AP-HP-UPEC, Institut du Rachis, Service de Chirurgie Orthopédique et Traumatologique, 51 avenue du Maréchal de Lattre de Tassigny, Creteil Cedex, France AU - Flouzat-Lachaniette, C. H. AU - Ratte, L. AU - Poignard, A. AU - Auregan, J. C. AU - Queinnec, S. AU - Hernigou, P. AU - Allain, J. C1 - inductos(Medtronic) DB - Embase Medline DO - 10.3171/2015.3.SPINE14772 KW - recombinant bone morphogenetic protein 2 adult adult degenerative scoliosis aged anterior lumbar interbody fusion article blood vessel injury bone graft cerebrovascular accident clinical article Cobb angle computer assisted tomography disease duration end to end anastomosis female follow up general condition deterioration human intraoperative period leg pain lordosis low back pain lumbar lordosis lung embolism male minimally invasive procedure operation duration operative blood loss Oswestry Disability Index outcome assessment percutaneous vertebroplasty phlebitis postoperative complication preoperative period retrospective study scoliosis Short Form 36 spine fusion surgical technique ureter injury visual analog scale wound infection inductos LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1547-5646 1547-5654 SP - 739-746 ST - Minimally invasive anterior lumbar interbody fusion for adult degenerative scoliosis with 1 or 2 dislocated levels T2 - Journal of Neurosurgery: Spine TI - Minimally invasive anterior lumbar interbody fusion for adult degenerative scoliosis with 1 or 2 dislocated levels UR - https://www.embase.com/search/results?subaction=viewrecord&id=L610838263&from=export http://dx.doi.org/10.3171/2015.3.SPINE14772 VL - 23 ID - 829353 ER - TY - JOUR AB - Pulmonary polymethylmethacrylate (PMMA) cement embolism after kyphoplasty (KP) surgery is a quite frequent event as well as the pulmonary embolization of central venous catheter fragment. This report shows the case of a subject who, after KP, developed pulmonary embolism and who underwent thoracic surgery. After hospital discharge, the subject advanced a claim for damages toward the hospital where he was operated, complaining sensation of tenderness at the chest surgical scar and esthetic damage. To understand the nature of the embolism (either central venous catheter fragment or cement), chemical investigations were then ordered. Spectrometry identified the PMMA cement used for KP. When doubts rise about the origin of the embolized material, chemical investigations may reveal important data not only for clinical but also for forensic purposes. AD - Department of Health Sciences, Forensic Medicine Section, University of Florence, Largo Brambilla 3, Florence, 50134, Italy. AN - 26524385 AU - Focardi, M. AU - Bonelli, A. AU - Pinchi, V. AU - De Luca, F. AU - Norelli, G. A. DA - Jan DO - 10.1111/1556-4029.12957 DP - NLM ET - 2015/11/03 J2 - Journal of forensic sciences KW - *Bone Cements Dental Cements Humans *Kyphoplasty Male Middle Aged Polymethyl Methacrylate *Pulmonary Embolism Spinal Fractures case reconstruction forensic pathology forensic science kyphoplasty polymethylmethacrylate pulmonary cement embolism LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 0022-1198 SP - S252-5 ST - Pulmonary Cement Embolism After Kyphoplasty T2 - J Forensic Sci TI - Pulmonary Cement Embolism After Kyphoplasty VL - 61 Suppl 1 ID - 828702 ER - TY - JOUR AN - 20675028 AU - Fornell-Pérez, R. AU - Santana-Montesdeoca, J. M. AU - Junquera-Rionda, P. DA - Sep DO - 10.1016/j.arbres.2010.04.007 DP - NLM ET - 2010/08/03 J2 - Archivos de bronconeumologia KW - Aged, 80 and over Female Humans Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/*chemically induced/pathology *Vertebroplasty LA - spa M1 - 9 N1 - PubMed NLM literature search January 5, 2021 OP - Embolismo pulmonar múltiple por cemento acrílico tras vertebroplastia. PY - 2010 SN - 0300-2896 SP - 493-4 ST - [Multiple pulmonary embolisms caused by acrylic cement after vertebroplasty] T2 - Arch Bronconeumol TI - [Multiple pulmonary embolisms caused by acrylic cement after vertebroplasty] VL - 46 ID - 828969 ER - TY - JOUR AB - During the course of a prospective, randomised trial comparing dextran 40 with antithrombin III plus heparin as prophylaxis against thrombosis after total hip replacement, an unexpectedly low incidence of postoperative thromboembolic disease was found in patients receiving non-cemented (0 of 23) rather than cemented prostheses (4 of 13, 31%). Despite the small number of patients, the difference was significant and necessitated modification of the protocol. These preliminary findings suggest that the type of hip replacement used was more important than the type of antithrombotic medication in preventing venous thrombosis and pulmonary embolism. AD - Hematology Unit, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642 AU - Francis, C. W. AU - Marder, V. J. AU - Evarts, C. M. C1 - kybernin DB - Embase Medline KW - antithrombin III antithrombin III concentrate dextran 40 heparin blood and hemopoietic system bone cardiovascular system case report drug comparison drug efficacy human intravenous drug administration joint lung embolism methodology peripheral vascular system preliminary communication prevention priority journal prosthesis respiratory system therapy thromboembolism total hip prosthesis vein thrombosis kybernin LA - English M1 - 8484 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1986 SN - 0140-6736 SP - 769-771 ST - Lower risk of thromboembolic disease after total hip replacement with non-cemented than with cemented prostheses T2 - Lancet TI - Lower risk of thromboembolic disease after total hip replacement with non-cemented than with cemented prostheses UR - https://www.embase.com/search/results?subaction=viewrecord&id=L16075651&from=export VL - 1 ID - 829960 ER - TY - JOUR AB - Osteoporotic vertebral compression fractures (VCFs) are associated with a series of clinical consequences leading to increased morbidity and even mortality. Early diagnosis and therapeutic intervention is desirable in order to remobilise patients and prevent further bone loss. Not all fractures are, however, sufficiently treatable by conservative measures. Here, vertebroplasty and kyphoplasty may provide immediate pain relief by minimally invasive fracture stabilisation. In cases of acute fractures, kyphoplasty has the potential to reduce kyphosis and restore the normal sagittal alignment of the spine. The complex nature of systemic osteoporosis, coupled with the intricate biomechanics of vertebral fractures, leads to a clinical setting which is ideally treated interdisciplinarily by the rheumatologist and spine surgeon. AD - Ctr Rheumatol, D-82487 Oberammergau, Germany. Berufsgenossenschaftliche Unfallklin, Dept Neurosurg, D-82418 Murnau, Germany. Franck, H (corresponding author), Ctr Rheumatol, Hubmertusstr 40, D-82487 Oberammergau, Germany. hfranck@wz-kliniken.de AN - WOS:000186708700012 AU - Franck, H. AU - Boszczyk, B. M. AU - Bierschneider, M. AU - Jaksche, H. DA - Oct DO - 10.1007/s00586-003-0591-2 J2 - Eur. Spine J. KW - vertebral compression fracture osteoporosis kyphoplasty vertebroplasty PERCUTANEOUS VERTEBROPLASTY PULMONARY-EMBOLISM ACRYLIC CEMENT WOMEN RISK COMPLICATION PREVALENT TRIAL SPINE Clinical Neurology Orthopedics LA - English M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2003 SN - 0940-6719 SP - S163-S167 ST - Interdisciplinary approach to balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures T2 - European Spine Journal TI - Interdisciplinary approach to balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures UR - ://WOS:000186708700012 VL - 12 ID - 830445 ER - TY - JOUR AB - STUDY DESIGN: We report a case of pulmonary embolism of polymethylmethacrylate material after percutaneous vertebroplasty. OBJECTIVE: To describe a severe vertebroplasty complication, the pulmonary embolism, which proved to be fatal in a patient with many chronic disabilities. SUMMARY OF BACKGROUND DATA: Until 2007, the literature noted that the risk of embolism of polymethylmethacrylate after a percutaneous vertebroplasty counted a small number of pulmonary cement embolism and a smaller number of fatal consequences. The most recent research revealed that the risk of a pulmonary cement embolism ranges from 3.5% to 23% for osteoporotic compression fractures. METHODS: This study is a case report of an 80-year-old patient with multiple medical comorbid factors, chronic obstructive pulmonary disease, mild renal failure, osteoporosis, and hepatic cirrhosis. Symptoms of pulmonary embolism developed 1 month after a percutaneous vertebroplasty. An echocardiography report suggested that the cement infiltrated the right atrium and the right pulmonary artery, and this was confirmed by a computed tomographic scan. As the therapy with oxygen and low-molecular-weight heparin failed to solve the thrombus, the patient required a surgical tricuspid annuloplasty and the extirpation of the right atrial and right pulmonary masses. RESULTS: The course of the operation was complicated by pulmonary infection, and the patient ultimately succumbed to infection/respiratory failure. CONCLUSION: The presence of intravascular/intracardiac foreign bodies is underreported in literature, but it is quite common in clinical practice. We need to discuss the choice of some non-risk-free interventions such as vertebroplasty in older patients already affected by multiple main disabilities. AD - Cardiology Division, Internal Medicine Department, Ospedale Civico di Chivasso (Turin), Italy. AN - 22422441 AU - Franco, E. AU - Frea, S. AU - Solaro, C. AU - Conti, V. AU - Pinneri, F. DA - Mar 15 DO - 10.1097/BRS.0b013e318230db1b DP - NLM ET - 2012/03/17 J2 - Spine KW - Aged, 80 and over Bone Cements/*adverse effects Fatal Outcome Humans Male Pulmonary Embolism/*etiology Vertebroplasty/*adverse effects LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0362-2436 SP - E411-3 ST - Fatal pulmonary embolism: when the cause is not a thrombus T2 - Spine (Phila Pa 1976) TI - Fatal pulmonary embolism: when the cause is not a thrombus VL - 37 ID - 828827 ER - TY - JOUR AB - Study design. We report a case of pulmonary embolism of polymethylmethacrylate material after percutaneous vertebroplasty. Purpose. To describe a severe vertebroplasty complication, the pulmonary embolism, which proved to be fatal in a patient with many chronic disabilities. Summary of background. Until 2007, the literature noted that the risk of embolism of polymethylmethacrylate (PMMA) following a percutaneous vertebroplasty counted a small number of pulmonary cement embolism (PCE) and a smaller number of fatal consequences. The most recent researches revealed that the risk of a PCE ranges from 3.5 to 23% for osteoporotic compression fractures. Data and method. This case report of a 80-year-old patient with multiple medical comorbid factors, chronic obstructive pulmonary disease, mild renal failure, osteoporosis, hepatic cirrhosis. Symptoms of pulmonary embolism developed 1 month following a percutaneous vertebroplasty. An echocardiography reported suspected that the cement infiltrated the right atrium (Fig. 1) and the right pulmonary artery, suspects confirmed by a CT scan (Fig. 2). As therapy with oxygen and low-molecular-weight heparin failed to solve the thrombus the patient required surgical tricuspid annuloplasty and extirpation of the right atrial and right pulmonary masses. Results. The course of the operation was complicated by pulmonary infection and the patient ultimately succumbed to infection/respiratory failure. Conclusions. The presence of intravascular/intracardiac foreign bodies is under-reported in literature, but it is quite common in clinical practice. We need to discuss the choice of some non risk-free interventions like vertebroplasty in older patients already affected by multiple main disabilities. (Figure Presented). AD - E. Franco, Cardiology Department, Chivasso, Italy AU - Franco, E. AU - Pinneri, F. DB - Embase DO - 10.1714/1079.11820 KW - cement poly(methyl methacrylate) low molecular weight heparin oxygen lung embolism thrombus human patient percutaneous vertebroplasty risk disability embolism foreign body lung infection tricuspid annuloplasty therapy computer assisted tomography pulmonary artery heart right atrium echocardiography liver cirrhosis osteoporosis kidney failure chronic obstructive lung disease case report compression fracture clinical practice study design L1 - http://www.giornaledicardiologia.it/r.php?v=1079&a=11820&l=16408&f=allegati/01079_2012_05/fulltext/02.Poster.pdf LA - English M1 - 5 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1827-6806 SP - 197S ST - Fatal pulmonary embolism: When the cause is not a thrombus T2 - Giornale Italiano di Cardiologia TI - Fatal pulmonary embolism: When the cause is not a thrombus UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70898922&from=export http://dx.doi.org/10.1714/1079.11820 VL - 13 ID - 829570 ER - TY - JOUR AB - Percutaneous vertebroplasty is increasingly used for the treatment of vertebral compression fractures. Local leakage of polymethylmethacrylate cement into the perivertebral space is a common complication, but important systemic effects have rarely been reported. The authors describe the case of a 52-year-old patient with central pulmonary embolism after percutaneous vertebroplasty of the eleventh thoracic vertebral body. The large cement embolus was removed from the right pulmonary artery with a hybrid technique combining an interventional catheter procedure with an open heart operation. The patient made an uneventful recovery. The authors review how appropriate arthroplasty techniques might minimize the risk of this dreadful complication. AD - State Univ Ghent Hosp, Dept Cardiac Surg, Cardiac Ctr, B-9000 Ghent, Belgium. State Univ Ghent Hosp, Dept Orthopaed Surg, B-9000 Ghent, Belgium. Francois, K (corresponding author), State Univ Ghent Hosp, Dept Cardiac Surg, Cardiac Ctr, De Pintelaan 185, B-9000 Ghent, Belgium. AN - WOS:000186068900024 AU - Francois, K. AU - Taeymans, Y. AU - Poffyn, B. AU - Van Nooten, G. DA - Oct DO - 10.1097/01.brs.0000092345.00563.e0 J2 - Spine KW - percutaneous vertebroplasty pulmonary embolism open heart procedure ACRYLIC CEMENT Clinical Neurology Orthopedics LA - English M1 - 20 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2003 SN - 0362-2436 SP - E424-E425 ST - Successful management of a large pulmonary cement embolus after percutaneous vertebroplasty: A case report T2 - Spine TI - Successful management of a large pulmonary cement embolus after percutaneous vertebroplasty: A case report UR - ://WOS:000186068900024 VL - 28 ID - 830443 ER - TY - JOUR AB - Percutaneous vertebroplasty is increasingly used for the treatment of vertebral compression fractures. Local leakage of polymethylmethacrylate cement into the perivertebral space is a common complication, but important systemic effects have rarely been reported. The authors describe the case of a 52-year-old patient with central pulmonary embolism after percutaneous vertebroplasty of the eleventh thoracic vertebral body. The large cement embolus was removed from the right pulmonary artery with a hybrid technique combining an interventional catheter procedure with an open heart operation. The patient made an uneventful recovery. The authors review how appropriate arthroplasty techniques might minimize the risk of this dreadful complication. AD - The Cardiac Center, University Hospital, Gent, Belgium. Katrien.Francois@UGent.be AN - 14560098 AU - François, K. AU - Taeymans, Y. AU - Poffyn, B. AU - Van Nooten, G. DA - Oct 15 DO - 10.1097/01.brs.0000092345.00563.e0 DP - NLM ET - 2003/10/16 J2 - Spine KW - Acenocoumarol/therapeutic use Anticoagulants/therapeutic use Bone Cements/metabolism Dyspnea/etiology Female Humans Middle Aged Polymethyl Methacrylate/metabolism Postoperative Complications/etiology Pulmonary Embolism/drug therapy/etiology/*surgery Spinal Fractures/etiology/*surgery Surgical Procedures, Operative/adverse effects/methods Thoracic Vertebrae/injuries/*surgery Treatment Outcome LA - eng M1 - 20 N1 - PubMed NLM literature search January 5, 2021 PY - 2003 SN - 0362-2436 SP - E424-5 ST - Successful management of a large pulmonary cement embolus after percutaneous vertebroplasty: a case report T2 - Spine (Phila Pa 1976) TI - Successful management of a large pulmonary cement embolus after percutaneous vertebroplasty: a case report VL - 28 ID - 828873 ER - TY - JOUR AB - Kyphoplasty, the newest of the tools treating vertebral osteoporotic compression fractures (VOCF) is the evolution of vertebroplasty, allowing not only pain control and strengthening of the fractured vertebra, but also offering the possibility to restore vertebral height with a lower risk of complications. We present our series of 41 consecutive VOCF treated by kyphoplasty in 30 patients between October 2003 and March 2006. Systematic spinal X rays and CT scan have be performed, occasionally followed by bone scintigraphy or spinal MRI. The mean preoperative duration of symptoms before surgery was 52 days. Pain control after the operation was considered excellent in all cases and all patients were mobilized the day after surgery. Kyphoplasty allowed a 50% restoration of vertebral height in 66% of the treated vertebras. The results were better when surgery was performed within the first three months after the fracture. The mean vertebral deformity correction by comparison of the pre- and postoperative Cobb angles was 9.7 degrees. One patient showed cement leakage in the spinal canal without neurological deterioration. The mean postoperative stay was 2.5 days. We found kyphoplasty to be a safe technique allowing immediate pain control after VOCF, with minimal risks of cement leakage or pulmonary embolism. Vertebral height and deformity correction are best achieved with early surgery, but pain control is always excellent even with a delayed procedure. AD - Centre Neurochirurgical de Bruxelles, C.H.I.R.E.C., Site Clinique du Parc Léopold, Bruxelles. AN - 17708471 AU - Fransen, P. AU - Collignon, F. DA - May-Jun DP - NLM ET - 2007/08/22 J2 - Revue medicale de Bruxelles KW - Aged Aged, 80 and over Bone Cements/therapeutic use Catheterization/instrumentation Fractures, Compression/*surgery Humans Lumbar Vertebrae/injuries/surgery Orthopedic Procedures/*methods Osteoporosis/*surgery Pain/surgery Retrospective Studies Spinal Fractures/*surgery Thoracic Vertebrae/injuries/surgery Time Factors LA - fre M1 - 3 N1 - PubMed NLM literature search January 5, 2021 OP - Traitement des fractures vertébrales ostéoporotiques avec kyphoplastie par ballonnet. PY - 2007 SN - 0035-3639 (Print) 0035-3639 SP - 159-63 ST - [Balloon kyphoplasty for treatment of vertebral osteoporotic compression fractures] T2 - Rev Med Brux TI - [Balloon kyphoplasty for treatment of vertebral osteoporotic compression fractures] VL - 28 ID - 828792 ER - TY - JOUR AB - Vertebroplasty consists of percutaneous injection of acrylic cement--polymethylmethacrylate (PMMA)--into a partially collapsed vertebral body in order to obtain pain relief and augment mechanical stability of the vertebral body. Although vertebroplasty is an efficient treatment it is not free of complications. Our present case report describes a woman with pulmonary polymethylmethacrylate embolism during percutaneous vertebroplasty who presented with hypotension, arrhythmia and hypocapnia. AD - Department of Anaesthesiology, University Medical Centre, Hamburg-Eppendorf, Hamburg, Germany. freitag@uke.uni-hamburg.de AN - 16430551 AU - Freitag, M. AU - Gottschalk, A. AU - Schuster, M. AU - Wenk, W. AU - Wiesner, L. AU - Standl, T. G. DA - Feb DO - 10.1111/j.1399-6576.2005.00821.x DP - NLM ET - 2006/01/25 J2 - Acta anaesthesiologica Scandinavica KW - Anticoagulants/administration & dosage Arrhythmias, Cardiac/chemically induced Bone Cements/*adverse effects Female Heparin/administration & dosage Humans Hypocapnia/chemically induced Hypotension/chemically induced Middle Aged Orthopedic Procedures/*methods Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/*chemically induced/diagnosis/therapy Radiography, Thoracic/methods Spinal Fractures/surgery Spine/diagnostic imaging/*surgery Tomography, X-Ray Computed/methods LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0001-5172 (Print) 0001-5172 SP - 248-51 ST - Pulmonary embolism caused by polymethylmethacrylate during percutaneous vertebroplasty in orthopaedic surgery T2 - Acta Anaesthesiol Scand TI - Pulmonary embolism caused by polymethylmethacrylate during percutaneous vertebroplasty in orthopaedic surgery VL - 50 ID - 828903 ER - TY - JOUR AB - In this case report, a 53-year-old female with a pathological subtrochanteric femur fracture received a cemented resection tumour prosthesis. The patient was post-operatively diagnosed with Purtscher's retinopathy due to fat embolisation. Purtscher's retinopathy has previously been described in trauma patients, however, no previous reports exist with patients treated with prosthesis. No treatment guideline is available. There is a risk of permanent visual impairment, and it is recommended, that patients presenting reduced vision post-operatively are referred to an ophthalmologist without delay for correct diagnosis. AD - sarah.freund@auh.rm.dk. AN - 31791468 AU - Freund, S. S. AU - Stoltz, R. K. AU - Bek, T. AU - Keller, J. AU - Baad-Hansen, T. DA - Oct 28 DP - NLM ET - 2019/12/04 J2 - Ugeskrift for laeger KW - Embolism, Fat/complications *Eye Injuries/etiology Female Humans Middle Aged Prostheses and Implants *Prosthesis Implantation/adverse effects *Retinal Diseases/etiology LA - dan M1 - 44 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 0041-5782 ST - [Purtscher's retinopathy as a complication to a cemented resection tumour prosthesis] T2 - Ugeskr Laeger TI - [Purtscher's retinopathy as a complication to a cemented resection tumour prosthesis] VL - 181 ID - 828503 ER - TY - JOUR AB - Osteoporosis is a metabolic disorder which may result in devastating medical problems if not treated appropriately. However, even in the best treated patients fractures may occur. The most devastating fractures are spine and hip. Traditionally, treating fractures of the spine consisted of bed rest, opioid analgesic medications, and bracing. This resulted in increased risk of side-effects from medication, myocardial infarction, pulmonary embolism, pneumonia, admissions to nursing homes, and death. Vertebroplasty and kyphoplasty techniques were developed to decrease the detrimental effects of "conservative care" by decreasing or eliminating the pain and stabilizing the fracture. The safety and efficacy of vertebroplasty and kyphoplasty are similar with several biased opinions in the literature which denotes conflict. Choosing one technique over the other is a physician and/or facility performed preference. There are a small percentage of patients that either vertebroplasty or kyphoplasty does not help. Possibilities could be that not enough cement was used, an adjacent level fracture has occurred, or worsening fracture around the previously treated fracture is causing the pain. For the latter, a repeat vertebral augmentation could be medically necessary. Due to technical constraints, placing an additional kyphoplasty after one has already been accomplished may be technically dangerous and a simpler less costly vertebroplasty technique may be beneficial. This is a case report and review of the literature on the treatment of repeat vertebral augmentation after a previously treated vertebral fracture with kyphoplasty technique. To this date, this is the first article published regarding the use of vertebroplasty technique over a kyphoplasty treated patient. In this case report, a redo vertebroplasty was performed over a previously treated kyphoplasty or vertebroplasty. This procedure can give a patient significant pain relief when they are suffering with pain after a previously treated fracture. AD - Virginia Commonwealth University, Richmond, VA, USA. mfreymd@comcast.net AN - 19461831 AU - Frey, M. E. DA - May-Jun DP - NLM ET - 2009/05/23 J2 - Pain physician KW - Accidental Falls Aged, 80 and over Back Pain/etiology/physiopathology/surgery Bone Cements/therapeutic use Edema/etiology/physiopathology/surgery Fractures, Compression/diagnostic imaging/pathology/surgery Humans Lumbar Vertebrae/diagnostic imaging/pathology/*surgery Male Pain, Postoperative/pathology/physiopathology/*surgery Radiography Reconstructive Surgical Procedures/methods Reoperation/*methods Spinal Fractures/diagnostic imaging/pathology/*surgery Treatment Outcome Vertebroplasty/*adverse effects/*methods LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 1533-3159 SP - 645-9 ST - Redo kyphoplasty with vertebroplasty technique: a case report and review of the literature T2 - Pain Physician TI - Redo kyphoplasty with vertebroplasty technique: a case report and review of the literature VL - 12 ID - 828769 ER - TY - JOUR AB - Osteoporosis is a metabolic disorder which may result in devastating medical problems if not treated appropriately. However, even in the best treated patients fractures may occur. The most devastating fractures are spine and hip. Traditionally, treating fractures of the spine consisted of bed rest, opioid analgesic medications, and bracing. This resulted in increased risk of side-effects from medication, myocardial infarction, pulmonary embolism, pneumonia, admissions to nursing homes, and death. Vertebroplasty and kyphoplasty techniques were developed to decrease the detrimental effects of "conservative care" by decreasing or eliminating the pain and stabilizing the fracture. The safety and efficacy of vertebroplasty and kyphoplasty are similar with several biased opinions in the literature which denotes conflict. Choosing one technique over the other is a physician and/or facility performed preference. There are a small percentage of patients that either vertebroplasty or kyphoplasty does not help. Possibilities could be that not enough cement was used, an adjacent level fracture has occurred, or worsening fracture around the previously treated fracture is causing the pain. For the latter, a repeat vertebral augmentation could be medically necessary. Due to technical constraints, placing an additional kyphoplasty after one has already been accomplished may be technically dangerous and a simpler less costly vertebroplasty technique may be beneficial. This is a case report and review of the literature on the treatment of repeat vertebral augmentation after a previously treated vertebral fracture with kyphoplasty technique. To this date, this is the first article published regarding the use of vertebroplasty technique over a kyphoplasty treated patient. In this case report, a redo vertebroplasty was performed over a previously treated kyphoplasty or vertebroplasty. This procedure can give a patient significant pain relief when they are suffering with pain after a previously treated fracture. AD - Virginia Commonwealth University, Richmond, VA, USA Virginia Commonwealth University, Richmond, VA; and Advanced Pain Management and Spine Specialists, Fort Myers, FL. AN - 105536234. Language: English. Entry Date: 20090918. Revision Date: 20170411. Publication Type: journal article AU - Frey, M. E. AU - Frey, Michael E. DB - cin20 DP - EBSCOhost KW - Kyphoplasty -- Adverse Effects Kyphoplasty -- Methods Lumbar Vertebrae -- Surgery Postoperative Pain -- Surgery Reoperation -- Methods Spinal Fractures -- Surgery Accidental Falls Aged, 80 and Over Back Pain -- Etiology Back Pain -- Physiopathology Back Pain -- Surgery Bone Cements -- Therapeutic Use Edema -- Etiology Edema -- Physiopathology Edema -- Surgery Fractures, Compression -- Pathology Fractures, Compression -- Radiography Fractures, Compression -- Surgery Lumbar Vertebrae -- Pathology Lumbar Vertebrae -- Radiography Male Postoperative Pain -- Pathology Postoperative Pain -- Physiopathology Spinal Fractures -- Pathology Spinal Fractures -- Radiography Surgery, Reconstructive -- Methods Treatment Outcomes M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 1533-3159 SP - 645-649 ST - Redo kyphoplasty with vertebroplasty technique: a case report and review of the literature T2 - Pain Physician TI - Redo kyphoplasty with vertebroplasty technique: a case report and review of the literature UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105536234&site=ehost-live&scope=site VL - 12 ID - 830732 ER - TY - JOUR AB - INTRODUCTION: Coil embolization is a therapy with excellent outcomes and low complication rates for symptomatic patients with persistent or recurrent varicoceles. Rarely, however, coils may migrate to the pulmonary vasculature. We present a patient with a pulmonary infarction after coil migration to the left pulmonary artery. CASE PRESENTATION: A 51 year-old male underwent coil embolization of the bilateral gonadal veins for chronic testicular pain. The procedure was complicated by migration of a 6×7mm coil into a subsegmental branch of the left pulmonary artery (figure 1A and 1B). The patient was asymptomatic and clinically stable. Attempts to retrieve the coil by endovascular snare were unsuccessful. Two months later, computed tomography demonstrated a small 4mm pulmonary infarct distal to the coil (figure 1C). The patient remained asymptomatic and the risk of surgical retrieval was determined to outweigh the potential benefits. DISCUSSION: Foreign body migration to the pulmonary vessels may complicate a variety of endovascular procedures. Most cases involve intravascular catheter fragments while other embolized foreign bodies include IVC filters, guidewires, stents, and bone cement. Iatrogenic devices can migrate to the pulmonary circulation from as far away as the pelvic and intracerebral venous systems. A review of 135 publications describing 574 cases of intravascular foreign body embolization found only 16 cases of embolization coil migration. Potential complications include secondary clot formation, secondary infection, pulmonary infarction, bronchus erosion, and even death. However, less than 6% of patients are symptomatic. The vast majority of iatrogenic foreign bodies can be retrieved by endovascular snare or other devices, though a minority will warrant surgical resection. Time to retrieval as long as 11 years after the initial event has been described. CONCLUSIONS: Foreign body migration to the pulmonary vasculature is a rare complication of coil embolization of varicoceles. Most patients are asymptomatic and the decision to retrieve the device should be made on an individual basis. AD - J. Fu, Harbor UCLA Medical Center, San Diego, CA, United States AU - Fu, J. AU - Hsia, D. DB - Embase DO - 10.1378/chest.2231762 KW - bone cement embolization coil coil migration lung embolism patient human foreign body lung blood vessel devices coil embolization lung infarction varicocele pulmonary artery chronic scrotal pain vein lung circulation intracerebral drug administration blood clotting filter intravascular catheter endovascular surgery risk infarction computer assisted tomography stent male procedures therapy pelvis venous circulation artificial embolization secondary infection bronchus death surgery L1 - http://journal.publications.chestnet.org/article.aspx?articleID=2456308 LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 0012-3692 ST - Embolization coil migration: An unusual cause of pulmonary embolism T2 - Chest TI - Embolization coil migration: An unusual cause of pulmonary embolism UR - https://www.embase.com/search/results?subaction=viewrecord&id=L72132780&from=export http://dx.doi.org/10.1378/chest.2231762 VL - 148 ID - 829361 ER - TY - JOUR AD - Department of Interventional Radiology Subei People's Hospital of Jiangsu Province (Clinical Medical College of Yangzhou University), Yangzhou, JiangSu Province, China Department of Radiology, Second Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, Hunan 410011, People's Republic of China AN - 120687533. Language: English. Entry Date: 20171222. Revision Date: 20170113. Publication Type: Article. Journal Subset: Biomedical AU - Fu-An, Wang AU - En-hua, Xiao DB - cin20 DP - EBSCOhost M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 1533-3159 SP - E208-E208 ST - Author's Reply to the Letter to Editor, "Transarterial Embolization Followed by Percutaneous Vertebroplasty in Treating Vertebral Metastases with Paravetebral Extension" T2 - Pain Physician TI - Author's Reply to the Letter to Editor, "Transarterial Embolization Followed by Percutaneous Vertebroplasty in Treating Vertebral Metastases with Paravetebral Extension" UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=120687533&site=ehost-live&scope=site VL - 20 ID - 830578 ER - TY - JOUR AD - Department of Interventional Radiology, Subei People's Hospital of Jiangsu Province (Clinical Medical College of Yangzhou University), Yangzhou, JiangSu Province, China Department of Radiology, Zhong-Da Hospital, Southeast University, Nanjing, JiangSu Province, China Department of Radiology, the Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China AN - 116772643. Language: English. Entry Date: 20170129. Revision Date: 20160713. Publication Type: Article. Journal Subset: Biomedical AU - Fu-An, Wang AU - Shi-Cheng, He AU - En-Hua, Xiao AU - Shu-Xiang, Wang AU - Ling, Sun AU - Peng-Hua, L. V. AU - Wen-Nuo, Huang DB - cin20 DP - EBSCOhost M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2016 SN - 1533-3159 SP - E559-E567 ST - Sequential Transarterial Embolization Followed by Percutaneous Vertebroplasty Is Safe and Effective in Pain Management in Vertebral Metastases T2 - Pain Physician TI - Sequential Transarterial Embolization Followed by Percutaneous Vertebroplasty Is Safe and Effective in Pain Management in Vertebral Metastases UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=116772643&site=ehost-live&scope=site VL - 19 ID - 830593 ER - TY - JOUR AB - Objective: Osteoporotic compression fractures, which can lead to neurological complications in some cases, are an increasingly frequent occurrence. These lesions require decompression surgery with or without spinal stabilization procedures. In this article, we present the preliminary results obtained using open kyphoplasty, a new method of treating vertebral compression disorders. Methods: Sixteen patients were included in this prospective study, and a total of 17 vertebrae were treated. All of the patients had vertebral compression fractures associated with neurological disorders. The surgical treatment consisted of open kyphoplasty after laminectomy and decompression. Short-segment vertebral osteosynthesis was also performed in patients with pronounced local kyphosis. Pain was rated at clinical assessments, and radiological assessments were performed to determine the restored vertebral height and the correction of any local vertebral kyphosis. Results: Analysis of the results obtained using this method showed that vertebral height was significantly improved (P < 0.001) and local kyphosis was significantly reduced (P < 0.001). The mean operating time was 90 minutes. The neurological status of all patients improved; 14 patients recovered completely from their neurological symptoms. The last 2 patients had associated neurological disease but were able to walk. There were 2 superficial postoperative infections. Conclusion: This method for treating severe osteoporotic compression fractures associated with neurological disorders gives successful results and can be used to treat neurological compression fractures while consolidating the vertebral body. Therefore, this less invasive approach seems to be particularly useful for treating compression fractures in the thoracolumbar spine junction in elderly patients who often have comorbidities. © 2009 by the Congress of Neurological Surgeons. AD - S. Fuentes, Service de Neurochirurgie, Professeur Dufour Hôpital de la Timone, 249 rue Saint Pierre, 13005 Marseille, France AU - Fuentes, S. AU - Blondel, B. AU - Metellus, P. AU - Adetchessi, T. AU - Gaudart, J. AU - Dufour, H. DB - Embase Medline KW - analgesic agent antibiotic agent adult aged article cervical spine clinical article clinical assessment clinical trial computer assisted tomography disease association disease severity female fragility fracture human kyphoplasty kyphosis laminectomy lung embolism male neurologic disease neurological complication nuclear magnetic resonance imaging open kyphoplasty open reduction (procedure) operation duration osteoporotic spinal fracture osteosynthesis outcome assessment pain postoperative infection postoperative pain priority journal prospective study radiology spinal cord compression spinal cord decompression spine fracture surgical technique symptom urinary tract infection vertebra vertebra compression walking aid LA - English M1 - 5 SUPPL. 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 0148-396X SP - ons350-ons354 ST - Open kyphoplasty for management of severe osteoporotic spinal fractures T2 - Neurosurgery TI - Open kyphoplasty for management of severe osteoporotic spinal fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L355830983&from=export VL - 64 ID - 829713 ER - TY - JOUR AB - BACKGROUND: The Exeter stem was introduced to the Japanese market in 1996. Since then, owing to excellent clinical results, the number of stems used has increased year by year and more than 2000 stems were implanted in 2009. The objective of this study was to prove the efficacy of the Exeter stem for Japanese patients by evaluating the short-term results of four major dedicated hip centers. METHODS: We performed a retrospective study of clinical and radiographic results of 1000 primary total hip arthroplasties (THA) performed using the Exeter stem on 881 patients who were followed-up for at least 2 years after surgery. The average age of the patients at operation was 62.3 years (range 23-89 years). Mean postoperative follow-up period was 4.0 (range 2-9) years. RESULTS: Thirty postoperative complications were observed, including 9 infections, 14 dislocations, 5 cases of deep vein thrombosis, and 2 cases of sciatic nerve palsy. No symptomatic pulmonary embolization or femoral fractures were observed. Re-operations for infection and dislocation were performed in 8 and 6 hips, respectively. According to Barrack's classification, the postoperative cementing grade was judged as A for 735 hips, B for 246 hips, and C for 4 hips. At final follow-up, no radiolucent line was observed at the bone-cement interface. Cortical hypertrophy was observed in 9.5 % of cases in Gruen zones 2-6. Kaplan-Meier survival analysis predicted 100 % survival at 5 years when a radiolucent line at the bone-cement interface of the femur was used as the endpoint, 98.8 % when re-operation was required for any reason. CONCLUSIONS: This study revealed that excellent short-term results were achieved by fixing the Exeter stem with modern cementing techniques for primary THA in Japanese patients. AD - Department of Orthopedic Surgery, Kyoto Katsura Hospital, Institute for Joint Replacement, Yamada-hirao-cho, Nishikyo-ku, Kyoto 615-8256, Japan. hfshoot@aol.com AN - 22552547 AU - Fujita, H. AU - Katayama, N. AU - Iwase, T. AU - Otsuka, H. DA - Jul DO - 10.1007/s00776-012-0237-5 DP - NLM ET - 2012/05/04 J2 - Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association KW - Adult Aged Aged, 80 and over Arthroplasty, Replacement, Hip/*instrumentation Female Hip Joint/diagnostic imaging/*surgery *Hip Prosthesis Humans Japan/epidemiology Male Middle Aged Postoperative Complications/epidemiology Prosthesis Design Radiography Retrospective Studies Survival Analysis Treatment Outcome LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0949-2658 SP - 370-6 ST - Multi-center study of use of the Exeter stem in Japan: evaluation of 1000 primary THA T2 - J Orthop Sci TI - Multi-center study of use of the Exeter stem in Japan: evaluation of 1000 primary THA VL - 17 ID - 828779 ER - TY - JOUR AB - Background: The Exeter stem was introduced to the Japanese market in 1996. Since then, owing to excellent clinical results, the number of stems used has increased year by year and more than 2000 stems were implanted in 2009. The objective of this study was to prove the efficacy of the Exeter stem for Japanese patients by evaluating the short-term results of four major dedicated hip centers. Methods: We performed a retrospective study of clinical and radiographic results of 1000 primary total hip arthroplasties (THA) performed using the Exeter stem on 881 patients who were followed-up for at least 2 years after surgery. The average age of the patients at operation was 62.3 years (range 23-89 years). Mean postoperative follow-up period was 4.0 (range 2-9) years. Results: Thirty postoperative complications were observed, including 9 infections, 14 dislocations, 5 cases of deep vein thrombosis, and 2 cases of sciatic nerve palsy. No symptomatic pulmonary embolization or femoral fractures were observed. Re-operations for infection and dislocation were performed in 8 and 6 hips, respectively. According to Barrack's classification, the postoperative cementing grade was judged as A for 735 hips, B for 246 hips, and C for 4 hips. At final follow-up, no radiolucent line was observed at the bone-cement interface. Cortical hypertrophy was observed in 9.5 % of cases in Gruen zones 2-6. Kaplan-Meier survival analysis predicted 100 % survival at 5 years when a radiolucent line at the bone-cement interface of the femur was used as the endpoint, 98.8 % when re-operation was required for any reason. Conclusions: This study revealed that excellent short-term results were achieved by fixing the Exeter stem with modern cementing techniques for primary THA in Japanese patients. AD - Department of Orthopedic Surgery, Kyoto Katsura Hospital, Institute for Joint Replacement, Yamada-hirao-cho, Nishikyo-ku, Kyoto 615-8256, Japan Department of Orthopedic Surgery, Kyoto Katsura Hospital, Institute for Joint Replacement, Yamada-hirao-cho, Nishikyo-ku, Kyoto, 615-8256, Japan, hfshoot@aol.com. AN - 104358253. Language: English. Entry Date: 20130201. Revision Date: 20200708. Publication Type: journal article AU - Fujita, H. AU - Katayama, N. AU - Iwase, T. AU - Otsuka, H. AU - Fujita, Hiroshi AU - Katayama, Naoyuki AU - Iwase, Toshiki AU - Otsuka, Hiromi DB - cin20 DO - 10.1007/s00776-012-0237-5 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Equipment and Supplies Hip Joint -- Surgery Joint Prosthesis Adult Aged Aged, 80 and Over Female Hip Joint -- Radiography Human Japan Male Middle Age Postoperative Complications -- Epidemiology Prosthesis Design Retrospective Design Survival Analysis Treatment Outcomes M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2012 SN - 0949-2658 SP - 370-376 ST - Multi-center study of use of the Exeter stem in Japan: evaluation of 1000 primary THA T2 - Journal of Orthopaedic Science TI - Multi-center study of use of the Exeter stem in Japan: evaluation of 1000 primary THA UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104358253&site=ehost-live&scope=site VL - 17 ID - 830678 ER - TY - CHAP A2 - Nakamura, T. A2 - Yamashita, K. A2 - Neo, M. AB - 29 cases of primary total hip arthroplasty (THA) using interface bioactive bone cement technique (IBBC) combined with third generation cementing technique were evaluated clinically and radiologically. The present study includes 2 men 2 cases and 24 women 27 cases with an average age at operation of 63 years old (ranging 42 to 81). Mean postoperative follow up period was 17.3 months (ranging 12 to 23 months). Pre- and postoperative (1 year) evaluation using Japan Orthopaedic Association (JOA) hip score were 36.0, and 85.0 points, respectively. Postoperative cementing grade using Barrack's classification was A in every case. At one year, radiolucent line at bone-cement interface was not observed, except one case of rheumatoid arthritis patient at zone 3 (Delee and Charnley) in the acetabular side. Neither osteolysis nor loosening was observed in every case. No major complications, such as infection, dislocation, pulmonary embolization, were observed. The present study revealed excellent short-term result was obtained by IBBC technique combined with third generation cementing technique for primary THAs. AD - Kyoto Katsura Hosp, Dept Orthoped Surg, Inst Joint Replacement, Nishikyo Ku, Kyoto 6158256, Japan. Fujita, H (corresponding author), Kyoto Katsura Hosp, Dept Orthoped Surg, Inst Joint Replacement, Nishikyo Ku, Yamada Hirao Cho 17, Kyoto 6158256, Japan. HFshoot@aol.com AN - WOS:000236902500323 AU - Fujita, H. AU - Miyata, M. AU - Nagahara, R. AU - Okumura, T. CY - Durnten-Zurich DO - 10.4028/www.scientific.net/KEM.309-311.1329 KW - total hip arthroplasty hydroxyapatite cementing technique bioactive bone cement TOTAL-HIP-ARTHROPLASTY REPLACEMENT Materials Science, Ceramics Materials Science, Biomaterials Materials Science, Composites LA - English N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PB - Trans Tech Publications Ltd PY - 2006 SN - 1013-9826 0-87849-992-X SP - 1329-1332 ST - Key eng mater T2 - Bioceramics 18, Pts 1 and 2 T3 - Key Engineering Materials TI - Preliminary result of THA using interface bioactive bone cement technique combined with third generation cementing technique UR - ://WOS:000236902500323 VL - 309-311 ID - 830415 ER - TY - JOUR AB - Purpose: One of the drawbacks of cemented total hip arthroplasty (THA) is raaseptic loosening after long period, major reason for which is bioinertness of PMMA bone cement. To improve longevity of THA, interface bioactive bone cement (IBBC) technique, which is characterised with smearing hydroxyapatite (HA) granules just before cementation, has been used in our institute. Objective: Objective of the present study was to thoroughly evaluate clinical and radiological results of the technique. Method: The present study includes 44 hips of primary THA with an average age at operation of 64 years old (ranging 48-81). Mean postoperative follow-up period was 6.7 (ranging 5-8) years. Results: Five cases (6 hips) died with unrelated disease and no patient was lost during follow-up period. Pre- and postoperative evaluation using Merle d'Aubign? score was 8.0 (2.2, 2.2, 3.6) and 16.0 (6.0, 5.2, 4.8) points, respectively. Re-operation for any reason was not needed. No major complications, such as infection, pulmonary embolisation, fracture were observed. One dislocation was treated conservatively. Neither osteolysis nor loosening was observed in every case. For the acetabular side, radiolucent line (RL) at bone cement interface less than 1mm width was observed in 9 hips (23.7%) at a single zone at 4.3 months. Seven (77.8%) became unclear at 2.2 years postoperatively and 5 (55.6%) of them had disappeared at 4.3 years postoperatively. Conclusion: The present study revealed excellent medium-term result by using IBBC technique combined with modern cementing technique for primary THAs. Osteoconductivity of HA granules at bone-cement interface seemed to be the reason for disappearing of RL. AD - H. Fujita, Institute for Joint Replacement, Department of Orthopedic Surgery, Kyoto Katsura Hospital, Kyoto, Japan AU - Fujita, H. AU - Okumura, T. AU - Yamamura, S. AU - Mizuno, Y. AU - Yoshida, M. DB - Embase DO - 10.5301/HIP.2012.9524 KW - bone cement hydroxyapatite European hip society follow up fracture human longevity total hip prosthesis cementation osteolysis patient infection artificial embolization L1 - http://www.hip-int.com/article/-abstracts-from-the-10th-congress-of-the-european-hip-society LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1120-7000 SP - 409-410 ST - Medium-term result of cemented tha using ibbc technique. Radiolucent line at bone-cement interface has been disappeared T2 - HIP International TI - Medium-term result of cemented tha using ibbc technique. Radiolucent line at bone-cement interface has been disappeared UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71960042&from=export http://dx.doi.org/10.5301/HIP.2012.9524 VL - 22 ID - 829558 ER - TY - JOUR AB - INTRODUCTION: There is a great deal of controversy about the effect of tourniquets on development of deep vein thrombosis (DVT) after total knee arthroplasty (TKA). PATIENTS AND METHODS: We investigated the incidence of postoperative DVT after TKA with or without the use of a tourniquet. The patients were 48 consecutive patients undergoing primary ipsilateral cemented TKA for osteoarthritis. Group A (21 patients) underwent the operation without a tourniquet, and Group B (27 patients) underwent the operation with a tourniquet. Ultrasonography to assess DVT was performed before and after the operation. RESULTS: Group B had less intraoperative and total blood loss than Group A. Postoperative DVT was detected in 81.3% of all cases, and symptomatic pulmonary embolism occurred in 1.7%. Most of DVT was found in the calf vein. There was no significant difference in the incidence of postoperative DVT between the two groups. CONCLUSION: We conclude that the use of a tourniquet is beneficial, because it decreases perioperative blood loss and does not increase the risk of DVT. The incidence of DVT after TKA is considerably high with or without use of a tourniquet. Therefore, prevention and early detection of DVT are important for prevention of fatal pulmonary thromboembolism. AD - Department of Orthopaedic Surgery, Mie University Faculty of Medicine, 2-174 Edobashi, Tsu city, Mie 514-8507, Japan. aki0611@clin.medic.mie-u.ac.jp AN - 17102960 AU - Fukuda, A. AU - Hasegawa, M. AU - Kato, K. AU - Shi, D. AU - Sudo, A. AU - Uchida, A. DA - Oct DO - 10.1007/s00402-006-0244-0 DP - NLM ET - 2006/11/15 J2 - Archives of orthopaedic and trauma surgery KW - Aged Aged, 80 and over Arthroplasty, Replacement, Knee/*methods Blood Loss, Surgical Female Humans Male Middle Aged Osteoarthritis, Knee/surgery *Postoperative Complications Prospective Studies Pulmonary Embolism/etiology *Tourniquets Venous Thrombosis/*etiology LA - eng M1 - 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 0936-8051 (Print) 0936-8051 SP - 671-5 ST - Effect of tourniquet application on deep vein thrombosis after total knee arthroplasty T2 - Arch Orthop Trauma Surg TI - Effect of tourniquet application on deep vein thrombosis after total knee arthroplasty VL - 127 ID - 828791 ER - TY - JOUR AB - Blood pressure changes around cement insertion during total hip arthroplasty have been investigated; however, there is little agreement regarding whether a similar phenomenon occurs during hemiarthroplasty in the elderly under spinal anaesthesia. Therefore, our objective was to examine blood pressure around cement insertion during hemiarthroplasty in the elderly. For this retrospective, single-centre, case series study, we identified 430 hips of patients aged >65 years who underwent cemented hemiarthroplasty under spinal anaesthesia from January 2010 to August 2018. The maximum regulation ratio (MRR) was used to express changes in blood pressure immediately after cement insertion and was calculated as follows: the greatest difference (positive or negative) during 5 min after cement insertion into the bone canal divided by systolic blood pressure just before cement insertion. The timings of vasopressor administration and blood transfusion were recorded. The median MRR was compared for each American Society of Anesthesiologists (ASA) classification. The mean MRR was 4.0% (SD:10.4; range -26 to 83). MRR of patients with a >10% increase in blood pressure was significantly less than that of patients with a <10% change in blood pressure. Vasopressor was used in three patients 10 min after cement insertion into the bone canal. There was no significant difference between MRR groups and ASA classification (p = 0.182, respectively). MRR was not significantly different for each ASA classification. However, few cases showed a reduction in blood pressure immediately after cement insertion, regardless of ASA classification. AD - [Funahashi, Hiroto; Iwase, Toshiki; Morita, Daigo] Hamamatsu Med Ctr, Dept Orthopaed Surg, Hamamatsu, Shizuoka, Japan. Iwase, T (corresponding author), Hamamatsu Med Ctr, Dept Orthopaed Surg, Naka Ku, 328 Tomitsuka Cho, Hamamatsu, Shizuoka 4328580, Japan. tossy.iwase@gmail.com AN - WOS:000592711600007 AU - Funahashi, H. AU - Iwase, T. AU - Morita, D. DA - Nov DO - 10.18999/nagjms.82.4.667 J2 - Nagoya J. Med. Sci. KW - cemented bipolar hemiarthroplasty spinal anaesthesia blood pressure American Society of Anaesthesiologists classification elderly BONE-CEMENT CARDIAC-OUTPUT ARTHROPLASTY EMBOLISM ECHOCARDIOGRAPHY Medicine, Research & Experimental LA - English M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2020 SN - 2186-3326 SP - 667-675 ST - Changes in blood pressure during cemented hemiarthroplasty for hip fracture in elderly patients under spinal anaesthesia T2 - Nagoya Journal of Medical Science TI - Changes in blood pressure during cemented hemiarthroplasty for hip fracture in elderly patients under spinal anaesthesia UR - ://WOS:000592711600007 VL - 82 ID - 830096 ER - TY - JOUR AB - Purpose: In this study we report a percutaneous technique to achieve sclerosis of vertebral hemangioma and decompression of the spinal cord and nerve roots. Methods: Under CT guidance the affected vertebral body is punctured by a biopsy needle and sclerosant is injected directly into the tumor. In the case of large paravertebral extension, additional injection is given in the paravertebral soft tissue component to induce shrinkage of the whole tumor mass and release of the compressed spinal cord. Results: Using this technique we treated five patients in whom vertebral hemangioma gave rise to neurologic symptoms. In three patients, sclerotherapy was the only treatment given. In the other two patients, sclerotherapy was preceded by transcatheter embolization. Neither decompressive surgery, radiation therapy nor stabilization was required with this technique. Conclusion: Our experience with CT-guided intraosseous sclerotherapy has proved highly satisfactory. AD - Al Azhar Univ, Sayed Galal Hosp, Ctr Med, Cairo 11563, Egypt. Gabal, AM (corresponding author), Rabigh Gen Hosp, POB 251, Rabigh 21911, Saudi Arabia. AN - WOS:000180194600006 AU - Gabal, A. M. DA - Nov-Dec DO - 10.1007/s00270-002-1944-7 J2 - Cardiovasc. Interv. Radiol. KW - vertebral hemangioma CT-guided vertebral puncture intralesional 5% ethanolamine sclerotherapy paravertebral sclerotherapy vertebroplasty PREOPERATIVE EMBOLIZATION INTRALESIONAL INJECTION TRANSPEDICULAR BIOPSY METHYL-METHACRYLATE THORACIC SPINE VERTEBROPLASTY RADIOTHERAPY MANAGEMENT FEATURES ETHANOL Cardiac & Cardiovascular Systems Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 6 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2002 SN - 0174-1551 SP - 494-500 ST - Percutaneous technique for sclerotherapy of vertebral hemangioma compressing spinal cord T2 - Cardiovascular and Interventional Radiology TI - Percutaneous technique for sclerotherapy of vertebral hemangioma compressing spinal cord UR - ://WOS:000180194600006 VL - 25 ID - 830449 ER - TY - JOUR AD - Department of Internal Medicine, Division of Pulmonary, Allergy, Critical Care & Sleep Medicine, University of Arizona College of Medicine, Tucson. Electronic address: gabe1@deptofmed.arizona.edu. Department of Medical Imaging, Section of Chest and Cardiac Imaging, University of Arizona College of Medicine, Tucson. AN - 27296328 AU - Gabe, L. M. AU - Oliva, I. B. DA - Nov DO - 10.1016/j.amjmed.2016.05.025 DP - NLM ET - 2016/10/25 J2 - The American journal of medicine KW - Bone Cements/*adverse effects Diagnosis, Differential Female Foreign-Body Migration/*diagnostic imaging Humans Incidental Findings Middle Aged Pulmonary Embolism/*chemically induced/*diagnostic imaging LA - eng M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 0002-9343 SP - e279-e280 ST - Pulmonary Cement Embolism T2 - Am J Med TI - Pulmonary Cement Embolism VL - 129 ID - 828583 ER - TY - JOUR AB - Purpose: Hip and knee arthroplasty surgeries are associated with embolism of materials such as air, cement, and fat. Patent foramen ovale (PFO) is a common congenital cardiac condition that has been reported to lead to paradoxical embolism. This observational study aimed to investigate if the presence of a PFO was associated with an increased risk of postoperative delirium in patients undergoing primary elective hip or knee arthroplasties.Method: This was a prospective cohort study at a tertiary teaching hospital. We enrolled patients undergoing primary elective hip or knee arthroplasty who did not have any risk factors for embolism or delirium. Bedside transthoracic echocardiography (TTE) with a bubble study was performed on all patients to detect the presence of PFO. The primary outcome was postoperative delirium as assessed by the standardized Confusion Assessment Method. Secondary outcomes included the ease of performing a TTE bubble study in the perioperative setting, the quality of the TTE images, length of stay, major cardiovascular and neurologic complications, and effects of anesthetic or analgesic management techniques on delirium.Results: Two hundred two patients completed the study. The median [interquartile range] duration of stay was 2 [2-3] days. Only 16 patients (8%) had a positive bubble study. Postoperative delirium was observed in only one patient. Major adverse events were not seen. The inter-rater reliability for the TTE image quality scores was fair (kappa statistic = 0.22).Conclusion: Given the very low incidence of PFO and postoperative delirium in this study, we could not form any conclusions regarding the impact of a PFO on important outcomes including delirium or other major adverse events. No recommendation can be made regarding screening for PFO in patients scheduled for lower extremity arthroplasty surgery.Trial Registration: ClinicalTrials.gov (NCT02400892). Registered 27 March 2015. AD - Department of Anesthesia & Perioperative Medicine, Western University, London, Canada Schulich School of Medicine & Dentistry, Western University, London, Canada Department of Epidemiology & Biostatistics, Western University, London, Canada Division of Orthopedic Surgery, Department of Surgery, Western University, London, ON, Canada Program in Critical Care, Department of Medicine, Western University, London, Canada LHSC-UH C3-108, London Health Sciences Centre, London, ON, Canada AN - 129684961. Language: English. Entry Date: 20190920. Revision Date: 20190920. Publication Type: journal article. Journal Subset: Biomedical AU - Gai, Nan AU - Lavi, Ronit AU - Jones, Philip M. AU - Lee, Hwa AU - Naudie, Douglas AU - Bainbridge, Daniel DB - cin20 DO - 10.1007/s12630-018-1073-7 DP - EBSCOhost KW - Surgery, Elective -- Methods Heart Septal Defects, Atrial Clinical Information Systems Delirium -- Etiology Echocardiography -- Methods Heart Septal Defects, Atrial -- Complications Arthroplasty, Replacement, Knee -- Methods Arthroplasty, Replacement, Hip -- Methods Prospective Studies Aged Male Heart Septal Defects, Atrial -- Epidemiology Middle Age Reproducibility of Results Delirium -- Epidemiology Confusion -- Etiology Confusion -- Epidemiology Postoperative Complications -- Epidemiology Delirium -- Psychosocial Factors Female Confusion -- Psychosocial Factors Observer Bias M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2018 SN - 0832-610X SP - 619-626 ST - Utilisation de l’échographie au point d’intervention pour le diagnostic de foramen ovale perméable chez des patients devant subir une arthroplastie élective de hanche ou de genou et son association à un delirium postopératoire T2 - Canadian Journal of Anaesthesia TI - Utilisation de l’échographie au point d’intervention pour le diagnostic de foramen ovale perméable chez des patients devant subir une arthroplastie élective de hanche ou de genou et son association à un delirium postopératoire UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=129684961&site=ehost-live&scope=site VL - 65 ID - 830550 ER - TY - JOUR AB - Bone cement implantation syndrome (BCIS) is known to increase perioperative morbidity and mortality in endoprosthetic surgery. The use of bone cement for arthroplasty can lead to haemodynamic compromise and instability. BCIS predominantly occurs during cemented arthroplasty of the hip but can be a problem with other arthroplasties as well. Hypoxia, hypotension, pulmonary hypertension, cardiac arrhythmia as well as loss of consciousness and ultimately cardiac arrest are characteristics of BCIS. Although different theories exist and there is ongoing discussion the aetiology and pathophysiology of BCIS are not fully understood yet. However, some risk factors as well as factors influencing the occurrence of BCIS have been identified. This article provides suggestions for the perioperative management of BCIS. Furthermore, we aim to give an overview on the identification of high-risk patients and measures to lower perioperative morbidity and mortality in case of cemented arthroplasty. AD - [Gaik, C.] Univ Klinikum Marburg, Klin Anasthesie & Intensivtherapie, Baldingerstr, D-35043 Marburg, Germany. Gaik, C (corresponding author), Univ Klinikum Marburg, Klin Anasthesie & Intensivtherapie, Baldingerstr, D-35043 Marburg, Germany. gaikc@med.uni-marburg.de AN - WOS:000463189500011 AU - Gaik, C. AU - Schmitt, N. AU - Wiesmann, T. DA - Mar DO - 10.19224/ai2019.124 J2 - Anasthesiol. Intensivmed. KW - Bone Cement Implantation Syndrome Palacos (R) Reaction Perioperative Complication Bone Cement Implantation Syndrome (BCIS) TOTAL HIP-ARTHROPLASTY FEMORAL-NECK FRACTURES FAT-EMBOLISM PERIOPERATIVE MORTALITY PREOPERATIVE EVALUATION CLINICAL-FEATURES CARDIAC-OUTPUT ADULT PATIENTS METHYLMETHACRYLATE HEMIARTHROPLASTY Anesthesiology Critical Care Medicine LA - German M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 0170-5334 SP - 124-133 ST - Bone cement implantation syndrome - pathophysiology, diagnostics & treatment options T2 - Anasthesiologie & Intensivmedizin TI - Bone cement implantation syndrome - pathophysiology, diagnostics & treatment options UR - ://WOS:000463189500011 VL - 60 ID - 830143 ER - TY - JOUR AD - F. Galván-Román, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain AU - Galván-Román, F. AU - Ruiz-Curiel, A. DB - Embase DO - 10.1016/j.rccl.2020.03.002 KW - article brain embolism case report clinical article human kyphoplasty LA - English Spanish M3 - Article in Press N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 2605-1575 2605-1532 ST - Kyphoplasty-related paradoxical cerebral arterial embolism. Case presentation and topic review T2 - REC: CardioClinics TI - Kyphoplasty-related paradoxical cerebral arterial embolism. Case presentation and topic review UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2005485274&from=export http://dx.doi.org/10.1016/j.rccl.2020.03.002 ID - 829090 ER - TY - JOUR AB - The authors describe a dedicated therapeutic vertebroplasty technique that uses newly designed instruments, acrylic cement, and dual guidance with fluoroscopy and computed tomography for pain control in patients with bone failure, and report their experience. Between 1990 and 2002, they performed 868 percutaneous cementoplasty procedures in patients with severe osteoporosis, vertebral tumors, and symptomatic hemangiomas. In patients with osteoporosis, satisfactory results were obtained in 78% of cases; in patients with vertebral tumors, satisfactory results were obtained in 83% of cases; and in patients with hemangiomas, satisfactory results were obtained in 73% of cases. In the global series of 868 cementoplasties, an epidural leak was observed in 15 cases, which caused neuralgia in only three patients without spinal cord compression. In two patients, an asymptomatic pulmonary embolism was detected. The needle of the new vertebroplasty set is designed with side wings for easier rotation and removal. The screw syringe increases the precision of injection. The risk of leak is substantially reduced. The system is safe, reduces the cement manipulation time, and allows excellent control of the injection. The authors performed 130 vertebroplasties with this system without major complications. AD - A. Gangi, Service de Radiologie, Hopital Civil, 1, place de l'Hôpital, 67091 Strasbourg Cedex, France AU - Gangi, A. DB - Embase DO - 10.1177/197140090401700315 KW - acrylic cement steroid analgesia bone biopsy bone scintiscanning bone screw cement leak computer assisted tomography conference paper epidural leakage fluoroscopy hemangioma hypertension local anesthesia lung embolism lung infarction neuralgia osteoporosis patient positioning percutaneous vertebroplasty phlebography postoperative complication postoperative infection postoperative pain risk assessment safety spinal cord tumor surgical equipment surgical technique treatment contraindication treatment indication treatment outcome LA - English M1 - 3 M3 - Conference Paper N1 - Embase Elsevier literature search January 5, 2021 PY - 2004 SN - 1120-9976 SP - 369-374 ST - Percutaneous vertebroplasty: Indications, technique, and results T2 - Rivista di Neuroradiologia TI - Percutaneous vertebroplasty: Indications, technique, and results UR - https://www.embase.com/search/results?subaction=viewrecord&id=L40142745&from=export http://dx.doi.org/10.1177/197140090401700315 VL - 17 ID - 829840 ER - TY - JOUR AB - Over the past 9 years, percutaneous injection of methyl methacrylate into pathologic vertebral bodies (vertebroplasty) was performed in 187 patients. A total of 289 vertebroplasties (mean: 1.54 vertebra/patient) were performed. The procedure was guided under computed tomography (CT) and fluoroscopy. The indications for vertebroplasty were severe painful osteoporosis in 105 cases, vertebral body tumors in 69 cases, symptomatic vertebral hemangioma in 11 cases, and postsurgical consolidation in two cases. Satisfactory results based on the reduction of analgesics were obtained in osteoporosis in 78% of the cases, in tumoral lesions in 83% of the cases, and in hemangioma in 73% of the cases. In 14 cases an epidural leak was observed that caused neuralgia in three cases, only without spinal cord compression. In one case, paravertebral overflow was observed along the needle tract; the glue was extracted percutaneously 2 days later. In two cases, the control CT scan reported an asymptomatic pulmonary embolus. The most critical elements to successful vertebroplasty are proper patient selection, correct needle placement, good timing with injection of pasty glue, and operator experience. AD - A. Gangi, Department of Radiology B, University Hospital of Strasbourg, 1, Place de l'Hopital, 67091 Strasbourg, France AU - Gangi, A. AU - Dietemann, J. L. AU - Guth, S. AU - Steib, J. P. AU - Roy, C. DB - Embase DO - 10.1055/s-0028-1082199 KW - article computer assisted tomography hemangioma human osteoporosis spinal cord compression spinal cord decompression spine scintiscanning spine surgery spine tumor vertebra LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1999 SN - 0739-9529 SP - 137-142 ST - Computed tomography (CT) and flouroscopy-guided vertebroplasty: Results and complications in 187 patients T2 - Seminars in Interventional Radiology TI - Computed tomography (CT) and flouroscopy-guided vertebroplasty: Results and complications in 187 patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L29293235&from=export http://dx.doi.org/10.1055/s-0028-1082199 VL - 16 ID - 829895 ER - TY - JOUR AB - The authors describe a dedicated therapeutic vertebroplasty technique that uses newly designed instruments, acrylic cement, and dual guidance with ultrasonography and computed tomography for pain control in patients with bone failure, and report their experience. Between 1990 and 2002, they performed 868 percutaneous cementoplasty procedures in patients with severe osteoporosis, vertebral tumors, and symptomatic hemangiomas. In patients with osteoporosis, satisfactory results were obtained in 78% of cases; in patients with vertebral tumors, satisfactory results were obtained in 83% of cases; and in patients with hemangiomas, satisfactory results were obtained in 73% of cases. In the global series of 868 cementoplasties, an epidural leak was observed in 15 cases, which caused neuralgia in only three patients without spinal cord compression. In two patients, an asymptomatic pulmonary embolism was detected. The needle of the new vertebroplasty set is designed with side wings for easier rotation and removal. The screw syringe increases the precision of injection. The risk of leak is substantially reduced. The system is safe, reduces the cement manipulation time, and allows excellent control of the injection. The authors performed 130 vertebroplasties with this system without major complications. AD - Department of Radiology, University Louis Pasteur, Strasbourg, France. AN - 12889460 AU - Gangi, A. AU - Guth, S. AU - Imbert, J. P. AU - Marin, H. AU - Dietemann, J. L. DA - Mar-Apr DO - 10.1148/rg.e10 DP - NLM ET - 2003/08/02 J2 - Radiographics : a review publication of the Radiological Society of North America, Inc KW - Adult Aged Aged, 80 and over Bone Cements/adverse effects/therapeutic use Contraindications Fluoroscopy/methods Hemangioma/*complications/diagnostic imaging Humans Lumbar Vertebrae/blood supply/diagnostic imaging/*pathology Medical Illustration Middle Aged Motion Pictures Osteoporosis/*complications/diagnostic imaging Pain/diagnostic imaging/etiology *Pain Management Polymethyl Methacrylate/adverse effects/*therapeutic use Radiography, Interventional/methods Spinal Neoplasms/*complications/diagnostic imaging Tomography, X-Ray Computed/methods LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2003 SN - 0271-5333 (Print) 0271-5333 SP - e10 ST - Percutaneous vertebroplasty: indications, technique, and results T2 - Radiographics TI - Percutaneous vertebroplasty: indications, technique, and results VL - 23 ID - 828750 ER - TY - JOUR AB - Background: Critical organ hypofunction and complications are common in elderly patients, so perioperative treatment becomes important for the success of total knee replacement (TKR). Objective: To explore clinical perioperative complications of TKR in the patients over 70 years old. Design, time and setting: Retrospective analysis of case data was performed at First Hospital of Gannan Medical University and People's Hospital of Peking University from January to December 2002. Participants: 109 patients (168 knees), including 29 males and 80 females, underwent TKR. Of them, 50 underwent single knee surgery, aged (74.2±15.1) years (range 70-85 years), and 59 underwent bilateral knee surgery, aged (73.4±13.2) years (range 70-85 years). In addition, 92 cases (84.4%) were obesity, and 88 were complicated by internal diseases. Methods: The surgery was performed by the same operator. All patients underwent patellar replacement with Scorpio posterior stable knee prosthesis. Knee anterior median incision and medial patellar approach was applied, and anterior and posterior cruciate ligaments were excised during the surgery, osteophyma and corpus liberum of posterior articular capsule were cleared. Patellofemoral joint track was tested until meeting the requirements. The prosthesis was fixed using antibiotics mixed with bone cement, and the incision was sutured at flexed position. Main outcome measures: Early complications following replacement; knee joint and functional evaluation. Results: During surgery and 24 hours after replacement, 8 cases developed hypertension, 7 cases hypotension, and 6 cases arrhythmia. All patients safely passed the perioperative period under treatment of related departments. One case developed pulmonary embolism, 1 case deep infection, 3 cases pulmonary infection, 5 cases urinary system infection, 1 case rapid reduction of platelet caused by Subining, 1 case cognitive disturbance, and 1 case dislocation of knee joint (Charcot arthritis). According to standards of HSS, the knee joint scores were significantly improved from 26.1 prior to replacement to 82.0 at discharge, and function scores were significantly improved from 32.1 prior to replacement to 89.1 at discharge. During 12.4-month follow-up (range 3-22 months), 18 cases lost the follow up; the retention rate was 83.5%. Of 91 retention patients, knee pain disappeared or relieved, restored self-care ability, and no prosthesis loosening or infection was found. At the final follow up, the HSS knee joint scores were significantly improved from 82.0 at discharge to 85.4, and function scores were improved from 89.1 at discharge to 92.3 at discharge. Conclusion: Skilled operative technique and positive treatment of complication can effectively prevent perioperative infection, dislocation and other complications following total knee replacement. AD - H. Gao, Department of Orthopaedics, First Hospital of Gannan Medical University, Ganzhou 341000 Jiangxi Province, China AU - Gao, H. AU - Lü, H. S. DB - Embase KW - antibiotic agent bone cement aged article cognitive defect deep infection electrolyte disturbance female follow up heart arrhythmia human hypertension hypotension infection knee dislocation knee prosthesis lung embolism lung infection major clinical study male patellofemoral joint peroperative complication prosthesis fixation prosthesis infection prosthesis loosening retrospective study Scorpio posterior stable knee prosthesis self care surgical approach surgical technique thrombocytopenia total knee arthroplasty urinary tract infection LA - English M1 - 30 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2008 SN - 1673-8225 SP - 5997-6000 ST - Perioperative complications following total kneel replacement in the elderly T2 - Journal of Clinical Rehabilitative Tissue Engineering Research TI - Perioperative complications following total kneel replacement in the elderly UR - https://www.embase.com/search/results?subaction=viewrecord&id=L352437088&from=export VL - 12 ID - 829741 ER - TY - JOUR AB - OBJECTIVE: To evaluate the effectiveness of percutaneous vertebroplasty (PVP) in the treatment of osteoporotic vertebral compression fractures with or without intravertebral clefts by unilateral approach and the impact of intravertebral clefts on the effectiveness. METHODS: The clinical data of 65 patients who met the inclusion criteria of osteoporotic vertebral compression fracture were retrospectively analyzed. According to having intravertebral clefts or not, the patients were divided into 2 groups: cleft group (group A, n=25) and non-cleft group (group B, n=40). There was no significant difference in gender, age, cause of injury, the level of fracture vertebrae, degree of damage, and interval of injury and operation between 2 groups (P > 0.05). All patients were given PVP procedure by unilateral approach. The operation time, the injected volume of bone cement, time to ambulate, complications, and adjacent vertebral re-fracture were recorded. The height of anterior and middle column and the posterior convex Cobb angle of injured spine were measured on the lateral X-ray film in standing position at preoperation and 1, 48 weeks after operation. The visual analogue scale (VAS) score and Oswestry disability index (ODI) system were used to evaluate the pain relief and improvement of daily activity function respectively at preoperation and 1, 4, and 48 weeks after operation. RESULTS: There was no significant difference in the operation time and time to ambulate between 2 groups (P > 0.05). The injected volume of bone cement in group B was significantly less than that in group A (t=1.833, P=0.034). Asymptomatic cement leakage occurred in 6 patients (4 in group A and 2 in group B), in group A including 1 case of venous leakage, 2 cases of paravertebral leakage, and 1 case of intradiscal leakage; in group B including 2 cases of venous leakage. No symptomatic pulmonary embolism was observed. The vital sign was stable during operation and postoperatively. All patients were followed up 12-30 months (mean, 18.5 months). No re-fracture of the vertebrae occurred during the follow-up. The postoperative VAS score, ODI, the height of anterior and middle column, and the posterior convex Cobb angle of injured spine were improved significantly when compared with the preoperative ones in 2 groups (P < 0.05), but no significant difference was found between 2 groups at pre- and post-operation (P > 0.05). CONCLUSION: PVP by unilateral approach is safty and efficacy in the treatment of osteoporosis vertebral compression fracture combined with intravertebral clefts. Intravertebral clefts have no significant impact on the effectiveness in the pain relief and function improvement. AD - Department of Orthopedics, Fengrun County People's Hospital, Tangshan Hebei, 064000, P.R.China. gaowanxu@sina.com AN - 23230667 AU - Gao, W. AU - Mi, S. AU - Gao, J. DA - Nov DP - NLM ET - 2012/12/13 J2 - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery KW - Aged Aged, 80 and over Bone Cements/therapeutic use Extravasation of Diagnostic and Therapeutic Materials/epidemiology Female Fractures, Compression/pathology/*surgery Humans Male Middle Aged Osteoporotic Fractures/pathology/*surgery Pain/etiology Pain Measurement Retrospective Studies Spinal Fractures/pathology/*surgery Spine/pathology/surgery Treatment Outcome Vertebroplasty/*methods LA - chi M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 1002-1892 (Print) 1002-1892 SP - 1330-5 ST - [Percutaneous vertebroplasty to treat osteoporotic vertebral compression fractures combined with intravertebral clefts by unilateral approach] T2 - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi TI - [Percutaneous vertebroplasty to treat osteoporotic vertebral compression fractures combined with intravertebral clefts by unilateral approach] VL - 26 ID - 828714 ER - TY - JOUR AD - Department of Thoracic Surgery, Vigo University Clinical Hospital, Vigo, Spain. AN - 23337329 AU - García-Fontán, E. AU - Blanco Ramos, M. AU - Obeso Carillo, G. A. DA - Jul DO - 10.1093/ejcts/ezs715 DP - NLM ET - 2013/01/23 J2 - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery KW - Aged Bone Cements/*adverse effects/therapeutic use *Embolism/diagnostic imaging/etiology Humans *Kyphoplasty/adverse effects/methods Male Pleural Effusion/diagnostic imaging/etiology Radiography, Thoracic Tomography, X-Ray Computed Cement embolism Cement leakage Kyphoplasty LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1010-7940 SP - 183 ST - Cement embolism during a kyphoplasty T2 - Eur J Cardiothorac Surg TI - Cement embolism during a kyphoplasty VL - 44 ID - 828516 ER - TY - JOUR AD - M.B. Ramos, Department of Thoracic Surgery, Vigo University Clinical Hospital, c/ Pizarro 22, 36204 Vigo, Spain AU - García-Fontán, E. AU - Ramos, M. B. AU - Carillo, G. A. O. DB - Embase DO - 10.1093/ejcts/ezs715 KW - bone cement aged article azygos vein case report cement embolism computer assisted tomography embolism foreign body fracture fixation human kyphoplasty male pedicle screw priority journal spine fracture thoracic spine LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1010-7940 1873-734X SP - 183 ST - Cement embolism during a kyphoplasty T2 - European Journal of Cardio-thoracic Surgery TI - Cement embolism during a kyphoplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L369219410&from=export http://dx.doi.org/10.1093/ejcts/ezs715 VL - 44 ID - 829487 ER - TY - JOUR AB - Background Cavernous hemangiomas of the cranial base are rare tumors. No case of symptomatic intraosseous angioma affecting the occipital condyle has been reported. This particular case was treated with surgical embolization using acrylic resin. Case description A 20-year-old man with a 1-year history of neck pain and torticollis was referred to our hospital. Neuroradiological examination revealed the typical picture of an intraosseous cavernous hemangioma located in the right occipital condyle. The patient was operated through a suboccipital approach. Biopsy and direct embolization with methacrylate was performed. The definitive pathological diagnosis confirms the neuro-radiological suspicion of intraosseous cavernous hemangioma. The follow-up of the patient (4 years) revealed no recurrence of pain or abnormal posture. Conclusions A rare case of cranial base cavernous hemangioma is reported. Methacrylate embolization can be a good option for the treatment of this uncommon lesion. (C) 2001 by Elsevier Science Inc. AD - Hosp Univ Canarias, Neurosurg Serv, Tenerife, Spain. Hosp Univ Canarias, Neuroradiol Sect, Tenerife, Spain. Garcia-Marin, V (corresponding author), San Sebastian 60 3 D, Santa Cruz De Tenerife 38005, Isl Canarias, Spain. AN - WOS:000172847500010 AU - Garcia-Marin, V. AU - Ravina, J. AU - Trujillo, E. AU - Gonzalez-Feria, L. DA - Nov DO - 10.1016/s0090-3019(01)00613-9 J2 - Surg. Neurol. KW - skull tumor intraosseous hemangioma methacrylate embolization VERTEBROPLASTY Clinical Neurology Surgery LA - English M1 - 5 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2001 SN - 0090-3019 SP - 301-303 ST - Symptomatic cavernous hemangioma of the occipital condyle treated with methacrylate embolization T2 - Surgical Neurology TI - Symptomatic cavernous hemangioma of the occipital condyle treated with methacrylate embolization UR - ://WOS:000172847500010 VL - 56 ID - 830457 ER - TY - JOUR AB - Study Design: Literature review.Objectives: To describe new treatments for painful osteoporotic compression fractures in light of available scientific literature and clinical experience.Summary Of Background Data: Painful vertebral osteoporotic compression fractures lead to significant morbidity and mortality. This relates to pulmonary dysfunction, eating disorders (nutritional deficits), pain, loss of independence, and mental status change (related to pain and medications). Medications to treat osteoporosis (primarily antiresorptive) do not effectively treat the pain or the fracture, and require over 1 year to reduce the degree of osteoporosis. Kyphoplasty and vertebroplasty are new techniques that help decrease the pain and improve function in fractured vertebrae.Methods: This is a descriptive review of the background leading to vertebroplasty and kyphoplasty, a description of the techniques, a review of the literature, as well as current ongoing studies evaluating kyphoplasty.Results: Both techniques have had a very high acceptance and use rate. There is 95% improvement in pain and significant improvement in function following treatment by either of these percutaneous techniques. Kyphoplasty improves height of the fractured vertebra, and improves kyphosis by over 50%, if performed within 3 months from the onset of the fracture (onset of pain). There is some height improvement, though not as marked, along with 95% clinical improvement, if the procedure is performed after 3 months. Complications occur with both and relate to cement leakage in both, and cement emboli with vertebroplasty.Conclusion: Kyphoplasty and vertebroplasty are safe and effective, and have a useful role in the treatment of painful osteoporotic vertebral compression fractures that do not respond to conventional treatments. Kyphoplasty offers the additional advantage of realigning the spinal column and regaining height of the fractured vertebra, which may help decrease the pulmonary, GI, and early morbidity consequences related to these fractures. Both procedures are technically demanding. AD - University of California, San Diego, California, USA Department of Orthopaedics, UCSD Medical Center, 200 West Arbor Drive, San Diego, CA 92103-8894; SGARFIN@UCSD.EDU AN - 106924049. Language: English. Entry Date: 20020517. Revision Date: 20190818. Publication Type: journal article AU - Garfin, S. R. AU - Yuan, H. A. AU - Reiley, M. A. AU - Garfin, S. R. AU - Yuan, H. A. AU - Reiley, M. A. DB - cin20 DP - EBSCOhost KW - Osteoporosis -- Complications Spinal Fractures -- Surgery Kyphosis -- Surgery Intervertebral Disk -- Surgery Bone Cements -- Therapeutic Use Injections Functional Status Back Pain -- Therapy Patient Satisfaction Treatment Complications, Delayed Embolism Body Weights and Measures Balloon Dilatation M1 - 14 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2001 SN - 0362-2436 SP - 1511-1515 ST - New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures T2 - Spine (03622436) TI - New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106924049&site=ehost-live&scope=site VL - 26 ID - 830797 ER - TY - JOUR AB - One hundred consecutive Biomet modular shoulder arthroplasties were studied prospectively and were evaluated with a minimum 2-year follow-up (average 41 months). Fifty-seven women and 43 men with an average age of 64 years were evaluated for pain, activities of daily living, range of motion, cost, and complications. Fourteen patients had undergone previous surgery to the shoulder. Seventy patients underwent total shoulder arthroplasty, and thirty underwent hemiarthroplasty. Pain and range of motion demonstrated statistically significant improvement. Eight activities of daily living were rated on a 0 to 3 scale, and all were significantly improved. Complications were noted in 18 patients and included urinary retention, pulmonary embolus, rotator cuff tear, titanium synovitis, subluxation, and dislocation. Twelve shoulders underwent secondary procedures for rotator cuff repair, open reduction, and component revision for instability. Lucent lines were present in 62.5% of glenoids, 92.3% of cemented stems, and 0% of cementless stems on postoperative radiographs. No patients underwent revision surgery for component loosening, and no cases of humeral head-stem dissociation were seen. Ninety-five shoulders were rated by the patients as improved, and five were made worse. AD - Texas Orthopedic Hospital, Houston 77030, USA. AN - 9285872 AU - Gartsman, G. M. AU - Russell, J. A. AU - Gaenslen, E. DA - Jul-Aug DO - 10.1016/s1058-2746(97)90000-8 DP - NLM ET - 1997/07/01 J2 - Journal of shoulder and elbow surgery KW - Activities of Daily Living Adult Aged Aged, 80 and over Arthritis/*surgery Arthroplasty/adverse effects/economics/*methods Female Humans Male Middle Aged Pain/prevention & control Prospective Studies Prosthesis Failure Range of Motion, Articular Reoperation Shoulder Joint/*injuries/*surgery Treatment Outcome LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 1997 SN - 1058-2746 (Print) 1058-2746 SP - 333-9 ST - Modular shoulder arthroplasty T2 - J Shoulder Elbow Surg TI - Modular shoulder arthroplasty VL - 6 ID - 828775 ER - TY - JOUR AB - OBJECTIVE: Percutaneous vertebroplasty with polymethylmethacrylate (PMMA) restores the stiffness and the strength of fractured vertebral bodies, but changes the pattern of the stress transfer. This effect may cause a secondary fracture of the adjacent vertebrae. Elastoplasty has emerged as a new technique to overcome this complication. The aim of this study is to retrospectively evaluate the clinical results of the elastoplasty procedure. MATERIALS AND METHODS: Thirthy nine patients (9 males, 30 females, 87 spinal levels) were clinically evaluated pre and postoperatively in terms of pain relief, leakage and silicone embolism. The mean age was 67 (range 38-84) years. The mean follow up period was 12,5 months. The patients were evaluated radiologically for the presence of adjacent level fractures postoperatively. Complications were recorded. RESULTS: The mean VAS score decreased from 7,5 to 3,5 during the last follow-up. Symptomatic silicone pulmonary embolism was not encountered in any patients. Leakage was observed in 5 (13%) cases. There was an adjacent level fracture in 1 case and another fracture which was not at the adjacent level in another one. A hematoma occurred in the needle entry site in a patient with trombocytopenia (<70,000). CONCLUSIONS: Elastoplasty is a safe, promising technique in the treatment of vertebral compression fractures (VCFs). Symptomatic silicone pulmonary embolism is not observed. The material's stiffness is close to intact vertebrae. Therefore, elastoplasty may be a good viable option in the treatment of VCFs as it cause less complications and can prevent adjacent level fractures. LEVEL OF EVIDENCE: Level IV, therapeutic study. AD - Istituto Ortopedico Rizzoli, Bologna, Italy. Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey. Electronic address: yemreakman@gmail.com. AN - 28202221 AU - Gasbarrini, A. AU - Ghermandi, R. AU - Akman, Y. E. AU - Girolami, M. AU - Boriani, S. C2 - Pmc6197590 DA - May DO - 10.1016/j.aott.2017.01.001 DP - NLM ET - 2017/02/17 J2 - Acta orthopaedica et traumatologica turcica KW - Adult Aged Aged, 80 and over Female Fluoroscopy Follow-Up Studies Fractures, Compression/diagnosis/*surgery Humans Lumbar Vertebrae/diagnostic imaging/injuries/*surgery Male Middle Aged Retrospective Studies Silicones/*pharmacology Spinal Fractures/diagnosis/*surgery Surgery, Computer-Assisted/*methods Thoracic Vertebrae/diagnostic imaging/injuries/*surgery Time Factors Treatment Outcome Vertebroplasty/*methods Elastoplasty Pmma Silicone Vertebral compression fracture Vertebroplasty LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 1017-995X (Print) 1017-995x SP - 209-214 ST - Elastoplasty as a promising novel technique: Vertebral augmentation with an elastic silicone-based polymer T2 - Acta Orthop Traumatol Turc TI - Elastoplasty as a promising novel technique: Vertebral augmentation with an elastic silicone-based polymer VL - 51 ID - 828569 ER - TY - JOUR AB - The present study illustrates two cases of Toxocara canis infection: A 77-year-old man presenting with bilateral uveitis, sepsis, and non-convulsive status epilepticus (patient A); and a 63-year-old woman with a history of treated breast cancer, presenting with sight loss and paralysis of the right eye, neurological symptoms, pulmonary embolism, pneumonia, and a post traumatic vertebral fracture (patient B). Both diagnoses were challenging because the acute comorbidities withdrew the attention from the actual cause of the disease, and in one case the steroid treatment possibly affected the laboratory indexes. The lack of response to antibiotics and the involvement of specific organs and districts suggested parasitic infection. Indeed, immunoblot assay revealed the presence of specific T. canis immunoglobulin G antibodies. Both patients improved with albendazole 800 mg/die (400 mg ×2) for 28 days; the neurological state normalized, while sight and eye motility remained impaired. Overall, the findings from these two toxocariasis cases indicate that the occurrence of severe neurological symptoms associated with ocular involvement should generate suspicion of parasitic infection rather than leading to differential diagnosis of common presentations such as bacterial and viral infections or autoimmune diseases. AD - M.L. Gastaldello, Department of Emergency Medicine, Università Del Piemonte Orientale, via Costa 9, Novara, Italy AU - Gastaldello, M. L. AU - Bigliocca, M. AU - Campanini, M. DB - Embase DO - 10.4081/itjm.2019.1056 KW - albendazole amoxicillin antibiotic agent anticoagulant agent antithrombocytic agent ceftriaxone levetiracetam prednisone vancomycin acute confusion adult aged anemia antibiotic therapy article brain damage case report clinical article computer assisted tomography conjunctivitis coughing deep vein thrombosis epilepsy epileptic state epistaxis Escherichia coli infection exophthalmos eye inflammation faintness female fever heart infarction human human tissue hypertensive crisis hyponatremia immunoglobulin deficiency lethargy leukocytosis lumbar puncture lung embolism male meningoencephalitis middle aged neuroimaging neurologic disease nuclear magnetic resonance imaging obesity orbit cellulitis papilledema paralysis percutaneous vertebroplasty pneumonia protein electrophoresis ptosis (eyelid) respiratory failure retina detachment sepsis spine fracture ST segment elevation myocardial infarction Staphylococcus epidermidis toxocariasis treatment response tumor biopsy urinary tract infection uveitis vascular disease visual impairment Western blotting LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1877-9352 1877-9344 SP - 59-63 ST - Challenging diagnoses of toxocariasis: A report of two cases T2 - Italian Journal of Medicine TI - Challenging diagnoses of toxocariasis: A report of two cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2001813338&from=export http://dx.doi.org/10.4081/itjm.2019.1056 VL - 13 ID - 829159 ER - TY - JOUR AB - OBJECTIVE: The goal of this study was to compare the clinical and radiological outcomes between fenestrated pedicle screws augmented with cement and expandable pedicle screws in percutaneous vertebral fixation surgical procedures for the treatment of degenerative and traumatic spinal diseases in aging patients with osteoporosis. METHODS: This was a prospective, single-center study. Twenty patients each in the expandable and cement-augmented screw groups were recruited. Clinical outcomes included visual analog scale (VAS), Oswestry Disability Index (ODI), and satisfaction rates. Radiographic outcomes comprised radiological measurements on the vertebral motion segment of the treated levels. Intraoperative data including complications were collected. All patients completed the clinical and radiological outcomes. Outcomes were compared preoperatively and postoperatively. RESULTS: An average shorter operative time was found in procedures in which expandable screws were used versus those in which cement-augmented screws were used (p < 0.001). No differences resulted in perioperative blood loss between the 2 groups. VAS and ODI scores were significantly improved in both groups after surgery. There was no significant difference between the 2 groups with respect to baseline VAS or ODI scores. The satisfaction rate of both groups was more than 85%. Radiographic outcomes also showed no significant difference in segment stability between the 2 groups. No major complications after surgery were seen. There were 4 cases (20%) of approach-related complications, all in fenestrated screw procedures in which asymptomatic cement extravasations were observed. In 1 case the authors detected a radiologically evident osteolysis around a cement-augmented screw 36 months after surgery. In another case they identified a minor loosening of an expandable screw causing local back discomfort at the 3-year follow-up. CONCLUSIONS: Expandable pedicle screws and polymethylmethacrylate augmentation of fenestrated screws are both safe and effective techniques to increase the pullout strength of screws placed in osteoporotic spine. In this series, clinical and radiological outcomes were equivalent between the 2 groups. To the authors' knowledge, this is the first report comparing the cement augmentation technique versus expandable screws in the treatment of aging patients with osteoporosis. AD - 1Department of Neurosurgery, San Giovanni-Addolorata Hospital, Rome. 2Department of Neurosurgery, IRCCS Istituto Nazionale Tumori "Regina Elena," Rome, Italy; and. 3Regional Service of Neurosurgery, "Virgen de la Arrixaca" University Hospital, Murcia, Spain. AN - 32738795 AU - Gazzeri, R. AU - Panagiotopoulos, K. AU - Galarza, M. AU - Bolognini, A. AU - Callovini, G. DA - Aug DO - 10.3171/2020.5.focus20232 DP - NLM ET - 2020/08/02 J2 - Neurosurgical focus KW - *DEXA = dual-energy x-ray absorptiometry *ODI = Oswestry Disability Index *PE = pulmonary embolism *PMMA = polymethylmethacrylate *PTH = parathyroid hormone *VAS = visual analog scale *cemented screw *degenerative spinal disease *expandable screw *fenestrated screw *listhesis *osseoscrew *osteopenic vertebra *spinal fixation *spinal fracture *spinal osteoporosis *vertebral fracture LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 1092-0684 SP - E14 ST - Minimally invasive spinal fixation in an aging population with osteoporosis: clinical and radiological outcomes and safety of expandable screws versus fenestrated screws augmented with polymethylmethacrylate T2 - Neurosurg Focus TI - Minimally invasive spinal fixation in an aging population with osteoporosis: clinical and radiological outcomes and safety of expandable screws versus fenestrated screws augmented with polymethylmethacrylate VL - 49 ID - 828631 ER - TY - JOUR AB - BACKGROUND: To evaluate the clinical effect of kyphoplasty with the extrapedicular approach in the treatment of thoracic osteoporotic compression fractures, including upper, middle, and lower thoracic. METHODS: From April 2014 to December 2016, 50 cases (55 vertebrae) of thoracic osteoporotic fractures were treated with balloon kyphoplasty using the extrapedicular approach. Symptomatic levels ranged from T3 to T12 and were confirmed based on medical history, physical examination, and medical imaging. Pain relief, restoration of vertebral anterior and median height, and kyphosis correction were retrospectively compared before and after operation by using the visual analogue scale and radiography, respectively. In addition, bone cement leakage location and complications were recorded. RESULTS: Operations were successfully performed in all the cases, with an average surgery time of 77 minutes and follow-up period of 15 months (range, 6-36 months). The visual analogue scale scores at 3 days after operation and final follow-up were significantly reduced (P < 0.05). The vertebral anterior margin and median height on radiography after surgery were significantly improved (P < 0.05), and the kyphosis was significantly corrected. Four cases had cement leakage but no other adverse events. No blood vessel or spinal cord puncture injury during surgery or blood vessel embolism, pulmonary embolism, or fat embolism after surgery was found. CONCLUSIONS: Extrapedicular kyphoplasty is safe and effective in treating thoracic osteoporotic vertebral compression fractures. It can rapidly relieve backache, restore the body height of the fractured thoracic vertebra, and correct kyphosis. In addition, it can improve patient quality of life. AD - Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. Electronic address: jzou@suda.edu.cn. AN - 31351209 AU - Ge, J. AU - Cheng, X. AU - Li, P. AU - Yang, H. AU - Zou, J. DA - Nov DO - 10.1016/j.wneu.2019.07.133 DP - NLM ET - 2019/07/28 J2 - World neurosurgery KW - Aged Aged, 80 and over Back Pain/etiology Female Fractures, Compression/complications/*surgery Humans Kyphoplasty/*methods Male Middle Aged Osteoporotic Fractures/complications/*surgery Pain Measurement Postoperative Complications/epidemiology Retrospective Studies Spinal Fractures/complications/*surgery Thoracic Vertebrae/injuries/*surgery Extrapedicular Kyphoplasty Osteoporosis Vertebral compression fracture LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 1878-8750 SP - e284-e289 ST - The Clinical Effect of Kyphoplasty Using the Extrapedicular Approach in the Treatment of Thoracic Osteoporotic Vertebral Compression Fracture T2 - World Neurosurg TI - The Clinical Effect of Kyphoplasty Using the Extrapedicular Approach in the Treatment of Thoracic Osteoporotic Vertebral Compression Fracture VL - 131 ID - 828585 ER - TY - JOUR AB - OBJECTIVE: To evaluate the therapeutic effect and security of CT guided unilateral percutaneous vertebroplasty (PVP) for the treatment of osteoporotic vertebral compression fracture (OVCF) in senile patients. METHODS: From April 2009 to June 2010, 26 patients undergoing CT guided unilateral percutaneous vertebroplasty were analyzed retrospectively. There were 9 males and 17 females,ranging in age from 60 to 85 years with an average of (67.50+/-6.76) years, ranging in course of disease from 2 to 30 days with an average of (8.92+/-4.36) d. The affected segments involved 35 vertebras. The major clinical manifestations of OVCF were lumbar-back pain (especially when turning over or stooping down) and unable to bear. The needle was punctured into vertebral of lesions through unilateral puncture under the CT guidance; and then 3-5 ml bone cement was injected into vertebral. Antibiotic was used 3 days to prevent postoperative infections. Postoperative complications were observed after operation, such as local leakage of bone cement, penetrating spinal cord and/or segmental spinal nerve injuries and pulmonary embolism. X-ray was used to measure the height of anterior, middle and exterior of vertebral before and after treatment. A visual analog scale (VAS) scoring was applied to evaluate pain score preoperative, 48 hours postoperative and the terminal follow-up. RESULTS: Twenty-six patients achieved success in punctuation without serious complications. Local leakage of bone cement occurred in 6 cases, but without clinical symptoms or signs. One patient suffered from acute intraoperative reactions to bone cement and relieved by 5 mg dexamethasone and oxygen. All patients were followed up for 6 to 12 months [averaged (8.4+/-1.6) months]. The postoperative vertebrae height was higher than preoperative,but there was no statistical difference between postoperative and preoperative (P>0.05). Preoperative VAS scores was 7.63+/-0.92, postoperative score was 3.00+/-1.09, the final follow-up score was 2.38+/-1.17; there was significant difference between preoperative and postoperative at 48 hours (P<0.05), but there was no statistical difference between final follow-up and postoperative at 48 hours (P>0.05). CONCLUSION: Unilateral PVP under CT guided can increase the vertebral strength and stabilize vertebral body,and the procedure is a safe and effective method for OVCF in elderly patients. AD - The First People's Hospital of Yongquan, Shanxi, China. gejianzhongyq@tom.com AN - 22097128 AU - Ge, J. Z. AU - Zhang, H. D. AU - Jin, W. J. AU - Huangpu, J. B. AU - Wang, M. H. DA - Oct DP - NLM ET - 2011/11/22 J2 - Zhongguo gu shang = China journal of orthopaedics and traumatology KW - Aged Aged, 80 and over Female Fractures, Compression/*surgery Humans Male Middle Aged Osteoporotic Fractures/*surgery Retrospective Studies Spinal Fractures/*surgery Tomography, X-Ray Computed/*methods Vertebroplasty/*methods LA - chi M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2011 SN - 1003-0034 (Print) 1003-0034 SP - 824-7 ST - [Clinical analysis of CT guided unilateral PVP for the treatment of osteoporotic vertebral compression fracture in senile patients] T2 - Zhongguo Gu Shang TI - [Clinical analysis of CT guided unilateral PVP for the treatment of osteoporotic vertebral compression fracture in senile patients] VL - 24 ID - 828772 ER - TY - JOUR AB - OBJECTIVE: To evaluate the clinical outcomes of single-balloon kyphoplasty in the treatment of thoracic osteoporotic compression fractures via extrapedicular approach METHODS: From July 2004 to May 2008, 38 cases (52 vertebra) of thoracic osteoporotic fractures were treated by balloon kyphoplasty via unilateral extrapedicular approach, including 12 males and 26 females with an average age of 60.3 years (range 55-72 years). There were 34 cases of primary osteoporosis, and 4 had administrated hormone due to other diseases for over 6 months. Symptomatic levels ranged from T4 to T12 confirmed by physical examination, MRI and X-ray. The pain relief, restoration of vertebral height and kyphosis correction were compared before and after operation by using visual analogue scale (VAS) and radiograph, respectively. In addition, bone cement leakage location and complications were recorded. RESULTS: Operation were successfully performed in 38 cases with an average injection of bone cement volume of (3.2± 1.4) mL (2.25-4.60 mL in unilateral infusion). The mean time of surgery was 25-55 minutes, and that of follow-up was 9.5 months (6-24 months). Back pain of 36 cases was improved, and the VAS 3 days postoperatively and the final follow-up was significantly reduced (P < 0.05). The vertebral anterior margin and median height following surgery were significantly improved detected by X-ray (P < 0.05), and average median height restoration was (50.90±34.60)%, but no significant change was found in posterior height (P > 0.05). No lateral wedging or changes in the coronal alignment was found. Three cases (5 vertebra) had cement leakage: the bone cement of 1 case leaked to posterior margin through the puncture channel, and 2 cases leaked to lateral vertebra through vertebral venous system without any adverse event. The patients could move the second day after surgery, discharged from the hospital at days 3-4, and restored to normal life at 1 month postoperatively. No blood vessel or spinal cord puncture injury or pulmonary embolism, or blood vessel embolism was found. CONCLUSION: Unilateral extrapedicular kyphoplasty is safe and effective in treating thoracic osteoporotic fractures. It rapidly releases backache, restores the body height of fractured thoracic vertebrae and improves quality of life of the patients. AD - Z.-H. Ge, Department of Spinal Surgery, Affiliated Hospital, Ningxia Medical University, Yinchuan 750004, Ningxia Hui Autonomous Region, China AU - Ge, Z. H. AU - Zhao, H. N. AU - Zhan, X. H. AU - Zhu, X. AU - Ding, H. Q. AU - Wang, Z. L. DB - Embase DO - 10.3969/j.issn.1673-8225.2009.48.031 KW - bone cement adult aged article clinical article compression fracture female follow up human kyphoplasty male operation duration osteoporosis surgical approach LA - Chinese M1 - 48 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 1673-8225 SP - 9536-9540 ST - Kyphoplasty through unilateral extrapedicular approach in the treatment of 38 patients with thoracic vertebral compression fracture T2 - Journal of Clinical Rehabilitative Tissue Engineering Research TI - Kyphoplasty through unilateral extrapedicular approach in the treatment of 38 patients with thoracic vertebral compression fracture UR - https://www.embase.com/search/results?subaction=viewrecord&id=L359030819&from=export http://dx.doi.org/10.3969/j.issn.1673-8225.2009.48.031 VL - 13 ID - 829688 ER - TY - JOUR AB - There are few reports in the literature of fat embolism syndrome after cementless total hip arthroplasty (THA). Most reported cases have occurred after fracture or cemented THA. We report a case of a healthy 51-year-old woman who underwent THA for osteoarthritis under spinal anesthesia. A press-fit cup and extensively porous-coated diaphyseal locking stem were used and inserted without cement. In the recovery room, the patient became hypoxemic and hypotensive and developed cortical blindness. The next day, a petechial rash was evident. Gurd's criteria for fat embolism syndrome were fulfilled. Her symptoms resolved over a 2-week period. Patients undergoing cementless THA are at risk for fat embolism syndrome, and this must be considered in the differential diagnosis for postoperative hypoxemia and neurologic deficits. AD - London Health Sciences Centre, Ontario, Canada. AN - 11021461 AU - Gelinas, J. J. AU - Cherry, R. AU - MacDonald, S. J. DA - Sep DO - 10.1054/arth.2000.6631 DP - NLM ET - 2000/10/06 J2 - The Journal of arthroplasty KW - Arthroplasty, Replacement, Hip/*methods Embolism, Fat/diagnosis/*etiology Female Humans Hypoxia/etiology Middle Aged Osteoarthritis/surgery Postoperative Complications Syndrome LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2000 SN - 0883-5403 (Print) 0883-5403 SP - 809-13 ST - Fat embolism syndrome after cementless total hip arthroplasty T2 - J Arthroplasty TI - Fat embolism syndrome after cementless total hip arthroplasty VL - 15 ID - 828933 ER - TY - JOUR AB - Introduction: Benign primary spinal neoplasms are rare tumors. Surgical treatment is required in cases of local bone destruction (leading to instability), invasion into adjacent neurovascular structures and in cases of therapy-refractory pain. Methods: Clinical records were reviewed for patients who underwent surgical treatment of benign primary vertebral tumors between January 2007 and May 2013. Lesion entities, extent of resection, pre- and postoperative neurological deficits, primary symptoms, lesion location, and type of surgery, as well as need for further treatment were assessed. Results: 12 patients who underwent surgical treatment of benign primary vertebral tumors were identified. Mean patient age was 45 years (16 to 70 years, 9 male, 3 female). 4 hemangiomas, 3 osteoidosteomas, 3 aneurysmatic bone cysts, 1 osteoblastoma, and 1 chondroid tumor were surgically treated. All patients suffered from pain due to the lesion, 2 patients had neurological symptoms. 2 hemangioma patients were treated with injection of bone cement only. In 5 of 12 patients dorsal stabilization was conducted (1 of the 5 patients already pretreated with stabilization). In 3 of 12 patients a dorsal and ventral approach was conducted, 1 hemangioma patients received an embolization preoperatively. All patients treated for aneurysmatic bone cysts received dorsal stabilization, 2 of them were operated via a dorsoventral approach. 1 patient received an extension of his stabilization due to kyphosis 3 months after the initial operation. Discussion: While in cases of symptomatic hemangiomas injection of bone cement can pose a sufficient treatment, other benign tumor entities, especially aneurysmatic bone cysts require combined and complex approaches. In spite of being benign, these lesions may cause neurological deficits depending on the location of the lesions. In cases of sufficient surgical treatment lesion control can be accomplished in most patients independent of lesions location (cervical, thoracic or lumbar). AD - J. Gempt, Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik und Poliklinik, München, Germany AU - Gempt, J. AU - Janssen, I. AU - Gerhardt, J. AU - Hüttinger, S. AU - Ryang, Y. M. AU - Ringel, F. AU - Meyer, B. DB - Embase DO - 10.1007/s00586-013-3050-8 KW - bone cement neoplasm surgery human patient hemangioma aneurysmal bone cyst injection pain artificial embolization bone destruction male female spinal cord tumor neurologic disease osteoblastoma benign neoplasm therapy kyphosis LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0940-6719 SP - 2661 ST - Surgical treatment of benign primary vertebral tumors T2 - European Spine Journal TI - Surgical treatment of benign primary vertebral tumors UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71283753&from=export http://dx.doi.org/10.1007/s00586-013-3050-8 VL - 22 ID - 829471 ER - TY - JOUR AD - Department of Surgery, Central Florida Cardiac and Vascular Institute, Osceola Regional Medical Center, Kissimmee, Florida. Electronic address: kgeorge@heartsurgery-csa.com. Health First, Holmes Regional Medical Center, Melbourne, Florida. AN - 25555963 AU - George, K. M. AU - Campbell, M. DA - Jan DO - 10.1016/j.athoracsur.2014.08.083 DP - NLM ET - 2015/01/06 J2 - The Annals of thoracic surgery KW - Aged, 80 and over Bone Cements/*adverse effects Foreign Bodies/*chemically induced *Heart Atria Humans *Kyphoplasty Male Methylmethacrylate/*adverse effects Postoperative Complications/*chemically induced LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 0003-4975 SP - 337 ST - Embolized methyl methacrylate to the right atrium after kyphoplasty T2 - Ann Thorac Surg TI - Embolized methyl methacrylate to the right atrium after kyphoplasty VL - 99 ID - 828518 ER - TY - JOUR AB - Introduction. Acrylic cement pulmonary embolism is a potentially serious complication following vertebroplasty. Case Report. A 70-year-old male patient was treated with percutaneous vertebroplasty for osteoporotic nontraumatic vertebral collapse of L5-S1. Asymptomatic pulmonary cement embolism was detected on routine postoperative chest radiogram and the patient was treated with enoxaparin, amoxicillin, and dexamethasone. At the followup CT scan no further migration of any cement material was reported; and the course was uneventful. Discussion. The frequency of local leakage of bone cement is relatively high (about 80-90%), moreover, the rate of cement leakage into the perivertebral veins (seen in up to 24% of vertebral bodies treated) with consequent pulmonary cement embolism varies from 4.6 to 6.8% (up to 26% in radiologic studies); the risk of embolism is increased with the liquid consistency of the cement and with the treatment of some malignant lesions. Patients may remain asymptomatic and develop no known long-term sequelae. Conclusions. Our ancedotal case illustrates the need for close monitoring of patients undergoing percutaneous vertebroplasty and emphasizes the importance of prompt and correct diagnosis and treatment, even if actually there is no agreement regarding the therapeutic strategy. AD - Section of General and Thoracic Surgery, University of Palermo, Via Liborio, Giuffrè 5, 90124 Palermo, Italy. AN - 23738182 AU - Geraci, G. AU - Lo Iacono, G. AU - Lo Nigro, C. AU - Cannizzaro, F. AU - Cajozzo, M. AU - Modica, G. C2 - Pmc3662203 DO - 10.1155/2013/591432 DP - NLM ET - 2013/06/06 J2 - Case reports in surgery LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 2090-6900 (Print) SP - 591432 ST - Asymptomatic bone cement pulmonary embolism after vertebroplasty: case report and literature review T2 - Case Rep Surg TI - Asymptomatic bone cement pulmonary embolism after vertebroplasty: case report and literature review VL - 2013 ID - 828615 ER - TY - JOUR AB - Fifty-four femoral neck fractures in young adults (20-50 years old; Group I) were compared with 397 fractures in the elderly population (older than 60 years of age; Group III). Patients in Group I were more frequently men and had often sustained vertical shear fractures in high-energy injuries. Treatment consisted mostly of open reduction and internal fixation (88%). There were no infections, pulmonary embolisms, or deaths. The rate of avascular necrosis was 10%; the rate of delayed union or nonunion, 17%; and the revision rate, 20%. Reoperation did not preclude an excellent final outcome. Patients in Group III were mostly women who fell at home and sustained an adduction fracture, which was most frequently (80%) treated with a cemented monopolar arthroplasty. Complications included pulmonary embolisms (3.5%), other cardiovascular complications (8%), and respiratory complications (7%). The death rate during hospitalization was 6.5%; for the first year after surgery it was 21%. These complications were not more frequent with either hemiarthroplasty or internal fixation. Local complications required revision of 17% of the cases treated with internal fixation and 1.4% of the patients treated with hemiarthroplasty. In the entire series, the deep infection rate without prophylactic antibiotics was 1.5%; with prophylactic systemic antibiotics it was 0.7%. The incidence of pulmonary embolism without thromboprophylaxis was 3.2%; with fixed-dose, subcutaneous heparin it was 1.1%. Of those treatments tested, open reduction and internal fixation with cancellous bone screws (for the younger patients) and hemiarthroplasty (for the elderly patients) yield the best short-to-midterm results. In addition, thromboprophylaxis with fixed-dose subcutaneous heparin and systemic antibiotic prophylaxis will continue to be used. AD - Department of Orthopaedic Surgery, University of Bern, Inselspital, Switzerland. AN - 8519139 AU - Gerber, C. AU - Strehle, J. AU - Ganz, R. DA - Jul DP - NLM ET - 1993/07/01 J2 - Clinical orthopaedics and related research KW - Adult Age Factors Aged Female Femoral Neck Fractures/classification/surgery/*therapy Follow-Up Studies Fracture Fixation, Internal/instrumentation Humans Male Middle Aged Postoperative Complications Reoperation Treatment Outcome LA - eng M1 - 292 N1 - PubMed NLM literature search January 5, 2021 PY - 1993 SN - 0009-921X (Print) 0009-921x SP - 77-86 ST - The treatment of fractures of the femoral neck T2 - Clin Orthop Relat Res TI - The treatment of fractures of the femoral neck ID - 829015 ER - TY - JOUR AB - Fifty-four femoral neck fractures in young adults (20-50 years old; Group I) were compared with 397 fractures in the elderly population (older than 60 years of age; Group III). Patients in Group I were more frequently men and had often sustained vertical shear fractures in high-energy injuries. Treatment consisted mostly of open reduction and internal fixation (88%). There were no infections, pulmonary embolisms, or deaths. The rate of avascular necrosis was 10%; the rate of delayed union or nonunion, 17%; and the revision rate, 20%. Reoperation did not preclude an excellent final outcome. Patients in Group III were mostly women who fell at home and sustained an adduction fracture, which was most frequently (80%) treated with a cemented monopolar arthroplasty. Complications included pulmonary embolisms (3.5%), other cardiovascular complications (8%), and respiratory complications (7%). The death rate during hospitalization was 6.5%; for the first year after surgery it was 21%. These complications were not more frequent with either hemiarthroplasty or internal fixation. Local complications required revision of 17% of the cases treated with internal fixation and 1.4% of the patients treated with hemiarthroplasty. In the entire series, the deep infection rate without prophylactic antibiotics was 1.5%; with prophylactic systemic antibiotics it was 0.7%. The incidence of pulmonary embolism without thromboprophylaxis was 3.2%; with fixed-dose, subcutaneous heparin it was 1.1%. Of those treatments tested, open reduction and internal fixation with cancellous bone screws (for the younger patients) and hemiarthroplasty (for the elderly patients) yield the best short-to-midterm results. In addition, thromboprophylaxis with fixed-dose subcutaneous heparin and systemic antibiotic prophylaxis will continue to be used. AD - UNIV BERN, INSELSPITAL, DEPT ORTHOPAED SURG, CH-3010 BERN, SWITZERLAND. AN - WOS:A1993LM05700010 AU - Gerber, C. AU - Strehle, J. AU - Ganz, R. DA - Jul J2 - Clin. Orthop. Rel. Res. KW - CANCELLOUS BONE SCREWS FOLLOW-UP FEMUR FIXATION PLATE Orthopedics Surgery LA - English M1 - 292 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1993 SN - 0009-921X SP - 77-86 ST - THE TREATMENT OF FRACTURES OF THE FEMORAL-NECK T2 - Clinical Orthopaedics and Related Research TI - THE TREATMENT OF FRACTURES OF THE FEMORAL-NECK UR - ://WOS:A1993LM05700010 ID - 830494 ER - TY - JOUR AB - Interventional radiology give us new ways to treat patients. In each country establishment of this disipline have it's especial strategy. Interventional radiology have been born in Imam khomeini University Hospital in Tehran. First deidcated interventional departement have been started from 1996. Stablishment of percutaneous laser dics decompression, vertebroplasty, vascular procedure including Uterine artery embolization, aortic stenting and neurointerventional procedures one by one have been done. Our strategy was: 1-Stablishing each new procedure that haven't done in country one by one. 2-Publishing our results after gathering enough cases. 3-Funding a research center “Avdance Diagnostic and Interventional Radiology Research Center” in Tehran University of Medical Sceinces. 4-Educational and research cooperation with moderen interventional departement of advanced countries. AD - H. Ghanaati, Tehran University of Medical Sciences, Iran AU - Ghanaati, H. DB - Embase KW - interventional radiology Iran Asia Pacific islands nuclear medicine procedures human percutaneous vertebroplasty university hospital decompression diagnosis laser stent uterine artery embolization publishing funding university patient L1 - http://irjnm.tums.ac.ir/?_action=showPDF&article=345&_ob=bbf7c91a9ee4e4899f669efd695f7006&fileName=full_text.pdf LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1681-2824 SP - 73 ST - Interventional radiology in Iran T2 - Iranian Journal of Nuclear Medicine TI - Interventional radiology in Iran UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70890175&from=export VL - 20 ID - 829569 ER - TY - JOUR AB - Introduction Vertebroplasty and kyphoplasty are considered treatments of choice for osteoporotic vertebral fractures and, in selected cases, even for pathological fractures due to primary or metastatic bone tumors. Both techniques make use of PMMA (poly-methylmethacrylate) cement. A new elastic polymer made by purified medical silicon (VK-100) was developed for both vertebroplasty and kyphoplasty. It is expected to be more biocompatible, decrease intraand post-operative complications (i.e. facture of the adjacent levels). The aim of the present work is to evaluate our preliminary results regarding the use of vertebroplasty with VK-100 for the treatment of osteoporotic and pathological vertebral fractures. Methods Twenty patients selected (14 females, 6 males) diagnosed with osteoporotic vertebral fractures or pathologic fractures. All patients were pre-operatively assessed with X-rays and MRI STIR sequences and evaluated with CT post-operatively and during followup. Age less than 55 and/or fractures above T5 were considered exclusion criteria. All patients received the same percutaneous treatment (elastoplasty) with VK-100 through a trans-pedicle access (20 cases). Results Average F.U. was 2 months (range 7-1). All patients reduced pain and were able to walk and stand in upright position post-operatively. No intra- nor post-operative complications (i.e. fractures of the adjacent vertebrae). Discussion Percutaneous vertebroplasty and kyphoplasty with PMMA are commonly used to treat osteoporotic vertebral fractures. Kyphoplasty provided the theoretical advantage to restore the height of the vertebral body and decrease cement leakage rates. Despite this we preferred vertebroplasty to kyphoplasty because the latter was not yet proved to be more effective being still more expensive. Conclusions Even if good results in terms of pain control and patient satisfaction were achieved, use of PMMA might have major complications such as increased adjacent level vertebral fracture rate, release of toxic monomers secondary to the exothermic polymerization reaction, peri-vertebral cement leakage and pulmonary embolism. The new elastic polymer (VK-100) is a great choice instead of PMMA because it allows the same vertebral augmentation efficacy in terms of pain control and functional ability restoration, without the risk of using PMMA. Especially VK-100 biomechanical characteristics (elastic modulus) is related to a decreased risk of adjacent level vertebral fracture. Results are encouraging and further studies can provide long-term results and validate the procedure. AD - R. Ghermandi, Istituto Ortopedico Rizzoli, Bologna, Italy AU - Ghermandi, R. AU - Gasbarrini, A. AU - De Iure, F. AU - Bosco, G. AU - Colangeli, S. AU - Girolami, M. AU - Boriani, S. DB - Embase DO - 10.1007/s10195-014-0316-9 KW - cement polymer silicon monomer methacrylic acid methyl ester orthopedics traumatology society spine fracture percutaneous vertebroplasty kyphoplasty human patient pain fracture postoperative complication pathologic fracture risk Young modulus lung embolism male female polymerization patient satisfaction vertebra body height vertebra standing bone metastasis follow up X ray procedures nuclear magnetic resonance imaging LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1590-9921 SP - S84 ST - VK-100 elastoplastic: New vertebral augmentation technique T2 - Journal of Orthopaedics and Traumatology TI - VK-100 elastoplastic: New vertebral augmentation technique UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71659998&from=export http://dx.doi.org/10.1007/s10195-014-0316-9 VL - 15 ID - 829402 ER - TY - JOUR AB - Background Context Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) are common problems after long-segment (>5 levels) thoracolumbar instrumented fusions in the treatment of adult spinal deformity (ASD). No specific surgical strategy has definitively been shown to lower the risk of PJK as the result of a multifactorial etiology. Purpose The study aimed to assess the incidence of PJK and PJF in patients treated with prophylactic polymethylmethacrylate (PMMA) cement augmentation at the uppermost instrumented vertebrae (UIV) and rostral adjacent vertebrae (UIV+1). Study Design/Setting This is a retrospective cohort-matched surgical case series at an academic institutional setting. Patient Sample Eighty-five adult patients over a 16-year enrollment period were identified with long-segment (>5 levels) posterior thoracolumbar instrumented fusions for ASD. Outcome Measures Primary outcomes measures were PJK magnitude and PJF formation. Secondary outcomes measures were spinopelvic parameters, as well as global and regional sagittal alignment. Methods The impact of adjunctive PMMA use in long-segment (≥5 levels) fusion for ASD was assessed in adult patients aged 18 and older. Patients were included with at least one of the following: lumbar scoliosis >20°, pelvic tilt >25°, sagittal vertical axis >5 cm, central sacral vertical line >2 cm, and thoracic kyphosis >60°. The frequency of PJF and the magnitude of PJK were measured radiographically preoperatively, postoperatively, and at maximum follow-up in controls (Group A) and PMMA at the UIV and UIV+1 (Group B). Results Eighty-five patients (64±11.1 years) with ASD were identified: 47 control patients (58±10.6) and 38 patients (71±6.8) treated with PMMA at the UIV and UIV+1. The mean follow-up was 27.9 and 24.2 months in Groups A and B, respectively (p=.10). Preoperative radiographic parameters were not significantly different, except the pelvic tilt which was greater in Group A (26.6° vs. 31.4°, p=.03). Postoperatively, the lumbopelvic mismatch was greater in Group B (14.6° vs. 7.9°, p=.037), whereas the magnitude of PJK was greater in controls (9.36° vs. 5.65°, p=.023). The incidence of PJK was 36% (n=17) and 23.7% (n=9) in Groups A and B, respectively (p=.020). The odds ratio of PJK with vertebroplasty was 0.548 (95% confidence interval=0.211 to 1.424). Proximal junctional kyphosis was observed in 6 (12.8%) controls only (p=.031). The UIV+1 angle, a measure of PJK, was significantly greater in controls (10.0° vs. 6.8°, p=.02). No difference in blood loss was observed. No complications were attributed to PMMA use. Conclusions The use of prophylactic vertebral cement augmentation at the UIV and rostral adjacent vertebral segment at the time of deformity correction appears to be preventative in the development of proximal junctional kyphosis and failure. AD - J.P. Gjolaj, Department of Orthopedic Surgery, University of Miami Miller School of Medicine, 1095 NW 14th Terrace (D4-6), Miami, FL, United States AU - Ghobrial, G. M. AU - Eichberg, D. G. AU - Kolcun, J. P. G. AU - Madhavan, K. AU - Lebwohl, N. H. AU - Green, B. A. AU - Gjolaj, J. P. DB - Embase Medline DO - 10.1016/j.spinee.2017.05.015 KW - Confidence Spinal System bone cement poly(methyl methacrylate) adult article case control study cohort analysis controlled study female follow up human incidence kyphosis lung embolism major clinical study male middle aged outcome assessment percutaneous vertebroplasty postoperative complication postoperative period priority journal proximal junctional failure proximal junctional kyphosis pseudarthrosis retrospective study spine disease spine fusion spine malformation surgical patient vertebra LA - English M1 - 10 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1878-1632 1529-9430 SP - 1499-1505 ST - Prophylactic vertebral cement augmentation at the uppermost instrumented vertebra and rostral adjacent vertebra for the prevention of proximal junctional kyphosis and failure following long-segment fusion for adult spinal deformity T2 - Spine Journal TI - Prophylactic vertebral cement augmentation at the uppermost instrumented vertebra and rostral adjacent vertebra for the prevention of proximal junctional kyphosis and failure following long-segment fusion for adult spinal deformity UR - https://www.embase.com/search/results?subaction=viewrecord&id=L617136927&from=export http://dx.doi.org/10.1016/j.spinee.2017.05.015 VL - 17 ID - 829236 ER - TY - JOUR AB - STUDY DESIGN: In vitro biomechanical investigation using human cadaveric vertebral bodies. OBJECTIVE: To evaluate differences in biomechanical stability of vertebral compression fractures (VCFs) repaired using an expandable titanium mesh implant, with and without cement, as compared with standard balloon kyphoplasty. SUMMARY OF BACKGROUND DATA: Vertebral augmentation, either in the form of vertebroplasty or kyphoplasty, is the treatment of choice for some VCFs. Polymethylmethacrylate, a common bone cement used in this procedure, has been shown to possibly cause injury to neural and vascular structures due to extravasation, embolization, and may be too rigid for an osteoporotic spine. Therefore, suitable alternatives for the treatment of VCFs have been sought. METHODS: Individual vertebral bodies from 5 human cadaveric spines (from T4 to L5) were stripped of all soft tissues, and compressed at 25% of the intact height using methods previously described. Vertebral bodies were then randomly assigned to the following repair techniques: (1) conventional kyphoplasty, (2) titanium implant with cement, (3) titanium implant without cement. All vertebral bodies were then recompressed at 25% of the repaired height. Yield load, ultimate load, and stiffness were recorded and compared in these groups before and after treatment. RESULTS: There were no differences in biomechanical data between intact groups, and between repaired groups. In all 3 treatment groups, yield load and ultimate load of repaired vertebrae were similar to that of intact vertebrae. However, the stiffness following repair was found to be statistically less than the stiffness of the intact vertebral body (P < 0.05 for all comparisons). CONCLUSION: Based on the biomechanical data, the titanium mesh implant with or without cement was similar to polymethylmethacrylate fixation by kyphoplasty in the treatment of VCFs. Avoiding the adverse effects caused by using cement may be the main advantage of the titanium mesh implant and warrants further study. AD - Department of Orthopaedic Surgery, University of California, San Diego, CA, USA. AN - 104912812. Language: English. Entry Date: 20110318. Revision Date: 20200708. Publication Type: Journal Article AU - Ghofrani, H. AU - Nunn, T. AU - Robertson, C. AU - Mahar, A. AU - Lee, Y. AU - Garfin, S. DB - cin20 DO - 10.1097/BRS.0b013e3181d260bf DP - EBSCOhost KW - Bone Cements -- Therapeutic Use Fractures, Compression -- Surgery Joint Instability -- Surgery Kyphoplasty -- Equipment and Supplies Kyphoplasty -- Methods Surgical Mesh -- Standards Titanium -- Therapeutic Use Aged Aged, 80 and Over Biomechanics -- Physiology Bone Cements -- Adverse Effects Bone Cements -- Standards Cadaver Female Human Joint Instability -- Physiopathology Joint Instability -- Prevention and Control Kyphoplasty -- Standards Male Outcome Assessment Methylmethacrylates -- Adverse Effects Methylmethacrylates -- Therapeutic Use Spinal Fractures -- Surgery M1 - 16 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2010 SN - 0362-2436 SP - E768-73 ST - An evaluation of fracture stabilization comparing kyphoplasty and titanium mesh repair techniques for vertebral compression fractures: is bone cement necessary? T2 - Spine (03622436) TI - An evaluation of fracture stabilization comparing kyphoplasty and titanium mesh repair techniques for vertebral compression fractures: is bone cement necessary? UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104912812&site=ehost-live&scope=site VL - 35 ID - 830707 ER - TY - JOUR AB - Intraprosthetic fracture of a femoral component is a rare but devastating complication after total hip arthroplasty (THA). We present the case of a 68-year-old man who presented with acute hip pain approximately 8 years after a left THA with a modern cementless, titanium femoral component. Radiographs revealed a fracture of the midportion of the neck of the stem, below the level of the trunnion. The patient underwent an isolated 1-component revision THA with a modular exchange. To our knowledge, this is the only reported case of a catastrophic failure fracture of this particular prosthesis. AD - E. Gibon, Division of Adult Reconstruction, Department of Orthopedics and Rehabilitation, University of Florida, 3450 Hull Road, Gainesville, FL, United States AU - Gibon, E. AU - Deen, J. T. DB - Embase DO - 10.1016/j.artd.2020.04.004 KW - cementless prosthesis hip stem osteotome C reactive protein titanium aged article body mass case report cerebrovascular accident clinical article comorbidity congestive heart failure erythrocyte count erythrocyte sedimentation rate femoral neck fracture follow up hemiplegia hip pain human lesser trochanter leukocyte count lung embolism male medical history neutrophil obesity paroxysmal atrial fibrillation passive movement physical examination preoperative care priority journal radiodiagnosis revision arthroplasty total hip replacement urinary tract infection Corail stem LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 2352-3441 SP - 176-179 ST - Fracture of the Neck of a Modern Cementless, Titanium Femoral Stem T2 - Arthroplasty Today TI - Fracture of the Neck of a Modern Cementless, Titanium Femoral Stem UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2005819594&from=export http://dx.doi.org/10.1016/j.artd.2020.04.004 VL - 6 ID - 829063 ER - TY - JOUR AB - $$graphic-{377E3A01-C8ED-4080-BCFF-E98E770FCB30}$$ Acrylic polymethyl methacrylate (PMMA) cement pulmonary embolism is a potentially life threatening complication seen after vertebroplasty. It is under recognized and patients often times fail to provide a history of the procedure. In addition, clinicians are not cognizant of potential complications from vertebroplasty. A case of pulmonary cement embolism is presented. The patient is a 91-year old female with a past medical history of hypertension, hyperlipidemia, peripheral vascular disease, and chronic back pain who presented to the Lung Nodule Clinic as a referral for 'abnormal imaging.' At the time of outpatient evaluation she has no complaints including shortness of breath, fever, or cough. Her past surgical history includes knee replacement and hernia repair. She denies pertinent social and family history. On physical examination, vital signs and physical are within normal limits. Recent outpatient labs show no gross abnormality. A representative image of a computed tomography (CT) scan of her chest is shown. Upon further questioning, she admitted to undergoing a vertebroplasty three years prior. Given this history and the imaging findings, she was deemed to have a pulmonary cement embolism. Due to lack of symptoms no further intervention was performed. Vertebroplasty is a common procedure for patients with vertebral pathology including compression fractures. The procedure is performed by mixing PMMA with tantalum (to increase radiopacity), which is then injected into a vertebral body under fluoroscopy. The injection of cement is stopped when epidural or paravertebral opacification is observed. The cement hardens quickly, stabilizing the fracture. The pathophysiology of pulmonary cement embolization involves early injection in the liquid phase resulting in accidental extravasation of bone cement into the valveless vertebral venous plexus. Other complications include cardiac perforation from cement material lodged in cardiac chambers and pulmonary hypertension. The incidence is though to be approximately 5%. Although the majority of patients with pulmonary cement embolization are asymptomatic, chest pain, shortness of breath, hypoxia can occur immediately after the procedure. More commonly the symptoms occur later, sometimes weeks or months after the procedure. Furthermore, at least six deaths have been reported due to pulmonary cement embolization. The cement may also induce a local inflammatory reaction at the vessel wall, leading to superimposed thrombosis on the surface of the cement and propagation of thrombus. Management options vary, ranging from observation to anticoagulation to embolectomy. In patients who have recently undergone vertebroplasty, clinicians should be cognizant of potential sequelae ranging from mild symptoms to death. (Figure Presented) . AD - K. Gill, UCSF (University of California San Francisco) Fresno, Fresno, CA, United States AU - Gill, K. AU - Upadhyay, D. DB - Embase KW - bone cement poly(methyl methacrylate) tantalum adverse drug reaction aged anticoagulation backache blood vessel wall case report clinical article complication compression fracture computer assisted tomography conference abstract coughing dyspnea embolectomy extravasation family history female fever fluoroscopy heart perforation hernioplasty human hyperlipidemia hypoxia incidence inflammation knee replacement lung embolism lung nodule outpatient patient referral percutaneous vertebroplasty peripheral vascular disease physical examination pulmonary hypertension side effect thorax pain vertebra body very elderly vital sign LA - English M1 - 9 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1535-4970 ST - An unusual case of a pulmonary vascular filling defect T2 - American Journal of Respiratory and Critical Care Medicine TI - An unusual case of a pulmonary vascular filling defect UR - https://www.embase.com/search/results?subaction=viewrecord&id=L630355433&from=export VL - 199 ID - 829143 ER - TY - JOUR AB - RATIONALE: Percutaneous vertebroplasty (PVP) is becoming the standard of care to relieve pain and augment bone strength of vertebral bodies involved in various conditions such as osteoporotic compression fractures. Polymethylmethacrylate cement ( a radio-opaque substance) leakage beyond the involved vertebral body into the venous system resulting in pulmonary embolism has been described as a complication mainly by case reports. Incidence of cement pulmonary embolism (CPE) (Fig 1) after PVP has been reported to vary between 1 to 4.6% in 2 studies. Data pertaining to incidence and prevalence of this complication is very limited. Although this procedure is widely practiced in the United States (estimated 700,000 a year osteoporosis related vertebral compression fractures), a dedicated study to evaluate the frequency and characteristics of this complication has not been done thus far. Moreover, previous studies had fewer numbers. METHODS: The purpose of this study was to determine the frequency, radiographic findings, and clinical charactersitics of cement pulmonary embolism occurring during PVP. RESULTS: We conducted a retrospective analysis of all patients who underwent PVP between June 2004 and June 2009. Demographic, Clinical and radiographic data were collected. Radiographic data were analyzed by two independent radiologists who were blinded to clinical data. 286 patients underwent 386 PVP procedures during this 5 year period. Mean age of patients was 79.45 +/- 10.88 (69.6% female and 30.4% male). of 286 patients, 113 had radiographic data to allow for analysis. 10 of the 113 (8.8%) patients were found to have clear cut evidence of CPE (9 identified on chest radiograph post PVP, 1 detected by fluoroscopy). 3 patients had high level of suspicion for CPE but deemed non-confirmatory. Only one patient was symptomatic. CPE was reported by radiologists in 3 instances prior to this study. Frequently, this finding was not reported. Please refer to Table-1 for findings pertaining to location of CPE. Previous studies have reported rib fractures as a common complication, although in our study, no rib fractures were encountered. (Table Presented) CONCLUSION: CPE is not a rare complication of PVP and occurred in 8.8% of patients. However, frequently it was asymptomatic. Routine post procedure chest radiograph after PVP may be indicated to further enhance the detection of this complication. AD - N.S. Gill, UCSF, Fresno, Fresno, CA, United States AU - Gill, N. S. AU - Hamidjaja, L. AU - Kandaswamy, C. AU - Venugopal, C. AU - Lesperance, R. AU - Balasubramanian, V. DB - Embase KW - cement povidone poly(methyl methacrylate) lung embolism percutaneous vertebroplasty procedures society human patient compression fracture rib fracture thorax radiography vertebra body radiologist fluoroscopy male clinical study female osteoporosis United States prevalence bone strength case report venous circulation telecommunication pain health care quality L1 - http://ajrccm.atsjournals.org/cgi/reprint/181/1_MeetingAbstracts/A1901?sid=d181b0fa-1a1b-4cb6-993b-dda8f2943527 LA - English M1 - 1 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 1073-449X ST - Incidence of cement pulmonary embolism after percutaneous vertebroplasty procedure T2 - American Journal of Respiratory and Critical Care Medicine TI - Incidence of cement pulmonary embolism after percutaneous vertebroplasty procedure UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70839367&from=export VL - 181 ID - 829668 ER - TY - JOUR AB - Vertebral hemangiomas (VHs) are very common radiological findings, and the majority of them are completely asymptomatic and harmless. However, although rarely, they can present as locally aggressive, symptomatic lesions, and requiring surgery. In these cases, early diagnosis and treatment are mandatory to avoid serious complications and invasive surgery; however, there is no consensus about the best therapeutic option. Minimally-invasive percutaneous techniques have recently gained interests as a therapeutic option. A case of a 58-year-old male with a symptomatic aggressive VH of L5 presenting with untractable low back and radicular pain without neurological deficits is reported. An early percutaneous procedure with selective embolization combined with biportal kyphoplasty of L5 was performed. No complications and a very low-intraoperative bleeding were reported. The patient has been monitored for the following 5 years with a good outcome and with no signs of recurrence. This case report highlights the importance of making the right diagnosis and the advantages of an early percutaneous treatment with selective embolization and augmentation to avoid major open surgery with high risks. AD - D. Compagnone, Piazza Ospedale Maggiore 3, Milan, Italy AU - Giorgi, P. AU - Compagnone, D. AU - Gallazzi, E. AU - Schirò, G. R. DB - Embase DO - 10.4103/jcvjs.JCVJS_31_20 KW - adult arteriography article artificial embolization bone atrophy bone biopsy case report clinical article computer assisted tomography fifth lumbar vertebra hemangioma human kyphoplasty low back pain lumbosacral spine male middle aged minimally invasive surgery nuclear magnetic resonance imaging numeric rating scale positron emission tomography-computed tomography priority journal radicular pain sciatica spine radiography surgical technique vertebra whole body CT LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 0976-9285 0974-8237 SP - 139-142 ST - Early percutaneous treatment of an aggressive vertebral hemangioma: A case report with a 5-year follow-up T2 - Journal of Craniovertebral Junction and Spine TI - Early percutaneous treatment of an aggressive vertebral hemangioma: A case report with a 5-year follow-up UR - https://www.embase.com/search/results?subaction=viewrecord&id=L632087564&from=export http://dx.doi.org/10.4103/jcvjs.JCVJS_31_20 VL - 11 ID - 829074 ER - TY - JOUR AB - Introduction: Pedicle screws’ stability, especially in osteoporotic fractures, is a really problem for spinal surgeons. Nowadays, little is known about the influence of different screw types and amount of cement applied. This single-center retrospective observational study has the aim of evaluating the middle- to long-term mechanical performances of different types of screws in elderly patients with thoracolumbar fractures. Materials and methods: A total of 91 patients (37 males and 54 females), treated between 2011 and 2016, affected by somatic osteoporotic fractures aged over 65 years were treated. We divided patients into three different populations: solid screws, cannulated screws and cannulated screws augmented with poly methyl methacrylate cement (PMMA). Patients were radiologically evaluated with X-rays in pre- and post-surgery and at the follow-up (FU). Clinical evaluations were made with VAS and Oswestry Disability Index. Results: A total of 636 screws were implanted (222 pedicle screws, 190 cannulated and 224 cannulated screws with PMMA augmentation). At FU, we found significative differences between populations in terms of mechanical performances. We founded five cases of loosening; these were reported in solid screws group and in cannulated screws one. No mechanical failures were reported in cannulated screws with augmentation of PMMA. No rods breakage cases were reported. Conclusion: All stabilization methods showed good clinical results, but cannulated screws augmented with PMMA seem to provide better implant stability with the lowest rate of loosening. Graphical abstract: These slides can be retrieved under Electronic Supplementary Material. [Figure not available: see fulltext.]. AD - M. Girardo, AOU Città della Salute e della Scienza di Torino, SC Chirurgia Vertebrale, Via Zuretti 29, Turin, Italy AU - Girardo, M. AU - Rava, A. AU - Fusini, F. AU - Gargiulo, G. AU - Coniglio, A. AU - Cinnella, P. DB - Embase Medline DO - 10.1007/s00586-018-5624-y KW - cannulated screw pedicle screw solid screw poly(methyl methacrylate) aged article biomechanics bladder disease claudication clinical evaluation controlled study embolism female follow up fragility fracture human long term care major clinical study male neurological complication observational study osteosynthesis Oswestry Disability Index population postoperative care priority journal retrospective study screw loosening spine fracture spine radiography thoracolumbar spine thoracolumbar vertebral fracture treatment duration visual analog scale wound dehiscence wound infection X ray LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1432-0932 0940-6719 SP - 198-205 ST - Different pedicle osteosynthesis for thoracolumbar vertebral fractures in elderly patients T2 - European Spine Journal TI - Different pedicle osteosynthesis for thoracolumbar vertebral fractures in elderly patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L622162153&from=export http://dx.doi.org/10.1007/s00586-018-5624-y VL - 27 ID - 829192 ER - TY - JOUR AB - OBJECTIVE: Vertebral hemangiomas (VHs) are the most common incidental lesions of vertebral body, but they are very challenging to treat if they become symptomatic. Several treatments have been proposed hut none was superior to others. The aim of this study is to analyze blood loss and long-term clinical and neurological results of aggressive VHs treated with arterial embolization the day before operation, followed by vertebroplasty, posterior decompression, and short segment stabilization. METHODS: Ten patients (4 males and 6 females) were treated for aggressive VHs with polyvinyl alcohol microparticles embolization, posterior short segment stabilization, and poly methyl methacrylate. Clinical and neurological outcomes were assessed with visual analog, Nurick, and American Spinal Injury Association (ASIA) scales. RESULTS: At last follow-up mean, visual analog scale was 1.8 +/- 1.3, with a significant difference with preoperative values (P = 0.00018). Neurological deficits persisted in 4 patients (ASIA scale: C in 1 patient [10%], D in 3 patients [30%]), but they improved from baseline in all cases. Also, Nurick scale rating improved in all patients (0 in 3 patients [30%], 1 in 4 patients [40%], 2 in 2 patients [20%], and 3 in the last one [10%]). A statistically significant difference between pre- and postoperative values was observed for both scores (ASIA, P = 0.0102; Nurick, P = 0.026). Relapse of pathology was recorded in 2 patients. CONCLUSIONS: Polyvinyl alcohol microparticles embolization, short segment fixation, and vertebroplasty is an effective treatment option for aggressive VHs, with a fast surgical time, poor blood loss, and improvement of preoperative clinical and neurological outcomes. AD - [Girardo, Massimo; Bruno, Laura Lorien] Univ Turin, Spine Surg Unit, Orthopaed & Trauma Ctr, Citta Salute & Sci Torino, Turin, Italy. [Zenga, Francesco] Molinette Mauriziano Hosp, Citta Salute & Sci Torino, Dept Neurosurg, Turin, Italy. [Rava, Alessandro; Masse, Alessandro; Fusini, Federico] Univ Turin, Citta Salute & Sci Torino, Dept Orthopaed & Traumatol, Orthopaed & Trauma Ctr, Turin, Italy. [Maule, Milena] Univ Turin, Dept Med Sci, Canc Epidemiol Unit, Turin, Italy. Rava, A (corresponding author), Univ Turin, Citta Salute & Sci Torino, Dept Orthopaed & Traumatol, Orthopaed & Trauma Ctr, Turin, Italy. dralessandrorava@gmail.com AN - WOS:000475895100032 AU - Girardo, M. AU - Zenga, F. AU - Bruno, L. L. AU - Rava, A. AU - Masse, A. AU - Maule, M. AU - Fusini, F. DA - Aug DO - 10.1016/j.wneu.2019.04.138 J2 - World Neurosurg. KW - Decompression Hemangioma Pedicle screw Poly-methyl-methacrylate Poly-vinyl alcohol PERCUTANEOUS VERTEBROPLASTY CEMENT AUGMENTATION ETHANOL EMBOLIZATION SURGICAL-TREATMENT PEDICLE SCREW KYPHOPLASTY MANAGEMENT INSTRUMENTATION DECOMPRESSION FRACTURES Clinical Neurology Surgery LA - English M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 1878-8750 SP - E283-E288 ST - Treatment of Aggressive Vertebral Hemangiomas with Poly Vinyl Alcohol (PVA) Microparticles Embolization, PMMA, and Short Segment Stabilization: Preliminary Results with at Least 5 Years of Follow-up T2 - World Neurosurgery TI - Treatment of Aggressive Vertebral Hemangiomas with Poly Vinyl Alcohol (PVA) Microparticles Embolization, PMMA, and Short Segment Stabilization: Preliminary Results with at Least 5 Years of Follow-up UR - ://WOS:000475895100032 VL - 128 ID - 830131 ER - TY - JOUR AB - OBJECTIVE: Vertebral hemangiomas (VHs) are the most common incidental lesions of vertebral body, but they are very challenging to treat if they become symptomatic. Several treatments have been proposed but none was superior to others. The aim of this study is to analyze blood loss and long-term clinical and neurological results of aggressive VHs treated with arterial embolization the day before operation, followed by vertebroplasty, posterior decompression, and short segment stabilization. METHODS: Ten patients (4 males and 6 females) were treated for aggressive VHs with polyvinyl alcohol microparticles embolization, posterior short segment stabilization, and poly methyl methacrylate. Clinical and neurological outcomes were assessed with visual analog, Nurick, and American Spinal Injury Association (ASIA) scales. RESULTS: At last follow-up mean, visual analog scale was 1.8 ± 1.3, with a significant difference with preoperative values (P = 0.00018). Neurological deficits persisted in 4 patients (ASIA scale: C in 1 patient [10%], D in 3 patients [30%]), but they improved from baseline in all cases. Also, Nurick scale rating improved in all patients (0 in 3 patients [30%], 1 in 4 patients [40%], 2 in 2 patients [20%], and 3 in the last one [10%]). A statistically significant difference between pre- and postoperative values was observed for both scores (ASIA, P = 0.0102; Nurick, P = 0.026). Relapse of pathology was recorded in 2 patients. CONCLUSIONS: Polyvinyl alcohol microparticles embolization, short segment fixation, and vertebroplasty is an effective treatment option for aggressive VHs, with a fast surgical time, poor blood loss, and improvement of preoperative clinical and neurological outcomes. AD - Spine Surgery Unit, Orthopaedic and Trauma Centre, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy. Department of Neurosurgery, Molinette Hospital, Città della Salute e della Scienza di Torino, Turin, Italy. Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy. Electronic address: dralessandrorava@gmail.com. Department of Orthopaedic and Traumatology, Orthopaedic and Trauma Centre, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy. Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy. AN - 31028979 AU - Girardo, M. AU - Zenga, F. AU - Bruno, L. L. AU - Rava, A. AU - Massè, A. AU - Maule, M. AU - Fusini, F. DA - Aug DO - 10.1016/j.wneu.2019.04.138 DP - NLM ET - 2019/04/28 J2 - World neurosurgery KW - Adult Aged Blood Loss, Surgical Bone Cements/*therapeutic use Decompression, Surgical/methods Embolization, Therapeutic/*methods Female Follow-Up Studies Hemangioma/*therapy Humans Male Middle Aged Operative Time Pedicle Screws Polymethyl Methacrylate/*therapeutic use Polyvinyl Alcohol/therapeutic use Spinal Neoplasms/*therapy Vertebroplasty/*methods Young Adult Decompression Hemangioma Pedicle screw Poly-methyl-methacrylate Poly-vinyl alcohol LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 1878-8750 SP - e283-e288 ST - Treatment of Aggressive Vertebral Hemangiomas with Poly Vinyl Alcohol (PVA) Microparticles Embolization, PMMA, and Short Segment Stabilization: Preliminary Results with at Least 5 Years of Follow-up T2 - World Neurosurg TI - Treatment of Aggressive Vertebral Hemangiomas with Poly Vinyl Alcohol (PVA) Microparticles Embolization, PMMA, and Short Segment Stabilization: Preliminary Results with at Least 5 Years of Follow-up VL - 128 ID - 828606 ER - TY - JOUR AB - Objective: The goal of spinal deformity surgery is to reestablish a physiologic sagittal profile of the spine. If large angles of correction are needed, osteotomies are applied, but often associated with significant complications. We present our results of pedicle subtraction osteotomies (PSO) in older patients with degenerative or iatrogenic sagittal imbalance. Methods: Retrospective analysis of 17 patients (n=13 female), divided into two groups who underwent a PSO at our institution: Group A received a thoracolumbar instrumentation (n=8, 6-11 segments with iliac screws) and group B a short fusion (n=9, 4-6 segments without iliac screws). Included were patients with iatrogenic (Group A n=7/ group B n=7) and degenerative ( Group A n=3/ Group B n=2) sagittal imbalance with a mean age of 66 years (53-77), ASA score 3 (n=13) and 2 (n=4). Examined were demographic data, ASA score, symptoms and outcome (pain on VAS, walking distance, etc.) and radiologic parameters [lumbar lordosis (LL), C7 plumb-line measured to the femoral-heads-axis (FHA), pelvic tilt (PT), pelvic incidence (PI)] were investigated pre- and postoperatively, details of surgery and complications. Results: The PSO was performed in group A at TH 12 (n=1), L1 (n=2), L3 (n=3) and L4 (n=5) with three patients receiving twolevel PSOs. In Group B L2 (n=1), L3 (n=3) and L4 (n=5) two patients received additionally a Smith-Peterson osteotomy. In two cases an asymmetric PSO was necessary. Follow-up was 25±11.5 months in Group A and 11±4.6 months in group B. Preoperatively the LL in group A amounted 19.8° (SD23.8°) in group B 16.3° (SD12.3°), the pelvic incidence group A was 59.9° (SD 11.8°), group B 54.6° (SD 6°) the C7 plumb-line was located 76.7mm (SD 49.4mm) group A and 48.4mm(SD49.2mm) group B in front oft the FHA. Postoperative LL improved to 59.1°(SD 9.3°) in group A (p=0,01) and 47.2°(SD 6.6°) in group B (P<0.0001).C7 plumb-line was corrected to -2.2mm(SD 38.4mm)(p<0.0001) in group A and -2mm (SD 22.3mm)(p=0.01) in group B behind the FHA. At final follow-up pain improved dramatically from VAS 9.3 to 3.4(p<0.0001) in group A, 7.8 to 2.4 (p=0.002) in group B and walking distance in group A about 720m (p=0.03) in group B about 3200m (p=0.01). The mean surgery time was in group A 491min (SD 35.9 min) in group B 410min (SD 78.9min). The perioperative complication rate amounted in group A to 50% (deep wound-infection n=2, embolic infarction n=1, 30 days mortality n=1), in group B only 11% with one new radicular deficit (mild foot paresis). In two cases from patient group A re-surgery was necessary because of screw-loosening and kyphotic junctional fracture one year postoperative. In group B one patient needed a vertebroplastie due to a trauma related osteoporotic fracture 3 months post op. Conclusion: The correction of adult deformity can be achieved adequately by PSO. Lumbar lordosis can be reestablished with surprisingly good clinical outcome. Perioperative complications, however, are common in this old and comorbid population, nevertheless we noticed a decrease of complications in short constructs (4-6 segments) without pelvic fixation and higher patient satisfaction. AD - P.-P. Girod, Medizinische Universität Innsbruck, Neurochirurgie, Innsbruck, Austria AU - Girod, P. P. AU - Ortler, M. AU - Kavakebi, P. AU - Örley, A. AU - Hartmann, S. AU - Thomé, C. DB - Embase DO - 10.1007/s00586-014-3600-8 KW - nitrogen 13 deformity devices pelvis adult human patient surgery osteotomy peroperative complication pain walking lordosis follow up female spine malformation population fragility fracture patient satisfaction femoral head fracture spine screw loosening parameters paresis mortality infarction wound infection injury LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 0940-6719 SP - 2517 ST - Clinical and radiological outcome of pedicle subtractionosteotomy (PSO) to correct sagittal balance in adult deformity-long thoracolumbar instrumentation with pelvic fixation versus short fusion without iliac screws T2 - European Spine Journal TI - Clinical and radiological outcome of pedicle subtractionosteotomy (PSO) to correct sagittal balance in adult deformity-long thoracolumbar instrumentation with pelvic fixation versus short fusion without iliac screws UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71815596&from=export http://dx.doi.org/10.1007/s00586-014-3600-8 VL - 23 ID - 829403 ER - TY - JOUR AB - INTRODUCTION: Vertebral haemangiomas are a common incidental finding and are largely asymptomatic. Extensive haemangiomas of the spine causing neurological deficits are exceedingly rare. Traditional open surgical approaches in these cases can be complicated by life-threatening blood loss. PATIENT CASE HISTORY: We describe 2 patients (ages 27 and 53 years) who presented with severe back pain and lower limb weakness. Radiological investigations revealed very extensive lesions of the L1 and L4 vertebral bodies, respectively, with severe narrowing of the lumbar canal. After selective embolisation of the spinal arterial feeders, both patients underwent a posterior decompression, vertebroplasty, and bilateral pedicle screw fixation in a minimally invasive fashion. Blood loss was minimal and a rapid clinical recovery was seen. CONCLUSIONS: Combinations of embolisation, vertebroplasty and minimally invasive posterolateral instrumentation are treatment strategies that can be used to treat extensive vertebral haemangiomas presenting with neurological deficits. AD - Department of Neurosurgery, Greater Manchester Neurosciences Centre, Salford Royal Foundation Trust, Manchester, UK. kanna.gnanalingham@srft.nhs.uk AN - 21302198 AU - Gnanalingham, K. K. AU - Afridi, M. B. AU - Abou-Zeid, A. AU - Herwadkar, A. DA - Oct DO - 10.1055/s-0030-1267925 DP - NLM ET - 2011/02/09 J2 - Minimally invasive neurosurgery : MIN KW - Adult Bone Screws Decompression, Surgical Hemangioma/*surgery Humans Lumbar Vertebrae/*surgery Male Middle Aged Minimally Invasive Surgical Procedures Spinal Fusion/instrumentation Spinal Neoplasms/*surgery Treatment Outcome Vertebroplasty LA - eng M1 - 5-6 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 0946-7211 SP - 275-8 ST - Minimally invasive decompression and stabilisation for extensive haemangiomas of lumbar spine T2 - Minim Invasive Neurosurg TI - Minimally invasive decompression and stabilisation for extensive haemangiomas of lumbar spine VL - 53 ID - 828884 ER - TY - JOUR AB - Introduction: Femoral impaction bone allografting in revision hip arthroplasty offers the most physiological reconstruction option for restoration of bone stock. It also allows for implantation of a standard cemented component. Objectives: We report early experience with impaction morselised cancellous bone allograft using custom impactors in femoral component revision hip arthroplasty using a cemented triple-taper polished stem (Depuy C-Stem). Methods: Cases of femoral impaction bone grafting with implantation of a Depuy C-stem were retrospective analysed from all femoral component revision hip arthroplasty undertaken by a single surgeon over a 5 year period. Outcome measures included radiographic analysis of component stability, bone remodelling, graft incorporation, and stem subsidence over time, as well as clinical progress. Results: 49 consecutive hips in 46 patients, mean age 63 years (37-94), had femoral impaction bone allograft as either 1 stage (42 cases) or two stage (7 cases) procedure. All patients received cemented C-stem prosthesis. The mean follow-up period was 2.4 years (0.4 to 5.8). The median preoperative bone defect score was 3 (interquartile range (IQR) 2 to 3) using the Endo-Klinik classification. Median radiographic graft incorporation score at last follow up was 2 (IQR 2 to 3) using the scoring system described by Gie et al. Median subsidence at last postoperative follow-up was 1 mm (IQR 0 to 1.5). There was no radiological sign of component loosening. Significant postoperative complications for all causes occurred in 3 patients, including 2 dislocations, and 1 pulmonary embolus. Intraoperative femoral perforation of compacted allograft occurred in 2 cases. 2 patients died within 1 year of follow-up. Conclusions: Encouraging early results have been obtained with allogenic impaction bone graft and a cemented C-stem prosthesis for the treatment of significant bone loss in revision hip arthroplasty. AD - T. Goff, Academic Department of Trauma and Orthopaedics, Leeds, United Kingdom AU - Goff, T. AU - Graham, S. AU - Bobak, P. DB - Embase DO - 10.5301/HIP.2012.9524 KW - bone cemented prosthesis hip arthroplasty European hip society experience human follow up patient bone allograft implantation prosthesis surgeon bone defect bone transplantation osteolysis bone graft classification scoring system allograft perforation lung embolism procedures bone remodeling postoperative complication trabecular bone L1 - http://www.hip-int.com/article/-abstracts-from-the-10th-congress-of-the-european-hip-society LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1120-7000 SP - 414 ST - Early experience with impaction femoral bone allografting with a standard cemented prosthesis for revision hip arthroplasty T2 - HIP International TI - Early experience with impaction femoral bone allografting with a standard cemented prosthesis for revision hip arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71960060&from=export http://dx.doi.org/10.5301/HIP.2012.9524 VL - 22 ID - 829559 ER - TY - JOUR AB - Introduction: Femoral impaction bone allografting in revision hip arthroplasty facilitates physiological reconstruction with restoration of bone stock, allowing implantation of a standard cemented femoral component. The purpose of this study was to report our experience in femoral component revision arthroplasty with impaction morsellised cancellous bone allograft using custom impactors and a cemented triple-taper polished stem. Methods: Retrospective analysis of all cases of femoral component revision hip arthroplasty with impaction bone grafting undertaken by a single surgeon from 2005 to 2011. Outcome measures included radiographic analysis of stem subsidence over time, graft remodelling and incorporation, and clinical progress. Results: We reviewed 47 consecutive hips in 44 patients, mean age 62 years (37-88). Femoral impaction with allograft was performed as either single stage (41 cases) or 2-stage (6 cases) procedures. All patients received a cemented C-stem prosthesis. The mean follow-up period was 5.1 (1.3-9.4) years. The median preoperative bone defect score was 3 (interquartile range [IQR] 2-3) using the Endo-Klinik classification. Radiological evidence of graft incorporation was observed in 89% (281 of 315 zones) with additional remodelling observed in 33% (103 of 315 zones). The median stem subsidence at 1-year follow-up was 1.1 mm (standard deviation [SD] 1.24 mm, range 0-6 mm). The median Oxford Hip Score at the most recent follow-up was 36.5. To date no femoral component has undergone further revision. Conclusions: Encouraging results have been obtained with this technique for the treatment of significant bone loss in revision hip arthroplasty, allowing implantation of a standard prosthesis. AD - T.A.J. Goff, Leeds General Infirmary, Great George Street, Leeds, United Kingdom AU - Goff, T. A. J. AU - Bobak, P. DB - Embase Medline DO - 10.5301/hipint.5000438 KW - adult aged article bone allograft bone radiography bone remodeling clinical article female follow up hematoma hip arthroplasty hip dislocation hip prosthesis human lung embolism male osteolysis Oxford Hip Score perforation postoperative complication prosthesis implantation retrospective study revision arthroplasty visual analog scale LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1120-7000 SP - 281-285 ST - Femoral impaction allografting for significant bone loss in revision hip arthroplasty T2 - HIP International TI - Femoral impaction allografting for significant bone loss in revision hip arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L616333823&from=export http://dx.doi.org/10.5301/hipint.5000438 VL - 27 ID - 829276 ER - TY - JOUR AB - Third generation cementing techniques using intramedullary restrictors, low porosity cement with pressurization, lavage, and cement-stem bond enhancement do not prevent implant malalignment and inadequate cement mantle thickness. This has led to the development of modular proximal and distal centralizers to control the alignment of the femoral component and maintain an adequate thickness of the cement, thereby theoretically decreasing the rate of aseptic loosening. A retrospective analysis was performed of 100 primary cemented centralized femoral components. At an average followup of 5.7 years (range, 4-8 years), the average Harris Hip Score was 90. There were no cases of aseptic loosening, osteolysis, or impending failure. Ninety-one percent of femoral stems were implanted with satisfactory alignment with an optimal cement thickness. However, six distal centralizers and one proximal centralizer fractured at the time of insertion and voids frequently were seen in and around the distal centralizer. Although centralizers improve prosthesis alignment and cement mantle thickness, the long term effects of centralizer fracture and distal cement voids need to be observed to determine if centralizers improve previous implant survival. AD - B.A. Goldberg, Barnhart Dept. of Orthopedic Surgery, Baylor College of Medicine, 6550 Fannin, Houston, TX 77030, United States AU - Goldberg, B. A. AU - Al-Habbal, G. AU - Noble, P. C. AU - Paravic, M. AU - Liebs, T. R. AU - Tullos, H. S. DB - Embase Medline DO - 10.1097/00003086-199804000-00020 KW - azathioprine cyclosporine immunosuppressive agent prednisone adult aged article deep vein thrombosis endoprosthesis loosening female hip dislocation hip prosthesis hip radiography human immunosuppressive treatment kidney transplantation lung embolism major clinical study male osteoarthritis postoperative complication postoperative infection priority journal total hip prosthesis treatment outcome Precision Hip System LA - English M1 - 349 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1998 SN - 1528-1132 0009-921X SP - 163-173 ST - Proximal and distal femoral centralizers in modern cemented hip arthroplasty T2 - Clinical Orthopaedics and Related Research TI - Proximal and distal femoral centralizers in modern cemented hip arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L28196560&from=export http://dx.doi.org/10.1097/00003086-199804000-00020 ID - 829910 ER - TY - JOUR AD - Radiologists at University Hospital Morales Meseguer, Murcia, Spain AN - 133066650. Language: English. Entry Date: 20181121. Revision Date: 20190514. Publication Type: Article AU - González, Carmen M. Botía AU - Martínez, Juana M. Plasencia AU - Romero, Alba Patricia Solano AU - Belmonte, María Jesús Gayán DB - cin20 DP - EBSCOhost KW - Pulmonary Embolism -- Diagnosis Pulmonary Embolism -- Surgery Bone Cements -- Adverse Effects Postoperative Complications Male Aged Dyspnea Immobilization Electrocardiography Radiography, Thoracic Computed Tomography Angiography Embolectomy M1 - 11 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2018 SN - 0160-9963 SP - 34-35 ST - Multiple bilateral pulmonary cement emboli T2 - Applied Radiology TI - Multiple bilateral pulmonary cement emboli UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=133066650&site=ehost-live&scope=site VL - 47 ID - 830542 ER - TY - JOUR AB - Introduction: With an aging population, 75,000-100,000 kyphoplasties are done yearly in the U.S. Pain relief and early mobilization are advantages over prior therapies. Perceived as relatively low-risk, most complications are minor and transient with little or no clinical consequence. This case describes a common complication, with catastrophic results. Clinical Scenario: A 79-year-old female with PMH of HBP, afib, prior DVT, and multiple compression fractures presented to the ER with a 2-3 week history of progressive dyspnea and subjective fevers without cough. She had no prior history of CHF or COPD. Multiple myeloma, stage 3 with bony involvement, was diagnosed two months prior. After a round of chemo, she was severely anemic and required transfusion. A previously prescribed NOAC was discontinued. Six weeks prior to the ER visit, she underwent kyphoplasty for vertebral fracture; her pain improved. On admission, she was hypoxic (78% on RA), tachycardic, tachypneic, in mild distress. BP was maintained. Lungs were clear. Temp was 99.9F. WBCs were 3.7; hemoglobin 8.9. CXR suggested CHF; CT thorax showed a RUL cavitary lesion read as organizing abscess, as well as multiple b/l densities consistent with MMA cement emboli. Blood cultures grew MSSA; Ancef was started. Her dyspnea increased and AKI developed. Hypotension required pressors; seizures followed, as did multi-organ system failure and intubation. Oncology recommended hospice. Palliative care (PC) was consulted to discuss goals of care with her family. Code status changed to DNR/DNI and life-sustaining measures were withdrawn. She died shortly thereafter. Discussion: The most common serious complication of kyphoplasty is cardiac perforation from cement emboli. Pulmonary MMA emboli have been reported in 4.6-26% of kyphoplasty patients. Most are asymptomatic, usually an incidental finding on imagining done for other reasons. This patient's catastrophic course from her MMA emboli was unusual; her immunocompromised state likely contributed. Important is the value of the PC consult for the patient, the family, and the healthcare system at large. PC consults facilitate communication between specialists, improve a stressful patient/family experience, can reduce the length of stay, and may lower the cost of health care. AD - J. Gonzalez, Family Medicine-Geriatric Fellowship Program, University of Arizona, College of Medicine Phoenix, Sun City, AZ, United States AU - Gonzalez, J. AU - Guthrie, R. AU - Ceimo, J. AU - Nieri, W. DB - Embase DO - 10.1111/imj.13426 KW - cefazolin cement endogenous compound hemoglobin abscess adverse drug reaction aged anemia blood culture case report chronic obstructive lung disease complication compression fracture coughing diagnosis distress syndrome doctor patient relationship drug therapy drug withdrawal dyspnea embolism family study female fever health care system heart perforation hospice human hypotension incidental finding intubation kyphoplasty length of stay multiple myeloma oncology organ pain palliative therapy seizure side effect tachycardia thorax LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 0002-8614 SP - S160 ST - A surprisingly common complication with an uncommon outcome T2 - Journal of the American Geriatrics Society TI - A surprisingly common complication with an uncommon outcome UR - https://www.embase.com/search/results?subaction=viewrecord&id=L616115801&from=export http://dx.doi.org/10.1111/imj.13426 VL - 65 ID - 829255 ER - TY - JOUR AB - BACKGROUND: Several hemostatic treatments intended to reduce the bleeding associated to total knee arthroplasty have been investigated with varying degrees of success. TT‐173 is a new topical agent based on recombinant tissue factor that activates the extrinsic pathway of coagulation. This trial aim is to evaluate the efficacy and safety of TT‐173 in total knee arthroplasty. METHODS/DESIGN: This is a phase II/III, sequential, simple blind, randomized, multicenter, placebo controlled and parallel clinical trial that will recruit 189 evaluable patients. Those randomized to treatment group will receive 2mg of TT‐173 over the surgical surfaces of the knee. Control patients will receive physiologic saline. The follow up will consist in 6 visits during a period of 35 (±7) days. Primary endpoints will be the total blood loss and the incidence and severity of adverse events. Secondary and exploratory endpoints will include drainage production, decrease in hemoglobin level, transfusion ratio, analytical alterations, pain intensity, motion range, immunogenicity of TT‐173 and the occurrence of systemic absorption. At the end of phase II, results will be evaluated by an independent committee that will recommend the continuation or the discontinuation of the trial. DISCUSSION: The design proposed maximizes the safety of the participants, avoids the risk of bias derived from the limitations of masking and enable the eventual discontinuation of the trial if this is recommended by the Interim Analysis Committee. If TT‐173 proves its efficacy and safety in this indication, it would become a useful tool to improve the bleeding control in total knee arthroplasty. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02687399. Registered the 9th of February 2016. AN - CN-01394813 AU - Gonzalez-Osuna, A. AU - Videla, S. AU - Cánovas, E. AU - Urrútia, G. AU - Rojas, S. AU - López, R. AU - Murat, J. AU - Aguilera, X. DO - 10.1016/j.cct.2017.07.004 KW - *drug absorption *drug efficacy *drug safety *hemostatic agent/cm [Drug Comparison] *hemostatic agent/ct [Clinical Trial] *hemostatic agent/pk [Pharmacokinetics] *immunogenicity *total knee arthroplasty *tt 173/cm [Drug Comparison] *tt 173/ct [Clinical Trial] *tt 173/pk [Pharmacokinetics] Abciximab/po [Oral Drug Administration] Acetylsalicylic acid/po [Oral Drug Administration] Arthroplasty, Replacement, Knee [*methods] Article Blood transfusion Cemented prosthesis Clopidogrel/po [Oral Drug Administration] Controlled study Dipyridamole/po [Oral Drug Administration] Disease severity Follow up Hemoglobin blood level Hemoglobin/ec [Endogenous Compound] Hemostasis, Surgical [*methods] Hemostatics [*therapeutic use] Human Humans Incidence Knee prosthesis Low molecular weight heparin Lung embolism/pc [Prevention] Major clinical study Multicenter study Operative blood loss Pain intensity Parallel design Phase 2 clinical trial Phase 3 clinical trial Placebo Postoperative complication/pc [Prevention] Randomized controlled trial Range of motion Research Design Single blind procedure Single‐Blind Method Thromboplastin [*therapeutic use] Triflusal/po [Oral Drug Administration] Unclassified drug M3 - Clinical Trial, Phase II; Clinical Trial, Phase III; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2017 SP - 16‐22 ST - HESTAT: study protocol for a phase II/III, randomized, placebo-controlled, single blind study to evaluate the new hemostatic agent TT-173 in total knee arthroplasty T2 - Contemporary clinical trials TI - HESTAT: study protocol for a phase II/III, randomized, placebo-controlled, single blind study to evaluate the new hemostatic agent TT-173 in total knee arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01394813/full VL - 61 ID - 830093 ER - TY - JOUR AD - Department of Radiology, Ramón y Cajal University Hospital, Madrid, Spain luisgorospe@yahoo.com. Department of Hematology, Ramón y Cajal University Hospital, Madrid, Spain. AN - 25378662 AU - Gorospe, L. AU - Blanchard-Rodríguez, M. J. AU - Chinea-Rodríguez, A. DA - May DO - 10.1177/0218492314558521 DP - NLM ET - 2014/11/08 J2 - Asian cardiovascular & thoracic annals KW - Bone Cements/*adverse effects Female Foreign-Body Migration/diagnostic imaging/*etiology Humans Middle Aged Multiple Myeloma/*complications/diagnosis Pulmonary Embolism/diagnostic imaging/*etiology Spinal Fractures/diagnosis/etiology/*surgery Tomography, X-Ray Computed Vertebroplasty/*adverse effects LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 0218-4923 SP - 400-1 ST - Cement pulmonary embolism after percutaneous vertebroplasty in multiple myeloma T2 - Asian Cardiovasc Thorac Ann TI - Cement pulmonary embolism after percutaneous vertebroplasty in multiple myeloma VL - 24 ID - 828869 ER - TY - JOUR AB - An 81-year-old woman who had undergone total hip arthroplasty 12 years earlier presented with a painful spontaneous hematoma in the proximal left thigh. A left hip radiograph showed a displaced cement fragment from the acetabular component of the hip prosthesis. Computed tomography confirmed an extruded cement fragment causing a large pseudoaneurysm of the deep femoral artery. The patient underwent successful percutaneous embolization of the pseudoaneurysm with coils. AD - 1 Department of Radiology, Ramón y Cajal University Hospital, Madrid, Spain. 2 Department of Radiology, La Milagrosa Hospital, Madrid, Spain. 3 Department of Radiology, La Paz University Hospital, Madrid, Spain. AN - 28906135 AU - Gorospe, L. AU - Tobío-Calo, R. AU - Rodríguez-Díaz, R. AU - Gómez-Barbosa, C. F. AU - García Gómez-Muriel, I. AU - García-Latorre, R. DA - Nov DO - 10.1177/0218492317732251 DP - NLM ET - 2017/09/15 J2 - Asian cardiovascular & thoracic annals KW - Aged, 80 and over Aneurysm, False/diagnostic imaging/*etiology/therapy Angiography, Digital Subtraction Arthroplasty, Replacement, Hip/*adverse effects Bone Cements/*adverse effects Computed Tomography Angiography Embolization, Therapeutic/instrumentation Female *Femoral Artery/diagnostic imaging Foreign-Body Migration/diagnostic imaging/*etiology/therapy Humans Time Factors Treatment Outcome Aneurysm Arthroplasty Bone cement Femoral artery Foreign-body migration Hematoma false hip replacement LA - eng M1 - 9 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 0218-4923 SP - 633-634 ST - Cement fragment from hip arthroplasty causing deep femoral artery pseudoaneurysm T2 - Asian Cardiovasc Thorac Ann TI - Cement fragment from hip arthroplasty causing deep femoral artery pseudoaneurysm VL - 25 ID - 828502 ER - TY - JOUR AD - Servicio de Radiodiagnóstico, Hospital Universitario Ramón y Cajal, Madrid, España. Electronic address: luisgorospe@yahoo.com. Servicio de Neumología, Hospital Universitario Ramón y Cajal, Madrid, España. Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, España. AN - 28705711 AU - Gorospe Sarasúa, L. AU - Arrieta, P. AU - Barrios-Barreto, D. AU - de la Puente-Bujido, C. DA - Sep-Oct DO - 10.1016/j.reuma.2017.06.004 DP - NLM ET - 2017/07/15 J2 - Reumatologia clinica KW - Aged, 80 and over Asymptomatic Diseases *Bone Cements Humans Male Postoperative Complications/*diagnostic imaging Pulmonary Embolism/*diagnostic imaging/pathology *Vertebroplasty/methods LA - eng spa M1 - 5 N1 - PubMed NLM literature search January 5, 2021 OP - Embolismo pulmonar central bilateral asintomático por cemento tras vertebroplastia múltiple. PY - 2019 SN - 1699-258x SP - e53-e54 ST - Asymptomatic Bilateral Central Pulmonary Embolism Following Multiple Cement Vertebroplasties T2 - Reumatol Clin TI - Asymptomatic Bilateral Central Pulmonary Embolism Following Multiple Cement Vertebroplasties VL - 15 ID - 828774 ER - TY - JOUR AD - Divisions of Cardiac Surgery and Interventional Cardiology, Brigham and Women's Hospital, 75 Frances St, Boston, MA 02115, USA. igosev@partners.org AN - 23509033 AU - Gosev, I. AU - Nascimben, L. AU - Huang, P. H. AU - Mauri, L. AU - Steigner, M. AU - Mizuguchi, A. AU - Shah, A. M. AU - Aranki, S. F. DA - Mar 19 DO - 10.1161/circulationaha.112.144535 DP - NLM ET - 2013/03/20 J2 - Circulation KW - Angiography Bone Cements/*adverse effects Cardiovascular Surgical Procedures Female Fractures, Compression/diagnostic imaging/*surgery Heart Ventricles/diagnostic imaging/*injuries/surgery Humans Kyphoplasty/*adverse effects Lumbar Vertebrae/diagnostic imaging/surgery Middle Aged Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/diagnostic imaging/*etiology/surgery Thoracic Vertebrae/diagnostic imaging/surgery Tomography, X-Ray Computed Treatment Outcome LA - eng M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 0009-7322 SP - 1251-3 ST - Right ventricular perforation and pulmonary embolism with polymethylmethacrylate cement after percutaneous kyphoplasty T2 - Circulation TI - Right ventricular perforation and pulmonary embolism with polymethylmethacrylate cement after percutaneous kyphoplasty VL - 127 ID - 828900 ER - TY - JOUR AD - Brigham and Women's Hospital, 75 Frances St, Boston, MA 02115. igosev@partners.org. AN - 107993904. Language: English. Entry Date: 20130719. Revision Date: 20200708. Publication Type: journal article AU - Gosev, Igor AU - Nascimben, Luigi AU - Huang, Pei-Hsiu AU - Mauri, Laura AU - Steigner, Michael AU - Mizuguchi, Annette AU - Shah, Amil M. AU - Aranki, Sari F. DB - cin20 DO - 10.1161/CIRCULATIONAHA.112.144535 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Fractures, Compression -- Surgery Heart Ventricle -- Injuries Kyphoplasty -- Adverse Effects Methylmethacrylates -- Adverse Effects Pulmonary Embolism -- Etiology Angiography Surgery, Cardiovascular Female Fractures, Compression -- Radiography Heart Ventricle -- Radiography Heart Ventricle -- Surgery Lumbar Vertebrae -- Radiography Lumbar Vertebrae -- Surgery Middle Age Pulmonary Embolism -- Radiography Pulmonary Embolism -- Surgery Thoracic Vertebrae -- Radiography Thoracic Vertebrae -- Surgery Tomography, X-Ray Computed Treatment Outcomes M1 - 11 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2013 SN - 0009-7322 SP - 1251-1253 ST - Right ventricular perforation and pulmonary embolism with polymethylmethacrylate cement after percutaneous kyphoplasty T2 - Circulation TI - Right ventricular perforation and pulmonary embolism with polymethylmethacrylate cement after percutaneous kyphoplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=107993904&site=ehost-live&scope=site VL - 127 ID - 830660 ER - TY - JOUR AB - Operative treatment of pathological fractures has to provide immediate stability, which allows full weight-bearing conditions and early mobilization of the patient. In adults, metastatic disease is the most common malignant neoplasm of the bone. Pathological fractures of the humerus or femur usually occur late in the course of metastatic disease. The aim of our surgical is to improve the individual patients quality of life with a minimum of complication, delay and morbidity, in a retrospective study we identified 90 patients with 99 pathological fractures (mean age 63.4 years) within a period of time of 4 years (1994-1997). Preoperatively 92% of the patients already showed multiple bone metastases. In 84 cases, depending on the character and localisation of the fracture, an extramedullary fixation strategy employing AO-plates and bone cement were favoured. 15 shaft fractures of the humerus or femur were managed with interlocking intramedullary nailing. Mostly we used the unreamed AO-nails (UFN, UHN), in 3 cases the operative treatment was performed with reamed AO-femoral nails. In the group with the intramedullary osteosynthesis we had no postoperative complications related to the wound, no infections or failures of fixation or of the implant. Importantly and in difference to other studies in our series no intraoperative complications such as pulmonary embolism or cardiopulmonary hazards were observed. All patients were mobilised under unlimited full weight-bearing conditions. The decision to favour an intramedullary fixation strategy with pathological fractures requires a specific indication: a diaphyseal lesion and a limited life expectancy of the patient considering the type of the tumor and character of the bone metastases (local or systemic involvement). The osteosynthesis has to guarantee absolute stability with full weight-bearing for the rest of the life of the patient. Evaluating these criteria, interlocking intramedullary nailing of pathological fractures provides immediate stability and can be accomplished with a closed technique, minimum morbidity and an early return of function and loadability of the extremity involved. AD - B. Gotze, Abteilung Unfallchirurgie, Chirurgische Univ.Klin. Freiburg, Hugstetterstrasse 55, 79106 Freiburg, Germany AU - Götze, B. AU - Schlickewei, W. AU - Seif, M. AU - Friedl, H. P. DB - Embase KW - article bone strength female follow up fracture healing human major clinical study male osteosynthesis pathologic fracture surgical technique trabecular bone treatment outcome weight bearing LA - German M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1999 SN - 0044-6173 SP - 41-47 ST - Intra- and extramedullary osteosynthesis of pathological fractures of tubular bones T2 - Aktuelle Traumatologie TI - Intra- and extramedullary osteosynthesis of pathological fractures of tubular bones UR - https://www.embase.com/search/results?subaction=viewrecord&id=L29180387&from=export VL - 29 ID - 829898 ER - TY - JOUR AB - Aim: To study the morphology of vertebra in senile patients with osteoporotic vertebral compressive fractures after percutaneous vertebroplasty (PVP), investigate the correlation between the outcome and bone cement volume of PVP, and explore the host biocompatibility after bone cement leakage and the curative effect of one year post-operation. Methods: 1 Objective: From October 2002 to March 2006, 82 patients (114 vertebra) underwent PVP in the Department of Orthopaedics at the Fifth Affiliated Hospital of Guangxi Medical University, 50 cases (68 vertebra) of them were followed up for over one year, aged 60-92 years and mean 71 years. Among 68 selected vertebra, there were 25 ones for vertebral superior endplate fracture collapse, 10 ones for vertebral central bone trabecula collapse, and 33 ones for vertebral inferior endplate fracture collapse. 2 Materials: Low-viscosity bone cement Corinplasty 3 (British Corin Medical Ltd), contrast medium iohexol (Jiangsu Yangtze Pharmacology Company), and self-made bone cement power: monomer: contrast medium at the ratio of 3 g: 2 mL: 1 mL. 3 Methods: Perspective by C-arm apparatus, transfixion pin was placed through laterosuperior border of vertebral arch pedicle (left at ten o'clock position and right at two o'clock position), at the angle of 10°-15° with antereposterior axes (angle was variable for vertebral rotation). And the included angle between pin and coronal axes (vertebral horizontal position) differed from the fracture type (pin tip was close to superior or inferior endplate and located middle for central compression fracture). It was satisfactory that transfixion pin arrived 1/3 anterior lateral vertebra via arch pedicle or trans-pedicle approach and the pin was near to midline. Bone cement was prepared and injected into vertebral body at the second phase of drawing-off, under digital subtraction angiography, 3.0-7.0 mL per body for average (5.5±1.5)mL. Results: 1 Fifty cases (68 vertebra) followed up at least one year were involved into this study, including 38 for one year and 12 for 1.5-2 years. 2 Postoperative outcome: There ware no significant difference in the excellence and good rate of instant postoperative outcome (94%) compared with that of one-year postoperation (90%). 3 The vertebral height increased 9.42% after PVP, but its rate didn't affect the outcome. 4 Injection of at least 3 mL bone cement for per body could gain a good results, and more than 3 mL cement didn't increase the rate of excellent and good results. 5 There were no serious complications such as pulmonary embolism, nerve roots and vessels puncture. The cement leakage was popular in the operation (17/68, 25%). 6 No adverse effect of host appeared during operation and after operation. Conclusion: 1 PVP can partly recover the vertebral body height, 3-mL injection into vertebra provides the satisfactory efficacy for clinical practice, and the outcome is maintained in one year follow-ups. 2 Cement leakage during operation is very common, and PVP has unobvious improvement on kyphosis. 3 The clinical result confirms the good biocompatibility between bone cement and host, no specific adverse effect of host is found for bone cement leakage. AD - L.-Y. Gou, Department of Orthopaedics, Hospital of Guangxi Medical University, Liuzhou 545001 Guangxi, China AU - Gou, L. Y. AU - Li, B. AU - Zhang, X. AU - Zheng, H. B. AU - Feng, S. DB - Embase KW - bone cement contrast medium iohexol monomer adult aged article biocompatibility blood vessel injury clinical practice compression fracture controlled study correlation analysis digital subtraction angiography female follow up human lung embolism major clinical study male morphology nerve root injury osteoporosis percutaneous vertebroplasty postoperative period senility vertebra body spine fracture Corinplasty 3 LA - Chinese M1 - 35 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2007 SN - 1673-8225 SP - 6978-6982 ST - Percutaneous vertebroplasty for treating osteoporotic vertebral compressive fractures in senile people: One year follow-up of vertebral height recovery T2 - Journal of Clinical Rehabilitative Tissue Engineering Research TI - Percutaneous vertebroplasty for treating osteoporotic vertebral compressive fractures in senile people: One year follow-up of vertebral height recovery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L350065860&from=export VL - 11 ID - 829762 ER - TY - JOUR AB - PURPOSE OF THE STUDY: Degenerative spondylolisthesis of the osteoarthritic spine can lead to severe invalidating back pain, decompensating a clinical situation previously well controlled with drugs. Hypothesizing that such invalidating spinal pain might be related to the unstable olisthy, we treated our patients with isolated intersomatic arthrodesis without reducing the displacement. We present here our results in a retrospective analysis of 39 patients who underwent surgery between 1981 and 1992. MATERIAL AND METHODS: Mean age of the 39 patients, 11 men and 28 women, was 62 years (mean, range 37-89). Lumbar spine pain had been well controlled for a mean 10 years. The development of important lumbalgia despite adequate drug treatment led to the indication for surgery in all cases. Thirty-four patients experienced radicular claudication which was severe in 16 cases with a walking distance of less than 100 m. Invalidating radiculalgia occurred in a territory compatible with the olisthy: 33 L4-L5, 2 L5-S1, 4 L2-L3. Twelve patients had a neurological deficit in the L5 territory. Myelography, performed in 26 patients, demonstrated complete interruption of the opaque column in 10 facing the superior surface of the oisthy and radicular amputation in 13; compression over several levels was observed in 13 cases. Anterior intersomatic arthrodesis was done with an iliac tricortical corticospongious graft, associated with en bloc cement insertion in 3 cases. A strut plate screwed on the adjacent vertebral bodies was adapted to the vertebral displacement that was not modified. The upright position was authorized on day 20-45 with a corset worn until day 90. No procedure was attempted on adjacent levels. Postoperative myelography or MRI was obtained for 30 patients. RESULTS: Mean follow-up was 4 years (range 1-10 years). Transient postoperative paresis (L5) occurred after L4-L5 arthrodesis in 2 patients and phlebitis in 3 patients (one complicated with pulmonary embolism without sequelae). Fusion of the arthrodesis was achieved in all cases. The degree of displacement and the height of the "intersomatic space" was modified little compared with the preoperative situation. Radicular claudication regressed totally in 29 cases (85%) and partially in 5 (15%). Radiculalgia regressed totally in 29 (74%) and partially but substantially in 7 (18%). Lumbalgia regressed totally in 20 cases (54%) and partially in 15 (40%). Function, as assessed wth the Beaujon scale, improved from 8 to 17/20 points. There was one case of secondary degradation with development of radiculalgia related to the level above the arthrodesis in one case. No cause could be identified to explain the failure to relieve preoperative radiculalgia in 8% of the patients. CONCLUSION: Strut plates screwed onto the vertebral bodies enabled intersomatic fusion in all cases. Stabilization of the olisthy alone, without correction of the displacement nor release of the canal, successfully relieved pain in all cases of severe radiculalgia due to osteoarthritic spondylolisthesis and even provided improvement of lumbar pain in patients with various levels of discopathy. Unstable olisthy would thus be the major cause of invalidating pain, particularly radiculalgia in these patients. AD - Service d'Orthopédie, Hôpital Henri-Mondor, 51, avenue du Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France. AN - 11685148 AU - Goutallier, D. AU - Djian, P. AU - Borgese, M. A. AU - Allain, J. DA - Oct DP - NLM ET - 2001/10/31 J2 - Revue de chirurgie orthopedique et reparatrice de l'appareil moteur KW - Adult Aged Aged, 80 and over Female Follow-Up Studies Humans *Lumbar Vertebrae Male Middle Aged Radiography Retrospective Studies Spinal Fusion/adverse effects/*methods Spondylolysis/diagnostic imaging/*surgery Time Factors LA - fre M1 - 6 N1 - PubMed NLM literature search January 5, 2021 OP - Spondylolisthésis lombaires dégénératifs traités par arthrodèse intersomatique isolée: résultats de 30 cas à 4 ans de recul moyen. PY - 2001 SN - 0035-1040 (Print) 0035-1040 SP - 569-78 ST - [Degenerative lumbar spondylolisthesis treated with isolated intersomatic arthrodesis: results of 30 cases with an average 4-year follow up] T2 - Rev Chir Orthop Reparatrice Appar Mot TI - [Degenerative lumbar spondylolisthesis treated with isolated intersomatic arthrodesis: results of 30 cases with an average 4-year follow up] VL - 87 ID - 829009 ER - TY - JOUR AB - Purpose of the study: Degenerative spondylolisthesis of the osteoarthritic spine can lead to severe invalidating back pain, decompensating a clinical situation previously well controlled with drugs. Hypothesizing that such invalidating spinal pain might be related to the unstable olisthy, we treated our patients with isolated intersomatic arthrodesis without reducing the displacement. We present here our results in a retrospective analysis of 39 patients who underwent surgery between 1981 and 1992. Material and methods: Mean age of the 39 patients, 11 men and 28 women, was 62 years (mean, range 37-89). Lumbar spine pain had been well controlled for a mean 10 years. The development of important lumbalgia despite adequate drug treatment led to the indication for surgery in all cases. Thirty-four patients experienced radicular claudication which was severe in 16 cases with a walking distance of less than 100 m. Invalidating radiculalgia occurred in a territory compatible with the olisthy: 33 L4-L5, 2 L5-S1, 4 L2-L3. Twelve patients had a neurological deficit in the L5 territory. Myelography, performed in 26 patients, demonstrated Complete interruption of the opaque column in 10 facing the superior surface of the oisthy and radicular amputation in 13; compression over several levels was observed in 13 cases. Anterior intersomatic arthrodesis was done with an iliac tricortical corticospongious graft, associated with en bloc cement insertion in 3 cases. A strut plate screwed on the adjacent vertebral bodies was adapted to the vertebral displacement that was not modified. The upright position was authorized on day 20-45 with a corset worn until day 90. No procedure was attempted on adjacent levels. Postoperative myelography or MRI was obtained for 30 patients. Results: Mean follow-up was 4 years (range 1-10 years). Transient postoperative paresis (L5) occurred after L4-L5 arthrodesis in 2 patients and phlebitis in 3 patients (one complicated with pulmonary embolism without sequelae). Fusion of the arthrodesis was achieved in all cases. The degree of displacement and the height of the "intersomatic space" was modified little compared with the preoperative situation. Radicular claudication regressed totally in 29 cases (85%) and partially in 5 (15%). Radiculalgia regressed totally in 29 (74%) and partially but substantially in 7 (18%). Lumbalgia regressed totally in 20 cases (54%) and partially in 15 (40%). Function, as assessed with the Beaujon scale, improved from 8 to 17/20 points. There was one case of secondary degradation with development of radiculalgia related to the level above the arthrodesis in one case. No cause could be identified to explain the failure to relieve preoperative radiculalgia in 8% of the patients. Conclusion: Strut plates screwed onto the vertebral bodies enabled intersomatic fusion in all cases. Stabilization of the olisthy alone, without correction of the displacement nor release of the canal, successfully relieved pain in all cases of severe radiculalgia due to osteoarthritic spondylolisthesis and even provided improvement of lumbar pain in patients with various levels of discopathy. Unstable olisthy would thus be the major cause of invalidating pain, particularly radiculalgia in these patients. AD - D. Goutallier, Service d'Orthopédie, Hôpital Henri-Mondor, 51, Ave. du Marec.-de-Latt.-de-Tass., 94010 Créteil, France AU - Goutallier, D. AU - Djian, P. AU - Borgese, M. A. AU - Allain, J. DB - Embase Medline KW - adult aged arthrodesis article backache clinical article female follow up human low back pain lumbar spine male myelography neurological complication osteoarthritis rating scale regression analysis spine disease spine fusion spondylolisthesis surgical technique treatment indication treatment outcome vertebra body LA - French M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2001 SN - 0035-1040 SP - 569-578 ST - Degenerative lumbar spondylolisthesis: Outcome after isolated intersomatic arthrodesis T2 - Revue de Chirurgie Orthopedique et Reparatrice de l'Appareil Moteur TI - Degenerative lumbar spondylolisthesis: Outcome after isolated intersomatic arthrodesis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L33015415&from=export VL - 87 ID - 829879 ER - TY - JOUR AB - The authors have operated on 62 hips in 43 patients. Thirty-eight were followed for more than three years. Out of 62 cases there were 2 early deaths, 2 instances of pulmonary embolus and 1 of sepsis. Five different types of prosthesis were used. On 11 occasions a border appeared around the cement of the femoral component and in three of these loosening was demonstrated. The number of these appeared to be higher than after total replacement for other etiologies and seemed to be aggravated by technical errors, such as varus positioning and lack of cement. In most cases a remarkable functional improvement was obtained but progressively secondary worsening of walking ability was seen due to involvement of other joints. It is concluded that special precautions should be observed in such cases and that other joints should be replaced earlier when necessary. AN - 6221365 AU - Goutallier, D. AU - Sterkers, Y. DP - NLM ET - 1982/01/01 J2 - Revue de chirurgie orthopedique et reparatrice de l'appareil moteur KW - Adult Aged Arthritis, Rheumatoid/*complications Bone Cements Female Hip Joint/diagnostic imaging *Hip Prosthesis/adverse effects Humans Male Middle Aged Postoperative Complications Radiography Retrospective Studies LA - fre M1 - 8 N1 - PubMed NLM literature search January 5, 2021 OP - Traitement des coxites des polyarthrites rhumatismales par prothèses totales cimentées. A propos de 62 prothèses totales de hanches dont 38 suivies plus de 3 ans. PY - 1982 SN - 0035-1040 (Print) 0035-1040 SP - 539-48 ST - [Treatment of inflammatory hip disease in rheumatoid arthritis with cemented total prostheses. Apropos of 62 total hip prostheses, of which 38 were followed for more than 3 years] T2 - Rev Chir Orthop Reparatrice Appar Mot TI - [Treatment of inflammatory hip disease in rheumatoid arthritis with cemented total prostheses. Apropos of 62 total hip prostheses, of which 38 were followed for more than 3 years] VL - 68 ID - 828979 ER - TY - JOUR AB - Cardiovascular collapse following use of methylmethacrylate for lower limb surgeries has been reported. However there are no reports of cement reaction following shoulder arthroplasty. We report series of four patients exhibiting cement reaction. Two of our patients had cardiovascular collapse following cement insertion during hip arthroplasty. Severe hemodynamic derangement and transient hypoxemia was observed during cemented arthroplasty of shoulder and knee respectively. Peripheral vasodilatory effects of the cement monomer, fat and marrow embolism and activation of the clotting cascade in the lungs, all contribute to cement reaction. Early and aggressive resuscitation with use of vasopressors, establishment of invasive hemodynamic monitoring and surgical modifications are the key to prevention of catastrophic outcome. AD - Consultant, Department of Anaesthesiology and Pain Management, Max Super specialty Hospital, Saket, New Delhi. 110017, India. AN - 20640126 AU - Govil, P. AU - Kakar, P. N. AU - Arora, D. AU - Das, S. AU - Gupta, N. AU - Govil, D. AU - Gupta, S. AU - Malohtra, A. C2 - Pmc2900109 DA - Apr DP - NLM ET - 2009/04/01 J2 - Indian journal of anaesthesia KW - Bone cement Complications Joint replacement surgeries LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0019-5049 (Print) 0019-5049 SP - 214-8 ST - Bone cement implantation syndrome: a report of four cases T2 - Indian J Anaesth TI - Bone cement implantation syndrome: a report of four cases VL - 53 ID - 829012 ER - TY - JOUR AB - Thyroid cancer incidence has increased significantly during the past decades and it has become one of the most frequent cancer types mainly in females, accounting for a prediction of 54.000 new cases in both genders in 2012 in the United States. As diagnostic techniques for thyroid cancer have become more sensitive, particularly with the advent of ultrasound and fine needle aspiration (FNA), the increasing incidence of thyroid cancer is predominantly due to the increased detection of small papillary cancers or microcarcinomas. Additionally, the 5-year relative survival rates for thyroid cancer have increased significantly from 93 % in 1983-1985 to 97 % in 1995-2001, probably due to the same reason. Thyroid cancer management has not changed substantially during the past decades. Treatment is based on total thyroidectomy, ablative doses of radioiodine and suppressive treatment. External beam radiotherapy, and cytotoxic chemotherapy, often have low efficacy and many patients with advanced disease ultimately die. The follow-up is based on measuring serum thyroglobulin (Tg) and imaging with radioiodine scans. Since among clinicians there is a tendency to overtreating patients with thyroid cancer, recently new proposals to change this algorithm have arisen. Most likely, the 2.4-fold increase in incidence of papillary microcarcinoma has also something to do with this. It is a fact that a more accurate prognostic stratification that improves thyroid cancer management is lacking. Loss of differentiation is associated with the progressive failure of these treatment strategies as happens in poorly differentiated and anaplastic thyroid carcinomas for which surgery is usually insufficient and efficacious post-surgical treatment options are presently not available. The great majority of patients with DTC present with limited disease and become disease-free after initial treatment. However, 10 %-15 % of patients with this type of thyroid cancer have persistent/recurrent disease. More frequently, the persistence of the disease is loco-regional located. In 25 % of cases it is represented by distant metastases that can occur in the lungs, bones, lungs and bones or at other sites. Therapeutic options for patients with persistent/recurrent follicular cell-derived thyroid cancers include, when feasible, additional surgery, radioiodine treatment in presence of radioiodine uptake in tumor foci, other local treatments (dependent on location and extent of disease) such as external beam radiation therapy, embolization, radiofrequencies, and cement injection. Reported 10-year-survival rates after recurrence of neck disease range from 49 % to 68 %, and neck lesions are responsible for one third of cancer-related deaths. Ten-year-survival rates in patients with distant metastases are even lower ranging from 25 % to 42 %. If surgery is not feasible or not radical, only radioiodine treatment can allow the achievement of a complete remission. Less than one third of patients with distant metastases is cured with radioiodine and usually achieves this result with a cumulative activity lower than 600 mCi. Typically, these patients are younger, have well differentiated tumors, high radioiodine uptake, small metastases, location in the lung, stable or slow progressive disease and low uptake of fluorodeoxyglucose on 18-FDG PET scan. The remaining patients show initial radioiodine uptake but poor or no response to the treatment or no initial uptake of the halogen at all. Typically, these patients are older, have poorly differentiated tumors, large metastases, location in bones, rapidly progressive disease and high uptake of fluorodeoxyglucose on 18-FDG PET scan. Until very recently, the only additional therapeutic option for this category of patients was represented by cytotoxic chemotherapy. The real impact of this approach is actually unknown, because only a few studies have addressed the problem and the available ones are plagued by small numbers of patients, aggregation of heterogeneous histologies (differentiated, medullary and anaplastic), confound ng interpretations, and variable definitions of responses. In the last two decades many of the molecular events involved in cancer formation have been uncovered. This knowledge has prompted the development of novel therapeutic strategies mainly based on the inhibition of key molecular mediators of the tumorigenic process. In particular the class of small-molecule tyrosine kinase inhibitors was enriched by many compounds that have reached clinical trials and in some cases have had approval for clinical use in specific cancers. Many of these compounds entered clinical trials also for locally advanced or metastatic thyroid carcinomas showing very promising results. The most studied pathway involved in thyroid tumorigenesis is the RTK/RAS/BRAF/MAP kinase pathway, which seems to be essential for the development of PTC. On the contrary, this pathway seems to play a more limited role in FTC. Accordingly, the main genetic events discovered so far related to PTC play important roles in this pathway and, as in many other cancers, these genetic events do not overlap, which highlights the requirement of this signalling system for transformation to PTC. However, although all the aforementioned genetic events activate this pathway, notable differences can be found among them. MAPKs regulate critical cellular functions required for homeostasis such as the expression of cytokines and proteases, cell cycle progression, cell adherence, motility and metabolism. MAPKs therefore influence cell proliferation, differentiation, survival, apoptosis and development; and not surprisingly, they also control the growth and survival of a broad spectrum of human tumours. Most studies exploring the effects of oncogenes have been performed in cells in whose growth is negatively regulated by cAMR Thyroid cells are an exception, since they are dependent on the presence of thyrotrophin (TSH) for growth, primarily through activation of adenylyl cyclase, cAMP generation and stimulation of protein kinase A activity. (Adapted from Fagin J.) Since thyroid follicular cancer conserves a certain degree of differentiation, one logical therapeutic approach is to redifferentiate the cells and reinduce endogenous NIS expression so that radioiodine treatment can be performed. Before targeted therapy became feasible, many groups focused on this strategy and several compounds, also known to have tumour-inhibitory effects, have partially succeeded in reaching this goal. Among them, the most well known has been re- tinoic acid (RA). Several clinical trials have been done using RA in order to increase radioiodide uptake and improve clinical outcome of patients with recurrent thyroid cancer. In general terms, radioiodide uptake was improved in 20-42 % of the cases, but tumour shrinkage was observed in very few cases after 131I treatment. Other compounds such as Troglitazone, HDAC inhibitors and demethylating agents are currently being tested with promising results. The prevalence of activating BRAF mutations, RET/PTC rearrangements and RAS mutations and consistent downstream activation of ERK suggests that activation of the MAP kinase signalling cascade may be an obligatory step in the transformation of thyrocytes. Allegedly, such dependency may represent a point of therapeutic attack. However, we should bear in mind that deregulation of other pathways and/or secondary genetic events may be playing important roles in thyroid tumorigenesis. Several lines of experimental evidence affirm the notion that targeting RAF activity can be a good starting point. First, depletion of BRAF, by small interfering RNA, in BRAF-positive thyroid cancer cell lines inhibits both ERK activation and proliferation while abrogating tumour xenograft formation. Secondly and most interestingly, RAF activity seems to be required for the transforming effects of the non-overlapping mutations of the other oncogenes signalling through the MAPK pathway. Indeed, RAF binds to and is a direct effector for RAS, and selective knockdown of BRAF (but not CRAF) abrogates RET/PTC3-induced ERK phosphorylation in thyr id cells. These data suggest that blocking RAF activity may be a logical approach to interfere with the effects of RET/PTC, RAS and BRAF oncoproteins. Advanced thyroid carcinoma treatment continues to represent a significant challenge for the different professional figures involved in its cure, including the endocrine oncologist, the endocrine surgeon, the nuclear medicine specialist and the radiotherapist. Ultimately, most of patients with locally advanced disease that is not surgically resectable or with metastatic disease, not responsive to radioiodine or to other therapeutic options, will die. This scenario has probably just started to change with the introduction of targeted therapies and in particular of TKIs. Indeed, with these novel drugs, we have started to experience tumor shrinkage or disease stabilization lasting for a significant amount of time even in clearly progressive cancers. With the exception of a few anecdotal cases, no other treatment, other than radioiodine when effective, has given such good results in advanced thyroid carcinoma in the past. Interestingly, the disease control rate (partial responses + disease stabilizations) obtained with the novel TKIs appears to be very high, in the order of 50 %-80 %, although limited in time. Moreover, it should also be noticed that complete remissions are not obtainable with any of the available drugs. AD - H. Graf, Department of Medicine, Thyroid Unite, Endocrine Service of the Federal University of Parani (SEMPR), Curitiba, Brazil AU - Graf, H. DB - Embase KW - radioactive iodine fluorodeoxyglucose cyclic AMP dependent protein kinase proteinase thyrotropin adenylate cyclase acid troglitazone cytokine halogen protein tyrosine kinase inhibitor cement phosphotransferase small interfering RNA iodine 131 histone deacetylase inhibitor mitogen activated protein kinase RNA thyroid cancer human neoplasm patient surgery thyroid carcinoma survival rate bone thyroid gland clinical trial (topic) distant metastasis mutation lung metastasis survival oncogene thyroid cell therapy external beam radiotherapy carcinogenesis remission positron emission tomography chemotherapy imaging thyroglobulin blood level follow up fine needle aspiration biopsy uterine cervix carcinoma ultrasound stratification cell function diagnostic procedure cancer incidence United States achievement death thyroidectomy gender neck injury neck injection histology homeostasis surgeon artificial embolization cell cycle progression cell adhesion metabolism cell proliferation prediction female apoptosis local therapy ovary follicle cell stimulation prevalence algorithm deregulation cancer cell culture xenograft phosphorylation nuclear medicine medical specialist disease control L1 - http://www.raem.org.ar/numeros/2012_supl/32-51-Simposios.pdf LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 0326-4610 SP - 27-29 ST - Non 131l responsive thyroid cancer T2 - Revista Argentina de Endocrinologia y Metabolismo TI - Non 131l responsive thyroid cancer UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71121169&from=export VL - 49 ID - 829542 ER - TY - JOUR AD - G. Grasso, Section of Neurosurgery, Department of Experimental Biomedicine and Clinical Neurosciences (BIONEC), University of Palermo, Palermo, Italy AU - Grasso, G. DB - Embase Medline DO - 10.1016/j.wneu.2018.05.015 KW - bone cement device anticoagulant agent aged anticoagulant therapy backache blood clotting bone cement leakage case report clinical article fragility fracture hospital discharge human inferior cava vein lung embolism lung lobe male medical history note percutaneous vertebroplasty postoperative period spine radiography LA - English M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1878-8769 1878-8750 SP - 489-490 ST - Does Optimal Volume Fraction in Percutaneous Vertebroplasty Prevent Cement Leakage? T2 - World Neurosurgery TI - Does Optimal Volume Fraction in Percutaneous Vertebroplasty Prevent Cement Leakage? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2000805801&from=export http://dx.doi.org/10.1016/j.wneu.2018.05.015 VL - 116 ID - 829184 ER - TY - JOUR AB - Learning Objectives 1. To become familiar with the most common indications 2. To know about the treatments used and how to choose them 3. To define the patient pathway and learn about collaboration with other specialists Radiotherapy (RT) and medical therapy (including analgesics, bisphosphonates and denosumab) are the current treatment modalities to treat pain and prevent fractures but unfortunately pain is not adequately treated in 56-82.3% of the cases. Stereotactic body RT yields higher rates of local tumor control and pain management compared with standard external beam RT but it leads to an increased risk of secondary fractures. Interventional radiology procedures may play an important primary or complementary role to manage bone metastasis, especially in the palliative setting where pain and fracture management is necessary. Percutaneous osteoplasty refers to polymethylmethacrylate (PMMA) injection into weakened or fractured bone. For long bones, effective pain management and functional amelioration can be achieved in 89.4% and in 71.8% cases,respectively. Percutaneous osteosynthesis is consistent with screw fixation to consolidate minimally/non-displaced fractures of the pelvic ring. In a study of 64 patients undergoing pelvic osteosynthesis alone or in combination with osteoplasty, a median pain reduction of 6/10 points was noted, with only two secondary fractures observed in the proximal femur (1). Thermal ablation is used to destroy tumors through the direct application of heat- or cold-based energies delivered percutaneously or in noninvasive way with High-intensity focused ultrasound (HIFU). Compared to RT, the effects of ablation are immediate and there is no limit to the number of ablative treatments that can be performed on the same tumor, which is not the case for RT as it cannot be repeated once the maximum dose of the target organ is reached. Thermal ablation can be performed with a curative (2,3) or palliative intent (4) and there is growing evidence in demonstrating the effectiveness of such therapeutic treatments in selected patients. Given the “non-invasive” profile of HIFU, it is likely that it will obtain a prominent position in the future for the palliative management of BM. The aim of trans-arterial embolization (TAE) is to devascularize hypervascular bone metastasis and to preserve all non-target vessels.For these reasosns, TAE should be as selective as possible. In the multidisciplinary tumor board, interventional techniques may be considered as the sole therapeutic option or as part of a more complex therapeutic strategy integrating different interventional and non-interventional treatments. AD - R.F. Grasso AU - Grasso, R. F. DB - Embase DO - 10.1007/s00270-019-02282-x KW - analgesic agent bisphosphonic acid derivative denosumab poly(methyl methacrylate) ablation therapy adult analgesia arterial embolization bone metastasis cancer control cancer patient cancer radiotherapy cold stress conference abstract controlled study drug combination drug therapy external beam radiotherapy female heat high intensity focused ultrasound human interventional radiology learning major clinical study male maximum permissible dose osteosynthesis prevention proximal femur radiotherapy stereotactic body radiation therapy target organ LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1432-086X SP - S168 ST - Treatment algorithm in peripheral skeleton metastatic disease T2 - CardioVascular and Interventional Radiology TI - Treatment algorithm in peripheral skeleton metastatic disease UR - https://www.embase.com/search/results?subaction=viewrecord&id=L629259971&from=export http://dx.doi.org/10.1007/s00270-019-02282-x VL - 42 ID - 829124 ER - TY - JOUR AB - Transcranial Doppler ultrasound has been used to detect cerebral emboli after hip arthroplasty. The cognitive effects of these embolic events are unclear. The aim of this study was to assess cognitive change after primary cemented hip arthroplasty using a range of neuropsychological tests and to measure intraoperative cerebral embolic load. Twenty primary cemented total hip arthroplasties underwent a series of cognitive tests before and at four days after surgery. A range of validated tests assessed: global cognitive function; verbal fluency and speed; immediate and delayed memory recall; attention and mental processing speeds. Intra-operative transcranial Doppler ultrasound monitoring of the middle cerebral artery for embolic signals was also performed. A one-sample Wilcoxon signed-rank test compared median cognitive results post-pre surgery and a Mann-Whitney U test established if there was a cognitive difference between those patients who had detectable cerebral emboli and those who did not. Scatter plot graphs were also used to establish any correlation between the embolic load and clinical cognitive dysfunction. A significant (p<0.01) difference was noted in specific tests assessing mental processing speed, visual searching and sustained and divided attention following surgery. Intra-operative cerebral embolic signals were detected in 11 out of 20 patients and the majority occurred with femoral component cementation and hip reduction. There was no difference in cognitive dysfunction between those patients who had detectable cerebral embolic signals and those who did not and there appeared to be no direct correlation between the size of the embolic load and the level of cognitive dysfunction. AD - Orthopaedic and Trauma Department, Edinburgh Royal Infirmary, Edinburgh, UK AN - 105778512. Language: English. Entry Date: 20080801. Revision Date: 20200623. Publication Type: Journal Article AU - Gray, A. C. AU - Torrens, L. AU - Howie, C. R. AU - Christie, J. AU - Robinson, C. M. DB - cin20 DO - 10.1177/112070000801800108 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Adverse Effects Intracranial Embolism and Thrombosis -- Ultrasonography Cognition Disorders Aged Confidence Intervals Data Analysis Software Descriptive Statistics Mann-Whitney U Test Middle Age Neuropsychological Tests Scales Ultrasonography, Doppler -- Methods Wilcoxon Signed Rank Test Human M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2008 SN - 1120-7000 SP - 40-45 ST - Cognitive function and cerebral emboli after primary hip arthroplasty T2 - Hip International TI - Cognitive function and cerebral emboli after primary hip arthroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105778512&site=ehost-live&scope=site VL - 18 ID - 830757 ER - TY - JOUR AD - Hospital for Joint Diseases Orthopaedic Institute, New York. AN - 3134372 AU - Grelsamer, R. DA - Jul 15 DO - 10.1080/21548331.1988.11703510 DP - NLM ET - 1988/07/15 J2 - Hospital practice (Office ed.) KW - Aged Bone Cements Female Hip Prosthesis/adverse effects Humans Infection Control Infections/etiology Joint Prosthesis/*adverse effects Male Middle Aged Phlebitis/etiology/prevention & control Prosthesis Failure Pulmonary Embolism/etiology/prevention & control Reoperation Time Factors LA - eng M1 - 7 N1 - PubMed NLM literature search January 5, 2021 PY - 1988 SN - 8750-2836 (Print) 8750-2836 SP - 164, 169-70, 172 ST - Medical complications in patients with joint replacements T2 - Hosp Pract (Off Ed) TI - Medical complications in patients with joint replacements VL - 23 ID - 828547 ER - TY - JOUR AB - Bicortical screw fixation is an established technique to increase screw strength in vertebral bodies, although it is associated with several complications, for example screw-loosening. Cement augmentation can increase stability of screw-fixation but can also cause various complications, such as cement-leakage or cement embolism. In this study, we tested a new, multicortical screw fixation technique in the sacrum. Four fresh-frozen sacrums were used. In group 1, standard screw insertion, with sagittal parallel and axial convergent screw-drive was performed. In group 2, the screw-drive of the first screw was similar to the screw-drive in group 1. In addition, a second screw was inserted descending into the intended hole in the head of the screw and at a stable angle. Therefore, the screws of the multiloc humerus nail-system (Synthes) were used. The specimens were connected to a testing-machine and underwent cyclic axial loading with an increase in the load after each completed stage. Multicortical screw fixation leads to a significant increase in the number of completed cycles and a significantly increased load until failure. Multicortical screw fixation in the sacrum offers a stronger attachment of the screws. In the future, multicortical implants, which fulfil the criteria demanded in spine surgery, can offer higher stability and may decrease the loosening rates of the implanted screws. • Sacral bicortical screw fixation is commonly used for strength and stability. • This study tested a new, multicortical screw fixation technique. • Fresh-frozen sacrums were used to compare bicortical and multicortical techniques. • Multicortical screw fixation resulted in more strength, stability and load bearing. AD - Department for Orthopaedic and Trauma Surgery, Faculty of Medicine, University Hospital of Cologne, Joseph-Stelzmann Strasse 24, 50931 Cologne, Germany AN - 136390009. Language: English. Entry Date: 20190514. Revision Date: 20190517. Publication Type: Article AU - Grevenstein, David AU - Meyer, Carolin AU - Wegmann, Kilian AU - Hackl, Michael AU - Bredow, Jan AU - Eysel, Peer AU - Prescher, Andreas AU - Scheyerer, Max J. DB - cin20 DO - 10.1016/j.clinbiomech.2019.04.007 DP - EBSCOhost KW - Sacrum -- Surgery Pedicle Screws -- Evaluation Biomechanics Fracture Fixation -- Methods Human Cadaver Comparative Studies N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2019 SN - 0268-0033 SP - 100-104 ST - First results of multicortical screw anchoring compared with conventional bicortical screw placement in the sacrum: A biomechanical investigation of a new screw design T2 - Clinical Biomechanics TI - First results of multicortical screw anchoring compared with conventional bicortical screw placement in the sacrum: A biomechanical investigation of a new screw design UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=136390009&site=ehost-live&scope=site VL - 65 ID - 830532 ER - TY - JOUR AB - We report the successful transcatheter retrieval of a 6-cm long, rigid methylmethacrylate glue fragment that embolized from a vertebral body to the right atrium. The glue fragment was adherent to the right atrial wall. Two snares were needed, advanced from opposite directions, to carefully separate the glue fragment from the atrial wall, then align it in a linear fashion directly into the sheath for an uneventful removal. AD - Helen DeVos Childrens Hospital, 100 Michigan Street NE, 10th Floor Cardiology, Grand Rapids, Michigan 49503, USA. AN - 22566411 AU - Grifka, R. G. AU - Tapio, J. AU - Lee, K. J. DA - Mar DO - 10.1002/ccd.24333 DP - NLM ET - 2012/05/09 J2 - Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions KW - Aged Bone Cements/*adverse effects Cardiac Catheterization/*instrumentation *Cardiac Catheters Equipment Design Foreign-Body Migration/diagnostic imaging/etiology/*therapy Heart Atria/diagnostic imaging Humans Male Methylmethacrylate/*adverse effects Radiography, Interventional Treatment Outcome Vertebroplasty/*adverse effects LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1522-1946 SP - 648-50 ST - Transcatheter retrieval of an embolized methylmethacrylate glue fragment adherent to the right atrium using bidirectional snares T2 - Catheter Cardiovasc Interv TI - Transcatheter retrieval of an embolized methylmethacrylate glue fragment adherent to the right atrium using bidirectional snares VL - 81 ID - 828526 ER - TY - JOUR AB - Objectives: To focus attention of the clinician on the anatomy and (patho)physiology of the vertebral venous system, so as to offer a tool to better understand and anticipate (potential) complications that are related to the application of percutaneous vertebroplasty and kyphoplasty.Background: Percutaneous vertebroplasty and kyphoplasty are newly developed, minimally invasive techniques for the relief of pain and for the strengthening of bone in vertebral body lesions. With the clinical implementation of these techniques, a number of serious neurologic and cardiopulmonary complications have been reported in the international medical literature. Most complications appear to be related to the extrusion of bone cement into the vertebral venous system.Methods: The literature about complications of percutaneous vertebroplasty and kyphoplasty is reviewed, and the anatomic and (patho)physiologic characteristics of the vertebral venous system are reported. Based on what is currently known from the anatomy and physiology of the vertebral venous system, the procedures of percutaneous vertebroplasty and kyphoplasty are analyzed, and suggestions are made to improve the safety of these techniques.Conclusions: Thorough knowledge of the anatomic and (patho)physiologic characteristics of the vertebral venous system is mandatory for all physicians that participate in percutaneous vertebroplasty and kyphoplasty. To reduce the risk of cement extrusion into the vertebral venous system during injection, vertebral venous pressure should be increased during surgery. This can be achieved by operating the patient in the prone position and by raising intrathoracic venous pressure with the aid of the anesthesiologist during intravertebral instrumentation and cement injection. Intensive theoretical and practical training, critical patient selection, and careful monitoring of the procedures, also taking into account patient positioning and intrathoracic and intra-abdominal pressures, will help to facilitate low morbidity outcomes in these very promising minimally invasive techniques. AD - Department of Neurosurgery, University Hospital Groningen, Grongingen, The Netherlands AN - 138086801. Language: English. Entry Date: 20050610. Revision Date: 20200706. Publication Type: journal article AU - Groen, Rob J. M. AU - du Toit, Don F. AU - Phillips, Frank M. AU - Hoogland, Piet V. J. M. AU - Kuizenga, Karel AU - Coppes, Maarten H. AU - Muller, Christo J. F. AU - Grobbelaar, Marie AU - Mattyssen, Johannes DB - cin20 DO - 10.1097/01.brs.0000128758.64381.75 DP - EBSCOhost KW - Methylmethacrylates -- Adverse Effects Kyphosis -- Therapy Bone Cements -- Adverse Effects Extravasation of Diagnostic and Therapeutic Materials -- Etiology Spinal Diseases -- Therapy Spine -- Blood Supply Blood Pressure Osteoporosis -- Surgery Fractures, Spontaneous -- Etiology Embolism -- Etiology Biophysics Bone Cements -- Therapeutic Use Osteoporosis -- Complications Extravasation of Diagnostic and Therapeutic Materials -- Prevention and Control Fractures, Spontaneous -- Prevention and Control Methylmethacrylates -- Therapeutic Use Veins -- Anatomy and Histology Prone Position Kyphosis -- Surgery Cranial Sinuses -- Anatomy and Histology Spinal Diseases -- Surgery Spinal Canal -- Blood Supply Methylmethacrylates -- Administration and Dosage Combined Modality Therapy Osteoporosis -- Prevention and Control Venae Cavae -- Anatomy and Histology Osteoporosis -- Therapy Relative Risk Injections, Intralesional Kyphosis -- Etiology Embolism -- Prevention and Control Scales M1 - 13 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2004 SN - 0362-2436 SP - 1465-1471 ST - Anatomical and pathological considerations in percutaneous vertebroplasty and kyphoplasty: a reappraisal of the vertebral venous system T2 - Spine (03622436) TI - Anatomical and pathological considerations in percutaneous vertebroplasty and kyphoplasty: a reappraisal of the vertebral venous system UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=138086801&site=ehost-live&scope=site VL - 29 ID - 830786 ER - TY - JOUR AB - Between 1988 and 1991, 40 Wagner SL femoral revision stems were implanted at the Orthopaedic Departments of the University of Basel and of the Kantonsspital Liestal, Switzerland. The indications were: 27 cases of extensive bone resorption and destruction of the proximal prosthetic bed, seven periprosthetic fractures, two Girdle-stone situations after removal of infected total hip arthroplasty (THA), 1 case each of primary arthroplasty for congenital dysplasia of the hip, failed osteosynthesis of a pertrochanteric fracture, subtrochanteric femoral fracture and femoral fracture with subsequent osteomyelitis. The average follow-up time was 47 months. The average age of the patients was 70 years (range 37-85 years). The average preoperative hip score was 32 points, postoperative 78 points. We noted to severe complications such as thrombosis, pulmonary embolism or nerve injury. No case of early infection has occurred to date. Four hips required further revision, one after a haematogenous infection of the prosthesis 2 years after implantation, one 4 weeks after surgery because of a stem which was significantly undersized compared with the medullary canal of the femur. Two hips were revised after 3 and 4 years, respectively, for continuous subsidence and loosening in the medullary canal. Both revisions were successfully achieved using a femoral component of larger diameter. We recommend the Wagner SL femoral revision stem, not as a routine procedure to treat loosening, but for patients with severe femoral bone resorption after THA or periprosthetic fractures, those in the Girdlestone situation and geriatric patients with pertrochanteric or subtrochanteric fractures. AD - Orthopaedic Department, Kantonsspital, Liestal, Switzerland. AN - 9128770 AU - Grünig, R. AU - Morscher, E. AU - Ochsner, P. E. DO - 10.1007/bf00393708 DP - NLM ET - 1997/01/01 J2 - Archives of orthopaedic and trauma surgery KW - Adult Aged Aged, 80 and over Bone Cements Female Follow-Up Studies Hip Joint/pathology/surgery Hip Prosthesis/*adverse effects Humans Male Middle Aged Postoperative Complications/diagnostic imaging/*surgery *Prosthesis Failure Radiography Reoperation Time Factors Treatment Outcome LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 1997 SN - 0936-8051 (Print) 0936-8051 SP - 187-97 ST - Three-to 7-year results with the uncemented SL femoral revision prosthesis T2 - Arch Orthop Trauma Surg TI - Three-to 7-year results with the uncemented SL femoral revision prosthesis VL - 116 ID - 828880 ER - TY - JOUR AB - BACKGROUND: Percutaneous vertebroplasty is characterized by small surgical trauma and good analgesic effect, and it can also increase the strength and stability of the vertebral body. Therefore, it has been widely used in clinical practice. However, postoperative bone cement leakage is still at high incidence. OBJECTIVE: To summarize the prevention and treatment of cement leakage in percutaneous vertebroplasty. METHODS: We retrieved PubMed for relevant articles published from January 1999 to June 2017. The key words were “percutaneous vertebroplasty; bone cement leakage; prevention and treatment”. We also retrieved CNKI database for relevant articles published from May 2006 to July 2017, with the key words of “percutaneous vertebroplasty; bone cement leakage; prevention and treatment” in Chinese. RESULTS AND CONCLUSION: In order to reduce the occurrence of the leakage of bone cement, there are somecautions as follows: (1) perform a detailed preoperative examination and inquire the medical history; (2) perfect imaging examination; (3) master the surgical indications and contraindications strictly; (4) choose the proper puncture path, and use C-arm perspective and communicate with patients during the operation; (5) use high-viscosity bone cement as much as possible, inject proper amount of bone cement in the dough consistency; and (6) pull the needle until a few minutes after the completion of the bone cement infusion. Cement leakage is asymptomatic in most cases, and some patients only feel local pain. Most patients can recur after the conservative treatment. Some catastrophic consequences, such as bone cement leakage via intervertebral pores, appear with the compression of the spinal cord and nerve, and conservative treatment cannot completely remove the compression. We should remove bone cement by open surgery if necessary. For serious complications such as pulmonary embolism and lower limb vein embolism, surgical treatments should be taken in the presence of unrelieved symptoms. AD - Y. Guang-Hua, Department of Orthopedics, Second People’s Hospital of Qinzhou, Qinzhou, Guangxi Zhuang Autonomous Region, China AU - Guang-Hua, Y. AU - Shun-Jie, G. AU - Ji-Ren, Q. AU - Mao-De, L. DB - Embase DO - 10.3969/j.issn.2095-4344.0780 KW - adult analgesic activity bone cement leakage clinical practice CNKI database complication conservative treatment contraindication dough human human tissue incidence lung embolism medical history Medline nerve open surgery pain percutaneous vertebroplasty peroperative complication preoperative evaluation puncture review spinal cord compression surgery surgical injury tissue engineering vein embolism vertebra body viscosity bone cement LA - Chinese M1 - 26 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 2095-4344 SP - 4241-4246 ST - Prevention and treatment of cement leakage in percutaneous vertebroplasty T2 - Chinese Journal of Tissue Engineering Research TI - Prevention and treatment of cement leakage in percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2004809655&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.0780 VL - 22 ID - 829180 ER - TY - JOUR AB - This study aimed to illustrate the validity of the treatment with vertebroplasty (VP) in patients with aggressive or symptomatic vertebral hemangioma (VH) with or without epidural extension. From January 2003 to December 2007, 24 consecutive patients have been treated with VP, for a total of 36 vertebral bodies affected by VH: two cervical, ten dorsal, 24 lumbar. All the patients complained of a pain syndrome resistant to continuous medical medication; four of 24 patients also presented aggressive magnetic resonance features of the vertebral lesion and two patients showed also epidural extension. A unipedicular approach has been performed in 16 patients; a bipedicular approach has been performed in six, while for the cervical spine an anterior-lateral approach with manual dislocation of the carotid axis has always been performed. Bone biopsy was never done. All procedures have been carried out with local anesthesia, except for the treatment of the cervical hemangiomas which has always been performed under general anesthesia. Four vertebral bodies in the same session have been treated in one case. Results have been evaluated with the visual analog scale and the Oswestry Disability Index methods. In all the patients, in the following 24-72 h, a successful outcome has been observed with a complete resolution of pain symptom. Extravertebral vascular or discal cement leakage has been observed in four patients, without any onset of clinical radicular syndrome due to epidural diffusion. Clinical and radiological follow-up until 4 years has been performed in 12 patients and it showed stability of the treatment and absence of pain. Percutaneous treatment with VP for aggressive and symptomatic vertebral hemangiomas even with epidural extension is a valuable, mini-invasive, and quick method that allows a complete and enduring resolution of the painful vertebral symptoms without findings of fracture of a vertebral body adjacent or distant to the one treated. AD - [Guarnieri, G.; Ambrosanio, G.; Vassallo, P.; Galasso, R.; Lavanga, A.; Izzo, R.; Muto, M.] AORNA Cardarelli, Serv Neuroradiol, Naples, Italy. [Pezzullo, M. G.] Univ Naples 2, Serv Radiol, SUN, Naples, Italy. Guarnieri, G (corresponding author), Via Catullo 30, I-80122 Naples, Italy. gianluigiguarnieri@hotmail.it AN - WOS:000266927000006 AU - Guarnieri, G. AU - Ambrosanio, G. AU - Vassallo, P. AU - Pezzullo, M. G. AU - Galasso, R. AU - Lavanga, A. AU - Izzo, R. AU - Muto, M. DA - Jul DO - 10.1007/s00234-009-0520-0 J2 - Neuroradiology KW - Vertebroplasty Vertebral hemangioma Mini-invasive percutaneous technique PERCUTANEOUS VERTEBROPLASTY NATURAL-HISTORY FAT-EMBOLISM CEMENT MANAGEMENT COMPRESSION LEAKAGE Clinical Neurology Neuroimaging Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 7 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2009 SN - 0028-3940 SP - 471-476 ST - Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up T2 - Neuroradiology TI - Vertebroplasty as treatment of aggressive and symptomatic vertebral hemangiomas: up to 4 years of follow-up UR - ://WOS:000266927000006 VL - 51 ID - 830350 ER - TY - JOUR AB - Aim: To illustrate the validity of one session multi-level vertebroplasty (VP) as treatment to prevent news vertebral fractures (VBFs) in patients affected by osteoporosis, who present, in the follow up, a new fracture in a vertebral soma adjacent or distant from the collapsed one. Materials and Methods: From our 2350 vertebral bodies treated by VP until 2008, retrospectively, we have observed that, in same session, a multilevel VP (minimum 4, max. ten bodies) was performed in 55 pts affected by osteoporosis VBF. All patients complained a pain syndrome resistant to continuous medical medication due to recurrent VBFs either in patients with systematic collagenopathy (rheumatoid arthritis, pulmonary ventilatory disease or Marfan disease. All procedures were performed in prone position under fluoroscopy with local or neuroleptoanaesthesia and by an unipedicular approach in 95% of cases. Results: In the following 24-72 hours, a successful outcome has been observed with a resolution of pain symptom, registering a reduction of 4 points in the VAS and a 40% reduction in the ODS. During multilevel or post treatment, no thrombo-embolic complications or extra-vertebral vascular or discal leakage have been observed. 3/55 patients (5%) developed a news fractures or refracture after VP. Conclusions: Multi-level VP can be performed in selected cases to treat VBF related to osteoporosis can prevent further fractures-refractures without any more thrombo-embolic peri or post-procedural complications. AD - G. Guarnieri, Neuroradiology Service Cardarelli Hospital, Naples, Italy AU - Guarnieri, G. AU - Izzo, R. AU - Vassallo, P. AU - Lavanga, A. AU - Ambrosanio, G. AU - Di Gaeta, A. AU - Muto, M. DB - Embase KW - carisoprodol patient neuroradiology percutaneous vertebroplasty diagnosis fracture osteoporosis pain validity follow up vertebra body drug therapy rheumatoid arthritis Marfan syndrome body position fluoroscopy spine fracture LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 1971-4009 SP - 364 ST - One session multi-level vertebroplasty: Indications and results of 55 patients T2 - Neuroradiology Journal TI - One session multi-level vertebroplasty: Indications and results of 55 patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70363833&from=export VL - 23 ID - 829648 ER - TY - JOUR AB - This study assessed the one-year clinical and radiographic outcomes, in terms of pain-relief, vertebral re-fracture and complications, after vertebroplasty (VP) using a new osteoconductive cement (calcium triglyceride bone cement - Kryptonite™ bone cement, Doctors Research Group Inc., Southbury, CT, USA) to treat osteoporotic vertebral compression fractures. Sixteen consecutive osteoporotic patients (12 women and four men, mean age 68+/-10.5) were treated with VP using Kryptonite™ bone cement for a total of 20 vertebral fractures. All the patients complained of a pain syndrome resistant to medical therapy and all procedures were performed under fluoroscopy control with neuroleptoanalgesia using a monopedicular approach in 12 patients and bipedicular approach in four patients. All patients were studied by MR and MDCT and were evaluated with the visual analogue scale (VAS) and the Oswestry disability index (ODI) before treatment and at one and 12 months after the procedure. A successful outcome was observed in 80% of patients, with a complete resolution of pain. Differences in pre and post treatment VAS and ODI at one-year follow-up were significant (P<0.0001). We observed a disk and venous leakage in 66% of patients but only in one case did an asymptomatic pulmonary embolism occur during cement injection. Two cases of vertebral re-fractures at distant metamers were observed during follow-up. VP using Kryptonite bone cement is a helpful procedure that allows complete and long-lasting resolution of painful vertebral symptoms. The cost of the material is very high and the rate of disk and venous leakage is too high compared to standard cement. AD - Neuroradiology Service, Cardarelli Hospital; Naples, Italy - gianluigiguarnieri@hotmail.it. Radiology Service, Seconda Università degli Studi di Napoli SUN; Naples, Italy. Neuroradiology Service, Cardarelli Hospital; Naples, Italy. AN - 25363260 AU - Guarnieri, G. AU - Tecame, M. AU - Izzo, R. AU - Vassallo, P. AU - Sardaro, A. AU - Iasiello, F. AU - Cavaliere, C. AU - Muto, M. C2 - Pmc4243227 DA - Oct 31 DO - 10.15274/inr-2014-10060 DP - NLM ET - 2014/11/05 J2 - Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences KW - Aged Aged, 80 and over *Bone Cements *Castor Oil/adverse effects/economics Female Follow-Up Studies Humans Male Middle Aged Osteoporotic Fractures/surgery Pain/etiology/surgery Pain Measurement *Polymers/adverse effects/economics Postoperative Complications/epidemiology Spinal Cord Compression/etiology/*surgery Spinal Fractures/complications/*surgery Treatment Outcome Vertebroplasty/*methods bioactive osteoconductive cement calcium triglyceride bone cement leakage rate vertebral re-fracture vertebroplasty LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1591-0199 (Print) 1591-0199 SP - 576-82 ST - Vertebroplasty Using Calcium Triglyceride Bone Cement (Kryptonite™) for Vertebral Compression Fractures. A Single-Centre Preliminary Study of Outcomes at One-Year Follow-up T2 - Interv Neuroradiol TI - Vertebroplasty Using Calcium Triglyceride Bone Cement (Kryptonite™) for Vertebral Compression Fractures. A Single-Centre Preliminary Study of Outcomes at One-Year Follow-up VL - 20 ID - 828646 ER - TY - JOUR AB - This study assessed the one-year clinical and radiographic outcomes, in terms of pain-relief, vertebral re-fracture and complications, after vertebroplasty (VP) using a new osteoconductive cement (calcium triglyceride bone cement Kryptonite (TM) bone cement, Doctors Research Group Inc., Southbury, CT, USA) to treat osteoporotic vertebral compression fractures. Sixteen consecutive osteoporotic patients (12 women and four men, mean age 68+/-10.5) were treated with VP using Kryptonite T bone cement for a total of 20 vertebral fractures. All the patients complained of a pain syndrome resistant to medical therapy and all procedures were performed under fluoroscopy control with neuroleptoanalgesia using a monopedicular approach in 12 patients and bipedicular approach in four patients. All patients were studied by MR and MDCT and were evaluated with the visual analogue scale (VAS) and the Oswestry disability index (ODI) before treatment and at one and 12 months after the procedure. A successful outcome was observed in 80% of patients, with a complete resolution of pain. Differences in pre and post treatment VAS and ODI at one-year follow-up were significant (P<0.0001). We observed a disk and venous leakage in 66% of patients but only in one case did an asymptomatic pulmonary embolism occur during cement injection. Two cases of vertebral re-fractures at distant metamers were observed during follow-up. VP using Kryptonite bone cement is a helpful procedure that allows complete and long-lasting resolution of painful vertebral symptoms. The cost of the material is very high and the rate of disk and venous leakage is too high compared to standard cement. AD - [Guarnieri, Gianluigi; Izzo, Roberto; Vassallo, Pasquale; Cavaliere, Carlo; Muto, Mario] Cardarelli Hosp, Serv Neuroradiol, I-80122 Naples, Italy. [Tecame, Mario; Sardaro, Angela; Iasiello, Francesca] Univ Naples 2, Serv Radiol, Naples, Italy. Guarnieri, G (corresponding author), Cardarelli Hosp, Serv Neuroradiol, Via A Cardarelli 8, I-80122 Naples, Italy. gianluigiguarnieri@hotmail.it AN - WOS:000353958200008 AU - Guarnieri, G. AU - Tecame, M. AU - Izzo, R. AU - Vassallo, P. AU - Sardaro, A. AU - Iasiello, F. AU - Cavaliere, C. AU - Muto, M. DA - Sep DO - 10.15274/inr-2014-10060 J2 - Interv. Neuroradiol. KW - vertebroplasty leakage rate vertebral re-fracture calcium triglyceride bone cement bioactive osteoconductive cement PERCUTANEOUS VERTEBROPLASTY PHOSPHATE CEMENT RISK AUGMENTATION POLYMETHYLMETHACRYLATE KYPHOPLASTY SUBSTITUTE INJECTION LEAKAGE VOLUME Clinical Neurology Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 5 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2014 SN - 1591-0199 SP - 576-582 ST - Vertebroplasty Using Calcium Triglyceride Bone Cement (Kryptonite (TM)) for Vertebral Compression Fractures A Single-Centre Preliminary Study of Outcomes at One-Year Follow-up T2 - Interventional Neuroradiology TI - Vertebroplasty Using Calcium Triglyceride Bone Cement (Kryptonite (TM)) for Vertebral Compression Fractures A Single-Centre Preliminary Study of Outcomes at One-Year Follow-up UR - ://WOS:000353958200008 VL - 20 ID - 830257 ER - TY - JOUR AB - Background: With an increasing life expectancy and improved treatment regimens for primary or secondary malignant diseases of soft tissue or bone, hemipelvectomy will have to be considered more often in elderly patients in the future. Scientific reviews concerned with the surgical and oncological outcome of elderly patients undergoing hemipelvectomy are scarce. Therefore, it is the purpose of this study to review the outcome of patients treated with that procedure at our hospital and investigate the feasibility of such extensive procedures at an increased age. Methods: A retrospective analysis of thirty-four patients who underwent hemipelvectomy at an age of 65 years or older was performed to determine their surgical and oncological outcome. The Kaplan-Meier method was used to calculate the cumulative probability of survival using the day of tumor resection as a starting point. Univariate analysis was carried out to investigate the influence of a particular single parameter. Results: The mean age at operation was 70.2 years. Thirty patients were treated for intermediate- To high-grade sarcoma and 81.8% of tumors were larger than or equal to 10 cm in the longest diameter. Thirteen patients underwent internal hemipelvectomy and nine patients external hemipelvectomy as a primary procedure. Twelve patients were treated with external hemipelvectomy after failed local tumor control at primary operation. Wound infection occurred in 61.7% of cases. Three patients underwent amputation for non-manageable infection after internal hemipelvectomy. Hospital mortality was 8.8%. Clear resection margins were obtained in 88% of patients; in another 6% of patients planned intralesional resections were performed. Local recurrence occurred in 8.8% of patients at a mean time of 26 months after operation. Eleven patients are alive with no evidence of disease and 23 patients died of disease or other causes. Patients with pulmonary metastases had a mean survival period after operation to DOD of 22 months compared to 37 months in the curative group. Conclusion: Despite an elevated rate in hospital mortality and wound infection, this study suggests that hemipelvectomy is feasible in elderly patients, although requiring long hospitalization periods and causing a limited functional outcome. AD - W.K. Guder, Department of Orthopedics and Tumor Orthopedics, University Hospital Muenster, Building A1 Muenster, Germany AU - Guder, W. K. AU - Hardes, J. AU - Gosheger, G. AU - Henrichs, M. P. AU - Nottrott, M. AU - Streitbürger, A. DB - Embase Medline DO - 10.1186/s12891-015-0494-5 KW - orthopedic endoprosthesis antibiotic agent poly(methyl methacrylate) age aged amputation antibiotic therapy article bleeding blood clotting disorder cancer chemotherapy cancer control cancer radiotherapy cancer size cancer surgery cause of death chondrosarcoma clinical article Clostridium difficile infection confusion conservative treatment deep vein thrombosis device infection disorientation distant metastasis enterocolitis epidural bleeding external hemipelvectomy female fibrosarcoma follow up functional status giant cell tumor hemipelvectomy human internal hemipelvectomy intraoperative period leiomyosarcoma length of stay limited mobility lung embolism lung metastasis lymph vessel metastasis male mortality multiple organ failure operation duration operative blood loss osteoclastoma osteosarcoma outcome assessment overall survival paralytic ileus pleomorphic sarcoma postoperative period recurrent disease retrospective study sarcoma soft tissue metastasis surgical infection survival time thyroid cancer thyroid carcinoma urogenital tract injury very elderly mutars LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1471-2474 ST - Analysis of surgical and oncological outcome in internal and external hemipelvectomy in 34 patients above the age of 65 years at a mean follow-up of 56 months T2 - BMC Musculoskeletal Disorders TI - Analysis of surgical and oncological outcome in internal and external hemipelvectomy in 34 patients above the age of 65 years at a mean follow-up of 56 months UR - https://www.embase.com/search/results?subaction=viewrecord&id=L602630557&from=export http://dx.doi.org/10.1186/s12891-015-0494-5 VL - 16 ID - 829383 ER - TY - JOUR AB - Object. There is a strong correlation between the venous drainage pattern of intracranial dural arteriovenous shunts (ICDAVSs) and the affected patients' clinical presentation. The ICDAVSs that have cortical venous reflux (CVR) (retrograde leptomeningeal drainage: Borden Type 2 and 3 lesions) are very aggressive and have a poor natural history. Although the necessity of treatment remains debatable in ICDAVSs that drain exclusively into a sinus (Borden Type 1), lesions with CVR must be treated because of the negative effects of the retrograde venous drainage. Surgery, radiosurgery, and embolization have been proposed for management of these lesions, but endovascular therapy is considered the most appropriate therapeutic strategy in ICDAVSs. New embolic materials, such as Onyx, have been recently developed and are considered to represent a kind of "gold standard" for embolization of these lesions. The purpose of this study is to emphasize the importance of transarterial embolization using acrylic glue in the therapeutic management of ICDAVSs with CVR, and to compare the results the authors obtained using this treatment with those reported in the literature for Onyx treatment of the same type of dural shunts. Methods. The clinical and radiological records of 53 consecutive patients suffering from ICDAVSs with CVR (Borden Types 2 or 3) were reviewed. All cases were managed with the same angiographic and therapeutic protocol. Localization of the lesions, their clinical symptoms, their angioarchitecture, their therapeutic management, and the results were analyzed. Results. Fourteen ICDAVSs were located at the superior sagittal sinus and/or convexity veins, 13 at the transverse and sigmoid sinuses, 10 at the tentorium, 5 in the anterior cranial fossa, 4 at the foramen magnum, 3 at the torcula, 2 at the straight sinus, and 1 at the vein of Galen. One patient presented with an infantile form of ICDAVS with multiple shunts. Hemorrhage had occurred in 36% of cases. Forty-three patients underwent transarterial embolization (42 with acrylic glue). Complete closure of the fistula was obtained in 34 patients. Suppression of the CVR with partial occlusion of the main shunt was achieved in all other cases. No mortality or permanent morbidity was observed in this series. Conclusions. Intracranial dural arteriovenous shunts can be safely managed by transarterial embolization, which can be considered in most instances as an effective first-intention treatment. Acrylic glue still allows a cheap, fast, and effective treatment with high rates of cures that compare favorably to those obtained with new embolic materials. AD - G. Rodesch, Service de Neuroradiologie Diagnostique et Thérapeutique, Hôpital Foch, 40, rue Worth, 92151 Suresnes, France AU - Guedin, P. AU - Gaillard, S. AU - Boulin, A. AU - Condette-Auliac, S. AU - Bourdain, F. AU - Guieu, S. AU - Dupuy, M. AU - Rodesch, G. DB - Embase Medline DO - 10.3171/2009.7.JNS08490 KW - acrylic cement onyx copolymer adolescent adult aged anterior cranial fossa article artificial embolization brain arteriovenous malformation brain hemorrhage catheterization cerebellum tentorium child controlled study female foramen magnum Galen vein human intracranial dural arteriovenous shunt leptomeninx major clinical study male preschool child priority journal school child sigmoid sinus straight sinus superior sagittal sinus transverse sinus treatment outcome venous reflux L1 - http://thejns.org/doi/pdf/10.3171/2009.7.JNS08490 LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0022-3085 1933-0693 SP - 603-610 ST - Therapeutic management of intracranial dural arteriovenous shunts with leptomeningeal venous drainage: Report of 53 consecutive patients with emphasis on transarterial embolization with acrylic glue: Clinical article T2 - Journal of Neurosurgery TI - Therapeutic management of intracranial dural arteriovenous shunts with leptomeningeal venous drainage: Report of 53 consecutive patients with emphasis on transarterial embolization with acrylic glue: Clinical article UR - https://www.embase.com/search/results?subaction=viewrecord&id=L358422368&from=export http://dx.doi.org/10.3171/2009.7.JNS08490 VL - 112 ID - 829677 ER - TY - JOUR AB - A 22-year-old man presented with a sudden backache and paraplegia (ASIA = B). Magnetic resonance imaging showed an anterior pan-spinal epidural haematoma. Digital subtraction angiography was performed and ruled out an underlying vascular malformation but showed an active contrast media leakage into the T-4 ventral epidural space with a pattern of pseudo-aneurysm. A rupture of a T-4 retrocorporeal artery was considered as the aetiology, possibly caused by a haemorrhagic sub-adventitial dissection. Treatment consisted in the embolisation of both the pseudo-aneurysm and the parent artery with liquid acrylic glue, followed by neurosurgical decompression in emergency. The patient had totally recovered (ASIA = E) by the 10-month clinical follow-up. AD - F. Di Maria, Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47, Boulevard de l’Hôpital, Paris, France AU - Guédon, A. AU - Clarençon, F. AU - Law-Ye, B. AU - Sourour, N. AU - Gabrieli, J. AU - Rojas, P. AU - Chiras, J. AU - Peyre, M. AU - Di Maria, F. DB - Embase Medline DO - 10.1007/s00701-016-2806-4 KW - acrylic cement contrast medium adult artery rupture article artificial embolization backache cardiovascular catheter case report computer assisted tomography contrast enhancement contrast medium extravasation decompression surgery digital subtraction angiography epidural space false aneurysm general anesthesia human incision male microcatheter neurosurgery nuclear magnetic resonance imaging paraplegia posterior longitudinal ligament priority journal rupture of the retrocorporeal artery spinal hematoma vertebral canal young adult Cobra 1 Glubran LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 0942-0940 0001-6268 SP - 1121-1124 ST - Rupture of the retrocorporeal artery: a rare cause of spontaneous spinal epidural haematoma T2 - Acta Neurochirurgica TI - Rupture of the retrocorporeal artery: a rare cause of spontaneous spinal epidural haematoma UR - https://www.embase.com/search/results?subaction=viewrecord&id=L610082205&from=export http://dx.doi.org/10.1007/s00701-016-2806-4 VL - 158 ID - 829316 ER - TY - JOUR AB - Introduction. Vertebroplasty is a new procedure used in interventional neuroradiology, involving percutaneous introduction of acrylic cement. Clinical case. We present the case of a D10 vertebral hemangioma, which had progressed so as to cause compression of the spinal cord We teed combined treatment. Vertebroplasty was done with acrylic cement, using transpedicular percutaneous puncture, with subsequent bilateral laminectomy to decompress the spinal cord. One year later the clinical condition is completely satisfactory. The signs of paraparesia ann dorsalgia have disappeared. Posterior fixation was not necessary. Conclusions. Vertebroplasty is effective since the vertebral body is consolidated and pain avoided. We give details of the methodology, indications and possible complications of the technique of percutaneous vertebroplasty [REV NEUROL 1999; 28: 397-400]. AD - Hosp Miguel Servet, Secc Neuroradiol, Serv Radiodiagnost, E-50009 Zaragoza, Spain. Hosp Miguel Servet, Serv Neuorcirurg, E-50009 Zaragoza, Spain. AN - WOS:000079062300014 AU - Guelbenzu, S. AU - Gomez, J. AU - Garcia-Asensio, S. AU - Barrena, R. AU - Ferrandez, D. DA - Feb DO - 10.33588/rn.2804.98281 J2 - Rev. Neurologia KW - interventional radiology percutaneous vertebroplasty spine angioma surgery VERTEBRAL HEMANGIOMAS METHYL-METHACRYLATE CORD COMPRESSION EMBOLIZATION INJECTION Clinical Neurology LA - Spanish M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1999 SN - 0210-0010 SP - 397-400 ST - Preoperative percutaneous vertebroplasty in hemangioma compression T2 - Revista De Neurologia TI - Preoperative percutaneous vertebroplasty in hemangioma compression UR - ://WOS:000079062300014 VL - 28 ID - 830471 ER - TY - JOUR AB - The reason for revision of primary total hip arthroplasty is quoted as aseptic loosening in 60.6% of cases between 1979 and 2003 in the Swedish National Hip Arthroplasty Registry. Much research effort has been directed toward enhancing the bone-cement interface of total joint arthroplasties, in an attempt to reduce this complication. Haemostatic agents have been popularized as effective means of retarding the development of potentially harmful debris interposition adjacent to, and blood lamination patterns within, the methylmethacrylate. Such agents include hydrogen peroxide (H2O2), local freezing saline, saline at room temperature and adrenaline solution. One main concern with the use of hydrogen peroxide is whether it affects the material properties of bone cement such that in the long term it contributes to aseptic loosening. This would have enormous clinical consequences. Preliminary studies indicate that porosity increases and that the tensile strength and yield stresses are reduced by up to a factor of 10 by contaminating samples with increasing concentrations of hydrogen peroxide. We postulate that the current use of hydrogen peroxide as an irrigation solution in arthroplasty contributes to the development of aseptic loosening. (c) 2006 Elsevier Ltd. All rights reserved. AD - Cork Inst Technol, Dept Mech & Mfg Engn, Cork, Ireland. Guerin, S (corresponding author), 12 Kinsella Hall,Collegewood, Castleknock 15, Dublin, Ireland. johnmguerin@hotmail.com AN - WOS:000237171700017 AU - Guerin, S. AU - Harty, J. AU - Thompson, N. AU - Bryan, K. DO - 10.1016/j.mehy.2005.12.027 J2 - Med. Hypotheses KW - CEMENT-BONE INTERFACE EMBOLISM Medicine, Research & Experimental LA - English M1 - 6 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2006 SN - 0306-9877 SP - 1142-1145 ST - Hydrogen peroxide as an irrigation solution in arthroplasty - A potential contributing factor to the development of aseptic loosening T2 - Medical Hypotheses TI - Hydrogen peroxide as an irrigation solution in arthroplasty - A potential contributing factor to the development of aseptic loosening UR - ://WOS:000237171700017 VL - 66 ID - 830418 ER - TY - JOUR AB - Introduction: The outcome of pathological fracture due to large aggressive benign stage 3 Dormans and Flynn lesions [6] is often unsatisfactory and the rate of recurrence is high. No single technique has been considered safe and successful. Many Authors suggested curettage and bone grafting as the unique effective treatment in cases of large defect but, because of the invasive and complex nature of the operation (it needs a double-step procedure), it is not preferred. The purpose of this study is to examine the effectiveness of a minimally invasive treatment in one step through ESIN, curettage and packing with self-setting calcium phosphate cement. Patients and Methods: This is a retrospective study of 116 children admitted at the Division of Pediatric Orthopaedics Surgery of Santobono Children Hospital between 2006 and 2014 with a diagnosis of pathological fracture due to large aggressive ostheolytic benign lesions (stage 3 Dormans and Flynn). The size of bone loss was measured on the AP and ML radiographs and all the cysts with a caudo cranial extension from 5 to 8 cm and with a medio lateral extension from 3 to 5 cm were included. Mean time follow up 24 months was performed. Results: The three-in-one procedure was applied in all 116 patients. After two years of follow up, 113 patients were classified as healed and just 3 required 3 years to complete heal. No severe life threatening adverse effects or complications associated with the use of ESIN and injectable HA were recorded during the follow up period of 24-36 months. Fracture healing occurred in all cases within 4-6 weeks with adequate periosteal and endosteal callus formation. No second pathological fractures occurred in our series as well as no cysts reoccurred. Patients with humeral localizations showed a more rapid regain of muscular function and reestablishment of a complete range of motion. Conclusions: The proposed three-in-one procedure has shown to be efficient, cost-effective, associated to high rates of definitive bone healing and low incidence of adverse effects. (C) 2016 Elsevier Ltd. All rights reserved. AD - [Guida, Pasquale; Ragozzino, Roberto; Sorrentino, Biagio; Casaburi, Antonio; D'Amato, Raffaele Dario; Federico, Gianluigi] Santobono Pausilipon Children Hosp, Dept Orthopaed Surg, Naples, Italy. [Guida, Lelio] Univ Milan, Dept Neurosurg, Milan, Italy. [Assantino, Annarita] Univ Milan, Dept Anesthesiol, Milan, Italy. Guida, P (corresponding author), Santobono Pausilipon Children Hosp, Dept Orthopaed Surg, Naples, Italy. ple.guida@gmail.com AN - WOS:000376504700011 AU - Guida, P. AU - Ragozzino, R. AU - Sorrentino, B. AU - Casaburi, A. AU - D'Amato, R. D. AU - Federico, G. AU - Guida, L. AU - Assantino, A. DA - Jun DO - 10.1016/j.injury.2016.01.006 J2 - Injury-Int. J. Care Inj. KW - Pathological fracture Ostheolytic lesions UBC Bone cysts ESIN Curettage Bone substitute Calcium phosphate based cement Minimally invasive surgery MIS SELECTIVE ARTERIAL EMBOLIZATION GRADE CALCIUM-SULFATE TERM-FOLLOW-UP METHYLPREDNISOLONE ACETATE PERCUTANEOUS SCLEROTHERAPY STEROID INJECTION LONG BONES CHILDREN PELLETS FEMUR Critical Care Medicine Emergency Medicine Orthopedics Surgery LA - English M1 - 6 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2016 SN - 0020-1383 SP - 1222-1228 ST - "Three-in-One minimally invasive approach to surgical treatment of pediatric pathological fractures with wide bone loss through bone cysts: ESIN, curettage and packing with injectable HA bone substitute. A retrospective series of 116 cases.'' T2 - Injury-International Journal of the Care of the Injured TI - "Three-in-One minimally invasive approach to surgical treatment of pediatric pathological fractures with wide bone loss through bone cysts: ESIN, curettage and packing with injectable HA bone substitute. A retrospective series of 116 cases.'' UR - ://WOS:000376504700011 VL - 47 ID - 830217 ER - TY - JOUR AD - *Department of Diagnostic and Interventional Imaging, The University of Texas Medical School at Houston, Houston, Texas (E-mail: girish.s.shroff@uth.tmc.edu). AN - 24534786 AU - Guirguis, M. S. AU - Shroff, G. S. DA - May DO - 10.1097/maj.0000000000000211 DP - NLM ET - 2014/02/19 J2 - The American journal of the medical sciences KW - Aged Asymptomatic Diseases Bone Cements/*therapeutic use Humans *Lumbar Vertebrae/injuries/surgery Male Postoperative Complications/*diagnostic imaging *Pulmonary Embolism/diagnostic imaging/etiology Radiography Spinal Fractures/*surgery Vertebroplasty/*adverse effects/methods LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 0002-9629 SP - e5 ST - Cement pulmonary embolism T2 - Am J Med Sci TI - Cement pulmonary embolism VL - 349 ID - 828701 ER - TY - JOUR AB - Objective: Vertebral hemangiomas are common benign vascular lesions. They are often asymptomatic. Pain is the most common symptom. Treatment options are: surgery, intralesional injection of alcohol, vertebroplasty with methyl methacrylate, embolisation, and radiotherapy. We present the results of radiotherapy in symptomatic vertebral hemangiomas treated in our clinic. Methods: 34 patients (24 female, 10 male; mean age 52; range 30 to 65 years) with symptomatic vertebral hemangiomas were treated with external radiotherapy at a dose of 24-40 Gy. All patients had pain and one patient had paraplegia at presentation. Results in terms of pain and pain reliefwere assessed before and after therapy and during follow-up. Results: After radiotherapy, 6 patients had less than 50% response to treatment, 10 patients had more than 50%, and 18 patients had a complete response with a median follow-up of 48 months. Conclusion: Radiotherapy is a non-invasive, safe, and effective treatment option for symptomatic vertebral hemangiomas, especially those cases in which pain is the main symptom. AD - S.K. Gul, Department of Radiation Oncology, Kartal Education and Research Hospital, Istanbul, Turkey AU - Gul, S. K. AU - Gul, H. L. AU - Karadaş, O. AU - Oruc, A. F. AU - Gedik, D. AU - Mayadagli, A. DB - Embase DO - 10.1016/j.jns.2013.07.1877 KW - alcohol methacrylic acid methyl ester hemangioma neurology radiotherapy human patient pain follow up percutaneous vertebroplasty external beam radiotherapy vascular lesion male female hospital intralesional drug administration artificial embolization paraplegia therapy surgery LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0022-510X SP - e533 ST - Radiotherapy in symptomatic vertebral hemangiomas T2 - Journal of the Neurological Sciences TI - Radiotherapy in symptomatic vertebral hemangiomas UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71189442&from=export http://dx.doi.org/10.1016/j.jns.2013.07.1877 VL - 333 ID - 829475 ER - TY - JOUR AD - Herzzentrum Niederrhein, Medizinische Klinik I, HELIOS Klinikum Krefeld. Institut für Herz-Kreislauf-Forschung Krefeld, An-Institut der Universität zu Köln. Institut für Diagnostische und Interventionelle Radiologie, HELIOS Klinikum Krefeld. AN - 30508861 AU - Gülker, J. E. AU - Keßler, M. AU - Freyhardt, P. DA - Dec DO - 10.1055/a-0734-3848 DP - NLM ET - 2018/12/07 J2 - Deutsche medizinische Wochenschrift (1946) KW - Embolectomy Female Humans Incidental Findings Kyphoplasty/*adverse effects Middle Aged *Pulmonary Embolism/diagnostic imaging/etiology/surgery Radiography, Thoracic Tomography, X-Ray Computed LA - ger M1 - 24 N1 - PubMed NLM literature search January 5, 2021 OP - Zufallsbefund im Röntgen-Thorax. PY - 2018 SN - 0012-0472 SP - 1789-1790 ST - [Incidental Finding in the Chest X-Ray] T2 - Dtsch Med Wochenschr TI - [Incidental Finding in the Chest X-Ray] VL - 143 ID - 828495 ER - TY - JOUR AB - Various complications including air embolism have been discussed in large clinical series regarding the parasagittal meningioma. We presented and discussed the patient suffering from persistent hypotension after excision of parasagittal meningioma. A 47-year-old man was admitted to our hospital with complaints of headache and frontal region swelling. His cranial MRI showed a bilaterally located parasagittal meningioma at the anterior one third of the sagittal sinus. Conspicuously, he had large frontal sinus and its length was about totally 7 cm in sagittal and transverse part. During cranitomy, we had to open frontal sinus because of its large size and open the sagittal sinus while removing of the tumor. So coincidental opening of the superior sagittal sinus and/or emissary veins located within diploe of the cranium and frontal sinus may cause hypotension after extubation due to normal respiration led to air escaping from the frontal sinus to the emissary veins placed next to the frontal sinus. Bilateral application of the tamponade embedded with vaseline inside to the nose prevents air escaping from the frontal sinus to the emissary veins. AD - S. Gulsen, Department of Neurosurgery, Faculty of Medicine, Baskent University Medical Faculty Department of Neurosurgery, Fevzi Cakmak Caddesi 10. Sokak no: 45, Cankaya, Bahcelievler, Ankara, Turkey AU - Gulsen, S. DB - Embase DO - 10.3889/oamjms.2014.086 KW - dopamine gadolinium poly(methyl methacrylate) adult article cancer surgery case report contrast enhancement craniotomy end tidal carbon dioxide tension frontal sinus frontoparietal cortex headache human hypotension magnetic resonance angiography male meningioma nuclear magnetic resonance imaging parasagittal meningioma pedicled skin flap persistent hypotension postoperative period superior sagittal sinus swelling tumor invasion LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1857-9655 SP - 483-487 ST - Management of persistent hypotension after resection of parasagittal meningioma T2 - Open Access Macedonian Journal of Medical Sciences TI - Management of persistent hypotension after resection of parasagittal meningioma UR - https://www.embase.com/search/results?subaction=viewrecord&id=L617472148&from=export http://dx.doi.org/10.3889/oamjms.2014.086 VL - 2 ID - 829411 ER - TY - JOUR AB - PurposeTo evaluate the incidence, type and risk factors of cement leakage (CL) with cement-augmented pedicle screw instrumentation (CAPSI) in degenerative lumbosacral disease.MethodsTwo hundred and two patients using a total of 950 cement-augmented screws were enrolled. CL was classified into three types: type S: leakage via segmental veins; type B: leakage via basivertebral veins; and type I: leakage via pedicle screw instrumentation to paravertebral soft tissue. The age, gender, operation stage (primary or later stage), body mass index, bone mineral density, the number and type of augmented screw, the position of the tip of screw (lateral or internal part of vertebral body), the position of screw (left or right side), the volume of bone cement, location of the augmented vertebra (lumbar or sacrum), the type of CL and complications were recorded. Binary logistic regression correlation was used to analyze risk factors of veins leakage (type S and type B).ResultsThe CL was observed in 165 patients (81.68%) and 335 screws (35.26%), leakage types of S, B and I were seen in 255 (76.12%), 77 (22.99%), and 30 (8.96%) of screws, respectively. Besides, double or multiple routes of leakage were seen in 27 screws. Number of augmented screw was a risk factor for vein leakage (OR 0.58; 95% CI 0.44-0.77; P=0.000). Furthermore, the doses of cement (OR 0.79; 95% CI 0.61-0.99; P=0.038) and the position of screw (OR 0.39; 95% CI 0.29-0.53; P=0.000) were identified as risk factors for type S, and the doses of bone cement (OR 0.37; 95% CI 0.25-0.54; P=0.000) and the position of the tip of screw (OR 0.07; 95% CI 0.04-0.13; P=0.000) were risk factors for type B.ConclusionsCAPSI bears a high risk of asymptomatic CL, with a higher rate of leakage into segmental veins and basivertebral veins. As is known, more augmented screws and larger doses of cement are risk factors for veins leakage (type S and type B), while the tip of screw approaching to the midline of the vertebral body is another risk factor to type B. Thus, the CL could be reduced by the amelioration of operative techniques and procedures.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material. [GRAPHICS] . AD - [Guo, Hui-zhi; Guo, Dan-qing; Zhang, Shun-cong; Li, Yong-xian; Mo, Guo-ye; Luo, Pei-jie; Zhou, Ten-peng; Ma, Yan-huai] Guangzhou Univ Chinese Med, 12 Airport Rd, Guangzhou 510405, Guangdong, Peoples R China. [Guo, Hui-zhi; Tang, Yong-chao; Zhang, Shun-cong; Li, Yong-xian; Mo, Guo-ye; Luo, Pei-jie; Zhou, Ten-peng; Ma, Yan-huai; Liang, De; Jiang, Xiao-bing] Guangzhou Univ Chinese Med, Affiliated Hosp 1, Guangzhou 510407, Guangdong, Peoples R China. Zhang, SC (corresponding author), Guangzhou Univ Chinese Med, 12 Airport Rd, Guangzhou 510405, Guangdong, Peoples R China.; Zhang, SC (corresponding author), Guangzhou Univ Chinese Med, Affiliated Hosp 1, Guangzhou 510407, Guangdong, Peoples R China. 18122436960@163.com AN - WOS:000476773100014 AU - Guo, H. Z. AU - Tang, Y. C. AU - Guo, D. Q. AU - Zhang, S. C. AU - Li, Y. X. AU - Mo, G. Y. AU - Luo, P. J. AU - Zhou, T. P. AU - Ma, Y. H. AU - Liang, D. AU - Jiang, X. B. DA - Jul DO - 10.1007/s00586-019-05985-4 J2 - Eur. Spine J. KW - Cement-augmented pedicle screw Cement leakage Risk factors Degenerative lumbosacral disease SPINAL-FUSION RISK-FACTORS PERCUTANEOUS VERTEBROPLASTY BONE FIXATION EMBOLISM KYPHOPLASTY VISCOSITY STRENGTH OUTCOMES Clinical Neurology Orthopedics LA - English M1 - 7 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 0940-6719 SP - 1661-1669 ST - The cement leakage in cement-augmented pedicle screw instrumentation in degenerative lumbosacral diseases: a retrospective analysis of 202 cases and 950 augmented pedicle screws T2 - European Spine Journal TI - The cement leakage in cement-augmented pedicle screw instrumentation in degenerative lumbosacral diseases: a retrospective analysis of 202 cases and 950 augmented pedicle screws UR - ://WOS:000476773100014 VL - 28 ID - 830134 ER - TY - JOUR AB - OBJECTIVE: To retrospectively review the different types of surgical procedures for pelvic metastases, especially for periacetabular metastases. METHODS: Eighty-eight patients with pelvic metastasis received surgical treatment between July 1997 and July 2005. The series included 40 females and 48 males, with an average age of 54 years. The original sites of carcinoma included 23 from breast, 15 from lung, 13 form kidney, 3 from thyroid, 2 from bladder, 3 from prostate, 3 form liver, 7 from gastro intestine, and 3 from gynecological viscera Thirteen cases were diagnosed as unknown primary metastases. Thirty-two patients had solitary metastasis and 56 patients had multiple bone metastases. Eighteen patients had Type I pelvic resections, 50 had type II, and 10 patients had Type III and Type IV each. Surgical treatments included 72 intralesional curettages and 16 en bloc resections. In 29 patients, the bone defect after tumor resection was reconstructed with methyl acrylate alone or combined with Steinmann pins and screw-rod system. Acetabular reconstructions underwent in 50 patients. Local resections with no reconstructions were done in 5 patients, and hemipelvectomy in 4 patients. RESULTS: The mean time of follow-up was 13 months, ranging from 6 to 24 months. Twenty-nine patients were lost follow-up. Postoperative improvements in 86 (97.8%) patients were seen in pain and mobility scores. The average VAS pain scores were 7.2 points preoperatively and 3.5 points postoperatively. Postoperative function was evaluated according to Enneking's criteria, with a mean score of 19.2 points, including 16.4 points for periacetabular lesions and 23.5 for others. Local recurrence was seen in 11 patients, the average recurrence time was 5.6 months after surgery. Surgical complications occurred in 12 patients, including 8 wound complications, 2 multi-organ function failures, 1 pulmonary embolism, and 2 dislocations. CONCLUSIONS: The indications of surgical intervention for pelvic metastasis are severe pain and difficulty in ambulation. The surgical objective is alleviation of pain, restore the mobility and stability of the hip. The surgical procedure for most metastases is curettage and cement filling. Wide resection is an alternative method for solitary pelvic metastasis with good prognosis. AD - Department of Orthopaedic Oncology, Peking University People's Hospital, Beijing 100044, China. bonetumor@163.com AN - 19035145 AU - Guo, W. AU - Tang, X. D. AU - Yang, Y. AU - Ji, T. DA - Jun 15 DP - NLM ET - 2008/11/28 J2 - Zhonghua wai ke za zhi [Chinese journal of surgery] KW - Acetabulum Adult Aged Aged, 80 and over Bone Neoplasms/pathology/*secondary/surgery Female Follow-Up Studies Humans Male Middle Aged Neoplasm Metastasis *Pelvic Bones Retrospective Studies Treatment Outcome LA - chi M1 - 12 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 0529-5815 (Print) 0529-5815 SP - 891-4 ST - [Surgical treatment and outcome of pelvic metastases] T2 - Zhonghua Wai Ke Za Zhi TI - [Surgical treatment and outcome of pelvic metastases] VL - 46 ID - 829000 ER - TY - JOUR AB - There is a paucity of literature on vertebroplasty in hemangioma. The effectiveness with short-term and long-term follow-up is an important insight for research. This study aims to evaluate the effectiveness and the long-term efficacy of vertebroplasty in the treatment of the patient with symptomatic vertebral hemangioma. Materials and methods: This is a retrospective cohort study. The outcome was evaluated by immediate post-procedure and 3 months, 1 year, and 5 years of follow-up clinical status of the patients. The significance was determined by using a paired t-test between the pre-procedure and post-procedure severity of pain, activity score, and analgesic. The P-value < 0.05 indicated statistical significance. Results: A total of 38 vertebroplasties were performed in 34 patients. Additionally, the embolization of residual soft tissue was performed in 4 patient and Percutaneous alcohol injection for posterior elements involvement was performed in 9 patients. Immediate after the procedure, 44.12% of patients became asymptomatic, 38.23% of patients showed significant improvement, 11.77% of patients remained static and 2.94% of patients deteriorated and needed laminectomy. The complication rate was 29.4%, but only 2 patients were symptomatic and needed surgical decompression. There was significant relief of pain (P < 0.05), reduced analgesic intake (P < 0.05), and increased activity (P < 0.05) immediately after the procedure, 3 months, 1 year, and 5 years follow-up. Conclusion: PVP is an effective therapeutic option for the treatment of VH with fewer complications. The additional procedures like preprocedural embolization and percutaneous alcohol injection enhance the outcome and avoid complicated surgical interventions. AD - P. Phukan, Department Radiology & Imaging, North Eastern Indira Gandhi Regional Institute of Health & Medical Science, Mawdiangdiang, Shilling, Meghalaya, India AU - Gupta, A. K. AU - Phukan, P. AU - Bodhey, N. DB - Embase DO - 10.1016/j.inat.2020.100968 KW - adult article artificial embolization case report clinical article cohort analysis comparative effectiveness complication decompression surgery female follow up human laminectomy male pain percutaneous vertebroplasty retrospective study soft tissue statistical significance vertebra hemangioma alcohol analgesic agent bone cement LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2021 SN - 2214-7519 ST - Percutaneous vertebroplasty for the treatment of symptomatic vertebral hemangioma with long-term follow-up T2 - Interdisciplinary Neurosurgery: Advanced Techniques and Case Management TI - Percutaneous vertebroplasty for the treatment of symptomatic vertebral hemangioma with long-term follow-up UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2010194073&from=export http://dx.doi.org/10.1016/j.inat.2020.100968 VL - 23 ID - 829042 ER - TY - JOUR AB - Aneurysmal bone cysts (ABC) are expansile lytic lesions constituting around 1% of all benign bone tumors with an annual incidence of 1.4/100000. A variety of treatments are available ranging from curettage with or without bone grafting (autologous or allogeneic), curettage with use of adjuvants [Polymethylmethacrylate (PMMA) bone cement, high speed burr, phenol, liquid nitrogen], wide en-block excision with or without reconstruction, selective arterial embolization of the feeding vessels, radiation therapy, high precision megavoltage radiotherapy and percutaneous radio-nuclide ablation, sclerotherapy (ethibloc, aetoxisclerol, alcohol gel, polidocanol). The optimal treatment is debatable due to various indications and contraindications of different modalities of treatment. Recent data suggest that percutaneous sclerotherapy with polidocanol is safe and effective alternative to surgery for treatment of ABCs as it has minimal side effects. We are reporting the first case of life-threatening adverse reaction to intra-lesional polidocanol in a three-year-old boy with a proximal femoral aneurysmal bone cyst. The importance of reporting this case is to make people aware regarding the adverse reaction of polidocanol and to highlight the precautions one should follow while using polidocanol for aneurysmal bone cysts. AD - Ortho Kids Clinic, Ahmedabad, India. Indraprastha Apollo Hospital, New Delhi, India. AN - 30828217 AU - Gupta, G. AU - Pandit, R. S. AU - Jerath, N. AU - Narasimhan, R. C2 - Pmc6383131 DA - Mar-Apr DO - 10.1016/j.jcot.2018.05.010 DP - NLM ET - 2019/03/05 J2 - Journal of clinical orthopaedics and trauma KW - Aneurysmal bone cyst Life-threatening Pediatric orthopedics Polidocanol Safety LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 0976-5662 (Print) 0976-5662 SP - 414-417 ST - Severe life-threatening hypersensitivity reaction to polidocanol in a case of recurrent aneurysmal bone cyst T2 - J Clin Orthop Trauma TI - Severe life-threatening hypersensitivity reaction to polidocanol in a case of recurrent aneurysmal bone cyst VL - 10 ID - 828686 ER - TY - JOUR AB - INTRODUCTION: The number of patients suffering from malignant tumors with bony metastases has been increasing. Surgery makes it possible to preserve physical function and decrease pain. Safe and efficient techniques for filling cancer-related bone defects within the pelvis are still being searched for. MATERIAL AND METHODS: A total of 13 patients with cancer metastases to the acetabular ceiling area in the hip were operated on using vertebroplasty sets in the Oncological Orthopedics Department in Brzozów in the years 2010-2013. A percutaneous approach was employed in 4 patients, while in 9 the surgery was combined with acetabulofemoral joint resection and arthroplasty. Patient qualification for the treatment took into account the size and shape of the bone defect as determined per computed tomography. Pain intensity (VAS scale) and gait efficiency were evaluated before and after the treatment. RESULTS: All patients reported a distinct decrease in pain intensity. All of them started to ambulate and loading the joint did not aggravate the symptoms. No thrombo-embolic or infectious complications were observed. The mobility of the operated joints was good. CONCLUSIONS: The filling of lytic bone defects in the acetabular ceiling area determines walking efficiency and reduced pain intensity. Surgical procedures take a long time, are complicated and associated with a high risk of complications. Percutaneous administration of bone cement may be an alternative solution in patients with an intact cortical bone layer. The literature data indicate good outcomes of this approach, with a minimal number of complications. Acetabuloplasty with bone cement is a safe and effective treatment method in the case of cancer metastases to the acetabular ceiling area. AD - Department of Oncological Orthopaedics, Specialist Hospital in Brzozów - Podkarpacie Oncological Centre, Poland. AN - 25041883 AU - Guzik, G. DA - Mar-Apr DO - 10.5604/15093492.1105221 DP - NLM ET - 2014/07/22 J2 - Ortopedia, traumatologia, rehabilitacja KW - Aged Arthroplasty, Replacement, Hip/*methods *Bone Cements Bone Neoplasms/*surgery Female Hip Joint/*surgery Hip Prosthesis/*adverse effects Humans Male Middle Aged Neoplasm Metastasis/*therapy Poland Prosthesis Failure Reoperation Vertebroplasty/*methods LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1509-3492 SP - 129-37 ST - Cemented reconstruction of acetabular ceiling using the vertebroplasty set in treatment of metastatic lesions T2 - Ortop Traumatol Rehabil TI - Cemented reconstruction of acetabular ceiling using the vertebroplasty set in treatment of metastatic lesions VL - 16 ID - 828675 ER - TY - JOUR AB - The authors reported a case of 75-year-old man who had pulmonary artery thromboembolism after femoral head endprosthesis, resulted in acute respiratory distress. He had a left femoral neck fracture by a fall during hospitalization for the treatment of his heart disease. He were underwent femoral head endprosthesis by using bone cement under spinal anesthesia. After one hour of operation, a severe respiratory distress, a drop of blood pressure were observed. Despite of immediate resusciation, he had cardiorespiratory arrest, resulted in acute death. At autopsy a massive fresh thromboembolus was found in the trunk of right pulmonary artery. During under microscopic examination erythropoetic cells in fatty tissue were identified in the thromboembolus. These findings suggested that femoral bone marrow tissue spreading at operation induced the thromboembolism in the pulmonary artery. For the prevention of the pulmonary artery thromboembolism, examination of medical specialist were important pre- and post-operatively. AD - M. Miyatsu, Department of Orthopaedic Surgery, Asahikawa Red Cross Hospital, Asahikawa, Japan AU - Habaguchi, T. AU - Miyatsu, M. AU - Kamo, Y. AU - Yasuda, M. AU - Yagura, U. DB - Embase KW - aged article bone marrow cardiopulmonary insufficiency case report femur head prosthesis femoral neck fracture heart arrest human lung embolism male postoperative complication pulmonary artery respiratory arrest respiratory distress thromboembolism LA - Japanese M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1998 SN - 1343-3873 SP - 56-58 ST - A case of pulmonary artery thromboembolism due to intra-venous flow marrow tissue after femoral head endprothesis T2 - Hokkaido Journal of Orthopaedics and Traumatology TI - A case of pulmonary artery thromboembolism due to intra-venous flow marrow tissue after femoral head endprothesis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L29019319&from=export VL - 41 ID - 829903 ER - TY - JOUR AB - BACKGROUND: Because of the aging of the American population, osteoporotic vertebral fractures are becoming a common problem in the elderly. Minimally invasive percutaneous vertebral augmentation techniques have gained a great deal of importance in relieving the pain associated with these fractures, and are becoming the standard of care. METHODS: These procedures involve the injection of polymethylmethacrylate (PMMA) into the vertebral body. However, these techniques have their complications, and among these, pulmonary embolism is one of the most feared. It is attributable to the passage of cement into the pulmonary vasculature. After encountering a case of PMMA embolism in our practice, we decided to highlight this topic and discuss the incidence, clinical presentation, diagnosis, and treatment of cement pulmonary embolisms. AD - Department of Medicine, Staten Island University Hospital, Staten Island, New York 10305, USA. AN - 22425258 AU - Habib, N. AU - Maniatis, T. AU - Ahmed, S. AU - Kilkenny, T. AU - Alkaied, H. AU - Elsayegh, D. AU - Chalhoub, M. AU - Harris, K. DA - Sep-Oct DO - 10.1016/j.hrtlng.2012.02.008 DP - NLM ET - 2012/03/20 J2 - Heart & lung : the journal of critical care KW - Bone Cements/*adverse effects/therapeutic use Diagnosis, Differential Female Fractures, Compression/*surgery Humans Kyphoplasty/*adverse effects/methods Middle Aged Polymethyl Methacrylate/adverse effects/therapeutic use Pulmonary Embolism/*chemically induced/diagnostic imaging Spinal Fractures/*surgery Thoracic Vertebrae/*injuries/surgery Tomography, X-Ray Computed Vertebroplasty/adverse effects/methods LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0147-9563 SP - 509-11 ST - Cement pulmonary embolism after percutaneous vertebroplasty and kyphoplasty: an overview T2 - Heart Lung TI - Cement pulmonary embolism after percutaneous vertebroplasty and kyphoplasty: an overview VL - 41 ID - 828786 ER - TY - JOUR AB - Background: Metastases to spine from renal cell carcinoma is challenging to manage as they are chemo and radioresistant along with being rapidly expansile and extremely hyper vascular. Also, they continue to cause pain and may result in cord compression leading to subsequent neurodeficit. Total en-bloc resection remains the gold standard surgical intervention but is associated with increased morbidity. Hence, posterior decompression and fixation has been the current standard of surgical care. However, considering the risk of massive blood loss in renal cell carcinoma, pre-operative embolization within 48 h of surgery is recommended. Vertebroplasty has been described for stabilization of osteoporotic compression fractures as well as for metastatic vertebral body lesions. It offers both pain relief and anterior column support which may be lacking with posterior fixation. Case Description: The authors describe a 26-year-old paraplegic female with grade 4 renal cell carcinoma having metastatic deposits to dorsal spine with cord compression. She underwent pre-operative embolization 36 h prior to surgical intervention, which included vertebroplasty, decompression and posterior fixation with screws/rod. Conclusion: Preoperative embolization decreases the risk of intraoperative haemorrhage in hyper vascular spinal metastases such as renal cell carcinoma. Vertebroplasty as an adjuvant to posterior surgical stabilisation is becoming a standard of care for palliative pain control associated with pathological vertebral compression fractures as it also provides an anterior column support helping in early ambulation. Also, Fuhrman's grading can be relied upon as an independent prognostic factor. AD - A. Zawar, Department of Orthopedics, University of Dundee, Dundee, United Kingdom AU - Hadgaonkar, S. AU - Zawar, A. AU - Sanghavi, S. AU - Kothari, A. AU - Sancheti, P. AU - Shyam, A. DB - Embase DO - 10.1016/j.inat.2020.100994 KW - adult analgesia article artificial embolization cancer adjuvant therapy cancer prognosis cancer surgery case report clinical article compression fracture decompression female health care quality human mobilization operative blood loss osteoporosis paraplegia percutaneous vertebroplasty renal cell carcinoma spinal cord compression spinal cord metastasis surgery vertebra body adjuvant LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2021 SN - 2214-7519 ST - Spinal metastases from renal cell carcinoma: Case note with an overview T2 - Interdisciplinary Neurosurgery: Advanced Techniques and Case Management TI - Spinal metastases from renal cell carcinoma: Case note with an overview UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2010078518&from=export http://dx.doi.org/10.1016/j.inat.2020.100994 VL - 23 ID - 829041 ER - TY - JOUR AB - Vertebral haemangiomas are usually asymptomatic and discovered fortuitously during imaging. A small proportion may develop variable degrees of pain and neurological deficit. We prospectively studied six patients who underwent eight surgical procedures on 11 vertebral bodies. There were 11 balloon kyphoplasties, six lumbar and five thoracic. The mean follow-up was 22.3 months (12 to 36). The indications for operation were pain in four patients, severe back pain with Frankel grade C paraplegia from cord compression caused by soft-tissue extension from a thoracic vertebral haemangioma in one patient, and acute bleeding causing Frankel grade B paraplegia from an asymptomatic vascular haemangioma in one patient. In four patients the exhibited aggressive vascular features, and two showed lipomatous, non-aggressive, characteristics. One patient who underwent a unilateral balloon kyphoplasty developed a recurrence of symptoms from the non-treated side of the vertebral body which was managed by a further similar procedure. Balloon kyphoplasty was carried out successfully and safely in all patients; four became asymptomatic and two showed considerable improvement. Neurological recovery occurred in all cases but bleeding was greater than normal. To avoid recurrence, complete obliteration of the lesion with bone cement is indicated. For acute bleeding balloon kyphoplasty should be combined with emergency decompressive laminectomy. For intraspinal extension with serious neurological deficit, a combination of balloon kyphoplasty with intralesional alcohol injection is effective. AD - Univ Crete, Div Spine Surg, Dept Orthopaed Surg & Traumatol, Iraklion 71110, Crete, Greece. Hadjipavlou, A (corresponding author), Univ Crete, Div Spine Surg, Dept Orthopaed Surg & Traumatol, Iraklion 71110, Crete, Greece. ahadjipa@med.uoc.gr AN - WOS:000246888000013 AU - Hadjipavlou, A. AU - Tosounidis, T. AU - Gaitanis, I. AU - Kakavelakis, K. AU - Katonis, P. DA - Apr DO - 10.1302/0301-620x.89b4.18121 J2 - J. Bone Joint Surg.-Br. Vol. KW - SPINAL-CORD COMPRESSION PERCUTANEOUS VERTEBROPLASTY INTRALESIONAL INJECTION NATURAL-HISTORY FOLLOW-UP RADIOTHERAPY EMBOLIZATION ALCOHOL LESIONS Orthopedics Surgery LA - English M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2007 SN - 0301-620X SP - 495-502 ST - Balloon kyphoplasty as a single or as an adjunct procedure for the management of symptomatic vertebral haemangiomas T2 - Journal of Bone and Joint Surgery-British Volume TI - Balloon kyphoplasty as a single or as an adjunct procedure for the management of symptomatic vertebral haemangiomas UR - ://WOS:000246888000013 VL - 89B ID - 830398 ER - TY - JOUR AD - Assistant Professor, Department of Orthopaedics, University Hospital of Crete, PO Box 1352, Heraklion 71110, Crete, Greece; ahadjipa@med.uoc.gr AN - 106418477. Language: English. Entry Date: 20060331. Revision Date: 20150711. Publication Type: Journal Article AU - Hadjipavlou, A. G. AU - Tzermiadianos, M. N. AU - Katonis, P. G. AU - Szpalski, M. DB - cin20 DP - EBSCOhost KW - Back Pain -- Surgery Orthopedic Surgery -- Methods Spinal Fractures -- Surgery Spinal Neoplasms -- Surgery Medical Practice, Evidence-Based Neoplasm Metastasis Patient Selection Decision Making, Clinical Meta Analysis Logistic Regression Data Analysis Software Descriptive Statistics Diagnostic Imaging -- Methods Magnetic Resonance Imaging Treatment Outcomes Body Weights and Measures Treatment Complications, Delayed Pulmonary Embolism -- Etiology Bone Cements Neurologic Manifestations Radiation Injuries -- Prevention and Control Osteoporosis Bone Resorption Human M1 - 12 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2005 SN - 0301-620X SP - 1595-1604 ST - Percutaneous vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures and osteolytic tumours T2 - Journal of Bone & Joint Surgery, British Volume TI - Percutaneous vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures and osteolytic tumours UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106418477&site=ehost-live&scope=site VL - 87B ID - 830778 ER - TY - JOUR AB - Intraoperative pulmonary embolism occurs not only during cemented but also during cementless total hip arthroplasty (THA). We determined whether the ROBODOC femoral milling system can reduce intraoperative pulmonary embolism, by using of transesophageal echocardiography and hemodynamic monitoring. We did a prospective clinical trial with 71 patients (75 hips) who were divided into 2 groups: group 1, 46 patients (50 hips) who underwent cementless THA with preparation of the femoral canal using ROBODOC; group 2, 25 patients (25 hips) who underwent conventional cementless THA surgery in whom separate measurements were made during preparation of the femur, insertion of the stem and relocation of the hip. The incidence of severe embolic events was lower in group 1 than in group 2. Our findings suggest that the ROBODOC femoral milling system may reduce the risk of clinically significant pulmonary embolism during cementless THA. AN - CN-00439783 AU - Hagio, K. AU - Sugano, N. AU - Takashina, M. AU - Nishii, T. AU - Yoshikawa, H. AU - Ochi, T. DO - 10.1080/00016470310014175 KW - Aged Arthroplasty, Replacement, Hip [*adverse effects] Blood Gas Analysis Bone Cements Cementation Echocardiography, Transesophageal Embolism, Fat [diagnosis, epidemiology, etiology, *prevention & control] Female Femur [*surgery] Hemodynamics Humans Incidence Male Middle Aged Monitoring, Intraoperative Osteotomy [*adverse effects, *instrumentation, methods] Prospective Studies Prosthesis Design Pulmonary Embolism [diagnosis, epidemiology, etiology, *prevention & control] Risk Factors Robotics [instrumentation, *methods] M1 - 3 M3 - Clinical Trial; Controlled Clinical Trial; Journal Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2003 SP - 264‐269 ST - Effectiveness of the ROBODOC system in preventing intraoperative pulmonary embolism T2 - Acta orthopaedica scandinavica TI - Effectiveness of the ROBODOC system in preventing intraoperative pulmonary embolism UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00439783/full VL - 74 ID - 830043 ER - TY - JOUR AB - Introduction Malignant disease and major orthopedic surgery are independently associated with a high risk of venous thromboembolism (VTE). We present a case of a massive pulmonary embolism during a routine orthopedic procedure. Results/Case report A 58 year-old male with a presumed pathologic left femur fracture presented for a scheduled left distal femur resection and reconstruction using a left knee endoprosthesis. He was physically active with no significant medical history. Prior to the procedure his left knee was tender to palpation with generalized swelling. A pre-operative left knee x-ray showed a lytic lesion of the lateral aspect of the left distal femur. MRI showed pathologic changes suggestive of necrosis consistent with metastatic disease, multiple myeloma, or a giant cell tumor with plans to follow-up biopsy results after the case. The patient received a pre-operative left femoral nerve block for post-operative pain control. After an uneventful induction with lidocaine 2%, propofol, and vecuronium, the patient was prepped and draped. The case progressed smoothly using desflurane for maintenance with stable vital signs until three hours into the case. As polymethylmethacrylate cement was impacted onto the patella, the patient's end tidal CO2 plummeted from a baseline of 28 to 11mmHg and he became progressively hypoxemic without response to 100% oxygen. The patient quickly became unstable with a heart rate in the 160's and blood pressure became unattainable prior to decompensating into cardiac arrest requiring advanced cardiac life support. A cardiothoracic surgeon and cardiothoracic anesthesiologist were called into the room and a transesophageal echocardiogram (TEE) probe was placed revealing cardiac standstill, severe tricuspid regurgitation, bowing of the intra-atrial septum to the left, and severe right sided heart dilation consistent with a diagnosis of acute pulmonary embolism. No flow was seen in the right pulmonary artery and limited flow seen in the left pulmonary artery. The patient was then placed on extracorporeal membrane oxygenation and vasopressor support. A pulmonary angiogram was performed revealing bilateral, multiple segmental pulmonary emboli. The patient was transferred to a fluoroscopy suite where a cardiac interventionalist performed a selective pulmonary embolectomy resulting in an approximate improvement of right lung circulation by 50-75%. The patient was transferred to the intensive care unit and once stabilized, received an inferior vena cava filter on post-operative day 5. The patient recovered well with physical and occupational therapy and was discharge to an acute rehabilitation facility on post-operative day 19. Discussion Malignant bone tumors during endoprosthesis procedures may warrant VTE prophylaxis prior to orthopedic surgery. AD - M. Hall, Keck Medicine of USC, United States AU - Hall, M. AU - Movahedi, R. DB - Embase DO - 10.1097/AAP.0000000000000680 KW - desflurane hypertensive factor lidocaine oxygen propofol vecuronium adult anesthesiologist biopsy blood pressure bone cancer cancer surgery case report dextrocardia diagnosis distal femur echocardiography embolectomy end tidal carbon dioxide tension extracorporeal oxygenation femoral nerve fluoroscopy follow up fracture giant cell tumor heart arrest heart rate human human tissue intensive care unit interatrial septum knee prosthesis lung angiography lung circulation lung embolism male medical history metastasis middle aged multiple myeloma necrosis nerve block nuclear magnetic resonance imaging occupational therapy orthopedic surgery palpation patella postoperative pain prophylaxis pulmonary artery rehabilitation resuscitation right lung surgery swelling thoracic surgeon tricuspid valve regurgitation vena cava filter vital sign X ray LA - English M1 - 6 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1532-8651 ST - Massive pulmonary embolism during a routine orthopedic procedure T2 - Regional Anesthesia and Pain Medicine TI - Massive pulmonary embolism during a routine orthopedic procedure UR - https://www.embase.com/search/results?subaction=viewrecord&id=L619777786&from=export http://dx.doi.org/10.1097/AAP.0000000000000680 VL - 42 ID - 829286 ER - TY - JOUR AB - Intracranial dural arteriovenous fistulas constitute a rare though potentially devastating disease. Because the arterial (high-pressure) blood flow drains directly into the low-pressure venous system, there is a high risk of bleeding and associated neurological deficit. The classifications by Borden and Cognard underline the correlation between bleeding risk and venous drainage pattern of the fistula. There are different treatment options for this vascular pathology, which always poses a challenge for the physicians involved to offer the optimal treatment for an individual patient. This case report illustrates how combining forces between the neurosurgical and endovascular team benefits outcome. Simultaneously, this contributes to the growing amount of evidence that a new endovascular technique with transarterial ONYX embolisation enables complete obliteration of the vascular malformation. AD - G. G. Hallaert, Department of Neurosurgery - 4K12 IE, Ghent University Hospital, De Pintelaan 185, B-9000 Ghent, Belgium AU - Hallaert, G. G. AU - De Keukeleire, K. M. AU - Vanhauwaert, D. J. AU - Defreyne, L. AU - Van Roost, D. DB - Embase Medline DO - 10.1136/jnnp.2009.174771 KW - bone cement onyx copolymer adult artery catheter article artificial embolization brain arteriovenous malformation case report catheterization digital subtraction angiography disease classification dizziness endovascular surgery human magnetic resonance angiography male nuclear magnetic resonance imaging priority journal 5F-Headhunter Antibiotic Simplex Leader-Cath 4F Radifocus Ultraflow 1.5F L1 - http://jnnp.bmj.com/content/81/6/685.full.pdf LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0022-3050 1468-330X SP - 685-689 ST - Intracranial dural arteriovenous fistula successfully treated by combined open - Endovascular procedure T2 - Journal of Neurology, Neurosurgery and Psychiatry TI - Intracranial dural arteriovenous fistula successfully treated by combined open - Endovascular procedure UR - https://www.embase.com/search/results?subaction=viewrecord&id=L359026198&from=export http://dx.doi.org/10.1136/jnnp.2009.174771 VL - 81 ID - 829664 ER - TY - JOUR AB - Septic pulmonary embolism (SPE) due to suppurative arthritis is very rare, A 54-year-old man who had untreated diabetes mellitus was admitted with right gonalgia and dysbasia due to suppurative arthritis. He was in a condition of septic shock presenting with hypotension and hypoxemia. Bilateral multiple cavitary nodules with feeding vessel signs in chest computed tomography led to the diagnosis of a septic pulmonary embolism (SPE) occurring from suppurative arthritis. The patient's general condition improved quickly under treatment by intravenous administration of cefepime dihydrochloride, arthroscopic synovectomy and antibiotic polymetylmethacrylate beads in the right knee cavum articulare. Severe SPE due to suppurative arthritis should be treated with administration of antibiotics and aggressive intervention in the local infectious lesion. AD - N. Hamaguchi, Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine AU - Hamaguchi, N. AU - Sakai, K. AU - Kadowaki, T. AU - Ito, R. AU - Hamada, H. AU - Higaki, J. DB - Embase KW - cefepime poly(methyl methacrylate) adult anamnesis article bacterial arthritis case report clinical feature computer assisted tomography disease association health status hospital admission human joint cavity lung embolism male rare disease synovectomy LA - Japanese M1 - 11 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2007 SN - 0452-3458 SP - 1277-1280 ST - Septic pulmonary embolism occurring from suppurative arthritis: A case report T2 - Respiration and Circulation TI - Septic pulmonary embolism occurring from suppurative arthritis: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L350126368&from=export VL - 55 ID - 829757 ER - TY - JOUR AB - OBJECTIVE: We describe the clinical outcomes in patients with aggressive vertebral hemangiomas (AVHs) after total tumor excision and discuss the treatment options for AVHs. METHODS: A retrospective data review of 15 patients (6 men, 9 women) with AVHs who underwent total excision between 1996 and 2018 was performed. RESULTS: In total, 13 thoracic and 2 lumbar lesions were involved with 8 type ALD tumors and 7 type BLD tumors based on the Weinstein-Boriani-Biagini classification. All tumors showed low or low-iso signal intensity by T1-weighted magnetic resonance imaging. All patients received a combination of preoperative transarterial embolization and total tumor excision including the tumor margins. Eleven patients underwent total tumor excision as the initial surgery (total en bloc spondylectomy = 10 patients, piecemeal total tumor excision = 1 patient), and 4 underwent it as either a revision procedure 2 weeks after ineffective laminectomy or in the long-term follow-up (4-14 years) as a piecemeal total tumor excision. Intraoperative blood loss ranged from 150 to 3400 mL (mean, 1314 mL). None of the cases had a recurrence during the mean follow-up period of 128.4 +/- 88.6 months. CONCLUSIONS: Low signal intensity on T1-weighted magnetic resonance imaging was observed in all the patients with AVHs. The long-term clinical results of the preoperative transarterial embolization and total tumor excision were satisfactory. The effect of decompressive incomplete tumor excision is temporary for AVHs, and repeated tumor excision may be necessary because of tumor recurrence in the long term. Reliable total tumor excision during the initial surgery is desirable. AD - [Handa, Makoto; Demura, Satoru; Kato, Satoshi; Shinmura, Kazuya; Yokogawa, Noriaki; Yonezawa, Noritaka; Shimizu, Takaki; Oku, Norihiro; Kitagawa, Ryo; Annen, Ryohei; Tsuchiya, Hiroyuki] Kanazawa Univ, Dept Orthopaed Surg, Grad Sch Med Sci, Kanazawa, Ishikawa, Japan. [Murakami, Hideki] Nagoya City Univ, Grad Sch Med Sci, Dept Orthopaed Surg, Nagoya, Aichi, Japan. [Kawahara, Norio] Kanazawa Med Univ, Dept Orthopaed Surg, Uchinada, Ishikawa, Japan. Kato, S (corresponding author), Kanazawa Univ, Dept Orthopaed Surg, Grad Sch Med Sci, Kanazawa, Ishikawa, Japan. skato323@gmail.com AN - WOS:000576459300058 AU - Handa, M. AU - Demura, S. AU - Kato, S. AU - Shinmura, K. AU - Yokogawa, N. AU - Yonezawa, N. AU - Shimizu, T. AU - Oku, N. AU - Kitagawa, R. AU - Annen, R. AU - Murakami, H. AU - Kawahara, N. AU - Tsuchiya, H. DA - Oct DO - 10.1016/j.wneu.2020.07.077 J2 - World Neurosurg. KW - Aggressive vertebral hemangioma Long-term follow-up Outcome Total en bloc spondylectomy Tumor excision NATURAL-HISTORY MANAGEMENT VERTEBROPLASTY DIAGNOSIS ALCOHOL Clinical Neurology Surgery LA - English M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2020 SN - 1878-8750 SP - E474-E480 ST - Long-Term Outcomes of Excision Surgery for Aggressive Vertebral Hemangiomas T2 - World Neurosurgery TI - Long-Term Outcomes of Excision Surgery for Aggressive Vertebral Hemangiomas UR - ://WOS:000576459300058 VL - 142 ID - 830100 ER - TY - JOUR AB - BACKGROUND: Vertebral hemangiomas are benign tumors with a rich vasculature. Symptoms may vary from simple vertebral pain, sometimes resistant to conservative medical treatment, to progressive neurological deficit. Surgery or radiotherapy have been the treatment of choice for several years, but they were worsened by intraoperative and postoperative hemorrhagic complications related to the rich vascularization that characterize these kinds of lesions, often preceded by a preoperative embolization in the acute setting. Recently, a percutaneous, minimally invasive technique of vertebroplasty has been introduced into clinical practice as an alternative to traditional surgical and radiotherapy treatment of symptomatic vertebral hemangiomas with or without features of aggressiveness at imaging studies. OBJECTIVE: This study aimed to illustrate the validity of treatment with percutaneous vertebroplasty (PVP) in patients with symptomatic vertebral hemangiomas (VHs). STUDY DESIGN: PVP in 26 patients with symptomatic VHs and its clinical effects were evaluated in 3-24 months follow-up. SETTING: An inteventional pain management practice, a medical center, major metropolitan city, China. METHODS: Twenty-six consecutive patients were treated with PVP; a total of 28 vertebral bodies. All patients were followed-up for 3-24 months, average 8.6 months. The clinical effects were evaluated with the visual analog scale (VAS) and 36-item short-form (SF-36) at preoperative and postoperative and final follow-up, comparing imaging before and post-treatment. RESULTS: Twenty-six patients (28 vertebral bodies) were treated successfully with a satisfying resolution of painful symptoms within 24 to 72 hours. Cement distribution was always diffuse and homogeneous. We found paravertebral cement leakage in 3 cases without any onset of radicular symptoms related to epidural diffusion. Spinal canal and intervertebral foramen cement leakage wasn't noticed. No pulmonary embolism ever occurred and no clinical and symptomatic complications were observed. Hemangioma was confirmed by pathology examination. VAS scores decreased from 7.5 ± 1.5 preoperatively to 1.6 ± 0.6 postoperatively, with a final score of 0.7 ± 0.5. There was significant difference between postoperative and preoperative, and between final follow-up and preoperative (P < 0.05). At the postoperative and final follow-up, the SF-36 scores of patients was significantly higher than the preoperative in Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, and Mental Health (P < 0.05). LIMITATIONS: An observational study with a relatively small sample size. CONCLUSIONS: PVP is an effective technique to treat symptomatic vertebral hemangioma, which is a valuable, minimally invasive, and quick method that allows a complete and lasting resolution of painful vertebral symptoms. AD - The First Affiliated Hospital, Chongqing Medical University, Chongqing, China. AN - 22270737 AU - Hao, J. AU - Hu, Z. DA - Jan-Feb DP - NLM ET - 2012/01/25 J2 - Pain physician KW - Adult Aged Back Pain/*surgery Bone Cements/therapeutic use Female Follow-Up Studies Hemangioma/*surgery Humans Male Middle Aged Pain Measurement Spinal Neoplasms/*surgery Spine/*surgery Treatment Outcome Vertebroplasty/*methods LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 1533-3159 SP - 43-9 ST - Percutaneous cement vertebroplasty in the treatment of symptomatic vertebral hemangiomas T2 - Pain Physician TI - Percutaneous cement vertebroplasty in the treatment of symptomatic vertebral hemangiomas VL - 15 ID - 828678 ER - TY - JOUR AB - Background: Vertebral hemangiomas are benign tumors with a rich vasculature. Symptoms may vary from simple vertebral pain, sometimes resistant to conservative medical treatment, to progressive neurological deficit. Surgery or radiotherapy have been the treatment of choice for several years, but they were worsened by intraoperative and postoperative hemorrhagic complications related to the rich vascularization that characterize these kinds of lesions, often preceded by a preoperative embolization in the acute setting. Recently, a percutaneous, minimally invasive technique of vertebroplasty has been introduced into clinical practice as an alternative to traditional surgical and radiotherapy treatment of symptomatic vertebral hemangiomas with or without features of aggressiveness at imaging studies. Objective: This study aimed to illustrate the validity of treatment with percutaneous vertebroplasty (PVP) in patients with symptomatic vertebral hemangiomas (VHs). Study Design: PVP in 26 patients with symptomatic VHs and its clinical effects were evaluated in 3-24 months follow-up. Setting: An inteventional pain management practice, a medical center, major metropolitan city, China. Methods: Twenty-six consecutive patients were treated with PVP; a total of 28 vertebral bodies. All patients were followed-up for 3-24 months, average 8.6 months. The clinical effects were evaluated with the visual analog scale (VAS) and 36-item short-form (SF-36) at preoperative and postoperative and final follow-up, comparing imaging before and post-treatment. Results: Twenty-six patients (28 vertebral bodies) were treated successfully with a satisfying resolution of painful symptoms within 24 to 72 hours. Cement distribution was always diffuse and homogeneous. We found paravertebral cement leakage in 3 cases without any onset of radicular symptoms related to epidural diffusion. Spinal canal and intervertebral foramen cement leakage wasn't noticed. No pulmonary embolism ever occurred and no clinical and symptomatic complications were observed. Hemangioma was confirmed by pathology examination. VAS scores decreased from 7.5 +/- 1.5 preoperatively to 1.6 +/- 0.6 postoperatively, with a final score of 0.7 +/- 0.5. There was significant difference between postoperative and preoperative, and between final follow-up and preoperative (P < 0.05). At the postoperative and final follow-up, the SF-36 scores of patients was significantly higher than the preoperative in Role Physical, Bodily Pain, General Health, Vitality, Social Functioning, Role Emotional, and Mental Health (P < 0.05). Limitations: An observational study with a relatively small sample size. Conclusions: PVP is an effective technique to treat symptomatic vertebral hemangioma, which is a valuable, minimally invasive, and quick method that allows a complete and lasting resolution of painful vertebral symptoms. AD - [Hao, Jie; Hu, ZhenMing] Chongqing Med Univ, Affiliated Hosp 1, Dept Orthopaed Surg, Chongqing 400016, Peoples R China. Hu, ZM (corresponding author), Chongqing Med Univ, Affiliated Hosp 1, Dept Orthopaed Surg, 1 Youyi Rd, Chongqing 400016, Peoples R China. zhenminghu62@yahoo.com.cn AN - WOS:000299785600014 AU - Hao, J. AU - Hu, Z. M. DA - Jan-Feb J2 - Pain Physician KW - Percutaneous vertebroplasty symptomatic vertebral hemangiomas CLINICAL FOLLOW-UP Anesthesiology Clinical Neurology LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2012 SN - 1533-3159 SP - 43-49 ST - Percutaneous Cement Vertebroplasty in the Treatment of Symptomatic Vertebral Hemangiomas T2 - Pain Physician TI - Percutaneous Cement Vertebroplasty in the Treatment of Symptomatic Vertebral Hemangiomas UR - ://WOS:000299785600014 VL - 15 ID - 830319 ER - TY - JOUR AB - Portal hypertension is a common disease worldwide. One of its rare complications is bleeding jejunal varices which is usually asymptomatic and may present with gastrointestinal bleeding. We present a case of a jejunal bleeding that was successfully embolised with acrylate glue and embolisation coils. A middle-aged woman with a history of multiple abdominal surgeries for adenocarcinoma of right ovary, presented to us with multiple episodes of haematochezia. On a CT scan of the abdomen, she was diagnosed with chronic liver disease with portal hypertension, multiple varices at porto-systemic anastomosis and ectopic jejunal varix. She was treated by interventional radiologists by percutaneous embolisation of bleeding varix using glue and embolisation coils through a portal venous approach. Copyright 2013 BMJ Publishing Group. All rights reserved. AD - R. Sayani, Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan AU - Haq, T. U. AU - AlQamari, N. AU - Sayani, R. AU - Hilal, K. DB - Embase Medline DO - 10.1136/bcr-2013-201874 KW - acrylic cement hemoglobin abdominal hysterectomy anastomosis article artificial embolization case report chemotherapy chronic liver disease clinical feature coil embolization computer assisted tomography cystadenocarcinoma female gastrointestinal hemorrhage hemicolectomy hemoglobin blood level human ileocolic anastomosis jejunal varix microcatheter ovary cystadenocarcinoma percutaneous angioembolisation peritoneal deposit peritoneal disease portal hypertension priority journal rectum hemorrhage salpingooophorectomy treatment response varicosis vein catheterization Progreat LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1757-790X ST - Successful percutaneous angioembolisation of bleeding jejunal varix by acrylate glue and coils T2 - BMJ Case Reports TI - Successful percutaneous angioembolisation of bleeding jejunal varix by acrylate glue and coils UR - https://www.embase.com/search/results?subaction=viewrecord&id=L370196856&from=export http://dx.doi.org/10.1136/bcr-2013-201874 ID - 829473 ER - TY - JOUR AB - Background Information: Musculoskeletal metastases are a major cause of morbidity. Symptoms predominantly relate to pain but also include fractures and compressive symptoms, including cord compression. Interventional radiology (IR) offers an ever increasing array of management options which are comprehensively reviewed in this pictorial essay including a presentation of more novel techniques. Educational Goals/Teaching Points: This review aims to present a thorough overview of the range of therapeutic options in the IR armamentarium in the management of musculoskeletal metastases. The relative risks and benefits encountered with each technique are discussed. Typical pre- and postoperative imaging appearances are presented. Potential complications, both major and minor are outlined. Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: We present a wide range of cases from our busy specialist tertiary center to illustrate imaging-guided techniques for the palliation of skeletal metastases including: embolization, direct chemical ablation, thermal ablation (radiofrequency [RF], cryotherapy, high-intensity focused ultrasound [HIFU], laser, and microwave) and cement injection. Combination therapies utilizing ablative techniques together with simultaneous cementoplasty are also presented. Conclusion: Interventional and musculoskeletal radiologists are playing an increasing role in the management of symptomatic skeletal metastases. The range of therapeutic options available in the palliation of skeletal metastatic disease is rapidly evolving and diagnostic and interventional radiologists alike should be aware of the therapeutic modalities now available in the management of these extremely common and diverse lesions. AD - R. Hargunani, Vancouver General Hospital, Vancouver, Canada AU - Hargunani, R. AU - Le Corroller, T. AU - Khashoggi, K. AU - Munk, P. DB - Embase KW - cement metastasis society interventional radiology X ray imaging palliative therapy radiologist high intensity focused ultrasound bone metastasis morbidity pain fracture compression risk factor medical specialist radiofrequency cryotherapy laser microwave radiation injection therapy ablation therapy diagnosis artificial embolization L1 - http://www.ajronline.org/cgi/content/full/196/5_Supplement/A284 LA - English M1 - 5 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 0361-803X SP - A284 ST - Musculoskeletal metastases: The evolving role of interventional radiology T2 - American Journal of Roentgenology TI - Musculoskeletal metastases: The evolving role of interventional radiology UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70503665&from=export VL - 196 ID - 829619 ER - TY - JOUR AD - Department of Respiratory Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia. AN - 17316341 AU - Harris, B. AU - Briggs, G. AU - Dennis, C. DA - Mar DO - 10.1111/j.1445-5994.2006.01282.x DP - NLM ET - 2007/02/24 J2 - Internal medicine journal KW - Bone Cements/*adverse effects/therapeutic use Female Fluoroscopy Humans Middle Aged Osteoporosis/*complications Polymethyl Methacrylate/*adverse effects/therapeutic use Spinal Fractures/diagnostic imaging/*etiology/*surgery Surgery, Computer-Assisted Thoracic Surgical Procedures/adverse effects Thoracic Vertebrae/diagnostic imaging/*injuries Tomography, X-Ray Computed LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 1444-0903 SP - 196-7 ST - Cement pulmonary embolism as a consequence of vertebroplasty T2 - Intern Med J TI - Cement pulmonary embolism as a consequence of vertebroplasty VL - 37 ID - 828948 ER - TY - JOUR AB - Care of the patient experiencing spinal surgery requires clear understanding of the normal anatomy, physiology, and functioning of the spine, as well as the effect of back pain and disability on human responses. Nurses must consider key assessments and interventions preoperatively, intraoperatively, and postoperatively to provide holistic care and recognize potential complications. Interdisciplinary care priorities with spinal surgery patients are addressed to promote uncomplicated rehabilitation and promotion of quality activities of daily living. AD - Professor of Nursing, Orthopaedic Clinical Nurse Specialist, Cypress College, Cypress, CA AN - 106399289. Language: English. Entry Date: 20060224. Revision Date: 20200708. Publication Type: Journal Article AU - Harvey, C. V. DB - cin20 DO - 10.1097/00006416-200511000-00009 DP - EBSCOhost KW - Orthopedic Nursing Orthopedic Surgery -- Nursing Spinal Diseases -- Nursing Spinal Diseases -- Surgery Spinal Injuries -- Nursing Spinal Injuries -- Surgery Spine -- Surgery Back Pain -- Diagnosis Back Pain -- Nursing Bladder, Neurogenic Cerebrospinal Fluid Diskectomy Education, Continuing (Credit) Embolism, Fat Endoscopy Inappropriate ADH Syndrome Intestinal Pseudo-Obstruction Intraoperative Care Kyphoplasty Laminectomy Neurologic Examination Nursing Assessment Orthopedic Surgery -- Adverse Effects Orthopedic Surgery -- Rehabilitation Patient History Taking Physical Examination Postoperative Care Postoperative Complications Preoperative Care Spinal Diseases -- Therapy Spinal Fractures -- Surgery Spinal Fusion Spinal Injuries -- Therapy Spine -- Anatomy and Histology Spine -- Radiography Surgical Wound Infection M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2005 SN - 0744-6020 SP - 426-442 ST - Spinal surgery patient care T2 - Orthopaedic Nursing TI - Spinal surgery patient care UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106399289&site=ehost-live&scope=site VL - 24 ID - 830779 ER - TY - JOUR AB - Tourniquet time and its relationship to blood loss and deep vein thrombosis were studied in 80 cases of unilateral total knee arthroplasty. These data were part of a prospective multicenter double-blind study on thromboprophylaxis for knee surgery. This study reports on the cases done at one institution in which the tourniquet was used in three different ways: group 1, no tourniquet use; group 2, limited tourniquet use for cementing time only; group 3, tourniquet use throughout the whole case. Blood loss was significantly related to tourniquet time (P = .0001). The incidence of deep vein thrombosis was not related to the tourniquet group (P = .9). AD - Harvey, EJ (corresponding author), DUKE UNIV,MED CTR,DEPT ORTHOPAED SURG,BOX 3000,DURHAM,NC 27710, USA. AN - WOS:A1997WU68800008 AU - Harvey, E. J. AU - Leclerc, J. AU - Brooks, C. E. AU - Burke, D. L. DA - Apr DO - 10.1016/s0883-5403(97)90025-5 J2 - J. Arthroplast. KW - tourniquet blood loss deep vein thrombosis total knee arthroplasty VENOUS THROMBOSIS PULMONARY-EMBOLISM SURGERY REPLACEMENT PREVENTION REDUCTION HEPARIN CALF Orthopedics LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1997 SN - 0883-5403 SP - 291-296 ST - Effect of tourniquet use on blood loss and incidence of deep vein thrombosis in total knee arthroplasty T2 - Journal of Arthroplasty TI - Effect of tourniquet use on blood loss and incidence of deep vein thrombosis in total knee arthroplasty UR - ://WOS:A1997WU68800008 VL - 12 ID - 830482 ER - TY - JOUR AB - A study is described in which clinically detectable air emboli which occurred during total hip replacement were eliminated by flushing the femoral shaft cavity with carbon dioxide. Transient falls in blood pressure were still observed immediately after insertion of bone cement, and alternative mechanisms are discussed. AN - CN-00028484 AU - Harvey, P. B. AU - Smith, J. A. DO - 10.1111/j.1365-2044.1982.tb01307.x KW - Aged Blood Pressure Bone Cements [administration & dosage] Carbon Dioxide [*therapeutic use] Embolism, Air [*prevention & control] Female Femur Hip Prosthesis Humans Intraoperative Complications [prevention & control] Male M1 - 7 M3 - Clinical Trial; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1982 SP - 714‐717 ST - Prevention of air emboli in hip surgery. Femoral shaft insufflation with carbon dioxide T2 - Anaesthesia TI - Prevention of air emboli in hip surgery. Femoral shaft insufflation with carbon dioxide UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00028484/full VL - 37 ID - 830003 ER - TY - JOUR AB - As the major hazard of percutaneous vertebroplasty (PV), cement extravasation into the venous system, systemic embolism, and spinal canal has been previously reported. However, to our knowledge, only one case of the arterial migration of cement has been previously reported that is directly associated with this technique without any symptom in the immediate post- intervention and in the follow-up period. An arterial embolus of cement occurred in a 46-year-old woman undergoing lumbar PV for breast cancer metastasis. Less than one hour later, the patient complained of severe pain and numbness in her left leg. A diagnosis of acute left leg ischemia due to the acute occlusion of the infrapopliteal arteries by the cement was made. Transluminal angioplasty (PTA)for the infrapopliteal arteries was recommended because there were diffuse and long vessel involvements, leaving no distal targets for bypass vascular surgery. The patient's postoperative course was uncomplicated; the extremity tenderness and mottled skin were improved. A follow-up ultrasound 2 months later revealed an acceptable distal flow in the arteries of the affected limb, and the patient remained asymptomatic (except for a mild leg pain on exertion) at the one-year follow-up examination. In conclusion, PTA may save the limb from amputation in case of peripheral arterial embolism caused by cement during PV. AD - Hazrat Rasool Hospital, Tehran University of Medical Sciences, Tehran, Iran. Bou Ali Hospital, Tehran Medical Branch of Islamic Azad University, Tehran, Iran. Laleh Hospital, Tehran, Iran. Amir-AI-Momenin Hospital, Tehran Medical Branch of Islamic Azad University, Tehran, Iran. Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. AN - 86405076. Language: English. Entry Date: 20130402. Revision Date: 20190513. Publication Type: Article AU - Hashem Sezavar Seyedi Jandaghi, Seyed AU - Abdolhoseinpour, Hesam AU - Ghofraniha, Afshin AU - Tofighirad, Navid AU - Dogmehchi, Enseyeh AU - Goodarzynejad, Hamidreza DB - cin20 DP - EBSCOhost KW - Surgery, Operative -- Methods Angioplasty Embolism -- Therapy Female Middle Age Breast Neoplasms -- Diagnosis Neoplasm Metastasis -- Diagnosis Peripheral Vascular Diseases M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2013 SN - 1735-8620 SP - 61-64 ST - A Limb-Saving Procedure for Treatment of Arterial Cement Embolism during Lumbar Percutaneous Vertebroplasty: A Case Report T2 - Journal of Tehran University Heart Center TI - A Limb-Saving Procedure for Treatment of Arterial Cement Embolism during Lumbar Percutaneous Vertebroplasty: A Case Report UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=86405076&site=ehost-live&scope=site VL - 8 ID - 830663 ER - TY - JOUR AB - Purpose: To evaluate feasibility and safety of the isocenter puncture (ISOP) method in various situations other than for PVP (percutaneous vertebroplasty). Material and Methods: The ISOP method was developed for PVP and makes use of the isocenter marker (ICM) displayed on the center of the fluoroscopy monitor screen. After positioning the target to the ICM, the C-arm can be rotated to any direction without losing the target as it remains at the center of the monitor. Then, the operator can puncture with a “bull's eye” method from a favorable angle and confirm puncture depth by lateral projection. We applied this method for situations other than for PVP. Fifty-one puncture cases [median age, 68 (10-86) years] were detected retrospectively between July 2006 and January 2014 in which the ISOP method was employed. Puncture target, indication, technical success rate, median fluoroscopy time, median time needed to puncture, conversion to CT-guided puncture, and complications were evaluated. Results: Puncture targets were as follows: pelvic bone: 11, pelvic abscess: 10, vertebral disk: 8, iliolumbar muscle: 6, vertebral body: 5, aortic aneurysm sac: 3, and others: 8. Indications were as follows: drainage: 29 cases, biopsy: 10, embolization of endoleak after EVAR/TEVAR: 3, and others: 9. Technical success was 98%. Median fluoroscopy time and median time needed to puncture were 9 (2-47) minutes and 11 (2-32) minutes, respectively. There was no conversion to CT-guided puncture. Unexpected external iliac vein puncture occurred in one case but did not lead to any serious consequence. Conclusion: The ISOP method is technically feasible and safe for various purposes under only fluoroscopic guidance. AD - K. Hashimoto, Radiology, St. Marianna University, School of Medicine, Kawasaki, Japan AU - Hashimoto, K. AU - Mimura, H. AU - Murakami, K. AU - Arai, Y. AU - Ogawa, Y. AU - Nakajima, Y. DB - Embase DO - 10.1007/s00270-015-1173-5 KW - povidone marker society Europe puncture fluoroscopy pelvis abscess percutaneous vertebroplasty endoleak pelvic girdle muscle intervertebral disk vertebra body aortic aneurysm biopsy artificial embolization eye iliac vein vein puncture arm safety LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 0174-1551 SP - S211-S212 ST - The isocenter puncture (ISOP) method in various situations T2 - CardioVascular and Interventional Radiology TI - The isocenter puncture (ISOP) method in various situations UR - https://www.embase.com/search/results?subaction=viewrecord&id=L72059807&from=export http://dx.doi.org/10.1007/s00270-015-1173-5 VL - 38 ID - 829363 ER - TY - JOUR AB - Background: Optimal radii of curvature of the articulating surfaces of the prosthetic components are factors associated with the longevity of cemented glenoid components in anatomical total shoulder arthroplasty. It was the purpose of this study, to evaluate the radiographic and clinical performance of an anatomical glenoid component of a total shoulder arthroplasty (TSA) with respect to radial mismatch of the glenoid and humeral component. Methods: In a retrospective study 75 TSA were analyzed for their clinical and radiographic performance with computed tomography by independent examiners using an established methodology. The study group was divided in two groups, one with mismatch < 4.5 mm (n:52) the others with mismatch ≥4.5 mm (n:23) and analyzed for confounding variables as indication, primary or revision surgery, age, gender, glenoid morphology and implant characteristics. Results: The mean glenohumeral radial mismatch was 3.4 mm (range 0.5-6.9). At median follow-up of 41 months (range 19-113) radiographic loosening (defined as modified Molé scores ≥6) was present in 7 cases (9.3%). Lucencies around the glenoid pegs (defined as modified Molé score ≥ 1) were present in 34 cases (45%). Radiolucencies were significantly associated with a radial mismatch < 4.5 mm (p = 0.000). The pre-to postoperative improvements in Subjective Shoulder Value and absolute Constant Score were significantly better in the group with a mismatch ≥4.5 mm (p = 0.018, p = 0.014). Conclusion: A lower conformity of the radii of humerus and glenoid seems to improve the loosening performance in TSA. Perhaps cut-off values regarding the recommended mismatch need to be revalued in the future. AD - A. Hasler, Department of Orthopaedics, University Hospital Balgrist, Forchstrasse 340, Zurich, Switzerland AU - Hasler, A. AU - Meyer, D. C. AU - Tondelli, T. AU - Dietrich, T. AU - Gerber, C. DB - Embase Medline DO - 10.1186/s12891-020-03219-z KW - computed tomography scanner implant mean glenohumeral radial mismatch SOMATOM Definition AS splint anticoagulant agent abduction splint absolute Constant Score adult age aged article bilateral pulmonary embolism clinical evaluation clinical outcome computer assisted tomography controlled study correlation analysis female follow up gender glenoid cavity glenoid morphology glenoid pegs human humeral subluxation humerus interrater reliability lung embolism major clinical study male methodology modified Mole score nerve lesion partial nerve lesion peroperative complication postoperative period preoperative period primary surgery radial head radial mismatch radiographic evaluation radiographic loosening radiolucencies rating scale retrospective study revision surgery Subjective Shoulder Value subluxation surgical anatomy surgical technique total shoulder arthroplasty treatment indication tuberosity fracture very elderly LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1471-2474 ST - Radiographic performance depends on the radial glenohumeral mismatch in total shoulder arthroplasty T2 - BMC Musculoskeletal Disorders TI - Radiographic performance depends on the radial glenohumeral mismatch in total shoulder arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L631487196&from=export http://dx.doi.org/10.1186/s12891-020-03219-z VL - 21 ID - 829069 ER - TY - JOUR AB - ObjectiveTo evaluate the incidence and risk factors for ICE during a PV.Materials and methodsSingle-center retrospective analysis of 1512 consecutive patients who underwent 1854 PV procedures for osteoporotic (34 %), malignant (39.9 %) or other cause (26.1 %) of vertebral compression fractures (VCFs)/spine tumor lesions. Only thoracic or lumbar PVs were included. PVs were performed with polymethylmethacrylate (PMMA) low-viscosity bone cement under fluoroscopic guidance. Chest imaging (X-ray or CT) was performed the same day after PV in patients with high clinical suspicion of ICE. All post-procedural chest-imaging examinations were reviewed, and all ICEs were agreed upon in consensus by two radiologists.ResultsICEs were detected in 72 patients (92 cement embolisms). In 86.1 % of the cases, concomitant pulmonary artery cement leakage was detected. Symptomatic ICEs were observed in six cases (8.3% of all ICEs; 0.32% of all PV procedures). No ICE led to death or permanent sequelae. Multiple levels treated during the same PV session were associated with a higher ICE rate [OR: 3.59, 95% CI: (1.98-6.51); p < 0.001]; the use of flat panel technology with a lower ICE occurrence [OR: 0.51, 95% CI: (0.32-0.83); p = 0.007].ConclusionIntracardiac cement embolism after PV has a low incidence (3.9 % in our study). Symptomatic complications related to ICE are rare (0.3%); none was responsible for clinical sequelae in our series. AD - [Hassani, Sarah Fadili; Cormier, Evelyne; Shotar, Eimad; Chiras, Jacques; Clarencon, Frederic] Hop La Pitie Salpetriere, AP HP, Dept Neuroradiol, 47 Bd Hop, F-75013 Paris, France. [Shotar, Eimad; Spano, Jean-Philippe; Chiras, Jacques; Clarencon, Frederic] Paris VI Univ Pierre & Marie Curie, Paris, France. [Drir, Mehdi] Hop La Pitie Salpetriere, Dept Anesthesiol, Paris, France. [Spano, Jean-Philippe] Hop La Pitie Salpetriere, Dept Oncoly, Paris, France. [Morardet, Laetitia] Hop La Pitie Salpetriere, Dept Rheumatol, Paris, France. [Collet, Jean-Philippe] Hop La Pitie Salpetriere, Dept Cardiol, Paris, France. Clarencon, F (corresponding author), Hop La Pitie Salpetriere, AP HP, Dept Neuroradiol, 47 Bd Hop, F-75013 Paris, France.; Clarencon, F (corresponding author), Paris VI Univ Pierre & Marie Curie, Paris, France. fredclare5@msn.com AN - WOS:000454706500021 AU - Hassani, S. F. AU - Cormier, E. AU - Shotar, E. AU - Drir, M. AU - Spano, J. P. AU - Morardet, L. AU - Collet, J. P. AU - Chiras, J. AU - Clarencon, F. DA - Feb DO - 10.1007/s00330-018-5647-0 J2 - Eur. Radiol. KW - Percutaneous vertebroplasty Leakage Cement Embolism Cardiac Complication EXPERIMENTAL-MODEL RARE COMPLICATION SPINAL METASTASES PULMONARY LEAKAGE POLYMETHYLMETHACRYLATE KYPHOPLASTY PERFORATION VISCOSITY Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 0938-7994 SP - 663-673 ST - Intracardiac cement embolism during percutaneous vertebroplasty: incidence, risk factors and clinical management T2 - European Radiology TI - Intracardiac cement embolism during percutaneous vertebroplasty: incidence, risk factors and clinical management UR - ://WOS:000454706500021 VL - 29 ID - 830148 ER - TY - JOUR AB - Background: Vertebroplasty carries multiple complications due to the leakage of polymethylmethacrylate (PMMA) into the venous system through the iliolumbar or epidural veins. The rate of venous cement complications may vary from 1 to 10 %, with cement extravasation into the venous system in 24 % of patients. Emboli may further migrate into the right heart chambers and pulmonary arteries. Patients may vary in presentation from asymptomatic or symptoms such as syncope to life-threatening complications.Case Report: We present a case of a 57-year-old lady diagnosed with osteoporosis who underwent a staged antero-posterior fixation with PMMA vertebroplasty of progressive thoraco-lumbar kyphosis caused by osteoporotic fractures to T12, L1 and L2 vertebral bodies. Four weeks after the operation, the patient developed symptoms of left-sided chest pain, tachycardia and tachypnea. CT pulmonary angiogram (CTPA) found a high-density material within the right atrium, whilst ECHO demonstrated normal systolic function. The patient was commenced on enoxaparin at therapeutic dose of 1.5 mg/kg for 3 months and remained asymptomatic. Follow-up ECHO found no change to the heart function and no blood clot on the PMMA embolus.Conclusions: Factors influencing the decision about conservative treatment included symptoms, localisation of the embolus, as well as time lapse between vertebroplasty and clinical manifestation. Patients that are commonly asymptomatic can be treated conservatively. The management of choice is anticoagulation with low-molecular-weight heparin or warfarin until the foreign body epithelialises and ceases in becoming potentially thrombogenic. Symptomatic patients with thrombi in the right atrium are commonly managed via percutaneous retrieval, whilst those with RV involvement or perforation are commonly managed with surgical retrieval. Management of individual patients should be based on individual clinical circumstances. Patients presenting with intracardiac bone cement embolism related to spinal procedures require thorough clinical assessment, cardiology input, and if required, surgical intervention. AD - The Centre for Spinal Studies and Surgery, Nottingham University Hospitals NHS Trust , Queens Medical Centre , D Floor, West Block, Derby Road Nottingham NG7 2UH UK Department of Radiology , Icahn School of Medicine at Mount Sinai , New York USA The Centre for Spinal Studies and Surgery, Nottingham University Hospitals NHS Trust, Queens Medical Centre, D Floor, West Block, Derby Road, Nottingham, NG7 2UH, UK AN - 126439798. Language: English. Entry Date: 20180619. Revision Date: 20181203. Publication Type: journal article. Journal Subset: Biomedical AU - Hatzantonis, Catherine AU - Czyz, Marcin AU - Pyzik, Renata AU - Boszczyk, Bronek AU - Boszczyk, Bronek M. DB - cin20 DO - 10.1007/s00586-016-4695-x DP - EBSCOhost KW - Embolism -- Etiology Heart Diseases Bone Cements -- Adverse Effects Heart Diseases -- Drug Therapy Heart Diseases -- Etiology Embolism Vertebroplasty -- Adverse Effects Embolism -- Drug Therapy Methylmethacrylates -- Adverse Effects Heparin, Low-Molecular-Weight -- Therapeutic Use Female Methylmethacrylates -- Therapeutic Use Anticoagulants -- Therapeutic Use Vertebroplasty -- Methods Middle Age Bone Cements -- Therapeutic Use Scales M1 - 12 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 0940-6719 SP - 3199-3205 ST - Intracardiac bone cement embolism as a complication of vertebroplasty: management strategy T2 - European Spine Journal TI - Intracardiac bone cement embolism as a complication of vertebroplasty: management strategy UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=126439798&site=ehost-live&scope=site VL - 26 ID - 830558 ER - TY - JOUR AB - BACKGROUND: Vertebroplasty carries multiple complications due to the leakage of polymethylmethacrylate (PMMA) into the venous system through the iliolumbar or epidural veins. The rate of venous cement complications may vary from 1 to 10 %, with cement extravasation into the venous system in 24 % of patients. Emboli may further migrate into the right heart chambers and pulmonary arteries. Patients may vary in presentation from asymptomatic or symptoms such as syncope to life-threatening complications. CASE REPORT: We present a case of a 57-year-old lady diagnosed with osteoporosis who underwent a staged antero-posterior fixation with PMMA vertebroplasty of progressive thoraco-lumbar kyphosis caused by osteoporotic fractures to T12, L1 and L2 vertebral bodies. Four weeks after the operation, the patient developed symptoms of left-sided chest pain, tachycardia and tachypnea. CT pulmonary angiogram (CTPA) found a high-density material within the right atrium, whilst ECHO demonstrated normal systolic function. The patient was commenced on enoxaparin at therapeutic dose of 1.5 mg/kg for 3 months and remained asymptomatic. Follow-up ECHO found no change to the heart function and no blood clot on the PMMA embolus. CONCLUSIONS: Factors influencing the decision about conservative treatment included symptoms, localisation of the embolus, as well as time lapse between vertebroplasty and clinical manifestation. Patients that are commonly asymptomatic can be treated conservatively. The management of choice is anticoagulation with low-molecular-weight heparin or warfarin until the foreign body epithelialises and ceases in becoming potentially thrombogenic. Symptomatic patients with thrombi in the right atrium are commonly managed via percutaneous retrieval, whilst those with RV involvement or perforation are commonly managed with surgical retrieval. Management of individual patients should be based on individual clinical circumstances. Patients presenting with intracardiac bone cement embolism related to spinal procedures require thorough clinical assessment, cardiology input, and if required, surgical intervention. AD - The Centre for Spinal Studies and Surgery, Nottingham University Hospitals NHS Trust, Queens Medical Centre, D Floor, West Block, Derby Road, Nottingham, NG7 2UH, UK. Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA. The Centre for Spinal Studies and Surgery, Nottingham University Hospitals NHS Trust, Queens Medical Centre, D Floor, West Block, Derby Road, Nottingham, NG7 2UH, UK. bronek.boszczyk@nuh.nhs.uk. AN - 27535287 AU - Hatzantonis, C. AU - Czyz, M. AU - Pyzik, R. AU - Boszczyk, B. M. DA - Dec DO - 10.1007/s00586-016-4695-x DP - NLM ET - 2016/08/19 J2 - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society KW - Anticoagulants/therapeutic use Bone Cements/*adverse effects/therapeutic use *Embolism/diagnostic imaging/drug therapy/etiology Enoxaparin/therapeutic use Female *Heart Diseases/diagnostic imaging/drug therapy/etiology Humans Middle Aged Osteoporotic Fractures/surgery Polymethyl Methacrylate/adverse effects/therapeutic use Vertebroplasty/*adverse effects/methods *Bone cement embolism *Intracardiac embolism *Vertebroplasty LA - eng M1 - 12 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 0940-6719 SP - 3199-3205 ST - Intracardiac bone cement embolism as a complication of vertebroplasty: management strategy T2 - Eur Spine J TI - Intracardiac bone cement embolism as a complication of vertebroplasty: management strategy VL - 26 ID - 828558 ER - TY - JOUR AB - Kyphoplasty and vertebroplasty have become recognized procedures for the treatment of vertebral fractures, especially in patients with osteoporosis. In most cases of osteoporotic spinal vertebral fracture in elderly patients, polymethylmethacrylate (PMMA) cement is used to fill the defect and stabilize the vertebral body. The techniques of vertebroplasty and kyphoplasty differ in the possibility of realignment and reconstruction of the vertebral body and spinal column. Long-term results in terms of integration of the cement and bioreactivity of the vertebral body are still lacking; so, these procedures are still no options in the treatment of younger patients. Vertebroplasty and kyphoplasty show different success in the management of fresh traumatic spine fractures. The acute traumatic vertebral fracture has to be classified sensitively, to find the right indication for cement augmentation. Mild acute compression fractures can be treated by vertebroplasty or kyphoplasty, severe compression and burst fractures by combination of internal fixation and kyphoplasty. The indications for use of biological or osteoinductive cement in spinal fracture management must still be regarded as restricted owing to the lack of basic biomechanical research data. Such cement should not be used except in clinical studies. © Urban & Vogel. AD - S. Hauck, Trauma and Orthopedic Surgery, Berufsgenossenschaftliche Unfallklinik Murnau, Prof.-Küntscher-Straße 8, 82418 Murnau, Germany AU - Hauck, S. AU - Beisse, R. AU - Bühren, V. DB - Embase DO - 10.1007/s00068-005-2104-y KW - bone cement calcium phosphate poly(methyl methacrylate) bone matrix computer assisted tomography human kyphoplasty lung embolism nuclear magnetic resonance imaging operation duration osteoporosis percutaneous vertebroplasty postoperative period review spinal cord compression spine injury surgical technique vertebra body spine fracture LA - English M1 - 5 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2005 SN - 1439-0590 SP - 453-463 ST - Vertebroplasty and kyphoplasty in spinal trauma T2 - European Journal of Trauma TI - Vertebroplasty and kyphoplasty in spinal trauma UR - https://www.embase.com/search/results?subaction=viewrecord&id=L41483924&from=export http://dx.doi.org/10.1007/s00068-005-2104-y VL - 31 ID - 829811 ER - TY - JOUR AB - One of the possible causes of bone cement implantation syndrome during total hip arthroplasty is pulmonary embolism, as has been suggested by a characteristic image seen during transoesophageal echocardiography, the so-called 'Snow Flurry'. However, the nature of the embolic material has not been definitively determined. We studied seven patients undergoing cemented or uncemented total hip arthroplasty. 'Snow Flurry' images were detected in all patients. Blood was aspirated from the right atrium during 'Snow Flurries' and was subjected to pathological examination. Amorphous, eosinophilic, fine granular material was seen in all specimens. The material did not originate from cement. Fat and bone marrow were not detected. The material seen may consist of fine particles of bone ('bone dust') originating from reamed bone. AD - Department of Anaesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, N15 W7, Kita-ku, Sapporo, 060-8638 Japan. mineji@dream.com AN - 104724858. Language: English. Entry Date: 20110610. Revision Date: 20170414. Publication Type: journal article. Journal Subset: Biomedical AU - Hayakawa, M. AU - Fujioka, Y. AU - Morimoto, Y. AU - Okamura, A. AU - Kemmotsu, O. DB - cin20 DO - 10.1111/j.1365-2044.2001.1913-2.x DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Adverse Effects Embolism -- Etiology Adult Aged Bone Cements Bone and Bones Echocardiography, Transesophageal Embolism -- Pathology Embolism -- Ultrasonography Female Heart Atrium -- Ultrasonography Middle Age M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2001 SN - 0003-2409 SP - 571-575 ST - Pathological evaluation of venous emboli during total hip arthroplasty T2 - Anaesthesia TI - Pathological evaluation of venous emboli during total hip arthroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104724858&site=ehost-live&scope=site VL - 56 ID - 830798 ER - TY - JOUR AU - Hayes, H. AU - Lukaszewicz, A. J. AU - Mirza, M. AU - Gerasymchuk, G. DB - Embase KW - poly(methyl methacrylate) aged case report computer assisted tomography embolism female human low back pain note percutaneous vertebroplasty postoperative complication spinal cord compression LA - English M1 - 1 M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1879-2898 0160-9963 SP - 47C-47D ST - Intracardiac cement embolus from vertebroplasty T2 - Applied Radiology TI - Intracardiac cement embolus from vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L614923107&from=export VL - 46 ID - 829275 ER - TY - JOUR AB - BACKGROUND: Bone cement leakage in patients with vertebral fracture limits the use of percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP). Finding a method to reduce bone cement leakage is clinically rather important. OBJECTIVE: To compare the efficacy and safety of bone-filling mesh containers (BFMCS) and simple percutaneous balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures. STUDY DESIGN: A randomized controlled clinical study discussing the effect of 3 methods in the treatment of vertebral fractures. METHODS: From October 2014 to August 2015, 80 patients with single osteoporotic vertebral compression fractures were admitted in our hospital, including 31 men and 49 women with an average age of 76.2 years (range, 63-82 years). Patients were divided into a percutaneous balloon kyphoplasty group (Group A) and a PVP with dilated balloon placement group (Group B), with 40 cases in each group. The visual analog scale (VAS), Oswestry disability index (ODI), height of the vertebral body and Cobb's angle of the injured vertebrae were observed before operation and at 1 day, 1 month, and 6 months after the operation. Bone cement leakage and postoperative complications were also observed. RESULTS: Operations were successfully completed in all 80 patients without pulmonary embolism and without spinal cord or nerve root injury. The operation time was (32.6 ± 6.1) minutes in Group A and (31.8 ± 5.8) minutes in Group B. Operation time did not significantly differ between the 2 groups (P > 0.05). Both groups differed significantly when comparing the results with those measured before treatment. In Group A, the ODIs before operation and at 1 day, 1 month, and 6 months after the operation were 84.125 ± 8.821, 29.300 ± 8.951, 16.175 ± 6.748, and 11.400 ± 6.164, respectively, and those in Group B were 84.300 ± 8.768, 29.200 ± 9.121, 15.975 ± 6.811, and 11.575 ± 6.460, respectively. Cobb's angle values in Group A before and after treatment were (19.225 ± 5.881)° and (13.900 ± 3.720)°, respectively, and those in Group B were (19.275 ± 6.210)° and (14.225 ± 4.016)°, respectively. CONCLUSION: Both bone-filling mesh bag and simple percutaneous balloon kyphoplasty for treating osteoporotic vertebral compression fractures can relieve pain effectively and correct the Cobb angle. The bone-filling mesh container can effectively prevent bone cement leakage and reduce the incidence of bone cement leakage. LIMITATIONS: The study has limitations due to the small number of cases and short period of follow-up time. Further studies are needed to determine whether the mesh bag can limit the distribution of bone cement within the vertebral body. KEY WORDS: Bone-filling mesh container, kyphoplasty, osteoporosis, vertebral compression fracture. AD - Department of Pain, People's Hospital of Guizhou Province, Guiyang 550002, China. 8th Department, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, China. AN - 29871370 AU - He, C. J. AU - Liu, G. D. DA - May DP - NLM ET - 2018/06/07 J2 - Pain physician KW - Aged Aged, 80 and over Bone Cements/*therapeutic use Extravasation of Diagnostic and Therapeutic Materials/*prevention & control Female Fractures, Compression/*surgery Humans Kyphoplasty/*methods Male Middle Aged Osteoporotic Fractures/*surgery Postoperative Complications/prevention & control Spinal Fractures/*surgery Treatment Outcome Visual Analog Scale LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 1533-3159 SP - 259-268 ST - Comparison of the Efficacy and Safety of Bone-filling Mesh Container and Simple Percutaneous Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures T2 - Pain Physician TI - Comparison of the Efficacy and Safety of Bone-filling Mesh Container and Simple Percutaneous Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures VL - 21 ID - 828581 ER - TY - JOUR AB - Background: Bone cement leakage in patients with vertebral fracture limits the use of percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP). Finding a method to reduce bone cement leakage is clinically rather important.Objective: To compare the efficacy and safety of bone-filling mesh containers (BFMCS) and simple percutaneous balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures.Study Design: A randomized controlled clinical study discussing the effect of 3 methods in the treatment of vertebral fractures.Methods: From October 2014 to August 2015, 80 patients with single osteoporotic vertebral compression fractures were admitted in our hospital, including 31 men and 49 women with an average age of 76.2 years (range, 63-82 years). Patients were divided into a percutaneous balloon kyphoplasty group (Group A) and a PVP with dilated balloon placement group (Group B), with 40 cases in each group. The visual analog scale (VAS), Oswestry disability index (ODI), height of the vertebral body and Cobb's angle of the injured vertebrae were observed before operation and at 1 day, 1 month, and 6 months after the operation. Bone cement leakage and postoperative complications were also observed.Results: Operations were successfully completed in all 80 patients without pulmonary embolism and without spinal cord or nerve root injury. The operation time was (32.6 ± 6.1) minutes in Group A and (31.8 ± 5.8) minutes in Group B. Operation time did not significantly differ between the 2 groups (P > 0.05). Both groups differed significantly when comparing the results with those measured before treatment. In Group A, the ODIs before operation and at 1 day, 1 month, and 6 months after the operation were 84.125 ± 8.821, 29.300 ± 8.951, 16.175 ± 6.748, and 11.400 ± 6.164, respectively, and those in Group B were 84.300 ± 8.768, 29.200 ± 9.121, 15.975 ± 6.811, and 11.575 ± 6.460, respectively. Cobb's angle values in Group A before and after treatment were (19.225 ± 5.881)° and (13.900 ± 3.720)°, respectively, and those in Group B were (19.275 ± 6.210)° and (14.225 ± 4.016)°, respectively.Conclusion: Both bone-filling mesh bag and simple percutaneous balloon kyphoplasty for treating osteoporotic vertebral compression fractures can relieve pain effectively and correct the Cobb angle. The bone-filling mesh container can effectively prevent bone cement leakage and reduce the incidence of bone cement leakage.Limitations: The study has limitations due to the small number of cases and short period of follow-up time. Further studies are needed to determine whether the mesh bag can limit the distribution of bone cement within the vertebral body.Key Words: Bone-filling mesh container, kyphoplasty, osteoporosis, vertebral compression fracture. AD - Department of Pain, People's Hospital of Guizhou Province, Guiyang 550002, China 8th Department, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, China AN - 130201221. Language: English. Entry Date: 20181219. Revision Date: 20191029. Publication Type: journal article AU - He, Chun-Jing AU - Liu, Guo-Dong DB - cin20 DP - EBSCOhost KW - Spinal Fractures -- Surgery Fractures, Compression -- Surgery Extravasation of Diagnostic and Therapeutic Materials -- Prevention and Control Kyphoplasty -- Methods Bone Cements -- Therapeutic Use Human Aged Visual Analog Scaling Postoperative Complications -- Prevention and Control Female Male Middle Age Treatment Outcomes Aged, 80 and Over Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials Scales M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2018 SN - 1533-3159 SP - 259-268 ST - Comparison of the Efficacy and Safety of Bone-filling Mesh Container and Simple Percutaneous Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures T2 - Pain Physician TI - Comparison of the Efficacy and Safety of Bone-filling Mesh Container and Simple Percutaneous Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=130201221&site=ehost-live&scope=site VL - 21 ID - 830553 ER - TY - JOUR AB - Objective: To evaluate percutaneous vertebroplasty (PVP) combined with endovascular chemotherapy and embolization (ECE) for the treatment of vertebrae malignant tumor. Methods: PVP and/or ECE were performed in 23 patiens with 50 vertebral bodies. PVP were performed only in 8 patients of 13 vertebraes. PVP and ECE were performed in 15 patiens of 37 vertebral bodies. Results: The successful rate of PVP and ECE were 96% and 100%. No severe complications were observed. The total effective rate was 91.3%. There were not new fracture in the pathological vertebral bodies of 23 cases in followed up period (3-10 months). Conclusion: PVP and ECE are ideal methods for treating vertebral malignant tumors. We think it will be the first way of treatment for the vertebrae malignant tumor. AD - M.-J. He, Department of Radiology, Hospital of Guangzhou Medical College, Guangzhou 510260, China AU - He, M. J. AU - Lian, H. AU - Shen, G. AU - Chen, D. J. DB - Embase KW - antineoplastic agent adult aged article cancer regression chemoembolization clinical article computer assisted tomography controlled study disease severity female follow up human male nuclear magnetic resonance imaging percutaneous vertebroplasty postoperative complication spine cancer treatment outcome spine fracture LA - Chinese M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2007 SN - 1672-8475 SP - 329-331 ST - Vertebral malignant tumors: Treatment with vertebroplasty and endovascular chemoembolization T2 - Chinese Journal of Interventional Imaging and Therapy TI - Vertebral malignant tumors: Treatment with vertebroplasty and endovascular chemoembolization UR - https://www.embase.com/search/results?subaction=viewrecord&id=L47611014&from=export VL - 4 ID - 829761 ER - TY - JOUR AB - OBJECTIVE: To evaluate the efficacy and safety of combining transarterial chemoembolization and percutaneous vertebroplasty (PVP) in the treatment of vertebral and paravertebral metastatic tumors. METHODS: A retrospective review was conducted in 49 patients with severer painful tumor metastasis in 72 vertebrae and paravertebral tissue who had failed noninvasive treatment at our institution from March 2003 to December 2009. Among them, there were intractable radicular pain (n = 17) and slight or no motor and sensory function (n = 6). All patients under transarterial chemoembolization were followed within 6 days by PVP. Computed tomography (CT) was performed within 3 days after PVP to observe the distribution of PMMA (para-methoxymethamphetamine)in vertebrae and whether or not there was any leakage. The efficacy was assessed by the change of pain level after combined treatment. RESULTS: Bilateral vertebral arteries were selected in 44 cases with 65 vertebrae. And only unilateral vertebral artery was selected in 5 cases with 7 vertebrae. Except for 2 vertebrae with simple artery infusion, 29 vertebrae were embolized by 1 - 2 ml of lipiodolization and gelfoam particles and 41 vertebrae by gelatine particles. And an average volume of 4.23 ml and 5.39 ml was injected in each thoracic and lumbar vertebra respectively. The rate of efficacy was at 87.8% within 3 months after combined therapy. There were CR (complete response) 21 cases (42.9%), PR (partial response) 22 cases (44.9%) and MR/NR (minimal/no response) 6 cases (12.2%). No serious complication related to the technique occurred. Only 12 cases with asymptomatic PMMA leakage around 16 vertebrae were demonstrated on post-operative CT. CONCLUSION: Transarterial chemoembolization plus PVP is an effective and safe procedure in the treatment of severe painful vertebral and paravertebral metastatic tumors. AD - Department of Radiology, Zhongda Hospital, Southeast University, Nanjing 210009, China. shichenghe@vip.sina.com AN - 21418898 AU - He, S. C. AU - Teng, G. J. AU - Fang, W. AU - Deng, G. AU - Guo, J. H. AU - Zhu, G. Y. AU - Li, G. Z. DA - Jan 18 DP - NLM ET - 2011/03/23 J2 - Zhonghua yi xue za zhi KW - Adult Aged Aged, 80 and over Combined Modality Therapy *Embolization, Therapeutic Female Humans Male Middle Aged Retrospective Studies Spinal Neoplasms/secondary/*therapy Treatment Outcome *Vertebroplasty LA - chi M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2011 SN - 0376-2491 (Print) 0376-2491 SP - 175-9 ST - [Combination treatment of vertebral and paravertebral metastatic tumors by transarterial chemoembolization and percutaneous vertebroplasty] T2 - Zhonghua Yi Xue Za Zhi TI - [Combination treatment of vertebral and paravertebral metastatic tumors by transarterial chemoembolization and percutaneous vertebroplasty] VL - 91 ID - 828685 ER - TY - JOUR AB - Objective: To evaluate the efficacy and safety of combining transarterial chemoembolization and percutaneous vertebroplasty (PVP) in the treatment of vertebral and paravertebral metastatic tumors. Methods: A retrospective review was conducted in 49 patients with severer painful tumor metastasis in 72 vertebrae and paravertebral tissue who had failed noninvasive treatment at our institution from March 2003 to December 2009.Among them, there were intractable radicular pain (n=17) and slight or no motor and sensory function (n=6). All patients under transarterial chemoembolization were followed within 6 days by PVP. Computed tomography (CT) was performed within 3 days after PVP to observe the distribution of PMMA (para-methoxymethamphetamine) in vertebrae and whether or not there was any leakage. The efficacy was assessed by the change of pain level after combined treatment. Results: Bilateral vertebral arteries were selected in 44 cases with 65 vertebrae. And only unilateral vertebral artery was selected in 5 cases with 7 vertebrae. Except for 2 vertebrae with simple artery infusion, 29 vertebrae were embolized by 1-2 ml of lipiodolization and gelfoam particles and 41 vertebrae by gelatine particles. And an average volume of 4.23 ml and 5.39 ml was injected in each thoracic and lumbar vertebra respectively. The rate of efficacy was at 87.8% within 3 months after combined therapy. There were CR(complete response)21 cases (42.9%), PR (partial response) 22 cases(44.9%) and MR/NR (minimal/no response) 6 cases (12.2%). No serious complication related to the technique occurred. Only 12 cases with asympotomatic PMMA leakage around 16 vertebrae were demonstrated on post-operative CT. Conclusion: Transarterial chemoembolization plus PVP is an effective and safe procedure in the treatment of severe painful vertebral and paravertebral metastatic tumors. AD - S.-C. He, Department of Radiology, Zhongda Hospital, Southeast University, Nanjing 210009, China AU - He, S. C. AU - Teng, G. J. AU - Fang, W. AU - Deng, G. AU - Guo, J. H. AU - Zhu, G. Y. AU - Li, G. Z. DB - Embase Medline DO - 10.3760/cma.j.issn.0376-2491.2011.03.008 KW - 4 methoxymethamphetamine article chemoembolization clinical article clinical effectiveness computer assisted tomography human patient safety percutaneous vertebroplasty radicular pain retrospective study spine metastasis treatment failure treatment response LA - Chinese M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 0376-2491 SP - 175-179 ST - Combination treatment of vertebral and paravertebral metastastic tumors by transarterial chemoembolization and percutaneous vertebroplasty T2 - National Medical Journal of China TI - Combination treatment of vertebral and paravertebral metastastic tumors by transarterial chemoembolization and percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L366056571&from=export http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2011.03.008 VL - 91 ID - 829627 ER - TY - JOUR AB - OBJECTIVE: To analyse the causes and resultes of intraoperative occurrence of an acetabular fracture in primary total hip arthroplasty and discuss propriate prevention and treatment of this problem. METHODS: Between July 2004 and December 2006, 326 primary total hip arthroplasties were retrospectively reviewed and found that eleven patients (eleven hips) had sustained an intraoperative acetabular fracture involving 7 male and 4 female,aged from 37 to 71 years (mean 54 years). Analyzed the causes of fractures, the anatomic location, treatment and outcome of the fractures. Acetabular component designs were categorized and each design was analyzed for fracture risk. RESULTS: Among 11 cases, the fractures occurrenced as setting the prosthesis in 6 cases, grinding and drilling in 3 cases, drawning hook in 2 cases. There were 5 cases of central type fracture, 3 of posterior-wall, 2 of anterior, 1 of posterior-upper. Nine of these patients (nine hips) had been followed-up for 12 to 29 months(mean 18 months). There were no heterotopic ossification, no dislocation, no deep venous embolism. All fractures were healing. CONCLUSION: Acetabular fracture during primary total hip arthroplasty is a complication of acetabular fixation without cement, which should be think highly of. In the present series, retention of a stable cup is associated with uneventful osseous in growth and excellent early-term outcomes. AD - Joint Surgery Department, Ningbo 6th Hospital, Ningbo 315040, Zhejiang, China. hezymd@21cn.com AN - 19281003 AU - He, Z. Y. AU - Di, Z. L. AU - Zhang, J. H. AU - Feng, J. X. AU - Xu, R. M. DA - Feb DP - NLM ET - 2009/03/14 J2 - Zhongguo gu shang = China journal of orthopaedics and traumatology KW - Acetabulum/*injuries/surgery Adult Aged Arthroplasty, Replacement, Hip/*adverse effects Female Fractures, Bone/complications/*surgery Humans Intraoperative Complications/*prevention & control/surgery Male Middle Aged Retrospective Studies LA - chi M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 1003-0034 (Print) 1003-0034 SP - 81-3 ST - [Strategy of prevention and management of intraoperative fractures of acetabulum during primary total hip arthroplasty] T2 - Zhongguo Gu Shang TI - [Strategy of prevention and management of intraoperative fractures of acetabulum during primary total hip arthroplasty] VL - 22 ID - 829036 ER - TY - JOUR AB - Metastatic spinal tumors are the most common type of malignant lesions of the spine. Prompt diagnosis and identification of the primary malignancy is crucial to overall treatment. Numerous factors affect outcome including the nature of the primary cancer, the number of lesions, the presence of distant nonskeletal metastases, and the presence and/or severity of spinal cord compression. Initial management consists of chemotherapy, external beam radiotherapy, and external orthoses. Surgical intervention must be carefully considered in each case. Patients expected to live longer than 12 weeks should be considered as candidates for surgery. Indications for surgery include intractable pain, spinal cord compression, and the need for stabilization of impending pathological fractures. Whereas various surgical approaches have been advocated, anterior-approach surgery is the most accepted procedure for spinal cord decompression. Posterior approaches have also been used with success, but they require longer-length fusion. To obtain a stable fixation, the placement of instrumentation, in conjunction with judicious use of polymethylmethacrylate augmentation, is crucial. Preoperative embolization should be considered in patients with extremely vascular tumors such as renal cell carcinoma. Vertebroplasty, a newly described procedure in which the metastatic spinal lesions are treated via a percutaneous approach, may be indicated in selected cases of intractable pain caused by non- or minimally fractured vertebrae. AD - The Spine Center of New Jersey, New Jersey Medical School, Newark, New Jersey 07103, USA. heary@umdnj.edu AN - 16463992 AU - Heary, R. F. AU - Bono, C. M. DA - Dec 15 DO - 10.3171/foc.2001.11.6.2 DP - NLM ET - 2006/02/09 J2 - Neurosurgical focus KW - Adult Aged Bone Neoplasms/complications/radiotherapy/*secondary/surgery/therapy Braces Carcinoma/complications/radiotherapy/secondary/surgery/therapy Combined Modality Therapy Decompression, Surgical Embolization, Therapeutic Fractures, Spontaneous/etiology/surgery Humans Internal Fixators Middle Aged Pain/etiology Palliative Care Preoperative Care Prognosis Spinal Cord Compression/etiology/surgery Spinal Neoplasms/complications/radiotherapy/secondary/surgery/therapy Treatment Outcome LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2001 SN - 1092-0684 SP - e1 ST - Metastatic spinal tumors T2 - Neurosurg Focus TI - Metastatic spinal tumors VL - 11 ID - 829037 ER - TY - JOUR AD - Trent Cardiac Centre, Nottingham University Hospitals NHS Trust, City Hospital Campus, Hucknall Road, Nottingham, NG51PB, UK. robert.henderson@nuh.nhs.uk. AN - 28405848 AU - Henderson, R. DA - Dec DO - 10.1007/s00586-017-5089-4 DP - NLM ET - 2017/04/14 J2 - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society KW - *Bone Cements Embolism Humans *Teaching Rounds Vertebroplasty LA - eng M1 - 12 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 0940-6719 SP - 3206-3208 ST - Expert's comment concerning Grand Rounds case entitled "Intracardiac bone cement embolism as a complication of vertebroplasty: management strategy" by Hatzantonis C, Czyz M, Pyzik R, Boszczyk BM. (Eur Spine J; 2016. doi:10.1007/s00586-016-4695-x) T2 - Eur Spine J TI - Expert's comment concerning Grand Rounds case entitled "Intracardiac bone cement embolism as a complication of vertebroplasty: management strategy" by Hatzantonis C, Czyz M, Pyzik R, Boszczyk BM. (Eur Spine J; 2016. doi:10.1007/s00586-016-4695-x) VL - 26 ID - 828753 ER - TY - JOUR AB - We performed a percutaneous vertebroplasty at the compressed L2 vertebral body of a 73-year-old female using a left-sided unilateral extrapedicular approach. She complained severe radiating pain and a tingling sensation in her left leg two hours after the vertebroplasty. Spinal computed tomographic scan showed a large retroperitoneal hematoma, and a subsequent spinal angiography revealed a left L2 segmental artery injury. Bleeding was successfully controlled by endovascular embolization. Recently, extrapedicular approaches have been attempted, allowing for the avoidance of facet and pedicle injury with only a unilateral approach. With this approach, however, the needle punctures the vertebral body directly. Therefore, this procedure carries the potential risk of a spinal segmental artery. AD - Department of Neurosurgery, Chuncheon Sacred Heart Hospital, College of Medicine, Hallym University, Chuncheon, Korea. AN - 21519505 AU - Heo, D. H. AU - Cho, Y. J. C2 - Pmc3079101 DA - Feb DO - 10.3340/jkns.2011.49.2.131 DP - NLM ET - 2011/04/27 J2 - Journal of Korean Neurosurgical Society KW - Compression fractures Vascular injury Vertebroplasty LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2011 SN - 2005-3711 (Print) 1225-8245 SP - 131-3 ST - Segmental artery injury following percutaneous vertebroplasty using extrapedicular approach T2 - J Korean Neurosurg Soc TI - Segmental artery injury following percutaneous vertebroplasty using extrapedicular approach VL - 49 ID - 829022 ER - TY - JOUR AB - Percutaneous vertebroplasty is a safe and effective alternative for the treatment of many different types of painful vertebral lesions, including osteoporotic compression fractures,hemangiomas, or malignancy-induced pathologic vertebral fractures. Medical therapy often is limited to pain control and immobilization. Because surgery is contraindicated frequently in patients who have osteoporotic compression fractures, and because patients who have widespread metastatic disease often are not surgical candidates, vertebroplasty may be the only practical option. In experienced hands and with appropriately selected patients, percutaneous vertebroplasty is a safe, inexpensive, and highly efficacious procedure; however, because of the potential for devastating complications, all efforts must be made to optimize patient safety. Copyright © 2006 by Elsevier Inc. AD - Department of Radiology, Division of Neuroradiology, Vancouver General Hospital, University of British Columbia, 899 West 12th Avenue, Vancouver, British Columbia, V5Z 1M9, Canada; manraj.heran@vch.ca AN - 106358575. Language: English. Entry Date: 20061110. Revision Date: 20150711. Publication Type: Journal Article AU - Heran, M. K. S. AU - Legiehn, G. M. AU - Munk, P. L. DB - cin20 DP - EBSCOhost KW - Orthopedic Surgery -- Methods Spine -- Surgery Antibiotics -- Administration and Dosage Back Pain -- Surgery Bone Cements Hemangioma -- Complications Orthopedic Surgery -- Adverse Effects Orthopedic Surgery -- Contraindications Osteoporosis -- Complications Patient Assessment Pulmonary Embolism Spinal Fractures -- Etiology Spinal Fractures -- Surgery Spinal Injuries -- Complications Treatment Outcomes M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2006 SN - 0030-5898 SP - 409-434 ST - Current concepts and techniques in percutaneous vertebroplasty T2 - Orthopedic Clinics of North America TI - Current concepts and techniques in percutaneous vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106358575&site=ehost-live&scope=site VL - 37 ID - 830771 ER - TY - JOUR AB - Study Design. Case report. Objective. To present a previously undescribed complication of bone cement use during spinal surgery. Summary of Background Data. Surgical cement reaching the circulation is a frequently described complication. The placement of caval vein filters is a routine measure in specific patients to prevent thrombotic material, usually from deep venous thrombosis in the lower extremities, from reaching the pulmonary circulation. A case of bone cement getting trapped in the caval filter rendering it unremovable has not been published. Methods. A 66-year-old patient underwent dorsal spondylodesis of the lumbar spine for superinfected metastasis with instability. Because of deep venous thrombosis of both femoral and iliac veins, a caval filter had been placed before surgery. Bone cement from the surgical procedure migrated into the venous bloodstream and got caught in the caval filter, thus rendering the filter unremovable. Results. Surgical removal of the filter was necessary. Conclusion. If caval filters are present in patients undergoing surgery involving the use of bone cement, the possibility of cement being caught by the filter must be considered. AD - Univ Klinikum Essen, Klin Anasthesiol & Intens Med, D-45122 Essen, Germany. Univ Klinikum Essen, Inst Diagnost & Intervent Radiol, D-45122 Essen, Germany. Herbstreit, F (corresponding author), Univ Klinikum Essen, Klin Anasthesiol & Intens Med, Hufelandstr 55, D-45122 Essen, Germany. frank.herbstreit@uni-essen.de AN - WOS:000242131900027 AU - Herbstreit, F. AU - Kuhl, H. AU - Peters, J. DA - Nov DO - 10.1097/01.brs.0000245824.63150.ef J2 - Spine KW - spondylodesis bone cement complication caval filter PERCUTANEOUS VERTEBROPLASTY COMPLICATIONS EMBOLISM Clinical Neurology Orthopedics LA - English M1 - 24 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2006 SN - 0362-2436 SP - E917-E919 ST - A cemented caval vein filter T2 - Spine TI - A cemented caval vein filter UR - ://WOS:000242131900027 VL - 31 ID - 830402 ER - TY - JOUR AB - OBJECTIVE: To evaluate the association between tourniquet and total operative time during total knee arthroplasty and the occurrence of deep vein thrombosis. METHODS: Seventy-eight consecutive patients from our institution underwent cemented total knee arthroplasty for degenerative knee disorders. The pneumatic tourniquet time and total operative time were recorded in minutes. Four categories were established for total tourniquet time: <60, 61 to 90, 91 to 120, and >120 minutes. Three categories were defined for operative time: <120, 121 to 150, and >150 minutes. Between 7 and 12 days after surgery, the patients underwent ascending venography to evaluate the presence of distal or proximal deep vein thrombosis. We evaluated the association between the tourniquet time and total operative time and the occurrence of deep vein thrombosis after total knee arthroplasty. RESULTS: In total, 33 cases (42.3%) were positive for deep vein thrombosis; 13 (16.7%) cases involved the proximal type. We found no statistically significant difference in tourniquet time or operative time between patients with or without deep vein thrombosis. We did observe a higher frequency of proximal deep vein thrombosis in patients who underwent surgery lasting longer than 120 minutes. The mean total operative time was also higher in patients with proximal deep vein thrombosis. The tourniquet time did not significantly differ in these patients. CONCLUSION: We concluded that surgery lasting longer than 120 minutes increases the risk of proximal deep vein thrombosis. AD - [Hernandez, Arnaldo Jose; de Almeida, Adriano Marques; Sguizzato, Guilherme Turola] Univ Sao Paulo, Fac Med, Dept Orthoped & Traumatol, Sao Paulo, Brazil. [Favaro, Edmar] Hosp Santa Casa Sao Paulo, Sao Paulo, Brazil. Hernandez, AJ (corresponding author), Univ Sao Paulo, Fac Med, Dept Orthoped & Traumatol, Sao Paulo, Brazil. adrianomalmeida@uol.com.br AN - WOS:000309240800012 AU - Hernandez, A. J. AU - de Almeida, A. M. AU - Favaro, E. AU - Sguizzato, G. T. DO - 10.6061/clinics/2012(09)12 J2 - Clinics KW - Deep Vein Thrombosis Prophylaxis Thromboembolism Tourniquet Knee Prosthesis VENOUS THROMBOEMBOLISM ORTHOPEDIC-SURGERY TOTAL HIP PULMONARY-EMBOLISM EPIDURAL-ANESTHESIA GENERAL-ANESTHESIA BLOOD-LOSS PREVENTION REPLACEMENT PROPHYLAXIS Medicine, General & Internal LA - English M1 - 9 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2012 SN - 1807-5932 SP - 1053-1057 ST - The influence of tourniquet use and operative time on the incidence of deep vein thrombosis in total knee arthroplasty T2 - Clinics TI - The influence of tourniquet use and operative time on the incidence of deep vein thrombosis in total knee arthroplasty UR - ://WOS:000309240800012 VL - 67 ID - 830317 ER - TY - JOUR AD - Servicio de Neumología, Hospital Universitario de Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España. Electronic address: paulahdezp@gmail.com. Servicio de Neumología, Hospital Universitario de Nuestra Señora de Candelaria, Santa Cruz de Tenerife, España. AN - 27431887 AU - Hernández Pérez, P. E. AU - Figueira Gonçalves, J. M. DA - Oct 21 DO - 10.1016/j.medcli.2016.06.004 DP - NLM ET - 2016/07/20 J2 - Medicina clinica KW - Aged Bone Cements/*adverse effects Humans Male Postoperative Complications/diagnosis/*etiology Pulmonary Embolism/diagnosis/*etiology Vertebroplasty/adverse effects/*instrumentation LA - spa M1 - 8 N1 - PubMed NLM literature search January 5, 2021 OP - Embolia pulmonar por cemento de vertebroplastia. PY - 2016 SN - 0025-7753 SP - e45 ST - [Pulmonary cement embolism after vertebroplasty] T2 - Med Clin (Barc) TI - [Pulmonary cement embolism after vertebroplasty] VL - 147 ID - 828680 ER - TY - JOUR AB - INTRODUCTION: Vertebral involvement is found in a high percentage of multiple myeloma (MM) patients, often requiring multilevel surgical treatment to reduce pain and disability and to receive prompt access to oncological care. We describe the clinical use of washout technique for multilevel vertebroplasty in MM patients with diffuse spinal involvement. The aim of this technique is to reduce the risk of pulmonary fat embolism after cement injection and possibly to increment the amount of cement and treated levels in one surgical stage. METHODS: Three patients were treated with the washout technique prior to multilevel vertebroplasty for thoracolumbar diffuse spinal involvement in multiple myeloma. We describe the surgical technique and review the pertinent literature. RESULTS: The technique is clinically safe and effective in reducing pain, without significant complications. Two six-level vertebroplasties were performed in one case, allowing a larger amount of cement injected and a prompt start of the oncological treatment. CONCLUSIONS: Multilevel vertebroplasty in MM patients with diffuse spinal involvement carries the advantages of reducing pain, avoid repeated surgeries and faster return to oncological regimen. Cardiovascular complications, including pulmonary embolism, are rare but can have fatal consequences. It is mainly due to bone marrow mobilization during cement injection and the risk increases with the amount of cement injected and the number of treated levels. Despite multilevel treatment at the same stage, we did not observe any significant complication in our series. Further studies are needed to confirm the preliminary results of this technique. These slides can be retrieved under electronic supplementary material. AD - Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham, NG7 2UH, UK. Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham, NG7 2UH, UK. clucantoni@gmail.com. AN - 30406405 AU - Hershkovich, O. AU - Lucantoni, C. AU - Kapoor, S. AU - Boszczyk, B. DA - Jun DO - 10.1007/s00586-018-5804-9 DP - NLM ET - 2018/11/09 J2 - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society KW - Aged *Bone Marrow Purging Humans Male Middle Aged Multiple Myeloma/*therapy Spinal Neoplasms/*therapy *Vertebroplasty *Fat pulmonary embolism *Lavage *Multiple myeloma *Vertebral washout LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 0940-6719 SP - 1455-1460 ST - Bone marrow washout for multilevel vertebroplasty in multiple myeloma spinal involvement. Technical note T2 - Eur Spine J TI - Bone marrow washout for multilevel vertebroplasty in multiple myeloma spinal involvement. Technical note VL - 28 ID - 828579 ER - TY - JOUR AB - Purpose: The current study analyzes the potential role of radiotherapy (RT) in symptomatic vertebral hemangioma (SVH). Methods and Materials: Seven cooperating German institutions collected clinical information, treatment plans, and outcome data for all patients with SVH referred for local RT. Results: From 1969 to 2008, a total of 84 patients with 96 symptomatic lesions were irradiated for SVH. The primary indication for radiotherapy was pain (97.6%), and 28.6% of patients had additional neurological symptoms. RT was performed at a median total dose of 34 Gy, with a median single dose of 2.0 Gy. After receiving a median follow-up of 68 months, the overall patient response rate was 90.5%. Complete symptom remission occurred in 61.9% of patients, 28.6% of patients had partial pain relief, and 9.5% of patients had no pain relief. In 26.2% of patients, radiological signs of reossification were observed in long-term follow-up but not significantly correlated with pain relief. Most importantly, total doses of >= 34 Gy resulted in significantly greater symptomatic relief and control rate than total doses of <34 Gy. Conclusions: This study consists of the largest database of cases reported so far using RT for SVH. RT is easy, safe, and effective for pain relief treatment for SVH. Total doses of at least 34 Gy give the best symptomatic response. (C) 2010 Elsevier Inc. AD - [Micke, Oliver] Franziskus Hosp, Klin Strahlentherapie Onkol & Radioonkol, Dept Radiotherapy & Radiat Oncol, D-33615 Bielefeld, Germany. [Heyd, Reinhard] Offenbach Hosp, Dept Radiotherapy, Offenbach, Germany. [Seegenschmedt, M. Heinrich] Alfried Krupp Hosp, Dept Radiat Oncol, Essen, Germany. [Rades, Dirk] Univ Hosp Eppendorf, Dept Radiat Oncol, Hamburg, Germany. [Winkler, Cornelia] Carl Gustav Carus Univ Hosp, Dept Radiotherapy, Dresden, Germany. [Eich, Hans T.] Univ Hosp, Dept Radiotherapy, Cologne, Germany. [Bruns, Frank] Univ Hosp, Dept Radiotherapy & Special Oncol, Hannover, Germany. [Gosheger, Georg] Univ Hosp, Dept Gen & Surg Orthoped, Munster, Germany. [Micke, Oliver] Univ Hosp, Dept Radiat Oncol, Munster, Germany. Micke, O (corresponding author), Franziskus Hosp, Klin Strahlentherapie Onkol & Radioonkol, Dept Radiotherapy & Radiat Oncol, Kiskerstr 26, D-33615 Bielefeld, Germany. omicke@benign-news.de AN - WOS:000277106900035 AU - Heyd, R. AU - Seegenschmedt, M. H. AU - Rades, D. AU - Winkler, C. AU - Eich, H. T. AU - Bruns, F. AU - Gosheger, G. AU - Willich, N. AU - Micke, O. AU - German Cooperative Grp, Radiotherap DA - May DO - 10.1016/j.ijrobp.2009.04.055 J2 - Int. J. Radiat. Oncol. Biol. Phys. KW - Symptomatic vertebral hemangioma Pain Paresis Radiotherapy Benign disease SPINAL-CORD COMPRESSION H-AE-MANGIOMA PERCUTANEOUS VERTEBROPLASTY RADIATION-THERAPY NATURAL-HISTORY MANAGEMENT IRRADIATION EMBOLIZATION EFFICACY Oncology Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2010 SN - 0360-3016 SP - 217-225 ST - RADIOTHERAPY FOR SYMPTOMATIC VERTEBRAL HEMANGIOMAS: RESULTS OF A MULTICENTER STUDY AND LITERATURE REVIEW T2 - International Journal of Radiation Oncology Biology Physics TI - RADIOTHERAPY FOR SYMPTOMATIC VERTEBRAL HEMANGIOMAS: RESULTS OF A MULTICENTER STUDY AND LITERATURE REVIEW UR - ://WOS:000277106900035 VL - 77 ID - 830341 ER - TY - JOUR AB - SESSION TITLE: Global Case Report Posters SESSION TYPE: Global Case Reports PRESENTED ON: October 18-21, 2020 INTRODUCTION: Percutaneous vertebroplasty or kyphoplasty is a minimal invasive procedure that is applied for the treatment of vertebral fracture. The leakage of bone cement outside the vertebral body leads to pulmonary cement embolism (PCE). Although PCE is mostly asymptomatic, clinicians should be aware of the possibility of respiratory manifestations that can occur after the vertebral augmentation procedure. CASE PRESENTATION: A 49-year-old female with a past medical history of asthma presented to the emergency department for dyspnea and pleuritic chest pain. Two days prior, the patient underwent vertebral kyphoplasty of her T10 vertebrae for a compression fracture resulting from a fall. Given her recent surgery and a positive d-dimer, a computed topography of the chest was performed revealing bilateral segmental PCE. The patient was admitted overnight for observation. Since the patient remained vitally stable and was in no acute distress, she was discharged with no further treatment. The patient presented to the emergency department on two separate occasions over the next three days with dyspnea and pleuritic chest pain. She continued to remain vitally stable, but was referred to the pulmonary clinic for recommendations regarding PCE. During her evaluation in the pulmonary clinic she continued to have dyspnea and pleuritic chest pain, but she remained vitally stable without hypoxia. Upon review of systems the patient reported cough, dizziness, and back pain. She was started on six months of anticoagulation therapy for symptomatic peripheral PCE. On six weeks follow up visit her dizziness resolved and dyspnea and cough had improved. DISCUSSION: Transvertebral cement leakages into surrounding tissues and paravertebral veins are common complications after percutaneous vertebroplasty and kyphoplasty. Majority of patients are asymptomatic and PCE may be found incidentally on follow-up chest imaging. Alternatively, patients may present with symptoms including dyspnea, tachycardia, dizziness, chest pain, cough, or hemoptysis. Deaths due to PCE are rare but reported. Uncommonly, acute respiratory distress syndrome has also been reported. In cases of symptomatic peripheral or asymptomatic central embolisms, it is recommended to follow standard treatment guidelines for pulmonary thromboembolism. With limited cases reported there is no clear therapeutic protocol that has been accepted as a standard for treatment. CONCLUSIONS: Patients with respiratory symptoms after vertebroplasty should be evaluated carefully in terms of PCE. The rarity of this disease limits the ability to perform randomized trials to determine the best treatment option. Our case adds to the literature given her symptomatic improvement with anticoagulation. Reference #1: Krueger A, Bliemel C, Zettl R, Ruchholtz S. Management of pulmonary cement embolism after percutaneous vertebroplasty and kyphoplasty: a systematic review of the literature. Eur Spine J. 2009;18(9):1257–1265. Reference #2: Ignacio JMF, Ignacio KHD. Pulmonary embolism from cement augmentation of the vertebral body. Asian Spine J. 2018;12(2):380–387. Reference #3: Wang LJ. Pulmonary cement embolism associated with percutaneous vertebroplasty or kyphoplasty: a systematic review. Orthop Surg. 2012 Aug;4(3):182-9. DISCLOSURES: No relevant relationships by Sarah Hadique, source=Web Response No relevant relationships by Alicia Hinerman, source=Web Response No relevant relationships by Rachel Leonard, source=Web Response AU - Hinerman, A. AU - Leonard, R. AU - Hadique, S. DB - Embase DO - 10.1016/j.chest.2020.08.392 KW - cement D dimer adult adult respiratory distress syndrome adverse drug reaction anticoagulant therapy asthma backache clinical trial complication compression fracture conference abstract coughing dizziness dyspnea emergency ward female follow up hemoptysis human hypoxia kyphoplasty lung embolism medical history middle aged randomized controlled trial (topic) side effect systematic review tachycardia thorax pain topography vein vertebra body LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1931-3543 0012-3692 SP - A401 ST - PULMONARY CEMENT EMBOLISM FOLLOWING VERTEBRAL KYPHOPLASTY T2 - Chest TI - PULMONARY CEMENT EMBOLISM FOLLOWING VERTEBRAL KYPHOPLASTY UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2008026892&from=export http://dx.doi.org/10.1016/j.chest.2020.08.392 VL - 158 ID - 829053 ER - TY - JOUR AB - Bone cement implantation syndrome (BC/S) is a rare and potentially fatal perioperative complication of cemented bone surgery. Clinically, it can be as benign as transient desaturation or mild hypotension. In its more severe presentation, BC/S can cause serious cardiac dysrhythmias and cardiac arrest, and in cemented hemiarthroplasty for femoral neck fracture, BC/S may carry up to a 16-fold increase in 30-day postoperative mortality. The etiology and pathophysiology of BC/S are not fully established; however, results of studies and clinical reports are consistent, citing right ventricular failure secondary to increased pulmonary artery pressure as the cause of systemic hypotension and sudden cardiac arrest. The purpose of this article was to review the literature for a comprehensive understanding of bone cement and BC/S. This article reviews the history of bone cement and its associated hazards, etiology/ pathophysiology and clinical presentation of BCIS, preoperative assessment and planning for cemented procedures, anesthetic management of BCIS, and the surgeon's role in reducing the risk of BC/S. AD - Staff anesthetist at Northport Medical Center in Northport, Alabama AN - 133475912. Language: English. Entry Date: 20181213. Revision Date: 20181218. Publication Type: Article AU - Hines, Cheryl B. DB - cin20 DP - EBSCOhost KW - Bone Cements -- Utilization Arthroplasty -- Methods Bone Cements -- Adverse Effects Intraoperative Complications -- Mortality Bone Cements -- History Pulmonary Embolism -- Physiopathology Postoperative Complications -- Etiology Anoxia -- Etiology Hypotension -- Etiology Preoperative Care Physician's Role Anesthesia -- Methods M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2018 SN - 0094-6354 SP - 433-441 ST - Understanding Bone Cement Implantation Syndrome T2 - AANA Journal TI - Understanding Bone Cement Implantation Syndrome UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=133475912&site=ehost-live&scope=site VL - 86 ID - 830541 ER - TY - JOUR AB - Bone cement implantation syndrome (BCIS) is a potentially fatal complication of orthopedic surgeries that use cement. The symptoms of BCIS occur primarily during femoral fracture repairs, but this complication has been reported in a wide variety of cemented procedures. Clinical presentation of this syndrome begins as a cascade with hypoxia and hypotension; if it is not reversed, it ends with right-sided heart failure and cardiac arrest. This syndrome usually occurs at cementation, prosthesis insertion, joint reduction, or tourniquet deflation, and should be treated with aggressive resuscitation and supportive care. This article provides a comprehensive explanation of bone cement, the identification and management of BCIS, and the roles of the perioperative team in the event of cardiopulmonary collapse. It includes a case study that can be used as an educational tool for simulation, mock drills, or staff meetings; it also may be used as a framework for creating policies. AN - 30694541 AU - Hines, C. B. AU - Collins-Yoder, A. DA - Feb DO - 10.1002/aorn.12584 DP - NLM ET - 2019/01/30 J2 - AORN journal KW - Arthroplasty, Replacement, Hip/*adverse effects/nursing Bone Cements/*adverse effects Education, Nursing, Continuing Heart Arrest/etiology/nursing Hip Prosthesis/*adverse effects Humans Intraoperative Complications/etiology/nursing Perioperative Nursing/education Syndrome *arthroplasty *bone cement implantation syndrome *embolic debris *methyl methacrylate *orthopedic surgery LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 0001-2092 SP - 202-216 ST - Bone Cement Implantation Syndrome: Key Concepts for Perioperative Nurses T2 - Aorn j TI - Bone Cement Implantation Syndrome: Key Concepts for Perioperative Nurses VL - 109 ID - 828563 ER - TY - JOUR AB - Aim: The purpose of this study was to survey and to evaluate the first clinical and radiological results with the cementless ZMR taper hip prosthesis. Method: The modular distal-tapered stem was designed with a roughened titanium surface and sharp splines to achieve secure distal fixation and rotational stability. 90ZMR taper hip prostheses were implanted between October 1999 and July 2002. Out of these, 4 interventions were primary and 86 were revision procedures. In 43 cases a complete hip prosthesis revision and in 43 cases a stem revision was necessary. The mean age of the 90 patients (42 males, 48 females) was 67.1 years. The mean follow-up period was 7.6 months (3 to 25 months). Results: The stem displayed an excellent distal fixation. The mean subsidence could be measured with 4.3 mm. Furthermore, most cases showed a particularly favourable remodelling of the proximal femoral bone stock. Complications associated with revision included intraoperatively 4 femur fractures, 3 femur fissures, 5 femur perforations, 2 trochanter fractures and postoperatively 19 dislocations, 5 superficial wound infections, 2 transient palsies, 1 pulmonary embolism, 1 stem rotation and 4 wound healing failures. Considering these complications 15 re-revisions were necessary and the ZMR taper hip prosthesis had to be exchanged in 3 cases. Conclusion: On the one hand the ZMR taper hip prosthesis proved its value, particularly with regard to the stem modularity, the excellent distal fixation in conjunction with the possibility of partial body weight bearing and the rapid bone remodelling of the femur. On the other hand an increased number of postoperative complications and re-revisions occurred. Further long-term studies seem to be essential. AD - Univ Marburg, Klin Orthopad & Rheumatol, D-35041 Marburg, Germany. Hinrichs, F (corresponding author), Univ Marburg, Klin Orthopad & Rheumatol, Baldingerstr, D-35041 Marburg, Germany. hinrichs@med.uni-marburg.de AN - WOS:000230333400025 AU - Hinrichs, F. AU - Boudriot, U. AU - Hunerkopf, M. AU - Griss, P. DA - May-Jun DO - 10.1055/s-2005-836456 J2 - Z. Orthop. Grenzg. KW - hip prosthesis revision cementless revision modular revision stem TOTAL HIP-ARTHROPLASTY FEMORAL COMPONENT STEM Orthopedics LA - German M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2005 SN - 0044-3220 SP - 355-359 ST - Design and first clinical results with the ZMR taper revision prosthesis T2 - Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete TI - Design and first clinical results with the ZMR taper revision prosthesis UR - ://WOS:000230333400025 VL - 143 ID - 830425 ER - TY - JOUR AB - AIM: The purpose of this study was to survey and to evaluate the first clinical and radiological results with the cementless ZMR taper hip prosthesis. METHOD: The modular distal-tapered stem was designed with a roughened titanium surface and sharp splines to achieve secure distal fixation and rotational stability. 90 ZMR taper hip prostheses were implanted between October 1999 and July 2002. Out of these, 4 interventions were primary and 86 were revision procedures. In 43 cases a complete hip prosthesis revision and in 43 cases a stem revision was necessary. The mean age of the 90 patients (42 males, 48 females) was 67.1 years. The mean follow-up period was 7.6 months (3 to 25 months). RESULTS: The stem displayed an excellent distal fixation. The mean subsidence could be measured with 4.3 mm. Furthermore, most cases showed a particularly favourable remodelling of the proximal femoral bone stock. Complications associated with revision included intraoperatively 4 femur fractures, 3 femur fissures, 5 femur perforations, 2 trochanter fractures and postoperatively 19 dislocations, 5 superficial wound infections, 2 transient palsies, 1 pulmonary embolism, 1 stem rotation and 4 wound healing failures. Considering these complications 15 re-revisions were necessary and the ZMR taper hip prosthesis had to be exchanged in 3 cases. CONCLUSION: On the one hand the ZMR taper hip prosthesis proved its value, particularly with regard to the stem modularity, the excellent distal fixation in conjunction with the possibility of partial body weight bearing and the rapid bone remodelling of the femur. On the other hand an increased number of postoperative complications and re-revisions occurred. Further long-term studies seem to be essential. AD - Klinik für Orthopädie und Rheumatologie, Philipps-Universität Marburg. hinrichs@med.uni-marburg.de AN - 15977127 AU - Hinrichs, F. AU - Boudriot, U. AU - Hünerkopf, M. AU - Griss, P. DA - May-Jun DO - 10.1055/s-2005-836456 DP - NLM ET - 2005/06/25 J2 - Zeitschrift fur Orthopadie und ihre Grenzgebiete KW - Aged Arthroplasty, Replacement, Hip/*instrumentation/*statistics & numerical data Causality Equipment Design Equipment Failure Analysis/methods Female Follow-Up Studies Germany/epidemiology Hip Fractures/diagnostic imaging/*epidemiology Hip Prosthesis/classification/*statistics & numerical data Humans Joint Instability/diagnostic imaging/*epidemiology Male Prevalence *Prosthesis Failure Prosthesis-Related Infections/diagnostic imaging/*epidemiology Radiography Reoperation/statistics & numerical data Treatment Outcome LA - ger M1 - 3 N1 - PubMed NLM literature search January 5, 2021 OP - Design und erste klinische Ergebnisse mit dem ZMR-Taper-Revisionsschaft. PY - 2005 SN - 0044-3220 (Print) 0044-3220 SP - 355-9 ST - [Design and first clinical results with the ZMR taper revision prosthesis] T2 - Z Orthop Ihre Grenzgeb TI - [Design and first clinical results with the ZMR taper revision prosthesis] VL - 143 ID - 828806 ER - TY - JOUR AB - We report on an intraoperative lethal fat embolism and bone marrow embolism of the lung caused by implantation of hip endoprosthesis using acrylic bone cement. Autopsy revealed massive fat embolism of the lung and multiple bone marrow emboli within branches of the pulmonary arteries. It is concluded that there is a close relationship between implantation of hip endoprosthesis and death because fat embolism and bone marrow embolism was the only available evidence on post mortem examination. AD - Institut für Pathologische Anatomie der Universität Wien. AN - 3673186 AU - Hochmeister, M. AU - Fellinger, E. AU - Denk, W. AU - Laufer, G. DA - May-Jun DO - 10.1055/s-2008-1044738 DP - NLM ET - 1987/05/01 J2 - Zeitschrift fur Orthopadie und ihre Grenzgebiete KW - Aged Aged, 80 and over Bone Marrow/*pathology Embolism, Fat/*pathology Female *Hip Prosthesis Humans Intraoperative Complications/*pathology Methylmethacrylates/*administration & dosage Pulmonary Artery/pathology Pulmonary Embolism/*pathology LA - ger M1 - 3 N1 - PubMed NLM literature search January 5, 2021 OP - Intraoperativ tödliche Fettund Knochenmarksembolie der Lunge bei Implantation einer Hüftendoprothese mit Polymethylmethacrylathältigem Knochenzement. PY - 1987 SN - 0044-3220 (Print) 0044-3220 SP - 337-9 ST - [Intraoperative fatal fat and bone marrow embolism of the lung in implantation of a hip endoprosthesis with polymethylmethacrylate bone cement] T2 - Z Orthop Ihre Grenzgeb TI - [Intraoperative fatal fat and bone marrow embolism of the lung in implantation of a hip endoprosthesis with polymethylmethacrylate bone cement] VL - 125 ID - 828944 ER - TY - JOUR AB - We report on an intraoperative lethal fat embolism and bone marrow embolism of the lung caused by implantation of hip endoprosthesis using acrylic bone cement. Autopsy revealed massive fat embolism of the lung and multiple bone marrow emboli within branches of the pulmonary arteries. It is concluded that there is a close relationship between implantation of hip endoprosthesis and death because fat embolism and bone marrow embolism was the only available evidence on post mortem examination. AD - Institut fur Pathologische Anatomie, Universitat Wien, A-1090 Wien AU - Hochmeister, M. AU - Fellinger, E. AU - Denk, W. AU - Laufer, G. DB - Embase Medline KW - bone cement autopsy case report fat embolism human lethality lung total hip prosthesis LA - German M1 - 3 N1 - Embase Elsevier literature search January 5, 2021 PY - 1987 SN - 0044-3220 SP - 337-339 ST - Intraoperative lethal fat embolism and bone marrow embolism of the lung caused by implantation of hip endoprosthesis using acrylic bone cement T2 - Zeitschrift fur Orthopadie und Ihre Grenzgebiete TI - Intraoperative lethal fat embolism and bone marrow embolism of the lung caused by implantation of hip endoprosthesis using acrylic bone cement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L18162934&from=export VL - 125 ID - 829956 ER - TY - JOUR AB - Since 1970 the fat embolism syndrome (FES) has been recognised as a severe complication of cemented total hip arthroplasty (THA). Initially and still today the toxicity of bone cement has been thought to be responsible for the cardiorespiratory problems. Meanwhile several reports have confirmed the causal relationship between intramedullary pressure (IMP), bone-marrow release into the circulation and subsequent cardiorespiratory deterioration during cemented THA. In recent publications it has been reported that bone-marrow release due to increased IMP also occurs during cementless THA. The clinical implication of these observations is controversial. For this reason in the first part of this paper two autopsy-proven FES deaths and five further clinically manifest FES cases are presented. In the second part of the study, IMP courses during four different surgical techniques (2 conventional, 2 modified) are compared. The aim of the modified surgical technique developed in our department was to minimize IMP peaks and bone-marrow release during cementless THA. Both modified techniques showed significantly lower IMPs during opening of the medullary canal, preparation with rasps, and implantation of the prosthesis than the conventional techniques. The observed FES cases for the first time strongly confirm the clinical relevance of the FES, also during cementless THA. On the basis of the data presented we recommend the modified surgical technique to reduce bone-marrow release during cementless THA. AD - S. Hofmann, Orthopadische Abteilung, Donauspital, Langobardenstrasse 122, A-1220 Wien, Austria AU - Hofman, S. AU - Hopf, R. AU - Huemer, G. AU - Kratochwill, C. AU - Koller-Strametz, J. AU - Schlag, G. AU - Salzer, M. DB - Embase Medline KW - adult article cardiopulmonary insufficiency case report fat embolism female human surgical technique total hip prosthesis LA - German M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1995 SN - 0085-4530 SP - 130-137 ST - Modified surgical technique to reduce bone-marrow release in uncemented endoprosthetic surgery of the hip T2 - Orthopade TI - Modified surgical technique to reduce bone-marrow release in uncemented endoprosthetic surgery of the hip UR - https://www.embase.com/search/results?subaction=viewrecord&id=L25137791&from=export VL - 24 ID - 829930 ER - TY - JOUR AB - Since 1970 the fat embolism syndrome (FES) has been recognised as a severe complication of cemented total hip arthroplasty (THA). Initially and still today the toxicity of bone cement has been thought to be responsible for the cardiorespiratory problems, Meanwhile several reports have confirmed the causal relationship between intramedullary pressure (IMP), bone-marrow release into the circulation and subsequent cardiorespiratory deterioration during cemented THA. In recent publications it has been reported that bone-marrow release due to increased IMP also occurs during cementless THA. The clinical implication of these observations is controversial. For this reason in the first part of this paper two autopsy-proven FES deaths and five further clinically manifest FES cases are presented. In the second part of the study, IMP courses during four different surgical techniques (2 conventional, 2 modified) are compared. The aim of the modified surgical technique developed in our department was to minimize IMP peaks and bone-marrow release during cementless THA. Both modified techniques showed significantly lower IMPs during opening of the medullary canal, preparation with rasps, and implantation of the prosthesis than the conventional techniques. The observed FES cases for the first time strongly confirm the clinical relevance of the FES, also during cementless THA. On the basis of the data presented we recommend the modified surgical technique to reduce bone-marrow release during cementless THA. AD - HOFMANN, S (corresponding author), DONAUSPITAL,ORTHOPAD ABT,LANGOBARDENSTR 122,A-1220 VIENNA,AUSTRIA. AN - WOS:A1995QW84400007 AU - Hofmann, S. AU - Hopf, R. AU - Huemer, G. AU - Kratochwill, C. AU - Kollerstrametz, J. AU - Schlag, G. AU - Salzer, M. DA - Apr J2 - Orthopade KW - FAT EMBOLISM UNCEMENTED THA MODIFIED SURGICAL TECHNIQUE Orthopedics LA - German M1 - 2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1995 SN - 0085-4530 SP - 130-137 ST - MODIFIED SURGICAL TECHNIQUE TO REDUCE BONE-MARROW RELEASE IN UNCEMENTED ENDOPROSTHETIC SURGERY OF THE HIP T2 - Orthopade TI - MODIFIED SURGICAL TECHNIQUE TO REDUCE BONE-MARROW RELEASE IN UNCEMENTED ENDOPROSTHETIC SURGERY OF THE HIP UR - ://WOS:A1995QW84400007 VL - 24 ID - 830488 ER - TY - JOUR AB - In the literature 20 cases of fat embolism syndrome (FES) after total knee replacement (TKR) are reported; 16 cases had cemented hinged TKR and 4 resurfacing TKR. Initially, it was believed that the bone cement was responsible for the FES. Since then, however, Fahmy et al. have published extraordinary data, demonstrating the causal relationship between increased intramedullary pressure (IMP) during the insertion of the intramedullary rod (IR) and cardiorespiratory deterioration. The industry responded by developing a fluted IR, disregarding the overdrilling in the distal femur required by Fahmy. In the first part of this paper clinically manifest FES cases after resurfacing TKR are reported. In the second part of the study the conventional surgical technique is compared with a modified technique, which focuses on a reduction of bone-marrow release into the circulation. In the conventional and the modified group, IRs with and without; flutes were compared. It was shown that only the opening of the intramedullary canal and insertion of the IR generated relevant IMP peaks during implantation of resurfacing TKR. When compared with the conventional surgical technique, the modified technique revealed significantly lower IMPs, and in neither group was a difference demonstrated between the IR with or without flutes. In 4 patients (2 conventional, 2 modified) transesophageal echocardiography (TEE) was performed for detection of bone-marrow release into the circulation. In the two patients operated on conventionally, TEE showed a markedly higher bone-marrow release than in the patients with modified operations. In conclusion, we recommend the presented modified surgical technique in order to reduce bone-marrow release into the circulation. AD - HOFMANN, S (corresponding author), DONAUSPITAL,ORTHOPAD ABT,LANGOBARDENSTR 122,A-1220 VIENNA,AUSTRIA. AN - WOS:A1995QW84400009 AU - Hofmann, S. AU - Hopf, R. AU - Huemer, G. AU - Kratochwill, C. AU - Kollerstrametz, J. AU - Schlag, G. AU - Salzer, M. DA - Apr J2 - Orthopade KW - FAT EMBOLISM TOTAL KNEE REPLACEMENT MODIFIED SURGICAL TECHNIQUE Orthopedics LA - German M1 - 2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1995 SN - 0085-4530 SP - 144-150 ST - MODIFIED SURGICAL TECHNIQUE TO REDUCE BONE-MARROW RELEASE DURING TOTAL KNEE REPLACEMENT T2 - Orthopade TI - MODIFIED SURGICAL TECHNIQUE TO REDUCE BONE-MARROW RELEASE DURING TOTAL KNEE REPLACEMENT UR - ://WOS:A1995QW84400009 VL - 24 ID - 830489 ER - TY - JOUR AB - In the literature 20 cases of fat embolism syndrome (FES) after total knee replacement (TKR) are reported; 16 cases had cemented hinged TKR and 4 resurfacing TKR. Initially, it was believed that the bone cement was responsible for the FES. Since then, however, Fahmy et al. have published extraordinary data, demonstrating the causal relationship between increased intramedullary pressure (IMP) during the insertion of the intramedullary rod (IR) and cardiorespiratory deterioration. The industry responded by developing a fluted IR, disregarding the overdrilling in the distal femur required by Fahmy. In the first part of this paper clinically manifest FES cases after resurfacing TKR are reported. In the second part of the study the conventional surgical technique is compared with a modified technique, which focuses on a reduction of bone-marrow release into the circulation. In the conventional and the modified group, IRs with and without flutes were compared. It was shown that only the opening of the intramedullary canal and insertion of the IR generated relevant IMP peaks during implantation of resurfacing TKR. When compared with the conventional surgical technique, the modified technique revealed significantly lower IMPs, and in neither group was a difference demonstrated between the IR with or without flutes. In 4 patients (2 conventional, 2 modified) transesophageal echocardiography (TEE) was performed for detection of bone-marrow release into the circulation. In the two patients operated on conventionally, TEE showed a markedly higher bone-marrow release than in the patients with modified operations. In conclusion, we recommend the presented modified surgical technique in order to reduce bone-marrow release into the circulation. AD - Orthopädische Abteilung, Donauspital, Wien. AN - 7753539 AU - Hofmann, S. AU - Hopf, R. AU - Huemer, G. AU - Kratochwill, C. AU - Koller-Strametz, J. AU - Schlag, G. AU - Salzer, M. DA - Apr DP - NLM ET - 1995/04/01 J2 - Der Orthopade KW - Aged Bone Marrow/*physiology Bone Nails Embolism, Fat/etiology/*prevention & control Extravasation of Diagnostic and Therapeutic Materials/prevention & control Female Humans Knee Prosthesis/*methods Male Middle Aged Pressure Prospective Studies Prosthesis Design LA - ger M1 - 2 N1 - PubMed NLM literature search January 5, 2021 OP - Modifizierte Operationstechniken zur Reduzierung der Knochenmarkausschüttung in der Knieendoprothetik. PY - 1995 SN - 0085-4530 (Print) 0085-4530 SP - 144-50 ST - [Modified surgical technique for the reduction of bone marrow spilling in knee endoprosthesis] T2 - Orthopade TI - [Modified surgical technique for the reduction of bone marrow spilling in knee endoprosthesis] VL - 24 ID - 828735 ER - TY - JOUR AB - Since 1970 the fat embolism syndrome (FES) has been recognised as a severe complication of cemented total hip arthroplasty (THA). Initially and still today the toxicity of bone cement has been though to be responsible for the cardiorespiratory problems. Meanwhile several reports have confirmed the causal relationship between intramedullary pressure (IMP), bone-marrow release into the circulation and subsequent cardiorespiratory deterioration during cemented THA. In recent publications it has been reported that bone-marrow release due to increased IMP also occurs during cementless THA. The clinical implication of these observations is controversial. For this reason in the first part of this paper two autopsy-proven FES deaths and five further clinically manifest FES cases are presented. In the second part of the study, IMP courses during four different surgical techniques (2 conventional, 2 modified) are compared. The aim of the modified surgical technique developed in our department was to minimize IMP peaks and bone-marrow release during cementless THA. Both modified techniques showed significantly lower IMPs during opening of the medullary canal, preparation with rasps, and implantation of the prosthesis than the conventional techniques. The observed FES cases for the first time strongly confirm the clinical relevance of the FES, also during cementless THA. On the basis of the data presented we recommend the modified surgical technique to reduce bone-marrow release during cementless THA. AD - Orthopädische Abteilung, Donauspital, Wien. AN - 7753537 AU - Hofmann, S. AU - Hopf, R. AU - Huemer, G. AU - Kratochwill, C. AU - Koller-Strametz, J. AU - Schlag, G. AU - Salzer, M. DA - Apr DP - NLM ET - 1995/04/01 J2 - Der Orthopade KW - Aged Aged, 80 and over Bone Marrow/physiopathology Embolism, Fat/physiopathology/*prevention & control Extravasation of Diagnostic and Therapeutic Materials Female Hip Prosthesis/*methods Humans Male Middle Aged Pressure Prospective Studies Prosthesis Design Respiratory Insufficiency/physiopathology LA - ger M1 - 2 N1 - PubMed NLM literature search January 5, 2021 OP - Modifizierte Operationstechniken zur Reduzierung der Knochenmarkausschüttung in der zementfreien Hüftendoprothetik. PY - 1995 SN - 0085-4530 (Print) 0085-4530 SP - 130-7 ST - [Modified surgical technique for reduction of bone marrow spilling in cement-free hip endoprosthesis] T2 - Orthopade TI - [Modified surgical technique for reduction of bone marrow spilling in cement-free hip endoprosthesis] VL - 24 ID - 828926 ER - TY - JOUR AB - In the literature 20 cases of fat embolism syndrome (FES) after total knee replacement (TKR) are reported; 16 cases had cemented hinged TKR and 4 resurfacing TKR. Initially, it was believed that the bone cement was responsible for the FES. Since then, however, Fahmy et al. have published extraordinary data, demonstrating the causal relationship between increased intramedullary pressure (IMP) during the insertion of the intramedullary rod (IR) and cardiorespiratory deterioration. The industry responded by developing a fluted IR, disregarding the overdrilling in the distal femur required by Fahmy. In the first part of this paper clinically manifest FES cases after resurfacing TKR are reported. In the second part of the study the conventional surgical technique is compared with a modified technique, which focuses on a reduction of bone-marrow release into the circulation. In the conventional and the modified group, IRs with and without flutes were compared. It was shown that only the opening of the intramedullary canal and insertion of the IR generated relevant IMP peaks during implantation of resurfacing TKR. When compared with the conventional surgical technique, the modified technique revealed significantly lower IMPs, and in neither group was a difference demonstrated between the IR with or without flutes. In 4 patients (2 conventional, 2 modified) transesophageal echocardiography (TEE) was performed for detection of bone-marrow release into the circulation. In the two patients operated on conventionally, TEE showed a markedly higher bone-marrow release than in the patients with modified operations. In conclusion, we recommend the presented modified surgical technique in order to reduce bone-marrow release into the circulation. AD - S. Hofman, Orthopadische Abteilung, Donauspital, Langobardenstrasse 122, A-1220 Wien, Austria AU - Hofmann, S. AU - Hopf, R. AU - Huemer, G. AU - Kratochwill, C. AU - Koller-Strametz, J. AU - Schlag, G. AU - Salzer, M. DB - Embase Medline KW - aged article case report fat embolism female human surgical technique total knee arthroplasty LA - German M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1995 SN - 0085-4530 SP - 144-150 ST - Modified surgical technique to reduce bone-marrow release during total knee replacement T2 - Orthopade TI - Modified surgical technique to reduce bone-marrow release during total knee replacement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L25137793&from=export VL - 24 ID - 829931 ER - TY - JOUR AB - There is evidence in several animal and human studies that high intramedullary pressure in the femur is of causal significance for bone marrow release into the circulation, causing pulmonary fatty marrow embolization. A previous clinical study provided evidence that in uncemented hip arthroplasty, high intramedullary pressure and subsequent fat embolism with cardiorespiratory deterioration can occur. In this prospective clinical trial, the effect of five surgical techniques on the femoral intramedullary pressure was recorded intraoperatively in 36 patients during uncemented press fit hip arthroplasty. In Group A, the conventional surgical technique (slide hammer and femoral rasps) showed intramedullary hypertension during opening of the femoral canal, femur preparation, and prosthesis insertion. In Group B, a mechanical high frequency vibration rasp was used, instead of the slide hammer, and provided reduction of the intramedullary pressure peaks during opening of the femoral canal but could not prevent intramedullary hypertension during rasping and prosthesis insertion. In Group C, a modified surgical technique to prevent high intramedullary pressure reduced pressure peaks during opening of the femoral canal and resulted in a significant reduction of intramedullary pressure during femur preparation and prosthesis insertion compared with the conventional surgical technique used with Group A. In Group D the results of the modified surgical technique could be improved additionally by using the high frequency vibration rasp, instead of the slide hammer. In Group E conventional surgical technique in combination with a distal venting hole has not proven to be efficient in uncemented hip arthroplasty. Based on the results of this in vivo study, the proposed modified surgical technique in cementless hip arthroplasty can be recommended to avoid high intramedullary pressure peaks, which should minimize the risk of significant bone marrow release into the circulation and the risk for cardiorespiratory deterioration caused by fat embolism. AN - CN-00306515 AU - Hofmann, S. AU - Hopf, R. AU - Mayr, G. AU - Schlag, G. AU - Salzer, M. DO - 10.1097/00003086-199903000-00017 KW - Aged Aged, 80 and over Arthroplasty, Replacement, Hip [instrumentation, *methods] Embolism, Fat [prevention & control] Female Femur [*physiopathology] Humans Male Middle Aged Postoperative Complications [prevention & control] Pressure Prospective Studies Risk Factors M1 - 360 M3 - Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1999 SP - 136‐146 ST - In vivo femoral intramedullary pressure during uncemented hip arthroplasty T2 - Clinical orthopaedics and related research TI - In vivo femoral intramedullary pressure during uncemented hip arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00306515/full ID - 830050 ER - TY - JOUR AB - We report a case of delayed hypoxemia in an aged healthy male patient, which developed 2 hours after cementation of the prosthesis in total hip replacement (THR) under spinal anesthesia. The patient was doing well throughout the operation but unfortunately, progressive tachypnea was noted 1 h after he was transferred to the recovery room (i.e. 2 h after the application of bone cement into the femur). An hour further, distinct wheeze was heard bilaterally on auscultation, which signified bronchospasm. Arterial blood gases analysis revealed a low PaO2 of 71 mmHg and a decrease of oxygen saturation to 91% with supplement of fractional oxygen of 35%. Aerosolization of bronchodilator with terbutaline was administered and supplemental fractional oxygen was increased to 50%. Although wheezing soon subsided, tachypnea and desaturation persisted. He was then transferred to the surgical intensive care unit for further management. Ventilation-perfusion lung scan was performed, which was suggestive of multiple pulmonary embolism. AD - Department of Anesthesia, Chang Gung Memorial Hospital at Chia Yi, No. 6, Sec West, Chia Pu Road, Putz City, Chia Yi, Taiwan, R.O.C. AN - 12747348 AU - Hong, C. L. AU - Liu, H. P. AU - Wu, C. Y. AU - Ho, A. C. AU - Shyr, M. H. AU - Wong, C. H. AU - Chun, H. S. DA - Mar DP - NLM ET - 2003/05/16 J2 - Acta anaesthesiologica Sinica KW - Aged *Anesthesia, Spinal Arthroplasty, Replacement, Hip/*adverse effects Bone Cements/*adverse effects Humans Hypoxia/*etiology Male Pulmonary Embolism/etiology LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2003 SN - 0254-1319 (Print) 0254-1319 SP - 47-51 ST - Delayed hypoxemia after bone cement insertion during total hip replacement under spinal anesthesia--a case report T2 - Acta Anaesthesiol Sin TI - Delayed hypoxemia after bone cement insertion during total hip replacement under spinal anesthesia--a case report VL - 41 ID - 828885 ER - TY - JOUR AB - We report a case of delayed hypoxemia in an aged healthy male patient, which developed 2 hours after cementation of the prosthesis in total hip replacement (THR) under spinal anesthesia. The patient was doing well throughout the operation but unfortunately, progressive tachypnea was noted 1 h after he was transferred to the recovery room (i.e. 2 h after the application of bone cement into the femur). An hour further, distinct wheeze was heard bilaterally on auscultation, which signified bronchospasm. Arterial blood gases analysis revealed a low PaO2 of 71 mmHg and a decrease of oxygen saturation to 91% with supplement of fractional oxygen of 35%. Aerosolization of bronchodilator with terbutaline was administered and supplemental fractional oxygen was increased to 50%. Although wheezing soon subsided, tachypnea and desaturation persisted. He was then transferred to the surgical intensive care unit for further management. Ventilation-perfusion lung scan was performed, which was suggestive of multiple pulmonary embolism. AD - H.S. Chun, Department of Anaesthesia, Chang Gung Mem. Hospital at Chia Yi, No. 6 Sec West, Chia Pu Road, Putz City, Chia Yi, Taiwan AU - Hong, C. L. AU - Liu, H. P. AU - Wu, C. Y. AU - Ho, A. C. Y. AU - Shyr, M. H. AU - Wong, C. H. AU - Chun, H. S. DB - Embase Medline KW - anesthetic agent bone cement diazepam poly(methyl methacrylate) terbutaline aerosol aged anemia anesthetic recovery arterial blood arterial oxygen saturation arterial oxygen tension article blood gas analysis bronchodilatation bronchospasm case report cementation disease course femoral neck fracture human hypoxemia intensive care unit lung auscultation lung embolism lung scintiscanning lung ventilation perfusion ratio male oxygen therapy patient transport physical examination spinal anesthesia supplementation tachypnea total hip prosthesis wheezing LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2003 SN - 0254-1319 SP - 47-51 ST - Delayed hypoxemia after bone cement insertion during total hip replacement under spinal anesthesia - A case report T2 - Acta Anaesthesiologica Sinica TI - Delayed hypoxemia after bone cement insertion during total hip replacement under spinal anesthesia - A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L36469409&from=export VL - 41 ID - 829855 ER - TY - JOUR AB - Purpose: This study aimed at assessing the cement leakage rate and the filling pattern in patients treated with vertebroplasty, kyphoplasty and stentoplasty with and without a newly developed lavage technique.Study Design: Retrospective clinical case-control study.Methods: A newly developed bipedicular lavage technique prior to cement application was applied in 64 patients (45.1 %) with 116 vertebrae, ("lavage" group). A conventional bipedicular cement injection technique was used in 78 patients (54.9 %) with 99 levels ("controls"). The outcome measures were filling patterns and leakage rates.Results: The overall leakage rate (venous, cortical defect, intradiscal) was 37.9 % in the lavage and 83.8 % in the control group (p < 0.001). Venous leakage (lavage 12.9 % vs. controls 31.3 %; p = 0.001) and cortical defect leakage (lavage 17.2 % vs. controls 63.3 %; p < 0.001) were significantly lower in the lavage group compared to "controls," whereas intradiscal leakages were similar in both groups (lavage 12.1 % vs. controls 15.2 %; p = 0.51). For venous leakage multivariate logistic regression analysis showed lavage to be the only independent predictor. Lavage was associated with 0.33-times (95 % CI 0.16-0.65; p = 0.001) lower likelihood for leakage in compared to controls.Conclusions: Vertebral body lavage prior to cement augmentation is a safe technique to reduce cement leakage in a clinical setting and has the potential to prevent pulmonary fat embolism. Moreover, a better filling pattern can be achieved. AD - Department for Orthopedic Surgery, Spine Unit, Inselspital , University Hospital of Bern , 3010 Bern Switzerland Spine Surgery Unit, El-Hadra University Hospital , Alexandria University , Alexandria Egypt Institute for Evaluative Research in Medicine , University of Bern , Stauffacherstrasse 78 3014 Bern Switzerland Department for Orthopedic Surgery, Spine Unit, Inselspital, University Hospital of Bern, 3010, Bern, Switzerland AN - 119539802. Language: English. Entry Date: 20171210. Revision Date: 20191029. Publication Type: journal article AU - Hoppe, Sven AU - Elfiky, Tarek AU - Keel, Marius AU - Aghayev, Emin AU - Ecker, Timo AU - Benneker, Lorin AU - Keel, Marius Johann Baptist AU - Ecker, Timo Michael AU - Benneker, Lorin Michael DB - cin20 DO - 10.1007/s00586-015-4191-8 DP - EBSCOhost KW - Therapeutic Irrigation Kyphoplasty -- Methods Bone Cements -- Therapeutic Use Extravasation of Diagnostic and Therapeutic Materials -- Prevention and Control Vertebroplasty -- Methods Middle Age Spinal Fractures -- Surgery Aged Adult Male Fractures, Compression -- Surgery Case Control Studies Aged, 80 and Over Female Retrospective Design Human M1 - 11 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2016 SN - 0940-6719 SP - 3463-3469 ST - Lavage prior to vertebral augmentation reduces the risk for cement leakage T2 - European Spine Journal TI - Lavage prior to vertebral augmentation reduces the risk for cement leakage UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=119539802&site=ehost-live&scope=site VL - 25 ID - 830584 ER - TY - JOUR AB - PURPOSE: This study aimed at assessing the cement leakage rate and the filling pattern in patients treated with vertebroplasty, kyphoplasty and stentoplasty with and without a newly developed lavage technique. STUDY DESIGN: Retrospective clinical case-control study. METHODS: A newly developed bipedicular lavage technique prior to cement application was applied in 64 patients (45.1 %) with 116 vertebrae, ("lavage" group). A conventional bipedicular cement injection technique was used in 78 patients (54.9 %) with 99 levels ("controls"). The outcome measures were filling patterns and leakage rates. RESULTS: The overall leakage rate (venous, cortical defect, intradiscal) was 37.9 % in the lavage and 83.8 % in the control group (p < 0.001). Venous leakage (lavage 12.9 % vs. controls 31.3 %; p = 0.001) and cortical defect leakage (lavage 17.2 % vs. controls 63.3 %; p < 0.001) were significantly lower in the lavage group compared to "controls," whereas intradiscal leakages were similar in both groups (lavage 12.1 % vs. controls 15.2 %; p = 0.51). For venous leakage multivariate logistic regression analysis showed lavage to be the only independent predictor. Lavage was associated with 0.33-times (95 % CI 0.16-0.65; p = 0.001) lower likelihood for leakage in compared to controls. CONCLUSIONS: Vertebral body lavage prior to cement augmentation is a safe technique to reduce cement leakage in a clinical setting and has the potential to prevent pulmonary fat embolism. Moreover, a better filling pattern can be achieved. AD - Department for Orthopedic Surgery, Spine Unit, Inselspital, University Hospital of Bern, 3010, Bern, Switzerland. svenhoppe@gmail.com. Spine Surgery Unit, El-Hadra University Hospital, Alexandria University, Alexandria, Egypt. Department for Orthopedic Surgery, Spine Unit, Inselspital, University Hospital of Bern, 3010, Bern, Switzerland. Institute for Evaluative Research in Medicine, University of Bern, Stauffacherstrasse 78, 3014, Bern, Switzerland. AN - 26275998 AU - Hoppe, S. AU - Elfiky, T. AU - Keel, M. J. AU - Aghayev, E. AU - Ecker, T. M. AU - Benneker, L. M. DA - Nov DO - 10.1007/s00586-015-4191-8 DP - NLM ET - 2016/10/28 J2 - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society KW - Adult Aged Aged, 80 and over Bone Cements/*therapeutic use Case-Control Studies Extravasation of Diagnostic and Therapeutic Materials/*prevention & control Female Fractures, Compression/surgery Humans Kyphoplasty/*methods Male Middle Aged Osteoporotic Fractures/surgery Retrospective Studies Spinal Fractures/surgery *Therapeutic Irrigation Vertebroplasty/*methods *Balloon kyphoplasty *Complication *Lavage *Leakage *Pmma *Vertebroplasty LA - eng M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 0940-6719 SP - 3463-3469 ST - Lavage prior to vertebral augmentation reduces the risk for cement leakage T2 - Eur Spine J TI - Lavage prior to vertebral augmentation reduces the risk for cement leakage VL - 25 ID - 828630 ER - TY - JOUR AB - Purpose: This study aimed at assessing the cement leakage rate and the filling pattern in patients treated with vertebroplasty, kyphoplasty and stentoplasty with and without a newly developed lavage technique. Study design: Retrospective clinical case–control study. Methods: A newly developed bipedicular lavage technique prior to cement application was applied in 64 patients (45.1 %) with 116 vertebrae, (“lavage” group). A conventional bipedicular cement injection technique was used in 78 patients (54.9 %) with 99 levels (“controls”). The outcome measures were filling patterns and leakage rates. Results: The overall leakage rate (venous, cortical defect, intradiscal) was 37.9 % in the lavage and 83.8 % in the control group (p < 0.001). Venous leakage (lavage 12.9 % vs. controls 31.3 %; p = 0.001) and cortical defect leakage (lavage 17.2 % vs. controls 63.3 %; p < 0.001) were significantly lower in the lavage group compared to “controls,” whereas intradiscal leakages were similar in both groups (lavage 12.1 % vs. controls 15.2 %; p = 0.51). For venous leakage multivariate logistic regression analysis showed lavage to be the only independent predictor. Lavage was associated with 0.33-times (95 % CI 0.16–0.65; p = 0.001) lower likelihood for leakage in compared to controls. Conclusions: Vertebral body lavage prior to cement augmentation is a safe technique to reduce cement leakage in a clinical setting and has the potential to prevent pulmonary fat embolism. Moreover, a better filling pattern can be achieved. AD - S. Hoppe, Department for Orthopedic Surgery, Spine Unit, Inselspital, University Hospital of Bern, Bern, Switzerland AU - Hoppe, S. AU - Elfiky, T. AU - Keel, M. J. B. AU - Aghayev, E. AU - Ecker, T. M. AU - Benneker, L. M. DB - Embase Medline DO - 10.1007/s00586-015-4191-8 KW - bone cement poly(methyl methacrylate) adult aged article bipedicular lavage bone cement leakage brain disease case control study clinical assessment comparative study controlled study female human kyphoplasty lavage major clinical study male outcome assessment percutaneous vertebroplasty priority journal retrospective study risk assessment spine fracture spine surgery stentoplasty surgical technique vein disease vertebra body LA - English M1 - 11 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1432-0932 0940-6719 SP - 3463-3469 ST - Lavage prior to vertebral augmentation reduces the risk for cement leakage T2 - European Spine Journal TI - Lavage prior to vertebral augmentation reduces the risk for cement leakage UR - https://www.embase.com/search/results?subaction=viewrecord&id=L605643908&from=export http://dx.doi.org/10.1007/s00586-015-4191-8 VL - 25 ID - 829297 ER - TY - JOUR AB - root The authors describe a new vertebroplasty technique for the treatment of chronic painful vertebral compression fractures (VCFs). A urinary balloon catheter is introduced into the vertebral body (VB) via a bilateral transpedicular approach and inflated with contrast medium to obtain sufficient space for endoscopic observation. The granulation tissue occupying the VB is then removed using a punch or curette inserted through one pedicle, with the guidance of an endoscope introduced through the contralateral pedicle. After endoscopic resection of granulation tissue in the fractured VB, vertebroplasty is performed by injecting calcium phosphate cement (CPC) into the VB. Fourteen patients in whom chronic painful VCFs were diagnosed underwent surgery involving the aforementioned technique. In all cases, intractable pain and ambulatory function improved after surgery, and there were no significant systemic complications. On radiological evaluation in eight cases in which the follow-up period exceeded 1 year, the mean height of the fractured VB improved from 38% of that of adjacent intact VBs to 85%. Although a slight loss of correction was routinely observed at 1 month postoperatively, an additional loss of VB height was not noted up to 1 year later. Bone formation was commonly seen along the anterior wall of the involved vertebrae in all cases. Vertebroplasty involving the endoscopic removal of granulation tissue proved to be an efficacious procedure for the treatment of chronic painful VCFs. The osteoconductive capacity of CPC facilitated callus formation and ultimately restoration of vertebral bone structure. AD - Osaka City Univ, Grad Sch Med, Dept Orthopaed Surg, Osaka 558, Japan. Nakamura, H (corresponding author), Osaka City Univ, Grad Sch Med, Dept Orthopaed Surg, Osaka 558, Japan. hnakamura@med.osaka-cu.ac.jp AN - WOS:000241678600014 AU - Hoshino, M. AU - Nakamura, H. AU - Konishi, S. AU - Nagayama, R. AU - Terai, H. AU - Tsujio, T. AU - Namikawa, T. AU - Kato, M. AU - Takaoka, K. DA - Nov DO - 10.3171/spi.2006.5.5.461 J2 - J. Neurosurg.-Spine KW - vertebral compression fracture pseudarthrosis vertebroplasty endoscopy INTRAVERTEBRAL VACUUM PHENOMENON CALCIUM-PHOSPHATE CEMENT PERCUTANEOUS VERTEBROPLASTY LUMBAR SPINE POSTTRAUMATIC KYPHOSIS PULMONARY-EMBOLISM RARE COMPLICATION WEDGE OSTEOTOMY ACRYLIC CEMENT KYPHOPLASTY Clinical Neurology Surgery LA - English M1 - 5 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2006 SN - 1547-5654 SP - 461-467 ST - Endoscopic vertebroplasty for the treatment of chronic vertebral compression fracture - Technical note T2 - Journal of Neurosurgery-Spine TI - Endoscopic vertebroplasty for the treatment of chronic vertebral compression fracture - Technical note UR - ://WOS:000241678600014 VL - 5 ID - 830403 ER - TY - JOUR AB - INTRODUCTION: Although cemented implants have proven beneficial over uncemented implants for treatment of displaced sub-capital proximal femoral fractures, there are concerns regarding the haemodynamic consequence of using cemented implants in hip fracture patients. National Patient Safety Agency recently issued an alert regarding the use of cement in hip fracture surgery. We compared the incidence and pattern of 48 h perioperative mortality between patients receiving cemented and uncemented implants after hip fracture surgery. METHODS: Using data prospectively recorded in hospital care records, we retrospectively reviewed the case records of all patients who died in hospital following hip fracture surgery between January 2005 and April 2010. We recorded demographic variables, type of fracture, implant used, medical co-morbidity, seniority of operating surgeon and anaesthetist, perioperative haemodynamic status, time and cause of death. RESULTS: We identified 15 cases of perioperative death (PoD) over a 64-month period. PoD was 1% (15/1402). Eight of 15 deaths occurred following cemented hemiarthroplasty insertion. There were four cases of intra-operative death, two of them were following cemented hemiarthroplasty insertion. PoD following cemented hemiarthroplasty was 2.54% (8/314) and nil (0/168) following uncemented Austin-Moore hemiarthroplasty. Operations were performed by both trainees (six) and consultants (two). Both trainees (five) and consultants (three) anaesthetised the patients. None of the patients belonged to American Society of Anesthesiologists (ASA) I or II (ASA III 5 and IV 3). All patients had significant cardiovascular or pulmonary co-morbidity. Apart from the cases of immediate haemodynamic collapse and death, cemented implant insertion was followed by intra-operative haemodynamic instability in 2/15 and perioperative instability in 3/15 patients. Post-mortem was performed in 3/8 patients: 2/3 demonstrated pulmonary embolism (PE), 1/3 bronchopneumonia. Of the rest, 3/5 had suspected myocardial infarction (MI). CONCLUSION: There was 1% risk of perioperative death after hip fracture surgery. Risk of perioperative death was significantly higher following cemented implant insertion. Mortality risk was exacerbated in patients with pre-existing cardiovascular morbidity and was independent of the seniority of the surgeon or the anaesthetist. AD - Department of Trauma and Orthopaedics, Ysbyty Gwynedd Hospital, Penrhosgarnedd Road, Bangor LL57 2LW, Wales, UK. munierh@doctors.org.uk AN - 23000051 AU - Hossain, M. AU - Andrew, J. G. DA - Dec DO - 10.1016/j.injury.2012.08.043 DP - NLM ET - 2012/09/25 J2 - Injury KW - Aged Aged, 80 and over Arthroplasty, Replacement, Hip/*adverse effects Bone Cements Cementation/*adverse effects Female Hip Fractures/*mortality/surgery Hospital Mortality Humans Male Perioperative Period Retrospective Studies Treatment Outcome United States/epidemiology LA - eng M1 - 12 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0020-1383 SP - 2161-4 ST - Is there a difference in perioperative mortality between cemented and uncemented implants in hip fracture surgery? T2 - Injury TI - Is there a difference in perioperative mortality between cemented and uncemented implants in hip fracture surgery? VL - 43 ID - 828754 ER - TY - JOUR AB - BACKGROUND: Increasing evidence has focused on the application of tranexamic acid to reduce bleeding during total knee arthroplasty, but its usage method remains controversial. OBJECTIVE: To explore and discuss the effect of tranexamic acid and different usage methods on blood loss in the perioperative period of primary unilateral cemented total knee arthroplasty. METHODS: Sixty patients who were candidates for unilateral cemented total knee replacement in the Second Department of Joint Sports Medicine, Tengzhou Central People's Hospital, from January 2013 to June 2014, were included in this study. All patients were randomly divided into three groups. Group A (n=20): patients were injected with 100 mL normal saline through intravenous drip when the operation began, and then with 10 mL normal saline through intra‐articular injection after skin closure. Group B (n=20): patients were injected with 10 mg/kg tranexamic acid which was dissolved in 100 mL normal saline when the operation began, and then with 10 mL normal saline through intra‐articular injection after skin closure. Group C (n=20): patients were injected with 100 mL normal saline when the operation began, and then with 500 mg tranexamic acid dissolved in 10 mL normal saline through intra‐articular injection after skin closure. The dominant blood loss, hidden blood loss, blood transfusion ratio and per capita of each group were compared. Clinical symptoms of pulmonary embolism and lower limb deep vein thrombosis were observed. Doppler ultrasound examine on lower extremity would be performed if necessary. RESULTS AND CONCLUSION: Dominant and hidden blood loss of patients from groups B and C were significantly lower than that of patients from group A (P < 0.05). Although the dominant blood loss between group B and group C showed no significant difference (P > 0.05), the hidden blood loss in group B was significantly less than that in group C (P < 0.05). The transfusion population and ratio of patients from groups B and C were significantly lower than that of patients from group A (P < 0.05). In all three groups, no deep vein thrombosis was found at 14 days after operation. Tranexamic acid can largely reduce the dominant and hidden blood loss, as well as blood transfusion ratio and per capita of each group after primary unilateral cemented total artificial knee arthroplasty, without increasing the risk of lower extremity deep vein thrombosis. The use of tranexamic acid injecting through intravenous drip is more effective than the use of intra‐articular injection. AN - CN-01131900 AU - Hou, Z. Y. AU - Su, C. Z. AU - Pang, T. AU - Lv, D. AU - Zhu, B. AU - Sun, Y. L. AU - Li, Z. AU - Chai, X. Y. AU - Xu, Z. W. DO - 10.3969/j.issn.2095-4344.2015.09.003 KW - *operative blood loss *total knee replacement *tranexamic acid Article Blood transfusion Deep vein thrombosis Doppler flowmetry Human Knee prosthesis Lower extremity deep vein thrombosis Lung embolism Major clinical study Perioperative period M1 - 9 M3 - Journal: Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2015 SP - 1329‐1334 ST - Primary unilateral cemented total knee arthroplasty: effect of tranexamic acid usage on blood loss T2 - Chinese journal of tissue engineering research TI - Primary unilateral cemented total knee arthroplasty: effect of tranexamic acid usage on blood loss UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01131900/full VL - 19 ID - 830041 ER - TY - JOUR AB - INTRODUCTION AND AIM: Vertebral hemangiomas (VH) are usually asymptomatic and, therefore, are commonly detected as accidental findings on spinal imaging. No treatment is indicated in these cases. Nevertheless, some hemangiomas may clinically manifest as axial pain and neurological deficit and may require surgery or other treatment. The aim of this study was to assess outcomes of surgical management of symptomatic vertebral hemangiomas at two neurosurgical clinics. MATERIAL AND METHODS: Prospective study of patients with symtomatic vertebral hemangioma managed surgically at Neurosurgical Clinic of Faculty Hospital and Medical Faculty (FN and LF UP) of Palacky University in Olomouc and at Neurosurgical Department of Ostrava-Fifejdy Hospital. Surgery was indicated in patients with confirmed thoracic and lumbar vertebral hemangioma, presenting with axial, eventually with radicular pain and/or neurological deficit, such as myelopathy or radicular lesion. In cases where the only basis for indication for surgery was axial lumbar pain, the procedure included only vertebroplasty (VP) of the vertebral body (Vertecem, Synthes, USA). In cases with neurological dysfunction, posterior decompression using hemilaminectomy with extirpation of hemangioma tissue protruding into the spinal canal, as well as vertebroplasty, was indicated. During the 13-month study period, 7 patients aged from 38 to 80 years (the mean age of 60.3 years) were operated. The subjects included 4 males and 3 females. Follow up examinations were performed during hospitalization, at 6 weeks and at 6 months after the procedure. On the last follow up examination, the patients were asked to assess axial and radicular pain based on the VAS scale, ODI and the surgeons evaluated the degree of myelopathy according to Frankel and JOA classification. RESULTS: Vertebroplasty had positive impact on the degree of axial and radicular pain in all subjects (seven patients) and combination of VP with decompression resulted in improvement of myelopathic symptoms in all the subjects concerned (three patients). No spinal canal cement leak or embolization during VP was recorded, neither surgical wound healing complications, such as hematoma or infection, were recorded. No surgical revisions were required. DISCUSSION: The aim of symptomatic vertebral hemangioma therapy include nervous tissue decompression, spinal stabilization and prevention of spontaneous or traumatic epidural bleeding. Nervous tissue decompression using laminectomy or hemilamine- ctomy can be indicated only in patients developing severe paraparesis and may have good outcome. It is advisable to combine decompression with vertebroplasty or balloon kyphoplasty, arterial embolization or intralesional alcohol injection. CONCLUSION: Vertebroplasty resulted in pain score improvement in all patients with symptomatic vertebral hemangiomas. Combinations of vertebroplasty and decompression had positive impact on myelopathic symptoms in all the patients concerned. AD - Neurochirurgická klinika FN a LF UP Olomouc. lumir.hrabalek@seznam.cz AN - 21838127 AU - Hrabálek, L. AU - Starý, M. AU - Rosík, S. AU - Wanek, T. DA - May DP - NLM ET - 2011/08/16 J2 - Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti KW - Adult Aged Aged, 80 and over Decompression, Surgical Female Hemangioma/diagnosis/*surgery Humans *Lumbar Vertebrae Magnetic Resonance Imaging Male Middle Aged Spinal Neoplasms/diagnosis/*surgery *Thoracic Vertebrae Tomography, X-Ray Computed Vertebroplasty LA - cze M1 - 5 N1 - PubMed NLM literature search January 5, 2021 OP - Chirurgická lécba symptomatických obratlových hemangiomů. PY - 2011 SN - 0035-9351 (Print) 0035-9351 SP - 264-9 ST - [Surgery for symptomatic vertebral hemangiomas] T2 - Rozhl Chir TI - [Surgery for symptomatic vertebral hemangiomas] VL - 90 ID - 828852 ER - TY - JOUR AD - W.-J. Lee, Department of Emergency Medicine, Chi Mei Medical Center, 901, Zhonghua Road, Yongkang District, Tainan, Taiwan AU - Hsieh, C. F. AU - Lee, W. J. DB - Embase DO - 10.1016/j.tcmj.2014.05.007 KW - bone cement device coumarin heparin adult anticoagulant therapy article case report female human lung embolism middle aged oxygen supply thorax pain thorax radiography vomiting LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1016-3190 SP - 195-196 ST - Cement pulmonary embolism - A rare cause of embolism T2 - Tzu Chi Medical Journal TI - Cement pulmonary embolism - A rare cause of embolism UR - https://www.embase.com/search/results?subaction=viewrecord&id=L53204073&from=export http://dx.doi.org/10.1016/j.tcmj.2014.05.007 VL - 26 ID - 829452 ER - TY - JOUR AB - Background: The risk factors, incidence, and clinical management of pulmonary cement embolism and neurological deficit during percutaneous vertebroplasty (PVP) were evaluated. Methods: Three thousand one hundred and seventy-five patients with symptomatic osteoporotic vertebral compression fractures (OVCFs) treated with PVP were retrospectively reviewed in a single institution. Clinical parameters such as age, gender, number of fractures, and time from fracture to vertebroplasty were recorded at the time of surgery. Image and surgical parameters including the amount of cement, the vertebral level, uni- or bipedicle surgical approach, and leakage pattern were recorded. Results: Type-C leakage, including paraspinal (25%), intradiscal (26%), and posterior (0.7%) leakage, was more common than type-B (11.4%) and type-S leaks (4.9%). Cement leakage into the spinal canal (type-C posterior) occurred in 26 patients (0.7%), and four patients needed surgical decompression. Three in nine patients with leakage into thoracic spine needed decompressive surgery, but only one of 17 patients into lumbar spine needed surgery (p < 0.01). Age, gender, number of fractures, and time from fracture to vertebroplasty were not risk factors of pulmonary cement embolism or neurological deficit. The risk factor of pulmonary cement embolism was higher volume of PMMA injected (p < 0.001) and risk factor of neurological deficit was type-C posterior cement leakage into thoracic spine. The incidence of pulmonary cement embolism was significantly high in the volume of PMMA injected (PMMA injection < 3.5 cc: 0%; 3.5–7.0 cc: 0.11%; > 7.0 cc: 0.9%; p < 0.01) which needed postoperative oxygen support. Conclusions: Cement leakage is relatively common but mostly of no clinical significance. Percutaneous vertebroplasty in thoracic spine and high amount of PMMA injected should be treated with caution in clinical practice. AD - Department of Orthopedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan College of Medicine, Chang Gung University, Taoyuan, Taiwan AN - 139922296. Language: English. Entry Date: 20191203. Revision Date: 20200102. Publication Type: Article AU - Hsieh, Ming-Kai AU - Kao, Fu-Cheng AU - Chiu, Ping-Yeh AU - Chen, Lih-Huei AU - Yu, Chia-Wei AU - Niu, Chi-Chien AU - Lai, Po-Liang AU - Tsai, Tsung-Ting DB - cin20 DO - 10.1186/s13018-019-1459-4 DP - EBSCOhost KW - Osteoporotic Fractures -- Surgery Fractures, Vertebral Compression -- Surgery Vertebroplasty -- Methods Vertebroplasty -- Adverse Effects Bone Cements -- Adverse Effects Postoperative Complications -- Risk Factors Pulmonary Embolism -- Risk Factors Neurologic Manifestations -- Risk Factors Risk Assessment Human Treatment Outcomes Incidence Retrospective Design Age Factors Sex Factors Injury Pattern Decompression, Surgical Thoracic Vertebrae -- Surgery Lumbar Vertebrae -- Surgery Oxygen Therapy Methylmethacrylates -- Administration and Dosage M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2019 SN - 1749-799X SP - N.PAG-N.PAG ST - Risk factors of neurological deficit and pulmonary cement embolism after percutaneous vertebroplasty T2 - Journal of Orthopaedic Surgery & Research TI - Risk factors of neurological deficit and pulmonary cement embolism after percutaneous vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=139922296&site=ehost-live&scope=site VL - 14 ID - 830519 ER - TY - JOUR AB - Background and Aims: Air-crescent sign is commonly observed in lung infection such as invasive aspergillosis and tumor thromboembolization. However, due to medical progression, new materials have been applied to our patient. Vertebral body instability due to osteoporosis has been a major issue. Percutaneous vertebroplasty is newly developed method to treat vertebral fracture. However, bone cement embolism has been widely reported ranging from 3.5-25%. Most cases of bone cement embolism are self-limited. Here, we presented an unusual case of pulmonary gangrene after bone cement injection. Methods: A 75-year-old female presented to our clinic due to dyspnea on exertion with the diagnosis of asthma. Interestingly, the CXR revealed white linear structure in both lung field. Tracing back her history, she received percutaneous vertebroplasty years ago for her backbone fracture. Her wheezing and dyspnea bothered her so much, and computed tomography (CT) was arranged. Results: A 75-year-old female presented to our clinic due to dyspnea on exertion with the diagnosis of asthma. Interestingly, the CXR revealed white linear structure in both lung field. Tracing back her history, she received percutaneous vertebroplasty years ago for her backbone fracture. Her wheezing and dyspnea bothered her so much, and computed tomography (CT) was arranged. Conclusion: Air-crescent sign has been linked to lung infections such as bacterial pneumonia, abscess leading gangrene change. Also, invasive aspergillosis is also another major cause. Few reports described vascular occlusion due to tumor thromboembolization leading to pulmonary gangrene. We reported an unusual form of bone cement embolization leading to pulmonary gangrene presenting as air-crescent. AD - Y.-S. Hsu, Kaohsiung Municipal Ta-Tung Hospital, Taiwan AU - Hsu, Y. S. AU - Tsai, Y. M. AU - Li, C. Y. DB - Embase DO - 10.1111/resp.13420_256 KW - bone cement abscess adverse drug reaction aged artificial embolization asthma bacterial pneumonia blood vessel occlusion case report clinical article computer assisted tomography conference abstract diagnosis dyspnea female gangrene human injection invasive aspergillosis neoplasm percutaneous vertebroplasty side effect spine fracture wheezing LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1440-1843 SP - 181 ST - Air-crescent is not always infectious event T2 - Respirology TI - Air-crescent is not always infectious event UR - https://www.embase.com/search/results?subaction=viewrecord&id=L625398457&from=export http://dx.doi.org/10.1111/resp.13420_256 VL - 23 ID - 829175 ER - TY - JOUR AB - BACKGROUND: Percutaneous vertebroplasty can embolize vertebral hemangioma, strengthen vertebral strength, and has analgesic effect. OBJECTIVE: To investigate the clinical effects of percutaneous vertebroplasty in the treatment of symptomatic cervical, thoracic, and lumbar hemangiomas. METHODS: A retrospective analysis was performed in 25 patients who had single cervical (n=3), thoracic (n=12) or lumbar (n=10) vertebral hemangioma and accepted percutaneous vertebroplasty via polymethyl methacrylate cement injection under C-arm X-ray guidance. Ordinary radiographs were performed to observe the changes of the vertebral height and distribution and leakage of bone cement postoperatively. The local pain was measured by visual analogue scale and Oswesty functional scores preoperatively and postoperatively. RESULTS AND CONCLUSION: No spinal cord and nerves injury occurred during the operation. The visual analogue scale and Oswesty scores had a significant decrease 3 days after operation and at the final follow-up (P < 0.05). During the follow-up periods, there was no significant vertebral height loss (P > 0.05), and no vertebral hemangioma recurrence happened. Percutaneous vertebroplasty is an effective therapeutic option for symptomatic vertebral hemangiomas, which has the characteristics of minimally invasive, low-risk, short recumbent period, and rapid pain relief. However, more attention should be paid in cortex deficiency cases to avoid bone cement leakage. AU - Hu, C. D. AU - Xi, L. AU - Zhou, Y. J. AU - Liu, F. J. AU - Li, D. F. AU - Huo, X. W. AU - Li, H. T. AU - Liu, J. X. DB - Embase DO - 10.3969/j.issn.2095-4344.2013.21.004 KW - bone cement cement poly(methyl methacrylate) analgesic activity article cervical hemangioma clinical article follow up human lumbarhemangioma Oswesty functional score pain percutaneous vertebroplasty postoperative period preoperative evaluation retrospective study scoring system thoracic hemangioma vertebra hemangioma visual analog scale X ray LA - Chinese M1 - 21 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1673-8225 SP - 3823-3830 ST - Polymethyl methacrylate cement injection in vertebroplasty T2 - Chinese Journal of Tissue Engineering Research TI - Polymethyl methacrylate cement injection in vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L373887067&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.2013.21.004 VL - 17 ID - 829516 ER - TY - JOUR AD - Hsinchu Cathay General Hospital Department of Cardiology Hsinchu Taiwan. Hsinchu Cathay General Hospital Department of Emergency Medicine Hsinchu Taiwan. AN - 32995193 AU - Huang, H. L. AU - Lin, C. S. C2 - Pmc7517900 DA - Dec 1 DO - 10.6705/j.jacme.2017.0704.007 DP - NLM ET - 2017/12/01 J2 - Journal of acute medicine LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 2211-5587 (Print) 2211-5587 SP - 174-176 ST - Complications of Pulmonary Cement Embolism Following Kyphoplasty T2 - J Acute Med TI - Complications of Pulmonary Cement Embolism Following Kyphoplasty VL - 7 ID - 829020 ER - TY - JOUR AB - INTRODUCTION: Only in recent years has balloon kyphoplasty gained significance in the treatment of vertebral fractures as an adequate minimally invasive vertebral stabilization technique. Kyphoplasty has also increasingly been used to treat vertebral osteolyses caused by multiple myeloma (MM). PATIENTS AND METHODS: In our cohort of 76 patients with MM with a total of 190 vertebral fractures treated with kyphoplasty, we performed a 30-day postoperative analysis of cement leakage, neurologic symptoms, pulmonary embolism, and infections. RESULTS: Painful osteolytic or fractured vertebrae or even imminent vertebral instability caused by osteolyses were seen as indications for kyphoplasty. One case of pulmonary embolism was observed because of cement leakage as the only postoperative complication. CONCLUSION: By careful interdisciplinary indication setting and a standardized treatment model, kyphoplasty presents a very safe and effective procedure for the treatment of vertebral osteolyses and fractures caused by MM. AD - Division of Traumatology and Reconstructive Surgery, Surgical Clinic, University of Heidelberg, Germany. franz-xaver.huber@med.uni-heidelberg.de AN - 105234166. Language: English. Entry Date: 20100101. Revision Date: 20200708. Publication Type: Journal Article AU - Huber, F. AU - McArthur, N. AU - Tanner, M. AU - Gritzbach, B. AU - Schoierer, O. AU - Rothfischer, W. AU - Krohmer, G. AU - Lessl, E. AU - Baier, M. AU - Meeder, P. J. AU - Kasperk, C. DB - cin20 DO - 10.3816/CLM.2009.n.073 DP - EBSCOhost KW - Multiple Myeloma -- Surgery Spinal Fractures -- Surgery Adult Aged Bone Cements Middle Age Multiple Myeloma -- Complications Orthopedic Surgery -- Methods Postoperative Complications Spinal Fractures -- Radiography Tomography, X-Ray Computed M1 - 5 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 1557-9190 SP - 375-380 ST - Kyphoplasty for patients with multiple myeloma is a safe surgical procedure: results from a large patient cohort T2 - Clinical Lymphoma & Myeloma TI - Kyphoplasty for patients with multiple myeloma is a safe surgical procedure: results from a large patient cohort UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105234166&site=ehost-live&scope=site VL - 9 ID - 830721 ER - TY - JOUR AB - INTRODUCTION: Only in recent years has balloon kyphoplasty gained significance in the treatment of vertebral fractures as an adequate minimally invasive vertebral stabilization technique. Kyphoplasty has also increasingly been used to treat vertebral osteolyses caused by multiple myeloma (MM). PATIENTS AND METHODS: In our cohort of 76 patients with MM with a total of 190 vertebral fractures treated with kyphoplasty, we performed a 30-day postoperative analysis of cement leakage, neurologic symptoms, pulmonary embolism, and infections. RESULTS: Painful osteolytic or fractured vertebrae or even imminent vertebral instability caused by osteolyses were seen as indications for kyphoplasty. One case of pulmonary embolism was observed because of cement leakage as the only postoperative complication. CONCLUSION: By careful interdisciplinary indication setting and a standardized treatment model, kyphoplasty presents a very safe and effective procedure for the treatment of vertebral osteolyses and fractures caused by MM. AD - Division of Traumatology and Reconstructive Surgery, Surgical Clinic, University of Heidelberg, Germany. franz-xaver.huber@med.uni-heidelberg.de AN - 19858057 AU - Huber, F. X. AU - McArthur, N. AU - Tanner, M. AU - Gritzbach, B. AU - Schoierer, O. AU - Rothfischer, W. AU - Krohmer, G. AU - Lessl, E. AU - Baier, M. AU - Meeder, P. J. AU - Kasperk, C. DA - Oct DO - 10.3816/CLM.2009.n.073 DP - NLM ET - 2009/10/28 J2 - Clinical lymphoma & myeloma KW - Adult Aged Cohort Studies Female Humans Male Middle Aged Multiple Myeloma/*surgery Retrospective Studies Vertebroplasty/*adverse effects/*methods LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 1557-9190 SP - 375-80 ST - Kyphoplasty for patients with multiple myeloma is a safe surgical procedure: results from a large patient cohort T2 - Clin Lymphoma Myeloma TI - Kyphoplasty for patients with multiple myeloma is a safe surgical procedure: results from a large patient cohort VL - 9 ID - 828717 ER - TY - JOUR AB - We report a case of pulmonary bone cement embolism in a female who presented with dyspnea following multiple sessions of vertebroplasty. She underwent spectral CT pulmonary angiography and the diagnosis was made based on enhanced visualization of radiopaque cement material in the pulmonary arteries and a corresponding decrease in the parenchymal iodine content. Here, we describe the CT angiography findings of bone cement embolism with special emphasis on the potential benefits of spectral imaging, providing additional information on the material composition. AD - Department of Radiology, Soonchunhyang University Hospital Bucheon, Bucheon 420-767, Korea. AN - 25053903 AU - Huh, S. AU - Lee, H. C2 - Pmc4105806 DA - Jul-Aug DO - 10.3348/kjr.2014.15.4.443 DP - NLM ET - 2014/07/24 J2 - Korean journal of radiology KW - Angiography/methods Bone Cements/*adverse effects Dyspnea/etiology Female Humans Hypotension/etiology Lung/diagnostic imaging Middle Aged Pulmonary Artery/diagnostic imaging Pulmonary Embolism/*diagnostic imaging/etiology Tomography, X-Ray Computed/*methods *Vertebroplasty Bone cement Dual-energy CT Pulmonary embolism Spectral imaging LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1229-6929 (Print) 1229-6929 SP - 443-7 ST - Pulmonary bone cement embolism: CT angiographic evaluation with material decomposition using gemstone spectral imaging T2 - Korean J Radiol TI - Pulmonary bone cement embolism: CT angiographic evaluation with material decomposition using gemstone spectral imaging VL - 15 ID - 828761 ER - TY - JOUR AB - Vertebroplasty, the augmentation of vertebral compression fractures by image-controlled intracorporeal injection of polymethylmethacrylate cement, has shown a steady increase in use. Its chief indication is to palliate pain after a failure of noninvasive therapies. Other benefits include preventing further compression of the treated vertebra and fusing unstable fractures. Controversies include questions regarding its long-term benefit compared with natural history, claims of height restoration, biomechanical compromise of adjacent vertebrae, and its performance compared with kyphoplasty. Complications are uncommon but can be devastating with reported cases of procedural death and paralysis. New operators should be adequately trained and respect the dangers of this procedure. AD - [Hurley, Michael C.; Dabus, Guilherme; Shaibani, Ali; Fessler, Richard G.; Bendok, Bernard R.] Northwestern Univ, Feinberg Sch Med, Dept Neurosurg, Chicago, IL 60611 USA. [Hurley, Michael C.; Kaakaji, Rami; Dabus, Guilherme; Shaibani, Ali; Walker, Mathew T.; Bendok, Bernard R.] Northwestern Univ, Feinberg Sch Med, Dept Radiol, Div Neuroradiol, Chicago, IL 60611 USA. Bendok, BR (corresponding author), Northwestern Univ, Feinberg Sch Med, Dept Neurosurg, 676 N St Clair St Suite 2210, Chicago, IL 60611 USA. bbendok@nmff.org AN - WOS:000270875500008 AU - Hurley, M. C. AU - Kaakaji, R. AU - Dabus, G. AU - Shaibani, A. AU - Walker, M. T. AU - Fessler, R. G. AU - Bendok, B. R. DA - Jul DO - 10.1016/j.nec.2009.03.001 J2 - Neurosurg. Clin. N. Am. KW - Vertebroplasty Compression Osteoporosis Kyphoplasty Augmentation Percutaneous VERTEBRAL COMPRESSION FRACTURES GUIDED RADIOFREQUENCY ABLATION CEMENT LEAKAGE OSTEOPOROTIC FRACTURES BALLOON KYPHOPLASTY PULMONARY-EMBOLISM SPINAL METASTASES PAIN RELIEF POLYMETHYLMETHACRYLATE RISK Clinical Neurology Surgery LA - English M1 - 3 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2009 SN - 1042-3680 SP - 341-+ ST - Percutaneous Vertebroplasty T2 - Neurosurgery Clinics of North America TI - Percutaneous Vertebroplasty UR - ://WOS:000270875500008 VL - 20 ID - 830351 ER - TY - JOUR AB - The management of bone metastases requires a multidisciplinary staff to include systemic and local treatments like radiotherapy, surgery or interventional radiology (IR). Patients are often fragile. Imaging allows safe guidance to create "mini-invasive" procedures under adequate anesthesia. Patients' selection is important. If the goal is pain relief, cementoplasty provides a very effective bone consolidation and pain control. Simple and low-risk, vertebroplasty is the technique of choice in case of lytic bone metastases with spinal fracture risk or after failure of analgesic radiotherapy. If the medical project is curative, the tumor ablation procedures are realised through thermic or embolic techniques. After 60?C, the heat induces a coagulative necrose. Under -20?C, the cold leads to destroy the tissues. The major advantage of the cryotherapy is the predictibility of the ablation zone due to the well-visualized ice ball on perprocedural images. This technique is much more adapted to spare the nervous structures closed to the metastasis. The development of these new techniques of IR will treat bone metastases earlier, sometimes asymptomatic and thus improves the quality of life in patients with bone metastases. AD - Centre de lutte contre le cancer, Centre Antoine-Lacassagne, Département d'imagerie diagnostique et de radiologie interventionnelle, 33, avenue de Valombrose, 06189 Nice cedex 2, France AU - Iannessi, A. AU - Garnon, J. AU - Cormier, E. AU - Clarencon, F. AU - Chiras, J. DB - Embase Medline DO - 10.1684/bdc.2013.1843 KW - anesthesia bone metastasis cancer radiotherapy cancer surgery cementoplasty cryotherapy human interventional radiology patient selection percutaneous vertebroplasty quality of life review risk factor spine fracture treatment failure tumor ablation L1 - http://www.jle.com/e-docs/00/04/8E/70/vers_alt/VersionPDF.pdf LA - French M1 - 11 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0007-4551 1769-6917 SP - 1163-1173 ST - Interventional radiology for bone metastases T2 - Bulletin du Cancer TI - Interventional radiology for bone metastases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L370391382&from=export http://dx.doi.org/10.1684/bdc.2013.1843 VL - 100 ID - 829468 ER - TY - JOUR AB - The management of bone metastases requires a multidisciplinary staff to include systemic and local treatments like radiotherapy, surgery or interventional radiology (IR). Patients are often fragile. Imaging allows safe guidance to create "mini-invasive" procedures under adequate anesthesia. Patients' selection is important. If the goal is pain relief, cementoplasty provides a very effective bone consolidation and pain control. Simple and low-risk, vertebroplasty is the technique of choice in case of lytic bone metastases with spinal fracture risk or after failure of analgesic radiotherapy. If the medical project is curative, the tumor ablation procedures are realised through thermic or embolic techniques. After 60°C, the heat induces a coagulative necrose. Under -20°C, the cold leads to destroy the tissues. The major advantage of the cryotherapy is the predictibility of the ablation zone due to the well-visualized ice ball on perprocedural images. This technique is much more adapted to spare the nervous structures closed to the metastasis. The development of these new techniques of IR will treat bone metastases earlier, sometimes asymptomatic and thus improves the quality of life in patients with bone metastases. AD - Centre de lutte contre le cancer, centre Antoine-Lacassagne, département d'imagerie diagnostique et de radiologie interventionnelle, 33, avenue de Valombrose, 06189 Nice cedex 2, France. AN - 24153025 AU - Iannessi, A. AU - Garnon, J. AU - Cormier, É AU - Clarencon, F. AU - Chiras, J. DA - Nov DO - 10.1684/bdc.2013.1843 DP - NLM ET - 2013/10/25 J2 - Bulletin du cancer KW - Bone Neoplasms/*secondary/*therapy Cementoplasty/methods Embolization, Therapeutic/methods Humans Hyperthermia, Induced/methods Pain/etiology Pain Management/methods Patient Care Team Radiology, Interventional/*methods Spinal Neoplasms/secondary/therapy Vertebroplasty/methods bone metastasis cancer cryotherapy pain palliation radiofrequency vertebroplasty LA - fre M1 - 11 N1 - PubMed NLM literature search January 5, 2021 OP - Radiologie interventionnelle des métastases osseuses. PY - 2013 SN - 0007-4551 SP - 1163-73 ST - [Interventional radiology for bone metastases] T2 - Bull Cancer TI - [Interventional radiology for bone metastases] VL - 100 ID - 828614 ER - TY - JOUR AB - We report one cervical and two thoracic vertebral haemangiomas with neurological disturbance successfully treated by percutaneous vertebroplasty followed by decompression surgery. Vertebroplasty consolidates the vertebral body and reduces the risk of haemorrhage. Subsequent surgery may be limited to decompressive laminectomy and resection of the epidural extension of the haemangioma. Embolisation was also carried out in one case. Complete neuroimaging workup, including CT, myelo-CT and MRI, is necessary prior to treatment. AD - J.L. Dietemann, Department of Radiology 2, University Hospital of Strasbourg, Hopital de Hautepierre, Avenue Moliere, F-67098 Strasbourg Cedex, France AU - Ide, C. AU - Gangi, A. AU - Rimmelin, A. AU - Beaujeux, R. AU - Maitrot, D. AU - Buchhei, F. AU - Sellal, F. AU - Dietemann, J. L. DB - Embase Medline DO - 10.1007/BF00626105 KW - methacrylic acid methyl ester adult aged article artificial embolization case report clinical feature computer assisted tomography decompression surgery female hemangioma human laminectomy myelography nuclear magnetic resonance imaging priority journal spinal cord compression spine tumor vertebra body LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1996 SN - 0028-3940 SP - 585-589 ST - Vertebral haemangiomas with spinal cord compression: The place of preoperative percutaneous vertebroplasty with methyl methacrylate T2 - Neuroradiology TI - Vertebral haemangiomas with spinal cord compression: The place of preoperative percutaneous vertebroplasty with methyl methacrylate UR - https://www.embase.com/search/results?subaction=viewrecord&id=L26288252&from=export http://dx.doi.org/10.1007/BF00626105 VL - 38 ID - 829925 ER - TY - JOUR AB - We report on cervical and two thoracic vertebral haemangiomas with neurological disturbance successfully treated by percutaneous vertebroplasty followed by decompression surgery. Vertebroplasty consolidates the vertebral body and reduces the risk of haemorrhage. Subsequent surgery may be limited to decompressive laminectomy and resection of the epidural extension of the haemangioma. embolisation was also carried out in one case. Complete neuroimaging workup, including CT, myelo-CT and MRI, is necessary prior to treatment. AD - Department of Radiology 2, University Hospital of Strasbourg, Hôpital de Hautepierre, France. AN - 8880725 AU - Ide, C. AU - Gangi, A. AU - Rimmelin, A. AU - Beaujeux, R. AU - Maitrot, D. AU - Buchheit, F. AU - Sellal, F. AU - Dietemann, J. L. DA - Aug DO - 10.1007/bf00626105 DP - NLM ET - 1996/08/01 J2 - Neuroradiology KW - *Bone Cements Cervical Vertebrae/pathology/surgery Combined Modality Therapy *Embolization, Therapeutic Hemangioma/diagnosis/*surgery Humans *Laminectomy Magnetic Resonance Imaging Methylmethacrylate *Methylmethacrylates Spinal Cord Compression/diagnosis/*surgery Spinal Neoplasms/diagnosis/*surgery Thoracic Vertebrae/pathology/surgery Tomography, X-Ray Computed Treatment Outcome LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 1996 SN - 0028-3940 (Print) 0028-3940 SP - 585-9 ST - Vertebral haemangiomas with spinal cord compression: the place of preoperative percutaneous vertebroplasty with methyl methacrylate T2 - Neuroradiology TI - Vertebral haemangiomas with spinal cord compression: the place of preoperative percutaneous vertebroplasty with methyl methacrylate VL - 38 ID - 828811 ER - TY - JOUR AB - Osteoporotic vertebral fractures are common among the geriatric population and are managed by vertebral augmentation procedures. Pulmonary cement embolism is a relatively rare complication of these procedures and can range from mild, transient respiratory sequelae to a more severe pulmonary infarction. We discuss the case of a 75-year-old woman, identified with osteoporotic thoracolumbar vertebral fractures, found to have pulmonary cement embolism four days following multi-level balloon kyphoplasty. We attempt to highlight, pulmonary cement embolism as a potential complication following a vertebral augmentation procedure and that systematic pulmonary imaging after surgery may be helpful to facilitate its detection and further management. AD - Sree Gokulam Medical College and Research Foundation, Trivandrum, India. Department of Internal Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY, 10305, USA. Department of Pulmonary and Critical Care Medicine, Staten Island University Hospital, Northwell Health, Staten Island, NY, 10305, USA. AN - 31304083 AU - Idiculla, P. S. AU - Rajdev, K. AU - Pervaiz, S. AU - Cinelli, M. AU - Habib, S. AU - Siddiqui, A. AU - Ahmed, S. C2 - Pmc6604037 DO - 10.1016/j.rmcr.2019.100887 DP - NLM ET - 2019/07/16 J2 - Respiratory medicine case reports LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 2213-0071 (Print) 2213-0071 SP - 100887 ST - Cement pulmonary embolism after balloon kyphoplasty T2 - Respir Med Case Rep TI - Cement pulmonary embolism after balloon kyphoplasty VL - 28 ID - 828593 ER - TY - JOUR AB - Pulmonary cement embolism (PCE) can follow cement augmentation procedures for spine fractures due to osteoporosis, traumatic injuries, and painful metastatic lesions. PCE is underreported and it is likely that many cases remain undiagnosed. Risk factors for PCE have been identified, which can help alert clinicians to patients likely to develop the condition, and there are recommended techniques to reduce its incidence. Most patients with PCE are asymptomatic or only develop transient symptoms, although a few may exhibit florid cardiorespiratory manifestations which can ultimately be fatal. Diagnosis is mainly by radiographic means, commonly using simple radiographs and computed tomography scans of the chest with ancillary tests that assess the patient's cardiorespiratory condition. Management depends on the location and size of the emboli as well as the patient's symptomatology. The aim of this review is to raise awareness of the not uncommon complications of PCE following vertebral cement augmentation and the possibility of serious sequelae. Recommendations for the diagnosis and management of PCE are presented, based on the most recent literature. AD - Department of Orthopedics, University of the Philippines Manila, Manila, Philippines. Institute of Orthopedics and Sports Medicine, St. Lukes Medical Center Global City, Taguig, Philippines. Department of Neurosciences, Philippine General Hospital, Manila, Philippines. AN - 29713422 AU - Ignacio, J. M. F. AU - Ignacio, K. H. D. C2 - Pmc5913032 DA - Apr DO - 10.4184/asj.2018.12.2.380 DP - NLM ET - 2018/05/02 J2 - Asian spine journal KW - Bone cement Kyphoplasty Polymethylmethacrylate Pulmonary embolism Vertebroplasty reported. LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 1976-1902 (Print) 1976-1902 SP - 380-387 ST - Pulmonary Embolism from Cement Augmentation of the Vertebral Body T2 - Asian Spine J TI - Pulmonary Embolism from Cement Augmentation of the Vertebral Body VL - 12 ID - 828580 ER - TY - JOUR AB - PURPOSE: Distal arterial embolization to the foot with PMMA during vertebral augmentation has not been previously reported. We report a rare case of distal PMMA embolization to the dorsal foot artery during ipsilateral percutaneous lumbar vertebral augmentation in a patient with spinal osteolytic metastases. METHODS: A 68-year-old woman was admitted because of severe disabling low back pain. Plain roentgenograms, MRI and CT-scan revealed osteolysis in the L4 and L5 vertebral bodies with prevertebral soft tissue involvement. Percutaneous vertebroplasty with PMMA was performed in L2 to L5 vertebrae under general anesthesia. Intraoperatively, leakage into the segmental vessels L3 and L5 was observed. RESULT: Four hours after the procedure the clinical diagnosis of acute ischemia and drop foot on the left was made. CT-angiography justified linear cement leakage in the course of the left third lumbar vein and fifth lumbar artery, and to the ipsilateral common iliac artery. The patient was treated with low molecular heparin and the ischemia resolved without further sequelae 1 week postoperatively. CONCLUSION: PMMA leakage is a complication associated with vertebroplasty and kyphoplasty. Although the outcome of the PMMA embolization to the vessels resolved without sequelae, in our case spine surgeons and interventional radiologists should be aware on this rare complication in patients with osteolytic vertebral metastases even when contemporary cement containment techniques are used. AN - 23884552 AU - Iliopoulos, P. AU - Korovessis, P. AU - Vitsas, V. DA - May DO - 10.1007/s00586-013-2919-x DP - NLM ET - 2013/07/26 J2 - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society KW - Aged Anticoagulants/therapeutic use Bone Cements/*adverse effects Extravasation of Diagnostic and Therapeutic Materials/*complications Female Foot/*blood supply Gait Disorders, Neurologic/etiology Heparin, Low-Molecular-Weight/therapeutic use Humans Ischemia/*etiology/therapy Lumbar Vertebrae/blood supply/pathology/*surgery Osteolysis/pathology Polymethyl Methacrylate/*adverse effects Spinal Neoplasms/secondary/surgery Thrombosis/etiology *Vertebroplasty LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 0940-6719 SP - 187-91 ST - PMMA embolization to the left dorsal foot artery during percutaneous vertebroplasty for spinal metastases T2 - Eur Spine J TI - PMMA embolization to the left dorsal foot artery during percutaneous vertebroplasty for spinal metastases VL - 23 Suppl 2 ID - 828704 ER - TY - JOUR AB - Foreign objects are occasionally seen on computed tomography and could pose a diagnostic challenge to the radiologist and clinicians. It is important to recognize, characterize and localize these objects and determine their clinical significance. Most foreign objects in and around the heart are the result of direct penetrating injury or represent venous embolization to the heart. Foreign objects may cause symptoms and require prompt medical attention or maybe asymptomatic. Clinicians should be familiar with foreign objects that are encountered and understand treatment options. This paper looks at some of foreign objects that can be found and correlates with pathology where possible. AD - Division of Cardiovascular Imaging, Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55902, USA Department of Laboratory Medicine & Pathology & Department of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55902, USA Division of Cardiopulmonary Radiology, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA University of Maryland Medical Center, 22 S. Greene Street, Baltimore, MD 21201, USA AN - 121037246. Language: English. Entry Date: 20180720. Revision Date: 20180211. Publication Type: journal article AU - Illman, Jeffery E. AU - Maleszewski, Joseph J. AU - Byrne, Suzanne C. AU - Gotway, Michael B. AU - Kligerman, Seth J. AU - Foley, Thomas A. AU - Young, Phillip M. AU - Bois, John P. AU - Malik, Neera AU - Morris, Jonathan M. AU - Araoz, Philip A. DB - cin20 DO - 10.2217/fca-2015-0010 DP - EBSCOhost KW - Foreign Bodies Heart Tomography, X-Ray Computed Brachytherapy -- Equipment and Supplies Methylmethacrylates Catheters Vena Cava Filters Bone Screws Bone Cements Scales M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2016 SN - 1479-6678 SP - 351-371 ST - Multimodality imaging of foreign bodies in and around the heart T2 - Future Cardiology TI - Multimodality imaging of foreign bodies in and around the heart UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=121037246&site=ehost-live&scope=site VL - 12 ID - 830591 ER - TY - JOUR AB - A 75-year-old lady was admitted to hospital with chest pain after lumbar osteosynthesis. She was fully oriented, spontaneously breathing, tachycardic and on vasopressor therapy. As to her recent medical history, bone cement was installed, since screws of a previous orthopedic surgery at her spinal column for lumbar torsion scoliosis had loosened. Laboratory showed elevated CRP, d-dimers, LDH and CK levels with normal CK-MB. There was no relevant coronary artery stenosis on angiography. CT scan showed a pulmonary embolus reaching from the inferior vena cava across the right heart to the right pulmonary artery (ESM 3, movie). The removal of the embolus was performed under protection of the heart-lung machine (Figure 1). Post-operatively, the patient was relieved from chest pain and infectious markers decreased. In summary, this case highlights the risk of life-threatening complications due to bone cement installation which is a commonly used procedure to fix osteoporotic and instable fractures. AD - J. Illner, Universitätsklinikum Münster, Klinik Für Kardiologie i, Münster, Germany AU - Illner, J. AU - Freisinger, E. AU - Reinecke, H. AU - Scherer, M. AU - Hoffmeier, A. DB - Embase DO - 10.1024/0301-1526/a000721 KW - bone cement creatine kinase MB D dimer endogenous compound hypertensive factor adverse drug reaction aged angiography breathing case report clinical article complication conference abstract coronary artery obstruction drug therapy female heart lung machine human inferior cava vein lung embolism movie osteoporosis osteosynthesis patient history of orthopedic surgery pulmonary artery scoliosis side effect spine tachycardia thorax pain torsion x-ray computed tomography LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1664-2872 SP - 35 ST - Pulmonary embolism after bone cement instillation T2 - Vasa - European Journal of Vascular Medicine TI - Pulmonary embolism after bone cement instillation UR - https://www.embase.com/search/results?subaction=viewrecord&id=L625461991&from=export http://dx.doi.org/10.1024/0301-1526/a000721 VL - 47 ID - 829183 ER - TY - JOUR AB - Here the authors report the case of a fresh vertebral body fracture with a large spinal intraosseous arteriovenous fistula (AVF). A 74-year-old woman started to experience low-back pain following a rear-end car collision. Plain radiography showed diffuse idiopathic skeletal hyperostosis (DISH). Sagittal CT sections revealed a transverse fracture of the L-4 vertebral body with a bone defect. Sagittal fat-suppressed T2-weighted MRI revealed a flow void in the fractured vertebra. Spinal angiography revealed an intraosseous AVF with a feeder from the right L-4 segmental artery. A fresh fracture of the L-4 vertebral body with a spinal intraosseous AVF was diagnosed. Observation of a flow void in the vertebral body on fat-suppressed T2-weighted MRI was important for the diagnosis of the spinal intraosseous AVF. Because conservative treatment was ineffective, surgery was undertaken. The day before surgery, embolization through the right L-4 segmental artery was performed using 2 coils to achieve AVF closure. Posterolateral fusion with instrumentation at the T12-S2 vertebral levels was performed without L-4 vertebroplasty. The spinal intraosseous AVF had disappeared after 4 months. At 24 months after surgery, the bone defect was completely replaced by bone and the patient experienced no limitations in daily activities. Given their experience with the present case, the authors believe that performing vertebroplasty or anterior reconstruction may not be necessary in treating spinal intraosseous AVF. AD - Department of Orthopaedic Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan. AN - 25635636 AU - Imajo, Y. AU - Kanchiku, T. AU - Yoshida, Y. AU - Nishida, N. AU - Taguchi, T. DA - Apr DO - 10.3171/2014.10.spine1487 DP - NLM ET - 2015/01/31 J2 - Journal of neurosurgery. Spine KW - Aged Arteriovenous Fistula/*diagnosis/*surgery Embolization, Therapeutic Female Humans Image Enhancement Lumbar Vertebrae/*blood supply/*injuries Magnetic Resonance Imaging Preoperative Care Sacrum/surgery Spinal Diseases/*diagnosis/*surgery Spinal Fractures/*diagnosis/*surgery Spinal Fusion Thoracic Vertebrae/surgery Tomography, X-Ray Computed AVF = arteriovenous fistula DISH = diffuse idiopathic skeletal hyperostosis lumbar spine oncology spinal intraosseous arteriovenous fistula surgical treatment LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 1547-5646 SP - 406-8 ST - Large spinal intraosseous arteriovenous fistula: case report T2 - J Neurosurg Spine TI - Large spinal intraosseous arteriovenous fistula: case report VL - 22 ID - 828818 ER - TY - JOUR AB - Background: Percutaneous injection of bone cement (acrylic cement) during percutaneous kyphoplasty and vertebroplasty can cause symptomatic or asymptomatic complications due to leakage, extravasation or vascular migration of cement. Purpose: To investigate and to compare the incidence and site of local leakage or complications of bone cement after percutaneous kyphoplasty and vertebroplasty using bone cement. Material and Methods: We retrospectively reviewed 473 cases of percutaneous kyphoplasty or vertebroplasty performed under fluoroscopic guidance. Of the 473 cases, follow-up CT scans that covered the treated bones were available for 83 cases (59 kyphoplasty and 24 vertebroplasty). Results: The rate of local leakage of bone cement was 87.5% (21/24) for percutaneous vertebroplasty and 49.2% (29/59) for kyphoplasty. The most common site of local leakage was perivertebral soft tissue ( n=8, 38.1%) for vertebroplasty. The most common site of local leakage was a perivertebral vein ( n=7, 24.1%) for kyphoplasty. Two cases of pulmonary cement embolism developed: one case after kyphoplasty and one case after vertebroplasty. Conclusion: Local leakage of bone cement was more common for percutaneous vertebroplasty compared with kyphoplasty ( P<0.005). The most common sites of local leakage were perivertebral soft tissue and perivertebral vein. AD - Department of Radiology, Hallym University College of Medicine, Seoul, Korea Department of Occupational Medicine, Hallym University College of Medicine, Seoul, Korea AN - 51290944. Language: English. Entry Date: 20100716. Revision Date: 20200708. Publication Type: Article. Journal Subset: Biomedical AU - In Jae, Lee AU - Choi, A. Lam AU - Mi-Yeon, Yie AU - Ji Young, Yoon AU - Eui Yong, Jeon AU - Sung Hye, Koh AU - Dae Young, Yoon AU - Kyung Ja, Lim AU - Hyoung June, Im DB - cin20 DO - 10.3109/02841851003620366 DP - EBSCOhost M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2010 SN - 0284-1851 SP - 649-654 ST - CT evaluation of local leakage of bone cement after percutaneous kyphoplasty and vertebroplasty T2 - Acta Radiologica TI - CT evaluation of local leakage of bone cement after percutaneous kyphoplasty and vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=51290944&site=ehost-live&scope=site VL - 51 ID - 830708 ER - TY - JOUR AB - Endovascular therapy for cerebral arteriovenous malformations, although generally accepted to be a safe procedure, is not without risks. We present a patient with a 20 cm free segment of a catheter in the anterior circulation as a complication of embolization. This is a very rare complication. To our knowledge, only six cases have been reported in the literature. We believe this to be the first reported case of this complication treated surgically via craniotomy and arteriotomy. AD - S. Inci, Emek mah, 4, cadde, No: 70/8, Ankara, Turkey AU - Inci, S. AU - Özcan, O. E. AU - Benli, K. AU - Saatçi, I. DB - Embase Medline DO - 10.1016/S0090-3019(96)00221-2 KW - acrylic cement cyanoacrylate enbucrilate heparin iofendylate protamine sulfate adult arteriotomy article artificial embolization brain arteriovenous malformation case report catheter computer assisted tomography craniotomy digital subtraction angiography fluoroscopy human intravenous drug administration male neurologic examination LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1996 SN - 0090-3019 SP - 562-567 ST - Microsurgical removal of a free segment of microcatheter in the anterior circulation as a complication of embolization T2 - Surgical Neurology TI - Microsurgical removal of a free segment of microcatheter in the anterior circulation as a complication of embolization UR - https://www.embase.com/search/results?subaction=viewrecord&id=L26412006&from=export http://dx.doi.org/10.1016/S0090-3019(96)00221-2 VL - 46 ID - 829919 ER - TY - JOUR AB - PURPOSE: The treatment of choice for a displaced femoral neck fracture in the most elderly patients is a cemented hemiarthroplasty (HA). The optimal design, unipolar or bipolar head, remains unclear. The possible advantages of a bipolar HA are a better range of motion and less acetabular wear. The aim of this study was to evaluate hip function, health related quality of life (HRQoL), surgical outcome and acetabular erosion in a medium‐term follow‐up. METHODS: One hundred and twenty patients aged 80 or more with a displaced fracture of the femoral neck (Garden III and IV) were randomised to treatment with a cemented Exeter HA using a unipolar or a bipolar head. All patients were able to walk independently, with or without aids, before surgery. Follow‐ups were performed at four, 12, 24 and 48 months postoperatively. Assessments included HRQoL (EQ‐5D index score), hip function (Harris hip score [HHS]) and radiological acetabular erosion. RESULTS: The mean EQ‐5D index score was generally higher among the patients with bipolar hemiarthroplasties at the follow‐ups with a significant difference at 48 months: unipolar HAs 0.59 and bipolar HAs 0.70 (p = 0.04). There was an increased rate of acetabular erosion among the patients with unipolar hemiarthroplasties at the early follow‐ups with a significant difference at 12 months (unipolar HAs 20% and bipolar HAs 5%, p = 0.03). At the later follow‐ups the incidence of acetabular erosion accelerated in the bipolar group, and there were no significant differences between the groups at the 24‐ and 48‐month follow‐ups. There was no difference in HHS or reoperation rate between the groups at any of the follow‐ups. CONCLUSION: The bipolar HAs seem to result in better HRQoL beyond the first two years after surgery compared to unipolar HAs. Bipolar HAs displayed a later onset of acetabular erosion compared to unipolar HAs. AN - CN-00961745 AU - Inngul, C. AU - Hedbeck, C. J. AU - Blomfeldt, R. AU - Lapidus, G. AU - Ponzer, S. AU - Enocson, A. DO - 10.1007/s00264-013-2117-9 KW - *arthroplasty *bipolar hemiarthroplasty *femur neck fracture/dm [Disease Management] *femur neck fracture/su [Surgery] *unipolar hemiarthroplasty Acetabulum Aged Aged, 80 and over Article Bone cement Bone erosion/co [Complication] Controlled study Decubitus/co [Complication] Deep vein thrombosis/co [Complication] Female Femoral Neck Fractures [*surgery] Femur Neck [surgery] Follow up Follow‐Up Studies Fracture reduction Harris hip score Heart infarction/co [Complication] Hemiarthroplasty [*classification, *methods] Hip Hip Joint [physiology] Hip Prosthesis Hip dislocation/co [Complication] Hip dislocation/su [Surgery] Hip pain Hip radiography Human Humans Intermethod comparison Joint function Longitudinal Studies Lung embolism/co [Complication] Major clinical study Male Operative blood loss/co [Complication] Periprosthetic fracture/co [Complication] Periprosthetic fracture/su [Surgery] Pneumonia/co [Complication] Postoperative care Postoperative infection/co [Complication] Postoperative infection/su [Surgery] Priority journal Prospective Studies Prosthesis infection/co [Complication] Prosthesis infection/su [Surgery] Quality of Life Randomized controlled trial Range of Motion, Articular [physiology] Range of motion Reoperation Scoring system Surgical mortality Time Factors Treatment Outcome Walking Walking aid M1 - 12 M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2013 SP - 2457‐2464 ST - Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in patients with displaced femoral neck fractures: a four-year follow-up of a randomised controlled trial T2 - International orthopaedics TI - Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in patients with displaced femoral neck fractures: a four-year follow-up of a randomised controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00961745/full VL - 37 ID - 830006 ER - TY - JOUR AB - Vertebral hemangiomas may be rarely aggressive, then called symptomatic in the event of back pain with or without nerve-root pain, or compressive in the event of spinal cord or cauda equina compression. We describe one case of symptomatic hemangiomas of the C3 vertebra and one case of compressive hemangiomas of the T9 vertebra. Aggressiveness of vertebral hemangiomas has been defined by Laredo on the basis of plain radiographic and computed tomography criteria (1) : thoracic location from T3 to T9, involvement of the entire vertebral body, extension to the neural arch, irregular vertical striation, poorly defined and expanded cortex, extension to the paravertebral soft-tissue and/or the epidural space. A soft-tissue content is also a sign of aggressiveness. In patient with a vertebral hemangiomas and isolated back pain of undetermined origin, the presence of three or more of these aggressiveness radiologic criteria or a soft-tissue content may indicate potentially symptomatic vertebral hemangiomas. Magnetic resonance imaging is especially valuable for the evaluation of epidural extension and myelopathy. In the event of atypical imaging, histology allows the diagnosis. Percutaneous vertebroplasty with acrylic cement, arterial embolization, surgery and radiotherapy are part of therapeutic means. But as yet, no therapeutic attitude is accepted unanimously. AD - P. Insalaco, Service de Rhumatologie, C.H.R. Metz-Thionville, Metz-Thionville, France AU - Insalaco, P. AU - Thomas, Ph AU - Saint-Eve, M. E. AU - Tamisier, J. N. AU - Toussaint, F. AU - Pourel, J. DB - Embase KW - aged article artificial embolization backache computer assisted tomography disease course hemangioma histology human nerve root compression nuclear magnetic resonance imaging spine radiography vertebra LA - French M1 - 3-4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1999 SN - 0249-7581 SP - 22-25 ST - Aggressive vertebral hemangiomas - Two new observations and review of the literature T2 - Rhumatologie TI - Aggressive vertebral hemangiomas - Two new observations and review of the literature UR - https://www.embase.com/search/results?subaction=viewrecord&id=L29519225&from=export VL - 51 ID - 829900 ER - TY - JOUR AB - Introduction: Authors report their experience on a series of 31 malignant tumors with a sacral location where liquid nitrogen was used as a local adjuvant associated with surgical therapy, together with the use of acrylic cement and\or antiblastic chemotherapy and radiotherapy differently according to histotype of the cancer. Materials and methods: Malignant lesions observed consist of 13 primary tumors (5 Chordoma, 3 Giant Cell Tumors, 3 Ewing's Sarcomas and 2 Chondrosarcomas), 10 Myelomas and 8 secondary localizations (3 from breast cancer, 2 from prostate K, 2 from renal cancer and 1 from lung K). The clinical pathology was different according to the location (proximal sacrum: S1-S2, distal sacrum: S3, S4, S5), the size and the histological aggressiveness. Leaving out Myelomas, where diagnostic biopsy has been always followed by antiblastic chemotherapy, after the biopsy all the other histotypes underwent a surgery that included the use of intralesional surgery (curettage) associated with use of liquid nitrogen and in three cases the use of methyl methacrylate. Selective arterial embolization was carried outpre-operatively in order to reduce the blood supply of the three cases of Giant Cell Tumors and in the two cases of Ewing's Sarcoma, being the Chordoma and Chondrosarcoma poorly vascularized tumors. Referring to metastases, the embolization was carried out in the secondary lesion of renal cancer, in lung K and in two out of three cases of breast cancer metastases. Discussion and conclusions: According to authors' experience, the surgical therapy “en block” has never been carried out because of the high operational risks and serious neurological impairments, especially in proximal locations. The use of liquid nitrogen gives greater incisiveness in the surgical intralesional treatment with a subsequentdisease-free interval. Its employment did not result in a permanent nerve damage in locations distal to S2. Comparing tumors with a local aggressiveness, although of a different biological nature Giant Cell Tumor, Chordoma and the I-II grade Chondrosarcoma), to highly malignant tumors (Metastases and Ewing's Sarcoma where surgery is always associated with multidisciplinary treatment including the use of chemotherapy and\or radiotherapy) the “disease-free interval”, is different. Following check-ups have included clinical examination and diagnostic imaging at 1, 2, 3 and 4 years post operation. Authors report their experience on survival and disease-free interval, even if it is always influenced by the histological diagnosis. AD - V. Ioli, Section of Orthopaedics, Surgical Specialities Department, Policlinico Universitario G. Martino, Messina, Italy AU - Ioli, V. AU - Cinanni, R. AU - Creaco, S. AU - Rosa, M. A. DB - Embase DO - 10.1007/s00586-010-1375-0 KW - liquid nitrogen acrylic cement methacrylic acid methyl ester adjuvant sacrum malignant neoplasm spine society surgery chemotherapy neoplasm chordoma metastasis giant cell tumor artificial embolization kidney cancer chondrosarcoma myeloma breast cancer disease free interval radiotherapy intralesional drug administration biopsy aggressiveness lung Ewing sarcoma survival diagnostic imaging primary tumor clinical examination nerve injury employment risk prostate vascularization histology diagnosis pathology curettage LA - English M1 - 5 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0940-6719 SP - 835 ST - Considerations on the use of liquid nitrogen in sacrum malignant neoplasms T2 - European Spine Journal TI - Considerations on the use of liquid nitrogen in sacrum malignant neoplasms UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71562037&from=export http://dx.doi.org/10.1007/s00586-010-1375-0 VL - 19 ID - 829669 ER - TY - JOUR AB - In recent years the use of percutaneous vertebroplasty with polymethylmethacrylate cement as treatment of osteoporotic vertebral fractures has increased, gradually replacing the conventional treatment. A 51-year-old female's case, who developed pulmonary embolism due to a precutaneous vertebroplasy, is presented in this article. AD - M.E. Iribarren, Servicio de Neumología, Hospital Universitario de La Princesa, Madrid, Spain AU - Iribarren, M. E. AU - Marcos, C. AU - Espinosa, E. V. AU - Noval, A. R. AU - Punter, R. M. G. AU - Muñiz, Á M. DB - Embase KW - bone cement poly(methyl methacrylate) adult article case report clinical article fragility fracture human lung embolism male middle aged percutaneous vertebroplasty postoperative complication spine fracture LA - Spanish M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 2173-920X 1576-9895 SP - 32-34 ST - Pulmonary embolism after percutaneous vertebroplasty T2 - Revista de Patologia Respiratoria TI - Pulmonary embolism after percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L623118089&from=export VL - 21 ID - 829217 ER - TY - JOUR AB - Objective: To assess early complications, mortality rate, and cement leakage in elderly patients who had undergone navigation-based pedicle screw placement of the thoracic and lumbar spine. Methods: Eighty-six patients older than 65 years of age who had received cement-augmented pedicle screws for various conditions were retrospectively included between May 2008 and December 2016. Complications, mortality, and cement leakage were determined. All patients had a radiograph as a control. In patients with cement leakage seen on radiographs, a computed tomography scan of the surgical area was also obtained. Results: Average age was 73.4 years (range 65–86 years). A total of 319 vertebral bodies with 637 screws were inserted, of which 458 screws were cement-augmented; 348 (76%) of the augmented screws were placed in the lumbar spine and 110 (24%) in the thoracic spine. Cement leakage occurred in 55 of 86 patients, of whom 52 (60%) were asymptomatic. In all cases with cement leakage (asymptomatic or symptomatic), cement could be found in the perivertebral veins: in the inferior vena cava in 25%, in the epidural space in 7%, in the azygos vein in 5%, and in pulmonary arteries in 7%. Conclusions: Our study confirms that the use of cement correlates with a high risk of cement leakage in elderly patients. Using computed tomography navigation for screw placement did not reduce the risk of venous cement leakage, but leakage into the epidural space or through a cortical defect seems to be low. AD - B. Ishak, Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany AU - Ishak, B. AU - Bajwa, A. A. AU - Schneider, T. AU - Tubbs, R. S. AU - Iwanaga, J. AU - Ramey, W. L. AU - Unterberg, A. W. AU - Kiening, K. L. DB - Embase Medline DO - 10.1016/j.wneu.2019.05.047 KW - bone cement pedicle screw VERTECEM low molecular weight heparin aged anaphylaxis article azygos vein bone cement leakage cohort analysis comparative study computer assisted tomography controlled study embolism epidural space female human inferior cava vein intraoperative period lumbar spine major clinical study male postoperative complication pulmonary artery pulmonary cement embolism retrospective study senescence surgical mortality thoracic spine vertebra body very elderly CORTOSS LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1878-8769 1878-8750 SP - e975-e981 ST - Early Complications and Cement Leakage in Elderly Patients Who Have Undergone Intraoperative Computed Tomography (CT)-Guided Cement Augmented Pedicle Screw Placement: Eight-Year Single-Center Experience T2 - World Neurosurgery TI - Early Complications and Cement Leakage in Elderly Patients Who Have Undergone Intraoperative Computed Tomography (CT)-Guided Cement Augmented Pedicle Screw Placement: Eight-Year Single-Center Experience UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2002090684&from=export http://dx.doi.org/10.1016/j.wneu.2019.05.047 VL - 128 ID - 829120 ER - TY - JOUR AB - Percutaneous balloon kyphoplasty is a relatively simple, convenient, and minimally invasive procedure in which polymethylmethacrylate bone cement is used to manage back pain and spinal instability associated with osteoporotic compression fractures and other osteolytic spinal lesions. However, cement leakage into the venous system is a serious complication following percutaneous balloon kyphoplasty. A 74-year-old woman presented with cardiac perforation and pulmonary embolism caused by cement leakage into her venous system. She subsequently underwent surgery to effectively remove a needle-shaped cement piece from the right ventricular wall, without cardiopulmonary bypass and cardiac arrest. AD - Maebashi Red Cross Hospital, Maebashi-city, Gunma, Japan. AN - 26542782 AU - Ishikawa, K. AU - Hayashi, H. AU - Mori, H. DA - Mar DO - 10.1177/0218492315613697 DP - NLM ET - 2015/11/07 J2 - Asian cardiovascular & thoracic annals KW - Aged Bone Cements/*adverse effects Cardiac Surgical Procedures/*methods Coronary Angiography Echocardiography Female Foreign-Body Migration/*complications/diagnosis/surgery Heart Injuries/diagnosis/*etiology/surgery Heart Ventricles/diagnostic imaging/*injuries/surgery Humans Kyphoplasty/*adverse effects Lumbar Vertebrae Postoperative Complications Spinal Fractures/*surgery Tomography, X-Ray Computed Bone cements Foreign bodies Fracture fixation Heart injuries Polymethyl methacrylate Pulmonary embolism internal LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 0218-4923 SP - 204-206 ST - Cardiac perforation caused by cement after percutaneous balloon kyphoplasty T2 - Asian Cardiovasc Thorac Ann TI - Cardiac perforation caused by cement after percutaneous balloon kyphoplasty VL - 25 ID - 828665 ER - TY - JOUR AD - Orthopaedic Trauma, Adult Reconstructive Surgery, and Metabolic Bone Diseases, Hospital for Special Surgery, 535 E 70th St., New York, NY 10021, USA. AN - 105493168. Language: English. Entry Date: 20090619. Revision Date: 20150711. Publication Type: Journal Article. Journal Subset: Biomedical AU - Issack, P. S. AU - Lauerman, M. H. AU - Helfet, D. L. AU - Sculco, T. P. AU - Lane, J. M. DB - cin20 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Adverse Effects Embolism, Fat -- Etiology Femoral Fractures -- Surgery Fracture Fixation -- Adverse Effects Respiratory Failure -- Etiology Bone Cements Embolism, Fat -- Pathology Embolism, Fat -- Prevention and Control Respiratory Failure -- Diagnosis M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 1078-4519 SP - 72-76 ST - Fat embolism and respiratory distress associated with cemented femoral arthroplasty T2 - American Journal of Orthopedics TI - Fat embolism and respiratory distress associated with cemented femoral arthroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105493168&site=ehost-live&scope=site VL - 38 ID - 830737 ER - TY - JOUR AB - Bone cement implantation syndrome (BCIS) is a known complication in patients undergoing cemented orthopedic surgeries; however, the etiology and pathophysiology of BCIS are not fully understood. We report the case of a patient who developed pulseless electrical activity (PEA) due to BCIS after cemented femoral head replacement. Transesophageal echocardiography (TEE) during PEA revealed a massive embolus extending from the main pulmonary artery to the inferior vena cava. Of note, this embolus disappeared completely and rapidly after return of spontaneous circulation. TEE proved to be useful in the diagnosis and management of this case of PEA. AD - Department of Anesthesiology and Critical Care, Teine Keijinkai Hospital, 006-0085 12-1-40, 1-jo, Maeda, Teine-ku, Sapporo, Hokkaido, Japan. izumiyuki@athena.ocn.ne.jp. Department of Anesthesiology and Critical Care, Teine Keijinkai Hospital, 006-0085 12-1-40, 1-jo, Maeda, Teine-ku, Sapporo, Hokkaido, Japan. Department of Clinical Residency, Teine Keijinkai Hospital, 006-0085, 12-1-40, 1-jo, Maeda, Teine-ku, Sapporo, Hokkaido, Japan. Department of Anesthesiology and Critical Care, Kobe City Medical Center General Hospital, 650-0047, 2-1-1, Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, Japan. AN - 32026061 AU - Izumi, Y. AU - Ishihara, S. AU - Cammack, I. AU - Miyawaki, I. C2 - Pmc6967219 DA - Jan 24 DO - 10.1186/s40981-019-0225-2 DP - NLM ET - 2020/02/07 J2 - JA clinical reports KW - Bone cement implantation syndrome (BCIS) Cemented orthopedic surgeries Pulmonary embolism (PE) Transesophageal echocardiography (TEE) LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 2363-9024 SP - 5 ST - Massive mass embolism detected by transesophageal echocardiography in bone cement implantation syndrome: a case report T2 - JA Clin Rep TI - Massive mass embolism detected by transesophageal echocardiography in bone cement implantation syndrome: a case report VL - 5 ID - 828604 ER - TY - JOUR AB - Objectives: Vascular malformations of the pelvis are rare and present a difficult therapeutic challenge. Surgical treatment is notoriously difficult and carries a high likelihood of recurrence. Surgical proximal ligation of a feeding vessel may in fact be contraindicated, because it can make subsequent transcatheter therapy impossible. The purpose of this study was to review our results with transcatheter embolization therapy in symptomatic complex pelvic vascular malformations in 35 patients. Methods: A retrospective review was conducted of a prospectively compiled database of all patients undergoing transcatheter therapy of a pelvic vascular malformation at our institution. Results: The mean age of the patients was 34 years (range, 16 months-66 years), and 51% were male. The most common presenting symptoms included pain (59%), a visible or palpable lesion (62%), associated palpable pulsation or thrill (44%), hemorrhage (27%), congestive heart failure (18%), and symptoms due to mass effect (35%). A significant number of patients had undergone previous, unsuccessful attempted surgical treatment of the lesion (32%). The most common type of lesion noted on arteriography was arteriovenous shunting (89%). Patients required a mean of 2.4 embolization procedures (range, 1-11 procedures) over a mean period of 23.3 months (range, 1-144 months). The most common agents used were rapidly polymerizing acrylic adhesives. The most common vessels involved and treated were branches of the hypogastric artery (82%). More than one procedure were performed in 20 patients (53%). Seven were planned as staged embolizations, whereas 13 were due to residual or recurrent symptoms. Adjunctive surgical procedures were performed subsequent to embolization therapy in five patients (15%). Eighty-three percent of patients were asymptomatic or significantly improved at a mean follow-up of 84 months (range, 1-204 months). Conclusions: Pelvic vascular malformations are difficult to eradicate completely, and recurrences are common. Many patients require multiple therapeutic interventions. However, most of these difficult cases have good results in the long term. Transcatheter embolization plays a significant role in, and may be the treatment of choice for, symptomatic pelvic vascular malformations. AD - G.R. Jacobowitz, New York University Medical Center, 530 First Avenue, New York, NY 10016, United States AU - Jacobowitz, G. R. AU - Rosen, R. J. AU - Rockman, C. B. AU - Nalbandian, M. AU - Hofstee, D. J. AU - Fioole, B. AU - Adelman, M. A. AU - Lamparello, P. J. AU - Gagne, P. AU - Riles, T. S. DB - Embase Medline DO - 10.1067/mva.2001.111738 KW - acrylic cement polyacrylic acid polymer adolescent adult aged arteriovenous shunt article artificial embolization bleeding child clinical article congenital blood vessel malformation congestive heart failure female human internal iliac artery male pain pelvis priority journal symptomatology LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2001 SN - 0741-5214 SP - 51-55 ST - Transcatheter embolization of complex pelvic vascular malformations: Results and long-term follow-up T2 - Journal of Vascular Surgery TI - Transcatheter embolization of complex pelvic vascular malformations: Results and long-term follow-up UR - https://www.embase.com/search/results?subaction=viewrecord&id=L32109606&from=export http://dx.doi.org/10.1067/mva.2001.111738 VL - 33 ID - 829884 ER - TY - JOUR AB - INTRODUCTION: Vertebroplasties are performed for pain relief in patients with vertebral body fractures when architectural remodeling and stability is required. PMMA is a liquid cement used in vertebroplasties that solidifies within minutes of preparation. It is injected percutaneously into the fractured vertebral body under fluoroscopic radio-guidance. In rare instances, embolization of cement may occur, and is immediate after injection while the cement is still liquid. We here report a delayed presentation of PMMA embolization in a patient who presented with pleuritic chest pain 6 days after vertebroplasty. CASE PRESENTATION: A 57-year-old male presented to the emergency department after a traumatic back injury with compression fractures of T11 and T12 vertebrae. He was admitted for a vertebroplasty and was discharged home the following day. He returned in 6 days with sudden onset of shortness of breath and pleuritic chest pain. His chest radiograph showed diffuse radio-opaque tubular densities in the lung fields. A computed tomographic (CT) scan of the chest showed irregular curvilinear opacities in multiple segmental branches of the pulmonary artery and an opacified right hemiazygous vein, consistent with PMMA embolization. The patient was anticoagulated and thoracic surgery was consulted to evaluate for surgical extraction of the embolized cement. It was decided not to operate due to diffuse and non-central location of the embolized cement. DISCUSSION: Vertebroplasty is a common outpatient procedure and patients are discharged home the same day, after a brief period of bed rest. Pulmonary embolism of PMMA is a known complication of vertebroplasty reported to be between 0 to 4.8% in various studies. The majority are asymptomatic, while some develop symptoms during the procedure. Patients with underlying cardiac and pulmonary pathology are at highest risk for bad outcomes from PMMA embolization. A routine chest radiograph following vertebroplasty can identify embolized cement in the pulmonary vasculature immediately post-procedure. CONCLUSIONS: We describe a patient who had an uneventful vertebroplasty and developed pulmonary symptoms related to PMMA embolization 6 days post-procedure. Most patients develop symptoms immediately but some may have a delayed presentation. The incidence of PMMA embolization is likely underestimated given asymptomatic cases. We recommend a chest radiograph in all patients post-vertebroplasty to identify cement pulmonary embolism. AD - B. Jalil, University of New Mexico, Albuquerque, NM, United States AU - Jalil, B. AU - Saeed, A. AU - Hnatiuk, O. DB - Embase DO - 10.1378/chest.1994101 KW - poly(methyl methacrylate) cement lung embolism percutaneous vertebroplasty vein human patient artificial embolization procedures thorax radiography telecommunication thorax pain vertebra body liquid thorax bed rest outpatient extraction thorax surgery pulmonary artery fracture lung density lung blood vessel dyspnea vertebra compression fracture injury emergency ward risk injection male analgesia pathology computer assisted tomography L1 - http://journal.publications.chestnet.org/article.aspx?articleID=1913257 LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 0012-3692 ST - Polymethyl-methylacrylate (PMMA) pulmonary embolism after vertebroplasty: A report of a delayed presentation with involvement of hemiazygos vein T2 - Chest TI - Polymethyl-methylacrylate (PMMA) pulmonary embolism after vertebroplasty: A report of a delayed presentation with involvement of hemiazygos vein UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71781026&from=export http://dx.doi.org/10.1378/chest.1994101 VL - 146 ID - 829406 ER - TY - JOUR AB - Fat embolism syndrome is usually seen following fractures involving long bones [1]; however, it is rare in the peri-operative period. It is characterised by petechial rash, respiratory distress and a varying degree of neurological deficits. Cerebral fat embolism involves only cerebral manifestations without any respiratory or cutaneous features. Description An 82-year-old patient underwent an elective cemented total hip replacement for severe osteoarthritis under spinal anaesthesia. His past medical history included atrial fibrillation and hypertension. Peri-operatively, he had 5 mg oxycodone orally, 1 mg midazolam and 25 lg of fentanyl intravenously. Postoperatively, he was alert, orientated, haemodynamically stable and requiring nasal oxygenation. Two hours after the end of the surgery, the patient became acutely drowsy and responsive only to pain. His blood sugar was normal. Naloxone was given with no improvement. Emergency computed tomography (CT) head did not show any evidence of haemorrhage or acute pathology. Five hours from the end of surgery, the Glasgow Coma Scale (GCS) decreased further to E3V1M1. He had to be intubated. CT pulmonary angiography showed cardiac enlargement, interstitial oedema in the upper lobe, tricuspid regurgitation but ruled out pulmonary embolism. In the intensive care unit, the patient was not waking up on sedation hold for 5 days with a GCS of E2VTM2. Electroencephalography showed widespread slow-wave activity, moderate encephalopathy but no seizures. Magnetic resonance imaging (MRI) showed innumerable tiny foci of diffusion restriction involving supra-tentorial brain parenchyma but no infarct and few scattered periventricular and deep white matter hyper-intensities on fluid-attenuated inversion recovery (FLAIR) imaging sequence, consistent with small-vessel ischaemic changes, which was suggestive of fat embolism. Echocardiography was unremarkable for any patent foramen ovale. After 6 days, the patient's GCS improved to E4VTM6. He was discharged from ICU after 4 weeks, having required mechanical ventilation for 26 days. He is currently communicating, orientated and able to walk with a frame. Discussion Cerebral fat embolism is a rare cause of acute postoperative decrease in GCS. Neurological recovery is variable, might not be complete and might be prolonged [2]. Anaesthetists should be aware of this rare cause of acute postoperative decrease in GCS. Clinical presentation and MRI are helpful in diagnosis. Treatment is to support the organs until remission of symptoms. AD - A. James, Lincoln County Hospital AU - James, A. AU - Baker, H. AU - Wilbourn, G. AU - Gupta, S. DB - Embase DO - 10.1111/anae.14740 KW - fentanyl midazolam naloxone oxycodone aged anesthesist artificial ventilation atrial fibrillation cardiomegaly case report clinical article computer assisted tomography conference abstract diffusion echocardiography edema electroencephalography emergency fat embolism fracture Glasgow coma scale glucose blood level human hypertension infarction intensive care unit lung angiography lung embolism male medical history neurologic disease nose nuclear magnetic resonance imaging osteoarthritis oxygenation pain parenchyma patent foramen ovale petechia remission respiratory distress sedation seizure spinal anesthesia total hip replacement tricuspid valve regurgitation very elderly wakefulness white matter LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1365-2044 SP - 81 ST - Successful recovery following cerebral fat embolism syndrome after elective hip replacement in an elderly patient T2 - Anaesthesia TI - Successful recovery following cerebral fat embolism syndrome after elective hip replacement in an elderly patient UR - https://www.embase.com/search/results?subaction=viewrecord&id=L628859552&from=export http://dx.doi.org/10.1111/anae.14740 VL - 74 ID - 829131 ER - TY - JOUR AB - As the major hazard of percutaneous vertebroplasty (PV), cement extravasation into the venous system, systemic embolism, and spinal canal has been previously reported. However, to our knowledge, only one case of the arterial migration of cement has been previously reported that is directly associated with this technique without any symptom in the immediate post-intervention and in the follow-up period. An arterial embolus of cement occurred in a 46-year-old woman undergoing lumbar PV for breast cancer metastasis. Less than one hour later, the patient complained of severe pain and numbness in her left leg. A diagnosis of acute left leg ischemia due to the acute occlusion of the infrapopliteal arteries by the cement was made. Transluminal angioplasty (PTA) for the infrapopliteal arteries was recommended because there were diffuse and long vessel involvements, leaving no distal targets for bypass vascular surgery. The patient's postoperative course was uncomplicated; the extremity tenderness and mottled skin were improved. A follow-up ultrasound 2 months later revealed an acceptable distal flow in the arteries of the affected limb, and the patient remained asymptomatic (except for a mild leg pain on exertion) at the one-year follow-up examination. In conclusion, PTA may save the limb from amputation in case of peripheral arterial embolism caused by cement during PV. AD - Hazrat Rasool Hospital, Tehran University of Medical Sciences, Tehran, Iran. AN - 23646051 AU - Jandaghi, S. H. AU - Abdolhoseinpour, H. AU - Ghofraniha, A. AU - Tofighirad, N. AU - Dogmehchi, E. AU - Goodarzynejad, H. C2 - Pmc3587677 DA - Jan DP - NLM ET - 2013/05/07 J2 - The journal of Tehran Heart Center KW - Angioplasty Polymethyl methocrylate Vertebroplasty LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1735-5370 (Print) 1735-5370 SP - 61-4 ST - A Limb-Saving Procedure for Treatment of Arterial Cement Embolism during Lumbar Percutaneous Vertebroplasty: A Case Report T2 - J Tehran Heart Cent TI - A Limb-Saving Procedure for Treatment of Arterial Cement Embolism during Lumbar Percutaneous Vertebroplasty: A Case Report VL - 8 ID - 828822 ER - TY - JOUR AB - As the major hazard of percutaneous vertebroplasty (PV), cement extravasation into the venous system, systemic embolism, and spinal canal has been previously reported. However, to our knowledge, only one case of the arterial migration of cement has been previously reported that is directly associated with this technique without any symptom in the immediate postintervention and in the follow-up period. An arterial embolus of cement occurred in a 46-year-old woman undergoing lumbar PV for breast cancer metastasis. Less than one hour later, the patient complained of severe pain and numbness in her left leg. A diagnosis of acute left leg ischemia due to the acute occlusion of the infrapopliteal arteries by the cement was made. Transluminal angioplasty (PTA) for the infrapopliteal arteries was recommended because there were diffuse and long vessel involvements, leaving no distal targets for bypass vascular surgery. The patient's postoperative course was uncomplicated; the extremity tenderness and mottled skin were improved. A follow-up ultrasound 2 months later revealed an acceptable distal flow in the arteries of the affected limb, and the patient remained asymptomatic (except for a mild leg pain on exertion) at the one-year follow-up examination. In conclusion, PTA may save the limb from amputation in case of peripheral arterial embolism caused by cement during PV. AD - S. H. S. S. Jandaghi, Laleh Hospital, Simaye Iran Street, Phase 5, Shahrake Gharb, Tehran, Iran AU - Jandaghi, S. H. S. S. AU - Abdolhoseinpour, H. AU - Ghofraniha, A. AU - Tofighirad, N. AU - Dogmehchi, E. AU - Goodarzynejad, H. DB - Embase KW - acetylsalicylic acid cement clopidogrel heparin poly(methyl methacrylate) abdominal radiography adult angiography artery embolism artery occlusion article metastatic breast cancer case report clinical feature computer assisted tomography disease severity drug effect female follow up human leg ischemia leg pain limb salvage loading drug dose paresthesia percutaneous transluminal angioplasty percutaneous vertebroplasty popliteal artery postoperative care postoperative pain treatment duration L1 - http://jthc.tums.ac.ir/index.php/jthc/article/view/469/324 LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1735-8620 SP - 61-64 ST - A limb-saving procedure fortreatment ofarterial cement embolism during lumbar percutaneous vertebroplasty: A case report T2 - Journal of Tehran University Heart Center TI - A limb-saving procedure fortreatment ofarterial cement embolism during lumbar percutaneous vertebroplasty: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L368446561&from=export VL - 8 ID - 829506 ER - TY - JOUR AB - Pulmonary cement embolism (PCE) is one of several complications of percutaneous vertebroplasty and kyphoplasty. Generally, PCE can be easily diagnosed based on typical chest radiograph findings such as single or multiple radiographically dense opacities with a tubular or branch shape in the lung field along with a recent history of percutaneous vertebroplasty or kyphoplasty. These findings can be alarming and may be encountered on routine chest radiographs, even in asymptomatic patients. One study showed that PCEs that were not visualized on chest radiograph were also not shown on chest computed tomography. However, we encountered a patient with dyspnea who had normal chest radiograph findings but was diagnosed with PCE through only the bone window setting on chest computed tomography. The present case will be beneficial to all physicians examining older patients with dyspnea. AD - Department of Internal Medicine, The Leon Wiltse Memorial Hospital, Anyang, Korea. Division of Pulmonology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea. Department of Internal Medicine, Daerim St. Mary's Hospital, Seoul, Korea. Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon, Korea. AN - 32466703 AU - Jang, E. C. AU - Ryu, W. AU - Woo, S. Y. AU - Kim, J. S. AU - Lee, K. H. AU - Ryu, J. S. AU - Kwak, S. M. AU - Lee, H. L. AU - Nam, H. S. C2 - Pmc7263131 DA - May DO - 10.1177/0300060520926005 DP - NLM ET - 2020/05/30 J2 - The Journal of international medical research KW - Bone window chest radiograph computed tomography dyspnea pulmonary cement embolism vertebroplasty LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 0300-0605 (Print) 0300-0605 SP - 300060520926005 ST - Diagnosis of pulmonary cement embolism using only the bone window setting on computed tomography: a case report T2 - J Int Med Res TI - Diagnosis of pulmonary cement embolism using only the bone window setting on computed tomography: a case report VL - 48 ID - 828592 ER - TY - JOUR AB - STUDY DESIGN: Three cases of pulmonary embolism caused by polymethylmethacrylate (PMMA) after percutaneous vertebroplasty are reported, and the literature is reviewed. OBJECTIVES: To report on three cases of pulmonary embolism caused by polymethylmethacrylate after percutaneous vertebroplasty, and to review the literature briefly for reduction of this complication. SUMMARY OF BACKGROUND DATA: Pulmonary embolus caused by polymethylmethacrylate during percutaneous vertebroplasty is a rare complication. However, there is always a potential risk of this complication, which may result in pulmonary infarction. METHODS: Three of 27 patients with malignant spinal tumor experienced pulmonary embolism caused by polymethylmethacrylate after percutaneous vertebroplasty. Cement migration into the venous channel was observed in two patients, but not during the procedure. Two patients had mild dyspnea and chest discomfort, and one was asymptomatic. Pulmonary embolism was confirmed on chest radiographs. Ventilation perfusion scanning was performed to detect perfusion defect in all cases. RESULTS: Ventilation perfusion scanning showed no perfusion defects in any case. The symptoms of dyspnea and chest discomfort in two patients subsided after treatment using supplemental oxygen inhalation and anticoagulants. CONCLUSIONS: Three cases of pulmonary embolism caused by polymethylmethacrylate after percutaneous vertebroplasty are reported. Proper techniques can minimize the risk of pulmonary embolism caused by poly-methylmethacrylate during percutaneous vertebroplasty. AD - Wooridul Spine Hospital, Seoul, Korea. spinejjs@yahoo.co.kr AN - 12394937 AU - Jang, J. S. AU - Lee, S. H. AU - Jung, S. K. DA - Oct 1 DO - 10.1097/00007632-200210010-00021 DP - NLM ET - 2002/10/24 J2 - Spine KW - Anticoagulants/therapeutic use Back Pain/etiology/therapy Drug Administration Routes Dyspnea/etiology Female Fractures, Spontaneous/etiology/therapy Humans Male Middle Aged Multiple Myeloma/complications Oxygen Inhalation Therapy Polymethyl Methacrylate/administration & dosage/*adverse effects Pulmonary Embolism/*diagnosis/*etiology/therapy *Spinal Fractures/therapy *Spine/drug effects/surgery LA - eng M1 - 19 N1 - PubMed NLM literature search January 5, 2021 PY - 2002 SN - 0362-2436 SP - E416-8 ST - Pulmonary embolism of polymethylmethacrylate after percutaneous vertebroplasty: a report of three cases T2 - Spine (Phila Pa 1976) TI - Pulmonary embolism of polymethylmethacrylate after percutaneous vertebroplasty: a report of three cases VL - 27 ID - 828758 ER - TY - JOUR AB - Percutaneous vertebroplasty is a minimal invasive method for the stabilization of vertebral bodies by means of acrylic cement - PMMA (polymethyl methacrylate). It has been used in the treatment of pain conditions of the spine associated with compressive fractures in osteoporosis and in neoplastic affections of vertebral bodies. The therapy is based on application of acrylic cement by means of a needle inserted into the affected vertebral body. The authors refer to 16 patients with a painful syndrome associated with osteoporosis-related compressive fractures, where vertebroplasty was made on 23 vertebral bodies. Symptomatic hemangiomas were treated in three vertebral bodies of two patients by embolization with ethanol and subsequent percutaneous vertebroplasty. In one case the cement penetrated into the disk and compressive fracture of the adjacent caudal vertebra occurred requiring a stabilization operation. No other serious complications were encountered. In 33 % of patients treated with percutaneous vertebroplasty the pain disappeared, a marked diminution of the pain occurred in 40% and a mild relief was observed in 215 of cases. The pain remained unchanged in one patient (6%). The authors also refer to new technical possibilities for the use of 3D imaging in rational seriography (3D RA) with the Alura apparatus of Philips in the therapy of compressive fractures of vertebral bodies by means of vertebroplasty. AD - V. Janík, Radimova 136A, 160 00 Praha 6, Czech Republic AU - Janík, V. AU - Daniel, J. AU - Pádr, R. AU - Neuwirth, J. AU - Vyskočil, T. AU - Šebesta, P. AU - Kryl, J. AU - Štulík, J. DB - Embase KW - acrylic cement alcohol poly(methyl methacrylate) analgesia article artificial embolization clinical article controlled study fragility fracture hemangioma human minimally invasive surgery percutaneous vertebroplasty postoperative complication spine stabilization spine tumor surgical technique three-dimensional imaging vertebra body Alura LA - Czech M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2005 SN - 1210-7883 SP - 171-177 ST - Percutaneous vetebroplasty with the use of 3D rotation seriography T2 - Ceska Radiologie TI - Percutaneous vetebroplasty with the use of 3D rotation seriography UR - https://www.embase.com/search/results?subaction=viewrecord&id=L40691509&from=export VL - 59 ID - 829815 ER - TY - JOUR AB - BACKGROUND: Traditional correction for flat back syndrome is performed with a posterior-based surgery or combined approaches in revision cases. OBJECTIVE: To evaluate outcome from anterior surgery with the use of hyperlordotic cages (HLCs) in patients with flat back syndrome. METHODS: All patients operated with or without prior posterior lumbar surgery were studied. Pre- to postoperative sagittal alignment was analyzed. Radiographic parameters were analyzed including T1 pelvic angle (T1PA), sagittal vertical axis (SVA), pelvic tilt (PT), pelvic incidence (PI), lumbar lordosis (LL), sacral slope (SS), pelvic incidence and lumbar lordosis (PI-LL), and T4-12TK. RESULTS: All 50 patients (mean age of 58 yr, 72% female with mean body mass index of 28) demonstrated significant radiographic alignment difference in their spinopelvic and global parameters from pre- to postoperative standing: LL (-37.04° vs -59.55°, P <. 001), SS (35.12 vs 41.13, P <. 001), PI-LL (23.55 vs 6.46), T4-12 TK (30.59 vs 41.67), PT (28.22 vs 22.13), SVA in mm (80.94 vs 37.39), and T1PA (28.70° vs 18.43°, P <. 001). Using linear regression analysis, predicted pre- to postoperative change in standing LL corresponded to a pre- to postoperative changes in standing PI-LL mismatch, T1PA, TK, SS, PT, and SVA (R2 = 0.59, 0.38, 0.25, 0.16, 0.12, and 0.17, respectively). Five degrees of pre- to postoperative change in T1PA translates to -4.15° change in LL. CONCLUSION: Anterior surgery with HLCs followed by posterior instrumentation is an effective technique to treat flat back syndrome. HLCs are effective to maximize LL up to 30°, which is equivalent in magnitude to a pedicle subtraction osteotomy, but associated with less blood loss, quicker recovery, lower complications, and good surgical outcome. AD - M.B. Janjua, Department of Neurosurgery, University of Pennsylvania Hospital, 800 Spruce Street, Philadelphia, PA, United States AU - Janjua, M. B. AU - Ozturk, A. K. AU - Ackshota, N. AU - McShane, B. J. AU - Saifi, C. AU - Welch, W. C. AU - Arlet, V. DB - Embase Medline DO - 10.1093/ons/opz141 KW - bone distractor intraoperative blood salvage device orthopedic fixation device osteotome self retaining retractor spinal rod fixation system stainless steel implant surgical hook titanium cage bone cement fresh frozen plasma poly(methyl methacrylate) acute kidney failure adult anterior spine fusion article atrial fibrillation catheterization clinical article clinical effectiveness cohort analysis delirium device failure discectomy erythrocyte concentrate female flat back syndrome fluoroscopy heart arrhythmia hospital readmission human hypotension length of stay lumbar spine lung embolism lymphatic system disease male medical device complication middle aged operative blood loss Oswestry Disability Index patient-reported outcome percutaneous vertebroplasty posterior longitudinal ligament posterior lumbar interbody fusion posterior spine fusion postoperative complication postoperative period preoperative period priority journal radicular pain reoperation spine malformation spine radiography surgical technique urine retention weakness wound infection Synframe LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 2332-4260 2332-4252 SP - 261-270 ST - Surgical Treatment of Flat Back Syndrome with Anterior Hyperlordotic Cages T2 - Operative Neurosurgery TI - Surgical Treatment of Flat Back Syndrome with Anterior Hyperlordotic Cages UR - https://www.embase.com/search/results?subaction=viewrecord&id=L631636737&from=export http://dx.doi.org/10.1093/ons/opz141 VL - 18 ID - 829079 ER - TY - JOUR AB - BACKGROUND: Cement-augmented pedicle screw instrumentation (CAPSI) of the thoracolumbar spine is indicated in osteoporosis or osteopenia to improve pullout strength and biomechanical stability of pedicle screws (PS). Only a few studies report on the incidence of pulmonary cement embolism or other complications associated with CAPSI. PURPOSE: The aim of this retrospective study was to assess the rate of CAPSI-associated complications. STUDY DESIGN: Retrospective cohort study. PATIENT SAMPLE: Patients who underwent CAPSI due to spinal tumors or degenerative spine disease. OUTCOME MEASURES: Cement leakage, pulmonary cement embolism (PCE), mortality rate. METHODS: Our clinical database was reviewed for patients who underwent CAPSI between January 2012 and June 2015. A total of 165 patients (mean age 71±11.2; range: 46 to 93 years; m=62, f=103) were included. Indications were osteoporotic fractures (n=40), spinal metastases (n=57), degenerative (n=49) or infectious spine disease (n=5), and traumatic vertebral fractures (n=14) with an associated osteoporosis. Every patient received between 2 and 21 (mean 8±3.3) cement-augmented pedicle screws in the thoracolumbar and lumbosacral spine. Both intraoperative cement leakage in prevertebral veins, the inferior vena cava, and/or pulmonary arteries, and leakage detected on postoperative imaging were evaluated. We assessed the incidence of clinically symptomatic and asymptomatic events. RESULTS: In 29 of 31 patients with intraoperative suspicion of cement leakage into prevertebral veins or the inferior vena cava on lateral fluoroscopy, which were without hemodynamic relevance, cement extrusion was confirmed on postoperative X-ray or computed tomography (CT) scan. In three of eight patients with suspicion of PCE, PCE was verified on thoracic CT. Four patients experienced life-threatening intraoperative hemodynamic reactions, either due to cement embolism (n=2; 1.2%) or anaphylactic shock (n=2; 1.2%) with need for intraoperative cardiopulmonary resuscitation in three cases. Two patients died due to fulminant PCE. Three patients with dyspnea 1 day after surgery were also confirmed with PCE on chest CT. In five patients, an asymptomatic PCE was found incidentally on postoperative imaging. In addition, 68 patients with cement leakage into prevertebral veins or the ascending cava vein were found incidentally on postoperative spine X-ray or CT. Two of 10 patients with intraspinal epidural cement leakage required revision surgery. One hundred ten of 165 patients (66.7%) had clinically asymptomatic cement leakage. Thirteen patients had PCE (7.9%), of whom five (3.0%) were symptomatic. Two patients experienced intraoperative cement-induced anaphylaxis (1.2%). The overall symptomatic complication rate was 5.5% (n=9). The 30-day mortality rate was 1.8% (n=3). CONCLUSIONS: CAPSI bears a high risk of asymptomatic cement leakage. The risk for associated severe complications was also relatively high and probably underestimated considering the retrospective nature of the present study. A strict indication for cement augmentation, especially in patients with cardiac predisposition, should be the consequence. We doubt that technical aspects of cement application and/or different types of cement are capable of reducing the risk of these complications substantially. AD - Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675 Munich, Germany. Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675 Munich, Germany. Electronic address: yu.ryang@tum.de. Department of Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675 Munich, Germany. AN - 28108403 AU - Janssen, I. AU - Ryang, Y. M. AU - Gempt, J. AU - Bette, S. AU - Gerhardt, J. AU - Kirschke, J. S. AU - Meyer, B. DA - Jun DO - 10.1016/j.spinee.2017.01.009 DP - NLM ET - 2017/01/22 J2 - The spine journal : official journal of the North American Spine Society KW - Aged Aged, 80 and over Bone Cements/*adverse effects/chemistry Female Humans Lumbar Vertebrae/surgery Male Middle Aged Osteoporotic Fractures/*surgery Pedicle Screws/*adverse effects Postoperative Complications/*etiology Pulmonary Embolism/*etiology Spinal Fractures/*surgery Spinal Fusion/*adverse effects/methods *Bone mineral density *Cement-augmented pedicle screw instrumentation *Osteoporosis *Osteoporotic fractures *Pulmonary cement embolism *Thoracolumbar spine LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 1529-9430 SP - 837-844 ST - Risk of cement leakage and pulmonary embolism by bone cement-augmented pedicle screw fixation of the thoracolumbar spine T2 - Spine J TI - Risk of cement leakage and pulmonary embolism by bone cement-augmented pedicle screw fixation of the thoracolumbar spine VL - 17 ID - 828578 ER - TY - JOUR AB - Background: Cement-augmented pedicle screw instrumentation (CAPSI) of the thoracolumbar spine is indicated in osteoporosis or osteopenia to improve pullout strength and biomechanical stability of pedicle screws (PS). Only a few studies report on the incidence of pulmonary cement embolism or other complications associated with CAPSI.Purpose: The aim of this retrospective study was to assess the rate of CAPSI-associated complications.Study Design: Retrospective cohort study.Patient Sample: Patients who underwent CAPSI due to spinal tumors or degenerative spine disease.Outcome Measures: Cement leakage, pulmonary cement embolism (PCE), mortality rate.Methods: Our clinical database was reviewed for patients who underwent CAPSI between January 2012 and June 2015. A total of 165 patients (mean age 71±11.2; range: 46 to 93 years; m=62, f=103) were included. Indications were osteoporotic fractures (n=40), spinal metastases (n=57), degenerative (n=49) or infectious spine disease (n=5), and traumatic vertebral fractures (n=14) with an associated osteoporosis. Every patient received between 2 and 21 (mean 8±3.3) cement-augmented pedicle screws in the thoracolumbar and lumbosacral spine. Both intraoperative cement leakage in prevertebral veins, the inferior vena cava, and/or pulmonary arteries, and leakage detected on postoperative imaging were evaluated. We assessed the incidence of clinically symptomatic and asymptomatic events.Results: In 29 of 31 patients with intraoperative suspicion of cement leakage into prevertebral veins or the inferior vena cava on lateral fluoroscopy, which were without hemodynamic relevance, cement extrusion was confirmed on postoperative X-ray or computed tomography (CT) scan. In three of eight patients with suspicion of PCE, PCE was verified on thoracic CT. Four patients experienced life-threatening intraoperative hemodynamic reactions, either due to cement embolism (n=2; 1.2%) or anaphylactic shock (n=2; 1.2%) with need for intraoperative cardiopulmonary resuscitation in three cases. Two patients died due to fulminant PCE. Three patients with dyspnea 1 day after surgery were also confirmed with PCE on chest CT. In five patients, an asymptomatic PCE was found incidentally on postoperative imaging. In addition, 68 patients with cement leakage into prevertebral veins or the ascending cava vein were found incidentally on postoperative spine X-ray or CT. Two of 10 patients with intraspinal epidural cement leakage required revision surgery. One hundred ten of 165 patients (66.7%) had clinically asymptomatic cement leakage. Thirteen patients had PCE (7.9%), of whom five (3.0%) were symptomatic. Two patients experienced intraoperative cement-induced anaphylaxis (1.2%). The overall symptomatic complication rate was 5.5% (n=9). The 30-day mortality rate was 1.8% (n=3).Conclusions: CAPSI bears a high risk of asymptomatic cement leakage. The risk for associated severe complications was also relatively high and probably underestimated considering the retrospective nature of the present study. A strict indication for cement augmentation, especially in patients with cardiac predisposition, should be the consequence. We doubt that technical aspects of cement application and/or different types of cement are capable of reducing the risk of these complications substantially. AD - Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675 Munich, Germany Department of Neuroradiology, Klinikum rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675 Munich, Germany AN - 123444717. Language: English. Entry Date: 20180121. Revision Date: 20190516. Publication Type: journal article AU - Janssen, Insa AU - Ryang, Yu-Mi AU - Gempt, Jens AU - Bette, Stefanie AU - Gerhardt, Julia AU - Kirschke, Jan S. AU - Meyer, Bernhard DB - cin20 DO - 10.1016/j.spinee.2017.01.009 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Spinal Fractures -- Surgery Pulmonary Embolism -- Etiology Pedicle Screws -- Adverse Effects Spinal Fusion -- Adverse Effects Postoperative Complications -- Etiology Bone Cements Aged Middle Age Female Lumbar Vertebrae -- Surgery Spinal Fusion -- Methods Male Aged, 80 and Over Human M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 1529-9430 SP - 837-844 ST - Risk of cement leakage and pulmonary embolism by bone cement-augmented pedicle screw fixation of the thoracolumbar spine T2 - Spine Journal TI - Risk of cement leakage and pulmonary embolism by bone cement-augmented pedicle screw fixation of the thoracolumbar spine UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=123444717&site=ehost-live&scope=site VL - 17 ID - 830567 ER - TY - JOUR AB - Polymethylmethacrylate (PMMA) has been extensively used as bone cement in orthopedic procedures. Adverse circulatory and pulmonary events associated with hip arthroplasty using PMMA bone cement have been documented. Percutaneous vertebroplasty is an image-guided procedure in which the bone cement is injected into the compression fracture due to osteoporosis or neoplasm. We experienced a case of sudden tachypnea associated with pulmonary cement embolism in an adult male who underwent percutaneous vertebroplasty. AD - S.-N. Jean, Department of Radiology, DA Chien General Hospital, No. 6, Shinguang Street, Miaoli 360, Taiwan AU - Jean, S. N. AU - Chen, Y. F. AU - Chen, J. F. AU - Chen, S. J. AU - Lo, T. C. AU - Hwang, S. J. DB - Embase KW - bronchodilating agent poly(methyl methacrylate) adult anamnesis article case report clinical feature computer assisted tomography hospital admission human lung embolism male oxygen therapy percutaneous vertebroplasty thorax radiography LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 1018-8940 SP - 47-51 ST - Pulmonary embolism of polymethylmethacrylate after percutaneous vertebroplasty: A case report T2 - Chinese Journal of Radiology TI - Pulmonary embolism of polymethylmethacrylate after percutaneous vertebroplasty: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L44005903&from=export VL - 31 ID - 829800 ER - TY - JOUR AN - 11949656 AU - Jenkins, K. AU - Wake, P. J. DA - Apr DO - 10.1046/j.1365-2044.2002.2575_20.x DP - NLM ET - 2002/04/13 J2 - Anaesthesia KW - Aged Arthroplasty, Replacement, Hip/*adverse effects Bone Cements/*adverse effects Embolism, Fat/*etiology Female Heart Arrest/*etiology Humans Hypotension/*etiology Syndrome LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2002 SN - 0003-2409 (Print) 0003-2409 SP - 416; author reply 416 ST - Cement implantation syndrome T2 - Anaesthesia TI - Cement implantation syndrome VL - 57 ID - 828519 ER - TY - JOUR AB - Numerous authors describe the efficacy and relative safety of simultaneous bilateral total hip replacement or bilateral surgeries separated by more than 6 weeks. We compare those reported results with our 32-year experience using a unique timing protocol: doing sequential bilateral total hip replacements during the same hospitalization separated by 5 to 7 days. From 1972 to 2004, 112 patients were selected for bilateral total hip replacement surgery during the same hospitalization. All surgeries were done using a direct lateral approach to the hip with a variety of cemented and cementless implants. Of the 112 patients, 96 charts were available for review. The average length of stay was 13.8 days. With an average of 6.3 years (range, 1-23 years) followup, Iowa hip scores improved from an average of 42 points to an average of 94 points. Implant survivorship compared favorably with other reports of similar implants, and there were no acute deep infections and two delayed infections. Sixteen patients developed medical complications, two had pulmonary emboli (one fatal) and two died (one of pulmonary embolism and one cerebral bleed not related to the surgery). Sequential bilateral total hip arthroplasty offers surgeons an alternative to simultaneous or staged surgery for the appropriately selected patient. LEVEL OF EVIDENCE: Therapeutic study, Level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence. AD - Orthopedic Healthcare Northwest, Eugene, OR 97405, USA. Brian.Jewett@OHN.com AN - 16331012 AU - Jewett, B. A. AU - Collis, D. K. DA - Dec DO - 10.1097/01.blo.0000192040.40523.df DP - NLM ET - 2005/12/07 J2 - Clinical orthopaedics and related research KW - Adult Aged Aged, 80 and over Arthroplasty, Replacement, Hip/*methods/*statistics & numerical data Blood Transfusion/statistics & numerical data Databases, Factual Female Hip Joint/*surgery Hospitalization/*statistics & numerical data Humans Length of Stay/statistics & numerical data Male Middle Aged Postoperative Complications/*epidemiology Retrospective Studies LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2005 SN - 0009-921X (Print) 0009-921x SP - 256-61 ST - Sequential bilateral total hip replacement during the same hospitalization T2 - Clin Orthop Relat Res TI - Sequential bilateral total hip replacement during the same hospitalization VL - 441 ID - 828844 ER - TY - JOUR AB - Unlabelled: Numerous authors describe the efficacy and relative safety of simultaneous bilateral total hip replacement or bilateral surgeries separated by more than 6 weeks. We compare those reported results with our 32-year experience using a unique timing protocol: doing sequential bilateral total hip replacements during the same hospitalization separated by 5 to 7 days. From 1972 to 2004, 112 patients were selected for bilateral total hip replacement surgery during the same hospitalization. All surgeries were done using a direct lateral approach to the hip with a variety of cemented and cementless implants. Of the 112 patients, 96 charts were available for review. The average length of stay was 13.8 days. With an average of 6.3 years (range, 1-23 years) followup, Iowa hip scores improved from an average of 42 points to an average of 94 points. Implant survivorship compared favorably with other reports of similar implants, and there were no acute deep infections and two delayed infections. Sixteen patients developed medical complications, two had pulmonary emboli (one fatal) and two died (one of pulmonary embolism and one cerebral bleed not related to the surgery). Sequential bilateral total hip arthroplasty offers surgeons an alternative to simultaneous or staged surgery for the appropriately selected patient.Level Of Evidence: Therapeutic study, Level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence. AD - Orthopedic Healthcare Northwest, Eugene, OR 97405, USA AN - 106004867. Language: English. Entry Date: 20080229. Revision Date: 20190610. Publication Type: journal article AU - Jewett, B. A. AU - Collis, D. K. AU - Jewett, Brian A. AU - Collis, Dennis K. DB - cin20 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Methods Arthroplasty, Replacement, Hip -- Statistics and Numerical Data Hip Joint -- Surgery Hospitalization -- Statistics and Numerical Data Postoperative Complications -- Epidemiology Adult Aged Aged, 80 and Over Blood Transfusion -- Statistics and Numerical Data Female Length of Stay -- Statistics and Numerical Data Male Middle Age Resource Databases Retrospective Design Human M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2005 SN - 0009-921X SP - 256-261 ST - Sequential bilateral total hip replacement during the same hospitalization T2 - Clinical Orthopaedics & Related Research TI - Sequential bilateral total hip replacement during the same hospitalization UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106004867&site=ehost-live&scope=site VL - 441 ID - 830777 ER - TY - JOUR AB - Purpose: To determine the effectiveness of vertebral augmentation in relieving pain, differences in pain relief outcomes based on procedure type were investigated. Variables that potentially influence outcomes were identified. Materials and Methods: A database of 525 cases (740 levels) treated for compression fractures with vertebroplasty, kyphoplasty, or S1-level sacroplasty was compiled. Average age was 75 years ± 12, and 72.4% of patients were female. Variables evaluated included age, sex, fracture etiology, procedure type, vertebral level treated, number of levels treated per procedure, and technical approach. Outcomes were assessed by a binary system of "responders" (ie, patients with improvement/resolution of pain) versus "non-responders" (ie, those with no change/worsening of pain) and with a four-level pain scale (1, pain resolution; 2, pain improvement; 3, no change; 4, worse pain) retrospectively applied from medical records. Univariate and multivariate analyses determined outcomes. Results: Four-hundred and sixty-seven patients (89%) showed a response to treatment: 40% had pain resolution and 49% had pain improvement. Multivariate analysis showed that women and older patients had greater odds of being responders (odds ratios [ORs], 0.56 and 0.98, respectively; P = .016 and P = .048, respectively). Patients without cancer (OR, 1.60; P = .012) and women (OR, 2.05; P = .0002) were more likely to experience pain resolution. Increasing numbers of levels treated per case were associated with decreased odds of pain resolution (OR, 0.69; P = .0081). Sex and number of levels treated were independently predictive of pain scale outcomes (ORs, 2.0 and 0.71, respectively; P = .0003 and P = .015). Conclusions: Vertebral augmentation procedures provide pain relief for a majority of patients regardless of underlying fracture etiology. There was no difference in pain outcomes among procedure types. Age and sex may be predictive of pain outcomes. © 2009 SIR. AD - R.M. Jha, Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States AU - Jha, R. M. AU - Yoo, A. J. AU - Hirsch, A. E. AU - Growney, M. AU - Hirsch, J. A. DB - Embase Medline DO - 10.1016/j.jvir.2009.01.037 KW - warfarin acute kidney tubule necrosis adult aged article asthma compression fracture controlled study female fracture treatment groups by age human hypotension kyphoplasty laceration lung embolism major clinical study male neoplasm pain assessment palliative therapy percutaneous vertebroplasty priority journal sacroplasty sex difference treatment outcome LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 1051-0443 SP - 760-768 ST - Predictors of Successful Palliation of Compression Fractures with Vertebral Augmentation: Single-center Experience of 525 Cases T2 - Journal of Vascular and Interventional Radiology TI - Predictors of Successful Palliation of Compression Fractures with Vertebral Augmentation: Single-center Experience of 525 Cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L354596931&from=export http://dx.doi.org/10.1016/j.jvir.2009.01.037 VL - 20 ID - 829709 ER - TY - JOUR AB - Objective: To detail our early experience and technique of a modified two-stage reimplantation protocol using antibiotic-loaded articulating cement spacers (ALACSs) for treatment of late periprosthetic infection after total knee arthroplasty (TKA). Methods: From January 2006 to February 2009, a series of 21 patients (21 knees) with late infected TKAs were treated by radical debridement and removal of all components and cement, and then articulating spacers were implanted using antibiotic-impregnated bone cement. For this purpose, 4 g vancomycin powder was mixed with per 40 g cement. Graduated knee motion and partial weight bearing activity were encouraged in the interval period. Each patient received an individual systemic organism-sensitive antimicrobial therapy for 4.9 (range, 2-8) weeks followed by a second-stage TKA revision. All the patients were regularly followed up using the American Knee Society Scoring System. Results: Each case underwent a successful two-stage exchange and had infection eradicated, none had recurrent infection after an average of 32.2 (range, 17-54) months of follow-up. Preoperatively, the mean knee score was 53.5 points, function score was 27.3 points, pain score was 25.7 points, range of motion (ROM) was 82.0°, extensor lag was 2°. Between stages, the mean knee score was increased to 61.3 points, function score to 45 points, pain score to 35 points, ROM to 88.2°, and extensor lag to 3.4°. At final follow-up, the mean knee score was further increased to 82.1 points, function score to 74.5 points, pain score to 42.1 points, ROM to 94.3°, and knee extension lag to 1.9°. The interval period was 11.5 (range, 6-32) weeks. The amount of bone loss was unchanged between stages. No patient developed noticeable dysfunction of the liver or kidney or other complications such as impaired wound healing, deep venous thrombosis, pulmonary embolism, cerebrovascular accidents, etc. Conclusions: Treating infected TKA with ALACS avoids spacer-related bone loss, preserves knee function between stages, and eradicates infection effectively without significant complications. The early clinical results are inspiring. The authors believe that radical and repeated (if needed) debridement, individual application of systemic antibiotics, and reasonable timing judgement upon the secondary revision are all key factors related to a successful outcome with two-stage reimplantation procedure for infected TKA. AD - Y. Zhang, Department of Orthopaedic Surgery, Tianjin Union Medicial Center, Tianjin 300121, China AU - Jia, Y. T. AU - Zhang, Y. AU - Ding, C. AU - Zhang, N. AU - Zhang, D. H. AU - Sun, Z. H. AU - Tian, M. Q. AU - Liu, J. C1 - refobacin(Biomet,United States) DB - Embase Medline DO - 10.3760/cma.j.issn.1008-1275.2012.04.004 KW - bone cement gentamicin rifampicin sulfamethoxazole vancomycin adult aged antibiotic therapy article cement spacer clinical article clinical protocol debridement drug safety female follow up functional assessment human knee knee arthritis knee osteoarthritis knee prosthesis male patient safety prosthesis infection range of motion reimplantation scoring system total knee arthroplasty weight bearing refobacin Osteobond LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1008-1275 SP - 212-221 ST - Antibiotic-loaded articulating cement spacers in twostage revision for infected total knee arthroplasty: Individual antibiotic treatment and early results of 21 cases T2 - Chinese Journal of Traumatology - English Edition TI - Antibiotic-loaded articulating cement spacers in twostage revision for infected total knee arthroplasty: Individual antibiotic treatment and early results of 21 cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L368715944&from=export http://dx.doi.org/10.3760/cma.j.issn.1008-1275.2012.04.004 VL - 15 ID - 829592 ER - TY - JOUR AB - OBJECTIVE: To detail our early experience and technique of a modified two-stage reimplantation protocol using antibiotic-loaded articulating cement spacers (ALACSs) for treatment of late periprosthetic infection after total knee arthroplasty (TKA). METHODS: From January 2006 to February 2009, a series of 21 patients (21 knees) with late infected TKAs were treated by radical debridement and removal of all components and cement, and then articulating spacers were implanted using antibiotic-impregnated bone cement. For this purpose, 4 g vancomycin powder was mixed with per 40 g cement. Graduated knee motion and partial weight bearing activity were encouraged in the interval period. Each patient received an individual systemic organism-sensitive antimicrobial therapy for 4.9 (range, 2-8) weeks followed by a second-stage TKA revision. All the patients were regularly followed up using the American Knee Society Scoring System. RESULTS: Each case underwent a successful two-stage exchange and had infection eradicated, none had recurrent infection after an average of 32.2 (range, 17-54) months of follow-up. Preoperatively, the mean knee score was 53.5 points, function score was 27.3 points, pain score was 25.7 points, range of motion (ROM) was 82.0 degree extensor lag was 2 degree Between stages, the mean knee score was increased to 61.3 points, function score to 45 points, pain score to 35 points, ROM to 88.2 degree and extensor lag to 3.4 degree At final follow-up, the mean knee score was further increased to 82.1 points, function score to 74.5 points, pain score to 42.1 points, ROM to 94.3 degree and knee extension lag to 1.9 degree The interval period was 11.5 (range, 6-32) weeks. The amount of bone loss was unchanged between stages. No patient developed noticeable dysfunction of the liver or kidney or other complications such as impaired wound healing, deep venous thrombosis, pulmonary embolism, cerebrovascular accidents, etc. CONCLUSIONS: Treating infected TKA with ALACS avoids spacer-related bone loss, preserves knee function between stages, and eradicates infection effectively without significant complications. The early clinical results are inspiring. The authors believe that radical and repeated (if needed) debridement, individual application of systemic antibiotics, and reasonable timing judgement upon the secondary revision are all key factors related to a successful outcome with two-stage reimplantation procedure for infected TKA. AD - Department of Orthopaedic Surgery, Tianjin Union Medicial Center, Tianjin 300121, China. AN - 22863338 AU - Jia, Y. T. AU - Zhang, Y. AU - Ding, C. AU - Zhang, N. AU - Zhang, D. L. AU - Sun, Z. H. AU - Tian, M. Q. AU - Liu, J. DP - NLM ET - 2012/08/07 J2 - Chinese journal of traumatology = Zhonghua chuang shang za zhi KW - Anti-Bacterial Agents *Arthroplasty, Replacement, Knee Humans Knee Joint *Knee Prosthesis Prosthesis-Related Infections LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 1008-1275 (Print) 1008-1275 SP - 212-21 ST - Antibiotic-loaded articulating cement spacers in two-stage revision for infected total knee arthroplasty: individual antibiotic treatment and early results of 21 cases T2 - Chin J Traumatol TI - Antibiotic-loaded articulating cement spacers in two-stage revision for infected total knee arthroplasty: individual antibiotic treatment and early results of 21 cases VL - 15 ID - 828809 ER - TY - JOUR AB - OBJECTIVE: To discuss the effect of dexamethasone in preventing fat embolism syndrome (FES) in cemented hip arthroplasty patients. METHODS: Forty patients scheduled for unilateral cemented hip arthroplasty between January 2008 and December 2009 were randomly divided into trial group (n = 20) and control group (n = 20). In trial group, there were 6 males and 14 females with an average age of 73.2 years (range, 54-95 years), including 4 cases of osteoarthritis, 3 cases of avascular necrosis of femoral head, and 13 cases of femoral neck fracture; the disease duration was 4 days to 6 years (median, 0.8 year). In control group, there were 10 males and 10 females with an average age of 71.9 years (range, 59-91 years), including 2 cases of osteoarthritis, 3 cases of avascular necrosis of femoral head, and 15 cases of femoral neck fracture; the disease duration was 3 days to 5 years (median, 0.6 year). There was no significant difference in gender, age, or disease duration (P > 0.05) between 2 groups. Cemented total or bipolar hip arthroplasty (with the same brand of cement and prosthesis) in 2 groups were performed by a group of surgeons. The patients were given intravenously injected with dexamethasone (20 mg) in trial group before 1 hour of cement injection and intravenously injected with normal saline (2 mL) in control group. Amount of 5 mL vein blood were withdrawn before surgery, after 4, 8, and 24 hours of cement injection to test the number and average diameter of fat droplets. According to Gurd diagnosis standard, related FES symptoms and signs were inspected. RESULTS: Primary healing of incision was achieved in all cases of 2 groups. According to Gurd standard of diagnosis, no FES occurred in each group at 2 weeks postoperatively; deep venous thrombosis occurred in 2 cases (10%) of trial group and in 5 cases (25%) of control group, showing significant difference (P < 0.05). The number and diameter of fat droplets in trial group were significantly lower than those in control group at 4, 8, and 24 hours of cement injection (P < 0.01). All cases were followed up 7.4 months on average (range, 3-13 months). The postoperative Harris score was 89.5 +/- 6.1 in trial group and 87.9 +/- 8.3 in control group, showing no significant difference (P > 0.05). No loosening occurred during follow-up period. CONCLUSION: Intravenous injection with dexamethasone can effectively reduce the number and diameter of venous fat droplets in cemented hip arthroplasty, which can decrease the risk of postoperative FES. AD - Department of Orthopaedics, People's Hospital of Leshan, Leshan Sichuan 614000, PR China. AN - 20839434 AU - Jiang, J. AU - Wang, H. AU - Wang, Y. DA - Aug DP - NLM ET - 2010/09/16 J2 - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery KW - Aged Aged, 80 and over Arthroplasty, Replacement, Hip/adverse effects Bone Cements Dexamethasone/*therapeutic use Embolism, Fat/etiology/*prevention & control Female Hip Prosthesis Humans Male Middle Aged Postoperative Complications/*prevention & control LA - chi M1 - 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 1002-1892 (Print) 1002-1892 SP - 913-6 ST - [Clinical study on effect of dexamethasone in preventing fat embolism syndrome after cemented hip arthroplasty] T2 - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi TI - [Clinical study on effect of dexamethasone in preventing fat embolism syndrome after cemented hip arthroplasty] VL - 24 ID - 828802 ER - TY - JOUR AB - Purpose: To report our experience in transcatheter arterial embolization of rectus sheath hematoma secondary to anticoagulant therapy refractory to conservative treatment. Material and methods: Twenty patients with rectus sheath hematoma secondary to anticoagulant therapy were treated in our hospital by transcatheter arterial embolization. All patients presented clinical signs of active bleeding, despite conservative treatment. A previous CT showed rectus sheath hematoma in all patients with extravasation of contrast in 19 cases (95%). We classified hematoma into 3 types: type 1 was confined to the rectus sheath musculature, type 2 affected the posterior space of the rectus sheath without blood in the abdominopelvic cavity, and type 3 affected this cavity. Coils, gelatine sponge, Onix, acrylic glue, and/or polyvinyl alcohol particles were used as embolic agents depending on the case and the preference of the operator. Results: CT showed 12 type 3 (60%), 4 type 2 (20%), and 4 type 1 (20%) rectus sheath hematomas. Transfemoral arteriogram revealed bleeding of inferior epigastric artery in 19 patients (95%). Technical success was 100%. Clinical success was 95% [1 patient had rebleeding 24 hours later and was treated by transcatheter embolization again and 3 patients (15%) died within 30 days after embolization due to multiple organ failure]. Conclusion: Transcatheter arterial embolization is an effective treatment to control the bleeding in patients with hematoma secondary to anticoagulant therapy refractory to conservative treatment. AD - J.M. Jimenez Perez, Radiodiagnostico, Hospital General Universitario Gregorio Marañón, Madrid, Spain AU - Jimenez Perez, J. M. AU - Rodriguez-Rosales, G. AU - González Leyte, M. AU - Alvarez Luque, A. AU - Echenagusia Boyra, M. AU - Calleja Cartón, E. DB - Embase DO - 10.1007/s00270-016-1405-3 KW - gelatin poly(methyl methacrylate) polyvinyl alcohol anticoagulant therapy arterial embolization arteriography bleeding clinical article conservative treatment contrast medium extravasation controlled study hematoma hospital human inferior epigastric artery multiple organ failure normal human rectus abdominis muscle LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1432-086X SP - S221 ST - Arterial embolization of rectus sheath hemorrhage secondary to anticoagulant therapy T2 - CardioVascular and Interventional Radiology TI - Arterial embolization of rectus sheath hemorrhage secondary to anticoagulant therapy UR - https://www.embase.com/search/results?subaction=viewrecord&id=L613933529&from=export http://dx.doi.org/10.1007/s00270-016-1405-3 VL - 39 ID - 829342 ER - TY - JOUR AB - STUDY DESIGN: Prospective study. OBJECTIVE: The aim of this study was to demonstrate the safe range of cement volume during percutaneous vertebroplasty. SUMMARY OF BACKGROUND DATA: A few clinical reports have addressed the relationship between cement volume and clinical outcome. However, the weakness of these studies was that subjects included were not homogeneous. No study in the clinical setting has confirmed results from biomechanical and computational studies. METHODS: We examined 96 patients with single compression fractures who underwent percutaneous vertebroplasty and postoperative three-dimensional CT scan within a week between June 2006 and April 2009. The volume and fraction were measured by a CT volumetry program. Relationships between predictors and volumetric data, outcome, leakage, intraverterbal vacuum cleft (IVVC), and subsequent fracture were examined. Relationships between volumetric data and outcome, leakage, IVVC, and subsequent fracture were analyzed with stratification by the treated level. Receiver-operator characteristic (ROC) curves were plotted to acquire cut-off values of volumetric data. RESULTS: Seventy-three patients (76%) were female, and the mean age was 76.3 ± 8.4 years (range 53-97). The mean duration of follow-up was 11 months (range 6-21). Locations were as follows: T4-T10 9, T11-L1-L57, and L2-L4 30. Seventy-eight patients (81%) reported a favorable outcome. Fractured body volume (FBV) and the level treated were associated with fraction, which had an influence on outcome. The fraction of the favorable group was significantly higher. Cut-off values to acquire a favorable outcome were 11.64% (P = 0.026) on the T4-L4 level and 3.35 cm (P = 0.059), 11.65% (P = 0.059) on the T11-L1 level. Group with intradiscal leakage had a smaller volume than nonleakage group on the L2-L4 level (3.86 cm vs. 5.65 cm, P = 0.002). There were no relationships of volumetric data with epidural leakage and pulmonary embolism. The presence of IVVC increased volume on the T4-L4 and L2-L4 level (P < 0.03). Larger volume increased significantly the incidence of adjacent fracture on the L2-L4 level. The significant cut-off volume to avoid adjacent fracture was 4.90 cm on the ROC curve. CONCLUSION: It is suggested that fraction is superior to volume for predicting outcome on the T11-L1 level and an amount of cement should be determined in terms of FBV and fraction according to the treated level. A lower fraction than required for the restoration of mechanical property was enough to obtain pain relief. Intradiscal leakage on the L2-L4 level may be inevitable to obtain appropriate mechanical properties in the case of severe endplate breakdown connected with the disc space. Smaller volume is needed to avoid an adjacent fracture on the L2-L4 level. Although we did not know the reason why there was a difference among the treated level groups, one thing that is certain is the fact that level-specific approaches may be necessary for good outcome in terms of volume, fraction and FBV. AD - Department of Neurosurgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea. AN - 21289575 AU - Jin, Y. J. AU - Yoon, S. H. AU - Park, K. W. AU - Chung, S. K. AU - Kim, K. J. AU - Yeom, J. S. AU - Kim, H. J. DA - May 20 DO - 10.1097/BRS.0b013e3181fc914e DP - NLM ET - 2011/02/04 J2 - Spine KW - Aged Aged, 80 and over Bone Cements/*therapeutic use Female Follow-Up Studies Fractures, Compression/diagnostic imaging/surgery Humans Lumbar Vertebrae/*diagnostic imaging/injuries/surgery Male Middle Aged Postoperative Complications/*diagnostic imaging/etiology Prospective Studies Radiography Spinal Fractures/*diagnostic imaging/surgery Thoracic Vertebrae/*diagnostic imaging/injuries/surgery Treatment Outcome Vertebroplasty/*adverse effects/methods LA - eng M1 - 12 N1 - PubMed NLM literature search January 5, 2021 PY - 2011 SN - 0362-2436 SP - E761-72 ST - The volumetric analysis of cement in vertebroplasty: relationship with clinical outcome and complications T2 - Spine (Phila Pa 1976) TI - The volumetric analysis of cement in vertebroplasty: relationship with clinical outcome and complications VL - 36 ID - 828699 ER - TY - JOUR AB - BACKGROUND: Bone filling mesh container vertebroplasty can effectively correct the kyphotic deformity of the vertebral body, restore the height of the vertebral body, and effectively reduce the rate of bone cement leakage. However, there are few reports on the poor prognosis of bone filling mesh container vertebroplasty in thoracolumbar compression fractures with vertebral body wall incompetence. OBJECTIVE: To discuss adverse outcomes of bone filling mesh container vertebroplasty for the treatment of osteoporotic vertebral compression fractures with vertebral body wall incompetence. METHODS: Totally 19 cases with osteoporotic vertebral compression fracture with vertebral body wall incompetence, who were treated in the Tianjin First Central Hospital from April 2017 to October 2018, were enrolled in this study, including 3 males and 16 females, at the age of 60-86 years. The patients underwent bone filling mesh container vertebroplasty. Postoperative complications were recorded during follow up. Visual analogue scale score and Oswestry disability index were assessed. X-ray films were taken to measure the height of injured vertebral body and Cobb’s angle. This study was approved by the Ethics Committee of Clinical Research Project of Tianjin First Central Hospital (approval No. 2018N150KY). RESULTS And CONCLUSION: (1) All 19 patients were follow-up for 9-20 months. No death occurred during and after operation, and no severe complications such as pulmonary embolism, bone cement allergy or infection occurred. Among them, seven cases had poor prognosis, including five cases of bone cement leakage, four cases of above moderate pain and two cases of adjacent vertebral fractures. (2) Visual analogue scale score, Oswestry disability index, height of injured vertebral body and Cobb’s angle were significantly improved during the final follow-up in 19 patients (P < 0.05). (3) Results showed that poor outcomes of bone filling mesh container vertebroplasty for the treatment of osteoporotic vertebral compression fractures with vertebral body wall incompetence included bone cement leakage, adjacent vertebral body fracture, and postoperative pain. The operation should be carried out in strict accordance with the relevant operation specifications, and the relevant treatment and preventive measures should be made to minimize the occurrence of adverse reactions. AD - W.L. Jing, Department of Orthopedics, Tianjin First Central Hospital, Tianjin, China AU - Jing, W. L. AU - Zhang, T. AU - Teng, D. H. AU - Shi, T. AU - Zhou, Q. DB - Embase DO - 10.3969/j.issn.2095-4344.3066 KW - surgical mesh bone cement adult aged article biomechanics bone cement leakage bone density bone filling clinical article clinical outcome Cobb angle compression fracture female follow up human male middle aged osteoporosis Oswestry Disability Index percutaneous vertebroplasty risk factor vertebra body vertebral body wall incompetence visual analog scale LA - Chinese M1 - 10 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 2095-4344 SP - 1522-1527 ST - Poor outcomes of bone filling mesh container vertebroplasty for the treatment of osteoporotic vertebral compression fractures with vertebral body wall incompetence T2 - Chinese Journal of Tissue Engineering Research TI - Poor outcomes of bone filling mesh container vertebroplasty for the treatment of osteoporotic vertebral compression fractures with vertebral body wall incompetence UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2005193166&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.3066 VL - 25 ID - 829072 ER - TY - JOUR AN - CN-02110022 AU - Jinwei, Xie AU - Jun, Ma AU - Chen, Yue AU - Pengde, Kang AU - Fuxing, Pei DO - 10.5301/hipint.5000291 KW - Administration and Dosage Administration, Topical Aged Arthroplasty, Replacement, Hip Blood Loss, Surgical Chi Square Test Combined Modality Therapy Data Analysis Software Descriptive Statistics Drug Administration Routes Epidemiology Female Fisher's Exact Test Funding Source Hemoglobins Human Incidence Infusions, Intravenous Male Middle Age One‐Way Analysis of Variance Post Hoc Analysis Power Analysis Prevention and Control Pulmonary Embolism P‐Value Randomized Controlled Trials Sample Size Determination Tranexamic Acid Venous Thrombosis M1 - 1 M3 - Academic Journal N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2016 SP - 36‐42 ST - Combined use of intravenous and topical tranexamic acid following cementless total hip arthroplasty: a randomised clinical trial T2 - Hip international TI - Combined use of intravenous and topical tranexamic acid following cementless total hip arthroplasty: a randomised clinical trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02110022/full VL - 26 ID - 830076 ER - TY - JOUR AB - Background and Aims: Although uncommon, symptomatic vertebral hemangiomas can be a painful condition limiting daily activities. Medical management, radiation therapy, intra-arterial embolization, and surgical removal have all been used with varying success. Each technique has known complications and limitations that limit its utility. Balloon kyphoplasty is a developing technique that has successfully been used in the treatment of vertebral hemangiomas in a few case studies. The aim of this abstract is to describe a case series of painful vertebral hemangiomas effectively treated with percutaneous balloon kyphoplasty. Methods: A 38-year-old male with a painful L5 biopsyproven hemangioma and a 75-year-old female with a painful T12 hemangioma on MRI both presented with thoraco-lumbar pain. Physical exams correlated with imaging findings and no neurological symptoms were present. Both patients received conservative management including physical therapy and a variety of spinal injections without benefit. Percutaneous balloon kyphoplasty was subsequently performed on each patient to relieve pain. Results: After kyphoplasty, both patients' pain almost completely resolved and they were able to resume previous levels of activity. Conclusions: Although symptomatic vertebral hemangiomas are rare, this case series demonstrates a successful response to vertebral augmentation using balloon kyphoplasty when other treatment modalities failed. When compared to other therapies, the benefits of kyphoplasty include a decreased exposure to radiation, a decreased risk of excessive hemorrhage, and a decreased risk of cement leakage. Balloon kyphoplasty is a potential first-line treatment option when compared to more traditional management methods such as radiation therapy and intra-arterial embolization. AD - J. Jones, Department of Anesthesiology and Pain Management, University of Texas Southwestern, Dallas, TX, United States AU - Jones, J. AU - Sreenadha, V. AU - Bruel, B. DB - Embase DO - 10.1111/j.1533-2500.2009.00267.x KW - cement kyphoplasty hemangioma pain patient case study risk radiotherapy artificial embolization bleeding exposure male female low back pain imaging neurologic disease disease management conservative treatment physiotherapy therapy intraspinal drug administration radiation nuclear magnetic resonance imaging LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 1530-7085 SP - 108 ST - Management of vertebral hemangiomas with kyphoplasty: A report of two cases T2 - Pain Practice TI - Management of vertebral hemangiomas with kyphoplasty: A report of two cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70207258&from=export http://dx.doi.org/10.1111/j.1533-2500.2009.00267.x VL - 9 ID - 829719 ER - TY - JOUR AB - Spinal cord or nerve root compression from an epidural metastasis occurs in 5-10% of patients with cancer and in up to 40% of patients with preexisting nonspinal bone metastases. Most metastatic spine diseases arise from the vertebral column, with the posterior half of the vertebral body being the most common initial focus, and/or the paravertebral region, tracking along the spinal nerves to enter the spinal column via the intervertebral foramina. An 82-year-old man diagnosed with sigmoid colon cancer and liver metastases experienced intractable pain described as being like an electric shock on the right T11 dermatome. Imaging studies revealed a huge metastatic mass destroying the right posterior T11 body and pedicle and compressing the right posterior spinal cord and nerve roots. Even after using neuropathic medication and a neural blockade, the extreme paroxysmal pain continued. Considering his elderly, debilitated state and life expectancy, removal of the vertebral metastatic tumor compressing the spinal nerve roots via a single-port, transforaminal, endoscopic approach and percutaneous vertebroplasty (PVP) under monitored anesthetic care (MAC), rather than 3-port endoscopic surgery and corpectomy with or without fusion under general anesthesia with lung deflation, was decided upon and scheduled prior to radiotherapy. A needle was placed into the intervertebral foramen under fluoroscopy in the same manner as a transforaminal epidural block at T11. A guidewire was inserted into the needle after the needle stylet had been removed. An obturator dilator was inserted over the guidewire, and a working sleeve was inserted over the dilator. After the dilator was removed, a spinal endoscope with a 2.7 mm working channel was placed over the guidewire. Careful removal of the tumor emboli during verbal interaction with the patient was performed under MAC using dexmedetomidine, fentanyl, and ketorolac. PVP at T11 was performed through the right osteolytic pedicle. The paroxysmal pain disappeared immediately after the operation without any complications. Removal of a vertebral metastatic tumor compressing the spinal nerve roots via a single-port, transforaminal, endoscopic approach under monitored anesthesia care without lung deflation may be an effective and safe modality for minimally invasive pain management of a single-level spinal tumor metastasis causing intractable radicular pain in patients with cancer who have generalized debilitation. AD - Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University Korea. AN - 22828683 AU - Joo, Y. C. AU - Ok, W. K. AU - Baik, S. H. AU - Kim, H. J. AU - Kwon, O. S. AU - Kim, K. H. DA - Jul-Aug DP - NLM ET - 2012/07/26 J2 - Pain physician KW - Adenocarcinoma/complications/secondary/surgery Aged, 80 and over Colonic Neoplasms/pathology Deep Sedation/methods Endoscopy/instrumentation/*methods Epidural Neoplasms/complications/secondary/*surgery Fluoroscopy Humans Male Minimally Invasive Surgical Procedures/instrumentation/*methods Radiculopathy/etiology/*surgery Spinal Cord Compression/etiology/*surgery LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 1533-3159 SP - 297-302 ST - Removal of a vertebral metastatic tumor compressing the spinal nerve roots via a single-port, transforaminal, endoscopic approach under monitored anesthesia care T2 - Pain Physician TI - Removal of a vertebral metastatic tumor compressing the spinal nerve roots via a single-port, transforaminal, endoscopic approach under monitored anesthesia care VL - 15 ID - 829024 ER - TY - JOUR AB - Introduction: Percutaneous Vertebroplasty (PVP) is a procedure involving injection of polymethylomethylacrylate (PMMA) cement into a fractured vertebral body under imaging guidance. It aims at pain relief and prevention of bone deformity. Although the leakage of bone cement into surrounding tissue isn't uncommon, pulmonary embolism due to seeding of cement into venous circulation is and can have potential life threatening complications. Case Description: A 79 year old female was seen for evaluation of acute dyspnea. CT Chest done to evaluate pulmonary pathology was remarkable for a radio-opaque wire/catheter like structure present in the right lower lobe pulmonary artery. These findings were unchanged in comparison to previous exam. She was also noted to have diffuse osteopenia of the entire spine and moderate compression fracture at multiple levels, primarily at T10 with evidence of PVP. Sagital section was significant for cement leakage from the vertebral body into the azygous vein which acted as the portal of entry into the venous system. The post procedural course was uneventful with no pulmonary distress or cardiac complications as per patient and chart review. Case Discussion: Percutaneous vertebroplasty (PVP) is indicated in vertebral fracture for a neurologically intact patient with incapacitating pain who has failed conservative management. The supportive evidence of efficacy is limited but the complications are well known. Extravasation of cement is quite common and can occur in about half the cases. Paravertebral veins can be seeded and act as portal or entry into venous system. Pulmonary embolism from cement leakage is uncommon and is only seen in about 5% cases where inferior vena cava gets implicated. In our patient, azygous vein was involved due to its close proximity to the vertebral body. The vein usually terminates in superior vena cava and ultimately reaches pulmonary circulation. Presentation may vary from being completely asymptomatic to acute dyspnea. Massive cement burden can lead to cardio-pulmonary compromise and even death. Management varies on the extent of embolization and is usually conservative with therapeutic anticoagulation and pain control. Characteristic finding of pulmonary embolism secondary to cement should be recognized in patients with evidence of PVP. The contrast is radio-opaque and the embolization can be visualized on a CT chest. Though uncommon, this complication should be considered in advance in patient with low pulmonary reserve. [Image Presented]. AD - E.S. Josan, East Tennessee State University, Johnson City, TN, United States AU - Josan, E. S. AU - McCommons, M. DB - Embase DO - 10.1164/ajrccmconference.2017.C70 KW - bone cement adverse drug reaction aged anticoagulation azygos vein case report catheter complication compression fracture conservative treatment death distress syndrome dyspnea extravasation female heart human inferior cava vein lung circulation lung embolism medical record review osteopenia pain percutaneous vertebroplasty pulmonary artery side effect superior cava vein thorax treatment failure venous circulation vertebra body LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1535-4970 ST - Is that a wire in my lung-pulmonary embolism from bone cement T2 - American Journal of Respiratory and Critical Care Medicine TI - Is that a wire in my lung-pulmonary embolism from bone cement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L617704990&from=export http://dx.doi.org/10.1164/ajrccmconference.2017.C70 VL - 195 ID - 829279 ER - TY - JOUR AB - Aim: Radioembolization is a procedure in which embolization and radiation therapy is combined to treat hepatocellular carcinoma or hepatic metastases from colorectal cancer. In this procedure tiny glass or resin beads (microspheres) filled with the radioactive yttrium (Y-90) is placed inside the blood vessels that feed a tumor in the liver and thereby blocking the supply of blood to the cancer cells and delivers a high dose of radiation to the tumor. In this paper, regulatory requirements and radiation safety aspects are deliberated for a facility which intends to carryout Y-90 based radioembolization. Regulatory Requirements: A facility which intends to carry out Y-90 based radioembolization should have nuclear medicine (NM) and the cathlab facility Licensed by the regulatory body. Also, in the cathlab facility one room should be allocated for the storage and handling of the Y-90 radionuclide. The cathlab also required to have qualified radiation safety professional such as interventional radiologist, radiographer etc., as stipulated in the relevant safety code of AERB. Furthermore, the procedure should be carried out under the guidance of approved Radiological Safety Officer (RSO) of nuclear medicine and cathlab facility. Suitable dose calibrator and survey meter with valid calibration should be available with the facility. Also, the radiation workers associated should be provided with personnel monitoring TLD badges. When the radionuclide is transported in-house from the NM facility to Cathlab or vice versa, stipulated regulatory requirements should be followed. Radiation Safety Aspects: NM and cathlab facility should follow practices of time, distance, and shielding during the handling of radionuclide. All the required safety procedures should be adhered during administration of the radionuclide. Suitable safety accessories (lead apron, thyroid shield, leaded eyewear etc) and appropriate radiation shields such as acrylic should be used during the procedure. RSO should ensure that no pregnant staff is available in the cathlab during the procedure. Post procedure, radiation survey of all the staffs involved should be conducted to identify any possible radioactive contamination. Radioactive waste generated should be managed as per the stipulated regulatory requirements. Post-treatment surgical procedures should be done in consultation with the RSO of the facility. In case of patient death, procedures laid down by the regulatory body should be followed. AD - K.J. Joseph, Atomic Energy Regulatory Board, Mumbai, Maharashtra, India AU - Joseph, K. J. AU - Tandon, P. DB - Embase DO - 10.4103/0972-3919.271608 KW - glass microsphere poly(methyl methacrylate) resin yttrium 90 adult blood vessel calibration calibrator cancer patient cancer radiotherapy cancer surgery case report circulation clinical article colorectal cancer conference abstract consultation drug combination drug megadose drug safety female human interventional radiologist liver cell carcinoma liver metastasis metastasis nuclear medicine personnel radiation monitoring pharmacokinetics pregnancy radiation safety radiation shield radioactive contamination radioactive waste radioembolization radiographer radiotherapy safety procedure staff surgical technique worker LA - English M1 - 5 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 0974-0244 SP - S79 ST - Regulatory requirements and radiation safety aspects for Yttrium-90 based radioembolization during treatment of hepatocellular carcinoma T2 - Indian Journal of Nuclear Medicine TI - Regulatory requirements and radiation safety aspects for Yttrium-90 based radioembolization during treatment of hepatocellular carcinoma UR - https://www.embase.com/search/results?subaction=viewrecord&id=L630549639&from=export http://dx.doi.org/10.4103/0972-3919.271608 VL - 34 ID - 829105 ER - TY - JOUR AB - Background. Total hip arthroplasty (THA) can be associated with substantial peri‐operative blood loss which can negatively influence a patient's clinical outcome. Few haemostatic agents have been tested in THA. The aim of this study was to determine whether the use of a collagen/thrombin/ autologous platelet haemostatic agent would result in a significant decrease of blood transfusions for patients undergoing primary THA. Materials and methods. THA patients meeting inclusion/exclusion criteria (n=109) were enrolled in this prospective, double‐blind trial and randomised to a treatment arm (standard haemostatic methods plus haemostatic agent) or control arm (standard haemostatic methods only). The primary outcome was transfusion. Secondary outcome measures included peri‐operative narcotic usage and post‐operative haemoglobin levels, pain scores, function, and general health quality of life. Results. Transfusions were required by 5/60 (8.3%) patients in the treatment group and 7/49 (14.3%) in the control group (p=0.33). The mean number of units transfused was not significantly different between the treatment group (2.2+/‐1.3) and the control group (1.6+/‐0.5) (p=0.36). Haemoglobin values on post‐operative days 1, 2, and 3 were significantly higher in the treatment group (p=0.002, 0.04, and 0.02, respectively). Hip Disability and Osteoarthritis Outcome Score and Short Form‐12 scores were not different between the two groups. Discussion. In relatively healthy patients undergoing primary cementless THA there was no significant difference in number of transfusions or number of units transfused. It is unlikely that we will routinely use the investigated haemostatic agent to reduce blood loss in a healthy patient undergoing THA. The product may have some benefit in patients who refuse blood transfusions, have minimal ability to increase blood volume, are undergoing total joint revision, or have markedly low pre‐operative haemoglobin levels, but this needs to be demonstrated. AN - CN-01104746 AU - Joyce, D. M. AU - Klika, A. K. AU - Mutnal, A. AU - Krebs, V. AU - Molloy, R. AU - Knothe, U. AU - Barsoum, W. K. DO - 10.2450/2015.0291-14 KW - *hemostatic agent/dt [Drug Therapy] *operative blood loss/dt [Drug Therapy] *operative blood loss/pc [Prevention] Adolescent Adult Aged Aged, 80 and over Antibiotic agent/dt [Drug Therapy] Arthroplasty, Replacement, Hip Article Blood Transfusion, Autologous Blood transfusion Cementless prosthesis Collagen [*blood] Controlled study Deep vein thrombosis Double blind procedure Double‐Blind Method Enoxaparin/dt [Drug Therapy] Enoxaparin/sc [Subcutaneous Drug Administration] Female Hemoglobin blood level Hemoglobin/ec [Endogenous Compound] Hemostatics [*administration & dosage] Hip Disability and Osteoarthritis Outcome Score Human Humans Infection/dt [Drug Therapy] Lung embolism Major clinical study Male Middle Aged Morphine/dt [Drug Therapy] Outcome assessment Pain assessment Perioperative period Platelet Transfusion Postoperative pain/dt [Drug Therapy] Prospective Studies Prospective study Quality of life Randomized controlled trial Range of motion Short Form 12 Thrombin [*metabolism] Total hip prosthesis Venous thromboembolism/dt [Drug Therapy] Venous thromboembolism/pc [Prevention] Very elderly M1 - 3 M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2015 SP - 455‐463 ST - Prospective randomised evaluation of a collagen/thrombin and autologous platelet haemostatic agent during cementless total hip arthroplasty T2 - Trasfusione del sangue [Blood transfusion] TI - Prospective randomised evaluation of a collagen/thrombin and autologous platelet haemostatic agent during cementless total hip arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01104746/full VL - 13 ID - 830056 ER - TY - JOUR AB - Study Design.: Prospective study. Objective.: The aim of this study was to demonstrate the safe range of cement volume during percutaneous vertebroplasty. Summary of Background Data.: A few clinical reports have addressed the relationship between cement volume and clinical outcome. However, the weakness of these studies was that subjects included were not homogeneous. No study in the clinical setting has confirmed results from biomechanical and computational studies. Methods.: We examined 96 patients with single compression fractures who underwent percutaneous vertebroplasty and postoperative three-dimensional CT scan within a week between June 2006 and April 2009. The volume and fraction were measured by a CT volumetry program. Relationships between predictors and volumetric data, outcome, leakage, intraverterbal vacuum cleft (IVVC), and subsequent fracture were examined. Relationships between volumetric data and outcome, leakage, IVVC, and subsequent fracture were analyzed with stratification by the treated level. Receiver-operator characteristic (ROC) curves were plotted to acquire cut-off values of volumetric data. Results.: Seventy-three patients (76%) were female, and the mean age was 76.3 ± 8.4 years (range 53-97). The mean duration of follow-up was 11 months (range 6-21). Locations were as follows: T4-T10 9, T11-L1-L57, and L2-L4 30. Seventy-eight patients (81%) reported a favorable outcome. Fractured body volume (FBV) and the level treated were associated with fraction, which had an influence on outcome. The fraction of the favorable group was significantly higher. Cut-off values to acquire a favorable outcome were 11.64% (P = 0.026) on the T4-L4 level and 3.35 cm (P = 0.059), 11.65% (P = 0.059) on the T11-L1 level. Group with intradiscal leakage had a smaller volume than nonleakage group on the L2-L4 level (3.86 cm vs. 5.65 cm, P = 0.002). There were no relationships of volumetric data with epidural leakage and pulmonary embolism. The presence of IVVC increased volume on the T4-L4 and L2-L4 level (P < 0.03). Larger volume increased significantly the incidence of adjacent fracture on the L2-L4 level. The significant cut-off volume to avoid adjacent fracture was 4.90 cm on the ROC curve. Conclusion.: It is suggested that fraction is superior to volume for predicting outcome on the T11-L1 level and an amount of cement should be determined in terms of FBV and fraction according to the treated level. A lower fraction than required for the restoration of mechanical property was enough to obtain pain relief. Intradiscal leakage on the L2-L4 level may be inevitable to obtain appropriate mechanical properties in the case of severe endplate breakdown connected with the disc space. Smaller volume is needed to avoid an adjacent fracture on the L2-L4 level. Although we did not know the reason why there was a difference among the treated level groups, one thing that is certain is the fact that level-specific approaches may be necessary for good outcome in terms of volume, fraction and FBV. Copyright © 2011 Lippincott Williams & Wilkins. AD - K.-J. Kim, Department of Neurosurgery, Seoul National University Bundang Hospital, 300 Gumi-dong Bundang-gu Seongnam-si, Gyeonggi-do 463-707, South Korea AU - Jun Jin, Y. AU - Yoon, S. H. AU - Park, K. W. AU - Chung, S. K. AU - Kim, K. J. AU - Yeom, J. S. AU - Kim, H. J. DB - Embase Medline DO - 10.1097/BRS.0b013e3181fc914e KW - bone cement adult aged biomechanics clinical trial compression fracture computer assisted tomography cone beam computed tomography disease severity female follow up fragility fracture human intraverterbal vacuum cleft liquorrhea lung embolism major clinical study male nerve ending osteoporotic thoracolumbar body fracture outcome assessment patient safety percutaneous vertebroplasty postoperative complication predictive value priority journal prospective study receiver operating characteristic review spine fracture three-dimensional imaging volumetry LA - English M1 - 12 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 0362-2436 1528-1159 SP - E761-E772 ST - The volumetric analysis of cement in vertebroplasty: Relationship with clinical outcome and complications T2 - Spine TI - The volumetric analysis of cement in vertebroplasty: Relationship with clinical outcome and complications UR - https://www.embase.com/search/results?subaction=viewrecord&id=L51259693&from=export http://dx.doi.org/10.1097/BRS.0b013e3181fc914e VL - 36 ID - 829617 ER - TY - JOUR AB - Study Design: Prospective study. Objective: The aim of this study was to demonstrate the safe range of cement volume during percutaneous vertebroplasty. Summary Of Background Data: A few clinical reports have addressed the relationship between cement volume and clinical outcome. However, the weakness of these studies was that subjects included were not homogeneous. No study in the clinical setting has confirmed results from biomechanical and computational studies. Methods: We examined 96 patients with single compression fractures who underwent percutaneous vertebroplasty and postoperative three-dimensional CT scan within a week between June 2006 and April 2009. The volume and fraction were measured by a CT volumetry program. Relationships between predictors and volumetric data, outcome, leakage, intraverterbal vacuum cleft (IVVC), and subsequent fracture were examined. Relationships between volumetric data and outcome, leakage, IVVC, and subsequent fracture were analyzed with stratification by the treated level. Receiver-operator characteristic (ROC) curves were plotted to acquire cut-off values of volumetric data. Results: Seventy-three patients (76%) were female, and the mean age was 76.3 ± 8.4 years (range 53-97). The mean duration of follow-up was 11 months (range 6-21). Locations were as follows: T4-T10 9, T11-L1-L57, and L2-L4 30. Seventy-eight patients (81%) reported a favorable outcome. Fractured body volume (FBV) and the level treated were associated with fraction, which had an influence on outcome. The fraction of the favorable group was significantly higher. Cut-off values to acquire a favorable outcome were 11.64% (P = 0.026) on the T4-L4 level and 3.35 cm (P = 0.059), 11.65% (P = 0.059) on the T11-L1 level. Group with intradiscal leakage had a smaller volume than nonleakage group on the L2-L4 level (3.86 cm vs. 5.65 cm, P = 0.002). There were no relationships of volumetric data with epidural leakage and pulmonary embolism. The presence of IVVC increased volume on the T4-L4 and L2-L4 level (P < 0.03). Larger volume increased significantly the incidence of adjacent fracture on the L2-L4 level. The significant cut-off volume to avoid adjacent fracture was 4.90 cm on the ROC curve. Conclusion: It is suggested that fraction is superior to volume for predicting outcome on the T11-L1 level and an amount of cement should be determined in terms of FBV and fraction according to the treated level. A lower fraction than required for the restoration of mechanical property was enough to obtain pain relief. Intradiscal leakage on the L2-L4 level may be inevitable to obtain appropriate mechanical properties in the case of severe endplate breakdown connected with the disc space. Smaller volume is needed to avoid an adjacent fracture on the L2-L4 level. Although we did not know the reason why there was a difference among the treated level groups, one thing that is certain is the fact that level-specific approaches may be necessary for good outcome in terms of volume, fraction and FBV. AD - Department of Neurosurgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea From the Department of Neurosurgery, Inje University College of Medicine, Seoul Paik Hospital, Seoul, Korea t Department of Neurosurgery and t Department of Orthopedic Surgery, Seoul National University College of Medicine, Spine Center, Seoul National University Bundang Hospital, Seongnam, Korea. AN - 108190007. Language: English. Entry Date: 20120413. Revision Date: 20170411. Publication Type: journal article AU - Jun Jin, Y. AU - Yoon, S. H. AU - Park, K. W. AU - Chung, S. K. AU - Kim, K. J. AU - Yeom, J. S. AU - Kim, H. J. AU - Jin, Yong Jun AU - Yoon, Sang Hoon AU - Park, Kun-Woo AU - Chung, Sang Ki AU - Kim, Ki-Jeong AU - Yeom, Jin Sup AU - Kim, Hyun-Jib DB - cin20 DO - 10.1097/BRS.0b013e3181fc914e DP - EBSCOhost KW - Bone Cements -- Therapeutic Use Lumbar Vertebrae -- Radiography Postoperative Complications -- Radiography Spinal Fractures -- Radiography Thoracic Vertebrae -- Radiography Kyphoplasty -- Adverse Effects Aged Aged, 80 and Over Female Prospective Studies Fractures, Compression -- Radiography Fractures, Compression -- Surgery Human Lumbar Vertebrae -- Injuries Lumbar Vertebrae -- Surgery Male Middle Age Postoperative Complications -- Etiology Spinal Fractures -- Surgery Thoracic Vertebrae -- Injuries Thoracic Vertebrae -- Surgery Treatment Outcomes Kyphoplasty -- Methods M1 - 12 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2011 SN - 0362-2436 SP - E761-72 ST - The volumetric analysis of cement in vertebroplasty: relationship with clinical outcome and complications T2 - Spine (03622436) TI - The volumetric analysis of cement in vertebroplasty: relationship with clinical outcome and complications UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=108190007&site=ehost-live&scope=site VL - 36 ID - 830690 ER - TY - GEN AD - Torrance, USA ckakazu@hotmail.com. Torrance, USA. AU - Kakazu, C. AU - Lippmann, M. AU - Karnwal, A. CY - New York, New York DB - cin20 DO - 10.1093/bja/aeu433 DP - EBSCOhost J2 - BJA: The British Journal of Anaesthesia KW - Bone Cements -- Adverse Effects Central Venous Catheters Methylmethacrylates -- Adverse Effects Pulmonary Embolism -- Etiology Vertebroplasty -- Adverse Effects Female N1 - CINAHL (EbscoHost) literature search January 5, 2021 PB - Elsevier B.V. PY - 2015 SN - 0007-0912 SP - 168-169 ST - Hazards of bone cement: for patient and operating theatre personnel...Br J Anaesth. 2014 Apr;112(4):672-4 TI - Hazards of bone cement: for patient and operating theatre personnel...Br J Anaesth. 2014 Apr;112(4):672-4 UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=103863530&site=ehost-live&scope=site VL - 114 ID - 830623 ER - TY - JOUR AB - Bone cement implantation syndrome (BCIS) is a rare but potentially fatal intraoperative complication that occurs in patients undergoing cemented orthopedic surgeries. Lack of a robust definition of the syndrome due to rarity of the condition has probably contributed to under reporting of cases. We report a case of a 72-year-old woman hospitalized for an elective orthopedic procedure with a postoperative course complicated by BCIS requiring supportive care in the intensive care unit setting. AD - [Kalra, Ankur] UMDNJ Robert Wood Johnson Med Sch, Cooper Univ Hosp, Div Internal Med, Camden, NJ USA. [Sharma, Abhishek] Washington Univ, Sch Med, Div Cardiovasc, St Louis, MO 63110 USA. [Palaniswamy, Chandrasekar] New York Med Coll, Dept Med, Valhalla, NY 10595 USA. [Palaniswamy, Chandrasekar] Westchester Cty Med Ctr, Valhalla, NY 10595 USA. [El-Oshar, Seraj; Desai, Priyank; Yazbeck, Moussa; Zanotti-Cavazzoni, Sergio L.] UMDNJ Robert Wood Johnson Med Sch, Cooper Univ Hosp, Div Crit Care Med, Camden, NJ USA. Kalra, A (corresponding author), UMDNJ Robert Wood Johnson Med Sch, Cooper Univ Hosp, Div Internal Med, Camden, NJ USA. ceo@kalrahospital.com AN - WOS:000313410100019 AU - Kalra, A. AU - Sharma, A. AU - Palaniswamy, C. AU - El-Oshar, S. AU - Desai, P. AU - Yazbeck, M. AU - Zanotti-Cavazzoni, S. L. DA - Jan DO - 10.1097/MJT.0b013e31820b3de3 J2 - Am. J. Ther. KW - cement implant kyphoplasty complication compression fracture BCIS implantation syndrome TOTAL HIP-ARTHROPLASTY FAT-EMBOLISM CARDIAC-ARREST INTRAMEDULLARY PRESSURE CARDIOVASCULAR COLLAPSE PULMONARY-EMBOLISM MARROW EMBOLISM REPLACEMENT METHYLMETHACRYLATE LAVAGE Pharmacology & Pharmacy LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2013 SN - 1075-2765 SP - 121-125 ST - Diagnosis and Management of Bone Cement Implantation Syndrome: Case Report and Brief Review T2 - American Journal of Therapeutics TI - Diagnosis and Management of Bone Cement Implantation Syndrome: Case Report and Brief Review UR - ://WOS:000313410100019 VL - 20 ID - 830291 ER - TY - JOUR AB - The prognosis of pulmonary cement embolism found incidentally on chest radiography after vertebroplasty has been rarely investigated. This study was performed to elucidate the impact of incidentally found pulmonary cement embolism on all‐cause mortality. Patients with pulmonary cement embolism diagnosed using chest radiography between 2008 and 2014 at one tertiary referral hospital were included. Their mortality risk was compared to that of randomly selected, age‐, sex‐, and year‐matched patients without pulmonary cement embolism (ratio, 1:10) by using Kaplan–Meier estimates and covariate‐adjusted Cox proportional regression analysis. The study included 11 patients with pulmonary cement embolism and 110 patients without pulmonary cement embolism. The patients showed no significant intergroup differences in baseline characteristics, except comorbid heart failure. During a mean follow‐up duration of 1.7 ± 1.6 years, five patients (45.5%) with pulmonary cement embolism and 60 (50.0%) without pulmonary cement embolism died, mostly because of underlying malignancy. Although the patients with pulmonary cement embolism were not treated, they did not show a higher mortality risk than did those without pulmonary cement embolism (adjusted hazard ratio, 1.10; 95% confidence interval, 0.43–2.85). Subgroup analyses showed similar results. Incidentally found pulmonary cement embolism had no significant impact on all‐cause mortality. AN - CN-02085727 AU - Kang, H. R. AU - Kim, T. H. AU - Chung, C. K. AU - Lee, C. H. DO - 10.1007/s11239-019-02027-0 KW - *lung embolism *mortality risk *percutaneous vertebroplasty *prognosis Adult All cause mortality Article Cancer patient Complication Controlled study Female Follow up Heart failure Human Kaplan Meier method Major clinical study Male Malignant neoplasm Randomized controlled trial Risk assessment Tertiary care center Thorax radiography M3 - Journal: Article in Press N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2020 ST - The impact of incidental pulmonary cement embolism on mortality risk T2 - Journal of thrombosis and thrombolysis TI - The impact of incidental pulmonary cement embolism on mortality risk UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02085727/full ID - 830017 ER - TY - JOUR AB - RATIONALE: Pulmonary cement embolism (PCE) is caused by cement leakage after vertebroplasy. The prognosis of PCE has been rarely investigated. The aim of this study was to evaluate the impact of pulmonary cement embolism on all cause-mortality. METHODS: Patients of PCE documented on chest radiographs between 2005 and 2014 in Seoul National University Hospital were enrolled. They were compared with randomly selected age, sex, and the year of chest radiographs-matched (1:5) controls who underwent vertebroplasty but revealed no PCE. Survival data were analyzed with cox proportional hazard regression models. RESULTS: In total, 42 PCE cases and 210 controls were included. PCE group had fewer cases with hypertension and malignancy compared with controls. Over 9 years, 12 (29%) cases among PCE cases and 98 (46%) cases among controls died. Most common cause of death in both PCE group and control group was malignancy (58%, 89%). We did not find a significant increase in the risk of all-cause mortality in patients with PCE after adjustment for comorbidities. (HR, 0.58; 95% CI 0.29-1.14) CONCLUSION: PCE has no significant impact on all-cause mortality. AD - H.-R. Kang, SNUH, Seoul, South Korea AU - Kang, H. R. AU - Lee, C. H. DB - Embase DO - 10.1164/ajrccm-conference.2017.A69 KW - cement cause of death comorbidity control group controlled clinical trial controlled study embolism female human hypertension lung male malignant neoplasm mortality percutaneous vertebroplasty population based case control study prognosis randomized controlled trial South Korea statistical model thorax radiography university hospital LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1535-4970 ST - Prognosis of pulmonary cement embolism developed after percutaneous vertebroplasty T2 - American Journal of Respiratory and Critical Care Medicine TI - Prognosis of pulmonary cement embolism developed after percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L617707399&from=export http://dx.doi.org/10.1164/ajrccm-conference.2017.A69 VL - 195 ID - 829280 ER - TY - JOUR AB - INTRODUCTION: The choice between unipolar and bipolar hemiarthroplasty for treatment of displaced intracapsular femoral neck fractures in elderly patients still remains controversial. Our objective was to compare series of elderly individuals with a displaced femoral neck fracture treated with either a cemented, modular unipolar or bipolar prosthesis with the same femoral component. MATERIALS AND METHODS: A prospective, randomized controlled trial of 175 displaced intracapsular femoral neck fractures in patients over 65 years was randomly allocated to unipolar (88) and to bipolar (87) hemiarthroplasty group. The primary end point was implant survival. Secondary end points included difference in ambulatory ability and mortality. Follow‐up evaluations were performed at 2 months, at 1, 3 and 5 years. Implant and patient survival were followed until 2/2012. Survival analyses were performed using Kaplan‐Meier curves with log‐rank test. Data were analyzed using Chi‐square test and Student's t test. RESULTS: Unipolar hemiarthroplasty group had a significantly higher dislocation rate when compared with bipolar hemiarthroplasty group. This did not translate into difference in revision rates at 8 years. Prosthetic survival ship was 0.98 (95% Cl 0.94‐1.00) in the unipolar group and 0.97 (95% Cl 0.93‐1.00) in the bipolar group. There were no statistically significant differences in ambulatory ability, possibility to return home mortality or early radiological acetabular erosion. There were significantly more one‐time dislocations in the unipolar group, but there was no difference in incidence of revisions due to recurrent dislocations. The overall mortality rate was 6% at 30 days, 9% at 90 days, 16% at 12 months, and 53% at 5 years. There was no difference in mortality between the groups. CONCLUSIONS: Unipolar hemiarthroplasty group had a significantly higher dislocation rate when compared with bipolar hemiarthroplasty group. However, both provide elderly patients with equal ambulatory ability and low revision rate at medium‐term follow‐up. AN - CN-01002517 AU - Kanto, K. AU - Sihvonen, R. AU - Eskelinen, A. AU - Laitinen, M. DO - 10.1007/s00402-014-2053-1 KW - *arthroplasty *bipolar hemiarthroplasty *femur neck fracture/su [Surgery] *unipolar hemiarthroplasty Acetabulum fracture Aged Aged, 80 and over Arthroplasty, Replacement, Hip [instrumentation, *methods] Article Brain infarction/co [Complication] Controlled study Female Femoral Neck Fractures [*surgery] Femur trochanteric fracture Follow up Follow‐Up Studies Geriatric patient Heart infarction/co [Complication] Hemiarthroplasty [instrumentation, *methods] Hip Dislocation [epidemiology, etiology] Hip Prosthesis Human Humans Incidence Kaplan‐Meier Estimate Lung embolism/co [Complication] Major clinical study Male Outcome assessment Peroneus nerve paralysis/co [Complication] Pneumonia/co [Complication] Postoperative Complications [epidemiology] Priority journal Prospective Studies Prospective study Prosthesis Failure Randomized controlled trial Reoperation [statistics & numerical data] Surgical mortality Survival rate Treatment Outcome Very elderly M1 - 9 M3 - Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2014 SP - 1251‐1259 ST - Uni- and bipolar hemiarthroplasty with a modern cemented femoral component provides elderly patients with displaced femoral neck fractures with equal functional outcome and survivorship at medium-term follow-up T2 - Archives of orthopaedic and trauma surgery TI - Uni- and bipolar hemiarthroplasty with a modern cemented femoral component provides elderly patients with displaced femoral neck fractures with equal functional outcome and survivorship at medium-term follow-up UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01002517/full VL - 134 ID - 830094 ER - TY - JOUR AB - Study Design. A case of inferior vena cava syndrome following percutaneous vertebroplasty is described herein. Objective. To alert clinicians to the potential occurrence of inferior vena cava syndrome following percutaneous vertebroplasty. Summary of Background Data. Vertebroplasty is a less invasive treatment solution for the osteoporotic compression fracture. There complications of the cement leakage would appear to have been rather infrequent. We report a case of inferior vena cava syndrome related to the cement leakage. Methods. A 59-year-old woman underwent percutaneous vertebroplasty for painful T11, L1, L2, and L3 compression fractures, under general anesthesia at a community hospital. A contralateral transpedicular approach was made in order to inject polymethylmethacrylate resin into the fractured vertebra. Results. Just subsequent to surgery, this patient developed dyspnea, arthralgia, myalgia, and progressive right lower-limb pain, redness, and swelling., conservative treatment being then undertaken, albeit in vain. One week after the attempted remediation of this patient's condition, she was transferred to our hospital for further management. After admission, radiography of the patient's lumbar spine (lateral view) revealed multiple cement leakage in the area of the posterior longitudinal ligament and also in the anterior paravertebral area. The abdominal and pelvic CT scan and venography revealed vertebroplasty cement leakage into the lumbar vein, the left renal vein, and the inferior vena cava. Thrombosis at the left common iliac vein and left femoral vein were noted with extension into the inferior part of the inferior vena cava. Intravenous heparin was then administered to our patient for the ensuing 20 days, at which time heparin was replaced by warfarin, in order to attempt to prevent progressive venous thrombosis. The patient's leg edema appeared to improve 10 weeks subsequent to her surgery, she then being able to perambulate using a rigid walker. Conclusion. This case illustrates the need for clinicians to be critically aware of the potential occurrence of inferior vena cava syndrome among patients who have undergone percutaneous vertebroplasty, especially when multiple levels of vertebra are injected as part of the vertebroplasty procedure. AD - [Kao, Feng-Chen; Chou, Ming-Chih] Chung Shan Med Univ, Dept Surg, Sch Med, Inst Med, Taichung, Taiwan. [Kao, Feng-Chen; Tu, Yuan-Kun; Yu, Shang-Won; Yen, Cheng-Yo] I Shou Univ, Dept Orthopaed, E Dal Hosp, Kaohsiung, Taiwan. [Lai, Po-Liang] Chang Gung Mem Hosp, Dept Orthopaed Surg, Tao Yuan, Taiwan. Chou, MC (corresponding author), Chung Shan Med Univ, Dept Surg, Sch Med, Inst Med, Taichung, Taiwan. harriet.fann@msa.hinet.net AN - WOS:000255523300028 AU - Kao, F. C. AU - Tu, Y. K. AU - Lai, P. L. AU - Yu, S. W. AU - Yen, C. Y. AU - Chou, M. C. DA - May DO - 10.1097/BRS.0b013e31816f6a10 J2 - Spine KW - polymethylmethacrylate cement inferior vena cava syndrome vertebroplasty PULMONARY-EMBOLISM MANAGEMENT CEMENT KYPHOPLASTY COMPLICATIONS HYPOTENSION Clinical Neurology Orthopedics LA - English M1 - 10 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2008 SN - 0362-2436 SP - E329-E333 ST - Inferior vena cava syndrome following percutaneous vertebroplasty with polymethylmethacrylate T2 - Spine TI - Inferior vena cava syndrome following percutaneous vertebroplasty with polymethylmethacrylate UR - ://WOS:000255523300028 VL - 33 ID - 830381 ER - TY - JOUR AB - Background Several cementing techniques are used for the proximal femur. Material and methods We evaluated 3 femoral cement pressurization techniques (standard, pressurizer in situ, and thumb pressurization) in 12 plastic femurs, with 4 sets of observations for each technique. Intramedullary pressure readings were obtained using proximal and distal pressure monitoring transducers. The peak pressure and the length of time for which the pressure was above a particular cutoff level (5 KPa and 100 KPa) were compared for the different techniques. Results We found significant differences between the 3 cementing techniques in the peak pressure and the length of time for which the pressure was above 100 KPa. The pressurizer in situ technique gave higher peak pressure (p < 0.001), both proximally (398) and distally (597). The standard technique produced a pressure of 100 KPa for a longer duration, both proximally and distally (mean 67 sec and 45 sec, p < 0.001) compared to the other two techniques (less than 5 and 17 sec for the thumb pressurization technique and the pressurizer in situ technique, respectively, both proximally and distally). Although the pressurizer in situ technique produced the highest peak pressure, the standard technique produced an optimum pressure of longer duration. Interpretation The standard technique appears to be adequate for achievement of optimum pressurization during femoral cementing without increased risk of embolization. AN - 106083885. Language: English. Entry Date: 20081219. Revision Date: 20150711. Publication Type: Journal Article. Journal Subset: Allied Health AU - Kapoor, B. AU - Datir, S. P. AU - Davis, B. AU - Wynn-Jones, C. H. AU - Maffulli, N. DB - cin20 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Methods Cementation -- Methods Femur -- Surgery Bone Cements Models, Biological Pressure M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2004 SN - 0001-6470 SP - 708-712 ST - Femoral cement pressurization in hip arthroplasty A laboratory comparison of three techniques T2 - Acta Orthopaedica Scandinavica TI - Femoral cement pressurization in hip arthroplasty A laboratory comparison of three techniques UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106083885&site=ehost-live&scope=site VL - 75 ID - 830783 ER - TY - JOUR AB - T55 patients with cement-augmented pedicle screw were retrospectively analyzed. All patients underwent computed tomography at a minimum of 2 years after index operation. Computed tomography scans were analyzed to determine pedicle screw loosening, cement leakage, and fusion rates at augmented levels. The purpose of this study was to analyze the efficacy and complications of cement augmentation in elderly patients. Screw loosening occurred at fused levels in all patients, except one patient with pseudoarthrosis. All cases of screw loosening occurred at levels without interbody fusion. Extravasation of cement was performed in 7 (12.7%) patients and three (5.4%) patients had asymptomatic pulmonary cement emboli. Three (5.4%) patients had deep wound infection, and they were treated successfully with debridement and antibiotic therapy without need for instrument removal. Cement augmentation of PSs in elderly osteoporotic patients prevents screw pull-out. However, a very low rate of screw loosening may be seen at the levels without interbody fusion. AN - 31315017 AU - Karaca, S. AU - Enercan, M. AU - Levent Ulusoy, O. AU - Hamaoglu, A. DA - Jun DP - NLM ET - 2019/07/18 J2 - Acta orthopaedica Belgica KW - Aged Aged, 80 and over Bone Cements/*therapeutic use Female Follow-Up Studies Humans Lumbar Vertebrae/diagnostic imaging/*surgery Male Middle Aged *Pedicle Screws Spinal Fractures/diagnostic imaging/*surgery Spinal Fusion/methods Tomography, X-Ray Computed LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 0001-6462 (Print) 0001-6462 SP - 247-252 ST - Radiologic and clinical outcome of the cement augmented pedicle screws after a minimum 2-year follow-up T2 - Acta Orthop Belg TI - Radiologic and clinical outcome of the cement augmented pedicle screws after a minimum 2-year follow-up VL - 85 ID - 828557 ER - TY - JOUR AB - T55 patients with cement-augmented pedicle screw were retrospectively analyzed. All patients underwent computed tomography at a minimum of 2 years after index operation. Computed tomography scans were analyzed to determine pedicle screw loosening, cement leakage, and fusion rates at augmented levels. The purpose of this study was to analyze the efficacy and complications of cement augmentation in elderly patients. Screw loosening occurred at fused levels in all patients, except one patient with pseudoarthrosis. All cases of screw loosening occurred at levels without interbody fusion. Extravasation of cement was performed in 7 (12.7%) patients and three (5.4%) patients had asymptomatic pulmonary cement emboli. Three (5.4%) patients had deep wound infection, and they were treated successfully with debridement and antibiotic therapy without need for instrument removal. Cement augmentation of PSs in elderly osteoporotic patients prevents screw pull-out. However, a very low rate of screw loosening may be seen at the levels without interbody fusion. AD - [Karaca, Sinan; Enercan, Meric; Ulusoy, Onur Levent; Hamaoglu, Azmi] Fatih Sultan Alehmet Training & Res Hosp, Istanbul, Turkey. [Karaca, Sinan] Fatih Sultan Mehmet Training & Res Hosp Atasehir, Dept Orthopaed Surg, Istanbul, Turkey. [Enercan, Meric; Hamaoglu, Azmi] Istanbul Florence Nightingale Hosp, Istanbul Spine Ctr, TR-34387 Istanbul, Turkey. [Ulusoy, Onur Levent] Istanbul Florence Nightingale Hosp, Dept Radiol, TR-34387 Istanbul, Turkey. Karaca, S (corresponding author), Fatih Sultan Mehmet Training & Res Hosp Atasehir, Dept Orthopaed Surg, Istanbul, Turkey. mdsnn@hotmail.com; enercan@yahoo.com; leventsoy@yahoo.com; istanbulspinecenter@gmail.com AN - WOS:000482220900014 AU - Karaca, S. AU - Enercan, M. AU - Ulusoy, O. L. AU - Hamaoglu, A. DA - Jun J2 - Acta Orthop. Belg. KW - pedicle screws osteoporotic patients elderly cement augmentation mechanical failure osteoporosis screw loosening interbody fusion elderly osteoporotic patients screw pull out PERCUTANEOUS VERTEBROPLASTY COMPRESSION FRACTURES PULLOUT STRENGTH BONE-CEMENT FIXATION POLYMETHYLMETHACRYLATE METHACRYLATE EMBOLISM SPINE Orthopedics LA - English M1 - 2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 0001-6462 SP - 247-252 ST - Radiologic and clinical outcome of the cement augmented pedicle screws after a minimum 2-year follow-up T2 - Acta Orthopaedica Belgica TI - Radiologic and clinical outcome of the cement augmented pedicle screws after a minimum 2-year follow-up UR - ://WOS:000482220900014 VL - 85 ID - 830138 ER - TY - JOUR AB - Purpose: Fat-embolism (FE) is a rare but severe complication involving the long tubular bones, presented during the second posttraumatic or post-operative day. The main characteristics are pulmonary distress, mental status disturbances and petechiae. The purpose is to present our case of fat embolism and the final outcome. Materials and methods: A female patient, aged 72, was admitted in our hospital after a low energy fall. The examination revealed a Garden IV subcapital hip fracture. A cemented hemiarthroplasty was performed in less than 24 h after the appropriate preoperative control. Results: The operation finished uncomplicated, but later the same day, the patient became hyper-febrile with signs of confusion. During the first post-operative day she deteriorated further and a full investigation was performed. The improvement started the following day and petechiae were developed. She was able to follow the post-operative mobilization protocol and was discharged on the 12th post-operative day. Discussion: We present a full documented case of FE with all the triad characteristics, which recovered rapidly and fully. We consider FE a severe complication and due to the mortality rate, all the orthopaedic surgeons must be aware of the early signs. © 2007 Springer-Verlag. AD - E.J. Karadimas, 10th Tim. Bassou, 11521 Athens, Greece AU - Karadimas, E. J. AU - Kapotas, J. B. AU - Pachantouris, E. G. AU - Karadimas, J. E. DB - Embase DO - 10.1007/s00590-007-0275-4 KW - aged arthroplasty article case report cementation fat embolism female fever hip fracture human mobilization petechia postoperative complication postoperative period preoperative period priority journal LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2008 SN - 1633-8065 1432-1068 SP - 147-151 ST - Fat embolism following a cemented hemiarthroplasty T2 - European Journal of Orthopaedic Surgery and Traumatology TI - Fat embolism following a cemented hemiarthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L351248682&from=export http://dx.doi.org/10.1007/s00590-007-0275-4 VL - 18 ID - 829750 ER - TY - JOUR AB - T he indication area of percutaneous vertebroplasty, which was first applied successfully for the management of aggressive vertebral hemangioma in 1987 in France, has grown in the years. One of these indications is osteoporotic vertebral compression fractures. Osteoporosis, common amongst elderly patients causes significant compression fractures. Most of the fractures that do not cause pressure on the spinal canal are successfully treated with percutaneous vertebroplasty. However most authors, claiming that in cases of severe vertebral compression fracture ( vertebra plana) associated with osteoporosis, cement leakage developing due to technical difficulties may cause dangerous complications such as emboli, death and disability, asserted that the application of percutaneous vertebroplasty is contraindicated. This study, presenting successful percutaneous vertebroplasty in two patients with the vertebra plana type compression fracture associated with osteoporosis, underlines that as long as it is performed meticulously, the complication risk in percutaneous vertebroplasty is very low. AD - [Karaman, Haktan; Taze, Hatice Aslanhan; Kavak, Gonul Olmez] Dicle Univ, Tip Fak, Anesteziyol Anabilim Dali, Diyarbakir, Turkey. [Akay, Hatice Ozturkmen] Ozel Veni Vidi Hastanesi Raydodiyagnostik, Diyarbakir, Turkey. [Kaya, Sedat] Ozel Veni Vidi Hastanesi Anesteziyol, Diyarbakir, Turkey. [Balkan, Bedih] Mehmer Akif Ersoy Egitim & Arastirma Hastanesi, Istanbul, Turkey. Karaman, H (corresponding author), Dicle Univ, Tip Fak, Anesteziyol Anabilim Dali, Diyarbakir, Turkey. haktan@dicle.edu.tr AN - WOS:000296697200015 AU - Karaman, H. AU - Akay, H. O. AU - Taze, H. A. AU - Kaya, S. AU - Kavak, G. O. AU - Balkan, B. J2 - Turk. J. Geriatr. KW - Aged Vertebroplasty Osteoporosis Vertebral Compression Fracture CEMENT WOMEN Geriatrics & Gerontology Gerontology LA - Turkish M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2011 SN - 1304-2947 SP - 269-272 ST - OUR APPLICATIONS OF PERCUTANEOUS VERTEBROPLASTY IN VERTEBRA PLANA TYPE COMPRESSION FRACTURES ASSOCIATED WITH OSTEOPOROSIS T2 - Turkish Journal of Geriatrics-Turk Geriatri Dergisi TI - OUR APPLICATIONS OF PERCUTANEOUS VERTEBROPLASTY IN VERTEBRA PLANA TYPE COMPRESSION FRACTURES ASSOCIATED WITH OSTEOPOROSIS UR - ://WOS:000296697200015 VL - 14 ID - 830331 ER - TY - JOUR AB - The indication area of percutaneous vertebroplasty, which was first applied successfully for the management of aggressive vertebral hemangioma in 1987 in France, has grown in the years. One of these indications is osteoporotic vertebral compression fractures. Osteoporosis, common amongst elderly patients causes significant compression fractures. Most of the fractures that do not cause pressure on the spinal canal are successfully treated with percutaneous vertebroplasty. However most authors, claiming that in cases of severe vertebral compression fracture (vertebra plana) associated with osteoporosis, cement leakage developing due to technical difficulties may cause dangerous complications such as emboli, death and disability, asserted that the application of percutaneous vertebroplasty is contraindicated. This study, presenting successful ercutaneous vertebroplasty in two patients with the vertebra plana type compression fracture associated with osteoporosis, underlines that as long as it is performed meticulously, the complication risk in percutaneous vertebroplasty is very low. AD - H. Karaman, Dicle Üniversitesi, Tip Fakültesi, Anesteziyoloji Anabilim, Turkey AU - Karaman, H. AU - Öztürkmen Akay, H. AU - Aslanhan Taze, H. A. AU - Kaya, S. AU - Ölmez Kavak, G. AU - Balkan, B. DB - Embase KW - article case report compression fracture disease association fragility fracture human osteoporosis percutaneous vertebroplasty postoperative complication Scheuermann disease L1 - http://geriatri.dergisi.org/pdf/pdf_TJG_595.pdf LA - English Turkish M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 1304-2947 1307-9948 SP - 269-272 ST - Our applications of percutaneous vertebroplasty in vertebra plana type compression fractures associated with osteoporosis T2 - Turk Geriatri Dergisi TI - Our applications of percutaneous vertebroplasty in vertebra plana type compression fractures associated with osteoporosis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L362576732&from=export VL - 14 ID - 829610 ER - TY - JOUR AB - During the last decade, two new treatment modalities for osteoporotic vertebral fractures have gained more interest: percutaneous vertebroplasty and kyphoplasty. The techniques and the short-term clinical results and complications have been presented but there is no scientific evidence-based information regarding the efficacy of the procedures, such as randomized controlled trials (RCT). Instead, we have to rely on prospective and retrospective uncontrolled short-term observational studies and case-control studies. These studies have shown consistently that the short-term results after the procedures are favorable as regards both pain relief and functional status. It is currently unknown, however, whether a vertebroplasty or a kyphoplasty gives a better outcome than nonoperative treatment, and whether the long-term results are as favorable as the short-term results. AD - Lund Univ, Malmo Univ Hosp, Dept Orthopaed, Dept Clin Sci,Clin & Mol Osteoporoses Res Unit, SE-20502 Malmo, Sweden. Karlsson, MK (corresponding author), Lund Univ, Malmo Univ Hosp, Dept Orthopaed, Dept Clin Sci,Clin & Mol Osteoporoses Res Unit, SE-20502 Malmo, Sweden. magnus.karlsson@med.lu.se AN - WOS:000233084500004 AU - Karlsson, M. K. AU - Hasserius, R. AU - Gerdhem, P. AU - Obrant, K. J. AU - Ohlin, A. DA - Oct DO - 10.1080/17453670510041682 J2 - Acta Orthop. KW - VERTEBRAL COMPRESSION FRACTURES PERCUTANEOUS VERTEBROPLASTY BALLOON KYPHOPLASTY CEMENT VOLUME BODY HEIGHT PAIN RELIEF RISK PREVALENCE EMBOLISM BIOMECHANICS Orthopedics LA - English M1 - 5 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2005 SN - 1745-3674 SP - 620-627 ST - Vertebroplasty and kyphoplasty - New treatment strategies for fractures in the osteoporotic spine T2 - Acta Orthopaedica TI - Vertebroplasty and kyphoplasty - New treatment strategies for fractures in the osteoporotic spine UR - ://WOS:000233084500004 VL - 76 ID - 830423 ER - TY - JOUR AB - The advent of the use of kyphoplasty in 1998 was the result of the expected evolution of materials and methods related to the successful introduction of vertebroplasty as a valid treatment of painful vertebral compression fractures. Kyphoplasty introduced a method of creating bilateral bone voids and in many cases elevation (reduction) of depressed end plates with variable degrees of height restoration. This was achieved by using bilateral balloon bone tamps capable of pressures significantly higher than conventional angioplasty balloons. This allows creation of bilateral bone voids, resulting in the ability to apply a much thicker cement mixture. This is felt to be the reason for fewer cement-related complications compared with vertebroplasty including extravasation and embolization. Although the procedural cost presently is higher for kyphoplasty, this is expected to decrease as patents expire and industry competition increases. Kyphoplasty indications include all those of vertebroplasty plus additional ones either contraindicated or not recommended for treatment with vertebroplasty. Kyphoplasty achieves the same degree of pain relief as vertebroplasty but may offer additional benefits of fewer complications, more indications, better biopsy specimens, and potential for height restoration of compression fractures of the spine. Further studies regarding potential benefits are warranted to assess any added value of kyphoplasty compared with vertebroplasty. AD - Division of Interventional Radiology, Mayo Hospital, Phoenix, Arizona. AN - 21629406 AU - Kasper, D. M. C2 - Pmc3036523 DA - Jun DO - 10.1055/s-0030-1253515 DP - NLM ET - 2011/06/02 J2 - Seminars in interventional radiology KW - Kyphoplasty osteoporosis pathological fractures vertebral augmentation vertebral compression fractures vertebroplasty LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 0739-9529 (Print) 0739-9529 SP - 172-84 ST - Kyphoplasty T2 - Semin Intervent Radiol TI - Kyphoplasty VL - 27 ID - 828632 ER - TY - JOUR AB - The best currently available evidence based treatment reduces vertebral fracture risk but does not totally prevent osteoporotic and malignant follow-up fractures. Kyphoplasty and vertebroplasty are options of a causal treatment to reduce pain by internal stabilization of fractured vertebrae. The indication for these minimal invasive procedures requires an interdisciplinary discussion of the individual case to guarantee technical feasibility, to increase the likelihood that these procedures will indeed reduce pain and to embed these procedures into the long term therapeutic concept of every single patient. In addition to internal stabilization of a painfully fractured vertebra kyphoplasty also seeks to restore lost vertebral height which appears promising in acute vertebral fractures. Due to the procedure there are more cement leakages after vertebroplasty. Available controlled prospective studies demonstrate only for kyphoplasty a long-term benefit for the patient in terms of pain reduction, increased mobility and improved quality of life. AD - [Kasperk, C.; Grafe, I.] Heidelberg Univ, Med Univ Klin, Abt Innere Med & Klin Chem 1, Sekt Osteol, D-69120 Heidelberg, Germany. [Noeldge, G.] Univ Klinikum, Abt Diagnost & Intervent Radiol, Heidelberg, Germany. [Meeder, P.; Huber, F.] Chirurg Univ Klin, Sekt Unfall & Wiederherstellungschirurg, Heidelberg, Germany. Kasperk, C (corresponding author), Heidelberg Univ, Med Univ Klin, Abt Innere Med & Klin Chem 1, Sekt Osteol, Neuenheimer Feld 410, D-69120 Heidelberg, Germany. Christian.Kasperk@med.uni-heidelberg.de AN - WOS:000259562700007 AU - Kasperk, C. AU - Noldge, G. AU - Grafe, I. AU - Meeder, P. AU - Huber, F. AU - Nawroth, P. DA - Oct DO - 10.1007/s00108-008-2116-x J2 - Internist KW - kyphoplasty vertebroplasty vertebral fracture back pain osteoporosis VERTEBRAL COMPRESSION FRACTURES BONE-MINERAL DENSITY PERCUTANEOUS VERTEBROPLASTY NONVERTEBRAL FRACTURES RISEDRONATE TREATMENT BALLOON KYPHOPLASTY PULMONARY-EMBOLISM HEIGHT RESTORATION CALCIUM-PHOSPHATE BACK-PAIN Medicine, General & Internal LA - German M1 - 10 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2008 SN - 0020-9554 SP - 1206-+ ST - Indications and results of kypho- and vertebroplasty T2 - Internist TI - Indications and results of kypho- and vertebroplasty UR - ://WOS:000259562700007 VL - 49 ID - 830372 ER - TY - JOUR AB - Painful osteoporotic and malignant vertebral fractures are frequent causes of chronic back pain with negative consequences regarding immobility, quality of life, morbidity, mortality, and fracture incidence. The best currently available evidence-based treatment reduces vertebral fracture risk but does not totally prevent follow-up fractures. Kyphoplasty is a causal treatment of pain by internal stabilization that prevents the ongoing pain of constant vertebral (micro-)fracture. The indication for this minimally invasive procedure requires interdisciplinary discussion of the individual case to guarantee technical feasibility, increase the likelihood that kyphoplasty will indeed reduce pain, and embed this procedure in the individual patient's long-term therapeutic concept or treatment of painful vertebral metastases. In addition to internal stabilization of painful vertebral fractures, kyphoplasty seeks to restore lost vertebral height, which appears promising in acute and painful vertebral fractures. Available controlled prospective studies demonstrate long-term patient benefits in terms of pain reduction, mobility, and improved quality of life. AD - [Kasperk, C.] Univ Heidelberg, Med Univ Klin Heidelberg, Innere Med Abt 1, Sekt Osteol, D-69120 Heidelberg, Germany. [Kasperk, C.; Nawroth, P.] Univ Heidelberg, Med Univ Klin Heidelberg, Klin Chem, D-69120 Heidelberg, Germany. [Meeder, P.; Huber, F. X.] Univ Heidelberg, Chirurg Univ Klin Heidelberg, Sekt Unfall & Wiederherstellungschirurg, D-69120 Heidelberg, Germany. [Noeldge, G.] Univ Klinikum Heidelberg, Abt Diagnost & Intervent Radiol, Heidelberg, Germany. Kasperk, C (corresponding author), Univ Heidelberg, Med Univ Klin Heidelberg, Innere Med Abt 1, Sekt Osteol, Neuenheimer Feld 410, D-69120 Heidelberg, Germany. Christian.Kasperk@med.uni-heidelberg.de AN - WOS:000260006200006 AU - Kasperk, C. AU - Noldge, G. AU - Meeder, P. AU - Nawroth, P. AU - Huber, F. X. DA - Oct DO - 10.1007/s00104-008-1520-z J2 - Chirurg KW - Kyphoplasty Vertebral fracture Back pain Osteoporosis Metastases EUROPEAN PROSPECTIVE OSTEOPOROSIS PROSPECTIVE CONTROLLED-TRIAL LOW-BACK-PAIN COMPRESSION FRACTURES PERCUTANEOUS VERTEBROPLASTY POSTMENOPAUSAL OSTEOPOROSIS BALLOON KYPHOPLASTY PULMONARY-EMBOLISM HEIGHT RESTORATION CALCIUM-PHOSPHATE Surgery LA - English M1 - 10 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2008 SN - 0009-4722 SP - 944-+ ST - Kyphoplasty Method for minimally invasive treatment of painful vertebral fractures T2 - Chirurg TI - Kyphoplasty Method for minimally invasive treatment of painful vertebral fractures UR - ://WOS:000260006200006 VL - 79 ID - 830371 ER - TY - JOUR AD - Department of Internal Medicine, Wayne State University, Detroit, MI, United States. Department of Cardiology, St. Joseph Mercy Oakland, Pontiac, MI, United States. Electronic address: younasf@trinity-health.org. AN - 23791716 AU - Kaur, R. AU - Younas, F. AU - Rajput, F. A. AU - Kumar, S. AU - Afonso, L. DA - Feb DO - 10.1016/j.hlc.2013.05.646 DP - NLM ET - 2013/06/25 J2 - Heart, lung & circulation KW - Female Humans Middle Aged Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/*chemically induced/*diagnostic imaging/drug therapy Radiography LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1443-9506 SP - e69-70 ST - Polymethyl methacrylate induced pulmonary embolism T2 - Heart Lung Circ TI - Polymethyl methacrylate induced pulmonary embolism VL - 23 ID - 828843 ER - TY - JOUR AB - BACKGROUND CONTEXT: Epithelioid hemangioendothelioma rarely occurs in the lumbosacral spine, with very few case reports of spinal hemangioendothelioma in the literature. There is variability in aggressiveness of these lesions without established treatment guidelines. PURPOSE: The aim was to present a case of epithelioid hemangioendothelioma in the lumbar spine, including magnetic resonance imaging (MRI) findings, which rapidly progressed over a 2-month period as regional multifocal lumbosacral spinal lesions with epidural extension causing severe spinal canal stenosis. STUDY DESIGN/SETTING: This was a case report in a university hospital setting. PATIENT SAMPLE: The sample included an otherwise healthy adult male with low back pain. METHODS: Multimodality imaging was performed to help with diagnosis and management including computed tomography, MRI, and positron emission tomography (PET). The patient was treated by embolization, L5 corpectomy and L4-S1 stabilization, and radiation therapy. The diagnosis was confirmed by tissue biopsy. RESULTS: The patient initially presented with severe back and leg pain after a vertebroplasty for an L5 compression fracture at an outside hospital where biopsy was negative for malignancy. Magnetic resonance imaging showed diffuse abnormality of L5 with several smaller lesions in the sacrum. Due to progressive pain 2 weeks after the vertebroplasty, the patient underwent an L5 laminectomy, L4-S1 instrumented posterior fusion, and attempted partial corpectomy for stenosis. At this surgery, the L5 corpectomy was aborted owing to profound bleeding. Pathology was again negative for malignancy. Presumed to be an atypical hemangioma, the lesion was embolized before repeat surgery where the thecal sac was decompressed by partial L5 corpectomy. Biopsy at this time revealed a vascular neoplasm, with hemangioendothelioma not excluded. Approximately 2 months after the stabilization procedure, the patient had increasing pain and bilateral lower extremity weakness. Magnetic resonance imaging was performed and demonstrated marked local progression of disease with new multifocal lesions involving L4 through S2 vertebrae and new severe spinal canal stenosis. These lesions were subsequently treated with localized radiation therapy. Magnetic resonance imaging 2 months after radiation therapy showed significant regression of the epidural tumor although a new metastatic lesion was discovered at T6 vertebra. CONCLUSIONS: Spinal hemangioendothelioma is a rare disease and can present in variable forms, including as a multifocal regional process--which may be mistaken for infection. Additionally, there are no standard treatment protocols for this entity. We present the extensive imaging and treatment of a single case of rapidly progressive lumbar epithelioid hemangioendothelioma, which to our knowledge has not been described with this multifocal appearance in the lumbar spine. AD - Department of Radiology, Medstar Georgetown University Hospital, 3800 Reservoir Rd NW, CG201, Washington, DC 20007, USA. Electronic address: Linda.c.kelahan@gunet.georgetown.edu. Department of Neurosurgery, Medstar Georgetown University Hospital, 3800 Reservoir Rd NW, 7PHC, Washington, DC 20007, USA. Department of Radiology, Medstar Georgetown University Hospital, 3800 Reservoir Rd NW, CG201, Washington, DC 20007, USA. AN - 26165479 AU - Kelahan, L. C. AU - Sandhu, F. A. AU - Sayah, A. DA - Nov 1 DO - 10.1016/j.spinee.2015.07.005 DP - NLM ET - 2015/07/15 J2 - The spine journal : official journal of the North American Spine Society KW - Adult Hemangioendothelioma/*diagnosis/radiotherapy/surgery Humans Laminectomy Lumbosacral Region/surgery Magnetic Resonance Imaging Male Multimodal Imaging Spinal Neoplasms/*diagnosis/radiotherapy/surgery Tomography, X-Ray Computed Bone neoplasm Epithelioid Hemangioendothelioma Imaging Radiation Spine Surgery Vascular Vascular tumor LA - eng M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 1529-9430 SP - e49-56 ST - Multifocal hemangioendothelioma of the lumbar spine and response to surgical resection and radiation T2 - Spine J TI - Multifocal hemangioendothelioma of the lumbar spine and response to surgical resection and radiation VL - 15 ID - 828757 ER - TY - JOUR AB - The strength of pedicle screws attachment to the vertebrae is an important factor affecting their motion resistance and long term performance. Low bone quality, e.g. in osteopenic patients, keeps the screw bone interface at risk for subsidence and dislocation. In such cases, bone cement could be used to augment pedicle screw fixation. But its use is not free of risk. Therefore, clinicians, especially spine surgeons, radiologists, and internists should become increasingly aware of cement migration and embolism as possible complications. Here, we present an instructive case of cement embolism into the venous system after augmented screw fixation with fortunately asymptomatic clinical course. In addition we discuss pathophysiology and prevention methods as well as therapeutic management of this potentially life-threatening complication in a comprehensive review of the literature. However, only a few case reports of cement embolism into the venous system were published after augmented screw fixation. AD - Department of Neurosurgery, Klinikum Nuernberg , Germany. AN - 24191184 AU - Kerry, G. AU - Ruedinger, C. AU - Steiner, H. H. C2 - Pmc3808799 DO - 10.4081/or.2013.e24 DP - NLM ET - 2013/11/06 J2 - Orthopedic reviews KW - cement embolism osteoporosis pedicle screw augmentation polymethylmethacrylate spinal fracture LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 2035-8237 (Print) 2035-8164 SP - e24 ST - Cement embolism into the venous system after pedicle screw fixation: case report, literature review, and prevention tips T2 - Orthop Rev (Pavia) TI - Cement embolism into the venous system after pedicle screw fixation: case report, literature review, and prevention tips VL - 5 ID - 828711 ER - TY - JOUR AB - Over the last few years bone resin based vertebral augmentation in the form of vertebro- and kyphoplasty has proved to be a safe therapeutic option in cases of vertebral compression fractures. Nevertheless, rare systemic complications have been seen, i.e., pulmonary embolisms ranging from harmless to lethal.The presence of an anesthesiologist can be especially useful in cases of systemic complications. Whether the form of anesthesia has any influence on the outcome of vertebro- or kyphoplasty is currently unknown. Local anesthesia supplemented by analgosedation is often used as an alternative to general anesthesia. The rationale for one or the other form of anesthesia can be factors like type of augmentation (vertebro- or kyphoplasty), number of vertebral levels to be treated as well as the patient's age, condition, and comorbidities.Single-shot epidural anesthesia is yet another anesthetic option that has been successfully used in our clinic for some years now. It combines the advantages of general and local anesthesia: excellent segmental analgesia even in multilevel cases in awake and responding patients. AD - Abteilung für Anästhosiologie und Intensivmedizin, Orthopädische Universitätsklinik Friedrichsheim gGmbH, Marienburgstrasse 2, 60528, Frankfurt, Deutschland. P.Kessler@friedrichsheim.de AN - 20567805 AU - Kessler, P. AU - Souquet, J. AU - Meisenzahl, D. AU - Rauschmann, M. AU - Richolt, J. DA - Jul DO - 10.1007/s00132-010-1605-5 DP - NLM ET - 2010/06/23 J2 - Der Orthopade KW - Anesthesia, Epidural/*methods Anesthesia, Local/methods Bone Substitutes/*adverse effects/therapeutic use Humans Pain/*etiology/*prevention & control Pulmonary Embolism/*etiology/*prevention & control Vertebroplasty/*adverse effects LA - ger M1 - 7 N1 - PubMed NLM literature search January 5, 2021 OP - Zementbasierte Augmentationsverfahren an der Wirbelsäule : Anästhesieverfahren und systemische Komplikationen. PY - 2010 SN - 0085-4530 SP - 693-8 ST - [Bone resin based vertebral augmentation: form of anesthesia and systemic complications] T2 - Orthopade TI - [Bone resin based vertebral augmentation: form of anesthesia and systemic complications] VL - 39 ID - 828713 ER - TY - JOUR AB - Over the last few years bone resin based vertebral augmentation in the form of vertebro- and kyphoplasty has proved to be a safe therapeutic option in cases of vertebral compression fractures. Nevertheless, rare systemic complications have been seen, i.e., pulmonary embolisms ranging from harmless to lethal. The presence of an anesthesiologist can be especially useful in cases of systemic complications. Whether the form of anesthesia has any influence on the outcome of vertebro- or kyphoplasty is currently unknown. Local anesthesia supplemented by analgosedation is often used as an alternative to general anesthesia. The rationale for one or the other form of anesthesia can be factors like type of augmentation (vertebro- or kyphoplasty), number of vertebral levels to be treated as well as the patient's age, condition, and comorbidities. Single-shot epidural anesthesia is yet another anesthetic option that has been successfully used in our clinic for some years now. It combines the advantages of general and local anesthesia: excellent segmental analgesia even in multilevel cases in awake and responding patients. AD - [Kessler, P.; Souquet, J.; Meisenzahl, D.] Orthopad Univ Klin Friedrichsheim gGmbH, Abt Anasthosiol & Intens Med, D-60528 Frankfurt, Germany. [Rauschmann, M.; Richolt, J.] Orthopad Univ Klin Friedrichsheim gGmbH, Abt Wirbelsaulenorthopadie, Frankfurt, Germany. Kessler, P (corresponding author), Orthopad Univ Klin Friedrichsheim gGmbH, Abt Anasthosiol & Intens Med, Marienburgstr 2, D-60528 Frankfurt, Germany. P.Kessler@friedrichsheim.de AN - WOS:000279587600007 AU - Kessler, P. AU - Souquet, J. AU - Meisenzahl, D. AU - Rauschmann, M. AU - Richolt, J. DA - Jul DO - 10.1007/s00132-010-1605-5 J2 - Orthopade KW - Vertebroplasty Kyphoplasty Pulmonary embolism Anesthesia Epidural anesthesia PULMONARY CEMENT EMBOLISM PERCUTANEOUS VERTEBROPLASTY INTRAOSSEOUS LIDOCAINE COMPRESSION FRACTURES BALLOON KYPHOPLASTY ANESTHESIA COMPLICATIONS EMBOLIZATION FLUOROSCOPY ANALGESIA Orthopedics LA - German M1 - 7 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2010 SN - 0085-4530 SP - 693-698 ST - Bone resin based vertebral augmentation T2 - Orthopade TI - Bone resin based vertebral augmentation UR - ://WOS:000279587600007 VL - 39 ID - 830340 ER - TY - GEN AD - Jeddah, Saudi Arabia. AU - Khan, J. A. CY - New York, New York DB - cin20 DO - 10.1093/bja/aeu432 DP - EBSCOhost J2 - BJA: The British Journal of Anaesthesia KW - Bone Cements -- Adverse Effects Central Venous Catheters Methylmethacrylates -- Adverse Effects Pulmonary Embolism -- Etiology Vertebroplasty -- Adverse Effects Female N1 - CINAHL (EbscoHost) literature search January 5, 2021 PB - Elsevier B.V. PY - 2015 SN - 0007-0912 SP - 351-351 ST - Bone cement embolism attached to central venous catheter...Br J Anaesth. 2014 Apr;112(4):672-4 TI - Bone cement embolism attached to central venous catheter...Br J Anaesth. 2014 Apr;112(4):672-4 UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=103875782&site=ehost-live&scope=site VL - 114 ID - 830620 ER - TY - JOUR AB - We present the case of a 63-year-old woman who suffered a cement pulmonary embolus that resulted from methylmethacrylate extravasation into the paravertebral venous plexus during percutaneous vertebroplasty. We discuss the radiographic diagnosis and strategies for prevention and treatment. AN - 27307807 AU - Khan, M. AU - Terk, M. C2 - Pmc4897972 DO - 10.2484/rcr.v4i2.282 DP - NLM ET - 2009/01/01 J2 - Radiology case reports KW - CT, computed tomography LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 1930-0433 (Print) 1930-0433 SP - 282 ST - Cement Pulmonary Embolus Complicating Percutaneous Vertebroplasty T2 - Radiol Case Rep TI - Cement Pulmonary Embolus Complicating Percutaneous Vertebroplasty VL - 4 ID - 828691 ER - TY - JOUR AB - Background and Aims: To determine mortality rates and predisposing factors in patients operated for a hip fracture in a 3-year follow-up period. Methods: The study included patients who underwent primary surgery for a hip fracture. The inclusion criteria were traumatic, non-traumatic, osteoporotic and pathological hip fractures requiring surgery in all age groups and both genders. Patients with periprosthetic fractures or previous contralateral hip fracture surgery and patients who could not be contacted by telephone were excluded. At 36 months after surgery, evaluation was made using a structured telephone interview and a detailed examination of the hospital medical records, especially the documents written during anesthesia by the anesthesiologists and the documents written at the time of follow-up visits by the orthopaedic surgeons. A total of 124 cases were analyzed and 4 patients were excluded due to exclusion criteria. The collected data included demographics, type of fracture, co-morbidities, American Society of Anesthesiologists (ASA) scores, anesthesia techniques, operation type (intramedullary nailing or arthroplasty; cemented-noncemented), peroperative complications, refracture during the followup period, survival period and mortality causes. Results: The total 120 patients evaluated comprised 74 females(61.7%) and 46 males(38.3%) with a mean age of 76.9-12.8 years (range 23-95 years). The ASA scores were ASA I (0.8%), ASA II (21.7%), ASA III (53.3%) and ASA IV (24.2%). Mortality was seen in 44 patients (36.7%) and 76 patients (63.3%) survived during the 36-month follow-up period. Of the surviving patients, 59.1% were female and 40.9% were male. The survival period ranged between 1-1190 days. The cumulative mortality rate in the first, second and third years were 29.17%, 33.33% and 36.67% respectively. The factors associated with mortality were determined as increasing age, high ASA score, coronary artery disease, congestive heart failure, Alzheimer's disease, Parkinson's disease, malignancy cementation and peroperative complications such as hypotension (p<0.05). Mortality was highest in the first month after fracture. Conclusion: The results of this study showed higher mortality rates in patients with high ASA scores due to associated co-morbidities such as congestive heart failure, malignancy and Alzheimer's disease or Parkinson's disease. The use of cemented prosthesis was also seen to significantly increase mortality whereas no effect was seen from the anesthesia technique used. Treatment of these patients with a multidiciplinary approach in an orthogeriatric ward is essential. There is a need for further studies concerning cemented vs. uncemented implant use and identification of the best anesthesia technique to decrease mortality rates in these patients. AU - Kilci, O. AU - Un, C. AU - Sacan, O. AU - Gamli, M. AU - Baskan, S. AU - Baydar, M. AU - Ozkurt, B. DB - Embase Medline DO - 10.1371/journal.pone.0162097 KW - adult age aged Alzheimer disease American Society of Anesthesiologists score arthroplasty article cemented prosthesis cementless prosthesis comorbidity congestive heart failure coronary artery disease disease predisposition embolism female follow up fracture treatment hip fracture human hypotension intramedullary nailing major clinical study male malignant neoplasm medical record mortality rate Parkinson disease peroperative complication recurrent disease scoring system structured interview surgical mortality survival telephone interview LA - English M1 - 10 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1932-6203 ST - Postoperative mortality after hip fracture surgery: A 3 years follow up T2 - PLoS ONE TI - Postoperative mortality after hip fracture surgery: A 3 years follow up UR - https://www.embase.com/search/results?subaction=viewrecord&id=L612931852&from=export http://dx.doi.org/10.1371/journal.pone.0162097 VL - 11 ID - 829302 ER - TY - JOUR AB - Background: Controversy exists regarding the safety of bilateral simultaneous total hip arthroplasty, in part because of the potentially higher prevalence of pulmonary fat embolism. The purpose of the present study was to determine if unilateral and bilateral simultaneous total hip arthroplasty procedures resulted in different prevalences of fat embolization, different degrees of hemodynamic compromise, or different levels of hypoxemia or mental status changes.Methods: One hundred and fifty-six consecutive patients undergoing primary total hip arthroplasty were prospectively enrolled in the study. The study group included fifty patients undergoing bilateral simultaneous total hip arthroplasty and 106 patients undergoing unilateral total hip arthroplasty. One hundred hips were treated with a cemented stem, and 106 were treated with a cementless stem. Arterial and right atrial blood samples were obtained before implantation (baseline); at one, three, five, and ten minutes after implantation of the acetabular and femoral components; and at twenty-four and forty-eight hours after the operation. Arterial blood pressure, right atrial pressure, arterial oxygen tension, and carbon-dioxide tension were also monitored at these times. The presence of lipid and cellular contents of bone marrow was determined.Results: The prevalence of fat embolism was not significantly different between the groups managed with bilateral and unilateral total hip arthroplasty or between the groups managed with cemented and cementless stems. Similarly, the prevalence of bone-marrow-cell embolization was not significantly different between the groups managed with bilateral and unilateral total hip arthroplasty or between the groups managed with cemented and cementless stems. Patients with bone-marrow-cell embolization had a significantly lower arterial oxygen tension (p = 0.022) and oxygen saturation (p = 0.017) than did patients without bone-marrow-cell embolization on the first postoperative day. Four patients with bone-marrow cells in the blood samples that were obtained from the right atrium on the first postoperative day had development of diffuse encephalopathy with confusion and agitation that lasted for about twenty-four hours.Conclusions: The prevalence of fat and bone-marrow-cell embolization was similar in the groups managed with bilateral simultaneous and unilateral total hip arthroplasty as well as in the groups managed with cemented and cementless stems. AD - The Joint Replacement Center of Korea, Seoul, Korea Joint Replacement Center of Korea Affiliated with HaeMin General Hospital, 627-3, JaYang 1-Dong, KwangJin-Gu, Seoul, Korea; younghookim@netsgo.com AN - 106799921. Language: English. Entry Date: 20030124. Revision Date: 20190610. Publication Type: journal article AU - Kim, B. Y. AU - Oh, S. AU - Kim, J. AU - Kim, Young-Hoo AU - Oh, S. W. AU - Kim, J. S. DB - cin20 DP - EBSCOhost KW - Anoxemia -- Epidemiology Arthroplasty, Replacement, Hip -- Methods Bone Cements -- Therapeutic Use Embolism, Fat -- Epidemiology Mental Status Adult Aged Aged, 80 and Over Arterial Pressure -- Evaluation Atrial Pressure -- Evaluation Bone Marrow Comparative Studies Descriptive Statistics Female Human Male Middle Age Oxygen Saturation -- Evaluation Phlebography Power Analysis Prospective Studies Randomized Controlled Trials M1 - 8 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2002 SN - 0021-9355 SP - 1372-1379 ST - Prevalence of fat embolism following bilateral simultaneous and unilateral total hip arthroplasty performed with or without cement: a prospective, randomized clinical study [corrected] [published erratum appears in J BONE JOINT SURG (AM) 2003 Feb;85A(2):332] T2 - Journal of Bone & Joint Surgery, American Volume TI - Prevalence of fat embolism following bilateral simultaneous and unilateral total hip arthroplasty performed with or without cement: a prospective, randomized clinical study [corrected] [published erratum appears in J BONE JOINT SURG (AM) 2003 Feb;85A(2):332] UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106799921&site=ehost-live&scope=site VL - 84 ID - 830793 ER - TY - JOUR AD - S.S. Kim, Department of Cardiology, Chosun University Hospital, Donggu, Gwangju, South Korea AU - Kim, D. H. AU - Kim, S. S. AU - Kim, H. K. DB - Embase DO - 10.6515/ACS.202007_36(4).20200213B KW - creatine kinase MB dimer poly(methyl methacrylate) troponin I tumor marker adult artery calcification artificial embolization blood pressure case report cement emboli clinical article creatinine blood level dyspnea electrocardiography erythrocyte sedimentation rate heart atrium septum defect heart perforation heart right atrium human letter leukocyte count liver function test male mass middle aged multidetector computed tomography paradoxical embolism percutaneous vertebroplasty platelet count right atrial mass thorax pain transthoracic echocardiography urea nitrogen blood level vein rupture LA - English M1 - 4 M3 - Letter N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1011-6842 SP - 390-393 ST - Cement emboli presenting as right atrial mass caused by percutaneous vertebroplasty T2 - Acta Cardiologica Sinica TI - Cement emboli presenting as right atrial mass caused by percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2004707954&from=export http://dx.doi.org/10.6515/ACS.202007_36(4).20200213B VL - 36 ID - 829085 ER - TY - JOUR AB - STUDY DESIGN: Retrospective cohort. OBJECTIVE: The purpose was to investigate the incidence of and risk factors for complications associated with vertebroplasty (VP) or kyphoplasty (KP) for osteoporotic vertebral compression fracture (OVCF) using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. METHODS: A cohort of patients undergoing VP/KP was constructed from the 2011-2013 ACS-NSQIP dataset using Current Procedural Terminology (CPT) codes. The incidences of minor complications (i.e. urinary tract infection, pneumonia, renal insufficiency, superficial infection, wound dehiscence), major complications (i.e. reoperation, deep vein thrombosis, pulmonary embolism, sepsis, dialysis, cardiac arrest, deep infection, stroke), and mortality within 30 days post-surgery were investigated, and their risk factors were assessed using logistic regression modeling. RESULTS: Of 1932 patients undergoing VP/KP, 166 (8.6%) experienced a complication, including minor complications in 53 (2.7%), major complications in 95 (4.9%), and death in 40 (2.1%). Multivariate logistic regression analysis indicated that the adjusted odds ratios (95% confidence interval [CI]) of mortality was significantly associated with ASA 4: 16.604 (1.956-140.959) and increased creatinine (≥ 1.3 mg/dL): 3.494 (1.128-10.823). History of chronic obstructive pulmonary disease was associated with minor complications. Increased WBC count and hypoalbuminemia (<3.0 g/dL) were also associated with major complications. CONCLUSIONS: The major complication and mortality rates associated with VP/KP were 4.9% and 2.1% respectively, higher than previous reports. Increased creatinine and ASA 4 were independently associated with mortality after VP/KP. Therefore, cautious monitoring and counseling is needed for elderly, patients with preexisting kidney disease or ASA 4 undergoing VP/KP. AD - Department of Orthopedic Surgery, Seoul National University College of Medicine and Seoul National University Bundang Hospital, and Spine Center, Seongnam, Republic of Korea. Division of Spinal Surgery, Department of Orthopedic Surgery, Columbia University, The Spine Hospital at New York-Presbyterian/Allen Hospital, New York, NY, USA. AN - 33380221 AU - Kim, H. J. AU - Zuckerman, S. L. AU - Cerpa, M. AU - Yeom, J. S. AU - Lehman, R. A., Jr. AU - Lenke, L. G. DA - Dec 30 DO - 10.1177/2192568220976355 DP - NLM ET - 2021/01/01 J2 - Global spine journal KW - American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) kyphoplasty mortality short-term complication vertebroplasty LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 2192-5682 (Print) 2192-5682 SP - 2192568220976355 ST - Incidence and Risk Factors for Complications and Mortality After Vertebroplasty or Kyphoplasty in the Osteoporotic Vertebral Compression Fracture-Analysis of 1,932 Cases From the American College of Surgeons National Surgical Quality Improvement T2 - Global Spine J TI - Incidence and Risk Factors for Complications and Mortality After Vertebroplasty or Kyphoplasty in the Osteoporotic Vertebral Compression Fracture-Analysis of 1,932 Cases From the American College of Surgeons National Surgical Quality Improvement ID - 829017 ER - TY - JOUR AB - OBJECTIVE: Kyphoplasty performed in the middle thoracic spine presents technical challenges that differ from those in the lower thoracic or lumbar region due to small pedicle size and angular severity for thoracic kyphosis. The purpose of this study was to evaluate the efficacy of balloon kyphoplasty through extrapedicular approach for the treatment of intractable osteoporotic compression fractures in the middle thoracic spine. METHODS: The patients who were performed with one level balloon kyphoplasty through extrapedicular approach due to painful osteoporotic compression fractures at T5-T8 from June 2003 to July 2005 were retrospectively analyzed. Imaging and clinical features were analyzed including involved vertebrae level, vertebral height, injected cement volume, clinical outcome and complications. RESULTS: Eighteen female patients (age ranged from 60 to 77 years old) were included in this study. The average amount of the implanted cement was 4.2+/-1.5 cc. The mean cobb angle and compression rate were improved from 12.1+/-6.5 degrees to 8.5+/-7.2 degrees and from 30% to 15%, respectively. The mean pain score (visual analogue scale) prior to kyphoplasty was 7.9 and it decreased to 3.0 after the procedure. Cement leakage to the adjacent disc (2 cases) and paravertebral soft tissues (1 case) were seen but there were no major complications such as pneumothorax, segmental artery injury, pulmonary embolism, or epidural leakage. CONCLUSION: Balloon kyphoplasty through extrapedicular approach is considered as a safe and effective in treating the middle thoracic regions with low complication rate. AD - Department of Neurosurgery , Mokpo Hankook Hospital, Mokpo, Korea. AN - 19096570 AU - Kim, H. S. AU - Kim, S. W. AU - Ju, C. I. C2 - Pmc2588193 DA - Nov DO - 10.3340/jkns.2007.42.5.363 DP - NLM ET - 2008/12/20 J2 - Journal of Korean Neurosurgical Society KW - Balloon kyphoplasty Extrapedicular approach Middle thoracic region Osteoporotic compression fracture LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 2005-3711 (Print) 1225-8245 SP - 363-6 ST - Balloon Kyphoplasty through Extrapedicular Approach in the Treatment of Middle Thoracic Osteoporotic Compression Fracture : T5-T8 Level T2 - J Korean Neurosurg Soc TI - Balloon Kyphoplasty through Extrapedicular Approach in the Treatment of Middle Thoracic Osteoporotic Compression Fracture : T5-T8 Level VL - 42 ID - 829007 ER - TY - JOUR AB - Kyphoplasty performed in the middle thoracic spine presents technical challenges that differ from those in the lower thoracic or lumbar region due to small pedicle size and angular severity for thoracic kyphosis. The purpose of this study was to evaluate the efficacy of balloon kyphoplasty through extrapedicular approach for the treatment of intractable osteoporotic compression fractures in the middle thoracic spine. Methods: The patients who were performed with one level balloon kyphoplasty through extrapedicular approach due to painful osteoporotic compression fractures at T5-T8 from June 2003 to July 2005 were retrospectively analyzed. Imaging and clinical features were analyzed including involved vertebrae level, vertebral height, injected cement volume, clinical outcome and complications. Results: Eighteen female patients (age ranged from 60 to 77 years old) were included in this study. The average amount of the implanted cement was 4.2=1.5 cc. The mean cobb angle and compression rate were improved from 12.1 ±6.5° to 8.5±7.2° and from 30% to 15%, respectively. The mean pain score (visual analogue scale) prior to kyphoplasty was 7.9 and it decreased to 3.0 after the procedure. Cement leakage to the adjacent disc (2 cases) and paravertebral soft tissues (1 case) were seen but there were no major complications such as pneumothorax, segmental artery injury, pulmonary embolism, or epidural leakage. Conclusion: Balloon kyphoplasty through extrapedicular approach is considered as a safe and effective in treating the middle thoracic regions with low complication rate. AD - S.W. Kim, Department of Neurosurgery, Chosun University, College of Medicine, 588 Seoseok-dong, Dong-gu, Gwangju 501-717, South Korea AU - Kim, H. S. AU - Kim, S. W. AU - Ju, C. I. DB - Embase DO - 10.3340/jkns.2007.42.5.363 KW - bone cement polymethacrylic acid adult aged article clinical article clinical feature compression fracture female fragility fracture human implant intractable pain kyphoplasty pain assessment postoperative complication preoperative evaluation retrospective study spine fracture spine radiography surgical approach thoracic spine visual analog scale LA - English M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2007 SN - 1225-8245 1598-7876 SP - 363-366 ST - Balloon kyphoplasty through extrapedicular approach in the treatment of middle thoracic osteoporotic compression fracture: TS-T8 Level T2 - Journal of Korean Neurosurgical Society TI - Balloon kyphoplasty through extrapedicular approach in the treatment of middle thoracic osteoporotic compression fracture: TS-T8 Level UR - https://www.embase.com/search/results?subaction=viewrecord&id=L350303464&from=export http://dx.doi.org/10.3340/jkns.2007.42.5.363 VL - 42 ID - 829758 ER - TY - JOUR AB - A 73-year-old woman took a chest radiography for medical check-up, and pulmonary cement embolism was diagnosed. She had undergone percutaneous vertebroplasty. Ventilation-perfusion imaging revealed V/Q mismatched perfusion defect on the lung. Then, she has taken rivaroxaban (orally active direct factor Xa inhibitor) for 6 months and took follow-up V/Q scan. It revealed the disappearance of previous 2 of 3 moderate V/Q mismatches. There are controversies in the role of anticoagulation in treatment of pulmonary cement embolism, and this case shows functional recovery through the perfusion scan after anticoagulation treatment. AU - Kim, H. W. AU - Kim, H. J. DB - Medline DO - 10.1097/RLU.0000000000003423 KW - aged anticoagulant therapy article artificial ventilation case report clinical article embolism female follow up human lung medical examination percutaneous vertebroplasty scintigraphy single photon emission computed tomography thorax radiography cement rivaroxaban LA - English M3 - Article in Press N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1536-0229 ST - Resolution of Pulmonary Cement Embolism After Treatment of Rivaroxaban on Ventilation/Perfusion SPECT Image T2 - Clinical nuclear medicine TI - Resolution of Pulmonary Cement Embolism After Treatment of Rivaroxaban on Ventilation/Perfusion SPECT Image UR - https://www.embase.com/search/results?subaction=viewrecord&id=L633534091&from=export http://dx.doi.org/10.1097/RLU.0000000000003423 ID - 829045 ER - TY - JOUR AB - A 73-year-old woman took a chest radiography for medical check-up, and pulmonary cement embolism was diagnosed. She had undergone percutaneous vertebroplasty. Ventilation-perfusion imaging revealed V/Q mismatched perfusion defect on the lung. Then, she has taken rivaroxaban (orally active direct factor Xa inhibitor) for 6 months and took follow-up V/Q scan. It revealed the disappearance of previous 2 of 3 moderate V/Q mismatches. There are controversies in the role of anticoagulation in treatment of pulmonary cement embolism, and this case shows functional recovery through the perfusion scan after anticoagulation treatment. AD - From the Departments of Nuclear Medicine. Internal Medicine, Dongsan Hospital, Keimyung University School of Medicine, Daegu, South Korea. AN - 33234931 AU - Kim, H. W. AU - Kim, H. J. DA - Feb 1 DO - 10.1097/rlu.0000000000003423 DP - NLM ET - 2020/11/26 J2 - Clinical nuclear medicine LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2021 SN - 0363-9762 SP - 142-143 ST - Resolution of Pulmonary Cement Embolism After Treatment of Rivaroxaban on Ventilation/Perfusion SPECT Image T2 - Clin Nucl Med TI - Resolution of Pulmonary Cement Embolism After Treatment of Rivaroxaban on Ventilation/Perfusion SPECT Image VL - 46 ID - 828681 ER - TY - JOUR AD - Department of Cardiology, Korea University College of Medicine, Seoul, Republic of Korea. AN - 20019023 AU - Kim, M. N. AU - Jung, J. S. AU - Kim, S. W. AU - Kim, Y. H. AU - Park, S. M. AU - Shim, W. J. DA - Apr DO - 10.1093/eurheartj/ehp565 DP - NLM ET - 2009/12/19 J2 - European heart journal KW - Aged Bone Cements/*adverse effects Embolism/*etiology Female Foreign Bodies Fractures, Compression/surgery Heart Diseases/*etiology Humans Polymethyl Methacrylate/*adverse effects Postoperative Complications/*etiology *Ventricular Septum Vertebroplasty LA - eng M1 - 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 0195-668x SP - 1006 ST - A sword-like foreign body lodged in the ventricular septum: a rare complication of percutaneous vertebroplasty T2 - Eur Heart J TI - A sword-like foreign body lodged in the ventricular septum: a rare complication of percutaneous vertebroplasty VL - 31 ID - 828544 ER - TY - JOUR AB - Percutaneous vertebroplasty is a widely used treatment for vertebral compression fracture. It is relatively safe, but it can be complicated by pulmonary or cerebral embolism caused by the cement injected during the procedure. Here, we present a case of a 69-year-old male with extensive deep vein thrombosis from the inferior vena cava to the right iliac and left femoral veins, which occurred 10 months after vertebroplasty. He was treated successfully by catheter-directed thrombolysis, angioplasty, and stenting. To the best of our knowledge, this is the first report of the successful treatment of delayed thrombosis caused by migrated cement inside the inferior vena cava. AD - Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. AN - 22572011 AU - Kim, S. M. AU - Min, S. K. AU - Jae, H. J. AU - Min, S. I. AU - Ha, J. AU - Kim, S. J. DA - Oct DO - 10.1016/j.jvs.2012.02.039 DP - NLM ET - 2012/05/11 J2 - Journal of vascular surgery KW - Aged *Angioplasty Bone Cements/adverse effects Humans Lumbar Vertebrae/injuries Male Polymethyl Methacrylate/adverse effects Spinal Fractures/therapy *Stents *Thrombolytic Therapy *Vena Cava, Inferior Venous Thrombosis/diagnosis/etiology/*therapy Vertebroplasty/*adverse effects LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0741-5214 SP - 1119-23 ST - Successful thrombolysis, angioplasty, and stenting of delayed thrombosis in the vena cava following percutaneous vertebroplasty with polymethylmethacrylate cement T2 - J Vasc Surg TI - Successful thrombolysis, angioplasty, and stenting of delayed thrombosis in the vena cava following percutaneous vertebroplasty with polymethylmethacrylate cement VL - 56 ID - 828824 ER - TY - JOUR AD - J.B. Seo, Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-2dong, Songpa-gu, Seoul 138-736, South Korea AU - Kim, S. Y. AU - Seo, J. B. AU - Do, K. H. AU - Lee, J. S. AU - Song, K. S. AU - Lim, T. H. DB - Embase Medline DO - 10.2214/AJR.04.1443 KW - acrylic cement poly(methyl methacrylate) aged anamnesis article backache case report echocardiography female heart injury human lung embolism open heart surgery percutaneous vertebroplasty perforation priority journal sternotomy symptomatology transesophageal echocardiography spine fracture LA - English M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2005 SN - 0361-803X SP - 1245-1247 ST - Cardiac perforation caused by acrylic cement: A rare complication of percutaneous vertebroplasty T2 - American Journal of Roentgenology TI - Cardiac perforation caused by acrylic cement: A rare complication of percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L43460547&from=export http://dx.doi.org/10.2214/AJR.04.1443 VL - 185 ID - 829808 ER - TY - JOUR AB - We have evaluated prospectively the incidence and location of deep-vein thrombosis (DVT), the risk factors for pulmonary embolism, and the natural history of thrombosis after total knee replacement (TKR) in patients who did not receive prophylactic or therapeutic treatment for DVT. We studied 227 patients who underwent primary TKR; 116 had one-stage bilateral and 111 unilateral procedures. Coagulation assays, the full blood count and blood typing tests for the serum chemical profile were undertaken in all patients on three separate occasions. Bilateral simultaneous or unilateral venograms were carried out at six or seven days after operation. Perfusion lung scanning was undertaken before and at seven or eight days after operation. Bilateral simultaneous or unilateral venograms were repeated six months after operation in all patients who had thrombi. In the 116 patients with a bilateral replacement, 97 of 232 venograms (41.8%) were positive for fresh thrombi while there were 46 positive venograms (41.4%) in the 111 patients with a unilateral replacement (p = 1.000). Of the 116 venograms in knees with a cemented replacement, 45 (38.8%) were positive for thrombi while 52 of the 116 venograms (44.8%) were positive in those with a cementless replacement (p = 0.675). Further venograms at six months after operation in all 143 limbs which had thrombi showed that all had completely resolved regardless of the size or location. No pulmonary embolism occurred as shown by negative perfusion lung scans and the absence of symptoms. Although the current prevailing opinion is that patients with thrombosis in the proximal veins should receive anticoagulant treatment, our study has shown that all thrombi regardless of their size or location resolved without causing pulmonary embolism. AD - President and Director, Joint Replacement Centre of Korea affiliated with Hae Min General Hospital, 627-3 Jayang 1-Dong, Kwang Jin-Gu, Seoul (143-191), Korea AN - 106976258. Language: English. Entry Date: 20021108. Revision Date: 20150711. Publication Type: Journal Article AU - Kim, Y. AU - Kim, J. DB - cin20 DP - EBSCOhost KW - Arthroplasty, Replacement, Knee Pulmonary Embolism -- Risk Factors Thrombosis -- Prognosis Venous Thrombosis -- Epidemiology Adult Aged Blood Cell Count Blood Coagulation Tests Blood Grouping and Crossmatching Chi Square Test Clinical Trials Confidence Intervals Descriptive Statistics Female Male Mann-Whitney U Test Middle Age Phlebography Prospective Studies Respiratory Function Tests T-Tests Human M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2002 SN - 0301-620X SP - 566-570 ST - Incidence and natural history of deep-vein thrombosis after total knee arthroplasty: a prospective, randomised study T2 - Journal of Bone & Joint Surgery, British Volume TI - Incidence and natural history of deep-vein thrombosis after total knee arthroplasty: a prospective, randomised study UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106976258&site=ehost-live&scope=site VL - 84B ID - 830794 ER - TY - JOUR AB - The incidence of deep vein thrombosis in 244 patients who had total knee replacement has been studied. In 120 the prosthesis was cemented and in 124 it was cementless. In all cases the replacement was primary and a porous-coated prosthesis with a porous-coated central tibial stem was used. Deep vein thrombosis was diagnosed by venography, and pulmonary embolism by perfusion scanning. The incidence of deep vein thrombosis in the cementless knees (23.8%) and in the cemented (25%) was approximately the same. The only significant predisposing factors for deep vein thrombosis in both groups were obesity, prolonged postoperative immobilisation, previous venous disease and hyperlipidaemia. AD - Yonsei University College of Medicine, Seoul. AN - 2211755 AU - Kim, Y. H. DA - Sep DO - 10.1302/0301-620x.72b5.2211755 DP - NLM ET - 1990/09/01 J2 - The Journal of bone and joint surgery. British volume KW - Aged Aged, 80 and over Arthritis/surgery Arthritis, Rheumatoid/surgery Body Weight *Bone Cements Female Humans Hypertension/epidemiology Incidence Knee Prosthesis/*adverse effects Male Middle Aged Osteoarthritis/surgery Phlebography Thrombophlebitis/diagnostic imaging/*epidemiology/etiology Tuberculosis, Osteoarticular/surgery LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 1990 SN - 0301-620X (Print) 0301-620x SP - 779-83 ST - The incidence of deep vein thrombosis after cementless and cemented knee replacement T2 - J Bone Joint Surg Br TI - The incidence of deep vein thrombosis after cementless and cemented knee replacement VL - 72 ID - 828925 ER - TY - JOUR AB - We have evaluated prospectively the incidence and location of deep‐vein thrombosis (DVT), the risk factors for pulmonary embolism, and the natural history of thrombosis after total knee replacement (TKR) in patients who did not receive prophylactic or therapeutic treatment for DVT. We studied 227 patients who underwent primary TKR; 116 had one‐stage bilateral and 111 unilateral procedures. Coagulation assays, the full blood count and blood typing tests for the serum chemical profile were undertaken in all patients on three separate occasions. Bilateral simultaneous or unilateral venograms were carried out at six or seven days after operation. Perfusion lung scanning was undertaken before and at seven or eight days after operation. Bilateral simultaneous or unilateral venograms were repeated six months after operation in all patients who had thrombi. In the 116 patients with a bilateral replacement, 97 of 232 venograms (41.8%) were positive for fresh thrombi while there were 46 positive venograms (41.4%) in the 111 patients with a unilateral replacement (p = 1.000). Of the 116 venograms in knees with a cemented replacement, 45 (38.8%) were positive for thrombi while 52 of the 116 venograms (44.8%) were positive in those with a cementless replacement (p = 0.675). Further venograms at six months after operation in all 143 limbs which had thrombi showed that all had completely resolved regardless of the size or location. No pulmonary embolism occurred as shown by negative perfusion lung scans and the absence of symptoms. Although the current prevailing opinion is that patients with thrombosis in the proximal veins should receive anticoagulant treatment, our study has shown that all thrombi regardless of their size or location resolved without causing pulmonary embolism. AN - CN-00389373 AU - Kim, Y. H. AU - Kim, J. S. DO - 10.1302/0301-620x.84b4.12330 KW - Adult Aged Arthroplasty, Replacement, Knee [*adverse effects] Female Humans Incidence Male Middle Aged Prospective Studies Venous Thrombosis [*epidemiology, *etiology] M1 - 4 M3 - Clinical Trial; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2002 SP - 566‐570 ST - Incidence and natural history of deep-vein thrombosis after total knee arthroplasty. A prospective, randomised study T2 - Journal of bone and joint surgery. British volume TI - Incidence and natural history of deep-vein thrombosis after total knee arthroplasty. A prospective, randomised study UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00389373/full VL - 84 ID - 830027 ER - TY - JOUR AB - We compared the clinical and radiological outcomes of two cementless femoral stems in the treatment of patients with a Garden III or IV fracture of the femoral neck. A total of 70 patients (70 hips) in each group were enrolled into a prospective randomised study. One group received a short anatomical cementless stem and the other received a conventional cementless stem. Their mean age was 74.9 years (50 to 94) and 76.0 years (55 to 96), respectively (p = 0.328). The mean follow‐up was 4.1 years (2 to 5) and 4.8 years (2 to 6), respectively. Perfusion lung scans and high resolution chest CTs were performed to detect pulmonary microemboli. At final follow‐up there were no statistically significant differences between the short anatomical and the conventional stems with regard to the mean Harris hip score (85.7 (66 to 100) versus 86.5 (55 to 100); p = 0.791), the mean Western Ontario and McMaster Universities Osteoarthritis Index (17 (6 to 34) versus 16 (5 to 35); p = 0.13) or the mean University of California, Los Angeles activity score (5 (3 to 6) versus 4 (3 to 6); p = 0.032). No patient with a short stem had thigh pain, but 11 patients (16%) with a conventional stem had thigh pain. No patients with a short stem had symptomatic pulmonary microemboli, but 11 patients with a conventional stem had pulmonary microemboli (symptomatic in three patients and asymptomatic in eight patients). One hip (1.4%) in the short stem group and eight (11.4%) in the conventional group had an intra‐operative undisplaced fracture of the calcar. No component was revised for aseptic loosening in either group. One acetabular component in the short stem group and two acetabular components in the conventional stem group were revised for recurrent dislocation. Our study demonstrated that despite the poor bone quality in these elderly patients with a fracture of the femoral neck, osseo‐integration was obtained in all hips in both groups. However, the incidence of thigh pain, pulmonary microemboli and peri‐prosthetic fracture was significantly higher in the conventional stem group than in the short stem group. AN - CN-00969300 AU - Kim, Y. H. AU - Oh, J. H. DO - 10.1302/0301-620X.94B6.29152 KW - Aged Aged, 80 and over Arthroplasty, Replacement, Hip [adverse effects, *instrumentation, methods] Cementation Female Femoral Neck Fractures [diagnostic imaging, *surgery] Hip Prosthesis [adverse effects] Humans Male Middle Aged Osseointegration Pain, Postoperative [etiology] Periprosthetic Fractures [etiology] Prosthesis Design Prosthesis Failure Pulmonary Embolism [etiology] Radiography Reoperation M1 - 6 M3 - Comparative Study; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2012 SP - 774‐781 ST - A comparison of a conventional versus a short, anatomical metaphyseal-fitting cementless femoral stem in the treatment of patients with a fracture of the femoral neck T2 - Journal of bone and joint surgery. British volume TI - A comparison of a conventional versus a short, anatomical metaphyseal-fitting cementless femoral stem in the treatment of patients with a fracture of the femoral neck UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00969300/full VL - 94 ID - 830073 ER - TY - JOUR AB - There are many reports concerning the aetiology and prophylaxis of deep‐vein thrombosis (DVT) but little is known about its natural history. The purpose of our study was to identify the incidence and site of DVT, the risk factors for pulmonary embolism and the natural history of DVT after total hip replacement (THR) in patients who do not receive any form of prophylactic or therapeutic treatment for DVT. Two hundred patients who had a primary THR were included: 100 had one‐staged bilateral THR and 100 had unilateral THR and 150 implants were cemented and 150 cementless. Coagulation assays, a full blood count, blood typing and serum chemical profile tests were performed for all patients on three separate occasions. Bilateral simultaneous or unilateral venograms were performed on the sixth or seventh postoperative day and perfusion lung scans preoperatively and on the seventh or eighth postoperative day. Further venograms were performed in all patients who had thrombi six months later. In the patients with bilateral THR, 52 (26%) venograms were positive for thrombi, while in the patients with unilateral THR 20 (20%) were positive (p = 0.89). In the patients with a cemented THR, 31 venograms (20.7%) were positive for thrombi, while in those with a cementless THR 41 (27.3%) were positive (p = 0.654). Further venograms in all 72 patients who had thrombi at six months after operation showed that they resolved completely and spontaneously regardless of their site and size. No patients had symptoms of pulmonary emboli and none were seen on the perfusion lung scans. Two patients died from unrelated causes. Although the prevailing opinion is that patients with proximal venous thrombosis should be treated with anticoagulants, our study has shown that all thrombi regardless of their site and size resolve spontaneously without associated pulmonary embolism. AN - CN-00439712 AU - Kim, Y. H. AU - Oh, S. H. AU - Kim, J. S. KW - Aged Arthroplasty, Replacement, Hip Cementation Female Femoral Vein [diagnostic imaging] Humans Incidence Leg [blood supply] Male Middle Aged Phlebography Postoperative Complications [*etiology] Prospective Studies Pulmonary Embolism [etiology] Risk Factors Venous Thrombosis [diagnostic imaging, *etiology] M1 - 5 M3 - Clinical Trial; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2003 SP - 661‐665 ST - Incidence and natural history of deep-vein thrombosis after total hip arthroplasty. A prospective and randomised clinical study T2 - Journal of bone and joint surgery. British volume TI - Incidence and natural history of deep-vein thrombosis after total hip arthroplasty. A prospective and randomised clinical study UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00439712/full VL - 85 ID - 830045 ER - TY - JOUR AN - CN-00626794 AU - Kim, Y. H. AU - Oh, S. H. AU - Kim, J. S. M1 - SUPP_IV N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2004 SP - 396 ST - Incidence of fat embolism following cemented or cementless bilateral simultaneous- and unilateral total hip arthroplasty a prospective randomized clinical study T2 - The journal of bone and joint surgery (proceedings) TI - Incidence of fat embolism following cemented or cementless bilateral simultaneous- and unilateral total hip arthroplasty a prospective randomized clinical study UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00626794/full VL - 86‐B ID - 830078 ER - TY - JOUR AB - BACKGROUND: Controversy exists regarding the safety of bilateral simultaneous total hip arthroplasty, in part because of the potentially higher prevalence of pulmonary fat embolism. The purpose of the present study was to determine if unilateral and bilateral simultaneous total hip arthroplasty procedures resulted in different prevalences of fat embolization, different degrees of hemodynamic compromise, or different levels of hypoxemia or mental status changes. METHODS: One hundred and fifty‐six consecutive patients undergoing primary total hip arthroplasty were prospectively enrolled in the study. The study group included fifty patients undergoing bilateral simultaneous total hip arthroplasty and 106 patients undergoing unilateral total hip arthroplasty. One hundred hips were treated with a cemented stem, and 106 were treated with a cementless stem. Arterial and right atrial blood samples were obtained before implantation (baseline); at one, three, five, and ten minutes after implantation of the acetabular and femoral components; and at twenty‐four and forty‐eight hours after the operation. Arterial blood pressure, right atrial pressure, arterial oxygen tension, and carbon‐dioxide tension were also monitored at these times. The presence of lipid and cellular contents of bone marrow was determined. RESULTS: The prevalence of fat embolism was not significantly different between the groups managed with bilateral and unilateral total hip arthroplasty or between the groups managed with cemented and cementless stems. Similarly, the prevalence of bone‐marrow‐cell embolization was not significantly different between the groups managed with bilateral and unilateral total hip arthroplasty or between the groups managed with cemented and cementless stems. Patients with bone‐marrow‐cell embolization had a significantly lower arterial oxygen tension (p = 0.022) and oxygen saturation (p = 0.017) than did patients without bone‐marrow‐cell embolization on the first postoperative day. Four patients with bone‐marrow cells in the blood samples that were obtained from the right atrium on the first postoperative day had development of diffuse encephalopathy with confusion and agitation that lasted for about twenty‐four hours. CONCLUSIONS: The prevalence of fat and bone‐marrow‐cell embolization was similar in the groups managed with bilateral simultaneous and unilateral total hip arthroplasty as well as in the groups managed with cemented and cementless stems. AN - CN-00390827 AU - Kim, Y. H. AU - Oh, S. W. AU - Kim, J. S. DO - 10.2106/00004623-200208000-00012 KW - Adult Aged Aged, 80 and over Arthroplasty, Replacement, Hip [*adverse effects, methods] Bone Cements Bone Marrow Diseases [etiology] Embolism, Fat [*etiology, physiopathology] Female Femur Head Necrosis [surgery] Hemodynamics Humans Male Middle Aged Osteoarthritis, Hip [surgery] Prospective Studies M1 - 8 M3 - Clinical Trial; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2002 SP - 1372‐1379 ST - Prevalence of fat embolism following bilateral simultaneous and unilateral total hip arthroplasty performed with or without cement : a prospective, randomized clinical study T2 - Journal of bone and joint surgery. American volume TI - Prevalence of fat embolism following bilateral simultaneous and unilateral total hip arthroplasty performed with or without cement : a prospective, randomized clinical study UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00390827/full VL - 84 ID - 830068 ER - TY - JOUR AB - Background: The major concern with the use of tranexamic acid is that it may promote a hypercoagulable state and increase the risk of deep vein thrombosis (DVT) and pulmonary embolism (PE), particularly when chemical thromboprophylaxis is not used. The objective of this study was to ascertain whether tranexamic acid reduces blood loss and transfusion amounts and increases the prevalence of DVT and PE in the patients undergoing primary cementless total hip arthroplasty (THA) without the use of routine chemical thromboprophylaxis.Methods: There were 480 patients (582 hips) in the control group who did not receive tranexamic acid and 487 patients (584 hips) in the study group who received tranexamic acid. Mechanical compression device was applied without any chemical thromboprophylaxis. Transfusion rates and volumes were recorded. DVT was diagnosed using both sonogram and venogram at 7 or 8 days postoperatively. All patients had pre- and postoperative perfusion lung scanning to defect pulmonary embolism (PE).Results: Intraoperative (614 vs 389 mL) and postoperative blood loss (515 vs 329 mL) and transfusion volumes (3 units vs 1.5 units) were significantly lower (P < .001) in the tranexamic acid group. The prevalence of DVT was 15% (87 of 582 hips) in the control group and 18% (105 of 584 hips) in the tranexamic acid group. No fatal PE occurred in either group.Conclusion: The use of tranexamic acid reduces the volume of blood transfusion and does not increase the prevalence of DVT or PE in the patients who did not receive routine chemical thromboprophylaxis after primary cementless THA. AD - The Joint Replacement Centers, SeoNam Hospital, Ewha Womans University, Seoul, Republic of Korea The Joint Replacement Centers, MokDong Hospital, Ewha Womans University, Seoul, Republic of Korea AN - 120833073. Language: English. Entry Date: 20171129. Revision Date: 20191029. Publication Type: journal article AU - Kim, Young-Hoo AU - Park, Jang-Won AU - Kim, Jun-Shik DB - cin20 DO - 10.1016/j.arth.2016.07.048 DP - EBSCOhost KW - Postoperative Hemorrhage -- Prevention and Control Pulmonary Embolism -- Chemically Induced Venous Thrombosis -- Chemically Induced Tranexamic Acid -- Therapeutic Use Arthroplasty, Replacement, Hip -- Adverse Effects Antifibrinolytic Agents -- Therapeutic Use Phlebography Postoperative Hemorrhage -- Etiology Adult Young Adult Aged Female Aged, 80 and Over Relative Risk Middle Age Venous Thrombosis -- Epidemiology Male Blood Transfusion -- Statistics and Numerical Data Retrospective Design Prevalence Thromboembolism Pulmonary Embolism -- Epidemiology Clinical Trials Human M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 0883-5403 SP - 641-644 ST - Chemical Thromboprophylaxis Is Not Necessary to Reduce Risk of Thromboembolism With Tranexamic Acid After Total Hip Arthroplasty T2 - Journal of Arthroplasty TI - Chemical Thromboprophylaxis Is Not Necessary to Reduce Risk of Thromboembolism With Tranexamic Acid After Total Hip Arthroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=120833073&site=ehost-live&scope=site VL - 32 ID - 830573 ER - TY - JOUR AD - Departments of Radiology and Orthopaedic Surgery, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeongi-do 463-707, South Korea; Department of Radiology, Wooridul Spine Hospital, Seoul, South Korea. AN - 105490933. Language: English. Entry Date: 20090508. Revision Date: 20150711. Publication Type: Journal Article AU - Kim, Y. J. AU - Lee, J. W. AU - Park, K. W. AU - Yeom, J. S. AU - Jeong, H. S. AU - Park, J. M. AU - Kang, H. S. DB - cin20 DO - 10.1148/radiol.2511080854 DP - EBSCOhost KW - Fractures, Compression -- Epidemiology Fractures, Compression -- Therapy Kyphoplasty -- Statistics and Numerical Data Osteoporosis -- Epidemiology Osteoporosis -- Therapy Pulmonary Embolism -- Epidemiology Spinal Fractures -- Epidemiology Spinal Fractures -- Therapy Aged Aged, 80 and Over Bone Cements -- Therapeutic Use Causal Attribution Comorbidity Female Incidence Korea Male Middle Age Risk Assessment -- Methods Risk Factors Human M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0033-8419 SP - 250-259 ST - Pulmonary cement embolism after percutaneous vertebroplasty in osteoporotic vertebral compression fractures: incidence, characteristics, and risk factors T2 - Radiology TI - Pulmonary cement embolism after percutaneous vertebroplasty in osteoporotic vertebral compression fractures: incidence, characteristics, and risk factors UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105490933&site=ehost-live&scope=site VL - 251 ID - 830733 ER - TY - JOUR AB - A total of 33 patients with renal cell carcinoma metastatic to the spine underwent spinal decompression over a 5-year period; 20 were operated on for neurologic dysfunction, and the remainder for pain alone. Surgery was performed anteriorly in 21, posteriorly in 9, and combined in 3 cases. The surgical approach was determined by the preoperative anatomic localization of the tumor. Of these patients 88% had fusions with instrumentation and polymethylmethacrylate; 88% of patients had partial or complete relief of pain; and 64% of bedridden patients subsequently were able to walk. Neurologic function improved in 60% of patients with a neurologic deficit; however, only 36% of incontinent patients regained bladder control. Survival averaged 8.0 +/- 1.5 months. Survival correlated with the degree of neurologic dysfunction and the presence of other known metastases. Recurrent cord compression developed in 49% of patients, usually at the same level; 9 of these 16 patients had repeat decompression, with similar operative results as the primary procedure in terms of pain and neurologic function. Blood loss was variable but often significant. Preoperative embolization appeared to be beneficial. Precise tumor localization preoperatively directing the surgical approach and better patient selection would likely improve results and decrease morbidity. Good palliation appeared to be achieved in regards to both pain relief and improved neurologic function. AD - Department of Orthopaedic Surgery, Toronto General Hospital, University of Toronto, Ontario. AN - 1709305 AU - King, G. J. AU - Kostuik, J. P. AU - McBroom, R. J. AU - Richardson, W. DA - Mar DO - 10.1097/00007632-199103000-00003 DP - NLM ET - 1991/03/01 J2 - Spine KW - Bone Cements/therapeutic use Carcinoma, Renal Cell/mortality/*secondary/surgery Female Humans Kidney Neoplasms/*pathology Male Methylmethacrylate Methylmethacrylates/therapeutic use Middle Aged *Palliative Care Spinal Fusion Spinal Neoplasms/mortality/*secondary/surgery Survival Rate LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 1991 SN - 0362-2436 (Print) 0362-2436 SP - 265-71 ST - Surgical management of metastatic renal carcinoma of the spine T2 - Spine (Phila Pa 1976) TI - Surgical management of metastatic renal carcinoma of the spine VL - 16 ID - 828896 ER - TY - JOUR AB - BACKGROUND Pulmonary cement embolism is an uncommon but serious complication of percutaneous kyphoplasty, with a stated incidence of 4.6%-26%. We present a case of pulmonary cement embolism in an older woman with progressive dyspnea with a history of multiple kyphoplasties for compression fractures. CASE A 74 year old woman with CHF, paroxysmal atrial fibrillation not treated with anticoagulation, COPD, multiple sclerosis, fatigue, and osteoporosis, presented with worsening dyspnea for 3 weeks. Surgical history included multiple kyphoplasties for compression fractures, with the last procedure four years prior to presentation. On admission, intravenous diuretics and transfusion of packed red blood cells did not improve dyspnea, despite brisk diuresis and an improved hematocrit. Echocardiogram demonstrated mild diastolic dysfunction and known basal hypokinesis. CT of the thorax revealed new peripheral linear densities consistent with emboli from kyphoplasty cement.V/Q scan did not demonstrate any ventilation and perfusion mismatches, so anticoagulation was not initiated. The patient was discharged home with oxygen. Her respiratory status slowly improved and she discontinued oxygen three months later. DISCUSSION After evaluation for multiple causes of progressive dyspnea, the patient was diagnosed with pulmonary cement embolism. Acute presentations involve dyspnea, chest pain, and can lead to death. Given that many older adults undergo kyphoplasty for compression fractures, pulmonary cement embolism should be included on the differential diagnosis for dyspnea. Although this was likely an incidental finding for this patient, older adults are highly vulnerable to multiple insults, and pulmonary cement embolism may have partially contributed to patient's history of fatigue and dyspnea. There is low awareness of cement embolism as a complication of kyphoplasty with no present guidelines for treatment and evidence limited to case reports. Most case reports recommend no treatment for asymptomatic patients and anticoagulation for patients with symptomatic peripheral embolism. CONCLUSION Pulmonary cement embolism should be considered as a potential etiology for dyspnea in older adults with a history of kyphoplasty. AD - N. Kinger, Boston University, School of Medicine, Boston, MA, United States AU - Kinger, N. AU - Yang, H. AU - McGlynn, P. AU - Liu, C. DB - Embase DO - 10.1111/jgs.12870 KW - cement oxygen diuretic agent embolism female human dyspnea geriatrics society patient kyphoplasty adult compression fracture anticoagulation fatigue case report osteoporosis multiple sclerosis etiology differential diagnosis atrial fibrillation death thorax pain perfusion air conditioning density thorax hypokinesia diastolic dysfunction echocardiography hematocrit diuresis erythrocyte incidental finding transfusion procedures medical history LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 0002-8614 SP - S95 ST - Pulmonary cement embolism in an older woman with shortness of breath T2 - Journal of the American Geriatrics Society TI - Pulmonary cement embolism in an older woman with shortness of breath UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71470414&from=export http://dx.doi.org/10.1111/jgs.12870 VL - 62 ID - 829427 ER - TY - JOUR AB - BACKGROUND: Hemangioma is one of the most common benign tumors of the spine, and it remains silent in the vast majority of subjects afflicted. Pregnancy is a known risk factor for symptomatic conversion of the previously silent vertebral hemangiomas. However, the occurrence is rare with only 26 cases reported in the English medical literature. CASE DESCRIPTION: A 22-year-old woman in her 36th week of gestation presented with acute onset of upper back pain and progressive paraplegia. Imaging studies revealed a T4 vertebral hemangioma, which involved the vertebral body, pedincules, transverse, and spinous process with a focal extradural extension of soft tissue component. She underwent emergent cesarean delivery and endovascular embolization, respectively. Her symptoms and neurologic deficits improved quickly. Her complaints restarted 2 years after embolization. Surgical treatment which consists of intraoperative vertebraplasty and segmental fixation was performed. The patient's postoperative recovery was excellent. CONCLUSION: According to literature review and our patient's outcome, pregnancy may induce neurologic symptoms and signs in silent spinal hemangiomas. The way of management is decided by whether the neurologic deficits depend on the deformity caused by hemangioma or some other factors including vascular insufficiency. AD - Department of Radiology, Pamukkale University Medical School, Denizli, Turkey. AN - 18295858 AU - Kiroglu, Y. AU - Benek, B. AU - Yagci, B. AU - Cirak, B. AU - Tahta, K. DA - Apr DO - 10.1016/j.surneu.2007.09.025 DP - NLM ET - 2008/02/26 J2 - Surgical neurology KW - Angiography Back Pain/etiology Cesarean Section Embolization, Therapeutic Female Hemangioma/diagnostic imaging/*pathology Humans Magnetic Resonance Imaging Neoplasm Recurrence, Local/diagnostic imaging/pathology/surgery Paraplegia/etiology Pregnancy Pregnancy Complications, Neoplastic/diagnostic imaging/*pathology Reconstructive Surgical Procedures/instrumentation/methods Reoperation Spinal Canal/diagnostic imaging/pathology Spinal Cord Compression/diagnostic imaging/*etiology/*pathology Spinal Neoplasms/diagnostic imaging/*pathology Thoracic Vertebrae/blood supply/diagnostic imaging/*pathology Treatment Outcome Vertebroplasty/instrumentation/methods Young Adult LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0090-3019 (Print) 0090-3019 SP - 487-92; discussion 492 ST - Spinal cord compression caused by vertebral hemangioma being symptomatic during pregnancy T2 - Surg Neurol TI - Spinal cord compression caused by vertebral hemangioma being symptomatic during pregnancy VL - 71 ID - 828854 ER - TY - JOUR AB - Purpose: This prospective study was to investigate the incidence and the fate of deep vein thrombosis (DVT) among Chinese patients following unilateral primary total knee replacement (TKR). The influence of tourniquet time and the mode of anaesthesia on DVT were evaluated. Method: 390 patients who underwent unilateral cemented primary TKR were investigated. Patients whose body-mass-index (BMI) exceeded 30kg/m(2) were given chemoprophylaxis with low molecular heparin postoperatively. DVT was diagnosed using duplex ultrasonography on 4th to 7th days after operation. DVT was classified into two groups, distal and proximal. Patients who had DVT on the first scan were assigned two follow-up scans. Result: The incidence of DVT was 25.7%. 97 patients (24.9%) had distal DVT, whereas 3 had proximal DVT (0.8%). Among patients with DVT, 18 (18%) of them resolved at first follow up scan, 82 persisted, and there were no proximal progression. At the 6th week scanning, 57 patients (57%) were free from DVT, while 42 patients (42%) had persistent DVT. There was one (1%) case which the distal DVT had proximal migration, but there was no pulmonary embolism. Tourniquet time and mode of anaesthesia did not reveal any statistical significance on the incidence of DVT. Conclusion: This prospective study showed that the incidence of DVT after unilateral primary TKR in Hong Kong Chinese patient was high. However, most of them are distal to popliteal vein with low risk of proximal migration. More than half of them resolved at about two months after the operation. AD - [Kit, Lai Chun; Jid, Lee Qunn; Chung, Wong Yiu; Leung, Wai Yuk] Yan Chai Hosp, Dept Orthopaed & Traumatol, Tsuen Wan, Hong Kong, Peoples R China. Kit, LC (corresponding author), Yan Chai Hosp, Dept Orthopaed & Traumatol, Tsuen Wan, Hong Kong, Peoples R China. lckkenneth@gmail.com AN - WOS:000391086600009 AU - Kit, L. C. AU - Jid, L. Q. AU - Chung, W. Y. AU - Leung, W. Y. DA - Dec DO - 10.1016/j.jotr.2015.06.006 J2 - J. Orthop. Trauma Rehabil. KW - total knee arthroplasty deep vein thrombosis ultrasound VENOUS THROMBOEMBOLISM TOTAL HIP ARTHROPLASTY VENOGRAPHY SURGERY DIAGNOSIS Orthopedics LA - English M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2016 SN - 2210-4917 SP - 35-38 ST - Incidence of Deep Vein Thrombosis and Its Natural History Following Unilateral Primary Total Knee Replacement in Local Chinese Patients-A Prospective Study T2 - Journal of Orthopaedics Trauma and Rehabilitation TI - Incidence of Deep Vein Thrombosis and Its Natural History Following Unilateral Primary Total Knee Replacement in Local Chinese Patients-A Prospective Study UR - ://WOS:000391086600009 VL - 21 ID - 830203 ER - TY - JOUR AB - Background We aimed to retrospectively investigate patients with multicentric giant cell tumor (MCGCT) who were treated at our hospital and to clarify their clinical features, treatment policy, and follow-up method. Methods Four patients with two or more giant cell tumor (GCT) that occurred in the same patient were treated at our institution between 1978 and 2015. These patients were evaluated for the following: frequency, age of onset, number and site of occurrence, time to occurrence of the next lesion, treatment, recurrence, malignant transformation, metastasis, and oncological outcome. Results The rate of occurrence was 1.7%. The average age was 25.2 (17–44). The total number of lesions was three in two cases and two in two cases. All four cases had only one lesion during the initial visit. The most frequent site of occurrence was the proximal femur, followed by two lesions that occurred in the metaphysis. The interval between confirmation of the initial lesion and occurrence of the second lesion was in average 12.1 years (0.8–27.0). Initial presentations of lesions were treated by en bloc resection in one case and curettage in three cases. Local recurrences occurred in two cases that underwent curettage. The six lesions that occurred after the initial lesion were treated as follows: en bloc resection in four lesions, curettage and radiation therapy in one, and embolization and radiation therapy in one. Pathologically, no lesions presented malignancy. Pulmonary metastasis occurred in one case. The oncological outcome was NED in three cases and AWD in one case. Conclusions No lesions were malignant, and by providing the same treatment as solitary GCT, the oncological outcome was good. It is unnecessary to be concerned of its risks and postoperatively conduct long-term searches for focal lesions across the body. AD - M. Kito, Department of Orthopaedic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, Japan AU - Kito, M. AU - Matsumoto, S. AU - Ae, K. AU - Tanizawa, T. AU - Gokita, T. AU - Hayakawa, K. AU - Funauchi, Y. AU - Takazawa, Y. DB - Embase Medline DO - 10.1016/j.jos.2017.08.004 KW - poly(methyl methacrylate) adolescent adult article artificial embolization bone destruction bone scintiscanning cancer surgery case report clinical article clinical feature cortical bone curettage disease course distal femur distal radius female femur epiphysis follow up human lung metastasis male malignant transformation metaphysis multicentric giant cell tumor of bone onset age osteoclastoma outcome assessment pain pathologic fracture proximal femur proximal tibia retrospective study rib sacrum swelling thoracic vertebra thorax radiography tumor recurrence young adult LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1436-2023 0949-2658 SP - 1107-1111 ST - Multicentric giant cell tumor of bone: Case series of 4 patients T2 - Journal of Orthopaedic Science TI - Multicentric giant cell tumor of bone: Case series of 4 patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L619140975&from=export http://dx.doi.org/10.1016/j.jos.2017.08.004 VL - 22 ID - 829231 ER - TY - JOUR AB - Introduction: Percutaneous cementoplasty (PC) has been widely used for the stabilization of impending fractures of the proximal femur due to metastatic lesions. Augmented percataneous cementoplasty (APC) with fixation devices aims to improve mechanical consolidation and stability of the construct. However, the clinical benefit of the combined technique has not been clearly established. The purpose of the current review was to compare the efficacy between APC and PC for impending pathologic proximal femoral fractures from metastatic malignancy, in terms of pain relief, operative time and fracture related complication rates. Material and methods: Medline, Scopus, and the Cochrane central register of controlled trials were searched for clinical studies up to July 2019. Studies relevant to cementoplasty of the proximal femur were included. The primary outcome of the study was pain relief as assessed using the Visual Analogue Scale (VAS) change. Secondary outcomes included incidence of post-intervention fracture, operative time and complication rate. Results: Twelve studies with a total of 343 patients were included. No difference was found for all outcomes. For pain relief, pooled results showed a mean difference in VAS score -4.6 ± 1.7 for PC, and -4.3 ± 2.5 for APC (p = 0.41). Post-intervention fractures of the proximal femur occurred in 7% of patients with PC and in 5% of patients with APC (p = 0.4), and the mean duration of interventions was 57.9 ± 8.4 and 56.5 ± 27.5 min, respectively (p = 0.58). Cement leakage into the hip joint or the soft tissues occurred in 5% of cases in PC group and in 8% of cases in APC group (p = 0.16). Six patients in the APC group (4%) experienced major systemic complications, which were treated successfully. Conclusions: APC does not seem to improve pain relief, fracture incidence, and operative time when compared with PC. Both techniques appeared effective in terms of resolution of symptoms, prevention of pathologic fractures, and early facilitation of weight-bearing. PC showed more clinical safety, as no major systemic complications occurred. However, due to the relative paucity of large clinical trials, the decision of augmentation of cementoplasty should be individualized according to the size and location of metastatic lesions and the overall medical condition of patients. AD - B. Chalidis, Aristotle University of Thessaloniki, 1st Orthopaedic Department, George Papanikolaou Hospital, Greece AU - Kitridis, D. AU - Saccomanno, M. F. AU - Maccauro, G. AU - Givissis, P. AU - Chalidis, B. DB - Embase Medline DO - 10.1016/j.injury.2020.02.045 KW - adverse event analgesia article augmented percutaneous cementoplasty bone cement leakage bone metastasis cementoplasty clinical assessment hip human incidence intermethod comparison lung embolism operation duration outcome assessment pathologic fracture percutaneous cementoplasty postoperative complication priority journal proximal femur proximal femur fracture quality control soft tissue systematic review therapy effect treatment duration venous thromboembolism visual analog scale LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1879-0267 0020-1383 SP - S66-S72 ST - Augmented versus non-augmented percutaneous cementoplasty for the treatment of metastatic impending fractures of proximal femur: A systematic review T2 - Injury TI - Augmented versus non-augmented percutaneous cementoplasty for the treatment of metastatic impending fractures of proximal femur: A systematic review UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2005024826&from=export http://dx.doi.org/10.1016/j.injury.2020.02.045 VL - 51 ID - 829061 ER - TY - JOUR AB - Background: Gold-standard surgical treatment for vertebral compression fractures (VCF) includes vertebroplasty and kyphoplasty, which relies on cement to provide vertebral body (VB) stability, VB height increase and lordotic alignment. However, cement-kyphoplasty fails primary VB restoration in 34% of cases and secondary loss of height in 18-63%. Cement has adverse effect of bony consolidation and fracture healing favoring the migration of the bloc of cement. It also affects biomechanical properties of bone, increases stiffness and rigidity, which may promote adjacent fractures. Additionally, cement leakage may cause spinal cord compression, and pulmonary embolism, which may be potentially serious. Recently, a novel OsseoFix Spinal Fracture Reduction System has become available. It features a percutaneously implantable titanium scaffold that expands within the vertebral body. The aim of this study is to evaluate VCF fixation using OsseoFix without cement. We hypothesized that the titanium mesh scaffold without cement can adequately restore VB height and sagittal alignment lost in VCFs, translating to good radiological outcomes. Material and Methods: 13 patients (5 males and 8 females, mean age 63.5) diagnosed with VCFs were included in this study. Osteoporosis, trauma and tumor were concomitant with VCFs in 7, 3 and 3 patients, respectively. A total of 28 vertebrae were treated, with one implant in 6 vertebrae and two implants in 22 vertebrae. Anterior, middle and posterior VB heights (AH, MH, PH) and index level Kyphotic angle (KA) were evaluated pre- operatively, at immediate post-operatively, and at last follow-ups. Results: All 50 implants were optimally positioned and deployed without any complication. Stabilization of the collapsed vertebral body was achieved in all 28 vertebras. Mean follow-up was 26 months (18-34months). The postoperative kyphotic angle (KA) revealed significant improvements (KA 12.2° to 7.2°, P < .01) with partial loss of reduction at final follow-up (KA 8.6°). AH, an indicator of vertebral body reduction, improved significantly from 20.6 ± 1.9mm preoperatively to 25.1 ± 2.0mm (P < .05) postoperatively, but decreased to 21.5 ± 1.1 (P < .01 [postoperative vs. follow-up]) at final follow-up. Correspondingly, MH improved from 18.39 ± 1.7mm to 24.6 ± 2.0 and finally declined to 22.5±1.9mm. PH changed from 28,31.8±1.7mm to 32.3± 1.9mm postoperatively to 30.7 ±1 .9mm at final follow-up. Conclusions: Percutaneous implantation of OsseoFix to treat VCFs provides good radiological outcomes at a low complication rate. As it provides an adequate maintenance of reduction, OsseoFix implantation offers an effective alternative to vertebroplasty or kyphoplasty, eliminating any cement-related complications. This study prompts additional studies with longer follow-ups for this novel cement-free vertebral stent as a potential next-generation treatment of VCFs. AD - D.J. Kitumba, Dep. Neurosurgery, Centro Hospitalar de Gaia, Porto, Portugal AU - Kitumba, D. J. AU - Reinas, R. AU - Alves, O. L. DB - Embase DO - 10.1177/2192568217708189 KW - cement titanium adult adverse drug reaction animal model body height clinical article complication compression fracture diagnosis female follow up fracture reduction human implant kyphoplasty language lung embolism male middle aged neoplasm osteoporosis rigidity side effect spinal cord compression stent surgery vertebra body LA - English M1 - 2 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 2192-5690 SP - 353S-354S ST - Radiological outcomes from cementless percutaneous implantation of osseofix for the treatment of vertebral compression fractures T2 - Global Spine Journal TI - Radiological outcomes from cementless percutaneous implantation of osseofix for the treatment of vertebral compression fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L616656848&from=export http://dx.doi.org/10.1177/2192568217708189 VL - 7 ID - 829258 ER - TY - JOUR AB - 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 degrees; so the mean correction achieved was 4.5 degrees. In traumatic group preoperative VA was 13 degrees whilst postoperatively it was 5.7 degrees; therefore the mean correction achieved was 7.3 degrees. 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. (C) 2011 Elsevier Ltd. All rights reserved. AD - [Klezl, Zdenek; Majeed, Haroon; Bommireddy, Rajendranath] Royal Derby Hosp, Derby, England. [Klezl, Zdenek] Charless Univ, Med Sch 3, Prague, Czech Republic. [John, Joby] Queens Med Ctr, Nottingham NG7 2UH, England. Klezl, Z (corresponding author), Royal Derby Hosp, Derby, England. zklezl@aospine.org AN - WOS:000294539800013 AU - Klezl, Z. AU - Majeed, H. AU - Bommireddy, R. AU - John, J. DA - Oct DO - 10.1016/j.injury.2011.04.006 J2 - Injury-Int. J. Care Inj. KW - Vertebroplasty Kyphoplasty Kyphoplasty stents Vertebral fractures Osteoporotic fractures Cement augmentation PERCUTANEOUS VERTEBROPLASTY COMPRESSION FRACTURES BALLOON KYPHOPLASTY BURST FRACTURES CALCIUM-PHOSPHATE POSTERIOR INSTRUMENTATION CEMENT POLYMETHYLMETHACRYLATE AUGMENTATION EMBOLISM Critical Care Medicine Emergency Medicine Orthopedics Surgery LA - English M1 - 10 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2011 SN - 0020-1383 SP - 1038-1042 ST - Early results after vertebral body stenting for fractures of the anterior column of the thoracolumbar spine T2 - Injury-International Journal of the Care of the Injured TI - Early results after vertebral body stenting for fractures of the anterior column of the thoracolumbar spine UR - ://WOS:000294539800013 VL - 42 ID - 830320 ER - TY - JOUR AB - Purpose: To describe the minimally invasive technique for cement augmentation of cannulated and fenestrated screws using an injection cannula as well as to report its safety and efficacy.Methods: A total of 157 cannulated and fenestrated pedicle screws had been cement-augmented during minimally invasive posterior screw-rod spondylodesis in 35 patients from January to December 2012. Retrospective evaluation of cement extravasation and screw loosening was carried out in postoperative plain radiographs and thin-sliced triplanar computed tomography scans.Results: Twenty-seven, largely prevertebral cement extravasations were detected in 157 screws (17.2%). None of the cement extravasations was causing a clinical sequela like a new neurological deficit. One screw loosening was noted (0.6%) after a mean follow-up of 12.8 months. We observed no cementation-associated complication like pulmonary embolism or hemodynamic insufficiency.Conclusions: The presented minimally invasive cement augmentation technique using an injection cannula facilitates convenient and safe cement delivery through polyaxial cannulated and fenestrated screws during minimally invasive screw-rod spondylodesis. Nevertheless, the optimal injection technique and design of fenestrated screws have yet to be identified. This trial is registered with German Clinical Trials DRKS00006726. AN - 109749311. Language: English. Entry Date: 20150923. Revision Date: 20160715. Publication Type: journal article. Journal Subset: Biomedical AU - Klingler, Jan-Helge AU - Scholz, Christoph AU - Kogias, Evangelos AU - Sircar, Ronen AU - Krüger, Marie T. AU - Volz, Florian AU - Scheiwe, Christian AU - Hubbe, Ulrich DB - cin20 DO - 10.1155/2015/979186 DP - EBSCOhost N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2015 SN - 1537-744X SP - 979186-979186 ST - Minimally Invasive Technique for PMMA Augmentation of Fenestrated Screws T2 - Scientific World Journal TI - Minimally Invasive Technique for PMMA Augmentation of Fenestrated Screws UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=109749311&site=ehost-live&scope=site VL - 2015 ID - 830624 ER - TY - JOUR AB - Intraosseous hibernoma is an uncommon brown fat tumor that with about 2-dozen case reports described in the literature. Hibernomas are more commonly found in soft tissues of the thigh, shoulder, and back. However, more cases of intraosseous hibernomas are coming to light as a result of work-up due to pain or as an incidental lesion finding. Herein, we present a case of a thoracic intraosseous hibernoma suspicious for an isolated ovarian cancer metastasis, successfully treated with radiofrequency ablation and kyphoplasty. AD - A. Ko, Eastern Virginia Medical School, 825 Fairfax Ave, Norfolk, VA, United States AU - Ko, A. AU - Rowell, C. C. AU - Vogler, J. B. AU - Samoilov, D. E. DB - Embase DO - 10.1016/j.radcr.2020.10.014 KW - radiofrequency ablation device aged article bone tumor case report clinical article computed tomographic angiography dyspnea female follow up hibernoma human human tissue kyphoplasty lung embolism musculoskeletal radiologist nuclear magnetic resonance imaging ovary metastasis priority journal radiofrequency ablation tachycardia thorax thorax pain vertebra body LA - English M1 - 12 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1930-0433 SP - 2677-2680 ST - Intraosseous hibernoma: A metastatic mimicker to consider on the differential T2 - Radiology Case Reports TI - Intraosseous hibernoma: A metastatic mimicker to consider on the differential UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2008355587&from=export http://dx.doi.org/10.1016/j.radcr.2020.10.014 VL - 15 ID - 829044 ER - TY - JOUR AD - The Catholic University of Korea College of Medicine, Seoul, Korea. AN - 19404949 AU - Ko, H. J. AU - Park, K. S. AU - Cho, C. S. AU - Kim, H. Y. DA - May DO - 10.1002/art.24455 DP - NLM ET - 2009/05/01 J2 - Arthritis and rheumatism KW - Aged Bone Cements/*adverse effects Embolism/*etiology Female Fractures, Compression/*diagnostic imaging/etiology Humans Polymethyl Methacrylate/*adverse effects Postoperative Complications Radiography *Vertebroplasty LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0004-3591 (Print) 0004-3591 SP - 1341 ST - Clinical images: Cement embolism following percutaneous vertebroplasty T2 - Arthritis Rheum TI - Clinical images: Cement embolism following percutaneous vertebroplasty VL - 60 ID - 828981 ER - TY - JOUR AB - To assess the immediate efficacy of percutaneous vertebroplasty (PVP) in relief of pain and improving mobility of patients with vertebral compression fractures (VCF) secondary to osteoporosis, 205 cases (175 patients) underwent 250 percutaneous injections of polymethylmethacrylate (PMMA; unilateral, 247 levels; bilateral, 3 levels) into vertebrae under CT and fluoroscopic guidance for 34 months. Patients were prospectively asked to quantify their pain on a visual analog scale (VAS) before and a day after PVP. The interval to mobilization was recorded in those who were immobilized because of pain and/or bed-rest therapy (115 cases). PVP was technically successful in all patients, with three cases of minimal complications. The mean VAS score available for 196 cases was improved from 7.22 +/- 1.89 (range, 3-10) to 2.07 +/- 1.19 (range, 0- 10) by PVP. Ninety-four of 115 immobilized cases (81.7%) were mobile by 24 h after PVP, and the mean value was 1.9 +/- 2.8 days. The incidence of recurrent and new fractures was 15.6% in 4-25 months (mean, 15.3 months). PVP is a safe and effective treatment for relieving the pain associated with osteoporotic VCF and strengthening the vertebrae, avoiding refractures. This therapy leads to early mobilization and avoidance of the dangers of conservative therapy of bed-rest. AD - Kyoto Renaiss Hosp, Dept Radiol, Kyoto 6200054, Japan. Kyoto Renaiss Hosp, Dept Internal Med, Kyoto 6200054, Japan. Shiga Univ Med Sci, Dept Radiol, Shiga 5202192, Japan. Kobayashi, K (corresponding author), Kyoto Renaiss Hosp, Dept Radiol, 1-38 Suehiro Cho, Kyoto 6200054, Japan. radiology@renaiss.jp AN - WOS:000227333900025 AU - Kobayashi, K. AU - Shimoyama, K. AU - Nakamura, K. AU - Murata, K. DA - Feb DO - 10.1007/s00330-004-2549-0 J2 - Eur. Radiol. KW - osteoporosis interventional procedures spine fractures vertebroplasty ACRYLIC SURGICAL CEMENT POLYMETHYLMETHACRYLATE VERTEBROPLASTY TRANSPEDICULAR VERTEBROPLASTY HIP-ARTHROPLASTY METASTASES INJECTION EMBOLISM Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2005 SN - 0938-7994 SP - 360-367 ST - Percutaneous vertebroplasty immediately relieves pain of osteoporotic vertebral compression fractures and prevents prolonged immobilization of patients T2 - European Radiology TI - Percutaneous vertebroplasty immediately relieves pain of osteoporotic vertebral compression fractures and prevents prolonged immobilization of patients UR - ://WOS:000227333900025 VL - 15 ID - 830428 ER - TY - JOUR AB - Aim: The aim of this study was to evaluate embolisation as a therapy option for aneurysmal bone cysts of the trunk. Method: Case reports about two males with intermittent pseudo-radicular lumboischialgia and coxalgia are discussed. Results: The diagnostic work-up and biopsies verified an aneurysmal bone cyst in both males. In one patient the tumour-like lesion was localised in the fifth lumbar vertebral body, in the other in the left ischium and pubis. Arterial embolisation was performed in both cases. Follow-up at 6 and 24 months after embolisation showed a significant increase of sclerosis and a reduced volume of the cysts. Conclusion: In accord with literature data, arterial embolisation seems to be a sufficient and minimally invasive therapy option in aneurysmal bone cysts of the spine and the pubis. © Georg Thieme Verlag KG Stuttgart. AD - T. Kocak, Orthopädische Universitätsklinik Ulm am RKU, Oberer Eselsberg 45, 89081 Ulm, Germany AU - Kocak, T. AU - Huch, K. AU - Ulmar, B. AU - Aschoff, A. AU - Reichel, H. DB - Embase Medline DO - 10.1055/s-2007-989392 KW - phenol derivative poly(methyl methacrylate) adolescent adult aneurysmal bone cyst angiography article artificial embolization bone biopsy bone scintiscanning case report computer assisted tomography follow up histology human ischium lumbar spine male nuclear magnetic resonance imaging pubic bone treatment outcome vertebra body LA - German M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2008 SN - 1864--669 SP - 256-260 ST - Embolisation of aneurysmal bone cysts as a minimally invasive treatment option - Presentation of two cases T2 - Zeitschrift fur Orthopadie und Unfallchirurgie TI - Embolisation of aneurysmal bone cysts as a minimally invasive treatment option - Presentation of two cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L351959745&from=export http://dx.doi.org/10.1055/s-2007-989392 VL - 146 ID - 829754 ER - TY - JOUR AB - Learning Objectives 1. To learn how to use different IR techniques in the palliative setting 2. To learn how to take advantage of radiotherapy in the palliative setting 3. To learn how to use data to improve safety and efficacy Most bone metastases develop in patients with breast, prostate, lung, thyroid, and kidney cancers. Most lesions are located in the spine, pelvis, and proximal part of the extremities. In 75% of cases, these lesions cause skeletal-related events (SREs) that are characterized by pain, pathological fractures, loss of limb function, and nerve compression. The goal of palliative treatment is not to radically destroy the tumor but to alleviate pain and prevent SREs (especially fractures). Radiotherapy is the gold standard treatment for symptomatic bone metastasis, but this technique has some limitations: its effects are slow and limited in time as the median time to response is 3 weeks and the median time to progression is about 6 months. Moreover, one third of the patients do not respond to radiotherapy treatment (1). Thus, interventional radiology (IR) has a place in palliative care. IR palliative treatment can be achieved with consolidative techniques (cementoplasty or screw fixation) or with ablative techniques, such as radio frequency ablation (RFA), microwave ablation (MWA), cryoablation, and high-intensity focused ultrasound (HIFU). A combination of ablative and consolidative techniques is recommended when an osteolytic lesion with extra-osseous component is treated or for large volumes of ablation in tumors involving weight-bearing bones to prevent the risk of secondary fractures. For hypervascular metastasis (e.g., kidney or thyroid cancers), intra-arterial embolization might be an option combined to percutaneous techniques. Cementoplasty consists of percutaneous injection of polymethylmethacrylate cement (PMMA) and provides pain relief and bone strengthening in patients with malignant bone tumors (2). Cementoplasty is indicated for patients with osteolytic tumors (metastasis, multiple myeloma, and lymphoma) located to the vertebral body, acetabulum, femoral condyles, talus, and calcaneus, causing local pain, disability, and high risk of compression fracture (3,4). Cementoplasty does not stop tumor growth; thus, it should not be considered as a radical treatment. PMMA is highly resistant to compression forces but susceptible to torsion forces. Thus, cement injection should not be used in long diaphysis, as it does not provide bone strengthening, with possible fracture of the cement rod. Screw fixation should be considered for the treatment of nondisplaced pathologic or bone insufficient fractures or in cases of impending fractures (i.e., osteolytic lesions weakening the bone); such technique can be applied when both compression and torsion forces are involved. Screw fixation might be used in bones of the pelvic ring (including the femoral neck and the sacrum) or shoulder girdle. Percutaneous ablation using RFA is produced by alteration of the electric current at the tip of an electrode, causing local ionic agitation and subsequent frictional heating. According to the size of the lesion and the generator used, different protocols are applied. The best guidance modality is CT, with or without fluoroscopy. The electrodes can be placed either directly inside the lesion or through a coaxial system. For sclerotic bone lesions a system of coaxial drill needle can be applied to penetrate the target lesion. Bone RFA is painful and requires regional block or general anesthesia. The difficulty of treating bone tumors with RFA lies in the thermal protection of vulnerable surrounding structures (particularly nerve roots) (5). When using RFA for pain palliation, significant (>50%) and rapid pain relief (during the first 24 hours to 1 week post-treatment) is achieved in 70-95% of cases, with substantial decrease of the consumption of analgesic drugs (6). Though recurrence of pain may occur (due to the advanced disease), the vast majority of patients remain pain free at the ablated area. Cryoablation rel es on the application of extreme cold aiming to destroy cells, by causing both direct cellular and vascular injury. The procedure is carried out by means of thin probes (17 gauge) and exploits the Joule-Thomson effect of gases in order to achieve rapid cooling at low temperatures (-100°C) of the surrounding tissue. The basic principles of cryosurgery for tumors are fast cooling of the tissue to a lethal temperature, slow thawing, and repetition of the freezing-thawing cycle. Percutaneous cryoablation proved to be a safe and effective for pain management due to metastatic disease involving bone and soft tissues. Regarding bone metastasis, cryoablation is not influenced by tissue impedance and thus, it is efficient for both osteolytic and sclerotic tumors. Similar to bone RFA, the procedure is performed under sedation or general anesthesia (though cryoablation appears to be less painful than RFA) (7). In most centers, cryoablation is performed under CT or MR guidance (with MR-compatible cryoprobes). The distance between probes should be ≤2 cm. With cryoablation the ablation zone (namely iceball) is clearly seen as a hypodense (on CT) or a signal-void area (on MRI), while the boundaries between the frozen and non-frozen areas are well defined and depicted with high contrast. Cryoablation has the advantage of synergic and simultaneous activation of many probes (up to 25) in order to treat large lesions. Pain palliation in malignant painful bone tumors is achieved in >70% of cases, with substantial decrease in the use of pain killers and improvement of the quality of life (8). The main advantages of cryoablation over RFA are that the former is less painful thus, requiring less intra and postprocedural analgesia, and that the area of ablation is clearly visualized with cryoablation, which is not the case with RFA. MWA utilizes dielectric hysteresis produced by a percutaneously applied electromagnetic field (900-2500 MHz) to produce heat energy. Interstitial antennas are used to couple energy from the generator power source to the tissue. In contrast to RFA, MW antennas are capable of propagating through and effectively heating many types of tissue, without being influenced by the tissue dielectric properties. According to the size of the lesion, one or more antennas are inserted and may be activated simultaneously. The best image guidance modality for MWA is CT (with or without fluoroscopy). No MR-compatible generators-antennas are available at the moment. MW antennas can be placed either directly inside the lesion or through coaxial systems. Compared to RFA, MWA can produce larger areas of ablation in less time; moreover, it is not influenced by tissue impedance and is less susceptible to heat sink effects. As MWA is a rather new technique, no long-term results exist at the moment. HIFU uses convergent high-intensity ultrasound to induce focalized tissue destruction by rapid increase of local temperature. To treat localized painful bone metastases, HIFU has been used in combination with MR guidance under conscious sedation (9). This technique demonstrated good pain relief at 1 and 3 months follow-up, with decrease in the use of analgesic drugs. At the 3-month CT follow-up, up to 56% of osteolytic lesions showed an increased bone density, suggesting a potential consolidative role of HIFU. However, further studies are needed to confirm this aspect. When hypervascular lesions are treated, ablative techniques, especially cryoablation and RFA, may be faced with the cold or heat sink effect. Pre-ablative intra-arterial embolization of the tumor may increase the effect of thermal ablation. AD - G. Koch, Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France AU - Koch, G. AU - Cazzato, R. L. AU - Tsoumakidou, G. AU - Caudrelier, J. AU - Garnon, J. AU - Gangi, A. DB - Embase DO - 10.1007/s00270-016-1405-3 KW - analgesic agent cement radical ablation therapy acetabulum agitation analgesia antenna (radio) arterial embolization blood vessel injury bone atrophy bone density bone lesion bone metastasis breast cancer calcaneus cancer size cancer susceptibility cell damage cementoplasty clinical study cold stress compression fracture conscious sedation controlled study cooling cryoprobe cryosurgery destruction diaphysis disability disease free interval DNA probe electric current electrode electromagnetism female femoral condyle femoral neck fluoroscopy follow up freezing gas gauge general anesthesia gold standard heat heating high intensity focused ultrasound human hysteresis impedance injection interventional radiology kidney cancer learning limb lung cancer lymphoma male microwave thermotherapy multiple myeloma nerve function nerve root nuclear magnetic resonance imaging palliative therapy pathologic fracture prevention prostate cancer quality of life radiofrequency ablation radiotherapy relapse reaction time sacrum safety shoulder girdle soft tissue talus thawing thyroid cancer torsion tumor growth vertebra body weight bearing LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1432-086X SP - S116-S117 ST - Palliative therapies in malignant tumours T2 - CardioVascular and Interventional Radiology TI - Palliative therapies in malignant tumours UR - https://www.embase.com/search/results?subaction=viewrecord&id=L613933564&from=export http://dx.doi.org/10.1007/s00270-016-1405-3 VL - 39 ID - 829343 ER - TY - JOUR AB - Background: Increase in intraosseous pressure and displacement of bone marrow contents leading to fat embolism and hypotension during cement injection in vertebroplasty (VP). We aimed to compare the effect of low and high viscosity cements during VP on pulmonary arterial pressure (PAP) with different cannula.Materials and Methods: Fifty-two patients having multilevel VP due to osteoporotic vertebral compression fractures were randomly treated either by a high viscosity cement (group A, n = 27 patients) and 2.8 mm cannula or a low viscosity cement (group B, n = 25 patients) injected through 4.2 mm cannula. PAP was measured by standard echocardiography and blood d-dimer values were recorded preoperatively, 24 h and third day after operation.Results: Mean age was 69 (62-87) years in group A and 70 (64-88) years in group B, and sex and comorbidities were similar. Average number of augmented levels was 5.4 in group A and 5.7 in group B. Preoperative mean PAP was 33 mm/Hg in group A, elevated to 41 mm/Hg on first day, and decreased to 36 mm/Hg on third day. The mean PAP in group B was 35 mm/Hg preoperatively, 51 mm/Hg on first day and 46 mm/Hg on third day (p < 0.05). The average blood d-dimer values in group A increased from 2.1 µg/mL to 2.3 µg/mL and in group B from 2.2 µg/mL to 4.2 µg/mL.Conclusion: The finding of this study showed that high viscosity cement injected through a narrower cannula results in lesser PAP increase and d-dimer levels when compared to low viscosity cement injected through a wider cannula. Higher PAP and d-dimer level may show possible thromboembolism. This finding may give spine surgeons to reconsider their choice of cement type and cannula size. AD - Orthopedic and Traumatology Department, Sakarya University Education and Research Hospital, Sakarya, Turkey Istanbul Spine Center, Florence Nightingale Hospital, Istanbul, Turkey Liv Hospital Ulus Orthopedic and Spine Surgery, Istanbul, Turkey AN - 142554978. Language: English. Entry Date: 20201217. Revision Date: 20201217. Publication Type: journal article AU - Kochai, Alauddin AU - Enercan, Meric AU - Kahraman, Sinan AU - Ozturk, Cagatay AU - Hamzaoglu, Azmi DB - cin20 DO - 10.1177/2309499019897659 DP - EBSCOhost KW - Vertebroplasty -- Methods Spinal Fractures -- Surgery Pulmonary Wedge Pressure -- Physiology Fractures, Compression -- Surgery Bone Cements Aged, 80 and Over Male Spinal Fractures -- Physiopathology Female Aged Fractures, Compression -- Physiopathology Human Middle Age Validation Studies Comparative Studies Evaluation Research Multicenter Studies Randomized Controlled Trials M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2020 SN - 1022-5536 SP - 1-5 ST - Effect of cementing on pulmonary arterial pressure in vertebroplasty: A comparison of two techniques T2 - Journal of Orthopaedic Surgery (10225536) TI - Effect of cementing on pulmonary arterial pressure in vertebroplasty: A comparison of two techniques UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=142554978&site=ehost-live&scope=site VL - 28 ID - 830517 ER - TY - JOUR AB - The first aim of this prospective clinical study was to characterize the relationship between embolic events observed during cemented total hip arthroplasty using transesophageal echocardiography (TEE), and changes in cardiopulmonary function. The second aim was to assess the efficiency of a modified cementing technique that was developed to reduce the risk of embolism. The modification consists in a vacuum drainage placed in the proximal femur to reduce the increase of intramedullary pressure during insertion of the prosthesis. One hundred twenty patients were randomized into two groups. Group 1 received a total hip arthroplasty cemented conventionally, whereas Group 2 was cemented with the modified technique. Continuous TEE, hemodynamic monitoring, and blood gas analysis were done during the perioperative period. Severe embolic events were imaged during the insertion of the femoral component and the reduction of the hip joint. Embolism occurred in 93.3% of patients operated on with the conventional cementing technique, compared with 13.3% of patients operated on with the modified technique (P < 0.05). Intraoperative shunt values during insertion of the femoral component increased from 8.2% to 10.3% (P < 0.05) in Group 1 patients, whereas there was no significant change in Group 2 patients. We observed no clinical signs of fat embolism syndrome in any study patient. The results of the study indicate that embolic events observed using TEE can cause increased pulmonary shunt values during hip arthroplasty, especially in patients with systemic disease (ASA physical status III). The modified surgical technique effectively reduced the incidence of embolization during cemented hip arthroplasty. IMPLICATIONS: Use of conventional cementing techniques is associated with echocardiographic evidence of embolism in 93% of patients and with a significant increase in pulmonary shunting. The incidence of embolism and change in shunting are reduced with a modified cementing technique that limits increases in intramedullary pressure. AN - CN-00330386 AU - Koessler, M. J. AU - Fabiani, R. AU - Hamer, H. AU - Pitto, R. P. DO - 10.1097/00000539-200101000-00010 KW - Aged Arthroplasty, Replacement, Hip [*adverse effects, *methods] Bone Cements Cementation [methods] Echocardiography, Transesophageal Embolism, Fat [diagnostic imaging, etiology, physiopathology, prevention & control] Female Hemodynamics Humans Male Monitoring, Intraoperative [methods] Prospective Studies Pulmonary Embolism [*diagnostic imaging, etiology, physiopathology, *prevention & control] Respiratory Function Tests M1 - 1 M3 - Clinical Trial; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2001 SP - 49‐55 ST - The clinical relevance of embolic events detected by transesophageal echocardiography during cemented total hip arthroplasty: a randomized clinical trial T2 - Anesthesia and analgesia TI - The clinical relevance of embolic events detected by transesophageal echocardiography during cemented total hip arthroplasty: a randomized clinical trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00330386/full VL - 92 ID - 830070 ER - TY - JOUR AB - A number of cardiovascular and pulmonary complications have been reported to occur occasionally after insertion of a total hip prosthesis. Of the proposed causes of these reactions, the possibility of fat embolism has received considerable support. The increase in intramedullary pressure, produced by the mechanical compression of the femoral canal during the insertion of the stem, seems to be the decisive pathogenic factor for the development of emboli. Surgeons' proclivity to deny the clinical relevance of intraoperative emboli is directly related to their awareness of and their attempt to avoid this phenomenon. Depending on the preoperative clinical condition of the patient, the cardiorespiratory impairment may be subclinical for those with good reserve, or clinical for those with poor reserve. In cases with preexisting cardiorespiratory diseases, severe embolism can also lead to death. Moreover, tissue thromboplastin from bone marrow forced into the draining veins of the proximal femur during insertion of the stem leads to activation of the clotting cascade, lesions of the venous endothelium, and thrombogenesis. A correlation was found between the embolic events observed using transesophageal echocardiography and the cardiopulmonary function of the patients during the perioperative period. A modified surgical technique was designed to reduce the intramedullary pressure during insertion of the stem to prevent intraoperative embolic events. Surgical prevention of fat and bone marrow embolism can also reduce the incidence of postoperative deep vein thrombosis. AD - Department of Anesthesiology and Intensive Care, Waldkrankenhaus, Erlangen, Germany. matthias.koessler@freenet.de AN - 11383302 AU - Koessler, M. J. AU - Pitto, R. P. DA - Apr DP - NLM ET - 2001/06/01 J2 - Acta orthopaedica Belgica KW - Arthroplasty, Replacement, Hip/*adverse effects/methods Bone Cements Bone Marrow Cells Echocardiography, Transesophageal Embolism, Fat/diagnosis/*etiology/prevention & control Femur/pathology/surgery Humans Magnetic Resonance Imaging Postoperative Complications/prevention & control Pressure Pulmonary Embolism/diagnosis/*etiology/prevention & control LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2001 SN - 0001-6462 (Print) 0001-6462 SP - 97-109 ST - Fat and bone marrow embolism in total hip arthroplasty T2 - Acta Orthop Belg TI - Fat and bone marrow embolism in total hip arthroplasty VL - 67 ID - 828737 ER - TY - JOUR AB - AIM: The aim of the study was the evaluation of the medium- to long-term results of the cementless Bicontact SD hip arthroplasty, which was designed specially for narrow femoral medullary cavities. METHOD: From February 1992 to December 1996 115 patients (123 joints) were treated with a Bicontact SD stem and various cup implants through a posterior approach. In one third of cases, the indication was dysplastic osteoarthritis of various degrees of severity. RESULTS: Between November 2006 and May 2007 90 patients (98 hip joints) were followed up in a retrospective study after an average of 12.2 (10.1-15.1) years. The average Harris Hip Score was 93 (60-100) points and the Merle d'Aubigné score was 16.7 (5-18) points. A stem implant had to be regarded as loosened according to radiological criteria. One patient died 7 days postoperatively of a pulmonary embolism. CONCLUSION: The clinical and radiological results confirmed the proximal fixation concept in dysplastic femurs and narrow medullary cavities. AD - HELIOS Clinic for Orthopaedics, Barbarastrasse 11, Bleicherode, Germany. steffen.kohler@helios-kliniken.de AN - 17939092 AU - Kohler, S. AU - Nahmmacher, V. DA - Sep-Oct DO - 10.1055/s-2007-965654 DP - NLM ET - 2007/11/21 J2 - Zeitschrift fur Orthopadie und Unfallchirurgie KW - Adult Aged Aged, 80 and over Cementation Female Femur/diagnostic imaging Femur Head Necrosis/diagnostic imaging/*surgery Hip Dislocation, Congenital/*surgery *Hip Prosthesis Humans Male Middle Aged Osteoarthritis, Hip/diagnostic imaging/*surgery Osteolysis/diagnostic imaging Postoperative Complications/diagnostic imaging Prosthesis Design Prosthesis Failure Prosthesis Fitting Radiography LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 1864-6697 (Print) 1864-6697 SP - S13-9 ST - 12-year results with the cementless Bicontact SD stem in dysplastic and narrow femoral bone conditions T2 - Z Orthop Unfall TI - 12-year results with the cementless Bicontact SD stem in dysplastic and narrow femoral bone conditions VL - 145 Suppl 1 ID - 829001 ER - TY - JOUR AD - Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria. AN - 22424531 AU - Kollmann, D. AU - Hoetzenecker, K. AU - Prosch, H. AU - Ankersmit, H. J. AU - Aigner, C. AU - Taghavi, S. AU - Klepetko, W. DA - Apr DO - 10.1016/j.jtcvs.2012.01.050 DP - NLM ET - 2012/03/20 J2 - The Journal of thoracic and cardiovascular surgery KW - Adult Anticoagulants/therapeutic use Arterial Occlusive Diseases/diagnostic imaging/*etiology/surgery Bone Cements/*adverse effects Embolism/diagnostic imaging/*etiology/surgery Female Foreign-Body Migration/diagnostic imaging/*etiology/surgery Humans Kyphoplasty/*adverse effects Polymethyl Methacrylate/*adverse effects *Pulmonary Artery/diagnostic imaging/surgery Thrombosis/etiology Tomography, X-Ray Computed Treatment Outcome LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0022-5223 SP - e22-4 ST - Removal of a large cement embolus from the right pulmonary artery 4 years after kyphoplasty: consideration of thrombogenicity T2 - J Thorac Cardiovasc Surg TI - Removal of a large cement embolus from the right pulmonary artery 4 years after kyphoplasty: consideration of thrombogenicity VL - 143 ID - 828522 ER - TY - JOUR AB - The right heart and the pulmonary vascular tree are at risk of embolization of nonthrombotic material. With the development of sealing resin in all surgical specialties, the risk of vascular embolization of glue during polymerization increases. We describe the presentation, management and clinical follow- up of three patients with symptomatic cement embolization following a vertebroplasty. Cement emboli are a frequent complication of vertebroplasty, which rarely requires specific management. AD - S. Cook, Département de Cardiologie, Université and Hôpital, Fribourg, Switzerland AU - Kolly, M. AU - Kolly, S. AU - Schlueter, L. AU - Fleury, Y. AU - Brugger, N. AU - Maestretti, G. AU - Cook, S. DB - Embase KW - bone cement article case report clinical feature follow up human lung embolism percutaneous vertebroplasty LA - English French M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1662-629X 1423-5528 SP - 132-135 ST - Laid cement, no anxiety - pulmonary cement embolism, do we have to worry? T2 - Kardiovaskulare Medizin TI - Laid cement, no anxiety - pulmonary cement embolism, do we have to worry? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L616416304&from=export VL - 20 ID - 829277 ER - TY - JOUR AB - Three patients with non-traumatic arteriovenous fistulas (AVFs) of the scalp were treated by embolization using acrylate glue through the transarterial route or by direct puncture of the lesions and then surgical resection. Complete cure was achieved in all three patients. Selective angiography is indispensable in the correct diagnosis of scalp AVEs. Embolization facilitates surgical removal when necessary, and this combination is the treatment of choice for scalp AVFs. AD - M. Komiyama, Department of Neurosurgery, Osaka City General Hospital, 2-13-22 Miyakojima-hondohri, Miyakojima-ku, Osaka 534, Japan AU - Komiyama, M. AU - Nishikawa, M. AU - Kitano, S. AU - Sakamoto, H. AU - Imai, K. AU - Tsujiguchi, K. AU - Mizuno, T. DB - Embase Medline KW - acrylic cement adult arteriovenous fistula article artificial embolization case report female human scalp surgical technique treatment outcome LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1996 SN - 0387-2572 SP - 162-165 ST - Non-traumatic arteriovenous fistulas of the scalp treated by a combination of embolization and surgical removal T2 - Neurologia Medico-Chirurgica TI - Non-traumatic arteriovenous fistulas of the scalp treated by a combination of embolization and surgical removal UR - https://www.embase.com/search/results?subaction=viewrecord&id=L26098223&from=export VL - 36 ID - 829924 ER - TY - JOUR AB - Chondromyxoid fibroma originating from axial skeleton is a very rare benign bone neoplasm. There are a few reported lumbar cases in the literature and it can be pre-operatively misdiagnosed as other tumors of spine. A 20-year-old girl presented to our outpatient clinic with right hip and leg pain of 3 months' duration. Physical and neurological examinations were unremarkable and laboratory test results were within normal limits. Imaging studies revealed a cystic lesion in the right half of the L5 vertebra and extending to the posterior elements of the vertebra. CT-guided biopsy result was inconclusive. Surgery was planned. Digital subtraction angiography and embolization were carried out preoperatively. During surgery, L5 laminectomy and curettage of the lesion were performed, taking care to leave the cortex intact. Bilateral L4, S1, and left L5 transpedicular instrumentation and right L5 vertebroplasty were also carried out. The operation relieved the patient's pain. The paper discusses the clinical, histological, and radiological characteristics of chondromyxoid fibroma, as well as differential diagnosis and treatment modalities. AD - [Konya, Deniz; Eksi, Murat Sakir; Seker, Askin; Bayri, Yasar] Marmara Univ, Fac Med, Istanbul, Turkey. [Yener, Ulas] Van Natl Hosp, Van, Turkey. Konya, D (corresponding author), Marmara Univ, Fac Med, Istanbul, Turkey. drdkonya@hotmail.com AN - WOS:000309218800027 AU - Konya, D. AU - Eksi, M. S. AU - Yener, U. AU - Seker, A. AU - Bayri, Y. J2 - J. Neurol. Sci.-Turk. KW - Chondromyxoid fibroma Lumbar spine Bone tumor Curettage Instrumentation THORACIC SPINE CERVICAL-SPINE CORD COMPRESSION BONE Neurosciences LA - English M1 - 3 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2012 SN - 1302-1664 SP - 645-653 ST - Chondromyxoid Fibroma of The Lumbar Spine: Case Report and Review of The Literature T2 - Journal of Neurological Sciences-Turkish TI - Chondromyxoid Fibroma of The Lumbar Spine: Case Report and Review of The Literature UR - ://WOS:000309218800027 VL - 29 ID - 830315 ER - TY - JOUR AB - Chondromyxoid fibroma originating from axial skeleton is a very rare benign bone neoplasm. There are a few reported lumbar cases in the literature and it can be pre-operatively misdiagnosed as other tumors of spine. A 20-year-old girl presented to our outpatient clinic with right hip and leg pain of 3 months' duration. Physical and neurological examinations were unremarkable and laboratory test results were within normal limits. Imaging studies revealed a cystic lesion in the right half of the L5 vertebra and extending to the posterior elements of the vertebra. CT-guided biopsy result was inconclusive. Surgery was planned. Digital subtraction angiography and embolization were carried out preoperatively. During surgery, L5 laminectomy and curettage of the lesion were performed, taking care to leave the cortex intact. Bilateral L4, S1, and left L5 transpedicular instrumentation and right L5 vertebroplasty were also carried out. The operation relieved the patient's pain. The paper discusses the clinical, histological, and radiological characteristics of chondromyxoid fibroma, as well as differential diagnosis and treatment modalities. AD - D. Konya, Marmara University Medical Faculty, Neurosurgery, Istanbul, Turkey AU - Konya, D. AU - EkşI, M. S. AU - Yener, U. AU - Şeker, A. AU - BayrI, Y. DB - Embase KW - adult analgesia article artificial embolization backache case report cauda equina syndrome chondromyxoid fibroma clinical feature computer assisted tomography contrast enhancement curettage diagnostic imaging differential diagnosis digital subtraction angiography female hip pain histopathology human incidental finding laboratory test laminectomy leg pain lumbar spine lumbosacral spine medical literature muscle weakness myxoma neurologic examination nuclear magnetic resonance imaging percutaneous vertebroplasty physical examination preoperative evaluation radiodiagnosis spine tumor treatment outcome treatment planning L1 - http://jns.dergisi.org/pdf/pdf_JNS_584.pdf LA - English Turkish M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1300-1817 1302-1664 SP - 645-653 ST - Chondromyxoid fibroma of the lumbar spine: Case report and review of the literature T2 - Journal of Neurological Sciences TI - Chondromyxoid fibroma of the lumbar spine: Case report and review of the literature UR - https://www.embase.com/search/results?subaction=viewrecord&id=L365766363&from=export VL - 29 ID - 829534 ER - TY - JOUR AB - Study Design. Prospective consecutive series. Objective. To evaluate the efficacy of minimal invasive surgery for acute lumbar fractures by means of balloon kyphoplasty with calcium phosphate plus segmental short posterior instrumented fusion. Summary of Background Data. In the surgical treatment of lumbar fractures with short pedicle screw instrumentation, the failure to support the anterior spinal column often results in loss of correction. Transpedicular augmentation techniques with bone and bone substitutes have been attempted whereas kyphoplasty has been increasingly used to augment fractured vertebral body. Methods. Eighteen consecutive patients with an average age of 64 +/- 15 years, who sustained lumbar ( L1 - L4) burst and severe compression fracture were included in this prospective study. On admission, 2 ( 11%) of 18 patients had incomplete neurologic impairment. All patients underwent bilateral balloon kyphoplasty with calcium phosphate bone cement to reduce segmental kyphosis and restore vertebral body height and segmental pedicle screw instrumentation and fusion. Gardner kyphosis angle, anterior ( AVBHr) and posterior vertebral body height ratio ( PVBHr), and spinal canal encroachment ( SCE) were calculated before to after surgery. VAS and SF- 36 were used to evaluate functional outcome. Results. All patients were operated within 24 hours after admission and were followed for an average 22 months ( 17 - 28 months) after index surgery. Operating time and blood loss averaged 45 minutes and 70 mL, respectively. VAS and SF- 36 ( role physical and bodily pain domains) were significantly improved after surgery. Both patients with incomplete neurologic lesions recovered, whereas no neurologic deterioration was observed in any case. Segmental kyphosis improved from an average preoperative kyphosis of 16 to 2 after surgery ( P < 0.000). AVBHr improved from an average before surgery 0.57 to 0.87 ( P < 0.000) after surgery, whereas PVBHr improved from 0.93 before surgery to 0.98 ( P < 0.05) after surgery. SCE was reduced from an average 25% before surgery to 19% ( P < 0.07) after surgery. Bone cement leakage was observed anteriorly to the fractured vertebral body or to the adjacent superior disc in 4 patients without clinical sequelae, whereas 3 pedicle screws were malpositioned medially to the pedicle in 3 patients without neurologic impairment or associated complaints. Posterolateral radiologic fusion was achieved within 6 to 8 months after index operation. There was no instrumentation failure or loss of sagittal curve and vertebral height correction. Conclusion. Balloon kyphoplasty with calcium phosphate cement combined with posterior segmental short minimal invasive fixation for fresh burst and severe compression lumbar fractures provided excellent immediate reduction of post- traumatic segmental kyphosis with simultaneous reduction of spinal canal encroachment and restoration of vertebral body height in the fracture level. AD - [Korovessis, Panagiotis; Hadjipavlou, Alexander; Repantis, Thomas] Gen Hosp Agios Andreas, GR-26224 Patras, Greece. Korovessis, P (corresponding author), Gen Hosp Agios Andreas, 65-67 Haralabi Str, GR-26224 Patras, Greece. korovess@otenet.gr AN - WOS:000254651900013 AU - Korovessis, P. AU - Hadjipavlou, A. AU - Repantis, T. DA - Mar DO - 10.1097/BRS.0b013e318166e0bb J2 - Spine KW - lumbar compression burst fracture calcium phosphate kyphoplasty short pedicle screw instrumentation SEGMENT PEDICLE INSTRUMENTATION PERCUTANEOUS VERTEBROPLASTY BIOMECHANICAL EVALUATION THORACOLUMBAR FRACTURES POLYMETHYL METHACRYLATE CEMENT AUGMENTATION PULMONARY-EMBOLISM REDUCTION SPINE STABILIZATION Clinical Neurology Orthopedics LA - English M1 - 6 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2008 SN - 0362-2436 SP - 658-667 ST - Minimal invasive short posterior instrumentation plus balloon kyphoplasty with calcium phosphate for burst and severe compression lumbar fractures T2 - Spine TI - Minimal invasive short posterior instrumentation plus balloon kyphoplasty with calcium phosphate for burst and severe compression lumbar fractures UR - ://WOS:000254651900013 VL - 33 ID - 830383 ER - TY - JOUR AB - Hemangioma of the bone is a benign tumor usually involving the spine and the bones of the skull and pelvis. It may be either a single lesion or part of a generalized multifocal disease. Multiple lesions involving non-adjacent vertebrae are rare. Two cases of multiple vertebral hemangiomas at non-adjacent levels with different pain patterns are presented at various stages of follow-up in order to emphasize the fact that multiple vertebral hemangiomas may present with different clinical characteristics over a long period of time. The change in the location and pattern of the initially presented pain in both patients suggested the passibility of multiple level involvement. Investigation revealed multiple hemangiomas involving three non-adjacent vertebrae in the first patient and four in the second. We stress the Fact that the existence of multiple non-adjacent lesions may remain undiagnosed for a considerable period of time and may be responsible fur even longer-term recurrent episodes of pain. Multifocal location of back pain in patients with a known vertebral hemangioma may be considered a relative indication for the presence of multiple non-adjacent level lesions. AD - Univ Athens, KAT Hosp, Dept Orthopaed, Athens, Greece. Univ Thessaly, Dept Orthopaed, Larisa, Greece. Korres, DS (corresponding author), Heyden 10, Athens 10434, Greece. AN - WOS:000087943700017 AU - Korres, D. S. AU - Karachalios, T. AU - Roidis, N. AU - Bargiotas, K. AU - Stamos, K. DA - Jun DO - 10.1007/s005860000152 J2 - Eur. Spine J. KW - adult case report spinal neoplasms hemangioma spine SPINAL-CORD COMPRESSION PREOPERATIVE EMBOLIZATION PERCUTANEOUS VERTEBROPLASTY RESECTION BONE RADIOTHERAPY INJECTION ETHANOL Clinical Neurology Orthopedics LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2000 SN - 0940-6719 SP - 256-260 ST - Pain pattern in multiple vertebral hemangiomas involving nonadjacent levels: report of two cases T2 - European Spine Journal TI - Pain pattern in multiple vertebral hemangiomas involving nonadjacent levels: report of two cases UR - ://WOS:000087943700017 VL - 9 ID - 830465 ER - TY - JOUR AB - In order to improve the positioning of the stem within the femur, to centralize it within the cement and to achieve a complete and homogeneous cement mantle, a new hip endoprosthesis with guided stem insertion was developed. The femoral component has a longitudinal channel that takes up a guidewire which directs it during insertion into the centre. The guidewire is attached to the cement stopper which is positioned in the marrow cavity before applying the bone cement. The first 100 endoprostheses of this type with an observation period of at least 6 years were assessed radiologically and clinically. The clinical evaluation according to the hip scores of Merle d'Aubigne and Harris revealed a marked improvement between preoperative and postoperative values for all criteria. On radiological assessment 94% of the stems had a neutral position within the femur; 98% of the stems were found to be ideally centred within the cement distally, 80% distally and proximally; 74% of the cement cuffs had a complete and homogeneous cement layer between 2 and 5 mm medially and laterally, while 25% had partially a dimension of more than 5 mm, predominantly proximally. In only 3 cases was one part of the cement mantle found to be less than 2 mm. The radiological follow-up was also documented according to the delineated zones of Gruen. It revealed zonal radiolucent lines in 15 cases, combined in 11 cases with reactive lines, never extending up to 4 zones out of 14. Five prostheses had subsided moderately between 2 and 3 mm, and only one 8 mm. None of these radiological signs was associated with clinical symptoms. There were five cement fractures. Two stems were symptomatic, radiologically loose and revised. Beside these two cases of aseptic loosening there was one septic case, so that in total 97% of the implants are still functioning well. AD - G. Koster, Department of Orthopaedic Surgery, University of Gottingen, Robert-Koch-Strasse 40, D-37075 Gottingen, Germany AU - Köster, G. AU - Willert, H. G. AU - Ernstberger, T. AU - Köhler, H. P. DB - Embase Medline DO - 10.1007/s004020050286 KW - bone cement aged article bone marrow deep vein thrombosis female femur follow up guide wire hip arthroplasty hip disease hip radiography human lung embolism major clinical study male postoperative complication priority journal prosthesis loosening reoperation sepsis surgical technique symptom total hip prosthesis treatment outcome LA - English M1 - 8 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1998 SN - 0936-8051 SP - 425-429 ST - Centralization of the femoral component in cemented hip arthroplasty using guided stem insertion T2 - Archives of Orthopaedic and Trauma Surgery TI - Centralization of the femoral component in cemented hip arthroplasty using guided stem insertion UR - https://www.embase.com/search/results?subaction=viewrecord&id=L28468413&from=export http://dx.doi.org/10.1007/s004020050286 VL - 117 ID - 829906 ER - TY - JOUR AB - Hemangioma is the most common primary benign hamartoma type spine tumor. Malignant degeneration has never been reported. In the majority of cases, this is an asymptomatic solitary lesion of the thoracic spine found incidentally during a radiographic examination. Only 1% of cases manifests clinically and this benign lesion is considered aggressive because of the expansive nature of the tumor and because it may cause pathological fracture of the vertebrae. Clinical symptoms then include dorsalgia and either root or spinal neurological symptoms. Radiological diagnosis is relatively easy because vertebral hemangioma is associated with quite typical graphic signs; graphic criteria to confirm the diagnosis of aggressive vertebral hemangioma have been clearly defined. The range of treatment options is very wide, from conservative treatment through frequently used vertebroplasty to radical surgical treatment. Embolization procedures, alcohol sclerotherapy and local radiotherapy are often used as complementary procedures. Aggressive vertebral hemangioma is a relatively rare diagnosis, so far there are no large cohorts or clinical studies from which it would be possible to determine an optimal therapeutic approach. AD - [Kostysyn, R.; Malek, V.] Neurochirurg Klin LF UK A FN, Hradec Kralove 50005, Czech Republic. Klin Onkol Radioterapie, Hradec Kralove, Czech Republic. Kostysyn, R (corresponding author), Neurochirurg Klin LF UK A FN, Sokolska 581, Hradec Kralove 50005, Czech Republic. roman.kostysyn@seznam.cz AN - WOS:000352676300003 AU - Kostysyn, R. AU - Pleskacova, Z. AU - Malek, V. J2 - Cesk. Slov. Neurol. Neurochir. KW - hemangioma vertebroplasty angiogenesis inhibitors angiomatosis propranolol SPINAL-CORD COMPRESSION EMBOLIZATION MANAGEMENT INHIBITOR Neurosciences Surgery LA - Czech M1 - 2 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2015 SN - 1210-7859 SP - 148-157 ST - Aggressive Vertebral Hemangioma T2 - Ceska a Slovenska Neurologie a Neurochirurgie TI - Aggressive Vertebral Hemangioma UR - ://WOS:000352676300003 VL - 78 ID - 830249 ER - TY - JOUR AB - Hemangioma is the most common primary benign hamartoma type spine tumor. Malignant degeneration has never been reported. In the majority of cases, this is an asymptomatic solitary lesion of the thoracic spine found incidentally during a radiographic examination. Only 1% of cases manifests clinically and this benign lesion is considered aggressive because of the expansive nature of the tumor and because it may cause pathological fracture of the vertebrae. Clinical symptoms then include dorsalgia and either root or spinal neurological symptoms. Radiological diagnosis is relatively easy because vertebral hemangioma is associated with quite typical graphic signs; graphic criteria to confirm the diagnosis of aggressive vertebral hemangioma have been clearly defined. The range of treatment options is very wide, from conservative treatment through frequently used vertebroplasty to radical surgical treatment. Embolization procedures, alcohol sclerotherapy and local radiotherapy are often used as complementary procedures. Aggressive vertebral hemangioma is a relatively rare diagnosis, so far there are no large cohorts or clinical studies from which it would be possible to determine an optimal therapeutic approach. AD - R. Kostyšyn, Neurochirurgická Klinika, LF UK a FN Hradec Králové, Sokolská 581, Hradec Králové, Czech Republic AU - Kostyšyn, R. AU - Pleskačová, Z. AU - Málek, V. DB - Embase KW - aggressive vertebral hemangioma alcohol sclerotherapy artificial embolization backache hemangioma human malignant transformation neurologic disease pathologic fracture percutaneous vertebroplasty radiodiagnosis review sclerotherapy spine fracture thoracic spine LA - Czech M1 - 2 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1802-4041 1210-7859 SP - 148-157 ST - Aggressive vertebral hemangioma T2 - Ceska a Slovenska Neurologie a Neurochirurgie TI - Aggressive vertebral hemangioma UR - https://www.embase.com/search/results?subaction=viewrecord&id=L604056922&from=export VL - 78 ID - 829388 ER - TY - JOUR AB - The treatment of conventional pulmonary embolism has become well studied with a multitude of therapies being offered. There however remains a paucity of literature regarding treatment guidelines for patients with cement pulmonary embolism after orthopedic surgery. Today we would like to present a unique approach to the management of these patients. The patient is a 65-year-old female with past medical history of chronic obstructive pulmonary disease, hyperlipidemia and compression fractures of the lumbosacral spine who recently underwent cementing and fusion three weeks prior at an outside facility. The patient was discharged for rehabilitation and subsequently went home. She began to develop progressive shortness of breath and presented to the emergency department for evaluation. Angiographic CT imaging of the chest demonstrated multiple subsegmental areas of bone cement pulmonary emboli, mainly in the right upper lobe, without evidence of traditional thromboembolic disease. Arterial blood gas was drawn and showed chronic carbon dioxide elevation that was well compensated, and it was thought that her dyspnea was largely due to cement emboli. Beta-natriuretic peptide was mildly elevated at 148 pg/mL but echocardiogram did not show evidence of right ventricular strain. The patient was treated with lovenox as a bridge to Coumadin and was discharged home. Percutaneous vertebroplasty is a non-invasive treatment approach for the management of compression fractures. Polymethyl methacrylate is injected into the vertebral body which helps provide pain relief by stabilizing the fracture. A rare complication of this procedure is the leakage of this 'cement' into vasculature leading to deposition of the material in the pulmonary arteries. It was once thought that this was a rare complication, but recent literature suggests that more patients are presenting with this incidental finding on chest imaging. Our case is unique in that our patient developed symptoms likely attributed to cement embolization several weeks after her intervention, which raises the concern of possible migration of the clot. Typical management includes anticoagulation with Coumadin for a short six-month course. We would like to stress the importance of keeping this entity in the differential for someone who presents with acute onset shortness of breath in the setting of recent spinal manipulation. We also encourage the use of postoperative chest x-rays in appropriate patients as a screening tool, as well as periodic echocardiograms to evaluate for right ventricular strain. AD - S. Kothari, Internal Medice, University of Illinois Chicago/Advocate Christ, Oak Lawn, IL, United States AU - Kothari, S. AU - Milas, A. AU - Sunbuli, M. DB - Embase KW - bone cement carbon dioxide endogenous compound enoxaparin natriuretic factor poly(methyl methacrylate) warfarin aged analgesia anticoagulation arterial gas case report chronic obstructive lung disease clinical article complication compression fracture conference abstract drug combination drug therapy dyspnea echocardiography emergency ward female heart right ventricle hospital discharge human hyperlipidemia incidental finding lumbosacral spine lung embolism medical history non invasive procedure percutaneous vertebroplasty pulmonary artery rehabilitation spine manipulation stress surgery thinking thorax radiography vascularization vertebra body LA - English M1 - MeetingAbstracts M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1535-4970 ST - Broken bones and pulmonary stones - A rare case of pulmonary embolism T2 - American Journal of Respiratory and Critical Care Medicine TI - Broken bones and pulmonary stones - A rare case of pulmonary embolism UR - https://www.embase.com/search/results?subaction=viewrecord&id=L622966658&from=export VL - 197 ID - 829216 ER - TY - JOUR AB - THE PURPOSE OF THE STUDY: The aim of the study was to verify the method after Slooff in our modification, i.e. "a cemented cup--cancellous bone grafts--a metal net" for the revision surgery of aseptic loosening of cemented polyethylene acetabular cup in combined defects of acetabulum. MATERIAL: The followed-up group of 52 patients (36 women and 16 men), average age of 65 years (age range, 50-81 years) with aseptic loosened cemented polyethylene Poldi cups included 52 operated on hip joints. The average interval between the primary implantation and the revision surgery was 9 years (2-21 years). METHOD: We reconstructed acetabulum with combined bone defects (AAOS III Degree--as a result of aseptic loosening and migration of cemented acetabular cups) by means of cancellous bone allografts, a shaped Howmedica metal net, Simplex bone cement and a polyethylene cup. RESULTS: Average follow-up was 36 months (range, 14-49 months). Clinical evaluation of the group was performed after Harris Hip Score averaging 80 points. Radiological evaluation focused on the density and presence of bridging trabeculae between the grafts and the host bone. Positive finding was in 46 patients, i.e. 90%. Further, we evaluated migration of the cup after Conn. In 4 patients (7.7%) it was less than 2 mm and in 3 patients (5.7%) it was greater than 5 mm. Reconstruction failed in 1 patient (1.9%). Radiolucent line was found in the zone between the host bone and bone grafts only in III zone after De Lee and Charnley in 8 cases (15.3%), in zones I and II it was not encountered in any of the patients in the group. One case required another revision surgery in which Burch-Schneider ring, bone allografts and Müller cemented cup were used for the reconstruction. In two patients of this group there developed a phlebographically verified phlebothrombosis without signs of embolism into pulmonary artery. In two cases there occurred a superficial inflammation of the wound which subsided before the removal of the suture. No deep infection of the wound was encountered. Particular ossifications were assessed after Brooker. Type I occurred in 7 cases and Type II in 1 patient. DISCUSSION: At present several methods are used for the reconstruction of acetabulum and their choice is limited by the extent of the bone loss. For cavitary defects it is possible to use the combination of bone grafts with cementless cups. In segmental and combined defects the situation is more complicated and it can be solved by the application of a solid bone graft. In case the solid bone graft assumed greater load, the situation logically resulted in the fatigue fracture of screws and failure of the whole reconstruction prior to the bone graft-host bone osteointegration. In cementless cups and solid bone grafts the situation is slightly more favourable. If there is a timely biological (secondary) osteointegration of the cup the reconstruction has a chance to survive. The timeliness of biological (secondary) osteointegration is significantly influenced also by the quality of the applied bone graft and a good contact of the bone graft and the host bone and the surface of the cementless cup. Our method of the reconstruction of acetabulum by means of cancellous bone grafts, metal net and cemented cup allows a relatively good primary stability of the cup. Due to its partial elasticity the metal net does not prevent transmission of forces on the bone grafts which are placed under the net. As a result there occurs a faster union of bone grafts with the host bone. CONCLUSION: The method of cemented cup--cancellous bone grafts--metal net after Slooff is in our modification one of the accepted options of the reconstruction of acetabulum. Its benefit is the possibility of early weight bearing of the limb operated on. The stress on the bone grafts under an elastic construction conduces to a relatively fast good secondary osteointegration. The method can be recommended for II and III Degrees of acetabular bone loss according to AAOS classification. Of no less importance is also the economic aspect of the whole reconstruction. AD - Klinika ortopedie a traumatologie pohybového ústrojí LF UK a FN, Plzen. Koudela@FNPlzen.cz AN - 11706538 AU - Koudela, K. AU - Malotín, T. DP - NLM ET - 2001/11/15 J2 - Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca KW - Acetabulum/*surgery Aged Aged, 80 and over *Arthroplasty, Replacement, Hip Bone Transplantation Cementation Female Humans Male Middle Aged Polyethylene *Prosthesis Failure Reoperation LA - cze M1 - 3 N1 - PubMed NLM literature search January 5, 2021 OP - Rekonstrukce acetabula pri výmĕnĕ asepticky uvolnĕné polyetylenové jamky. PY - 2001 SN - 0001-5415 (Print) 0001-5415 SP - 162-7 ST - [Reconstruction of the acetabulum during replacement of the aseptically loosened polyethylene cup] T2 - Acta Chir Orthop Traumatol Cech TI - [Reconstruction of the acetabulum during replacement of the aseptically loosened polyethylene cup] VL - 68 ID - 829002 ER - TY - JOUR AB - The Purpose of the Study. The aim of the study was to verify the method after Slooff in our modification, i.e. "a cemented cup - cancellous bone grafts - a metal net" for the revision surgery of aseptic loosening of cemented polyethylene acetabular cup in combined defects of acetabulum. Material. The followed-up group of 52 patients (36 women and 16 men), average age of 65 years (age range, 50-81 years) with aseptic loosened cemented polyethylene Poldi cups included 52 operated on hip joints. The average interval between the primary implantation and the revision surgery was 9 years (2-21 years). Method. We reconstructed acetabulum with combined bone defects (AAOS III Degree - as a result of aseptic loosening and migration of cemented acetabular cups) by means of cancellous bone allografts, a shaped Howmedica metal net, Simplex bone cement and a polyethylene cup. Results. Average follow-up was 36 months (range, 14-49 months). Clinical evaluation of the group was performed after Harris Hip Score averaging 80 points. Radiological evaluation focused on the density and presence of bridging trabeculae between the grafts and the host bone. Positive finding was in 46 patients, i.e. 90%. Further, we evaluated migration of the cup after Conn. In 4 patients (7,7%) it was less than 2 mm and in 3 patients (5,7%) it was greater than 5 mm. Reconstruction failed in 1 patient (1,9%). Radiolucent line was found in the zone between the host bone and bone grafts only in III zone after De Lee and Charnley in 8 cases (15,3%), in zones I and II it was not encountered in any of the patients in the group. One case required another revision surgery in which Burch-Schneider ring, bone allografts and Müller cemented cup were used for the reconstruction. In two patients of this group there developed a phlebographically verified phlebothrombosis without signs of embolism into pulmonary artery. In two cases there occurred a superficial inflammation of the wound which subsided before the removal of the suture. No deep infection of the wound was encountered. Paraarticular ossifications were assessed after Brooker. Type I occured in 7 cases and Type II in 1 patient. Discussion. At present several methods are used for the reconstruction of acetabulum and their choice is limited by the extent of the bone loss. For cavitary defects it is possible to use the combination of bone grafts with cementless cups. In segmental and combined defects the situation is more complicated and it can be solved by the application of a solid bone graft. In case the solid bone graft assumed greater load, the situation logically resulted in the fatigue fracture of screws and failure of the whole reconstruction prior to the bone graft-host bone osteointegration. In cementless cups and solid bone grafts the situation is slightly more favourable. If there is a timely biological (secondary) osteointegration of the cup the reconstruction has a chance to survive. The timeliness of biological (secondary) osteointegration is significantly influenced also by the quality of the applied bone graft and a good contact of the bone graft and the host bone and the surface of the cementless cup. Our method of the reconstruction of acetabulum by means of cancellous bone grafts, metal net and cemented cup allows a relatively good primary stability of the cup. Due to its partial elasticity the metal net does not prevent transmission of forces on the bone grafts which are placed under the net. As a result there occurs a faster union of bone grafts with the host bone. Conclusion. The method of cemented cup - cancellous bone grafts - metal net after Slooff is in our modification one of the accepted options of the reconstruction of acetabulum. Its benefit is the possibility of early weight bearing of the limb operated on. The stress on the bone grafts under an elastic construction conduces to a relatively fast good secondary osteointegration. The method can be recommended for II and III Degrees of acetabular bone loss according to AAOS classification. Of no less importance is also the economic a pect of the whole reconstruction. AD - K. Koudela, Klinika Ortopedie a Traumatologie, Pohyboveho ustroji LF UK a FN Plzen, Alej Svobody 80, 304 60 Plzeň, Czech Republic AU - Koudela, K. AU - Malotín, T. DB - Embase Medline KW - bone cement polyethylene acetabuloplasty adult age aged allograft article asepsis bone allograft bone atrophy bone density bone stress trabecular bone clinical examination controlled study disease classification economic aspect elasticity embolism endoprosthesis loosening female follow up force gender hip radiography hip surgery human inflammation major clinical study male migration ossification phlebography pulmonary artery reoperation scoring system surgical technique suture vein thrombosis weight bearing wound infection Howmedica Poldi Simplex LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2001 SN - 0001-5415 SP - 162-167 ST - Reconstruction of acetabulum during the replacement of aseptic loosened polyethylene cup T2 - Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca TI - Reconstruction of acetabulum during the replacement of aseptic loosened polyethylene cup UR - https://www.embase.com/search/results?subaction=viewrecord&id=L32952105&from=export VL - 68 ID - 829880 ER - TY - JOUR AD - Department of Anesthesia and Perioperative Medicine, University of Manitoba, Winnipeg, MB, Canada, sekowalski@hsc.mb.ca. AN - 109755366. Language: English. Entry Date: 20150703. Revision Date: 20150923. Publication Type: Journal Article. Journal Subset: Biomedical AU - Kowalski, Stephen AU - Bell, Dean AU - Pilkey, Brad DB - cin20 DO - 10.1007/s12630-014-0137-6 DP - EBSCOhost KW - Arthroplasty -- Adverse Effects Pulmonary Embolism -- Etiology Animals Bone Cements Bone Marrow Models, Biological Dogs Embolism, Fat -- Etiology M1 - 9 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2014 SN - 0832-610X SP - 876-880 ST - From the Journal archives: Pulmonary marrow embolism: lessons learned from a canine model simulating dual component cemented arthroplasty T2 - Canadian Journal of Anaesthesia TI - From the Journal archives: Pulmonary marrow embolism: lessons learned from a canine model simulating dual component cemented arthroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=109755366&site=ehost-live&scope=site VL - 61 ID - 830630 ER - TY - JOUR AB - Background: Intraoperative cardiovascular deterioration as a result of pulmonary embolization of bone marrow fat is a potentially serious complication during vertebroplasty. The release of fatty material and thromboplastin from the bone marrow cavity during vertebroplasty may activate the coagulation cascade resulting in thrombogenesis, and pharmacological prophylaxis may therefore prevent cardiovascular complications. Thus, the effects of bone marrow fat embolism on coagulation activation during vertebroplasty were investigated with use of an animal model.Methods: Polymethylmethacrylate was injected into three lumbar vertebrae of six sheep in order to force bone marrow fat into the circulation. Invasive blood pressures and heart rate were recorded continuously until sixty minutes after the last injection. Cardiac output, arterial and mixed venous blood gas parameters, and coagulation parameters were measured at selected time-points. Postmortem lung biopsy specimens were assessed for the presence of intravascular fat.Results: Embolization of bone marrow fat resulted in a sudden and dramatic increase in mean pulmonary arterial pressure and a decrease in mean arterial blood pressure. There were no significant changes in any coagulation parameter from before the injection to after the injection. Intravascular fat and bone marrow cells were present in all lung lobes.Conclusions: Injection of polymethylmethacrylate into vertebral bodies caused embolization of bone marrow fat with subsequent transient cardiovascular deterioration, but no changes in coagulation parameters were observed. Thromboembolism did not contribute to the observed cardiovascular changes. AD - MEM Research Center, Institute for Surgical Technology and Biomechanics, Medical Faculty, University of Bern, Stauffacherstrasse 78, 3014 Bern, Switzerland MEM Research Center, Institute for Surgical Technology and Biomechanics, Medical Faculty, University of Bern, Stauffacherstrasse 78, 3014 Bern, Switzerland. jorg.krebs@memcenter.unibe.ch AN - 105744798. Language: English. Entry Date: 20080620. Revision Date: 20200708. Publication Type: journal article AU - Krebs, J. AU - Ferguson, S. J. AU - Hoerstrup, S. P. AU - Goss, B. G. AU - Haeberli, A. AU - Aebli, N. AU - Krebs, Jörg AU - Ferguson, Stephen J. AU - Hoerstrup, Simon P. AU - Goss, Ben G. AU - Haeberli, André AU - Aebli, Nikolaus DB - cin20 DO - 10.2106/JBJS.G.00058 DP - EBSCOhost KW - Bone Marrow Embolism, Fat -- Complications Orthopedic Surgery -- Adverse Effects Spine -- Surgery Arthroplasty, Replacement, Hip -- Adverse Effects Arthroplasty, Replacement, Knee -- Adverse Effects Blood Coagulation Embolism, Fat -- Physiopathology Embolism, Fat -- Prevention and Control Funding Source Hypotension Intraoperative Complications Models, Biological Thromboplastin Human M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2008 SN - 0021-9355 SP - 349-356 ST - Influence of bone marrow fat embolism on coagulation activation in an ovine model of vertebroplasty T2 - Journal of Bone & Joint Surgery, American Volume TI - Influence of bone marrow fat embolism on coagulation activation in an ovine model of vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105744798&site=ehost-live&scope=site VL - 90 ID - 830756 ER - TY - JOUR AB - Skeletal metastases in cancer patients are quite common (in 70 % of cases) and cause significant morbidity. Mostly they are asymptomatic, but if they are not, they are a source of severe complications, pain and compromised quality of life. When metastasis is suspected, the primary imaging modality in long bones and skull is the X-ray imaging. However, in the spine and pelvis, the radiograph is often false negative and magnetic resonance imaging (MRI) is used. If this is not available, then computerized tomography (CT) can be regarded as an option. If dissemination is suspected, scintigraphy, SPECT, or whole-body MR is the method of choice. Expensive hybrid modalities, like positron emission tomography (PET-CT and PET-MR) are typically used in patients already treated with clinical suspicion of dissemination. Biopsy (either percutaneous or peroperative) is only recommended if origin is unclear or additional histological, immunological or genetic testing is required. In the case of a known cancer diagnosis, verification is usually not performed. When assessing the risk of pathological fracture, the location and nature of the lesion, pain, bone destruction, and bone quality are assessed. The Mirels score can be used in long bones, Spinal Instability Neoplastic Score (SIN score) is an alternative for spine lesions, which can give guidance on whether to perform surgical or other stabilization. In solitary or oligometastatic disease (maximum of five foci under 3 cm), curative treatment in the form of radiotherapy, surgery or some of the methods of interventional radiology, or a combination of all, can be considered an addition to the oncological treatment itself. With more extensive disease, palliative therapy aims to maintain mobility and the highest possible quality of life for the patient, to analgesize and prevent pathological fractures. In the case of painful lesions insufficiently responding to medication, especially in the axial skeleton, the first choice is classic external radiotherapy or recently stereatactic radiation therapy. Surgical solutions - splints, nailing, implantation of tumor endoprostheses, vertebral somatectomy with stabilization, resection, amputation can be considered in indicated cases. From minimally invasive methods transarterial embolisation, percutaneous ablation (radiofrequency, microwave, cryoablation, high-intensity focused ultrasound, cementoplasty, neurolysis, pharmacological blocks) are used. The minimally invasive possibilities of interventional radiology are sometimes inadequately used in treatment of painful conditions. Certainly, the treatment of patients in complex oncology centers with sufficient human and technical background is advantageous. Indications for more advanced interventions should in principle be subject to discussion at multidisciplinary boards in collaboration with an oncologist, orthopedic surgeon, surgeon, radiotherapist, diagnostic and interventional radiologist, algesiologist, pathologist, or other specialist as appropriate. AD - J. Křístek, Oddělení Radiodiagnostiky, Masarykův Onkologický ústav Žlutý Kopec 7, Brno, Czech Republic AU - Křístek, J. AU - Pazourek, L. AU - Řehák, Z. DB - Embase KW - endoprosthesis splint amputation arterial embolization article bone biopsy bone destruction bone metastasis bone pain bone radiography bone scintiscanning cementoplasty computer assisted tomography cryoablation disease severity external beam radiotherapy false negative result high intensity focused ultrasound human interventional radiologist interventional radiology intramedullary nailing long bone microwave thermotherapy minimally invasive procedure morbidity neurolysis nuclear magnetic resonance imaging oncologist orthopedic surgeon pathologic fracture pathologist patient monitoring pelvis positron emission tomography positron emission tomography-computed tomography quality of life radiofrequency ablation radiotherapist single photon emission computed tomography skull spine stereotactic radiosurgery surgeon LA - Czech M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1803-5345 1802-4475 SP - 115-122 ST - Bone metastases: Diagnosis and monitoring on imaging methods, interventional radiology T2 - Onkologie (Czech Republic) TI - Bone metastases: Diagnosis and monitoring on imaging methods, interventional radiology UR - https://www.embase.com/search/results?subaction=viewrecord&id=L628038491&from=export VL - 13 ID - 829166 ER - TY - JOUR AB - In spite of continuing progress, total knee arthroplasty still presents many problems. In this clinic 25 arthroplasties have been performed in 22 patients over the last 4 1/2 years. Guépar hinges were used in 21 knees and Marmor modular knees in 4. Acrylic cement was used in all cases. The mean age of the patients was 69 years. 13 had osteoarthritis, 5 rheumatoid disease and 4 other conditions. There were no serious general complications or infections in the early postoperative period. The commonest local complication was malalignment of the patella (17 cases); 2 of these were complete but reducible dislocations. In only 3 knees did patellar subluxation produce sufficient pain to spoil an otherwise good result. Prostheses have loosened in 2 knees, one of which has been fused with success. Striking features of the early results have been reliable pain relief, improvement of joint movement, and generally an increased walking capacity. In spite of its present problems, arthroplasty remains the procedure of choice in knees where the amount of articular damage contraindicates conservative surgery. AN - 301289 AU - Kritsikis, N. AU - Courvoisier, E. AU - Manouar, M. E. DA - May 14 DP - NLM ET - 1977/05/14 J2 - Schweizerische medizinische Wochenschrift KW - Aged Arthroplasty/*methods Female Gait Hemarthrosis/etiology Humans Joint Dislocations/etiology *Knee Joint/physiology Male Middle Aged Osteoarthritis/surgery Patella Postoperative Complications Pulmonary Embolism/etiology Rheumatic Diseases/surgery LA - fre M1 - 19 N1 - PubMed NLM literature search January 5, 2021 OP - Arthroplasties du genou Notre expérience à propos de 22 cas. PY - 1977 SN - 0036-7672 (Print) 0036-7672 SP - 666-74 ST - [Knee arthroplasty. Our experiences with 22 cases] T2 - Schweiz Med Wochenschr TI - [Knee arthroplasty. Our experiences with 22 cases] VL - 107 ID - 828990 ER - TY - JOUR AB - Balloon kyphoplasty and percutaneous vertebroplasty are relatively recent procedures in the treatment of painful vertebral fractures. There are, however, still some uncertainties about the incidence and treatment strategies of pulmonary cement embolisms (PCE). In order to work out a treatment strategy for the management of this complication, we performed a review of the literature. The results show that there is no clear diagnostic or treatment standard for PCE. The literature research revealed that the risk of a pulmonary embolism ranges from 3.5 to 23% for osteoporotic fractures. In cases of asymptomatic patients with peripheral PCE we recommend no treatment besides clinical follow-up; in cases of symptomatic or central embolisms, however, we recommend to proceed according to the guidelines regarding the treatment of thrombotic pulmonary embolisms, which includes initial heparinization and a following 6-month coumarin therapy. In order to avoid any types of embolisms, both procedures should only be performed by experienced surgeons after critical determination of the indications. AD - Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Giessen and Marburg, Baldingerstrasse, 35043, Marburg, Germany. akrueger@med.uni-marburg.de AN - 19575243 AU - Krueger, A. AU - Bliemel, C. AU - Zettl, R. AU - Ruchholtz, S. C2 - Pmc2899525 DA - Sep DO - 10.1007/s00586-009-1073-y DP - NLM ET - 2009/07/04 J2 - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society KW - Anticoagulants/therapeutic use Bone Cements/*adverse effects Humans Osteoporosis/complications Patient Selection Postoperative Complications/chemically induced/physiopathology/therapy Pulmonary Embolism/*chemically induced/*drug therapy/physiopathology Spinal Curvatures/etiology/prevention & control/*surgery Spinal Fractures/complications/*surgery Vertebroplasty/*adverse effects/methods LA - eng M1 - 9 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0940-6719 (Print) 0940-6719 SP - 1257-65 ST - Management of pulmonary cement embolism after percutaneous vertebroplasty and kyphoplasty: a systematic review of the literature T2 - Eur Spine J TI - Management of pulmonary cement embolism after percutaneous vertebroplasty and kyphoplasty: a systematic review of the literature VL - 18 ID - 828639 ER - TY - JOUR AB - Background and purpose - We present two cases of angio-proliferative tumors that were misdiagnosed and treated as typical hemangiomas with epidural expansion. Materials and methods - Two middle-aged women presented with symptoms and radiological signs characteristic for aggressive hemangioma with epidural expansion. In the first case preoperative embolization and decompressive surgery with open transpedicular vertebroplasty was performed. Within less than a year epidural recurrence of the tumor prompted for radical excision and corpectomy. The diagnosis after the histological studies and the further clinical evolution was metastasizing leiomyomatosis. No further recurrence occured during the next 6 years. In the second case percutaneous vertebroplasty was performed and complicated by epidural polymethyl-methacrylcate (PMMA) leakage, requiring urgent decompressive surgery. Histological study of the lesion raised the possibility of myopericytoma. This was confirmed 16 months later when complete vertebrectomy was performed due to severe epidural propagation of the recurring tumor. No further recurrence occurred in next the two years. Conclusions - Rare angio-proliferative tumors, like benign metastasizing leiomyoma and myopericytoma radiologically may resemble aggressive vertebral hemangiomas of the spine. Unlike hemangiomas, such tumors require radical removal due to their likely recurrence. As imaging studies may not be able to completely exclude such pathologies, bone biopsy and thorough histopathological studies are warranted prior to the therapeutic decision. AD - [Kulcsar, Zsolt] Swiss Neuro Inst, Hirslanden Clin, Dept Neuroradiol, CH-8032 Zurich, Switzerland. [Kulcsar, Zsolt; Veres, Robert; Hanzely, Zoltan; Berentei, Zsolt; Marosfoei, Miklos; Nyary, Istvan; Szikora, Istvan] Natl Inst Neurosci, Budapest, Hungary. Kulcsar, Z (corresponding author), Swiss Neuro Inst, Hirslanden Clin, Dept Neuroradiol, Witellikerstr 40, CH-8032 Zurich, Switzerland. kulcsarzsolt22@gmail.com AN - WOS:000300032400007 AU - Kulcsar, Z. AU - Veres, R. AU - Hanzely, Z. AU - Berentei, Z. AU - Marosfoi, M. AU - Nyary, I. AU - Szikora, I. DA - Jan J2 - Ideggyogy. Szle. KW - aggressive spinal hemangioma myopericytoma metastasizing leiomyoma vertebroplasty sclerotization embolization BENIGN METASTASIZING LEIOMYOMA SYMPTOMATIC VERTEBRAL HEMANGIOMAS PERCUTANEOUS VERTEBROPLASTY FOLLOW-UP MYOPERICYTOMA MANAGEMENT INJECTION Clinical Neurology Neurosciences LA - English M1 - 1-2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2012 SN - 0019-1442 SP - 42-47 ST - RARE ANGIOPROLIFERATIVE TUMORS MIMICKING AGGRESSIVE SPINAL HEMANGIOMA WITH EPIDURAL EXPANSION T2 - Ideggyogyaszati Szemle-Clinical Neuroscience TI - RARE ANGIOPROLIFERATIVE TUMORS MIMICKING AGGRESSIVE SPINAL HEMANGIOMA WITH EPIDURAL EXPANSION UR - ://WOS:000300032400007 VL - 65 ID - 830314 ER - TY - JOUR AB - BACKGROUND AND PURPOSE: We present two cases of angio-proliferative tumors that were misdiagnosed and treated as typical hemangiomas with epidural expansion. MATERIALS AND METHODS: Two middle-aged women presented with symptoms and radiological signs characteristic for aggressive hemangioma with epidural expansion. In the first case preoperative embolization and decompressive surgery with open transpedicular vertebroplasty was performed. Within less than a year, epidural recurrence of the tumor prompted for radical excision and corpectomy. The diagnosis after the histological studies and the further clinical evolution was metastasizing leiomyomatosis. No further recurrence occured during the next 6 years. In the second case percutaneous vertebroplasty was performed and complicated by epidural polymethyl-methacrylcate (PMMA) leakage, requiring urgent decompressive surgery. Histological study of the lesion raised the possibility of myopericytoma. This was confirmed 16 months later when complete vertebrectomy was performed due to severe epidural propagation of the recurring tumor. No further recurrence occurred in next the two years. CONCLUSIONS: Rare angio-proliferative tumors, like benign metastasizing leiomyoma and myopericytoma radiologically may resemble aggressive vertebral hemangiomas of the spine. Unlike hemangiomas, such tumors require radical removal due to their likely recurrence. As imaging studies may not be able to completely exclude such pathologies, bone biopsy and thorough histopathological studies are warranted prior to the therapeutic decision. AD - National Institute of Neurosciences, Budapest. kulcsarzsolt22@gmail.com AN - 22338846 AU - Kulcsár, Z. AU - Veres, R. AU - Hanzély, Z. AU - Berentei, Z. AU - Marosfoi, M. AU - Nyáry, I. AU - Szikora, I. DA - Jan 30 DP - NLM ET - 2012/02/22 J2 - Ideggyogyaszati szemle KW - Bone Cements/therapeutic use Decompression, Surgical Diagnosis, Differential *Embolization, Therapeutic Emergencies Epidural Neoplasms/*secondary/surgery/therapy Female Hemangioma/*diagnosis/pathology/surgery Humans Magnetic Resonance Imaging Middle Aged Neoplasm Recurrence, Local/*diagnosis/pathology/surgery/therapy *Pericytes Polymethyl Methacrylate/therapeutic use Spinal Neoplasms/*diagnosis/pathology/surgery Thoracic Vertebrae Tomography, X-Ray Computed *Vertebroplasty LA - eng M1 - 1-2 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0019-1442 (Print) 0019-1442 SP - 42-7 ST - Rare angioproliferative tumors mimicking aggressive spinal hemangioma with epidural expansion T2 - Ideggyogy Sz TI - Rare angioproliferative tumors mimicking aggressive spinal hemangioma with epidural expansion VL - 65 ID - 828864 ER - TY - JOUR AB - INTRODUCTION: Percutaneous balloon kyphoplasty is a safer treatment option of compression fractures, especially in elderly patients. Cement (polymethylmethacrylate or PMM) leakage is most common complication which may rarely cause pulmonary cement embolism. We report a case of elderly woman with cement pulmonary embolism 4 days following balloon kyphoplasty. CASE PRESENTATION: A 90 year-old Caucasian lady with complex medical history of chronic lymphocytic leukemia (CLL), systemic hypertension and osteoporosis presented with increasing shortness of breath since 1 day for which she went to her cardiologist office. She was then sent to emergency room for further workup. Her vitals were stable with 96% oxygen saturation on room air. No other symptoms. Chest CT angiogram was done with contrast since she recently underwent successful uncomplicated balloon kyphoplasty of T9 & T10 vertebrae 4 days ago for pathologic fractures. CT showed hyperdense material within right upper, middle & lower lobe and left upper lobe pulmonary arteries consistent with cement pulmonary embolism. Also seen was hyperdense material in perivertebral venous system. However, X-rays done postoperatively showed cement to be in good position. Her echocardiogram showed left ventricular ejection fraction of 60% with normal right heart. She was then started on heparin and bridged to warfarin with target INR 2-3. She did have few episodes of non-sustained ventricular tachycardia and atrial arrhythmias which resolved on its own. Her vitals were stable when she was discharged to home after 5 days. DISCUSSION: PMM cement has been widely used in various orthopedic and neurosurgical procedures since more than 25 years. Although percutaneous balloon kyphoplasty is a relatively safe procedure, local cement leaks are seen in 80% of cases. It can also leak into perivertebral veins from where it can rarely embolise in the pulmonary arteries. There is no consensus in management guidelines with some authors suggesting conservative approach (careful observation) while others suggest surgical embolectomy or percutaneous removal. In our patient because of her co-morbid conditions she was deemed a poor candidate for surgery. We felt that there is increased risk of platelet aggregation and clot formation on the cement in pulmonary arteries and we decided to do long term anticoagulation. CONCLUSIONS: Our case shows the need to consider pulmonary cement embolism in patients, especially with pathological fractures, who have undergone balloon kyphoplasty recently and present with increased shortness of breath. AD - N. Kumar, Providence Hospital and Medical Center, Southfield, MI, United States AU - Kumar, N. AU - Malviya, M. AU - De Meireles, M. DB - Embase DO - 10.1378/chest.1826525 KW - cement poly(methyl methacrylate) warfarin heparin thorax disease physical disease by body function embolism kyphoplasty human pulmonary artery lung embolism dyspnea patient pathologic fracture aged thorax vertebra ambient air oxygen saturation emergency ward cardiologist hypertension osteoporosis female compression fracture chronic lymphatic leukemia thrombocyte aggregation anticoagulation consensus heart atrium arrhythmia heart ventricle tachycardia medical history heart left ventricle ejection fraction echocardiography Caucasian heart X ray venous circulation neurosurgery procedures vein embolectomy surgery risk blood clotting international normalized ratio L1 - http://journal.publications.chestnet.org/article.aspx?articleID=1837477 LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 0012-3692 ST - Signs and symptoms of chest diseases | march 2014 it should not be here! A strange case of pulmonary cement embolism following balloon kyphoplasty T2 - Chest TI - Signs and symptoms of chest diseases | march 2014 it should not be here! A strange case of pulmonary cement embolism following balloon kyphoplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71429118&from=export http://dx.doi.org/10.1378/chest.1826525 VL - 145 ID - 829426 ER - TY - JOUR AD - [Kumar, Navneet; Malviya, Meenal; De Meireles, Mario] Providence Hosp & Med Ctr, Southfield, MI USA. AN - WOS:000364518700475 AU - Kumar, N. AU - Malviya, M. AU - De Meireles, M. DA - Mar DO - 10.1378/chest.1826525 J2 - Chest KW - Critical Care Medicine Respiratory System LA - English M1 - 3 M3 - Meeting Abstract N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2014 SN - 0012-3692 SP - 2 ST - It Should Not Be Here! A Strange Case of Pulmonary Cement Embolism Following Balloon Kyphoplasty T2 - Chest TI - It Should Not Be Here! A Strange Case of Pulmonary Cement Embolism Following Balloon Kyphoplasty UR - ://WOS:000364518700475 VL - 145 ID - 830268 ER - TY - JOUR AB - BACKGROUND: Management of fractures of neck of femur in the elderly is largely joint sacrificing, with hemiarthroplasties being the most common entity used. Cemented and uncemented, both the techniques, are universally accepted; however, the former has been more time tested, despite its theoretical disadvantage in the form of cement embolism leading to intra-operative complications. Uncemented stems have been ever evolving with newer designs to increase incorporation, stability and durability. They have their own reported sets of disadvantages like subsidence and fractures. However, overall there is no established gold standard out of the two. OBJECTIVE: The present systematic review and meta-analysis of current literature was conducted, so as to determine the superiority of one technique over the other by comparing the primary outcomes like hip function, residual pain, local and general complications and mortality. Additionally secondary outcomes like duration of surgery, blood loss and re-operations were analysed as well. METHODOLOGY: Three databases of PubMed, EMBASE and SCOPUS were searched for relevant articles of last 10 years that directly compare uncemented and cemented hemiarthroplasties, and based on our inclusion and exclusion criteria, article selection was done. RESULTS: We analysed a total of six randomised controlled studies dated from 2008 to 2017. PRIMARY OUTCOMES: There was a significant difference in post-operative ability to ambulate at 1 year, between 2 groups with odds ratio 0.45 (95% CI 0.29-0.67, p = 0.0001) favouring cemented hemiarthroplasty. Prosthesis-related complications like fractures and subsidence and general complications like lung complications were more in uncemented group. Mortality at 1 year was more in cemented group. SECONDARY OUTCOMES: Mean surgical time was lesser in uncemented cases. There was no difference in blood loss and re-operation rates. CONCLUSION: Cementing techniques are here to stay, until a better, durable and more stable uncemented stem evolves, that could lessen the complications related to uncemented surgeries and match the cemented implants in pain relief and ambulation. AD - Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India. drprasoonksingh@gmail.com. Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India. AN - 30694383 AU - Kumar, P. AU - Rajnish, R. K. AU - Neradi, D. AU - Kumar, V. AU - Agarwal, S. AU - Aggarwal, S. DA - May DO - 10.1007/s00590-019-02364-z DP - NLM ET - 2019/01/30 J2 - European journal of orthopaedic surgery & traumatology : orthopedie traumatologie KW - Bone Cements/*therapeutic use Femoral Neck Fractures/*surgery *Hemiarthroplasty Hip Prosthesis Humans Operative Time Postoperative Complications Prosthesis Design Cemented Complications Hemiarthroplasty Nof Neck femur fractures Outcomes Uncemented LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 1633-8065 (Print) 1633-8065 SP - 731-746 ST - Hemiarthroplasty for neck of femur fractures: to cement or not? A systematic review of literature and meta-analysis T2 - Eur J Orthop Surg Traumatol TI - Hemiarthroplasty for neck of femur fractures: to cement or not? A systematic review of literature and meta-analysis VL - 29 ID - 828603 ER - TY - JOUR AB - Introduction Interventional radiology offers several palliative procedures resulting in improvement of quality of life for terminally ill patients, which are often overlooked and are unknown to non-radiology physicians Content Outline In this educational exhibit, we will discuss and provide a pictorial review of the various palliative procedures performed by interventional radiology at our multi-center academic healthcare system for gastrointestinal-related malignancies. The clinical indications, patient selection criteria, contraindications technique, complications, and results of the procedures will be examined. The cases include portal vein recanalization, biliary drain placement, and stenting in the setting of obstructive malignancy as well as celiac plexus cryoablation/block for chronic pain relief (i.e., pancreatic cancer). Also, percutaneous decompression gastrostomy tube (PDGT) placement for patients with malignant bowel obstruction and pleural/abdominal drainage catheters for malignant effusions will be discussed. Furthermore, we will explore ablations, chemo- and radio-embolization, and bland embolization of hepatic tumors in the setting of palliative care. Procedures, such as kyphoplasty, vertebroplasty, and ablation of osseous metastasis for pain relief will also be discussed in detail Lastly, we will review cases demonstrating palliative treatment of venous and arterial thromboses related to malignancy Learning Points Interventional radiology plays an important role in the multidisciplinary field of palliative care by offering a wide range of minimally invasive procedures to increase the quality of a patient's life and to achieve goals of care. AD - D. Kumari, Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, United States AU - Kumari, D. AU - Bochnakova, T. AU - Walker, L. AU - Azar, N. AU - Tavri, S. AU - Patel, I. DB - Embase DO - 10.1055/s-0038-1641653 KW - abdominal drainage adult analgesia artery thrombosis biliary drain bone metastasis cancer patient cancer radiotherapy case study celiac plexus chronic pain complication conference abstract contraindication decompression health care system hepatic portal vein human interventional radiology intestine obstruction kyphoplasty learning liver tumor malignant pleura effusion minimally invasive procedure palliative therapy pancreas cancer patient selection physician quality of life radioembolization recanalization stent stomach tube terminally ill patient vein thrombosis LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 2472-873X ST - Palliative gastrointestinal interventions T2 - Digestive Disease Interventions TI - Palliative gastrointestinal interventions UR - https://www.embase.com/search/results?subaction=viewrecord&id=L625235272&from=export http://dx.doi.org/10.1055/s-0038-1641653 VL - 1 ID - 829229 ER - TY - JOUR AD - Universitätsklinik und Poliklinik für Diagnostische Radiologie Halle-Wittenberg, Salle. mathias.kunde@uk-halle.de AN - 23549626 AU - Kunde, M. AU - Schramm, D. AU - Bach, A. G. DA - Apr DO - 10.1055/s-0032-1327390 DP - NLM ET - 2013/04/04 J2 - Deutsche medizinische Wochenschrift (1946) KW - Bone Cements/*adverse effects Diagnosis, Differential Extravasation of Diagnostic and Therapeutic Materials/diagnostic imaging/*etiology Female Humans Inflammation/diagnostic imaging/*etiology Kyphoplasty/*adverse effects Middle Aged Pulmonary Embolism/diagnostic imaging/*etiology Radiography LA - ger M1 - 15 N1 - PubMed NLM literature search January 5, 2021 OP - 49-jährige Patientin nach Kyphoplastie. PY - 2013 SN - 0012-0472 SP - 781-2 ST - [49-year-old woman after kyphoplasty] T2 - Dtsch Med Wochenschr TI - [49-year-old woman after kyphoplasty] VL - 138 ID - 828529 ER - TY - JOUR AB - Osteoporosis diminishes the quality and quantity of bone, resulting in compromised bone strength and increased fracture risk in 200 million women worldwide. Hip fractures are the most devastating complication. They are associated with a 25% increase in mortality in the following year and a 4-fold increase of mortality risk in the first 3 months after fracture. The incidence of death from a hip fracture equals the breast cancer mortality rate. Furthermore, patients with a recent hip fracture carry at least a 10% early risk of a contralateral fracture. Hence, osteoporosis is a severe and escalating socio-economic problem. The prevention of osteoporotic fractures, especially hip fractures, remains a challenge. Currently available pharmaceutical treatments fail to address fracture risk during the early stages of therapy, taking up to 18 months to reduce fracture risk. Furthermore, efficacy is not 100% even with full compliance and compliance is, at best, around 50% after 1 year. An estimated 20% increase in bone mineral density is required to prevent a hip from fracture in a simple fall. Hence, complementary approaches to immediately prevent hip fractures in patients at very high risk are still an unmet clinical need. The use of protective devices, such as hip pads or an energyabsorbing floor, have been developed and investigated. However, the compliance is low and effectiveness is still unclear. Surgical approaches, in order to augment the local bone have been proposed to strengthen fragile bone, particularly proximal femur, prior to subsequent fracture. Techniques are prophylactic nailing, femoroplasty with cement and bone grafting with osteoconductive or osteoinductive materials. Prophylactic nailing: Prophylactic nailing to stabilize highly fragile osteoporotic hips is not currently performed in clinical practice. In a randomized controlled trial, contralateral hip fixation using a hydroxyapatite-coated titanium tubular screw was evaluated on the risk of recurrent fracture. Although the feasibility and safety of the procedure were confirmed, the results were not conclusive since no contralateral hip fracture occurred over the 16-month follow-up. A device called YSTRUT ®, which is indicated for contralateral percutaneous internal fixation of proximal femur in patients with a low-energy pertrochanteric fracture. This device is implanted during the same anesthesia as for the fracture stabilization. The implant consists of two interlocking peek rods linked with surgical cement (polymethylmethacrylate (PMMA)). The loadings until failure of cadaver specimens with this implant showed increased both fracture load (+18%) and energy to fracture (+32%) as compared to contralateral femur. However, peri-prosthetic fracture risk should be taken into consideration in a careful benefit-risk and costeffectiveness analysis for any new local procedure aimed at preventing hip fractures. Indeed, prophylactic fixation with a cephalomedullary nail was not found to be cost-effective in elderly women with hip fracture. However, the case may differ in selected patients. Bone Augmentation: Several preclinical and clinical studies addressing the augmentation of bones by cement have been published over the last decades, investigating the augmentation of fractures of different locations, which have shown a better stability, stiffness and strength. For the hip, the augmentation of conventional osteosynthesis of femoral neck fractures and intertrochanteric fractures has been studied, as well as the effectiveness of different types of cements. In the spine, cement-augmentation of fractured or sintered vertebral bodies, well known as Vertebroplasty and Kyphoplasty, has been introduced in clinical use several years ago and has shown significant positive outcome with regard to pain reduction. Prophylactic cement augmentation of the proximal femur (“Femoroplasty”) may reduce fracture risk. This technique has only been evaluated to date in cadaver or animals. The results showed 30-80% improvement in bone strength, the results being volume dependen (cement augmentations of 20 to 40 ml) and location dependent. Despite the encouraging positive biomechanical effects of PMMA augmentation, this cement augmentation has not gained wide acceptance, as it cures with shrinkage in an exothermic reaction with possible associated bone necrosis, can compromise healing and is difficult to remove in revision surgery and the subsequent drilling and osteosynthesis with the cement left in situ might be difficult. Furthermore, femoroplasty may be associated with the occurrence of sub-trochanteric fractures, fat embolism, circulatory damage and stress concentration. Thus, further clinical validation of the technique is mandatory. Bone grafts with osteoconductive or osteoinductive materials: Very promising results in preclinical and clinical studies have been published for bioactive cements. They cure with a non-or less-exothermic reaction and are considered to be osteoconductive, meaning that they can be resorbed gradually with time and replaced by host bone. Synthetic bone grafts are mainly made of calcium-phosphate (e.g. hydroxyapatite and tricalcium phosphate), bioglass and calcium sulphate. Such materials can be used as carriers for growth factors (e.g. BMPs) as well to enhance bone graft efficacy, drugs (bisphosphonates) or ions (strontium) to promote osteoblast proliferation. In osteoporosis, the administration of osteoconductive or osteoinductive materials requires low viscosity material to avoid injection under high pressure in the trabecular bone network of the proximal femur. One new investigational treatment to lower hip fracture risk in osteoporosis uses a minimally-invasive local osteoenhancement procedure (LOEP) to inject a unique, resorbable, triphasic calcium sulfate/calcium phosphate implant material (AGN1) into the proximal femur with the intent of immediate increasing femoral strength by regenerating bone lost due to osteoporosis. Preclinical studies demonstrate that the AGN1 fully resorbs and is replaced with host bone, suggesting that fracture protection may be sustained over time. Furthermore, AGN1 implantation provides an adjunctive treatment to deliver targeted immediate enhancement of strength of the proximal femur. A clinical study using AGN1 was conducted to evaluate the biomechanical performance of the injected proximal femurs of 12 post-menopausal osteoporotic women (age range 56-89; hipBMD T-scores:-3.0 ± 0.7). As a result, there appeared to be newly generated integrated load-bearing bone tissue within the original implant area through the 5-7 years follow up. These results suggest that local osteo-enhancement of the proximal femur using AGN1 in osteoporotic women can substantially increase proximal femoral strength and that this benefit is apparent soon after treatment and persists for at least 5-7 years. Conclusion: The prevention of hip fractures, the most devastating complication of osteoporosis, remains a challenge. Current medical treatment of osteoporosis, result in an increase in bone mass and reduction of fracture risk. However, there are non-responders, a lack of compliance and the effect of an antiresorptiv or osteoanabolic treatmentmay need a long time to achieve a sufficient gain of bone density and fracture risk reduction. Hence, complementary approaches, such as surgical procedures, to immediately prevent hip fractures in patients at very high risk are needed. Prophylactic osteosynthesis and PMMA augmentation of osteoporotic bone has been investigated pre-clinically and in clinical studies, but have not gained clinical acceptance over the years. Some new materials are currently being developed that are synthetic, resorbable, osteoconductive and osteoinductivematerials, with the aim of an early local strengthening of fragile bone, e.g. hip, to fill an unmet clinical need in the management of elderly patients with an increased imminent risk of hip fracture. AD - A. Kurth, Orthopaedic Hospital, Birkenwerder, Germany AU - Kurth, A. DB - Embase DO - 10.1007/s00198-018-4438-42 KW - bisphosphonic acid derivative calcium phosphate calcium sulfate cement endogenous compound growth factor hydroxyapatite ion titanium adult adverse device effect aged anesthesia bone density bone mass bone necrosis bone strength breast cancer cadaver cancer mortality cancer patient cancer recurrence cancer staging cancer surgery cell proliferation clinical practice complication conference abstract controlled study drill drug therapy experimental therapy fat embolism feasibility study female femoral neck fracture femur intertrochanteric fracture femur pertrochanteric fracture femur subtrochanteric fracture follow up fracture reduction fragility fracture hip fracture human implant incidence injection kyphoplasty major clinical study mortality risk osteoblast osteoporosis osteosynthesis pain periprosthetic fracture preclinical study prevention protective equipment proximal femur randomized controlled trial rigidity risk assessment risk reduction stress surgery surgical approach synthetic bone graft trabecular bone treatment failure validation process vertebra body viscosity LA - English M1 - 1 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1433-2965 SP - S95-S97 ST - Local bone treatment in osteoporosis T2 - Osteoporosis International TI - Local bone treatment in osteoporosis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L623595656&from=export http://dx.doi.org/10.1007/s00198-018-4438-42 VL - 29 ID - 829218 ER - TY - JOUR AB - Osteoporosis diminishes the quality and quantity of bone, resulting in compromised bone strength and increased fracture risk. In 2010, it was estimated that 22 million women and 5.5million men in the EU had osteoporosis using the diagnostic criterion of the WHO (Herlund, Kanis, et al. 2013). Fractures in older adults are often the precursor of disability, loss of independence, and premature death. The number of new fractures in 2010 in the EU was estimated at 3.5 million, comprising approximately 610,000 hip fractures, 520,000 vertebral fractures, 560,000 forearm fractures and 1,800,000 other fractures. Hip fractures are the most devastating complication. They are associated with a 25% increase in mortality in the following year and a 4-fold increase of mortality risk in the first 3 months after fracture. The incidence of death from a hip fracture equals the breast cancer mortality rate. Furthermore, patients with a recent hip fracture carry at least a 10% early risk of a contralateral fracture. Hence, osteoporosis is a severe and escalating socio-economic problem. The prevention of osteoporotic fractures, especially hip fractures, remains a challenge. Currently available pharmaceutical treatments fail to address fracture risk during the early stages of therapy, taking up to 18 months to reduce fracture risk. Furthermore, efficacy is not 100% even with full compliance and compliance is, at best, around 50% after 1 year. An estimated 20%increase in bone mineral density is required to prevent a hip from fracture in a simple fall. Hence, complementary approaches to immediately prevent hip fractures in patients at very high risk are still an unmet clinical need. The use of protective devices, such as hip pads or an energy absorbing floor, have been developed and investigated. However, the compliance is low and effectiveness is still unclear. Surgical approaches, in order to augment the local bone have been proposed to strengthen fragile bone, particularly proximal femur, prior to subsequent fracture. Techniques are prophylactic nailing, femoroplasty with cement and bone grafting with osteoconductive or osteoinductive materials. Prophylactic nailing: Prophylactic nailing to stabilize highly fragile osteoporotic hips is not currently performed in clinical practice. In a randomized controlled trial, contralateral hip fixation using a hydroxyapatite-coated titanium tubular screw was evaluated on the risk of recurrent fracture. Although the feasibility and safety of the procedure were confirmed, the results were not conclusive since no contralateral hip fracture occurred over the 16-month follow-up. A device called YSTRUT ®, which is indicated for contralateral percutaneous internal fixation of proximal femur in patients with a low-energy pertrochanteric fracture. This device is implanted during the same anesthesia as for the fracture stabilization. The implant consists of two interlocking peek rods linked with surgical cement (polymethylmethacrylate (PMMA)). The loadings until failure of cadaver specimens with this implant showed increased both fracture load (+18%) and energy to fracture (+32%) as compared to contralateral femur. However, peri-prosthetic fracture risk should be taken into consideration in a careful benefit-risk and cost effectiveness analysis for any new local procedure aimed at preventing hip fractures. Indeed, prophylactic fixation with a intramedullary nail was not found to be cost-effective in elderly women with hip fracture. However, the case may differ in selected patients. Bone Augmentation: Several preclinical and clinical studies addressing the augmentation of bones by cement have been published over the last decades, investigating the augmentation of fractures of different locations, which have shown a better stability, stiffness and strength. For the hip, the augmentation of conventional osteosynthesis of femoral neck fractures and intertrochanteric fractures has been studied, as well as the effectiveness of different types of cements. In the spine, cement-augmentation of fractured or sintered ertebral bodies, well known as Vertebroplasty and Kyphoplasty, has been introduced in clinical use several years ago and has shown significant positive outcome with regard to pain reduction. Prophylactic cement augmentation of the proximal femur (Femoroplasty) may reduce fracture risk. This technique has only been evaluated to date in cadaver or animals. The results showed 30-80% improvement in bone strength, the results being volume dependent (cement augmentations of 20 to 40 ml) and location dependent. Despite the encouraging positive biomechanical effects of PMMA augmentation, this cement augmentation has not gained wide acceptance, as it cures with shrinkage in an exothermic reaction with possible associated bone necrosis, can compromise healing and is difficult to remove in revision surgery and the subsequent drilling and osteosynthesis with the cement left in situ might be difficult. Furthermore, femoroplasty may be associated with the occurrence of sub-trochanteric fractures, fat embolism, circulatory damage and stress concentration. Thus, further clinical validation of the technique is mandatory. Bone grafts with osteoconductive or osteoinductive materials: Very promising results in preclinical and clinical studies have been published for bioactive cements. They cure with a non- or lessexothermic reaction and are considered to be osteoconductive, meaning that they can be resorbed gradually with time and replaced by host bone. Synthetic bone grafts are mainly made of calcium-phosphate (e.g. hydroxyapatite and tricalcium phosphate), bioglass and calcium sulphate. Such materials can be used as carriers for growth factors (e.g. BMPs) as well to enhance bone graft efficacy, drugs (bisphosphonates) or ions (strontium) to promote osteoblast proliferation. In osteoporosis, the administration of osteoconductive or osteoinductive materials requires low viscosity material to avoid injection under high pressure in the trabecular bone network of the proximal femur. One new approach for a local treatment of osteoporotic bone is AGN 1. The AGN1 local osteo-enhancement procedure (LOEP) is a novel minimally invasive approach intended to strengthen the hip by delivering a unique, resorbable, triphasic calcium sulfate/calcium phosphate implant material (AGN1) into the proximal femur. The implant material sets in situ and is designed to be resorbed and replaced with new bone. Preclinical studies demonstrate that the AGN1 fully resorbs and is replaced with host bone, suggesting that fracture protection may be sustained over time. Furthermore, AGN1 implantation provides an adjunctive treatment to deliver targeted immediate enhancement of strength of the proximal femur. One preclinical study evaluated the immediate effect ofAGN1 LOEP on the biomechanical properties of cadaveric femurs in a sideways fall configuration. AGN1 LOEP delivered AGN1 without compromising the biomechanical properties of the proximal femur. In the treated group, no femurs fractured through the lateral cortical access portal. It immediately increased failure load and work to failure in osteopenic and osteoporotic femurs with the largest benefit in osteoporotic femurs. It was concluded that AGN1 LOEP is a biomechanically safe, minimally invasive procedure and a promising new surgical approach to treat patients at high risk of hip fracture. Furthermore; a clinical study using AGN1 was conducted to evaluate the biomechanical performance of the injected proximal femurs of 12 post-menopausal osteoporotic women (age range 56-89; hip BMD T-scores: -3.0 ± 0.7). As a result, there appeared to be newly generated integrated load-bearing bone tissue within the original implant area through the 5-7 years follow up. These results suggest that local osteo-enhancement of the proximal femur using AGN1 in osteoporotic women can substantially increase proximal femoral strength and that this benefit is apparent soon after treatment and persists for at least 5-7 years. Conclusion: The prevention of hip fractures, the most devastating complication of osteoporosis, remains a challenge Current medical treatment of osteoporosis, result in an increase in bone mass and reduction of fracture risk. However, there are non-responders, a lack of compliance and the effect of an antiresorptiv or osteoanabolic treatment may need a long time to achieve a sufficient gain of bone density and fracture risk reduction. Hence, complementary approaches, such as surgical procedures, to immediately prevent hip fractures in patients at very high risk are needed. Prophylactic osteosynthesis and PMMA augmentation of osteoporotic bone has been investigated pre-clinically and in clinical studies, but have not gained clinical acceptance over the years. Some new materials are currently being developed that are synthetic, resorbable, osteoconductive and osteoinductivematerials, with the aim of an early local strengthening of fragile bone, e.g. hip, to fill an unmet clinical need in the management of elderly patients with an increased imminent risk of hip fracture. The most advanced local osteo-enhancement procedure is using AGN 1 as for the prevention of proximal femur fractures. AD - A.A. Kurth, Department of Orthopedic and Trauma Surgery, Campus Kemperhof, Community Clinics Middle Rhine, Koblenz, Germany AU - Kurth, A. A. DB - Embase DO - 10.1007/s00198-019-04980-1 KW - bisphosphonic acid derivative calcium phosphate calcium sulfate cement endogenous compound growth factor hydroxyapatite titanium adult advanced cancer adverse device effect aged anesthesia bone density bone mass bone necrosis bone strength breast cancer cadaver cancer mortality cancer patient cancer recurrence cancer staging cancer surgery cell proliferation clinical practice complication conference abstract controlled study cost effectiveness analysis disability drill engineered bone graft fat embolism feasibility study female femoral neck fracture femur intertrochanteric fracture femur pertrochanteric fracture femur subtrochanteric fracture follow up forearm fracture fracture reduction fragility fracture hip fracture human incidence intramedullary nail kyphoplasty local therapy major clinical study male minimally invasive procedure mortality risk osteoblast osteoporosis osteosynthesis pain periprosthetic fracture preclinical study prevention protective equipment proximal femur fracture randomized controlled trial rigidity risk assessment risk reduction spine fracture stress surgical approach synthetic bone graft trabecular bone treatment failure vertebra body viscosity LA - English M1 - SUPPL 2 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1433-2965 SP - S206-S207 ST - Is there a role for local bone treatment in osteoporosis? T2 - Osteoporosis International TI - Is there a role for local bone treatment in osteoporosis? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L633780250&from=export http://dx.doi.org/10.1007/s00198-019-04980-1 VL - 30 ID - 829171 ER - TY - JOUR AB - Introduction: Radiofrequency Kyphoplasty (RFK) is a novel vertebral augmentation procedure that consists of non-balloon, targeted delivery of an ultra-high viscosity cement. The most likely mechanism for pain relief after osteoplasty of fractured vertebral bodies is the mechanical stabilization of the vertebral body. The main risk of these minimally invasive techniques is leakage of PMMA into the venous system, reported to be as high as 72% and 27% in large prospective randomized trials of vertebroplasty and balloon kyphoplasty, respectively. The purpose of the present study was to evaluate the novel device usability and procedural adaptation with observational evaluation of procedural and short term clinical outcomes. Methods: The first 20 RFK cases performed at six German centers and one Swiss center were enrolled in this observational study. Following each case, physicians completed extensive questionnaires and provided pre- and postoperative radiographs that documented procedural and clinical detail of each RFK procedure. The questionnaire consisted of questions about the underlying cause of the vcfs, site of the procedure, the approach, the estimated age of the fracture, cement volume delivered per level, cement extravasation, height restoration, improvement of the patient, and satisfaction of the surgeon. All report forms and preoperative and postoperative x-rays were independently analyzed by a third reader. Results: In seven centers 138 patients were enrolled into the observational study. The underlying cause of the fracture was postmenopausal or secondary osteoporosis, and malignant bone diseases of the spine. Of the 186 vertebral bodies augmented, 101 patients (73%) were treated for one level, 27 (20%) for two levels, 9 (6%) for 3 levels and 1 (1%) for 4 levels. All multiple levels interventions were performed in the same procedure. The approach to the spine was unipediculate in 95% and bipedicular in 5%. There was no evidence of clinical complications and only one technical complication (0.7%) of the device. Cement extravasation (after re-evaluation of the x-rays) was found in 15,5% of all cases, but no clinical significant complication was reported (0%). In all patients was an improvement of the patient's satisfaction and function in the short term after the intervention documented. Conclusion: Minimal-invasive, percutaneous osteoplasty has become a standard for the treatment of painful osteoporotic vertebral compression fractures and bone metastases of the spine. The results of the observational series presented, demonstrate that RF-kyphoplasty with high-viscosity cement application can be considered a safe procedure, if performed in a hospital-based setting. The cement leakage rate was lower than those reported in large prospective clinical studies for both vertebroplasty and balloon kyphoplasty. This suggests that even after minimal initial training this procedure can be performed with a good degree of safety for the patient and convenience for the surgeon. AD - [Kurth, A. A.] Univ Med Ctr, Dep Orthopaed Surg Mainz, Mainz, Germany. [Bayer-Helms, H.] St Josefs Hosp, Hilden, Germany. [Hartwig, E.] Ev Diakonissenanstalt Karlsruhe, Clin Trauma & Orthopaed Surg, Karlsruhe, Germany. [Jerosch, J.] Johanna Etienne Krankenhaus, Clin Orthopaed & Trauma Surg, Neuss, Germany. [Joellenbeck, B.] Univ Magdeburg, Dept Neurosurg, D-39106 Magdeburg, Germany. [Maestretti, G.] Kantonsspital, Clin Orthopaed & Traumasurg, Fribourg, Switzerland. [Boewe, C.; Hoehn, W.; Vogler, W.] Ev Krankenhaus Konigin Elisabeth Herzberge, Berlin, Germany. Univ Hosp Halle, Dept Orthopaed Surg, Halle, Germany. Kurth, AA (corresponding author), Weidmannstr 61, D-55131 Mainz, Germany. Kurthfrankfurt@aol.de AN - WOS:000309648500006 AU - Kurth, A. A. AU - Bayer-Helms, H. AU - Bowe, C. AU - Hartwig, E. AU - Hohn, W. AU - Jerosch, J. AU - Jollenbeck, B. AU - Maestretti, G. AU - Vogler, W. AU - Rollinghoff, M. J2 - Osteologie KW - Radiofrequency Kyphoplasty vertebral augmentation procedure ultra-high viscosity cement PERCUTANEOUS VERTEBROPLASTY COMPRESSION FRACTURES BALLOON KYPHOPLASTY PULMONARY-EMBOLISM CEMENT LEAKAGE BODY PAIN Orthopedics LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2012 SN - 1019-1291 SP - 174-179 ST - Radiofrequency Kyphoplasty - a novel vertebral augmentation system A prospective, multi-center observational study T2 - Osteologie TI - Radiofrequency Kyphoplasty - a novel vertebral augmentation system A prospective, multi-center observational study UR - ://WOS:000309648500006 VL - 21 ID - 830316 ER - TY - JOUR AB - As with percutaneous ablation of tumors in the liver, lungs, and kidneys, ablation of bone and non-visceral soft tissue tumors carries risk, primarily from collateral damage to vital structures in proximity to the target tumor. Certain risks are of particular interest when ablating bone and non-visceral soft tissue tumors, namely neural or skin injury, bowel injury, fracture, and gas embolism from damaged applicators. Ablation of large volume tumors also carries special risk. Many techniques may be employed by the interventional radiologist to minimize complications when treating tumors in the musculoskeletal system. These methods include those to depict, displace, or monitor critical structures. Thus, measures to provide thermoprotection may be active, such as careful ablation applicator placement and use of various displacement techniques, as well as passive, including employment of direct temperature, radiographic, or neurophysiologic monitoring techniques. Cementoplasty should be considered in certain skeletal locations at risk of fracture. Patients treated with large volume tumors should be monitored for renal dysfunction and properly hydrated. Finally, ablation applicators should be cautiously placed in the constrained environment of intact bone. AD - Department of Radiology , Mayo Clinic , 200 1st Street SW Rochester 55905 USA Department of Radiology, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA AN - 120548590. Language: English. Entry Date: 20170506. Revision Date: 20180519. Publication Type: journal article AU - Kurup, A. AU - Schmit, Grant AU - Morris, Jonathan AU - Atwell, Thomas AU - Schmitz, John AU - Weisbrod, Adam AU - Woodrum, David AU - Eiken, Patrick AU - Callstrom, Matthew AU - Kurup, A. Nicholas AU - Schmit, Grant D. AU - Morris, Jonathan M. AU - Atwell, Thomas D. AU - Schmitz, John J. AU - Weisbrod, Adam J. AU - Woodrum, David A. AU - Eiken, Patrick W. AU - Callstrom, Matthew R. DB - cin20 DO - 10.1007/s00270-016-1487-y DP - EBSCOhost KW - Catheter Ablation -- Methods Postoperative Complications -- Prevention and Control Soft Tissue Neoplasms -- Surgery Bone Neoplasms -- Surgery Fractures -- Prevention and Control Scales M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 0174-1551 SP - 166-176 ST - Avoiding Complications in Bone and Soft Tissue Ablation T2 - CardioVascular & Interventional Radiology TI - Avoiding Complications in Bone and Soft Tissue Ablation UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=120548590&site=ehost-live&scope=site VL - 40 ID - 830572 ER - TY - JOUR AB - Introduction The adult scoliosis is primarily degenerative with a prevalence of 1 % to 10 % and it affects more than 30 % of adults without a history of spinal deformity. The surgical treatment is no longer a technical problem since we have last generation of vertebral instrumentation, with the possibility of using cemented screws combined with vertebral osteotomies. The osteotomies we regularly used are the Ponte procedure (PP) for the thoracic spine, the Smith-Petersen osteotomy (SPO) in the lumbar region and the pedicle subtraction osteotomy (PSO). This last procedure is particularly complex and subject to a higher risk of general and neurological complications. Materials and methods Our experience is based on 110 cases (ages between 30 and 72 years) of spinal deformity operated since 2007. All patients underwent extended posterior surgery (thoraco-lumbar) for the treatment of the spinal deformity (treatment levels V and VI of Lenke-Silva). Results Eleven patients (11/110) had a complication (10 % of cases) with a reoperation rate of 5.4 % (6 patients undergoing reoperation). Patients over sixty years (30/110) were analyzed clinically and radiographically in order to evaluate the results but also to assess the complication rate of this type of surgery. In the group over 60 years (n = 30) we observed a complication rate of 26.6 % (8/30) for a total of 13 complications in 30 patients (43.3 %). The complications we observed were: 1 deep infection, 2 root injuries (1 transient), 3 dural tears, 1 pulmonary embolism, 6 hardware failures. The rate of reintervention was 16.6 %. All patients had at least one co-morbidity and three patients who had a complication (37.5 %) were over 65 years old and underwent a PSO. Discussion The complication rates reported in the literature about adult deformity surgery vary according to the type of surgical procedure performed and in particular we can have a risk of 2.5 % to 35.2 % for the procedures of spinal decompression alone, which increases to 21.4 %-37 % in the case of instrumented spinal fusion and becomes dramatically high with a mortality rate of approximately 10 % in patients older than eighty years. Conclusions In conclusion, patients with more than 60 years with severe thoraco-lumbar kyphoscoliosis candidates for posterior surgery (treatment levels V and VI of Lenke-Silva) have a high risk of complications, estimated in the order of about 40 %. In particular, the risk of complication seems to be particularly high in patients older than 65 years and in those undergoing PSO. Surprisingly the degree of patient satisfaction is very high, even in those who have experienced a complication. AD - G.A. La Maida, Istituto Ortopedico Gaetano Pini, Milan, Italy AU - La Maida, G. A. AU - Zottarelli, L. AU - Mineo, G. V. AU - Misaggi, B. DB - Embase DO - 10.1007/s10195-013-0258-7 KW - surgery spine malformation adult aged human society orthopedics traumatology risk patient osteotomy procedures reoperation prevalence injury infection neurological complication scoliosis spinal cord decompression spine fusion mortality kyphoscoliosis lacrimal fluid morbidity computer lung embolism thoracic spine deformity surgical technique devices patient satisfaction LA - English M1 - 1 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1590-9921 SP - S40-S41 ST - Results and risks of surgery to correct spinal deformities in adult and elderly T2 - Journal of Orthopaedics and Traumatology TI - Results and risks of surgery to correct spinal deformities in adult and elderly UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71249457&from=export http://dx.doi.org/10.1007/s10195-013-0258-7 VL - 14 ID - 829478 ER - TY - JOUR AB - The adult scoliosis is primarily degenerative with a prevalence of 1 to 10 % and it affects more than 30 % of adults without a history of spinal deformity. Typically the deformity occurs in the sixth decade of lifewith mechanical symptoms (low back pain), but also often radicular compression (cruralgia, sciatica). The deformity tends to worsen from 1 to 6 degrees for each year and it has a high risk of progression if it's greater than thirty degrees or if it shows a lateral slipping of more than six millimeters. The surgical treatment is no longer a technical problemsincewe have last generation of vertebral instrumentation, with the possibility of using cemented screws combined with vertebral osteotomies that are often required for the correction of severe deformity with sagittal imbalance. The osteotomies we regularly used are the Ponte procedure (PP) for the thoracic spine, the Smith-Petersen osteotomy (SPO) in the lumbar region and the pedicle subtraction osteotomy (PSO). This last procedure is particularly complex and subject to a higher risk of general and neurological complications. The complication rates reported in the literature about adult deformity surgery vary according to the type of surgical procedure performed and in particular we can have a risk of 2.5 to 35.2 %for the procedures of spinal decompression alone, which increases to 21.4-37 % in the case of instrumented spinal fusion and becomes dramatically high with a mortality rate of approximately 10 % in patients older than eighty years. Our experience is based on 110 cases (ages between 30 and 72 years) of spinal deformity operated since 2007. All patients underwent extended posterior surgery (thoraco-lumbar) for the treatment of the spinal deformity (treatment levels V and VI of Lenke-Silva). Eleven patients (11/110) had a complication (10 % of cases) with a reoperation rate of 5.4 % (6 patients undergoing reoperation). Patients over sixty years (30/110) were analyzed clinically and radiographically in order to evaluate the results but also to assess the complication rate of this type of surgery. In the group over 60 years (n = 30) we observed a complication rate of 26.6 % (8/30) for a total of 13 complications in 30 patients (43.3 %). The complications we observed were: 1 deep infection, 2 root injuries (1 transient), 3 dural tears, 1 pulmonary embolism, 6 hardware failures. The rate of re-intervention was 16.6 %. All patients had at least one comorbidity and three patients who had a complication (37.5 %) were over 65 years old and underwent a PSO. In conclusion, patients with more than 60 years with severe thoracolumbar kyphoscoliosis candidates for posterior surgery (treatment levels V and VI of Lenke-Silva) have a high risk of complications, estimated in the order of about 40 %. In particular, the risk of complication seems to be particularly high in patients older than 65 years and in those undergoing PSO. Surprisingly the degree of patient satisfaction is very high, even in those who have experienced a complication. AD - G.A. La Maida, Spine Surgery, Department Orthopaedic Institute Gaetano Pini, Milan, Italy AU - La Maida, G. A. AU - Zottarelli, L. A. AU - Ferraro, M. AU - Misaggi, B. DB - Embase DO - 10.1007/s00586-013-2746-0 KW - spine surgery adult aged human spine society deformity patient surgery risk osteotomy spine malformation procedures reoperation thoracic spine lung embolism devices lacrimal fluid sciatica scoliosis computer comorbidity leg pain prevalence spine fusion nerve root compression spinal cord decompression mortality infection injury surgical technique patient satisfaction neurological complication kyphoscoliosis low back pain LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0940-6719 SP - 944-945 ST - Results and complications in deformity spine surgery of the adult and elderly T2 - European Spine Journal TI - Results and complications in deformity spine surgery of the adult and elderly UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71314714&from=export http://dx.doi.org/10.1007/s00586-013-2746-0 VL - 22 ID - 829504 ER - TY - JOUR AB - This is the first report of fat embolism syndrome after bilateral total knee arthroplasty with the total condylar prosthesis. Cementing techniques and increased systemic monomer may play a role in the etiology of this syndrome. It is reasonable to suppose that fat embolism syndrome often occurs after total knee arthroplasty in an occult form. AN - 7285408 AU - Lachiewicz, P. F. AU - Ranawat, C. S. DA - Oct DP - NLM ET - 1981/10/01 J2 - Clinical orthopaedics and related research KW - Aged Bone Cements Embolism, Fat/*etiology Female Humans Knee Prosthesis/*adverse effects/methods Osteoarthritis/*surgery LA - eng M1 - 160 N1 - PubMed NLM literature search January 5, 2021 PY - 1981 SN - 0009-921X (Print) 0009-921x SP - 106-8 ST - Fat embolism syndrome following bilateral total knee replacement with total condylar prosthesis: report of two cases T2 - Clin Orthop Relat Res TI - Fat embolism syndrome following bilateral total knee replacement with total condylar prosthesis: report of two cases ID - 828533 ER - TY - JOUR AB - Purpose of the study. -Mobile-bearing total knee arthroplasty has become increasingly popular over the last few years since this option presents several theoretical advantages compared with the fixed-bearing models. The clinical advantage remains to be demonstrated. We therefore conducted a prospective randomized trial to ascertain the potential benefits. Material and methods. -This study included patients treated by three senior orthopedic surgeons. Each group included 52 prostheses in 52 patients in the fixed-bearing group and 50 patients in the mobile-bearing group. The per- and postoperative protocols were the same for both groups. Implants were cemented in all cases and patellae were resurfaced. The SF-12, the Knee Society Score (KSS), the Hospital of Special Surgery score (HSS) and pain and joint motion were noted before and after surgery. Results. -Among the 104 prostheses implanted, 100 were reviewed at mean follow-up of 36 months (range 24-41). One patient in the fixed-bearing group died six months after surgery from an unrelated cause. Three patients were lost to follow-up: one in the fixed-bearing group and two in the mobile-bearing group. There was no difference between groups for the SF-12, KSS, HSS, pain and joint motion measured postoperatively. Postoperative femorotibial alignment was one degree varus on average in the fixed-bearing group and zero degree in the mobile-bearing group. At last follow-up, there were no radiological signs of prosthesis loosening. One patient in the fixed-bearing group developed a deep venous thrombosis, complicated by pulmonary embolism. Two of the mobile-bearing, prostheses were revised, one for patellar fracture caused by a bicycle accident and one for prosthesis infection in a patient with endocarditis 1.5 years after implantation. Discussion. -The clinical results were similar for the two groups in terms of function, pain, general status and complications. The outcome at 36 months was considered excellent or good in 90% of the fixed-bearing group and 88% in the mobile-bearing group. This study did not reveal any difference between the two groups regarding maximal flexion and anterior knee pain, two parameters which would theoretically show short-term improvement with the mobile bearing. Mid- and tong-term follow wilt be required to confirm these findings and to determine the survival of these two types of implants. (c) 2008 Elsevier Masson SAS. AD - [Laedermann, A.; Saudan, M.; Riand, N.; Fritschy, D.] Hop Cantonal Univ Geneva, Dept Chirurg, Serv Chirurg Orthoped & Traumatol Appareil Moteur, CH-1211 Geneva 4, Switzerland. Ladermann, A (corresponding author), Hop Cantonal Univ Geneva, Dept Chirurg, Serv Chirurg Orthoped & Traumatol Appareil Moteur, 24 Rue Micheli du Crest, CH-1211 Geneva 4, Switzerland. alexandre.laedermann@hcuge.ch AN - WOS:000256285200004 AU - Ladermann, A. AU - Saudan, M. AU - Riand, N. AU - Fritschy, D. DA - May DO - 10.1016/j.rco.2007.04.004 J2 - Rev. Chir. Orthop. Reparatrice Appareil Moteur KW - total knee arthroplasty tibial platform fixed mobile FOLLOW-UP ROTATIONAL ALIGNMENT PATELLAR TRACKING MENISCAL BEARING REPLACEMENT SYSTEM FEMORAL COMPONENT PROSTHESES DESIGN RATIONALE Orthopedics Surgery LA - French M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2008 SN - 0035-1040 SP - 247-251 ST - Fixed-bearing versus mobile-bearing total knee arthroplasty: A prospective randomized clinical and radiological study T2 - Revue De Chirurgie Orthopedique Et Reparatrice De L Appareil Moteur TI - Fixed-bearing versus mobile-bearing total knee arthroplasty: A prospective randomized clinical and radiological study UR - ://WOS:000256285200004 VL - 94 ID - 830380 ER - TY - JOUR AB - PURPOSE OF THE STUDY: Mobile-bearing total knee arthroplasty has become increasingly popular over the last few years since this option presents several theoretical advantages compared with the fixed-bearing models. The clinical advantage remains to be demonstrated. We therefore conducted a prospective randomized trial to ascertain the potential benefits. MATERIAL AND METHODS: This study included patients treated by three senior orthopedic surgeons. Each group included 52 prostheses in 52 patients in the fixed-bearing group and 50 patients in the mobile-bearing group. The per- and postoperative protocols were the same for both groups. Implants were cemented in all cases and patellae were resurfaced. The SF-12, the Knee Society Score (KSS), the Hospital of Special Surgery score (HSS) and pain and joint motion were noted before and after surgery. RESULTS: Among the 104 prostheses implanted, 100 were reviewed at mean follow-up of 36 months (range 24-41). One patient in the fixed-bearing group died six months after surgery from an unrelated cause. Three patients were lost to follow-up: one in the fixed-bearing group and two in the mobile-bearing group. There was no difference between groups for the SF-12, KSS, HSS, pain and joint motion measured postoperatively. Postoperative femorotibial alignment was one degree varus on average in the fixed-bearing group and zero degree in the mobile-bearing group. At last follow-up, there were no radiological signs of prosthesis loosening. One patient in the fixed-bearing group developed a deep venous thrombosis, complicated by pulmonary embolism. Two of the mobile-bearing prostheses were revised, one for patellar fracture caused by a bicycle accident and one for prosthesis infection in a patient with endocarditis 1.5 years after implantation. DISCUSSION: The clinical results were similar for the two groups in terms of function, pain, general status and complications. The outcome at 36 months was considered excellent or good in 90% of the fixed-bearing group and 88% in the mobile-bearing group. This study did not reveal any difference between the two groups regarding maximal flexion and anterior knee pain, two parameters which would theoretically show short-term improvement with the mobile bearing. Mid- and long-term follow will be required to confirm these findings and to determine the survival of these two types of implants. AD - Service de chirurgie orthopédique et traumatologie de l'appareil moteur, Département de chirurgie, hôpitaux universitaires de Genève, 24, rue Micheli-du-Crest, 1211 Genève 14, Switzerland. alexandre.laedermann@hcuge.ch AN - 18456059 AU - Lädermann, A. AU - Saudan, M. AU - Riand, N. AU - Fritschy, D. DA - May DO - 10.1016/j.rco.2007.04.004 DP - NLM ET - 2008/05/06 J2 - Revue de chirurgie orthopedique et reparatrice de l'appareil moteur KW - Aged Aged, 80 and over Arthritis/surgery Arthroplasty, Replacement, Knee/*methods Female Humans Male Pain *Prosthesis Design Range of Motion, Articular Treatment Outcome LA - fre M1 - 3 N1 - PubMed NLM literature search January 5, 2021 OP - Prothèse totale du genou: étude prospective randomisée comparant les plateaux tibiaux fixes et mobiles. PY - 2008 SN - 0035-1040 (Print) 0035-1040 SP - 247-51 ST - [Fixed-bearing versus mobile-bearing total knee arthroplasty: a prospective randomized clinical and radiological study] T2 - Rev Chir Orthop Reparatrice Appar Mot TI - [Fixed-bearing versus mobile-bearing total knee arthroplasty: a prospective randomized clinical and radiological study] VL - 94 ID - 829008 ER - TY - JOUR AB - Background Context: Minimally invasive procedures for the treatment of vertebral compression fractures (VCFs) have been in use since the mid-1980s. A mixture of liquid monomer and powder is introduced through a needle into one or both pedicles, and it polymerizes within the vertebral body in an exothermic chemical reaction. The interaction between cement and the fractured vertebral body determines whether and how the cement stabilizes the fragments, alters morphology, and extravasates. The cement is intended to remain within the vertebral body. However, some studies have reported cement leakage in more than 80% of the procedures. Although cement leakage can have no or minimal clinical consequences, adverse events, such as paraplegia, spinal cord and nerve root compression, cement pulmonary embolisms, or death, can occur. The details of how the cement infiltrates a vertebral body or extravasates out of the body are poorly understood and may help to identify strategies to reduce complications and improve clinical efficacy. Purpose: Apply novel techniques to demonstrate the cement spread inside vertebrae as well as the points and pattern of cement extravastation. Study Design: Ex vivo assessment of vertebral augmentation procedures. Methods: Vertebrae from six fresh whole human cadaver spines were used to create 24 specimens of three vertebrae each. The specimens were placed in a pneumatic testing system, designed to create controlled anterior wedge compression fractures. Unipedicular augmentation was performed on the central vertebra of 24 specimens using polymethylmethacrylate/barium sulfate Vertebroplastic cements (DePuy Spine, Raynham, MA, USA). The volume of cement injected into each vertebra was recorded. Fine-cut computed tomography (CT) scans of all segments were obtained (Brilliance 64; Philips Medical Imaging, Amsterdam, The Netherlands). Using multiplanar reconstructions and volume compositing three-dimensional imaging (Osirix, www.osirix-viewer.com), each specimen was carefully assessed for cement extravasation. Specimens were then immersed in a 50% sodium hypochlorite solution until all overlying soft tissues were removed, leaving the bone and cement intact. The specimens were dried and visually examined and photographed to assess cement extravasation and fracture patterns. Specimens were cut in the axial or sagittal plains to assess the gross morphology of cement infiltration and extravasation. Finally, 25-mm block sections were removed from selected specimens and imaged at 14-μm resolution using a GE Locus-SP micro-CT system (GE Healthcare, London, Ontario, Canada). Results: Infiltration was characterized by an intimate capture of trabecular bone within the cement, forming an irregular border at the perimeter of the cement that is determined by the morphology of the trabeculae and marrow spaces. Extravasation of the cement was assessed as "any" if any small or large amount of extravastation was detected and was also assessed as severe if a large amount of extravasation was found. Out of the 23 levels studied, some extravasation was visibly apparent in all levels. A wide spectrum of filling patterns, leakage points, and interdigitation of the cement was observed and appeared to be determined by the interaction of the cement with the trabecular morphology. The results support the fact that the cement generally advances through the vertebrae with relatively regular and easily identifiable borders. Conclusions: Using a cadaver VCF model, this study demonstrated the exact filling and extravastation patterns of bone cement inside and out of fractured vertebrae. These data enhance our understanding of the vertebral augmentation and extravastation mechanics. AD - Department of Orthopedic Surgery, Baylor College of Medicine, Houston, TX 77030, USA Department of Orthopedic Surgery, Baylor College of Medicine, 6620 Main St., 11th Floor, Houston, TX 77030, USA. AN - 104952714. Language: English. Entry Date: 20110318. Revision Date: 20200708. Publication Type: journal article AU - Lador, R. AU - Dreiangel, N. AU - Ben-Galim, P. J. AU - Hipp, J. A. AU - Lador, Ran AU - Dreiangel, Niv AU - Ben-Galim, Peleg J. AU - Hipp, John A. DB - cin20 DO - 10.1016/j.spinee.2010.09.020 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Extravasation of Diagnostic and Therapeutic Materials -- Classification Fractures, Compression -- Surgery Spinal Fractures -- Surgery Spine -- Surgery Kyphoplasty -- Methods Bone Cements -- Therapeutic Use Human Spinal Fractures -- Radiography Spine -- Radiography M1 - 12 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2010 SN - 1529-9430 SP - 1118-1127 ST - A pictorial classification atlas of cement extravasation with vertebral augmentation T2 - Spine Journal TI - A pictorial classification atlas of cement extravasation with vertebral augmentation UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104952714&site=ehost-live&scope=site VL - 10 ID - 830698 ER - TY - JOUR AB - This case report demonstrates embolization of echogenic material detected by transoesophageal echocardiography during a cemented total hip arthroplasty in a 76-yr-old woman without patent foramen ovale. During the placement of the acetabular and femoral components, and during relocation of the hip joint, a "snow flurry" appearing in the right atrium was followed by several highly echogenic and mobile emboli of various sizes, some of them with a vermiform shape 1 to 5 cm long. At skin closure, echogenic material was seen in the right branch of the pulmonary artery adherent to the vascular wall of the bifurcation of the main pulmonary artery. No changes were observed in any haemodynamic variable monitored (heart rate, systemic and right atrial pressures). Also, no desaturation was detected by pulse oximetry and blood gases at the time of embolism and there was no decrease in PETCO2. This case report is in line with other studies which failed to show a haemodynamic impact of TEE detected emboli during THA. AD - Department of Anesthesiology and Intensive Care, Reine Fabiola Hospital, Montignies-sur-Sambre, Belgium. AN - 7955002 AU - Lafont, N. D. AU - Kostucki, W. M. AU - Marchand, P. H. AU - Michaux, M. N. AU - Boogaerts, J. G. DA - Sep DO - 10.1007/bf03011592 DP - NLM ET - 1994/09/01 J2 - Canadian journal of anaesthesia = Journal canadien d'anesthesie KW - Aged Blood Pressure/physiology Bone Cements *Echocardiography, Transesophageal Embolism/*diagnostic imaging Female Heart Atria/diagnostic imaging Heart Diseases/*diagnostic imaging Heart Rate/physiology Hip Prosthesis/*adverse effects Humans Intraoperative Complications/*diagnostic imaging Pulmonary Embolism/*diagnostic imaging LA - eng M1 - 9 N1 - PubMed NLM literature search January 5, 2021 PY - 1994 SN - 0832-610X (Print) 0832-610x SP - 850-3 ST - Embolism detected by transoesophageal echocardiography during hip arthroplasty T2 - Can J Anaesth TI - Embolism detected by transoesophageal echocardiography during hip arthroplasty VL - 41 ID - 828932 ER - TY - JOUR AB - This case report demonstrates embolization of echogenic material detected by transoesophageal echocardiography during a cemented total hip arthroplasty in a 76-yr-old woman without patent foramen ovale. During the placement of the acetabular and femoral components, and during relocation of the hip joint, a ''snow flurry'' appearing in the right atrium was followed by several highly echogenic and mobile emboli of various sizes, some of them with a vermiform shape 1 to 5 cm long. At skin closure, echogenic material was seen in the right branch of the pulmonary artery adherent to the vascular wall of the bifurcation of the main pulmonary artery. No changes were observed in any haemodynamic variable monitored (heart rare, systemic and right atrial pressures). Also, no desaturation was detected by pulse oximetry and blood gases at the rime of embolism and there was no decrease in PETCO(2). This case report is in line with other studies which failed to show a haemodynamic impact of TEE detected emboli during THA. AD - ANDRE VESALE HOSP,DEPT CARDIOL,B-6110 MONTIGNIES TILLEUL,BELGIUM. REINE FABIOLA HOSP,DEPT ORTHOPEDY,B-6061 MONTIGNIES SAMBRE,BELGIUM. LAFONT, ND (corresponding author), REINE FABIOLA HOSP,DEPT ANESTHESIA & INTENS CARE,73 AVE CENTENAIRE,B-6061 MONTIGNIES SAMBRE,BELGIUM. AN - WOS:A1994PE60800013 AU - Lafont, N. D. AU - Kostucki, W. M. AU - Marchand, P. H. AU - Michaux, M. N. AU - Boogaerts, J. G. DA - Sep DO - 10.1007/bf03011592 J2 - Can. J. Anaesth.-J. Can. Anesth. KW - COMPLICATIONS, PULMONARY EMBOLISM MONITORING, ECHOCARDIOGRAPHY, TRANSESOPHAGEAL SURGERY, ORTHOPEDIC TWO-DIMENSIONAL ECHOCARDIOGRAPHY FAT-EMBOLISM REPLACEMENT Anesthesiology LA - English M1 - 9 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1994 SN - 0832-610X SP - 850-853 ST - EMBOLISM DETECTED BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY DURING HIP-ARTHROPLASTY T2 - Canadian Journal of Anaesthesia-Journal Canadien D Anesthesie TI - EMBOLISM DETECTED BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY DURING HIP-ARTHROPLASTY UR - ://WOS:A1994PE60800013 VL - 41 ID - 830491 ER - TY - JOUR AB - Purpose: This prospective study was to investigate the incidence and the fate of deep vein thrombosis (DVT) among Chinese patients following unilateral primary total knee replacement (TKR). The influence of tourniquet time and the mode of anaesthesia on DVT were evaluated. Method: 390 patients who underwent unilateral cemented primary TKR were investigated. Patients whose body-mass- index (BMI) exceeded 30kg/m2 were given chemoprophylaxis with low molecular heparin postoperatively. DVT was diagnosed using duplex ultrasonography on 4th to 7th days after operation. DVT was classified into two groups, distal and proximal. Patients who had DVT on the first scan were assigned two follow-up scans. Result: The incidence of DVT was 25.7%. 97 patients (24.9%) had distal DVT, whereas 3 had proximal DVT (0.8%). Among patients with DVT, 18 (18%) of them resolved at first follow up scan, 82 persisted, and there were no proximal progression. At the 6th week scanning, 57 patients (57%) were free from DVT, while 42 patients (42%) had persistent DVT. There was one (1%) case which the distal DVT had proximal migration, but there was no pulmonary embolism. Tourniquet time and mode of anaesthesia did not reveal any statistical significance on the incidence of DVT. Conclusion: This prospective study showed that the incidence of DVT after unilateral primary TKR in Hong Kong Chinese patient was high. However, most of them are distal to popliteal vein with low risk of proximal migration. More than half of them resolved at about two months after the operation. AD - C.K. Lai, Department of Orthopaedics and Traumatology, Yan Chai Hospital, Tsuen Wan, New Territories, Hong Kong AU - Lai, C. K. AU - Lee, Q. J. AU - Wong, Y. C. AU - Wai, Y. L. DB - Embase DO - 10.1016/j.jotr.2015.06.006 KW - enoxaparin adult aged anesthesiological procedure article body mass Chinese controlled study deep vein thrombosis disease classification disease course echography female follow up Hong Kong human incidence lung embolism major clinical study male medical procedures operation duration popliteal vein postoperative care priority journal prospective study thrombosis prevention total knee arthroplasty tourniquet time very elderly LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 2210-4925 2210-4917 SP - 35-38 ST - Incidence of Deep Vein Thrombosis and Its Natural History Following Unilateral Primary Total Knee Replacement in Local Chinese Patients-A Prospective Study T2 - Journal of Orthopaedics, Trauma and Rehabilitation TI - Incidence of Deep Vein Thrombosis and Its Natural History Following Unilateral Primary Total Knee Replacement in Local Chinese Patients-A Prospective Study UR - https://www.embase.com/search/results?subaction=viewrecord&id=L611244429&from=export http://dx.doi.org/10.1016/j.jotr.2015.06.006 VL - 21 ID - 829291 ER - TY - JOUR AB - We present a case report of fat embolism syndrome (FES) that resulted in prolonged coma after cemented hemiarthroplasty in a patient with metastatic breast cancer. After the cemented hip prosthesis was placed, the patient developed decreased sensorium that progressed to coma in association with hypoxemia and tachypnea. Pulmonary compromise was mild, and the patient required only supplemental oxygen for support. The patient demonstrated no petechiae. Magnetic imaging results were consistent with FES. While the pulmonary symptoms resolved quickly, the patient remained unresponsive for 11 days without purposeful motor function. After waking she recovered rapidly, and at her 2-month follow-up appointment, demonstrated no adverse orthopedic, pulmonary, or neurologic sequelae. AD - Department of Surgery, University of Wisconsin, Madison, USA. AN - 10784020 AU - Lairmore, J. R. AU - Heiner, J. AU - Wood, K. DA - Apr DP - NLM ET - 2000/04/28 J2 - American journal of orthopedics (Belle Mead, N.J.) KW - Aged *Arthroplasty, Replacement, Hip Breast Neoplasms/pathology Coma/*etiology Embolism, Fat/*complications Female Femoral Neoplasms/complications/secondary/*surgery Hip Fractures/etiology Humans *Postoperative Complications LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2000 SN - 1078-4519 (Print) 1078-4519 SP - 308-11 ST - Coma from fat embolism syndrome after hemiarthroplasty of the hip for metastatic breast cancer to the proximal femur: a case report T2 - Am J Orthop (Belle Mead NJ) TI - Coma from fat embolism syndrome after hemiarthroplasty of the hip for metastatic breast cancer to the proximal femur: a case report VL - 29 ID - 828938 ER - TY - JOUR AB - Case Presentation: A 25 year old Hispanic woman, G4P3 pregnant at 18 weeks with underlying hypertension and gallstones, initially presented with low back pain for 10 days. The pain started suddenly, constant, sharp with no precipitating events. It was aggravated by movement and relieved partially with painkillers. She denied lower extremity weakness, numbness, tingling or incontinence. However she experienced occasional chest tightness and shortness of breath. On examination, bruises were noted on bilateral upper and lower limbs. She also had mild tenderness at lower lumbar spine with normal neurological findings. Initial abnormal blood results were platelet 57k/uL and alkaline phosphatase 262u/L. CT Chest showed no evidence of pulmonary embolism or aortic dissection but incidental findings were right lower lobe bronchopneumonia and diffuse osteopenia in thoracic spine with vertebral height loss in T8. Consequent MRI Spine revealed patchy areas of abnormal increased T2 signals consistent with diffuse infiltrative metastasis and pathological compression fracture of L3 and T8. Core bone biopsy of L3 and T8 vertebrae and subsequent bone marrow biopsy reported poorly differentiated adenocarcinoma with associated mucin production and signet ring cell features. Patient then underwent elective termination of pregnancy in preparation for further diagnosis and treatment. EGD revealed a large infiltrative non circumferential mass in distal gastric body while EUS demonstrated the outer margin of the 40mm diameter mass was irregular and tumor had invaded the serosa. Gastric mass biopsy was positive for in situ signet ring cell adenocarcinoma (SRCA) in a background of chronic inactive gastritis. Patient underwent kyphoplasty and was started on consolidative radiotherapy. She was discharged home with a plan to start FOLFOX (Folinic Acid, Fluorouracil, Oxaliplatin). 2 months later, patient returned with intractable vomiting, nausea and severe headache. CT Brain showed left subdural hematoma with subfalcine herniation and she underwent craniotomy to drain the hematoma. While in Neurology ICU a few days later, she decompensated quickly despite maximum vasopressors and passed away. Discussion: Gastric cancers are currently the 12th leading cause of cancer-related deaths in United States. Early diagnosis is challenging as they are usually asymptomatic and there are no routine screening guidelines. Signet ring cell is a subtype of diffuse-type adenocarcinomas, and are characterized by their rapid progression, poor prognosis and high rate of metastasis. They are distinguished by the presence of >50% signet ring cells with prominent intracytoplasmic mucins. Upto 29% of gastric cancers are noted to be SRCAs. The usual sites of metastasis for gastric cancers are the liver or lungs while the incidence of bone metastasis is only 1%. Gastric cancer presenting as bone metastases without any preceding gastrointestinal symptoms has been infrequently reported in the literature. The prognosis after bone marrow involvement is very poor with patients living an average of 44 days from diagnosis, as seen in our patient. Conclusions: There should be acute clinical awareness for varied presentations of gastric SRCA. Although the prevalence of gastric cancer appears to be low, it is prudent to consider them as the possible primary site of malignancy even in the absence of overt gastrointestinal symptoms. More importance should be given to early diagnosis and treatment of gastric cancer due to its poor prognosis and high mortality rate. (Figure Presented) . AD - S. Lakshmanan, Florida Hospital, Orlando, FL, United States AU - Lakshmanan, S. AU - Kashi, M. DB - Embase KW - alkaline phosphatase endogenous compound fluorouracil folinic acid mucin oxaliplatin unclassified drug adult aortic dissection awareness bone marrow biopsy bone metastasis brain bronchopneumonia cancer mortality cancer patient cancer prognosis cancer radiotherapy cancer size case report chest tightness clinical article compression fracture conference abstract contusion craniotomy drain dyspnea early diagnosis female gallstone gastritis gastrointestinal symptom gene expression headache hernia Hispanic human human cell hypertension hypesthesia incidence incidental finding incontinence kyphoplasty liver low back pain lower limb lung embolism mortality rate nausea neurology nuclear magnetic resonance imaging osteopenia practice guideline pregnancy prevalence prognosis radiotherapy serosa signet ring carcinoma stomach cancer subdural hematoma thoracic spine thrombocyte United States vomiting weakness LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1553-5606 ST - A rare presentation of gastric signet ring cell adenocarcinoma (SRCA) T2 - Journal of Hospital Medicine TI - A rare presentation of gastric signet ring cell adenocarcinoma (SRCA) UR - https://www.embase.com/search/results?subaction=viewrecord&id=L629665416&from=export VL - 13 ID - 829224 ER - TY - JOUR AB - A perfect technic of implantation is the fundamental factor to guarantee a postoperative course free of complications. The position of the prosthesis and a high initial stability are important factors, too. In the OHH 1 561 patients were given 1 973 cemented total endoprostheses from 1968 to 1978. From 1975 to 1980, an additional number of 212 total endoprostheses without cement (ceramic prostheses) were implanted. The following aseptic complications were most common: (1) loosening, (2) luxation, (3) fractures of the shaft of the prosthesis, (4) bursting of the femur-shaft, (5) protrusio acetabuli, and (6) periarticular deposition of calcium. The rate of complications in cemented total endoprostheses was 2.7%, in cement-free endoprostheses 5.7%. In 10.3% of the cemented endoprostheses early complications were observed; among the patients with cement-free endoprostheses there occurred one luxation and one fatal case (pulmonary embolism). Late complications of the cemented endoprostheses were seen in 8%; among the cement-free endoprostheses 4 loosenings of the acetabulum, 3 loosenings of the shaft, 1 protrusio acetabuli and 1 fracture of the ceramic neck were found. 77.5% of the patients, with cemented prostheses judged their ability to walk as much improved, compared to the previous state. In 15.7% the results were unchanged, in 6.7% the state had deteriorated. Among the patients with cement-free endoprostheses 61% considered their walking ability to be much better, 29% moderately improved and 8.5% unchanged. 1% felt worse than before surgical treatment. AN - 7314293 AU - Lambiris, E. AU - Stoboy, H. AU - Bortz, W. DA - Oct DO - 10.1007/bf02589668 DP - NLM ET - 1981/10/01 J2 - Unfallchirurgie KW - Femoral Fractures/diagnostic imaging/etiology Fracture Fixation Hip Prosthesis/*adverse effects Humans Radiography LA - ger M1 - 5 N1 - PubMed NLM literature search January 5, 2021 OP - Aseptische Komplikationen bei der Totalalloarthroplastik am Hüftgelenk. PY - 1981 SN - 0340-2649 (Print) 0340-2649 SP - 242-8 ST - [Aseptic complications in total alloarthroplasty of the hip joint (author's transl)] T2 - Unfallchirurgie TI - [Aseptic complications in total alloarthroplasty of the hip joint (author's transl)] VL - 7 ID - 829016 ER - TY - JOUR AB - A perfect technic of implantation is the fundamental factor to guarantee a postoperative course free of complications. The position of the prosthesis and a high initial stability are important factors, too. In the University Orthopedic Clinic in the Oskar-Helene-Heim, 1561 patients were given 1973 cemented total endoprostheses from 1968 to 1978. From 1975 to 1980, an additional number of 212 total endoprostheses without cement (ceramic prostheses) were implanted. The following aseptic complications were most common: (1) loosening, (2) luxation, (3) fractures of the shaft of the prosthesis, (4) bursting of the femur shaft, (5) protrusio acetabuli, and (6) periarticular deposition of calcium. The rate of complications in cemented total endoprostheses was 2.7%, in cement-free endoprostheses 5.7%. In 10.3% of the cemented endoprostheses early complications were observed; among the patients with cement-free endoprostheses there occurred one luxation and one fatal case (pulmonary embolism). Late complications of the cemented endoprostheses were seen in 8% of cases; among the cement-free endoprostheses 4 loosenings of the acetabulum, 3 loosenings of the shaft, 1 protrusio acetabuli and 1 fracture of the ceramic neck were found. 77.5% of the patients with cemented prostheses judged their ability to walk as much improved, compared to the previous state. In 15.7% the results were unchanged, in 6.7% the state had deteriorated. Among the patients with cement-free endoprostheses 61% considered their walking ability to be much better, 29% moderately improved and 8.5% unchanged. 1% felt worse after surgical treatment. AD - Orthop. Klin., Freie Univ., Berlin AU - Lambiris, E. AU - Stoboy, H. AU - Bortz, W. DB - Embase Medline KW - complication etiology implant joint major clinical study total hip prosthesis LA - German M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1981 SN - 0340-2649 SP - 242-248 ST - Aseptic complications in total alloarthroplasty of the hip joint T2 - Unfallchirurgie TI - Aseptic complications in total alloarthroplasty of the hip joint UR - https://www.embase.com/search/results?subaction=viewrecord&id=L12231757&from=export VL - 7 ID - 829966 ER - TY - JOUR AB - We present a case of a 41-year-old man with symptomatic pulmonary cement embolism following percutaneous vertebral augmentation, which was successfully retrieved via a percutaneous endovascular approach, a novel technique with only two prior cases reported. Cement leakage, including venous embolization of cement into the cardiopulmonary circulation, is a known potential complication following percutaneous kyphoplasty and vertebroplasty. While many patients with pulmonary cement embolism are asymptomatic and likely go undiagnosed, others experience respiratory distress and hemodynamic compromise requiring surgical and medical intervention. The optimal management for pulmonary cement embolism must be tailored to fit each individual patient, dependent upon the acuity of the clinical presentation, coexisting patient comorbidities, and the risks of systemic anticoagulation. In our patient, cement migration was visualized in real-time during vertebral augmentation. Endovascular retrieval by our Interventional Radiology section obviated the need for anticoagulation therapy or more invasive open surgical procedures. AD - Department of Radiology, NYU Langone Medical Center, New York, NY, USA. Department of Neurology, NYU Langone Medical Center, New York, NY, USA. Department of Radiology, NYU Langone Medical Center, New York, NY, USA; Department of Neurology, NYU Langone Medical Center, New York, NY, USA. AN - 27761188 AU - Lamparello, N. A. AU - Jaswani, V. AU - DeSousa, K. AU - Shapiro, M. AU - Kovacs, S. C2 - Pmc5065278 DA - Jul DO - 10.3941/jrcr.v10i7.2806 DP - NLM ET - 2016/10/21 J2 - Journal of radiology case reports KW - Adult Bone Cements/*adverse effects *Endovascular Procedures Foreign-Body Migration/*diagnostic imaging/*therapy Fractures, Compression/*surgery Humans Male Pulmonary Artery/*diagnostic imaging Spinal Fractures/*surgery Vertebroplasty/*adverse effects *Endovascular Retrieval *Intervention *Kyphoplasty/Vertebroplasty *Pulmonary Angiogram *Pulmonary Cement Embolism LA - eng M1 - 7 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1943-0922 SP - 40-47 ST - Percutaneous Retrieval of an Embolized Kyphoplasty Cement Fragment From the Pulmonary Artery: A Case Report and Literature Review T2 - J Radiol Case Rep TI - Percutaneous Retrieval of an Embolized Kyphoplasty Cement Fragment From the Pulmonary Artery: A Case Report and Literature Review VL - 10 ID - 828656 ER - TY - JOUR AB - Vertebral fracture (VF) is the most common osteoporotic fracture and is associated with high morbidity and mortality. Conservative treatment combining antalgic agents and rest is usually recommended for symptomatic VFs. The aim of this paper is to review the randomized controlled trials comparing the efficacy and safety of percutaneous vertebroplasty (VP) and percutaneous balloon kyphoplasty (KP) versus conservative treatment. VP and KP procedures are associated with an acceptable general safety. Although the case series investigating VP/KP have all shown an outstanding analgesic benefit, randomized controlled studies are rare and have yielded contradictory results. In several of these studies, a short-term analgesic benefit was observed, except in the prospective randomized sham-controlled studies. A long-term analgesic and functional benefit has rarely been noted. Several recent studies have shown that both VP and KP are associated with an increased risk of new VFs. These fractures are mostly VFs adjacent to the procedure, and they occur within a shorter time period than VFs in other locations. The main risk factors include the number of preexisting VFs, the number of VPs/KPs performed, age, decreased bone mineral density, and intradiscal cement leakage. It is therefore important to involve the patients to whom VP/KP is being proposed in the decision-making process. It is also essential to rapidly initiate a specific osteoporosis therapy when a VF occurs (ideally a bone anabolic treatment) so as to reduce the risk of fracture. Randomized controlled studies are necessary in order to better define the profile of patients who likely benefit the most from VP/KP. © 2013 International Osteoporosis Foundation and National Osteoporosis Foundation. AD - O. Lamy, Center of Bone Diseases-Bone and Joint Department, Lausanne University Hospital, Av Pierre-Decker, 4, 1011 Lausanne, Switzerland AU - Lamy, O. AU - Uebelhart, B. AU - Aubry-Rozier, B. DB - Embase DO - 10.1007/s00198-013-2574-4 KW - analgesic agent bone cement bone density case study conservative treatment fragility fracture hematoma human intermethod comparison intervertebral disc cement leakage kyphoplasty long term care lung embolism medical device complication meta analysis (topic) neurological complication osteoporosis patient decision making percutaneous vertebroplasty postoperative hemorrhage postoperative infection priority journal prospective study randomized controlled trial (topic) review risk benefit analysis sham procedure spine fracture LA - English M1 - 3 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 0937-941X 1433-2965 SP - 807-819 ST - Risks and benefits of percutaneous vertebroplasty or kyphoplasty in the management of osteoporotic vertebral fractures T2 - Osteoporosis International TI - Risks and benefits of percutaneous vertebroplasty or kyphoplasty in the management of osteoporotic vertebral fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L372475253&from=export http://dx.doi.org/10.1007/s00198-013-2574-4 VL - 25 ID - 829422 ER - TY - JOUR AB - OBJECTIVE: We report the safety and efficacy of combined radiofrequency ablation and cementoplasty in treating painful neoplastic bone lesions. MATERIALS AND METHODS: Fifty-three combined radiofrequency ablation and cementoplasty procedures were completed in 36 patients. Thirty-four vertebrae (20 lumbar, 14 thoracic), 14 acetabulae, 3 sacra, 1 pubic symphysis, and 1 humerus were treated. Patient age ranged from 34 to 81 years (mean 57.6 years, SD=12.6). Primary malignancies included: 12 breast, 5 lung, 6 multiple myeloma, 2 prostate, 2 renal cell carcinoma, 1 synovial sarcoma, 1 endometrial, 1 oral squamous cell carcinoma, 1 lymphoma, 1 colon, 1 transitional cell carcinoma, 1 colorectal, 1 cholangiocarcinoma, and 1 pheochromocytoma. Primary neoplasm location, pain levels pre- and post-procedure (as assessed using the Visual Analog Scale), number of radiofrequency (RF) treatments and any extravasation were documented. RESULTS: Combined radiofrequency ablation (RFA) and cementoplasty procedures were performed with 100% technical success (53 out of 53). The mean pre-procedure and post-procedure pain, as measured by the Visual Analog Scale (VAS), was 7.2/10 and 3.4/10 respectively. Symptomatic complications included one case of self-resolving transient thermal sciatic neurapraxia following RFA and acetabuloplasty. Two cases of transient pain following epidural leaks during treatment of thoracic vertebrae and breast metastases also occurred. Non-symptomatic complications, from a variety of cases, included cement emboli to the lung, incidental, non-symptomatic leaks into the needle track, spinal canal, draining veins, disc spaces, and an intra-articular leak into the hip joint. CONCLUSION: Combined RFA and cementoplasty appears to be safe, practical and effective in the palliative treatment of painful neoplastic lesions. AD - Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W 12th Avenue, Vancouver, BC, V52 1M9, Canada. AN - 20686765 AU - Lane, M. D. AU - Le, H. B. AU - Lee, S. AU - Young, C. AU - Heran, M. K. AU - Badii, M. AU - Clarkson, P. W. AU - Munk, P. L. DA - Jan DO - 10.1007/s00256-010-1010-5 DP - NLM ET - 2010/08/06 J2 - Skeletal radiology KW - Adult Aged Aged, 80 and over Bone Cements/*therapeutic use Bone Neoplasms/*radiotherapy/secondary/therapy Combined Modality Therapy Humans Middle Aged *Palliative Care LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2011 SN - 0364-2348 SP - 25-32 ST - Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients T2 - Skeletal Radiol TI - Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients VL - 40 ID - 828728 ER - TY - JOUR AB - Purpose: We report the safety and efficacy of combined radiofrequency ablation and cementoplasty in treating painful neoplastic bone lesions. Materials and methods: fifty-three combined radiofrequency ablation and cementoplasty procedures were completed in 35 patients. Thirty-six vertebrae (20 lumbar, 16 thoracic), 12 acetabulae, 3 sacra, 1 pubic symphysis and 1 humerus were treated. Patient age ranged from 34-81 years (mean 57.5 years). Primary malignancies included: 11 breast, 5 lung, 6 multiple myeloma, 2 prostate, 2 renal cell carcinoma, 1 synovial sarcoma, 1 endometrial, 1 oral squamous cell carcinoma, 1 lymphoma, 1 colon, 1 transitional cell carcinoma, 1 rectal, 1 cholangiocarcinoma and 1 pheochromocytoma. Primary neoplasm location, lesion size, pain levels pre and post procedure (as assessed using the visual analog scale), number of RF treatments, procedural temperature, RF time, cement volume and any extravasation were documented. Results: combined RFA and cementoplasty procedures were performed with 100% technical success (53/53). The mean preprocedure and post-procedure pain, as measured by the visual analog scale (VAS), was 7.2/10 and 3.5/10, respectively. Symptomatic complications included one case of self-resolving transient thermal sciatic neurapraxia following RFA and acetabuloplasty. Two cases of transient pain following epidural leaks during treatment of thoracic vertebrae breast metastases also occurred. Non-symptomatic complications, from a variety of cases, included cement emboli to the lung, trivial leaks into the needle track, spinal canal, draining veins, disc spaces and a hip intra-articular leak. Conclusion: combined radiofrequency ablation and cementoplasty appears to be a safe, practical and effective in the treatment of painful neoplastic lesions. AD - M.D. Lane, Radiology, University of British Columbia, Vancouver, BC, Canada AU - Lane, M. D. AU - Le, H. B. Q. AU - Lee, S. AU - Heran, M. K. S. AU - Young, C. AU - Liu, D. M. AU - Badii, M. AU - Munk, P. L. DB - Embase KW - cement bone lesion Europe society pain radiofrequency ablation patient lung vertebra visual analog scale extravasation acetabuloplasty epidural drug administration neoplasm metastatic breast cancer embolism needle vertebral canal vein hip safety sacrum pubis symphysis humerus primary tumor breast prostate kidney carcinoma connective tissue tumor synovial sarcoma squamous cell carcinoma lymphoma transitional cell carcinoma bile duct carcinoma pheochromocytoma temperature multiple myeloma LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 0174-1551 SP - 405 ST - Utility of combined RFA and cementoplasty in treatment of painful neoplastic bone lesions T2 - CardioVascular and Interventional Radiology TI - Utility of combined RFA and cementoplasty in treatment of painful neoplastic bone lesions UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70339790&from=export VL - 32 ID - 829705 ER - TY - JOUR AB - Objective: We report the safety and efficacy of combined radiofrequency ablation and cementoplasty in treating painful neoplastic bone lesions. Materials and Methods: Fifty-three combined radiofrequency ablation and cementoplasty procedures were completed in 36 patients. Thirty-four vertebrae (20 lumbar, 14 thoracic), 14 acetabulae, 3 sacra, 1 pubic symphysis, and 1 humerus were treated. Patient age ranged from 34 to 81 years (mean 57.6 years, SD = 12.6). Primary malignancies included: 12 breast, 5 lung, 6 multiple myeloma, 2 prostate, 2 renal cell carcinoma, 1 synovial sarcoma, 1 endometrial, 1 oral squamous cell carcinoma, 1 lymphoma, 1 colon, 1 transitional cell carcinoma, 1 colorectal, 1 cholangiocarcinoma, and 1 pheochromocytoma. Primary neoplasm location, pain levels pre- and post-procedure (as assessed using the Visual Analog Scale), number of radiofrequency (RF) treatments and any extravasation were documented. Results: Combined radiofrequency ablation (RFA) and cementoplasty procedures were performed with 100% technical success (53 out of 53). The mean pre-procedure and post-procedure pain, as measured by the Visual Analog Scale (VAS), was 7.2/10 and 3.4/10 respectively. Symptomatic complications included one case of self-resolving transient thermal sciatic neurapraxia following RFA and acetabuloplasty. Two cases of transient pain following epidural leaks during treatment of thoracic vertebrae and breast metastases also occurred. Non-symptomatic complications, from a variety of cases, included cement emboli to the lung, incidental, non-symptomatic leaks into the needle track, spinal canal, draining veins, disc spaces, and an intra-articular leak into the hip joint. Conclusion: Combined RFA and cementoplasty appears to be safe, practical and effective in the palliative treatment of painful neoplastic lesions. © 2010 ISS. AD - P.L. Munk, Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W 12th Avenue, Vancouver, V52 1M9, BC, Canada AU - Lane, M. D. AU - Le, H. B. Q. AU - Lee, S. AU - Young, C. AU - Heran, M. K. S. AU - Badii, M. AU - Clarkson, P. W. AU - Munk, P. L. DB - Embase Medline DO - 10.1007/s00256-010-1010-5 KW - cement patient radiofrequency ablation bone metastasis palliative therapy pain vertebra visual analog scale lung bile duct carcinoma pheochromocytoma neoplasm radiofrequency extravasation acetabuloplasty epidural drug administration metastatic breast cancer embolism needle vertebral canal vein hip safety bone lesion sacrum pubis symphysis humerus primary tumor multiple myeloma prostate kidney carcinoma connective tissue tumor synovial sarcoma squamous cell carcinoma lymphoma transitional cell carcinoma breast LA - English M3 - Article in Press N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0364-2348 1432-2161 SP - 1-8 ST - Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients T2 - Skeletal Radiology TI - Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L51019565&from=export http://dx.doi.org/10.1007/s00256-010-1010-5 ID - 829653 ER - TY - JOUR AB - We report the safety and efficacy of combined radiofrequency ablation and cementoplasty in treating painful neoplastic bone lesions. Fifty-three combined radiofrequency ablation and cementoplasty procedures were completed in 36 patients. Thirty-four vertebrae (20 lumbar, 14 thoracic), 14 acetabulae, 3 sacra, 1 pubic symphysis, and 1 humerus were treated. Patient age ranged from 34 to 81 years (mean 57.6 years, SD = 12.6). Primary malignancies included: 12 breast, 5 lung, 6 multiple myeloma, 2 prostate, 2 renal cell carcinoma, 1 synovial sarcoma, 1 endometrial, 1 oral squamous cell carcinoma, 1 lymphoma, 1 colon, 1 transitional cell carcinoma, 1 colorectal, 1 cholangiocarcinoma, and 1 pheochromocytoma. Primary neoplasm location, pain levels pre- and post-procedure (as assessed using the Visual Analog Scale), number of radiofrequency (RF) treatments and any extravasation were documented. Combined radiofrequency ablation (RFA) and cementoplasty procedures were performed with 100% technical success (53 out of 53). The mean pre-procedure and post-procedure pain, as measured by the Visual Analog Scale (VAS), was 7.2/10 and 3.4/10 respectively. Symptomatic complications included one case of self-resolving transient thermal sciatic neurapraxia following RFA and acetabuloplasty. Two cases of transient pain following epidural leaks during treatment of thoracic vertebrae and breast metastases also occurred. Non-symptomatic complications, from a variety of cases, included cement emboli to the lung, incidental, non-symptomatic leaks into the needle track, spinal canal, draining veins, disc spaces, and an intra-articular leak into the hip joint. Combined RFA and cementoplasty appears to be safe, practical and effective in the palliative treatment of painful neoplastic lesions. AD - [Lane, Michael David; Le, Huy B. Q.; Lee, Steven; Young, Casey; Heran, Manraj K. S.; Munk, Peter L.] Univ British Columbia, Vancouver Gen Hosp, Dept Radiol, Vancouver, BC V52 1M9, Canada. [Badii, Maziar] Univ British Columbia, Vancouver Gen Hosp, Dept Internal Med, Div Rheumatol, Vancouver, BC V52 1M9, Canada. [Clarkson, Paul William] Univ British Columbia, Dept Orthopaed, Vancouver, BC V52 1M9, Canada. Munk, PL (corresponding author), Univ British Columbia, Vancouver Gen Hosp, Dept Radiol, 899 W 12th Ave, Vancouver, BC V52 1M9, Canada. Peter.Munk@vch.ca AN - WOS:000284422400004 AU - Lane, M. D. AU - Le, H. B. Q. AU - Lee, S. AU - Young, C. AU - Heran, M. K. S. AU - Badii, M. AU - Clarkson, P. W. AU - Munk, P. L. DA - Jan DO - 10.1007/s00256-010-1010-5 J2 - Skeletal Radiol. KW - Painful bone metastasis Radiofrequency ablation Cementoplasty Palliative care RANDOMIZED-TRIAL THERMAL ABLATION OSTEOID OSTEOMA SOFT-TISSUE VERTEBROPLASTY INJECTION TUMOR Orthopedics Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2011 SN - 0364-2348 SP - 25-32 ST - Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients T2 - Skeletal Radiology TI - Combination radiofrequency ablation and cementoplasty for palliative treatment of painful neoplastic bone metastasis: experience with 53 treated lesions in 36 patients UR - ://WOS:000284422400004 VL - 40 ID - 830330 ER - TY - JOUR AB - Vertebroplasty is an efficient treatment of vertebral collapses of malignant or benign origin but also carries a risk of complications. Cement extravasation is a frequent occurrence in vertebroplasty. It is well tolerated in the large majority of cases but is also the main source of complications especially nerve root compression in case of cement leakage into the intervertebral foramen and pulmonary embolism of cement complicating venous cement leakage. Rate of these complications are much higher in malignant than in osteoporotic collapses. The risk of neurological complication also increases at the cervical level. In addition, incidence of new vertebral fractures in adjacent vertebrae may be increased by vertebroplasty. General reactions possibly due to a reflex reaction to intramedullary bone injection and fat embolism may also occur. This article reviews the safety measures to reduce the risk of cement extravasation including high quality permanent radiological guidance enabling early detection of cement extravasation, use of conscious sedation, bilateral transpedicular approach at the thoracic and lumbar levels, careful selection of the bone penetration site in order to make a single vertebral needle path, careful needle placement to avoid the risk of cortical breakthrough, use of a well-opacified and refrigerated cement with a toothpaste consistency. AD - Hopital Lariboisière, Service de Radiologie Ostéo-Articulaire, 2, rue Ambroise-Paré, 75475 Paris 10, France. jean-denis.laredo@lrb.ap-hop-paris.fr AN - 15856808 AU - Laredo, J. D. AU - Hamze, B. DA - Apr DO - 10.1053/j.sult.2005.02.003 DP - NLM ET - 2005/04/29 J2 - Seminars in ultrasound, CT, and MR KW - Adult Aged Back Pain/*surgery Bone Cements/*adverse effects/therapeutic use Extravasation of Diagnostic and Therapeutic Materials/complications/*etiology/prevention & control Female Fractures, Spontaneous/surgery Humans Injections, Spinal/methods Male Methylmethacrylate/administration & dosage/*adverse effects Middle Aged Minimally Invasive Surgical Procedures/adverse effects/methods Nerve Compression Syndromes/etiology Orthopedic Procedures/*adverse effects/methods Postoperative Complications/prevention & control Radiography, Interventional Spinal Fractures/*surgery Spinal Nerve Roots Spine/*surgery LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2005 SN - 0887-2171 (Print) 0887-2171 SP - 65-80 ST - Complications of percutaneous vertebroplasty and their prevention T2 - Semin Ultrasound CT MR TI - Complications of percutaneous vertebroplasty and their prevention VL - 26 ID - 828626 ER - TY - JOUR AB - Background: A two-month-old with idiopathic dilated cardiomyopathy developed worsening heart function necessitating placement of biventricular assist devices (BiVAD). The patient's kidney function declined postoperatively and he developed severe oliguria. Attempts to perform peritoneal dialysis failed when dialysate fluid leaked out around the VAD cannulas. Due to limited vascular access secondary to deep venous thrombosis and history of chylothorax, we explored the possibility of providing access for CRRT via one of the VAD circuits. We knew that placing dialysis access somewhere in the VAD circuitry was possible, as the VAD was a paracorpor-eal continuous flow device (Pedi-Mag; Thoratec, Pleasanton, California) as opposed to pulsatile. Methods: We elected to use the RVAD circuit both because it exerts a lower positive pressure and because it is safer in the event of an air embolism. We elected the RVAD outflow because air proximal to the pump would have caused pump failure. We took two 1/4” x 1/4” Leur lock, polycarbonate connecters attached to a stopcock and connected them to one another with a 3” piece of pressure line 2 in apart. We sterilely prepped the RVAD circuit, turned down the LVAD flow, clamped, and then cut the RVAD outflow line. We then attached and deaired the connections, assuring access sites were air-free prior to reinitiating RVAD support. Once RVAD support was reinitiated, BiVAD flow was returned to baseline. The entire process took 30 seconds. Results: The Prismaflex machine (Baxter, Chicago, Illinois) with an M60 filter was connected to the Leur-lock connectors from the RVAD outlet line in series (Figure 1). CRRT was performed per hospital protocol (using commercially available calcium-based convective and diffusive fluids with an estimated clearance of 2,000 mL/h/1.73 m2) and blood flow of 50 mL/min. Systemic heparin anticoagulation was titrated with goal to keep anti-Xa level between 0.3 and 0.7 U/mL. The patient was on CRRT via RVAD for 81 days. The patient had 17 circuit initiations, none of which caused any hemodynamic instability. The median filter life was 5.12 days (IQR: 4.4-6.6 days). One circuit clotted, eight were changed due to gain/loss limit or machine error, and all others were changed routinely every seven days. Unfortunately, the patient decompensated after developing abdominal distension and bloody stools. He became hemodynamically unstable and died after withdrawal of technological support. Conclusions: We were able to effectively and safely provide CRRT via the RVAD without complications or compromising BiVAD function. To the authors' knowledge, this is the first case report describing this approach for CRRT access in a patient with BiVADs and provides a viable alternative to pla-cement of a traditional dialysis catheter in patients with limited or difficult access. AD - C. Lasley, University of Alabama at Birmingham, United States AU - Lasley, C. AU - Askenazi, D. AU - Timpa, J. AU - O'Meara, C. AU - Borasino, S. AU - Short, K. AU - Ingram, D. DB - Embase DO - 10.1177/2150135118757908 KW - calcium polycarbonate abdominal distension air embolism anticoagulation biventricular assist device blood flow California cannula case report chylothorax clearance clinical article complication conference abstract congestive cardiomyopathy continuous renal replacement therapy deep vein thrombosis dialysate dialysis catheter drug withdrawal filter heart function hemodialysis machine human Illinois infant kidney function liquid male oliguria peritoneal dialysis rectum hemorrhage right ventricular assist device vascular access LA - English M1 - 2 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 2150-136X SP - NP4 ST - Continuous renal replacement therapy (crrt) via a right ventricular assist device (rvad) in an infant T2 - World Journal for Pediatric and Congenital Hearth Surgery TI - Continuous renal replacement therapy (crrt) via a right ventricular assist device (rvad) in an infant UR - https://www.embase.com/search/results?subaction=viewrecord&id=L621548005&from=export http://dx.doi.org/10.1177/2150135118757908 VL - 9 ID - 829204 ER - TY - JOUR AB - OBJECTIVE Posterior-based thoracolumbar 3-column osteotomy (3CO) is a formidable surgical procedure. Surgeon experience and case volume are known factors that influence surgical complication rates, but these factors have not been studied well in cases of adult spinal deformity (ASD). This study examines how surgeon experience affects perioperative complications and operative measures following thoracolumbar 3CO in ASD. METHODS A retrospective study was performed of a consecutive cohort of thoracolumbar ASD patients who underwent 3CO performed by the senior authors from 2006 to 2018. Multivariate analysis was used to assess whether experience (years of experience and/or number of procedures) is associated with perioperative complications, operative duration, and blood loss. RESULTS A total of 362 patients underwent 66 vertebral column resections (VCRs) and 296 pedicle subtraction osteotomies (PSOs). The overall complication rate was 29.4%, and the surgical complication rate was 8.0%. The rate of postoperative neurological deficits was 6.2%. There was a trend toward lower overall complication rates with greater operative years of experience (from 44.4% to 28.0%) (p = 0.115). Years of operative experience was associated with a significantly lower rate of neurological deficits (p = 0.027); the incidence dropped from 22.2% to 4.0%. The mean operative time was 310.7 minutes overall. Both increased years of experience and higher case numbers were significantly associated with shorter operative times (p < 0.001 and p = 0.001, respectively). Only operative years of experience was independently associated with operative times (p < 0.001): 358.3 minutes from 2006 to 2008 to 275.5 minutes in 2018 (82.8 minutes shorter). Over time, there was less deviation and more consistency in operative times, despite the implementation of various interventions to promote fusion and prevent construct failure: utilization of multiple-rod constructs (standard, satellite, and nested rods), bone morphogenetic protein, vertebroplasty, and ligament augmentation. Of note, the use of tranexamic acid did not significantly lower blood loss. CONCLUSIONS Surgeon years of experience, rather than number of 3COs performed, was a significant factor in mitigating neurological complications and improving quality measures following thoracolumbar 3CO for ASD. The 3- to 5-year experience mark was when the senior surgeon overcame a learning curve and was able to minimize neurological complication rates. There was a continuous decrease in operative time as the surgeon’s experience increased; this was in concurrence with the implementation of additional preventative surgical interventions. Ongoing practice changes should be implemented and can be done safely, but it is imperative to self-assess the risks and benefits of those practice changes. AD - D. Lau, Departments of Neurological Surgery, University of California, San Francisco, CA, United States AU - Lau, D. AU - Deviren, V. AU - Ames, C. P. DB - Embase Medline DO - 10.3171/2019.7.SPINE19656 KW - bone morphogenetic protein tranexamic acid abdominal injury acute kidney failure adult allodynia article bleeding brain infarction cerebrovascular accident Clostridioides difficile cohort analysis coxitis deep vein thrombosis disseminated intravascular clotting extensor hallucis longus feces incontinence female gastrointestinal hemorrhage heart arrest heart arrhythmia heart infarction Horner syndrome human hypotension ileus iliac vein intestine volvulus kidney disease learning curve lung embolism major clinical study male meningitis multivariate analysis muscle weakness neurological complication operation duration osteotomy outcome assessment pancreatitis paraplegia paresthesia percutaneous vertebroplasty peroperative complication pleura effusion pneumonia pneumothorax quadriceps femoris muscle quadriplegia radiculopathy respiratory failure retrospective study rhabdomyolysis risk benefit analysis seizure sepsis shock skeletal muscle spine malformation surgeon surgical infection surgical patient thoracolumbar spine thoracolumbar three column osteotomy tibialis anterior muscle urinary tract infection vein injury work experience LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1547-5646 1547-5654 SP - 207-220 ST - The impact of surgeon experience on perioperative complications and operative measures following thoracolumbar 3-column osteotomy for adult spinal deformity: Overcoming the learning curve T2 - Journal of Neurosurgery: Spine TI - The impact of surgeon experience on perioperative complications and operative measures following thoracolumbar 3-column osteotomy for adult spinal deformity: Overcoming the learning curve UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2004817107&from=export http://dx.doi.org/10.3171/2019.7.SPINE19656 VL - 32 ID - 829086 ER - TY - JOUR AB - Pulmonary embolism (PE) by solid particles is an infrequent complication encountered during orthopedic procedures. A patent foramen ovate (PFO) allows embolic material into the left-sided circulation, potentially affecting several organs. A case of a 33-year-old woman undergoing total proximal femur resection with megaprosthesis reconstruction is presented. Towards the end of surgery, cement was injected to stabilize the prosthesis. Echodense particulate matter was first seen in the right atrium, subsequently in the right ventricle, and also in significant quantities in the left atrium and ventricle. This was accompanied by significant changes in partial pressure of arterial oxygen. Despite the aforementioned disturbances, hemodynamic stability was observed throughout the event. Postoperative follow-up showed persistent hypoxemia but no other abnormalities. This intriguing case of embolism via particulate material in a patient with PFO during hip replacement surgery allows review of the physiology and pathophysiology of PE phenomena. Published by Elsevier Inc. AD - [Laudanski, Krzysztof; Patel, Samir P.] Univ Florida, Coll Med, Dept Anesthesiol, Gainesville, FL 32610 USA. Laudanski, K (corresponding author), Univ Florida, Coll Med, Dept Anesthesiol, POB 100254, Gainesville, FL 32610 USA. klaudanski@anest.ufl.edu AN - WOS:000276783600013 AU - Laudanski, K. AU - Patel, S. P. DA - Nov DO - 10.1016/j.jclinane.2008.10.018 J2 - J. Clin. Anesth. KW - Femoral megaprosthesis Paradoxical embolism Patent foramen ovale Pulmonary embolism Transesophageal echocardiography PATENT FORAMEN OVALE RANDOMIZED CLINICAL-TRIAL TOTAL HIP-ARTHROPLASTY PULMONARY-EMBOLISM TRANSESOPHAGEAL ECHOCARDIOGRAPHY KNEE ARTHROPLASTY FAT-EMBOLISM HYPERTENSION MANAGEMENT CEMENT Anesthesiology LA - English M1 - 7 M3 - Editorial Material N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2009 SN - 0952-8180 SP - 533-537 ST - Ongoing paradoxical particulate embolism during megaprosthesis placement T2 - Journal of Clinical Anesthesia TI - Ongoing paradoxical particulate embolism during megaprosthesis placement UR - ://WOS:000276783600013 VL - 21 ID - 830346 ER - TY - JOUR AB - Pulmonary embolism (PE) by solid particles is an infrequent complication encountered during orthopedic procedures. A patent foramen ovale (PFO) allows embolic material into the left-sided circulation, potentially affecting several organs. A case of a 33-year-old woman undergoing total proximal femur resection with megaprosthesis reconstruction is presented. Towards the end of surgery, cement was injected to stabilize the prosthesis. Echodense particulate matter was first seen in the right atrium, subsequently in the right ventricle, and also in significant quantities in the left atrium and ventricle. This was accompanied by significant changes in partial pressure of arterial oxygen. Despite the aforementioned disturbances, hemodynamic stability was observed throughout the event. Postoperative follow-up showed persistent hypoxemia but no other abnormalities. This intriguing case of embolism via particulate material in a patient with PFO during hip replacement surgery allows review of the physiology and pathophysiology of PE phenomena. AD - Department of Anesthesiology, University of Florida College of Medicine, PO Box 100254, Gainesville, FL 32610-0254, USA. klaudanski@anest.ufl.edu AN - 20006264 AU - Laudanski, K. AU - Patel, S. P. AU - Peng, Y. G. DA - Nov DO - 10.1016/j.jclinane.2008.10.018 DP - NLM ET - 2009/12/17 J2 - Journal of clinical anesthesia KW - Adenocarcinoma/complications Adult Arthroplasty, Replacement, Hip/*adverse effects Bone Cements/adverse effects Bone Neoplasms/complications Echocardiography, Transesophageal Female Femur/*surgery Hemodynamics/physiology Hip Fractures/etiology/surgery Humans Oxygen/blood Particulate Matter/*adverse effects Postoperative Complications/etiology/therapy Prosthesis Implantation/*adverse effects Pulmonary Embolism/diagnostic imaging/*etiology/therapy LA - eng M1 - 7 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0952-8180 SP - 533-7 ST - Ongoing paradoxical particulate embolism during megaprosthesis placement T2 - J Clin Anesth TI - Ongoing paradoxical particulate embolism during megaprosthesis placement VL - 21 ID - 828534 ER - TY - JOUR AB - Pulmonary embolism (PE) by solid particles is an infrequent complication encountered during orthopedic procedures. A patent foramen ovale (PFO) allows embolic material into the left-sided circulation, potentially affecting several organs. A case of a 33-year-old woman undergoing total proximal femur resection with megaprosthesis reconstruction is presented. Towards the end of surgery, cement was injected to stabilize the prosthesis. Echodense particulate matter was first seen in the right atrium, subsequently in the right ventricle, and also in significant quantities in the left atrium and ventricle. This was accompanied by significant changes in partial pressure of arterial oxygen. Despite the aforementioned disturbances, hemodynamic stability was observed throughout the event. Postoperative follow-up showed persistent hypoxemia but no other abnormalities. This intriguing case of embolism via particulate material in a patient with PFO during hip replacement surgery allows review of the physiology and pathophysiology of PE phenomena. AD - Department of Anesthesiology, University of Florida College of Medicine, PO Box 100254, Gainesville, FL 32610-0254, USA Department of Anesthesiology, University of Florida College of Medicine, PO Box 100254, Gainesville, FL 32610-0254, USA. klaudanski@anest.ufl.edu AN - 105271510. Language: English. Entry Date: 20100312. Revision Date: 20200708. Publication Type: journal article AU - Laudanski, K. AU - Patel, S. P. AU - Peng, Y. G. AU - Laudanski, Krzysztof AU - Patel, Samir P. AU - Peng, Yong G. DB - cin20 DO - 10.1016/j.jclinane.2008.10.018 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Adverse Effects Femur -- Surgery Particulate Matter -- Adverse Effects Prostheses and Implants -- Adverse Effects Pulmonary Embolism -- Etiology Adenocarcinoma -- Complications Adult Bone Cements -- Adverse Effects Bone Neoplasms -- Complications Echocardiography, Transesophageal Female Hemodynamics -- Physiology Hip Fractures -- Etiology Hip Fractures -- Surgery Oxygen -- Blood Postoperative Complications -- Etiology Postoperative Complications -- Therapy Pulmonary Embolism -- Therapy Pulmonary Embolism -- Ultrasonography M1 - 7 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0952-8180 SP - 533-537 ST - Ongoing paradoxical particulate embolism during megaprosthesis placement T2 - Journal of Clinical Anesthesia TI - Ongoing paradoxical particulate embolism during megaprosthesis placement UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105271510&site=ehost-live&scope=site VL - 21 ID - 830718 ER - TY - JOUR AB - We randomised 250 patients undergoing unilateral, elective hip arthroplasty for osteoarthritis to receive either a cemented or a non‐cemented Mallory Head prosthesis. Aspirin was used as prophylaxis against thromboembolism during the first half of the study and adjusted‐dose warfarin during the second half. Postoperatively, all patients were asked to have bilateral venography and 80% agreed. All were evaluated clinically for pulmonary embolism. There was no difference in the frequency of deep‐venous thrombosis between the two groups (50% cemented nu 47% non‐cemented, p = 0.73; 95% CI of the difference ‐13.6% to 19.3%). Three of the 64 patients (5%) in whom venography had demonstrated isolated distal thrombi developed pulmonary emboli. AN - CN-00124461 AU - Laupacis, A. AU - Rorabeck, C. AU - Bourne, R. AU - Tugwell, P. AU - Bullas, R. AU - Rankin, R. AU - Vellet, A. D. AU - Feeny, D. AU - Wong, C. KW - Aged Anticoagulants [therapeutic use] Aspirin [therapeutic use] Female Hip Prosthesis [methods] Humans Male Middle Aged Ontario [epidemiology] Phlebography Pulmonary Embolism [diagnosis] Thrombophlebitis [diagnostic imaging, *epidemiology, prevention & control] M1 - 2 M3 - Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1996 SP - 210‐212 ST - The frequency of venous thrombosis in cemented and non-cemented hip arthroplasty T2 - Journal of bone and joint surgery. British volume TI - The frequency of venous thrombosis in cemented and non-cemented hip arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00124461/full VL - 78 ID - 830051 ER - TY - JOUR AB - Vertebroplasty (VP) is a mini-invasive percutaneous technique for the treatment of symptomatic, vertebral body fracture (VBF) caused by porotic or other diseases and its outcome has now been demonstrated by many trials. Beyond the results of these trials on the efficacy and safety of VP, the real problem for patients with osteoporotic and non-osteoporotic vertebral fractures is the risk of new fractures to adjacent or distant vertebra following VP that is reported to range from 10% to 30%. It is still unclear whether this is related to the natural history of the underlying disease (osteoporotic and non-osteoporotic diseases) or to the treatment, especially when a single vertebral fracture in an osteoporotic patient is highly predictive of future fractures. To prevent new fractures to adjacent or distant vertebra following VP in porotic patients multiple non-pharmacologic interventions are recommended (diet with vitamin D or calcium supplements, smoking cessation, exercise) in addition to a specific medical therapy to block the activation of osteoclast cells responsible for bone resorption, and to re-establish correct bone remodeling. These drugs include anti-catabolic drugs: bisphosphonate, oestrogen hormone, and anabolic drugs: PTH analogues and strontium ranelate. Bisphosphonate are the most commonly used compounds to treat postmenopausal osteoporosis. However, medical treatment appears to be too slow to prevent the natural history of patients with VBF. One session multilevel VP could be performed to prevent vertebral refracture risk in porotic or non-porotic patients with recurrent VBFs also after the first VP even if there is not a true vertebral collapse. Even if there are no limits to how many body levels can be treated in one session, European and American guidelines suggest doing no more than three body levels in the same session to reduce patient discomfort, and to prevent peri-procedural anesthesiologic problems, like uncontrolled fat-embolism, cement leakage, and pulmonary embolism, that could be increased. How many vertebrae could be treated in same session could be analyzed beforehand based on MDCT vertebral morphology and trabecular structure, or on MRI-signal changes. Added to medical therapy, multilevel VP can be performed in selected cases to treat VBF related to osteoporosis, preventing fractures or refracture without any further thrombo-embolic or fat uncontrolled embolism peri or post-procedural complications. AD - Neuroradiology Service, A. Cardarelli Hospital; Naples, Italy - arcangelo.lavanga@ospedalecardarelli.it. AN - 24148545 AU - Lavanga, A. AU - Guarnieri, G. AU - Muto, M. DA - Apr DO - 10.1177/197140091002300215 DP - NLM ET - 2010/04/01 J2 - The neuroradiology journal LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 1971-4009 (Print) 1971-4009 SP - 244-8 ST - Medical therapy and multilevel vertebroplasty in osteoporosis: when and why T2 - Neuroradiol J TI - Medical therapy and multilevel vertebroplasty in osteoporosis: when and why VL - 23 ID - 828706 ER - TY - JOUR AB - Case report of an 89-year-old patient who had cardiorespiratory arrest during cemented hip hemiarthroplasty and required cardiopulmonary resuscitation. This complication occurred immediately after using the carbon dioxide-based lavage system known as CarboJet and was attributed to gas embolism once other entities were ruled out. The possible factors that may contribute to this surgical complication are discussed. AN - 26031138 AU - Lax-Prez, R. AU - Ferrero-Manzanal, F. AU - Marin- Peñia, O. AU - Murcia-Asensio, A. DA - Jan-Feb DP - NLM ET - 2014/01/01 J2 - Acta ortopedica mexicana KW - Aged, 80 and over Embolism, Air/*etiology Female *Hemiarthroplasty Humans Intraoperative Complications/*etiology Therapeutic Irrigation/*adverse effects LA - spa M1 - 1 N1 - PubMed NLM literature search January 5, 2021 OP - Embolismo gaseoso tras el uso del sistema de lavado CarboJet durante la hemiartroplastía de cadera. Caso clinico y revisión de la literature. PY - 2014 SN - 2306-4102 (Print) 2306-4102 SP - 45-8 ST - [Gas embolism after the use of the CarboJet lavage system during hip hemiarthroplasty. Clinical case and literature review] T2 - Acta Ortop Mex TI - [Gas embolism after the use of the CarboJet lavage system during hip hemiarthroplasty. Clinical case and literature review] VL - 28 ID - 828973 ER - TY - JOUR AB - Learning Objectives 1. To learn how to recognise patients indicated for sacroplasty 2. To learn how to choose the most appropriate approach and technique in different settings 3. To learn how to use data to improve safety and efficacy Sacroplasty, sometimes termed as sacral vertebroplasty, is a minimally invasive procedure whose goal is stabilization and relief of pain associated with sacral fractures or lytic sacral masses. Majority sacral fractures are insufficiency fractures related to osteoporosis. However, high-energy trauma can also result in sacral fractures with normal underlying bone density. Additionally, pathologic sacral fractures related to lytic osseous metastatic disease can be a source of severe pain and disability. Although a pathologic fracture is often associated with lytic tumors of the sacrum, there can be a significant amount of pain related to the tumor even in the absence of a fracture. Sacroplasty can be an effective treatment for osteoporotic insufficiency fractures by introducing poly (methyl methacrylate) cement through a needle directly into the fractured sacrum similar to traditional vertebroplasty. Combined treatments for pathologic tumor-related lesions can sometimes include initial endovascular tumor embolization and/or tumor ablation techniques prior to the introduction of cement into the sacrum. Although sacral fractures can be preceded by an identified fall or traumatic event, it is very common for patients to describe the onset of symptoms that are unrelated to any specific event. Furthermore, the symptoms of a sacral fracture can sometimes be insidious in onset and nonspecific in nature. Hip, buttock, groin, tailbone, perineal, and back pain have all been described by patients with a sacral fracture. Most patients will have significant difficulty in walking as this erect weight-bearing act places additional shear stress to the fractured sacrum. Although less common than pain and difficulty walking, some patients will also experience bowel or bladder dysfunction and decreased strength and sensory complaints in the lower extremities. Similar to patients with thoracic and lumbar vertebral compression fractures, pain and disability associated with a sacral fracture can lead to a downward spiral in overall health. Bedridden patients can develop bedsores, deep venous thrombosis, pulmonary emboli, loss of muscle mass, further loss in bone density, and even death. Patients requiring long-term narcotic treatment for alleviation of pain may also experience cognitive decline and constipation associated with the narcotics. Sacral fractures often go undiagnosed or are diagnosed in a delayed fashion. Factors contributing to the delay in diagnosis include nonspecific and often nonlocalizing symptoms, lack of inclusion in the differential diagnosis, and challenges in imaging. Sacral insufficiency fracture is relatively new to the medical community and was first describe by Dr. Lourie in 1982. As the disease becomes more familiar to medical professionals, the timely diagnosis will inevitably improve as they begin to look for the fractures with tailored imaging techniques. Currently, patients with sacral fractures are often initially imaged with CT of the pelvis or MRI of the lumbar spine depending on the predominant symptoms. Careful attention to the imaging studies is necessary to make the correct diagnosis. CT imaging can be insensitive to the diagnosis of a sacral fracture, particularly in the absence of sclerotic healing and offset fracture margins in the osteoporotic bone. Attention to subtle cortical disruption at the periphery of the sacral ala or along the circular sacral neural foramina is mandatory, and edema in the presacral fat adjacent to the fracture may be the only sign in an acute sacral insufficiency fracture. On the contrary, the presence of a pathologic metastatic lesion should be readily apparent. With respect to MRI of the lumbar spine, the difficulty generally lies in the field of view parameters that include little, if any, of the sacrum in the axial sequences and often n glect the lateral sacral ala in the sagittal sequences. Therefore, it is incumbent upon the radiologist to specifically look at all portions of the sacrum visible on a routine lumbar spine MRI keeping the diagnosis of sacral fractures in mind as a cause of most generic symptoms that beget MRI of the lumbar spine. If there is a question of sacral fracture, bone scintigraphy with SPECT can be useful and is highly sensitive to the diagnosis. However, the relative lack of spatial resolution generally requires additional cross-sectional imaging to evaluate the relationship of the fracture(s) to the sacroiliac joints, neural foramina, and sacral spinal canal. If possible, MRI of the pelvis is an ideal study. It is just as sensitive as bone scintigraphy but also allows for high spatial resolution and the depiction of sacral foramina and common anatomic variations in the shape of the sacrum and sacroiliac joints. If the patient cannot undergo an MRI, CT can be useful in addition to scintigraphy. The use of cement in the treatment of pathologic sacral lesions and insufficiency fractures was first described between 2000 and 2002. Injecting cement through a needle into the abnormal sacral bone was a natural extension of the more common vertebroplasty techniques used in the thoracic and lumbar spine at that time. Since those initial case reports, there have been numerous case reports and case series describing the technique of sacroplasty and its clinical utility. Despite the similarities with traditional thoracolumbar vertebroplasty, sacroplasty is generally considered more challenging because of the variation and complexity of the sacral anatomy compared with thoracic and lumbar vertebrae anatomy. Naturally, any proceduralist wanting to learn sacroplasty should first be highly experienced in the traditional thoracolumbar vertebroplasty technique. Majority reports in the literature claim that pain relief and improvement in disability with sacroplasty is similar to those with vertebroplasty and kyphoplasty. Furthermore, every proceduralist who performs sacroplasty on a routine basis will assert the undeniable benefit of the procedure for insufficiency fractures and pathologic lesions of the sacrum. However, a true randomized controlled trial has yet to be published comparing sacroplasty with standard medical therapy. Consequently, the same controversy that surrounds the effectiveness of vertebral augmentation in the thoracolumbar spine is undoubtedly present in any discussion on the use of cement in the sacrum. A well-planned multicenter randomized trial that focused on the use of sacroplasty for osteoporotic insufficiency fractures would be valuable in affirming the use of this procedure. As sacroplasty has slowly advanced as a recognized procedure for pain relief related to sacral lesions, multiple techniques for percutaneously depositing cement into the sacrum have been described. Fluoroscopy, CT, and a combination of both modalities have been described as safe and effective for treating sacral insufficiency fractures. The choice of image guidance is often based upon the resources available at an institution as well as the personal preference of the proceduralist. Each modality has benefits as well as limitations when compared with the other modality. Fluoroscopy allows for exaggerated camera angles to assist with precise needle placement, whereas the use of CT allows for more direct visualization of anatomic structures, such as the SI joints and foramina. Beyond the modality used for performing the procedure, nuances of needle placement and cement injection techniques also vary widely. Given the shape of the sacrum and the typical configuration of sacral fractures, percutaneous needle placement strategy should be tailored as per the individual sacral fracture. Multiple ipsilateral needles placed perpendicular to the long axis of the sacral ala have been described as the preferred technique for sacroplasty. However, others have demonstrated equivalent safety and success with a single needle advanced parallel to the long axis of t e upper sacral ala and generally parallel to the vertical fracture component. While proponents of each technique tend to defend their method as superior, there is no convincing evidence that one technique is any safer or more successful than the other. As opposed to thoracolumbar vertebral cement augmentation, the widely varied techniques and modalities used to treat sacral insufficiency fractures will undoubtedly make the design of any randomized sacroplasty trial difficult. For pathologic lytic sacral masses, with or without associated fractures, the treatment techniques are even more diverse. If the lesion is potentially hypervascular, initial angiography and possible embolization can be useful prior to subsequent penetration and manipulation of the tumor. This is particularly true if the lesion is adjacent to critical structures that might be affected by iatrogenic bleeding. Ablation techniques to create a void within the tumor of a lytic sacral mass can also be a critical adjunct to successful sacroplasty. This allows for the controlled deposition of cement and limits the displacement of tumor cells into the circulation or into adjacent spaces, such as the sacral spinal canal or foramina. In summary, percutaneous sacroplasty has emerged as a promising procedure for treating sacral insufficiency fractures and pathologic lytic sacral lesions. There is an abundance of case series in the literature describing the successful outcomes and safety of the procedure and its utilization will likely increase over time, particularly as awareness of its availability permeates the medical community. Ideally, a well-designed randomized trial is desired to clarify the future expansion of sacroplasty. AD - K.F. Layton, Department of Radiology, Baylor University Medical Center, Dallas, TX, United States AU - Layton, K. F. DB - Embase DO - 10.1007/s00270-017-1725-y KW - cement narcotic agent ablation therapy adult adverse drug reaction analgesia anatomy angiography awareness backache bladder dysfunction bleeding body weight bone density bone scintiscanning brain cortex buttock case report case study coccyx cognitive defect compression fracture constipation controlled study death decubitus deep vein thrombosis diagnosis differential diagnosis drug combination drug therapy edema female fluoroscopy hip human immobility inguinal region intestine kyphoplasty learning lumbar region lumbar vertebra lung embolism male metastasis minimally invasive procedure multicenter study muscle mass needle neglect nuclear magnetic resonance imaging osteoporosis pathologic fracture pelvis perineum radiologist randomized controlled trial sacral spinal cord sacroiliac joint sacrum sensory dysfunction shear stress side effect single photon emission computed tomography thoracic vertebra thoracolumbar spine thorax tumor ablation tumor-related gene vertebral canal walking difficulty weight bearing LA - English M1 - 2 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1432-086X SP - S95-S97 ST - Sacroplasty T2 - CardioVascular and Interventional Radiology TI - Sacroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L618085934&from=export http://dx.doi.org/10.1007/s00270-017-1725-y VL - 40 ID - 829244 ER - TY - JOUR AB - Thromboembolism following total hip arthroplasty is a common complication that may result in significant morbidity and mortality. Despite this, optimal prophylactic regimen is controversial. We investigated the efficacy of a comprehensive approach encompassing the use of aspirin, intermittent compression devices ('foot pumps'), and early mobilization in a cohort of 200 consecutive patients after non-cemented total hip replacements. The surgical procedures were carried out under epidural anesthesia in most cases (91%). All patients were allowed full weight bearing and received ambulation training starting on the first post-operative day. Ankle-high pneumatic boots ('foot pumps') and aspirin (325 mg p.o./qd) were used immediately after surgery. The presence of deep vein thrombosis was determined with the routine use of venous duplex scans on post-operative day number 5 to 10 (mean 6.8). The duration of the follow-up was 3 months. No patients were lost to follow-up. Four distal DVT's (2%) were detected in three patients. None of the patients developed symptomatic pulmonary embolism during the follow-up period. There were no major wound complications. Venous thromboembolic disease after hip replacement surgery is largely associated with postoperative immobilization and venous stasis. It is the authors' opinion that a prevention strategy should include mechanical as well as pharmacological measures. The concomitant use of epidural anesthesia, "foot pumps", aspirin and early full weight bearing ambulation may be effective in further reducing the incidence of DVT after surgery. AD - Department of Orthopaedic Surgery, New York University Medical Center-Hospital for Joint Diseases, USA. alex.leali@med.nyu.edu AN - 12050997 AU - Leali, A. AU - Fetto, J. AU - Moroz, A. DA - Apr DP - NLM ET - 2002/06/08 J2 - Acta orthopaedica Belgica KW - Adult Aged Anti-Inflammatory Agents, Non-Steroidal/*therapeutic use Arthroplasty, Replacement, Hip/*adverse effects Aspirin/*therapeutic use Combined Modality Therapy Female Foot Humans Immobilization/adverse effects Male Middle Aged Movement Physical Therapy Modalities Postoperative Complications/*prevention & control Pressure Risk Factors Thromboembolism/etiology/*prevention & control Weight-Bearing LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2002 SN - 0001-6462 (Print) 0001-6462 SP - 128-34 ST - Prevention of thromboembolic disease after non-cemented hip arthroplasty. A multimodal approach T2 - Acta Orthop Belg TI - Prevention of thromboembolic disease after non-cemented hip arthroplasty. A multimodal approach VL - 68 ID - 828890 ER - TY - JOUR AB - Purpose: To assess early outcome, safety, and complications of an alternative to open surgical treatments of osteolytic lesions in periarticular load-bearing bones.Materials and Methods: A single-center, prospective clinical cohort study of 26 lesions in 23 consecutive patients with painful osteolytic skeletal lesions was performed. Patients were followed for an average of 7 mo (1-18 mo). Lesions were targeted from the most intact bone via minimally invasive percutaneous approach for stable anchorage of internal fixation screws using fluoroscopic guidance. Cannulated screws served as universal portals for ablation, balloon osteoplasty, and delivery of bone cement in addition to internal fixation for cement anchoring and prophylactic stabilization of uninvolved bone.Results: There were 19 osteolytic lesions in the pelvis, 4 in the proximal femur, 2 in the proximal tibia, and 1 in the calcaneus. All defects were associated with severe pain or fractures. There were no conversions to open surgery and no infection or bleeding requiring transfusion, embolization, or additional procedures. There was significant improvement in visual analogue scale (VAS) pain score from 8.32 ± 1.70 to 2.36 ± 2.23, combined pain and functional ambulation score from 4.48 ± 2.84 to 7.28 ± 2.76, and Musculoskeletal Tumor Society score from 45% to 68% (P < .05).Conclusions: Ablation, osteoplasty, reinforcement, and internal fixation is a safe and effective minimally invasive percutaneous image-guided treatment option for functional improvement or palliation of painful osteolytic lesions in the pelvis and periarticular loadbearing bones. AD - Department of Orthopaedics and Rehabilitation, Yale School of Medicine, 47 College Pl., New Haven, CT, 06510 Yale Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, 47 College Pl., New Haven, CT, 06510 AN - 142100351. Language: English. Entry Date: In Process. Revision Date: 20201001. Publication Type: journal article. Supplement Title: 2020 Supplement. Journal Subset: Biomedical AU - Lee, Francis Y. AU - Latich, Igor AU - Toombs, Courtney AU - Mungur, Alana AU - Conway, Devin AU - Alder, Kareme AU - Ibe, Izuchukwu AU - Lindskog, Dieter AU - Friedlaender, Gary DB - cin20 DO - 10.1016/j.jvir.2019.11.029 DP - EBSCOhost KW - Ablation Techniques Fracture Fixation Femur -- Surgery Bone Cements -- Therapeutic Use Pelvic Bones -- Surgery Calcaneus -- Surgery Cementoplasty -- Adverse Effects Bone Neoplasms -- Surgery Osteolysis -- Surgery Fracture Fixation -- Adverse Effects Tibia -- Surgery Aged Postoperative Complications -- Etiology Female Pelvic Bones Femoral Neoplasms Calcaneus Adult Tibia -- Physiopathology Bone Screws Bone Neoplasms -- Physiopathology Bone Remodeling Femoral Neoplasms -- Surgery Femur -- Physiopathology Weight-Bearing Aged, 80 and Over Bone Neoplasms Middle Age Prospective Studies Tibia Pelvic Bones -- Physiopathology Time Factors Osteolysis -- Physiopathology Femoral Neoplasms -- Physiopathology Male Femur Recovery Osteolysis Calcaneus -- Physiopathology Treatment Outcomes Bone Cements -- Adverse Effects Clinical Assessment Tools Scales N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2020 SN - 1051-0443 SP - N.PAG-N.PAG ST - Minimally Invasive Image-Guided Ablation, Osteoplasty, Reinforcement, and Internal Fixation (AORIF) for Osteolytic Lesions in the Pelvis and Periarticular Regions of Weight-Bearing Bones T2 - Journal of Vascular & Interventional Radiology TI - Minimally Invasive Image-Guided Ablation, Osteoplasty, Reinforcement, and Internal Fixation (AORIF) for Osteolytic Lesions in the Pelvis and Periarticular Regions of Weight-Bearing Bones UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=142100351&site=ehost-live&scope=site VL - 31 ID - 830514 ER - TY - JOUR AB - BACKGROUND: Percutaneous injection of bone cement (acrylic cement) during percutaneous kyphoplasty and vertebroplasty can cause symptomatic or asymptomatic complications due to leakage, extravasation or vascular migration of cement. PURPOSE: To investigate and to compare the incidence and site of local leakage or complications of bone cement after percutaneous kyphoplasty and vertebroplasty using bone cement. MATERIAL AND METHODS: We retrospectively reviewed 473 cases of percutaneous kyphoplasty or vertebroplasty performed under fluoroscopic guidance. Of the 473 cases, follow-up CT scans that covered the treated bones were available for 83 cases (59 kyphoplasty and 24 vertebroplasty). RESULTS: The rate of local leakage of bone cement was 87.5% (21/24) for percutaneous vertebroplasty and 49.2% (29/59) for kyphoplasty. The most common site of local leakage was perivertebral soft tissue (n=8, 38.1%) for vertebroplasty. The most common site of local leakage was a perivertebral vein (n=7, 24.1%) for kyphoplasty. Two cases of pulmonary cement embolism developed: one case after kyphoplasty and one case after vertebroplasty. CONCLUSION: Local leakage of bone cement was more common for percutaneous vertebroplasty compared with kyphoplasty (P<0.005). The most common sites of local leakage were perivertebral soft tissue and perivertebral vein. AD - Department of Radiology, Hallym University College of Medicine, Seoul, Korea. ijlee2003@medimail.co.kr AN - 20528649 AU - Lee, I. J. AU - Choi, A. L. AU - Yie, M. Y. AU - Yoon, J. Y. AU - Jeon, E. Y. AU - Koh, S. H. AU - Yoon, D. Y. AU - Lim, K. J. AU - Im, H. J. DA - Jul DO - 10.3109/02841851003620366 DP - NLM ET - 2010/06/10 J2 - Acta radiologica (Stockholm, Sweden : 1987) KW - *Bone Cements Humans Kyphosis/*diagnostic imaging/*surgery Postoperative Complications/diagnostic imaging Retrospective Studies Spinal Fractures/*diagnostic imaging/*surgery *Tomography, X-Ray Computed Vertebroplasty/*adverse effects LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 0284-1851 SP - 649-54 ST - CT evaluation of local leakage of bone cement after percutaneous kyphoplasty and vertebroplasty T2 - Acta Radiol TI - CT evaluation of local leakage of bone cement after percutaneous kyphoplasty and vertebroplasty VL - 51 ID - 828662 ER - TY - JOUR AB - Background: Percutaneous injection of bone cement (acrylic cement) during percutaneous kyphoplasty and vertebroplasty can cause symptomatic or asymptomatic complications due to leakage, extravasation or vascular migration of cement. Purpose: To investigate and to compare the incidence and site of local leakage or complications of bone cement after percutaneous kyphoplasty and vertebroplasty using bone cement. Material and Methods: We retrospectively reviewed 473 cases of percutaneous kyphoplasty or vertebroplasty performed under fluoroscopic guidance. Of the 473 cases, follow-up CT scans that covered the treated bones were available for 83 cases (59 kyphoplasty and 24 vertebroplasty). Results: The rate of local leakage of bone cement was 87.5% (21/24) for percutaneous vertebroplasty and 49.2% (29/59) for kyphoplasty. The most common site of local leakage was perivertebral soft tissue (n=8, 38.1%) for vertebroplasty. The most common site of local leakage was a perivertebral vein (n=7, 24.1%) for kyphoplasty. Two cases of pulmonary cement embolism developed: one case after kyphoplasty and one case after vertebroplasty. Conclusion: Local leakage of bone cement was more common for percutaneous vertebroplasty compared with kyphoplasty (P<0.005). The most common sites of local leakage were perivertebral soft tissue and perivertebral vein. AD - Department of Radiology, Hallym University College of Medicine, Seoul, Korea Department of Radiology, Hallym University College of Medicine, Seoul, Korea. ijlee2003@medimail.co.kr AN - 105025038. Language: English. Entry Date: 20100716. Revision Date: 20200708. Publication Type: journal article AU - Lee, I. J. AU - Choi, A. L. AU - Yie, M. Y. AU - Yoon, J. Y. AU - Jeon, E. Y. AU - Koh, S. H. AU - Yoon, D. Y. AU - Lim, K. J. AU - Im, H. J. AU - Lee, In Jae AU - Choi, A. Lam AU - Yie, Mi-Yeon AU - Yoon, Ji Young AU - Jeon, Eui Yong AU - Koh, Sung Hye AU - Yoon, Dae Young AU - Lim, Kyung Ja AU - Im, Hyoung June DB - cin20 DO - 10.3109/02841851003620366 DP - EBSCOhost KW - Bone Cements Kyphosis -- Radiography Kyphosis -- Surgery Spinal Fractures -- Radiography Spinal Fractures -- Surgery Tomography, X-Ray Computed Kyphoplasty -- Adverse Effects Human Postoperative Complications -- Radiography Retrospective Design M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2010 SN - 0284-1851 SP - 649-654 ST - CT evaluation of local leakage of bone cement after percutaneous kyphoplasty and vertebroplasty T2 - Acta Radiologica TI - CT evaluation of local leakage of bone cement after percutaneous kyphoplasty and vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105025038&site=ehost-live&scope=site VL - 51 ID - 830709 ER - TY - JOUR AB - We report here on an uncommon case of metastatic choriocarcinoma to the lung, brain and lumbar spine. A 33-year-old woman was admitted to the pulmonary department with headache, dyspnea and hemoptysis. There was a history of cesarean section due to intrauterine fetal death at 37-weeks gestation and this occurred 2 weeks before admission to the pulmonary department. The radiological studies revealed a nodular lung mass with hypervascularity in the left upper lobe and also a brain parenchymal lesion in the parietal lobe with marginal bleeding and surrounding edema. She underwent embolization for the lung lesion, which was suspected to be an arteriovenous malformation according to the pulmonary arteriogram. Approximately 10 days after discharge from the pulmonary department, she was readmitted due to back pain and progressive paraparesis. The neuroradiological studies revealed a hypervascular tumor occupying the entire L3 vertebral body and pedicle, and the tumor extended to the epidural area. She underwent embolization of the hypervascular lesion of the lumbar spine, and after which injection of polymethylmethacrylate in the L3 vertebral body, total laminectomy of L3, subtotal removal of the epidural mass and screw fixation of L2 and L4 were performed. The result of biopsy was a choriocarcinoma. © 2010 The Korean Neurosurgical Society. AD - C. W. Park, Department of Neurosurgery, Gachon University of Medical and Science, Gil Medical Center, 1198 Guwol-dong, Namdong-gu, Incheon 405-760, South Korea AU - Lee, J. H. AU - Park, C. W. AU - Chung, D. H. AU - Kim, W. K. DB - Embase DO - 10.3340/jkns.2010.47.2.143 KW - chorionic gonadotropin beta subunit cyclophosphamide dactinomycin etoposide methotrexate placenta lactogen poly(methyl methacrylate) polyvinyl acetate vincristine adult article artificial embolization backache bone screw brain edema brain hematoma brain hemorrhage case report choriocarcinoma dyspnea female follow up headache hemangioma hemoptysis hospital readmission human laminectomy lumbar spine lung hemorrhage magnetic resonance angiography paraplegia parietal lobe spine metastasis L1 - http://www.jkns.or.kr/htm/journal_v.asp?v=47&n=2 LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 2005-3711 1598-7876 SP - 143-147 ST - A case of lumbar metastasis of choriocarcinoma masquerading as an extraosseous extension of vertebral hemangioma T2 - Journal of Korean Neurosurgical Society TI - A case of lumbar metastasis of choriocarcinoma masquerading as an extraosseous extension of vertebral hemangioma UR - https://www.embase.com/search/results?subaction=viewrecord&id=L358675499&from=export http://dx.doi.org/10.3340/jkns.2010.47.2.143 VL - 47 ID - 829666 ER - TY - JOUR AB - Multiple treatment options have been introduced for the treatment of sacral tumoral bone pain. These options include pre-operative sacral embolization, percutaneous cryoablation, alcohol ablation, and sacroplasty. We intend to show that in the correct clinical scenario, a combination of the four procedures performed as a two-stage process can effectively treat tumoral bone pain refractory to medical therapy. AD - UMDNJ Robert Wood Johnson University Hospital, New Brunswick, NJ, USA. AN - 23693052 AU - Lee, J. H. AU - Stein, M. AU - Roychowdhury, S. C2 - Pmc3670067 DA - Jun DO - 10.1177/159101991301900217 DP - NLM ET - 2013/05/23 J2 - Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences KW - Aged Carcinoma, Renal Cell/etiology/*secondary/*therapy Combined Modality Therapy Cryosurgery/methods Embolization, Therapeutic/methods Ethanol/therapeutic use Hemostatics/therapeutic use Humans Male Pain/etiology/*prevention & control Sacrum/*surgery Sclerosing Solutions/therapeutic use Spinal Neoplasms/complications/*secondary/*therapy Treatment Outcome Vertebroplasty/*methods LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1591-0199 (Print) 1591-0199 SP - 250-3 ST - Percutaneous treatment of a sacral metastasis with combined embolization, cryoablation, alcohol ablation and sacroplasty for local tumor and pain control T2 - Interv Neuroradiol TI - Percutaneous treatment of a sacral metastasis with combined embolization, cryoablation, alcohol ablation and sacroplasty for local tumor and pain control VL - 19 ID - 828930 ER - TY - JOUR AB - Infection in total knee arthroplasty (TKA) is a challenging complication. We reviewed 20 cases of infected TKAs treated by two-stage reimplantation procedure involving the use of a temporary articulating system composed of autoclaved femoral component, low temperature hydrogen peroxide gas plasma sterilized polyethylene insert, and antibiotic-impregnated bone cement. The knee and functional score of the Knee Society scoring system at the last follow (average, 64.8 months) up was 86.2 points and 78.8 points. The success rate in terms of eradication of infection was 95% (19/20 knees). Use of a temporary articulating system composed of the re-sterilized components with antibiotic-impregnated bone cement was an effective therapy not only for the eradication of the infection but also for the recovery of soft tissue health and knee function. © 2012 Elsevier Inc. AD - C.H. Choi, Department of Orthopaedic Surgery, Hanyang University College of Medicine, 222 Wangsimni-Ro, Seongdong-Gu, Seoul 133-792, South Korea AU - Lee, J. K. AU - Choi, C. H. DB - Embase Medline DO - 10.1016/j.arth.2012.03.013 KW - antibiotic agent bone cement C reactive protein hydrogen peroxide polyethylene antibiotic therapy arthrodesis article clinical article debridement deep vein thrombosis disease course endoprosthesis loosening female follow up human knee function leukocyte count lung embolism male motion nonhuman postoperative infection prosthesis infection Pseudomonas infection range of motion recurrent infection reimplantation rheumatoid arthritis total knee arthroplasty wound healing LCCK Scorpio TS LA - English M1 - 9 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 0883-5403 1532-8406 SP - 1701-1706.e1 ST - Two-stage Reimplantation in Infected Total Knee Arthroplasty Using a Re-sterilized Tibial Polyethylene Insert and Femoral Component T2 - Journal of Arthroplasty TI - Two-stage Reimplantation in Infected Total Knee Arthroplasty Using a Re-sterilized Tibial Polyethylene Insert and Femoral Component UR - https://www.embase.com/search/results?subaction=viewrecord&id=L51957244&from=export http://dx.doi.org/10.1016/j.arth.2012.03.013 VL - 27 ID - 829536 ER - TY - JOUR AB - BACKGROUND CONTEXT: Controversy exists regarding percutaneous balloon kyphoplasty (PBK) in patients with a very severe osteoporotic vertebral compression fracture (vsOVCF). PURPOSE: The study was conducted to investigate the clinical and radiological outcomes of PBK for the treatment of vsOVCF compared with those of non-vsOVCF. STUDY DESIGN/SETTING: This is a retrospective, case-control study. PATIENT SAMPLE: A total of 167 consecutive patients (210 vertebral bodies) who underwent PBK for OVCF between March 2010 and January 2015 were assessed. OUTCOME MEASURES: Visual analog scale (VAS) scores for back pain, Korean Oswestry disability index (K-ODI) scores, vertebral body height variations, and kyphotic angles were evaluated preoperatively, postoperatively, and 1 year after treatment. MATERIALS AND METHODS: Patients in the non-vsOVCF group (anterior vertebral compression of more than two-thirds on plain radiograph) who had undergone PBK where compared with those in the non-vsOVCF group (compression between 30% and two-thirds). Clinical and radiological outcomes were compared. In addition, complications were evaluated. RESULTS: In total, 31 patients (33 vertebrae) in the vsOVCF group and 136 patients (177 vertebrae) in the non-vsOVCF group were treated with PBK. Both groups had significant postoperative improvements in the clinical and radiological outcomes (VAS score, K-ODI score, vertebral body height variation, and kyphotic angle). There was no difference regarding the VAS score and the K-ODI score between the two groups at the final follow-up (p>.05). The cement leakage occurred frequently in the vsOVCF group (26 vertebrae, 78.8%) than in the non-vsOVCF group (92 vertebrae, 52.0%), the difference was statistically significant (p<.05). But there was no case that showed neurologic complication or pulmonary embolism caused by cement leakage. The incidence of recollapse was significantly higher in the vsOVCF group (five vertebrae, 15.2%) than in the non-vsOVCF group (seven vertebrae, 4.0%) (p<.05). The incidence of an adjacent segment fracture (vsOVCF group, 6 vertebrae, 18.2%; non-vsOVCF group, 21 vertebrae, 11.9%) was not significantly different (p=.320). CONCLUSIONS: Percutaneous balloon kyphoplasty is a safe and effective procedure for the treatment of vsOVCF. AD - Department of Orthopaedic Surgery, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea. Department of Orthopaedic Surgery, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea. Electronic address: cnkang65@hanyang.ac.kr. AN - 29055740 AU - Lee, J. K. AU - Jeong, H. W. AU - Joo, I. H. AU - Ko, Y. I. AU - Kang, C. N. DA - Jun DO - 10.1016/j.spinee.2017.10.006 DP - NLM ET - 2017/10/23 J2 - The spine journal : official journal of the North American Spine Society KW - Aged Aged, 80 and over Case-Control Studies Female Fractures, Compression/*surgery Humans Kyphoplasty/adverse effects/*methods Male Middle Aged Osteoporotic Fractures/*surgery Postoperative Complications/*epidemiology Spinal Fractures/*surgery *Clinical outcome *Complications *Osteoporosis *Percutaneous balloon kyphoplasty *Radiological outcome *Vertebral compression fracture LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 1529-9430 SP - 962-969 ST - Percutaneous balloon kyphoplasty for the treatment of very severe osteoporotic vertebral compression fractures: a case-control study T2 - Spine J TI - Percutaneous balloon kyphoplasty for the treatment of very severe osteoporotic vertebral compression fractures: a case-control study VL - 18 ID - 828624 ER - TY - JOUR AB - Background Context: Controversy exists regarding percutaneous balloon kyphoplasty (PBK) in patients with a very severe osteoporotic vertebral compression fracture (vsOVCF).Purpose: The study was conducted to investigate the clinical and radiological outcomes of PBK for the treatment of vsOVCF compared with those of non-vsOVCF.Study Design/setting: This is a retrospective, case-control study.Patient Sample: A total of 167 consecutive patients (210 vertebral bodies) who underwent PBK for OVCF between March 2010 and January 2015 were assessed.Outcome Measures: Visual analog scale (VAS) scores for back pain, Korean Oswestry disability index (K-ODI) scores, vertebral body height variations, and kyphotic angles were evaluated preoperatively, postoperatively, and 1 year after treatment.Materials and Methods: Patients in the non-vsOVCF group (anterior vertebral compression of more than two-thirds on plain radiograph) who had undergone PBK where compared with those in the non-vsOVCF group (compression between 30% and two-thirds). Clinical and radiological outcomes were compared. In addition, complications were evaluated.Results: In total, 31 patients (33 vertebrae) in the vsOVCF group and 136 patients (177 vertebrae) in the non-vsOVCF group were treated with PBK. Both groups had significant postoperative improvements in the clinical and radiological outcomes (VAS score, K-ODI score, vertebral body height variation, and kyphotic angle). There was no difference regarding the VAS score and the K-ODI score between the two groups at the final follow-up (p>.05). The cement leakage occurred frequently in the vsOVCF group (26 vertebrae, 78.8%) than in the non-vsOVCF group (92 vertebrae, 52.0%), the difference was statistically significant (p<.05). But there was no case that showed neurologic complication or pulmonary embolism caused by cement leakage. The incidence of recollapse was significantly higher in the vsOVCF group (five vertebrae, 15.2%) than in the non-vsOVCF group (seven vertebrae, 4.0%) (p<.05). The incidence of an adjacent segment fracture (vsOVCF group, 6 vertebrae, 18.2%; non-vsOVCF group, 21 vertebrae, 11.9%) was not significantly different (p=.320).Conclusions: Percutaneous balloon kyphoplasty is a safe and effective procedure for the treatment of vsOVCF. AD - Department of Orthopaedic Surgery, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea AN - 129792163. Language: English. Entry Date: 20181221. Revision Date: 20190217. Publication Type: journal article. Journal Subset: Biomedical AU - Lee, Jin Kyu AU - Jeong, Hae-won AU - Joo, Il-Han AU - Ko, Young-Il AU - Kang, Chang-Nam DB - cin20 DO - 10.1016/j.spinee.2017.10.006 DP - EBSCOhost KW - Postoperative Complications -- Epidemiology Fractures, Compression -- Surgery Spinal Fractures -- Surgery Kyphoplasty -- Methods Aged, 80 and Over Kyphoplasty -- Adverse Effects Middle Age Female Aged Male Case Control Studies M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2018 SN - 1529-9430 SP - 962-969 ST - Percutaneous balloon kyphoplasty for the treatment of very severe osteoporotic vertebral compression fractures: a case-control study T2 - Spine Journal TI - Percutaneous balloon kyphoplasty for the treatment of very severe osteoporotic vertebral compression fractures: a case-control study UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=129792163&site=ehost-live&scope=site VL - 18 ID - 830552 ER - TY - JOUR AN - 20197363 AU - Lee, J. S. AU - Jeong, Y. S. AU - Ahn, S. G. DA - Mar DO - 10.1136/hrt.2009.182162 DP - NLM ET - 2010/03/04 J2 - Heart (British Cardiac Society) KW - Aged Bone Cements/*adverse effects Female Heart Atria Heart Ventricles Humans Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/*etiology Vertebroplasty/*adverse effects LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 1355-6037 SP - 387 ST - Intracardiac bone cement embolism T2 - Heart TI - Intracardiac bone cement embolism VL - 96 ID - 828836 ER - TY - JOUR AB - Vertebroplasty (VP) is a well-known therapeutic modality used to treat pain associated with vertebral compression fractures. Major complications such as cord or root compression, epidural and subdural hematomas (SDH) and pulmonary emboli, occur in less than 1% of patients who undergo VP after compression fracture. Spinal SDH is an extremely rare complication that usually happens a few hours after the procedure. We report a case of spinal SDH that developed at two weeks after a successful VP. We also reviewed related literatures and discussed its possible pathogenesis. AD - Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. AN - 25983834 AU - Lee, K. D. AU - Sim, H. B. AU - Lyo, I. U. AU - Kwon, S. C. AU - Park, J. B. C2 - Pmc4431021 DA - Sep DO - 10.14245/kjs.2012.9.3.285 DP - NLM ET - 2012/09/01 J2 - Korean Journal of Spine KW - Complication Spine Subdural hematoma Vertebroplasty LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 1738-2262 (Print) 1738-2262 SP - 285-8 ST - Delayed onset of spinal subdural hematoma after vertebroplasty for compression fracture: a case report T2 - Korean J Spine TI - Delayed onset of spinal subdural hematoma after vertebroplasty for compression fracture: a case report VL - 9 ID - 828756 ER - TY - JOUR AN - 23525163 AU - Lee, S. H. AU - Kim, W. H. AU - Ko, J. K. DA - Sep DO - 10.1093/qjmed/hct079 DP - NLM ET - 2013/03/26 J2 - QJM : monthly journal of the Association of Physicians KW - Bone Cements/*adverse effects Humans Lumbar Vertebrae/surgery Male Middle Aged Osteoporosis/surgery Pulmonary Embolism/diagnosis/*diagnostic imaging/etiology Radiography Vertebroplasty/*adverse effects LA - eng M1 - 9 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1460-2393 SP - 877-8 ST - Multiple pulmonary cement embolism after percutaneous vertebroplasty T2 - Qjm TI - Multiple pulmonary cement embolism after percutaneous vertebroplasty VL - 106 ID - 828952 ER - TY - JOUR AD - V. Lee, Heart Hospital, University College London Hospital NHS Foundation Trust, 16-18 Westmoreland Street, London W1G 8PH, United Kingdom AU - Lee, V. AU - Patel, R. AU - Meier, P. AU - Lawrence, D. AU - Roberts, N. DB - Embase Medline DO - 10.3899/jrheum.130570 KW - adult respiratory distress syndrome asymptomatic disease case report cement extravasation computer assisted tomography conservative treatment death device removal dyspnea echocardiography echography emergency surgery extravasation fragility fracture heart right ventricle heart tamponade human inferior cava vein lung angiography lung embolism note percutaneous vertebroplasty pericardial effusion pericardiocentesis postoperative period priority journal L1 - http://www.jrheum.org/content/41/1/141.full.pdf LA - English M1 - 1 M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 0315-162X 1499-2752 SP - 141-142 ST - Conservative management of inferior vena cava cement spike after percutaneous vertebroplasty causes fatal cardiac tamponade T2 - Journal of Rheumatology TI - Conservative management of inferior vena cava cement spike after percutaneous vertebroplasty causes fatal cardiac tamponade UR - https://www.embase.com/search/results?subaction=viewrecord&id=L372065033&from=export http://dx.doi.org/10.3899/jrheum.130570 VL - 41 ID - 829432 ER - TY - JOUR AB - Distant metastases in differentiated thyroid cancer involve mainly lung and bone. Lung metastases were found in 5% of papillary forms and 10% of follicular forms respectively. I 131 uptake was found in 55% of the cases irrespective of histology. Bone metastases were found in 20% of follicular and 3.5% of papillary forms, respectively. Ablation of post-operative thyroid remnants is obtained by administering 3.7 GBq 1 131; I 131 (.2 to .4 GBq) is then used to localize distant metastases and a further 3.7 to 7.4 GBq is administered for therapy. Results are good in lung metastases, with a survival of 72% at 5 years. Bone metastases cannot be cured with I 131 alone. Surgery is indicated as a first line therapy if possible. In order to reduce the vascularization of the metastase a pre-operative embolization should be attempted. After bone surgery a therapeutic dose of I 131 is given if a post-operative 1 131 uptake is found. Others treatments of bone metastases are palliative surgery, external radiotherapy, cementing of the metastases. AD - Service central de radioisotopes, Hôpital Necker-Enfants Malades, Paris. AN - 7677405 AU - Leger, A. F. DP - NLM ET - 1995/01/01 J2 - Annales d'endocrinologie KW - Bone Neoplasms/diagnostic imaging/*secondary/therapy Humans *Iodine Radioisotopes/therapeutic use Lung Neoplasms/diagnostic imaging/*secondary/therapy Radionuclide Imaging Thyroid Neoplasms/*pathology LA - fre M1 - 3 N1 - PubMed NLM literature search January 5, 2021 OP - Métastases à distance des cancers thyroïdiens différenciés. Diagnostic par l'iode 131 (I 131) et traitement. PY - 1995 SN - 0003-4266 (Print) 0003-4266 SP - 205-8 ST - [Distant metastasis of differentiated thyroid cancers. Diagnosis by 131 iodine (I 131) and treatment] T2 - Ann Endocrinol (Paris) TI - [Distant metastasis of differentiated thyroid cancers. Diagnosis by 131 iodine (I 131) and treatment] VL - 56 ID - 829039 ER - TY - JOUR AB - Distant metastases in differentiated thyroid cancer involve mainly lung and bone. Lung metastases were found in 5% of papillary forms and 10% of follicular forms respectively. I 131 uptake was found in 55% of the cases irrespective of histology. Bone metastases were found in 20% of follicular and 3.5% of papillary forms, respectively. Ablation of postoperative thyroid remnants is obtained by administering 3.7 GBq 1 131; I 131 (.2 to.4 GBq) is then used to localize distant metastases and a further 3.7 to 7.4 GBq is administered for therapy. Results are good in lung metastases, with a survival of 72% at 5 years. Bone metastases cannot be cured with I 131 alone. Surgery is indicated as a first line therapy if possible. In order to reduce the vascularization of the metastase a pre-operative embolization should be attempted. After bone surgery a therapeutic dose of I 131 is given if a postoperative 1 131 uptake is found. Other treatments of bone metastases are palliative surgery, external radiotherapy, cementing of the metastases. AD - A.F. Leger, Service Central de Radioisotopes, Hopital Necker-Enfants Malades, 149 Rue de Sevres, F-75015 Paris, France AU - Leger, A. F. DB - Embase Medline KW - iodine 131 article bone metastasis human lung metastasis thyroid cancer LA - French M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1995 SN - 0003-4266 SP - 205-208 ST - Distant metastases of differentiated thyroid cancer. Diagnosis by 131 iodine and treatment T2 - Annales d'Endocrinologie TI - Distant metastases of differentiated thyroid cancer. Diagnosis by 131 iodine and treatment UR - https://www.embase.com/search/results?subaction=viewrecord&id=L25200090&from=export VL - 56 ID - 829928 ER - TY - JOUR AB - Distant metastases in differentiated thyroid cancer involve mainly lung and bone. Lung metastases were found in 5 % of papillary forms and 10% of follicular forms respectively. I 131 uptake was found in 55 % of the cases irrespective of histology. Bone metastases were found in 20 % of follicular and 3.5 % of papillary forms, respectively. Ablation of postoperative thyroid remnants is obtained by administering 3.7 GBq I 131; I 131 (.2 to .4 GBq) is then used to localize distant metastases and a further 3.7 to 7.4 GBq is administered for therapy. Results are good in lung metastases, with a survival of 72% at 5 years. Bone metastases cannot be cured with I 131 alone. Surgery is indicated as a first line therapy if possible. In order to reduce the vascularization of the metastase a pre-operative embolization should be attempted. After bone surgery a therapeutic dose of I 131 is given if a postoperative I 131 uptake is found. Others treatments of bone metastases are palliative surgery, external radiotherapy, cementing of the metastases. AD - LEGER, AF (corresponding author), HOP NECKER ENFANTS MALAD,SERV CENT RADIOISTOPES,RUE SEVRES,F-75015 PARIS,FRANCE. AN - WOS:A1995RG52000008 AU - Leger, A. F. J2 - Ann Endocrinol. KW - METASTASES THYROID CANCER CARCINOMA TUMOR Endocrinology & Metabolism LA - French M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1995 SN - 0003-4266 SP - 205-208 ST - DISTANT METASTASES OF DIFFERENTIATED THYROID-CANCER - DIAGNOSIS BY IODINE-131 AND TREATMENT T2 - Annales D Endocrinologie TI - DISTANT METASTASES OF DIFFERENTIATED THYROID-CANCER - DIAGNOSIS BY IODINE-131 AND TREATMENT UR - ://WOS:A1995RG52000008 VL - 56 ID - 830490 ER - TY - JOUR AB - Background and Goal of Study: Pursuant to a female patient's cerebral infarction following a kyphoplasty, we were faced with the question: How often do these patients exhibit an intracardial shunt and do these cases usually result in clinically relevant paradoxical embolisms? Materials and Methods: We examined 97 patients after undergoing a percutaneous kyphoplasty. After explaining risks and objective written consent was obtained and a TOE was performed in order to detect a right-to-left shunt at cardiac level. Following induction of general anaesthesia the atrial and interventricular septum were inspected at a minimum of 2 levels. A “provocative manoeuvre” to raise the pressure in the right ventricle was performed by increasing the ventilation pressures (PEEP min. 15mmHg, Pinsp min. 25mmHg).For the shunt diagnosis we used both, color-duplex and i.v. contrast examinations (2ml air foamed with 10ml hydroxyethyl starch). Once the shunt had been diagnosed the probe was left in situ, in order to detect the transfer of hyperechogenic structures through the shunt during the operation. Prior to the patients' discharge a neurological examination was performed. Results and Discussion: A shunt at cardiac level was diagnosed in 14 out of 97 patients (14,4%). In 4 out of 14 of these patients we observed hyperechogenic structures in the right heart during insertion of the trocar into the vertebral body as well as during injection of bone cement. In one case we were able to observe a cardiac right-to-left transfer. At the time of discharge from hospital none of the patients showed symptoms of a cerebral infarction. Conclusion(s): -Cardiovascular embolization occasionally occurs through percutaneous kyphoplasty- Clinically relevant cerebral embolizations are very rare despite frequent intracardiac shunts- The TOE for purposes of perioperative risk stratification is to be viewed as questionable. AD - C. Lehner, BG Traumacenter Murnau, Department of Anaesthesiology and Intensive Care, Murnau am Staffelsee, Germany AU - Lehner, C. AU - Dieterich, F. AU - Matthes, T. AU - Reisig, F. AU - Knebel, J. AU - Büttner, J. DB - Embase KW - bone cement hetastarch patient female human brain ischemia kyphoplasty paradoxical embolism patent foramen ovale transesophageal echocardiography risk stratification anesthesiology brain infarction heart right left shunt hospital artificial embolization heart septum defect vertebra body trocar neurologic examination examination heart color diagnosis injection air conditioning heart right ventricle general anesthesia LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 0265-0215 SP - 57 ST - A female patient with cerebral ischemia after percutaneous kyphoplasty due to a paradoxical embolism via a persistent foramen ovale (PFO)-is a perioperative transesophageal echocardiography (TOE) helpful in the context of cardiac risk stratification? T2 - European Journal of Anaesthesiology TI - A female patient with cerebral ischemia after percutaneous kyphoplasty due to a paradoxical embolism via a persistent foramen ovale (PFO)-is a perioperative transesophageal echocardiography (TOE) helpful in the context of cardiac risk stratification? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71084175&from=export VL - 29 ID - 829565 ER - TY - JOUR AB - OBJECTIVE: To discuss short-term effect of rotating hinge knee prosthesis. METHODS: From July 2002 to April 2005, 17 cases of severe knee joint deformity and instability received rotating hinge knee prosthesis for total knee arthroplasty. There were 8 males and 9 females, aging from 4l to 79 years. The left joints were involved in 10 cases and right joint in 7 cases. All patients were admitted because of pain. The course of disease was from 1 to 7 years. There were 10 cases of osteoarthritis, 5 cases of rheumatoid arthritis, 1 case of traumatic arthritis after operation of left femur fracture,and 1 case of traumatic arthritis with injury of anterior cruciate ligament, meniscus medialis and medial collateral ligament after operation of left fracture of tibial plateau. According to HSS (hospital for special surgery) scoring system, the preoperative score was 36 to 58 with an average of 48.6. The preoperative flexed motion range of articulation was 21 degrees to 80 degrees with an average of 57.4 degrees. RESULTS: All patients were followed up from 7 months to 3 years with an average of 23. 6 months. There were no complications of thrombogenesis of veins of lower extremity, pulmonary embolism, palsy of peroneal nerve, fracture, and breakage of extended knee structure. Infection occurred in 1 case at 3 months postoperatively, the prosthesis was dislodged, antibiotic-impregnated cement was filled with knee joint, two-stage arthroplasty was expected. At the last follow-up, the HSS score was 78 to 98 with an average of 91.1 in 16 patients. The flexed motion range of articulation was 75 degrees to 100 degrees with an average of 85.2 degrees at 2 weeks postoperatively. The flexed motion range of articular was 85 degrees to 123 degrees with an average of 108.3 degrees at the last follow-up. There were significant differences in HSS score and motion range of articular between preoperation and the last follow-up (P < 0.05). CONCLUSION: The short-term outcome of rotating hinge knee prosthesis is good and a long term follow-up is necessary. AD - Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha Hunan, 410008, PR China. lgh9640@sina.com AN - 17419198 AU - Lei, G. AU - Gao, S. AU - Li, K. DA - Mar DP - NLM ET - 2007/04/11 J2 - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery KW - Adult Aged *Arthroplasty, Replacement, Knee Female Follow-Up Studies Humans Joint Instability/physiopathology/surgery Knee Joint/physiopathology/*surgery *Knee Prosthesis Male Middle Aged Osteoarthritis, Knee/*surgery Prosthesis Design Range of Motion, Articular/physiology Reoperation Treatment Outcome LA - chi M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 1002-1892 (Print) 1002-1892 SP - 231-4 ST - [Short-term effect of rotating hinge knee prosthesis] T2 - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi TI - [Short-term effect of rotating hinge knee prosthesis] VL - 21 ID - 828943 ER - TY - JOUR AB - Intraoperative circulatory and pulmonary problems occuring during the repair of femoral neck fractures with cemented hip arthroplasty are a common problem,that cannot be ultimately explained. As a possible reason for this problem is air embolism during the polymerisation of the methylmethacrylat discussed. We started a prospective randomised clinical examination with 72 patients to prove the efficiency of palacos mixed in vacuum, with respect to the reduction of severe cardiovascular complications during endoprosthetic repair of femoral neck fractures. In the control group with 36 patients, surgical repair was performed with palacos mixed conventionally. In the second group (vacuum group), also consisting of 36 patients, surgical repair was performed with palacos mixed in vacuum. Invasive hemodynamic monitoring and transesophageal echocardiography was performed in all cases. In the control group pulmonary embolism occured echocardiographically in 86% of the cases vs. 14% in the vacuum group. 53% of the controll patients - vs. 11% of the vacuum patients - showed clinical complications in form of significant decrease of arterial oxygenation and circulatory insufficiency with the need of katecholamins. Clinical complications occured in the control group in 80% of the patients -vs. 13.7% in the vacuum group - whose pulmonal arterial pressure was higer than 30 mmHg preoperatively and only in 18,8% of the cases - vs. 7.1% in the vacuum group - with a normal pulmonal arterial pressure. Mortality in the control group amounted to 13,8% in the vacuum group to 2,8%. Through the use of methylmethacrylate mixed in vacuum for surgical repair of femoral neck fractures with cemented hip arthroplasty, the incidence of severe cardiac complications could be reduced significantly. Patients with increased pulmonal arterial pressure have the highest risk for cardiac complications. AD - Klinikum Garmisch Partenkirchen, Abt Anasthesie & Operat Intensivmed, D-82467 Garmisch Partenkirchen, Germany. Leidinger, W (corresponding author), Klinikum Garmisch Partenkirchen, Abt Anasthesie & Operat Intensivmed, Auenstr 6, D-82467 Garmisch Partenkirchen, Germany. AN - WOS:000177726400003 AU - Leidinger, W. AU - Hoffmann, G. AU - Meierhofer, J. N. DA - Aug DO - 10.1007/s00113-001-0410-3 J2 - Unfallchirurg KW - femoral neck fractures air embolism circulatory complication in hip arthroplasty TWO-DIMENSIONAL ECHOCARDIOGRAPHY AIR-EMBOLISM BONE-CEMENT REPLACEMENT HEMIARTHROPLASTY HISTAMINE SURGERY RELEASE Emergency Medicine Surgery LA - German M1 - 8 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2002 SN - 0177-5537 SP - 675-679 ST - Reduction of severe cardiac complications during surgical repair of femoral neck fractures with cemented hip arthroplasty T2 - Unfallchirurg TI - Reduction of severe cardiac complications during surgical repair of femoral neck fractures with cemented hip arthroplasty UR - ://WOS:000177726400003 VL - 105 ID - 830452 ER - TY - JOUR AB - Intraoperative circulatory and pulmonary problems occuring during the repair of femoral neck fractures with cemented hip arthroplasty are a common problem, that cannot be ultimately explained. As a possible reason for this problem is air embolism during the polymerisation of the methylmethacrylat discussed. We started a prospective randomised clinical examination with 72 patients to prove the efficiency of palacos mixed in vacuum, with respect to the reduction of severe cardiovascular complication during endoprosthetic repair of femoral neck fractures. In the control group with 36 patients, surgical repair was performed with palacos mixed conventionally. In the second group (vacuum group), also consisting of 36 patients, surgical repair was performed with palacos mixed in vacuum. Invasive hemodynamic monitoring and transesophageal echocardiography was performed in all cases. In the control group pulmonary embolism occurred echocardiographically in 86% of the cases vs. 14% in the vacuum group. 53% of the control patients--vs. 11% of the vacuum patients--showed clinical complications in form of significant decrease of arterial oxygenation and circulatory insufficiency with the need of catecholamines. Clinical complications occurred in the control group in 80% of the patients--vs. 13.7% in the vacuum group--whose pulmonal arterial pressure was higher than 30 mmHg preoperatively and only in 18.8% of the cases--vs. 7.1% in the vacuum group--with a normal pulmonal arterial pressure. Mortality in the control group amounted to 13.8% in the vacuum group to 2.8%. Through the use of methylmethacrylate mixed in vacuum for surgical repair of femoral neck fractures with cemented hip arthroplasty, the incidence of severe cardiac complications could be reduced significantly. Patients with increased pulmonal arterial pressure have the highest risk for cardiac complications. AD - Klinikum Garmisch-Partenkirchen, Abteilung für Anästhesie und operative Intensivmedizin, Blutdepot, Auenstrasse 6, 82467 Garmisch-Partenkirchen. Werner.Leidinger@t-online.de AN - 12243012 AU - Leidinger, W. AU - Hoffmann, G. AU - Meierhofer, J. N. AU - Wölfel, R. DA - Aug DO - 10.1007/s00113-001-0410-3 DP - NLM ET - 2002/09/24 J2 - Der Unfallchirurg KW - Aged Aged, 80 and over *Arthroplasty, Replacement, Hip Bone Cements/adverse effects/chemistry/*therapeutic use Cause of Death Echocardiography Echocardiography, Transesophageal Embolism, Fat/diagnostic imaging/mortality/pathology/*prevention & control Female Femoral Neck Fractures/mortality/*surgery Humans Intraoperative Complications/diagnostic imaging/pathology/*prevention & control Lung/diagnostic imaging/pathology Male Polymethyl Methacrylate/*administration & dosage/adverse effects/chemistry Pulmonary Embolism/diagnostic imaging/mortality/*prevention & control Pulmonary Wedge Pressure/physiology Risk Factors Survival Rate Vacuum LA - ger M1 - 8 N1 - PubMed NLM literature search January 5, 2021 OP - Verminderung von schweren kardialen Komplikationen während der Implantation von zementierten Hüfttotalendoprothesen bei Oberschenkelhalsfrakturen. PY - 2002 SN - 0177-5537 (Print) 0177-5537 SP - 675-9 ST - [Reduction of severe cardiac complications during implantation of cemented total hip endoprostheses in femoral neck fractures] T2 - Unfallchirurg TI - [Reduction of severe cardiac complications during implantation of cemented total hip endoprostheses in femoral neck fractures] VL - 105 ID - 828877 ER - TY - JOUR AB - Intraoperative circulatory and pulmonary problems occuring during the repair of femoral neck fractures with cemented hip arthroplasty are a common problem, that cannot be ultimately explained. As a possible reason for this problem is air embolism during the polymerisation of the methylmethacrylat discussed. We started a prospective randomised clinical examination with 72 patients to prove the efficiency of palacos mixed in vacuum, with respect to the reduction of severe cardiovascular complications during endoprosthetic repair of femoral neck fractures. In the control group with 36 patients, surgical repair was performed with palacos mixed conventionally. In the second group (vacuum group), also consisting of 36 patients, surgical repair was performed with palacos mixed in vacuum. Invasive hemodynamic monitoring and transesophageal echocardiography was performed in all cases. In the control group pulmonary embolism occured echocardiographically in 86% of the cases vs. 14% in the vacuum group. 53% of the controll patients - vs. 11% of the vacuum patients - showed clinical complications in form of significant decrease of arterial oxygenation and circulatory insufficiency with the need of katecholamins. Clinical complications occured in the control group in 80% of the patients - vs. 13.7% in the vacuum group - whose pulmonal arterial pressure was higer than 30 mmHg preoperatively and only in 18,8% of the cases - vs. 7.1% in the vacuum group - with a normal pulmonal arterial pressure. Mortality in the control group amounted to 13,8% in the vacuum group to 2,8%. Through the use of methylmethacrylate mixed in vacuum for surgical repair of femoral neck fractures with cemented hip arthroplasty, the incidence of severe cardiac complications could be reduced significantly. Patients with increased pulmonal arterial pressure have the highest risk for cardiac complications. AD - Klinikum Garmisch-Partenkirchen, Abteilung fur Anasthesie und Operative Intensivmedizin, Germany AU - Leidinger, W. AU - Hoffmann, G. AU - Meierhofer, J. N. AU - Wölfel, R. DB - Embase Medline DO - 10.1007/s00113-001-0410-3 KW - acrylic cement methacrylic acid methyl ester air embolism article cardiovascular risk controlled study femoral neck fracture hip arthroplasty human human tissue lung embolism major clinical study postoperative complication risk management thromboembolism LA - German M1 - 8 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2002 SN - 0177-5537 SP - 675-679 ST - Reduction of severe cardiac complications during surgical repair of femoral neck fractures with cemented hip arthroplasty T2 - Unfallchirurg TI - Reduction of severe cardiac complications during surgical repair of femoral neck fractures with cemented hip arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L36062245&from=export http://dx.doi.org/10.1007/s00113-001-0410-3 VL - 105 ID - 829859 ER - TY - JOUR AB - Percutaneous vertebroplasty (PV) is a procedure commonly used for the treatment of vertebral compression fractures, and the number of procedures has been steadily increasing over the past decade. We report a case of an 81 year old female with a history of breast cancer that developed two vertebral body compression fractures and was subsequently treated with PV. The patient developed a subsegmental pulmonary polymethylmethacrylate (PMMA) embolus as a complication of the procedure. Ten years following the procedure, she remained asymptomatic with the PMMA embolus being discovered incidentally during workup for a suspected chronic obstructive pulmonary disease (COPD) exacerbation. In reviewing the case, we describe the typical presentation of a pulmonary PMMA embolus and consider methods to decrease the incidence of this complication. AD - Department of Radiology, Madigan Army Medical Center, Tacoma, WA 98431, USA. David.Leitman@us.army.mil AN - 22470765 AU - Leitman, D. AU - Yu, V. AU - Cox, C. C2 - Pmc3303462 DO - 10.3941/jrcr.v5i10.815 DP - NLM ET - 2011/01/01 J2 - Journal of radiology case reports KW - Aged, 80 and over *Bone Cements Extravasation of Diagnostic and Therapeutic Materials/*complications Female Fractures, Compression/*therapy Humans Lumbar Vertebrae/diagnostic imaging *Polymethyl Methacrylate Pulmonary Disease, Chronic Obstructive/diagnostic imaging Pulmonary Embolism/*etiology Radiography Spinal Fractures/*therapy Time Factors Vertebroplasty/*adverse effects/methods Pulmonary cement embolus kyphoplasty polymethylmethacrylate vertebroplasty LA - eng M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2011 SN - 1943-0922 SP - 14-21 ST - Investigation of polymethylmethacrylate pulmonary embolus in a patient ten years following vertebroplasty T2 - J Radiol Case Rep TI - Investigation of polymethylmethacrylate pulmonary embolus in a patient ten years following vertebroplasty VL - 5 ID - 828886 ER - TY - JOUR AB - Background: Haemangiomas are the most frequently encountered angiomatous lesions of the bone often detected incidentally on crosssectional imaging. Its diagnosis is often straight forward with typical radiographic, computed tomographic and magnetic resonance imaging findings. However, haemangiomas may display various atypical radiological appearances and can sometimes be mistaken for an aggressive lesion. They may be expansile, show mass effect, cause pathological fractures and impinge on eloquent areas in the bone causing pain or neuropathy. Interventional radiologists may be called upon to biopsy these lesions for histological confirmation. In addition, vertebroplasty for symptomatic lesions or embolisation for haemorrhage or prior to surgical resection may be needed in certain cases. Clinical Findings/Procedure: We discuss the typical appearance of bone haemangiomas with helpful clues to the diagnosis. In addition, we demonstrate various aggressive and atypical bone haemangiomas where image-guided biopsy was required to exclude a more sinister lesion. We discuss the role of interventional radiology in the biopsy of atypical lesions as well as the treatment of lesions with selective embolisation and vertebroplasty, including procedural indications, contraindications, technique and complications. Conclusion: Interventional radiology plays a vital role in the diagnosis and management of bone haemangiomas, ranging from percutaneous biopsy to vertebroplasty and embolisation. The procedural indications, contraindications, technique and complications are discussed in this educational exhibit. AD - S. Leong, Dept. of Radiology, Tallaght Hospital, Dublin, Ireland AU - Leong, S. AU - Kok, H. K. AU - Salati, U. AU - Hurley, A. AU - Courtney, K. AU - Ryan, D. AU - Donnellan, J. AU - Harrington, K. AU - Phelan, E. AU - Browne, R. AU - Govender, P. AU - Torreggiani, W. C. DB - Embase KW - interventional radiology society Europe bone percutaneous vertebroplasty diagnosis artificial embolization biopsy nuclear magnetic resonance imaging neuropathy surgery radiologist pain pathologic fracture human bleeding image guided biopsy percutaneous biopsy imaging LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0174-1551 SP - S272 ST - Bone haemangiomas and interventional radiology T2 - CardioVascular and Interventional Radiology TI - Bone haemangiomas and interventional radiology UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71323446&from=export VL - 36 ID - 829485 ER - TY - JOUR AD - Service de Médecine Interne, Centre Hospitalier Universitaire de la Pitié-Salpêtrière, 75651 Paris cedex 13, France. AN - 17174451 AU - Leroux, G. AU - Costedoat-Chalumeau, N. AU - Chiras, J. AU - de Gennes, C. AU - Piette, J. C. DA - Jul DO - 10.1016/j.revmed.2006.11.006 DP - NLM ET - 2006/12/19 J2 - La Revue de medecine interne KW - Aged, 80 and over Dyspnea/*etiology Female Humans Postoperative Complications/diagnosis Pulmonary Embolism/diagnostic imaging/*surgery Radiography, Thoracic Thoracic Vertebrae/*surgery LA - fre M1 - 7 N1 - PubMed NLM literature search January 5, 2021 OP - Une vertébroplastie dyspnéisante. PY - 2007 SN - 0248-8663 (Print) 0248-8663 SP - 492-4 ST - [A vertebroplasty with dyspnea] T2 - Rev Med Interne TI - [A vertebroplasty with dyspnea] VL - 28 ID - 828541 ER - TY - JOUR AB - BACKGROUND Fat embolism syndrome is a well-known complication in orthopedic and trauma surgery, caused by a massive release of fat into the circulation that can lead to cardiopulmonary insufficiency and multiorgan failure. CASE REPORT We present the case of a 72-year-old man with osteoarthritis who underwent an elective right cementless total hip arthroplasty. Two hours after surgery, the patient lost consciousness and was found hypotensive and with reduced oxygen saturation, with a severe right heart dilatation at echocardiographic evaluation. Death occurred after cardiopulmonary resuscitation attempts. Post-mortem microscopic examination revealed that the final cause of death was pulmonary fat embolism associated with coronary amyloidosis and atherosclerosis. CONCLUSIONS This case called our attention on the sudden onset of fat embolism syndrome after arthroplasty and the insidious nature of amyloidosis infiltrative disease. The autopsy findings substantially aided understanding the immediate cause of death. AD - Pathology Unit, Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy. Pathology Unit, Careggi University Hospital, Firenze, Italy. Pathology Unit, Santa Chiara Hospital, Trento, Italy. Pathology Unit, San Maurizio Hospital, Bolzano, Italy. Forensic Pathology Unit,Department of Diagnostics and Public Health, University and Hospital Trust of Verona, Verona, Italy. Division of Endocrinology, University and Hospital Trust of Verona, Verona, Italy. AN - 29937538 AU - Lever, V. AU - Erdini, F. AU - Ghimenton, C. AU - Novelli, L. AU - Brunelli, M. AU - Barbareschi, M. AU - Mazzoleni, G. AU - Vermiglio, E. AU - Mantovani, A. AU - Cima, L. AU - Valotto, G. AU - Eccher, A. C2 - Pmc6047570 DA - Jun 25 DO - 10.12659/ajcr.908561 DP - NLM ET - 2018/06/26 J2 - The American journal of case reports KW - Aged Amyloidosis/*complications/diagnosis Arthroplasty, Replacement, Hip/*adverse effects Autopsy Coronary Artery Disease/*complications/diagnosis Embolism, Fat/diagnosis/*etiology Fatal Outcome Humans Male Osteoarthritis, Hip/complications/*surgery Pulmonary Embolism/diagnosis/*etiology LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 1941-5923 SP - 744-747 ST - Pulmonary Fat Embolism and Coronary Amyloidosis T2 - Am J Case Rep TI - Pulmonary Fat Embolism and Coronary Amyloidosis VL - 19 ID - 828610 ER - TY - JOUR AB - BACKGROUND INFORMATION: Percutaneous vertebroplasty is a therapeutic, interventional radiologic procedure that involves injection of bone cement into a cervical, thoracic, or lumbar vertebral body lesion for the relief of pain and the strengthening of bone. This procedure only recently has been introduced, and is being used for patients with lytic lesions due to bone metastases, aggressive hemangiomas, or multiple myeloma, and for patients who have medically intractable debilitating pain resulting from osteoporotic vertebral collapse. FINDINGS: Results from two uncontrolled prospective studies and several case series reports, including one with 187 patients, indicate that percutaneous vertebroplasty can produce significant pain relief and increase mobility in 70 percent to 80 percent of patients with osteolytic lesions in the vertebrae from hemangiomas, metastases, or myeloma, or with osteoporotic compression fractures. In these reports, pain relief was apparent within one to two days after injection, and persisted for at least several months up to several years. While experimental studies and preliminary clinical results suggest that percutaneous vertebroplasty can also strengthen the vertebral bodies and increase mobility, it remains to be proven whether this procedure can prevent additional fractures in the injected vertebrae. In addition, the duration of effect is not known; there were no long-term follow-up data on most of these patients, and these data may be difficult to obtain and interpret in patients with an underlying malignant process, because disease progression may confound evaluation of the treatment effect. Complications were relatively rare, although some studies reported a high incidence of clinically insignificant leakage of bone cement into the paravertebral tissues. In a few cases, the leakage of polymer caused compression of spinal nerve roots or neuralgia. Several instances of pulmonary embolism were also reported. Although patient selection criteria have not been definitely established, percutaneous vertebroplasty is considered appropriate treatment for patients with vertebral lesions resulting from osteolytic metastasis and myeloma, hemangioma, and painful osteoporotic compression fractures if the following criteria have been met: o Severe debilitating pain or loss of mobility that cannot be relieved by correct medical therapy. o Other causes of pain, such as herniated intervertebral disk have been ruled out by computed tomography or magnetic resonance imaging. o The affected vertebra has not been extensively destroyed and is at least one third of its original height. o Radiation therapy or concurrent surgical interventions, such as laminectomy, may also be required in patients with compression of the spinal cord due to ingrowth of a tumor. CONCLUSIONS: Percutaneous vertebroplasty has only recently been introduced as a treatment for osteolytic lesions and osteoporotic compression fractures of the vertebrae, but early results are promising. Up to 80 percent of patients with pain unresponsive to correct medical treatment experience a significant degree of pain relief, and few serious complications have been reported. However, relatively few patients have undergone this procedure, and there are no data from controlled clinical trials or from studies with long-term follow-up. At the present time this procedure is still in the investigational stages, but may be appropriate for patients with no other reasonable options for medical treatment. AN - 11066214 AU - Levine, S. A. AU - Perin, L. A. AU - Hayes, D. AU - Hayes, W. S. DA - Mar DP - NLM ET - 2000/11/07 J2 - Managed care (Langhorne, Pa.) KW - Bone Cements/adverse effects/*therapeutic use Centers for Medicare and Medicaid Services, U.S. Cost-Benefit Analysis *Evidence-Based Medicine Humans Minimally Invasive Surgical Procedures/adverse effects/*methods Pain/etiology/surgery Radiology, Interventional Spinal Diseases/complications/*surgery Spine/*surgery United States LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2000 SN - 1062-3388 (Print) 1062-3388 SP - 56-60, 63 ST - An evidence-based evaluation of percutaneous vertebroplasty T2 - Manag Care TI - An evidence-based evaluation of percutaneous vertebroplasty VL - 9 ID - 828812 ER - TY - JOUR AB - The prevalence of combination devices is increasing. Significant clinical advantages have been recognised by combining medical devices, which perform predominantly physical functions, with drugs or biologics that provide a therapeutic effect. The combination device may increase treatment efficacy by loco-regional targeting of the drug whilst reducing the side effects associated with systemic treatments. The drug-device combination market is currently valued at around US$6 billion and is expected to grow to US$10 billion by 2009 (1). This includes product developments in the areas of critical care catheters, bone cements, drug-eluting intravascular devices such as stents, bone graft substitutes, cancer treatments and diabetes management. Often, the keys to the success of a combination device are the means by which the drug or biologic is unified with the device and the modulation of its subsequent release. These requirements have driven advances in delivery technologies, in particular coating platforms, which are able to load and release a wide range of actives. Here we will review two drug-device configurations that have different physical functions but both enable intra-arterial drug delivery, with a focus on the polymer technologies that have been developed to make this possible. The first is the drug-eluting stent (DES), the purpose of which is to keep the artery open for as long as possible; the second is the drug-eluting bead (DEB), which is used to embolise blood vessels feeding tumours to starve them of nutrients and oxygen. AD - A. Lewis, Biocompatibles UK Ltd., Surrey, United Kingdom AU - Lewis, A. AU - Driver, M. C1 - abt 578 DB - Embase KW - zotarolimus bone cement dexamethasone doxorubicin everolimus ibuprofen irinotecan paclitaxel rapamycin tacrolimus adjuvant therapy artificial embolization bone graft malignant neoplasm cancer adjuvant therapy catheter clinical trial colorectal cancer coronary stent drug absorption drug blood level drug delivery system drug efficacy drug eluting stent drug mechanism drug release drug tumor level heart disease heart infarction human liver cell carcinoma nonhuman review abt 578 BioMatrix Cypher DC Bead Dexamet Endeavor Janus MedStent Nobori Taxus Xience V ZoMaxx LA - English M1 - SUMMER M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2005 SN - 1364-369X SP - 82+84+86-87 ST - The benefits of drug-device combinations: An open and shut case T2 - EBR - European Biopharmaceutical Review TI - The benefits of drug-device combinations: An open and shut case UR - https://www.embase.com/search/results?subaction=viewrecord&id=L41051602&from=export ID - 829816 ER - TY - JOUR AB - Fourteen patients who underwent Charnley or Howse total hip replacement using CMW bone cement were studied. Mean values of C-4 and C-3 determined before the induction of anaesthesia and insertion of bone cement and also after this procedure showed no significant difference and were within the normal range. Furthermore, no evidence of C-3 breakdown products was found. It was therefore concluded that neither the general anaesthetic technique nor the insertion of bone cement activated the classical or alternative complement pathways and such a mechanism was not responsible for the hypotension which occurred shortly after the insertion of bone cement in 10 cases studied. AD - S SHORE ORTHOPAED HOSP, BLACKPOOL FY4 1HX, LANCS, ENGLAND. AN - WOS:A1997WG55800007 AU - Lewis, R. N. DA - Jan DO - 10.1046/j.1365-2346.1997.00084.x J2 - Eur. J. Anaesth. KW - general anaesthesia, total hip replacement bone cement hypotension complement system activation FAT-EMBOLISM Anesthesiology LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1997 SN - 0265-0215 SP - 35-39 ST - Some studies of the complement system during total hip replacement using bone cement under general anaesthesia T2 - European Journal of Anaesthesiology TI - Some studies of the complement system during total hip replacement using bone cement under general anaesthesia UR - ://WOS:A1997WG55800007 VL - 14 ID - 830486 ER - TY - JOUR AB - OBJECTIVE: To evaluate the effectiveness of Confidence high viscosity bone cement system and postural reduction in treating acute severe osteoporotic vertebral compression fracture (OVCF). METHODS: Between June 2004 and June 2009, 34 patients with acute severe OVCF were treated with Confidence high viscosity bone cement system and postural reduction. There were 14 males and 20 females with an average age of 72.6 years (range, 62-88 years). All patients had single thoracolumbar fracture, including 4 cases of T11, 10 of T12, 15 of L1, 4 of L2, and 1 of L3. The bone density measurement showed that T value was less than -2.5. The time from injury to admission was 2-72 hours. All cases were treated with postural reduction preoperatively. The time of reduction in over-extending position was 7-14 days. All patients were injected unilaterally. The injected volume of high viscosity bone cement was 2-6 mL (mean, 3.2 mL). RESULTS: Cement leakage was found in 3 cases (8.8%) during operation, including leakage into intervertebral space in 2 cases and into adjacent paravertebral soft tissue in 1 case. No clinical symptom was observed and no treatment was performed. No pulmonary embolism, infection, nerve injury, or other complications occurred in all patients. All patients were followed up 12-38 months (mean, 18.5 months). Postoperatively, complete pain relief was achieved in 31 cases and partial pain relief in 3 cases; no re-fracture or loosening at the interface occurred. At 3 days after operation and last follow-up, the anterior and middle vertebral column height, Cobb angle, and visual analogue scale (VAS) score were improved significantly when compared with those before operation (P < 0.05); and there was no significant difference between 3 days and last follow-up (P > 0.05). CONCLUSION: Confidence high viscosity bone cement system and postural reduction can be employed safely in treating acute severe OVCF, which has many merits of high viscosity, long time for injection, and easy-to-control directionally. AD - Department of Spinal Surgery, Affiliated Yongchuan Hospital of Chongqing Medical University, Yongchuan Chongqing, 402160, P.R.China. AN - 21500583 AU - Li, B. AU - Wang, Q. AU - Yu, Y. AU - Du, W. AU - Shao, G. DA - Mar DP - NLM ET - 2011/04/20 J2 - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery KW - Aged Aged, 80 and over Bone Cements/*therapeutic use Female Fractures, Compression/etiology/*surgery Humans Lumbar Vertebrae/surgery Male Middle Aged Osteoporosis/complications Retrospective Studies Thoracic Vertebrae/surgery Treatment Outcome Vertebroplasty/*methods LA - chi M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2011 SN - 1002-1892 (Print) 1002-1892 SP - 307-10 ST - [Confidence high viscosity bone cement system and postural reduction in treating acute severe osteoporotic vertebral compression fractures] T2 - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi TI - [Confidence high viscosity bone cement system and postural reduction in treating acute severe osteoporotic vertebral compression fractures] VL - 25 ID - 828684 ER - TY - JOUR AB - OBJECTIVE: To explore the safety and effectiveness of polymethylmethacrylate-augmented screw fixation (PASF) in the treatment of elderly thoracolumbar tuberculosis combined with severe osteoporosis. METHODS: The clinical data of 20 elderly patients with thoracolumbar tuberculosis and severe osteoporosis who underwent PASF after anterior or posterior debridement and bone grafting and met the selection criteria between December 2012 and December 2014 were retrospectively analyzed. There were 8 males and 12 females with an average age of 68.5 years (range, 65-72 years). T value of bone mineral density was -4.2 to -3.6, with an average of -3.9. There were 12 cases of thoracic tuberculosis, 3 cases of thoracolumbar tuberculosis, and 5 cases of lumbar tuberculosis. The diseased segments involved T (3)-L (4), including 11 cases of single-segment disease, 6 cases of double-segment disease, and 3 cases of multi-segment disease. The disease duration was 3-9 months, with an average of 6 months. The preoperative spinal nerve function of the patients was evaluated by the American Spinal Injury Association (ASIA) grading. There were 2 cases of grade A, 5 cases of grade B, 6 cases of grade C, 4 cases of grade D, and 3 cases of grade E. Postoperative imaging examination was used to evaluate the bone graft fusion and paravertebral abscess absorption, and to measure the Cobb angle of the segment to evaluate the improvement of kyphosis. The levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were tested. The visual analogue scale (VAS) score, Oswestry disability index (ODI), and ASIA grading were used to evaluate the effectivreness before operation, at 1 month after operation, and at last follow-up. The clinical cure of tuberculosis was also evaluated. RESULTS: All operation successfully completed. The operation time was 154-250 minutes, with an average of 202 minutes; the intraoperative blood loss was 368-656 mL, with an average of 512 mL. All 20 patients were followed up 18-42 months, with an average of 26.8 months. The postoperative pain and symptoms of tuberculosis in all patients relieved, and the paravertebral abscess was absorbed, reaching the cure standard for spinal tuberculosis. All bone grafts fusion achieved within 1 year after operation. Only 1 case had asymptomatic bone cement leakage into the paravertebral veins, and the remaining patients had no serious complications such as bone cement leakage in the spinal canal, pulmonary embolism, and neurovascular injury. At last follow-up, spinal cord nerve function significantly improved when compared with preoperative one. Among them, ASIA grading were 7 cases of grade C, 8 cases of grade D, and 5 cases of grade E, showing significant difference when compared with preoperative one ( Z=2.139, P=0.000). VAS score, ODI score, segmental Cobb angle, ESR, and CRP at 1 month after operation and at last follow-up were significantly improved when compared with preoperative ones ( P<0.05); there was no significant difference between 1 month after operation and last follow-up ( P>0.05). During the follow-up, no complications such as failure of internal fixation, proximal junctional kyphosis, or tuberculosis recurrence occurred. CONCLUSION: For elderly patients with thoracolumbar tuberculosis and severe osteoporosis, PASF treatment is safe and effective. AD - Yan'an University, Yan'an Shaanxi, 716000, P.R.China;Department of Spinal Surgery, Honghui Hospital Affiliated to Medical School of Xi'an Jiaotong University, Xi'an Shaanxi, 710054, P.R.China. Department of Spinal Surgery, Honghui Hospital Affiliated to Medical School of Xi'an Jiaotong University, Xi'an Shaanxi, 710054, P.R.China. AN - 33319530 AU - Li, Q. AU - Chen, H. AU - Liu, T. AU - He, L. AU - Liu, P. AU - Zhao, Y. AU - Du, J. AU - Zou, P. AU - Zhang, Z. AU - He, B. AU - Yang, J. AU - Hao, D. DA - Dec 15 DO - 10.7507/1002-1892.202006014 DP - NLM ET - 2020/12/16 J2 - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery KW - Aged Bone Screws Female Fracture Fixation, Internal Humans Lumbar Vertebrae Male *Osteoporosis Polymethyl Methacrylate Retrospective Studies *Spinal Fusion Thoracic Vertebrae Treatment Outcome *Tuberculosis, Spinal Bone cement internal fixation osteoporosis pedicle screw spinal tuberculosis LA - chi M1 - 12 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 1002-1892 (Print) 1002-1892 SP - 1526-1532 ST - [Polymethylmethacrylate-augmented screw fixation in treatment of senile thoracolumbar tuberculosis combined with severe osteoporosis] T2 - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi TI - [Polymethylmethacrylate-augmented screw fixation in treatment of senile thoracolumbar tuberculosis combined with severe osteoporosis] VL - 34 ID - 828617 ER - TY - JOUR AB - A 58-year-old female patient, diagnosed with adenocarcinoma of the lung, underwent percutaneous vertebroplasty at the L4 vertebral body due to painful spinal metastases. Because of deep venous thrombosis of the left femoral and iliac veins, an inferior vena cava filter had been placed before vertebroplasty. Bone cement migrated into the venous bloodstream and then was being trapped within the previously placed filter. This case illustrates that caval filter could capture the bone cement and prevent it from migrating to the pulmonary circulation. AD - Department of Interventional Radiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China. AN - 23690712 AU - Li, Z. AU - Ni, R. F. AU - Zhao, X. AU - Yang, C. AU - Li, M. M. C2 - Pmc3655299 DA - May-Jun DO - 10.3348/kjr.2013.14.3.451 DP - NLM ET - 2013/05/22 J2 - Korean journal of radiology KW - Adenocarcinoma/secondary Bone Cements/*adverse effects Embolism/*etiology Female Humans Iliac Vein Lumbar Vertebrae/surgery Lung Neoplasms/pathology Middle Aged Pulmonary Embolism/prevention & control Radiography Spinal Neoplasms/secondary *Vena Cava Filters *Vena Cava, Inferior Venous Thrombosis/diagnostic imaging Vertebroplasty/*adverse effects/methods Complication Inferior vena cava filter Percutaneous vertebroplasty Pulmonary embolism LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1229-6929 (Print) 1229-6929 SP - 451-4 ST - Cement embolus trapped in the inferior vena cava filter during percutaneous vertebroplasty T2 - Korean J Radiol TI - Cement embolus trapped in the inferior vena cava filter during percutaneous vertebroplasty VL - 14 ID - 828858 ER - TY - JOUR AB - Background Controversies on the safety of the cement application between cemented and uncemented total hip arthroplasty (THA) have been existing for decades. The purpose of this study was to observe the changes in mean arterial pressure (MAP), heart rate (HR) and oxygen pressure (PaO2) during cemented THA, and to evaluate the intraoperative safety of using the third-generation cementing technique and investigate whether the intraoperative risk is higher in acute femoral neck fracture patients than non-traumatic patients. Methods Forty-two patients who underwent cemented THA between November 2005 and September 2007 were prospectively included in this study. The third-generation cementing technique as vacuum mixing and pulsatile lavage was used strictly. The MAP and HR were monitored and documented during each operation. Blood gas analysis was performed at exposure, cup implantation, stem implantation and wound closure. MAP, HR and PaO2 were compared between pre- and post-cement application. Comparisons of MAP, HR and PaO2 between patients with acute femoral neck fracture and non-traumatic patiens were performed as well, Results No intraoperative cardiopulmonary complication occurred in these cases. No obvious changes were observed in MAP, HR and PaO2 after cement application. There was no significant difference in MAP, HR and PaO2 between acute femoral fracture patients (18 patients) and non-traumatic patients (24 patients). Conclusions The results of this study suggested that the invasive blood pressure monitoring and blood gas analysis are essential for patients undergoing cemented THA, especially for patients with femoral neck fracture. The third-generation cementing technique is safe to use in THA. AD - [Li Zi-jian; Zhang Ke; Yang Hong; Liu Yan] Peking Univ Third Hosp, Dept Orthoped, Beijing 100191, Peoples R China. [Lue Jing-qiao] Peking Univ Third Hosp, Res Ctr Clin Epidemiol, Beijing 100191, Peoples R China. Zhang, K (corresponding author), Peking Univ Third Hosp, Dept Orthoped, Beijing 100191, Peoples R China. zhangke60@medmail.com.cn AN - WOS:000262888500012 AU - Li, Z. J. AU - Zhang, K. AU - Yang, H. AU - Liu, Y. AU - Lue, J. Q. DA - Jan DO - 10.3760/cma.j.issn.0366-6999.2009.02.012 J2 - Chin. Med. J. KW - arthroplasty hip bone cement monitoring intraoperative FAT-EMBOLISM SYNDROME INTRAMEDULLARY PRESSURE FEMORAL COMPONENT MEDULLARY-PLUG FOLLOW-UP REPLACEMENT Medicine, General & Internal LA - English M1 - 2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2009 SN - 0366-6999 SP - 174-177 ST - Intraoperative monitoring for safety of total hip arthroplasty using third-generation cementing technique T2 - Chinese Medical Journal TI - Intraoperative monitoring for safety of total hip arthroplasty using third-generation cementing technique UR - ://WOS:000262888500012 VL - 122 ID - 830361 ER - TY - JOUR AB - From January 2005 to December 2008, a total of 148 patients with 205 vertebral fractures were Kyphoplastietreated with the Balloon-Kyphoplasty System of Metronic with good clinical results at our Asklepios Südpfalzkliniken in Kandel. During this period a cement-leakage was observed in 27 %. In one case a pulmonary embolism occured. Since February 2009 a total of 21 patients with 26 vertebral fractures were treated with a new method - the radio frequency kyphoplasty by DFine - with very good clinical outcome. AD - A. W. Licht, Klinik für Unfallchirurgie, Asklepios-Südpfalzkliniken, Luitpoldstraße 14, D-76870 Kandel, Austria AU - Licht, A. W. AU - Kramer, W. DB - Embase KW - bone cement article case report compression fracture devices fragility fracture human kyphoplasty lung embolism osteoporosis postoperative complication radiofrequency ablation surgical technique treatment outcome spine fracture L1 - http://www.kup.at/kup/pdf/9110.pdf LA - German M1 - SONDERHEFT 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 1023-7763 1680-9408 SP - 35-37 ST - Radio frequency kyphoplasty. A new method of treating osteoporotic vertebral compression fractures - A case study T2 - Journal fur Mineralstoffwechsel TI - Radio frequency kyphoplasty. A new method of treating osteoporotic vertebral compression fractures - A case study UR - https://www.embase.com/search/results?subaction=viewrecord&id=L360037219&from=export VL - 17 ID - 829631 ER - TY - JOUR AB - Introduction: Vertebroplasty and Kyphoplasty are two conventional minimally invasive procedures established for treatment of vertebral compression fractures (VCFs). Since the introduction of balloon assisted kyphoplasty (BAK), many innovations in terms of kyphoplasty instruments with different augmentation systems have been developed. Conventional balloon assisted kyphoplasty (BAK) was introduced in our clinic in 2005. Since February 2009 in our clinic an unconventional vertebral augmentation method, Radio frequency-Kyphoplasty (RFK), has been in use for management of VCFs. RFK uses RF energy to heat cement ex vivo (significantly increasing cement viscosity immediately prior to delivery) uses a navigational osteotome for cavity creation and remote controlled cement delivery. Aim of this study was to analyze advantages and disadvantages of BAK and RFK methods. Method: Between 1/2005 and 12/2008 N=137 patients with N=203 VCFs were treated using conventional BAK (Medtronic) and evaluated in a prospective, randomized study related to age of fracture (old VCFs = ≥6Weeks, Median: 159d n=57P. /96VCF vs. recent VCFs = <6 Weeks, Median: 12d n=81P/107 VCF). Pain relief (VAS, 0-10 points), restored vertebral body height (Follow-Up: Post-op and after 12 months) and rate of complications following the procedure were measured. Since February 2009, 24 patients with 39 VCFs had been treated using RFK (DFine) and evaluated regarding pain relief (VAS), reduction of deformity and rate of cement-extravasation and complications. Results: In the BAK group average improvement in VAS was 5.4+/-1.0 in recent VCFs and 3.4+/-0.8 Pts. in old VCFs (p<0.0001). Height restoration was Ø 6.85mm in recent VCFs and Ø 4.6mm in old VCFs (p<0.001) an cement leakage rate was on average, 18.7% (recent VCFs 11.2%, old VCFs 27.7%). In this 4-years period two major complications were noted with one cement extravasation posterior resulting in spinal cord compression and incomplete paraplegia and one case of pulmonary cement embolization. In the RFK group an average pain relief in VAS of 4.8 +/-1.5Pts (p<0.001) was observed, fracture reduction was Ø5.9mm and rate of cement leakage 12.8% with no complications observed. Discussion: RFK and BAK reveal similar results with regard to pain relief and vertebral body height restoration, but RFK shows lower cement extravasation rate and over all complications in our study. In addition and especially in multi-segmental treatment shortened intervention time appears beneficial, not only monetary. Furthermore remote controlled cement delivery permitted reduction in radiation exposure to medical staff. Due to the extended working time using RFK-cement augmentation is more controlled and directed. In our study we received similar results with this new approach treating VCFs with RFK, but without creating a void by destroying bone before cement application. AD - A.W. Licht, Asklepios Südpfalzkliniken, Unfallchirurgie, Kandel, Germany AU - Licht, A. W. AU - Kramer, W. DB - Embase DO - 10.1007/s00586-010-1601-9 KW - cement spine compression fracture radiofrequency warming follow up kyphoplasty society analgesia human extravasation vertebra body hospital body height patient viscosity radiation exposure implantable cardiac monitor ex vivo study heat telecommunication artificial embolization paraplegia spinal cord compression minimally invasive procedure percutaneous vertebroplasty height deformity fracture reduction procedures fracture bone medical staff working time osteotome LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0940-6719 SP - 2054 ST - Comparison of clinical outcomes after treatment of vertebral compression fractures with radiofrequency warming of PMMA cement versus balloon assisted kyphoplasty-One year observational follow-up T2 - European Spine Journal TI - Comparison of clinical outcomes after treatment of vertebral compression fractures with radiofrequency warming of PMMA cement versus balloon assisted kyphoplasty-One year observational follow-up UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71558068&from=export http://dx.doi.org/10.1007/s00586-010-1601-9 VL - 19 ID - 829642 ER - TY - JOUR AB - From January 2005 to December 2008, a total of 148 patients with 205 vertebral fractures were treated with the balloon kyphoplasty system of Medtronic Company at the Asklepios Südpfalzkliniken in Kandel. The outcome of the procedure was favourable. During this period, cement leakages were observed in 27 % of cases, and a pulmonary embolism requiring intervention occurred in one case. Since February 2009, 21 patients with 26 vertebral fractures have been treated by the new radiofrequency kyphoplasty procedure of DFine Company. Very good clinical results have been obtained with this method. AD - A. W. Licht, Klinik für Unfallchirurgie, Asklepios-Südpfalzkliniken, Luitpoldstrasse 14, D-76870 Kandel, Germany AU - Licht, A. W. AU - Kramer, W. DB - Embase KW - bone cement aged article case report compression fracture devices female fragility fracture human kyphoplasty lung embolism radiofrequency ablation radiofrequency kyphoplasty treatment failure treatment outcome spine fracture StabiliT ER2 L1 - http://www.kup.at/kup/pdf/9578.pdf LA - English M1 - SUPPL.1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 1023-7763 1680-9408 SP - 26-28 ST - Radiofrequency kyphoplasty: A new method for the treatment of osteoporotic vertebral body compression fractures - A case report T2 - Journal fur Mineralstoffwechsel TI - Radiofrequency kyphoplasty: A new method for the treatment of osteoporotic vertebral body compression fractures - A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L361361523&from=export VL - 18 ID - 829622 ER - TY - JOUR AB - Osteoporotic vertebral compression fractures pose a significant clinical problem, causing spinal deformity, pain, reduced pulmonary function and mobility, as well as an overall increase in mortality. Traditional medical and surgical options in many cases have proved to be inadequate. As a result, the new less-invasive surgical techniques of vertebroplasty and kyphoplasty have evolved. Vertebroplasty is a relatively non-invasive technique that has gained increased acceptance. The available clinical studies describe pain relief being achieved in as many as 90% of symptomatic fractures, with only infrequent and mostly minor complications. Some of the drawbacks of vertebroplasty arise from the use of polymethylmethacrylate bone cement and the risks of cement leak. Kyphoplasty is a modification of vertebroplasty that reportedly may add a margin of safety by virtue of a lower observed incidence of cement leakage. Kyphoplasty has been shown to be worthwhile in acute vertebral fractures to predictably restore vertebral height and to facilitate a controlled fill of the vertebral body. Favorable outcomes in early trials appear to imply that kyphoplasty is associated with significant pain relief and restoration of patient mobility. Nussbaum et al (1) attempt to compare vertebroplasty and kyphoplasty by reviewing the FDA-MAUDE database. Their methodology is flawed, and consequently their assertions are not well substantiated. Their conclusions; that the FDA-MAUDE database "provides a unique view of complications" and provides data "for comparison of vertebroplasty with kyphoplasty," and that kyphoplasty is associated with greater risk than vertebroplasty are in no way supported by any evidence they present in the paper. It is very difficult for us to reconcile their conclusion that kyphoplasty is associated with greater risk than vertebroplasty when they report that seven of eight deaths were associated with the vertebroplasty technique. Unfortunately, this study does little to provide a scientifically based appraisal of the risks of vertebroplasty or kyphoplasty. However, Nussbaum et al (1) do raise a number of controversial issues surrounding the use of vertebroplasty and kyphoplasty in the treatment of vertebral compression fractures. With such large numbers of patients undergoing these procedures each year, it would seem that a methodologically sound clinical trial could be conducted in a relatively short period of time to answer these issues. Vertebroplasty and kyphoplasty should not be considered mutually exclusive surgical interventions in the treatment of vertebral compression fractures. These two tools lie on the spectrum from stabilization to reduction to reconstruction, and we should consider using the most appropriate method to achieve the desired outcome. AD - I.H. Lieberman, Department of Orthopaedic Surgery, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195, United States AU - Lieberman, I. H. AU - Phillips, F. M. AU - Togawa, D. AU - Modic, M. AU - Masaryk, T. AU - Obuchowski, N. AU - Slipman, C. W. DB - Embase Medline DO - 10.1097/01.RVI.0000136028.86147.A4 KW - bone cement poly(methyl methacrylate) article brain embolism cardiotoxicity clinical trial controlled clinical trial controlled study data base Food and Drug Administration human intermethod comparison kyphoplasty lung function major clinical study neurologic disease paraplegia percutaneous vertebroplasty plastic surgery postoperative complication priority journal radiculopathy risk assessment safety spinal cord compression spine surgery surgical approach surgical risk treatment outcome vertebra compression spine fracture visual analog scale LA - English M1 - 11 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2004 SN - 1051-0443 SP - 1193-1196 ST - Vertebral augmentation and the limits of interpreting complications reported in the food and drug administration manufacturer and user facility device experience database T2 - Journal of Vascular and Interventional Radiology TI - Vertebral augmentation and the limits of interpreting complications reported in the food and drug administration manufacturer and user facility device experience database UR - https://www.embase.com/search/results?subaction=viewrecord&id=L39487848&from=export http://dx.doi.org/10.1097/01.RVI.0000136028.86147.A4 VL - 15 ID - 829827 ER - TY - JOUR AD - Department of Neurosurgery, E-Da Hospital, I-Shou University, Yan-Chau Shiang, Taiwan. liliang@url.com.tw AN - 17081543 AU - Liliang, P. C. AU - Lu, K. AU - Liang, C. L. AU - Tsai, Y. D. AU - Hsieh, C. H. AU - Chen, H. J. DA - Feb DO - 10.1016/j.injury.2006.08.031 DP - NLM ET - 2006/11/04 J2 - Injury KW - Aged, 80 and over Bone Cements/*adverse effects Chest Pain/etiology Dyspnea/etiology Female Humans Lumbar Vertebrae/surgery Polymethyl Methacrylate/adverse effects Pulmonary Embolism/*etiology Spinal Fractures/*surgery Thoracic Vertebrae/surgery Vertebroplasty/*adverse effects LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 0020-1383 (Print) 0020-1383 SP - 245-8 ST - Dyspnoea and chest pain associated with pulmonary polymethylmethacrylate embolism after percutaneous vertebroplasty T2 - Injury TI - Dyspnoea and chest pain associated with pulmonary polymethylmethacrylate embolism after percutaneous vertebroplasty VL - 38 ID - 828964 ER - TY - JOUR AB - Although percutaneous vertebroplasty is a simple and generally safe method for the management of vertebral compression fractures, cement leakage outside the vertebral body is a potential source of serious complications. We report a patient who presented with dyspnea and edema five years after percutaneous vertebroplasty and underwent open-heart surgery. This case demonstrates an intraatrial thrombus and pulmonary thromboembolism caused by venous leakage of polymethylmethacrylate as a late complication of the procedure. AD - Department of Anesthesiology, College of Medicine, Seoul National University, Seoul, Korea. AN - 17377108 AU - Lim, K. J. AU - Yoon, S. Z. AU - Jeon, Y. S. AU - Bahk, J. H. AU - Kim, C. S. AU - Lee, J. H. AU - Ha, J. W. DA - Apr DO - 10.1213/01.ane.0000256974.84535.7a DP - NLM ET - 2007/03/23 J2 - Anesthesia and analgesia KW - Bone Cements/*adverse effects Female Foreign-Body Migration/diagnostic imaging/*etiology Fractures, Compression/surgery Heart Atria/diagnostic imaging Hepatic Veins/diagnostic imaging Humans Lumbar Vertebrae/surgery Middle Aged Minimally Invasive Surgical Procedures/adverse effects Orthopedic Procedures/*adverse effects Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/*etiology Spinal Fractures/surgery Thrombosis/diagnostic imaging/*etiology Time Factors Tomography, X-Ray Computed Vena Cava, Inferior/diagnostic imaging LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 0003-2999 SP - 924-6 ST - An intraatrial thrombus and pulmonary thromboembolism as a late complication of percutaneous vertebroplasty T2 - Anesth Analg TI - An intraatrial thrombus and pulmonary thromboembolism as a late complication of percutaneous vertebroplasty VL - 104 ID - 828853 ER - TY - JOUR AB - Percutaneous vertebroplasty is a minimally invasive procedure in which polymethylmethacrylate polymer is used to treat painful diseased vertebral bodies. However, despite its minimally invasive nature and relative safety, cement leakage beyond involved vertebral bodies into the venous system can induce devastating cardiovascular complications. Here, the authors report a case of multiple cardiac perforations and pulmonary embolism caused by cement leakage after percutaneous vertebroplasty. AD - Department of Anesthesiology and Pain Clinic, College of Medicine, Korea University, Seoul, Republic of Korea. AN - 18226539 AU - Lim, S. H. AU - Kim, H. AU - Kim, H. K. AU - Baek, M. J. DA - Mar DO - 10.1016/j.ejcts.2007.12.012 DP - NLM ET - 2008/01/30 J2 - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery KW - Bone Cements/*adverse effects Female Fractures, Compression/surgery Heart Injuries/diagnostic imaging/*etiology/surgery Humans Middle Aged Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/diagnostic imaging/*etiology/surgery Spinal Fractures/surgery Tomography, X-Ray Computed Treatment Outcome LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 1010-7940 (Print) 1010-7940 SP - 510-2 ST - Multiple cardiac perforations and pulmonary embolism caused by cement leakage after percutaneous vertebroplasty T2 - Eur J Cardiothorac Surg TI - Multiple cardiac perforations and pulmonary embolism caused by cement leakage after percutaneous vertebroplasty VL - 33 ID - 828868 ER - TY - JOUR AB - Pneumatic tourniquet and hone cement are often applied in orthopaedic surgery. In lower limb surgery, deep vein thrombosis may occur after release of tourniquet, causing embolism of lungs and vital organs. Paradoxical embolism may develop if the patients present extracardiac or intracardiac right to left shunt, such as atrial septum defect, etc. A 60-year-old female patient suffered from osteoarthritis of both knees was admitted for total knee replacement (TKR). Pneumatic tourniquet was inflated on the operated leg for the orthopaedic surgery which lasted for 2h. Dyspnea, sinus tachycardia and abdominal pain were noted after TKR. Blood gases analysis showed arterial hypoxemia and respiratory alkalosis. Chest X-ray revealed diffused bilateral pulmonary infiltration, pulmonary trunk engorgement, and decreased lung markings. Two days after TKR under the impression of peritonitis, she received exploratory laparotomy in which ischemic bowel and gall bladder were found. Pulmonary and paradoxical embolism were diagnosed, both of which were the well-known complications of TKR with tourniquet and bone cement application. The patient finally succumbed because of multiple organ failures. AD - 805 Army General Hospital. AN - 9084531 AU - Lin, S. Y. AU - Ding, B. H. AU - Huang, S. J. AU - Lin, B. C. AU - Chen, I. H. AU - Yeh, F. C. DA - Jun DP - NLM ET - 1996/06/01 J2 - Acta anaesthesiologica Sinica KW - Embolism, Paradoxical/*etiology Female Humans Knee Prosthesis/*adverse effects Middle Aged Pulmonary Embolism/*etiology LA - chi M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 1996 SN - 0254-1319 (Print) 0254-1319 SP - 103-7 ST - [Pulmonary and paradoxical embolism after total knee replacement--a case report] T2 - Acta Anaesthesiol Sin TI - [Pulmonary and paradoxical embolism after total knee replacement--a case report] VL - 34 ID - 828804 ER - TY - JOUR AB - Background: Percutaneous vertebroplasty (PVP) is an effective procedure to relieve pain caused by osteoporotic vertebral compression fractures (VCFs). New VCF is a common complication of the vertebroplasty. Many scholars have focused on new VCFs after PVP, but the risk factors of new VCFs have not been fully revealed. Therefore, the incidence and the risk factors of new VCFs were investigated in the study. Methods: From July 2010 to September 2014, 112 patients who underwent PVP at 141 levels for osteoporotic VCFs were retrospectively analyzed. Potential risk factors, such as age, gender, bone mineral density (BMD), intradiscal leakage, injected cement volume, and numbers of fractures and thoracolumbar junction fractures were evaluated. Results: 22 patients (19.6%) had subsequent symptomatic new VCFs at the last follow-up. The incidence of new fractures in 3-months, 1-year and 2-years was 31.8% (6 cases), 40.9% (9 cases), and 77.3% (17 cases) respectively. Among the risk factors, only the BMD showed a significant relationship to new VCFs (univariate analysis, P = 0.001; multivariate analysis, P = 0.003). None of other factors showed a statistically significant effect by multivariate analysis. Conclusion: The most important risk factor affecting new VCFs is osteoporosis. The incidence of new symptomatic VCFs after PVP is higher in osteoporotic patients with lower BMD. AD - J. Wang, Department of Orthopedics, The First Affiliated Hospital of Jinan University, West 601, Huangpu Raod, Tianhe District, Guangzhou, Guangdong, China AU - Lin, Z. AU - Du, J. AU - Lu, C. AU - Wang, J. DB - Embase KW - bone cement calcium colecalciferol adult age aged article bone cement leakage bone density compression fracture female follow up gender human incidence intervertebral disk degeneration lung embolism major clinical study male nuclear magnetic resonance imaging osteoporosis percutaneous vertebroplasty radiography retrospective study risk factor vertebra compression LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1940-5901 SP - 949-954 ST - Risk factors of new symptomatic vertebral compression fractures after percutaneous vertebroplasty T2 - International Journal of Clinical and Experimental Medicine TI - Risk factors of new symptomatic vertebral compression fractures after percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2001530877&from=export VL - 12 ID - 829158 ER - TY - JOUR AB - Background and purpose - The use of cementless total hip arthroplasty (THA) in elderly patients is debated because of increased risk of early periprosthetic femoral fractures. However, cemented femoral components carry a risk of bone cement implantation syndrome. Hence, we compared in-hospital complications, complications leading to readmission and mortality ≤ 30 days postoperatively between hybrid/cemented (cemented femoral component) vs. cementless THA in osteoarthritis patients > 70 years.Patients and methods - This is a prospective observational cohort study in 9 centers from January 2010 to August 2017. We used 30-day follow-up from the Danish National Patient Registry, patient records, and data from the Danish Hip Arthroplasty Register. Only THAs performed as a result of osteoarthritis were included.Results - 3,368 (42%) of the THAs were cemented/hybrid and 4,728 (58%) cementless. The in-hospital complication risk was 7.7% after cemented/hybrid vs. 5.3% after cementless THA (< 0.001), statistically not significant when adjusting for comorbidities (p = 0.1). There were similar risks of complications causing readmission (5.7% vs. 6.2%) and mortality ≤ 30 days (0.2% vs. 0.3%). 15 cases (0.4%) of pulmonary embolism (PE) were found after cemented/hybrid vs. 4 (0.1%) after cementless THA (p = 0.001); none occurred within 24 hours postoperatively. 2 of the PEs after cementless THA led to mortality. Cemented/hybrid THA remained significantly associated with risk of PE (RR 3.9, p = 0.02), when adjusting for comorbidities. BMI > 35 was associated with highest risk of PE (RR 5.7, p = 0.003). The risk of periprosthetic femoral fracture was 0.2% after cemented/hybrid vs. 1.5% after cementless THA (p < 0.001) and the risk of dislocations was 1.2% after cemented/hybrid THA vs. 1.8% after cementless THA (p = 0.04).Interpretation - The higher risk of PE after cemented/hybrid THA and higher risk of periprosthetic femoral fractures and dislocations after cementless THA highlights that both medically and surgically complications are related to fixation technique and have to be considered. AD - Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty. Orthopaedic Research Unit, Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Department of Clinical Research, University of Southern Denmark. Section for Surgical Pathophysiology, Rigshospitalet, Copenhagen, Denmark. AN - 32285735 AU - Lindberg-Larsen, M. AU - Petersen, P. B. AU - Jørgensen, C. C. AU - Overgaard, S. AU - Kehlet, H. DA - Jun DO - 10.1080/17453674.2020.1745420 DP - NLM ET - 2020/04/15 J2 - Acta orthopaedica KW - Aged Arthroplasty, Replacement, Hip/adverse effects/*methods Bone Cements/*therapeutic use Female Hip Prosthesis/*adverse effects Humans Male Osteoarthritis, Hip/*surgery Postoperative Complications/epidemiology/*etiology Prospective Studies Risk Factors LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 1745-3674 SP - 286-292 ST - Postoperative 30-day complications after cemented/hybrid versus cementless total hip arthroplasty in osteoarthritis patients > 70 years T2 - Acta Orthop TI - Postoperative 30-day complications after cemented/hybrid versus cementless total hip arthroplasty in osteoarthritis patients > 70 years VL - 91 ID - 828625 ER - TY - JOUR AB - Background and purpose — The use of cementless total hip arthroplasty (THA) in elderly patients is debated because of increased risk of early periprosthetic femoral fractures. However, cemented femoral components carry a risk of bone cement implantation syndrome. Hence, we compared in-hospital complications, complications leading to readmission and mortality ≤ 30 days postoperatively between hybrid/cemented (cemented femoral component) vs. cementless THA in osteoarthritis patients > 70 years. Patients and methods — This is a prospective observational cohort study in 9 centers from January 2010 to August 2017. We used 30-day follow-up from the Danish National Patient Registry, patient records, and data from the Danish Hip Arthroplasty Register. Only THAs performed as a result of osteoarthritis were included. Results — 3,368 (42%) of the THAs were cemented/hybrid and 4,728 (58%) cementless. The in-hospital complication risk was 7.7% after cemented/hybrid vs. 5.3% after cementless THA (< 0.001), statistically not significant when adjusting for comorbidities (p = 0.1). There were similar risks of complications causing readmission (5.7% vs. 6.2%) and mortality ≤ 30 days (0.2% vs. 0.3%). 15 cases (0.4%) of pulmonary embolism (PE) were found after cemented/hybrid vs. 4 (0.1%) after cementless THA (p = 0.001); none occurred within 24 hours postoperatively. 2 of the PEs after cementless THA led to mortality. Cemented/hybrid THA remained significantly associated with risk of PE (RR 3.9, p = 0.02), when adjusting for comorbidities. BMI > 35 was associated with highest risk of PE (RR 5.7, p = 0.003). The risk of periprosthetic femoral fracture was 0.2% after cemented/hybrid vs. 1.5% after cementless THA (p < 0.001) and the risk of dislocations was 1.2% after cemented/hybrid THA vs. 1.8% after cementless THA (p = 0.04). Interpretation — The higher risk of PE after cemented/hybrid THA and higher risk of periprosthetic femoral fractures and dislocations after cementless THA highlights that both medically and surgically complications are related to fixation technique and have to be considered. AD - M. Lindberg-Larsen, Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty, Denmark AU - Lindberg-Larsen, M. AU - Petersen, P. B. AU - Jørgensen, C. C. AU - Overgaard, S. AU - Kehlet, H. DB - Embase Medline DO - 10.1080/17453674.2020.1745420 KW - nct01515670 aged article cohort analysis comorbidity controlled study dislocation female femur fracture follow up heart disease hip dislocation hospital readmission human lung embolism major clinical study male medical record observational study osteoarthritis periprosthetic fracture periprosthetic joint infection postoperative complication prospective study risk factor surgical mortality total hip replacement very elderly LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1745-3682 1745-3674 SP - 286-292 ST - Postoperative 30-day complications after cemented/hybrid versus cementless total hip arthroplasty in osteoarthritis patients > 70 years: A multicenter study from the Lundbeck Foundation Centre for Fast-track Hip and Knee replacement database and the Danish Hip Arthroplasty Register T2 - Acta Orthopaedica TI - Postoperative 30-day complications after cemented/hybrid versus cementless total hip arthroplasty in osteoarthritis patients > 70 years: A multicenter study from the Lundbeck Foundation Centre for Fast-track Hip and Knee replacement database and the Danish Hip Arthroplasty Register UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2004679725&from=export http://dx.doi.org/10.1080/17453674.2020.1745420 VL - 91 ID - 829064 ER - TY - JOUR AB - Background and purpose - The use of cementless total hip arthroplasty (THA) in elderly patients is debated because of increased risk of early periprosthetic femoral fractures. However, cemented femoral components carry a risk of bone cement implantation syndrome. Hence, we compared in-hospital complications, complications leading to readmission and mortality <= 30 days postoperatively between hybrid/cemented (cemented femoral component) vs. cementless THA in osteoarthritis patients > 70 years. Patients and methods - This is a prospective observational cohort study in 9 centers from January 2010 to August 2017. We used 30-day follow-up from the Danish National Patient Registry, patient records, and data from the Danish Hip Arthroplasty Register. Only THAs performed as a result of osteoarthritis were included. Results - 3,368 (42%) of the THAs were cemented/hybrid and 4,728 (58%) cementless. The in-hospital complication risk was 7.7% after cemented/hybrid vs. 5.3% after cementless THA (< 0.001), statistically not significant when adjusting for comorbidities (p = 0.1). There were similar risks of complications causing readmission (5.7% vs. 6.2%) and mortality <= 30 days (0.2% vs. 0.3%). 15 cases (0.4%) of pulmonary embolism (PE) were found after cemented/hybrid vs. 4 (0.1%) after cementless THA (p = 0.001); none occurred within 24 hours postoperatively. 2 of the PEs after cementless THA led to mortality. Cemented/hybrid THA remained significantly associated with risk of PE (RR 3.9, p = 0.02), when adjusting for comorbidities. BMI > 35 was associated with highest risk of PE (RR 5.7, p = 0.003). The risk of periprosthetic femoral fracture was 0.2% after cemented/hybrid vs. 1.5% after cementless THA (p < 0.001) and the risk of dislocations was 1.2% after cemented/hybrid THA vs. 1.8% after cementless THA (p = 0.04). Interpretation - The higher risk of PE after cemented/hybrid THA and higher risk of periprosthetic femoral fractures and dislocations after cementless THA highlights that both medically and surgically complications are related to fixation technique and have to be considered. AD - [Lindberg-Larsen, Martin; Jorgensen, Christoffer Calov; Kehlet, Henrik] Lundbeck Fdn Ctr Fast Track Hip & Knee Arthroplas, Copenhagen, Denmark. [Lindberg-Larsen, Martin; Overgaard, Soren] Univ Southern Denmark, Odense Univ Hosp, Dept Clin Res, Orthopaed Res Unit,Dept Orthopaed Surg & Traumato, Copenhagen, Denmark. [Petersen, Pelle Baggesgaard; Jorgensen, Christoffer Calov; Kehlet, Henrik] Rigshosp, Sect Surg Pathophysiol, Copenhagen, Denmark. [Madsen, Frank] Aarhus Univ Hosp, Dept Orthoped, Aarhus, Denmark. [Hansen, Torben B.] Reg Hosp Holstebro, Dept Orthoped, Holstebro, Denmark. [Hansen, Torben B.] Univ Aarhus, Holstebro, Denmark. [Gromov, Kirill] Hvidovre Univ Hosp, Dept Orthoped, Hvidovre, Denmark. [Laursen, Mogens] Aalborg Univ Hosp, Northern Orthopaed Div, Aalborg, Denmark. [Hansen, Lars T.] Sydvestjysk Hosp Esbjerg Grindsted, Dept Orthoped, Grindsted, Denmark. [Kjaersgaard-Andersen, Per] Vejle Hosp, Dept Orthoped, Vejle, Denmark. [Solgaard, Soren] Gentofte Univ Hosp, Dept Orthoped, Copenhagen, Denmark. [Krarup, Niels Harry] Viborg Hosp, Dept Orthoped, Viborg, Denmark. [Bagger, Jens] Copenhagen Univ Hosp Bispebjerg, Dept Orthopaed Surg, Copenhagen NV, Denmark. Lindberg-Larsen, M (corresponding author), Lundbeck Fdn Ctr Fast Track Hip & Knee Arthroplas, Copenhagen, Denmark.; Lindberg-Larsen, M (corresponding author), Univ Southern Denmark, Odense Univ Hosp, Dept Clin Res, Orthopaed Res Unit,Dept Orthopaed Surg & Traumato, Copenhagen, Denmark. martin.lindberg-larsen@rsyd.dk AN - WOS:000544404500020 AU - Lindberg-Larsen, M. AU - Petersen, P. B. AU - Jorgensen, C. C. AU - Overgaard, S. AU - Kehlet, H. AU - Madsen, F. AU - Hansen, T. B. AU - Gromov, K. AU - Laursen, M. AU - Hansen, L. T. AU - Kjaersgaard-Andersen, P. AU - Solgaard, S. AU - Krarup, N. H. AU - Bagger, J. AU - Lundbeck Fdn Ctr Fast-track, Hip DA - May DO - 10.1080/17453674.2020.1745420 J2 - Acta Orthop. KW - RISK-FACTORS MORTALITY FRACTURE MORBIDITY Orthopedics LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2020 SN - 1745-3674 SP - 286-292 ST - Postoperative 30-day complications after cemented/hybrid versus cementless total hip arthroplasty in osteoarthritis patients > 70 years A multicenter study from the Lundbeck Foundation Centre for Fast-track Hip and Knee replacement database and the Danish Hip Arthroplasty Register T2 - Acta Orthopaedica TI - Postoperative 30-day complications after cemented/hybrid versus cementless total hip arthroplasty in osteoarthritis patients > 70 years A multicenter study from the Lundbeck Foundation Centre for Fast-track Hip and Knee replacement database and the Danish Hip Arthroplasty Register UR - ://WOS:000544404500020 VL - 91 ID - 830105 ER - TY - JOUR AB - There have been reports about the growing incidence of cardiovascular complications during hip joint replacement. Therefore the authors analysed 300 cases since 1970. They found a hypotension in more than the half of the patients (57.6%) during implantation of bone cement (Palacos): in 29 of them hypotension exceeded 30%. The alterations in the cardiovascular system were favoured by some preoperative complicating diseases. In digitalized patients dysthmia was seen besides hypotension. Hypotension lasted in most cases longer than 20 min until blood pressure returned to normal. Though there was no intraoperative cardiac arrest, 4 patients died postoperative, one of them 5 hr after operation in consequence of massive lung fat embolism (autopsy). The controversial pathogenesis of fat embolism has been discussed. The primary toxic effect of bone cement on the cardiovascular system may play an important role in causing hypotension and consequently also fat embolism. Anesthesists should know these dangers and try to reduce hypotension by earlier volume substitution and by prevention of fat embolism. Operators should use less toxic bone cement and care should be taken to improve the operation technique and find a harmless mixture. AD - Anasth. Abt., Krankenh. Neuburg/Donau, Neuburg/Donau AU - Lipecz, J. AU - Nemes, C. AU - Baumann, F. AU - Csernohorszky, V. DB - Embase KW - bone cement arthroplasty blood pressure cardiovascular system fat embolism hip hip surgery hypotension major clinical study total hip prosthesis LA - German M1 - 9 N1 - Embase Elsevier literature search January 5, 2021 PY - 1974 SN - 0003-2417 SP - 382-388 ST - Circulatory complications during alloarthroplastic operations on the hip joint T2 - Anaesthesist TI - Circulatory complications during alloarthroplastic operations on the hip joint UR - https://www.embase.com/search/results?subaction=viewrecord&id=L5123278&from=export VL - 23 ID - 829976 ER - TY - JOUR AB - BACKGROUND: Percutaneous kyphoplasty has become widely recognized as an effective method to treat elderly patients with acute severe osteoporotic compression fractures, but the number of cases involved in the relevant literature is less. OBJECTIVE: To explore the clinical effect of percutaneous balloon kyphoplasty on acute severe osteoporotic compression fractures in the elderly. METHODS: A total of 62 elderly patients with acute severe osteoporotic compression fractures (87 vertebrae) were treated with percutaneous balloon kyphoplasty, 2.5-7.1 mL bone cement for one vertebra. All the patients were followed up for over 3 months to observe changes in various indexes. RESULTS AND CONCLUSION: Patients receiving percutaneous balloon kyphoplasty had a significant improvement in the vertebral height and scores on visual analog scale (P < 0.01). No death or spinal cord/nerve injury occurred. Leakage of polymethyl methacrylate was found in two cases from anterior longitudinal ligament, one case from the vertebral arch, and one case from the intervertebral space. No infection and embolism happened, and the vertebral height recovered ≥75%. All patients had pain relief, including two cases of low back pain that relieved following oral administration of analgesic drug. Final follow-up results showed that the vertebral height had no changes. These findings indicate that percutaneous balloon kyphoplasty is safe and effective to treat acute severe osteoporotic compression fractures in the elederly. AD - L. Liu, Department of Orthopedics, Handan Central Hospital, Handan 056000, Hebei Province, China AU - Liu, B. z AU - Li, Y. b AU - Liu, Z. w AU - Zhao, W. g AU - Yan, J. y AU - Yang, Z. h AU - Xie, Y. p AU - Liu, L. DB - Embase DO - 10.3969/j.issn.2095-4344.2012.29.036 KW - analgesic agent bone cement poly(methyl methacrylate) analgesia article compression fracture disease severity fracture treatment fragility fracture human kyphoplasty low back pain major clinical study percutaneous balloon kyphoplasty postoperative complication spine fracture treatment response visual analog scale LA - English Chinese M1 - 29 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1673-8225 SP - 5493-5496 ST - Percutaneous kyphoplasty with bone cement repairs elderly acute severe osteoporotic compression fractures in 62 cases T2 - Chinese Journal of Tissue Engineering Research TI - Percutaneous kyphoplasty with bone cement repairs elderly acute severe osteoporotic compression fractures in 62 cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L365796031&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.2012.29.036 VL - 16 ID - 829533 ER - TY - JOUR AD - Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China. AN - 23109313 AU - Liu, F. J. AU - Ren, H. AU - Shen, Y. AU - Ding, W. Y. AU - Wang, L. F. C2 - Pmc6583462 DA - Nov DO - 10.1111/os.12010 DP - NLM ET - 2012/10/31 J2 - Orthopaedic surgery KW - Bone Cements/*adverse effects Chest Pain/chemically induced Female Humans Kyphoplasty/*adverse effects Middle Aged Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/*chemically induced/diagnostic imaging Tomography, X-Ray Computed LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 1757-7853 (Print) 1757-7853 SP - 263-5 ST - Pulmonary embolism caused by cement leakage after percutaneous kyphoplasty: a case report T2 - Orthop Surg TI - Pulmonary embolism caused by cement leakage after percutaneous kyphoplasty: a case report VL - 4 ID - 828849 ER - TY - JOUR AB - Background: Osteoporotic vertebral compression fractures (OVCFs) are the most common osteoporotic fractures. Pain is the main symptom. Percutaneous vertebroplasty (PVP) is a therapeutic procedure performed to reduce pain in vertebral compression fractures. Numerous case series and several small, non-blinded, non-randomized controlled studies have suggested that vertebroplasty is an effective means of relieving pain from osteoporotic fractures. However, a recent pooled analysis from 2 multicenter randomized controlled trials concluded that the improvement in pain afforded by PVP was similar to placebo. Objective: To compare the amount of pain reduction measured using the visual analog scale when OVCF is treated with vertebroplasty or conservatively, and assess the clinical utility of PVP. Design: A meta-analysis and systematic review of randomized controlled trials was performed comparing pain reduction following vertebroplasty and conservative treatment. Limitations: There were few data sources from which to extract abstracted data or published studies. There were only 5 randomized controlled trials that met our criteria. The conservative treatments used as comparators in these trials were different. Methods: A search of MEDLINE from January 1980 to July 2012 using PubMed, the Cochrane Database of Systematic Reviews and Controlled Trials, CINAHL, and EMBASE. Relevant reports were examined by 2 independent reviewers and the references from these reports were searched for additional trials, using the criteria established in the QUOROM statement. Results: Pooled results from 5 randomized controlled trials are shown. There was no difference in pain relief in the PVP group at 2 weeks and one month when compared with the conservatively managed group. Pain relief in the PVP group was greater than that of the conservative group at 3 months, 6 months, and 12 months. However, after subgroup analysis, pain scores were similar between the PVP group and the sham injection group from 2 weeks to 6 months. Compared with non-operative therapy, PVP reduced pain at all times studied. Conclusion: PVP has some value for relieving pain; however, the possibility of a placebo effect should be considered. PVP has gained acceptance as a complementary treatment when conservative management has failed before its benefits have been fully understood. More large scale, double blinded, controlled trials are necessary in order to quantify the pain relief afforded by PVP more precisely. AD - [Liu, Jintao; Li, Xiaochun; Yu, Penfei; Qian, Xiang; Jiang, Hong] Suzhou Hosp Tradit Chinese Med, Dept Orthoped Surg, Suzhou 215009, Jiangsu, Peoples R China. [Li, Xiaofeng; Tang, Dezhi; Cui, Xuejun; Yao, Min; Wang, Yongjun] Shanghai Univ Tradit Chinese Med, Inst Spine, Shanghai 200032, Peoples R China. Jiang, H (corresponding author), Suzhou Hosp Tradit Chinese Med, Dept Orthoped Surg, 889 Wuzhongxi Rd, Suzhou 215009, Jiangsu, Peoples R China. doctorhong@yeah.net AN - WOS:000327547400022 AU - Liu, J. T. AU - Li, X. F. AU - Tang, D. Z. AU - Cui, X. J. AU - Li, X. C. AU - Yao, M. AU - Yu, P. F. AU - Qian, X. AU - Wang, Y. J. AU - Jiang, H. DA - Sep-Oct J2 - Pain Physician KW - Vertebroplasty osteoporosis vertebral compression fracture randomized controlled trials systemic review meta-analysis PERCUTANEOUS VERTEBROPLASTY CLINICAL-OUTCOMES PLACEBO TIME IMPROVEMENT MANAGEMENT EMBOLISM THERAPY Anesthesiology Clinical Neurology LA - English M1 - 5 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2013 SN - 1533-3159 SP - 455-464 ST - Comparing Pain Reduction Following Vertebroplasty and Conservative Treatment for Osteoporotic Vertebral Compression Fractures: A Meta-Analysis of Randomized Controlled Trials T2 - Pain Physician TI - Comparing Pain Reduction Following Vertebroplasty and Conservative Treatment for Osteoporotic Vertebral Compression Fractures: A Meta-Analysis of Randomized Controlled Trials UR - ://WOS:000327547400022 VL - 16 ID - 830281 ER - TY - JOUR AB - BACKGROUND: We reviewed the reported data related to iatrogenic lumbar artery injury (ILAI) in spine surgery with a focus on which iatrogenic procedure might cause lumbar artery injury. METHODS: We conducted a comprehensive search in the Web of Science, PubMed, EMBASE, and Chinese biomedical databases in July 2018. RESULTS: A total of 20 reports on ILAI were selected for the present study. Most of these were case reports, with a total of 26 cases. The causes of ILAI were as follows: puncture injury in 9 cases, transforaminal endoscopic operation in 5 cases, pedicle screw injury in 3 cases, intervertebral foramen decompression in 2 cases, disc rongeur injury during discectomy in 2 cases, lumbar artery tear caused by transverse process fracture in 1 case, vertebral fracture restoration in 1 case, retractor injury in 1 case, cage insertion or pedicle screw injury in 1 case, and drainage tube stimulation in 1 case. The treatment methods included transarterial embolization in 20 cases, percutaneous embolization in 2 cases, surgical ligation in 1 case, and steroid and cyclophosphamide treatment in 1 case. All patients were treated successfully. One patient died during antishock therapy, and another patient died because her family refused any further intervention. CONCLUSIONS: Attention should be given to the surgical procedures that are likely to cause ILAI, such as percutaneous vertebroplasty/percutaneous kyphoplasty, vertebral biopsy, pedicle screw implantation, discectomy, transforaminal endoscopic operation, and intervertebral foramen decompression. Once a diagnosis of ILAI has been confirmed, selective endovascular transarterial embolization is the preferred treatment. AD - Graduate School, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China; Department of Spine Surgery, The Third Affiliated Hospital of Chongqing Medical University (General Hospital), Chongqing, China. Department of Orthopedics, Three Gorges Central Hospital, Chongqing, China. Hillsborough Community College, Tampa, Florida, USA. Outpatient Department, General Hospital, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China. Department of Spinal Surgery, General Hospital, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China. Department of Spine Surgery, The Third Affiliated Hospital of Chongqing Medical University (General Hospital), Chongqing, China. Department of Spinal Surgery, General Hospital, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region, China. Electronic address: wangzlnx@126.com. AN - 30419401 AU - Liu, L. AU - Li, N. AU - Wang, Q. AU - Wang, H. AU - Wu, Y. AU - Jin, W. AU - Zhou, Q. AU - Wang, Z. DA - Feb DO - 10.1016/j.wneu.2018.10.219 DP - NLM ET - 2018/11/13 J2 - World neurosurgery KW - Aged Aged, 80 and over Cyclophosphamide/therapeutic use Decompression, Surgical/adverse effects Diskectomy, Percutaneous/adverse effects Embolization, Therapeutic/methods Endoscopy/adverse effects Female Humans Iatrogenic Disease Immunosuppressive Agents/therapeutic use Intraoperative Complications/*etiology Kyphoplasty/adverse effects Ligation/methods Lumbar Vertebrae/*surgery Male Middle Aged Pedicle Screws/adverse effects Spinal Diseases/surgery Steroids/therapeutic use Tomography, X-Ray Computed Treatment Outcome Vertebral Artery/*injuries Vertebroplasty/adverse effects Iatrogenic injury Lumbar artery Lumbar artery pseudoaneurysm Spine surgery LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 1878-8750 SP - 266-271 ST - Iatrogenic Lumbar Artery Injury in Spine Surgery: A Literature Review T2 - World Neurosurg TI - Iatrogenic Lumbar Artery Injury in Spine Surgery: A Literature Review VL - 122 ID - 828564 ER - TY - JOUR AB - BACKGROUND: We reviewed the reported data related to iatrogenic lumbar artery injury (ILAI) in spine surgery with a focus on which iatrogenic procedure might cause lumbar artery injury. METHODS: We conducted a comprehensive search in the Web of Science, PubMed, EMBASE, and Chinese biomedical databases in July 2018. RESULTS: A total of 20 reports on ILAI were selected for the present study. Most of these were case reports, with a total of 26 cases. The causes of ILAI were as follows: puncture injury in 9 cases, transforaminal endoscopic operation in 5 cases, pedicle screw injury in 3 cases, intervertebral foramen decompression in 2 cases, disc rongeur injury during discectomy in 2 cases, lumbar artery tear caused by transverse process fracture in 1 case, vertebral fracture restoration in 1 case, retractor injury in 1 case, cage insertion or pedicle screw injury in 1 case, and drainage tube stimulation in 1 case. The treatment methods included transarterial embolization in 20 cases, percutaneous embolization in 2 cases, surgical ligation in 1 case, and steroid and cyclophosphamide treatment in 1 case. All patients were treated successfully. One patient died during antishock therapy, and another patient died because her family refused any further intervention. CONCLUSIONS: Attention should be given to the surgical procedures that are likely to cause ILAI, such as percutaneous vertebroplasty/percutaneous kyphoplasty, vertebral biopsy, pedicle screw implantation, discectomy, transforaminal endoscopic operation, and intervertebral foramen decompression. Once a diagnosis of ILAI has been confirmed, selective endovascular transarterial embolization is the preferred treatment. AD - [Liu, Liehua] Ningxia Med Univ, Gen Hosp, Grad Sch, Yinchuan, Ningxia Hui Aut, Peoples R China. [Wu, Yuexiang] Ningxia Med Univ, Gen Hosp, Outpatient Dept, Yinchuan, Ningxia Hui Aut, Peoples R China. [Jin, Weidong; Wang, Zili] Ningxia Med Univ, Gen Hosp, Dept Spinal Surg, Yinchuan, Ningxia Hui Aut, Peoples R China. [Liu, Liehua; Zhou, Qiang] Chongqing Med Univ, Gen Hosp, Affiliated Hosp 3, Dept Spine Surg, Chongqing, Peoples R China. [Li, Nan; Wang, Haoming] Three Gorges Cent Hosp, Dept Orthoped, Chongqing, Peoples R China. [Wang, Qian] Hillsborough Community Coll, Tampa, FL USA. Wang, ZL (corresponding author), Ningxia Med Univ, Gen Hosp, Dept Spinal Surg, Yinchuan, Ningxia Hui Aut, Peoples R China. wangzlnx@126.com AN - WOS:000457328100249 AU - Liu, L. H. AU - Li, N. AU - Wang, Q. AU - Wang, H. M. AU - Wu, Y. X. AU - Jin, W. D. AU - Zhou, Q. AU - Wang, Z. L. DA - Feb DO - 10.1016/j.wneu.2018.10.219 J2 - World Neurosurg. KW - Iatrogenic injury Lumbar artery Lumbar artery pseudoaneurysm Spine surgery LATERAL INTERBODY FUSION VASCULAR INJURY PSEUDOANEURYSM VERTEBROPLASTY DECOMPRESSION EMBOLIZATION MANAGEMENT INSTRUMENTATION COMPLICATIONS COMPRESSION Clinical Neurology Surgery LA - English M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 1878-8750 SP - 266-271 ST - Iatrogenic Lumbar Artery Injury in Spine Surgery: A Literature Review T2 - World Neurosurgery TI - Iatrogenic Lumbar Artery Injury in Spine Surgery: A Literature Review UR - ://WOS:000457328100249 VL - 122 ID - 830147 ER - TY - JOUR AB - RATIONALE: Malignant pheochromocytoma in the spine is a rare disease without standard curative managements so far. The objective of this article is to report a very rare case of malignant pheochromocytoma with sacrum metastases causing severe lumbosacral pain, which was presented with acute radiculopathy and treated with three operations combined with cement augmentation and stabilization. The management of these unique cases has yet to be well-documented. PATIENT CONCERNS: A 58-year-old man presented with lumbosacral pain, radiating pain and numbness of the right extremity. The patient underwent excision of right adrenal pheochromocytoma in 2010. Imaging studies revealed the density of soft tissues, obvious bony destruction in the sacrum, and significant spinal cord obstruction. DIAGNOSES: We believe this is the first report of malignant pheochromocytoma with sacrum metastases. INTERVENTIONS: The patient underwent tissue biopsy and osteoplasty after embolization of the internal iliac artery in January 2015, and exploratory surgery, circumferential spinal cord decompression, and a stabilization procedure via a posterior approach in June 2015 due to spinal canal stenosis caused by cement. Since the position of pedicle screw was not good enough, a revision surgery was performed the next day following the procedures in June 2015. OUTCOMES: The patient's neurological deficits improved significantly after the third surgery, and the postoperative period was uneventful at the three-year follow-up visit. LESSONS: We recommend the posterior approach for spinal decompression of the metastatic pheochromocytoma when the tumor has caused neurological deficits. Osteoplasty by cement augmentation is also a good choice for surgical treatment. However, the potential risk of complications in bone cement applications need to be fully recognized. AD - Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences. Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, People's Republic of China. Department of Neurosurgery, Wayne State University School of Medicine, Detroit, Michigan. AN - 30170467 AU - Liu, S. AU - Zhou, X. AU - Song, A. AU - Li, W. A. AU - Rastogi, R. AU - Wang, Y. AU - Liu, Y. C2 - Pmc6393136 DA - Aug DO - 10.1097/md.0000000000012184 DP - NLM ET - 2018/09/02 J2 - Medicine KW - Adrenal Gland Neoplasms/pathology/*surgery Cementoplasty/methods Decompression, Surgical/methods Humans Male Middle Aged Pheochromocytoma/pathology/*surgery Sacrum/pathology/*surgery Spinal Neoplasms/secondary/*surgery LA - eng M1 - 35 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 0025-7974 (Print) 0025-7974 SP - e12184 ST - Successful treatment of malignant pheochromocytoma with sacrum metastases: A case report T2 - Medicine (Baltimore) TI - Successful treatment of malignant pheochromocytoma with sacrum metastases: A case report VL - 97 ID - 828715 ER - TY - JOUR AB - Rationale: Malignant pheochromocytoma in the spine is a rare disease without standard curative managements so far. The objective of this article is to report a very rare case of malignant pheochromocytoma with sacrum metastases causing severe lumbosacral pain, which was presented with acute radiculopathy and treated with three operations combined with cement augmentation and stabilization. The management of these unique cases has yet to be well-documented. Patient concerns: A 58-year-old man presented with lumbosacral pain, radiating pain and numbness of the right extremity. The patient underwent excision of right adrenal pheochromocytoma in 2010. Imaging studies revealed the density of soft tissues, obvious bony destruction in the sacrum, and significant spinal cord obstruction. Diagnoses: We believe this is the first report of malignant pheochromocytoma with sacrum metastases. Interventions: The patient underwent tissue biopsy and osteoplasty after embolization of the internal iliac artery in January 2015, and exploratory surgery, circumferential spinal cord decompression, and a stabilization procedure via a posterior approach in June 2015 due to spinal canal stenosis caused by cement. Since the position of pedicle screw was not good enough, a revision surgery was performed the next day following the procedures in June 2015. Outcomes: The patient's neurological deficits improved significantly after the third surgery, and the postoperative period was uneventful at the three-year follow-up visit. Lessons: We recommend the posterior approach for spinal decompression of the metastatic pheochromocytoma when the tumor has caused neurological deficits. Osteoplasty by cement augmentation is also a good choice for surgical treatment. However, the potential risk of complications in bone cement applications need to be fully recognized. AD - [Liu, Shuzhong; Zhou, Xi; Wang, Yipeng; Liu, Yong] Beijing Union Med Coll Hosp, Peking Union Med Coll, Dept Orthopaedc Surg, 1 Shuaifuyuan Wangfujing, Beijing 100730, Peoples R China. [Liu, Shuzhong; Zhou, Xi; Wang, Yipeng; Liu, Yong] Chinese Acad Med Sci, 1 Shuaifuyuan Wangfujing, Beijing 100730, Peoples R China. [Song, An] Chinese Acad Med Sci, Peking Union Med Coll Hosp, Natl Hlth & Family Planning Commiss, Dept Endocrinol,Key Lab Endocrinol, Beijing, Peoples R China. [Song, An] Peking Union Med Coll, Beijing, Peoples R China. [Li, William A.; Rastogi, Radhika] Wayne State Univ, Sch Med, Dept Neurosurg, Detroit, MI USA. Wang, YP; Liu, Y (corresponding author), Beijing Union Med Coll Hosp, Peking Union Med Coll, Dept Orthopaedc Surg, 1 Shuaifuyuan Wangfujing, Beijing 100730, Peoples R China.; Wang, YP; Liu, Y (corresponding author), Chinese Acad Med Sci, 1 Shuaifuyuan Wangfujing, Beijing 100730, Peoples R China. ypwang_pumch@163.com; liuyong_pumch@126.com AN - WOS:000446601900099 AU - Liu, S. Z. AU - Zhou, X. AU - Song, A. AU - Li, W. A. AU - Rastogi, R. AU - Wang, Y. P. AU - Liu, Y. C7 - e12184 DA - Aug DO - 10.1097/md.0000000000012184 J2 - Medicine KW - cement augmentation metastatic spinal pheochromocytoma revision surgery sacrum stabilization surgical treatment OF-THE-LITERATURE PREOPERATIVE EMBOLIZATION LOCAL TUMOR SPINE PARAGANGLIOMA HYPERTENSION EXPERIENCE RESECTION SURGERY Medicine, General & Internal LA - English M1 - 35 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 0025-7974 SP - 7 ST - Successful treatment of malignant pheochromocytoma with sacrum metastases A case report T2 - Medicine TI - Successful treatment of malignant pheochromocytoma with sacrum metastases A case report UR - ://WOS:000446601900099 VL - 97 ID - 830160 ER - TY - JOUR AB - BACKGROUND: Biceps femoris tendon and lateral collateral ligament are two important components of the knee posterolateral complex, and play important roles in maintaining the stability of knee posterolateral complex. OBJECTIVE: To study the impact of biceps femoris tendon and lateral collateral ligament attachment point reconstruction on the stability of the knee joint after the fibula head composite flap surgery. METHODS: Ten cases of male fresh frozen knee cadaver specimens were selected; biomechanical torsion testing machine was used to measure the tibial external rotation angle at different torques before fibula head composite flap surgery and after biceps femoris tendon and lateral collateral ligament attachment point reconstruction. RESULTS AND CONCLUSION: Under the condition of the same torque, the tibial external rotation angle was increased with extension of knee flexion angle, and there was significant difference of the tibial external rotation angle before fibula head composite flap surgery and after biceps femoris tendon and lateral collateral ligament attachment point reconstruction; under the condition of the different torques, there was a positive correlation between external rotation angle and knee flexion angle. After the fibula head composite flap surgery, biceps femoris tendon and lateral collateral ligament attachment point reconstruction will not influence the stability of the knee joint. AU - Liu, X. T. AU - Li, Z. AU - Wang, C. Q. DB - Embase DO - 10.3969/j.issn.2095-4344.2012.52.016 KW - bone cement article clinical article Cobb angle disease duration follow up fragility fracture geriatric patient human local sagittal Cobb angle lung embolism mortality Oswestry Disability Index outcome assessment pain assessment percutaneous vertebroplasty postoperative infection quality of life spine fracture symptomatology treatment outcome visual analog scale LA - Chinese M1 - 52 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1673-8225 SP - 9771-9775 ST - Biomechanical stability of the knee joint after fibula head composite flap surgery T2 - Chinese Journal of Tissue Engineering Research TI - Biomechanical stability of the knee joint after fibula head composite flap surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L373887956&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.2012.52.016 VL - 16 ID - 829593 ER - TY - JOUR AB - OBJECTIVE: To evaluate the effect of remote controlled injection manipulator system (RCIM) assisted percutaneous kyphoplasty (PKP) for the treatment of rupture of posterior vertebral osteoporotic vertebral fracture by comparing with intermittent hand bolus injection of bone cement during operation. METHODS: Between September 2010 and January 2016, a retrospective analysis was made on the clinical data of 48 senile patients with single segment rupture of the posterior vertebral osteoporotic thoracolumbar fracture undergoing PKP who accorded with the inclusion criteria. Of 48 patients, 22 received intermittent hand bolus injection of bone cement in the control group, and 26 received RCIM assisted bone cement perfusion in the trial group. There was no significant difference in age, gender, duration of disease, causes of injury, implicated vertebral bodies, bone mineral density T value, pain duration, preoperative visual analogue scale (VAS), relative vertebral body height in the anterior part, and posterior convex Cobb angle between groups ( P>0.05). The bone cement perfusion time, the radiation dose of both doctors and patients, and the amount of bone cement injection were recorded; treatment effects were evaluated based on VAS score, posterior convex Cobb angle, relative ver-tebral body height in the anterior part, ratios of bone cement diffusion area and bone cement leakage rate. RESULTS: The patients were followed up for 6 months; no complications of toxic effect of bone cement, spinal cord or nerve root injuries, infection and vascular embolization occurred during follow-up period. There was no significant difference in bone cement injection amount and radiation dose of doctors between groups ( P>0.05), but bone cement perfusion time, ratios of bone cement diffusion area, and radiation dose of patients were significantly lower in the trial group than the control group ( P<0.05). Bone cement leakage was observed in 6 cases of the control group (27.27%) and 2 cases of the trial group (7.69%), showing significant difference between groups ( χ(2)=4.850, P=0.029); no cement leakage into the spinal canal was found in both groups. VAS score, relative vertebral body height in the anterior part, and posterior convex Cobb angle were significantly improved at 3 days and 6 months after operation when compared with preoperative ones ( P<0.05), but no significant difference was observed in the above indexes between groups at 3 days and 6 months after operation ( P>0.05). CONCLUSION: Satisfactory effectiveness can be achieved by applying RCIM assisted PKP for the treatment of rupture of posterior vertebral osteoporotic vertebral fracture. RCIM can shorten perfusion time, reduce radiation dose, and decrease incidence of bone cement leakage. AD - Department of Spinal Surgery, the People's Hospital of Laibin, Laibin Guangxi, 546100, P.R.China.liuyiqiang518@163.com. Department of Spinal Surgery, the People's Hospital of Laibin, Laibin Guangxi, 546100, P.R.China. AN - 29798540 AU - Liu, Y. AU - Wang, C. AU - Wei, G. AU - Huang, R. DA - May 15 DO - 10.7507/1002-1892.201612104 DP - NLM ET - 2018/05/26 J2 - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery KW - Bone Cements Fractures, Compression/*surgery Humans Kyphoplasty/*instrumentation Osteoporotic Fractures Retrospective Studies *Robotics Spinal Fractures/*surgery Treatment Outcome *Vertebroplasty *Osteoporotic vertebral fracture *percutaneous kyphoplasty *remote controlled injection manipulator system LA - chi M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 1002-1892 (Print) 1002-1892 SP - 527-533 ST - [Effect of remote controlled injection manipulator system assisted percutaneous kyphoplasty for treatment of rupture of posterior vertebral osteoporotic vertebral fracture] T2 - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi TI - [Effect of remote controlled injection manipulator system assisted percutaneous kyphoplasty for treatment of rupture of posterior vertebral osteoporotic vertebral fracture] VL - 31 ID - 828649 ER - TY - JOUR AB - BACKGROUND: Patients with spinal metastases may appear different degrees of pain and abnormal spinal stability, and can be treated with percutaneous balloon kyphoplasty combined with bone cement implantation. OBJECTIVE: To explore the effect of percutaneous balloon kyphoplasty with bone cement implantation on spinal stability and pain in patients with spinal metastases. METHODS: Twenty-three patients with metastatic spinal tumor were treated with percutaneous balloon dilatation kyphoplasty with polymethyl methacrylate bone cement. There were 10 females and 13 males, and their age ranged from 23 to 71 years. The visual analogue scale score, anterior and posterior edge height of vertebral body, quality of life, and motor function score of patients were observed before and after treatment. RESULTS AND CONCLUSION: Compared with before treatment, the visual analogue scale score and motor function score were significantly decreased, while anterior and posterior edge height of vertebral body were significantly increased in 23 patients at 24 hours after treatment (P < 0.05). After 12 months of follow-up, no case appeared to have spinal nerve root damage, serious adverse reactions and bone cement embolism. The patient’s quality of life was significantly improved, compared with before treatment (P < 0.05). Experimental findings indicate that percutaneous balloon dilatation kyphoplasty with polymethyl methacrylate bone cement can significantly improve the spinal stability, relieve the degree of pain, and exert exact effects in treatment of spinal metastases. AD - X.-F. Li, Feicheng Mining Industry Central Hospital, Taian, Shandong Province, China AU - Liu, Y. AU - Xia, B. AU - Li, X. F. DB - Embase DO - 10.3969/j.issn.2095-4344.2015.16.005 KW - bone cement poly(methyl methacrylate) adult aged article assessment of humans body height clinical article controlled clinical trial controlled study female human implantation kyphoplasty male motor function score percutaneous balloon kyphoplasty quality of life spinal cord metastasis spinal pain spine instability vertebra body visual analog scale LA - Chinese M1 - 16 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1673-8225 SP - 2484-2488 ST - Percutaneous kyphoplasty with bone cement injection for treatment of spinal metastases: Changes of spinal stability and pain T2 - Chinese Journal of Tissue Engineering Research TI - Percutaneous kyphoplasty with bone cement injection for treatment of spinal metastases: Changes of spinal stability and pain UR - https://www.embase.com/search/results?subaction=viewrecord&id=L606147677&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.2015.16.005 VL - 19 ID - 829376 ER - TY - JOUR AN - 23386253 AU - Llanos, R. A. AU - Viana-Tejedor, A. AU - Abella, H. R. AU - Fernandez-Avilés, F. DA - May DO - 10.1007/s00392-013-0542-9 DP - NLM ET - 2013/02/07 J2 - Clinical research in cardiology : official journal of the German Cardiac Society KW - Aged Bone Cements/*adverse effects Cardiac Surgical Procedures Echocardiography, Transesophageal Female Foreign-Body Migration/diagnosis/*etiology/surgery Heart Diseases/diagnosis/*etiology/surgery Humans Predictive Value of Tests Pulmonary Embolism/diagnosis/*etiology/surgery Tomography, X-Ray Computed Treatment Outcome Vertebroplasty/*adverse effects LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1861-0684 SP - 395-7 ST - Pulmonary and intracardiac cement embolism after a percutaneous vertebroplasty T2 - Clin Res Cardiol TI - Pulmonary and intracardiac cement embolism after a percutaneous vertebroplasty VL - 102 ID - 828835 ER - TY - JOUR AB - Percutaneous vertebroplasty (PV) is widely used as a treatment for painful vertebral compression fractures (VCFs). Although generally considered a safe treatment, occasionally adverse events may occur during or after the procedure. Complications due to PV can be divided into two categories: complications related to polymethylmetacrylate (PMMA) cement leakage from the VCF or other complications. Cement leakage occurs frequently in PV, but is well tolerated in the vast majority of patients. Cement leakage in the para‐ or prevertebral soft tissue is almost always asymptomatic. Leakage into the spinal canal may occur when destruction of the dorsal wall of the vertebral body is present. This type of leakage is usually well tolerated if there is enough residual space remaining. Cement leakage into the foramen is rare, especially when applying the transpedicular approach. Cement leakage in the soft tissue dorsal to the vertebral body, such as cement spikes in the needle tract, may cause discomfort to the patient. Intervertebral disk leakage is common but asymptomatic. Some reports suggest it may have long‐term mechanical consequences on adjacent vertebral bodies. Venous cement leakage occurs frequent but this is usually without clinical sequellae. Venous cement leakage may also extent into the inferior vena cava mostly without symptoms. Pulmonary embolism of PMMA may occur, usually due to unnoticed venous migration of cement into venes or the inferior vena cava. Complications such as arterial cement leakage or cement leakage into the brain have been reported, but are extremely rare. Factors that are likely to increase the rate of complications are cortical destruction, presence of an epidural soft tissue mass, highly vascularised lesions and severe VCFs. The complication rate is probably higher in PV for malignant diseases than osteoporotic VCFs. Little is known whether PV increases the risk of secondary fractures over time. Until now, there are no randomized controlled trials (RCTs) comparing the incidence of secondary fractures in patients with osteoporotic VCFs either treated with PV or treated conservatively. An increased fracture rate higher than of the natural history of the disease has not been definitively demonstrated. In a non‐RCT comparing PV and conservative therapy, Diamond et al. reported secondary fractures in only few of the PV patients during midterm follow‐up. The authors demonstrated no increased risk of secondary fractures between the control group and the PV group and no increased rate of secondary fractures of adjacent vertebral bodies. Systemic reactions may occur during PV in the absence of cement leakage, e.g., decrease in blood pressure, arrhythmogenic and cardiotoxic effect. Other general reactions need to be considered, such as pulmonary embolism caused by tissue debris or bone marrow expelled from the vertebral body with fat embolism or vasodilatating/vasovagal effects of the PMMA monomer. To prevent or minimize the risk of complications, correct patient selection is important. The main indication for PV in osteoporotic VCFs is intractable, local back pain at the level of the fracture. The VCF must be proven by plain radiography, CT or MRI. Absolute contraindications for PV are asymptomatic VCF, improvement of patient's pain on medication, non‐correctable bleeding disorder, osteomyelitis or active systemic infection, allergy to bone cement and prophylactic PV. Relative contraindications include radicular pain, inability to lie in prone position for the duration of the treatment, lack of surgical or neurosurgical back‐up and lack of patients monitoring facilities. Vertebra plana, VCF of more than 70% of the original vertebral body height and retropulsion of a fragment into the spinal canal are no longer regarded as absolute contraindications; however, only experienced interventionalists should try to perform a PV on these patients. Crucial ingredients for optimal treatment are understanding of the vertebral bone, nerve and vascular anatomy, high‐quality fluoroscopy and patient po itioning. Of paramount importance is a correct needle approach and placement, followed by accurate cement application under permanent fluoroscopy enabling early recognition of a potential cement leak. Intraosseous venography is advocated by some authors. This allows identification of potential sites of cement leakage along fracture lines before injecting PMMA. However, the value of venography remains controversial. PV is a safe and efficient therapeutic option for patients suffering from otherwise untreatable disabling local back pain caused by osteoporotic VCFs. Indications, contraindications, the technique and possible complications of the treatment have to be taken into account. PV has a low rate of clinical complications, but potential complications can be devastating. AN - CN-01774689 AU - Lohle, P. N. M. KW - *Europe *percutaneous vertebroplasty *society Allergy Backache Bleeding disorder Blood pressure Body height Body position Bone Bone marrow Brain Cardiotoxicity Compression fracture Conservative treatment Control group Drug therapy Epidural drug administration Fat embolism Fluoroscopy Follow up Fracture History Infection Inferior cava vein Intervertebral disk Lung embolism Monitoring Needle Nerve Nuclear magnetic resonance imaging Osteomyelitis Pain Patient Patient positioning Patient selection Phlebography Radicular pain Radiography Randomized controlled trial Risk Scheuermann disease Soft tissue Spike Tissues Vertebra body Vertebral canal M3 - Journal: Conference Abstract N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2009 SP - 268‐ ST - Complications of vertebroplasty T2 - Cardiovascular and interventional radiology TI - Complications of vertebroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01774689/full VL - 32 ID - 830004 ER - TY - JOUR AB - Objective: To evaluate technical effectiveness and complication rate of portosystemic collateral embolization during TIPS procedure in patient with varicose bleeding. Material and method: In the past 8 years authors performed 334 TIPS procedures in patients with variceal bleeding, the embolization of varices was done in 274 patients (82%). The authors embolized 310 portosystemic collaterals (the left gastric vein in 224 cases, the short gastric veins in 46 cases, the splenorenal shunt in four cases). A mixture of acrylate glue was used in most cases of embolization. Results: The success rate of TIPS procedure and adjunctive embolization for initial control of bleeding was 84%, the incidence of rebleeding was 13% (always with shunt dysfunction). Seven patients (2%) continued to bleed even after adequate portal decompression by TIPS. The secondary success rate for control of bleeding was 98%. A partial dislocation or embolization of glue to the portal or pulmonary system was observed in 7 patients (2.5%). Conclusion: An adequate reduction of the portosystemic gradient is the basic method of treatment of bleeding in patients with portosystemic hypertension. Adjunctive embolization of portosystemic collaterals can reduce the rebleeding rate. AD - M. Lojík, Radiologická Klinika FN, 500 05 Hradec Králové, Czech Republic AU - Lojík, M. AU - Krajina, A. AU - Vaňásek, T. AU - Fejar, T. AU - Chovanec, V. AU - Raupach, J. DB - Embase KW - acrylic cement adult article artificial embolization bleeding controlled study epigastric artery female hemostasis human liver circulation lung circulation major clinical study male portal hypertension hepatic portal vein portosystemic anastomosis postoperative complication pressure gradient recurrent disease splenorenal shunt treatment outcome varicosis LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2002 SN - 1210-7883 SP - 188-192 ST - TIPS and adjunctive embolization of variceal bleeding in patients with portal hypertension - Own experience and review of literature T2 - Ceska Radiologie TI - TIPS and adjunctive embolization of variceal bleeding in patients with portal hypertension - Own experience and review of literature UR - https://www.embase.com/search/results?subaction=viewrecord&id=L34546009&from=export VL - 56 ID - 829868 ER - TY - JOUR AB - We report a case of spinal cord and root compression during percutaneous transpedicular polymethylmethacrylate vertebroplasty (PTPV) for a compression fracture due to osteoporosis. Sudden onset of excruciating pain in the distribution of the right sixth intercostal nerve with hyperemia along its path, prompted the interruption of the procedure. Under narcotic sedation the patient was taken to the ICU and 10mg of dexamethasone was administered intravenously. Few hours later she developed paraplegia with preservation of light touch and a CT scan and MRI showed epidural extravasation of polymethylmethacrylate with spinal cord and root compression. Surgical decompression was followed by neurological recovery. The cement could be removed after been thinned out by high speed drill, with microsurgical technique, through a wide three level laminectomy of D5 to D7. Extravasation of cement is commonly encountered in PTPV and most of the time it is asymptomatic. Root compression may require surgical intervention if nonresponsive to steroid treatment. Cord compression is less often seen and requires emergency surgery. The cement does not adhere to the duramater and it can be removed easily. AD - Hosp Moinhos Vento, Serv Neurol & Neurocirurg, Porto Alegre, RS, Brazil. Univ Luterana Brasil, Fac Med, Canoas, RS, Brazil. Univ Luterana Brasil, Neurol Serv, Canoas, RS, Brazil. Lopes, NM (corresponding author), Hosp Moinhos Vento, Serv Neurol & Neurocirurg, Porto Alegre, RS, Brazil. AN - WOS:000227697700027 AU - Lopes, N. M. AU - Lopes, V. K. DA - Sep DO - 10.1590/s0004-282x2004000500027 J2 - Arq. Neuro-Psiquiatr. KW - spinal fracture polymethylmethacrylate osteoporosis vertebroplasty paraplegia METHACRYLATE EMBOLISM Neurosciences Psychiatry LA - English M1 - 3B M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2004 SN - 0004-282X SP - 879-881 ST - Paraplegia complicating percutaneous vertebroplasty for osteoporotic vertebral fracture - Case report T2 - Arquivos De Neuro-Psiquiatria TI - Paraplegia complicating percutaneous vertebroplasty for osteoporotic vertebral fracture - Case report UR - ://WOS:000227697700027 VL - 62 ID - 830433 ER - TY - JOUR AB - We report a prospective study of 30 patients who underwent total hip arthroplasty for osteoarthrosis in order to investigate the haemodynamic and respiratory changes which occur during operation. Cement was used in 17 cases and the implants were not cemented in 13. Pulmonary and cardiac function, blood levels of methylmethacrylate monomer, intramedullary pressure and transoesophageal echocardiography were recorded. Two well differentiated echogenic patterns appeared consistently during the operation. The intramedullary pressure became raised as the cement was inserted. The following changes occurred within seconds and continued for some minutes: elevation of mean arterial pressure and mean pulmonary artery pressure; decrease of arterial oxygen tension and of mixed venous PO2, and greater tissue consumption of oxygen. Although we recorded raised concentration of methylmethacrylate monomer in venous blood after the cement was inserted, there is no evidence that the monomer is responsible for the haemodynamic changes which take place. AD - HOSP UNIV SAN CARLOS, SERV CIRUGIA ORTOPED & TRAUMATOL, E-28040 MADRID, SPAIN. AN - WOS:A1997XZ93700010 AU - LopezDuran, L. AU - GarciaLopez, A. AU - Duran, L. AU - Hurtado, J. AU - Ruiz, C. AU - Rodrigo, J. L. DA - Sep DO - 10.1007/s002640050161 J2 - Int. Orthop. KW - FAT-EMBOLISM CEMENTED ARTHROPLASTY BONE CEMENT REPLACEMENT METHACRYLATE HYPOTENSION MONOMERS Orthopedics LA - English M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1997 SN - 0341-2695 SP - 253-258 ST - Cardiopulmonary and haemodynamic changes during total hip arthroplasty T2 - International Orthopaedics TI - Cardiopulmonary and haemodynamic changes during total hip arthroplasty UR - ://WOS:A1997XZ93700010 VL - 21 ID - 830479 ER - TY - JOUR AB - Percutaneous vertebroplasty is a minimally invasive procedure that uses a bonecutting needle to percutaneously approach a partially collapsed vertebral body, to inject bone cement with the aim to relief pain, as well as stabilize and reinforce the remaining bone structure. The procedure was initially used to treat aggressive hemangiomas, myeloma and osteolytic metastases, but it is currently employed either in osteoporotic compression fractures refractory to medical therapy or traumatic fractures. It has been reported that percutaneous vertebroplasty is useful to relieve pain, improving mobilization, and to reduce or even eliminate analgesic drugs requirements, improving so the quality of life. Although this is a non-free complications procedure, the appropriate patient selection and a thorough technique could make that the benefits surpass the potential risks. AD - F.G. López-Espinoza, Hosp. Civ. de Guadalajara F. A. A., Serv. de Neurologia y Neurocirugia, 44280, Guadalajara, Jalisco, Mexico AU - López-Espinoza, F. G. AU - González-Garrido, A. A. DB - Embase KW - poly(methyl methacrylate) adult case report female fracture treatment human hypotension lung embolism minimally invasive surgery mortality neurological complication osteoporosis percutaneous vertebroplasty pneumothorax postoperative complication postoperative hemorrhage postoperative infection review spine metastasis spine surgery surgical technique treatment outcome vertebra body vertebra compression spine fracture LA - Spanish M1 - 3 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2004 SN - 0187-4705 SP - 175-186 ST - Percutaneous vertebroplasty T2 - Archivos de Neurociencias TI - Percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L40123196&from=export VL - 9 ID - 829837 ER - TY - JOUR AB - INTRODUCTION There is considerable controversy regarding the best method to prevent venous thrombo-embolism. In 2008, the American College of Chest Physicians (ACCP) published specific guidelines recommending the use of low-molecular-weight heparin or warfarin, and a target international normalised ratio of 2.0-3.0 for a duration of at least 7-10 days, after elective knee arthroplasties. Many orthopaedic surgeons believe that these recommendations are biased toward reducing deep venous thrombosis (DVT), but neglect the implicated possibility of a higher incidence of wound complications. In order to enable an objective evaluation of the fit of the ACCP recommendations to the needs of our local cohort of patients, we aimed to look at the incidence of DVT in our local population. Methods This study was a prospective observational study involving existing local patients in Singapore General Hospital, Singapore, who underwent total knee arthroplasty (TKA) and were on a short course of chemothrombo-prophylaxis (< 7 days) after the operation. The incidence of DVT in patients was evaluated using DVT imaging 4-6 days after the operation and at one month after the operation. RESULTS In our study cohort, the prevalence of DVT during the period between postoperative Days 4 and 6 was 12% (11% were distal DVT and 1% was proximal DVT). Only 9% of the patients had DVT one month after the operation. Using chi-square analysis, we found that there was no significant increase in the number of DVT and pulmonary embolism cases 4-6 days and 1 month after the operation (p > 0.05). Conclusion Contrary to the ACCP guidelines, a short course of chemothromboprophylaxis post TKA, lasting no more than 7 days, is safe and adequate in the low-risk Asian population. AD - [Low, Mun Hon; Yeo, Seng Jin; Chin, Pak Lin; Chia, Shi Lu; Lo, Ngai Nung; Tay, Keng Jin] Singapore Gen Hosp, Dept Orthopaed Surg, Singapore 169608, Singapore. Low, MH (corresponding author), Singapore Gen Hosp, Dept Orthopaed Surg, Outram Rd, Singapore 169608, Singapore. mhlow1@gmail.com AN - WOS:000327245300011 AU - Low, M. H. AU - Yeo, S. J. AU - Chin, P. L. AU - Chia, S. L. AU - Lo, N. N. AU - Tay, K. J. DA - Oct J2 - Singap. Med. J. KW - Asians deep venous thrombosis deep venous thrombosis incidence deep venous thrombosis prophylaxis total knee arthroplasty DEEP-VEIN THROMBOSIS VENOUS THROMBOSIS CHINESE PATIENTS PREVENTION THROMBOEMBOLISM PROPHYLAXIS REPLACEMENT CEMENTLESS MUTATION WARFARIN Medicine, General & Internal LA - English M1 - 10 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2013 SN - 0037-5675 SP - 560-563 ST - A Singapore perspective on the use of a short course of chemothromboprophylaxis in patients who underwent total knee arthroplasty T2 - Singapore Medical Journal TI - A Singapore perspective on the use of a short course of chemothromboprophylaxis in patients who underwent total knee arthroplasty UR - ://WOS:000327245300011 VL - 54 ID - 830278 ER - TY - JOUR AB - Introduction and Objective: Multiple studies of first-generation cemented hip replacements (THR) in patients with hemophilia (PWH) showed failure rates as high as 38% at 6 years. 1 Subsequent studies of THR using cementless fixation have shown a reduced but still significant rate of osteolysis and failure of 10-15% after 8-10 years. 2 It is known that the primary mode of failure is polyethylene wear debris migrating into the cement or implant bone interface. Using hip implant wear simulators, McKellop demonstrated dramatic reduction in wear of acetabular liners using highly crosslinked polyethylene(HXLP). 3 In a five-year, double-blinded study of non-hemophilia patients, Mutimer showed 80% reduced wear of HXLP compared to ultrahigh molecular weight polyethylene (0.05 versus 0.26 mm/year respectively)4. In a review of the literature, none of the series of THR in PWH identified the use of HXLP. The objective of this study is to evaluate the efficacy of HXPE in THR in PWH. Materials and Methods: Our center has exclusively used HXLP (Marathon®) in all hip replacements in PWH since 1998. To date, there have been 18 consecutive primary THR in 17 PWH. Four patients died during the study. All hips had cementless fixation. Femoral stems were AML® in 7 and Summit® in the remainder. Twelve femoral heads were cobalt chrome and the remainder ceramic. Acetabular shells were Pinnacle®. All implants were manufactured by Johnson & Johnson DePuy. All surgeries were performed by the same primary surgeon. Linear wear was determined by comparison of immediate post-operative and latest follow-up x-rays. Periacetabular osteolysis zones as described by DeLee and femoral zones described by Gruen were analyzed at follow-up evaluations. Results: Mean follow-up was 9 years (1-16). Patients were not routinely anticoagulated. There were no cases of deep vein thrombosis or pulmonary embolus. There have been no infections, revisions, or reoperations for any reason. No acetabular or femoral osteolysis or acetabular linear wear is evident on any of the films. All patients are “very satisfied” with their result and would recommend it to other PWH. Conclusion: Highly crosslinked polyethylene appears to greatly extend the longevity of THR in PWH and deserves consideration as a bearing material of choice for all acetabular liners. . AD - J. Luck, Orthopaedic Hemophilia Treatment Center, University of California at Los Angeles, Los Angeles, CA, United States AU - Luck, J. AU - Ebramzadeh, E. AU - Quon, D. AU - Mercolino, K. AU - Silva, M. DB - Embase DO - 10.1111/hae.13856 KW - polyethylene ultra high molecular weight polyethylene acetabular liner adult clinical article comparative effectiveness conference abstract controlled study cross linking deep vein thrombosis double blind procedure female femoral head follow up hemophilia human longevity lung embolism male osteolysis reoperation simulator surgeon total hip replacement X ray LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1365-2516 SP - 11 ST - The role of highly crossed linked polyethylene in the longevity of total hip replacements in patients with hemophilia T2 - Haemophilia TI - The role of highly crossed linked polyethylene in the longevity of total hip replacements in patients with hemophilia UR - https://www.embase.com/search/results?subaction=viewrecord&id=L631798122&from=export http://dx.doi.org/10.1111/hae.13856 VL - 25 ID - 829170 ER - TY - JOUR AB - We present a case of a 64-year old female with bilateral knee pain several months after undergoing staged bilateral TKA. Radiolucencies surrounding the keels of bilateral tibial components were found to represent metastatic poorly differentiated endometrial carcinoma. PET scan showed adrenal, pulmonary and tibial foci consistent with metastatic disease. No other cases of bilateral periprosthetic metastasis of endometrial carcinoma have been described in the literature. Metastases around orthopedic implants are a rare occurrence. The possibility of periprosthetic metastasis should remain in the differential diagnosis for any patient with a painful total joint arthroplasty, especially in the setting of a patient with a known diagnosis of cancer elsewhere in their body. AD - W.S. Crawford, Department of Orthopaedics, John Peter Smith Hospital, 1500 S. Main St, Fort Worth, TX, United States AU - Luedke, C. AU - Crawford, W. S. AU - Payne, J. AU - Sanchez, H. B. DB - Embase DO - 10.1016/j.artd.2015.04.001 KW - rotating hinge knee prosthesis 5,10 methylenetetrahydrofolate reductase (FADH2) antineoplastic agent blood clotting factor 5 Leiden C reactive protein cytokeratin AE1 cytokeratin AE3 gentamicin bone cement heparin warfarin adult anticoagulant therapy arthrocentesis article bilateral total knee arthroplasty blood clotting disorder bone biopsy bone cancer cancer chemotherapy cancer diagnosis cancer radiotherapy cancer surgery carcinomatous peritonitis case report cementation computer assisted tomography deep vein thrombosis endometrium biopsy endometrium carcinoma female follow up gene mutation human hysterectomy knee osteoarthritis knee pain knee radiography laparoscopic surgery lung embolism lymph node dissection middle aged omentum carcinoma ovary carcinoma periprosthetic fracture postmenopause bleeding postoperative pain postoperative period postoperative thrombosis robot assisted surgery salpingooophorectomy surgical risk total knee arthroplasty uterine tube carcinoma wheelchair Vanguard LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 2352-3441 SP - 31-35 ST - Metastatic endometrial carcinoma invading bilateral total knee arthroplasties T2 - Arthroplasty Today TI - Metastatic endometrial carcinoma invading bilateral total knee arthroplasties UR - https://www.embase.com/search/results?subaction=viewrecord&id=L608376318&from=export http://dx.doi.org/10.1016/j.artd.2015.04.001 VL - 1 ID - 829372 ER - TY - JOUR AB - PURPOSE OF REVIEW: Vertebroplasty, kyphoplasty and lordoplasty are minimally invasive procedures mainly performed for refractory pain due to osteoporotic vertebral body fractures. This review summarizes recent findings on outcome, complications and their impact on anesthetic management. RECENT FINDINGS: Despite an increasing number of publications on surgical technique, therapeutic efficacy and side effects of these interventions, anesthetic management per se is hardly investigated. All three treatments provide similar pain relief. Adverse effects include local cement leakage and new fractures adjacent to augmented vertebrae. Asymptomatic pulmonary cement embolism occurs in 4.6-6.8% of patients depending on cement viscosity, injection pressure and number of injected vertebrae. Potentially life-threatening embolism of cement or fat may occur. Kyphoplasty and lordoplasty aim at correcting vertebral deformity and are equally effective; lordoplasty is substantially less expensive, however. The incidence of systemic cement or fat embolism is similar to that in vertebroplasty. Whereas vertebroplasty is mostly performed under local anesthesia and sedation, general anesthesia is required for kyphoplasty and lordoplasty. The anesthetic regimen follows the principles of anesthesia in the elderly population. SUMMARY: Vertebroplasty, kyphoplasty and lordoplasty are effective minimally invasive treatments for stable vertebral compression fractures without compression of the spinal canal. The anesthesiologist must be prepared to manage systemic cement or fat embolism. AD - Department of Anesthesiology, University Hospital, Bern, Switzerland. martin.luginbuehl@dkf.unibe.ch AN - 105650984. Language: English. Entry Date: 20080926. Revision Date: 20150711. Publication Type: Journal Article AU - Luginbühl, M. DB - cin20 DP - EBSCOhost KW - Anesthesia -- Methods Kyphoplasty -- Methods Aged Anesthesiology Female Minimally Invasive Procedures Osteoporosis -- Complications Pulmonary Embolism -- Prevention and Control Spinal Fractures Surgery, Operative -- Adverse Effects Surgery, Operative -- Methods M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2008 SN - 0952-7907 SP - 504-513 ST - Percutaneous vertebroplasty, kyphoplasty and lordoplasty: implications for the anesthesiologist T2 - Current Opinion in Anesthesiology TI - Percutaneous vertebroplasty, kyphoplasty and lordoplasty: implications for the anesthesiologist UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105650984&site=ehost-live&scope=site VL - 21 ID - 830747 ER - TY - JOUR AB - Learning Objectives: To show a series of cases which illustrate how 3D laser-guided navigational software (iGuide) can facilitate technical success and decrease complications in a variety of technically challenging cases. Background: Syngo iGuide (Siemens Healthcare AG, Forchheim Germany) is a laser-guided navigational software used for needle guidance after a path is defined on an intraprocedural cone-beam computed tomography (CT) image and the 3D path is transposed onto fluoroscopic images to facilitate percutaneous needle advancement. iGuide allows the procedure to be performed in interventional radiology (IR) rather than the conventional CT suite by combining cone-beam CT with live fluoroscopic imaging. Clinical Findings/Procedure Details: Illustrate the use of iGuide in a variety of complex and technically challenging cases involving percutaneous access for: 1. Single-stick nephrostomy in renal TB with disconnected excretory system. 2. Bilateral nephrostomies in a patient with vesicovaginal fistula and completely decompressed system, which failed regular nephrostomy. 3. Transthoracic PGJ in a non-surgical candidate. 4. Retroperitoneal pancreatic abscess drainage. 5. Spine biopsy right after IVC filter placement in the IR suite. 6. Unipedicular lumbar kyphoplasty in osteolytic breast metastasis. 7. Single-stick, intrahepatic biliary reconnection in type D (acute transection) and type E (chronic occlusion) of main left and main right bile ducts in 2 non-operable patients. 8. Direct Type II aortic endoleak embolization (Onyx). 9. Splanchnic nerve block. 10. Single-stick juxta-aneurysmal calyceal puncture for nephrostomy access after intrarenal aneurysm coiling. 100% technical success was achieved in all cases without any post-procedure complications. The clinical background, indications, and outcomes of these procedures will be discussed in the essay. Conclusions: The iGuide laser-guided navigational system which is based on co-registration of a 3D data set with 2D live fluoroscopic imaging has a spectrum of applications in the IR suite, particularly in clinical cases involving complex vascular and non-vascular interventions which require a high degree of precision and needle guidance in order to achieve technical success without complications. AD - J. Luka, University of Miami, Jackson Memorial Hospital, Miami, FL, United States AU - Luka, J. AU - Kably, M. AU - Salsamendi, J. AU - Narayanan, G. DB - Embase KW - silver interventional radiology society nephrostomy laser procedures needle software human cone beam computed tomography patient imaging filter bone biopsy pancreas abscess nerve block abscess drainage accuracy cystovaginal fistula health care kyphoplasty splanchnic nerve artificial embolization endoleak bile duct occlusion metastatic breast cancer Germany puncture aneurysm registration learning LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1051-0443 SP - S284 ST - iGuide in complex clinical scenarios: A pictorial essay T2 - Journal of Vascular and Interventional Radiology TI - iGuide in complex clinical scenarios: A pictorial essay UR - https://www.embase.com/search/results?subaction=viewrecord&id=L72230014&from=export VL - 27 ID - 829327 ER - TY - JOUR AB - PThirty-seven patients suffering from internal fixation failure in treating intertrochanteric fracture were selected from Department of Orthopaedics, First People's Hospital of Chenzhou between July 2000 and March 2008, including 20 males and 17 females aged 74 years (range 63-84 years). All were treated by total hip replacement (THR) due to cutting damage of screws to femoral head, neck and acetabulum. The THR was performed 13-23 months from the first internal fixation. All patients had no severe cardiorespiratory dysfunction, local infection or other contraindication for replacement. Preoperative Harris scores were (40.0±12.2) points. Among all patients, 18 were treated by cemented THR, and the others by un-cemented. All 37 patients were followed up for average of 6.3 months. The average operative time was (81±13.6) minutes; the average amount of bleeding in operation was (662±51.8) mL. No infection, hypostatic pneumonia, pressing sore or deep venous embolism of lower limbs was found after replacement. Hip pain, weakness, limitation of motion did not occur during the follw-up period. In addition, no loosening or breaking of prosthesis was found on X-ray films, but the osteoporosis was gradually improved. The Harris scores were (83.0±12.4) postoperatively. The outcomes were excellent in 20 cases, good in 12 cases, fair in 4 cases, and poor in 1 case, and the rate of excellent and good was 86.49%. THR is an effective method for intertrochanteric fracture after internal fixation failure. AD - W. Luo, Department of Orthopaedics, First People's Hospital of Chenzhou, Chenzhou 424300 Hunan Province, China AU - Luo, W. AU - Liu, Q. K. AU - Cheng, M. H. DB - Embase KW - bone cement adult aged article clinical article clinical effectiveness female femur intertrochanteric fracture human internal fixator male operation duration osteoporosis osteosynthesis postoperative hemorrhage preoperative evaluation prosthesis complication prosthesis loosening scoring system total hip prosthesis treatment outcome X ray film LA - Chinese M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 1673-8225 SP - 759-762 ST - Total hip replacements for intertrochanteric facture after internal fixation failure in 37 patients T2 - Journal of Clinical Rehabilitative Tissue Engineering Research TI - Total hip replacements for intertrochanteric facture after internal fixation failure in 37 patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L354336582&from=export VL - 13 ID - 829724 ER - TY - JOUR AD - Department of Neuroradiology, University Medical Center Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany. niklas.luetzen@uniklinik-freiburg.de. Department of Neurology, University Medical Center Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany. Department of Anaesthesiology and Critical Care Medicine Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany. Department of Neuroradiology, University Medical Center Freiburg, Breisacher Straße 64, 79106, Freiburg, Germany. AN - 26480873 AU - Lützen, N. AU - Niesen, W. D. AU - Kalbhenn, J. AU - Urbach, H. DA - Jun DO - 10.1007/s00062-015-0474-z DP - NLM ET - 2015/10/21 J2 - Clinical neuroradiology KW - Aged Arthroplasty, Replacement, Hip/*adverse effects Cementation/*adverse effects Cerebral Angiography Diagnosis, Differential Embolism, Fat/*diagnostic imaging/*etiology Female Humans Intracranial Embolism/*diagnostic imaging/*etiology Magnetic Resonance Angiography Treatment Outcome LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1869-1439 SP - 249-50 ST - Teaching Neuroimages: Cerebral Fat Embolism After Cemented Hip Replacement T2 - Clin Neuroradiol TI - Teaching Neuroimages: Cerebral Fat Embolism After Cemented Hip Replacement VL - 26 ID - 828510 ER - TY - JOUR AB - Objective: To study the clinical efficacy of modified percutaneous vertebroplasty (PVP) in the treatment of painful old osteoporosis vertebral compression fractures (OVCF). Methods: From April 2007 to October 2009, 16 cases (23 vertebrae) of symptomic old OVCF were treated with a modified PVP. Before operation, all the patients were examined by standing anteroposterior and lateral X-Ray and MRI. The pain level of each patient was assessed before operation and 1 week, 6, 12 months after the operation using visual analogue scale (VAS) and Oswestry disability index (ODI). The middle line vertebral body height and local sagittal Cobb's angle were also measured. Results: Postoperative average VAS, Oswestry disability index (ODI), the local sagittal Cobb's angle decreased from 7.8, 72.3%, and 38.28 to 3.1, 26.8%, and 21.58 respectively before and after surgery (p < 0.05). The mean midline vertebral height increased from 13.8 mm to 26.6 mm before and after surgery (p < 0.05). There was no infection, nerve injury, pulmonary embolism, or death after operation. Conclusions: The modified PVP can increase the space for bone cement filling and is good for the restoration of vertebral body height. It is an optimal procedure for the treatment of painful old OVCF. (C) 2011 Elsevier Ltd. All rights reserved. AD - [Ma Shengzhong; Wu Dongjin; Wu Shiqing; Song Yang; Ren Peng; Ma Wanli; Gao Chunzheng] Shandong Univ, Dept Spinal Surg, Hosp 2, Jinan 250033, Shandong, Peoples R China. Gao, CZ (corresponding author), Shandong Univ, Dept Spinal Surg, Hosp 2, 247 Beiyuan Rd, Jinan 250033, Shandong, Peoples R China. gaochunzheng@yahoo.com.cn AN - WOS:000302140100017 AU - Ma, S. Z. AU - Wu, D. J. AU - Wu, S. Q. AU - Song, Y. AU - Ren, P. AU - Ma, W. L. AU - Gao, C. Z. DA - Apr DO - 10.1016/j.injury.2011.12.021 J2 - Injury-Int. J. Care Inj. KW - Old OVCF Modification PVP Clinical outcome BALLOON KYPHOPLASTY CLINICAL-OUTCOMES EFFICACY Critical Care Medicine Emergency Medicine Orthopedics Surgery LA - English M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2012 SN - 0020-1383 SP - 486-489 ST - Modification of percutaneous vertebroplasty for painful old osteoporotic vertebral compression fracture in the elderly: Preliminary report T2 - Injury-International Journal of the Care of the Injured TI - Modification of percutaneous vertebroplasty for painful old osteoporotic vertebral compression fracture in the elderly: Preliminary report UR - ://WOS:000302140100017 VL - 43 ID - 830308 ER - TY - JOUR AB - Aims: To report two cases of anterior spinal cord syndrome and two other complications of direct cement leakage in the arterial vessels after vertebroplasty. Methods: The first case is the case of a 20-year-old man who has been diagnosed with multifocal Ewing sarcoma since 5 months. The imaging studies, X-ray and CT scan, showed the presence of pathologic fractures of T8 and L1 vertebrae. There was no retropulsion of bony fragment in the vertebral canal. A percutaneous vertebroplasty of T8 and L1 level was performed. Immediately after the procedure, the patient experienced a total paralysis and loss of sensitivity to pain and temperature in both lower limbs; however, deep pressure sensation and 2-point discrimination below the umbilicus were preserved. CT scans showed no leakage of polymethylmethacrylate (PMMA) out of T8 and L1 vertebral bodies, with opacification of the right intercostal artery at the L1 level, and a segment of the anterior spinal artery at the T10-L1 level. The second case is another case of an anterior spinal artery syndrome following vertebroplasty in a 63 y.o female who was operated of open decompression with vertebroplasty for a pathologic compression fracture of T9-T10 level from metastatic adenocacinoma. The third case is the case of an aortic embolism of cement in a 72 y.o female who underwent percutaneous vertebroplasty for a pathologic L3 compression fracture due to metastatic breast cancer. The last one is the case of a peripheral arterial embolization of cement during revision spine surgery in a 47 y.o female who was operated of T8-S1 spine fusion. The patient presented, immediately after the surgery, an acute ischemic leg syndrome and the cement was identified in the posterior tibial artery Results: Vertebroplasty is commonly performed for the management of pain associated with benign compression fractures, multiple myelomas, lymphomas, vertebral metastatic lesions, and hemangiomas. We describe four severe complications associated with this procedure; Conclusion: Although percutaneous vertebroplasty has many benefits, including its simplicity and relative safety, it could lead to serious complications. Theses current cases demonstrate the direct leakage of cement within the arterial system leading to severe complications. Thus we note the importance of viscosity of the cement in order to prevent leakage within the vascular system and we highlight the advantage of kyphoplasty in preventing cement leakage to the arterial system by high pressure introduction. AD - G.N. Maalouf, Musculo Skeletal Department, Belle View University Medical Center, Mansourieh, Lebanon AU - Maalouf, G. N. AU - Yazbeck, P. AU - Bachour, F. AU - Rouhbane, R. AU - Slaba, S. AU - Kreichaty, G. AU - Kharrat, K. DB - Embase DO - 10.1007/s00198-011-1743-6 KW - cement poly(methyl methacrylate) percutaneous vertebroplasty osteoporosis Africa Middle East artery compression fracture human female pain leg patient computer assisted tomography safety viscosity cardiovascular system spine surgery kyphoplasty hyperbarism spinal cord male Ewing sarcoma imaging X ray pathologic fracture vertebra vertebral canal paralysis temperature umbilicus vertebra body spinal cord ischemia decompression embolism breast cancer artificial embolization spine fusion surgery tibial artery multiple myeloma lymphoma hemangioma pressure sensation LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 0937-941X SP - S747 ST - Arterial complications of vertebroplasty T2 - Osteoporosis International TI - Arterial complications of vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70585830&from=export http://dx.doi.org/10.1007/s00198-011-1743-6 VL - 22 ID - 829608 ER - TY - JOUR AB - An acrylic cement pulmonary embolus is a rare complication of percutaneous vertebroplasty. Many patients remain completely asymptomatic, but others may present with chest discomfort, dyspnea, and even cardiovascular collapse leading to death. Here we present an asymptomatic patient initially thought to have a central venous catheter pulmonary artery embolus based on the morphology of the foreign body on imaging exams. A more thorough investigation established the diagnosis of an acrylic cement pulmonary embolus resulting from percutaneous vertebroplasty procedures performed many months before the embolus discovery. The diagnostic work-up, treatment strategy, and a review of the literature are presented. AD - Department of Surgery, University of Nebraska Medical Center, Omaha, NE 68198-3280, USA. AN - 16414409 AU - MacTaggart, J. N. AU - Pipinos, II AU - Johanning, J. M. AU - Lynch, T. G. DA - Jan DO - 10.1016/j.jvs.2005.09.002 DP - NLM ET - 2006/01/18 J2 - Journal of vascular surgery KW - Aged *Catheterization Catheterization, Central Venous/*instrumentation Diagnosis, Differential Equipment Failure Female Foreign-Body Migration/*complications/*diagnostic imaging Humans *Polymethyl Methacrylate *Pulmonary Artery Pulmonary Embolism/*diagnostic imaging/*etiology Radiography LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0741-5214 (Print) 0741-5214 SP - 180-3 ST - Acrylic cement pulmonary embolus masquerading as an embolized central venous catheter fragment T2 - J Vasc Surg TI - Acrylic cement pulmonary embolus masquerading as an embolized central venous catheter fragment VL - 43 ID - 828910 ER - TY - JOUR AB - An acrylic cement pulmonary embolus is a rare complication of percutaneous vertebroplasty. Many patients remain completely asymptomatic, but others may present with chest discomfort, dyspnea, and even cardiovascular collapse leading to death. Here we present an asymptomatic patient initially thought to have a central venous catheter pulmonary artery embolus based on the morphology of the foreign body on imaging exams. A more thorough investigation established the diagnosis of an acrylic cement pulmonary embolus resulting from percutaneous vertebroplasty procedures performed many months before the embolus discovery. The diagnostic work-up, treatment strategy, and a review of the literature are presented. Copyright © 2006 by The Society for Vascular Surgery. AD - I.I. Pipinos, Department of Surgery, 983280 Nebraska Medical Center, Omaha, NE 68198-3280, United States AU - MacTaggart, J. N. AU - Pipinos, I. I. AU - Johanning, J. M. AU - Lynch, T. G. DB - Embase Medline DO - 10.1016/j.jvs.2005.09.002 KW - acrylic cement aged bone biopsy cancer chemotherapy case report central venous catheter computed tomographic angiography female human lung embolism multiple myeloma percutaneous vertebroplasty priority journal review stem cell transplantation spine fracture LA - English M1 - 1 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 0741-5214 SP - 180-183 ST - Acrylic cement pulmonary embolus masquerading as an embolized central venous catheter fragment T2 - Journal of Vascular Surgery TI - Acrylic cement pulmonary embolus masquerading as an embolized central venous catheter fragment UR - https://www.embase.com/search/results?subaction=viewrecord&id=L43083530&from=export http://dx.doi.org/10.1016/j.jvs.2005.09.002 VL - 43 ID - 829803 ER - TY - JOUR AD - Heart Center Leipzig - University Hospital, Department of Cardiology, Leipzig, Germany. Electronic address: nicolas.majunke@medizin.uni-leipzig.de. Heart Center Leipzig - University Hospital, Department of Cardiology, Leipzig, Germany. AN - 30268873 AU - Majunke, N. AU - Unger, E. AU - Besler, C. AU - Sandri, M. DA - Oct 22 DO - 10.1016/j.jcin.2018.07.033 DP - NLM ET - 2018/10/01 J2 - JACC. Cardiovascular interventions KW - Aged Bone Cements/*adverse effects Diagnosis, Differential Embolism/*diagnostic imaging/etiology Female Foreign-Body Migration/*diagnostic imaging/etiology Humans Predictive Value of Tests Spinal Fusion/*adverse effects Vena Cava, Inferior/*diagnostic imaging *cement emboli *intracaval foreign body *transcatheter retrieval LA - eng M1 - 20 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 1936-8798 SP - e171-e172 ST - Differential Diagnosis for an Intracaval Foreign Body T2 - JACC Cardiovasc Interv TI - Differential Diagnosis for an Intracaval Foreign Body VL - 11 ID - 828498 ER - TY - JOUR AB - Percutaneous vertebroplasty has gained widespread popularity and demonstrated clinical efficacy in the treatment of spinal osteoporotic compression fractures and pathologic osteolytic lesions. Despite its rapid pain relief and safety, this minimally invasive intervention has exhibited some rare complications over the past decade. In this case study, we describe a patient with an uncommon complication of polymethylmethacrylate (PMMA) cement pulmonary embolism following fluoroscopy-guided percutaneous vertebroplasty for treatment of pain associated with an osteoporotic vertebral fracture. We present this case to highlight that vertebroplasty is not risk-free and that knowledge of such potentially severe complication is necessary for prevention and optimal operative outcomes. AD - Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. Department of Radiology, Mount Carmel West Medical Center, Columbus, Ohio, USA. AN - 26331092 AU - Makary, M. S. AU - Zucker, I. L. AU - Sturgeon, J. M. C2 - Pmc4548728 DA - Aug DO - 10.1177/2058460115595660 DP - NLM ET - 2015/09/04 J2 - Acta radiologica open KW - Vertebroplasty complication polymethylmethacrylate (PMMA) pulmonary embolism LA - eng M1 - 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 2058-4601 (Print) SP - 2058460115595660 ST - Venous extravasation and polymethylmethacrylate pulmonary embolism following fluoroscopy-guided percutaneous vertebroplasty T2 - Acta Radiol Open TI - Venous extravasation and polymethylmethacrylate pulmonary embolism following fluoroscopy-guided percutaneous vertebroplasty VL - 4 ID - 828759 ER - TY - JOUR AB - INTRODUCTION: Pulmonary artery (PA) cement embolus (CE) is an infrequently reported complication of vertebral augmentation procedures, including vertebroplasty and kyphoplasty, and has a reported rate between 3.5% and 23%.1,2 Cement can leak into the immediately surrounding vertebral venous system, through the azygous vein and right atrium, and into the PA system, where the PA-CE can cause acute pulmonary distress and detriment to the patient. CASE PRESENTATION: We present three cancer patients who developed PA-CE following vertebral augmentation procedures. Patient 1 (Pt1) presented with back pain attributed to multiple myeloma and underwent T9 and L4 kyphoplasty. On postoperative day (POD) 1, Pt1 complained of dyspnea and band-like chest pain with inspiration, was diagnosed by CT pulmonary angiogram with a left lower PA-CE, and was managed with dalteparin. Patient 2 (Pt2) presented with back pain attributed to metastatic breast carcinoma and underwent L2 corpectomy, followed by L1-L3 instrumented fusion and L1 and L3 vertebroplasty. Pt2 developed persistent tachycardia, dyspnea, and chest pain, was diagnosed on POD9 by CT pulmonary angiogram with a left lower PA-CE as well as by echocardiogram with a right atrial echogenic structure, and was managed with dalteparin initially, followed by enoxaparin for 2 months, and then rivaroxaban for another 2 months. Patient 3 (Pt3) presented with back pain attributed to multiple myeloma and underwent T8-T12 kyphoplasty, with L2 kyphoplasty 2 months later. Pt3 presented with pneumonia-like symptoms on POD74, was diagnosed by contrast CT scan with a right lower PA-CE, and underwent right lower lobectomy after an attempted PA embolectomy. DISCUSSION: PA-CE is unpredictable in onset and presentation and, therefore, a challenging diagnosis without imaging. Risk of cement extravasation is increased with low viscosity, increased pressure, and volume of cement injection.3 Intraoperative recommendations aim to reduce extravasation accordingly. Postoperative chest x-ray screening is recommended for all patients2,3, and treatment is recommended for symptomatic patients or patients with central emboli.2 Anticoagulation therapy for six months is preferred in most cases. However, surgery is indicated with large emboli and cardiopulmonary dysfunction.2 CONCLUSIONS: PA-CE is a clinically significant, although underreported, complication arising from vertebral augmentation procedures. As this complication has variable presentation and may follow a seemingly uncomplicated surgery, recognition may provide a challenge for clinicians. AD - A. Malik, Moffitt Cancer Center, Tampa, FL, United States AU - Malik, A. AU - Litz, C. AU - Tran, N. AU - Moodie, C. AU - Garrett, J. AU - Fontaine, J. P. AU - Toloza, E. DB - Embase DO - 10.1016/j.chest.2017.08.1055 KW - cement dalteparin enoxaparin rivaroxaban adult anticoagulant therapy artificial embolization backache cancer patient cancer surgery carcinoma case report complication diagnosis dyspnea echocardiography embolectomy extravasation female heart right atrium human injection kyphoplasty lobectomy lung angiography male metastatic breast cancer multiple myeloma pneumonia pulmonary artery surgery tachycardia thorax pain vertebra viscosity x-ray computed tomography LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1931-3543 SP - A1022 ST - Pulmonary artery cement embolization after vertebral augmentation procedures T2 - Chest TI - Pulmonary artery cement embolization after vertebral augmentation procedures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L619296522&from=export http://dx.doi.org/10.1016/j.chest.2017.08.1055 VL - 152 ID - 829237 ER - TY - JOUR AD - Moffitt Cancer Center, Tampa, FL AN - 125701789. Language: English. Entry Date: In Process. Revision Date: 20191127. Publication Type: Article. Supplement Title: Oct2017 Supplement. Journal Subset: Biomedical AU - Malik, Adil AU - Litz, Cristen AU - Tran, Nam AU - Moodie, Carla AU - Garrett, Joseph AU - Fontaine, Jacques-Pierre AU - Toloza, Eric DB - cin20 DO - 10.1016/j.chest.2017.08.1055 DP - EBSCOhost N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 0012-3692 SP - A1022-A1022 ST - Pulmonary Artery Cement Embolization After Vertebral Augmentation Procedures T2 - CHEST TI - Pulmonary Artery Cement Embolization After Vertebral Augmentation Procedures UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=125701789&site=ehost-live&scope=site VL - 152 ID - 830563 ER - TY - JOUR AB - Introduction: Minimally invasive approaches entail an increased risk of malpositioning and peri-operative complications. Most studies analyzed these data only on plain X-ray rather than computed tomodensitometry (CT) in assessing implant positioning. Hypothesis: A Röttinger minimally invasive anterolateral (MIS-AL) approach provides rapid complication-free functional recovery with reliable implant positioning on CT-scan. Patients and method: One hundred and three primary cemented total hip replacements (THR) performed by a single surgeon using a MIS-AL approach underwent clinical assessment at six weeks and three, six and 12 months on X-ray, including CT and postoperative myoglobinemia and creatine phosphokinase (CPK). Results: Pain, on a visual analog scale, was graded less than 1 at 36. hours; canes ceased to be used at a mean three weeks; and mean Postel-Merle-D'Aubigné score at six months was 17.36 (range, 13-18). There were ten approach-related complications (9.7%: one femoral perforation, two dislocations, two femoral neck fissures, two cases of meralgia paresthetica and three of tensor tendinitis). Mean CPK level was 390.9 ± 252 μg/L (range, 88-1095 μg/L) at 24 hr postoperatively and 319 ± 256 μg/L (95-1028 μg/L) at 48 hr. Mean postoperative myoglobinemia was 299 ± 152.6 μg/L (75-914 μg/L). Mean acetabular inclination and anteversion on CT were respectively 44.7° ± 4.6° (34°-56°) and 9.2° ± 9.2° (-17°-35°) and mean femoral anteversion 23.5° ± 9.4° (2°-53°). Discussion: Functional recovery was quick, but with an 8.7% complications rate (excluding four cases of spontaneously resolved tendon pain). CT showed reliable cup positioning, but a wide scatter in femoral anteversion. Elevated muscle enzyme levels possibly testified to approach-related tissue attrition. The MIS-AL approach involves a learning curve to avoid femoral perforation. It provided rapid functional recovery with reliable positioning, at least for the cup, and a low rate of associated complications. Level of evidence: III, prospective continuous study. © 2011 Elsevier Masson SAS. AD - C. Mandereau, Charles-Nicolle University Hospital Center, 1, rue de Germont, 76031 Rouen, France AU - Mandereau, C. AU - Brzakala, V. AU - Matsoukis, J. DB - Embase Medline DO - 10.1016/j.otsr.2011.10.005 KW - creatine kinase morphine myoglobin adduction adult aged article body mass clinical assessment computer assisted tomography controlled study creatine kinase blood level female femoral perforation follow up hematocrit hip dislocation human lung embolism major clinical study male minimally invasive surgery ossification osteoarthritis outcome assessment perforation postoperative care postoperative complication postoperative myoglobinemia postoperative pain priority journal prospective study tendinitis thrombophlebitis total hip prosthesis visual analog scale LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1877-0568 SP - 8-16 ST - Functional recovery, complications and CT positioning of total hip replacement performed through a Röttinger anterolateral mini-incision. Review of a continuous series of 103 cases T2 - Orthopaedics and Traumatology: Surgery and Research TI - Functional recovery, complications and CT positioning of total hip replacement performed through a Röttinger anterolateral mini-incision. Review of a continuous series of 103 cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L364198186&from=export http://dx.doi.org/10.1016/j.otsr.2011.10.005 VL - 98 ID - 829581 ER - TY - JOUR AB - Introduction:Burst fractures can be debilitating in elderly population and surgical intervention is the desired treatment if conservative management is not tolerated. Here we highlight a rare potential life-threatening complication of vertebroplasty/kyphoplasty. Case Presentation: A 76 year old woman with medical history of osteoporosis and diastolic heart failure presented with a fall. Computed Tomography (CT) Spine showed acute burst fracture of L1 vertebra requiring T9- pelvis posterior spinal fusion with cement augmentation. Postoperative Chest X-ray (CXR) showed multiple radio densities superimposed over both lungs, with some branching. On Postoperative day (POD) 2 she needed diuresis for hypoxia due to pulmonary edema. On POD 7 she underwent thoracentesis for a right sided pleural effusion. On POD 8 she had hypoxia for which a CT Angiogram thorax was done which was negative for pulmonary embolism and redemonstrated large right sided pleural effusion and was followed by a chest tube placement. Repeat CT thorax (FIG 1) on POD 11 showed multiple radiopaque densities involving the distal pulmonary arteries, likely representing cement emboli from recent spinal surgery. On POD 13 she was diagnosed with asymptomatic distal Pulmonary Cement Embolism (PCE). Patient was discharged without anti-coagulation with outpatient follow up Discussion: PCE is a rare potentially life-threatening complication of vertebroplasty/kyphoplasty which occurs as a result of transvertebral cement leakage into the paravertebral veins that embolize to pulmonary arteries. There is a 80 -90% incidence of focal cement leakage to the surrounding tissues following vertebral procedures. However the risk of cement embolism ranges from 3.5 -23%. PCE appears as multiple radio densities with tubular and branching shape, scattered throughout the lungs as seen in our patient's CXR. As cement is high attenuating on CT scan, non-contrast imaging is better for appreciation of the distribution of PCE. Treatment options include clinical monitoring, anti-coagulation, surgical removal. Asymptomatic patients with peripheral emboli are generally managed conservatively. Conclusion : Postoperative CXR can help with early diagnosis of PCE. Treatment is patient specific as there are no set guidelines. (Figure Presented). AD - R. Mandru, Internal Medicine, SUNY Upstate Medical University, Syracuse, NY, United States AU - Mandru, R. AU - Grewal, H. AU - Amzuta, I. G. AU - Martinez-Balzano, C. DB - Embase KW - cement aged anticoagulation case report chest tube clinical article complication computer assisted tomography conference abstract diagnosis diastolic heart failure diuresis drug combination early diagnosis female first lumbar vertebra follow up fracture hospital discharge human human cell hypoxia incidence kyphoplasty lung edema lung embolism medical history osteoporosis outpatient pelvis pharmacokinetics pleura effusion practice guideline pulmonary artery spine fusion surgery thoracocentesis thorax radiography vein LA - English M1 - 9 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1535-4970 ST - Is there a paved path between the lungs and back bone? T2 - American Journal of Respiratory and Critical Care Medicine TI - Is there a paved path between the lungs and back bone? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L630350038&from=export VL - 199 ID - 829140 ER - TY - JOUR AB - Although the first percutaneous vertebroplasty operation on man was performed in a patient with an expanding odontoid angioma, the scientific literature has focused mainly on the possible applications of injecting polymethylmethacrylate cement to treat vertebral body compression fractures caused by osteoporosis. However, in recent years there has been a renewed interest in the use of vertebroplasty to treat benign and malignant spinal tumours as it reduces the risk of vertebral collapse. The technique is less invasive than vertebrectomy and can be applied instead of or in addition to radiotherapy which does not always relieve pain. In the case of expanding angiomas, vertebroplasty can precede possible glue embolization of the lesion, thereby shrinking the tumour's vascular bed. The expanding diseases of the spine for which percutanous vertebroplasty is indicated include expanding angiomas, vertebral body tumours (usually from chronic myeloid leukaemia or multiple myeloma), and metastases, as long as the vertebral posterior arch is spared: damage to the arch would preclude true spinal stability even after treatment and reduce the analgesic potential of the procedure. Vertebroplasty usually relieves pain in a period varying from 24-48 h up to 30 days, with an average of seven days. The main risk of vetebroplasty in patients with spinal tumour is leakage of cement during injection. Nowadays, vertebroplasty represents a new weapon in the arsenal available to interventional neuroradiology in the treatment of single or multiple tumours of the spine. AD - AO Cannizzario, UO Neuroradiol, Catania, Italy. luigi_manfre@ctonline.it AN - WOS:000180056300012 AU - Manfre, L. AU - Tomarchio, L. AU - Materazzo, D. AU - Leonardo, M. AU - Cristaudo, C. DA - Aug DO - 10.1177/197140090201500416 J2 - Riv. Neuroradiol. KW - spinal tumours vertebroplasty PERCUTANEOUS VERTEBROPLASTY BONE METASTASES COMPRESSION FRACTURES RADIATION-THERAPY PAIN RELIEF POLYMETHYLMETHACRYLATE IRRADIATION INJECTION CEMENT Neurosciences Neuroimaging Radiology, Nuclear Medicine & Medical Imaging LA - Italian M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2002 SN - 1120-9976 SP - 461-472 ST - Vertebroplasty in spinal tumours T2 - Rivista Di Neuroradiologia TI - Vertebroplasty in spinal tumours UR - ://WOS:000180056300012 VL - 15 ID - 830451 ER - TY - JOUR AB - Although the first percutaneous vertebroplasty operation on man was performed in a patient with an expanding odontoid angioma, the scientific literature has focused mainly on the possible applications of injecting polymethylmethacrylate cement to treat vertebral body compression fractures caused by osteoporosis. However, in recent years there has been a renewed interest in the use of vertebroplasty to treat benign and malignant spinal tumours as it reduces the risk of vertebral collapse. The technique is less invasive than vertebrectomy and can be applied instead of or in addition to radiotherapy which does not always relieve pain. In the case of expanding angiomas, vertebroplasty can precede possible glue embolization of the lesion, thereby shrinking the tumour's vascular bed. The expanding diseases of the spine for which percutanous vertebroplasty is indicated include expanding angiomas, vertebral body tumours (usually from chronic myeloid leukaemia or multiple myeloma), and metastases, as long as the vertebral posterior arch is spared: damage to the arch would preclude true spinal stability even after treatment and reduce the analgesic potential of the procedure. Vertebroplasty usually relieves pain in a period varying from 24-48 h up to 30 days, with an average of seven days. The main risk of vetebroplasty in patients with spinal tumour is leakage of cement during injection. Nowadays, vertebroplasty represents a new weapon in the arsenal available to interventional neuroradiology in the treatment of single or multiple tumours of the spine. AD - L. Manfrè, Servizio di Neuroradiologia, Ospedale Cannizzaro, via Messina 829, 95126 Catania, Italy AU - Manfrè, L. AU - Tomarchio, L. AU - Materazzo, D. AU - Leonardo, M. AU - Cristaudo, C. DB - Embase DO - 10.1177/197140090201500416 KW - bone cement poly(methyl methacrylate) analgesia artificial embolization conference paper fracture human injection intermethod comparison multiple myeloma myeloid leukemia neuroradiology osteoporosis percutaneous vertebroplasty risk assessment spine metastasis spine stabilization spine surgery spine tumor procedures treatment outcome LA - Italian M1 - 4 M3 - Conference Paper N1 - Embase Elsevier literature search January 5, 2021 PY - 2002 SN - 1120-9976 SP - 461-472 ST - Vertebroplasty in spinal tumours T2 - Rivista di Neuroradiologia TI - Vertebroplasty in spinal tumours UR - https://www.embase.com/search/results?subaction=viewrecord&id=L36432966&from=export http://dx.doi.org/10.1177/197140090201500416 VL - 15 ID - 829877 ER - TY - JOUR AB - The ability to have on-site access to cross-sectional imaging in a biplane neuroangiography suite has tremendous potential for enhancing current neurointerventional practice.Although a few prototypical multimodality suites have been created, several problems/limitations have prevented widespread implementation. Recently, a portable CT scanner has been developed, which may overcome previous shortcomings. We review our recent clinical experience with this new modality, exploring numerous adjunctive diagnostic and therapeutic applications. Forty-one patients underwent periprocedural CT using the Tomoscan M/EG portable CT (Philips). The portable CT scanner is kept at the "head-end" of the biplane neuroangiography suite, being moved into position as needed before, after, or during a procedure. A pivoting angiographic table permits excellent z-plane mobility for rapid gantry to fluoroscopy positioning. Five mm slices at five mm increments were obtained. High quality images were obtained in all cases. The portable CT scanner could be quickly positioned and activated within five min. Total scanning time for a typical case, including initial positioning and set-up was 10-12 min. Twelve of 41 cases were performed adjunctively during diagnostic angiography; 29/41 were performed in an interventional setting.Twenty of 29 scan evaluated baseline or post-therapeutic status of the brain (e.g., Guglielmi detachable coil aneurysm obliteration, arteriovenous malformation (AVM) embolisation, local thrombolysis); 9/29 provided cross-sectional guidance to various interventions (direct puncture embolisation, percutaneous vertebroplasty, spinal biopsy, discography). Use of the portable CT scanner permitted rapidly accessible high quality cross sectional imaging within the biplane neuroangiography suite, which augmented diagnostic and therapeutic decision-making, and therapeutic intervention. AD - The Interventional Neuroradiology Service, Department of Radiology, Yale New-Haven Hospital; New Haven, Connecticut, USA - john-chaloupka@niowa.edu. AN - 20667200 AU - Mangla, S. AU - Chaloopka, J. C. AU - Huddle, D. C. C2 - Pmc3679679 DA - Sep 30 DO - 10.1177/159101990000600306 DP - NLM ET - 2000/09/30 J2 - Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2000 SN - 1591-0199 (Print) 1591-0199 SP - 211-20 ST - Early clinical experience with a dedicated portable computed tomography scanner in a biplane neuroangiography suite: assessment of feasibility and utility in neurointerventional practice T2 - Interv Neuroradiol TI - Early clinical experience with a dedicated portable computed tomography scanner in a biplane neuroangiography suite: assessment of feasibility and utility in neurointerventional practice VL - 6 ID - 829027 ER - TY - JOUR AB - The ability to have on-site access to cross-sectional imaging in a biplane neuroangiography suite has tremendous potential for enhancing current neurointerventional practice. Although a few prototypical multimodality suites have been created, several problems/limitations have prevented widespread implementation. Recently, a portable CT scanner has been developed, which may overcome previous shortcomings. We review our recent clinical experience with this new modality, exploring numerous adjunctive diagnostic and therapeutic applications. Forty-one patients underwent periprocedural CT using the Tomoscan M/EG portable CT (Philips). The portable CT scanner is kept at the "head-end" of the biplane neuroangiography suite, being moved into position as needed before, after, or during a procedure. A pivoting angiographic table permits excellent z-plane mobility for rapid gantry to fluoroscopy positioning. Five mm slices at five mm increments were obtained. High quality images were obtained in all cases. The portable CT scanner could be quickly positioned and activated within five min. Total scanning time for a typical case, including initial positioning and set-up was 10-12 min. Twelve of 41 cases were performed adjunctively during diagnostic angiography; 29/41 were performed in an interventional setting. Twenty of 29 scan evaluated baseline or post-therapeutic status of the brain (e.g., Guglielmi detachable coil aneurysm obliteration, arteriovenous malformation (AVM) embolisation, local thrombolysis); 9/29 provided cross-sectional guidance to various interventions (direct puncture embolisation, percutaneous vertebroplasty, spinal biopsy, discography). Use of the portable CT scanner permitted rapidly accessible high quality cross sectional imaging within the biplane neuroangiography suite, which augmented diagnostic and therapeutic decision-making, and therapeutic intervention. AD - J.C. Chaloupka, Interventional Neuroradiology Serv., Univ. of Iowa Hospital and Clinics, JPP 3891 Univ. of Iowa Hosp./Clinics, 200 Hawkins Drive, Iowa City, IA 52242-1077, United States AU - Mangla, S. AU - Chaloupka, J. C. AU - Huddle, D. C. DB - Embase KW - arteriovenous malformation article artificial embolization biomedical technology assessment brain artery aneurysm computed tomography scanner software diagnostic imaging digital subtraction angiography feasibility study neuroradiology surgical technique BN3000 Sun SPARC 5 Tomoscan M/EG LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2000 SN - 1123-9344 SP - 211-220 ST - Early clinical experience with a dedicated portable computed tomography scanner in a biplane neuroangiography suite: Assessment of feasibility and utility in neurointerventional practice T2 - Interventional Neuroradiology TI - Early clinical experience with a dedicated portable computed tomography scanner in a biplane neuroangiography suite: Assessment of feasibility and utility in neurointerventional practice UR - https://www.embase.com/search/results?subaction=viewrecord&id=L32011138&from=export VL - 6 ID - 829886 ER - TY - JOUR AB - Background: Vertebroplasty is a minimally invasive procedure commonly performed for vertebral compression fractures secondary to osteoporosis or malignancy. Leakage of bone cement into the paravertebral venous system and cement pulmonary embolism (cPE) are well described, mostly in patients with osteoporosis. Little is known about the clinical sequelae and outcomes in cancer patients. In this study, we report our experience with cPE following vertebroplasty performed in cancer patients.Methods: Records of all consecutive cancer patients who underwent vertebroplasty at our institution were retrospectively reviewed. The procedure was performed via percutaneous injection of barium-opacified polymethyl-methacrylate cement.Results: A total of 102 cancer patients with a median age of 53 (19-83) years were included. Seventy-eight (76.5%) patients had malignant vertebral fractures, and 24 (23.5%) patients had osteoporotic fractures. Cement PE was detected in 13 (12.7%) patients; 10 (76.9%) patients had malignant fractures, and the remaining three had osteoporotic fractures. Cement PE was mostly asymptomatic; however, 5 (38.5%) patients had respiratory symptoms that led to the diagnosis. Only the five symptomatic patients were anticoagulated. Cement PE was more common with multiple myeloma (MM); it occurred in 7 (18.9%) of the 37 patients with MM compared with only three (7.3%) of the 41 patients with other malignancies. No difference in incidence was observed between patients with osteoporotic or malignant vertebral fractures.Conclusions: Cement PE is a relatively common complication following vertebroplasty and is mostly asymptomatic. Multiple myeloma is associated with the highest risk. Large-scale prospective studies can help identify risk factors and clinical outcomes and could lead to better prevention and therapeutic strategies. AD - Department of Radiology, King Hussein Cancer Center, Amman, Jordan Istishari Hospital, Amman, Jordan Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan AN - 127895126. Language: English. Entry Date: 20180801. Revision Date: 20180801. Publication Type: journal article AU - Mansour, Asem AU - Abdel-Razeq, Nayef AU - Abuali, Hussein AU - Makoseh, Mohammad AU - Shaikh-Salem, Nouran AU - Abushalha, Kamelah AU - Salah, Samer DB - cin20 DO - 10.1186/s40644-018-0138-8 DP - EBSCOhost KW - Pulmonary Embolism -- Etiology Neoplasms -- Complications Vertebroplasty -- Adverse Effects Spinal Fractures -- Surgery Postoperative Complications -- Etiology Bone Cements -- Adverse Effects Aged, 80 and Over Male Middle Age Female Adult Postoperative Complications -- Epidemiology Spinal Fractures -- Etiology Pulmonary Embolism -- Epidemiology Aged Human N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2018 SN - 1740-5025 SP - 1-6 ST - Cement pulmonary embolism as a complication of percutaneous vertebroplasty in cancer patients T2 - Cancer Imaging TI - Cement pulmonary embolism as a complication of percutaneous vertebroplasty in cancer patients UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=127895126&site=ehost-live&scope=site VL - 18 ID - 830554 ER - TY - JOUR AB - Introduction: Kyphoplasty is a recent procedure aplyed in Geraiatric Medicine. One of the complications is Cement Embolism. The incidence, diagnostic procedure and tratment of this complications still remain unclear. Method: We expose here a case of pumonary cement embolism. A kiphoplasty was performed in a 86 years-old woman. This treatment soon resolve the pain, even she could leave opioids. However, she refered malaise, exercise intolerance and dyspnea, so intense that she could not walk more than 10 meters. She had Hypertension, and a stage IIIb Cronic Renal Disease. She lived alone, without physical or mental handicap. She went to Emergy Department where a diagnosis of morfic withdrawl syndrome was made and discharged with tapentalol at tappering doses. After 15 days she went to Geriatric Deparment. At rest she was in no distress but when she walk she felt bad an dyspneic suddenly, with tachycardia and tachypnea with no others signs on phycal report. Electrochardiogram disclosed sinus rythm without rigth ventricular overload. Creatinine was 3'2 miligrams/dL and D-Dimero was 10 times over normal range. Results: Thoracic computed tomography showed high intensity radiolucent material deposition in pulmonary arteries and distal segments. An echocardiogram indicated no Rigth Ventricular Overload or significant Pulmonary Hypertension. Key conclusions: Cement pulmonary embolism should be considered as a complication of Kyphoplasty. We should improve our knoledge of this problem to avoid clinical and functional decline in othogeriatric medicine. AD - J. Manzarbeitia, Servicio De Geriatria Hospital, Universitario De Gefate Universidad Europea De Madrid, Spain AU - Manzarbeitia, J. AU - Martin, V. AU - Costa, J. AU - Ramon, C. DB - Embase KW - cement creatinine aged case report computer assisted tomography diagnosis distress syndrome dyspnea echocardiography female heart ventricle overload human kidney disease kyphoplasty lung embolism malaise medicine mental deficiency pain physical disability pulmonary hypertension rest tachycardia tachypnea thorax very elderly LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1878-7649 SP - S39 ST - Pulmonary cement pulmonary embolism after percuateneous kyphoplasty: Report of one case T2 - European Geriatric Medicine TI - Pulmonary cement pulmonary embolism after percuateneous kyphoplasty: Report of one case UR - https://www.embase.com/search/results?subaction=viewrecord&id=L613002739&from=export VL - 7 ID - 829303 ER - TY - JOUR AB - Background: Historically, performing a successful hip joint replacement in patients aged fewer than 30 years has been an orthopedic challenge. The newer generation of prostheses and surgical techniques has the potential to increase the longevity of implants. The purpose of this study was to evaluate the outcomes of cementless hip arthroplasty in patients aged fewer than 30 years. Materials and methods: In this cross-sectional study, 41 patients (46 hips) were studied with a mean age of 24, 4 (from 17 to 30 years) of whom underwent cementless metal-polyethylene hip arthroplasty from 2004 to 2007. The Harris hip score (HHS) was used to assess the functional consequences. Patients were followed up in terms of early complications (thrombophlebitis of the lower limbs, dislocation, hematoma and infection) and late complications (aseptic loosening, dislocation and reoperation) at weeks 3 and 6, at 3 and 6 months, 1 year after surgery and annually thereafter. Results: Patients were followed for an average of 5 years and 2 months (from 51 to 82 months). One early complication (symptomatic thrombophlebitis) and one late dislocation (2.2 %) were observed. There were no cases of aseptic loosening or osteolysis at the end of follow-up. The preoperative HHS was 59.6 (from 41 to 76), which rose to 82 and 83.5 after the 1-year and final follow-up, respectively, which was a significant increase. Conclusions: Hip arthroplasty using a new generation of cementless proximal porous prosthesis with resistant polyethylene to cover the joint surfaces in patients aged fewer than 30 years is satisfactory and is accompanied by low complications. © 2012 Springer-Verlag. AD - M. Mardani-Kivi, Orthopedic Research Center, Poursina Hospital, Guilan University of Medical Sciences, Parastaar St P.O. Box: 4193713191, Rasht, Guilan, Iran AU - Mardani-Kivi, M. AU - Karimi-Mobarakeh, M. AU - Asadi, K. AU - Hashemi-Motlagh, K. AU - Saheb-Ekhtiari, K. DB - Embase Medline DO - 10.1007/s00590-012-1084-y KW - anticoagulant agent active stem adolescent adult age article avascular necrosis bone atrophy captive PRF cup cementless total hip arthroplasty clinical article cross-sectional study female femur osteotomy fracture reduction Harris hip score hematoma hip arthroplasty hip dislocation hip dysplasia hip fracture human leg thrombophlebitis lung embolism male priority journal prosthesis loosening reoperation surgical infection survival rate total hip prosthesis trabecular metal modular acetabular system trabecular metal primary hip prosthesis treatment outcome LA - English M1 - 7 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1633-8065 1432-1068 SP - 785-790 ST - Evaluation of clinical outcomes of cementless total hip arthroplasty in patients under 30 years of age T2 - European Journal of Orthopaedic Surgery and Traumatology TI - Evaluation of clinical outcomes of cementless total hip arthroplasty in patients under 30 years of age UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52229884&from=export http://dx.doi.org/10.1007/s00590-012-1084-y VL - 23 ID - 829472 ER - TY - JOUR AB - Major neurologic morbidity and mortality with vertebroplasty are rare. We describe a 71-year-old woman who had a stroke approximately 30 minutes after vertebroplasty. Imaging revealed that bone cement had embolized to the left middle cerebral artery. Emergency embolectomy was attempted but was unsuccessful. This report emphasizes the need to be aware that intracranial embolization of polymethylmethacrylate can occur and describes management strategies to consider. AD - Department of Radiology, Inova Fairfax Hospital, Falls Church, VA, USA. mardenf@alexian.net AN - 18617589 AU - Marden, F. A. AU - Putman, C. M. DA - Nov DO - 10.3174/ajnr.A1159 DP - NLM ET - 2008/07/12 J2 - AJNR. American journal of neuroradiology KW - Aged Bone Cements/*adverse effects Female Humans Intracranial Embolism/*diagnostic imaging/*etiology Polymethyl Methacrylate/*adverse effects Radiography Stroke/*diagnostic imaging/*etiology Vertebroplasty/*adverse effects LA - eng M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 0195-6108 SP - 1986-8 ST - Cement-embolic stroke associated with vertebroplasty T2 - AJNR Am J Neuroradiol TI - Cement-embolic stroke associated with vertebroplasty VL - 29 ID - 828916 ER - TY - JOUR AB - High-pressure cementing techniques, involving the use of a cement gun and cement restrictor, placed within the femoral medullary cavity, are commonly used to secure the femoral component of hip arthroplasties. Such techniques have been shown to be important in maintaining the integrity of the bone-cement interface and also the integrity of the cement itself. This case report illustrates that such techniques are not without complications. AD - Cardiff Royal Infirmary. AN - 1793703 AU - Marshall, P. D. AU - Douglas, D. L. AU - Henry, L. DA - Summer DP - NLM ET - 1991/01/01 J2 - The British journal of clinical practice KW - Cementation/*adverse effects Embolism, Fat/*etiology Female Femur Hip Joint/surgery *Hip Prosthesis Humans Middle Aged Orthopedics/*methods Osteoporosis/*complications Pulmonary Embolism/*etiology LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 1991 SN - 0007-0947 (Print) 0007-0947 SP - 148-9 ST - Fatal pulmonary fat embolism during total hip replacement due to high-pressure cementing techniques in an osteoporotic femur T2 - Br J Clin Pract TI - Fatal pulmonary fat embolism during total hip replacement due to high-pressure cementing techniques in an osteoporotic femur VL - 45 ID - 828521 ER - TY - JOUR AB - High-pressure cementing techniques, involving the use of a cement gun and cement restrictor, placed within the femoral medullary cavity, are commonly used to secure the femoral component of hip arthroplasties. Such techniques have been shown to be important in maintaining the integrity of the bone-cement interface and also the integrity of the cement itself.1 This case report illustrates that such techniques are not without complications. AD - ROYAL HALLAMSHIRE HOSP,SHEFFIELD S10 2JF,S YORKSHIRE,ENGLAND. MARSHALL, PD (corresponding author), CARDIFF ROYAL INFIRM,CARDIFF CF2 1SZ,S GLAM,WALES. AN - WOS:A1991GB48100022 AU - Marshall, P. D. AU - Douglas, D. L. AU - Henry, L. DA - Sum J2 - Br. J. Clin. Pract. KW - Medicine, General & Internal LA - English M1 - 2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1991 SN - 0007-0947 SP - 148-149 ST - FATAL PULMONARY FAT-EMBOLISM DURING TOTAL HIP-REPLACEMENT DUE TO HIGH-PRESSURE CEMENTING TECHNIQUES IN AN OSTEOPOROTIC FEMUR T2 - British Journal of Clinical Practice TI - FATAL PULMONARY FAT-EMBOLISM DURING TOTAL HIP-REPLACEMENT DUE TO HIGH-PRESSURE CEMENTING TECHNIQUES IN AN OSTEOPOROTIC FEMUR UR - ://WOS:A1991GB48100022 VL - 45 ID - 830495 ER - TY - JOUR AB - Vertebral cement augmentation (vertebroplasty) has recently garnered increasing attention as a possible prophylactic treatment for the prevention of proximal junctional kyphosis and proximal junctional failure in osteoporotic patients undergoing long spinal fusions. The supporting data mostly comes from small retrospective case series, but indicates a modest benefit, particularly in the prevention of proximal junctional failure. Common risks include possible cement extravasation leading to embolization events, and a theoretical increased risk of adjacent segment fracture. Deformity surgeons should familiarize themselves with the pros and cons of this technique and may wish to utilize it in appropriately selected cases. AD - C.T. Martin, Department of Orthopaedic Surgery, University of Minnesota, 2512 South 7th Street Suite R200, Minneapolis, MN, United States AU - Martin, C. T. DB - Embase DO - 10.1097/BTO.0000000000000453 KW - adult artificial embolization attention case study conference paper extravasation female fracture human kyphosis male osteoporosis percutaneous vertebroplasty prevention prophylaxis retrospective study scoliosis spine fusion surgeon theoretical study treatment failure cement LA - English M3 - Article in Press N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 2333-0600 0885-9698 ST - Prevention of Proximal Junctional Kyphosis or Failure: Cement Augmentation T2 - Techniques in Orthopaedics TI - Prevention of Proximal Junctional Kyphosis or Failure: Cement Augmentation UR - https://www.embase.com/search/results?subaction=viewrecord&id=L631823810&from=export http://dx.doi.org/10.1097/BTO.0000000000000453 ID - 829098 ER - TY - JOUR AB - Interventional radiology of the spine consists of minimally invasive techniques for the treatment of some spinal diseases proposed before or in addition to an open spine surgery. By using imaging guidance, one can significantly increase accuracy and decrease complication rates. This presentation will discuss physiopathology, indications, methods, complications and results of performing percutaneous spine procedures for upper and lower back pain in different levels (cervical, thoracic, lumbar and sacroiliac) and different kind of treatments (nerve block, nerve radiofrequency, disc treatment and bone treatment). Finally we will review the current literature on the controversial issues involved. Neck, dorsal or lumbar pain due to radiculopathy, are a common problem, which is quite costly to society. Effective management is a challenge. Most cases are successfully treated conservatively (analgesics or physical therapy), but in a small percentage of cases, surgery may also be performed. Infiltrations are a minimal image guided technique, proposed before surgery. By using imaging guidance, one can significantly increase accuracy and decrease complication rates [1]. This presentation will discuss different kind of treatment involved in back pain, due to nerve entrapment such as foraminal, epidural and facet injections. These injections are adapted to the pathology and usually foraminal or peridiscal injections are used for disco-radicular conflict, intra-articular injection are used for facet syndrom and epidural for narrowing canal. These injections have two major role, treatment by anti-inflammatory action and pain block to confirm the origin of pain. Local steroid injection are usually preceded by a contrast agent injection to prove the good anatomical distribution and to avoid an intra-arterial injection, especially at cervical level. Long acting steroid are linked to microcrystal and vascular injection have to be avoid. Depending of clinical data and result of pain block second minimal invasive therapies have to be discussed like discal treatment and dorsal nerve ablation. Intradiscal or peridiscal O3 injection especially used for discoradicular conflict have a close action to steroid by an anti-inflammatory effect. This injection could be performed in the disk because of the antiseptic effect of O3. For facet pain, dorsal nerve ablation could be perform using radiofrequency or cryotherapy. Technique will be presented. For discal pain or disco-radicular conflict, today there is a multitude of different percutaneous techniques proposed. Percutaneous approaches under fluoroscopy and CT have really evolved in recent years. In disc generated pain, The most popular, such as percutaneous disc ablation (PDA), percutaneous laser disc decompression (PLDD) and electrothermal therapy (IDET) and the most recent ones such as ethanol cellulose will be presented and analyzed. These techniques are based on the theory published by Hijikata et al. [2] in 1975 on the role of intradiscal pressure. The authors stated that: “Reduction of intradiscal pressure, reduced the irritation of the nerve root and the pain receptors in the annulus and peridiscal area.” All of the above techniques use similar postero-lateral approach to puncture the disc, the purpose being to place the canula with the ablative system at the center of the disc. Each technique had advantages and disadvantages, which will be presented. Standard indications are contained herniation determined by imaging (CT or MRI), combined with neurological response (leg pain, motor response and tendon reflex) which persist after six weeks of conservative treatment [3]. Bone related lesions The first case of Vertebroplasty (Vp) using poly-methyl-methacrylate (PMMA) was reported in 1985 by Gallibert and Deramond for treating vertebral body instability with aggressive forms of vertebral body hemangioma [4]. Soon, other indications, such as bone metastasis and secondary osteoporotic collapses showed favorable results with the same technique. Nowadays Vp has become a main alternative o tion for treating back pain related to vertebral fractures either due to benign or malignant disease [5]. Vp can also be associated with bone biopsy, usually performed just before cement injection, during the same procedure. A variant technique, kyphoplasty, consist to introduced a balloon or a cavity device before cement embolization and have a particularly interest in treatment of fresh fracture and used of biocement. Other lesions can be treated with the same technique, including pedicular, sacral and pelvic lesions due to benign and malignant disease (osteoplasty) [6]. The overall good success in relieving pain and recovering mobility justifies the interest to promote the use of this treatment concept, mostly for the comfort of patients. Approach to the vertebral body is similar to bone biopsy, using a postero-lateral or transpedicular approach, and can be performed under fluoroscopy or CT. Injection of cement is mandatory to be performed under fluoroscopy, as it is the only means of real time imaging, covering the height of the injected vertebral body. The procedure can be performed, under local or general anesthesia, depending on the number of levels to be treated and the patient's general condition. Strict aseptic techniques are mandatory, as for any percutaneous spine procedure. The use of prophylactic antibiotherapy is suggested, although not proven mandatory by any study. In conclusion, management of upper and lower back pain has become an intricate part of interventional radiology of the spine and has found its own niche, after conservative treatment and before major surgical operations [7]. AD - J.-B. Martin, Radiology, Rive Droite Centre d'Imagerie Médicale, Geneva, Switzerland AU - Martin, J. B. DB - Embase KW - steroid cement analgesic agent contrast medium antiinfective agent alcohol cellulose poly(methyl methacrylate) low back pain Europe society injection pain imaging vertebra body spine fluoroscopy nerve surgery epidural drug administration backache intervertebral disk bone biopsy conservative treatment bone interventional radiology antiinflammatory activity radiofrequency patient spine surgery pathophysiology neck radiculopathy physiotherapy nerve compression pathology intraarterial drug administration crystal clinical study invasive procedure cryotherapy laser decompression therapy bone remodeling nuclear magnetic resonance imaging nerve root pain receptor puncture hernia leg pain tendon reflex percutaneous vertebroplasty hemangioma bone metastasis spine fracture kyphoplasty devices artificial embolization fracture pelvis height general anesthesia general condition minimally invasive procedure spine disease nerve block LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 0174-1551 SP - 162 ST - Upper and lower back pain T2 - CardioVascular and Interventional Radiology TI - Upper and lower back pain UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70339130&from=export VL - 32 ID - 829701 ER - TY - JOUR AD - Department of Emergency Medicine, University of Tennessee Health Science Center College of Medicine at Chattanooga, Chattanooga, TN. Department of Emergency Medicine, University of Tennessee Health Science Center College of Medicine at Chattanooga, Chattanooga, TN; Erlanger Medical Center, Chattanooga, TN. Erlanger Medical Center, Chattanooga, TN. Department of Internal Medicine, University of Tennessee Health Science Center College of Medicine at Chattanooga, Chattanooga, TN. AN - 27894631 AU - Martin, R. A. AU - Wharton, D. AU - Barker, C. AU - Haivas, C. D. AU - Kaur, B. AU - Whittle, J. DA - Dec DO - 10.1016/j.annemergmed.2016.04.002 DP - NLM ET - 2016/11/30 J2 - Annals of emergency medicine KW - Aged Bone Cements/*adverse effects *Computed Tomography Angiography Confusion/*etiology Female Humans Hypoxia/*etiology Kyphoplasty/*instrumentation Postoperative Complications/*diagnostic imaging/etiology Pulmonary Embolism/*diagnostic imaging/etiology LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 0196-0644 SP - 778-789 ST - Elderly Woman With Altered Mental Status and Hypoxia T2 - Ann Emerg Med TI - Elderly Woman With Altered Mental Status and Hypoxia VL - 68 ID - 828501 ER - TY - JOUR AB - Background: Acetabular bone deficiency, especially proximal and lateral deficiency, is a difficult technical problem during primary total hip arthroplasty (THA) in developmental dysplasia of the hip (DDH). We report a new reconstruction method using a medial-reduced cemented socket and additional bulk bone in conjunction with impaction morselized bone grafting (additional bulk bone grafting method). Questions/purposes: In a population of patients with acetabular dysplasia undergoing THA using a medial-reduced cemented socket and additional bulk bone with impacted morselized bone grafting, we evaluated (1) the radiographic appearance of bone graft; (2) the proportion of cups that developed loosening and subsequent revision; and (3) clinical results (outcome scores and complications). Methods: Forty percent of 330 THAs for DDH performed at one center between 1999 and 2009 were defined as shallow dysplastic hips. The additional bulk bone grafting method was performed on 102 THAs with shallow acetabulum (31% for DDH) at one center between 1999 and 2009. We used this approach and technique for shallow acetabuli when a cup protruded from the lateral acetabular edge in preoperative templating. The other 132 dysplastic hips without bone grafting had THA performed at the same periods and served as a control. Acetabuli were defined as shallow when the depth was less than or equal to one-fifth of the pelvic height (cranial-caudal length on radiograph). The additional bulk bone grafting technique was as follows: the resected femoral head was sectioned at 1 to 2 cm thickness, and a suitable size of the bulk bone graft was placed on the lateral iliac cortex and fixed by poly-l-lactate absorbable screws. Autologous impaction morselized bone grafting, with or without hydroxyapatite granules, was performed along with the implantation of a medial-reduced cemented socket. We defined an “incorporated” graft as remodeling and trabeculation including rounding off of the protruding edge of a graft beyond the socket. Radiographic criteria used for determining loosening were migration or a continuous radiolucent zone between the prosthesis/bone cement and host bone. Clinical outcomes were assessed using the Japanese Orthopaedic Association (JOA) and the Merle d’Aubigne and Postel score; complications were tallied from chart review. The followup was 10 ± 3 years (range, 6–15 years). Results: One acetabular component (1%) with severe shallow and steep acetabuli showed definite radiographic evidence of loosening and was revised. Clinically, the mean JOA score for the hips treated with additional bulk bone grafting THA in this study improved from 39 ± 10 points preoperatively to 95 ± 5 points postoperatively (p < 0.05, paired t-test). The mean Merle d’Aubigne and Postel score for the hips improved from 7 ± 2 points to 17 ± 1 points (p < 0.05, paired t-test). Complications included a Trendelenburg sign in one hip, dislocation in one, and transient partial sciatic nerve palsy in one. Within 3 years 6 months postoperatively, 101 of 102 additional bulk bone grafting cases showed successful bone remodeling and bone graft reorientation without collapse on radiographs. Partial resorption of the additional bone graft on the lateral side was observed in two hips (2%) with socket abduction angles of < 35°. Conclusions: Achieving stable acetabular fixation is often challenging in the dysplastic hip, especially shallow acetabulum, and a variety of techniques have been described. Early results of combining bulk graft with impaction of morselized graft are promising. Although each surgical technique was well established, further investigation for clinical results of a combination of these techniques might be necessary to confirm longer term outcomes. Level of Evidence: Level IV, therapeutic study. AD - M. Maruyama, Department of Orthopedic Surgery, Shinonoi General Hospital, 666-1 Ai, Shinonoi, Nagano, Japan AU - Maruyama, M. AU - Wakabayashi, S. AU - Ota, H. AU - Tensho, K. DB - Embase Medline DO - 10.1007/s11999-016-5107-6 KW - hydroxyapatite polyethylene polylactic acid zirconium oxide abduction acetabulum adult aged article autologous bulk bone graft bioabsorbable screw body mass body weight bone cement device bone graft bone remodeling bone transplantation clinical outcome controlled study deep vein thrombosis female femoral head follow up greater trochanter hip dislocation hip dysplasia human Japanese Orthopaedic Association score lung embolism major clinical study male nerve paralysis postoperative care priority journal sciatic nerve thickness total hip prosthesis LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1528-1132 0009-921X SP - 387-395 ST - Reconstruction of the Shallow Acetabulum With a Combination of Autologous Bulk and Impaction Bone Grafting Fixed by Cement T2 - Clinical Orthopaedics and Related Research TI - Reconstruction of the Shallow Acetabulum With a Combination of Autologous Bulk and Impaction Bone Grafting Fixed by Cement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L613215500&from=export http://dx.doi.org/10.1007/s11999-016-5107-6 VL - 475 ID - 829271 ER - TY - JOUR AB - Background: Cemented hip arthroplasty is an established treatment for femoral neck fracture in the mobile elderly. Cement pressurization raises intramedullary pressure and may lead to fat embolization, resulting in fatal bone cement implantation syndrome, particularly in patients with multiple comorbidities. The cementless stem technique may reduce this mortality risk but it is technically demanding and needs precise planning and execution. We report the perioperative mortality and morbidity of cementless bipolar hemiarthroplasty in a series of mobile elderly patients (age >70 years) with femoral neck fractures. Materials and Methods: Twenty-nine elderly patients with mean age of 83 years (range:71-102 years) with femoral neck fractures (23 neck of femur and 6 intertrochanteric) were operated over a 2-year period (Nov 2005-Oct 2007). All were treated with cementless bipolar hemiarthroplasty. Clinical and radiological follow-up was done at 3 months, 6 months, 12 months, and then yearly. Results: The average follow-up was 36 months (range 26-49 months). The average duration of surgery and blood loss was 28 min from skin to skin (range, 20-50 min) and 260 ml (range, 95-535 ml), respectively. Average blood transfusion was 1.4 units (range, 0 to 4 units) Mean duration of hospital stay was 11.9 days (7-26 days). We had no perioperative mortality or serious morbidity. We lost two patients to follow-up after 12 months, while three others died due to medical conditions (10-16 months post surgery). Twenty-four patients were followed to final follow-up (average 36 months; range: 26-49 months). All were ambulatory and had painless hips; the mean Harris hip score was 85 (range: 69-96). Conclusion: Cementless bipolar hemiarthroplasty for femoral neck fractures in the very elderly permits early return to premorbid life and is not associated with any untoward cardiac event in the perioperative period. It can be considered a treatment option in this select group. AD - Max Institute of Orthopedics and Joint Replacement, Max Super Specialty Hospitals, Saket, New Delhi, India AN - 104894445. Language: English. Entry Date: 20110602. Revision Date: 20200708. Publication Type: Journal Article AU - Marya, S. K. S. AU - Thukral, R. AU - Hasan, R. AU - Tripathi, M. DB - cin20 DO - 10.4103/0019-5413.80042 DP - EBSCOhost KW - Arthroplasty -- Evaluation Arthroplasty -- Classification Femoral Fractures -- Surgery Femur Neck -- Pathology Human Aged Comorbidity Aged, 80 and Over Male Female Orthopedic Surgery -- Methods Surveys Walking -- Evaluation Quality of Life -- Evaluation M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2011 SN - 0019-5413 SP - 236-242 ST - Cementless bipolar hemiarthroplasty in femoral neck fractures in elderly T2 - Indian Journal of Orthopaedics TI - Cementless bipolar hemiarthroplasty in femoral neck fractures in elderly UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104894445&site=ehost-live&scope=site VL - 45 ID - 830692 ER - TY - JOUR AB - The aim of this presentation is to describe the state of the art of the interventional radiology in the treatment of benign bone tumours. In the past years, minimally invasive surgical techniques in bone benign and malignant neoplasms management have been added to the therapeutic armamentarium as an alternative option to conventional treatments in order to improve patient's quality of life and duration of survival. For example, the diffusely utilized percutaneous vertebroplasty was first performed in 1984 in France by Galibert and Deramound for the treatment of a painful cervical aggressive haemangioma. Up to now, patient candidates for this procedure are carefully informed about features, benefits and risks bound to procedure. In order to minimise the risk of bleeding related to the percutaneous access, patient's blood coagulation profile is assessed and discontinued any anticoagulant therapy five days before procedure. The procedure is executed in supine or prone position depending on spinal level treated into angiographic suite utilizing a biplanar “C” arch or within CT room under combined CTangiographic guidance. The vertebral approach is anterior in cervical levels, either transpedicular or intercostovertebral in thoracic levels and transpedicular in lumbar levels. The injection of PMMA is executed using 11-13 Gauge bone biopsy needle and is performed with lateral and antero-posterior fluoroscopic guidance. Post-procedural CT control is performed in order to visualise the distribution of cement within haemangiomatous lesion. The patients are kept under observation following the procedure and generally discharged on the following day. The minimally invasive techniques has rapidly reached the standard of care for treatment of several benign bone tumours with medically refractory pain or which would require an extensive approach with conventional surgery. Another example is osteoid osteoma (OO) a small, self-limiting, benign osteogenic tumour. Successful treatment of OO requires complete resection or destruction of the nidus. Surgery, which consists of “en bloc” excision of the nidus, followed by internal fixation, bone grafting, or both, is successful in almost all cases but markedly intrusive. Actually patients undergo destruction of the nidus, under CT guidance, through a percutaneous approach using thermocoagulation or ethanol injection. Interventional radiology is distinctly utilized as preliminary step in osteolytic bone lesions characterization or as operative second step such as in bone aneurysmal cyst treatment. Aneurysmal bone cysts (ABC) are rare, benign, but locally destructive bone tumors. At present these lesions, typically observed in children, are treated alternatively to surgical excision through percutaneous approach with direct fibrosing agent injection (Ethibloc or others). Ethibloc in particular is a fibrogenic and thrombogenic agent proposed for the treatment of bone cysts. Complete healing of the osteolityc lesion is manifested by increased cortical and septal thickening. Minimal inflammatory reactions are observed with local pain and fever. No major complications such as deep infection, pulmonary embolism, epiphyseal necrosis or malignant degeneration are generally observed. The advantage of interventional radiology techniques, in comparison with conventional surgery, is their capability to be minimally invasive, safe, simple, and cost effective. Postoperative complications are rare and considerably reduced instead of surgery with an early return to normal activities. AD - S. Masala, Diagnostic Imaging and Interventional Radiology, University of Rome, Rome, Italy AU - Masala, S. DB - Embase KW - ethibloc alcohol cement bone Europe society surgery patient injection interventional radiology pain aneurysmal bone cyst risk excision thermocoagulation bone lesion bone tumor child bone cyst healing inflammation fever lung embolism epiphysis necrosis malignant transformation infection postoperative complication minimally invasive surgery malignant neoplasm quality of life survival percutaneous vertebroplasty France hemangioma anticoagulant therapy body position bone biopsy biopsy blood clotting minimally invasive procedure osteoid osteoma needle biopsy neoplasm osteosynthesis bone transplantation bleeding LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 0174-1551 SP - 266-267 ST - Benign bone tumours T2 - CardioVascular and Interventional Radiology TI - Benign bone tumours UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70339249&from=export VL - 32 ID - 829703 ER - TY - JOUR AB - STUDY DESIGN AND OBJECTIVE: The aim of this study was to assess the effectiveness and safety of percutaneous vertebroplasty, a new technique for the treatment of vertebral pain deriving from fracture or gross osteolytic lesion due to multiple myeloma spinal involvement. SUMMARY OF BACKGROUND DATA: Spinal osteolytic lesions are frequently associated with hematologic malignancies due to primary localization of disease (multiple myeloma and rarely lymphoma) or secondary effect of intensive corticosteroid therapy. METHODS: We treated 64 patients (34 males, 30 females; mean age 71.4+/-9.6 y) with pain refractory to conventional medical therapy (analgesics, bed-rest, bracing with orthopedic devices for more than 3 wk) localized in spine, in the absence of neurologic signs. RESULTS: This treatment generated swift pain relief associated with an evident augmentation in vertebral resistance. Average preprocedural pain level for all patients was reported to be 8.04+/-1.4 whereas average pain level at 1 and 6 months follow-up period was 1.82+/-1.84 and 1.92+/-1.68, respectively. Although preprocedure and postprocedure demonstrated a statistically significant reduction in numeric pain scores (P<0.01), the pain level at 1 and 6 months was not considered statistically significant. No procedure-related complications were observed in either leakages of polymethylmethacrylate in the epidural or foraminal area or in complications of pulmonary embolism for venous plexus involvement. CONCLUSIONS: Vertebroplasty is widely considered as an alternative, effective, simple, and safe technique in the treatment of neoplastic vertebral localizations consequent to hematologic malignancies. The same injection of polymethylmethacrylate can be executed before radiation therapy treatment, synergizing its delayed analgesic action to pain, after failure or in the case of local recurrences. AD - Department of Diagnostic and Molecular Imaging, Interventional Radiology, Nuclear Medicine and Radiation Therapy, University of Rome Tor Vergata, Rome, Italy. salva.masala@tiscali.it AN - 18600145 AU - Masala, S. AU - Anselmetti, G. C. AU - Marcia, S. AU - Massari, F. AU - Manca, A. AU - Simonetti, G. DA - Jul DO - 10.1097/BSD.0b013e3181454630 DP - NLM ET - 2008/07/05 J2 - Journal of spinal disorders & techniques KW - Aged Aged, 80 and over Back Pain/etiology/physiopathology/surgery Bone Cements/therapeutic use Female Humans Lumbar Vertebrae/diagnostic imaging/pathology/surgery Male Middle Aged Multiple Myeloma/diagnostic imaging/pathology/*surgery Osteoporosis/chemically induced/physiopathology/surgery Polymethyl Methacrylate/therapeutic use Postoperative Complications/epidemiology Prednisone/adverse effects/therapeutic use Retrospective Studies Spinal Fractures/etiology/physiopathology/*surgery Spinal Neoplasms/diagnostic imaging/pathology/*surgery Spine/diagnostic imaging/pathology/*surgery Tomography, X-Ray Computed Treatment Outcome Vertebroplasty/*methods/standards LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 1536-0652 (Print) 1536-0652 SP - 344-8 ST - Percutaneous vertebroplasty in multiple myeloma vertebral involvement T2 - J Spinal Disord Tech TI - Percutaneous vertebroplasty in multiple myeloma vertebral involvement VL - 21 ID - 828760 ER - TY - JOUR AB - Aims and background: The purpose of our research was to assess the effectiveness and safety of percutaneous kyphoplasty, the new method of treatment for pain deriving from vertebral compression fractures due to myeloma. Methods: We treated 3 patients with pain refractory to conventional medical therapy (analgesics, bed-rest, bracing with orthopedic devices for more than 4 weeks), localized in the lumbar area, painful to the touch and in the absence of neurological signs. Results: The method demonstrated a swift pain relief associated with an evident augmentation in the resistance and restoration of the vertebral body's physiological shape. Polymethylmethacrylate leaks were not observed in the epidural or foraminal area, nor were complications such as pulmonary embolism for involvement of the venous plexus or related to phenomenon of infections due to the procedure, or toxicity due to the polymethylmethacrylate. Conclusions: Kyphoplasty was found to be an effective alternative, simple and safe in the treatment of vertebral collapse consequent to multiple myeloma. The same injection of polymethylmethacrylate can be done before the radiotherapy treatment, thereby synergizing its delayed analgesic action to pain, or after the failure or in the case of local recurrence. AD - S. Masala, Department of Diagnostic Radiology, Tor Vergata Univ. General Hospital, Rome, Italy AU - Masala, S. AU - Fiori, R. AU - Massari, F. AU - Cantonetti, M. AU - Postorino, M. AU - Simonetti, G. DB - Embase Medline KW - poly(methyl methacrylate) analgesic activity article bed rest brace case report conservative treatment controlled study epidural space fracture treatment human intervertebral disk medical research myeloma percutaneous kyphoplasty percutaneous vertebroplasty spine stabilization vertebra body vertebra dislocation LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2004 SN - 0300-8916 SP - 22-26 ST - Percutaneous kyphoplasty: Indications and technique in the treatment of vertebral fractures from myeloma T2 - Tumori TI - Percutaneous kyphoplasty: Indications and technique in the treatment of vertebral fractures from myeloma UR - https://www.embase.com/search/results?subaction=viewrecord&id=L38541721&from=export VL - 90 ID - 829845 ER - TY - JOUR AB - Using percutaneous kyphoplasty, we treated a patient with a diagnosis of Guillain-Barré syndrome who complained of an unremitting pain in the spine, refractory to the conventional medical therapy, elicited by pressure over the spinous process, and in absence of neurologic deficits. The method provided swift midline back pain relief associated with an evident augmentation in the stability and in the vertebral body's height. The injection of polymethylmethacrylate was effective and safe, no cement leakages were observed, and no complications such as pulmonary embolism, toxicity, or infection were observed. Due to the rapid pain relief, a rehabilitation program was promptly undertaken with a good improvement of the disability score (FIM scale score). Kyphoplasty is a new method for treatment of vertebral collapses consequent to osteoporosis, aggressive hemangiomas, myelomas, and metastases, and it may aid in rehabilitation of the underlying systemic neurologic disorder if the pain is interfering with those therapies. AD - Department of Diagnostics for Images and Interventional Radiology, University of Rome Tor Vergata, Policlinico Tor Vergata General Hospital, Rome, Italy. AN - 15385794 AU - Masala, S. AU - Tropepi, D. AU - Fiori, R. AU - Semprini, R. AU - Martorana, A. AU - Massari, F. AU - Bernardi, G. AU - Simonetti, G. DA - Oct DO - 10.1097/01.phm.0000137319.22908.eb DP - NLM ET - 2004/09/24 J2 - American journal of physical medicine & rehabilitation KW - Aged Female Guillain-Barre Syndrome/*complications Humans Orthopedic Procedures/instrumentation/methods Spinal Fractures/*etiology/pathology/*surgery Thoracic Vertebrae/*injuries/pathology/*surgery Treatment Outcome LA - eng M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2004 SN - 0894-9115 (Print) 0894-9115 SP - 810-2 ST - Kyphoplasty: a new opportunity for rehabilitation of neurologic disabilities T2 - Am J Phys Med Rehabil TI - Kyphoplasty: a new opportunity for rehabilitation of neurologic disabilities VL - 83 ID - 828993 ER - TY - JOUR AD - Service d'anesthésie et réanimation, hHôpital Nord, Aix-Marseille université, chemin des Bourrely, 13915 Marseille, cedex 20, France. AN - 24176720 AU - Mathieu, C. AU - Meresse, Z. AU - Vigne, C. AU - Melot, A. AU - Léone, M. DA - Nov DO - 10.1016/j.annfar.2013.09.008 DP - NLM ET - 2013/11/02 J2 - Annales francaises d'anesthesie et de reanimation KW - Adult Contrast Media Humans Male Minimally Invasive Surgical Procedures/*adverse effects Multiple Trauma/surgery/therapy Postoperative Complications/*therapy Spinal Fractures/surgery Tissue Adhesives Vertebroplasty Adverse effect Cement Ciment Embolie pulmonaire Multiple traumas Pulmonary embolism Traumatisme Vertébroplastie LA - fre M1 - 11 N1 - PubMed NLM literature search January 5, 2021 OP - Procédure mini-invasive ne signifie pas sans complications.. PY - 2013 SN - 0750-7658 SP - 820-1 ST - [Minimally invasive procedure doesn't mean no complications...] T2 - Ann Fr Anesth Reanim TI - [Minimally invasive procedure doesn't mean no complications...] VL - 32 ID - 828539 ER - TY - JOUR AB - Cement intravasation occurs in hemiarthroplasty when pressurization of cement through the medullary canal backflows through the nutrient vessels. This case report describes a 70-year-old woman who underwent hip hemiarthroplasty for a displaced left femoral neck fracture. Postoperative radiographs demonstrated radio-opacity consistent with local cement intravasation. A Doppler ultrasound study subsequently revealed a mobile thrombus at the confluence of the femoral and profunda femoris veins, as well as a nonmobile thrombus within the profunda femoris vein. The more proximal thrombus was determined to be cement that had intravasated during the index operation. The cement likely impeded venous flow, ultimately leading to the development of deep vein thrombosis just distal to the site of cement occlusion. AD - Department of Orthopaedic Surgery, George Washington University, Washington, DC, USA. George Washington University, School of Medicine, Washington, DC, USA. AN - 32577479 AU - Mathur, A. AU - Fassihi, S. C. AU - Ramamurti, P. AU - Doerre, T. C2 - Pmc7303492 DA - Jun DO - 10.1016/j.artd.2020.03.007 DP - NLM ET - 2020/06/25 J2 - Arthroplasty today KW - Cement intravasation Deep vein thrombosis Embolism Hemiarthroplasty LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 2352-3441 (Print) 2352-3441 SP - 283-287 ST - Deep Vein Thrombosis after Cement Intravasation during Hip Hemiarthroplasty T2 - Arthroplast Today TI - Deep Vein Thrombosis after Cement Intravasation during Hip Hemiarthroplasty VL - 6 ID - 828676 ER - TY - JOUR AB - Serious complications related to percutaneous vertebral augmentation procedures, vertebroplasty and kyphoplasty, are rare and most often result from local cement leakage or venous embolization. We describe an adult patient who underwent multi-level, thoracic percutaneous vertebral augmentation procedures for painful osteoporotic compression fractures. The patient's percutaneous vertebroplasty performed at the T9 level was complicated by the asymptomatic, direct embolization of the right T9 segmental artery with penetration of cement into the radicular artery beneath the pedicle. We review the literature regarding the unusual occurrence of direct arterial cement embolization during vertebral augmentation procedures, discuss possible pathomechanisms, and alert clinicians to this potentially catastrophic vascular complication. AD - Department of Neurosurgery, Yale University School of Medicine, New Haven, CT, USA. charles.matouk@yale.edu AN - 22958778 AU - Matouk, C. C. AU - Krings, T. AU - Ter Brugge, K. G. AU - Smith, R. C2 - Pmc3442313 DA - Sep DO - 10.1177/159101991201800318 DP - NLM ET - 2012/09/11 J2 - Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences KW - Aged, 80 and over Arterial Occlusive Diseases/*diagnosis/*etiology Bone Cements/*adverse effects Embolism, Paradoxical/*diagnosis/*etiology *Extravasation of Diagnostic and Therapeutic Materials Female Humans Magnetic Resonance Imaging Osteoporotic Fractures/*surgery Postoperative Complications/*diagnosis/*etiology Spinal Fractures/*surgery Tomography, X-Ray Computed *Vertebroplasty LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 1591-0199 (Print) 1591-0199 SP - 358-62 ST - Cement embolization of a segmental artery after percutaneous vertebroplasty: a potentially catastrophic vascular complication T2 - Interv Neuroradiol TI - Cement embolization of a segmental artery after percutaneous vertebroplasty: a potentially catastrophic vascular complication VL - 18 ID - 828718 ER - TY - JOUR AB - Background and Objectives: Calcium phosphate cement (CPC) is an injectable biocompatible bone substitute that has been used for various applications in orthopedic surgery. However, no extensive clinical studies of the use of CPC to fill bone cavities after curettage of musculoskeletal tumors have been reported. The present study reviewed the results for 56 musculoskeletal tumors treated by curettage and CPC implantation. Methods: Assessment was based on clinical examination and radiographic findings. Variables for clinical assessment included pain, limb function, and complications. Median follow-up was 18.5 months (range 6-47 months). Results: One patient experienced post-operative fractures. Three patients displayed local recurrence. One patient developed post-operative superficial wound infection, and two patients with large bony defect exhibited non-infectious serous discharge. No serious adverse effects such as deep venous thrombosis, pulmonary embolism were encountered. In all cases, CPC was radiographically well adapted to the surrounding host bone as of final follow-up. Conclusions: CPC appears to offer a useful bone substitute for the treatment of musculoskeletal tumors. As the follow-up period for this study was short, further long-term follow-up studies are needed. © 2006 Wiley-Liss, Inc. AD - A. Matsumine, Department of Orthopaedic Surgery, Mie University School of Medicine, 2-174, Edobashi, Tsu-city, Mie 514-8507, Japan AU - Matsumine, A. AU - Kusuzaki, K. AU - Matsubara, T. AU - Okamuka, A. AU - Okuyama, N. AU - Miyazaki, S. AU - Shintani, K. AU - Uchida, A. DB - Embase Medline DO - 10.1002/jso.20355 KW - bone cement calcium phosphate adolescent adult aged article bone cancer bone pain bone radiography child clinical examination curettage deep vein thrombosis female follow up human limb disease long term care lung embolism major clinical study male muscle cancer musculoskeletal disease postoperative infection priority journal wound infection LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 0022-4790 1096-9098 SP - 212-220 ST - Calcium phosphate cement in musculoskeletal tumor surgery T2 - Journal of Surgical Oncology TI - Calcium phosphate cement in musculoskeletal tumor surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L43381994&from=export http://dx.doi.org/10.1002/jso.20355 VL - 93 ID - 829793 ER - TY - JOUR AB - BACKGROUND AND OBJECTIVES: Calcium phosphate cement (CPC) is an injectable biocompatible bone substitute that has been used for various applications in orthopedic surgery. However, no extensive clinical studies of the use of CPC to fill bone cavities after curettage of musculoskeletal tumors have been reported. The present study reviewed the results for 56 musculoskeletal tumors treated by curettage and CPC implantation. METHODS: Assessment was based on clinical examination and radiographic findings. Variables for clinical assessment included pain, limb function, and complications. Median follow-up was 18.5 months (range 6-47 months). RESULTS: One patient experienced post-operative fractures. Three patients displayed local recurrence. One patient developed post-operative superficial wound infection, and two patients with large bony defect exhibited non-infectious serous discharge. No serious adverse effects such as deep venous thrombosis, pulmonary embolism were encountered. In all cases, CPC was radiographically well adapted to the surrounding host bone as of final follow-up. CONCLUSIONS: CPC appears to offer a useful bone substitute for the treatment of musculoskeletal tumors. As the follow-up period for this study was short, further long-term follow-up studies are needed. AD - Department of Orthopaedic Surgery, Mie University School of Medicine, 2-174, Edobashi, Tsu-city, Mie, Japan. matsumin@clin.medic.mie-u.ac.jp AN - 16482601 AU - Matsumine, A. AU - Kusuzaki, K. AU - Matsubara, T. AU - Okamura, A. AU - Okuyama, N. AU - Miyazaki, S. AU - Shintani, K. AU - Uchida, A. DA - Mar 1 DO - 10.1002/jso.20355 DP - NLM ET - 2006/02/17 J2 - Journal of surgical oncology KW - Adolescent Adult Aged Aged, 80 and over *Bone Cements Bone and Bones/surgery *Calcium Phosphates Child Child, Preschool Curettage Follow-Up Studies Humans Male Middle Aged Musculoskeletal Diseases/*surgery Neoplasms/*surgery Postoperative Complications Prostheses and Implants LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0022-4790 (Print) 0022-4790 SP - 212-20 ST - Calcium phosphate cement in musculoskeletal tumor surgery T2 - J Surg Oncol TI - Calcium phosphate cement in musculoskeletal tumor surgery VL - 93 ID - 828783 ER - TY - JOUR AB - Introduction Venous malformations of the zygoma are rare. Historically, venous malformations have been misrepresented as "hemangiomas". The International Society for the Study of Vascular Anomaly (ISSVA) classification is a reasonable classification that leads to appropriate clinical diagnosis and treatment strategies. Collaboration between surgeons, radiologists, and pathologists is necessary for accurate diagnosis and management. Presentation of case We present here a case of an IOVM in a 59-year-old woman who was treated with a multidisciplinary approach. Superselective arteriography and embolization were effective for diagnosis as well as for prevention of large hemorrhage during surgery. En-bloc resection of the zygoma was performed within hours after embolization and autologous calvarial bone graft was used for primary reconstruction. Discussion We performed a literature review consisting of reviewing 52 cases of IOVM of the zygoma discussing optimal material for reconstruction of the defect for intraosseous venous malformation of the zygoma nationally and internationally. Conclusion The combination of surgery and preoperative angiography makes it possible to prevent high risk of hemorrhage. For primary reconstruction of the zygoma, use of autologous calvarial bone can maintain the volume and reconstruct the natural malar contour. AD - T. Matsumiya, Department of Plastic and Reconstructive Surgery of Fujigaoka, Hospital of Showa University, 1-30 Fujigaoka, Aobaku, Yokohamashi, Kanagawa, Japan AU - Matsumiya, T. AU - Nemoto, H. AU - Kasai, Y. AU - Maruyama, N. AU - Sumiya, N. DB - Embase DO - 10.1016/j.ijscr.2015.04.032 KW - bone cement eosin hematoxylin hydroxyapatite adult arteriography article artificial embolization bone biopsy bone graft bone malformation brain hemorrhage case report cavernous hemangioma cheek clinical effectiveness clinical examination computer assisted tomography congenital blood vessel malformation cranioplasty disease classification donor site endothelium external carotid artery face asymmetry facial nerve paralysis female follow up histopathology human human tissue iliac bone intraosseous venous malformation of the zygoma maxillary artery medical history middle aged nuclear magnetic resonance imaging operative blood loss periosteum priority journal soft tissue surgical approach swelling three-dimensional imaging zygoma LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 2210-2612 SP - 132-136 ST - Intraosseous venous malformation of the zygoma: A case report and literature review T2 - International Journal of Surgery Case Reports TI - Intraosseous venous malformation of the zygoma: A case report and literature review UR - https://www.embase.com/search/results?subaction=viewrecord&id=L604789885&from=export http://dx.doi.org/10.1016/j.ijscr.2015.04.032 VL - 12 ID - 829371 ER - TY - JOUR AB - Study Design Case report and literature review. Objective Spinal subdural hematomas are rare events that often progress with severe neurologic deficits. Although there have been several case reports in the literature of spontaneous spinal subdural hematomas in the setting of anticoagulation, antiplatelet therapy, or coagulation disorders, the exact pathophysiology of such phenomena remains obscure. Methods We present the first report of a subdural hematoma after a percutaneous vertebroplasty and provide a comprehensive review on the anatomy of venous drainage of the vertebral bodies with emphasis on the possible effects of venous congestion caused by cement obstruction. Results Because the subdural hematoma occurred in the absence of major cement extravasation to the spinal canal and two levels above the site of the vertebroplasty, we discuss the possible role of venous congestion as the main etiologic factor leading to rupture of the fragile, valveless radiculomedullary veins into the subdural space. Conclusions The reported case supports a possible new pathophysiological scheme for the development of spinal subdural hematoma in which venous congestion plays a pivotal etiologic role. The reported findings suggests that future anatomical and histologic studies investigating the response of the radiculomedullary veins to congestive venous hypertension may shed new light into the pathophysiology of spinal subdural hematomas. AD - [Mattei, Tobias A.] Brain & Spine Inst, Dept Neurosurg, Buffalo, NY 14221 USA. [Rehman, Azeem A.] Univ Illinois, Coll Med Peoria, Dept Med, Peoria, IL USA. [Dinh, Dzung H.] Univ Illinois, Coll Med Peoria, Dept Neurosurg, Peoria, IL USA. Mattei, TA (corresponding author), Brain & Spine Inst, 400 Int Dr, Buffalo, NY 14221 USA. tobiasmattei@yahoo.com AN - WOS:000366209200003 AU - Mattei, T. A. AU - Rehman, A. A. AU - Dinh, D. H. DA - Oct DO - 10.1055/s-0035-1544155 J2 - Glob. Spine J. KW - spinal subdural hematomas venous congestion vertebroplasty pathophysiology radiculomedullary veins PERCUTANEOUS VERTEBROPLASTY SPONTANEOUS RESOLUTION PATIENT PLEXUS COMPRESSION MYELOPATHY FRACTURES MEMBRANE EMBOLISM ANATOMY Clinical Neurology Orthopedics LA - English M1 - 5 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2015 SN - 2192-5682 SP - E52-E58 ST - Acute Spinal Subdural Hematoma after Vertebroplasty: A Case Report Emphasizing the Possible Etiologic Role of Venous Congestion T2 - Global Spine Journal TI - Acute Spinal Subdural Hematoma after Vertebroplasty: A Case Report Emphasizing the Possible Etiologic Role of Venous Congestion UR - ://WOS:000366209200003 VL - 5 ID - 830233 ER - TY - JOUR AN - 22525028 AU - Mattis, T. AU - Knox, M. AU - Mammen, L. DA - May DO - 10.1016/j.jvir.2011.12.027 DP - NLM ET - 2012/04/25 J2 - Journal of vascular and interventional radiology : JVIR KW - Aged Bone Cements/*adverse effects Embolism/diagnostic imaging/*etiology/therapy Endovascular Procedures Foreign-Body Migration/diagnostic imaging/*etiology/therapy Heart Atria/injuries Heart Injuries/diagnostic imaging/*etiology/therapy Humans Male Methylmethacrylate/*adverse effects Pericarditis/diagnostic imaging/*etiology/therapy Tomography, X-Ray Computed Treatment Outcome Vertebroplasty/*adverse effects LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 1051-0443 SP - 719-20 ST - Intracardiac methylmethacrylate embolism resulting in right atrial wall perforation and pericarditis following percutaneous vertebroplasty T2 - J Vasc Interv Radiol TI - Intracardiac methylmethacrylate embolism resulting in right atrial wall perforation and pericarditis following percutaneous vertebroplasty VL - 23 ID - 828922 ER - TY - JOUR AB - Report on 3 cases of intraoperative death during total hip replacement in treatment of transcervical fracture of the femur, using acrylic bone cement. The patients were two female (83 and 87 years-old) and one male (78 years old), who suffered from a sudden fall at home. Autopsy revealed massive fat embolism (FE) of the lung and in one case also in the other organs; in 2 cases this FE was the cause of death alone, in the third case together with an unusual severe coronary heart disease (heart weight 700 g). Discussion of the medico-legal aspects, i.e. the coincidence of FE of different causes (traumatic, by operation, by reanimation). Reflections on the certainty to attribute the death to specific (in particular deficient) technical factors. AN - 2818512 AU - Maxeiner, H. DP - NLM ET - 1989/01/01 J2 - Beitrage zur gerichtlichen Medizin KW - Aged Aged, 80 and over Embolism, Fat/*pathology Female Hip Fractures/*surgery *Hip Prosthesis Humans Intraoperative Complications/*pathology Lung/pathology Male Pulmonary Embolism/*pathology LA - ger N1 - PubMed NLM literature search January 5, 2021 OP - Tödliche intraoperative Lungenfettembolie bei Endoprothese des Hüftgelenkes. PY - 1989 SN - 0067-5016 (Print) 0067-5016 SP - 415-27 ST - [Fatal intraoperative lung fat embolism in endoprosthesis of the hip joint] T2 - Beitr Gerichtl Med TI - [Fatal intraoperative lung fat embolism in endoprosthesis of the hip joint] VL - 47 ID - 828956 ER - TY - JOUR AB - Report on 3 cases of intraoperative death during total hip replacement in treatment of transcervical fracture of the femus, using acriylic bone cement. The patients were two female (83 and 87 years old) and one male (78 years old), who suffered from a sudden fall at home. Autopsy revealed massive fat embolism (FE) of the lung and in one case also in the other organs; in 2 cases this FE was the cause of death alone, in the third case together with an unusual severe coronary heart disease (heart weight 700 g). Discussion of the medico-legal aspects, i.e. the coincidence of FE of different causes (traumatic, by operation, by reanimation). Reflections on the certainty to attribute the death to specific (in particular deficient) technical factors. AD - Institut fur Rechtsmedizin, Freie Universitat, D-1000 Berlin 33 AU - Maxeiner, H. DB - Embase Medline KW - autopsy case report fat embolism fatality female histology human lung embolism male pathophysiology total hip prosthesis LA - German N1 - Embase Elsevier literature search January 5, 2021 PY - 1989 SP - 415-427 ST - Fatal intraoperative lung embolism during total hip replacement T2 - Beitrage zur Gerichtlichen Medizin TI - Fatal intraoperative lung embolism during total hip replacement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L19198166&from=export VL - 47 ID - 829950 ER - TY - JOUR AB - Primary cardiac lymphoma is an extremely rare disease, especially in immunocompetent patients, accounting for 1.3% of primary cardiac tumors and 0.5% of extranodal lymphomas. We report a case of a patient with a primary cardiac B Cell Lymphoma whose early detection was key to a prolonged survival. A 54 yo Caucasian male presented to the ER for urinary retention and hematuria, he was a construction worker, tobacco smoker and had a history of melanoma excision. Upon further questioning he revealed progressive dyspnea on exertion for the last two months and a recent episode of brief chest pain that he associated to lifting 80lb cement bags at his job. He denied edema, weight loss or hemoptysis. Initial evaluation revealed a hemodynamically stable patient with no respiratory distress or hypoxia, no lymphadenopathies were palpated, no jugular venous distention, mildly elevated troponins and no ischemic pattern on EKG. To rule out cardiac disease an echocardiogram was performed revealing a large density involving the right heart. CT angiogram of the chest, abdomen and pelvis showed a thickened bladder, bilateral hydronephrosis, cardiomegaly, bilateral lower lobe pulmonary emboli and a 12.8cm mass infiltrating the right atrium, right ventricle, tricuspid valve and extending into the pericardium. The mass was biopsied via an upper abdominal subxiphoid laparotomy and histological diagnosis confirmed stage IIE high-grade diffuse large B cell lymphoma. Metastatic workup (PET CT and Bone scan) was negative, while a cytoscopy revealed significant benign prostate hypertrophy without any bladder tumor, deemed to be chronic cystitis changes. A bone marrow aspirate showed normal flowcytometry without lymphomatous features. The pulmonary emboli were managed with argatroban after the patient developed Heparin Induced Thrombocytopenia (then continued anticoagulation with coumadin) and received chemotherapy consisting of 8 cycles of CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) followed by rituximab maintenance. Primary cardiac lymphoma is described as a lymphoma involving only the heart and/or pericardium or with the main bulk of disease localized to the heart. It remains asymptomatic until it produces a mass effect when the tumor obstructs cardiac output or causes local invasion, embolization, or systemic manifestations. They progress quickly and although prognosis is poor, early accurate diagnosis combined with appropriate therapy may improve survival and quality of life. Despite the large size of the tumor our patient survived with the combination of surgery and chemotherapy. At present the patient is well, with complete remission, 27 months after diagnosis. AD - L. May, Eisenhower Medical Center, Rancho Mirage, CA, United States AU - May, L. AU - Law, A. AU - Wilson, J. AU - Bencheqroun, H. DB - Embase KW - warfarin vincristine prednisone cement argatroban cyclophosphamide doxorubicin rituximab hematuria American society heart human patient lymphoma lung embolism chemotherapy pericardium diagnosis neoplasm survival bladder smoking melanoma density tobacco heart tumor construction worker heart disease urine retention hypoxia respiratory distress Caucasian bladder tumor hemoptysis prostate hypertrophy cystitis aspiration heparin induced thrombocytopenia echocardiography thorax abdomen pelvis hydronephrosis cardiomegaly body weight loss edema B cell lymphoma work large cell lymphoma male laparotomy histology pet animal bone scintiscanning thorax pain heart right ventricle remission bone marrow heart right atrium rare disease anticoagulation quality of life therapy exercise prognosis artificial embolization dyspnea heart output excision surgery tricuspid valve L1 - http://www.atsjournals.org/doi/pdf/10.1164/ajrccm-conference.2014.189.1_MeetingAbstracts.A4070 LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1073-449X ST - A rare case of a big heart and hematuria T2 - American Journal of Respiratory and Critical Care Medicine TI - A rare case of a big heart and hematuria UR - https://www.embase.com/search/results?subaction=viewrecord&id=L72046022&from=export VL - 189 ID - 829407 ER - TY - JOUR AB - Background. Bone metastases in the knee are rare. The most difficult challenge in this area is to achieve a stabile fixation. The aim of the study was to evaluate results of various techniques of operative treatment of bone metastases to the knee in relation to its localisation and lesion patomorphology.
Material and methods. We assed 13 patients (5,9%) out of 220 treated operatively. The destruction area was located in femur in 12 patients and in 1 in tibia. Bone metastases were found in physis of femur in 5 patients and cross the line drawn through epicondyles. In 8, metastases were located in the epicondylar area. Pathological fractures were noted in 7 patients.
Results. Successful stabilisation was achieved in 4 patients without pathological fracture and in one patient where we resected distal part of femur and stabilised it with tibia using Küntscher nail, plate and bone cement.
In 8 patients complications were observed. One died due to pulmonary embolism on the fifth day after operation. In 3 patients we observed local recurence of tumor if the curetage alone was performed. In 2 cases where we used 2 rods introduced from the epicondylar area the stabilisation become loose. It was due to short distal femoral part. In one patient we noticed stress fracture of plate and in one the stabilisation of tibia and femur become unstabile because of local progression of metastases. AD - Katedra i Klinika Ortopedii, Traumatologii i Rehabilitacji, Akademia Medyczna, Lublin. AN - 18034029 AU - Mazurkiewicz, T. AU - Warda, E. AU - Kopacz, J. DA - Jun 30 DP - NLM ET - 2007/11/24 J2 - Ortopedia, traumatologia, rehabilitacja LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2003 SN - 1509-3492 (Print) 1509-3492 SP - 343-7 ST - Technique and results of operative treatment of bone metastases to the knee T2 - Ortop Traumatol Rehabil TI - Technique and results of operative treatment of bone metastases to the knee VL - 5 ID - 828749 ER - TY - JOUR AB - In our cohort of 555 patients with a total of 1150 vertebral fractures treated with kyphoplasty we performed a 30-day postoperative analysis of cement leakage, neurological symptoms, pulmonary embolism, and infections. In our department, 22% of kyphoplasties were performed with calcium phosphate cement and the remainder with polymethylmethacrylate. All patients were initially assessed by an interdisciplinary kyphoplasty colloquium, composed of consultants in traumatology, radiology, and endocrinology. Indications included fresh traumatic vertebral fractures; painful sintered osteoporotic vertebrae; osteolysis and painful vertebral body collapse caused by multiple myelomas; and lymphomas and pathological fractures due to metastases of malignant tumors (prostate cancer, breast cancer, ovarian cancer, and malignant melanoma) or benign vertebral tumors (hemangioma).Contraindications included patients with instability of the posterior wall and/or pedicles, an infection of the fractured vertebra, a severe hemorrhagic diathesis, known allergies to the cements, pregnancy, and ASA score of 4. The standard postoperative computed tomography scan of the kyphoplasty-treated vertebrae revealed a dorsal cement leakage in 38 vertebrae..representing 3.3% of all levels. A permanent monoparesis of the left leg, 2 cases of temporary neurological deficits, 2 cases of hemorrhage, and 1 asymptomatic pulmonary embolism were observed as postoperative complications. We observed no complications relating to polymethylmethacrylate described in the literature. By careful interdisciplinary indication setting and a standardized treatment model, kyphoplasty presents a safe and effective procedure for the treatment of various vertebral fractures. AD - Surgical Clinic, Division of Traumatology and Reconstructive Surgery, University of Heidelberg AN - 105455821. Language: English. Entry Date: 20090501. Revision Date: 20200708. Publication Type: Journal Article AU - McArthur, N. AU - Kasperk, C. AU - Baier, M. AU - Tanner, M. AU - Gritzbach, B. AU - Schoierer, O. AU - Rothfischer, W. AU - Krohmer, G. AU - Hillmeier, J. AU - Kock, H. AU - Meeder, P. J. AU - Huber, F. DB - cin20 DO - 10.3928/01477447-20090201-15 DP - EBSCOhost KW - Decision Making, Clinical Kyphoplasty Postoperative Complications Spinal Fractures -- Surgery Treatment Outcomes Adolescence Adult Aged Aged, 80 and Over Bone Cements Descriptive Statistics Female Kyphoplasty -- Contraindications Male Middle Age Neurologic Manifestations Patient Selection Prospective Studies Pulmonary Embolism Surgical Wound Infection Tomography, X-Ray Computed Human M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0147-7447 SP - 90-90 ST - 1150 kyphoplasties over 7 years: indications, techniques, and intraoperative complications T2 - Orthopedics TI - 1150 kyphoplasties over 7 years: indications, techniques, and intraoperative complications UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105455821&site=ehost-live&scope=site VL - 32 ID - 830738 ER - TY - JOUR AB - In our cohort of 555 patients with a total of 1150 vertebral fractures treated with kyphoplasty we performed a 30-day postoperative analysis of cement leakage, neurological symptoms, pulmonary embolism, and infections. In our department, 22% of kyphoplasties were performed with calcium phosphate cement and the remainder with polymethylmethacrylate. All patients were initially assessed by an interdisciplinary kyphoplasty colloquium, composed of consultants in traumatology, radiology, and endocrinology. Indications included fresh traumatic vertebral fractures; painful sintered osteoporotic vertebrae; osteolysis and painful vertebral body collapse caused by multiple myelomas; and lymphomas and pathological fractures due to metastases of malignant tumors (prostate cancer, breast cancer, ovarian cancer, and malignant melanoma) or benign vertebral tumors (hemangioma). Contraindications included patients with instability of the posterior wall and/or pedicles, an infection of the fractured vertebra, a severe hemorrhagic diathesis, known allergies to the cements, pregnancy, and ASA score of 4. The standard postoperative computed tomography scan of the kyphoplasty-treated vertebrae revealed a dorsal cement leakage in 38 vertebrae representing 3.3% of all levels. A permanent monoparesis of the left leg, 2 cases of temporary neurological deficits, 2 cases of hemorrhage, and 1 asymptomatic pulmonary embolism were observed as postoperative complications. We observed no complications relating to polymethylmethacrylate described in the literature. By careful interdisciplinary indication setting and a standardized treatment model, kyphoplasty presents a safe and effective procedure for the treatment of various vertebral fractures. AD - Surgical Clinic, Division of Traumatology and Reconstructive Surgery, University of Heidelberg, Heidelberg, Germany. AN - 19301801 AU - McArthur, N. AU - Kasperk, C. AU - Baier, M. AU - Tanner, M. AU - Gritzbach, B. AU - Schoierer, O. AU - Rothfischer, W. AU - Krohmer, G. AU - Hillmeier, J. AU - Kock, H. J. AU - Meeder, P. J. AU - Huber, F. X. DA - Feb DP - NLM ET - 2009/03/24 J2 - Orthopedics KW - Adolescent Adult Aged Aged, 80 and over Cohort Studies Female Humans Intraoperative Complications/*epidemiology Male Middle Aged Postoperative Complications/*epidemiology Retrospective Studies Spinal Fractures/epidemiology/*surgery Vertebroplasty/adverse effects/*methods Young Adult LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0147-7447 SP - 90 ST - 1150 kyphoplasties over 7 years: indications, techniques, and intraoperative complications T2 - Orthopedics TI - 1150 kyphoplasties over 7 years: indications, techniques, and intraoperative complications VL - 32 ID - 828764 ER - TY - JOUR AB - The newer techniques of cementing aim to improve interlock between cement and bone around a femoral stem by combining high pressure and reduced viscosity. This may produce increased embolisation of fat and marrow leading to hypotension, impaired pulmonary gas exchange and death. For this reason the use of high pressures has been questioned. We compared finger‐packing with the use of a cement gun by measuring intramedullary pressures during the cementing of 31 total hip replacements and measuring physiological changes in 19 patients. We also measured pressure in more detail in a laboratory model. In the clinical series the higher pressures were produced by using a gun, but this caused less physiological disturbance than finger‐packing. The laboratory studies showed more consistent results with the gun technique, but for both methods of cementing the highest pressures were generated during the insertion of the stem of the prosthesis. AN - CN-00140441 AU - McCaskie, A. W. AU - Barnes, M. R. AU - Lin, E. AU - Harper, W. M. AU - Gregg, P. J. DO - 10.1302/0301-620x.79b3.7301 KW - *cement *total hip prosthesis Article Bone Cements [*therapeutic use] Clinical article Clinical trial Comparative study Controlled clinical trial Controlled study Experimental model Hip Prosthesis [instrumentation, *methods, statistics & numerical data] Human Humans In Vitro Techniques Laboratory test Pressure Priority journal Prospective Studies Prosthesis Design [statistics & numerical data] Randomized controlled trial Statistics, Nonparametric Surgical technique Viscosity M1 - 3 M3 - Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1997 SP - 379‐384 ST - Cement pressurisation during hip replacement T2 - Journal of bone and joint surgery. British volume TI - Cement pressurisation during hip replacement UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00140441/full VL - 79 ID - 830036 ER - TY - JOUR AB - Longevity of cemented femoral components is dependent upon many factors. It is certainly related to the cementing technique. A dilemma exists between adequate cement pressurization and risk of embolic events. A cementation pressure above bleeding pressure, to allow optimum cement bone interdigitation but not high enough to produce embolic or cardiorespiratory events, is the ideal situation. We present a case where cement pressurization resulted in the appearance of a cement venogram on the routine postoperative x-ray. AD - Melbourne Orthopaedic Group, Windsor, Victoria, Australia. AN - 16446200 AU - McClelland, D. AU - Bracy, D. DA - Jan DO - 10.1016/j.arth.2005.01.024 DP - NLM ET - 2006/02/01 J2 - The Journal of arthroplasty KW - Aged *Arthroplasty, Replacement, Hip *Bone Cements Cementation/*methods Female Foreign Bodies/*diagnostic imaging Humans *Phlebography Pressure LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0883-5403 (Print) 0883-5403 SP - 141-3 ST - Cement venogram--a risk of satisfactory cement pressurization T2 - J Arthroplasty TI - Cement venogram--a risk of satisfactory cement pressurization VL - 21 ID - 828942 ER - TY - JOUR AB - Longevity of cemented femoral components is dependent upon many factors. It is certainly related to the cementing technique. A dilemma exists between adequate cement pressurization and risk of embolic events. A cementation pressure above bleeding pressure, to allow optimum cement bone interdigitation but not high enough to produce embolic or cardiorespiratory events, is the ideal situation. We present a case where cement pressurization resulted in the appearance of a cement venogram on the routine postoperative x-ray. AD - D. McClelland, Melbourne Orthopaedic Group, 33 The Avenue, Windsor, Vic. 3181, Australia AU - McClelland, D. AU - Bracy, D. DB - Embase Medline DO - 10.1016/j.arth.2005.01.024 KW - cement aged article case report clinical feature embolism female human pneumonia postoperative period prosthesis X ray LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 0883-5403 SP - 141-143 ST - Cement venogram - A risk of satisfactory cement pressurization T2 - Journal of Arthroplasty TI - Cement venogram - A risk of satisfactory cement pressurization UR - https://www.embase.com/search/results?subaction=viewrecord&id=L43163000&from=export http://dx.doi.org/10.1016/j.arth.2005.01.024 VL - 21 ID - 829804 ER - TY - JOUR AB - SESSION TITLE: Case Report Semifinalists 8 SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM INTRODUCTION: A 61-year old male presented to the emergency department with progressive shortness of breath two days after a kyphoplasty of T11-L1 due to a T12 fracture. The immediate post-operative course was uneventful. No post-procedure imaging was ordered and the patient was discharged to a rehabilitation center the day after surgery. CASE PRESENTATION: Vital signs showed a heart rate of 108 beats per minute, blood pressure of 130/87 mmHg, and temperature of 101 degrees Fahrenheit. Physical exam demonstrated a patient in respiratory distress with decreased breath sounds and crackles bilaterally on auscultation. Arterial blood gas demonstrated severe hypoxemia. An abdominal CT incidentally confirmed large polymethymethacrylate (PMMA) bone cement embolisms in both main pulmonary arteries and in a vertebral vein anterior to T11. He soon became obtunded with rapidly progressive hemodynamic and respiratory failure, was intubated and transferred to the intensive care unit. Despite all resuscitation efforts, he went into refractory shock necessitating vasopressors. Due to the ongoing progression of cardiac and hypoxemic respiratory failure and scarcity of therapeutic options, the patient was transferred to a hospital with a cardiothoracic surgery team for possible extra corporeal membrane oxygenation (ECMO) or surgical pulmonary artery embolectomy. After a safe transfer, the patient went into cardiopulmonary arrest while being evaluated and expired before he could benefit from any procedure. DISCUSSION: Pulmonary cement embolisms (PCE) are a complication of percutaneous vertebroplasty (PV) and balloon kyphoplasty procedures. In both procedures PMMA is injected into the body of the vertebra, either directly (vertebroplasty) or within an inflated balloon (kyphoplasty). Cement can leak into the vertebral vein, continue to the inferior vena cava and reach the pulmonary arteries. Fatalities due to PCE remain extremely rare, relate to PV, and occur during the procedure (3,6) or a few days after (7,8). Our case is, to our knowledge, the first fatality occurring in a kyphoplasty patient. CONCLUSIONS: No standardized treatment exists for PCE but many interventions are possible to retrieve larger emboli before they can become life threatening, if they are identified immediately (1,2,4,5). Additional studies should be conducted to identify patients at risk and avoid this occurrence. In the meantime, it seems reasonable to infer from past cases and our personal experience that routine intra-operative identification of leakages with fluoroscopy and post-operative CXR may be helpful in rapid recognition and treatment of this patient population before they become symptomatic and irreversibly hemodynamically unstable. Reference #1: 1. Barbero, S, et al. “Percutaneous Vertebroplasty: the Follow-up.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Feb. 2008,. Reference #2: 2. Baumann, A. et al. Cement Embolization into the Vena Cava and Pulmonal Arteries After Vertebroplasty: Interdisciplinary Management. European Journal of Vascular and Endovascular Surgery, Volume 31, Issue 5, 558 - 561 3. Chen, H L, et al. “A Lethal Pulmonary Embolism during Percutaneous Vertebroplasty.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Oct. 2002,. 4. François, K, et al. “Successful Management of a Large Pulmonary Cement Embolus after Percutaneous Vertebroplasty: a Case Report.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 15 Oct. 2003,. Reference #3: 5. Li, Z, et al. “Cement Embolus Trapped in the Inferior Vena Cava Filter during Percutaneous Vertebroplasty.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2013,. 6. Monticelli, F, et al. “Fatal Pulmonary Cement Embolism Following Percutaneous Vertebroplasty (PVP).” Current Neurology and Neuroscience Reports., U.S. Nation l Library of Medicine, 20 Apr. 2005,. 7. Stricker, K, et al. “Severe Hypercapnia Due to Pulmonary Embolism of Polymethylmethacrylate during Vertebroplasty.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, Apr. 2004,. 8. Yoo, K Y, et al. “Acute Respiratory Distress Syndrome Associated with Pulmonary Cement Embolism Following Percutaneous Vertebroplasty with Polymethylmethacrylate.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 15 July 2004,. DISCLOSURES: No relevant relationships by Mariam Abboud, source=Web Response No relevant relationships by Brooke McDonald, source=Web Response AU - McDonald, B. AU - Abboud, M. DB - Embase DO - 10.1016/j.chest.2019.08.176 KW - bone cement poly(methyl methacrylate) adult adult respiratory distress syndrome arterial gas auscultation blood pressure cardiopulmonary arrest case report clinical article complication conference abstract crackle dyspnea embolectomy emergency ward endovascular surgery extracorporeal oxygenation fatality fluoroscopy follow up fracture heart rate hospital discharge human hypercapnia hypoxemia intensive care unit kyphoplasty lung embolism male middle aged neurology personal experience physical examination pulmonary artery rehabilitation center resuscitation risk assessment surgery thorax surgery vena cava filter vertebra body vital sign LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1931-3543 0012-3692 SP - A84-A85 ST - FATAL CENTRAL PULMONARY CEMENT EMBOLISM AFTER KYPHOPLASTY T2 - Chest TI - FATAL CENTRAL PULMONARY CEMENT EMBOLISM AFTER KYPHOPLASTY UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2002982670&from=export http://dx.doi.org/10.1016/j.chest.2019.08.176 VL - 156 ID - 829111 ER - TY - JOUR AB - Purpose: To assess the readability of online patient education materials (OPEM) related to common diseases treated by and procedures performed by interventional radiology (IR).Materials and Methods: The following websites were chosen based on their average Google search return for each IR OPEM content area examined in this study: Society of Interventional Radiology (SIR), Cardiovascular and Interventional Radiological Society of Europe (CIRSE), National Library of Medicine, RadiologyInfo, Mayo Clinic, WebMD, and Wikipedia. IR OPEM content area was assessed for the following: peripheral arterial disease, central venous catheter, varicocele, uterine artery embolization, vertebroplasty, transjugular intrahepatic portosystemic shunt, and deep vein thrombosis. The following algorithms were used to estimate and compare readability levels: Flesch-Kincaid Grade Formula, Flesch Reading Ease Score, Gunning Frequency of Gobbledygook, Simple Measure of Gobbledygook, and Coleman-Liau Index. Data were analyzed using general mixed modeling.Results: On average, online sources that required beyond high school grade-level readability were Wikipedia (15.0), SIR (14.2), and RadiologyInfo (12.4); sources that required high school grade-level readability were CIRSE (11.3), Mayo Clinic (11.0), WebMD (10.6), and National Library of Medicine (9.0). On average, OPEM on uterine artery embolization, vertebroplasty, varicocele, and peripheral arterial disease required the highest level of readability (12.5, 12.3, 12.3, and 12.2, respectively).Conclusions: The IR OPEM assessed in this study were written above the recommended sixth-grade reading level and the health literacy level of the average American adult. Many patients in the general public may not have the ability to read and understand health information in IR OPEM. AD - Vascular Disease Research Center, Division of Vascular and Interventional Radiology, Department of Diagnostic Imaging, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 593 Eddy Street, 338 Gerry House, Providence, RI 02903. Vascular Disease Research Center, Division of Vascular and Interventional Radiology, Department of Diagnostic Imaging, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 593 Eddy Street, 338 Gerry House, Providence, RI 02903. Electronic address: mnaeem@lifespan.org. Biostatistics Core, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, 593 Eddy Street, 338 Gerry House, Providence, RI 02903. AN - 109607589. Language: English. Entry Date: 20150923. Revision Date: 20160525. Publication Type: journal article. Journal Subset: Biomedical AU - McEnteggart, Gregory E. AU - Naeem, Muhammad AU - Skierkowski, Dorothy AU - Baird, Grayson L. AU - Ahn, Sun H. AU - Soares, Gregory DB - cin20 DO - 10.1016/j.jvir.2015.03.019 DP - EBSCOhost M1 - 8 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2015 SN - 1051-0443 SP - 1164-1168 ST - Readability of Online Patient Education Materials Related to IR T2 - Journal of Vascular & Interventional Radiology TI - Readability of Online Patient Education Materials Related to IR UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=109607589&site=ehost-live&scope=site VL - 26 ID - 830612 ER - TY - JOUR AB - PURPOSE: Percutaneous vertebroplasty is a novel approach for treating patients with painful vertebral body compression fractures. The use of intraosseous venography before the percutaneous injection of polymethylmethacrylate (PMMA) is not universally accepted. The purpose of this study was to determine if intraosseous venography predicts PMMA flow characteristics when injected into a vertebral body. MATERIALS AND METHODS: One hundred thirty-five intraosseous venograms were obtained during 96 vertebroplasty procedures (39 thoracic, 57 lumbar) in 61 patients (49 women, 12 men; age, 36-94 y) over a 32-month period. All venograms were obtained by injecting water-soluble contrast material through the vertebroplasty needle that had been placed percutaneously via a transpedicular approach. The venograms were retrospectively reviewed by the authors and compared in a blinded fashion with the subsequent final vertebroplasty result. RESULTS: Several venographic patterns were observed: bilateral or unilateral marrow blush with or without venous filling, direct venous filling, leakage of contrast material through an endplate or cortical defect, and stasis within the marrow space. Venograms that demonstrated a bilateral marrow blush predicted flow of PMMA across the midline to adequately fill the contralateral hemivertebrae 95% of the time (40 of 42 cases). A unilateral marrow blush predicted the necessity of a second puncture 97% of the time (32 of 33 cases). Intraosseous venography predicted PMMA entering endplate/cortical defects in all cases (22 of 22) and venous structures in 29% (22 of 75) of cases. Direct venous filling was observed during two vertebroplasty procedures and gelatin foam embolization was performed before PMMA instillation. Stasis of contrast material in the marrow space was observed in 15 cases. Overall, in 83% (80 of 96) of the vertebroplasty procedures, intraosseous venography was believed to predict the flow characteristics of PMMA. CONCLUSION: Intraosseous venography provides useful information in predicting PMMA flow characteristics within the vertebral body and in predicting potential undesirable sites of cement deposition, such as through cortical defects and within venous structures. AD - Department of Vascular and Interventional Radiology, Riverside Methodist Hospital, Columbus, OH 43214, USA. jkmcgraw@hotmail .com AN - 11830620 AU - McGraw, J. K. AU - Heatwole, E. V. AU - Strnad, B. T. AU - Silber, J. S. AU - Patzilk, S. B. AU - Boorstein, J. M. DA - Feb DO - 10.1016/s1051-0443(07)61931-9 DP - NLM ET - 2002/02/07 J2 - Journal of vascular and interventional radiology : JVIR KW - Adult Aged Aged, 80 and over Extravasation of Diagnostic and Therapeutic Materials/*diagnostic imaging Female Humans Male Middle Aged Minimally Invasive Surgical Procedures *Phlebography Polymethyl Methacrylate/*administration & dosage Predictive Value of Tests Retrospective Studies Spinal Fractures/*surgery Spinal Fusion/*methods Treatment Outcome LA - eng M1 - 2 Pt 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2002 SN - 1051-0443 (Print) 1051-0443 SP - 149-53 ST - Predictive value of intraosseous venography before percutaneous vertebroplasty T2 - J Vasc Interv Radiol TI - Predictive value of intraosseous venography before percutaneous vertebroplasty VL - 13 ID - 828801 ER - TY - JOUR AB - Interventional radiology procedures are being increasingly used to mitigate chronic pain. In addition to established therapies such as thermal bone lesion ablation, kyphoplasty, and chemical neurolysis, ongoing research has shown promising results for the use of embolization in treatment of osteoarthritic knee pain and chronic pain secondary to adhesive shoulder capsulitis. This review will highlight some of the most common interventional radiology pain procedures, as well as provide insight into future pain-relieving embolization. • Interventional radiology has many widespread applications for relieving chronic pain. • Thermal ablation techniques are proving successful at treating numerous forms of bone pain. • Superior hypogastric nerve blocks can lessen postprocedural uterine artery embolization pain. • Genicular artery embolization is a novel treatment for painful knee osteoarthritis. • Adhesive capsulitis embolization can reduce pain and stiffness caused by frozen shoulder. AD - Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC Vascular Interventional Partners, NOVA, McLean, VA AN - 147342437. Language: English. Entry Date: 20201208. Revision Date: 20201208. Publication Type: Article AU - McKnight, Kyle H. AU - Bagla, Sandeep AU - Dixon, Robert G. AU - Isaacson, Ari J. DB - cin20 DO - 10.1016/j.jradnu.2020.06.010 DP - EBSCOhost KW - Radiography, Interventional Chronic Pain -- Surgery Kyphoplasty Nerve Block Embolization, Therapeutic Adhesive Capsulitis Treatment Outcomes M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2020 SN - 1546-0843 SP - 286-292 ST - A Review of Interventional Radiology Treatments for Chronic Pain T2 - Journal of Radiology Nursing TI - A Review of Interventional Radiology Treatments for Chronic Pain UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=147342437&site=ehost-live&scope=site VL - 39 ID - 830500 ER - TY - JOUR AB - Purpose: To assess adoption and survey-based satisfaction rates following deployment of standardized interventional radiology (IR) procedure reports across multiple institutions.Materials and Methods: Standardized reporting templates for 5 common interventional procedures (central venous access, inferior vena cava [IVC] filter insertion, IVC filter removal, uterine artery embolization, and vertebral augmentation) were distributed to 20 IR practices in a prospective quality-improvement study. Participating sites edited the reports according to institutional preferences and deployed them for a 1-year pilot study concluding in July 2015. Study compliance was measured by sampling 20 reports of each procedure type at each institution, and surveys of interventionalists and referring physicians were performed. Modifications to the standardized reporting templates at each site were analyzed.Results: Ten institutions deployed the standardized reports, with 8 achieving deployment of 3-12 months. The mean report usage rate was 57%. Each site modified the original reports, with 26% mean reduction in length, 18% mean reduction in wordiness, and 60% mean reduction in the number of forced fill-in fields requiring user input. Linear-regression analysis revealed that reduced number of forced fill-in fields correlated significantly with increased usage rate (R2 = 0.444; P = .05). Surveys revealed high satisfaction rates among referring physicians but lower satisfaction rates among interventional radiologists.Conclusions: Standardized report adoption rates increased when reports were simplified by reducing the number of forced fill-in fields. Referring physicians preferred the standardized reports, whereas interventional radiologists preferred standard narrative reports. AD - Department of Radiology, Division of Interventional Radiology, Ronald Reagan University of California, Los Angeles (UCLA), Medical Center, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, 2nd Floor, Suite 2125C, Los Angeles, CA 90095 Department of Radiology, Division of Vascular and Interventional Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin Division of Diagnostic Imaging, Department of Interventional Radiology, University of Texas MD Anderson Cancer Center, Houston, Texas Department of Radiology, Section of Interventional Radiology, University of Washington Medical Center, Seattle, Washington Department of Diagnostic Radiology and Molecular Imaging, Section of Interventional Radiology, Beaumont Health, Oakland University William Beaumont School of Medicine, Rochester, Michigan Department of Radiology, Division of Interventional Radiology, Weill Cornell/New York Presbyterian Hospital, New York, New York Division of Interventional Radiology and Image Guided Medicine, Emory University School of Medicine, Atlanta, Georgia Department of Radiology, Interventional Radiology Service, Memorial Sloan–Kettering Cancer Center, New York, New York AN - 119650904. Language: English. Entry Date: 20170724. Revision Date: 20190620. Publication Type: journal article AU - McWilliams, Justin P. AU - Shah, Rajesh P. AU - Quirk, Matthew AU - White, Sarah B. AU - Dybul, Stephanie L. AU - Ahrar, Judy AU - Steele, Joseph R. AU - Kwan, Sharon W. AU - Handel, Jeremy AU - Winokur, Ronald S. AU - Gilliland, Charles A. AU - Durack, Jeremy C. DB - cin20 DO - 10.1016/j.jvir.2016.07.016 DP - EBSCOhost KW - Coding -- Standards Medical Records -- Standards Radiography, Interventional -- Standards Documentation -- Standards Documentation -- Methods United States Guideline Adherence -- Standards Vena Cava Filters Quality Improvement -- Standards Clinical Indicators -- Standards Uterine Artery Embolization -- Standards Prostheses and Implants -- Standards Catheterization, Central Venous -- Standards Radiography, Interventional -- Methods Male Human Practice Guidelines -- Standards Pilot Studies Device Removal -- Standards Surveys Female Vertebroplasty -- Standards Prospective Studies Prostheses and Implants -- Equipment and Supplies Validation Studies Comparative Studies Evaluation Research Multicenter Studies M1 - 12 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2016 SN - 1051-0443 SP - 1779-1785 ST - Standardized Reporting in IR: A Prospective Multi-Institutional Pilot Study T2 - Journal of Vascular & Interventional Radiology TI - Standardized Reporting in IR: A Prospective Multi-Institutional Pilot Study UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=119650904&site=ehost-live&scope=site VL - 27 ID - 830580 ER - TY - JOUR AB - Vertebroplasty is a recently developed technique that consists of introducing polymethylmetacrilate (PMMA) through percutaneous puncture of the vertebral body to achieve functional stability and pain relief. It is mainly used to treat osteoporosis, hemangiomas, and metastases. Although uncommon, complications can occur during the procedure. Pulmonary embolism due to acrylic cement extravasation and venous migration is one possible complication. AD - J. Meca, Servicio de Radiodiagnóstico, Hospital Vega Baja de Orihuela, 03314 San Bartolomé, Orihuela, Spain AU - Meca, J. AU - Sánchez, L. AU - Cantero, G. AU - Balonga, C. DB - Embase DO - 10.1016/s0033-8338(05)72793-4 KW - acrylic cement poly(methyl methacrylate) aged article case report extravasation female hemangioma human iatrogenic disease lung embolism osteoporosis percutaneous vertebroplasty spine metastasis LA - Spanish M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2005 SN - 0033-8338 SP - 27-28 ST - Pulmonary embolism due to acrylic cement after percutaneous vertebroplasty T2 - Radiologia TI - Pulmonary embolism due to acrylic cement after percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L40343407&from=export http://dx.doi.org/10.1016/s0033-8338(05)72793-4 VL - 47 ID - 829823 ER - TY - JOUR AB - Cement pulmonary embolism is a rare complication of cement kyphoplasty. These emboli are often asymptomatic and commonly detected many years after the procedure as incidental findings on radiographic imaging. We herein report a case of a 32-year-old professional diver who was diagnosed with asymptomatic cement pulmonary emboli during his annual diving physical exam. After two years of follow-up the patient remained asymptomatic and resumed his career in professional diving, which included deep sea diving activities with no evidence of respiratory limitations or long-term complications. AN - 27416693 AU - Memarpour, R. AU - Tashtoush, B. AU - Nasim, F. AU - Grobman, D. AU - Upadhyay, B. K. AU - Rahaghi, F. DA - May-Jun DP - NLM ET - 2016/07/16 J2 - Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc KW - Adult Asymptomatic Diseases Bone Cements/*adverse effects *Diving Humans Incidental Findings *Kyphoplasty Male Pulmonary Embolism/diagnostic imaging/*etiology Radiography *Seawater LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1066-2936 (Print) 1066-2936 SP - 249-55 ST - A deep-sea diver with cement pulmonary embolism T2 - Undersea Hyperb Med TI - A deep-sea diver with cement pulmonary embolism VL - 43 ID - 828659 ER - TY - JOUR AB - Admission rates of orthopedic patients to intensive care units are increasing. Thus, an intensivist's familiarity with specific problems associated with major joint replacement surgery is of utmost importance in order to meet the needs of this particular patient population. In this article, the authors review the most commonly encountered complications after major hip and knee arthroplasty. Perioperative risk factors for morbidity and mortality and the epidemiology, diagnosis, and treatment of cardiopulmonary complications in this patient population are discussed. Procedure-specific complications such as fat embolism and acrylic bone cement-related issues are reviewed. AN - 105993295. Language: English. Entry Date: 20080222. Revision Date: 20150711. Publication Type: Journal Article. Journal Subset: Biomedical AU - Memtsoudis, S. G. AU - Rosenberger, P. AU - Walz, J. M. DB - cin20 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip Arthroplasty, Replacement, Knee Bone Cements -- Adverse Effects Cardiovascular Diseases -- Therapy Critical Care -- Methods Embolism, Fat -- Diagnosis Intensive Care Units Lung Diseases -- Therapy Methylmethacrylates -- Adverse Effects Postoperative Complications -- Therapy Cardiovascular Diseases -- Etiology Cardiovascular Diseases -- Mortality Embolism, Fat -- Etiology Embolism, Fat -- Physiopathology Lung Diseases -- Etiology Lung Diseases -- Mortality Postoperative Care Postoperative Complications -- Mortality Risk Factors M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2007 SN - 0885-0666 SP - 92-104 ST - Critical care issues in the patient after major joint replacement T2 - Journal of Intensive Care Medicine (Sage Publications Inc.) TI - Critical care issues in the patient after major joint replacement UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105993295&site=ehost-live&scope=site VL - 22 ID - 830765 ER - TY - JOUR AB - Background and Objectives: The transient and rarely clinically relevant effect of bone and cement embolization during unilateral joint arthroplasty is a known phenomenon. However, available studies do not address events surrounding bilateral total hip arthroplasties, during which embolic load is presumably doubled. To elucidate events surrounding this increasingly used procedure and assess the effect on the pulmonary hemodynamics in the intraoperative and postoperative periods, we studied 24 subjects undergoing cemented bilateral total hip arthroplasty during the same anesthetic session.Materials: Twenty-four patients without previous pulmonary history undergoing cemented bilateral total hip arthroplasty under controlled epidural hypotension were enrolled. Pulmonary artery catheters were inserted and hemodynamic variables were recorded at baseline, 5 mins after the implantation of each hip joint, 1 hr and 1 day after surgery. Mixed venous blood gases and complete blood counts were analyzed at every time point.Results: An increase in pulmonary vascular resistance was observed after the second but not the first hip implantation when compared with values at incision. Pulmonary vascular resistance remained elevated 1 hr after surgery. Pulmonary artery pressures were significantly elevated on postoperative day 1 compared with those at baseline. The white blood cell count increased in response to the second hip implantation but not the first compared with incision.Conclusions: The embolization of material during bilateral total hip arthroplasty is associated with prolonged increases in pulmonary artery pressures and vascular resistance, particularly after completion of the second side. Performance of bilateral procedures should be cautiously considered in patients with diseases suggesting decreased right ventricular reserve. AD - Department of Anesthesiology, Hospital for Special Surgery, New York, NY 10021, USA From the Departments of *Anesthesiology, daggerOrthopedic Surgery, and double daggerPublic Health and Biostatistics, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY. AN - 104920099. Language: English. Entry Date: 20110121. Revision Date: 20200708. Publication Type: journal article AU - Memtsoudis, S. G. AU - Salvati, E. A. AU - Go, G. AU - Ma, Y. AU - Sharrock, N. E. AU - Memtsoudis, Stavros G. AU - Salvati, Eduardo A. AU - Go, George AU - Ma, Yan AU - Sharrock, Nigel E. DB - cin20 DO - 10.1097/AAP.0b013e3181e85a07 DP - EBSCOhost KW - Anesthesia, Conduction Arthroplasty, Replacement, Hip -- Adverse Effects Pulmonary Circulation Adult Aged Aged, 80 and Over Blood Pressure Female Male Middle Age Intraoperative Period Pulmonary Artery -- Physiology Vascular Resistance M1 - 5 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2010 SN - 1098-7339 SP - 417-421 ST - Perioperative pulmonary circulatory changes during bilateral total hip arthroplasty under regional anesthesia T2 - Regional Anesthesia & Pain Medicine TI - Perioperative pulmonary circulatory changes during bilateral total hip arthroplasty under regional anesthesia UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104920099&site=ehost-live&scope=site VL - 35 ID - 830706 ER - TY - JOUR AB - STUDY DESIGN: Systematic review of the literature. OBJECTIVE: Should cement augmentation procedures such as vertebroplasty and kyphoplasty be used in patients with painful compression fractures associated with metastatic spine disease? What is the role of embolization in the treatment of metastatic spine disease? SUMMARY OF BACKGROUND DATA: Vertebral augmentation is commonly employed in treating osteoporotic fractures and is now increasingly used in the management of pain in patients with spinal tumors. Intra-arterial and transcutaneous embolization techniques are also available in the management of spinal tumors. To date, the effectiveness and safety of these procedures have not been adequately demonstrated. METHODS: A review of the English literature was performed in Pub-Med. One search was performed using the following keywords: cancer, tumor, vertebroplasty, kyphoplasty, vertebral augmentation, outcome, safety, pain, and quality of life. A Second search was performed using the keywords: embolization, spinal, and tumors. Original studies reporting on at least 10 patients were included and systematically reviewed. The results were reviewed and discussed through consensus among a multidisciplinary panel of expert members of the Spine Oncology Study Group. Recommendations were made according to the Guyatt Guidelines. RESULTS: A total of 1665 abstracts were identified. Twenty-eight articles using vertebroplasty reported on 877 patients and 1599 treated levels. Medical and neurologic complications varied from 0% to 7.1% and 0% to 8.1%, respectively. Twelve articles using kyphoplasty reported on 333 patients and 481 treated levels. Medical complication rates varied from 0% to 0.5%, without any neurologic complications. Pain and functional outcomes were universally successful using either technique. Ten studies on embolization reported on 330 patients. There were 4 permanent complications (1.4%). Complete or partial embolization was possible in 97.5% with an estimated reduction of intraoperative blood loss of 2.3 L. CONCLUSION: There is strong recommendation and moderate evidence for vertebral augmentation as safe and effective in providing pain relief and improving functional outcome in patients with vertebral body fractures and axial pain due to metastatic disease. There is a strong recommendation and very low evidence for embolization techniques as safe and effective in decreasing intraoperative blood loss in hypervascular tumors. AD - Department of Neurosurgery, The Ohio State University Medical Center and The James Cancer Center, Columbus, OH, USA. ehud.mendel@osumc.edu AN - 105289295. Language: English. Entry Date: 20100212. Revision Date: 20150711. Publication Type: Journal Article AU - Mendel, E. AU - Bourekas, E. AU - Gerszten, P. AU - Golan, J. D. DB - cin20 DO - 10.1097/BRS.0b013e3181b77895 DP - EBSCOhost KW - Fractures, Compression -- Surgery Kyphoplasty Spinal Neoplasms -- Pathology Spinal Neoplasms -- Surgery Spine -- Surgery Fractures, Compression -- Pathology Human Neoplasm Metastasis -- Pathology Pain -- Surgery PubMed Spine -- Pathology Systematic Review Treatment Outcomes M1 - 22S N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0362-2436 SP - S93-100 ST - Percutaneous techniques in the treatment of spine tumors: what are the diagnostic and therapeutic indications and outcomes? T2 - Spine (03622436) TI - Percutaneous techniques in the treatment of spine tumors: what are the diagnostic and therapeutic indications and outcomes? UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105289295&site=ehost-live&scope=site VL - 34 ID - 830720 ER - TY - JOUR AB - A 69-year-old man developed pulmonary metastases following vertebroplasties for pathological fractures of vertebrae T12-L4. The fractures developed due to spinal metastases from castrate-resistant prostate cancer. A CT scan performed 1 month prior indicated no evidence of pulmonary malignancy. However, CT scans performed 2 months after the vertebroplasties demonstrated intravascular pulmonary metastases distributed similarly to embolized polymethylmethacrylate. Vertebroplasty is a well-established procedure for symptomatic management of vertebral compression fractures. However, studies have demonstrated an increase in circulating tumor cells following vertebroplasties, theoretically increasing the risk of distant metastases. In this case, the chronicity and radiological findings suggest that the pulmonary intravascular metastases may have resulted from the vertebroplasties. AD - Divisions of1Cardiothoracic Imaging and. 2Department of Medicine, University of Toronto; and. 3Neuroradiology, Toronto Joint Department of Medical Imaging, University Health Network. 4Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. AN - 31783355 AU - Mercer, J. AU - Lam, A. C. L. AU - Smith, R. AU - Fallah-Rad, N. AU - Kavanagh, J. DA - Nov 29 DO - 10.3171/2019.9.spine19915 DP - NLM ET - 2019/11/30 J2 - Journal of neurosurgery. Spine KW - CTC = circulating tumor cell MIP = maximum intensity projection PMMA = polymethylmethacrylate PSA = prostate-specific antigen complications metastasis oncology prostate cancer vertebroplasty LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 1547-5646 SP - 1-4 ST - Development of pulmonary endovascular metastases following vertebroplasty: case report T2 - J Neurosurg Spine TI - Development of pulmonary endovascular metastases following vertebroplasty: case report ID - 828648 ER - TY - JOUR AB - A 69-year-old man developed pulmonary metastases following vertebroplasties for pathological fractures of vertebrae T12–L4. The fractures developed due to spinal metastases from castrate-resistant prostate cancer. A CT scan performed 1 month prior indicated no evidence of pulmonary malignancy. However, CT scans performed 2 months after the vertebroplasties demonstrated intravascular pulmonary metastases distributed similarly to embolized polymethylmethacrylate. Vertebroplasty is a well-established procedure for symptomatic management of vertebral compression fractures. However, studies have demonstrated an increase in circulating tumor cells following vertebroplasties, theoretically increasing the risk of distant metastases. In this case, the chronicity and radiological findings suggest that the pulmonary intravascular metastases may have resulted from the vertebroplasties. AD - J. Kavanagh, University Health Network, Toronto, ON, Canada AU - Mercer, J. AU - Lam, A. C. L. AU - Smith, R. AU - Fallah-Rad, N. AU - Kavanagh, J. DB - Embase Medline DO - 10.3171/2019.9.SPINE19915 KW - antineoplastic agent poly(methyl methacrylate) prostate specific antigen aged androgen deprivation therapy article case report castration resistant prostate cancer cerebrovascular accident circulating tumor cell clinical article compression fracture distant metastasis follow up human human tissue lung metastasis male pathologic fracture percutaneous vertebroplasty prostatectomy spine fracture spine metastasis x-ray computed tomography LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1547-5646 1547-5654 SP - 452-455 ST - Development of pulmonary endovascular metastases following vertebroplasty: Case report T2 - Journal of Neurosurgery: Spine TI - Development of pulmonary endovascular metastases following vertebroplasty: Case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2005111777&from=export http://dx.doi.org/10.3171/2019.9.SPINE19915 VL - 32 ID - 829087 ER - TY - JOUR AB - This study reports the surgical and clinical outcomes of spinal tumors managed with total en bloc spondylectomy. The authors searched their prospectively maintained database for patients undergoing total en bloc spondylectomy between 2001 and 2013. Ten patients (9 men, 1 woman; average age, 50.7 years; range, 42-68 years) were identified. The authors obtained demographic information, surgical outcomes (estimated blood loss, complications), and clinical outcomes (recurrence, survival). All patients had pain and were classified as American Spinal Injury Association grade E. The lesions were located in the thoracic (8 patients) and lumbar (2 patients) spine. Anterior column reconstruction was performed with strut allograft (7 patients), mesh cage (2 patients), and polymethyl methacrylate (1 patient). An average of 2.3 (range, 2-4) of 6 portions of the vertebrae were involved, according to the Kostuik classification. Mean estimated blood loss, operative time, and hospital stay were 3.5 L, 500 minutes, and 7.8 days, respectively. Perioperative complications included pleural tear (2 patients) and aortic tear, vena cava tear, retained sponge, pulmonary embolism, urinary tract infection, pneumothorax, anterior column support failure, and prominent instrumentation requiring removal (1 patient each). Postoperatively, all patients remained classified as American Spinal Injury Association grade E. Two patients had recurrence at distant spinal segments, and 1 had a new lesion in the thigh. Five patients had died (mean, 34.5 months after surgery), and 5 were alive a mean of 19.6 months after surgery (range, 6-48 months). Total en bloc spondylectomy is challenging, but in appropriately selected patients, it can be used to treat primary and metastatic spinal lesions. AD - Department of Orthopaedic Surgery and Oncology, University of Rochester School of Medicine and Dentistry, Rochester, New York Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia AN - 110906453. Language: English. Entry Date: 20160624. Revision Date: 20181015. Publication Type: journal article AU - Mesfin, Addisu AU - El Dafrawy, Mostafa H. AU - Jain, Amit AU - Hassanzadeh, Hamid AU - Kebaish, Khaled M. DB - cin20 DO - 10.3928/01477447-20151020-08 DP - EBSCOhost KW - Orthopedic Surgery Spine -- Surgery Spinal Neoplasms -- Surgery Methylmethacrylates Adult Spinal Neoplasms Aged Blood Loss, Surgical Female Prostheses and Implants Male Bone Transplantation Length of Stay Bone Cements Middle Age Human M1 - 11 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2015 SN - 0147-7447 SP - e995-e1000 ST - Total En Bloc Spondylectomy for Primary and Metastatic Spine Tumors T2 - Orthopedics TI - Total En Bloc Spondylectomy for Primary and Metastatic Spine Tumors UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=110906453&site=ehost-live&scope=site VL - 38 ID - 830602 ER - TY - JOUR AB - This retrospective case-control study reviewed 124 consecutive patients undergoing cemented total knee arthroplasty under regional anesthesia for osteoarthritis. Seven (5.6%) patients developed symptomatic pulmonary embolism despite warfarin prophylaxis. Bilateral procedures and preoperative hemoglobin were identified as significant risk factors for the development of symptomatic pulmonary embolism after total knee arthroplasty (hemoglobin > or =14 g/L, odds ratio 2.4, confidence interval [CI] 1.2-4.6, and bilateral cases odds ratio 7.2, CI 1.3-39.6). Additionally, preoperative hemoglobin <14 gm/L was associated with a 98% negative predictive value of developing symptomatic pulmonary embolism with a 14% false-negative rate (sensitivity 85.7%, 95% CI 80-92; specificity 67.9%, 95% CI 60-77; positive predictive value 14%, 95% CI .08-2). These findings indicate preoperative hemoglobin levels should be considered in addition to the usual patient demographics in future thromboembolism studies as a potential risk factor for symptomatic pulmonary embolism. AD - Aspen Medical Group, St Paul, Minn 55108, USA. AN - 10604808 AU - Messieh, M. DA - Dec DP - NLM ET - 1999/12/22 J2 - Orthopedics KW - Anticoagulants/therapeutic use Arthroplasty, Replacement, Knee/*adverse effects Case-Control Studies Humans Logistic Models Predictive Value of Tests Pulmonary Embolism/*etiology/prevention & control Retrospective Studies Risk Factors Warfarin/therapeutic use LA - eng M1 - 12 N1 - PubMed NLM literature search January 5, 2021 PY - 1999 SN - 0147-7447 (Print) 0147-7447 SP - 1147-9 ST - Preoperative risk factors associated with symptomatic pulmonary embolism after total knee arthroplasty T2 - Orthopedics TI - Preoperative risk factors associated with symptomatic pulmonary embolism after total knee arthroplasty VL - 22 ID - 828797 ER - TY - JOUR AD - Department of Orthopedic Surgery, University of Virginia, Charlottesville, VA AN - 105769130. Language: English. Entry Date: 20080718. Revision Date: 20200708. Publication Type: Journal Article AU - Mihalko, W. AU - Mounasamy, V. AU - Ellison, M. AU - Saleh, K. DB - cin20 DO - 10.1007/s00590-007-0288-z DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Methods Embolism -- Risk Factors Orthopedic Surgery -- Methods Arthroplasty, Replacement, Hip -- Adverse Effects Biomechanics Descriptive Statistics Materials Testing Quantitative Studies Repeated Measures Statistical Significance Human M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2008 SN - 1633-8065 SP - 217-221 ST - Distal femoral canal pressurization after introduction of cement restrictor plugs: an in vitro analysis T2 - European Journal of Orthopaedic Surgery & Traumatology TI - Distal femoral canal pressurization after introduction of cement restrictor plugs: an in vitro analysis UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105769130&site=ehost-live&scope=site VL - 18 ID - 830752 ER - TY - JOUR AB - Purpose: We have performed percutaneous vertebroplasty (PV) using polymethylmethacrylate (PMMA) for patients with vertebral metastases since 2002. This study investigated the therapeutic effects of PV on vertebral metastases.Materials and Methods: A retrospective (2002-2008) review was conducted for 69 consecutive patients with 141 metastatic vertebrae treated with PV using PMMA. The clinical background of the patients, visual analog scale (VAS), improvement rate, outcomes, and complications were evaluated.Results: The mean preoperative VAS score was 7.3 and significantly improved to 1.9 postoperatively (at discharge), with a mean improvement rate of 73.3%. With regard to complications, no new fractures of adjacent vertebral bodies were encountered, but cement leakage was seen in 49% of the patients. Most patients were asymptomatic during the postoperative course, although two patients (3%) experienced dyspnea that was suspected to be adult respiratory distress syndrome or a pulmonary embolism.Conclusion: PV can offer pain relief to patients with painful vertebral metastases and short life expectancy whose general condition makes surgery difficult. AD - Department of Orthopaedic Surgery, St. Luke's International Hospital, 9-1 Akashicho, Chuo-ku, Tokyo 104-8560, Japan Department of Orthopaedic Surgery, St. Luke's International Hospital, 9-1 Akashicho, Chuo-ku, Tokyo, 104-8560, Japan, yumikami@luke.or.jp. AN - 104883780. Language: English. Entry Date: 20110923. Revision Date: 20171113. Publication Type: journal article AU - Mikami, Y. AU - Numaguchi, Y. AU - Kobayashi, N. AU - Fuwa, S. AU - Hoshikawa, Y. AU - Saida, Y. AU - Mikami, Yuji AU - Numaguchi, Yuji AU - Kobayashi, Nobuo AU - Fuwa, Sokun AU - Hoshikawa, Yoshimitsu AU - Saida, Yukihisa DB - cin20 DO - 10.1007/s11604-010-0542-x DP - EBSCOhost KW - Fractures, Spontaneous -- Surgery Spinal Fractures -- Surgery Spinal Neoplasms Kyphoplasty -- Methods Adult Aged Aged, 80 and Over Bone Cements -- Therapeutic Use Female Fractures, Spontaneous -- Etiology Human Lumbar Vertebrae -- Surgery Male Middle Age Pain -- Etiology Pain -- Surgery Pain Measurement Methylmethacrylates -- Therapeutic Use Retrospective Design Spinal Fractures -- Etiology Spinal Neoplasms -- Complications Spinal Neoplasms -- Surgery Thoracic Vertebrae -- Surgery Treatment Outcomes M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2011 SN - 1867-1071 SP - 202-206 ST - Therapeutic effects of percutaneous vertebroplasty for vertebral metastases T2 - Japanese Journal of Radiology TI - Therapeutic effects of percutaneous vertebroplasty for vertebral metastases UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104883780&site=ehost-live&scope=site VL - 29 ID - 830693 ER - TY - JOUR AB - Current femoral cementing techniques for total hip arthroplasty (THA) have improved over recent years. High pressurisation is achieved using a cement gun with a proximal seal and a cement restrictor, maximising the microinterlock at the bone cement interface. However, there are concerns regarding over pressurisation of the femoral canal resulting in an increased risk of cardiorespiratory collapse secondary to embolic phenomena. We report on three cases over a one year period of cement within a vein (cement venogram) on a post-operative radiograph following THA. We feel that the cement venogram is an important indicator of high pressurisation and that its incidence may be on the increase with improved cementing techniques. © Wichtig Editore, 2008. AD - A. Frost, 25 King Street, Shrewsburry SY2 5ER, United Kingdom AU - Miller, D. AU - Frost, A. AU - Chokse, A. AU - Perkins, R. DB - Embase Medline DO - 10.5301/HIP.2008.1021 KW - bone cement chlorhexidine hydrogen peroxide low molecular weight heparin polyethylene aged article case report comorbidity deep vein thrombosis female follow up hip osteoarthritis human male phlebography postoperative complication postoperative thrombosis pressure measurement surgical approach surgical technique total hip prosthesis viscosity L1 - http://www.hip-int.com/public/hip/Article/Attach.action?cmd=Download&uid=2FA38F5C-D160-4D94-A7C6-6161032B4C34 LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2008 SN - 1120-7000 SP - 228-230 ST - Cement venogram: As a result of high femoral cement pressurisation. A report of 3 cases T2 - HIP International TI - Cement venogram: As a result of high femoral cement pressurisation. A report of 3 cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L352794817&from=export http://dx.doi.org/10.5301/HIP.2008.1021 VL - 18 ID - 829728 ER - TY - JOUR AB - Current femoral cementing techniques for total hip arthroplasty (THA) have improved over recent years. High pressurisation is achieved using a cement gun with a proximal seal and a cement restrictor, maximising the microinterlock at the bone cement interface. However, there are concerns regarding over pressurisation of the femoral canal resulting in an increased risk of cardiorespiratory collapse secondary to embolic phenomena. We report on three cases over a one year period of cement within a vein (cement venogram) on a post-operative radiograph following THA. We feel that the cement venogram is an important indicator of high pressurisation and that its incidence may be on the increase with improved cementing techniques. AD - Department of Trauma and Orthopaedics, Princess Royal Hospital, Telford, UK. AN - 18924080 AU - Miller, D. AU - Frost, A. AU - Choksey, A. AU - Perkins, R. DA - Jul-Sep DO - 10.5301/hip.2008.1021 DP - NLM ET - 2008/10/17 J2 - Hip international : the journal of clinical and experimental research on hip pathology and therapy KW - Aged Aged, 80 and over Arthroplasty, Replacement, Hip/*methods Bone Cements/*adverse effects Cementation/adverse effects Femur/blood supply Hip Prosthesis Humans Phlebography *Postoperative Complications/etiology Pressure Veins/pathology LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 1120-7000 SP - 228-30 ST - Cement venogram: as a result of high femoral cement pressurisation. A report of 3 cases T2 - Hip Int TI - Cement venogram: as a result of high femoral cement pressurisation. A report of 3 cases VL - 18 ID - 828833 ER - TY - JOUR AN - 4728158 AU - Milne, I. S. DA - Sep DO - 10.1111/j.1365-2044.1973.tb00522.x DP - NLM ET - 1973/09/01 J2 - Anaesthesia KW - Aged Bone Cements/*adverse effects Cyanosis/chemically induced Embolism, Fat/etiology Female Hip Joint Hot Temperature/adverse effects Humans Hypotension/chemically induced Joint Prosthesis Knee Joint Male Methylmethacrylates/*adverse effects Pulse/drug effects Tourniquets LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 1973 SN - 0003-2409 (Print) 0003-2409 SP - 538-43 ST - Hazards of acrylic bone cement. A report of two cases T2 - Anaesthesia TI - Hazards of acrylic bone cement. A report of two cases VL - 28 ID - 828980 ER - TY - JOUR AB - Percutaneous vertebroplasty is frequently used in the treatment of vertebral body fractures due to osteoporosis, vertebral body metastasis, or myeloma. Acrylic cement of polymethylmethacrylate injected into the vertebral body can leak into the paravertebral venous system and reach the pulmonary artery via the azygos vein leading to a cement pulmonary embolism. We are presenting a case of a 78 year old woman who was found to have polymethylmethacrylate pulmonary embolism as a result of vertebroplasty used for vertebral collapse from metastatic breast cancer. The appearance of new intrapulmonary artery tubular opaque density on CXR performed post procedure is highly suggestive of the diagnosis. In this case, we are exploring the importance of clinical and radiographic correlations, as well as evaluation of the hemodynamic and perfusion effect of the cement pulmonary embolism as essential steps in the management of this condition. AN - 25668922 AU - Milojkovic, N. AU - Homsi, S. DA - Dec DP - NLM ET - 2015/02/12 J2 - The Journal of the Arkansas Medical Society KW - Aged Bone Cements/*adverse effects Breast Neoplasms/complications/*pathology Female Humans Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/diagnostic imaging/*etiology Radiography Spinal Fractures/etiology/*therapy Spinal Neoplasms/complications/*secondary Vertebroplasty/*adverse effects LA - eng M1 - 7 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 0004-1858 (Print) 0004-1858 SP - 140-2 ST - Polymethylmethacrylate pulmonary embolism as a complication of percutaneous vertebroplasty in cancer patients T2 - J Ark Med Soc TI - Polymethylmethacrylate pulmonary embolism as a complication of percutaneous vertebroplasty in cancer patients VL - 111 ID - 828679 ER - TY - JOUR AB - Objective: To evaluate the functional and radiological outcome of balloon kyphoplasty and to endorse the unilateral single balloon extrapedicular kyphoplasty as practically more feasible and safer method in comparison to the conventional methods. Methods: Totally, 81 patients were presented to our center with osteoporotic vertebral compression fracture. Among these, 59 patients (61 vertebrae) were enrolled with stable wedge osteoporotic compression fracture. Pre-operatively percentage of vertebral height loss and kyphotic angle were calculated and single balloon extrapedicular kyphoplasty was performed in all cases. Results: Postoperatively, anterior vertebral height improved to 79.61% of normal subjects. In our study, the mean segmental kyphosis correction following balloon kyphoplasty was 14.27°. Overall incidence of cement leak in our study was 15.25%. Conclusion: Although we encountered the few difficulties, but this technique holds the safety and feasibility measures. Furthermore, it is effective in restoring anterior vertebral height, alignment and angle of kyphosis. AD - P.K. Mishra, Department of Orthopaedics, Gandhi Medical College, Hamidia Hospital, Bhopal, M.P., India AU - Mishra, P. K. AU - Dwivedi, R. AU - Dhillon, C. S. DB - Embase DO - 10.29252/beat-080106 KW - adult aged anterior vertebral height article cement leak Cobb angle compression fracture female follow up fragility fracture functional assessment height loss human kyphoplasty kyphosis kyphotic angle major clinical study male musculoskeletal system parameters paravertebral leak postoperative complication radiodiagnosis range of motion single balloon extrapedicular kyphoplasty vein embolism visual analog scale LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 2322-3960 2322-2522 SP - 34-40 ST - Osteoporotic vertebral compression fracture and single balloon extrapedicular kyphoplasty: Findings and technical considerations T2 - Bulletin of Emergency and Trauma TI - Osteoporotic vertebral compression fracture and single balloon extrapedicular kyphoplasty: Findings and technical considerations UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2004362227&from=export http://dx.doi.org/10.29252/beat-080106 VL - 8 ID - 829083 ER - TY - JOUR AD - Lehigh Valley Health Network, Allentown, PA, USA. yehia.mishriki@lvh.com AN - 22416294 AU - Mishriki, Y. Y. AU - Hallinan, B. DA - Jan DO - 10.3810/pgm.2012.01.2530 DP - NLM ET - 2012/03/16 J2 - Postgraduate medicine KW - *Bone Cements Female Foreign-Body Migration/*diagnosis Humans Middle Aged Postoperative Complications/*diagnostic imaging/etiology Pulmonary Embolism/*diagnostic imaging/etiology Radiography Vertebroplasty LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0032-5481 SP - 174-6 ST - Puzzles in practice. Cement pulmonary embolism T2 - Postgrad Med TI - Puzzles in practice. Cement pulmonary embolism VL - 124 ID - 828975 ER - TY - JOUR AD - Lehigh Valley Health Network, Allentown, PA, USA Lehigh Valley Health Network, Allentown, PA, USA. yehia.mishriki@lvh.com AN - 108168661. Language: English. Entry Date: 20120518. Revision Date: 20161119. Publication Type: journal article AU - Mishriki, Y. Y. AU - Hallinan, B. AU - Mishriki, Yehia Y. AU - Hallinan, Brigid DB - cin20 DP - EBSCOhost KW - Bone Cements Foreign-Body Migration -- Diagnosis Postoperative Complications -- Radiography Pulmonary Embolism -- Radiography Female Middle Age Postoperative Complications -- Etiology Pulmonary Embolism -- Etiology Kyphoplasty M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2012 SN - 0032-5481 SP - 174-176 ST - Puzzles in practice. Cement pulmonary embolism T2 - Postgraduate Medicine TI - Puzzles in practice. Cement pulmonary embolism UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=108168661&site=ehost-live&scope=site VL - 124 ID - 830687 ER - TY - JOUR AB - Background: Little is known about how bone cement and American Society of Anesthesiologists (ASA) classification influence the cardiovascular system in elderly patients with femoral-neck fractures treated with cemented hemiarthroplasty. Therefore, we performed a case-control study to investigate these questions and compared the following: >= ASA III with <= ASA II patients who underwent cemented hemiarthroplasty; and cemented with cementless hemiarthroplasty in >= ASA III patients. Hypothesis: ASA classification influences the cardiovascular system during cemented hemiarthroplasty and bone cement influences intraoperative blood pressure [IBP] in patients rated >= ASA III. Materials and methods: This multicenter, prospective study included patients with acute displaced femoral-neck fractures. Baseline data, medical history, anesthesia, FiO(2), vasopressor use, femoral component, IBP, SpO(2), and complications were evaluated. Of 200 patients, 100 were cemented (mean age, 77 +/- 10 years), and 100 were cementless (mean age, 78 +/- 9 years). Cemented hemiarthroplasty employed a third-generation technique (plugging, irrigating, drying and filling the canal with cement under pressurization). Results: Systolic blood pressure (SBP) decreased significantly during cementing, versus pre-rasping in <= ASA II patients (from 117.9 +/- 24.5 [range, 65-199 ] to 106.9 +/- 20.3 [range, 59-172]; p = 0.007), in >= ASA III patients (from 129.5 +/- 21.0 [range, 90-169] to 110.4 +/- 17.9 [range, 79-157]; p = 0.006), and poststem-insertion, versus pre-rasping in <= ASA II patients (from 117.9 +/- 24.5 [range, 65-199 ] to 103.9 +/- 20.7 [range, 53-178]; p = 0.0004), and in >= ASA III patients (from 129.5 +/- 21.0 [range, 90-169] to 111.2 +/- 24.6 [range, 70-156]; p = 0.009). In >= ASA III patients, SBP decreased significantly during cementing or rasping, versus pre-rasping in cemented patients (from 129.5 +/- 21.0 [range, 90-169] to 110.4 +/- 17.9 [range, 79-157]; p = 0.006), in cementless patients (from 115.0 +/- 17.7 [range, 85-150] to 100.7 +/- 15.7 [range, 75-142 ]; p = 0.004), and post-stem-insertion, versus pre-rasping in cemented patients (from 129.5 +/- 21.0 [range, 90-169] to 111.2 +/- SD [range]; p = 0.009), and in cementless patients (from 115.0 +/- 17.7 [range, 85-150] to 89.4 +/- 17.5 [range, 58-140]; p < 0.0001). There were no lethal complications. Conclusions: This study indicate a similar hemodynamic change intraoperatively between <= ASA II patients and >= ASA III patients in the cemented group, and between patients with cemented and cementless hemiarthroplasty in the >= ASA III patients. With modern hemiarthroplasty techniques, bone cement might be as safe as cementless techniques in elderly, >= ASA III patients. (C) 2018 Elsevier Masson SAS. All rights reserved. AD - [Miyamoto, Shuichi; Takeshita, Munenori; Otsuka, Makoto] Kimitsu Cent Hosp, 1010 Sakurai, Kisarazu City, Chiba 2928535, Japan. [Nakamura, Junichi; Orita, Sumihisa; Ohtori, Seiji] Chiba Univ, Grad Sch Med, Chuo Ku, 1-8-1 Inohana, Chiba, Chiba 2608677, Japan. [Iida, Satoshi] Matudo City Hosp, 4005 Kamihongou, Matudo City, Chiba 2718511, Japan. [Shigemura, Tomonori] Sanmu Med Ctr, 167 Narutou, Sanmu City, Chiba 2891326, Japan. [Kishida, Shunji] Seirei Sakura Citizen Hosp, 2-36-2 Eharadai, Sakura, Chiba 2858765, Japan. [Abe, Isao] Chiba Med Ctr, Natl Hosp Org, Chuo Ku, 4-1-2 Tubakinomori, Chiba, Chiba 2608606, Japan. [Harada, Yoshitada] Saiseikai Narashino Hosp, 1-1-1 Izumichou, Narashino, Chiba 2758580, Japan. Miyamoto, S (corresponding author), Kimitsu Cent Hosp, Dept Orthopaed Surg, 1010 Sakurai, Kisarazu, Chiba 2928535, Japan. shuichi0220miyamoto@helen.ocn.ne.jp AN - WOS:000442425800024 AU - Miyamoto, S. AU - Nakamura, J. AU - Iida, S. AU - Shigemura, T. AU - Kishida, S. AU - Abe, I. AU - Takeshita, M. AU - Otsuka, M. AU - Harada, Y. AU - Orita, S. AU - Ohtori, S. DA - Sep DO - 10.1016/j.otsr.2018.03.014 J2 - Orthop. Traumatol.-Surg. Res. KW - Intraoperative blood pressure American Society of Anesthesiologists classification Cemented,Cementless Bipolar hemiarthroplasty TOTAL HIP-ARTHROPLASTY IMPLANTATION SYNDROME ELDERLY-PATIENTS FAT-EMBOLISM UNCEMENTED HEMIARTHROPLASTY BLOOD-PRESSURE STEMS RISK ECHOCARDIOGRAPHY MORTALITY Orthopedics Surgery LA - English M1 - 5 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 1877-0568 SP - 687-694 ST - The influence of bone cement and American Society of Anesthesiologists (ASA) class on cardiovascular status during bipolar hemiarthroplasty for displaced femoral-neck fracture: A multicenter, prospective, case-control study T2 - Orthopaedics & Traumatology-Surgery & Research TI - The influence of bone cement and American Society of Anesthesiologists (ASA) class on cardiovascular status during bipolar hemiarthroplasty for displaced femoral-neck fracture: A multicenter, prospective, case-control study UR - ://WOS:000442425800024 VL - 104 ID - 830159 ER - TY - JOUR AB - Background: Extensile interventions to provide anterior spinal column support in metastatic spinal cord compression (MSCC) surgery incur added morbidity in this surgically frail group of patients. We present our preliminary results of posterior spinal decompression and stabilization coupled with vertebral body cemented stents for anterior column support in MSCC. Methods: Fourteen patients underwent posterior spinal decompression and pedicle screw construct along with vertebral body stenting (VBS) technique for reconstruction and augmentation of the vertebral body. The primary in all except one was solid organ malignancy and 10 patients (71%) were treatment naïve. The mean revised Tokuhashi score was 10.7 ± 2.7 and the mean spinal instability neoplastic score was 9.6 ± 1.9. All vertebral body lesions were purely lytic and were associated with a cortical defect in the posterior wall. Results: A mean 5.3 ± 2.7 ml low-viscosity polymethyl methacrylate bone cement was injected within the stent at each compression level. No cement extrusion posteriorly was noted in any case from intraoperative fluoroscopy or postoperative radiographs. Five patients died at a mean 6.8 months (range 1-15 months), while the remaining patients have a mean survival of 18 months. Neither further revision surgical intervention nor any neurological deterioration was noted in any patient, who all continued to be ambulatory. The mean postoperative Core Outcome Measures Index score for 11 patients was 4.03 (standard deviation 3.11, 95% confidence interval (1.93-6.12). Conclusion: In lytic vertebral body lesions with posterior wall erosions, cemented VBS technique adds to the surgical armamentarium in MSCC surgery showing promising early results without added complications. AD - R. Mohammed, Department of Complex Spinal Surgery, Salford Royal NHS Foundation Trust, Stott Lane, Manchester, United Kingdom AU - Mohammed, R. AU - Lee, M. AU - Panikkar, S. AU - Yasin, N. AU - Hassan, K. AU - Mohammad, S. DB - Embase DO - 10.25259/SNI_315_2020 KW - balloon catheter cementless prosthesis Confidence Spinal Cement pedicle screw vascular stent bone cement poly(methyl methacrylate) adult aged article clinical article cohort analysis computer assisted tomography controlled study core outcome measures index female fluoroscopy human lung embolism male middle aged nuclear magnetic resonance imaging patient satisfaction postoperative complication postoperative period priority journal quality of life scoring system spinal cord decompression spinal cord metastasis spine stabilization surgical infection surgical technique thoracolumbar spine tokuhashi score vertebral body stenting technique LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 2152-7806 ST - Vertebral body cemented stents combined with posterior stabilization in the surgical treatment of metastatic spinal cord compression of the thoracolumbar spine T2 - Surgical Neurology International TI - Vertebral body cemented stents combined with posterior stabilization in the surgical treatment of metastatic spinal cord compression of the thoracolumbar spine UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2007671828&from=export http://dx.doi.org/10.25259/SNI_315_2020 VL - 11 ID - 829094 ER - TY - JOUR AB - Background: Acute intramedullary stabilization of femoral shaft fractures in multiply injured patients is controversial. Intravasation of medullary fat during canal pressurization has been suspected to trigger adult respiratory distress syndrome. The goal of the present study was to evaluate the effect, on the lungs, of a filter placed into the ipsilateral common iliac vein during medullary canal pressurization in a canine model.Methods: With use of an established model of fat embolization, twelve mongrel dogs were randomized into two groups. In six dogs, a special filter was inserted percutaneously into the left common iliac vein while the dogs were under general anesthesia. In all dogs, the left femur and tibia were then pressurized by injection of bone cement and insertion of intramedullary rods. Hemodynamic measurements and echocardiographic images were recorded throughout the experiment. After one hour, the animals were killed and the lungs were harvested for histomorphometric analysis.Results: Without the filter, the mean pulmonary artery pressure increased by 11.8 +/- 2.1 mm Hg (p < 0.001). With the filter, the mean pulmonary artery pressure increased by only 2.2 +/- 0.8 mm Hg (p < 0.02). Without the filter, there was a significant increase in the index of pulmonary vascular resistance as compared with the baseline value (p < 0.05). With the filter, there was no such increase. Histomorphometric analysis demonstrated that the presence of the filter reduced the absolute area of embolization and the volume percentages of lung and pulmonary vasculature embolized.Conclusions: In this canine experiment, temporary placement of a venous filter prior to medullary canal pressurization reduced the embolic load and minimized its hemodynamic effects. AD - University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, United Kingdom University Hospital of Wales, Heath Park, Cardiff, CF14 4XW, United Kingdom. khitishmohanty@hotmail.com AN - 106238194. Language: English. Entry Date: 20070216. Revision Date: 20160517. Publication Type: journal article AU - Mohanty, K. AU - Powell, J. N. AU - Musso, D. AU - Traboulsi, M. AU - Belenkie, I. AU - Mullen, J. B. M. AU - Tyberg, J. V. AU - Mohanty, K. AU - Powell, J. N. AU - Musso, D. AU - Traboulsi, M. AU - Belenkie, I. AU - Mullen, J. B. M. AU - Tyberg, J. V. DB - cin20 DP - EBSCOhost KW - Embolism, Fat -- Physiopathology Filtration -- Equipment and Supplies Orthopedic Surgery Prostheses and Implants Animal Studies Bone Marrow Dogs Embolism, Fat -- Prevention and Control Hemodynamics Iliac Vein Models, Biological One-Way Analysis of Variance Pressure Pulmonary Artery -- Physiopathology Repeated Measures T-Tests M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2005 SN - 0021-9355 SP - 1332-1337 ST - The effect of a venous filter on the embolic load during medullary canal pressurization: a canine study T2 - Journal of Bone & Joint Surgery, American Volume TI - The effect of a venous filter on the embolic load during medullary canal pressurization: a canine study UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106238194&site=ehost-live&scope=site VL - 87 ID - 830781 ER - TY - JOUR AB - Purpose of review: The purpose of this review is to provide a summary of the past year's published literature involving the increasingly popular percutaneous vertebral augmentation procedures (vertebroplasty and kyphoplasty). Recent findings: There is ample literature in the form of short-term, retrospective reviews with small numbers of patients undergoing vertebroplasty. There is much less, but similar quality, literature for the newer kyphoplasty procedure. The reported clinical results from both procedures appear to be excellent and suggest that percutaneous cement augmentation of fractured osteoporotic vertebra can consistently produce significant pain relief, increased mobility, and improved quality of life in 70 to 95% of selected patients. To date, the literature lacks a prospective, case-controlled study comparing the efficacy of kyphoplasty and vertebroplasty. It appears that kyphoplasty may offer greater potential for reversal of vertebral deformity as well as a reduced risk of extravasation since the bone cement is injected under lower pressure than for vertebroplasty alone. It is still unknown whether the incidence of adjacent level fractures is higher with the deformity-reducing kyphoplasty procedure. Complications are relatively rare with both procedures. However, some studies reported a higher incidence of clinically insignificant leakage of bone cement into paravertebral tissues with vertebroplasty. Definitive patient selection criteria for these procedures have not been established. However, there is evidence that cement augmentation may be an appropriate option for patients with vertebral lesions resulting from osteolytic vertebral metastasis and myeloma, vertebral hemangioma, and osteoporotic compression fracture if the following criteria have been met: 1. Pain is severe and debilitating and cannot be relieved by correct medical therapy. 2. Other causes of pain, such as hemiated intervertebral disc, have been ruled out. 3. The affected vertebra has not been extensively destroyed and is at least one third of its original height. Cement augmentation is contraindicated in patients with spinal infections, unstable vertebral fractures, fractures with retropulsed bone fragments in the spinal canal, and in patients with coagulation disorders. Some authors consider destruction of the posterior wall of the vertebral body to be a relative contraindication and suggest that extreme caution must be used in these patients to prevent cement leakage into the spinal canal. Summary: There is evidence from a number of uncontrolled studies that most patients with pain unresponsive to standard medical treatment will experience significant pain relief, increased function and quality of life following vertebral cement augmentation, with few serious complications. While early results are promising, more research is needed to better understand the long-term effects of cement augmentation on the human spine. The most recent literature is summarized in this review. © 2004 Lippincott Williams & Wilkins. AD - R.W. Molinari, Univ. of Rochester Medical Center, Box 665, 601 Elmwood Ave, Rochester, NY 14642, United States AU - Molinari, R. W. DB - Embase KW - bone cement poly(methyl methacrylate) analgesia biomechanics blood clotting disorder extravasation fracture fragility fracture hemangioma human infection intermethod comparison intervertebral disk hernia kyphoplasty lung embolism medical research myeloma neurologic disease osteolysis pain paralysis patient selection percutaneous vertebroplasty postoperative complication pressure priority journal prospective study quality of life review risk reduction spine metastasis spine mobility surgical technique treatment contraindication treatment outcome neoplasm vertebra body spine fracture vertebra malformation vertebral canal LA - English M1 - 3 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2004 SN - 1041-9918 SP - 142-149 ST - Vertebroplasty and kyphoplasty: Biomechanics, outcomes, and complications T2 - Current Opinion in Orthopaedics TI - Vertebroplasty and kyphoplasty: Biomechanics, outcomes, and complications UR - https://www.embase.com/search/results?subaction=viewrecord&id=L38624809&from=export VL - 15 ID - 829839 ER - TY - JOUR AD - Department of Medicine, Division of Hematology-Oncology, University of North Carolina School of Medicine, Chapel Hill, NC, USA. smoll@med.unc.edu AN - 20484312 AU - Moll, S. AU - Kuzma, C. DA - Aug DO - 10.1177/1358863x10365180 DP - NLM ET - 2010/05/21 J2 - Vascular medicine (London, England) KW - Aged Bone Cements/*adverse effects Female Foreign-Body Migration/complications/*diagnostic imaging Humans Kyphoplasty/*adverse effects Osteoporosis/*therapy Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/*diagnostic imaging/etiology Radiography Thoracic Vertebrae LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 1358-863x SP - 339-40 ST - Images in vascular medicine: cement pulmonary embolism T2 - Vasc Med TI - Images in vascular medicine: cement pulmonary embolism VL - 15 ID - 828945 ER - TY - JOUR AB - Percutaneous vertebroplasty (PVP) is an increasingly common intervention, and complications resulting from embolization are increasingly observed. We report a case of polymethyl methacrylate (PMMA) embolization resulting in cardiac complications in a frail patient, which was managed with endoscopic robotic-assisted removal of the embolized material. AD - Northwest Regional Heart and Vascular, Adventist Medical Center, Portland, Oregon. Northwest Regional Heart and Vascular, Adventist Medical Center, Portland, Oregon. Electronic address: amy.piwowarski@ah.org. AN - 27106432 AU - Molloy, T. AU - Kos, A. AU - Piwowarski, A. DA - May DO - 10.1016/j.athoracsur.2015.06.117 DP - NLM ET - 2016/04/24 J2 - The Annals of thoracic surgery KW - Aged Artifacts Atrial Fibrillation/etiology Bone Cements/*adverse effects Cardiac Catheterization Computed Tomography Angiography Diagnostic Errors Echocardiography Embolism/complications/*surgery Endoscopy/instrumentation/*methods Extravasation of Diagnostic and Therapeutic Materials/diagnostic imaging/*surgery Female Foreign-Body Migration/complications/diagnostic imaging/*surgery Heart Ventricles/injuries/*surgery Humans Kyphoplasty/*adverse effects Pericardial Effusion/etiology Pericarditis/etiology/surgery Pericardium/*surgery Pleurodesis Polymethyl Methacrylate/adverse effects Postoperative Complications/etiology/therapy *Robotics Subcutaneous Emphysema/etiology/therapy Thoracic Vertebrae *Tricuspid Valve LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 0003-4975 SP - 1974-6 ST - Robotic-Assisted Removal of Intracardiac Cement After Percutaneous Vertebroplasty T2 - Ann Thorac Surg TI - Robotic-Assisted Removal of Intracardiac Cement After Percutaneous Vertebroplasty VL - 101 ID - 828698 ER - TY - JOUR AB - Objectives: The objective of this study was to compare the early migration of the cruciate retaining and posterior stabilising versions of the recently introduced Triathlon total knee system, with a view to predicting long term fixation performance. Methods: Sixty patients were prospectively randomised to receive either Triathlon posterior stabilised cemented knee prosthesis or Triathlon cruciate retaining cemented knee prosthesis. Tibial component migration was measured by radiostereometric analysis postoperatively and at three months, one year and two years. Clinical outcome was measured by the American Knee Society Score and Knee Osteoarthritis and Injury Outcome Score. Results: There were no differences in rotation around the three coordinal axes or in the maximum total point motion (MTPM) during the two year follow‐up. The posterior stabilised prosthesis had more posterior‐anterior translation at three months and one year and more caudal‐cranial translation at one year and two years. There were no differences in functional outcome between the groups. Conclusion: The tibial tray of the Triathlon cemented knee prosthesis showed similar early stability. Level of evidence: Level I. Article summary: Article focus:. This was a prospective randomised trial aiming to compare the single radius posterior stabilised (PS) Triathlon total knee arthroplasty (TKA) to the cruciate retaining Triathlon TKA system with regard to fixation.Strengths and limitations of this study:. Strength of this study was that it is a randomised prospective trial using an objective measuring tool. The sample size of 25‐30 patients was reportedly sufficient for the screening of implants using RSA [1].Trial registration:. ClinicalTrials.gov Identifier: NCT00436982. AN - CN-01022294 AU - Molt, M. AU - Toksvig-Larsen, S. DO - 10.1016/j.knee.2014.05.012 KW - *cemented prosthesis *cruciate retaining knee endoprosthesis *knee endoprosthesis *medical device complication/co [Complication] *posterior stabilizing knee endoprosthesis *tibial component migration/co [Complication] *total knee replacement Aged American knee society score Article Caudal cranial translation Cerebrovascular accident/co [Complication] Clinical assessment Controlled study Disease severity Equipment design Female Follow up Human Joint stability Knee Osteoarthritis and Injury Outcome Score Knee osteoarthritis/su [Surgery] Lung embolism/co [Complication] Major clinical study Male Maximum total point motion Musculoskeletal system parameters Outcome assessment Posterior anterior translation Postoperative infection/co [Complication] Prospective study Radiostereometric analysis Randomized controlled trial Scoring system Single blind procedure Superficial infection/co [Complication] M1 - 5 M3 - Journal: Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2014 SP - 949‐954 ST - Similar early migration when comparing CR and PS in Triathlon TKA: a prospective randomised RSA trial T2 - The knee TI - Similar early migration when comparing CR and PS in Triathlon TKA: a prospective randomised RSA trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01022294/full VL - 21 ID - 830049 ER - TY - JOUR AN - 1231496 AU - Monteny, E. AU - Burny, F. AU - Dubois-Primo, J. AU - Gepts, W. DA - Sep-Oct DP - NLM ET - 1975/09/01 J2 - Acta orthopaedica Belgica KW - Aged Bone Cements/adverse effects Embolism, Fat/*etiology Humans Joint Prosthesis/*adverse effects Pulmonary Embolism/*etiology LA - fre M1 - 5 N1 - PubMed NLM literature search January 5, 2021 OP - Prothèse fémorale cervico-céphalique. Décès par embolie graisseuse pulmonaire massive d'origine mécanique. PY - 1975 SN - 0001-6462 (Print) 0001-6462 SP - 536-9 ST - [Cervico-cephalic femoral prosthesis. Death by massive pulmonary fat embolism mechanical origin] T2 - Acta Orthop Belg TI - [Cervico-cephalic femoral prosthesis. Death by massive pulmonary fat embolism mechanical origin] VL - 41 ID - 828552 ER - TY - JOUR AB - A case of fatal pulmonary embolism with acrylic cement occuring during a percutaneous vertebroplasty on account of a fracture of L1 is described. Autopsy confirmed the presence of large amounts of surgical cement in the paravertebral venous system and in the pulmonary arteries. This rare complication occurred because perivertebral venous cement migration was not recognized during vertebroplasty. To our knowledge, this is the first case of fatal pulmonary embolism caused by surgical cement following a percutaneous vertebroplasty. AD - Institute of Forensic Medicine, Salzburg University, Ignaz Harrer Str. 79, 5020 Salzburg, Austria. fabio.monticelli@sbg.ac.at AN - 15734107 AU - Monticelli, F. AU - Meyer, H. J. AU - Tutsch-Bauer, E. DA - Apr 20 DO - 10.1016/j.forsciint.2004.06.010 DP - NLM ET - 2005/03/01 J2 - Forensic science international KW - Aged Aged, 80 and over Bone Cements/*adverse effects Extravasation of Diagnostic and Therapeutic Materials/*complications Fatal Outcome Female Heart Arrest/etiology Humans Injections, Spinal/adverse effects Lumbar Vertebrae/injuries/surgery Pulmonary Embolism/*etiology Spinal Fractures/surgery LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2005 SN - 0379-0738 (Print) 0379-0738 SP - 35-8 ST - Fatal pulmonary cement embolism following percutaneous vertebroplasty (PVP) T2 - Forensic Sci Int TI - Fatal pulmonary cement embolism following percutaneous vertebroplasty (PVP) VL - 149 ID - 828881 ER - TY - JOUR AD - Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, Catholic University of Korea, 505, Banpo-dong, Seocho-gu, 137-701 Seoul, Republic of Korea. AN - 23876810 AU - Moon, M. H. AU - Jo, K. H. AU - Kim, H. W. DA - Jun-Jul DO - 10.1016/j.acvd.2011.11.010 DP - NLM ET - 2013/07/24 J2 - Archives of cardiovascular diseases KW - Aged, 80 and over Bone Cements/*adverse effects Cardiac Surgical Procedures Embolism/diagnostic imaging/*etiology/surgery Female Foreign-Body Migration/diagnostic imaging/*etiology/surgery Heart Injuries/diagnostic imaging/*etiology/surgery Heart Ventricles/injuries Humans Tomography, X-Ray Computed Treatment Outcome Vertebroplasty/*adverse effects Wounds, Penetrating/diagnostic imaging/*etiology/surgery Ct Cardiac perforation Cement embolization Embolisation Perforation cardiaque Vertrobroplasty Vertébroplastie computed tomography LA - eng M1 - 6-7 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1875-2128 SP - 413-4 ST - Cardiac perforation caused by bone cement embolism T2 - Arch Cardiovasc Dis TI - Cardiac perforation caused by bone cement embolism VL - 106 ID - 828940 ER - TY - JOUR AB - Percutaneous vertebroplasty for osteoporotic compression fracture or malignant osteolytic spinal tumors provides pain relief. Pulmonary embolism caused by polymethylmethacrylate migration after this procedure is rare and its major complication, pulmonary infarction, involves necrosis of lung parenchyme, resulting from interference with blood supply. We report a case of large pulmonary embolus (diameter 2 cm) after cement vertebroplasty for osteoporotic vertebral compression fracture and successful management with anticoagulation only. AD - S. Moon, Department of Orthopedic Surgery, Sunlin Hospital, Pohang, Kyongbook, South Korea AU - Moon, S. AU - Lee, S. AU - Kong, G. AU - Kim, J. AU - Lee, E. DB - Embase DO - 10.1016/j.bone.2009.01.192 KW - mineral poly(methyl methacrylate) cement percutaneous vertebroplasty New Zealand lung embolism bone compression fracture society case report anticoagulation spinal cord tumor lung infarction necrosis lung parenchyma vascularization analgesia L1 - http://www.sciencedirect.com/science?_ob=MImg&_imagekey=B6T4Y-4VX7MD9-69-1&_cdi=4987&_user=8184434&_pii=S875632820900221X&_orig=browse&_coverDate=05%2F31%2F2009&_sk=999559999.8998&view=c&wchp=dGLbVlb-zSkWb&md5=e14e2eb4ac887810994f020214b442f7&ie=/sdarticle.pdf LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 8756-3282 SP - S86 ST - Large pulmonary embolus after percutaneous vertebroplasty in osteoporotic compression fracture - A case report T2 - Bone TI - Large pulmonary embolus after percutaneous vertebroplasty in osteoporotic compression fracture - A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70099545&from=export http://dx.doi.org/10.1016/j.bone.2009.01.192 VL - 44 ID - 829715 ER - TY - JOUR AB - Purpose: Tranexamic acid (TXA) has been shown to be effective in reducing blood loss after total knee replacement. The purpose of this study was to prospectively assess the effectiveness of topical TXA use, to reduce blood loss after primary total knee replacement without tourniquet, and to compare these outcomes with a control group that did not receive tranexamic acid. Methods: This is a prospective, randomized study to assess the effect of a 2‐g topical tranexamic acid in 50Â mL physiological saline solution in total knee replacement without tourniquet and drain. Primary outcomes were total blood loss. Secondary outcomes were hemoglobin and hematocrit level, hemoglobin and hematocrit drop, transfusion rates, length of hospital stay, deep vein thrombosis, and pulmonary embolism events. Results: Preoperative and intraoperative data were similar between the two groups. The mean total blood loss was 620Â mL in the topical tranexamic acid group and 1094Â mL in the control group with significant differences (p = 0.001), which meant 43% reduction in total blood loss. The hemoglobin and hematocrit postoperative value was significantly higher in the topical tranexamic acid group than in the control group (p = 0.002). Transfusion rates were 0% in the topical tranexamic group and 4.3% in the control group. The length of stay was significantly lower in the topical tranexamic acid group (p = 0.01). There were no DVT or PE in any group. Conclusion: A single dose of 2‐g TXA in 50Â mL topical administration significantly reduces blood loss and improves postoperative blood chemistries in patients undergoing unilateral primary cemented TKA without tourniquet and drain compared to a control group, without increasing the risk of thromboembolic complications. AN - CN-02100017 AU - Morales Santias, M. AU - Mas Martinez, J. AU - Sanz-Reig, J. AU - Martinez Gimenez, E. AU - Verdu Roman, C. AU - Bustamante Suarez de Puga, D. DO - 10.1007/s00590-020-02656-9 KW - *operative blood loss *prospective study *total knee arthroplasty *tourniquet Adult Article Blood chemistry Clinical trial Comparative effectiveness Complication Controlled study Deep vein thrombosis Drain Drug therapy Female Hematocrit Hospitalization Human Length of stay Lung embolism Male Preoperative evaluation Randomized controlled trial Topical drug administration M3 - Journal: Article in Press N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2020 ST - Topical tranexamic acid in cemented primary total knee arthroplasty without tourniquet: a prospective randomized study T2 - European journal of orthopaedic surgery & traumatology : orthopedie traumatologie TI - Topical tranexamic acid in cemented primary total knee arthroplasty without tourniquet: a prospective randomized study UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02100017/full ID - 830034 ER - TY - JOUR AB - Purpose: Tranexamic acid (TXA) has been shown to be effective in reducing blood loss after total knee replacement. The purpose of this study was to prospectively assess the effectiveness of topical TXA use, to reduce blood loss after primary total knee replacement without tourniquet, and to compare these outcomes with a control group that did not receive tranexamic acid. Methods: This is a prospective, randomized study to assess the effect of a 2-g topical tranexamic acid in 50 mL physiological saline solution in total knee replacement without tourniquet and drain. Primary outcomes were total blood loss. Secondary outcomes were hemoglobin and hematocrit level, hemoglobin and hematocrit drop, transfusion rates, length of hospital stay, deep vein thrombosis, and pulmonary embolism events. Results: Preoperative and intraoperative data were similar between the two groups. The mean total blood loss was 620 mL in the topical tranexamic acid group and 1094 mL in the control group with significant differences (p = 0.001), which meant 43% reduction in total blood loss. The hemoglobin and hematocrit postoperative value was significantly higher in the topical tranexamic acid group than in the control group (p = 0.002). Transfusion rates were 0% in the topical tranexamic group and 4.3% in the control group. The length of stay was significantly lower in the topical tranexamic acid group (p = 0.01). There were no DVT or PE in any group. Conclusion: A single dose of 2-g TXA in 50 mL topical administration significantly reduces blood loss and improves postoperative blood chemistries in patients undergoing unilateral primary cemented TKA without tourniquet and drain compared to a control group, without increasing the risk of thromboembolic complications. AD - Knee Unit, Department of Orthopedic Surgery, HLA Clinica Vistahermosa, Av de Denia 76, 03016, Alicante, Spain AN - 144423823. Language: English. Entry Date: 20200722. Revision Date: 20200722. Publication Type: Article AU - Morales Santias, Manuel AU - Mas Martinez, Jesus AU - Sanz-Reig, Javier AU - Martínez Gimenez, Enrique AU - Verdu Román, Carmen AU - Bustamante Suarez de Puga, David DB - cin20 DO - 10.1007/s00590-020-02656-9 DP - EBSCOhost KW - Arthroplasty, Replacement, Knee -- Adverse Effects Blood Loss, Surgical -- Prevention and Control Tranexamic Acid -- Administration and Dosage Administration, Topical Tourniquets Treatment Outcomes -- Evaluation Human Randomized Controlled Trials Random Assignment Prospective Studies Postoperative Period Hemoglobins -- Blood Hematocrit Blood Transfusion Length of Stay Venous Thrombosis Pulmonary Embolism M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2020 SN - 1633-8065 SP - 1003-1008 ST - Topical tranexamic acid in cemented primary total knee arthroplasty without tourniquet: a prospective randomized study T2 - European Journal of Orthopaedic Surgery & Traumatology TI - Topical tranexamic acid in cemented primary total knee arthroplasty without tourniquet: a prospective randomized study UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=144423823&site=ehost-live&scope=site VL - 30 ID - 830506 ER - TY - JOUR AB - Background: Although intraoperative transoesophageal echocardiography (TOE) has been used to detect the occurrence of echogenic macro- and/or microembolic phenomena during total hip arthroplasty (THA), no direct correlation between macroembolism and the formation of pulmonary embolism (PE) has been conclusively determined in early postoperative periods after THA.Methods: Sixty-two patients scheduled for primary THA were enrolled in this study. Intraoperative TOE images were continuously recorded on videotape and the echogenic events were evaluated throughout surgery. Perfusion lung scintigraphy was performed on the first postoperative day (POD1).Results: Perfusion lung scintigraphy revealed the existence of PE in nine (15%) of the 62 patients who underwent THA: five (25%) of 20 patients with cemented THA and four (10%) of 42 patients with non-cemented THA. The grading score of intraoperative TOE findings, including the amount of echogenic particles in right atrium, the longest time of echogenesis and the diameter of the largest echogenic particles, did not differ between the groups with and without PE. The sensitivity, specificity, and positive and negative predictive values for the detection of echogenic macroemboli for the prediction of the development of PE on POD1 were 0.78, 0.60, 0.25 and 0.94, respectively.Conclusion: Intraoperative TOE monitoring did not predict the occurrence of PE on POD1. AD - Department of Anaesthesiology, Kurume University School of Medicine, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan. AN - 104741236. Language: English. Entry Date: 20110610. Revision Date: 20180129. Publication Type: journal article AU - Moriyama, M. AU - Watanabe, S. AU - Hiraki, T. AU - Kano, T. AU - Okawa, T. AU - Ishibashi, M. DB - cin20 DO - bja/aei112 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Adverse Effects Echocardiography, Transesophageal Embolism -- Ultrasonography Intraoperative Complications -- Ultrasonography Intraoperative Monitoring -- Methods Adult Aged Aged, 80 and Over Cementation Embolism -- Etiology Female Human Male Middle Age Postoperative Care -- Methods Predictive Value of Tests Pulmonary Embolism -- Etiology Pulmonary Embolism -- Radiography Sensitivity and Specificity Videorecording M1 - 5 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2005 SN - 0007-0912 SP - 607-612 ST - Relationship between intraoperative transoesophageal echocardiography findings and perfusion lung scintigraphy results on first postoperative day T2 - BJA: The British Journal of Anaesthesia TI - Relationship between intraoperative transoesophageal echocardiography findings and perfusion lung scintigraphy results on first postoperative day UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104741236&site=ehost-live&scope=site VL - 94 ID - 830782 ER - TY - JOUR AB - SESSION TITLE: Medical Student/Resident Pulmonary Vascular Disease Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: In the United States there are over 700,000 new vertebral compression fractures each year.1 While a majority of these can be successfully medically managed, some patients will develop chronic pain and undergo kyphoplasty or vertebroplasty in seek of pain relief. Cement pulmonary embolism is a common adverse event of these frequently performed procedures that clinicians should be familiar with. CASE PRESENTATION: A 63-year-old female presented to the emergency room after developing chest pain and dyspnea that started thirty minutes after a T11-L2 kyphoplasty. Initial vital signs were significant for an oxygen saturation of 88% on room air, heart rate of 111, blood pressure of 133/84, and respiratory rate of 22. On exam the patient was tachycardic and demonstrated decreased breath sounds over the right middle and lower lung fields. Basic laboratory work was significant for a white blood cell count of 13,700 (87% neutrophils), undetectable troponin x 2, and BNP of 60. Chest radiograph showed a small to moderate right pleural effusion with right lower lobe airspace disease. Electrocardiogram demonstrated sinus tachycardia with no ST segment changes. Wells score was six, therefore CT angiography was pursued to evaluate for pulmonary embolism. The CT scan revealed a pulmonary cement embolism involving the subsegmental pulmonary arteries of the bilateral upper lobes with evidence of cement leaking into the azygos and IVC. The patient was admitted to the hospital where she was initially treated with antibiotics for aspiration pneumonia and started on therapeutic dose anticoagulation. She was discharged on two liters of oxygen on hospital day two. She was to continue anticoagulation for six months and complete a five day course of antibiotics. At her two month follow-up her dyspnea and chest pain had completely resolved. DISCUSSION: During kyphoplasty cement is injected into the vertebrae and can leak into the epidural veins and travel through the venous system and lodge in the right ventricle or pulmonary arteries causing a pulmonary cement embolism. This is a reported complication in up to twenty five percent of cases when CT is used as the diagnostic modality.2 Patients can present with chest pain, dyspnea, hypoxia, tachycardia, and even cardiogenic shock and sudden death usually days to weeks after their procedure. Diagnosis can be made with standard chest radiograph however CT is the diagnostic test of choice. Current treatment guidelines are based upon case series and expert opinion. If patients are stable but symptomatic it is recommended that they be anticoagulated for three to six months.3 In cases of hemodynamic instability immediate surgical retrieval of the embolus is recommended.3 CONCLUSIONS: Clinicians should be familiar with the diagnosis and management of pulmonary cement embolism as it is a common adverse event after vertebral augmentation procedures. Reference #1: 1. Riggs BL, Melton LJ. The worldwide problem of osteoporosis: insights afforded by epidemiology. Bone 1995;17(5 Suppl):505s–11s. Reference #2: 2. Kim YJ, Lee JW, Park KW, et al. Pulmonary cement embolism after percutaneous vertebroplasty in osteoporotic vertebral compression fractures: incidence, characteristics, and risk factors. Radiology. 2009;251(1):250-259. Reference #3: 3. Krueger A, Bliemel C, Zetti R, and Ruchholtz S. Management of pulmonary cement embolism after percutaneous vertebroplasty and kyphoplasty: systematic review of the literature. Eur Spine J. 2009 Sep; 18(9): 1257–1265. DISCLOSURES: No relevant relationships by Chris Morris, source=Web Response No relevant relationships by Samuel Rafla, source=Web Response AU - Morris, C. AU - Rafla, S. DB - Embase DO - 10.1016/j.chest.2020.08.1846 KW - antibiotic agent cement endogenous compound oxygen troponin abnormal respiratory sound adult ambient air anticoagulation aspiration pneumonia blood pressure breathing rate cardiogenic shock case study complication compression fracture computed tomographic angiography conference abstract dyspnea emergency ward female follow up heart rate heart right ventricle human human cell hypoxia incidence information retrieval kyphoplasty leukocyte count lung embolism middle aged neutrophil osteoporosis oxygen saturation pleura effusion practice guideline pulmonary artery risk factor sinus tachycardia ST segment sudden death systematic review therapeutic dose thorax pain thorax radiography travel venous circulation vertebra vital sign x-ray computed tomography LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1931-3543 0012-3692 SP - A2142 ST - CEMENT EMBOLISM AS A CAUSE OF DYSPNEA AFTER MULTILEVEL KYPHOPLASTY T2 - Chest TI - CEMENT EMBOLISM AS A CAUSE OF DYSPNEA AFTER MULTILEVEL KYPHOPLASTY UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2008025410&from=export http://dx.doi.org/10.1016/j.chest.2020.08.1846 VL - 158 ID - 829051 ER - TY - JOUR AB - Aim of study: Unicompartmental knee arthroplasty (UKA) has been increasingly utilized over the past decade secondary to favorable reports of better range of motion, higher activity levels, and increased patient satisfaction compared with total knee arthroplasty (TKA). The aim of this study was to determine the 90-day incidence of perioperative complications and mortality of patients undergoing UKA. Methods: One thousand consecutive UKA in 828 patients were retrospectively reviewed. A retrospective review was performed to evaluate 90-day perioperative complication and mortality rates. Results: There were zero deaths during the study period. Twelve percent of surgeries were complicated by variances within the 90-day postoperative period. There was one deep venous thrombosis (0.1%) and no pulmonary emboli. Cardiovascular complications were infrequent. Three patients had a myocardial infarction (0.31%), one developed congestive heart failure (0.1%), one angina (0.1%), and three had arrhythmias (0.31%). Secondary procedures were performed in 15 patients during the follow-up period: seven were manipulations under anesthesia for arthrofibrosis, one was an arthroscopic removal of retained cement, one arthroscopic removal of a drain, one repeat wound closure after a dehiscence secondary to a fall, one open reduction internal fixation for a supracondylar femur fracture, three irrigation and debridement procedures for an aseptic hematoma, and one radical debridement with later successful conversion to a total knee arthroplasty for a periprosthetic infection. Conclusion: This study supports the notion that UKA is a safe procedure that is associated with a low rate of mortality and serious post-operative complications. Level of evidence: Level IV, therapeutic study case series. © 2012 Elsevier B.V. AD - M.J. Morris, Joint Implant Surgeons, Inc., 7277 Smith's Mill Road, Suite 200, New Albany, OH 43054, United States AU - Morris, M. J. AU - Molli, R. G. AU - Berend, K. R. AU - Lombardi, A. V. DB - Embase Medline DO - 10.1016/j.knee.2012.10.019 KW - adult aged angina pectoris arthroscopy article cardiovascular disease congestive heart failure debridement deep vein thrombosis heart arrhythmia heart infarction human incidence knee arthroplasty lavage lung embolism major clinical study morbidity mortality patient satisfaction peroperative complication priority journal range of motion retrospective study total knee arthroplasty unicompartmental knee arthroplasty LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0968-0160 1873-5800 SP - 218-220 ST - Mortality and perioperative complications after unicompartmental knee arthroplasty T2 - Knee TI - Mortality and perioperative complications after unicompartmental knee arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52301331&from=export http://dx.doi.org/10.1016/j.knee.2012.10.019 VL - 20 ID - 829492 ER - TY - JOUR AB - We report a case of polymethylmethacrylate cement pulmonary embolism (PE) that occurred two days following a minimally invasive kyphoplasty procedure. Our patient developed non-specific rib pain postoperatively followed by dyspnea, prompting presentation to the emergency department. The polymethylmetacrylate cement was visualized on initial chest radiograph and further characterized using computed tomography. The patient was admitted and anticoagulation started, later having an uncomplicated hospital course. The polymethylmethacrylate cement has a well-documented history of leakage and other postoperative complications. Cement PE, while rare, can present similarly to a thrombotic PE and requires adequate long-term anticoagulation with close follow-up. AD - St. Lucie Medical Center, Department of Emergency Medicine, Port St. Lucie, Florida. AN - 31403097 AU - Morris, O. AU - Mathai, J. AU - Weller, K. C2 - PMC6682235 required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. The authors disclosed none. DA - Aug DO - 10.5811/cpcem.2019.4.42324 DP - NLM ET - 2019/08/14 J2 - Clinical practice and cases in emergency medicine LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 2474-252x SP - 226-228 ST - Polymethylmethacrylate Pulmonary Embolism Following Kyphoplasty T2 - Clin Pract Cases Emerg Med TI - Polymethylmethacrylate Pulmonary Embolism Following Kyphoplasty VL - 3 ID - 828586 ER - TY - JOUR AB - Purpose: To assess safety and efficacy of multi-level vertebroplasty, when treating 6 or more levels in the same procedural setting for the management of osteoporotic vertebral compression fractures (oVCF) in cancer patients.Materials and Methods: Single institution retrospective review from 2015 to 2019 of patients treated for multi-level oVCF in a single session procedural setting by vertebroplasty of 6 or more levels. Procedure outcomes collected included procedural complications, pre- and 4 week post-procedure pain score by numeric rating scale, opioid usage, and vertebral height changes.Results: In total, 197 vertebral levels were treated in 24 procedures (mean 8.2 ± 1.8 levels). Mean procedure duration was 167 + / - 41 min, and mean postoperative hospitalization duration was 2.1 + / - 1.9 days. Four grade I or II complications occurred according to CIRSE classification. Two patients had a symptomatic pulmonary cement embolism; although there was no statistical difference between pre- and postoperative mean blood saturation (95.9 + / - 1.7% and 94.8 + / - 2.0%, respectively, p = 0.066). Pain score significantly improved after treatment (6.5 ± 1.3 vs 3.2 + / - 1.4, p < 0.0001) with a mean decrease of 3.3 (51%). Post-procedure daily opioid use also significantly improved (mean 35.8 + / - 36.8 mg/24 h vs 18.5 + / - 27.8 mg/24 h, p = 0.0089), with a mean decrease of 17.3 mg/24 h (48%). Refracture was found in 2 of 105 levels treated (1.9%), and no difference was found in thoraco-lumbar height and angulation. Five patients experienced new painful fractures at a non-treated level.Conclusion: Multi-level vertebroplasty for 6 or more levels is a safe and effective treatment for the management of multi-level oVCF in cancer patients. AD - Department Interventional Radiology Unit, Imaging Department, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, 94805, Villejuif, France Université Paris-Sud, Le Kremlin Bicêtre, France Pain Management Unit, Institut Gustave Roussy, Paris, Villejuif, France AN - 143819619. Language: English. Entry Date: 20201203. Revision Date: 20201203. Publication Type: journal article. Journal Subset: Biomedical AU - Moulin, Benjamin AU - Delpla, Alexandre AU - Tselikas, Lambros AU - Al Ahmar, Marc AU - Prud'homme, Clara AU - Roux, Charles AU - Yevich, Steven AU - Laurent, Sophie AU - Hakime, Antoine AU - Territehau, Christophe AU - Gravel, Guillaume AU - De Baere, Thierry AU - Deschamps, Fréderic DB - cin20 DO - 10.1007/s00270-020-02480-y DP - EBSCOhost KW - Fractures, Compression -- Surgery Vertebroplasty -- Methods Fractures, Compression -- Complications Neoplasms -- Complications Male Retrospective Design Treatment Outcomes Bone Cements -- Therapeutic Use Aged Middle Age Female Tomography, X-Ray Computed -- Methods Pain -- Etiology Fractures, Compression Aged, 80 and Over M1 - 7 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2020 SN - 0174-1551 SP - 1041-1048 ST - Multi-Level Vertebroplasty for 6 or More Painful Osteoporotic Vertebral Body Compression Fractures Performed in the Same Procedural Setting: A Safety and Efficacy Report in Cancer Patients T2 - CardioVascular & Interventional Radiology TI - Multi-Level Vertebroplasty for 6 or More Painful Osteoporotic Vertebral Body Compression Fractures Performed in the Same Procedural Setting: A Safety and Efficacy Report in Cancer Patients UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=143819619&site=ehost-live&scope=site VL - 43 ID - 830507 ER - TY - JOUR AB - PURPOSE: To assess the safety and efficacy of multilevel thoracolumbar vertebroplasty in the simultaneous treatment of ≥ 6 painful pathologic compression fractures. MATERIALS AND METHODS: Retrospective review was conducted of 50 consecutive patients treated with vertebroplasty for ≥ 6 pathologic compression fractures in a single session for pain palliation at a tertiary single cancer center from 2015 to 2019. Outcomes measured included procedural safety according to Common Terminology Criteria for Adverse Events (CTCAE), change in 4-week postprocedure back pain by numeric rating scale (NRS), comparison of daily opioid medication consumption, and development of skeletal-related events. RESULTS: A total of 397 pathologic compression fractures were treated during 50 sessions (mean, 7.9 per patient ± 1.5). Mean procedure duration was 162 minutes ± 35, mean postoperative hospitalization duration was 1.6 days ± 0.9, and mean follow-up duration was 401 days ± 297. Seven complications were recorded, including 1 case of symptomatic polymethyl methacrylate pulmonary embolism. No major complications (CTCAE grade 4/5) were reported. NRS pain score was significantly decreased (5.0 ± 1.8 vs 1.7 ± 1.4; P < .0001), with a mean score decrease of 3.3 points (66%). Opioid agent use decreased significantly (76 mg/24 h ± 42 vs 45 mg/24 h ± 37; P = .0003), with a mean decrease of 30 mg/24 h (39%). Skeletal-related events occurred in 7 patients (14%). CONCLUSIONS: Multilevel vertebroplasty for ≥ 6 pathologic compression fractures is safe and provides significant palliative benefit when performed simultaneously. AD - Interventional Radiology Unit and Imaging Department and Anesthesiology Unit, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif 94805, France. Electronic address: b.moulin00@gmail.com. Interventional Radiology Unit and Imaging Department and Anesthesiology Unit, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif 94805, France; Université Paris-Sud, Le Kremlin Bicêtre, France. Interventional Radiology Unit and Imaging Department and Anesthesiology Unit, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif 94805, France. AN - 32921566 AU - Moulin, B. AU - Tselikas, L. AU - Gravel, G. AU - Al Ahmar, M. AU - Delpla, A. AU - Yevich, S. AU - Hakime, A. AU - Territehau, C. AU - De Baere, T. AU - Deschamps, F. DA - Oct DO - 10.1016/j.jvir.2020.03.011 DP - NLM ET - 2020/09/15 J2 - Journal of vascular and interventional radiology : JVIR KW - Aged Back Pain/diagnosis/etiology/*prevention & control Female Fractures, Compression/complications/diagnostic imaging/*therapy Fractures, Multiple/complications/diagnostic imaging/*therapy Fractures, Spontaneous/complications/diagnostic imaging/*therapy Humans Lumbar Vertebrae/diagnostic imaging/*injuries Male Middle Aged *Palliative Care Retrospective Studies Spinal Fractures/complications/diagnostic imaging/*therapy Thoracic Vertebrae/diagnostic imaging/*injuries Treatment Outcome *Vertebroplasty/adverse effects LA - eng M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 1051-0443 SP - 1683-1689.e1 ST - Safety and Efficacy of Multilevel Thoracolumbar Vertebroplasty in the Simultaneous Treatment of Six or More Pathologic Compression Fractures T2 - J Vasc Interv Radiol TI - Safety and Efficacy of Multilevel Thoracolumbar Vertebroplasty in the Simultaneous Treatment of Six or More Pathologic Compression Fractures VL - 31 ID - 828600 ER - TY - JOUR AB - Object. The goal of this study was to quantify volumetrically cement fill and leakage in patients with osteoporotic and metastatic vertebral lesions undergoing percutaneous vertebroplasty and to establish whether these factors have any clinical significance at follow up. Methods. Digital computerized tomography data were retrospectively collected from all cases at the authors' institution in which percutaneous vertebroplasty was performed for osteoporosis or metastatic disease. Patient selection was based on the consensus of a multidisciplinary team consisting of an orthopedic surgeon, an oncologist, and a neuroradiologist. A semiautomated thresholding technique was used to measure vertebral body volume, the volume of cement injected directly into the vertebra, and the volume of cement leakage. Pain-related scores were collected at four early stages of treatment, and all clinical complications were recorded. Cement leakage was found in 87.9% of vertebrae treated with percutaneous vertebroplasty. In osteoporotic vertebrae it occurred mainly in the disc, whereas in metastatic lesions, it was found in multiple areas. Irrespective of leakage, both patients with osteoporotic and metastatic disease experienced significant immediate pain relief postoperatively. Conclusions. Although there was no correlation between cement fill or cement leakage and pain relief, there exists a risk of serious complications due to cement leakage. AD - Sunnybrook & Womens Coll Hlth Sci Ctr, Orthopaed Biomech Lab, Toronto, ON M4N 3M5, Canada. Whyne, C (corresponding author), Sunnybrook & Womens Coll Hlth Sci Ctr, Orthopaed Biomech Lab, 2075 Bayview Ave,U-B, Toronto, ON M4N 3M5, Canada. cari.whyne@swchsc.on.ca AN - WOS:000184034000013 AU - Mousavi, P. AU - Roth, S. AU - Finkelstein, J. AU - Cheung, G. AU - Whyne, C. DA - Jul DO - 10.3171/spi.2003.99.1.0056 J2 - J. Neurosurg. KW - cement vertebroplasty osteoporosis metastasis spine pain EMBOLISM Clinical Neurology Surgery LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2003 SN - 0022-3085 SP - 56-59 ST - Volumetric quantification of cement leakage following percutaneous vertebroplasty in metastatic and osteoporotic vertebrae T2 - Journal of Neurosurgery TI - Volumetric quantification of cement leakage following percutaneous vertebroplasty in metastatic and osteoporotic vertebrae UR - ://WOS:000184034000013 VL - 99 ID - 830447 ER - TY - JOUR AB - Background: Bone cement implantation syndrome has been reported frequently after total hip arthroplasty with a patent foramen ovale. We report a case of BCIS after total elbow arthroplasty. A 47 y/o obese female with hypertension, rheumatoid arthritis, asthma and undiagnosed patent foramen ovale presented to the OR for left total elbow arthroplasty. She received a supraclavicular block pre-operatively, was taken to the OR and underwent induction of general anesthesia uneventfully. During the cementing process, the patient suddenly developed bradycardia and a precipitous drop in end tidal CO2. The patient underwent ACLS resuscitation, a TEE was performed, an intra-aortic balloon pump was placed, and the patient was taken to the cardiac catheterization lab. The patient was noted to have multiple peripheral pulmonary emboli and poor cardiac function. Methods: We examine the effects of methyl methacrylate on patients undergoing total elbow arthroplasty, and highlight the potential physiologic response after cementing. It has been documented on numerous occasions that methyl methacrylate can cause microemboli and cause severe hypotension resulting in fatal myocardial depression. In a patient with a patent foramen ovale, the results can be devastating. Conclusion: Methyl methacrylate used intraoperatively during total elbow arthroplasty as a routine procedure, but can have fatal results in patients with cardiac defects. It is important to be aware of the immediate and potentially fatal consequences during the cementing. If patients experience cardiovascular collapse, it is imperative that the anesthesiologist understand the physiology of methyl methacrylate, immediately initiate ACLS, and utilize the appropriate hospital resources to treat the BCIS. AD - R. Movahedi, Anesthesiology, Keck School of Medicine, Los Angeles, CA, United States AU - Movahedi, R. AU - Sharma, S. DB - Embase DO - 10.1097/AAP.0b013e31826a8366 KW - bone cement methacrylic acid methyl ester implantation patent foramen ovale society regional anesthesia human patient elbow arthroplasty aortic balloon general anesthesia asthma rheumatoid arthritis total hip prosthesis lung embolism procedures physiology heart catheterization resuscitation hypertension heart function bradycardia hypotension shock anesthesist female hospital LA - English M1 - 5 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1098-7339 SP - E251 ST - Bone cement implantation syndrome during total elbowarthroplasty with a patent foramen ovale T2 - Regional Anesthesia and Pain Medicine TI - Bone cement implantation syndrome during total elbowarthroplasty with a patent foramen ovale UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70881035&from=export http://dx.doi.org/10.1097/AAP.0b013e31826a8366 VL - 37 ID - 829551 ER - TY - JOUR AB - Percutaneous vertebroplasty (PVP) with polymethylmethacrylate (PMMA) is a minimally invasive procedure that provides significant pain relief in a high percentage of patients with osteoporotic fractures. The complication rate of PVP is reported to be below 6%. This case illustrates, for the first time, an arterial PMMA embolus to the aorta and its branches as a complication of PVP. AD - H. Zirakzadeh, Vascular Surgery Research Center, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran AU - Mozaffar, M. AU - Radpay, M. R. AU - Zirakzadeh, H. AU - Nabavizadeh, P. AU - Sobhiye, M. R. AU - Langroudi, R. M. DB - Embase DO - 10.1016/j.jvs.2012.04.010 KW - adult analgesia aorta article complication embolism fragility fracture human minimally invasive procedure percutaneous vertebroplasty acrylic cement poly(methyl methacrylate) LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1097-6809 0741-5214 SP - 1107-1109 ST - Intra-arterial injection of acrylic cement as a complication of percutaneous vertebroplasty T2 - Journal of Vascular Surgery TI - Intra-arterial injection of acrylic cement as a complication of percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52118110&from=export http://dx.doi.org/10.1016/j.jvs.2012.04.010 VL - 56 ID - 829539 ER - TY - JOUR AB - Percutaneous vertebroplasty (PVP) with polymethylmethacrylate (PMMA) is a minimally invasive procedure that provides significant pain relief in a high percentage of patients with osteoporotic fractures. The complication rate of PVP is reported to be below 6%. This case illustrates, for the first time, an arterial PMMA embolus to the aorta and its branches as a complication of PVP. AD - Vascular Surgery Research Center, Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. AN - 22818832 AU - Mozaffar, M. AU - Radpay, M. R. AU - Zirakzadeh, H. AU - Nabavizadeh, P. AU - Sobhiye, M. R. AU - Motiei Langroudi, R. DA - Oct DO - 10.1016/j.jvs.2012.04.010 DP - NLM ET - 2012/07/24 J2 - Journal of vascular surgery KW - Aged Bone Cements/*adverse effects Embolism/*diagnosis/*etiology/therapy Female Humans Injections, Intra-Arterial Lumbar Vertebrae/injuries Polymethyl Methacrylate/administration & dosage/*adverse effects Spinal Fractures/etiology/pathology/*therapy Thoracic Vertebrae/injuries Vertebroplasty/*adverse effects LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0741-5214 SP - 1107-9 ST - Intra-arterial injection of acrylic cement as a complication of percutaneous vertebroplasty T2 - J Vasc Surg TI - Intra-arterial injection of acrylic cement as a complication of percutaneous vertebroplasty VL - 56 ID - 828928 ER - TY - JOUR AB - Background: We present the results of cementless total hip arthroplasty performed with use of an anatomically adapted femoral stem and hemispherical cup with a fully coated Spongiosa-I metal surface, which was designed to achieve a surface similar to human cancellous bone. The purpose of the present retrospective case series was to determine the long-term outcomes of this hip arthroplasty system after a minimum of twenty years of follow-up. Methods: Between 1983 and 1985, 209 consecutive total hip arthroplasty procedures (199 patients) were performed with use of the first-generation Spongiosa metal-surface chromium-cobalt total hip implant with an articulating surface consisting of a ceramic head and an ultra-high-molecular-weight polyethylene liner. We report the clinical and radiographic outcomes, the rates of and reasons for revision, and the influence of sex and age on outcome and complications. Results: At the time of the latest follow-up, twenty-seven patients had died and thirteen patients had been lost to follow-up; none of these forty patients had had revision surgery. The outcomes for 159 patients (169 prostheses) were reviewed. The mean duration of follow-up was 262 months (range, 242 to 275 months). There were nineteen revisions, including fourteen revisions of the femoral stem, two revisions of the acetabular cup, and three revisions of both components. The mean Harris hip score for patients who did not undergo revision surgery was 82 points. The probability of survival of both components at twenty years, with revision for any reason as the end point, was 97%. The probability of survival of the acetabular component was 98%, and the probability of survival of the femoral component only was 86%. The probability of component survival was significantly increased among older patients. Conclusions: The results of cementless hip arthroplasty with use of the first-generation Spongiosa implant were excellent at a minimum of twenty years of follow-up. The probability of survival of the acetabular component exceeded that of the femoral stem. Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence. Copyright © 2011 by The Journal of Bone and Joint Surgery, Incorporated. AD - M.A. Muderis, Macquarie University Hospital, Sydney Adventist Hospital, 116 Macquarie Street, Parramatta, NSW 2150, Australia AU - Muderis, M. A. AU - Bohling, U. AU - Grittner, U. AU - Gerdesmeyer, L. AU - Scholz, J. DB - Embase Medline DO - 10.2106/JBJS.I.01757 KW - anticoagulant agent chromium cobalt ultra high molecular weight polyethylene acetabulum adult age aged article trabecular bone ceramic prosthesis cohort analysis deep vein thrombosis female femur femur fracture follow up gender Harris hip score hip dislocation hip radiography human leg pain lung embolism major clinical study male molecular weight musculoskeletal stiffness outcome assessment postoperative infection priority journal reoperation retrospective study spongiosa i metal surface hip prosthesis survival rate total hip prosthesis L1 - http://www.jbjs.org/data/Journals/JBJS/1892/jobojos_93_11_I01757.pdf LA - English M1 - 11 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 0021-9355 1535-1386 SP - 1039-1044 ST - Cementless total hip arthroplasty using the spongiosa-I fully coated cancellous metal surface: A minimum twenty-year follow-up T2 - Journal of Bone and Joint Surgery - Series A TI - Cementless total hip arthroplasty using the spongiosa-I fully coated cancellous metal surface: A minimum twenty-year follow-up UR - https://www.embase.com/search/results?subaction=viewrecord&id=L362258746&from=export http://dx.doi.org/10.2106/JBJS.I.01757 VL - 93 ID - 829613 ER - TY - JOUR AB - OBJECTIVE Loosening and pullout of pedicle screws are well-known problems in pedicle screw fixation surgery. Augmentation of pedicle screws with bone cement, first described as early as 1975, increases the pedicle-screw interface and pullout force in osteoporotic vertebrae. The aim of the present study was to identify cement leakage and pulmonary embolism rates in a large prospective single-center series of pedicle screw augmentations. METHODS All patients who underwent cement-augmented pedicle screw placement between May 2006 and October 2010 at the authors' institution were included in this prospective cohort study. Perivertebral cement leakage and pulmonary cement embolism were evaluated with a CT scan of the area of operation and with a radiograph of the chest, respectively. RESULTS A total of 98 patients underwent placement of cement-augmented pedicle screws; 474 augmented screws were inserted in 237 vertebrae. No symptomatic perivertebral cement leakage or symptomatic pulmonary cement embolism was observed, but asymptomatic perivertebral cement leakage was seen in 88 patients (93.6%) and in 165 augmented vertebrae (73.3%). Cement leakage most often occurred in the perivertebral venous system. Clinically asymptomatic pulmonary cement embolism was found in 4 patients (4.1%). CONCLUSIONS Perivertebral cement leakage often occurs in pedicle screw augmentation, but in most cases, it is clinically asymptomatic. Cement augmentation should be performed under continuous fluoroscopy to avoid high-volume leakage. Alternative strategies, such as use of expandable screws, should be examined in more detail for patients at high risk of screw loosening. AD - Department of Neurosurgery, University Medicine Greifswald. Department of Radiology and Neuroradiology, University Medicine Greifswald, Germany. AN - 26943258 AU - Mueller, J. U. AU - Baldauf, J. AU - Marx, S. AU - Kirsch, M. AU - Schroeder, H. W. AU - Pillich, D. T. DA - Jul DO - 10.3171/2015.10.spine15511 DP - NLM ET - 2016/03/05 J2 - Journal of neurosurgery. Spine KW - Adult Aged Aged, 80 and over Bone Cements/*adverse effects/*therapeutic use Equipment Failure Female Humans Lung/diagnostic imaging Male Middle Aged Orthopedic Procedures/*adverse effects/*methods *Pedicle Screws Postoperative Complications/diagnostic imaging Prospective Studies Pulmonary Embolism/diagnostic imaging/etiology Spinal Fractures/*surgery Spine/surgery Tomography, X-Ray Computed ASIA = American Spinal Injury Association PMMA = polymethylmethacrylate VAS = visual analog scale cement augmentation cement leakage pedicle screw technique LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1547-5646 SP - 103-9 ST - Cement leakage in pedicle screw augmentation: a prospective analysis of 98 patients and 474 augmented pedicle screws T2 - J Neurosurg Spine TI - Cement leakage in pedicle screw augmentation: a prospective analysis of 98 patients and 474 augmented pedicle screws VL - 25 ID - 828584 ER - TY - JOUR AB - Objective Loosening and pull-out of pedicle screws are well-known problems in pedicle screw fixation surgery. Augmentation of pedicle screws with bone cement, first described as early as 1975, increases the pedicle-screw interface and pullout force in osteoporotic vertebrae. The aim of the present study was to identify cement leakage and pulmonary embolism rates in a large prospective single-center series of pedicle screw augmentations. Methods All patients who underwent cement-augmented pedicle screw placement between May 2006 and October 2010 at the authors' institution were included in this prospective cohort study. Perivertebral cement leakage and pulmonary cement embolism were evaluated with a CT scan of the area of operation and with a radiograph of the chest, respectively. Resu lts A total of 98 patients underwent placement of cement-augmented pedicle screws; 474 augmented screws were inserted in 237 vertebrae. No symptomatic perivertebral cement leakage or symptomatic pulmonary cement embolism was observed, but asymptomatic perivertebral cement leakage was seen in 88 patients (93.6%) and in 165 augmented vertebrae (73.3%). Cement leakage most often occurred in the perivertebral venous system. Clinically asymptomatic pulmonary cement embolism was found in 4 patients (4.1%). Conclus ions Perivertebral cement leakage often occurs in pedicle screw augmentation, but in most cases, it is clinically asymptomatic. Cement augmentation should be performed under continuous fluoroscopy to avoid high-volume leakage. Alternative strategies, such as use of expandable screws, should be examined in more detail for patients at high risk of screw loosening. AD - S. Marx, Department of Neurosurgery, University Medicine Greifswald, Sauerbruchstraße, Greifswald, Germany AU - Mueller, J. U. AU - Baldauf, J. AU - Marx, S. AU - Kirsch, M. AU - Schroeder, H. W. S. AU - Pillich, D. T. DB - Embase Medline DO - 10.3171/2015.10.SPINE15511 KW - pedicle screw polymethylmethacrylate cement augmented pedicle screw bone cement polymethylmethacrylate cement unclassified drug adult aged article bone cement leakage clinical trial cohort analysis computer assisted tomography female fracture fixation fragility fracture human liquorrhea lung embolism major clinical study male operative blood loss pathologic fracture perivertebral venous system cement leakage peroperative complication prospective study thorax radiography treatment indication Tango System LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1547-5646 1547-5654 SP - 103-109 ST - Cement leakage in pedicle screw augmentation: A prospective analysis of 98 patients and 474 augmented pedicle screws T2 - Journal of Neurosurgery: Spine TI - Cement leakage in pedicle screw augmentation: A prospective analysis of 98 patients and 474 augmented pedicle screws UR - https://www.embase.com/search/results?subaction=viewrecord&id=L611125849&from=export http://dx.doi.org/10.3171/2015.10.SPINE15511 VL - 25 ID - 829312 ER - TY - JOUR AB - Giant cell tumors of the bone (GCTB) account for 5% of all primary skeletal tumors. Although the tumors are normally benign, recurrence and metastasis of GCTB does occur. The most usual sites of a primary GCTB lesion are the distal femur and proximal tibia, and similar to 3% of these metastasize to the lung. Primary GCTB lesions in the spine are rare, and there have been few cases reporting the pulmonary metastasis of GCTB in the spine. The present study reports two cases of thoracic and sacral spinal GCTB lesions with pulmonary metastasis. One of the patients was a 45-year-old male who presented to hospital with gradually worsening pain in the left buttock during the last two years and was diagnosed with GCTB of the sacrum. The other patient was a 30-year-old female who complained of persistent back pain for a year and was also diagnosed with GCTB of the sacrum. Arterial embolization was performed prior to surgery and computer navigation was used during the surgery, resulting in the two patients achieving en bloc resection of their respective tumors, with satisfactory rehabilitation to follow. AD - [Muheremu, Aikeremujiang; Huang, Zhen; Niu, Xiaohui] Beijing Jishuitan Hosp, Dept Orthoped Oncol Surg, Beijing 100035, Peoples R China. [Muheremu, Aikeremujiang] Tsinghua Univ, Med Ctr, Beijing 100084, Peoples R China. Niu, XH (corresponding author), Beijing Jishuitan Hosp, Dept Orthoped Oncol Surg, 31 Xinjiekou East St, Beijing 100035, Peoples R China. niuxiaohui@263.net AN - WOS:000350918100056 AU - Muheremu, A. AU - Huang, Z. AU - Niu, X. H. DA - Mar DO - 10.3892/ol.2014.2837 J2 - Oncol. Lett. KW - giant cell tumor of the bone spine pulmonary metastasis LONG BONES CURETTAGE RADIOTHERAPY THERAPY CEMENT Oncology LA - English M1 - 3 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2015 SN - 1792-1074 SP - 1321-1326 ST - Treatment for giant cell tumor of the spine metastasizing to the lung: A report of two cases and a literature review T2 - Oncology Letters TI - Treatment for giant cell tumor of the spine metastasizing to the lung: A report of two cases and a literature review UR - ://WOS:000350918100056 VL - 9 ID - 830244 ER - TY - JOUR AB - Percutaneous vertebroplasty (PVP) using polymethylmethacrylate bone cement is frequently used in the treatment of painful osteoporotic vertebral compression fractures in the Netherlands. In three patients there was another indication. A 44-year-old woman suffering from vertebral pain due to an osteolytic lesion caused by multiple myeloma was treated with vertebroplasty of 4 vertebral levels. A 60-year-old woman with progressive complaints of back pain due to an aggressive vertebral haemangioma was treated with vertebroplasty after embolisation had only been partially successful. Lastly, a 50-year-old non-osteoporotic man with back pain persisting for six weeks due to a stable traumatic burst fracture of TIX could not be treated with standard care, i.e. corset and analgesics, because of obesity. He was treated with PVP after a cavity had been created in the vertebral corpus. Vertebroplasty is a minimal invasive procedure resulting in most patients in rapid diminishment of the pain caused by pathological vertebral fractures, which may be present for a longer period and may have different causes. The indication triad for vertebroplasty consists of localised back pain, pain when pressure is applied to the processus spinosus of the fractured level and MRI bone oedema, findings suggestive of microfractures in a pathologically changed vertebral body. The procedure is also suitable in patients with extensive comorbidity or a short life expectancy. AD - Afd. Orthopedie, Leids Universitair Medisch Centrum, Leiden. AN - 18714523 AU - Muijs, S. P. AU - Dijkstra, P. D. AU - van Erkel, A. R. DA - Jul 26 DP - NLM ET - 2008/08/22 J2 - Nederlands tijdschrift voor geneeskunde KW - Adult Back Pain Bone Cements/therapeutic use Female Hemangioma/complications/*surgery Humans Male Middle Aged Multiple Myeloma/complications/*surgery Obesity/complications Spinal Fractures/complications/surgery Spinal Neoplasms/complications/*surgery Treatment Outcome Vertebroplasty/*methods LA - dut M1 - 30 N1 - PubMed NLM literature search January 5, 2021 OP - Percutane vertebroplastiek bij wervelfracturen door de ziekte van kahler, agressief vertebraal hemangioom en bij een traumatische burstfractuur. PY - 2008 SN - 0028-2162 (Print) 0028-2162 SP - 1686-93 ST - [Percutaneous vertebroplasty for vertebral fractures caused by multiple myeloma, an aggressive vertebral haemangioma and in a traumatic burst fracture] T2 - Ned Tijdschr Geneeskd TI - [Percutaneous vertebroplasty for vertebral fractures caused by multiple myeloma, an aggressive vertebral haemangioma and in a traumatic burst fracture] VL - 152 ID - 828815 ER - TY - JOUR AB - Percutaneous vertebroplasty (PVP) using polymethylmethacrylate bone cement is frequently used in the treatment of painful osteoporotic vertebral compression fractures in the Netherlands. In three patients there was another indication. A 44-year-old woman suffering from vertebral pain due to an osteolytic lesion caused by multiple myeloma was treated with vertebroplasty of 4 vertebral levels. A 60-year-old woman with progressive complaints of back pain due to an aggressive vertebral haemangioma was treated with vertebroplasty after embolisation had only been partially successful. Lastly, a 50-year-old non-osteoporotic man with back pain persisting for six weeks due to a stable traumatic burst fracture of TIX could not be treated with standard care, i.e. corset and analgesics, because of obesity. He was treated with PVP after a cavity had been created in the vertebral corpus. Vertebroplasty is a minimal invasive procedure resulting in most patients in rapid diminishment of the pain caused by pathological vertebral fractures, which may be present for a longer period and may have different causes. The indication triad for vertebroplasty consists of localised back pain, pain when pressure is applied to the processus spinosus of the fractured level and MRI bone oedema, findings suggestive of microfractures in a pathologically changed vertebral body. The procedure is also suitable in patients with extensive comorbidity or a short life expectancy. AD - P. D. S. Dijkstra, Afd. Orthopedie, Leids Universitair Medisch Centrum, Postbus 9600, 2300 RC Leiden AU - Muijs, S. P. J. AU - Dijkstra, P. D. S. AU - Van Erkel, A. R. DB - Embase Medline KW - aged article artificial embolization backache bone atrophy bone pain case report female hemangioma human male minimally invasive surgery multiple myeloma percutaneous vertebroplasty treatment indication spine fracture LA - Dutch M1 - 30 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2008 SN - 0028-2162 SP - 1686-1693 ST - Percutaneous vertebroplasty for vertebral fractures caused by multiple myeloma, an aggressive vertebral haemangioma and in a traumatic burst fracture T2 - Nederlands Tijdschrift voor Geneeskunde TI - Percutaneous vertebroplasty for vertebral fractures caused by multiple myeloma, an aggressive vertebral haemangioma and in a traumatic burst fracture UR - https://www.embase.com/search/results?subaction=viewrecord&id=L352134798&from=export VL - 152 ID - 829740 ER - TY - JOUR AB - In a prospective study between August 2002 and August 2005, we studied the quantitative clinical and radiological outcome 36 months after percutaneous vertebroplasty for intractable type-II osteoporotic vertebral compression fractures which had been unresponsive to conservative treatment for at least eight weeks. We also examined the quality of life (QoL). The clinical follow-up involved the use of a pain intensity numerical rating scale (PI-NRS, 0 to 10), the Short-Form 36 (SF-36) QoL questionnaire and an anamnestic questionnaire before and at seven days (PI-NRS only), and one, three, 12 and 36 months post-operatively. A total of 30 consecutive patients received percutaneous vertebroplasty for 62 vertebral compression fractures with a mean time between fracture and treatment of 7.7 months (2.2 to 39). An immediate, significant and lasting reduction in the average and worst back pain was found, represented by a decrease of 3.1 and 2.7 points after seven days and 3.1 and 2.8 points after 36 months, respectively (p < 0.00). Comparison of the pre- and post-vertebroplasty scores on the various SF-36 domains showed an ultimate significant increase in six of eight domains and both summary scores. Asymptomatic leakage of cement was found in 47 of 58 (81%) of treated vertebrae. Two minor complications occurred, an asymptomatic pulmonary cement embolism and a cement spur along the needle track. Percutaneous vertebroplasty in the treatment of chronic vertebral compression fractures results in an immediate, significant and lasting reduction in back pain, and overall improvement in physical and mental health. AN - 105506014. Language: English. Entry Date: 20090515. Revision Date: 20150711. Publication Type: Journal Article AU - Muijs, S. P. J. AU - Nieuwenhuijse, M. J. AU - Van Erkel, A. R. AU - Dijkstra, P. D. DB - cin20 DO - 10.1302/0301-620X.91B3.20970 DP - EBSCOhost KW - Kyphoplasty -- Methods Osteoporosis -- Complications Spinal Fractures -- Surgery Activities of Daily Living Aged Back Pain -- Etiology Back Pain -- Surgery Comparative Studies Data Analysis Software Female Fractures, Spontaneous -- Etiology Fractures, Spontaneous -- Pathology Fractures, Spontaneous -- Surgery Magnetic Resonance Imaging Male Pain Measurement -- Methods Paired T-Tests Prospective Studies Quality of Life Questionnaires Scales Short Form-36 Health Survey (SF-36) Spinal Fractures -- Etiology Spinal Fractures -- Pathology Treatment Outcomes Wilcoxon Signed Rank Test Human M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0301-620X SP - 379-384 ST - Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures: evaluation after 36 months T2 - Journal of Bone & Joint Surgery, British Volume TI - Percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures: evaluation after 36 months UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105506014&site=ehost-live&scope=site VL - 91B ID - 830735 ER - TY - JOUR AB - Vertebral compression fractures are among the most common forms of manifestations of osteoporosis. Conservative treatment comprises adequate analgesia, osteoporosis medication and individualized physiotherapy or braces. Nevertheless, vertebral compression fractures frequently lead to persisting pain and decrease daily activity and quality of life. In these cases, kyphoplasty and vertebroplasty can be efficient treatment options. Vertebroplasty is a minimally invasive procedure, in which bone cement is filled into the vertebral body under fluoroscopic control. In most cases, this internal stabilization leads to a rapid reduction in pain. Kyphoplasty additionally aims to correct the kyphotic deformation of the broken vertebra via introducing and inflating a balloon catheter. There is broad clinical experience with both procedures. For kyphoplasty, randomized controlled trials showed significant improvements in pain and quality of life in patients undergoing kyphoplasty. However, cement leakages lead to rare but severe complications such as pulmonary embolism and nerve palsies. AN - CN-01736128 AU - Muller, C. W. AU - Gosling, T. AU - Mameghani, A. AU - Stier, R. AU - Klein, M. AU - Hufner, T. AU - Krettek, C. KW - *compression fracture /surgery *osteoporosis /surgery *pathologic fracture /surgery *percutaneous vertebroplasty *spine disease /surgery *spine fracture /surgery Aged Article Brace Case report Computer assisted tomography Contrast medium extravasation /etiology Devices Equipment design Evidence based medicine Female Human Injury Kyphosis /surgery Lumbar vertebra /surgery Lung embolism /etiology Methodology Pain assessment Physiotherapy Postoperative complication /etiology Quality of life Radiography Randomized controlled trial Recurrent disease Reoperation Treatment outcome Vertebra /surgery M1 - 4 M3 - Journal: Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2010 SP - 417‐424 ST - Vertebral fractures due to osteoporosis. Kyphoplasty and vertebroplasty vs conservative treatment T2 - Der orthopäde TI - Vertebral fractures due to osteoporosis. Kyphoplasty and vertebroplasty vs conservative treatment UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01736128/full VL - 39 ID - 829995 ER - TY - JOUR AB - Vertebral compression fractures are among the most common forms of manifestations of osteoporosis. Conservative treatment comprises adequate analgesia, osteoporosis medication and individualized physiotherapy or braces. Nevertheless, vertebral compression fractures frequently lead to persisting pain and decrease daily activity and quality of life. In these cases, kyphoplasty and vertebroplasty can be efficient treatment options. Vertebroplasty is a minimally invasive procedure, in which bone cement is filled into the vertebral body under fluoroscopic control. In most cases, this internal stabilization leads to a rapid reduction in pain. Kyphoplasty additionally aims to correct the kyphotic deformation of the broken vertebra via introducing and inflating a balloon catheter. There is broad clinical experience with both procedures. For kyphoplasty, randomized controlled trials showed significant improvements in pain and quality of life in patients undergoing kyphoplasty. However, cement leakages lead to rare but severe complications such as pulmonary embolism and nerve palsies. © 2010 Springer‐Verlag. AN - CN-01774713 AU - Muller, C. W. AU - Gosling, T. AU - Mameghani, A. AU - Stier, R. AU - Klein, M. AU - Hufner, T. AU - Krettek, C. DO - 10.1007/s00132-009-1576-6 KW - *conservative treatment *kyphoplasty *osteoporosis *percutaneous vertebroplasty *spine fracture Analgesia Balloon catheter Brace Compression fracture Drug therapy Lung embolism Minimally invasive procedure Nerve paralysis Pain Patient Physiotherapy Quality of life Randomized controlled trial Vertebra Vertebra body M3 - Journal: Article in Press N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2010 SP - 1‐7 ST - Vertebral fractures due to osteoporosis - Kyphoplasty and vertebroplasty vs conservative treatment T2 - Der Orthopade TI - Vertebral fractures due to osteoporosis - Kyphoplasty and vertebroplasty vs conservative treatment UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01774713/full ID - 829996 ER - TY - JOUR AB - Vertebral compression fractures are among the most common forms of manifestations of osteoporosis. Conservative treatment comprises adequate analgesia, osteoporosis medication and individualized physiotherapy or braces. Nevertheless, vertebral compression fractures frequently lead to persisting pain and decrease daily activity and quality of life. In these cases, kyphoplasty and vertebroplasty can be efficient treatment options. Vertebroplasty is a minimally invasive procedure, in which bone cement is filled into the vertebral body under fluoroscopic control. In most cases, this internal stabilization leads to a rapid reduction in pain. Kyphoplasty additionally aims to correct the kyphotic deformation of the broken vertebra via introducing and inflating a balloon catheter. There is broad clinical experience with both procedures. For kyphoplasty, randomized controlled trials showed significant improvements in pain and quality of life in patients undergoing kyphoplasty. However, cement leakages lead to rare but severe complications such as pulmonary embolism and nerve palsies. AD - Abteilung Unfallchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625, Hannover, Deutschland. mueller.christian@mh-hannover.de AN - 20232195 AU - Müller, C. W. AU - Gösling, T. AU - Mameghani, A. AU - Stier, R. AU - Klein, M. AU - Hüfner, T. AU - Krettek, C. DA - Apr DO - 10.1007/s00132-009-1576-6 DP - NLM ET - 2010/03/17 J2 - Der Orthopade KW - Aged, 80 and over Bone Cements/adverse effects Braces Equipment Design Evidence-Based Medicine Extravasation of Diagnostic and Therapeutic Materials/etiology Female Fractures, Compression/diagnostic imaging/*surgery Fractures, Spontaneous/diagnostic imaging/*surgery Humans Kyphosis/diagnostic imaging/surgery Lumbar Vertebrae/diagnostic imaging/injuries/surgery Osteoporosis/diagnostic imaging/*surgery Pain Measurement Physical Therapy Modalities Postoperative Complications/diagnostic imaging/etiology Pulmonary Embolism/etiology Quality of Life Randomized Controlled Trials as Topic Recurrence Reoperation Spinal Diseases/diagnostic imaging/*surgery Spinal Fractures/diagnostic imaging/*surgery Thoracic Vertebrae/diagnostic imaging/injuries/surgery Tomography, X-Ray Computed Treatment Outcome Vertebroplasty/*instrumentation/*methods LA - ger M1 - 4 N1 - PubMed NLM literature search January 5, 2021 OP - Osteoporosebedingte Wirbelkörperfrakturen. Kyphoplastie und Vertebroplastie vs. konservative Therapie. PY - 2010 SN - 0085-4530 SP - 417-24 ST - [Vertebral fractures due to osteoporosis. Kyphoplasty and vertebroplasty vs conservative treatment] T2 - Orthopade TI - [Vertebral fractures due to osteoporosis. Kyphoplasty and vertebroplasty vs conservative treatment] VL - 39 ID - 828813 ER - TY - JOUR AB - Vertebral compression fractures are among the most common forms of manifestations of osteoporosis. Conservative treatment comprises adequate analgesia, osteoporosis medication and individualized physiotherapy or braces. Nevertheless, vertebral compression fractures frequently lead to persisting pain and decrease daily activity and quality of life. In these cases, kyphoplasty and vertebroplasty can be efficient treatment options. Vertebroplasty is a minimally invasive procedure, in which bone cement is filled into the vertebral body under fluoroscopic control. In most cases, this internal stabilization leads to a rapid reduction in pain. Kyphoplasty additionally aims to correct the kyphotic deformation of the broken vertebra via introducing and inflating a balloon catheter. There is broad clinical experience with both procedures. For kyphoplasty, randomized controlled trials showed significant improvements in pain and quality of life in patients undergoing kyphoplasty. However, cement leakages lead to rare but severe complications such as pulmonary embolism and nerve palsies. © 2010 Springer-Verlag. AD - C.W. Müller, Abteilung Unfallchirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, Hannover, 30625, Germany AU - Müller, C. W. AU - Gösling, T. AU - Mameghani, A. AU - Stier, R. AU - Klein, M. AU - Hüfner, T. AU - Krettek, C. DB - Embase DO - 10.1007/s00132-009-1576-6 KW - cement bone cement kyphoplasty osteoporosis percutaneous vertebroplasty conservative treatment spine fracture pain quality of life compression fracture vertebra balloon catheter patient lung embolism nerve paralysis analgesia drug therapy physiotherapy brace minimally invasive procedure vertebra body randomized controlled trial LA - German M3 - Article in Press N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0085-4530 1433-0431 SP - 1-7 ST - Vertebral fractures due to osteoporosis - Kyphoplasty and vertebroplasty vs conservative treatment T2 - Orthopade TI - Vertebral fractures due to osteoporosis - Kyphoplasty and vertebroplasty vs conservative treatment UR - https://www.embase.com/search/results?subaction=viewrecord&id=L50834040&from=export http://dx.doi.org/10.1007/s00132-009-1576-6 ID - 829676 ER - TY - JOUR AB - OBJECTIVE AND IMPORTANCE: Benign osteoblastoma (OB) has a rather aggressive growth that potentially endangers adjacent structures as well as the spinal canal. There is little literature about OB of the second cervical vertebrae (C2) and its management. This is the first report of vertebroplasy of odontoid in a child with OB of the axis. CLINICAL PRESENTATION: An 11 y/o girl with painful torticolis, sudden onset of hemiparesis and a palpable posterior cervical mass showed at our E.R. Significant myelopathic findings and irregular breathing pattern were found on admission. A bone reconstructed CT scan showed a 3608 C2 tumor with markedly hypertrophy of dens and posterior elements. Ventral and posterior compression of the upper medulla was confirmed on MRI. INTERVENTION: Posterior dural decompression was performed a day after admission. The biopsy reported benign OB. On a second procedure, through an open anterior cervical approach and using real-time biplanar fluoroscopy, a 14 G needle was introduced at C5 level and advanced to the tip of the odontoid. Then, a vertebroplasty with polymethyl methacrylate and barium sulfate was carried out. A third procedure delivered cement to the posterior aspect of C2 as to “seal” the open stumps of the tumor containing vertebrae. At present, she has total motor recovery; no head rotation impairment and no tumor growth on an 18 month follow up. Posterior fixation wasn't needed. CONCLUSION: Until now, complete resection or curettage of osteoblastic lessions has been the standard. A tendency to embolize awkward placed spine bone tumors has been developed recently. Although anterior open cervical dens vertebroplasty have been performed on adult patients very few times, it is also a feassible procedure on a pediatric patient by which to achieve stability and deprive an osteoblastic tumor from irrigation. This is the first pediatric case description. AD - M. Munoz, Hospital Nacional de Niños Benjamin Bloom, San Salvador, El Salvador AU - Munoz, M. DB - Embase DO - 10.1093/neuonc/nos104 KW - cement barium sulfate poly(methyl methacrylate) human percutaneous vertebroplasty odontoid process patient osteoblastoma case report oncology neoplasm procedures female hypertrophy vertebral canal computer assisted tomography bone decompression breathing pattern vertebra follow up surgery spine bone tumor hemiparesis girl child head movement tumor growth needle fluoroscopy biopsy curettage cervical spine adult compression nuclear magnetic resonance imaging LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1522-8517 SP - i117 ST - Vertebroplasty of odontoid trough an anterior cervical aproach in a pediatric patient with a C2 osteoblastoma: A case report T2 - Neuro-Oncology TI - Vertebroplasty of odontoid trough an anterior cervical aproach in a pediatric patient with a C2 osteoblastoma: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70813814&from=export http://dx.doi.org/10.1093/neuonc/nos104 VL - 14 ID - 829564 ER - TY - JOUR AB - Pathological fractures caused by metastatic malignant disease have been the subject of increasing interest in recent years. This article describes our experience with the treatment of metastatic bone disease of the upper extremity and our attempt to clarify the indications for different surgical procedures. Of 53 patients with metastatic lesions to the upper extremity, 20 who had been surgically treated were analyzed retrospectively. These comprised 13 men and 7 women with a mean patient age of 62 years. The most common primary tumors to metastasize were lung and liver, with the humerus involved in 12 cases and the scapula and forearm in 4 cases each. Four patients with scapula and forearm involvement underwent tumor resection due to uncontrollable tumor size, while 3 were successfully treated by selective arterial embolization. Three metastases to the humeral head were reconstructed with endoprosthesis, but functional restriction was noted. Five cases with metastases to the humeral shaft were treated with tumor curettage, internal fixation using intramedullary nailing, adjuvant cryosurgery, and cementing. This achieved good results for pain relief and functional restoration with minimal complications. Two metastases to the humeral condyle were unable to be stabilized with plate and locking screws. Metastatic lesions to the scapula and forearm are commonly treated nonsurgically, but some patients with uncontrollable tumor mass require surgical resection. Endoprosthetic replacement is recommended if the lesion involves the humeral head or condyle. Most patients with the humeral shaft lesion are likely to benefit from tumor curettage, intramedullary nailing with locking screw, and cementing. AD - Department of Orthopedic Surgery, Yamaguchi University School of Medicine, Yamaguchi, Japan. AN - 21053874 AU - Muramatsu, K. AU - Ihara, K. AU - Iwanagaa, R. AU - Taguchi, T. DA - Nov 2 DO - 10.3928/01477447-20100924-29 DP - NLM ET - 2010/11/09 J2 - Orthopedics KW - Adult Aged Aged, 80 and over Algorithms Bone Neoplasms/complications/*secondary/*surgery Female Forearm/pathology Fractures, Bone/etiology/*surgery Humans Humerus/pathology Liver Neoplasms/pathology Lung Neoplasms/pathology Male Middle Aged Postoperative Complications Retrospective Studies Scapula/pathology Upper Extremity/*pathology LA - eng M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 0147-7447 SP - 807 ST - Treatment of metastatic bone lesions in the upper extremity: indications for surgery T2 - Orthopedics TI - Treatment of metastatic bone lesions in the upper extremity: indications for surgery VL - 33 ID - 829029 ER - TY - JOUR AB - Palliative care is an important aspect of treating patients with end stage malignant disease (ESMD). Interventional Radiologists are frequently consulted after standard palliative algorithms fail. The purpose of this study is to demonstrate successful utilization of cryoablation in palliative treatment of refractory pain in patients with ESMD. Methods: Retrospective study. 6 cases (5 patients) treated at UNMC from April, 2009 through January, 2011. M:F, 4:2. Mean age: 58.6 years. Age range: 28-81 years. Lesions treated: pathologic vertebral compression fractures (2 Ewing sarcoma metastases), pelvic mass with neural invasion (synovial sarcoma metastasis), pathologic iliac fracture (multiple myeloma), invasive chest wall mass (squamous cell lung carcinoma), and adrenal mass (lung adenocarcinoma metastasis). No exclusion criteria. All patients had pain refractory to, or were poor candidates for, standard palliative treatment algorithms. Cryoablation (Galil Medical, MN) applications included ablation of metastatic lesions (6), rhizotomies (2) and sacroiliac joint ablation (1). Cryoablation was used alone, or combined with other interventional pain therapies, including cement augmentation (3) and bland embolization (1). Other palliative therapies were continued, including opiates (6), NSAIDs (3) and radiation therapy (2). Complications were monitored. Visual Analogue Scale (VAS) of pain, and opiate requirement, was evaluated before and after procedure. Paired T-test used for statistical analysis. Results: VAS decreased from 8.0 ± 0.6 (SEM) to 0.8 ± 0.6 (p ≤ 0.001). All patients demonstrated decreased opiate requirements. Mean response duration: 9.0 ± 3.2 months. No major complications observed. Conclusion: Cryoablation, used alone or in combination with other interventional pain therapies, offers safe palliative therapeutic options for successful treatment of refractory pain in patients with ESMD. AD - N. Murdoch, University of Nebraska Medical Center, Department of Radiology, United States AU - Murdoch, N. AU - Goodrich, N. AU - Johnson, C. AU - Gordon, G. DB - Embase DO - 10.1111/j.1526-4637.2011.01225.x KW - opiate cement spine patient human pain cryoablation society palliative therapy metastasis algorithm therapy artificial embolization radiotherapy visual analog scale Student t test statistical analysis radiologist retrospective study compression fracture Ewing sarcoma connective tissue tumor synovial sarcoma fracture multiple myeloma thorax wall squamous cell lung carcinoma adrenal gland lung adenocarcinoma rhizotomy sacroiliac joint pelvis LA - English M1 - 9 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 1526-2375 SP - 1445 ST - Palliative cryoablation plays an important role in treating refractory pain in patients with end stage malignant disease T2 - Pain Medicine TI - Palliative cryoablation plays an important role in treating refractory pain in patients with end stage malignant disease UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70565767&from=export http://dx.doi.org/10.1111/j.1526-4637.2011.01225.x VL - 12 ID - 829611 ER - TY - JOUR AB - Little is known regarding the incidence of early postoperative pulmonary embolus (PE) following hip fracture surgery. Clinical suspicion of PE mandates therapeutic anticoagulation, adding a further insult to those of trauma and surgery in a physiologically frail population. The aim of the study was to evaluate for the presence of PEs by performing postoperative CT pulmonary angiography (CTPA) in patients who demonstrated intraoperative, or early postoperative cardiorespiratory lability following surgery with a cemented prosthesis for intracapsular hip fracture.~Purpose~Objective~All patients undergoing cemented hemiarthroplasty for displaced intracapsular neck of femur fracture were recruited during a 6-month period, and signed consent obtained from the patient or their next of kin for CTPA in the event of any cardiorespiratory instability. Patient demographics, comorbidities were reviewed, and premorbid mobility status documented.~Methods~Methods~18 of the 66 patients in the study having cemented hemiarthropalsty demonstrated intra- or early postoperative lability, all had early postoperative CTPA scans. 6 of the 18 were noted to have PE. All had more than 1 risk factor for VTE on admission (excluding their injury). Patients diagnosed with PE had a higher ASA grade, and lower mobility scores than those who did not have a PE.~Results~Results~Clinical suspicion alone is inadequate to diagnosis PE in patients undergoing cemented hip arthroplasty. Only 1 in 3 patients suspected of PE on account of intraoperative or immediate postoperative cardiorespiratory lability was found to have a PE based on CTPA. Early postoperative CTPA is helpful to prevent unnecessary anticoagulation for suspected PE.~Conclusions~Conclusions AD - Department of Orthopaedics, St. Vincent's University Hospital, Dublin - Ireland Department of Radiology, St. Vincent's University Hospital, Dublin - Ireland AN - 116655855. Language: English. Entry Date: 20160712. Revision Date: 20190723. Publication Type: Article AU - Murphy, Colin G. AU - Moran, Deirdre E. AU - Gerstenmaier, Jan F. AU - Bruce-Brand, Rob AU - O'Toole, Gary C. AU - O'Rourke, S. Kieran AU - Heffernan, Eric J. DB - cin20 DO - 10.5301/hipint.5000341 DP - EBSCOhost KW - Pulmonary Embolism -- Epidemiology Hemiarthroplasty Hip Fractures -- Surgery Pulmonary Embolism -- Diagnosis Incidence Postoperative Period Tomography, X-Ray Computed -- Methods Angiography Pulmonary Embolism -- Risk Factors Clinical Assessment Tools Prospective Studies Aged Aged, 80 and Over Female Male Human M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2016 SN - 1120-7000 SP - 295-300 ST - Evaluation of the incidence of pulmonary embolus in the early postoperative period following cemented hemiarthroplasty T2 - Hip International TI - Evaluation of the incidence of pulmonary embolus in the early postoperative period following cemented hemiarthroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=116655855&site=ehost-live&scope=site VL - 26 ID - 830592 ER - TY - JOUR AB - We report a case of a pseudoaneurysm of the medial circumflex femoral artery that presented 4 months following cementless left total hip arthroplasty (THA). A successful embolization was achieved using super-selective catheterization and coil embolization. Arterial complications associated with THA are remarkably rare. Endovascular techniques have been shown to be effective and are considered a valid alternative to conventional surgery. AD - [Mutlu, Serhat] Kanuni Sultan Suleyman Training & Res Hosp, Dept Orthoped & Traumatol, Istanbul, Turkey. [Guler, Olcay; Mahirogullari, Mahir] Istanbul Medipol Univ, Fac Med, Dept Orthoped & Traumatol, TR-34083 Istanbul, Turkey. [Ucar, Adem] Istanbul Univ, Istanbul Fac Med, Dept Radiol, Istanbul, Turkey. Mahirogullari, M (corresponding author), Istanbul Medipol Univ, Ataturk Bulvari 27, TR-34083 Istanbul, Turkey. mahirogullari@yahoo.com AN - WOS:000335199600019 AU - Mutlu, S. AU - Guler, O. AU - Ucar, A. AU - Mahirogullari, M. DA - Jan-Feb DO - 10.3944/aott.2014.3000 J2 - Acta Orthop. Traumatol. Turc. KW - Aneurysm coil embolization femoral artery total hip replacement vascular complication EXTERNAL ILIAC ARTERY FALSE ANEURYSM ENDOPROSTHESIS REPLACEMENT SURGERY INJURY Orthopedics LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2014 SN - 1017-995X SP - 106-108 ST - An unusual complication following total hip arthroplasty: median circumflex femoral artery pseudoaneurysm T2 - Acta Orthopaedica Et Traumatologica Turcica TI - An unusual complication following total hip arthroplasty: median circumflex femoral artery pseudoaneurysm UR - ://WOS:000335199600019 VL - 48 ID - 830271 ER - TY - JOUR AB - We report a case of a pseudoaneurysm of the medial circumflex femoral artery that presented 4 months following cementless left total hip arthroplasty (THA). A successful embolization was achieved using super-selective catheterization and coil embolization. Arterial complications associated with THA are remarkably rare. Endovascular techniques have been shown to be effective and are considered a valid alternative to conventional surgery. © 2014 Turkish Association of Orthopaedics and Traumatology. AD - M. Mahiroǧullari AU - Mutlu, S. AU - Güler, O. AU - Uçar, A. AU - Mahiroǧullari, M. DB - Medline DO - 10.3944/AOTT.2014.3000 KW - aged article artificial embolization case report endovascular surgery false aneurysm femoral artery hip arthroplasty human male methodology nuclear magnetic resonance imaging LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1017-995X SP - 106-108 ST - An unusual complication following total hip arthroplasty: Median circumflex femoral artery pseudoaneurysm T2 - Acta Orthopaedica et Traumatologica Turcica TI - An unusual complication following total hip arthroplasty: Median circumflex femoral artery pseudoaneurysm UR - https://www.embase.com/search/results?subaction=viewrecord&id=L1372660845&from=export http://dx.doi.org/10.3944/AOTT.2014.3000 VL - 48 ID - 829431 ER - TY - JOUR AB - We report a case of a pseudoaneurysm of the medial circumflex femoral artery that presented 4 months following cementless left total hip arthroplasty (THA). A successful embolization was achieved using super-selective catheterization and coil embolization. Arterial complications associated with THA are remarkably rare. Endovascular techniques have been shown to be effective and are considered a valid alternative to conventional surgery. AD - Department of Orthopedics and Traumatology, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey. Department of Orthopedics and Traumatology, İstanbul Medipol University Faculty of Medicine, İstanbul, Turkey. Department of Radiology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey. AN - 24643110 AU - Mutlu, S. AU - Güler, O. AU - Uçar, A. AU - Mahiroğulları, M. DO - 10.3944/aott.2014.3000 DP - NLM ET - 2014/03/20 J2 - Acta orthopaedica et traumatologica turcica KW - Aged Aneurysm, False/*etiology/therapy Arthroplasty, Replacement, Hip/*adverse effects Embolization, Therapeutic/methods Endovascular Procedures *Femoral Artery Humans Magnetic Resonance Imaging Male LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1017-995x SP - 106-8 ST - An unusual complication following total hip arthroplasty: median circumflex femoral artery pseudoaneurysm T2 - Acta Orthop Traumatol Turc TI - An unusual complication following total hip arthroplasty: median circumflex femoral artery pseudoaneurysm VL - 48 ID - 828971 ER - TY - JOUR AB - Osteoporosis is a common disease and is constantly increasing due to the rising average age of the human race. Many different treatments have been advocated to curb the effects of osteoporosis, but the current rate of vertebral collapse or back pain from osteoporosis remains high. Vertebroplasty is a percutaneous treatment for vertebral fractures and microfractures caused by osteoporosis, but can also be applied in the non-surgical and non -radiological treatment of painful or compressive osteo-angiomas and vertebral metastases. The technique consists of injecting acrylic cement into the vertebral bodies to stabilize and strengthen them and relieve pain. Vertebroplasty also leads to decompression of the dural sac and spinal cord in the case of painful or compressive osteo-angiomas. The treatment must be carried out under CT and/or fluoroscopic guidance using 8 or 11 G needles with a transpeduncular or trans-somatic approach, positioning the needle in the anterior III of the vertebral bodies. The cement is injected under fluoroscopic guidance in L-L view to have perfect control of the cement (made opaque by addition of sterile barium sulphate or other radio-opaque substances like tantalum) and to be sure to have an excellent control of the posterior wall which should never be penetrated during the injection. X-ray and CT follow-up show total or subtotal filling of the vertebral body and patients can be discharged 24 h after treatment. Side effects include epidural diffusion of the cement with secondary compression on the anterior CSF band and possible cord compression or even pulmonary embolism. AD - M. Muto, U.O. Neuroradiologia, AORN Cardarelli, via Cardarelli 9, 80131 Napoli, Italy AU - Muto, M. DB - Embase DO - 10.1177/197140090201500413 KW - barium sulfate bone cement contrast medium analgesia angioma computer assisted tomography conference paper decompression fluoroscopy follow up human injection interventional radiology lung embolism needle osteoporosis percutaneous vertebroplasty spinal cord compression spine metastasis spine radiography spine stabilization procedures vertebra body spine fracture X ray LA - Italian M1 - 4 M3 - Conference Paper N1 - Embase Elsevier literature search January 5, 2021 PY - 2002 SN - 1120-9976 SP - 439-444 ST - Vertebroplasty in osteoporosis disease T2 - Rivista di Neuroradiologia TI - Vertebroplasty in osteoporosis disease UR - https://www.embase.com/search/results?subaction=viewrecord&id=L36432963&from=export http://dx.doi.org/10.1177/197140090201500413 VL - 15 ID - 829867 ER - TY - JOUR AB - PURPOSE: The aim of this study is to show the utility of vertebroplasty in the treatment of some types of back pain. Vertebroplasty is a venous embolisation of the vertebral body performed under computed tomography (CT) or fluoroscopy guidance with transpedicular, anterolateral, intercostovertebral or posterolateral approach with acrylic cement. MATERIALS AND METHODS: We report our experience in 85 patients suffering from low back and thoracic pain and treated with percutaneous vertebroplasty owing to osteoporotic vertebral compression fractures, vertebral haemangiomas or secondary lytic lesions of the spine. Patient selection was performed on the basis of physical examination, magnetic resonance or less frequently, with bone scan. CT has a minor role in selected cases to evaluate the integrity of the posterior wall. We treated 55 patients affected by acute osteoporotic vertebral compression fracture, 10 patients with vertebral haemangioma and 20 patients with metastatic lesions. The patients were placed in the prone position and the procedure was performed under fluoroscopy guidance in 80 patients and under CT guidance in 5 patients affected by metastatic lesions. In no cases was phlebography performed before the treatment. The approach adopted was bilateral in 45 patients and unilateral in the remaining 30 cases. Injection with a low viscosity cement was performed under fluoroscopy guidance with extreme precision in all cases. The amount of cement injected ranged from 4 ml (thoracic level) up to 12 ml (lumbar level). RESULTS: The results were better for osteoporotic cases (95%) and patients with vertebral haemangioma (90%) than with metastatic lesions (77%), with improvement within 24-72 hours after the treatment. We noted asymptomatic cement leakage in 39 cases but only in 2 cases was there an acute radiculopathy due to epidural cement leakage, which was treated and resolved medically in 1 month. At follow-up no cases were noted of fractures of vertebral bodies adjacent to the treated vertebrae. DISCUSSION AND CONCLUSIONS: Since the first case of vertebroplasty was used in vertebral haemangioma, the possibility of using this technique in other pathological conditions such as metastatic lesions and osteoporotic compression fractures has been clear. MR has a key role in the selection of patients while bone scan and CT can be useful in selected cases. Absolute controindication is local or systemic infection while relative controindications are epidural extension of the neoplastic lesion, vertebra plana, clinical signs of myelopathy or radiculopathy and coagulation disorders. The results of our study were better in patients treated for osteoporosis or haemangioma than in cancer patients. We consider percutaneous vertebroplasty a valid technique for the treatment of the pain due to osteoporotic compression fractures, vertebral haemangiomas or metastatic lesions. AD - U. O. di Neuroradiologia, AORN Cardarelli, Naples. mutomar@tiscali.it AN - 15775889 AU - Muto, M. AU - Muto, E. AU - Izzo, R. AU - Diano, A. A. AU - Lavanga, A. AU - Di Furia, U. DA - Mar DP - NLM ET - 2005/03/19 J2 - La Radiologia medica KW - Back Pain/*surgery Bone Cements/*therapeutic use Contraindications Extravasation of Diagnostic and Therapeutic Materials/etiology Fluoroscopy Follow-Up Studies Hemangioma/surgery Humans Lumbar Vertebrae/*surgery Orthopedic Procedures/methods Osteoporosis/surgery Polymethyl Methacrylate/therapeutic use Prone Position Radiography, Interventional/methods Spinal Diseases/*surgery Spinal Fractures/surgery Spinal Neoplasms/secondary/surgery Thoracic Vertebrae/*surgery Tomography, X-Ray Computed/methods Treatment Outcome LA - eng ita M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2005 SN - 0033-8362 (Print) 0033-8362 SP - 208-19 ST - Vertebroplasty in the treatment of back pain T2 - Radiol Med TI - Vertebroplasty in the treatment of back pain VL - 109 ID - 828752 ER - TY - JOUR AB - This paper aims to compare vertebroplasty and kyphoplasty by illustrating the two techniques, analysing the results and discussing the indications in relation to the type of fracture. Vertebroplasty was performed on 805 vertebral bodies in 485 patients affected by osteoporosis (310), metastasis (160) and vertebral haemangioma (15). The approach was unipedicular in 365 patients and bipedicular in 120 patients. Biopsies were obtained in patients with no known primary cancer (75). Kyphoplasty was performed in 39 patients with Magerl type A1 and A3 fractures within 3 months from the trauma. A bipedicular approach was used in all cases. Outcomes were assessed on the basis of the visual analogue scale and the Oswestry Disability Index. In patients treated with vertebroplasty, success rates at 24-72 h were 90% for osteoporotic fractures, 100% for vertebral haemangiomas and 77% for metastatic fractures. Extravertebral vascular or discal leakage of cement occurred in 39 patients, but only two of them reported radicular pain due to epidural involvement. Osteoporotic patients developed new vertebral fractures at adjacent levels in 25 cases and at distal levels in 19 cases. In patients treated with kyphoplasty, pain relief was achieved within one month after treatment in 90% of cases. None of the patients wore orthotic braces after treatment, and no vertebral collapse was observed. Vertebroplasty and kyphoplasty are both useful in the management of vertebral pain. In light of our experience, vertebroplasty is better indicated for vertebral fractures due to osteoporosis, haemangioma or metastasis on account of its simplicity and minimal invasiveness. Kyphoplasty is suggested in acute traumatic fractures of type A1 and A3 according to Magerl, as it allows recovery of vertebral stability and a better distribution of the cement. AD - [Muto, M.; Guarnieri, G.; Lavanga, A.; Vassallo, P.] AORNA Cardarelli, UOC Neuroradiol, I-80100 Naples, Italy. [Perrotta, V.; Reginelli, R.; Rotondo, A.] Univ Naples 2, Cattedra Radiol, Naples, Italy. Muto, M (corresponding author), AORNA Cardarelli, UOC Neuroradiol, Via Cardarelli, I-80100 Naples, Italy. mutomar@tiscali.it AN - WOS:000262701000008 AU - Muto, M. AU - Perrotta, V. AU - Guarnieri, G. AU - Lavanga, A. AU - Vassallo, P. AU - Reginelli, R. AU - Rotondo, A. DA - Dec DO - 10.1007/s11547-008-0301-6 J2 - Radiol. Med. KW - Vertebral fractures Vertebroplasty Kyphoplasty VERTEBRAL COMPRESSION FRACTURES PERCUTANEOUS TRANSPEDICULAR VERTEBROPLASTY BALLOON KYPHOPLASTY BODY FRACTURE FAT-EMBOLISM FOLLOW-UP CEMENT HEIGHT OSTEOPOROSIS POLYMETHYLMETHACRYLATE Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 8 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2008 SN - 0033-8362 SP - 1171-1184 ST - Vertebroplasty and kyphoplasty: friends or foes? T2 - Radiologia Medica TI - Vertebroplasty and kyphoplasty: friends or foes? UR - ://WOS:000262701000008 VL - 113 ID - 830367 ER - TY - JOUR AB - Aim: To compare the efficacy and safety of cemented and uncemented hemiarthroplasty in elderly patients with femoral neck fracture.Materials and Methods: We searched PubMed, EMBASE, and Cochrane Library databases for published randomized clinical trials comparing cemented hemiarthroplasty with uncemented hemiarthroplasty in elderly patients with a femoral neck fracture. The search was not limited to language, time, or other factors. The quality of each study was assessed using the revised Jadad scale. Two researchers independently extracted data from all selected studies, including the following base line data: study period, fracture stage, number of patients, male female ratio, average age, and per-protocol (PP) or intent-to-treat (ITT), and the interest outcomes: the mortality at 12 months, operative time, hospital stay, common complications, prosthetic-related complications, blood loss and Harris Hip Score (HHS). Fixed-effects or random-effects models with mean differences and odds ratios were used to pool the continuous and dichotomous variables to determine heterogeneity of the included studies.Results: A total of 8 studies involving 1577 hips (782 uncemented and 795 cemented) were included in this meta-analysis. The meta-analysis is indicated that the operation time of cemented hemiarthroplasty was longer than uncemented hemiarthroplasty and there was statistical significance between two groups (OR = -7.30, 95%CI, -13.13, -1.46; P = .01). However, there was no significant difference between the two methods of fixation in mortality at 12 months (OR = 1.22, 95%CI, 0.94-1.59; P = .14), hospital stay (OR = 0.26, 95%CI, -0.41, 0.93; P = .44), blood loss (OR = -17.94, 95%CI, -65.83, 29.95; P = .46), and HHS score. There were significant differences in the common complications of pulmonary embolism between the two groups, but there were no differences in the other five common complications. The results showed that uncemented hemiarthroplasty could reduce the incidence of pulmonary embolism after operation. Moreover, the outcomes of prosthetic-related complications showed that there were significant differences between the two groups in periprosthetic fracture (OR = 8.32, 95%CI, 3.85-17.98; P < .00001) and prosthetic subsidence and loosening (OR = 5.33, 95%CI, 2.18-13.00; P = .0002).Conclusions: Our study shows that uncemented prosthesis can shorten the operation time and reduce the incidence of pulmonary embolism, but it does not reduce mortality, blood loss, and hospital stay. Most importantly, the incidence of prosthetic-related complications was higher in uncemented patients. AD - Department of Orthopedics, The Second Hospital of Jilin University Center for Applied Statistical Research and College of Mathematics, Jilin University Department of Pediatrics, The First Hospital of Jilin University, Changchun, Jilin, China AN - 143885286. Language: English. Entry Date: 20200625. Revision Date: 20200625. Publication Type: journal article AU - Na, Li AU - Lei, Zhong AU - Chang, Wang AU - Meng, Xu AU - Wei, Li AU - Li, Na AU - Zhong, Lei AU - Wang, Chang AU - Xu, Meng AU - Li, Wei DB - cin20 DO - 10.1097/MD.0000000000019039 DP - EBSCOhost KW - Hip Fractures -- Surgery Postoperative Complications -- Epidemiology Hemiarthroplasty -- Trends Bone Cements -- Adverse Effects Pulmonary Embolism -- Epidemiology Blood Loss, Surgical Hip Fractures -- Mortality Joint Prosthesis -- Adverse Effects Male Aged Hemiarthroplasty -- Methods Aged, 80 and Over Human Length of Stay -- Statistics and Numerical Data Incidence Clinical Trials Hemiarthroplasty -- Mortality Female Meta Analysis Validation Studies Comparative Studies Evaluation Research Multicenter Studies Clinical Assessment Tools Scales M1 - 8 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2020 SN - 0025-7974 SP - 1-10 ST - Cemented versus uncemented hemi-arthroplasty for femoral neck fractures in elderly patients: A systematic review and meta-analysis of randomized controlled trials T2 - Medicine TI - Cemented versus uncemented hemi-arthroplasty for femoral neck fractures in elderly patients: A systematic review and meta-analysis of randomized controlled trials UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=143885286&site=ehost-live&scope=site VL - 99 ID - 830516 ER - TY - JOUR AB - Vertebroplasty provides excellent pain relief and functional restoration for osteoporotic fractures. Short-term complications such as cement leak and embolism are well described. Incident fractures are the only well-reported long-term complications. The authors describe the cases of 5 patients who presented with back pain caused by instability or worsening neurological status 13 months (range 8-17 months) after vertebroplasty. They further classify this postvertebroplasty instability into intervertebral instability and intravertebral instability, depending on the apex of abnormal mobility. One patient presented with cement migration and progressive collapse of the augmented vertebral body. Another patient presented with an additional fracture. Both cases were classified as intravertebral instability. The cases of 3 other patients presenting with adjacent endplate erosion, vacuum disc phenomenon, and bridging osteophyte formation were classified as having intervertebral instability. Long-term effect of cements on the augmented vertebral body and adjacent endplates and discs is a cause for concern. Vertebroplasty acts as a mechanical stabilizer and provides structural support but does not bring about union. Micromotion has been shown to persist for years after vertebroplasty. This study describes persistent instability after vertebroplasty in a series of 5 cases. The authors propose that postvertebroplasty instability occurs due to collapse of soft osteoporotic bone and endplates around cement. All 3 cases of intervertebral instability were associated with an intradiscal cement leak. With increased longevity and higher functional demands of the geriatric population, the durability of this "rock (cement) between cushions (of osteoporotic bone)" arrangement (as seen in vertebroplasty) will be increasingly challenged. AD - Division of Spine Surgery, Department of Orthopaedics, P. D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, India. AN - 22225486 AU - Nagad, P. AU - Rawall, S. AU - Kundnani, V. AU - Mohan, K. AU - Patil, S. S. AU - Nene, A. DA - Apr DO - 10.3171/2011.12.spine11671 DP - NLM ET - 2012/01/10 J2 - Journal of neurosurgery. Spine KW - Aged Back Pain/diagnostic imaging/*etiology/surgery Decompression, Surgical Female Follow-Up Studies Humans Joint Instability/diagnostic imaging/*etiology/surgery Lumbar Vertebrae/diagnostic imaging/*surgery Middle Aged *Neurologic Examination Osteoporotic Fractures/diagnostic imaging/*surgery Pain, Postoperative/diagnostic imaging/etiology Postoperative Complications/diagnostic imaging/*etiology/surgery Reoperation Spinal Cord Compression/diagnostic imaging/etiology/surgery Spinal Fractures/etiology/*surgery Spinal Fusion Thoracic Vertebrae/diagnostic imaging/*surgery Tomography, X-Ray Computed Vertebroplasty/*adverse effects *Zygapophyseal Joint LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 1547-5646 SP - 387-93 ST - Postvertebroplasty instability T2 - J Neurosurg Spine TI - Postvertebroplasty instability VL - 16 ID - 828664 ER - TY - JOUR AB - Vertebroplasty provides excellent pain relief and functional restoration for osteoporotic fractures. Short-term complications such as cement leak and embolism are well described. Incident fractures are the only well-reported long-term complications. The authors describe the cases of 5 patients who presented with back pain caused by instability or worsening neurological status 13 months (range 8-17 months) after vertebroplasty. They further classify this postvertebroplasty instability into intervertebral instability and intravertebral instability, depending on the apex of abnormal mobility. One patient presented with cement migration and progressive collapse of the augmented vertebral body. Another patient presented with an additional fracture. Both cases were classified as intravertebral instability. The cases of 3 other patients presenting with adjacent endplate erosion, vacuum disc phenomenon, and bridging osteophyte formation were classified as having intervertebral instability. Long-term effect of cements on the augmented vertebral body and adjacent endplates and discs is a cause for concern. Vertebroplasty acts as a mechanical stabilizer and provides structural support but does not bring about union. Micromotion has been shown to persist for years after vertebroplasty. This study describes persistent instability after vertebroplasty in a series of 5 cases. The authors propose that postvertebroplasty instability occurs due to collapse of soft osteoporotic bone and endplates around cement. All 3 cases of intervertebral instability were associated with an intradiscal cement leak. With increased longevity and higher functional demands of the geriatric population, the durability of this "rock (cement) between cushions (of osteoporotic bone)" arrangement (as seen in vertebroplasty) will be increasingly challenged. AD - S. Rawall, Spine Clinic, P. D. Hinduja National Hospital, Veer Savarkar Marg, Mahim, Mumbai, 400016, India AU - Nagad, P. AU - Rawall, S. AU - Kundnani, V. AU - Mohan, K. AU - Patil, S. S. AU - Nene, A. DB - Embase Medline DO - 10.3171/2011.12.SPINE11671 KW - bone cement adult aged article backache bone erosion clinical article diabetes mellitus disease exacerbation female geriatric patient human hypertension hypothyroidism limb weakness longevity nuclear magnetic resonance imaging osteophyte osteoporosis paraplegia percutaneous vertebroplasty physiotherapy spine instability spine radiography vertebra body spine fracture L1 - Http://thejns.org/doi/pdf/10.3171/2011.12.spine11671 LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1547-5654 1547-5646 SP - 387-393 ST - Postvertebroplasty instability: Report of 5 cases T2 - Journal of Neurosurgery: Spine TI - Postvertebroplasty instability: Report of 5 cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L364597850&from=export http://dx.doi.org/10.3171/2011.12.SPINE11671 VL - 16 ID - 829573 ER - TY - JOUR AB - Vertebroplasty provides excellent pain relief and functional restoration for osteoporotic fractures. Short-term complications such as cement leak and embolism are well described. Incident fractures are the only well-reported long-term complications. The authors describe the cases of 5 patients who presented with back pain caused by instability or worsening neurological status 13 months (range 8-17 months) after vertebroplasty. They further classify this postvertebroplasty instability into intervertebral instability and intravertebral instability, depending on the apex of abnormal mobility. One patient presented with cement migration and progressive collapse of the augmented vertebral body. Another patient presented with an additional fracture. Both cases were classified as intravertebral instability. The cases of 3 other patients presenting with adjacent endplate erosion, vacuum disc phenomenon, and bridging osteophyte formation were classified as having intervertebral instability. Long-term effect of cements on the augmented vertebral body and adjacent endplates and discs is a cause for concern. Vertebroplasty acts as a mechanical stabilizer and provides structural support but does not bring about union. Micromotion has been shown to persist for years after vertebroplasty. This study describes persistent instability after vertebroplasty in a series of 5 cases. The authors propose that postvertebroplasty instability occurs due to collapse of soft osteoporotic bone and endplates around cement. All 3 cases of intervertebral instability were associated with an intradiscal cement leak. With increased longevity and higher functional demands of the geriatric population, the durability of this "rock (cement) between cushions (of osteoporotic bone)" arrangement (as seen in vertebroplasty) will be increasingly challenged. AD - Division of Spine Surgery, Department of Orthopaedics, P. D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim, India Division of Spine Surgery, Department of Orthopaedics, P. D. Hinduja National Hospital and Medical Research Centre, Veer Savarkar Marg, Mahim; and. AN - 108173882. Language: English. Entry Date: 20120601. Revision Date: 20170411. Publication Type: journal article AU - Nagad, P. AU - Rawall, S. AU - Kundnani, V. AU - Mohan, K. AU - Patil, S. S. AU - Nene, A. AU - Nagad, Premik AU - Rawall, Saurabh AU - Kundnani, Vishal AU - Mohan, Kapil AU - Patil, Sanganagouda S. AU - Nene, Abhay DB - cin20 DO - 10.3171/2011.12.SPINE11671 DP - EBSCOhost KW - Back Pain -- Etiology Joint Instability -- Etiology Joints Kyphoplasty -- Adverse Effects Lumbar Vertebrae -- Surgery Neurologic Examination Osteoporosis -- Complications Postoperative Complications -- Etiology Spinal Fractures -- Surgery Thoracic Vertebrae -- Surgery Aged Back Pain -- Radiography Back Pain -- Surgery Decompression, Surgical Female Human Joint Instability -- Radiography Joint Instability -- Surgery Lumbar Vertebrae -- Radiography Middle Age Postoperative Complications -- Radiography Postoperative Complications -- Surgery Postoperative Pain -- Etiology Postoperative Pain -- Radiography Prospective Studies Reoperation Spinal Cord Compression -- Etiology Spinal Cord Compression -- Radiography Spinal Cord Compression -- Surgery Spinal Fractures -- Etiology Spinal Fusion Thoracic Vertebrae -- Radiography Tomography, X-Ray Computed M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2012 SN - 1547-5654 SP - 387-393 ST - Postvertebroplasty instability T2 - Journal of Neurosurgery: Spine TI - Postvertebroplasty instability UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=108173882&site=ehost-live&scope=site VL - 16 ID - 830682 ER - TY - JOUR AB - INTRODUCTION: Polymethylmethacrylate (PMMA) cement is useful for spinal reconstruction, but can cause complications including new vertebral fractures, neurological disorders and pulmonary embolism. We report a case in PMMA cement used for spinal reconstruction after tumor curettage dislodged and penetrated the gastrointestinal tract. DIAGNOSES: The patient was diagnosed with a retroperitoneal extragonadal germ cell tumor at age 27 years. After chemotherapy and tumor resection, the tumor remained. It gradually increased in size and infiltrated lumbosacral vertebrae, causing him to present at age 35 years with increased low back pain. Image findings showed bone destruction in the vertebral bodies accompanied by neoplastic lesions. The left and right common iliac arteries and inferior vena cava were enclosed in the tumor on the anterior side of the vertebral bodies. Lumbosacral bone tumor due to direct extragonadal germ cell tumor infiltration was diagnosed. A 2-step operation was planned; first, fixation of the posterior side of the vertebral bodies, followed by tumor resection using an anterior transperitoneal approach, and spinal reconstruction using PMMA cement. After surgery, the PMMA cement gradually dislodged towards the anterior side and, 2 years 9 months after surgery, it had penetrated the retroperitoneum. The patient subsequently developed nausea and abdominal pain and was readmitted to hospital. The diagnosis was intestinal blockage with dislodged PMMA cement, and an operation was performed to remove the cement present in the small intestine. There was strong intra-abdominal adhesion, the peritoneum between the vertebral bodies and intestine could not be identified, and no additional treatment for vertebral body defects could be performed. After surgery, gastrointestinal symptoms resolved. CONCLUSION: Although this was a rare case, when using bone cement for vertebral body reconstruction, the way of anchoring for the cement must be thoroughly planned to assure no cement dislodgement can occur. AD - aDepartment of Orthopaedics bDepartment of Rehabilitation Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan cDepartment of Spinal Surgery, Rakuwakai Marutamachi Hospital, Kyoto, Japan.. AN - 27759653 AU - Nagae, M. AU - Mikami, Y. AU - Mizuno, K. AU - Harada, T. AU - Ikeda, T. AU - Tonomura, H. AU - Takatori, R. AU - Fujiwara, H. AU - Kubo, T. C2 - Pmc5079337 DA - Oct DO - 10.1097/md.0000000000005178 DP - NLM ET - 2016/10/21 J2 - Medicine KW - Adult Bone Cements/*adverse effects Digestive System Surgical Procedures/methods Follow-Up Studies Foreign-Body Migration/*diagnosis/etiology/surgery Humans *Intestine, Small *Lumbar Vertebrae Magnetic Resonance Imaging Male Radiography, Abdominal Spinal Neoplasms/diagnosis/*surgery Vertebroplasty/*adverse effects LA - eng M1 - 42 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 0025-7974 (Print) 0025-7974 SP - e5178 ST - Dislodgement and gastrointestinal tract penetration of bone cement used for spinal reconstruction after lumbosacral vertebral tumor excision: A case report T2 - Medicine (Baltimore) TI - Dislodgement and gastrointestinal tract penetration of bone cement used for spinal reconstruction after lumbosacral vertebral tumor excision: A case report VL - 95 ID - 828666 ER - TY - JOUR AB - Background: Hemangiomas are benign vascular tumors associated with proliferation of blood vessels in bone or soft tissue and they are usually incidental findings in vertebrae. When symptomatic, they present with features of radiculopathy, myelopathy, or vertebral fractures. Treatment options are varied, include sole embolization, embolization combined with surgical excision, surgical excision alone, percutaneous ablation, and radiotherapy. We hereby describe a series of seven cases of symptomatic vertebral hemangiomas operated from 2006 to 2009. Materials and Methods: Their clinical and radiological profile and outcome have been described. All patients were subjected to surgical excision followed by instrumentation. Outcome was assessed at a followup of 2 years following surgery with Frankel grading system. Results: Seven patients (five females and two males) were included in the study. The mean age was 33.85 years with the mean duration of symptoms of 12 months. All seven cases were symptomatic vertebral hemangiomas with cord compression and underwent surgical excision. Preoperatively, patients with poor Frankel grade such as A and B improved postoperatively to C, D, or E. Conclusion: Surgical excision of these lesions is difficult due to the tremendous amount of intraoperative bleeding. During surgery, brisk bleeding is usually encountered, but can be brought under control with adequate preoperative preparation and expertize. Preoperative embolization may help to reduce the bleeding, but at times it may be difficult to do if vertebrae are replaced by a solid hard mass. In spite of the risks associated with surgery, it still is the treatment of choice as a single intervention, especially in aggressive vertebral hemangiomas. AD - [Kumar, Raj] SGPGIMS, Dept Neurosurg, Ctr Trauma, Lucknow 14, Uttar Pradesh, India. Kumar, R (corresponding author), SGPGIMS, Dept Neurosurg, Ctr Trauma, Lucknow 14, Uttar Pradesh, India. rajkumar1959@gmail.com AN - WOS:000309599000007 AU - Nair, A. P. AU - Kumar, R. AU - Srivastav, A. K. AU - Sahu, R. N. AU - Kumar, B. DA - Sep-Oct DO - 10.4103/0019-5413.101033 J2 - Indian J. Orthop. KW - Hemangioma myelopathy spinal extradural compressive myelopathy spinal hemangioma SPINAL-CORD COMPRESSION PERCUTANEOUS CATHETER EMBOLIZATION RELIEF VERTEBROPLASTY MANAGEMENT ETHANOL ALCOHOL Orthopedics LA - English M1 - 5 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2012 SN - 0019-5413 SP - 536-541 ST - Outcome of dorsolumbar vertebral hemangiomas presenting with neuraxial compression T2 - Indian Journal of Orthopaedics TI - Outcome of dorsolumbar vertebral hemangiomas presenting with neuraxial compression UR - ://WOS:000309599000007 VL - 46 ID - 830298 ER - TY - JOUR AB - To describe the surgical experience of spondylectomy and spinal reconstruction for aggressive vertebral hemangioma (VH) induced at the C4 vertebra. No reports have described surgical strategy in cases covering an entire cervical vertebra presenting with progressive myelopathy. Methods A 28-year-old man presented with rapidly progressing skilled motor dysfunction and gait disorder. The Japanese Orthopedic Association (JOA) score was 6. Radiography showed a honeycomb appearance for the entire circumference of the C4 vertebra. Spinal computed tomography and magnetic resonance imaging showed vertebral tumor with extraosseous extension causing spinal cord compression. Results of diagnostic imaging were strongly suggestive of VH. Transarterial embolization of the spinal body branch was performed first to decrease intraoperative bleeding, followed by cervical posterior fixation to stabilize the unstable segment and excision biopsy to obtain a definitive diagnosis. After definitive diagnosis of cavernous hemangioma, two-stage surgery (anterior and posterior) was performed to complete total spondylectomy and 360 degrees spinal reconstruction. Results Despite multiple operations, JOA scores were 8.5 after posterior fixation, 10.5 after anterior surgery, 11 after final surgery and 16 on postoperative day 90. The patient acquired excellent clinical results without complications and returned to society. Conclusions The present three-stage surgery comprising fixation, biopsy, and final spondylectomy with circumferential fusion from anterior and posterior approaches may offer a useful choice for aggressive VH covering the entire cervical spine with rapidly progressive myelopathy. AD - [Nakahara, Masayuki] Fukuoka Wajiro Hosp, Dept Spinal Surg, Higashi Ku, 2-75 Wajirogaoka, Fukuoka, Fukuoka 8110213, Japan. [Harada, Kei] Fukuoka Wajiro Hosp, Dept Neuro Surg, Fukuoka, Japan. [Nishida, Kenki; Kumamoto, Shinji; Hijikata, Yasukazu] Shinkomonji Hosp, Dept Spinal Surg, Fukuoka, Japan. Nakahara, M (corresponding author), Fukuoka Wajiro Hosp, Dept Spinal Surg, Higashi Ku, 2-75 Wajirogaoka, Fukuoka, Fukuoka 8110213, Japan. n-masayuki@hotmail.com AN - WOS:000405718300012 AU - Nakahara, M. AU - Nishida, K. AU - Kumamoto, S. AU - Hijikata, Y. AU - Harada, K. DA - May DO - 10.1007/s00586-016-4765-0 J2 - Eur. Spine J. KW - Aggressive hemangioma Cervical spine Spondylectomy Spinal reconstruction NATURAL-HISTORY FOLLOW-UP MANAGEMENT VERTEBROPLASTY DIAGNOSIS Clinical Neurology Orthopedics LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2017 SN - 0940-6719 SP - S69-S74 ST - A case report of spondylectomy with circumference reconstruction for aggressive vertebral hemangioma covering the whole cervical spine (C4) with progressive spinal disorder T2 - European Spine Journal TI - A case report of spondylectomy with circumference reconstruction for aggressive vertebral hemangioma covering the whole cervical spine (C4) with progressive spinal disorder UR - ://WOS:000405718300012 VL - 26 ID - 830193 ER - TY - JOUR AB - A 72-year-old man complained of a right thigh pain at walking. He had a right renal cell carcinoma with right ileac bone metastasis. He underwent trasnscatheter renal arterial embolization by ethanol, and percutaneous injection of surgical bone cement for bone metastasis. He was subsequently given interferon-α combined with cimetidine in out patient clinic. Furthermore, radiofrequency ablation of renal tumor was added. One year after initiating the treatment, he could walk well by himself and CT scan revealed necrosis of renal tumor, free of tumor in pelvic space, and osteosclerotic change of ileac bone. AD - Department of Urology, Hiroshima City Asa Hospital AU - Nakamoto, T. AU - Ikeda, H. AU - Naitoh, A. DB - Embase KW - alcohol alpha interferon bone cement cimetidine aged article artificial embolization bone metastasis case report catheter ablation computer assisted tomography human iliac bone injection kidney carcinoma leg pain male osteosclerosis outpatient tumor necrosis LA - Japanese M1 - 12 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2003 SN - 0385-2393 SP - 1013-1016 ST - A case of renal cell carcinoma with ileac bone metastasis successfully treated by percutaneous injection of surgical bone cement T2 - Japanese Journal of Clinical Urology TI - A case of renal cell carcinoma with ileac bone metastasis successfully treated by percutaneous injection of surgical bone cement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L37498643&from=export VL - 57 ID - 829846 ER - TY - JOUR AB - Interventional Oncology (IO) has evolved into its own subspecialty in IR and locoregional treatments have grown from a last resort treatment option to becoming the standard of care for some cancers. This growth has its own set of challenges. In the past adoption of new technology was based mostly on anectodal evidence, case series, or retrospective studies. A few randomized controlled trials (RCT) were completed, but none in the scope or size of medical oncology trials. IO has seen major advances in two main forms of locoregional treatments, mainly ablation and embolization. Alcohol ablation led to RFA, Microwave, Cryoablation and Irreversible electroporation. Transarterial chemoembolization was followed by drug eluting embolics and Selective Internal Radiation therapy. Regulatory approvals in the USA for many of these technologies has been without a specific indication, and they are used in an off-label fashion. Insurance reimbursement for IO procedures usually requires a specific indication for a particular type of cancer, which in turn requires investment in trials. Lack of data has insurance providers dismissing promising technologies as experimental, leading to scant adoption or even early demise of promising technologies. Finally introduction of new versions of devices at break neck speed, takes away the ability to study them in a meaningful fashion and produce robust data. Our colleagues who deal with oncology patient have also had significant improvements. Robotic surgery, combination chemotherapy and checkpoint inhibitors in medical oncology, SBRT and Proton beam therapy in radiation oncology and Immuno-oncology, all have the potential to revolutionize the way cancer is managed. So how does IO compete with these challenges, stay relevant and make progress? Embracing the clinical model and being a part of multidisciplinary tumor boards is a start. Collaborations with other specialists to find treatment synergies, will help broaden the spectrum of treatment options in oncology. IO delivers precise, cutting edge, minimally invasive treatment solutions with less morbidity and good outcomes. Recording outcome measures for the care we deliver will be key in demonstrating this ability to all the health care players with data to back up the claims. Well planned registries right from when a technology is introduced will collect data points to understand outcomes and pitfalls. Positive RCT's will help pave the way for approvals for specific indications and move IO treatments into national treatment guidelines. These steps and the spirit of innovation in IO will cement IO as the fourth pillar in cancer care. AD - G. Narayanan AU - Narayanan, G. DB - Embase DO - 10.1007/s00270-019-02282-x KW - alcohol cement adoption adult cancer model cancer radiotherapy cancer size case study chemoembolization combination chemotherapy conference abstract cryoablation female human investment irreversible electroporation male microwave radiation minimally invasive procedure morbidity neck outcome assessment practice guideline proton therapy radiation oncology radioembolization radiofrequency ablation randomized controlled trial (topic) reimbursement retrospective study robot assisted surgery stereotactic body radiation therapy surgery velocity LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1432-086X SP - S170 ST - Pathways and challenges to innovation in interventional oncology T2 - CardioVascular and Interventional Radiology TI - Pathways and challenges to innovation in interventional oncology UR - https://www.embase.com/search/results?subaction=viewrecord&id=L629260148&from=export http://dx.doi.org/10.1007/s00270-019-02282-x VL - 42 ID - 829125 ER - TY - JOUR AB - BACKGROUND: Vertebral cement augmentation procedures, as kyphoplasty (KP) or percutaneous vertebroplasty (PVP), are commonly used for the management of pain of the vertebral column usually due to fractures related to traumatic injury, osteoporosis or metastatic lesion. It is a useful and safe technique with few complications. Among them, symptomatic pulmonary cement embolism (PCE) can happened, even rarely described in the literature, leading to severe cardio-respiratory manifestations depending on the location and size of the cement emboli. CASE PRESENTATION: A 55 yo woman presented with atypical chest pain and presyncope three weeks after a motor vehicle accident resulting in an L1 compression fracture treated with kyphoplasty. She was hemodynamically stable. Blood tests showed D-Dimer 0.29 μg/mL, troponin <5ng/mL, Brain Natriuretic Protein 14 ng/mL and a PaO2 of 99 mmHg on arterial blood gas analysis. A computed tomography scan of chest showed linear hyperdense foreign bodies in two segmental pulmonary arteries at the level of middle lobe and right lower lobe compatible with pulmonary cement embolism. Anticoagulation with rivaroxaban for sixth months resulted in resolution of symptoms. CONCLUSIONS: In this case, the pulmonary cement embolism occurred after kyphoplasty, which is associated with less risk of PCE than vertebroplasty. The procedure was done under biplanar fluoroscopy and no leakage of cement was noted, which would raise suspicion for CPE. Repeat imagine after this procedure is not routinely done. This case demonstrates that systematic imaging post procedure should be considered.An anticoagulation with rivaroxaban seems to be effective in our patient. AD - Department of Thoracic Oncology, Pleural Diseases and Interventional Pulmonology, Hôpital Nord, Marseille, France. Aix-Marseille University, France. AN - 32923362 AU - Naud, R. AU - Guinde, J. AU - Astoul, P. C2 - Pmc7475197 DO - 10.1016/j.rmcr.2020.101188 DP - NLM ET - 2020/09/15 J2 - Respiratory medicine case reports KW - CT, computed tomography Cement embolism KP, kyphoplasty Kyphoplasty PCE, pulmonary cement embolism PMMA, polymethylmethacrylate PVP, percutaneous vertebroplasty Pulmonary cement embolism Pulmonary embolism Vertebroplasty LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 2213-0071 (Print) 2213-0071 SP - 101188 ST - Pulmonary cement embolism complicating percutaneous kyphoplasty: A case report T2 - Respir Med Case Rep TI - Pulmonary cement embolism complicating percutaneous kyphoplasty: A case report VL - 31 ID - 828595 ER - TY - JOUR AB - Case Objective: Gait ignition failure syndrome, where immobility occurs only upon initiation ofambulation and normal gait ensues once entrained, hasbeen reported with frontal lobe and midbrain locomotorregion pathology. However, gait ignition failure syndrome secondary to lumbosacral spinal stenosis hasnot heretofore been described.METHODS: Case Study: A 65-year-old right-handed womanunderwent a right frontal parasagittal arteriovenousmalformation embolization 25 years prior to presentation. After a fall resulting in a T12 and L1 compressionfracture, two kyphoplasties were performed. After thesecond kyphoplasty, one year prior to presentation, shedeveloped new onset of gait ignition failure, left anteriorthigh pain, lower back pain at L5 with radiation to bothhips, and bilateral lower extremity weakness. The gaitdifficulty duration correlates to the duration she is in aseated position. Upon standing, she is unable to moveher legs and exhibits basophobia, feeling she may fall dueto weakness and she is unable to lift up her left foot toinitiate gait, as if it is glued to the floor. She is able toinitiate gait after one minute, but has an unsteadyscissors-gait for the first few steps. Afterwards, hergaitreturns to baseline. Anteroflexion was noted toeliminate her back and leg pain.RESULTS: Gait examination shows inability to initiate gaitafter standing, feeling as if frozen. However, shedemonstrated scissors-gait after 30 seconds for 3-5 steps,which gradually improved to baseline. Her quadricepsfemoris reflex was absent on the right, 3+ on the left. HerAchilles reflex was absent on left. MRI indicated spinalstenosis with broad based osteophytes at T9-T12 andbilateral neural foraminal stenosis at L1-S1. Exercisetherapy designed for spinal stenosis was initiated, andresulted in elimination of gaitignition failure.CONCLUSION: Gait ignition failure syndrome may not benecessarily due to frontal or midbrain dysfunction, but canbe secondary to lumbosacral impairment. In this patient,dysfunctional arachnoid villi in the lumbosacral nerveroots may have led to transient increases in pressurethroughout the neural axis, including the brain, andassociated NPH-like symptoms, such as magnetic gait.Seeing that posture affects epidural pressure in lumbarspinal stenosis, with a decrease pressure in response toanteroflexion and reduced pain [Takahashi 1995], onecan postulate that this may be a mechanism affecting thepatient. Furthermore, since her symptoms are episodicand directly associated with the duration of time she isseated, one may deduce gait ignition failure to be amanifestation of cerebrospinal fluid or intracranialpressure changes influenced by posture. In addition,symptom resolution via exercise therapy strongly suggeststhat gait apraxia can also be a manifestation of lumbosacral dysfunction. Therefore, those with gait ignitionfailuresyndrome warrant evaluation for lumbosacral pathology. AD - J.T. Nayati, St. James School of Medicine, Park Ridge, IL, United States AU - Nayati, J. T. AU - Rekhi, A. AU - Hirsch, A. R. DB - Embase DO - 10.1017/S1092852918000342 KW - aged arachnoid artificial embolization body position case report cerebrospinal fluid clinical article conference abstract fear of falling female foot gait apraxia hindlimb human immobility kinesiotherapy kyphoplasty leg pain low back pain mesencephalon nuclear magnetic resonance imaging osteophyte radiation reflex scissors treatment failure vertebral canal stenosis weakness LA - English M1 - 1 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1092-8529 SP - 86-87 ST - Gait ignition failure syndrome secondary to spinal stenosis T2 - CNS Spectrums TI - Gait ignition failure syndrome secondary to spinal stenosis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L626874440&from=export http://dx.doi.org/10.1017/S1092852918000342 VL - 23 ID - 829205 ER - TY - JOUR AB - This is a fixed‐bearing knee intended for use in patients undergoing cemented total knee arthroplasty. The devices to be used are both FDA approved via 510k clearance. A total of 572 cases (286 per group) will be entered. Each patient will be assessed pre‐operatively and post‐operatively at three months and two, five, seven and ten years. The primary endpoint will be the revision rate at ten years. The result for these will be analyzed using an unconditional test of equivalence between two independent binomials. Chi‐square analysis will be used to compare the instance of mortality, revision surgery, deep vein thrombosis, pulmonary embolus, neurovascular complication, and infection. Other outcome measures incorporated in the Knee Society Clinical rating scale will undergo appropriate generalized linear regression for the type of outcome involved. The primary aim of the study is to compare the survivorship of two types of polyethylene (conventional N2Vac and highly cross‐linked X3) used in a fixed‐bearing total knee system in patients undergoing cemented total knee arthroplasty. These results will be measured through radiographs at each post‐operative interval with an independent radiograph review being performed after all patients have reached 7 and 10 year follow‐up. Secondary results will also be collected and will focus on disease‐specific (Knee Society Scores), global (SF‐12 v1), and outcome measures. Radiographic results consisting of standing anteroposterior, lateral and Merchant views of the surgical knee will be recorded and analyzed. Completion of the initial investigation will occur at the 10‐year interval after the last enrolled. AN - CN-01498033 AU - Nct N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2007 ST - X-3 Polyethylene Survival Outcomes Study T2 - https://clinicaltrials.gov/show/NCT00493792 TI - X-3 Polyethylene Survival Outcomes Study UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01498033/full ID - 830032 ER - TY - JOUR AB - SUMMARY A prospective, randomized, single‐blinded clinical trial is proposed to compare three tibial tray designs for patients undergoing total knee arthroplasty. This study is designed to address the clinically important issues of tibial component modularity and fixation in total knee replacement. The Zimmer NexGen Legacy knee system is an FDA approved device and in this study will be used with 1) a modular tibial tray inserted with cement and 2) a non‐modular tibial tray inserted with cement, and 3) a non‐modular tibial tray inserted without cement. The insertion of total knee components without cement has been done clinically for over 20 years but has not been specifically approved by the FDA. Thus treatment arm 3, a non‐modular tray inserted without cement, would involve the so‐called off‐label use of the device. 136 cases will be assigned to each arm of the study. Each patient will be assessed two months after surgery, one year after surgery, two years after surgery, five years after surgery, and every three to five years thereafter. The principal outcome measures will be the Knee Society Clinical rating scale, the SF‐36 and the presence of significant lucent lines.. These measures will be compared among patients in the 3 trial arms at 5 years post surgery (or at the last follow‐up point for those who drop out or become lost to follow‐up). The Knee Society scores and SF‐36 scores will be analyzed using analysis of variance models Rates of significant lucencies, perioperative mortality, as well as complications such as deep vein thrombosis, pulmonary embolus, neurovascular complication, and infection will be compared among the groups using chi‐square tests . Rates of revision surgery will be compared among the groups using survivorship methods. PURPOSE The primary aim of the study is to compare the results obtained with each of three tibial designs for patients undergoing total knee arthroplasty. Those results will be measured with disease‐specific (Knee Society Scores), global (SF‐36), and outcome measures. Radiographic results consisting of standing alignment, lateral and skyline views of the surgical knee will be recorded and analyzed. Completion of the intial investigation will occur at the 5‐year interval after the last enrolled patient. AN - CN-01516385 AU - Nct N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2007 ST - A Prospective, Randomized, Controlled Study Comparing Three Tibial Component Designs in Total Knee Arthoplasty T2 - https://clinicaltrials.gov/show/NCT00589147 TI - A Prospective, Randomized, Controlled Study Comparing Three Tibial Component Designs in Total Knee Arthoplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01516385/full ID - 830081 ER - TY - JOUR AB - Elderly patients undergoing major, orthopedic surgery are at risk of developing postoperative cognitive dysfunction (POCD) or memory impairment following surgery. Transcranial doppler (TCD) monitoring of blood flow to the brain has detected cerebral emboli in 60% of patients following release of the thigh tourniquet during total knee replacement or arthroplasty (TKA). These cerebral embolic events may represent one of the mechanisms responsible for postoperative cognitive problems. The standard surgical technique for TKA involves cleaning the bone surfaces with pulsed saline lavage prior to cementation and prosthesis insertion. The CarboJet Assisted technique utilizes carbon dioxide lavage to clean and dry the femur canal and bone surfaces prior to cementation and implantation. Because it removes fat globules and marrow particulates from the bone surfaces, it is hypothesized that the use of a carbon dioxide lavage technique in TKA will result in fewer thromboembolic events and increased cement penetration compared with the standard technique using pulsed saline lavage. Cement penetration affects the strength of the bone‐cement interface and, therefore, contributes to implant longevity. AN - CN-01520236 AU - Nct KW - Memory Disorders Postoperative Complications N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2008 ST - A Study to Determine if Carbon Dioxide Lavage During Total Knee Surgery Reduces Intraoperative Embolic Events T2 - https://clinicaltrials.gov/show/NCT00736125 TI - A Study to Determine if Carbon Dioxide Lavage During Total Knee Surgery Reduces Intraoperative Embolic Events UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01520236/full ID - 830008 ER - TY - JOUR AB - The hip semiendoprosthesis is an acceptable method to treat the proximal femoral fractures. Traditionally, the cemented version of the semiendoprosthesis has been used for this indication. However, the cementing carries a risk of fat embolism during the pressurization of the cement. The fat embolism can be avoided when using the non‐cemented semiendoprosthesis. In this study we want to find out whether there are any differences in the treatment results between the cemented and non‐cemented semiendoprostheses when treating the proximal femoral fractures. AN - CN-01499849 AU - Nct KW - Femoral Fractures Fractures, Bone Hip Fractures N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2009 ST - Cemented vs Non-cemented Semiendoprosthesis in the Treatment of Proximal Femoral Fractures T2 - https://clinicaltrials.gov/show/NCT00859378 TI - Cemented vs Non-cemented Semiendoprosthesis in the Treatment of Proximal Femoral Fractures UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01499849/full ID - 830029 ER - TY - JOUR AB - Corail‐SP study. A prospective randomized study to compare the quality of treatment between cemented versus uncemented hydroxyapatite coated femoral stems in Total Hip Arthroplasty (THA) in patients who suffers from dislocated femoral neck fractures. Femoral neck fractures often occurs among the fragile elderly patients who have a higher degree of co‐morbidity. The 3‐month mortality is 13%. The incidence of risk of fracture complications when using osteosyntheses are as high as 30‐40%, mainly due to non union, which leads to impairments in quality of life, locomotion and pain. For that reason more patients nowadays are submitted to a cemented hemiarthroplasty or a total hip arthroplasty directly after their injury ‐ at the same time the problem with fatty embolism syndrome has been recognized. When cementing during surgery, the bone marrow is pushed into the blood stream, which can affect the cardiopulmonary function and even the mental functions. As a measure for reducing those risks an uncemented hip arthroplasty is sometimes used instead. The pros and cons with uncemented fixation is poorly examined which this study will try to scrutinize. 100 patients with dislocated (Garden classification III‐IV) femoral neck fractures who have the clinical indication of undergoing a Total Hip Arthroplasty are asked and included at Mölndals Hospital (part of Sahlgrenska University Hospital). Randomization to either; an inversed hybrid arthroplasty with an uncemented hydroxyapatite coated Corail stem and a cemented Marathon cup (DePuy), alternatively to, a totally cemented option with a Lubinus SPII stem and a IP cup (Link). Preoperatively: Patient questionnaires regarding cognitive and social status, hip function, quality of life (QoL), activity level. Standard hip and pelvis X‐ray. Blood sample for biomarkers. Peroperatively: Pulmonary artery catheter measurements of pulmonary artery pressure, cardiac output, ejection fraction of the right ventricle. Surgeon's questionnaire regarding prosthesis components, duration of surgery, blood group, bleeding volume, oxygen saturation. Half of the patients are marked with tantalum pellets for radiostereometric analysis (RSA). Biomarkers. Postoperatively: Standard X‐ray. On the patients marked with tantalum pellets RSA is performed. Bone density scan (DXA). Measurements regarding cognition, ADL, mobilization. Eventual confusion is noted. Biomarkers every second day until discharge from hospital. Eventual wound infections or thromboembolic episodes are noted. Follow up: Outpatient return visits to physician 3, 6 months, 1, 2, 5, 7, 10 years postoperatively. Standard X‐ray, RSA, DXA, Patient questionnaires regarding patient's satisfaction, QoL, activity level, hip function. Biomarkers. Eventual gains with an uncemented prosthesis: Reduced fatty embolism risk, reduced inflammatory response, reduced generalized symptoms/confusion, faster mobilization, shorter surgery. AN - CN-01531592 AU - Nct KW - Femoral Neck Fractures Fractures, Bone N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2012 ST - Cemented Versus Uncemented Stems in Total Hip Arthroplasty in Patients With Femoral Neck Fractures T2 - https://clinicaltrials.gov/show/NCT01578408 TI - Cemented Versus Uncemented Stems in Total Hip Arthroplasty in Patients With Femoral Neck Fractures UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01531592/full ID - 830067 ER - TY - JOUR AB - Most subcapital femoral neck fractures occur in the elderly population and are the result of low‐energy trauma. Return of the patient to prefracture level of function usually can best be accomplished with surgery. Nonsurgical management has resulted in an excessive rate of medical morbidity and mortality. The overall 1‐year mortality rate after hip fracture in the elderly ranges from 14% to 36%. Prosthetic replacement has been favored for the treatment of displaced femoral neck fractures in the frail, elderly population with multiple medical comorbidities because of the challenges of achieving stable proximal fragment fixation in osteopenic bone, and the need for early, full weight‐bearing mobilization. Failure rates of 30% to 40% have been consistently reported over multiple series over the past few decades in elderly patients with displaced femoral neck fractures treated with internal fixation. Once prosthetic arthroplasty has been chosen, further controversy surrounds the type of fixation, cemented or cementless. Good to excellent results can be expected with either cemented or cementless newer generation arthroplasties. Risks of cementless arthroplasty include femoral fracture, prosthesis subsidence, and anterior thigh pain. Cementation of the prosthesis places the patient at risk for intraoperative death or embolization of marrow content during cementation. The aim of the study is to assess the clinical relevance of a collared uncemented stem compared with use of cemented stem in elderly population with displaced femoral neck fracture. A randomised trial will include 150 patients with an acute displaced femoral neck fracture in an elderly population. All patient will give informed consent, and the research protocol is approved by the regional ethics committee. The inclusion criteria are an age of at least 70 years old, a displaced femoral neck fracture (Garden stage III or IV), an ASA grade< 4, ambulatory and non cognive impairment patients. Clinical and radiographic examinations will be perform at perioperative period, at 3 and 12 month after surgery. The main outcome measures will be functional score, pain, mobility, complications, reoperations, activity of daily living, quality of life, strenght, and radiolographic subsidence. The primary hypothesis of this study is that use of a collared uncemented stem would not provide an improvement in functional outcome compared with use of cemented stem in elderly population with displaced femoral neck fracture. AN - CN-01540401 AU - Nct KW - Femoral Neck Fractures Fractures, Bone N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2013 ST - Displaced Femoral Neck Fracture in Elderly Patient. Should Cement be Used for Hip Hemiarthroplasty ? T2 - https://clinicaltrials.gov/show/NCT01787929 TI - Displaced Femoral Neck Fracture in Elderly Patient. Should Cement be Used for Hip Hemiarthroplasty ? UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01540401/full ID - 830039 ER - TY - JOUR AB - Introduction and Background: Total knee arthroplasty is characterized by a large amount of postoperative blood loss and frequent need for blood transfusions.1 Also of concern is the risk of hematomas which can potentially lead to infection or wound complications and delay the overall rehabilitation process.2 By reducing postoperative bleeding, the outcomes of total knee arthroplasty would be improved by better range of motion, less frequency of blood transfusion and decreased incidence of arthrofibrosis.3 Several studies have looked at different blood conservation strategies including reinfusion of drains, tourniquets, autologous blood transfusions, topical and intravenous antifibrinolytic alone, topical fibrin sealant alone, and monopolar and bipolar electrocautery. The combined use of a topical fibrin sealant (Evicel®) with an antifibrinolytic (Tranexamic acid) represents another approach to reducing blood loss in patients undergoing total knee arthroplasty. Evicel® is a fibrin sealant consisting of human‐derived thrombin and fibrinogen that work in combination to form a stable blood clot at the bleeding site. Evicel® is regularly used in orthopaedic and other sub‐specialty surgeries. One investigation has reported on the use of a topical hemostatic agent in total knee arthroplasty.4 It compared the use of a fibrin sealant for hemostasis with standard hemostasis protocols and found that the topical hemostatic agent decreased post operative blood loss, increased post operative hemoglobin levels, and resulted in a decrease in the need for post operative blood transfusion. Tranexamic Acid is given topically or intravenously to occlude the fibrin cleavage sites on plasminogen and inhibit the breakdown of fibrin clots. Tranexamic acid is also regularly used in orthopaedic and other sub‐specialty surgeries. Studies have found that intravenous dosing of tranexamic acid prior to incision, and again after tourniquet release reduces the need for the blood transfusion versus standard hemostasis.5, 6 Research Questions/Objectives: Does the combination use of a fibrin sealant and an antifibrinolytic in our institutional total knee arthroplasty protocol decrease postoperative drain output/hematocrit drop/hemoglobin drop or the need for post operative blood transfusions compared to standard hemostasis technique? Secondary objectives will be measuring differences in postoperative pain, postoperative range of motion, and rates of postoperative complications including pulmonary embolism, deep vein thrombosis, and wound complications requiring a return to the operating room between treatment and control groups. Study Design: The null hypothesis states that the combined use of a topical fibrin sealant and an antifibrinolytic in total knee arthroplasty will show no difference in the amount of postoperative blood loss compared to the standard means of hemostasis (tourniquet and electrocauterization). The study will be a prospective randomized trial with patients that are undergoing elective primary, unilateral, cemented total knee arthroplasty. Patients will be randomly divided into two groups. A control group, in which the standard means of hemostasis will be applied and a treatment group, in which the standard means of hemostasis will be applied with the additional use of Evicel® (a fibrin sealant) and Tranexamic acid (an antifibrinolytic). All operations will be standardized between four surgeons. Subjects: The target population is patients seen in the outpatient office who are indicated for primary total knee arthroplasty. Patients will be asked if they would like to participate in the study; only patients capable of consenting to surgery will be enrolled. Patients undergoing total knee arthroplasty revisions and patients with blood disorders, on chronic anti‐thrombotic medication such as Coumadin and any patients with a history of deep vein thrombosis and/or pulmonary embolism will be excluded. Despite that Evicel® contains human‐derived blood products, Jehovah's Witnesses will not be excluded and these patients w ll be given an opportunity whether they would like to participate or not. As tranexamic acid is renally cleared, renally impaired individuals will be excluded. Study Procedures: All participating surgeons will adhere to the same protocol. Upon enrolling in the study, patient demographics including age, gender, height, weight will be recorded and stored in an encrypted, protected database. Eligible / consenting patients will be randomized in a 1:1 ratio to receive either treatment or non‐treatment. The randomization will be stratified by surgeon to ensure balanced assignment of treatment / non‐treatment in each of participating surgeons. Randomization schemes will be generated and maintained by Dr. David Leibelt, the study statistician. Dr. Leibelt will provide Mr. Bharat Tiwari with a set of randomization envelopes to be stored and used in the study clinic. Mr. Tiwari will assign these envelopes in sequential order, by envelope number and surgeon, to eligible /consenting patients. . During the process, Dr. Jason Wong and Mr. Andrew Schwartz will be blinded and will have no access to the randomization assignment. Preoperative blood work including hematocrit and hemoglobin will be performed, a standard for patients undergoing joint arthroplasty. On the day of surgery, the patients will be seen in the preoperative holding area, and again be asked if they consent to take part in the study. Total knee arthroplasty will then be performed with a standard medial parapatellar approach using a 350 mm Hg pneumatic tourniquet on the operative leg. All surgeons will use Zimmer implants. After patient is put to sleep, attending surgeon will inform the operating team that whether the patient is randomized into the treatment or control group. If the patient is part of the treatment group, they will receive a 10 mg/kg dose of tranexamic acid prior to tourniquet inflation. After removal of trial implants and irrigation/thorough drying, 2 mL of Evicel® will be sprayed (under 15‐25 psi of CO2) into the posterior joint capsule (via the gap between femur and tibia). Once the implants are in place and the methylmethacrylate cement is cured, the joints will be irrigated copiously and dried thoroughly for the final time. 2 mL of Evicel® will be dripped into pinholes, another 2 mL of Evicel® will be dripped along the exposed edges of bony tissue, and an additional 2 mL of Evicel® will be sprayed on all remaining soft tissue. After 2 minutes, the tourniquet will be released and a second dose of 10 mg/kg tranexamic acid will be given as electrocautery is being performed. After joint capsule closure, a final 2 mL of Evicel® will be sprayed along the arthrotomy incision and on subcutaneous soft tissue. On top of the treatment protocol mentioned above, patient will also receive the standard tourniquet protocol and electrocautery. If the patient is in the control group, the standard tourniquet protocol and electrocautery alone will be used for hemostasis. In both groups, an auto transfusion drain will then be placed within the deep layer of the knee. The joint will then be closed and dressed in standard fashion. The patient will then be taken to the postoperative anesthesia care unit. Immediate postoperative hemoglobin and hematocrit levels will be recorded, a standard practice at our institution. The drain output will be recorded over a 24‐hour period. As is standard, hemoglobin and hematocrit levels will be recorded for the three days postoperatively. Any transfusions and/or complications (pulmonary embolism, deep vein thrombosis, and wound complications requiring a return to the operating room) and length of stay will be monitored (according to standard protocol) and recorded. Pain scores utilizing the WOMAC, SF‐36, and VAS scales will be recorded during postoperative follow up in the clinic. Range of motion will be compared to preoperative values at two and six weeks postoperatively. Safety outcomes to be monitored Potential complications associated with the study such as pulmonary embolism, deep vein thrombosis, and wound complicati ns that require a return to the operating room will be monitored by the surgical team. Risks and Benefits Potential benefits include decreased perioperative blood loss, which would sequentially decrease the chance of blood transfusion (lower costs, fewer infections and errors, and less frequent seroconversion) and decreased pain secondary to joint hematoma. This study also aims to eliminate the need for post‐operative drain usage (lower cost, fewer infections, fewer drain complications and less time in the operating room). Evicel consists of human‐derived thrombin and fibrinogen. Patients with known allergies to human blood products should not participate in this study. Also, the human‐derived blood products carry a risk of transmitting infectious agents such as viruses and theoretically, the Creutzfeldt‐Jakob disease (CJD) agent. This risk is theoretically equal to the risk of a blood transfusion; however, there have been NO known incidents of infectious agent being transmitted from the use of Evicel. Evicel is FDA approved and routinely used in orthopaedic surgery. Tranexamic acid is a pro‐coagulant molecule that should not be used in patients with a past medical history of intravascular clotting. Dosing of tranexamic acid should be reduced in a renally impaired patient. The compound also should be avoided in those with known allergies to tranexamic acid. Tranexamic acid is FDA approved and routinely used in a variety of surgeries, including orthopaedics Data Safety Monitoring Plan A data safety monitoring board consists of an independent physician, Dr. Tony Wanich, Mr. Bharat Tiwari and Dr.Yungtai Lo. At the 50 and 100 patient mark, the board will decide based on the following criteria and decide on whether or not the study should be continued: 1. whether or not the complications rates (includes deep vein thrombosis, cerebrovascular accidents) between the treatment group and the control group is significantly different 2. whether or not the transfusion rates between the treatment group and control group is significantly different 3. whether or not the drain output between the treatment group and the control group is significant different If any of the above criteria is met, the board will inform the principle investigator and decide on whether or not the study should be terminated early. Data Management and Analysis: Measures: The primary outcome measured will be 24‐hour drain output that will be measured from the time it is introduced. Secondary measures will be the serum hemoglobin and hematocrit levels measured approximately 2 weeks prior to surgery and each of the first three days after surgery. Transfusions throughout the duration of stay and the length of hospital stay will also be recorded. Scores obtained from 3 pain scales will be recorded: WOMAC (Pre‐op and Post‐op at 6 months), SF‐36 (Pre‐op and Post‐op at 6 months), and VAS (Pre‐op, Post‐op day # 1, 2, 3, Post‐op visit #1 and 2). Range of motion at two and six weeks postoperatively will be compared to the preoperative range. All measurements will be recorded in an encrypted and protected database. Statistical Analysis: The primary (drain output) and secondary (hemoglobin/hematocrit) outcomes are continuous variables. Values for the intervention (Evicel®/Tranexamic acid) and the standard of care control groups will be compared with the Mann‐Whitney test. Results for individual day measures and the summary measures (total drainage and average hemoglobin/hematocrit) will not be adjusted for multiple comparisons. However, if any statistically significant results from different days of the same measure and the composite measure are not consistent, the possibility of type I error will be emphasized. We will assume the data will not be normally distributed and therefore a non‐parametric test, Mann Whitney test, will be performed. We expect our randomization to result in balanced study groups in regards to characteristics like age, sex, race, and BMI. Therefore stratified randomization is unnecessary. However, if the two study arms are not reasonably balanced, additional analyses using linear regression adjusting for any unbalanced variables will be performed. Intention to treat analyses will be performed. Statistical analyses will be completed by Dr. Jason Wong and medical student, Andrew Schwartz. Both Dr. Wong and Mr. Schwartz will be blinded about the randomization. Sample Size: Based on previous studies looking at similar outcomes and using a conservative estimate for true difference of means of drain output, we need 50 patients per group for 90% power and 150 patients per group for 97% power to detect a difference in 24 hour drain output. Implementation Plan/Timetable: Patients will be seen in the office and, if indicated for total knee arthroplasty, we will request consent for the study. The attending surgeons will answer any question at that time. A physician assistant who is blinded will collect data daily. An average of 15‐20 total knee arthroplasties are done each week. The data collection will likely take 3‐6 months. The data collected will be kept on an encrypted and protected database accessible only to the physicians caring for the patients enrolled in the study. AN - CN-01492340 AU - Nct KW - Tranexamic Acid N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2015 ST - The Combined Efficacy of Evicel and Tranexamic Acid on Total Knee Arthroplasty T2 - https://clinicaltrials.gov/show/NCT02553122 TI - The Combined Efficacy of Evicel and Tranexamic Acid on Total Knee Arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01492340/full ID - 830046 ER - TY - JOUR AB - Objectives:To assess the efficacy and safety between the two different applying routes. Patients in this project will be randomly divided into three groups , one group is a blank group and the rest two receive either the topical or the intravenous form of tranexamic acid during unilateral TKA(total knee arthroplasty).The total blood loss(TBL) will be calculated as the primary outcome for efficacy while Deep Vein Thrombosis、Pulmonary Embolism、Acute Myocardial Infarction 、 Acute Kidney Infarction and Cerebral Infarction events will be recorded to assess the safety of the tranexamic acid during a six‐week follow‐up for each patient. All surgery are under general anesthesia, through direct lateral approach with cementless prosthesis.For all patients, the drain tube will be clamped and closed completely for 2 hours; then the clamp will be fully opened. AN - CN-01505110 AU - Nct KW - Exsanguination Hemorrhage Tranexamic Acid N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2015 ST - Comparison of Topical Versus Intravenous Tranexamic Acid in TKA T2 - https://clinicaltrials.gov/show/NCT02393300 TI - Comparison of Topical Versus Intravenous Tranexamic Acid in TKA UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01505110/full ID - 830048 ER - TY - JOUR AB - Background Knee osteoarthritis (OA) is a common joint disease, which may cause severe pain and lead to a reduced quality of life. It has been shown that the prevalence of symptomatic OA in those aged 60 and above was 9.6% in men and 18% in women. Primary treatment of knee OA is conservative including physical activity, exercise and analgesics. Meta‐analysis shows small to moderately sized effects of exercise on pain and function. Total knee arthroplasty (TKA) is the gold standard option for the treatment of painful OA of the knee when conservative treatment is not sufficient. Unicondylar knee arthroplasty (UKA) can be used as the treatment of knee OA isolated to a single compartment instead of TKA. Both UKA and TKA have been used for decades as a treatment of knee OA. However, operative indications for TKA and UKA overlaps, but they are not similar. Therefore, the outcome or survivorship of these procedures cannot be compared directly. Some advantages of UKA over TKA have been reported, including faster recovery time, reduced perioperative morbidity and mortality, a subjective preference of feeling more normal knee, lower cost and improved return to work and sport. On the other side national arthroplasty registers like the National Joint Registry of England and Wales (NJR), the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR), the Swedish Knee Arthroplasty Register (SKAR), and the Finnish Arthroplasty Register (FAR) consistently report around a threefold increase in crude cumulative revision rate at 8 to 10 years for UKA compared with TKA 7‐10. Few reports have been published about patient‐perceived outcomes following TKA compared with UKA. Newman et all compared fixed bearing UKA to TKA and published better range of movement (ROM) after UKA. Sun PF et all compared mobile bearing UKA to fixed bearing TKA. They didn't had significant difference in ROM or Knee Society score (KSS) postoperatively after mean 52 months follow‐up, but in TKA group had significantly more postoperative deep vein thrombosis and more blood loss. A study comparing cemented UKA (Oxford, Biomet) and TKA, have been published using patient‐perceived outcome measures, but the study protocol lacks of blinding. There is no published randomized controlled, double‐blind trial which compares patient‐perceived outcomes after TKA and UKA. Oxford mobile bearing UKA is most used unicondylar prosthesis according to national registries. The most common reason for revision of UKA according to NJR is aseptic loosening, accounting for up to 48% of all UKA revisions. Other reasons for UKA revision in Finland where malalignment, prosthesis fracture, instability, infection, fracture, patella complication and other reasons (35%). A randomized controlled trial of 62 knees comparing cemented and cementless Oxford UKA has demonstrated a greatly reduced incidence of tibial radiolucencies with similar functional outcomes at 1 year 15. Cementless Oxford unicondylar knee is relative new product and was developed to address problems related to cement fixation, and has been demonstrated in a randomised study to have similar clinical outcomes with fewer radiolucencies than observed with the cemented device. New Zealand Joint Registry (NZJR) data shows revision rate 1,37/100 component years for cemented Oxford phase 3 and 0,72/100 component years for cementless Oxford phase 3 UKA. The uncemented Oxford UKA has a significantly lower revision rate than the overall mean of 1.27 /100 observer component years. Also the NJR show better survivorship for cementless unicondylar arthroplasty compared to cemented unicondylar arthroplasty. On the other hand cementless TKA shows lower survivorship compared cemented TKA in Finnish Arthroplasty Register (FAR). There are no published randomized controlled, double‐blind trial which compare patient‐perceived outcomes after cemented TKA and cementless Oxford UKA. The aim of the study The aim of this study is to compare functional, clinical, patient satisfaction, and implant survival results of ementless UKA with those of cemented TKA at 2 months, 1, 2, 5 and 10 years after the procedure. Study setting The study design is a multicenter, double‐blind and randomized trial of knee replacement patients. Arthroplasty procedures will be performed by experienced knee surgeons who are experienced in both UKA and TKA operations. As UKA we will use cementless Oxford phase 3 mobile bearing prosthesis with Microplasty instrumentation (Biomet) and as TKA cemented Triathlon CR condylar prothesis (Stryker). According to power analysis, we are going to recruit 140 patients from 3 orthopedic units in Finland. Participants will be randomized to UKR or TKR. Study participants Participants with anteromedial osteoarthritis of knee will be included in the study. Patients must be applicable for both a medial UKR and TKR. Recruitment and consent Potential patients will be contacted in outpatient clinics by the participating orthopedic surgeon. At this stage patients will be provided with an 'Invitation letter' and a information sheet which will explain why they have been approached and will provide further details about the study. Those patients, who voluntary will take part to the study, will be screened for inclusion and exclusion criteria. If the patient is appropriate for the study, pre‐assessment clinic appointment will be organized. The pre‐assessment appointments are routine appointment for a short time before their scheduled operation date. Study assessments Preoperative assessments will include a patient reported questionnaire examining pain, other Symptoms, function in daily living, function in sport and recreation and knee related Quality of life. (OKS and KOOS). Also a clinical assessment of range of motion and function of the knee, will be carried out. Preoperative weight bearing X‐rays knees 20 degrease flexion, valgus stress x‐rays and mechanical axis will also be taken. After the operation, the operative details will be recorded and routine postoperative radiographs collected. Operative details will be sealed and saved. Code will be opened and randomization will be cancelled only if it's necessary. Reasons which might result in cancellation of randomization are, for example, symptoms of the operated knee which might require revision arthroplasty. Cancellation of randomization occurs also if the patient wants to discontinue participating to the study. Control outpatient policlinic appointment will be arranged for the clinical examination at 2 months, 1, 2, 5 and 10 years post operation. Outpatient controls will be carried out by orthopedic surgeons, who are not aware which type of operation ‐UKA or TKA ‐ was performed. Range of movement and stability are assessed. The radiographs are not available for the patient at the outpatient policlinic, but they are controlled by radiologists and the orthopedic surgeon to complications. Patients are informed of any surgical complications or possible abnormal findings in X‐rays, and are treated using standard methods. A postal questionnaire (containing the 15D, OKS and KOOS) will be sent out at 2 months, 1, 2, 5 and 10 years post randomization. Additional clinical appointments (if needed) will be performed by surgeon not participating study operations or controls. Randomisation 2 to 24 hours before the operation, if a patient is confirmed to be eligible for the trial, the surgeon opens an envelope containing the study‐group assignment (TKA or UKA). The assignment will not be revealed to the patient. The sequentially numbered, sealed envelopes will prepared by a statistician with no involvement in the clinical care of patients in the trial. Randomizations will be performed in a 1:1 ratio with a block size of 4. The randomization sequence involved stratification according to age (45 to 60 or 61 to 79 years of age), sex, and preoperative OKS (0‐17, 18‐27, or 28‐48). Only the orthopedic surgeon and other staff in the operating room will be aware of the group assignment, and they do not participate in further treatment or follow‐up of the patient. Total knee re lacement procedure TKA is performed through a standard medial parapatellar incision, which provides easy access to the knee joint. Skin incision is done to midline. Intramedullary guide is used for alignment of femoral and tibia saw cuts and component positions. Components will be cemented in position. The patella will not be resurfaced. Intraoperative local infiltration analgesia (LIA) is used for postoperative pain management. Drain is not used. Partial knee replacement procedure UKA involves only the replacement of affected medial compartment. In the study, the operation will be performed through standard medial parapatellar incision with midline skin incision, but the knee joint and fascia will be opened like in standard Oxford minimally invasive incision. The procedure will be performed by using Oxford Microplasty instrumentation and following Microplasty surgical technique (Biomet Orthopedics). Intraoperative local infiltration analgesia is used for postoperative pain management. Drain is not used. Safety The study participants have symptomatic medial knee OA and have failed conservative treatment. Patients, which are suitable for knee replacement have been selected from outpatient clinic. The operation will be performed as standard knee replacement. The study participants will be informed of the risks associated with anesthesia and knee replacement surgery. Potential intra‐ or perioperative complication are; anesthesia‐related complications, wound infection, bleeding, fracture, rupture of collateral or patellar ligament, thrombo‐embolic complications, death, ongoing pain, and deterioration of existing co‐morbidity. Surgical long‐term complications following the knee replacement are loosening of implant, lack of osteointegration of a cementless implant, periprosthetic fracture, luxation‐ or wear of bearing, infection, adverse knee pain 12 months after operation, knee stiffness, and lateral compartment OA in UKA. These complications may need surgery as revision, open debridement, washout or as worse even amputation. Ethics and study registration We have approval of the institutional review board of Ethics Committee, Hospital District of Southwest Finland. AN - CN-01553162 AU - Nct KW - Osteoarthritis Osteoarthritis, Knee N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2015 ST - Finnish Unicompartmental and Total Knee Arthroplasty Investigation T2 - https://clinicaltrials.gov/show/NCT02481427 TI - Finnish Unicompartmental and Total Knee Arthroplasty Investigation UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01553162/full ID - 830071 ER - TY - JOUR AB - Detailed Description: Main Hypothesis: 1. The uncemented TM Zimmer Persona® TKA will have migration on the same level as the cemented Zimmer Persona® TKA. 2. The uncemented TM Zimmer Persona® TKA will have less loss of BMD compared to the cemented version of the implant. Material and Methods: A prospective randomized study where the patients scheduled for TKA are randomized to receive tibial and femoral components with two different fixation modes: Group A: an uncemented TM Zimmer Persona® TKA (uncemented tibia and femur components). Group B: a cemented Zimmer Persona® TKA (cemented tibia and femur components). Operation: Operation Planning of the operations are performed based upon standing knee X‐rays (not involving the ankle and hip joint) and no preoperative templating is performed. The operations are performed at the Department of Orthopedic Surgery, Gentofte Hospital by three experienced TKA surgeons that will be included in the research group. All patellas will be resurfaced with a cemented all polyethylene patella component. During surgery the patients participating in the study will be prepared for MB‐RSA by insertion of a minimum of 6 Tantalum markers (0.8 mm) in the bone of the proximal tibia and 6 markers in the distal femur. Intravenous antibiotics (1.5g Cefuroxim) are administered three times during the first day and night of surgery and low molecular weight heparin is administered for prevention of deep venous thrombosis and pulmonary embolism. Local analgesics (Naropin ®, Toradol ®) are injected in the knee joint and in the soft tissue around the knee during surgery. Physiotherapy begins on the day of surgery and the patients will be mobilized with full weight‐bearing using crutches. Research plan 1. Clinical examination (n=60): preoperatively and with follow‐up after 1 and 2 years with evaluation of the knee function using the Knee Society's Knee Scoring System. 2. Patient‐reported outcome measurements (n=60). Obtained preoperatively and after 1 and 2 years using the Oxford knee score. 3. Conventional X‐rays (n=60) are obtained preoperatively (standing knee X‐rays (not involving the ankle and hip joint)), with classification of the degree of arthrosis estimating the Ahlbäck score. X‐rays are also obtained postoperatively before the patients are discharged and after 1 year and 2 years with the aim of evaluating knee alignment, and development of osteolytic lesions. 4. CT‐scans (n=60) 3 months postoperatively for measurements of hip‐knee‐ankle (HKA) angle, and component slope, rotation, and size matching. 5. Special X‐rays suitable for MB‐RSA measurements (n=60) of migration of the tibial and femoral components is performed within the first week after the operation and after 3, 6, 12, and 24 months. The precision of the RSA measurements is estimated from double examinations in 12 patients of the study. RSA X‐rays will be performed using a biplane RSA arrangement with a 90° angle between the two X‐ray tubes (Calibration cage 21; Tilly Medical Products AB, Lund, Sweden) and analysis of X‐rays will be performed by the MB‐RSA commercial software (RSAcore, Department of Orthopedics, Leiden University Medical Center, Leiden, The Netherlands), available at the Skaane University Hospital, Lund, Sweden. The manufacturer (Zimmer Biomet) will provide the CAD models. 6. DEXA analysis of the adaptive changes in BMD of the periprosthetic bone of the distal femur and proximal tibia. DEXA analysis will be performed preoperatively of the distal femur (lateral projection) and proximal tibia (coronal projection) as baseline, then again within the first postoperative week and subsequently at 3 months, 6 months, 1 year, and 2 years. The precision of the BMD measurements of the proximal tibia and distal femur will be estimated from double measurements of patients (n=12) included in the study. Calculation of sample size MB‐RSA There exist only three previously published studies measuring femoral component migration. In all studies the marker‐based RSA technique was used, and one of them presented results with mean and standard deviation (SD). However, one study gave the results as mean MTPM, and we chose the mean MTPM after 2 years of follow‐up (0.88 mm for cemented components) as our primary effect parameter, used in the sample size calculation. The rationale for using MTPM two years postoperatively, is because it has been shown to be the best predictor for later aseptic loosening of the tibial component after primary TKA. SD was estimated from the most recently published study using MB‐RSA for evaluation of cemented tibial component migration. In that study, the mean (+/‐ SD) MTPM after 2 years of follow‐up was 0.47 (+/‐ 0.16) and 0.45 (+/‐0.21) in the two study groups. Since the level of MTPM of the tibial components was substantially lower than seen for the above mentioned femoral components. We adjusted the SD in the sample size calculation to constitute the same percentages of the mean values as in the tibial component MB‐RSA study by Ejaz et al. (2015). Since the previously published studies measuring femoral component migration did not find any statistically significant difference between cemented and uncemneted fixation we selected a relatively low minimum relevant difference (MIREDIF). Using: Type I error = 5% Statistical power = 85 % MIREDIF 0.3 mm SD = 0.35 mm Sample size calculation resulted in a sample size of n = 24 in each group. In the study we have planned to include and randomize (block‐randomization with 10 in each block) a total of 60 patients. This will secure a high statistical power even if some of the participants should drop out during the study. DEXA The data for the sample size calculations were obtained from new DEXA data for our own research group: data from a study evaluating the adaptive bone remodeling around the Vanguard® uncemented porous‐coated femoral component with one year of follow‐up. Using one‐year follow‐up data could be justified because the decrease in BMD seen beyond the first postoperative year is very limited in most studies. We considered a difference of 8% between groups to be a clinically relevant difference that we wanted to be able to detect with a high statistical power: Using: Type I error = 5% Statistical power = 90 % MIREDIF 8% SD = 8.4% Sample size calculation resulted in a sample size of n = 25 in each group. In the study we have planned to include and randomize (block‐randomization with 10 in each block) a total of 60 patients. This will secure a high statistical power even if some of the participants should drop out during the study. Ethical considerations We do not expect that the patients participating in the study will experience any special side effects or complications related to the use of the two TKAs. There has not been performed any fundamental changes in implant design compared to other types of standard TKAs and the implant fixation modes (cemented or uncemented with a TM ingrowth surface) are well known and in wide spread use. Radiation dose to the patients from MB‐RSA X‐rays and DEXA is relatively low compared with many conventional X‐ray examinations.The total accumulated radiation dose to a patient participating in all examinations during the study is estimated to be approximately 2 mSv. Tantalum has been used for more than 50 years and is a very biocompatible material without any tendency to corrosion.Tantalum beads for RSA have been used in several clinical studies for more than 20 years. More than 20.000 beads have been implanted in more than 2.000 patients and no side effects from Tantalum beads have been observed. This investigation will be performed in accordance with the principles of the Helsinki Declaration, and all patients will receive both oral and written information before informed consent to participate is obtained. At any time being the patient will be able to cancel participation (also without any explanation) in this investigation. The patient will receive the best possible treatment in any circumstances. The study will not be started until approval from the Scientif c Ethical Committee of the Capital Region of Denmark and the Danish Data Protection Agency has been obtained, and it will be registered at clinicaltrials.gov. Risks and inconveniences:This investigation will not add to the general risks of getting TKA. Patients participating must accept some inconvenience in terms of additional examinations and hence transportation to and from the hospitals. Adverse events: All adverse events will be recorded in the CRF and will include details concerning the nature, onset, duration, severity, relationship to the device and relationship to the operative procedure and outcome. The affected patient(s) will be questioned about any adverse event(s) at each subsequent follow‐up visit. Patients experiencing adverse events will be relevantly monitored by clinical assessment and lab examinations decided by the treating physician. All adverse events will be monitored until recovery or stabilization. Information and consent Patients who are planned to receive a TKA (and fits within the inclusion and exclusion criteria of the study) at Gentofte Hospital will be informed about the trial in the preoperative interview. In addition to the oral information provided, the patients will be given written information. This conversation will take place in an enclosed space without distractions or interruptions. The patient will receive adequate verbal and written information about the purposes, processes, potential benefits and risks including possible side effects. Investigator will ensure all patients have read and understood the information and consent form. Patients will be informed that they are entitled to consideration before consent is given. The subjects will also be informed that it is voluntary and that they at any time may withdraw from the trial. It is the investigator's responsibility to ensure the above. There will be obtained written informed consent from all subjects before enrollment, and a copy of the information and consent form will be given to the subjects.Existing legislations made by the Scientific Ethical Committee regarding informed consent will be followed. Data protection All information will be kept confidential, and all data handled according the guidelines of the Danish Data Protection agency. The persons involved in this trial are obliged to professional secrecy. The investigator will maintain a list of identification of all enrolled patients. This list will contain the patients' full names and dates of birth (including social security numbers (CPR‐numbers)). Collected data will be recorded in a case report form (CRF). CRFs and the medical records will be made available to third parties according to Danish law. Patients will be informed in writing that the results will be stored and analyzed in a computer which preserve patients' anonymity and that the local laws regarding personal data will be complied. Patients will also receive written information concerning the possibility of audit from the public authorities, and patients will be informed that the GCP unit of Copenhagen University Hospital likewise is granted access. Investigator ensures that the project will follow the rules of Good Clinical Practice AN - CN-01660494 AU - Nct KW - Osteoarthritis Osteoarthritis, Knee N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2018 ST - Tibial and Femoral Components Migration and Adaptive Bone Remodeling After Insertion of Persona® TKA T2 - https://clinicaltrials.gov/show/NCT03563131 TI - Tibial and Femoral Components Migration and Adaptive Bone Remodeling After Insertion of Persona® TKA UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01660494/full ID - 830031 ER - TY - JOUR AB - 394 participants with Garden III‐IV (20) femoral neck fractures treated with hemiarthroplasty participated in a cluster‐randomised study during 2010‐2014 at Skane University Hospital, Malmö. Inclusion criteria was an acute displaced femoral neck fracture treated with a bipolar hemiarthroplasty inserted via a direct lateral approach in supine position. All such participants were considered potential study participants and invited to the study by an occupational therapist (OT), within the first postoperative days. If the participants was not capable of making decisions, relatives were asked. The study was approved by The Regional Ethical Review Board in Lund on condition that all participants, regardless of group, or their next‐in‐kin gave written consent (Dnr 2009/754). The four wards managing hip fracture patients were assigned either to provide the standard postoperative hip precaution regime or the non‐precaution regime during the entire study period. In two of the wards, the precaution group (PG) had standard postoperative hip precautions included limited flexion of the hip to 90° (avoid reaching down to toes or bringing knee up beyond 90°) and limited adduction of the hip (avoid sleeping on side and avoid crossing legs at knees or ankles). The mandatory assistive equipment to use for at least 3 months were reacher and stocking application aid. The participants were instructed only to use elevated chair, bed and toilet in order not to flex more than 90° in the hip. For the same reason a brace over the knee was prescribed for 6 weeks, particularly in participants with cognitive limitations. The non‐precaution group (NPG) consisted of participants treated in the other two wards. Participants in the NPG had no restrictions on mobility, i.e. they were encouraged to move freely during the recovery phase and assistive equipment were prescribed only if needed. Admittance of a participant to either ward was only decided by any available bed, i.e. the health status of the participants or any other factors did not influence placement of participants. The investigators recruited 168 participants to the PG and 226 participants to the NPG. The initial power analysis was directed towards dislocation rate as primary outcome. When designing the trial, the investigators had a dislocation rate of 0.5% at the department. The investigators calculated that, in order to detect an increase of 3.5%, i.e. a clinical relevant effect, the investigators needed 340 participants in each group (p<0.05). The original plan was to additionally monitor PROM in the first 400 participants, and then dislocation rate only in the remaining 400. In order to monitor the safety of the study, the investigators also calculated a non‐inferiority model, with warning levels at which the investigatorswould discontinue the study. This model was based on 200 participants in each group. Due to recruitment difficulties, the study was closed after inclusion of approximately 400 participants. Both groups had functional assessment by an OT done as part of standard‐of‐care, usually within the three first postoperative days. The surgical procedure was a bipolar hemiarthroplasty inserted via a direct lateral approach (Hardinge). All implants were cemented, except 5 in the NPG and 2 in the PG (2.2 and 1.2 %). During hospital stay the investigators registered time from admission to surgery, time of surgery, type of implant, adversities during surgery, the experience of the surgeon, radiological evaluation, length of stay, any deaths and dismissal address. The work burden of the rehabilitation personnel during hospital stay was estimated by themselves as "very short", "short", "normal", "long" or "very long" work effort. No one reported "very long". "Very short" and "short" was grouped together in the analyses. The participants were followed up with postal questionnaire at 6 weeks and 3 months including EQ‐5D and a visual analogue scale on pain and satisfaction (0 to 100). A physiotherapist assessed participants with functional tests at 3 months. As only half of participants chose to participate in functional testing, the investigators do not report these data. Medical records from all somatic departments of the hospital were reviewed and all adverse events (death, dislocation, surgical site infection (SSI), periprosthetic fracture, deep vein thrombosis, pulmonary embolism, pneumonia, falls and new fractures, stroke and ischemic heart attack) up to 6 months postoperatively were recorded. SSI was divided in to superficial incisional SSI and deep incisional SSI and were defined according to Horan et al.The follow‐up cannot consider to be blinded, as some results were gathered during hospital stay were the group belonging of the participants were obvious. AN - CN-01567249 AU - Nct KW - Hip Fractures N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2018 ST - Cluster-randomized Study of 394 Patients Operated With Direct Anterolateral Approach T2 - https://clinicaltrials.gov/show/NCT03468192 TI - Cluster-randomized Study of 394 Patients Operated With Direct Anterolateral Approach UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01567249/full ID - 830092 ER - TY - JOUR AB - In the early 1960's Sir John Charnley revolutionized total hip arthroplasty (THA) with the introduction of polyethylene as a bearing surface. This innovation allowed THA to become a very successful procedure to treat degeneration of the hip joint, with excellent long term clinical outcome and patient satisfaction. However, this technique requires sacrifice of the whole femoral head and part of the neck. This bone will not be available for future revision surgery, which seems inevitable in the younger patient. THA does not always allow precise reconstitution of normal hip biomechanics. The femoral canal is also violated, fat and cement embolism can occur and thrombogenic material is released in the bloodstream. Postoperatively the femoral stem can cause thigh pain, proximal stress shielding, and periprosthetic fracture may occur . Finally the use of a 28 millimeter non anatomic femoral head during conventional THA increases the risk of hip impingement and dislocation while limiting hip range of motion. There is renewed interest in the concept of hip resurfacing and the use of large diameter femoral heads in total hip arthroplasty, since both these options recreate more optimal hip biomechanics. Total hip resurfacing is less invasive than conventional THA using a femoral stem and allows restoration of normal hip anatomy. Additionally, compared to conventional THA, hip resurfacing has the following advantages: preservation of the femoral head and neck, better hip stability, improved hip biomechanics (leg length, offset) and possibly better proprioception. Since the femoral canal is not violated, there is less risk of residual thigh pain, and patients probably have the sensation of a more normal feeling joint. As for conventional THA with large diameter femoral heads, the use of a near anatomic head size (compared to the small 28mm diameter head use with conventional THA) restores normal stability, helps reduce the incidence of impingement and increases range of motion to a greater extent than hip resurfacing, and might improve proprioception as well. The investigators believe these advantages will have a positive influence on clinical function and gait pattern compared to conventional THA. Gait analysis has demonstrated that gait pattern is modified after THA and patients do not recover normal gait. Kinematics analysis further showed that abnormal gait pattern is not only observed in the operated hip but also in other articulations, including the contra lateral limb. Walking kinetics are affected to some extent, especially the force generated by the lower limb and synchronization of muscle activity. Finally a subjective feeling of an abnormal hip function may still persists after THA. The goal of this double‐blind prospective randomized study is to compare subjective outcome measures and gait parameters between conventional THA using large diameter femoral heads and total hip resurfacing AN - CN-02162888 AU - Nct N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2020 ST - Comparison of Metal on Metal Total Hip Arthroplasty With Large Diameter Femoral Head and Metal on Metal Total Hip Resurfacing T2 - https://clinicaltrials.gov/show/NCT04516239 TI - Comparison of Metal on Metal Total Hip Arthroplasty With Large Diameter Femoral Head and Metal on Metal Total Hip Resurfacing UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-02162888/full ID - 830030 ER - TY - JOUR AB - Vascular complications are rare following total hip replacement arthroplasty and these are primarily injuries to veins. Only two cases of direct arterial trauma have been reported. The authors present a third case, peripheral embolization to the limb from a perforation of the femoral artery by methylmethacrylate. AD - Dept. Surg., Univ. New Mexico Sch. Med., Albuquerque, N.M. 87131 AU - Neal, J. AU - Wachtel, T. L. AU - Garza, O. T. AU - Edwards, W. S. DB - Embase Medline KW - bone cement methacrylic acid methyl ester artery artificial embolization case report femoral artery joint peripheral vascular system therapy total hip prosthesis LA - English M1 - A3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1979 SN - 0021-9355 SP - 429-430 ST - Late arterial embolization complicating total hip replacement. A case report T2 - Journal of Bone and Joint Surgery - Series A TI - Late arterial embolization complicating total hip replacement. A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L9154286&from=export VL - 61 ID - 829969 ER - TY - JOUR AB - Aims: Vertebroplasty for vertebral insufficiency fractures is considered as a foolproof method of treating this pathology. Only technique related problems of cement leak and embolism have been highlighted in literature. We bring forward a less described, but common 'side effect' of vertebroplasty that can happen after a well done vertebroplasty. Methods: We present 5 cases who had a recurrence of back pain and instability after a good initial result of vertebroplasty. All 5 cases (Age 55-78 yrs, M:F=1:4, levels T12-L4) had vertebroplasty for osteoporotic fracture (4 single level, 1 double level vertebroplasty) with good to excellent pain relief immediately post procedure. Results: All five patients reported recurrence of back pain and instability, similar to the pre procedural symptoms, between 1 month and 6 months post vertebroplasty. The pain was gradual in onset, with no triggering factor, aggravated by loading the spine and relieved by rest. Radiological examination revealed adjacent level fracture in three cases, and collapse of the same vertebral body in two cases. None of the cases had any neurological signs or symptoms. Three cases needed surgical stabilization while two were managed conservatively with upgraded medical therapy and rest. Conclusions: Surgeons must realize that vertebroplasty merely strengthens the affected vertebra, but does not treat osteoporosis. This strengthened vertebra acts like a hard interface between the soft adjacent vertebrae, which can cave in on constant load transfer and friction with this cemented rigid bone. This can cause the adjacent bones or on some occasions, the same bone in the periphery of the unyielding bone cement, to collapse. Knowledge and potential prevention of this situation (by appropriate medical treatment) is important to surgeons performing vertebroplasty. AD - A. Nene, Spine Surgery, Orthopedics, PD Hinduja National Hospital, Mumbai, India AU - Nene, A. DB - Embase DO - 10.1007/s00198-010-1433-9 KW - bone cement cement percutaneous vertebroplasty osteoporosis Asia bone vertebra therapy surgeon fracture backache side effect fragility fracture analgesia patient prevention spine radiodiagnosis vertebra body neurologic disease friction pathology embolism pain LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0937-941X SP - S756 ST - Vertebroplasty-happily ever after? T2 - Osteoporosis International TI - Vertebroplasty-happily ever after? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70338269&from=export http://dx.doi.org/10.1007/s00198-010-1433-9 VL - 21 ID - 829636 ER - TY - JOUR AB - Fat embolization following major trauma is reported to be a quite common event, while the clinical fat embolism syndrome (FES) seems to be a much rarer event. Fat embolism occurs in 2 up to 23% of patients with isolated femoral shaft fractures. This complication appears to be related not only to the fracture, but also to the timing of stabilization. Sometimes it may be impossible to perform histochemical reactions on frozen sections to detect fat emboli thus confirming diagnosis or suspicion of FES. The finding of fibrinogen and platelets around the apparently empty spaces in the blood vessels has been proposed as an evidence for vital reaction due to either a vital cellular reaction or a flotation mechanism, thus supporting an intravital fat embolism. We report a fatal case due to fat embolism syndrome in a young man hospitalized for a right femoral neck fracture, treated with orthopaedic surgery and subjected to an intra-surgery transesophageal echocardiography that revealed embolization of numerous highly echogenic bodies. Four hours after the onset of clinical symptoms the man died from respiratory failure. The autopsy confirmed the clinical diagnosis of fat embolism syndrome. The histological examination revealed a large amount of fat globules in cerebral and pulmonary arteries and in glomerular capillaries, as well as fibrin and platelet deposition confirmed by the positive results by Sudan III staining for lipids and immunohistochemistry with anti-CD61 and anti-fibrinogen antibodies. The quantitative classification of fat embolism was grade 3 of Sevitt's classification or grade 4 of Fineschi's quantification, according to the current quantitative microscopic methods used for grading fat embolism in pulmonary tissue. © 2010 Elsevier Ireland Ltd. AD - V. Fineschi, Department of Forensic Pathology, University of Foggia, Ospedale Colonnello D'avanzo, Viale degli Aviatori 1, 71100 Foggia, Italy AU - Neri, M. AU - Riezzo, I. AU - Dambrosio, M. AU - Pomara, C. AU - Turillazzi, E. AU - Fineschi, V. DB - Embase Medline DO - 10.1016/j.forsciint.2010.04.034 KW - bone cement beta3 integrin fibrin fibrinogen lipid metal methylprednisolone oil scarlet adult article autopsy brain artery case report clinical feature confocal laser scanning microscopy cyanosis disease classification disease severity disorientation end tidal carbon dioxide tension fat pad fat embolism fatality femoral neck fracture fibrin deposition fracture immobilization glomerulus capillary histopathology human human tissue hypotension hypoxemia immunohistochemistry lung parenchyma male motorcycle orthopedic prosthesis orthopedic surgery peroperative echography priority journal pulmonary artery quantitative analysis respiratory distress respiratory failure seizure shock tachycardia thrombocyte aggregation tissue distribution traction therapy traffic accident transesophageal echocardiography wheezing LA - English M1 - 1-3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0379-0738 SP - e13-e17 ST - CD61 and fibrinogen immunohistochemical study to improve the post-mortem diagnosis in a fat embolism syndrome clinically demonstrated by transesophageal echocardiography T2 - Forensic Science International TI - CD61 and fibrinogen immunohistochemical study to improve the post-mortem diagnosis in a fat embolism syndrome clinically demonstrated by transesophageal echocardiography UR - https://www.embase.com/search/results?subaction=viewrecord&id=L50914588&from=export http://dx.doi.org/10.1016/j.forsciint.2010.04.034 VL - 202 ID - 829646 ER - TY - JOUR AB - Percutaneous vertebroplasty is a minimally invasive surgical technique involving transpedicular injection of polymethylmetacrylate into the vertebral body. The aim of this procedure is to enhance the mechanical strength of a pathologically changed vertebra. Currently, the method is most often used for painful osteoporotic vertebral fractures, aggressive haemangiomas, necrotic lesions and spinal tumours, particularly the metastatic ones. Although this method is less invasive, relatively straight-forward and effective, there may be complications. The authors present the case of a 70-year-old woman who, on the second day after surgery, developed a rare symptomatic pulmonary polymethylmetacrylate embolism after percutaneous vertebroplasty performed for osteoporotic fractures of the lumbar spine. AD - [Nesnidal, P.; Stulik, J.; Sebesta, P.] Spondylochirurg Oddeleni FN Motol, Prague 15006 5, Czech Republic. [Stulik, J.; Sebesta, P.] 3 Chirurg Klinika 1 LF UK, Prague, Czech Republic. [Stulik, J.; Sebesta, P.] FN Motol, Prague, Czech Republic. [Stulik, J.] Ortoped Klin Deti & Dospelych 2 LF UK, Prague, Czech Republic. Nesnidal, P (corresponding author), Spondylochirurg Oddeleni FN Motol, V Uvalu 84, Prague 15006 5, Czech Republic. pnesnidal@centrum.cz AN - WOS:000281535100012 AU - Nesnidal, P. AU - Stulik, J. AU - Sebesta, P. DA - Aug J2 - Acta Chir. Orthop. Traumatol. Cechoslov. KW - complications polymethylmetacrylate pulmonary embolism vertebroplasty ACRYLIC CEMENT POLYMETHYLMETHACRYLATE KYPHOPLASTY Orthopedics LA - Czech M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2010 SN - 0001-5415 SP - 337-340 ST - Pulmonary Polymethylmetacrylate Embolism: A Rare Complication of Percutaneous Vertebroplasty T2 - Acta Chirurgiae Orthopaedicae Et Traumatologiae Cechoslovaca TI - Pulmonary Polymethylmetacrylate Embolism: A Rare Complication of Percutaneous Vertebroplasty UR - ://WOS:000281535100012 VL - 77 ID - 830337 ER - TY - JOUR AB - Percutaneous vertebroplasty is a minimally invasive surgical technique involving transpedicular injection of polymethylmetacrylate into the vertebral body. The aim of this procedure is to enhance the mechanical strength of a pathologically changed vertebra. Currently, the method is most often used for painful osteoporotic vertebral fractures, aggressive haemangiomas, necrotic lesions and spinal tumours, particularly the metastatic ones. Although this method is less invasive, relatively straight-forward and effective, there may be complications. The authors present the case of a 70-year-old woman who, on the second day after surgery, developed a rare symptomatic pulmonary polymethylmetacrylate embolism after per- cutaneous vertebroplasty performed for osteoporotic fractures of the lumbar spine. AD - Spondylochirurgické oddělení FN Motol, Praha. pnesnidal@centrum.cz AN - 21059333 AU - Nesnídal, P. AU - Stulík, J. AU - Sebesta, P. DA - Aug DP - NLM ET - 2010/11/10 J2 - Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca KW - Aged *Bone Cements Female Fractures, Compression/therapy Humans *Lumbar Vertebrae/injuries *Polymethyl Methacrylate Pulmonary Embolism/*etiology Spinal Fractures/therapy Vertebroplasty/*adverse effects LA - cze M1 - 4 N1 - PubMed NLM literature search January 5, 2021 OP - Plicní embolizace polymetylmetakrylátu - vzácná komplikace perkutánní vertebroplastiky. PY - 2010 SN - 0001-5415 (Print) 0001-5415 SP - 337-40 ST - [Pulmonary polymethylmetacrylate embolism: a rare complication of percutaneous vertebroplasty] T2 - Acta Chir Orthop Traumatol Cech TI - [Pulmonary polymethylmetacrylate embolism: a rare complication of percutaneous vertebroplasty] VL - 77 ID - 828965 ER - TY - JOUR AB - Percutaneous vertebroplasty is a minimally invasive surgical technique involving transpedicular injection of polymethylmetacrylate into the vertebral body. The aim of this procedure is to enhance the mechanical strength of a pathologically changed vertebra. Currently, the method is most often used for painful osteoporotic vertebral fractures, aggressive haemangiomas, necrotic lesions and spinal tumours, particularly the metastatic ones. Although this method is less invasive, relatively straight-forward and effective, there may be complications. The authors present the case of a 70-year-old woman who, on the second day after surgery, developed a rare symptomatic pulmonary polymethylmetacrylate embolism after percutaneous vertebroplasty performed for osteoporotic fractures of the lumbar spine. AD - P. Nesnídal, Spondylochirurgické Oddelení FN Motol, V Úvalu 84, 150 06 Praha 5-Motol, Czech Republic AU - Nesnídal, P. AU - Štulík, J. AU - Šebesta, P. DB - Embase Medline KW - aged article bone strength case report female fragility fracture hemangioma human lumbar spine lung embolism metastasis necrosis percutaneous vertebroplasty postoperative complication pulmonary polymethylmetacrylate embolism spinal cord tumor spine fracture LA - Czech M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0001-5415 SP - 337-340 ST - Pulmonary polymethylmetacrylate embolism: A rare complication of percutaneous vertebroplasty T2 - Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca TI - Pulmonary polymethylmetacrylate embolism: A rare complication of percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L359478035&from=export VL - 77 ID - 829649 ER - TY - JOUR AB - Giant cell tumor of bone is a locally aggressive lesion with a predilection for local recurrence, and in a small proportion of patients, metastatic disease can develop. Surgery is the mainstay of management for extremity-based lesions. For tumors located in challenging anatomical locations such as the sacrum and spine however, surgery may be associated with unacceptable functional morbidity. There are limited data regarding other treatment modalities such as radiation therapy, cytotoxic chemotherapy, interferon and bisphosphonates. Serial arterial embolization can be effective in some cases. Recent evidence has demonstrated denosumab to be a promising agent in the treatment of unresectable or metastatic disease. © 2014 Informa UK, Ltd. AD - R.L. Jones, Seattle Cancer Care Alliance, 825 Eastlake Avenue East, G3630, Seattle, WA 98109, United States AU - Ng, V. Y. AU - Davidson, D. J. AU - Kim, E. Y. AU - Pollack, S. M. AU - Conrad Iii, E. U. AU - Jones, R. L. DB - Embase Medline DO - 10.1586/14737140.2014.901891 KW - bisphosphonic acid derivative bone cement cytotoxic agent denosumab interferon phenol artificial embolization bone pain cancer adjuvant therapy cancer chemotherapy cancer control cancer growth cancer localization cancer pain cancer patient cancer radiotherapy cancer recurrence cancer surgery cryotherapy curettage cytotoxicity disease activity functional disease growth rate human malignant transformation metastasis potential orthopedic surgery osteoclastoma pathophysiology review risk reduction sacrum serial arterial embolization spine cancer symptom systemic therapy LA - English M1 - 7 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1744-8328 1473-7140 SP - 783-790 ST - The multidisciplinary management of giant cell tumor of bone T2 - Expert Review of Anticancer Therapy TI - The multidisciplinary management of giant cell tumor of bone UR - https://www.embase.com/search/results?subaction=viewrecord&id=L373378415&from=export http://dx.doi.org/10.1586/14737140.2014.901891 VL - 14 ID - 829438 ER - TY - JOUR AB - LEARNING OBJECTIVE #1: Assess the need for anticoagulation in patients with pulmonary cement embolism LEARNING OBJECTIVE #2: Manage the complications of cement embolism caused by kyphoplasty CASE: A 79 year-old woman with recent T12/L1 compression fractures presented with left leg pain for 2 weeks. Five months prior to presentation, she underwent an uncomplicated kyphoplasty for T12/L1 compression fractures. Two weeks prior to presentation the patient began to experience left leg pain with ambulation without associated sensory loss or urinary/fecal incontinence. A computed tomography (CT) scan of the thoracic and lumbosacral spines showed prior T12 and L1 kyphoplasty with extravasation of cement into the surrounding vasculature and bilateral pulmonary arteries. A CT angiogram showed central cement pulmonary emboli extending from the pulmonary artery bifurcation into the left main pulmonary artery. A transthoracic echocardiogram did not reveal evidence of right heart strain. As the patient was asymptomatic and clinically stable with normal cardiac function post-procedurally for 5 months, initiation of anticoagulation was deferred. IMPACT: This case emphasizes considering pulmonary cement embolism in the risk and benefit profile of kyphoplasties for intractable pain due to fractures secondary to metastases or osteoporosis. DISCUSSION: Percutaneous kyphoplasty (PKP) is a minimally invasive procedure where polymethylmethacrylate (PMMA) is injected into damaged vertebral bodies for pain relief. Pulmonary cement embolism(PCE) is a known complication of PKP with a reported incidence of 3.5 to 23%. Currently, there are no published guidelines to guide the management of PCE. One proposed schema, based on expert opinion, is to risk-stratify patients with PCE by symptoms. Patients with symptomatic PCE typically present periprocedurally with chest pain, dyspnea, tachycardia and/or cough. In patients with central, symptomatic PCE, some authors suggest surgical removal as pharmacologic intervention may be insufficient. In patients with symptomatic, peripheral PCE, CHEST guidelines on thrombotic pulmonary emboli recommend initial intravenous heparin followed by at least 3 months of oral anticoagulation. It is important to note, however, that there is no data to suggest that PMMA is itself thrombogenic either in vitro or in vivo. Given numerous case reports of recovery from symptomatic PCE with anticoagulation, many clinicians hypothesize that anticoagulation prevents thrombus formation while the cement is endothelialized. PCEs in asymptomatic individuals are typically discovered incidentally. The true incidence of PCE may be much higher than what is reported as many patients are asymptomatic. In asymptomatic individuals, it may be reasonable to avoid further intervention and instead monitor longitudinally. In one study of 11 asymptomatic patients with PCE identified post-procedurally, none developed symptoms during 1-year follow-up. Given the paucity of prospective data to direct management of PCEs, further research is warranted. AD - C. Ngai, NYU Langone Medical Center, New York, NY, United States AU - Ngai, C. AU - Manmadhan, A. AU - Teich, N. AU - Smith, J. DB - Embase KW - cement heparin poly(methyl methacrylate) aged analgesia anticoagulation blood clotting cancer susceptibility clinical article complication compression fracture computer assisted tomography consensus development coughing drug therapy drug toxicity dyspnea extravasation feces incontinence female follow up heart function human in vitro study intractable pain kyphoplasty learning leg pain lumbosacral spine lung embolism metastasis minimally invasive procedure mobilization osteoporosis pulmonary artery sensory dysfunction side effect surgery symptom tachycardia thoracic spine thorax pain thrombosis transthoracic echocardiography urine incontinence vascularization vertebra body LA - English M1 - 2 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 0884-8734 SP - S572 ST - Pulmonary cement embolism T2 - Journal of General Internal Medicine TI - Pulmonary cement embolism UR - https://www.embase.com/search/results?subaction=viewrecord&id=L615580817&from=export VL - 32 ID - 829263 ER - TY - JOUR AB - 45 cases of vertebral hemangiomas with neurologic involvement are reported. This series corresponds to the french experience between 1969 to 1988 (series of the "Société Française de Neuro-Chirurgie" (S.F.N.)). In this report, the therapeutic results are detailed. 16 patients were treated by a simple laminectomy, 6 by laminectomy associated with radiotherapy, 4 by radiotherapy alone. In 9 patients, a large removal of the hemangioma was performed by mean of a lamino-arthrectomy (7 cases) or a corporectomy (2 cases). 7 patients were treated by embolization or vertebroplasty. Both techniques were used alone or in association with surgery or radiotherapy. 3 patients had no therapy. Results of the S.F.N. series demonstrated that 75.5% of the patients had a long term favorable clinical course. 13.4% of the patients were not improved. Mortality was of 11.1%. The mean follow up time was of 51.6 months. Recurrence was encountered in 13 cases. It was mainly observed in the first two years. In cases of total involvement of the vertebrae by hemangioma, laminectomy associated with radiotherapy was the best mean of therapy: 93% of recovery without recurrence. Treatment of body localization appeared to be difficult. Corporectomy could be unefficient if a complete removal of the hemangioma could not be performed. In contrast, posterior arch localization was successfully treated by a simple laminectomy without radiotherapy, even in cases of incomplete removal of the hemangioma: all such cases (10 cases) had a complete recovery without recurrence. AD - Service de Neurochirurgie, C.H.U. Henri-Mondor, Créteil. AN - 2630927 AU - Nguyen, J. P. AU - Djindjian, M. AU - Pavlovitch, J. M. AU - Badiane, S. DP - NLM ET - 1989/01/01 J2 - Neuro-Chirurgie KW - Combined Modality Therapy Hemangioma/complications/radiotherapy/*surgery Humans Laminectomy Neoplasm Recurrence, Local Nervous System Diseases/etiology/radiotherapy/*surgery Spinal Neoplasms/complications/radiotherapy/*surgery Time Factors LA - fre M1 - 5 N1 - PubMed NLM literature search January 5, 2021 OP - Hémangiomes vertébraux avec signes neurologiques. Les résultats thérapeutiques. Enquête de la S.N.F. PY - 1989 SN - 0028-3770 (Print) 0028-3770 SP - 299-303, 305-8 ST - [Vertebral hemangioma with neurologic signs. Therapeutic results. Survey of the French Society of Neurosurgery] T2 - Neurochirurgie TI - [Vertebral hemangioma with neurologic signs. Therapeutic results. Survey of the French Society of Neurosurgery] VL - 35 ID - 829033 ER - TY - JOUR AB - Background Pulmonary emboli (PTE) are often due to lower extremity (LE) deep vein thrombosis (DVT); other etiologies are less likely. Case 67 yo male developed dyspnea following kyphoplasty for cervical spine disease. LE Dopplers revealed DVT; CT angio revealed PTE; he received IVC filter and apixaban. Symptoms progressed over few weeks. Repeat CXR (Fig 1B) and CT angio (Fig 1D) revealed calcification within the pulmonary vasculature suggestive of cement deposition, new compared to prior normal exams (Fig 1A; 1C respectively). Echo showed new calcium deposits in the right ventricle (Fig 1F), not seen previously (Fig. 1E). Transesophageal echo (Fig 1G; 1H) confirmed subvalvular calcifications in RV along the tricuspid valve chordae. He was maintained on anticoagulation, with slow improvement. Decision-making Dyspnea was initially attributed to LE DVT and pulmonary emboli in the setting of recent surgery. Progression of symptoms despite anticoagulation prompted repeat CT angio, showing pulmonary calcifications. Echo revealed RV calcium deposits along the tricuspid valve chordae supporting diagnosis of cement embolization from prior kyphoplasty. Conclusion Considering a broader differential diagnosis even with an obvious cause of symptoms is prudent. Follow-up CT angio and echo should be considered in patient with post kyphoplasty recurrent dyspnea so as not to miss the potential diagnosis of cement embolization. [Figure presented] AU - Nguyen, L. AU - Sachdev, S. AU - Tahir, H. AU - Malozzi, C. M. AU - Rahimi, F. AU - Awan, G. AU - Amritphale, A. AU - Omar, B. DB - Embase DO - 10.1016/S0735-1097(20)33042-4 KW - apixaban cement adult anticoagulation cervical spine conference abstract controlled study decision making differential diagnosis dyspnea filter follow up heart right ventricle human kyphoplasty lower extremity deep vein thrombosis lung blood vessel lung calcification lung embolism male transesophageal echocardiography tricuspid valve LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1558-3597 0735-1097 SP - 2415 ST - CARDIAC CEMENT EMBOLIZATION - UNEXPECTED CONSEQUENCE OF KYPHOPLASTY T2 - Journal of the American College of Cardiology TI - CARDIAC CEMENT EMBOLIZATION - UNEXPECTED CONSEQUENCE OF KYPHOPLASTY UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2005042747&from=export http://dx.doi.org/10.1016/S0735-1097(20)33042-4 VL - 75 ID - 829075 ER - TY - JOUR AB - Purpose: To analyse and summarize the complications of percutaneous kyphoplasty (PKP) in 175 patients with painful osteoporotic vertebral compression fractures, and to speculate on its possible mechanism of production. Materials and Methods: Retrospective data of 175 patients with painful osteoporotic vertebral compression fractures treated with PKP were analysed about the clinical signs and symptoms and CT or/and MRI findings after the procedure. There were 30 male and 145 female patients, aged from 36-to 92-years-old (median age: 69). Results: PKP was performed in 175 patients with 214 vertebrae. Cement leakage was found in 58 cases with 62 vertebrae, and pulmonary embolism occurred in 3 cases. Besides, nerve root injury, intercostal neuralgia and excessive blood loss happened individually. The leakage rate of PMMA was 34.3% (60/175) according to the number of patients, or 29.9 % (62/214) according to the number of vertebrae. After systemic management, the clinical symptoms were basically disappeared in all other paitents except that 2 patients died after PKP due to the pulmonary embolism. Conclusion: PMMA leakage is the most common complication in PKP as PVP. Although most leakage doesn't cause any symptoms, there still is life-threatening risk. The probable mechanism of complication resulting from PKP may lie in the cement leakage secondary to easy rupture of vertebral body and pedicle caused by the increase of working pathway and complexity of the procedure, and in other factors such as the comorbidity, need for general anesthesia and long immobilization after PKP. AD - R. Ni, Interventional Radiology, First Affiliated Hospital, Soochow University, Suzhou, China AU - Ni, R. AU - Chen, L. AU - Yang, C. DB - Embase DO - 10.1016/j.jvir.2011.01.217 KW - cement povidone kyphoplasty interventional radiology society patient vertebra lung embolism compression fracture male physical disease by body function general anesthesia immobilization nuclear magnetic resonance imaging nerve root injury neuralgia bleeding risk rupture vertebra body comorbidity female LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 1051-0443 SP - S85 ST - The complications and speculation about the mechanism of production after percutaneous kyphoplasty (with analysis of 175 cases) T2 - Journal of Vascular and Interventional Radiology TI - The complications and speculation about the mechanism of production after percutaneous kyphoplasty (with analysis of 175 cases) UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70368394&from=export http://dx.doi.org/10.1016/j.jvir.2011.01.217 VL - 22 ID - 829624 ER - TY - JOUR AB - A new method, intraoperative retrograde embolization with a methyl methacrylate polymer injected into a vertebral hemangioma, is described. This method achieves complete intraoperative hemostasis and postoperative stabilization. No further stabilization procedures and radiation therapy are necessary. Preoperative selective angiography with embolization and consecutive laminectomy are required for this method. AD - Department of Neurosurgery and Neuroradiology, University of Dusseldorf, 4000 Dusseldorf AU - Nicola, N. AU - Lins, E. C1 - palacos DB - Embase Medline DO - 10.1016/0090-3019(87)90258-8 KW - methacrylic acid methyl ester palacos artificial embolization bone case report diagnosis drug administration drug efficacy drug indication hemangioma human methodology peripheral vascular system priority journal spine therapy vertebra LA - English M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1987 SN - 0090-3019 SP - 481-486 ST - Vertebral hemangioma: Retrograde embolization-stabilization with methyl methacrylate T2 - Surgical Neurology TI - Vertebral hemangioma: Retrograde embolization-stabilization with methyl methacrylate UR - https://www.embase.com/search/results?subaction=viewrecord&id=L17064359&from=export http://dx.doi.org/10.1016/0090-3019(87)90258-8 VL - 27 ID - 829957 ER - TY - JOUR AB - Vertebral fractures are very common. The estimated annual incidence is 1.4 million cases worldwide-the most frequent underlying cause being osteoporosis. The first-line treatment for symptomatic Vertebral fractures is generally conservative and is based on analgesics, rest, orthesis, and rehabilitation. However, up to one-third of all patients fail to respond to such treatment and require surgery. In the last 20 years, 2 safe and effective minimally invasive procedures have been developed as an alternative to conservative management and open surgery: vertebroplasty and kyphoplasty. The complications of both these techniques, although infrequent, are not negligible and include infection, bleeding, worsening of the pain, radiculopathy, canal stenosis, local trauma, and embolisms. Most complications are directly or indirectly related to cement injection-the most common problem being cement leakage from the vertebral body not only into the intervertebral space but also into the spinal canal. Pulmonary embolization may even occur. The present study describes the most common complications during treatment and the ways to improve the technique and procedures, with a view to avoiding such problems. AD - C. Nieto-Iglesias, Area of Anesthesiology and Resuscitation, Fundación Alcorcón University Hospital, c/ Budapest 1, Alcorcón, Madrid, Spain AU - Nieto-Iglesias, C. AU - Andrés-Nieto, I. AU - Peces-García, E. AU - Roca-Amatria, G. AU - De Andrés Ares, J. AU - Franco-Gay, M. L. AU - Bovaira-Forner, M. DB - Embase DO - 10.1053/j.trap.2015.01.007 KW - acenocoumarol analgesic agent antibiotic agent bone cement heparin nonsteroid antiinflammatory agent antibiotic therapy article bandaging technique bone scintiscanning cement leakage computer assisted tomography conservative treatment human kyphoplasty lung embolism nuclear magnetic resonance imaging paralysis percutaneous vertebroplasty pneumothorax postoperative complication postoperative hemorrhage postoperative infection postoperative pain radiculopathy rib fracture spine fracture spine radiography surgical infection surgical technique vertebral canal stenosis LA - English M1 - 1-2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1558-4534 1084-208X SP - 40-48 ST - Vertebroplasty and kyphoplasty: Techniques, complications, and troubleshooting T2 - Techniques in Regional Anesthesia and Pain Management TI - Vertebroplasty and kyphoplasty: Techniques, complications, and troubleshooting UR - https://www.embase.com/search/results?subaction=viewrecord&id=L603172232&from=export http://dx.doi.org/10.1053/j.trap.2015.01.007 VL - 18 ID - 829460 ER - TY - JOUR AB - To improve the surgical results of severe osteoarthritis of the hip, surface replacement of the hip using a double cup without cement was employed on 75 hips during the period from 1972 to 1977. The results of the procedures have been analyzed on 67 hips followed for more than 6 months. The most dramatic improvement following the procedure has been pain relief, observed in 58 of 67 hips (86%). Three reoperations were necessary. Failures were treated satisfactorily either by total hip replacement, or by arthrodesis and/or by placing a new cup on the head respectively. There was no operative death, pulmonary embolism, thrombophlebitis, nor deep infection. We do not think this procedure replaces more definitive surgery such as the Charnley-type total hip replacement, but it is a good adjunctive procedure particularly in patients younger than 60 years of age. AN - 729267 AU - Nishio, A. AU - Eguchi, M. AU - Kaibara, N. DA - Jul-Aug DP - NLM ET - 1978/07/01 J2 - Clinical orthopaedics and related research KW - Acetabulum/surgery Adult Age Factors Aged Female Femur Head/surgery Hip Joint/*surgery Humans Male Methods Middle Aged Osteoarthritis/surgery Pain Postoperative Care Postoperative Complications LA - eng M1 - 134 N1 - PubMed NLM literature search January 5, 2021 PY - 1978 SN - 0009-921X (Print) 0009-921x SP - 53-8 ST - Socket and cup surface replacement of the hip T2 - Clin Orthop Relat Res TI - Socket and cup surface replacement of the hip ID - 828991 ER - TY - JOUR AB - Pain relief is the most striking feature following this procedure. In Group I, in which the metal acetabular socket and the metal femoral cup were used, 60 per cent of the patients gained satisfactory pain relief at five to nine years of follow-up. In Group II, in which the metal-polyethylene socket and the metal cup were used, 84 per cent of the patients gained satisfactory pain relief, with 1 to 5 years of follow-up. There have been 12 revision cases in the 130 hips operated on, with the average time to revision being 3 years and 10 months. Revision procedures consisted of the conventional total hip replacement (seven cases), replacement of the socket and/or the cup (four cases), and arthrodesis (one case). The secondary operations could be performed without difficulties, probably because no bone cement was used in our surface replacement. No cases of pulmonary embolism, thrombophlebitis, deep infection, heterotopic ossification, or femoral neck fracture were encountered after the procedure. AN - 7145350 AU - Nishio, A. AU - Eguchi, M. AU - Ogata, K. DA - Oct DP - NLM ET - 1982/10/01 J2 - The Orthopedic clinics of North America KW - Adult Age Factors Aged Female Femur Head/surgery Femur Neck/surgery Follow-Up Studies Hip Joint/diagnostic imaging/*surgery Hip Prosthesis/*adverse effects Humans Joint Diseases/*surgery Male Methods Middle Aged Osteoarthritis/surgery Pain/etiology/surgery Radiography LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 1982 SN - 0030-5898 (Print) 0030-5898 SP - 843-56 ST - Symposium on Surface Replacement Arthroplasty of the Hip. Socket and cup surface replacement T2 - Orthop Clin North Am TI - Symposium on Surface Replacement Arthroplasty of the Hip. Socket and cup surface replacement VL - 13 ID - 828959 ER - TY - JOUR AB - Pain relief is the most striking feature following this procedure. In Group I, in which the metal acetabular socket and the metal femoral cup were used, 60 per cent of the patients gained satisfactory pain relief at five to nine years of follow-up. In Group II, in which the metal-polyethylene socket and the metal cup were used, 84 per cent of the patients gained satisfactory pain relief, with 1 to 5 years of follow-up. There have been 12 revision cases in the 130 hips operated on, with the average time to revision being 3 years and 10 months. Revision procedures consisted of the conventional total hip replacement (seven cases), replacement of the socket and/or the cup (four cases), and arthrodesis (one case). These secondary operations could be performed without difficulties, probably because no bone cement was used in our surface replacement. No cases of pulmonary embolism, thrombophlebitis, deep infection, heterotopic ossification, or femoral neck fracture were encountered after the procedure. AD - Dep. Orthop. Surg., Fac. Med., Kyushu Univ., Fukuoka 812 AU - Nishio, A. AU - Eguchi, M. AU - Ogata, K. DB - Embase Medline KW - human joint major clinical study total hip prosthesis LA - English M1 - 4 N1 - Embase Elsevier literature search January 5, 2021 PY - 1982 SN - 0030-5898 SP - 843-856 ST - Socket and cup surface replacement T2 - Orthopedic Clinics of North America TI - Socket and cup surface replacement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L13212974&from=export VL - 13 ID - 829965 ER - TY - JOUR AD - Department of Anesthesiology, Medical College of Oita, Oita 879-56 AU - Noguchi, T. AU - Iwasaka, H. AU - Hayano, Y. DB - Embase Medline KW - acrylic cement bone cement adverse drug reaction animal experiment cardiovascular system case report dog drug administration drug efficacy drug therapy fat embolism great blood vessel human joint lung edema methodology priority journal pulmonary hypertension respiratory system therapy total hip prosthesis triacylglycerol lipase blood level LA - Japanese M1 - 11 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1986 SN - 0021-4892 SP - 1727-1731 ST - Effects of acrylic bone cement following total hip replacement T2 - Japanese Journal of Anesthesiology TI - Effects of acrylic bone cement following total hip replacement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L17201367&from=export VL - 35 ID - 829958 ER - TY - JOUR AN - 3820564 AU - Noguchi, T. AU - Iwasaka, H. AU - Hayano, Y. AU - Miyamoto, M. AU - Oda, S. AU - Taniguchi, K. AU - Honda, N. AU - Honda, Y. DA - Nov DP - NLM ET - 1986/11/01 J2 - Masui. The Japanese journal of anesthesiology KW - Acrylates/*adverse effects Aged Animals Bone Cements/*adverse effects Dogs Embolism, Fat/*complications Female *Hip Prosthesis Humans Intraoperative Complications/etiology Methacrylates/*adverse effects Middle Aged Pulmonary Edema/*etiology LA - jpn M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 1986 SN - 0021-4892 (Print) 0021-4892 SP - 1727-31 ST - [Effects of acrylic bone cement following total hip replacement] T2 - Masui TI - [Effects of acrylic bone cement following total hip replacement] VL - 35 ID - 828551 ER - TY - JOUR AB - Background Context. Vertebroplasty is a minimally invasive procedure most commonly used for the treatment of vertebral compression fractures. Although it is relatively safe, complications have been reported over time. Among those complications, massive cement pulmonary embolism is considered a rare complication. Here we report a case of massive diffuse cement pulmonary embolism following percutaneous vertebroplasty for a vertebral compression fracture. Study Design. CASE REPORT: Methods. This is a 70-year-old female who underwent vertebroplasty for T11 and T12 vertebral compression fracture. Results. CT-scan revealed an incidental finding of cement embolism in the pulmonary trunk and both pulmonary arteries. Since the patient was asymptomatic, she was monitored closely and she did not need any intervention. Conclusion. Vertebroplasty is a minimally invasive procedure used for treatment of vertebral compression fracture. Despite the low rate of complications, a pulmonary cement embolism can occur. The consequences of cement embolism range widely from being asymptomatic to embolism that can cause paralysis, radiculopathy, or a fatal pulmonary embolism. AD - McGill Scoliosis & Spine Centre, McGill University Health Centre, Montreal, QC, Canada H3A 0G4 ; Department of Orthopedic Surgery, King Abdulaziz University, Jeddah, Saudi Arabia. Department of Orthopedic Surgery, King Abdulaziz University, Jeddah, Saudi Arabia ; Department of Diagnostic Radiology, Dalhousie University, Halifax, NS, Canada B3H 4R2. McGill Scoliosis & Spine Centre, McGill University Health Centre, Montreal, QC, Canada H3A 0G4. AN - 26221556 AU - Nooh, A. AU - Abduljabbar, F. H. AU - Abduljabbar, A. H. AU - Jarzem, P. C2 - Pmc4499392 DO - 10.1155/2015/582769 DP - NLM ET - 2015/07/30 J2 - Case reports in orthopedics LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 2090-6749 (Print) 2090-6757 SP - 582769 ST - Pulmonary Artery Cement Embolism after a Vertebroplasty T2 - Case Rep Orthop TI - Pulmonary Artery Cement Embolism after a Vertebroplasty VL - 2015 ID - 828618 ER - TY - JOUR AB - INTERVENTION: Percutaneous vertebroplasty with either high or low viscosity PMMA bone cement. CONDITION: ; Painful osteoporotic vertebral fractures ; ; PRIMARY OUTCOME: Incidence of cement leakage. SECONDARY OUTCOME: 1. Incidence and clinical relevance of pulmonary and cardiac cement emboli; ; ; 2. Incidence of new (adjacent) OVCFs during the first year after PVP; ; ; 3. Postoperative pain and health‐related quality of Life. INCLUSION CRITERIA: All consecutive patients with one or more osteoporotic vertebral compression fractures attending our clinic and considered suitable candidates for PVP will be asked to take participate in this study. AN - CN-01869795 AU - Ntr N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2012 ST - PMMA bone cement viscosity in vertebroplasty T2 - http://www.who.int/trialsearch/Trial2.aspx?TrialID=NTR3282 TI - PMMA bone cement viscosity in vertebroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01869795/full ID - 829982 ER - TY - JOUR AB - In 2002, approximately 38,000 vertebroplasties and 16,000 kyphoplasties were performed in the United States. As the use of both modalities for the treatment of vertebral compression fractures has increased, so have questions regarding safety and efficacy. The authors addressed this by reviewing both the current literature and complications data reported to the Food and Drug Administration (FDA) Center for Devices and Radiological Health through the on-line database (http://www.fda.gov/cdrh/maude.html) and through the Office of the Freedom of Information Act at the FDA. Although both procedures are largely safe, the FDA data highlight two main concerns: reactions to the use of acrylic (polymethylmethacrylate) bone cement, including hypotension and, in some cases, death, especially when multiple vertebral levels are treated in one setting; and a possible increased risk with kyphoplasty of pedicle fracture and cord compression. AD - K. Murphy, Div. of Interventional Neuroradiol., Dept. of Radiol./Radiological Sci., Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, United States AU - Nussbaum, D. A. AU - Gailloud, P. AU - Murphy, K. DB - Embase Medline DO - 10.1097/01.RVI.0000144757.14780.E0 KW - bone cement poly(methyl methacrylate) anaphylaxis cement embolus clinical trial controlled clinical trial controlled study data base diskitis epidural hematoma equipment breakage Food and Drug Administration heart arrest human hypotension ileus kyphoplasty lung embolism major clinical study motor dysfunction muscle weakness online system osteomyelitis paralysis paresthesia percutaneous vertebroplasty pneumothorax postoperative complication priority journal radiculopathy review safety spinal cord compression spine surgery surgical approach surgical mortality spine fracture LA - English M1 - 11 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2004 SN - 1051-0443 SP - 1185-1192 ST - A review of complications associated with vertebroplasty and kyphoplasty as reported to the food and drug administration medical device related web site T2 - Journal of Vascular and Interventional Radiology TI - A review of complications associated with vertebroplasty and kyphoplasty as reported to the food and drug administration medical device related web site UR - https://www.embase.com/search/results?subaction=viewrecord&id=L39487847&from=export http://dx.doi.org/10.1097/01.RVI.0000144757.14780.E0 VL - 15 ID - 829826 ER - TY - JOUR AB - Vertebroplasty is a well-established treatment for both pathological and painful osteoporotic fractures. It is a frequently performed and generally low risk, but severe complications can occur. We report on a patient with metastatic breast cancer requiring vertebroplasty for pain relief who suffered an unusual complication: a pulmonary cement embolism. We describe our management of the case and the controversies related to the use of anticoagulation. In addition, we carried out a brief literature review of common practices in relation to this complication. This case highlights the difficulty of managing anticoagulation in the complex setting of cancer and the need for greater awareness among clinicians of this uncommon, but possibly catastrophic complication. AD - Departments of Medical Oncology. Radiology, Beaumont Hospital, Dunlin, Ireland. AN - 30950837 AU - O'Connor-Byrne, N. AU - Logan, C. AU - Keegan, N. AU - Brennan, P. AU - Breathnach, O. S. AU - Grogan, L. AU - Hennessy, B. AU - Morris, P. G. DA - Jul DO - 10.1097/cad.0000000000000755 DP - NLM ET - 2019/04/06 J2 - Anti-cancer drugs KW - Adult Anticoagulants/*therapeutic use Antineoplastic Combined Chemotherapy Protocols/therapeutic use Bone Cements/*adverse effects Breast Neoplasms/*complications/drug therapy/pathology Female Fractures, Compression/physiopathology/*surgery Humans Prognosis Pulmonary Embolism/*drug therapy/etiology Vertebroplasty/*adverse effects LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 0959-4973 SP - 646-648 ST - An uncommon complication of vertebroplasty: the role of anticoagulation T2 - Anticancer Drugs TI - An uncommon complication of vertebroplasty: the role of anticoagulation VL - 30 ID - 828560 ER - TY - JOUR AB - BACKGROUND: Endovascular aortic repair (EVAR) requires further intervention in 20-30 % of cases, often due to type II endoleak (T2EL). Management options for T2EL include transarterial embolization, direct puncture (DP), or transcaval embolization. We report the case of an 80-year-old man with T2EL who successfully underwent DP embolization. METHODS: Embolization by DP was performed with a transpedicular approach using an isocenter puncture (ISOP) method. An isocenter marker (ICM) was placed at a site corresponding to the aneurysm sac on fluoroscopy in two directions (frontal and lateral views). A vertebroplasty needle was inserted tangentially to the ICM under fluoroscopy and advanced to the anterior wall of the vertebral body. A 20 cm-length, 20-G-PTCD needle was inserted through the outer needle of the 13-G needle and advanced to the ICM. Sac embolization using 25 % N-buty-2-cyanoacrylate diluted with Lipiodol was performed. After complete embolization, rotational DA confirmed good filling of the sac with Lipiodol. The outer cannula and 13-G needle were removed and the procedure was completed. RESULTS: The patient was discharged the next day. Contrast-enhanced computed tomography 1 and 8 months later showed no Lipiodol washout in the aneurysm sac, no endoleak recurrence, and no expansion of the excluded aneurysm. CONCLUSION: DP with a transpedicular approach using ISOP may be useful when translumbar and transabdominal approaches prove difficult. AD - Department of Radiology, St. Marianna University, School of Medicine, 2-16-1, Sugao, Miyamae-ku, Kawasaki, 216-8511, Japan, yukky.oct.22@gmail.com. AN - 25737457 AU - Ogawa, Y. AU - Hamaguchi, S. AU - Nishimaki, H. AU - Kon, Y. AU - Chiba, K. AU - Sakurai, Y. AU - Murakami, K. AU - Arai, Y. AU - Miyairi, T. AU - Nakajima, Y. DA - Jun DO - 10.1007/s00270-015-1065-8 DP - NLM ET - 2015/03/05 J2 - Cardiovascular and interventional radiology KW - Aged, 80 and over Aortic Aneurysm, Abdominal/*surgery Blood Vessel Prosthesis Embolization, Therapeutic/instrumentation/*methods Endoleak/*therapy *Endovascular Procedures Humans Male Postoperative Complications/*therapy Punctures/instrumentation/*methods Treatment Outcome LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 0174-1551 SP - 731-5 ST - Embolization by Direct Puncture with a Transpedicular Approach Using an Isocenter Puncture (ISOP) Method in a Patient with a Type II Endoleak After Endovascular Aortic Repair (EVAR) T2 - Cardiovasc Intervent Radiol TI - Embolization by Direct Puncture with a Transpedicular Approach Using an Isocenter Puncture (ISOP) Method in a Patient with a Type II Endoleak After Endovascular Aortic Repair (EVAR) VL - 38 ID - 828838 ER - TY - JOUR AB - Background: Bundled payment initiatives were introduced to reduce costs and improve quality of care. Cemented vs cementless femoral fixation is a modifiable variable that may influence the cost and quality of care. New bundled payment data from the Centers for Medicare and Medicaid Services allowed us to study the influence of femoral fixation strategy on (1) 90-day costs; (2) readmission rates; (3) reoperation rates; (4) length of stay (LOS); and (5) discharge disposition for Medicare patients undergoing total hip arthroplasty. Methods: We retrospectively studied 1671 primary total hip arthroplasty Medicare cases, comparing 359 patients who received cemented femoral fixation to 1312 patients who received cementless fixation. Centers for Medicare and Medicaid Services cost data as well as clinical data were reviewed. Demographic differences were present between the 2 cohorts. Statistical analyses were performed, including multiple regression models to adjust for baseline differences. Results: Controlling for cohort differences, cemented patients were significantly more likely to be discharged home compared to cementless patients. Cemented patients also demonstrated trends toward lower costs, lower readmission rates, and shorter LOS compared to cementless patients. All reoperations within the early postoperative period occurred in patients managed with cementless femoral fixation. Conclusion: Among Medicare patients, cemented femoral fixation outperformed cementless fixation with respect to discharge disposition and also trended toward superiority with regards to LOS, readmission, cost of care, and reoperation. Cemented femoral fixation remains relevant and useful despite the rising popularity of cementless fixation. (C) 2020 Elsevier Inc. All rights reserved. AD - [Oh, Jason H.; Yang, William W.; Moore, Tara; Dushaj, Kristina; Hepinstall, Matthew S.] Lenox Hill Hosp, Dept Orthopaed Surg, 130 East 77th St,11th Floor, New York, NY 10075 USA. [Cooper, H. John] Columbia Univ, Dept Orthopaed Surg, Med Ctr, New York, NY USA. Oh, JH (corresponding author), Lenox Hill Hosp, Dept Orthopaed Surg, 130 East 77th St,11th Floor, New York, NY 10075 USA. AN - WOS:000535698400008 AU - Oh, J. H. AU - Yang, W. W. AU - Moore, T. AU - Dushaj, K. AU - Cooper, H. J. AU - Hepinstall, M. S. DA - Jun DO - 10.1016/j.arth.2020.01.035 J2 - J. Arthroplast. KW - Medicare bundled payments hip arthroplasty cement cost CHARLSON COMORBIDITY INDEX NECK FRACTURES UNCEMENTED HEMIARTHROPLASTY RISK-FACTORS SURGICAL APPROACH FAT-EMBOLISM CEMENTLESS COMPLICATIONS REPLACEMENT MORTALITY Orthopedics LA - English M1 - 6 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2020 SN - 0883-5403 SP - 1489-+ ST - Does Femoral Component Cementation Affect Costs or Clinical Outcomes After Hip Arthroplasty in Medicare Patients? T2 - Journal of Arthroplasty TI - Does Femoral Component Cementation Affect Costs or Clinical Outcomes After Hip Arthroplasty in Medicare Patients? UR - ://WOS:000535698400008 VL - 35 ID - 830104 ER - TY - JOUR AB - Pulmonary embolism (PE) is usually associated with deep vein thrombosis (DVT) in the lower extremities. However, foreign bodies in the pulmonary arteries can rarely cause PE without evidence of DVT. In this report, we present a case of diffuse PE associated with a migrated thread-like structure of the right-side heart and pulmonary arteries in a 70 year-old woman. The patient underwent several episodes of percutaneous vertebroplasty (PV) to treat compression fractures. The thread-like foreign bodies were identified as the bone cement injected during the previous PV procedures. We present this case study to emphasise that clinicians should consider the possibility of PE as a late complication, especially those with a history of PV. AD - Department of Cardiology in Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea. Department of Cardiology in Internal Medicine, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea. Electronic address: jaehpark@cnu.ac.kr. Division of Cardiothoracic Radiology, Department of Radiology, School of Medicine, Chungnam National University, Chungnam National University Hospital, Daejeon, Korea. AN - 25797324 AU - Oh, J. K. AU - Park, J. H. AU - Kim, S. S. AU - Han, J. H. AU - Kwon, H. J. AU - Kim, J. H. AU - Lee, J. H. AU - Choi, S. W. AU - Jeong, J. O. AU - Seong, I. W. DA - Jul DO - 10.1016/j.hlc.2015.02.017 DP - NLM ET - 2015/03/24 J2 - Heart, lung & circulation KW - Aged Bone Cements/*adverse effects/pharmacology *Coronary Vessels/pathology/physiopathology Female Fractures, Compression/*surgery Humans *Postoperative Complications/pathology/physiopathology *Pulmonary Artery/pathology/physiopathology *Pulmonary Embolism/etiology/pathology/physiopathology Spinal Fractures/*surgery Vertebroplasty/*adverse effects Bone cement Computerised tomography Echocardiography Percutaneous vertebroplasty Pulmonary embolism LA - eng M1 - 7 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 1443-9506 SP - e104-7 ST - Thread-like Bone Cement in the Right-side Heart and Pulmonary Arteries Causing Diffuse Pulmonary Embolism as a Late Complication T2 - Heart Lung Circ TI - Thread-like Bone Cement in the Right-side Heart and Pulmonary Arteries Causing Diffuse Pulmonary Embolism as a Late Complication VL - 24 ID - 828763 ER - TY - JOUR AB - Pulmonary embolism (PE) is usually associated with deep vein thrombosis (DVT) in the lower extremities. However, foreign bodies in the pulmonary arteries can rarely cause PE without evidence of DVT. In this report, we present a case of diffuse PE associated with a migrated thread-like structure of the right-side heart and pulmonary arteries in a 70 year-old woman. The patient underwent several episodes of percutaneous vertebroplasty (PV) to treat compression fractures. The thread-like foreign bodies were identified as the bone cement injected during the previous PV procedures. We present this case study to emphasise that clinicians should consider the possibility of PE as a late complication, especially those with a history of PV. AN - 109749045. Language: English. Entry Date: 20150923. Revision Date: 20200708. Publication Type: journal article AU - Oh, Jin Kyung AU - Park, Jae-Hyeong AU - Kim, Song Soo AU - Han, Ji Hye AU - Kwon, Hee Jin AU - Kim, Jun Hyung AU - Lee, Jae-Hwan AU - Choi, Si-Wan AU - Jeong, Jin-Ok AU - Seong, In-Whan DB - cin20 DO - 10.1016/j.hlc.2015.02.017 DP - EBSCOhost M1 - 7 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2015 SN - 1443-9506 SP - e104-7 ST - Thread-like Bone Cement in the Right-side Heart and Pulmonary Arteries Causing Diffuse Pulmonary Embolism as a Late Complication T2 - Heart, Lung & Circulation TI - Thread-like Bone Cement in the Right-side Heart and Pulmonary Arteries Causing Diffuse Pulmonary Embolism as a Late Complication UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=109749045&site=ehost-live&scope=site VL - 24 ID - 830613 ER - TY - JOUR AB - OBJECTIVE: Preinjection gelfoam embolization during percutaneous vertebroplasty (PVP) has been thought alternative technique to prevent the leakage of bone cement. The goal of this study was to evaluate whether the gelfoam techniques are useful to reduce bone cement leakage. METHODS: Total 100 PVPs of osteoporotic spine compression fractures were performed by 1 spine surgeon who experienced more than 500 PVP cases under prospective control study. Operation was done in T-L junction (T10-L2) fractures with bi-transpedicular approach. Preinjection gelfoam PVP was done in the 50 levels. As control group, PVP without gelfoam was done in the 50 levels. We did not perform preoperative venography. We inserted normal saline-mixed gelfoam to the anterior third of vertebral body via PVP needle, and then 3mL of polymethylmetacrylate (PMMA) was injected. We prospectively evaluated the incidence and leakage pattern of PMMA by postoperative computed tomography. RESULTS: Between gelfoam and control groups, there were 11 leaks (22%) versus 12 leaks (26%). The mean operation time was 7.00 minutes versus 6.30 minutes. In gelfoam group, there were 6 spinal canal leaks, 4 paravertebral venous leaks, and 1 soft tissue leaks. In control group, there were 4 spinal canal leaks, 8 paravertebral venous leaks, and 1 disc space leak. In spite of cement leakage, there was no symptomatic case in both groups. Statistically, gelfoam technique was not related to decrease the incidence of leakage (p=0.64). CONCLUSION: Our prospective study showed that it did not significantly decrease cement leakage when vertebroplasty is performed by experienced spine surgeon. AD - Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. AN - 27437015 AU - Oh, J. S. AU - Doh, J. W. AU - Shim, J. J. AU - Lee, K. S. AU - Yoon, S. M. AU - Bae, H. G. C2 - Pmc4949169 DA - Jun DO - 10.14245/kjs.2016.13.2.63 DP - NLM ET - 2016/07/21 J2 - Korean Journal of Spine KW - Gelfoam Osteoporotic fracture Spine fractures Vertebroplasty reported. LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1738-2262 (Print) 1738-2262 SP - 63-6 ST - The Effectiveness of Gelfoam Technique before Percutaneous Vertebroplasy: Is It Helpful for Prevention of Cement Leakage? A Prospective Randomized Control Study T2 - Korean J Spine TI - The Effectiveness of Gelfoam Technique before Percutaneous Vertebroplasy: Is It Helpful for Prevention of Cement Leakage? A Prospective Randomized Control Study VL - 13 ID - 828674 ER - TY - JOUR AB - When a large amount of iodized oil (LPD) is selectively administered to targeted segments of the liver, the tumor vessels and sinusoids around the tumor are filled with LPD, subsequently regurgitating excessive LPD via the hepatic arterioportal communication into the portal branches surrounding the tumor. Segmental arterioportal chemoembolization in HCC with Doxorubicin-in-oil emulsion (DOE), which we named cement therapy, was performed in 18 patients with HCC. DOE was administered selectively into one segment division of Couinaud in ten patients, two segments in seven and three segments in one. Computed tomography and ultrasonography following the cement therapy revealed an overall response rate of 39%. The one-year cumulative survival rate was 80%, and that for three-years was 33%. Three cases underwent segmental hepatectomy and these specimens revealed total necrosis of the main tumor and whole daughter nodules, followed by various degrees of hepatic parenchymal infarction. This cement therapy realizes the simultaneous chemoembolization via the artery and portal vein, and was considered an effective treatment for extra-capsular infiltration and daughter nodules of HCC nourished by the portal vein blood flow. Limited administration of DOE to the targeted segments enables transarterial oily chemoembolization (TOCE) without any serious side effects. AD - Dept. of Radiology, Osaka Teishin Hospital. AN - 2551228 AU - Oi, H. AU - Yamamoto, T. AU - Sawai, Y. AU - Fujino, M. AU - Okamura, J. AU - Nakamura, H. DA - Aug DP - NLM ET - 1989/08/01 J2 - Gan to kagaku ryoho. Cancer & chemotherapy KW - Adult Aged Carcinoma, Hepatocellular/mortality/pathology/*therapy Doxorubicin/*administration & dosage *Embolization, Therapeutic/methods Emulsions Evaluation Studies as Topic Female Hepatic Artery Humans Iodized Oil/*administration & dosage Liver Neoplasms/mortality/pathology/*therapy Male Middle Aged Necrosis Portal Vein Remission Induction LA - jpn M1 - 8 Pt 2 N1 - PubMed NLM literature search January 5, 2021 PY - 1989 SN - 0385-0684 (Print) 0385-0684 SP - 2853-7 ST - [Segmental arterio-portal chemo-embolization in hepatocellular carcinoma (cement therapy)] T2 - Gan To Kagaku Ryoho TI - [Segmental arterio-portal chemo-embolization in hepatocellular carcinoma (cement therapy)] VL - 16 ID - 829032 ER - TY - JOUR AB - The authors describe a 21-year-old man in whom a large arteriovenous malformation of the scalp was eliminated using a combined interventional, neuroradiological and neurosurgical approach. Embolization was utilized to reduce arterial blood supply to the malformation. Eudragit-E, as a liquid embolic material from a cationic polymer, methyl and butyl methacrylate, and dimethylaminoethyl methacrylate copolymer, was injected through the transarterial route and then by direct percutaneous puncture of the nidus. One week after embolization, the nidus was easily resected with minimal blood loss. A postoperative angiogram showed nearly total extirpation of the nidus as well as complete clinical recovery. Preoperative embolization in this case was a safe and effective ablative technique. AD - H. Oishi, Department of Neurosurgery, Hitachi General Hospital, 2-11 Jonan-cho, Hitachi, Ibaraki 317-0077, Japan AU - Oishi, H. AU - Yoshida, K. AU - Tange, Y. AU - Tsuji, O. AU - Sonobe, M. C1 - eudragit e DB - Embase KW - biomaterial eudragit poly(methyl methacrylate) polymer adult angiography arteriovenous malformation arteriovenous shunt artery blood flow artery catheterization article artificial embolization bleeding case report clinical feature disease course excision human male neuroradiology neurosurgery plastic surgery postoperative hemorrhage puncture safety scalp surgical technique eudragit e LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2002 SN - 1123-9344 SP - 293-297 ST - Treatment of a scalp arteriovenous malformation by a combination of embolization and surgical removal T2 - Interventional Neuroradiology TI - Treatment of a scalp arteriovenous malformation by a combination of embolization and surgical removal UR - https://www.embase.com/search/results?subaction=viewrecord&id=L35439247&from=export VL - 8 ID - 829866 ER - TY - JOUR AB - Study Design. Case report. Objective. The aim of this work is to describe a case of infected vertebroplasty due to uncommon bacteria solved surgically with 2 years of follow-up and to discuss 6 other cases found in literature. Summary of Background Data. Vertebroplasty is a well-known and useful technique for the treatment of painful osteoporotic vertebral fractures. Complications, such as cord or root compression or pulmonary embolisms, are infrequent and are mainly related with the frequent escape of cement throughout the vertebral veins. Infection is even more rare, but when it occurs is difficult to manage and can be a life-threatening complication. Methods. A 63-year old-man had a spondylitis of L2 after vertebroplasty. The patient was initially managed with antibiotics without clinical improvement. Surgical treatment by anterior debridement and anterior and posterior stabilization was done. The bacteria isolated from the intraoperative cultures were Serratia marcescens, Stenotrophomonas maltophilia, and Burkholderia cepacia. After surgery, the patient was treated with antibiotics for 3 month. Results. After 2 years of follow-up, the patient was free of pain, without signs of infection, and a correct fusion was achieved. Conclusion. When facing an infected vertebroplasty, initial conservative treatment with needle biopsy culture and antibiotic administration are a rational option to start. If this treatment fails, surgical debridement is then indicated in order to remove the infected tissue and the acrylic cement and to stabilize the spine. Although this can be an effective treatment, it could be a difficult and hazardous surgical procedure. AD - Univ Clin Navarra, Dept Orthopaed Surg, Navarra, Spain. Olmos, MA (corresponding author), Pio XII 36, Navarra 31080, Spain. malfonsool@unav.es AN - WOS:000240696400037 AU - Olmos, M. A. AU - Gonzalez, A. S. AU - Clemente, J. D. AU - Tome, C. V. DA - Sep DO - 10.1097/01.brs.0000240202.91336.99 J2 - Spine KW - infected vertebroplasty adult spondylitis PMMA vertebroplasty complication SPONDYLITIS FOLLOWING VERTEBROPLASTY OSTEOPOROTIC COMPRESSION FRACTURES PERCUTANEOUS VERTEBROPLASTY ACRYLIC CEMENT POLYMETHYLMETHACRYLATE Clinical Neurology Orthopedics LA - English M1 - 20 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2006 SN - 0362-2436 SP - E770-E773 ST - Infected vertebroplasty due to uncommon bacteria solved surgically: A rare and threatening life complication of a common procedure T2 - Spine TI - Infected vertebroplasty due to uncommon bacteria solved surgically: A rare and threatening life complication of a common procedure UR - ://WOS:000240696400037 VL - 31 ID - 830407 ER - TY - JOUR AB - STUDY DESIGN. Case report. OBJECTIVE. The aim of this work is to describe a case of infected vertebroplasty due to uncommon bacteria solved surgically with 2 years of follow-up and to discuss 6 other cases found in literature. SUMMARY OF BACKGROUND DATA. Vertebroplasty is a well-known and useful technique for the treatment of painful osteoporotic vertebral fractures. Complications, such as cord or root compression or pulmonary embolisms, are infrequent and are mainly related with the frequent escape of cement throughout the vertebral veins. Infection is even more rare, but when it occurs is difficult to manage and can be a life-threatening complication. METHODS. A 63-year-old-man had a spondylitis of L2 after vertebroplasty. The patient was initially managed with antibiotics without clinical improvement. Surgical treatment by anterior debridement and anterior and posterior stabilization was done. The bacteria isolated from the intraoperative cultures were Serratia marcescens, Stenotrophomonas maltophilia, and Burkholderia cepacia. After surgery, the patient was treated with antibiotics for 3 month. RESULTS. After 2 years of follow-up, the patient was free of pain, without signs of infection, and a correct fusion was achieved. CONCLUSION. When facing an infected vertebroplasty, initial conservative treatment with needle biopsy culture and antibiotic administration are a rational option to start. If this treatment fails, surgical debridement is then indicated in order to remove the infected tissue and the acrylic cement and to stabilize the spine. Although this can be an effective treatment, it could be a difficult and hazardous surgical procedure. ©2006, Lippincott Williams & Wilkins, Inc. AD - M.A. Olmos, Pío XII 36, Pamplona, Navarra, 31080, Spain AU - Olmos, M. A. AU - González, A. S. AU - Clemente, J. D. AU - Tomé, C. V. DB - Embase Medline DO - 10.1097/01.brs.0000240202.91336.99 KW - ceftazidime ciprofloxacin cotrimoxazole levofloxacin poly(methyl methacrylate) teicoplanin adult anamnesis blood culture Burkholderia cepacia case report clinical feature computer assisted tomography debridement disease course human laboratory test male needle biopsy nuclear magnetic resonance imaging percutaneous vertebroplasty postoperative infection priority journal review Serratia marcescens spine fusion spine stabilization spondylitis Stenotrophomonas maltophilia LA - English M1 - 20 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 0362-2436 1528-1159 SP - E770-E773 ST - Infected vertebroplasty due to uncommon bacteria solved surgically: A rare and threatening life complication of a common procedure - Report of a case and a review of the literature T2 - Spine TI - Infected vertebroplasty due to uncommon bacteria solved surgically: A rare and threatening life complication of a common procedure - Report of a case and a review of the literature UR - https://www.embase.com/search/results?subaction=viewrecord&id=L44423522&from=export http://dx.doi.org/10.1097/01.brs.0000240202.91336.99 VL - 31 ID - 829786 ER - TY - JOUR AB - Pre-operative spine tumour embolization is a useful adjunct to minimize operative complications and blood loss during complex resections. While the efcacy of this procedure has been well studied, relatively little is documented regarding how to optimize technical parameters for tumour characteristics. This pictorial case series seeks to review our centre's experience over the last decade in using a range of embolization techniques. As experience with this procedure has matured, we propose an approach based on the patient's vascular anatomy and tumour angioarchitecture. This includes the use of coils as protective barriers rather than primary embolics; particle embolization to permeate fne capillary networks; consideration for liquid embolic agents in the presence of large caliber tumour vessels with associated arte-riovenous shunting; and percutaneous intralesional embolization when endovascular access is insufcient to achieve the desired outcome. In many cases, a combination of these methods is needed, and close communication with the surgeon ensures the best outcome. Despite these advances, continued work is needed to determine how to optimize complete devascularization, and thus surgical beneft, while safely sparing critical neuroanatomical structures. AD - M.K.S. Heran, Division of Neuroradiology, Vancouver General Hospital, University of British Columbia, Vancouver, Canada AU - Omid-Fard, N. AU - Fisher, C. G. AU - Heran, M. K. S. DB - Embase Medline DO - 10.1259/bjr.20180899 KW - liquid embolic agent artificial embolization chemoembolization coil embolization human percutaneous vertebroplasty preoperative treatment review spine tumor LA - English M1 - 1100 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1748-880X 0007-1285 ST - The evolution of pre-operative spine tumour embolization T2 - British Journal of Radiology TI - The evolution of pre-operative spine tumour embolization UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2002527640&from=export http://dx.doi.org/10.1259/bjr.20180899 VL - 92 ID - 829162 ER - TY - JOUR AB - INTRODUCTION: Giant cell tumors (GCT) are locally highly aggressive tumor of bone comprising 5 to 10% of all benign bone tumors. GCT of the sacrum is uncommon, with a 2% to 8.2% of incidence rate. We report a case of GCT of sacrum managed successfully without surgery. CASE REPORT: A 22 year old lady who had progressive lower back pain associated with unsteady gait due to pain. Clinically there was a sacral mass measuring 5 × 5 cm and tender on palpation. Neurological assessment of the lower limbs was unremarkable and anal tone was intact. Laboratory investigations were unremarkable. X-ray of the pelvis showed lytic lesion over the upper sacrum. MRI spine revealed sacral giant cell tumor with L5/S1 spinal canal narrowing and bilateral S1 nerve roots compression (Figure 1). Pelvic arteriogram showed no evidence if arterial feeders or tumor blush. Subsequently a biopsy was performed and histopathology study reported as giant cell tumor. (Figure Parsented) DISCUSSIONS: The standard treatment for GCT is curettage combined with adjuvant bone grafting or cement-augmented stabilization. It is effective in local tumor control and overall survival. Embolization may also prove palliative and/or curative in cases in which the tumor is unresectable or refractory to treatment. Three to four decades ago, radiation of GCT with appendicular, pelvic, sacral and spinal lesions was commonly undertaken. The results were disappointing since the doses were below 35 Gy. However, in recent times the use modern equipment such with doses of 40 to 60 Gy, 3 to 5 times a week result in local oncological control of 85% to 90%. Besides there is 0% to 8% risk of secondary radiation induced malignant tumor which is considered very small. Moreover in selected cases where the area of tumor is inoperable or deemed to be risky for surgery (neurological or functional morbidity - sacral, vertebral lesions), radiation is believed to be an effective alternative. The use of bisphosphonate as an adjuvant therapy in GCT of bone had resulted in decreased local recurrence. It demonstrates anti osteoclastic effects thus protecting bone from further resorption. In vitro studies showed apoptotic effect of biposphonates on GCT stromal cells and osteoclast. CONCLUSION: This patient's sacral GCT was successfully treated with radiotherapy (30 cycles) with adjuvant systemic and oral biphosponates over 5 years. Yearly imaging studies revealed the lesion remained stable and patient is asymptomatic. She is currently on her second year devoid of treatment years. AD - T.J. Ong, Department of Orthopaedic Surgery, Penang General Hospital, Malaysia AU - Ong, T. J. AU - Amaleswaran, A. AU - Zulkiflee, O. DB - Embase KW - adjuvant bisphosphonic acid derivative cement adjuvant chemotherapy adult apoptosis arteriography artery artificial embolization biopsy bone transplantation cancer adjuvant therapy cancer control cancer patient cancer recurrence cancer surgery cancer survival compression conference abstract curettage drug combination female histopathology human human cell human tissue in vitro study low back pain morbidity nerve root nuclear magnetic resonance imaging osteoclast osteoclastoma overall survival palpation pelvis radiotherapy relapse sacral spinal cord sacrum spinal cord lesion stroma cell surgery unsteady gait vertebral canal X ray young adult LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1985-2533 ST - Radiotherapy in management of sacral giant cell tumor: A case report T2 - Malaysian Orthopaedic Journal TI - Radiotherapy in management of sacral giant cell tumor: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L623052254&from=export VL - 11 ID - 829288 ER - TY - JOUR AD - Venous Thromboembolism Unit, Internal Medicine Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain. School of Medicine, Universidad Complutense de Madrid, Madrid, Spain. AN - 30310781 AU - Ordieres Ortega, L. AU - Demelo-Rodríguez, P. AU - García Fernández-Bravo, I. AU - Del Toro-Cervera, J. C2 - Pmc6170301 DA - Sep DO - 10.5045/br.2018.53.3.186 DP - NLM ET - 2018/10/13 J2 - Blood research LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 2287-979X (Print) 2287-979x SP - 186 ST - Methacrylate pulmonary embolism after percutaneous vertebroplasty T2 - Blood Res TI - Methacrylate pulmonary embolism after percutaneous vertebroplasty VL - 53 ID - 828654 ER - TY - JOUR AB - Evidence is accumulating that embolization of bone marrow contents to the lungs can cause the hypotension, hypoxemia, cardiac arrest and death reported after total hip arthroplasty and that the embolism results from high intramedullary pressures exerted during implantation of the prosthesis. The authors describe such an occurrence in an 80-year-old man who had a cemented long-stem total knee prosthesis inserted. Autopsy revealed numerous pulmonary fat emboli that were distributed predominantly in arterioles and capillaries. The possibility of pulmonary fat microembolism occurring during cemented total knee arthroplasty should be recognized, particularly when prostheses with long intramedullary stems are used. Preventive or prophylactic measures that should be considered to avoid fat embolism during implantation include venting the intramedullary canal and meticulous lavage to clear away intramedullary debris. Increasing the inspired oxygen concentration as the prosthesis is inserted and monitoring of cardiopulmonary status to avoid simultaneous hypotension and hypoxemia may help to prevent the cardiopulmonary changes associated with pulmonary fat microembolism. AN - 3756668 AU - Orsini, E. C. AU - Richards, R. R. AU - Mullen, J. M. DA - Sep DP - NLM ET - 1986/09/01 J2 - Canadian journal of surgery. Journal canadien de chirurgie KW - Aged Embolism, Fat/*etiology/mortality Humans Knee Prosthesis/*adverse effects Male Pulmonary Embolism/*etiology/mortality LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 1986 SN - 0008-428X (Print) 0008-428x SP - 385-6 ST - Fatal fat embolism during cemented total knee arthroplasty: a case report T2 - Can J Surg TI - Fatal fat embolism during cemented total knee arthroplasty: a case report VL - 29 ID - 828912 ER - TY - JOUR AB - Evidence is accumulating that embolization of bone marrow contents to the lungs can cause the hypotension, hypoxemia, cardiac arrest and death reported after total hip arthroplasty and that the embolism results from high intramedullary pressures exerted during implantation of the prosthesis. The authors describe such an occurrence in an 80-year-old man who had a cementd long-stem total knee prosthesis inserted. Autopsy revealed numerous pulmonary fat emboli that were distributed predominantely in arterioles and capillaries. The possibility of pulmonary fat microembolism occurring during cemented total knee arthroplasty should be recognized, particularly when prostheses with long intramedullary stems are used. Preventive or prophylactic measures that should be considered to avoid fat embolism during implantation include venting the intramedullary canal and meticulous lavage to clear away intramedullary debris. Increasing the inspired oxygen concentration as the prosthesis is inserted and monitoring of cardiopulmonary status to avoid simulataneous hypotension and hypoxemia may help to prevent the cardiopulmonary changes associated with pulmonary fat microembolism. AD - Department of Surgery, St. Michael's Hospital, Toronto, Ont. AU - Orsini, E. C. AU - Richards, R. R. AU - Mullen, J. M. B. DB - Embase Medline KW - bone cement aged autopsy blood and hemopoietic system cardiovascular system case report diagnosis etiology fat embolism fatality human joint knee prosthesis therapy total knee arthroplasty LA - English M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1986 SN - 0008-428X SP - 385-386 ST - Fatal fat embolism during cemented total knee arthroplasty: A case report T2 - Canadian Journal of Surgery TI - Fatal fat embolism during cemented total knee arthroplasty: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L17204754&from=export VL - 29 ID - 829959 ER - TY - JOUR AD - UNIV TORONTO,ST MICHAELS HOSP,DEPT SURG,TORONTO M5B 1W8,ONTARIO,CANADA. UNIV TORONTO,ST MICHAELS HOSP,DEPT PATHOL,TORONTO M5B 1W8,ONTARIO,CANADA. AN - WOS:A1986E143100034 AU - Orsini, E. C. AU - Richards, R. R. AU - Mullen, J. M. B. DA - Sep J2 - Can. J. Surg. KW - Surgery LA - English M1 - 5 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1986 SN - 0008-428X SP - 385-386 ST - FATAL FAT-EMBOLISM DURING CEMENTED TOTAL KNEE ARTHROPLASTY - A CASE-REPORT T2 - Canadian Journal of Surgery TI - FATAL FAT-EMBOLISM DURING CEMENTED TOTAL KNEE ARTHROPLASTY - A CASE-REPORT UR - ://WOS:A1986E143100034 VL - 29 ID - 830498 ER - TY - JOUR AD - L.O. Ortega, Venous Thromboembolism Unit, Internal Medicine Department, Hospital General Universitario Gregorio Marañón, C/Dr. Esquerdo 46, Madrid, Spain AU - Ortega, L. O. AU - Demelo-Rodríguez, P. AU - Fernández-Bravo, I. G. AU - Toro-Cervera, J. D. DB - Embase DO - 10.5045/br.2018.53.3.186 KW - acenocoumarol bemiparin methacrylic acid rivaroxaban aged atrial fibrillation blood pressure measurement breathing case report clinical article computed tomographic angiography crackle heart rate human international normalized ratio kyphoplasty lung auscultation lung embolism male note oxygen saturation percutaneous vertebroplasty thorax radiography transthoracic echocardiography LA - English M1 - 3 M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 2288-0011 2287-979X SP - 186 ST - Methacrylate pulmonary embolism after percutaneous vertebroplasty T2 - Blood Research TI - Methacrylate pulmonary embolism after percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L624254669&from=export http://dx.doi.org/10.5045/br.2018.53.3.186 VL - 53 ID - 829221 ER - TY - JOUR AB - Hip arthroplasty is a common surgical intervention in our hospital practice, involving high perioperative risk related to patients age and multiple concomitant diseases. Hemodynamic complications described vary from slight hypotension during surgery to heart failure and sudden death, particularly if the operation involves a cemented femoral component. Because of the type of patients undergoing such operations (elderly patients, with osteoporosis and scarce cardiopulmonary reserve), the unclear origin of complications and the lack of consensus on what constitutes adequate monitoring during surgery, hip arthroplasty is problematic for the specialists involved. We report on five deaths during cemented hip arthroplasty; after reviewing the case history and autopsy report of one, we believe the events leading to death were triggered by massive pulmonary embolism. AD - Servicio de Anestesiología, Reanimación y Terapia del Dolor, Hospital Miguel Servet, Zaragoza. AN - 10730088 AU - Ortega, S. AU - Ortega, J. P. AU - Pascual, A. AU - Fraca, C. AU - García-Enguita, M. A. AU - Arauzo, P. AU - Urieta-Solanas, A. DA - Jan DP - NLM ET - 2000/03/24 J2 - Revista espanola de anestesiologia y reanimacion KW - Aged Aged, 80 and over Bone Cements/*adverse effects Female Heart Arrest/*etiology Hip Prosthesis/*adverse effects Humans Male Pulmonary Embolism/*complications/*etiology LA - spa M1 - 1 N1 - PubMed NLM literature search January 5, 2021 OP - Paro cardíaco en artroplastia de cadera cementada. PY - 2000 SN - 0034-9356 (Print) 0034-9356 SP - 31-5 ST - [Heart arrest in cemented hip arthroplasty] T2 - Rev Esp Anestesiol Reanim TI - [Heart arrest in cemented hip arthroplasty] VL - 47 ID - 828951 ER - TY - JOUR AB - Asymptomatic polymethyl methacrylate cardiac embolism is an uncommon complication of kyphoplasty. We report a case of a 56-year-old female with an incidentally noted radiopaque foreign body in the right ventricular cavity on chest x-ray following kyphoplasty. In this report, we discuss how to differentiate between the potential intracardiac foreign bodies and how to establish the diagnosis of polymethyl methacrylate embolism. Once diagnosed, the management of these patients remains controversial. AD - University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL 60637, USA. AN - 30069279 AU - Oshinsky, C. AU - Bhavani, S. AU - Funaki, A. C2 - Pmc6068336 DA - Aug DO - 10.1016/j.radcr.2018.06.001 DP - NLM ET - 2018/08/03 J2 - Radiology case reports KW - Cardiac embolism Cement Pmma Polymethyl methacrylate LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 1930-0433 (Print) 1930-0433 SP - 914-916 ST - Cement cardiac embolism following kyphoplasty noted on thoracic imaging T2 - Radiol Case Rep TI - Cement cardiac embolism following kyphoplasty noted on thoracic imaging VL - 13 ID - 828689 ER - TY - JOUR AB - A case is presented in which a large embolus was detected passing through the right side of the heart during total hip arthroplasty. Although tricuspid regurgitation and an elevated right ventricular pressure resulted, there was no perturbation in systemic hemodynamics or gas exchange. The emboli detected during total hip arthroplasty are most likely composed of fat. No specific treatment is required, although heightened vigilance for disturbances in systemic hemodynamics is important. AD - Department of Anaesthesia, Sunnybrook Health Science Centre and University of Toronto, Ontario, Canada. AN - 9603596 AU - Oxorn, D. AU - Edelist, G. DA - May DO - 10.1016/s0952-8180(98)00014-2 DP - NLM ET - 1998/05/29 J2 - Journal of clinical anesthesia KW - Aged Arthroplasty, Replacement, Hip/*adverse effects Blood Pressure/physiology Cementation Echocardiography, Doppler Echocardiography, Transesophageal Embolism, Fat/complications Heart Rate/physiology Hemodynamics Humans *Intraoperative Complications/diagnostic imaging/physiopathology Male Oxygen Consumption/physiology Pulmonary Embolism/diagnostic imaging/*etiology/physiopathology Pulmonary Gas Exchange/physiology Tricuspid Valve Insufficiency/etiology Ultrasonography, Interventional Ventricular Pressure/physiology LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 1998 SN - 0952-8180 (Print) 0952-8180 SP - 238-41 ST - Large pulmonary embolus without systemic hemodynamic consequences during cemented hip arthroplasty T2 - J Clin Anesth TI - Large pulmonary embolus without systemic hemodynamic consequences during cemented hip arthroplasty VL - 10 ID - 828530 ER - TY - JOUR AB - Thirteen patients with aneurysmal bone cyst of the spine (excluding sacral lesions) were retrospectively reviewed. Treatment for aneurysmal bone cysts remains controversial, but surgical resection, irradiation, and embolization are common treatment modalities for those involving the spine. Of 102 patients with aneurysmal bone cysts, 15 had a lesion of the spine, including 2 sacral cases. Of the 13 patients with a lesion of the thoracic or lumbar spine, 9 underwent resection of the lesion, 2 curettage and cementation, and 2 only currettage. Eleven patients underwent segmental arthrodesis with instrumentation after treatment of the primary or recurrent lesion, while 2 patients underwent segmental arthrodesis using autogeneic bone. Nine patients did not develop a local recurrence after resection of the lesion. However, the 2 patients who underwent curettage alone developed local recurrences. None of 4 patients developed recurrences after curettage and cementation. After recurrence, 1 patient underwent additional resection with irradiation, and 1 patient underwent resection alone. At the final follow-up, all lesions were under control. In one patient, lumbar kyphosis developed after segmental arthrodesis with instrumentation, and arthrodesis was performed again. Radical resection of aneurysmal bone cysts of the spine with instrumentation is the optimal method of acquiring a high degree of local control and preventing spinal deformity. AD - Department of Orthopaedics, Westfälische Wilhelms University, Münster, Germany. AN - 10392510 AU - Ozaki, T. AU - Halm, H. AU - Hillmann, A. AU - Blasius, S. AU - Winkelmann, W. DO - 10.1007/s004020050381 DP - NLM ET - 1999/07/07 J2 - Archives of orthopaedic and trauma surgery KW - Adolescent Adult Bone Cysts, Aneurysmal/*surgery Child Child, Preschool Curettage Female Humans Male Middle Aged Recurrence Retrospective Studies Spinal Diseases/*surgery Spinal Fusion Treatment Outcome LA - eng M1 - 3-4 N1 - PubMed NLM literature search January 5, 2021 PY - 1999 SN - 0936-8051 (Print) 0936-8051 SP - 159-62 ST - Aneurysmal bone cysts of the spine T2 - Arch Orthop Trauma Surg TI - Aneurysmal bone cysts of the spine VL - 119 ID - 829031 ER - TY - JOUR AB - Mandibular arteriovenous malformations (AVMs) are rare and potentially life-threatening vascular lesions. Surgery, embolization, or bone cement implantation is an option for the treatment of mandibular AVMs. We present a case of huge mandibular AVM refractory to multiple embolizations of the supplying arteries, which was treated with polymethylmethacrylate (PMMA) bone cement implantation after the extraction of a molar tooth. AD - [Ozturk, Kerem; Gode, Sercan; Gursan, Gulce; Turhal, Goksel] Ege Univ, Fac Med, Dept Otorhinolaryngol, Izmir, Turkey. [Cinar, Celal; Bozkaya, Halil] Ege Univ, Fac Med, Dept Radiol, Izmir, Turkey. Ozturk, K (corresponding author), Ege Univ, Tip Fak, Kulak Burun Bogaz Hastaliklari Anabilim Dali, Izmir, Turkey. drkeremm@yahoo.com AN - WOS:000369048800009 AU - Ozturk, K. AU - Gode, S. AU - Gorsan, G. AU - Turhal, G. AU - Cinar, C. AU - Bozkaya, H. DA - Jun DO - 10.5152/tao.2015.820 J2 - Turk. Arch. Otorhinolaryn. KW - Arteriovenous malformation mandible polymethylmethacrylate bone cement EMBOLIZATION Otorhinolaryngology LA - English M1 - 2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2015 SN - 2149-3987 SP - 80-83 ST - Obliteration of a Large Mandibular Arterio-Venous Malformation with Polymethyl Methacrylate Bone Cement T2 - Turkish Archives of Otorhinolaryngology-Turk Otorinolarengoloji Arsivi TI - Obliteration of a Large Mandibular Arterio-Venous Malformation with Polymethyl Methacrylate Bone Cement UR - ://WOS:000369048800009 VL - 53 ID - 830239 ER - TY - JOUR AB - Mandibular arteriovenous malformations (AVMs) are rare and potentially life-threatening vascular lesions. Surgery, embolization, or bone cement implantation is an option for the treatment of mandibular AVMs. We present a case of huge mandibular AVM refractory to multiple embolizations of the supplying arteries, which was treated with polymethylmethacrylate (PMMA) bone cement implantation after the extraction of a molar tooth. AD - Department of Otorhinolaryngology, Ege University Faculty of Medicine, İzmir, Turkey. Department of Radiology, Ege University Faculty of Medicine, İzmir, Turkey. AN - 29391986 AU - Öztürk, K. AU - Göde, S. AU - Gürsan, G. AU - Turhal, G. AU - Çınar, C. AU - Bozkaya, H. C2 - Pmc5783006 DA - Jun DO - 10.5152/tao.2015.820 DP - NLM ET - 2015/06/01 J2 - Turkish archives of otorhinolaryngology KW - Arteriovenous malformation mandible polymethylmethacrylate bone cement LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 2667-7466 (Print) 2667-7466 SP - 80-83 ST - Obliteration of a Large Mandibular Arterio-Venous Malformation with Polymethyl Methacrylate Bone Cement T2 - Turk Arch Otorhinolaryngol TI - Obliteration of a Large Mandibular Arterio-Venous Malformation with Polymethyl Methacrylate Bone Cement VL - 53 ID - 828865 ER - TY - JOUR AB - Background - Over the last few decades many innovative operation technique were developed due to the increase of porotic vertebral fractures. These new techniques aim to reach the required stability of the vertebral column. In case of significant instability, spinal canal stenosis or neural compression, decompressive intervention may be necessary, which results in further weakening of the column of the spine, the minimal invasive percutan vertebroplasty is not an adequate method to reach the required stability, that is why insertion of complementary pedicular screws is needed. Considering the limited screw-fixing ability of the porotic bone structure, with this new technique we are able to reach the appropriate stability of cement-augmented pedicle screws by dosing cement carefully through the screws into the vertebral body. We used this technique in our Institute in case of 12 patients and followed up the required stability and the severity of complications. Methods - Fifteen vertebral compression fractures of 12 patients were treated in our Institute. Using the classification proposed by Genant et al. we found that the severity of the vertebral compression was grade 3 in case of 13, while grade 2 in case of two fractures. The average follow up time of the patients was 22 months (12-39), during this period X-ray, CT and clinical control examinations were taken. During the surgery the involved segments were localised by using X-ray and after the exploration the canulated screws were put through the pedicles of the spine and the vertebral body was filled through the transpedicular screws with bone cement. Depending on the grade of the spinal canal stenosis, we made the decompression, vertebroplasty or corpectomy of the fractured vertebral body, and the replacement of the body. Finally the concerned segments were fixed by titanium rods. Results - In all cases the stenosis of spinal canal was resolved and the bone cement injected into the corpus resulted in adequated stability of the spine. In case of six patients we observed cement extravasation without any clinical signs, and by one patient as a serious complication pulmonary embolism. Neurological progression or screw loosening were not detected during the follow up period. Part of the patients had residual disability after the surgery due to their older ages and the problem of their rehabilitation process. Conclusion - After the right consideration of indications, age, general health condition and the chance of successful rehabilitation, the technique appears to be safe for the patients. With the use of this surgical method, the stability of the spine can be improved compared to the preoperative condition, the spinal canal stenosis can be solved and the neural structures can be decompressed. The severity of complications can be reduced by a precise surgical technique and the careful use of the injected cement. The indication of the surgical method needs to be considered in the light of the expected outcome and the rehabilitation. AD - [Padanyi Csaba; Misik Ferenc; Papp Zoltan; Vitanovics Dusan; Balogh Attila; Veres Robert; Lipoth Laszlo; Banczerowski Peter] Orszagos Klin Idegtudomanyi Int, H-1145 Budapest, Hungary. [Veres Robert; Lipoth Laszlo] Kozponti Honved Korhaz Idegsebeszeti Osztaly, HM, Budapest, Hungary. [Banczerowski Peter] Semmelweis Egyet, AOK, Idegsebeszeti Tanszek, Budapest, Hungary. Banczerowski, P (corresponding author), Orszagos Klin Idegtudomanyi Int, Amer Ut 57, H-1145 Budapest, Hungary. banczerowski.peter@med.semmelweis-univ.hu AN - WOS:000363075400007 AU - Padanyi, C. AU - Misik, F. AU - Papp, Z. AU - Vitanovics, D. AU - Balogh, A. AU - Veres, R. AU - Lipoth, L. AU - Banczerowski, P. DA - Jan J2 - Ideggyogy. Szle. KW - augmentation transpedicular fixation osteoporosis vertebral body fracture PERCUTANEOUS VERTEBROPLASTY CEMENT AUGMENTATION POLYMETHYLMETHACRYLATE BONE INJECTION Clinical Neurology Neurosciences LA - Hungarian M1 - 1-2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2015 SN - 0019-1442 SP - 52-58 ST - TREATMENT OF OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURE WITH PMMA AUGMENTED PEDICLE SCREW FIXATION T2 - Ideggyogyaszati Szemle-Clinical Neuroscience TI - TREATMENT OF OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURE WITH PMMA AUGMENTED PEDICLE SCREW FIXATION UR - ://WOS:000363075400007 VL - 68 ID - 830245 ER - TY - JOUR AB - BACKGROUND: Over the last few decades many innovative operation technique were developed due to the increase of porotic vertebral fractures. These new techniques aim to reach the required stability of the vertebral column. In case of significant instability, spinal canal stenosis or neural compression, decompressive intervention may be necessary, which results in further weakening of the column of the spine, the minimal invasive percutan vertebroplasty is not an adequate method to reach the required stability, that is why insertion of complementary pedicular screws is needed. Considering the limited screw-fixing ability of the porotic bone structure, with this new technique we are able to reach the appropriate stability of cement-augmented pedicle screws by dosing cement carefully through the screws into the vertebral body. We used this technique in our Institute in case of 12 patients and followed up the required stability and the severity of complications. METHODS: Fifteen vertebral compression fractures of 12 patients were treated in our Institute. Using the classification proposed by Genant et al. we found that the severity of the vertebral compression was grade 3 in case of 13, while grade 2 in case of two fractures. The average follow up time of the patients was 22 months (12-39), during this period X-ray, CT and clinical control examinations were taken. During the surgery the involved segments were localised by using X-ray and after the exploration the canulated screws were put through the pedicles of the spine and the vertebral body was filled through the transpedicular screws with bone cement. Depending on the grade of the spinal canal stenosis, we made the decompression, vertebroplasty or corpectomy of the fractured vertebral body, and the replacement of the body. Finally the concerned segments were fixed by titanium rods. RESULTS: In all cases the stenosis of spinal canal was resolved and the bone cement injected into the corpus resulted in adequated stability of the spine. In case of six patients we observed cement extravasation without any clinical signs, and by one patient--as a serious complication--pulmonary embolism. Neurological progression or screw loosening were not detected during the follow up period. Part of the patients had residual disability after the surgery due to their older ages and the problem of their rehabilitation process. CONCLUSION: After the right consideration of indications, age, general health condition and the chance of successful rehabilitation, the technique appears to be safe for the patients. With the use of this surgical method, the stability of the spine can be improved compared to the preoperative condition, the spinal canal stenosis can be solved and the neural structures can be decompressed. The severity of complications can be reduced by a precise surgical technique and the careful use of the injected cement. The indication of the surgical method needs to be considered in the light of the expected outcome and the rehabilitation. AN - 25842917 AU - Padányi, Csaba AU - Misik, F. AU - Papp, Z. AU - Vitanovics, D. AU - Balogh, A. AU - Veres, R. AU - Lipóth, L. AU - Banczerowski, P. DA - Jan 30 DP - NLM ET - 2015/04/07 J2 - Ideggyogyaszati szemle KW - Aged *Decompression, Surgical Female Follow-Up Studies Fracture Fixation, Internal/instrumentation/*methods Fractures, Compression/etiology/*surgery Humans Lumbar Vertebrae/surgery Male Osteoporosis/*complications Osteoporosis, Postmenopausal/complications *Pedicle Screws *Polymethyl Methacrylate Retrospective Studies Spinal Fractures/etiology/*surgery Thoracic Vertebrae/surgery Treatment Outcome Vertebroplasty/instrumentation/*methods LA - hun M1 - 1-2 N1 - PubMed NLM literature search January 5, 2021 OP - Osteoporoticus kompressziós csigolyatörések kezelése PMMA-augmentált csavaros transpedicularis rögzítéssel. PY - 2015 SN - 0019-1442 (Print) 0019-1442 SP - 52-8 ST - [Treatment of osteoporotic vertebral compression fractures with PMMA-augmented pedicle screw fixation] T2 - Ideggyogy Sz TI - [Treatment of osteoporotic vertebral compression fractures with PMMA-augmented pedicle screw fixation] VL - 68 ID - 828651 ER - TY - JOUR AB - Background: Over the last few decades many innovative operation technique were developed due to the increase of porotic vertebral fractures. These new techniques aim to reach the required stability of the vertebral column. In case of significant instability, spinal canal stenosis or neural compression, decompressive intervention may be necessary, which results in further weakening of the column of the spine, the minimal invasive percutan vertebroplasty is not an adequate method to reach the required stability, that is why insertion of complementary pedicular screws is needed. Considering the limited screw-fixing ability of the porotic bone structure, with this new technique we are able to reach the appropriate stability of cement-augmented pedicle screws by dosing cement carefully through the screws into the vertebral body. We used this technique in our Institute in case of 12 patients and followed up the required stability and the severity of complications. Methods: Fifteen vertebral compression fractures of 12 patients were treated in our Institute. Using the classification proposed by Genant et al. we found that the severity of the vertebral compression was grade 3 in case of 13, while grade 2 in case of two fractures. The average follow up time of the patients was 22 months (12-39), during this period X-ray, CT and clinical control examinations were taken. During the surgery the involved segments were localised by using X-ray and after the exploration the canulated screws were put through the pedicles of the spine and the vertebral body was filled through the transpedicular screws with bone cement. Depending on the grade of the spinal canal stenosis, we made the decompression, vertebroplasty or corpectomy of the fractured vertebral body, and the replacement of the body. Finally the concerned segments were fixed by titanium rods. Results: In all cases the stenosis of spinal canal was resolved and the bone cement injected into the corpus resulted in adequated stability of the spine. In case of six patients we observed cement extravasation without any clinical signs, and by one patient - as a serious complication-pulmonary embolism. Neurological progression or screw loosening were not detected during the follow up period. Part of the patients had residual disability after the surgery due to their older ages and the problem of their rehabilitation process. Conclusion: After the right consideration of indications, age, general health condition and the chance of successful rehabilitation, the technique appears to be safe for the patients. With the use of this surgical method, the stability of the spine can be improved compared to the preoperative condition, the spinal canal stenosis can be solved and the neural structures can be decompressed. The severity of complications can be reduced by a precise surgical technique and the careful use of the injected cement. The indication of the surgical method needs to be considered in the light of the expected outcome and the rehabilitation. AD - P. Banczerowski, Országos Klinikai Idegtudományi Intézet, Amerikai út 57, Budapest, Hungary AU - Padányi, C. AU - Misik, F. AU - Papp, Z. AU - Vitanovics, D. AU - Balogh, A. AU - Veres, R. AU - Lipóth, L. AU - Banczerowski, P. DB - Embase Medline KW - bone cement device pedicle screw fixation device bone cement titanium age article bone cement extravasation bone structure clinical article clinical examination compression fracture computer assisted tomography controlled study decompression surgery disability disease severity follow up fracture fixation fragility fracture human lung embolism medical device complication percutaneous vertebroplasty screw loosening spine fracture spine radiography surgical technique treatment outcome vertebra body vertebral canal vertebral canal stenosis LA - Hungarian M1 - 1-2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 0019-1442 SP - 52-58 ST - Treatment of osteoporotic vertebral compression fracture with pmma augmented pedicle screw fixation T2 - Ideggyogyaszati Szemle TI - Treatment of osteoporotic vertebral compression fracture with pmma augmented pedicle screw fixation UR - https://www.embase.com/search/results?subaction=viewrecord&id=L602973721&from=export VL - 68 ID - 829385 ER - TY - JOUR AB - A pulmonary embolus of acrylic cement was present in a 41-year-old woman with Langerhans' cell vertebral histiocytosis (LCH) after percutaneous vertebroplasty. Chest radiograph and CT confirmed pulmonary infarction and the presence of cement in the pulmonary arteries. She was treated with anticoagulants, and responded favorably. This rare complication occurred because perivertebral venous migration was not recognized during vertebroplasty. Adequate preparation of cement and biplane fluoroscopy are recommended for vertebroplasty. AD - Department of Radiology, Hôpital Pasteur, Nice, France. AN - 10219399 AU - Padovani, B. AU - Kasriel, O. AU - Brunner, P. AU - Peretti-Viton, P. C2 - Pmc7056072 DA - Mar DP - NLM ET - 1999/04/29 J2 - AJNR. American journal of neuroradiology KW - Adult Anticoagulants/therapeutic use Bone Cements/*adverse effects Female Fluoroscopy Foreign-Body Migration/etiology Histiocytosis, Langerhans-Cell/*therapy Humans Lumbar Vertebrae/blood supply/*pathology Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/diagnostic imaging/drug therapy/*etiology Radiography, Interventional Spinal Diseases/*therapy Tomography, X-Ray Computed Veins Vena Cava, Inferior LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 1999 SN - 0195-6108 (Print) 0195-6108 SP - 375-7 ST - Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty T2 - AJNR Am J Neuroradiol TI - Pulmonary embolism caused by acrylic cement: a rare complication of percutaneous vertebroplasty VL - 20 ID - 828825 ER - TY - JOUR AB - Three fatalities after procedures involving the use of polymethyl methacrylate cement are reported. Autopsy studies showed varying degrees of pulmonary fat embolism although lack of correction of operative blood loss was the major factor. AN - 1270197 AU - Pahuja, K. AU - Chand, K. DA - Jan DP - NLM ET - 1976/01/01 J2 - International surgery KW - Acrylates/*adverse effects Aged Bone Cements/*adverse effects Embolism, Fat/*etiology/mortality Female Fractures, Bone/*surgery Humans Male Methacrylates/*adverse effects LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 1976 SN - 0020-8868 (Print) 0020-8868 SP - 19-22 ST - Fatal fat embolism associated with polymethyl methacrylate bone cement T2 - Int Surg TI - Fatal fat embolism associated with polymethyl methacrylate bone cement VL - 61 ID - 828897 ER - TY - JOUR AB - One hundred thirteen cases of cementless femoral revision total hip arthroplasty using either cortical strut or proximal calcar allografts were reviewed for radiographic incorporation at an average 4.75 years after operation. All cortical strut grafts were used to supplement the host bone after achieving stable femoral fixation by a tight distal diaphyseal fit. Eighty-seven of the 95 cortical strut grafts showed radiographic evidence of graft incorporation. Eleven of the 18 calcar grafts had resorbed. Complications consisted of eight dislocations, three pulmonary embolisms, two superficial infections, two myocardial infarctions, and two sciatic nerve palsies. When stable distal fixation of cementless femoral prostheses have been achieved, the cortical strut allograft can be readily incorporated into the host femur and augments the host bone structure. AD - Department of Orthopaedics and Rehabilitation, Loyola University Medical Center, Maywood, IL 60153. AN - 8403644 AU - Pak, J. H. AU - Paprosky, W. G. AU - Jablonsky, W. S. AU - Lawrence, J. M. DA - Oct DP - NLM ET - 1993/10/01 J2 - Clinical orthopaedics and related research KW - Adult Aged Aged, 80 and over *Bone Transplantation Female Femur/*transplantation Hip Prosthesis/*methods Humans Male Middle Aged Prosthesis Failure Reoperation LA - eng M1 - 295 N1 - PubMed NLM literature search January 5, 2021 PY - 1993 SN - 0009-921X (Print) 0009-921x SP - 172-8 ST - Femoral strut allografts in cementless revision total hip arthroplasty T2 - Clin Orthop Relat Res TI - Femoral strut allografts in cementless revision total hip arthroplasty ID - 828962 ER - TY - JOUR AB - One hundred thirteen cases of cementless femoral revision total hip arthroplasty using either cortical strut or proximal calcar allografts were reviewed for radiographic incorporation at an average 4.75 years after operation. All cortical strut grafts were used to supplement the host bone after achieving stable femoral fixation by a tight distal diaphyseal fit. Eighty-seven of the 95 cortical strut grafts showed radiographic evidence of graft incorporation. Eleven of the 18 calcar grafts had resorbed. Complications consisted of eight dislocations, three pulmonary embolisms, two superficial infections, two myocardial infarctions, and two sciatic nerve palsies. When stable distal fixation of cementless femoral prostheses have been achieved, the cortical strut allograft can be readily incorporated into the host femur and augments the host bone structure. AD - LOYOLA UNIV,MED CTR,DEPT ORTHOPAED & REHABIL,2160 S 1ST AVE,MAYWOOD,IL 60153. AN - WOS:A1993MA85000025 AU - Pak, J. H. AU - Paprosky, W. G. AU - Jablonsky, W. S. AU - Lawrence, J. M. DA - Oct J2 - Clin. Orthop. Rel. Res. KW - Orthopedics Surgery LA - English M1 - 295 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1993 SN - 0009-921X SP - 172-178 ST - FEMORAL STRUT ALLOGRAFTS IN CEMENTLESS REVISION TOTAL HIP-ARTHROPLASTY T2 - Clinical Orthopaedics and Related Research TI - FEMORAL STRUT ALLOGRAFTS IN CEMENTLESS REVISION TOTAL HIP-ARTHROPLASTY UR - ://WOS:A1993MA85000025 ID - 830493 ER - TY - JOUR AB - Clinical History/Pre-treatment Imaging: 73-year-old male with remote history of metastatic renal cell carcinoma status and left nephrectomy with new left hip pain and cane-dependent. Imaging demonstrated a large soft tissue and osteolytic mass of the left ilum. Treatment Options/Results: The patient agreed to undergo embolization, RFA, with screw fixation and cementoplasty for stability. Gelfoam embolization of the left superior gluteal artery. CT-guided placement of two Kyphon (Medtronic) introducer needles and RFA via two Osteocool (Medtronic) probes. Placement of two K wires and 2 transiliac fixation screws. CT-guided injection Confidence (DePuy Synthes) cement. Following physical therapy, he has returned to normal daily activites including climbing ladders to Do housework. Discussion: Many patients with RCC develop metastatic bone lesions, which are associated with fracture, severe pain, and local mass efffect. While medical management, radiotherapy, and surgery have been common approaches, embolization, ablation, and cementoplasty has been found to significantly improve patients' pain-related disability. This case is unique as it incorporates this multifaceted approach in a single-session and acheives better stability with percutaneous transiliac screw fixation. Take-home points: Embolization, ablation, and cementoplasty of metastatic RCC is effective. In cases of severe cortical destruction and instability, percutaneous screw fixation can provide adequate mechanical support. AD - R.A. Pampati, Radiology, University of Michigan Hospitals, Ann Arbor, MI, United States AU - Pampati, R. A. AU - Patel, N. A. AU - Mahn, J. J. AU - Gemmete, J. J. DB - Embase DO - 10.1007/s00270-019-02282-x KW - cement gelfoam aged artificial embolization body weight bone metastasis bone screw cancer patient cancer radiotherapy cancer surgery case report cementoplasty climbing clinical article conference abstract destruction disability fracture hip pain housekeeping human kidney metastasis kyphoplasty system lifestyle male needle nephrectomy osteolysis physiotherapy radiofrequency ablation radiotherapy soft tissue surgery LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1432-086X SP - S278 ST - Quadruple threat: Single-session embolization, radiofrequency ablation (RFA), cementoplasty, and transiliac screw fixation for lifestyle limiting pelvic renal cell carcinoma (RCC) metastases T2 - CardioVascular and Interventional Radiology TI - Quadruple threat: Single-session embolization, radiofrequency ablation (RFA), cementoplasty, and transiliac screw fixation for lifestyle limiting pelvic renal cell carcinoma (RCC) metastases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L629258907&from=export http://dx.doi.org/10.1007/s00270-019-02282-x VL - 42 ID - 829122 ER - TY - JOUR AB - Purpose: Distal arterial embolization to the foot with PMMA during vertebral augmentation has not been previously reported. We report a rare case of distal PMMA embolization to the dorsal foot artery during ipsilateral percutaneous lumbar vertebral augmentation in a patient with spinal osteolytic metastases. Methods: A 68-year-old woman was admitted because of severe disabling low back pain. Plain roentgenograms, MRI and CT-scan revealed osteolysis in the L4 and L5 vertebral bodies with prevertebral soft tissue involvement. Percutaneous vertebroplasty with PMMA was performed in L2 to L5 vertebrae under general anesthesia. Intraoperatively, leakage into the segmental vessels L3 and L5 was observed. Result: Four hours after the procedure the clinical diagnosis of acute ischemia and drop foot on the left was made. CT-angiography justified linear cement leakage in the course of the left third lumbar vein and fifth lumbar artery, and to the ipsilateral common iliac artery. The patient was treated with low molecular heparin and the ischemia resolved without further sequelae 1 week postoperatively. Conclusion: PMMA leakage is a complication associated with vertebroplasty and kyphoplasty. Although the outcome of the PMMA embolization to the vessels resolved without sequelae, in our case spine surgeons and interventional radiologists should be aware on this rare complication in patients with osteolytic vertebral metastases even when contemporary cement containment techniques are used. © Springer-Verlag 2013. AD - I. Panagiotis, Radiology Department, Patras General Hospital, Tsertidou 1, Achaia, Patra, Greece AU - Panagiotis, I. AU - Panagiotis, K. AU - Vasilios, V. DB - Embase Medline DO - 10.1007/s00586-013-2919-x KW - bone cement low molecular weight heparin poly(methyl methacrylate) aged anticoagulant therapy artery embolism article bone cement leakage bone implant case report computed tomographic angiography computer assisted tomography disease course dorsal foot artery female human iliac artery limb blood vessel limb ischemia low back pain lumbar artery lumbar vein nuclear magnetic resonance imaging osteolysis percutaneous vertebroplasty peroneus nerve paralysis postoperative complication priority journal spinal cord metastasis spine radiography vein Kiva VCF Treatment System LA - English M1 - SUPPL.2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1432-0932 0940-6719 SP - S187-S191 ST - PMMA embolization to the left dorsal foot artery during percutaneous vertebroplasty for spinal metastases T2 - European Spine Journal TI - PMMA embolization to the left dorsal foot artery during percutaneous vertebroplasty for spinal metastases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L52697876&from=export http://dx.doi.org/10.1007/s00586-013-2919-x VL - 23 ID - 829445 ER - TY - JOUR AB - Purpose: Distal arterial embolization to the foot with PMMA during vertebral augmentation has not been previously reported. We report a rare case of distal PMMA embolization to the dorsal foot artery during ipsilateral percutaneous lumbar vertebral augmentation in a patient with spinal osteolytic metastases.Methods: A 68-year-old woman was admitted because of severe disabling low back pain. Plain roentgenograms, MRI and CT-scan revealed osteolysis in the L4 and L5 vertebral bodies with prevertebral soft tissue involvement. Percutaneous vertebroplasty with PMMA was performed in L2 to L5 vertebrae under general anesthesia. Intraoperatively, leakage into the segmental vessels L3 and L5 was observed.Result: Four hours after the procedure the clinical diagnosis of acute ischemia and drop foot on the left was made. CT-angiography justified linear cement leakage in the course of the left third lumbar vein and fifth lumbar artery, and to the ipsilateral common iliac artery. The patient was treated with low molecular heparin and the ischemia resolved without further sequelae 1 week postoperatively.Conclusion: PMMA leakage is a complication associated with vertebroplasty and kyphoplasty. Although the outcome of the PMMA embolization to the vessels resolved without sequelae, in our case spine surgeons and interventional radiologists should be aware on this rare complication in patients with osteolytic vertebral metastases even when contemporary cement containment techniques are used. AD - Radiology Department, Patras General Hospital, Tsertidou 1, Achaia, Patra, Greece, eliopan1@gmail.com. AN - 103824586. Language: English. Entry Date: 20150116. Revision Date: 20200708. Publication Type: journal article AU - Panagiotis, Iliopoulos AU - Panagiotis, Korovessis AU - Vasilios, Vitsas AU - Iliopoulos, Panagiotis AU - Korovessis, Panagiotis AU - Vitsas, Vasilios DB - cin20 DO - 10.1007/s00586-013-2919-x DP - EBSCOhost KW - Bone Cements -- Adverse Effects Extravasation of Diagnostic and Therapeutic Materials -- Complications Foot -- Blood Supply Ischemia -- Etiology Lumbar Vertebrae -- Surgery Methylmethacrylates -- Adverse Effects Vertebroplasty Aged Anticoagulants -- Therapeutic Use Female Gait Disorders, Neurologic -- Etiology Heparin, Low-Molecular-Weight -- Therapeutic Use Ischemia -- Therapy Lumbar Vertebrae -- Blood Supply Lumbar Vertebrae -- Pathology Osteolysis -- Pathology Spinal Neoplasms Spinal Neoplasms -- Surgery Thrombosis -- Etiology N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2014 SN - 0940-6719 SP - 187-191 ST - PMMA embolization to the left dorsal foot artery during percutaneous vertebroplasty for spinal metastases T2 - European Spine Journal TI - PMMA embolization to the left dorsal foot artery during percutaneous vertebroplasty for spinal metastases UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=103824586&site=ehost-live&scope=site VL - 23 ID - 830635 ER - TY - JOUR AB - Introduction: Several studies have proven that vacuum cementing in hip replacement produces a more homogenous cement with a superior bone cement interface in comparison to the standard technique. It also has the potential to reduce so called cement embolism. We therefore thought of a simple technique to apply this advantage also in kyphoplasty. Material and Methods: Each patient had the standard Kyphoplasty procedure with a ballon placed in the vertebra via the two pedicles of the fractured vertebra in the routine manner. A 50ml Luer Lock Syringe (encluded in the Set) was then fixed to the one side and pressure applied by pulling on the syringe whilst the cement was slowly applied or sucked in via the other side. In case there was too much blood aspirated the syringe was constantly changed to maintain constant pressure. This maneuver was repeated until cement visibly seeped out into the vacuum syringe. Then cement was also applied via the vacuum side. The total amount of cement was measured and the post op Xray was assessed by an independent blinded radiologist. He had to record any cement leak and the spreading of the cement. If there was any doubt about leakage a CT scan was performed. Results: 74 consecutive patients with 88 Kyphoplasties were prospectively collected so far. We found less cement leak than in a previous group and in the published results of kyphoplasty when counting any leak. The Cement seemed more homogeneously spread throughout the vertebra. Conclusion: Vacuum assisted cement application is a simple procedure with a minimal prolongation of the operating time and no added cost that so far has the potential to lead to less cement leak than classic kyphoplasty. However, to prove its value this will have to be verified by proper designed randomized controlled studies. AD - K. Pankert, Department of Orthopaedics, Spine, Brig, Switzerland AU - Pankert, K. AU - Krappel, F. AU - Frey, M. DB - Embase DO - 10.1177/2192568217708189 KW - cement blood clinical trial controlled clinical trial controlled study human kyphoplasty major clinical study male operation duration radiologist randomized controlled trial single blind procedure spine fracture syringe vacuum x-ray computed tomography LA - English M1 - 2 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 2192-5690 SP - 298S-299S ST - Kyphoplasty is a safe procedure-can it be made even safer? A technical note of a simple vacuum procedure T2 - Global Spine Journal TI - Kyphoplasty is a safe procedure-can it be made even safer? A technical note of a simple vacuum procedure UR - https://www.embase.com/search/results?subaction=viewrecord&id=L616656622&from=export http://dx.doi.org/10.1177/2192568217708189 VL - 7 ID - 829257 ER - TY - JOUR AB - A 52-year-old woman underwent vertebroplasty for fractures of the T10, T11, and L2 vertebrae secondary to multiple myeloma. She was discharged uneventfully within a week. Nine months later, she was readmitted for syncope. Echocardiography revealed a mass in the right atrium. Magnetic resonance imaging (MRI) revealed a low signal intensity irregular mass (8x7 mm) and a comma-shaped mass (12 mm) in the right atrium. She was prophylactically anticoagulated for the probable emboli. Repeat cardiac MRI performed 2 weeks later showed that the size of the masses remained unchanged. Surgical intervention was not suggested by the cardiothoracic surgeons. Three months later, the patient remained uneventful. AD - Department of Orthopedic Surgery, National University Hospital, Singapore. AN - 25163966 AU - Pannirselvam, V. AU - Hee, H. T. DA - Aug DO - 10.1177/230949901402200228 DP - NLM ET - 2014/08/29 J2 - Journal of orthopaedic surgery (Hong Kong) KW - Bone Cements/*adverse effects Embolism/diagnosis/*etiology/therapy Female Fractures, Compression/*surgery Heart Atria Heart Diseases/diagnosis/*etiology/therapy Humans Lumbar Vertebrae/injuries Middle Aged Spinal Fractures/*surgery Thoracic Vertebrae/injuries Vertebroplasty/*adverse effects bone cements embolism vertebroplasty LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1022-5536 SP - 244-7 ST - Asymptomatic cement embolism in the right atrium after vertebroplasty using high-viscosity cement: a case report T2 - J Orthop Surg (Hong Kong) TI - Asymptomatic cement embolism in the right atrium after vertebroplasty using high-viscosity cement: a case report VL - 22 ID - 828855 ER - TY - JOUR AB - A 52-year-old woman underwent vertebroplasty for fractures of the T10, T11, and L2 vertebrae secondary to multiple myeloma. She was discharged uneventfully within a week. Nine months later, she was readmitted for syncope. Echocardiography revealed a mass in the right atrium. Magnetic resonance imaging (MRI) revealed a low signal intensity irregular mass (8x7 mm) and a comma-shaped mass (12 mm) in the right atrium. She was prophylactically anticoagulated for the probable emboli. Repeat cardiac MRI performed 2 weeks later showed that the size of the masses remained unchanged. Surgical intervention was not suggested by the cardiothoracic surgeons. Three months later, the patient remained uneventful. AD - Department of Orthopedic Surgery, National University Hospital, Singapore Department of Orthopedic Surgery, National University Hospital, Singapore. AN - 103843424. Language: English. Entry Date: 20150529. Revision Date: 20170615. Publication Type: journal article AU - Pannirselvam, V. AU - Hee, H. T. AU - Pannirselvam, Vinodhkumar AU - Hee, Hwan Tak DB - cin20 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Embolism -- Etiology Fractures, Compression -- Surgery Heart Diseases -- Etiology Spinal Fractures -- Surgery Vertebroplasty -- Adverse Effects Embolism -- Diagnosis Embolism -- Therapy Female Heart Atrium Heart Diseases -- Diagnosis Heart Diseases -- Therapy Lumbar Vertebrae -- Injuries Middle Age Thoracic Vertebrae -- Injuries M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2014 SN - 1022-5536 SP - 244-247 ST - Asymptomatic cement embolism in the right atrium after vertebroplasty using high-viscosity cement: a case report T2 - Journal of Orthopaedic Surgery (10225536) TI - Asymptomatic cement embolism in the right atrium after vertebroplasty using high-viscosity cement: a case report UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=103843424&site=ehost-live&scope=site VL - 22 ID - 830632 ER - TY - JOUR AB - Giant cell bone tumors (GCT) are benign but partially locally aggressive osteolytic tumors which typically occur around the knee joint in the epiphysis and metaphysis of long bones after maturation of the skeleton is completed. Due to the locally aggressive growth behavior with destruction of the bone structure, the rare possibility of pulmonary metastases in recurrent cases and a very rare possibility of malignancy, GCTs were previously also described as semimalignant bone tumors. The established therapy of these tumors at the typical locations consists of intralesional curettage, extension of resection margins using a high speed trephine and defect reconstruction with bone cement. The local recurrence rate is high (10-40 %) and lowest after using thermal extension of resection margins with a high speed trephine and defect reconstruction with bone cement. For uncommon localizations, such as the spinal column and the sacrum as well as in cases of recurrence, surgical treatment is more complicated. Histologically, GCTs consist of osteoclastic giant and oval-shaped stromal cells which show a high expression of receptor activator of nuclear factor-kappa B ligand (RANKL) and decisively contribute to the osteolytic activity of the tumor. Novel pharmaceutical therapy approaches with human monoclonal RANKL antibodies interfere in this osteodestructive process in an inhibitory manner and can represent alternative treatment options just as the osteosupportive therapy with bisphosphonates. After unsatisfactory attempts at surgical treatment of GCT patients, the new treatment option with denosumab is a promising alternative due to its effect as a monoclonal RANKL inhibitor. Nach unbefriedigenden chirurgischen Therapieversuchen bei RZT-Patienten ist Denosumab durch seine Wirkung als monoklonaler RANKL-Inhibitor als neue Behandlungsoption eine vielversprechende Alternative. AD - [Panzica, M.; Lueke, U.; Omar, M.; Krettek, C.] Hannover Med Sch, Unfallchirurg Klin, D-30625 Hannover, Germany. [Laenger, F.] Hannover Med Sch, Inst Pathol, D-30625 Hannover, Germany. [v. Falck, C.] Hannover Med Sch, Inst Radiol, D-30625 Hannover, Germany. Panzica, M (corresponding author), Hannover Med Sch, Unfallchirurg Klin, Carl Neuberg Str 1, D-30625 Hannover, Germany. Panzica.Martina@mh-hannover.de AN - WOS:000343137500004 AU - Panzica, M. AU - Luke, U. AU - Omar, M. AU - Langer, F. AU - von Falck, C. AU - Krettek, C. DA - Oct DO - 10.1007/s00113-014-2580-9 J2 - Unfallchirurg KW - Intralesional resection Physical and chemical adjuvants Arterial embolization RANK ligand Bisphosphonates BONE CURETTAGE DENOSUMAB CEMENT Emergency Medicine Surgery LA - German M1 - 10 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2014 SN - 0177-5537 SP - 883-891 ST - New therapy approaches for giant cell tumors T2 - Unfallchirurg TI - New therapy approaches for giant cell tumors UR - ://WOS:000343137500004 VL - 117 ID - 830255 ER - TY - JOUR AB - Cancer-related fractures of the spine are different from osteoporotic ones, not only in pathogenesis but also in natural history and treatment. Higher class evidence now supports offering balloon kyphoplasty to a patient with cancer, provided that the pain is significant in intensity, has a positional character, and correlates to the area of the fractured vertebrae. Absence of clinical spinal cord compression and overt instability are paramount. Because of the frequent disruption of the posterior vertebral body cortex in these patients, the procedure should be performed by experienced operators who could also quickly perform an open decompression if cement extravasation occurs. Patients will benefit from vertebral augmentation, even in chronic malignant fractures. A biopsy should be routinely performed and a combination with radiation treatment would be beneficial in most cases. © JNCCN - Journal of the National Comprehensive Cancer Network. AD - I.D. Papanastassiou, H. Lee Moffitt Cancer Center, Research Institute, Tampa, FL, United States AU - Papanastassiou, I. D. AU - Aghayev, K. AU - Berenson, J. R. AU - Schmidt, M. H. AU - Vrionis, F. D. DB - Embase Medline DO - 10.6004/jnccn.2012.0074 KW - article bone biopsy cancer chemotherapy cancer patient cancer radiotherapy compression fracture human kyphoplasty lung embolism osteolysis osteomyelitis percutaneous vertebroplasty pneumothorax polymerization postoperative complication prospective study radiofrequency ablation retroperitoneal hematoma spine fracture vertebral augmentation L1 - http://www.jnccn.org/content/10/6/715.full.pdf+html LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1540-1405 1540-1413 SP - 715-719 ST - Is vertebral augmentation the right choice for cancer patients with painful vertebral compression fractures? T2 - JNCCN Journal of the National Comprehensive Cancer Network TI - Is vertebral augmentation the right choice for cancer patients with painful vertebral compression fractures? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L365142293&from=export http://dx.doi.org/10.6004/jnccn.2012.0074 VL - 10 ID - 829562 ER - TY - JOUR AB - Percutaneous vertebroplasty (PVP) is a minimally invasive surgical treatment for patients with osteoporotic vertebral compression fracture (OVCF) and can rapidly alleviate pain, improve mobility, and stabilize the vertebrae. However, it has the potential to cause complications such as cement embolism. A 55-year-old female presented with pain in the lumbar region as a chief complaint. PVP was performed after diagnosis of acute OVCFs at L4 and L5. No abnormal symptoms were reported after surgery, but a large cement embolism was observed in her right atrium and ventricle. After discussion in a multi-disciplinary team, the large cement embolism was successfully removed by a combination of endovascular procedure and an inferior vena cava exploration. Surgeons must consider the possibility of intra-cardiac cement embolism after PVP. A hybrid approach of an endovascular procedure and a vascular surgery may be a reasonable treatment option to minimize the surgical procedure in cases of a large intra-cardiac cement embolism. AD - Department of Orthopedic Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea. Department of Cardiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea. Department of Vascular Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea. AN - 29736157 AU - Park, J. S. AU - Kim, J. AU - Lee, Y. AU - Gwon, J. G. AU - Park, Y. S. C2 - Pmc5934517 DA - May 7 DO - 10.3346/jkms.2018.33.e141 DP - NLM ET - 2018/05/08 J2 - Journal of Korean medical science KW - Coronary Angiography Echocardiography Endovascular Procedures/*adverse effects Female Fractures, Compression/*surgery Heart Atria/diagnostic imaging Humans Lumbar Vertebrae/diagnostic imaging Magnetic Resonance Imaging Middle Aged Postoperative Complications Pulmonary Embolism/*etiology Vena Cava, Inferior Vertebroplasty/*adverse effects Embolism Endovascular Procedures Inferior Vena Cava Vertebroplasty LA - eng M1 - 19 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 1011-8934 (Print) 1011-8934 SP - e141 ST - Intra-cardiac Embolism of a Large Bone Cement Material after Percutaneous Vertebroplasty Removed through a Combination of an Endovascular Procedure and an Inferior Vena Cava Exploration: a Case Report T2 - J Korean Med Sci TI - Intra-cardiac Embolism of a Large Bone Cement Material after Percutaneous Vertebroplasty Removed through a Combination of an Endovascular Procedure and an Inferior Vena Cava Exploration: a Case Report VL - 33 ID - 828647 ER - TY - JOUR AD - Department of Cardiology, Ajou University School of Medicine. AN - 27725527 AU - Park, J. S. AU - Shin, J. H. AU - Lim, S. H. AU - Yang, H. M. DA - Dec 22 DO - 10.1253/circj.CJ-16-0930 DP - NLM ET - 2016/10/12 J2 - Circulation journal : official journal of the Japanese Circulation Society KW - Bone Cements/*adverse effects/pharmacology Embolism/*chemically induced/*diagnostic imaging Fatal Outcome Humans Kyphoplasty/*adverse effects Male Middle Aged LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1346-9843 SP - 119-120 ST - Lethal Cement Leakage Embolization After Kyphoplasty T2 - Circ J TI - Lethal Cement Leakage Embolization After Kyphoplasty VL - 81 ID - 828497 ER - TY - JOUR AD - H.-M. Yang, Department of Cardiology, Ajou University School of Medicine, 164 Worldcup-ro, Suwon, South Korea AU - Park, J. S. AU - Shin, J. H. AU - Lim, S. H. AU - Yang, H. M. DB - Embase Medline DO - 10.1253/circj.CJ-16-0930 KW - methacrylic acid methyl ester adult artificial embolization bone cement leakage bone radiography case report coronary angiography echocardiography fluoroscopy heart perforation human kyphoplasty male middle aged note sternotomy thorax pain LA - English M1 - 1 M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1347-4820 1346-9843 SP - 119-120 ST - Lethal cement leakage embolization after kyphoplasty T2 - Circulation Journal TI - Lethal cement leakage embolization after kyphoplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L613847114&from=export http://dx.doi.org/10.1253/circj.CJ-16-0930 VL - 81 ID - 829274 ER - TY - JOUR AB - Objective: For symptomatic metastasis of the long bones, intramedullary nailing has been the most accepted fixation method. Intramedullary nailing has effective control of pain, perioperative bleeding, and local tumor progression by augmentation with bone cement around the nail. Here, we report the preliminary results of a new surgical implant that allows for simultaneous injection of bone cement while inserting a percutaneous, flexible intramedullary nail.Materials and Methods: We performed palliative surgeries for long-bone metastasis using a multi-hole injection nail (MIN) with multiple side holes in the distal one third. When the nail tip entered the metastatic cancer lesion, the bone cement injection was started, and continued until the nail was completely seated. Ten patients with advanced cancer underwent palliative surgery using the new implant with simultaneous bone cement injection for humeral (n = 4), femoral (n = 4), and tibial (n = 2) metastases.Results: The mean operative time was 42 min (range, 36-52 min). The mean length of the injection nail was 23.0 cm (range, 18.0-33.0 cm), and the mean volume of cement was 28.0 ml (range, 14.0-40.0 ml). Marked pain palliation (p < 0.001) and functional recovery (p = 0.01) were verified. The mean Musculoskeletal Tumor Society (MSTS) functional score improved significantly from 12.5 at 6 weeks preoperatively, to 24.9 postoperatively. No acute postoperative complications, including cement embolism, occurred.Conclusion: This minimally invasive surgical method with MIN could be useful for stabilization of long-bone metastases in patients with advanced cancer. AD - Orthopaedic Oncology Clinic, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, 10408, Goyang-si, Gyeonggi-do, South Korea Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, South Korea AN - 133695354. Language: English. Entry Date: In Process. Revision Date: 20200309. Publication Type: journal article. Journal Subset: Biomedical AU - Park, Jong Woong AU - Kim, Yong-il AU - Kang, Hyun Guy AU - Kim, June Hyuk AU - Kim, Han Soo DB - cin20 DO - 10.1007/s00256-018-2998-1 DP - EBSCOhost KW - Bone Neoplasms -- Surgery Humerus -- Surgery Bone Cements -- Therapeutic Use Fracture Fixation -- Methods Tibia -- Surgery Fractures, Spontaneous -- Surgery Femur -- Surgery Orthopedic Fixation Devices Bone Neoplasms Treatment Outcomes Humerus Fractures, Spontaneous Male Female Femur Palliative Care Aged Tibia Prospective Studies Middle Age Clinical Assessment Tools M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2019 SN - 0364-2348 SP - 219-225 ST - Preliminary results: use of multi-hole injection nails for intramedullary nailing with simultaneous bone cement injection in long-bone metastasis T2 - Skeletal Radiology TI - Preliminary results: use of multi-hole injection nails for intramedullary nailing with simultaneous bone cement injection in long-bone metastasis UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=133695354&site=ehost-live&scope=site VL - 48 ID - 830540 ER - TY - JOUR AB - BACKGROUND: Many different surgical techniques have been described for the internal fixation of extracapsular hip fractures. OBJECTIVES: To compare different aspects of surgical technique used in operations for internal fixation of extracapsular hip fractures in adults. SEARCH STRATEGY: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (January 2008), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 1), MEDLINE, EMBASE, CINAHL, Current Controlled Trials, orthopaedic journals, conference proceedings and reference lists of articles. Date of last search was January 2008. No language restriction was applied. SELECTION CRITERIA: All randomised and quasi-randomised trials investigating operative techniques used in operations for the treatment of extracapsular hip fractures in adults. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials, assessed trial quality and extracted data. Wherever appropriate, data were pooled. MAIN RESULTS: Predominantly older people with trochanteric fractures were treated in the 11 included trials.One trial (65 participants undergoing fixation with a fixed nail-plate) found no statistically significant differences between osteotomy versus anatomical reduction. Four trials, involving 465 participants undergoing fixation with a sliding hip screw (SHS), compared osteotomy versus anatomical reduction. Osteotomy was associated with an increased operative blood loss and length of surgery. There were no statistically significant differences for mortality, morbidity or measures of anatomical deformity.Two trials (138 participants) compared SHS fixation of a trochanteric hip fracture augmented with cement against a standard fixation. There were no reoperations even for the four cases of fixation failure in the cement group. The cement group had significantly better quality of life scores at six months. One trial (200 participants) comparing compression versus no compression of a trochanteric fracture in conjunction with SHS fixation found no significant differences between the two groups. One trial (120 participants) found a tendency to improved outcomes with a hydroxyapatite coated lag screw, but none reached statistical significance. One trial (19 participants) reported reduced temperatures when using a modified reaming method. Another trial (50 participants) found reduced bone marrow intravascular embolism, detected by oesophageal ultrasound, when a Gamma nail was inserted with a distal pressure venting hole in the femur. AUTHORS' CONCLUSIONS: There is inadequate evidence to support the use of osteotomy for internal fixation of a trochanteric hip fracture. Similarly, there is insufficient evidence to support the use of the other techniques examined in the trials included in this review. AD - Orthopaedic Department, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough District Hospital, Thorpe Road, Peterborough, Cambridgeshire, UK, PE3 6DA. martyn.parker@pbh-tr.nhs.uk AN - 19370559 AU - Parker, M. J. AU - Handoll, H. H. C2 - Pmc7032640 DA - Apr 15 DO - 10.1002/14651858.CD000522.pub2 DP - NLM ET - 2009/04/17 J2 - The Cochrane database of systematic reviews KW - Bone Cements/therapeutic use Fracture Fixation, Internal/*methods Hip Fractures/*surgery Humans Internal Fixators Osteotomy/*methods Randomized Controlled Trials as Topic LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 1361-6137 SP - Cd000522 ST - Osteotomy, compression and other modifications of surgical techniques for internal fixation of extracapsular hip fractures T2 - Cochrane Database Syst Rev TI - Osteotomy, compression and other modifications of surgical techniques for internal fixation of extracapsular hip fractures VL - 2009 ID - 828670 ER - TY - JOUR AB - Background: Many different surgical techniques have been described for the internal fixation of extracapsular hip fractures. Objectives: To compare different aspects of surgical technique used in operations for internal fixation of extracapsular hip fractures in adults. Search strategy: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (January 2008), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2008, Issue 1), MEDLINE, EMBASE, CINAHL, Current Controlled Trials, orthopaedic journals, conference proceedings and reference lists of articles. Date of last search was January 2008. No language restriction was applied. Selection criteria: All randomised and quasi-randomised trials investigating operative techniques used in operations for the treatment of extracapsular hip fractures in adults. Data collection and analysis: Two review authors independently selected trials, assessed trial quality and extracted data. Wherever appropriate, data were pooled. Main results: Predominantly older people with trochanteric fractures were treated in the 11 included trials. One trial (65 participants undergoing fixation with a fixed nail-plate) found no statistically significant differences between osteotomy versus anatomical reduction. Four trials, involving 465 participants undergoing fixation with a sliding hip screw (SHS), compared osteotomy versus anatomical reduction. Osteotomy was associated with an increased operative blood loss and length of surgery. There were no statistically significant differences for mortality, morbidity or measures of anatomical deformity. Two trials (138 participants) compared SHS fixation of a trochanteric hip fracture augmented with cement against a standard fixation. There were no reoperations even for the four cases of fixation failure in the cement group. The cement group had significantly better quality of life scores at six months. One trial (200 participants) comparing compression versus no compression of a trochanteric fracture in conjunctionwith SHS fixation found no significant differences between the two groups. One trial (120 participants) found a tendency to improved outcomes with a hydroxyapatite coated lag screw, but none reached statistical significance. One trial (19 participants) reported reduced temperatures when using a modified reaming method. Another trial (50 participants) found reduced bone marrow intravascular embolism, detected by oesophageal ultrasound, when a Gamma nail was inserted with a distal pressure venting hole in the femur. Authors' conclusions: There is inadequate evidence to support the use of osteotomy for internal fixation of a trochanteric hip fracture. Similarly, there is insufficient evidence to support the use of the other techniques examined in the trials included in this review. Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. AD - M. J. Parker, Orthopaedic Department, Peterborough and Stamford Hospitals NHS Foundation Trust, Peterborough District Hospital, Thorpe Road, Peterborough, Cambridgeshire, PE3 6DA, United Kingdom AU - Parker, M. J. AU - Handoll, H. H. G. DB - Embase Medline DO - 10.1002/14651858.CD000522.pub2 KW - bone cement hydroxyapatite bone marrow clinical trial compression fracture control group data extraction deep vein thrombosis femur osteotomy femur trochanteric fracture fracture fixation hip fracture human lung embolism osteosynthesis pelvis osteotomy pneumonia postoperative complication review surgical technique thromboembolism L1 - http://www.mrw.interscience.wiley.com/cochrane/clsysrev/articles/CD000522/pdf_fs.html LA - English M1 - 2 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 1469-493X ST - Osteotomy, compression and other modifications of surgical techniques for internal fixation of extracapsular hip fractures T2 - Cochrane Database of Systematic Reviews TI - Osteotomy, compression and other modifications of surgical techniques for internal fixation of extracapsular hip fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L355267491&from=export http://dx.doi.org/10.1002/14651858.CD000522.pub2 ID - 829693 ER - TY - JOUR AB - Echogenic venous emboli accompany tourniquet deflation during total knee arthroplasty. Two types of echogenic emboli appear in the central circulation: small venous emboli (miliary emboli) and large venous emboli (masses of echogenic material superimposed on miliary emboli). Presumably, medullary cavity trespass releases small and large echogenic emboli. However, patients undergoing lower extremity procedures with a tourniquet have large echogenic emboli regardless of medullary cavity invasion. Avoiding tourniquet inflation may decrease the release of large venous emboli. Thirteen patients undergoing total knee arthroplasty without pneumatic tourniquet received intramedullary guides and 11 patients received tibial extramedullary guides. Recordings of hemodynamic variables, mixed venous oximetry, end‐tidal CO2, and echocardiographic images were made after the induction of anesthesia and for 15 min after femoral prosthesis cementing. Mean arterial pressure did not change during the study, and mean pulmonary arterial pressure increased minimally. Large venous emboli appeared in eight patients, small venous emboli appeared in 12 patients, and no emboli appeared in four patients. Compared with previous investigations of large venous emboli during total knee arthroplasty with a pneumatic tourniquet, multiple logistic regression analysis discloses a 5.33‐fold greater risk of large venous embolism accompanied the use of a tourniquet during total knee arthroplasty. IMPLICATIONS: One third of knee replacements performed without a tourniquet demonstrated large emboli. Reducing marrow cavity invasion did not decrease the release of large emboli. Compared with knee replacement without tourniquet, tourniquet use places patients at a 5.33‐fold greater risk of having a large emboli. AN - CN-00153914 AU - Parmet, J. L. AU - Horrow, J. C. AU - Berman, A. T. AU - Miller, F. AU - Pharo, G. AU - Collins, L. DO - 10.1097/00000539-199808000-00039 KW - Adult Aged Anesthesia, General Arthroplasty, Replacement, Knee [*adverse effects, methods] Echocardiography, Transesophageal Embolism [diagnostic imaging, *etiology] Hemodynamics Humans Middle Aged Monitoring, Intraoperative Regression Analysis Risk Factors Tourniquets [*adverse effects] Veins M1 - 2 M3 - Clinical Trial; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1998 SP - 439‐444 ST - The incidence of large venous emboli during total knee arthroplasty without pneumatic tourniquet use T2 - Anesthesia and analgesia TI - The incidence of large venous emboli during total knee arthroplasty without pneumatic tourniquet use UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00153914/full VL - 87 ID - 830077 ER - TY - JOUR AD - J.L. Parmet, Hahnemann University, Broad and Vine Streets, Philadelphia, PA 19102-1192, United States AU - Parmet, J. L. AU - Horrow, J. C. AU - Keykhah, M. M. AU - Sirianni, A. AU - Singer, R. AU - Weiss, A. DB - Embase Medline DO - 10.1097/00000539-199503000-00033 KW - bone cement heparin methacrylic acid methyl ester warfarin aged arterial pressure arthroplasty article case report diagnostic accuracy embolism femoral neck fracture human male osteoarthritis postoperative complication priority journal transesophageal echocardiography LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1995 SN - 0003-2999 SP - 614-616 ST - Accumulation of a right ventricular mass during shoulder hemiarthroplasty T2 - Anesthesia and Analgesia TI - Accumulation of a right ventricular mass during shoulder hemiarthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L25068393&from=export http://dx.doi.org/10.1097/00000539-199503000-00033 VL - 80 ID - 829932 ER - TY - JOUR AB - The records of 23 patients who died intraoperatively during hip arthroplasty at the authors' institution were reviewed. Of the 38,488 hip arthroplasties in 29,431 patients performed between 1969 and 1997, there were 23 deaths during surgery. There were 15 women and eight men with a mean age of 80.9 years. Preoperative diagnoses were acute hip fracture (13 patients), pathologic fracture (four patients), femoral neck nonunion (one patient), osteoarthritis (four patients), and rheumatoid arthritis (one patient). Eleven patients undergoing cemented total hip arthroplasty died and 12 patients undergoing cemented hemiarthroplasty died. All deaths occurred because of irreversible cardiorespiratory disturbances that were initiated during cementing. There were no deaths among 12,551 patients receiving 15,411 uncemented hip arthroplasties during the 28-year period under review. Autopsy was performed in 13 patients. Bone marrow microemboli were seen in the lungs of 11 of 13 patients in whom an autopsy was performed and methylmethacrylate particles were seen in the lungs of three of 13 patients. These data suggest that elderly patients with preexisting cardiovascular conditions undergoing cemented arthroplasty, especially for fracture diagnosis, are at increased risk for intraoperative death compared with patients undergoing elective hip arthroplasty. In the latter years of the current study, modifications of the operative techniques designed to minimize intramedullary hypertension were associated with a reduction greater than three-fold in overall intraoperative mortality rate. These changes in surgical technique should be considered when cement fixation is used in patients thought to be at risk for having cardiopulmonary disturbances develop from venous embolization of marrow contents. AD - Department of Orthopedics, Mayo Clinic, Rochester, MN 55905, USA AN - 120361907. Language: English. Entry Date: 20000201. Revision Date: 20190529. Publication Type: journal article AU - Parvizi, J. AU - Holiday, A. D. AU - Ereth, M. H. AU - Lewallen, D. G. DB - cin20 DP - EBSCOhost KW - Death, Sudden -- Epidemiology Arthroplasty, Replacement, Hip -- Mortality Intraoperative Complications -- Mortality Time Factors Intraoperative Complications -- Pathology Minnesota Death, Sudden -- Pathology Arthroplasty, Replacement, Hip -- Methods Death, Sudden -- Etiology Middle Age Human Male Aged Aged, 80 and Over Arthroplasty, Replacement, Hip -- Statistics and Numerical Data Risk Factors Demography Incidence Analysis of Variance Female Validation Studies Comparative Studies Evaluation Research Multicenter Studies Arthritis Impact Measurement Scales N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 1999 SN - 0009-921X SP - 39-48 ST - The Frank Stinchfield Award. Sudden death during primary hip arthroplasty T2 - Clinical Orthopaedics & Related Research TI - The Frank Stinchfield Award. Sudden death during primary hip arthroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=120361907&site=ehost-live&scope=site VL - 369 ID - 830800 ER - TY - JOUR AB - Background Information: The field of hospice and palliative medicine is expanding with certification cosupported by 10 medical boards, including the American Board of Radiology. As part of a patient-oriented approach to palliative care, there has been an increasing emphasis on limiting the suffering experienced by patients. Interventional radiologists are uniquely positioned to care for these patients and can thereby expand the scope of their practice to include palliative medicine for the oncologic patient with debilitating pain. Educational Goals/Teaching Points: In viewing this exhibit, the participant will become familiar with the variety of therapeutic modalities now available to the interventional radiologist to treat various types and sites of pain, review the technical aspects of minimally invasive imaging-guided procedures currently in use via a pictorial review of patient cases from a single academic university-based practice, and gain knowledge of and insight into the indications, expected results, and associated complications of the various palliative procedures available to the oncologic patient. Key Anatomic/Physiologic Issues and Imaging Findings/Techniques: The interventional radiologist possesses a unique skill set with experience in both diagnostic image interpretation as well as a depth of knowledge in minimally invasive imaging-guided procedures. One should become familiar with the techniques of radiofrequency ablation, cryoablation, microwave ablation, transarterial embolization, plasma-mediated radiofrequency-based coblation, and instillation of polymethylmethacrylate for palliative purposes. Specifically, these minimally invasive imaging-guided techniques can then be used to provide patients with symptomatic pain relief in a timely fashion and has successfully been used in the treatment of pain due to primary and secondary neoplastic disease from a variety of organs and tissues, most notably those of the head and neck, bone, lung, and liver. Conclusion: Percutaneous imaging-guided interventions can and should be incorporated into the treatment algorithm of managing the oncologic patient in regards to the practice of pain and palliative medicine. The interventional radiologist is appropriately positioned to care for these patients as part of an interdisciplinary team. It is imperative to familiarize oneself with the indications, technical procedures, expected results, as well as associated complications of the many treatment options available to treat the offending lesions contributing to patients' pain as they are gaining traction in the arena of pain palliation. AD - I. Patel, University Hospitals, Case Medical Center, Cleveland Heights, OH, United States AU - Patel, I. AU - Dar, S. AU - Hsu, D. AU - Prologo, J. DB - Embase KW - poly(methyl methacrylate) palliative therapy patient human X ray society pain imaging radiologist procedures university radiofrequency neoplasm plasma certification artificial embolization microwave thermotherapy traction therapy cryoablation radiology radiofrequency ablation liver diagnosis skill analgesia bone tissues neck lung algorithm hospice L1 - http://www.ajronline.org/doi/full/10.2214/ajr.198.5_supplement.ajronline_198_5_supplement_040 LA - English M1 - 5 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 0361-803X ST - Interventional pain palliation for the oncologic patient T2 - American Journal of Roentgenology TI - Interventional pain palliation for the oncologic patient UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71321223&from=export VL - 198 ID - 829571 ER - TY - JOUR AB - Aneurysmal bone cysts (ABCs) of spine are conventionally treated with en-bloc resection or intralesional excision/curettage and reconstruction or filling of defects with bone cement. For the treatment of upper cervical ABCs, en-bloc resections are often not desirable considering the risk/benefit ratio while the risk of recurrence after intralesional excision is high. Hence, alternative management options are often necessary. We describe our clinical experience with one such treatment alternative-denosumab for the treatment of ABC of Atlas. We present a case of 16-year-old boy who presented with neck pain and restriction of neck movements. A large lytic lesion with multiple fluid-fluid interfaces involving vertebral arch of atlas was identified on further imaging. There was destruction of right lateral mass and the lesion was found encasing the right vertebral artery. Core needle biopsy confirmed the diagnosis of ABC. With no visible CT response after first session of intra-lesional injection of Calcitonin and Methylprednisolone, the patient was treated with denosumab (120 mg SC once-a-month) for a period of 12 months. His symptoms resolved within 7 months of onset of treatment and serial CT scans over 12-month treatment period showed complete ossification of the lesion. Further there was no evidence of recurrence at 12 months after completion of treatment. Our case report contributes to the accruing evidence on the effectiveness of denosumab for the treatment of spinal ABCs. However, long-term safety, risk of recurrence, optimal duration of treatment and consistency of denosumab are yet to be determined. AD - [Patel, Ravish Shammi; Kumar, Nishant; Kumar, Naresh] Natl Univ Singapore Hosp, Dept Orthopaed Surg, Univ Orthopaed Hand & Reconstruct Microsurgery Cl, 1E Kent Ridge Rd,NUHS Tower Block,Level 11, Singapore 119228, Singapore. [Dhamne, Chetan Anil] Natl Univ Singapore Hosp, Dept Paediat Haematol & Oncol, Singapore, Singapore. [Gopinathan, Anil] Natl Univ Singapore Hosp, Dept Diagnost Imaging, Singapore, Singapore. Kumar, N (corresponding author), Natl Univ Singapore Hosp, Dept Orthopaed Surg, Univ Orthopaed Hand & Reconstruct Microsurgery Cl, 1E Kent Ridge Rd,NUHS Tower Block,Level 11, Singapore 119228, Singapore. dosksn@nus.edu.sg AN - WOS:000440663500041 AU - Patel, R. S. AU - Dhamne, C. A. AU - Gopinathan, A. AU - Kumar, N. AU - Kumar, N. DA - Jul DO - 10.1007/s00586-018-5528-x J2 - Eur. Spine J. KW - Spine Atlas Aneurysmal bone cyst Denosumab Methylprednisolone and calcitonin injection SELECTIVE ARTERIAL EMBOLIZATION GIANT-CELL TUMOR CERVICAL-SPINE MOBILE SPINE RESECTION CHILDREN SAFETY Clinical Neurology Orthopedics LA - English M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 0940-6719 SP - S494-S500 ST - Denosumab: a potential treatment option for aneurysmal bone cyst of the atlas T2 - European Spine Journal TI - Denosumab: a potential treatment option for aneurysmal bone cyst of the atlas UR - ://WOS:000440663500041 VL - 27 ID - 830163 ER - TY - JOUR AB - SESSION TITLE: Monday Medical Student/Resident Case Report Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: 10/21/2019 02:30 PM - 03:15 PM INTRODUCTION: Pulmonary cement embolism (PCE) is an under-recognized complication of percutaneous vertebroplasty (PVP), a widely used treatment of vertebral compression fractures. Though, often asymptomatic, PCE can be associated with increased morbidity and mortality. We report a case of asymptomatic PCE following PVP. CASE PRESENTATION: A 70 year old female with a history of chronic obstructive pulmonary disease (COPD) presented to the hospital with 3 days of dyspnea. She had undergone thoracic PVP 2 weeks prior. She was not hypoxic. Bronchospasm was noted on lung exam. Chest Xray revealed faint hyperdensities in the periphery of the lungs bilaterally. Computed tomography (CT) pulmonary angiogram demonstrated multiple hyperdense filling defects of the subsegmental pulmonary arteries consistent with cement embolization. Cement from vertebral bodies was also seen extending into multiple paravertebral veins. Transthoracic echocardiogram (TTE) was unremarkable. She was prescribed systemic anticoagulation with a heparin drip. This was transitioned to therapeutic enoxaparin 2 days later. She was also treated for COPD exacerbation. Her wheezing resolved and dyspnea improved over the next 5 days. Anticoagulation was subsequently discontinued as it was ultimately felt her symptoms were primarily related to COPD exacerbation. She was discharged with close outpatient monitoring and follow up TTE in 3 months to evaluate for development of pulmonary hypertension. DISCUSSION: In PCE, bone cement is absorbed into the paravertebral veins and embolizes to the lungs. Reported incidence ranges from 4.6-26%. Most cases are discovered incidentally, however 1-5% are symptomatic. Incidence of asymptomatic PCE is likely underestimated as chest imaging is not routinely performed post procedure. Risk factors include treatment of vascular malignant lesions, overfilling of vertebral body, incorrect needle positioning, and insufficient polymerization of bone cement. Symptoms can include hypoxemia, dyspnea, hemoptysis, chest pain, low-grade fever and/or hypotension. Severe complications include shock, acute respiratory distress syndrome, and death. CONCLUSIONS: PCE is an under-recognized complication of PVP that lacks standard guidelines for screening, treatment, and long-term follow up. Treatment recommendations are inconsistent in the literature and largely based on expert opinion. Currently, management is determined on a case by case basis depending on symptoms, severity, and location of PCE. Options include observation, 3-6 months of anticoagulation, and surgical embolectomy in the most severe cases. We decided to closely observe our patient with asymptomatic PCE after weighing the risks and benefits of anticoagulation. Further research toward this potentially morbid and fatal condition is needed. Reference #1: Wang, L., Yang, H., Shi, Y., Jiang, W. and Chen, L.(2012), Pulmonary Embolism with PVP or PKP. Orthopaedic Surgery, 4:182-189. Reference #2: Kim YJ, Lee JW, Park KW et-al. Pulmonary cement embolism after percutaneous vertebroplasty in osteoporotic vertebral compression fractures: incidence, characteristics, and risk factors. Radiology. 2009;251 (1): 250-9. Reference #3: Krueger A, Bliemel C, Zettl R, Ruchholtz S. Management of pulmonary cement embolism after percutaneous vertebroplasty and kyphoplasty: a systematic review of the literature. Eur Spine J. 2009;18(9):1257-65. DISCLOSURES: No relevant relationships by Briana DiSilvio, source=Web Response No relevant relationships by Tiffany Dumont, source=Web Response No relevant relationships by Samir Patel, source=Web Response AU - Patel, S. AU - DiSilvio, B. AU - Dumont, T. DB - Embase DO - 10.1016/j.chest.2019.08.678 KW - bone cement enoxaparin heparin adult respiratory distress syndrome aged anticoagulation bronchospasm chronic obstructive lung disease complication compression fracture computer assisted tomography conference abstract disease exacerbation drug combination drug therapy dyspnea embolectomy female fever follow up hemoptysis human hypotension hypoxemia incidence kyphoplasty lung angiography lung embolism osteoporosis outpatient polymerization practice guideline pulmonary hypertension risk factor systematic review thorax pain thorax radiography transthoracic echocardiography vein vertebra body wheezing LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1931-3543 0012-3692 SP - A701 ST - STUCK BETWEEN A ROCK AND A HARD PLACE: A CASE OF PULMONARY CEMENT EMBOLISM T2 - Chest TI - STUCK BETWEEN A ROCK AND A HARD PLACE: A CASE OF PULMONARY CEMENT EMBOLISM UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2002983970&from=export http://dx.doi.org/10.1016/j.chest.2019.08.678 VL - 156 ID - 829113 ER - TY - JOUR AB - Seven patients had a cardiac arrest during hip arthroplasty with a cemented long-stem femoral component. Four patients died in the operating room, and three patients were successfully resuscitated. When the three survivors were eventually discharged from the hospital, they had no known permanent cardiac, pulmonary, or neurological sequelae. Factors that were common to all of the patients were advanced age, osteoporotic bone, a previously undisturbed intramedullary canal, and use of a long-stem femoral component and several batches of methylmethacrylate. Hip arthroplasty with a long-stem femoral component is associated with substantial risk in these patients. Excessive pressurization of cement should be avoided, and invasive hemodynamic monitoring should be used when the described conditions are present. AD - PATTERSON, BM (corresponding author), HOSP SPECIAL SURG, 535 E 70TH ST, NEW YORK, NY 10021 USA. AN - WOS:A1991FA23400015 AU - Patterson, B. M. AU - Healey, J. H. AU - Cornell, C. N. AU - Sharrock, N. E. DA - Feb DO - 10.2106/00004623-199173020-00015 J2 - J. Bone Joint Surg.-Am. Vol. KW - ACRYLIC BONE CEMENT FATAL FAT-EMBOLISM REPLACEMENT COAGULATION COLLAPSE FEMUR Orthopedics Surgery LA - English M1 - 2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1991 SN - 0021-9355 SP - 271-277 ST - CARDIAC-ARREST DURING HIP-ARTHROPLASTY WITH A CEMENTED LONG-STEM COMPONENT - A REPORT OF 7 CASES T2 - Journal of Bone and Joint Surgery-American Volume TI - CARDIAC-ARREST DURING HIP-ARTHROPLASTY WITH A CEMENTED LONG-STEM COMPONENT - A REPORT OF 7 CASES UR - ://WOS:A1991FA23400015 VL - 73A ID - 830496 ER - TY - JOUR AB - We evaluated the reliability of a rotational angiographic unit (RA) with flat-panel detector as a single technique to guide percutaneous vertebroplasty (PVP) and for post-procedure assessment by 2D and 3D reformatted images. Fifty-five consecutive patients (104 vertebral bodies) were treated under RA fluoroscopy. Rotational acquisitions with 2D and 3D reconstruction were obtained in all patients for immediate post-procedure assessment. In complex cases, this technique was also used to evaluate the needle position during the procedure. All patients underwent CT scan after the procedure. RA and CT findings were compared. In all cases, a safe trans-pedicular access and an accurate control of the bone-cement injection were successfully performed with high-quality fluoroscopy, even at the thoracic levels and in case of vertebra plana. 2D and 3D rotational reconstructions permitted CT-like images that clearly showed needle position and were similar to CT findings in depicting intrasomatic implant-distribution. RA detected 40 cement leakages compared to 42 demonstrated by CT and showed overall 95% sensitivity and 100% specificity compared to CT for final post-procedure assessment. Our preliminary results suggest that high-quality RA is reliable and safe as a single technique for PVP guidance, control and post-procedure assessment. It permits fast and cost-effective procedures avoiding multi-modality imaging. © 2007 Elsevier Ireland Ltd. All rights reserved. AD - A. Pedicelli, Department of Bioimaging and Radiological Sciences, Catholic University of Sacred Heart, Policl. A.Gemelli, l.go Gemelli 1, 00168 Rome, Italy AU - Pedicelli, A. AU - Rollo, M. AU - Piano, M. AU - Re, T. J. AU - Cipriani, M. C. AU - Colosimo, C. AU - Bonomo, L. DB - Embase Medline DO - 10.1016/j.ejrad.2007.10.017 KW - bone cement oxycodone paracetamol adult aged angiography article bone metastasis cement leakage comparative study computer assisted tomography controlled study cost effectiveness analysis diagnostic accuracy diagnostic value female fluoroscopy fragility fracture human implant injection lung embolism major clinical study male needle percutaneous vertebroplasty postoperative complication priority journal radicular pain reliability Scheuermann disease thoracic spine vertebra body spine fracture Allura Xper FD 20 LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 0720-048X SP - 289-295 ST - Percutaneous vertebroplasty with a high-quality rotational angiographic unit T2 - European Journal of Radiology TI - Percutaneous vertebroplasty with a high-quality rotational angiographic unit UR - https://www.embase.com/search/results?subaction=viewrecord&id=L354154695&from=export http://dx.doi.org/10.1016/j.ejrad.2007.10.017 VL - 69 ID - 829720 ER - TY - JOUR AD - Faculté de Médecine, Université Paris Descartes - Sorbonne Paris Cité, Paris, France, olivier.pellerin@egp.aphp.fr. AN - 103823602. Language: English. Entry Date: 20150206. Revision Date: 20200708. Publication Type: Journal Article AU - Pellerin, Olivier AU - Medioni, Jacques AU - Vulser, Claire AU - Déan, Carole AU - Oudard, Stéphane AU - Sapoval, Marc DB - cin20 DO - 10.1007/s00270-013-0740-x DP - EBSCOhost KW - Bone Neoplasms Bone Neoplasms -- Therapy Carcinoma, Renal Cell Carcinoma, Renal Cell -- Therapy Kidney Neoplasms -- Pathology Pelvic Bones -- Pathology Adult Aged Brief Pain Inventory Catheter Ablation Cementoplasty Clinical Assessment Tools Combined Modality Therapy Data Collection Embolization, Therapeutic Female Human Male Middle Age Pain Measurement Pelvic Pain -- Etiology Prospective Studies Quality of Life Questionnaires Radio Waves M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2014 SN - 0174-1551 SP - 730-736 ST - Management of Painful Pelvic Bone Metastasis of Renal Cell Carcinoma Using Embolization, Radio-frequency Ablation, and Cementoplasty: A Prospective Evaluation of Efficacy and Safety T2 - CardioVascular & Interventional Radiology TI - Management of Painful Pelvic Bone Metastasis of Renal Cell Carcinoma Using Embolization, Radio-frequency Ablation, and Cementoplasty: A Prospective Evaluation of Efficacy and Safety UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=103823602&site=ehost-live&scope=site VL - 37 ID - 830634 ER - TY - JOUR AB - We report two cases of spinal cord compression due to vertebral hemangioma in the first patient and myeloma in the other. Vertebroplasty was performed in both patients, combined with surgery for the first and radiotherapy for the second. Postprocedural pain decreased within 24 hours. Indications for percutaneous vertebroplasty are limited to aggressive vertebral hemangiomas, malignant spinal tumors including metastasis, multiple myeloma and solitary bone plasmocytoma. Vertebroplasty consolidates the vertebral body and reduces the risk of hemorrhage. It allows provides a rapid antalgesic effect, radicullo-medullary decompression associated with neurosurgery, spinal stabilization and can restrict progression of vascular malformations or tumors. Incidents and complications appear to be rare. AD - CHU Nord, Serv Neurochirurg, F-80054 Amiens 1, France. CHU Nord, Serv Neuroradiol, F-80054 Amiens, France. Peltier, J (corresponding author), CHU Nord, Serv Neurochirurg, Pl Victor Pauchet, F-80054 Amiens 1, France. jojo.peltier@caramail.com AN - WOS:000224659900006 AU - Peltier, J. AU - Toussaint, P. AU - Deramond, H. AU - Desenclos, C. AU - Le Gars, D. DA - Sep DO - 10.1016/s0028-3770(04)98329-4 J2 - Neurochirurgie KW - vertebroplasty vertebral hemangiomas spinal metastasis myeloma solitary plasmocytoma VERTEBRAL HEMANGIOMA PREOPERATIVE EMBOLIZATION MULTIPLE-MYELOMA CEMENT EXPERIENCE MANAGEMENT METASTASES INJECTION FRACTURE DISEASE Clinical Neurology Surgery LA - French M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2004 SN - 0028-3770 SP - 484-491 ST - Contribution of percutaneous acrylic vertebroplasty for tumor-related spinal cord compression T2 - Neurochirurgie TI - Contribution of percutaneous acrylic vertebroplasty for tumor-related spinal cord compression UR - ://WOS:000224659900006 VL - 50 ID - 830435 ER - TY - JOUR AB - One of the most serious potential complications of vertebroplasty or kyphoplasty is the embolization of methylmethacrylate cement into the pulmonary arteries. We present an overview of the subject and a pictorial review the spectrum of radiographic and computed tomographic appearances of methylmethacrylate cement pulmonary emboli. AD - Department of Radiology, Cleveland Clinic Foundation, Cleveland, OH, USA Department of Radiology, Cleveland Clinic Foundation, Cleveland, OH, USA. AN - 105223447. Language: English. Entry Date: 20100319. Revision Date: 20170411. Publication Type: journal article AU - Pelton, W. M. AU - Kirsch, J. AU - Candocia, F. J. AU - Allen, B. C. AU - Bhalla, S. AU - Mohammed, T. L. AU - Pelton, William M. AU - Kirsch, Jacobo AU - Candocia, Fabian J. AU - Allen, Brian C. AU - Bhalla, Sanjeev AU - Mohammed, Tan-Lucien H. DB - cin20 DO - 10.1097/RTI.0b013e3181a6e5c9 DP - EBSCOhost KW - Methylmethacrylates Pulmonary Embolism -- Chemically Induced Pulmonary Embolism -- Radiography Tomography, X-Ray Computed Aged Female Human Male Pulmonary Embolism -- Therapy Retrospective Design M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0883-5993 SP - 241-247 ST - Methylmethacrylate pulmonary emboli: radiographic and computed tomographic findings T2 - Journal of Thoracic Imaging TI - Methylmethacrylate pulmonary emboli: radiographic and computed tomographic findings UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105223447&site=ehost-live&scope=site VL - 24 ID - 830725 ER - TY - JOUR AB - One of the most serious potential complications of vertebroplasty or kyphoplasty is the embolization of methylmethacrylate cement into the pulmonary arteries. We present an overview of the subject and a pictorial review the spectrum of radiographic and computed tomographic appearances of methylmethacrylate cement pulmonary emboli. © 2009 Lippincott Williams & Wilkins, Inc. AD - J. Kirsch, Department of Radiology, Cleveland Clinic Florida, 2950, Cleveland Clinic Boulevard, Weston, FL 33331, United States AU - Pelton, W. M. AU - Kirsch, J. AU - Candocia, F. J. AU - Allen, B. C. AU - Bhalla, S. AU - Mohammed, T. L. H. DB - Embase Medline DO - 10.1097/RTI.0b013e3181a6e5c9 KW - methacrylic acid methyl ester adult aged article case report compression fracture computer assisted tomography diagnostic imaging female human kyphoplasty lung embolism male optical density pathogenesis percutaneous vertebroplasty radiodiagnosis retrospective study surgical technique thorax radiography vertebra LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 0883-5993 SP - 241-247 ST - Methylmethacrylate pulmonary emboli: radiographic and computed tomographic findings T2 - Journal of Thoracic Imaging TI - Methylmethacrylate pulmonary emboli: radiographic and computed tomographic findings UR - https://www.embase.com/search/results?subaction=viewrecord&id=L355182950&from=export http://dx.doi.org/10.1097/RTI.0b013e3181a6e5c9 VL - 24 ID - 829706 ER - TY - JOUR AB - Spinal cord compression (SCC) is a well-known complication in cancer patients, with an enormous potential impact on quality of life. In most cases, treatment is palliative, but a prompt diagnosis and immediate treatment is essential to preserving neurological function. Whereas steroids and radiation have been the mainstay of therapy for many years, the role and timing of surgery has remained controversial. However, class I evidence now exists to support the benefit of pre-irradiation surgical decompression in a carefully selected subpopulation of patients with SCC. A multidisciplinary approach is required to maximize the therapeutic and functional outcome of these patients. Copyright © 2008 by Current Medicine Group LLC. AD - M. Penas-Prado, Department of Neuro-Oncology, University of Texas, M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, United States AU - Penas-Prado, M. AU - Logbin, M. E. DB - Embase Medline DO - 10.1007/s11912-008-0012-0 KW - anthracycline antibiotic agent anticoagulant agent anticonvulsive agent antidepressant agent antineoplastic agent bisphosphonic acid derivative carmustine central stimulant agent cisplatin cytarabine dexamethasone fludarabine gadolinium pentetate methotrexate misoprostol nonsteroid antiinflammatory agent omeprazole opiate osmotic agent steroid thiotepa Vinca alkaloid analgesia bleeding bolus injection bone metastasis bone necrosis bone pain catheterization clinical feature clinical trial cognitive therapy computer assisted radiotherapy computer assisted tomography constipation contrast enhancement cryotherapy deep vein thrombosis differential diagnosis digestive system perforation drug dose reduction drug induced disease drug megadose drug tolerability electrostimulation epidural hematoma gastrointestinal symptom human thermotherapy jaw disease kyphoplasty leg compression leg exercise lipomatosis low drug dose lung embolism malignant neoplasm massage meninx disorder nephrotoxicity neuroblastoma neuropathic pain nuclear magnetic resonance imaging overall survival percutaneous vertebroplasty positron emission tomography postoperative infection postoperative pain protective clothing psychosis quality of life radiation dose fractionation radiation injury rectum hemorrhage review social support spinal cord compression spinal cord decompression spinal cord disease spine instability spine metastasis stomach ulcer surgical technique treatment indication urine retention LA - English M1 - 1 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2008 SN - 1523-3790 SP - 78-85 ST - Spinal cord compression in cancer patients: Review of diagnosis and treatment T2 - Current Oncology Reports TI - Spinal cord compression in cancer patients: Review of diagnosis and treatment UR - https://www.embase.com/search/results?subaction=viewrecord&id=L351082946&from=export http://dx.doi.org/10.1007/s11912-008-0012-0 VL - 10 ID - 829753 ER - TY - JOUR AB - Background: One of the most feared complications in total hip arthroplasty is undoubtedly hip dislocation. Patients with neuromuscular disorders, neck femoral pseudarthrosis, dementia or any other condition associated with muscle weakness or low compliance can have a risk of dislocation as high as 40%. Aim: To evaluate the clinical and radiographic results of a cemented stem (Lubinus®) with a snap-fit cup at the short-medium term in “high-risk of dislocation patients”. Methods: Retrospective study of 30 patients (4 male and 26 female) that underwent total hip arthroplasty (posterior approach) with Lubinus® stem and snap-fit cup between June 2007 and January 2010. Clinical (functional status, patient satisfaction, complications) and radiographic evaluation (standart AP, lateral and long axis) has been made at 0, 3, 9, 12 and 24 months after surgery. Results: Average age at the time of surgery was 77 (56-90) and the average follow- up was 16 months. Pseudarthrosis (6) or failure of the osteosyntheses (13) of the neck of the femur and unstable total hip arthroplasty (5) were the main causes. Primary coxarthrosis in patients with hemiplegia or dementia was responsible for four cases. The other two were from conversions from hemiarthroplasty and Girdlestone. Two of the patients died from medical problems complications. One of the patients was re-operated after an acetabular periprothesic fracture. One case of pulmonary thromboembolism was reported. All patients were satisfied with the result and returned to their previous functional status. There were no dislocations or neurovascular lesions. Radiographic analysis showed that all hips were stable and there were no signs of cup or stem loosening. Discussion and conclusions: There are several implant and technique options to counteract dislocation in “high-risk” patients. The use of cemented snap-fit cups is an excellent alternative in low-demand patients because of its easier technique with low morbidity and scarce of complications. AD - A.G. Pereira, Centro Hospitalar Do Porto, Porto, Portugal AU - Pereira, A. G. AU - Massada, M. AU - Sousa, R. AU - Aido, R. AU - Ramos, J. AU - Coelho, R. AU - Lemos, R. DB - Embase KW - total hip prosthesis risk patient human European hip society surgery neck functional status dementia pseudarthrosis hip dislocation muscle weakness arthroplasty hip osteoarthritis fracture lung embolism retrospective study neuromuscular disease femur follow up patient satisfaction hemiplegia morbidity implant male female L1 - http://www.hip-int.com/article/abstracts-from-the-9th-domestic-meeting-of-the-european-hip-society-art006629 LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 1120-7000 SP - 396 ST - Cemented total hip arthroplasty in “high-risk of dislocation patients” T2 - HIP International TI - Cemented total hip arthroplasty in “high-risk of dislocation patients” UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71960532&from=export VL - 20 ID - 829662 ER - TY - JOUR AD - Servicio de Radiodiagnóstico, Centro de Diagnóstico por la Imagen Clínic (CDIC), Hospital Clínic, Barcelona, España. Servicio de Radiodiagnóstico, Centro de Diagnóstico por la Imagen Clínic (CDIC), Hospital Clínic, Barcelona, España. Electronic address: vollmer@clinic.ub.es. AN - 28927860 AU - Pérez-Serrano, C. AU - Vollmer, I. AU - Perea, R. J. DA - Mar DO - 10.1016/j.arbres.2017.05.008 DP - NLM ET - 2017/09/21 J2 - Archivos de bronconeumologia KW - Aged Bone Cements/*adverse effects Female Humans Postoperative Complications/*diagnostic imaging/etiology Pulmonary Embolism/*diagnostic imaging/etiology Spinal Fractures/surgery Thoracic Vertebrae/injuries Tomography, X-Ray Computed/*methods Vertebroplasty/*methods LA - eng spa M1 - 3 N1 - PubMed NLM literature search January 5, 2021 OP - Utilidad de la tomografía computarizada con doble energía, en el diagnóstico del tromboembolismo pulmonar por cemento posvertebroplastia: a propósito de un caso. PY - 2018 SN - 0300-2896 SP - 155 ST - The Utility Of Dual-Energy Computed Tomography In The Diagnosis Of Pulmonary Thromboembolism Caused By Post-Vertebroplasty Cement: A Case Report T2 - Arch Bronconeumol TI - The Utility Of Dual-Energy Computed Tomography In The Diagnosis Of Pulmonary Thromboembolism Caused By Post-Vertebroplasty Cement: A Case Report VL - 54 ID - 828816 ER - TY - JOUR AB - Our series comprises 29 children (18 boys, 11 girls; mean age 11.5 years) treated for a pial cerebral arteriovenous malformation. Haemorrhage was the most common presenting symptom (19 patients) followed by epilepsy (9 patients) and hydrocephalus (1 patient). Embolisation was performed by different techniques depending on the time of treatment which was initiated in 1983. Two children were injected with free flow silastic sponge fragments directly into the lumen of the internal carotid or vertebral arteries; 17 children were treated by selective embolisation of the afferent vessels with micro-emboli using 2 mm long suture thread while ten children received an intranidal injection of acrylic glue. Endovascular treatment was performed prior to surgery in nine children, radiosurgery in eight and as the sole procedure in nine children; treatment is still underway in three cases. We assessed the outcome of treatment and complications comparing the children with a series of treated adult patients. The main differences between the two groups concerned angio-architecture and the site of the malformations. Plexiform AVMs fed by one or more peduncles were more common in children (45% against 17%) and embolisation using acrylic glue followed by radiosurgery was the treatment of choice in these patients. For plexiform and fistulous direct arteriovenous malformations and AVMs (20% against 12%) we used long pieces of suture thread alone or combined with acrylic glue. Giant subtentorial AVMs (5 patients) never encountered in adults were embolised with acrylic glue at multiple sittings until they were reduced to a size compatible with radiosurgery (2 patients). None of the embolisation techniques proved valid for deep centrally located AVMs (17% children against 5% adults). Complications in our series included temporary neurological deficit which was mild in all cases (2 motor deficit, 1 campimetric deficit) and slightly more common in the group embolised with acrylic glue as opposed to particles. No permanent deficit occurred in patients treated with acrylic glue. One child died following injection of free flow silastic sponge particles into the vertebral artery for a giant cerebellar AVM presenting with coma due to hydrocephalus caused by acqueductal obstruction. In conclusion, it was more difficult to establish a therapeutic protocol for cerebral arteriovenous malformations in children than in adults, mainly due to the frequent occurrence of deep subtentorial and centrally located lesions. Each individual case required a careful assessment of the risk/benefit ratio and the likelihood of bleeding, morbidity and mortality in the natural history of the condition. AD - S. Perini, Servizio di Neuroradiologia, Ospedale Maggiore Borgo Trento, Piazzale Stefani, 1, 37126 Verona, Italy AU - Perini, S. AU - Zampieri, P. AU - Rosta, L. AU - Piovan, E. AU - Barone, G. AU - Ruatti, P. AU - Benati, A. DB - Embase KW - acrylic cement adolescent arteriovenous malformation artificial embolization bleeding child clinical article clinical trial conference paper epilepsy female human male pia artery LA - Italian M1 - 6 M3 - Conference Paper N1 - Embase Elsevier literature search January 5, 2021 PY - 1996 SN - 1120-9976 SP - 743-748 ST - Pial cerebral arteriovenous malformations in children. Technical aspects, indications and limitations of endovascular treatment T2 - Rivista di Neuroradiologia TI - Pial cerebral arteriovenous malformations in children. Technical aspects, indications and limitations of endovascular treatment UR - https://www.embase.com/search/results?subaction=viewrecord&id=L27088962&from=export VL - 9 ID - 829920 ER - TY - JOUR AB - Although venous escape of cement has been frequently noted during percutaneous vertebroplasty, no case of pulmonary embolus directly linked to this manoeuvre has been described in the literature. We report a case of pulmonary embolus of acrylic cement occurring immediately after the procedure. Outcome was favorable following anticoagulant therapy despite the persistence of some vascular obstruction suggesting the association of residual fibrinous matter in the pulmonary artery. AD - Sevice de Pneumologie et Réanimation Respiratoire, Hôpital Pasteur, Centre Hospitalier Régional et Universitaire de Nice. AN - 10339767 AU - Perrin, C. AU - Jullien, V. AU - Padovani, B. AU - Blaive, B. DA - Apr DP - NLM ET - 1999/05/26 J2 - Revue des maladies respiratoires KW - Acrylic Resins/*adverse effects Adult Anticoagulants/therapeutic use Female Humans Pulmonary Embolism/drug therapy/*etiology Radiography, Interventional/*adverse effects Spinal Diseases/*therapy Treatment Outcome LA - fre M1 - 2 N1 - PubMed NLM literature search January 5, 2021 OP - Une vertébroplastie percutanée compliquée d'une embolie pulmonaire de ciment acrylique. PY - 1999 SN - 0761-8425 (Print) 0761-8425 SP - 215-7 ST - [Percutaneous vertebroplasty complicated by pulmonary embolus of acrylic cement] T2 - Rev Mal Respir TI - [Percutaneous vertebroplasty complicated by pulmonary embolus of acrylic cement] VL - 16 ID - 828984 ER - TY - JOUR AB - INTRODUCTION: Management of patients with poor bone stock remains difficult due to the risks of mechanical complications such as screws pullouts. At the same time, development of minimal invasive spinal techniques using a percutaneous approach is greatly adapted to these fragile patients with a reduction in operative time and complications. The aim of this study was to report our experience with cemented percutaneous screws in the management of patients with a poor bone stock. METHODS: Thirty-five patients were included in this retrospective study. In each case, a percutaneous osteosynthesis using cemented screws was performed. Indications were osteoporotic fractures, metastasis or fractures on ankylosing spine. Depending on radiologic findings, short or long constructs (2 levels above and below) were performed and an anterior column support (kyphoplasty or anterior approach) was added. Evaluation of patients was based on pre and postoperative CT-scans associated with clinical follow-up with a minimum of 6 months. RESULTS: Eleven men and 24 women with a mean age of 73 years [60-87] were included in the study. Surgical indication was related to an osteoporotic fracture in 20 cases, a metastasis in 13 cases and a fracture on ankylosing spine in the last 2 cases. Most of the fractures were located between T10 and L2 and a long construct was performed in 22 cases. Percutaneous kyphoplasty was added in 24 cases and a complementary anterior approach in 3 cases. Average operative time was 86minutes [61-110] and blood loss was estimated as minor in all the cases. In the entire series, average volume of cement injected was 1.8 cc/screw. One patient underwent a major complication with a vascular leakage responsible for a cement pulmonary embolism. With a 9 months average follow-up [6-20], no cases of infection or mechanical complication was reported. CONCLUSION: Minimal invasive spinal techniques are greatly adapted to the management of fragile patients. The use of percutaneous cemented screws is, in our experience, a valuable alternative for spinal fixation in patients with poor bone stock. This technique allows a good bony fixation with a low rate of complications. However, rigorous preoperative planning is necessary in order to avoid complications. AD - Unité de chirurgie du rachis, CHU Timone, 264, rue Saint-Pierre, 13005 Marseille, France. Unité de chirurgie du rachis, CHU Timone, 264, rue Saint-Pierre, 13005 Marseille, France. Electronic address: sfuentes@ap-hm.fr. AN - 28120768 AU - Pesenti, S. AU - Graillon, T. AU - Mansouri, N. AU - Adetchessi, T. AU - Tropiano, P. AU - Blondel, B. AU - Fuentes, S. DA - Dec DO - 10.1016/j.neuchi.2016.06.009 DP - NLM ET - 2017/01/26 J2 - Neuro-Chirurgie KW - Aged Aged, 80 and over *Bone Cements/adverse effects Bone Density *Bone Screws Equipment Failure Female Follow-Up Studies Fracture Fixation, Internal/*instrumentation Humans Kyphoplasty Male Middle Aged Osteoporotic Fractures/surgery Postoperative Complications/chemically induced Pulmonary Embolism/chemically induced Spinal Fractures/etiology/*surgery Spinal Neoplasms/complications/secondary Spondylitis, Ankylosing/complications *Aging spine *Augmented screw *Ostéoporose *Ostéosynthèse percutanée *Percutaneous osteosynthesis *Spine fixation *Vis à augmentation LA - fre M1 - 6 N1 - PubMed NLM literature search January 5, 2021 OP - Utilisation de vis cimentées percutanées dans la prise en charge rachidienne des patients à faible capacité osseuse. PY - 2016 SN - 0028-3770 SP - 306-311 ST - [Use of pedicle percutaneous cemented screws in the management of patients with poor bone stock] T2 - Neurochirurgie TI - [Use of pedicle percutaneous cemented screws in the management of patients with poor bone stock] VL - 62 ID - 828640 ER - TY - JOUR AB - Objective. Fast track concepts are used to reduce the risk of perioperative and postoperative complications after total knee arthroplasty. Indications. The described concepts are used for patients with indications for the implantation of a total knee prosthesis. Contraindications. Contraindications for fast track concepts are aged patients, dementia, American Society of Anesthesiologists (ASA) grade IV and implantation of large revision or tumor prostheses. Contraindications for tranexamic acid are bleeding in the urinary tract, caution in cases of known epilepsy, individual risk assessment in existing thromboses or increased thrombosis risk, fresh myocardial infarction, conditions following fresh pulmonary embolism, percutaneous transluminal coronary angioplasty (PTCA) and stent implantation. Contraindications for ropivacaine are hypersensitivity (allergy) to ropivacaine and other amide type topical anesthetics and hypovolemia. Surgical technique. Preoperative administration of 1 g tranexamic acid and intraoperative local infiltration anesthesia are carried out. After femoral and tibial bone resection and before cementing the femoral and tibial components, approximately 40 ml of ropivacaine (2%) is injected into the posterior capsule. This is followed by injection of the medial and lateral collateral ligaments with approximately 20 ml each and infiltration of Hoffa's fat pad and the extensor apparatus also with approximately 20 ml local anesthetic. After cementing, the subcutaneous tissue is infiltrated with approximately 50 ml ropivacaine solution. Postoperative management. On the same day as the operation the patient is mobilized with the help of a physiotherapist. The patient should, if possible, walk a few steps on crutches. Systemic analgesic treatment is carried out according to the World Health Organization (WHO) staged scheme II with a weak opioid and first stage non-opioid analgesic (nonsteroidal anti-inflammatory drug, NSAID and/or metamizole). Gabapentin can be used as an adjuvant comedication. Medicinal thrombosis prophylaxis is carried out with a low molecular weight heparin for 2 weeks postoperatively. Results. In 100 patients who preoperatively received 1 g tranexamic acid and intra-articular infiltration anesthesia, in the evening of the day of the operation the pain was on average 2.1 (+/- 1.8) on the numeric pain rating scale (NPRS). In one patient, there was a sensitive deficit of the lower leg and foot. A motor deficit was not observed. A total of 90 patients were able to raise and straighten leg. On the day of surgery 68 patients were able to walk more than 10 steps and 22 patients could be mobilized to a standing position. The mean length of hospital stay was 6.6 days (5-11 days). No infections, thromboses or pulmonary embolisms occurred. AD - [Petersen, Wolf; Bierke, Sebastian; Hees, Tillmann; Karpinski, Katrin; Haener, Martin] Martin Luther Krankenhaus, Klin Orthopadie & Unfallchirurg, Caspar Theyss Str 27-31, D-14193 Berlin, Germany. Petersen, W (corresponding author), Martin Luther Krankenhaus, Klin Orthopadie & Unfallchirurg, Caspar Theyss Str 27-31, D-14193 Berlin, Germany. wolf.petersen@pgdiakonie.de AN - WOS:000487654800008 AU - Petersen, W. AU - Bierke, S. AU - Hees, T. AU - Karpinski, K. AU - Haner, M. DA - Oct DO - 10.1007/s00064-019-00628-9 J2 - Oper. Orthopade Traumatol. KW - Length of stay Tranexamic acid Anesthesia conduction Local anesthesia Ropivacaine INFILTRATION ANALGESIA HIP SURGERY EFFICACY PAIN REPLACEMENT RECOVERY FALLS Orthopedics LA - German M1 - 5 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 0934-6694 SP - 447-462 ST - Fast track concepts in total knee arthroplasty: use of tranexamic acid and local intra-articular anesthesia technique T2 - Operative Orthopadie Und Traumatologie TI - Fast track concepts in total knee arthroplasty: use of tranexamic acid and local intra-articular anesthesia technique UR - ://WOS:000487654800008 VL - 31 ID - 830124 ER - TY - JOUR AB - OBJECTIVE: Fast track concepts are used to reduce the risk of perioperative and postoperative complications after total knee arthroplasty. INDICATIONS: The described concepts are used for patients with indications for the implantation of a total knee prosthesis. CONTRAINDICATIONS: Contraindications for fast track concepts are aged patients, dementia, American Society of Anesthesiologists (ASA) grade IV and implantation of large revision or tumor prostheses. Contraindications for tranexamic acid are bleeding in the urinary tract, caution in cases of known epilepsy, individual risk assessment in existing thromboses or increased thrombosis risk, fresh myocardial infarction, conditions following fresh pulmonary embolism, percutaneous transluminal coronary angioplasty (PTCA) and stent implantation. Contraindications for ropivacaine are hypersensitivity (allergy) to ropivacaine and other amide type topical anesthetics and hypovolemia. SURGICAL TECHNIQUE: Preoperative administration of 1 g tranexamic acid and intraoperative local infiltration anesthesia are carried out. After femoral and tibial bone resection and before cementing the femoral and tibial components, approximately 40 ml of ropivacaine (2%) is injected into the posterior capsule. This is followed by injection of the medial and lateral collateral ligaments with approximately 20 ml each and infiltration of Hoffa's fat pad and the extensor apparatus also with approximately 20 ml local anesthetic. After cementing, the subcutaneous tissue is infiltrated with approximately 50 ml ropivacaine solution. POSTOPERATIVE MANAGEMENT: On the same day as the operation the patient is mobilized with the help of a physiotherapist. The patient should, if possible, walk a few steps on crutches. Systemic analgesic treatment is carried out according to the World Health Organization (WHO) staged scheme II with a weak opioid and first stage non-opioid analgesic (nonsteroidal anti-inflammatory drug, NSAID and/or metamizole). Gabapentin can be used as an adjuvant comedication. Medicinal thrombosis prophylaxis is carried out with a low molecular weight heparin for 2 weeks postoperatively. RESULTS: In 100 patients who preoperatively received 1 g tranexamic acid and intra-articular infiltration anesthesia, in the evening of the day of the operation the pain was on average 2.1 (±1.8) on the numeric pain rating scale (NPRS). In one patient, there was a sensitive deficit of the lower leg and foot. A motor deficit was not observed. A total of 90 patients were able to raise and straighten leg. On the day of surgery 68 patients were able to walk more than 10 steps and 22 patients could be mobilized to a standing position. The mean length of hospital stay was 6.6 days (5-11 days). No infections, thromboses or pulmonary embolisms occurred. AD - Klinik für Orthopädie und Unfallchirurgie, Martin-Luther-Krankenhaus, Berlin Grunewald, Caspar-Theyss-Straße 27-31, 14193, Berlin, Deutschland. wolf.petersen@pgdiakonie.de. Klinik für Orthopädie und Unfallchirurgie, Martin-Luther-Krankenhaus, Berlin Grunewald, Caspar-Theyss-Straße 27-31, 14193, Berlin, Deutschland. AN - 31520092 AU - Petersen, W. AU - Bierke, S. AU - Hees, T. AU - Karpinski, K. AU - Häner, M. DA - Oct DO - 10.1007/s00064-019-00628-9 DP - NLM ET - 2019/09/15 J2 - Operative Orthopadie und Traumatologie KW - *Anesthesia, Local *Anesthetics, Local/therapeutic use *Arthroplasty, Replacement, Knee Humans Tranexamic Acid/*therapeutic use Treatment Outcome Anesthesia, conduction Length of stay Local anesthesia Ropivacaine Tranexamic acid LA - ger M1 - 5 N1 - PubMed NLM literature search January 5, 2021 OP - „Fast-Track-Konzepte“ in der Knieendoprothetik: Einsatz von Tranexamsäure und Technik der lokalen intraartikulären Anästhesie. PY - 2019 SN - 0934-6694 SP - 447-462 ST - [Fast track concepts in total knee arthroplasty: use of tranexamic acid and local intra-articular anesthesia technique] T2 - Oper Orthop Traumatol TI - [Fast track concepts in total knee arthroplasty: use of tranexamic acid and local intra-articular anesthesia technique] VL - 31 ID - 829004 ER - TY - JOUR AN - 23263480 AU - Petridis, A. K. AU - Maslehaty, H. AU - Eichenhofer, T. AU - Gillner, S. AU - Scholz, M. DA - Feb DO - 10.1007/s00701-012-1584-x DP - NLM ET - 2012/12/25 J2 - Acta neurochirurgica KW - Bone Cements/*adverse effects Humans Male Middle Aged Osteoporotic Fractures/surgery Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/diagnosis/*etiology/therapy Spinal Fractures/*surgery Thoracic Vertebrae/*injuries Vertebroplasty/*adverse effects LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 0001-6268 SP - 319-20 ST - Pulmonary embolism associated with poly(methyl methacrylate) (PMMA) after vertebroplasty. A complication more often than one thinks T2 - Acta Neurochir (Wien) TI - Pulmonary embolism associated with poly(methyl methacrylate) (PMMA) after vertebroplasty. A complication more often than one thinks VL - 155 ID - 828860 ER - TY - JOUR AB - Introduction: Since 2004 vertebroplasty combined with pedicle screws is used, longtime outcome is left. Aim was the evaluation of cement leakage into disc, vessels, spinal canal, embolism, loosening, adjacent degeneration, necrosis of vertebral bodies and fractures of adjacent vertebral bodies in cement augmented instrumentations versus no augmentation. Method: T-score < -2,5, from 1/2007 - 06/2011 129 patients have beenoperated with cement augmented screws (OP s: 2007 15, 2008 28, 2009 32, 2010 36,2011:18), 3 surgeons, PMMA cement was used, 54 male and 75 female patients, with an age of 79 (50-86) years (71,6 a male, 72,5 a female). Primary diagnosis osteoporosis 49%, osteochondrosis 12%, spondylolisthesis 35%, FBSS 14%, stenosis 60%, scoliosis 18%, fractures 26%, screw loosening 23%, tumour 0,05%, secundäry kyphosis 53%. 1-2 segments 28%, 3-5% 51%, more than 5 segments 21%. In 129 operations cement augmented screws were used in: BWK 5: 2, BWK 6: 5, BWK 7: 5, BWK 8: 6, BWK 9: 10, BWK 10: 20, BWK 11: 20, BWK 12: 20, LWK 1: 24, LWK 2: 54, LWK 3: 54, LWK 4: 88, LWK 5: 88 and SWK 1: 18 times. 6/35 screws were used in 1%, 6/40 screws in 10%, 6/45 screws in 48%, 6/50 screws in 22%, 6/55 screws in 4%, 7/45 screws in 7%, 7/50 screws in 8%.Implanted cement volume per screw 1,4 ml, max. 2 ml, min. 1 ml. From 1/2007 - 06/2011 364 patients with same diagnosis have been operated without cemented screws in 1-2 segments in 26%, in 3-5 segments in 52% and more than 5 segments in 22%.Fusion was diagnosed by x-ray or CT scan 12 months post OP. Results: Cement leakage (1,6%), dorsal longitudinal ligament (2%), trailing edge of the vertebral body (1%), disc (1%), lateral (1,2%). Cement leakage was found in D9: 1%, D10: 1%, D11 1%, D12 2%, L 1 2%, L2 1%, L3 1%, L4 1%, L5 1%. Follow up 14 months (3-23), lost to FU 6/129 patients, revision surgery 6/129 (7,74%) cause of adjacent disc desease (disc necrosis 0,8%, vertebral necrosis 0,8%, adjacent pedicle fractures 1,7%, adjacent vertebral fractures 2,8%, next but one vertebrae 2%, screw loosening 3,8%, revision because of pseudoarthrosis in 3 cases. Screw loosening in non cement augmented implants 20% and pseudoarthrosis 12%. Follow up 4,5 year post OP: back pain pre /post OP: VAS 8 (6-10)/ VAS 2 (7-4), leg pain pre/ post OP: VAS 7 (3-8)/ VAS 2,4 (0-6). Patient satisfaction score (n): excellent: 78, better: 40, same: 8, worse: 3. Discussion: The avulsion of the cemented screws compaired to non cemented screws is much lower. When less than 4 ml cement is used per each vertebrae, then the risk for and adjacent disc degeneration and vertebral necrosis is significant lower. It is a safe procedure, there are little complications. First longtime results look promising, but have still to be controlled further on. AD - T. Pfandlsteiner, Schön Klinik Vogtareuth, Klinik für Wirbelsäulenchirurgie mit Skoliosezentrum, Vogtareuth, Germany AU - Pfandlsteiner, T. AU - Seidel, K. AU - Wimmer, C. DB - Embase DO - 10.1007/s00586-011-2033-x KW - cement spine follow up devices society human necrosis patient fracture vertebra body vertebra female degeneration pseudarthrosis male diagnosis leg pain backache implant vertebral canal spine fracture surgery posterior longitudinal ligament percutaneous vertebroplasty computer assisted tomography kyphosis pedicle screw neoplasm scoliosis stenosis spondylolisthesis embolism osteochondrosis osteoporosis surgeon avulsion injury patient satisfaction risk procedures failed back surgery syndrome X ray LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 0940-6719 SP - 2029-2030 ST - 4,5 year follow up outcome with cementaugmented instrumentation versus no augmentation T2 - European Spine Journal TI - 4,5 year follow up outcome with cementaugmented instrumentation versus no augmentation UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71314010&from=export http://dx.doi.org/10.1007/s00586-011-2033-x VL - 20 ID - 829601 ER - TY - JOUR AB - OBJECTIVE: To evaluate polymethyl methacrylate hydrogel microspheres (HMs) as an embolization material in the management of hypervascular craniofacial and spinal lesions. MATERIAL AND METHODS: Sixty-nine patients with vascular lesions of the craniofacial and spinal regions underwent embolization with HM. The pathologies included craniofacial tumours (n=38), cranial arteriovenous malformations (AVMs) (n=7), dural AVM (n=1), cavernous carotid fistula (n=1), spinal tumours (n=7), spinal AVMs (n=6), orbital lesions (n=4) and scalp AVMs (n=5). Surgery was done in 56 patients. The blood loss at surgery, tumour shrinkage, surgical cleavage and ease of removal of tumour was noted from the records. Histopathology was available in 39 patients. A follow-up of 3 months to 6 years was available in 13 patients in whom embolization was the sole treatment. Surgical and histopathological findings were correlated with angio-embolization findings. RESULTS: HMs were easy to inject through the microcatheter with good control. Good devascularization was obtained in 61 patients and partial in 8 patients. Two patients developed complications due to presence of anastomoses between intra- and extracranial circulation and 1 patient due to tumor swelling. Histopathology showed presence of HMs in all the lesions, with minimal inflammatory reaction in 2 patients. Patients with spinal lesions treated with embolization only stabilised in neurologic deficits. CONCLUSION: HMs are highly suitable as embolization agents in the management of craniofacial and spinal hypervascular lesions. AD - Department of Radiodiagnosis, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Rae Barely Road, Lucknow, U.P., India 226 014. AN - 11972456 AU - Phadke, R. AU - Venkatesh, S. K. AU - Kumar, S. AU - Tandon, V. AU - Pandey, R. AU - Tyagi, I. AU - Jain, V. K. AU - Chhabra, D. K. DA - Jan DP - NLM ET - 2002/04/26 J2 - Acta radiologica (Stockholm, Sweden : 1987) KW - Antimutagenic Agents/*therapeutic use Central Nervous System Vascular Malformations/pathology/*therapy *Embolization, Therapeutic Facial Neoplasms/pathology/*therapy Humans Hydrogel, Polyethylene Glycol Dimethacrylate/*therapeutic use Microspheres Polymethyl Methacrylate/*therapeutic use Retrospective Studies Skull Neoplasms/pathology/*therapy Spinal Neoplasms/pathology/*therapy Treatment Outcome LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2002 SN - 0284-1851 (Print) 0284-1851 SP - 15-20 ST - Embolization of cranial/spinal tumours and vascular malformations with hydrogel microspheres. An experience of 69 cases T2 - Acta Radiol TI - Embolization of cranial/spinal tumours and vascular malformations with hydrogel microspheres. An experience of 69 cases VL - 43 ID - 829038 ER - TY - JOUR AB - OBJECTIVE: To evaluate polymethyl methacrylate hydrogel microspheres (HMs) as an embolization material in the management of hypervascular craniofacial and spinal lesions. MATERIAL AND METHODS: Sixty-nine patients with vascular lesions of the craniofacial and spinal regions underwent embolization with HM. The pathologies included craniofacial tumours (n=38), cranial arteriovenous malformations (AVMs) (n=7), dural AVM (n=1), cavernous carotid fistula (n=1), spinal tumours (n=7), spinal AVMs (n=6), orbital lesions (n=4) and scalp AVMs (n=5). Surgery was done in 56 patients. The blood loss at surgery, tumour shrinkage, surgical cleavage and ease of removal of tumour was noted from the records. Histopathology was available in 39 patients. A follow-up of 3 months to 6 years was available in 13 patients in whom embolization was the sole treatment. Surgical and histopathological findings were correlated with angio-embolization findings. RESULTS: HMs were easy to inject through the microcatheter with good control. Good devascularization was obtained in 61 patients and partial in 8 patients. Two patients developed complications due to presence of anastomoses between intra- and extracranial circulation and 1 patient due to tumor swelling. Histopathology showed presence of HMs in all the lesions, with minimal inflammatory reaction in 2 patients. Patients with spinal lesions treated with embolization only stabilised in neurologic deficits. CONCLUSION: HMs are highly suitable as embolization agents in the management of craniofacial and spinal hypervascular lesions. AD - R.V. Phadke, Department of Radiodiagnosis, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Rae Barely Road, Lucknow, U.P., India 226 014. AU - Phadke, R. V. AU - Venkatesh, S. K. AU - Kumar, S. AU - Tandon, V. AU - Pandey, R. AU - Tyagi, I. AU - Jain, V. K. AU - Chhabra, D. K. DB - Medline KW - antimutagenic agent microsphere poly(methyl methacrylate) article artificial embolization central nervous system malformation face tumor human hydrogel pathology retrospective study skull tumor spinal cord tumor treatment outcome LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2002 SN - 0284-1851 SP - 15-20 ST - Embolization of cranial/spinal tumours and vascular malformations with hydrogel microspheres. An experience of 69 cases T2 - Acta radiologica (Stockholm, Sweden : 1987) TI - Embolization of cranial/spinal tumours and vascular malformations with hydrogel microspheres. An experience of 69 cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L35662238&from=export VL - 43 ID - 829876 ER - TY - JOUR AB - Objective: To evaluate polymethyl methacrylate hydrogel microspheres (HMs) as an embolization material in the management of hypervascular craniofacial and spinal lesions. Material and Methods: Sixty-nine patients with vascular lesions of the craniofacial and spinal regions underwent embolization with HM. The pathologies included craniofacial tumours (n=38), cranial arteriovenous malformations (AVMs) (n=7), dural AVM (n=1), cavernous carotid fistula (n=1), spinal tumours (n=7), spinal AVMs (n=6), orbital lesions (n=4) and scalp AVMs (n=5). Surgery was done in 56 patients. The blood loss at surgery, tumour shrinkage, surgical cleavage and ease of removal of tumour was noted from the records. Histopathology was available in 39 patients. A follow-up of 3 months to 6 years was available in 13 patients in whom embolization was the sole treatment. Surgical and histopathological findings were correlated with angio-embolization findings. Results: HMs were easy to inject through the microcatheter with good control. Good devascularization was obtained in 61 patients and partial in 8 patients. Two patients developed complications due to presence of anastomoses between intra- and extracranial circulation and 1 patient due to tumor swelling. Histopathology showed presence of HMs in all the lesions, with minimal inflammatory reaction in 2 patients. Patients with spinal lesions treated with embolization only stabilised in neurologic deficits. Conclusion: HMs are highly suitable as embolization agents in the management of craniofacial and spinal hypervascular lesions. AD - Sanjay Gandhi Postgrad Inst Med Sci, Dept Radiodiag, Lucknow 226014, Uttar Pradesh, India. Sanjay Gandhi Postgrad Inst Med Sci, Dept Pathol, Lucknow 226014, Uttar Pradesh, India. Sanjay Gandhi Postgrad Inst Med Sci, Dept ENT Neurosurg, Lucknow 226014, Uttar Pradesh, India. Sanjay Gandhi Postgrad Inst Med Sci, Dept Neurosurg, Lucknow 226014, Uttar Pradesh, India. Phadke, RV (corresponding author), Sanjay Gandhi Postgrad Inst Med Sci, Dept Radiodiag, Rae Barely Rd, Lucknow 226014, Uttar Pradesh, India. AN - WOS:000174586000004 AU - Phadke, R. V. AU - Venkatesh, S. K. AU - Kumar, S. AU - Tandon, V. AU - Pandey, R. AU - Tyagi, I. AU - Jain, V. K. AU - Chhabra, D. K. DA - Jan DO - 10.1034/j.1600-0455.2002.430104.x J2 - Acta Radiol. KW - spinal lesions cranial lesions, embolization hydrogel microspheres interventional radiology CROSSLINKED POLY(METHYL METHACRYLATE) TRISACRYL GELATIN MICROSPHERES ENDOVASCULAR EMBOLIZATION POLY(2-HYDROXYETHYL METHACRYLATE) PREOPERATIVE EMBOLIZATION POLYMETHYL METHACRYLATE SPHERICAL-PARTICLES EMBOLIC AGENT MENINGIOMAS BEADS Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2002 SN - 0284-1851 SP - 15-20 ST - Embolization of cranial/spinal tumours and vascular malformations with hydrogel microspheres - An experience of 69 cases T2 - Acta Radiologica TI - Embolization of cranial/spinal tumours and vascular malformations with hydrogel microspheres - An experience of 69 cases UR - ://WOS:000174586000004 VL - 43 ID - 830456 ER - TY - JOUR AB - Pathologic fractures of the femur because of bone metastases seriously affect the quality of life of cancer patients. Different surgical options are indicated to achieve a durable and solid fixation, depending on several clinical, prognostic and mechanical factors. Locked intramedullary nailing is currently used to treat pathologic femoral fractures in patients with multiple metastases when the trochanteric region or shaft is mainly involved. This study evaluates intramedullary nailing for treatment of patients with pathologic femoral fractures, focussing on complications, clinical and functional outcomes and survival rates. The series included 80 pathologic fractures treated with a titanium alloy Proximal Nail (Standard or Antirotation) or Lateral Anterograde Femoral Nail (PFN, PFNA or LAFN, Synthes) inserted in a locked static mode. Acrylic cement was used to fill the bone cavity after nail insertion in eight patients; percutaneous cementoplasty was simultaneously performed in 11 cases of severe ipsilateral acetabular osteolysis. Postoperative outcomes focussed on pain relief, postoperative mobility and quality of life and they were analysed retrospectively using QOL-ACD and ECOG. Eleven patients (13.75%) suffered from non-fatal DVT post-surgery, with no pulmonary embolism. Six patients (7.5%) developed superficial wound infections and two patients (2.5%) developed pnaeumonia. There was no loss of reduction, breakage, screw pull out, or hardware or implant failure that required component substitution or revision. Lung histotype and the contemporary presence of cerebral and visceral metastases appeared to be predisposing factors in reducing survival time. All patients attained satisfactory pain relief, early deambulation and a marked clinical improvement during the first 6-10 postoperative months, with gradual worsening thereafter from deterioration of their general condition due to cancer progression. The patients' survival rate was 40% at 1 year, 25% at 2 years and 15% at 3 years. Results confirm that multiple factors related to patients and primary cancer may affect survival rate after femoral fracture. Intramedullary nailing should be indicated for pathologic fractures at femoral diaphysis and metaphysis when cancer is in an advanced stage. This procedure offers good and durable stability, and enables pain relief, early postoperative mobilisation and weight-bearing, thus improving the quality of life of cancer patients. AD - Unit of Orthopedic Oncology, University La Sapienza, Rome, Italy. Department of Orthopedics, Catholic University, Rome, Italy. Electronic address: barbararossi82@yahoo.it. Unit of Spinal Surgery, Orthopedic Institute Galeazzi, Milan, Italy. Department of Orthopedics, Catholic University, Rome, Italy. Department of Orthopedics, Tumor Hospital of Yunnan Province, Kunming Medical University, Yunnan, China. AN - 24119652 AU - Piccioli, A. AU - Rossi, B. AU - Scaramuzzo, L. AU - Spinelli, M. S. AU - Yang, Z. AU - Maccauro, G. DA - Feb DO - 10.1016/j.injury.2013.09.025 DP - NLM ET - 2013/10/15 J2 - Injury KW - Adult Aged Aged, 80 and over Bone Cements/*therapeutic use Bone Nails Female Femoral Fractures/etiology/pathology/*surgery *Fracture Fixation, Intramedullary *Fracture Healing Fractures, Spontaneous/pathology/*surgery Humans Locomotion Male Middle Aged Neoplasms/complications/*pathology Pain Measurement Prognosis Quality of Life Retrospective Studies Surveys and Questionnaires Survival Rate Treatment Outcome *Weight-Bearing Femur Intramedullary nailing Metastases Pathologic fractures Prognostic factors LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 0020-1383 SP - 412-7 ST - Intramedullary nailing for treatment of pathologic femoral fractures due to metastases T2 - Injury TI - Intramedullary nailing for treatment of pathologic femoral fractures due to metastases VL - 45 ID - 828722 ER - TY - JOUR AB - Pathologic fractures of the femur because of bone metastases seriously affect the quality of life of cancer patients. Different surgical options are indicated to achieve a durable and solid fixation, depending on several clinical, prognostic and mechanical factors. Locked intramedullary nailing is currently used to treat pathologic femoral fractures in patients with multiple metastases when the trochanteric region or shaft is mainly involved. This study evaluates intramedullary nailing for treatment of patients with pathologic femoral fractures, focussing on complications, clinical and functional outcomes and survival rates. The series included 80 pathologic fractures treated with a titanium alloy Proximal Nail (Standard or Antirotation) or Lateral Anterograde Femoral Nail (PFN, PFNA or LAFN, Synthes) inserted in a locked static mode. Acrylic cement was used to fill the bone cavity after nail insertion in eight patients; percutaneous cementoplasty was simultaneously performed in 11 cases of severe ipsilateral acetabular osteolysis. Postoperative outcomes focussed on pain relief, postoperative mobility and quality of life and they were analysed retrospectively using QOL-ACD and ECOG. Eleven patients (13.75%) suffered from non-fatal DVT post-surgery, with no pulmonary embolism. Six patients (7.5%) developed superficial wound infections and two patients (2.5%) developed pnaeumonia. There was no loss of reduction, breakage, screw pull out, or hardware or implant failure that required component substitution or revision. Lung histotype and the contemporary presence of cerebral and visceral metastases appeared to be predisposing factors in reducing survival time. All patients attained satisfactory pain relief, early deambulation and a marked clinical improvement during the first 6-10 postoperative months, with gradual worsening thereafter from deterioration of their general condition due to cancer progression. The patients' survival rate was 40% at 1 year, 25% at 2 years and 15% at 3 years. Results confirm that multiple factors related to patients and primary cancer may affect survival rate after femoral fracture. Intramedullary nailing should be indicated for pathologic fractures at femoral diaphysis and metaphysis when cancer is in an advanced stage. This procedure offers good and durable stability, and enables pain relief, early postoperative mobilisation and weight-bearing, thus improving the quality of life of cancer patients. (C) 2013 Elsevier Ltd. All rights reserved. AD - [Piccioli, Andrea] Univ Roma La Sapienza, Unit Orthoped Oncol, Rome, Italy. [Rossi, Barbara; Spinelli, Maria Silvia; Maccauro, Giulio] Catholic Univ, Dept Orthoped, Rome, Italy. [Scaramuzzo, Laura] Orthoped Inst Galeazzi, Unit Spinal Surg, Milan, Italy. [Yang, Zuozhang] Kunming Med Univ, Tumor Hosp Yunnan Prov, Dept Orthoped, Yunnan, Peoples R China. Rossi, B (corresponding author), Catholic Univ, Dept Orthoped, Rome, Italy. barbararossi82@yahoo.it AN - WOS:000329825700013 AU - Piccioli, A. AU - Rossi, B. AU - Scaramuzzo, L. AU - Spinelli, M. S. AU - Yang, Z. Z. AU - Maccauro, G. DA - Feb DO - 10.1016/j.injury.2013.09.025 J2 - Injury-Int. J. Care Inj. KW - Pathologic fractures Femur Metastases Intramedullary nailing Prognostic factors SURGICAL-TREATMENT SKELETAL METASTASIS SCORING SYSTEM PROXIMAL FEMUR BONE-DISEASE SURVIVAL ACETABULOPLASTY MANAGEMENT REGISTER SURGERY Critical Care Medicine Emergency Medicine Orthopedics Surgery LA - English M1 - 2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2014 SN - 0020-1383 SP - 412-417 ST - Intramedullary nailing for treatment of pathologic femoral fractures due to metastases T2 - Injury-International Journal of the Care of the Injured TI - Intramedullary nailing for treatment of pathologic femoral fractures due to metastases UR - ://WOS:000329825700013 VL - 45 ID - 830269 ER - TY - JOUR AB - Background and Objectives: We describe a novel technique for percutaneous tumor debulking and cavity creation in patients with extensive lytic lesions of the vertebral body including posterior wall dehiscence prior to vertebral augmentation (VA) procedures. The mechanical cavity is created with a combination of curettage and vacuum suction (Q-VAC). Balloon kyphoplasty and vertebral body stenting are used to treat neoplastic vertebral lesions and might reduce the rate of cement leakage, especially in presence of posterior wall dehiscence. However, these techniques could theoretically lead to increased intravertebral pressure during balloon inflation with possible mobilization of soft tissue tumor through the posterior wall, aggravation of spinal stenosis, and resultant complications. Creation of a void or cavity prior to balloon expansion and/or cement injection would potentially reduce these risks. Materials and Methods: A curette is coaxially inserted in the vertebral body via transpedicular access trocars. The intravertebral neoplastic soft tissue is fragmented by multiple rotational and translational movements. Subsequently, vacuum aspiration is applied via one of two 10 G cannulas that had been introduced directly into the fragmented lesion, while saline is passively flushed via the contralateral cannula, with lavage of the fragmented solid and fluid-necrotic tumor parts. Results: We applied the Q-VAC technique to 35 cases of thoracic and lumbar extreme osteolysis with epidural mass before vertebral body stenting (VBS) cement augmentation. We observed extravertebral cement leakage on postoperative CT in 34% of cases, but with no clinical consequences. No patients experienced periprocedural respiratory problems or new or worsening neurological deficit. Conclusion: The Q-VAC technique, combining mechanical curettage and vacuum suction, is a safe, inexpensive, and reliable method for percutaneous intravertebral tumor debulking and cavitation prior to VA. We propose the Q-VAC technique for cases with extensive neoplastic osteolysis, especially if cortical boundaries of the posterior wall are dehiscent and an epidural soft tissue mass is present. AD - [Piechowiak, Eike, I; Cianfoni, Alessandro] Bern Univ Hosp, Univ Inst Diagnost & Intervent Neuroradiol, Inselspital, CH-3010 Bern, Switzerland. [Isalberti, Maurizio; Pileggi, Marco; Distefano, Daniela; Cianfoni, Alessandro] Neuroctr Southern Switzerland, Dept Neuroradiol, CH-6900 Lugano, Switzerland. [Hirsch, Joshua A.] Harvard Med Sch, Massachusetts Gen Hosp, Dept Radiol, Boston, MA 02114 USA. Piechowiak, EI (corresponding author), Bern Univ Hosp, Univ Inst Diagnost & Intervent Neuroradiol, Inselspital, CH-3010 Bern, Switzerland. eike.piechowiak@insel.ch; Maurizio.Isalberti@eoc.ch; Marco.Pileggi@eoc.ch; Daniela.Distefano@eoc.ch; jahirsch@mgh.harvard.edu; Alessandro.Cianfoni@eoc.ch AN - WOS:000503463400025 AU - Piechowiak, E. I. AU - Isalberti, M. AU - Pileggi, M. AU - Distefano, D. AU - Hirsch, J. A. AU - Cianfoni, A. C7 - 633 DA - Oct DO - 10.3390/medicina55100633 J2 - Med. Lith. KW - vertebral augmentation cavity creation lytic vertebral body lesions vertebral body stent PERCUTANEOUS VERTEBROPLASTY COMPRESSION FRACTURES BONE-CEMENT FAT-EMBOLISM TUMOR KYPHOPLASTY INJECTION LAVAGE RISK Medicine, General & Internal LA - English M1 - 10 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 1010-660X SP - 9 ST - Mechanical Cavity Creation with Curettage and Vacuum Suction (Q-VAC) in Lytic Vertebral Body Lesions with Posterior Wall Dehiscence and Epidural Mass before Cement Augmentation T2 - Medicina-Lithuania TI - Mechanical Cavity Creation with Curettage and Vacuum Suction (Q-VAC) in Lytic Vertebral Body Lesions with Posterior Wall Dehiscence and Epidural Mass before Cement Augmentation UR - ://WOS:000503463400025 VL - 55 ID - 830119 ER - TY - JOUR AB - PURPOSE: Prosthetic revision of hip fractures may result in embolization of tissue products leading to death. In this report, from cases reported to the Anaesthesia Advisory Committee to the Chief Coroner of Ontario, emphasis is placed on the immediate resuscitative procedures which may offset a fatal outcome. CLINICAL FEATURES: Two elderly patients are reported in whom hip fractures necessitated primary prosthetic hip repair. The first patient, with a history of limited cardiac reserve and syncope, suffered a subcapital hip fracture. Under general anaesthesia, a Moore's prosthesis was inserted. The anaesthetic period remained relatively stable until surgical reaming of the femoral canal. Bradycardia, hypotension and cyanosis developed and quickly proceeded to a fatal cardiac arrest. Autopsy demonstrated diffuse pulmonary embolism of fat and thrombus. The second patient suffered a fracture around the stem of a previously inserted femoral prosthesis. Under general anaesthesia, a new cemented hip prosthesis was inserted, following which hypotension occurred. This was supported with small doses of ephedrine, ventilation was controlled with oxygen and the procedure was quickly terminated. Despite addition of a dopamine infusion, cardiac arrest and death followed. Autopsy disclosed massive fat and bone marrow embolization. CONCLUSION: The combination of hip fracture, activated clotting factors and borderline cardiopulmonary function presents a risk of death from embolization of tissue products released during the placement of a cemented hip prosthesis. While the outcome of this catastrophe is generally poor, all practitioners should be prepared to immediately institute resuscitative procedures to manage the accompanying cardiovascular collapse. AD - Department of Anaesthesia, Queen's University, Kingston, Ontario. AN - 9043733 AU - Pietak, S. AU - Holmes, J. AU - Matthews, R. AU - Petrasek, A. AU - Porter, B. DA - Feb DO - 10.1007/bf03013009 DP - NLM ET - 1997/02/01 J2 - Canadian journal of anaesthesia = Journal canadien d'anesthesie KW - Acute Disease Aged Aged, 80 and over Embolism/etiology Female Heart Arrest/*etiology Hip Fractures/*surgery Hip Prosthesis/*adverse effects Humans LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 1997 SN - 0832-610X (Print) 0832-610x SP - 198-201 ST - Cardiovascular collapse after femoral prosthesis surgery for acute hip fracture T2 - Can J Anaesth TI - Cardiovascular collapse after femoral prosthesis surgery for acute hip fracture VL - 44 ID - 828955 ER - TY - JOUR AB - Cement extravasation is a rather common complication of vertebroplasty, which can be observed in up to 30-40% of patients undergoing this procedure, further associated with venous leakage occurring in up to 24% of cases. Pulmonary embolism may eventually develop once the cement migrates within the pulmonary artery, and is the most common complication of cement extravasation (involving similar to 4.6% of patients). Intra-cardiac cement embolism is considerably less frequent, but is a potentially fatal complication, mostly managed with cardiac surgery. We describe here a rare case of near-fatal cardiac cement embolism, with a large fragment perforating the right ventricle and reaching the pericardium, who presented to the Emergency Department (ED) for syncope. The patient, who displayed this severe complication after a vertebroplasty procedure performed for osteoporotic compression fracture, needed cardiac surgery. AD - [Pigna, Federica; Scioscioli, Francesco] Univ Hosp Parma, Emergency Dept, Parma, Italy. [Calamai, Simone] Univ Parma, Postgrad Emergency Med Sch, Parma, Italy. [Buttarelli, Lorenzo] Univ Hosp Parma, Dept Radiol, Parma, Italy. [Nicolini, Francesco] Univ Hosp Parma, Cardiac Surg Unit, Parma, Italy. [Cervellin, Gianfranco] Acad Emergency Med & Care AcEMC, Via Maugeri, I-27100 Pavia, PV, Italy. Cervellin, G (corresponding author), Acad Emergency Med & Care AcEMC, Via Maugeri, I-27100 Pavia, PV, Italy. gianfranco.cervellin@gmail.com AN - WOS:000566726100011 AU - Pigna, F. AU - Calamai, S. AU - Scioscioli, F. AU - Buttarelli, L. AU - Nicolini, F. AU - Cervellin, G. C7 - 8739 DO - 10.4081/ecj.2020.8739 J2 - Emer. Care J. KW - Vertebroplasty cardiac embolism osteoporotic compression fractures acrylic cement extravasation PULMONARY-EMBOLISM RANDOMIZED-TRIAL CEMENT LEAKAGE BONE-CEMENT RISK COMPLICATIONS KYPHOPLASTY Emergency Medicine LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2020 SN - 1826-9826 SP - 39-41 ST - Thorned heart. Description of a near-fatal cardiac embolism after percutaneous Vertebroplasty T2 - Emergency Care Journal TI - Thorned heart. Description of a near-fatal cardiac embolism after percutaneous Vertebroplasty UR - ://WOS:000566726100011 VL - 16 ID - 830113 ER - TY - JOUR AN - 19451160 AU - Pigot, B. AU - Kirkham, D. AU - Eyrolles, L. AU - Rosencher, N. AU - Safran, D. AU - Cholley, B. DA - Jun DO - 10.1093/bja/aep119 DP - NLM ET - 2009/05/20 J2 - British journal of anaesthesia KW - Aged Arthroplasty, Replacement, Hip/*adverse effects Bone Cements/adverse effects Embolism/*prevention & control Female Foramen Ovale, Patent/*surgery Humans Intraoperative Complications/*prevention & control LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0007-0912 SP - 888-9 ST - Preventive closure of a patent foramen ovale before total hip replacement T2 - Br J Anaesth TI - Preventive closure of a patent foramen ovale before total hip replacement VL - 102 ID - 828546 ER - TY - JOUR AB - Background: University Hospital, Coventry, UK (UHCW), offers percutaneous vertebroplasty (PVP) to patients with painful osteoporotic vertebral fractures. The National Institute for Health and Care Excellence (NICE) Technology Appraisal 279 (TA279) (2013) restricts the use of PVP to patients with severe ongoing pain despite optimal pain management, where the pain corresponds to the level of fracture on examination and imaging.1 Objectives: To audit the use of PVP by Rheumatology at UHCW against NICE TA279.1 To assess the clinical outcomes of PVP for our patients. Methods: The records of all UHCW Rheumatology patients who received PVP from MD3 (Interventional Radiologist) between September 2007 and August 2014 were retrospectively assessed against NICE TA279.1 We defined a 'recent' fracture as occurring 6-12 weeks prior to PVP as this allows time for natural bone healing whilst minimising therapeutic delay.1 'Optimal pain management' was defined as analgesia in addition to, or stronger than, paracetamol. Results: 57 of the 221 PVP performed by MD were for Rheumatology patients. 38 patients were female and 19 were male. They were aged 42-95 years (median 73), and 95% were Caucasian. 26 had taken corticosteroids for more than 6 months. 7 patients received PVP 6-12 weeks after their fracture. 10 patients had PVP within 6 weeks. 39 patients waited 12 weeks or longer due to late patient presentation, slow referral processes, and the time taken to optimise analgesia. 38 (67%) patients received optimal analgesia before PVP. 46 (81%) patients had pain that correlated with the level of vertebral fracture.1 Following PVP back pain was gone for 9 (16%) patients, improved for 38 (66%), not changed for 4 (7%), and worse for 1 (2%) patient. Complications included leakage of cement locally (57%) or into local veins (5%). 2 patients had pulmonary cement emboli. One presented with breathlessness and the second was found incidentally. Both recovered with conservative therapy. Conclusions: In line with NICE TA279, most patients had pain at the level of their fracture and received optimal pain management prior to receiving PVP. 10 patients received PVP earlier than our standard of 6 weeks. However, recent randomised trials suggest that PVP may be beneficial in this group.2 Most (68%) patients received PVP later than 12 weeks but they often found benefit. The VERTOS V trial may help determine the role of PVP for chronic fractures.3 Introducing an osteoporotic vertebral fracture pathway at UHCW will help ensure appropriate management, timely review and, when necessary, prompt PVP. AD - J. Pinnell, Rheumatology, Coventry, United Kingdom AU - Pinnell, J. AU - Merris, H. AU - Dhillon, M. AU - Chaudhuri, K. DB - Embase DO - 10.1136/annrheumdis-2018-eular.2217 KW - cement corticosteroid paracetamol adult aged analgesia backache case report Caucasian clinical article complication conference abstract conservative treatment drug therapy dyspnea embolism female fracture healing human interventional radiologist male osteoporosis patient referral percutaneous vertebroplasty randomized controlled trial retrospective study rheumatology spine fracture vein LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1468-2060 SP - 451 ST - An audit of the use of percutaneous vertebroplasty for osteoporotic vertebral fractures in a UK rheumatology clinic T2 - Annals of the Rheumatic Diseases TI - An audit of the use of percutaneous vertebroplasty for osteoporotic vertebral fractures in a UK rheumatology clinic UR - https://www.embase.com/search/results?subaction=viewrecord&id=L623991407&from=export http://dx.doi.org/10.1136/annrheumdis-2018-eular.2217 VL - 77 ID - 829193 ER - TY - JOUR AB - Methylmethacrylate has been used extensively in the United States since 1971 for the fixation of orthopedic prostheses. A chemical compound that generates a considerable amount of heat as it sets and hardens, it has been known to cause mild to moderate hypotension as well as cardiovascular collapse and death in some instances. Some of the purported etiologies of the untoward effects of methylmethacrylate include fat embolism, air embolism, bone marrow embolism, peripheral vasodilation, activation within the lungs of the clotting cascade, direct cardiovascular depressant effects of methylmethacrylate cement or monomer, and others. In this article, the use of methylmethacrylate in orthopedic procedures is reviewed, along with a discussion of some of the previously hypothesized causes of its side effects. Then a case report of its use in a 59-year-old woman with a pathological fracture of her left femur is presented. Finally, the implications for the anesthetist are noted, and suggested interventions to limit untoward effects with the use of methylmethacrylate are presented. AN - 8266779 AU - Pinto, P. W. DA - Dec DP - NLM ET - 1993/12/01 J2 - AANA journal KW - Female Femoral Fractures/surgery Fractures, Spontaneous/surgery Humans Intraoperative Complications/*chemically induced/nursing Methylmethacrylate Methylmethacrylates/*adverse effects Middle Aged Nurse Anesthetists Shock/*chemically induced/nursing LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 1993 SN - 0094-6354 (Print) 0094-6354 SP - 613-6 ST - Cardiovascular collapse associated with the use of methylmethacrylate T2 - Aana j TI - Cardiovascular collapse associated with the use of methylmethacrylate VL - 61 ID - 828831 ER - TY - JOUR AB - STUDY DESIGN: Meta-analysis. OBJECTIVE: To understand the benefits and limitations of surgical management and adjuvant therapies for patients presenting with neurological deficits from vertebral hemangiomas (VH). SUMMARY OF BACKGROUND DATA: VH is the most common benign spine tumor but rarely causes symptoms. Patients with back pain alone are treated with conservative management (kyphoplasty and radiation therapy), while those with neurological deficits require complex multi-modal treatment plans. METHODS: A PubMed literature search for "symptomatic vertebral hemangioma with spinal cord compression" identified 47 articles. From these articles and their references, 19 observational studies on patients who underwent surgery for VH met inclusion criteria. Meta-analyses were performed comparing outcomes of the surgical and adjuvant therapies using Stata13 software. For those with insufficient data for meta-analyses, descriptive analyses of variables were completed. RESULTS: One hundred ninety seven surgical cases of VH with neurologic deficits were identified. Surgery provided a complete remission of symptoms in 84% of patients, however 18% of patients had recurrence of hemangioma. Adjuvant interventions included radiation, embolization, and kyphoplasty. Radiation therapy (XRT) was associated with a lower recurrence rate and an increase in minor transient adverse effects. Preoperative embolization performed in 98 patients was associated with improved symptoms, reduced complications, lower recurrence rate, less blood loss, and higher incidence of pathologic vertebral fractures. Meta-analyses did not yield statistically significant results, likely due to the heterogeneity amongst the studies and small sample sizes, but the results compiled together provide insight on potential benefits of preoperative embolization for symptomatic relief and reduced risk of recurrence with XRT that deserves further study. CONCLUSION: For patients with neurologic deficits from spinal cord or nerve root compression, surgery provides improvement in symptoms. Recurrence of VH and symptoms refractory to surgery can be further reduced by adjuvant therapies such as embolization, kyphoplasty, and radiation with some unique risks to each therapy. LEVEL OF EVIDENCE: 2. AD - University of Rochester School of Medicine, Rochester, New York. Department of Neurosurgery, University of Rochester Medical Center, Rochester, New York. Department of Neurosurgery, University of South Florida, Tampa, Florida. Department of Medical Statistics, Medical School, Tongji University, Shanghai, China. Department of Obstetrics & Gynecology, Clinical and Translational Science Institute, University of Rochester Medical Center, Rochester, New York. AN - 31365517 AU - Piper, K. AU - Zou, L. AU - Li, D. AU - Underberg, D. AU - Towner, J. AU - Chowdhry, A. K. AU - Li, Y. M. DA - Jan 15 DO - 10.1097/brs.0000000000003181 DP - NLM ET - 2019/08/01 J2 - Spine KW - Combined Modality Therapy Decompression, Surgical *Embolization, Therapeutic Hemangioma/*complications/pathology/*therapy Humans Kyphoplasty/adverse effects *Neoplasm Recurrence, Local/surgery Radiculopathy/etiology/surgery Radiotherapy, Adjuvant Spinal Cord Compression/etiology/surgery Spinal Neoplasms/*complications/*therapy LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 0362-2436 SP - E99-e110 ST - Surgical Management and Adjuvant Therapy for Patients With Neurological Deficits From Vertebral Hemangiomas: A Meta-Analysis T2 - Spine (Phila Pa 1976) TI - Surgical Management and Adjuvant Therapy for Patients With Neurological Deficits From Vertebral Hemangiomas: A Meta-Analysis VL - 45 ID - 828575 ER - TY - JOUR AB - Forty patients suffering from a medial femoral neck fracture participated in a prospective, randomized study. In 20 patients, the femoral component was cemented using a contemporary technique. In the patient group operated on with the bone vacuum technique, the medullary cavity was drained during the insertion of the stem. The proximal draining hole was placed in the intertrochanteric region, along the prolongation of the linea aspera. The distal hole was placed 2 cm below the tip of the femoral component. Embolic phenomena were documented intraoperatively by continuous transesophageal echocardiographic imaging of the right atrium and ventricle. The clinical relevance of the emboli was noted simultaneously by recording hemodynamic and blood gas parameters. Patients of the control group showed severer and longer‐lasting episodes of embolism than patients of the bone vacuum group. Ongoing emboli were first seen during the injection of the cement, and continued during stem insertion. Massive emboli of small particles could be verified in 19 patients (95%) of the control group and in 1 patient (5%) of the bone vacuum group (P < 0.05). During massive emboli, a distinct decrease in the arterial oxygen saturation and the end‐expiratory carbon dioxide level was observed. The calculated average pulmonary shunt volume showed an increase after the insertion of the stem using the contemporary technique (36.5%; P < 0.05). These distinct hemodynamic changes were not observed in the bone vacuum group. This study was able to show a clearly reduced risk of pulmonary emboli using the bone vacuum cementing technique. The presence of pre‐existing disease greatly magnified the clinical relevance of fat embolism. AN - CN-00266162 AU - Pitto, R. P. AU - Blunk, J. AU - Kössler, M. DO - 10.1007/pl00021216 KW - Aged Aged, 80 and over Arthroplasty, Replacement, Hip [*methods] Cementation [methods] Echocardiography, Transesophageal Embolism, Fat [diagnostic imaging, *prevention & control] Female Femoral Neck Fractures [*surgery] Hemodynamics Humans Male Postoperative Complications [*prevention & control] Prospective Studies Pulmonary Gas Exchange M1 - 1‐2 M3 - Clinical Trial; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2000 SP - 53‐58 ST - Transesophageal echocardiography and clinical features of fat embolism during cemented total hip arthroplasty. A randomized study in patients with a femoral neck fracture T2 - Archives of orthopaedic and trauma surgery TI - Transesophageal echocardiography and clinical features of fat embolism during cemented total hip arthroplasty. A randomized study in patients with a femoral neck fracture UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00266162/full VL - 120 ID - 830022 ER - TY - JOUR AB - BACKGROUND: Clinical and experimental studies have suggested that the maximum risk of thrombogenesis occurs during, rather than after, total hip arthroplasty. With use of conventional cementing techniques, insertion of a femoral component results in marrow embolization of tissue thromboplastin into the veins of the proximal part of the femur, leading to activation of the clotting cascade and thrombogenesis. We hypothesized that an operative technique designed for the prevention of fat and bone‐marrow embolism can also reduce the incidence of postoperative deep‐vein thrombosis and pulmonary embolism. METHODS: A total of 130 consecutive patients with osteoarthritis who were to have a primary total hip arthroplasty were randomly assigned to one of two groups. One group consisted of sixty‐five patients (sixty‐five hips) who had the femoral component inserted with our standard cementing technique without use of a bone vacuum, and the other group included sixty‐five patients (sixty‐five hips) who had the femoral component cemented with use of a bone‐vacuum technique. In the hips managed with the bone vacuum, suction (‐800 mbar) was applied to a drainage cannula placed along the linea aspera of the femur in order to prevent an increase in intramedullary pressure during the insertion of the stem. We measured the incidence of intraoperative fat and bone‐marrow embolism with use of echocardiography and a transesophageal probe and the incidence of deep‐vein thrombosis with use of serial duplex ultrasonography on the day before the operation and on postoperative days 4, 14, and 45. All patients were managed with prolonged pharmacological prophylaxis (low‐molecular‐weight heparin) against deep‐vein thrombosis. RESULTS: The control group had significantly more severe and prolonged echocardiographic embolic events than did the group managed with the bone‐vacuum technique (p < 0.05). A cascade of fine echogenic particles or embolic masses with a diameter of < or =5 mm was observed during the insertion of the stem in fifty‐nine hips (91%) in which our standard cementing technique was used and in ten hips (15%) in which the bone‐vacuum cementing technique was used. Deep‐vein thrombosis was detected on postoperative day 4 in twelve patients (18%) in the control group and in two patients (3%) in the group managed with the bone‐vacuum technique; the difference was significant (p < 0.05). CONCLUSIONS: Intraoperative prophylaxis against fat and bone‐marrow embolism during total hip arthroplasty with cement can reduce the incidence of postoperative deep‐vein thrombosis. We now use the bone‐vacuum technique routinely in all total hip arthroplasties performed with cement. AN - CN-00386990 AU - Pitto, R. P. AU - Hamer, H. AU - Fabiani, R. AU - Radespiel-Troeger, M. AU - Koessler, M. DO - 10.2106/00004623-200201000-00007 KW - *deep vein thrombosis/co [Complication] *deep vein thrombosis/pc [Prevention] *fat embolism/pc [Prevention] *poly(methyl methacrylate) *polyethylene *total hip prosthesis Adult Aged Arthroplasty, Replacement, Hip [*methods] Article Artificial embolism Bone Marrow Cementation Clinical trial Controlled clinical trial Controlled study Echocardiography Echography Embolism [*prevention & control] Embolism, Fat [*prevention & control] Female Human Humans Incidence Lung embolism Major clinical study Male Osteoarthritis Osteoarthritis [surgery] Peroperative care Postoperative Complications [prevention & control] Postoperative complication Priority journal Prophylaxis Randomized controlled trial Surgical technique Vacuum Venous Thrombosis [*prevention & control] M1 - 1 M3 - Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2002 SP - 39‐48 ST - Prophylaxis against fat and bone-marrow embolism during total hip arthroplasty reduces the incidence of postoperative deep-vein thrombosis: a controlled, randomized clinical trial T2 - Journal of bone and joint surgery. American volume TI - Prophylaxis against fat and bone-marrow embolism during total hip arthroplasty reduces the incidence of postoperative deep-vein thrombosis: a controlled, randomized clinical trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00386990/full VL - 84 ID - 829992 ER - TY - JOUR AB - Background: Clinical and experimental studies have suggested that the maximum risk of thrombogenesis occurs during, rather than after, total hip arthroplasty. With use of conventional cementing techniques, insertion of a femoral component results in marrow embolization of tissue thromboplastin into the veins of the proximal part of the femur, leading to activation of the clotting cascade and thrombogenesis. We hypothesized that an operative technique designed for the prevention of fat and bone-marrow embolism can also reduce the incidence of postoperative deep-vein thrombosis and pulmonary embolism.Methods: A total of 130 consecutive patients with osteoarthritis who were to have a primary total hip arthroplasty were randomly assigned to one of two groups. One group consisted of sixty-five patients (sixty-five hips) who had the femoral component inserted with our standard cementing technique without use of a bone vacuum, and the other group included sixty-five patients (sixty-five hips) who had the femoral component cemented with use of a bone-vacuum technique. In the hips managed with the bone vacuum, suction (-800 mbar) was applied to a drainage cannula placed along the linea aspera of the femur in order to prevent an increase in intramedullary pressure during the insertion of the stem. We measured the incidence of intraoperative fat and bone-marrow embolism with use of echocardiography and a transesophageal probe and the incidence of deep-vein thrombosis with use of serial duplex ultrasonography on the day before the operation and on postoperative days 4, 14, and 45. All patients were managed with prolonged pharmacological prophylaxis (low-molecular-weight heparin) against deep-vein thrombosis.Results: The control group had significantly more severe and prolonged echocardiographic embolic events than did the group managed with the bone-vacuum technique (p < 0.05). A cascade of fine echogenic particles or embolic masses with a diameter of < or =5 mm was observed during the insertion of the stem in fifty-nine hips (91%) in which our standard cementing technique was used and in ten hips (15%) in which the bone-vacuum cementing technique was used. Deep-vein thrombosis was detected on postoperative day 4 in twelve patients (18%) in the control group and in two patients (3%) in the group managed with the bone-vacuum technique; the difference was significant (p < 0.05).Conclusions: Intraoperative prophylaxis against fat and bone-marrow embolism during total hip arthroplasty with cement can reduce the incidence of postoperative deep-vein thrombosis. We now use the bone-vacuum technique routinely in all total hip arthroplasties performed with cement. AD - Department of Orthopaedic Surgery, University of Auckland, Middlemore Hospital, Otahuhu, Auckland, New Zealand Department of Orthopaedic Surgery, University of Auckland, Middlemore Hospital, Private Bag 93311, Otahuhu, Auckland, New Zealand; rpitto@middlemore.co.nz AN - 106955364. Language: English. Entry Date: 20030307. Revision Date: 20190610. Publication Type: journal article AU - Pitto, R. P. AU - Hamer, H. AU - Fabiani, R. AU - Radespiel-Troeger, M. AU - Koessler, M. AU - Pitto, Rocco Paolo AU - Hamer, Hendrik AU - Fabiani, Renato AU - Radespiel-Troeger, Martin AU - Koessler, Matthias DB - cin20 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Methods Bone Marrow Embolism -- Prevention and Control Embolism, Fat -- Prevention and Control Intraoperative Complications -- Prevention and Control Postoperative Complications -- Prevention and Control Pulmonary Embolism -- Prevention and Control Venous Thrombosis -- Prevention and Control Clinical Trials Descriptive Statistics Drainage Electrocardiography Funding Source Heparin -- Therapeutic Use Multivariate Analysis Osteoarthritis -- Surgery Prospective Studies Random Assignment Reliability and Validity Sensitivity and Specificity Suction Venous Thrombosis -- Ultrasonography Human M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2002 SN - 0021-9355 SP - 39-48 ST - Prophylaxis against fat and bone-marrow embolism during total hip arthroplasty reduces the incidence of postoperative deep-vein thrombosis: a controlled, randomized clinical trial T2 - Journal of Bone & Joint Surgery, American Volume TI - Prophylaxis against fat and bone-marrow embolism during total hip arthroplasty reduces the incidence of postoperative deep-vein thrombosis: a controlled, randomized clinical trial UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106955364&site=ehost-live&scope=site VL - 84 ID - 830796 ER - TY - JOUR AB - The increase in intramedullary pressure in the femur is the most decisive pathogenic factor for the development of embolic phenomena during total hip replacement. The aim of this study was to assess the risk of embolism and its clinical relevance during surgery by means of transesophageal echocardiography, hemodynamic and hemogasanalytic monitoring. A total of 65 arthroplasties entered the clinical trial. Total hip arthroplasty was cemented conventionally. The right heart was monitored intraoperatively by an echocardiography probe positioned in the patient's esophagus. Hemodynamic and hemogasanalytic monitoring were performed. Severe embolism occurred in 91% of the cases during implantation of the femoral component. Emodynamic and respiratory parameters showed significant changes after major embolism. The timing suggests a nearly immediate cause-and-effect relationship. Acute hypotension was observed in 62% of the cases. Mean pulmonary shunt values increment was 30.5%. Patients with intraoperative embolism who had pre-existing associated diseases showed more severe and persistent cardiopulmonary dysfunction than healthy patients. The surgeon's proclivity to deny the clinical relevance of fat and bone marrow during during total hip arthroplasty is directly related to his awareness of and attempt to avoid embolism. Patients at risk require more intensive monitoring to obtain detailed information about hemodynamic and oxymetric parameters. AD - Orthopädische Klinik, Friedrich Alexander Universität, Erlangen, Deutschland. AN - 11569070 AU - Pitto, R. P. AU - Koessler, M. DA - Apr-Jun DP - NLM ET - 2001/09/25 J2 - La Chirurgia degli organi di movimento KW - Age Factors Aged Aged, 80 and over *Arthroplasty, Replacement, Hip Bone Cements Embolism, Fat/*epidemiology Female Humans Intraoperative Complications/*epidemiology Male Risk Factors LA - eng ita M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 1999 SN - 0009-4749 (Print) 0009-4749 SP - 119-28 ST - The risk of fat embolism during cemented total hip replacement in the elderly patient T2 - Chir Organi Mov TI - The risk of fat embolism during cemented total hip replacement in the elderly patient VL - 84 ID - 828857 ER - TY - JOUR AN - CN-00308428 AU - Pitto, R. P. AU - Koessler, M. N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1999 SP - 209 ST - Fat and bone marrow embolism during total hip arthroplasty with uncemented and cemented stems T2 - Journal of bone and joint surgery - british volume TI - Fat and bone marrow embolism during total hip arthroplasty with uncemented and cemented stems UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00308428/full VL - 81 Suppl 2 ID - 830079 ER - TY - JOUR AB - The efficiency of a new cementing technique developed to prevent the risk of intraoperative pulmonary embolism was assessed. Seventy patients with coxarthrosis entered into a prospective, randomized clinical trial. In the control group of 35 cases the total hip replacement was cemented conventionally. In the second group a proximal drainage placed along the Linea aspera, and a distal drainage placed in the diaphysis, created a vacuum in the medullary cavity of the femur during the insertion of the stem. The operation was performed with the patient under blood gas analysis and hemodynamic and transesophageal echocardiography monitoring. Severe transatrial embolic events were observed during the insertion of the femoral component in 94% of the cases of the control group and in 14% of the cases of the vacuum group; the difference is statistically significant. A significant decrease of arterial partial pressure of O2 (-40.8 mm Hg) and increase of the pulmonary shunt values (+28.3%) occurred 5 minutes after the observation of embolic events in the cases operated on conventionally, but these parameters showed minimal changes in the vacuum group. The rise of intramedullary pressure in the femur is the most decisive pathogenic factor of pulmonary embolism during total hip arthroplasty. The logical prophylactic measure to prevent intravasation of fat and bone marrow is to create sufficient drainage. The cohorted investigation showed the value of the vacuum cementing technique for a substantial reduction of intraoperative embolism and pulmonary impairment. AD - Department of Orthopaedic Surgery, Friedrich-Alexander University of Erlangen-Nuremberg, Germany. AN - 9917588 AU - Pitto, R. P. AU - Koessler, M. AU - Draenert, K. DA - Oct DO - 10.1097/00003086-199810000-00004 DP - NLM ET - 1999/01/26 J2 - Clinical orthopaedics and related research KW - Aged Arthroplasty, Replacement, Hip/*adverse effects/*methods Bone Cements/*therapeutic use *Bone Marrow Echocardiography, Transesophageal Embolism, Fat/diagnostic imaging/etiology/*prevention & control Female Humans Infant, Newborn Male Monitoring, Intraoperative Osteoarthritis, Hip/*surgery Prospective Studies Pulmonary Embolism/diagnostic imaging/etiology/*prevention & control Risk Factors Suction/*methods LA - eng M1 - 355 N1 - PubMed NLM literature search January 5, 2021 PY - 1998 SN - 0009-921X (Print) 0009-921x SP - 23-34 ST - The John Charnley Award. Prophylaxis of fat and bone marrow embolism in cemented total hip arthroplasty T2 - Clin Orthop Relat Res TI - The John Charnley Award. Prophylaxis of fat and bone marrow embolism in cemented total hip arthroplasty ID - 828819 ER - TY - JOUR AB - The efficiency of a new cementing technique developed to prevent the risk of intraoperative pulmonary embolism was assessed. Seventy patients with coxarthrosis entered into a prospective, randomized clinical trial. In the control group of 35 cases the total hip replacement was cemented conventionally. In the second group a proximal drainage placed along the Linea aspera, and a distal drainage placed in the diaphysis, created a vacuum in the medullary cavity of the femur during the insertion of the stem. The operation was performed with the patient under blood gas analysis and hemodynamic and transesophageal echocardiography monitoring. Severe transatrial embolic events were observed during the insertion of the femoral component in 94% of the cases of the control group and in 14% of the cases of the vacuum group; the difference is statistically significant. A significant decrease of arterial partial pressure of O2 (-40.8 mm Hg) and increase of the pulmonary shunt values (+28.3%) occurred 5 minutes after the observation of embolic events in the cases operated on conventionally, but these parameters showed minimal changes in the vacuum group. The rise of intramedullary pressure in the femur is the most decisive pathogenic factor of pulmonary embolism during total hip arthroplasty. The logical prophylactic measure to prevent intravasation of fat and bone marrow is to create sufficient drainage. The cohorted investigation showed the value of the vacuum cementing technique for a substantial reduction of intraoperative embolism and pulmonary impairment. AD - R.P. Pitto, Department of Orthopaedics, F.-Alexander Univ. Erlan.-Nuremberg, Waldkrankenhaus, Rathsbergerstrasse 57, 91054 Erlangen, Germany AU - Pitto, R. P. AU - Koessler, M. AU - Draenert, K. DB - Embase Medline DO - 10.1097/00003086-199810000-00004 KW - bone cement polyethylene aged bone marrow clinical article conference paper controlled study end tidal carbon dioxide tension fat embolism female hemodynamic monitoring hip prosthesis human intraoperative period lung embolism male priority journal total hip prosthesis transesophageal echocardiography Modified Muller Straight-Stem Muller Low-Profile Palacos-R LA - English M1 - 355 M3 - Conference Paper N1 - Embase Elsevier literature search January 5, 2021 PY - 1998 SN - 1528-1132 0009-921X SP - 23-34 ST - Prophylaxis of fat and bone marrow embolism in cemented total hip arthroplasty T2 - Clinical Orthopaedics and Related Research TI - Prophylaxis of fat and bone marrow embolism in cemented total hip arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L28538099&from=export http://dx.doi.org/10.1097/00003086-199810000-00004 ID - 829911 ER - TY - JOUR AB - Background: Acute hypotension, hypoxemia, cardiac arrest, and sudden death are well recognized complications during total hip arthroplasty, and they have been attributed to embolization of fat and bone marrow. An increase in intramedullary pressure in the femur is the most important pathogenic factor for the development of embolic events. Intravasation of fat, bone marrow, and bone debris during the implantation of a femoral component, and the embolization of these elements through the venous system located along the linea aspera and through the metaphyseal vessels, have been demonstrated experimentally and clinically. The purpose of the present study was to compare the effects of fixation of the femoral component without cement with those of fixation with a bone‐vacuum cementing technique on the severity of embolic phenomena and cardiopulmonary impairment during total hip arthroplasty. Fixation with a conventional cementing technique was also evaluated as a control. Methods: Sixty patients (sixty hips) were entered into a prospective, randomized clinical trial. The patients were assigned to one of three groups. Group 1 consisted of twenty patients who had the femoral component inserted without cement, Group 2 comprised twenty patients who had the component inserted with a conventional cementing technique, and Group 3 included twenty patients who had fixation with the so‐called bonevacuum cementing technique. In the hips in Group 3, a suction of‐800 millibars (‐ 80,000 pascals) was applied to a proximal drainage cannula placed along the linea aspera and a distal drainage cannula placed in the diaphysis in order to produce a vacuum in the medullary cavity of the femur during the application of cement and the insertion of the stem. Transesophageal echocardiography and hemodynamic and blood‐gas analysis were performed during the operation. Results: Severe embolic events (defined as a cascade of fine echogenic particles of less than five millimeters in diameter) were observed in seventeen (85 percent) of the twenty patients during insertion of the stem with use of a conventional cementing technique but in none of the patients who had the stem inserted without cement (p < 0.05). Insertion of the femoral component with the bone‐vacuum cementing technique prevented embolic phenomena in all but one patient (5 percent). Arterial oxygen saturation decreased significantly (p < 0.05) from a mean of 99.5 to 92.9 percent after insertion of the stem with a conventional cementing technique, but only slight changes were observed in the patients who had fixation of the component without cement and in those who were managed with the bone‐vacuum cementing technique. Intraoperative pulmonary shunt values increased a mean of 24 percent (p < 0.05) when the femoral component was inserted with a conventional cementing technique, but with the numbers available we did not detect a significant change in those values when the component was fixed without cement or when it was inserted with use of the bone‐vacuum cementing technique. Conclusions: The present study showed that severe embolic events and intraoperative pulmonary impairment are common when a femoral component is fixed with use of a conventional cementing technique. The results clearly demonstrated a low risk of embolism during total hip arthroplasty when the femoral component was fixed without cement and when it was fixed with the bone‐vacuum cementing technique. The ability of a patient to withstand an embolic event should be considered before fixation of the femoral component with use of a conventional cementing technique is planned. AN - CN-00414079 AU - Pitto, R. P. AU - Koessler, M. AU - Kuehle, J. W. KW - *bone cement *total hip prosthesis Adult Aged Arterial pressure Article Clinical trial Controlled clinical trial Controlled study Demography Disease severity Fat embolism/di [Diagnosis] Female Human Human cell Human tissue Major clinical study Male Pathogenesis Priority journal Randomized controlled trial Surgical technique Transesophageal echocardiography M1 - 6 M3 - Journal: Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1999 SP - 831‐843 ST - Comparison of fixation of the femoral component without cement and fixation with use of a bone-vacuum cementing technique for the prevention of fat embolism during total hip arthroplasty T2 - Journal of bone and joint surgery. American volume TI - Comparison of fixation of the femoral component without cement and fixation with use of a bone-vacuum cementing technique for the prevention of fat embolism during total hip arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00414079/full VL - 81 ID - 829997 ER - TY - JOUR AB - BACKGROUND: Acute hypotension, hypoxemia, cardiac arrest, and sudden death are well recognized complications during total hip arthroplasty, and they have been attributed to embolization of fat and bone marrow. An increase in intramedullary pressure in the femur is the most important pathogenic factor for the development of embolic events. Intravasation of fat, bone marrow, and bone debris during the implantation of a femoral component, and the embolization of these elements through the venous system located along the linea aspera and through the metaphyseal vessels, have been demonstrated experimentally and clinically. The purpose of the present study was to compare the effects of fixation of the femoral component without cement with those of fixation with a bone‐vacuum cementing technique on the severity of embolic phenomena and cardiopulmonary impairment during total hip arthroplasty. Fixation with a conventional cementing technique was also evaluated as a control. METHODS: Sixty patients (sixty hips) were entered into a prospective, randomized clinical trial. The patients were assigned to one of three groups. Group 1 consisted of twenty patients who had the femoral component inserted without cement, Group 2 comprised twenty patients who had the component inserted with a conventional cementing technique, and Group 3 included twenty patients who had fixation with the so‐called bone‐vacuum cementing technique. In the hips in Group 3, a suction of ‐800 millibars (‐80,000 pascals) was applied to a proximal drainage cannula placed along the linea aspera and a distal drainage cannula placed in the diaphysis in order to produce a vacuum in the medullary cavity of the femur during the application of cement and the insertion of the stem. Transesophageal echocardiography and hemodynamic and blood‐gas analysis were performed during the operation. RESULTS: Severe embolic events (defined as a cascade of fine echogenic particles of less than five millimeters in diameter) were observed in seventeen (85 percent) of the twenty patients during insertion of the stem with use of a conventional cementing technique but in none of the patients who had the stem inserted without cement (p < 0.05). Insertion of the femoral component with the bone‐vacuum cementing technique prevented embolic phenomena in all but one patient (5 percent). Arterial oxygen saturation decreased significantly (p < 0.05) from a mean of 99.5 to 92.9 percent after insertion of the stem with a conventional cementing technique, but only slight changes were observed in the patients who had fixation of the component without cement and in those who were managed with the bone‐vacuum cementing technique. Intraoperative pulmonary shunt values increased a mean of 24 percent (p < 0.05) when the femoral component was inserted with a conventional cementing technique, but with the numbers available we did not detect a significant change in those values when the component was fixed without cement or when it was inserted with use of the bone‐vacuum cementing technique. CONCLUSIONS: The present study showed that severe embolic events and intraoperative pulmonary impairment are common when a femoral component is fixed with use of a conventional cementing technique. The results clearly demonstrated a low risk of embolism during total hip arthroplasty when the femoral component was fixed without cement and when it was fixed with the bone‐vacuum cementing technique. The ability of a patient to withstand an embolic event should be considered before fixation of the femoral component with use of a conventional cementing technique is planned. AN - CN-00164842 AU - Pitto, R. P. AU - Koessler, M. AU - Kuehle, J. W. DO - 10.2106/00004623-199906000-00010 KW - Aged Arthroplasty, Replacement, Hip [instrumentation, *methods, statistics & numerical data] Bone Cements [*therapeutic use] Cementation [instrumentation, *methods] Echocardiography, Transesophageal Embolism, Fat [diagnostic imaging, *prevention & control] Female Hip Prosthesis [statistics & numerical data] Humans Intraoperative Complications [diagnostic imaging, *prevention & control] Male Middle Aged Monitoring, Intraoperative Osteoarthritis, Hip [diagnostic imaging, surgery] Prospective Studies Vacuum M1 - 6 M3 - Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1999 SP - 831‐843 ST - Comparison of fixation of the femoral component without cement and fixation with use of a bone-vacuum cementing technique for the prevention of fat embolism during total hip arthroplasty. A prospective, randomized clinical trial T2 - Journal of bone and joint surgery. American volume TI - Comparison of fixation of the femoral component without cement and fixation with use of a bone-vacuum cementing technique for the prevention of fat embolism during total hip arthroplasty. A prospective, randomized clinical trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00164842/full VL - 81 ID - 830023 ER - TY - JOUR AN - CN-00156258 AU - Pitto, R. P. AU - Kössler, M. AU - Draenert, K. KW - Aged Aged, 80 and over Arthroplasty, Replacement, Hip Bone Cements Bone Marrow Embolism, Fat [*prevention & control] Female Humans Intraoperative Complications [*prevention & control] Male Prospective Studies Pulmonary Embolism [*prevention & control] Risk Factors Vacuum M1 - 4 M3 - Clinical Trial; News; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1998 SP - Oa24 ST - Prevention of fat and bone marrow embolism in cemented total hip endoprosthesis with vacuum cement technique T2 - Zeitschrift fur orthopadie und ihre grenzgebiete TI - Prevention of fat and bone marrow embolism in cemented total hip endoprosthesis with vacuum cement technique UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00156258/full VL - 136 ID - 830059 ER - TY - JOUR AB - The aim of this study was to assess the relevance of drainage placed along the linea aspera for the prevention of fat embolism and cardiopulmonary impairment during the insertion of a cemented stem. We studied 40 patients with coxarthrosis randomly allocated to total hip arthroplasty with proximal drainage or without it. The venting hole for the drainage of the medullary cavity was placed posteriorly, between the greater and the smaller trochanter, in the prolongation of the linea aspera. The heart was monitored intraoperatively by a echocardiography probe positioned in the patient's oesophagus. During the operation we monitored the hemodynamics and blood gas values. Severe embolic events were observed in 85% of the control group and in 20% of the drainage group (P = 0.01). Embolism occurred during the insertion of the femoral component and continued after reduction of the hip joint. After major embolism, the pulmonary shunt values increased significantly in the control group (+22.7%), but there were no marked changes in the drainage group (+7.1%). The logical therapeutic measure to avoid intravasation of bone marrow, fat, and bone debris during the insertion of the femoral component is to prevent the rise of intraosseous pressure. The drainage of the venous system located along the linea aspera significantly reduces the risk of intraoperative embolism and cardiopulmonary impairment. AN - CN-00164879 AU - Pitto, R. P. AU - Schramm, M. AU - Hohmann, D. AU - Kössler, M. DO - 10.1007/s004020050378 KW - Aged Arthroplasty, Replacement, Hip Drainage Embolism, Fat [*prevention & control] Female Humans Male Middle Aged Postoperative Complications [*prevention & control] Pressure Prospective Studies Treatment Outcome M1 - 3‐4 M3 - Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1999 SP - 146‐150 ST - Relevance of the drainage along the linea aspera for the reduction of fat embolism during cemented total hip arthroplasty. A prospective, randomized clinical trial T2 - Archives of orthopaedic and trauma surgery TI - Relevance of the drainage along the linea aspera for the reduction of fat embolism during cemented total hip arthroplasty. A prospective, randomized clinical trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00164879/full VL - 119 ID - 830021 ER - TY - JOUR AB - The aim of this study was to analyze the technical results, the extraosseous cement leakages, and the complications in our first 500 vertebroplasty procedures. Patients with osteoporotic vertebral compression fractures or osteolytic lesions caused by malignant tumors were treated with CT-guided vertebroplasty. The technical results were documented with CT, and the extraosseous cement leakages and periinterventional clinical complications were analyzed as well as secondary fractures during follow-up. Since 2002, 500 vertebroplasty procedures have been performed on 251 patients (82 male, 169 female, age 71.5 +/- 9.8 years) suffering from osteoporotic compression fractures (n=217) and/or malignant tumour infiltration (n=34). The number of vertebrae treated per patient was 1.96 +/- 1.29 (range 1-10); the numbers of interventions per patient and interventions per vertebra were 1.33 +/- 0.75 (range 1-6) and 1.01 +/- 0.10, respectively. The amount of PMMA cement was 4.5 +/- 1.9 ml and decreased during the 5-year period of investigation. The procedure-related 30-day mortality was 0.4% (1 of 251 patients) due to pulmonary embolism in this case. The procedure-related morbidity was 2.8% (7/251), including one acute coronary syndrome beginning 12 h after the procedure and one missing patellar reflex in a patients with a cement leak near the neuroformen because of osteolytic destruction of the respective pedicle. Additionally, one patient developed a medullary conus syndrome after a fall during the night after vertebroplasty, two patients reached an inadequate depth of conscious sedation, and two cases had additional fractures (one pedicle fracture, one rib fracture). The overall CT-based cement leak rate was 55.4% and included leakages predominantly into intervertebral disc spaces (25.2%), epidural vein plexus (16.0%), through the posterior wall (2.6%), into the neuroforamen (1.6%), into paravertebral vessels (7.2%), and combinations of these and others. During follow-up (15.2 +/- 13.4 months) the secondary fracture rate was 17.1%, including comparable numbers for vertebrae at adjacent and distant levels. The presence of intradiscal cement leaks was not associated with increased adjacent fracture rates. CT-guided vertebroplasty is safe and effective for treatment of vertebral compression fractures. CT-fluoroscopy provides an excellent control of the posterior vertebral wall. The number of cement leakages alone is not directly associated with clinical complications. However, even small volumes of pulmonary PMMA embolism might be responsible for the fatal outcome in cases with underlying cardiopulmonary insufficiency. AD - [Pitton, Michael Bernhard; Herber, Sascha; Koch, Ulrike; Oberholzer, Katja; Dueber, Christoph] Johannes Gutenberg Univ Mainz, Dept Diagnost & Intervent Radiol, D-55131 Mainz, Germany. [Drees, Philip] Johannes Gutenberg Univ Mainz, Dept Orthoped Surg, Univ Hosp, D-55131 Mainz, Germany. Pitton, MB (corresponding author), Johannes Gutenberg Univ Mainz, Dept Diagnost & Intervent Radiol, Langenbeckstr 1, D-55131 Mainz, Germany. pitton@radiologie.klinik.unimainz.de AN - WOS:000259964200025 AU - Pitton, M. B. AU - Herber, S. AU - Koch, U. AU - Oberholzer, K. AU - Drees, P. AU - Duber, C. DA - Nov DO - 10.1007/s00330-008-1020-z J2 - Eur. Radiol. KW - Osteoporosis Vertebroplasty Complications PERCUTANEOUS VERTEBROPLASTY PULMONARY-EMBOLISM COMPRESSION FRACTURES VERTEBRAL FRACTURES RARE COMPLICATION PREDICTIVE-VALUE POLYMETHYLMETHACRYLATE VENOGRAPHY OUTCOMES VOLUME Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 11 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2008 SN - 0938-7994 SP - 2568-2578 ST - CT-guided vertebroplasty: analysis of technical results, extraosseous cement leakages, and complications in 500 procedures T2 - European Radiology TI - CT-guided vertebroplasty: analysis of technical results, extraosseous cement leakages, and complications in 500 procedures UR - ://WOS:000259964200025 VL - 18 ID - 830369 ER - TY - JOUR AB - The aim of this study was to analyze the technical results, the extraosseous cement leakages, and the complications in our first 500 vertebroplasty procedures. Patients with osteoporotic vertebral compression fractures or osteolytic lesions caused by malignant tumors were treated with CT-guided vertebroplasty. The technical results were documented with CT, and the extraosseous cement leakages and periinterventional clinical complications were analyzed as well as secondary fractures during follow-up. Since 2002, 500 vertebroplasty procedures have been performed on 251 patients (82 male, 169 female, age 71.5 +/- 9.8 years) suffering from osteoporotic compression fractures (n = 217) and/or malignant tumour infiltration (n = 34). The number of vertebrae treated per patient was 1.96 +/- 1.29 (range 1-10); the numbers of interventions per patient and interventions per vertebra were 1.33 +/- 0.75 (range 1-6) and 1.01 +/- 0.10, respectively. The amount of PMMA cement was 4.5 +/- 1.9 ml and decreased during the 5-year period of investigation. The procedure-related 30-day mortality was 0.4% (1 of 251 patients) due to pulmonary embolism in this case. The procedure-related morbidity was 2.8% (7/251), including one acute coronary syndrome beginning 12 h after the procedure and one missing patellar reflex in a patients with a cement leak near the neuroformen because of osteolytic destruction of the respective pedicle. Additionally, one patient developed a medullary conus syndrome after a fall during the night after vertebroplasty, two patients reached an inadequate depth of conscious sedation, and two cases had additional fractures (one pedicle fracture, one rib fracture). The overall CT-based cement leak rate was 55.4% and included leakages predominantly into intervertebral disc spaces (25.2%), epidural vein plexus (16.0%), through the posterior wall (2.6%), into the neuroforamen (1.6%), into paravertebral vessels (7.2%), and combinations of these and others. During follow-up (15.2 +/- 13.4 months) the secondary fracture rate was 17.1%, including comparable numbers for vertebrae at adjacent and distant levels. The presence of intradiscal cement leaks was not associated with increased adjacent fracture rates. CT-guided vertebroplasty is safe and effective for treatment of vertebral compression fractures. CT-fluoroscopy provides an excellent control of the posterior vertebral wall. The number of cement leakages alone is not directly associated with clinical complications. However, even small volumes of pulmonary PMMA embolism might be responsible for the fatal outcome in cases with underlying cardiopulmonary insufficiency. AD - Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University of Mainz, Mainz, Germany. pitton@radiologie.klinik.uni-mainz.de AN - 18523783 AU - Pitton, M. B. AU - Herber, S. AU - Koch, U. AU - Oberholzer, K. AU - Drees, P. AU - Düber, C. DA - Nov DO - 10.1007/s00330-008-1020-z DP - NLM ET - 2008/06/05 J2 - European radiology KW - Adult Aged Aged, 80 and over Bone Cements/*therapeutic use Comorbidity Extravasation of Diagnostic and Therapeutic Materials/*mortality Female Germany/epidemiology Humans Male Middle Aged Radiography, Interventional/*statistics & numerical data Retrospective Studies Risk Assessment/*methods Risk Factors Tomography, X-Ray Computed/*statistics & numerical data Vertebroplasty/*mortality LA - eng M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 0938-7994 SP - 2568-78 ST - CT-guided vertebroplasty: analysis of technical results, extraosseous cement leakages, and complications in 500 procedures T2 - Eur Radiol TI - CT-guided vertebroplasty: analysis of technical results, extraosseous cement leakages, and complications in 500 procedures VL - 18 ID - 828695 ER - TY - JOUR AB - The aim of this study was to analyze the technical results, the extraosseous cement leakages, and the complications in our first 500 vertebroplasty procedures. Patients with osteoporotic vertebral compression fractures or osteolytic lesions caused by malignant tumors were treated with CT-guided vertebroplasty. The technical results were documented with CT, and the extraosseous cement leakages and periinterventional clinical complications were analyzed as well as secondary fractures during follow-up. Since 2002, 500 vertebroplasty procedures have been performed on 251 patients (82 male, 169 female, age 71.5 +/- 9.8 years) suffering from osteoporotic compression fractures (n = 217) and/or malignant tumour infiltration (n = 34). The number of vertebrae treated per patient was 1.96 +/- 1.29 (range 1-10); the numbers of interventions per patient and interventions per vertebra were 1.33 +/- 0.75 (range 1-6) and 1.01 +/- 0.10, respectively. The amount of PMMA cement was 4.5 +/- 1.9 ml and decreased during the 5-year period of investigation. The procedure-related 30-day mortality was 0.4% (1 of 251 patients) due to pulmonary embolism in this case. The procedure-related morbidity was 2.8% (7/251), including one acute coronary syndrome beginning 12 h after the procedure and one missing patellar reflex in a patients with a cement leak near the neuroformen because of osteolytic destruction of the respective pedicle. Additionally, one patient developed a medullary conus syndrome after a fall during the night after vertebroplasty, two patients reached an inadequate depth of conscious sedation, and two cases had additional fractures (one pedicle fracture, one rib fracture). The overall CT-based cement leak rate was 55.4% and included leakages predominantly into intervertebral disc spaces (25.2%), epidural vein plexus (16.0%), through the posterior wall (2.6%), into the neuroforamen (1.6%), into paravertebral vessels (7.2%), and combinations of these and others. During follow-up (15.2 +/- 13.4 months) the secondary fracture rate was 17.1%, including comparable numbers for vertebrae at adjacent and distant levels. The presence of intradiscal cement leaks was not associated with increased adjacent fracture rates. CT-guided vertebroplasty is safe and effective for treatment of vertebral compression fractures. CT-fluoroscopy provides an excellent control of the posterior vertebral wall. The number of cement leakages alone is not directly associated with clinical complications. However, even small volumes of pulmonary PMMA embolism might be responsible for the fatal outcome in cases with underlying cardiopulmonary insufficiency. AD - Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University of Mainz, Mainz, Germany Department of Diagnostic and Interventional Radiology, Johannes Gutenberg-University of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany, pitton@radiologie.klinik.uni-mainz.de. AN - 105617870. Language: English. Entry Date: 20090417. Revision Date: 20200402. Publication Type: journal article AU - Pitton, M. B. AU - Herber, S. AU - Koch, U. AU - Oberholzer, K. AU - Drees, P. AU - Düber, C. AU - Pitton, Michael Bernhard AU - Herber, Sascha AU - Koch, Ulrike AU - Oberholzer, Katja AU - Drees, Philip AU - Düber, Christoph DB - cin20 DO - 10.1007/s00330-008-1020-z DP - EBSCOhost KW - Bone Cements -- Therapeutic Use Extravasation of Diagnostic and Therapeutic Materials -- Mortality Kyphoplasty -- Mortality Radiography, Interventional -- Statistics and Numerical Data Risk Assessment -- Methods Tomography, X-Ray Computed -- Statistics and Numerical Data Adult Aged Aged, 80 and Over Comorbidity Female Germany Male Middle Age Retrospective Design Risk Factors Human M1 - 11 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2008 SN - 0938-7994 SP - 2568-2578 ST - CT-guided vertebroplasty: analysis of technical results, extraosseous cement leakages, and complications in 500 procedures T2 - European Radiology TI - CT-guided vertebroplasty: analysis of technical results, extraosseous cement leakages, and complications in 500 procedures UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105617870&site=ehost-live&scope=site VL - 18 ID - 830744 ER - TY - JOUR AD - Intensive Care Unit, Dupuytren Teaching Hospital, Limoges, France. Electronic address: olivier.plateker@gmail.com. Intensive Care Unit, Dupuytren Teaching Hospital, Limoges, France; Inserm CIC1435, Dupuytren Teaching Hospital, Limoges, France; Inserm UMR 1092, University of Limoges, Limoges, France. Cardiology Department, Dupuytren Teaching Hospital, Limoges, France. Cardio-thoracic Surgery Department, Dupuytren Teaching Hospital, Limoges, France. AN - 32088176 AU - Plateker, O. AU - Daix, T. AU - Boulogne, C. AU - Rousselle, V. AU - Vignon, P. AU - Porterie, J. DA - Nov-Dec DO - 10.1016/j.jcct.2020.02.003 DP - NLM ET - 2020/02/24 J2 - Journal of cardiovascular computed tomography KW - Embolism Kyphoplasty Pericardium competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 1876-861x SP - e159-e160 ST - Post-kyphoplasty cement embolism migrating to the peritoneum through the right ventricle T2 - J Cardiovasc Comput Tomogr TI - Post-kyphoplasty cement embolism migrating to the peritoneum through the right ventricle VL - 14 ID - 829021 ER - TY - JOUR AB - We report on an 80-year-old female patient with osteoporotic collapse of the L1 vertebra who developed absolute stenosis of the spinal canal. During preoperative vertebra augmentation with PMMA (polymethylmethacrylate), pulmonary embolism developed due to perivertebral leakage of acrylic cement. According to the literature, leakage of PMMA during (percutaneous) vertebroplasty is a more frequent complication than assumed so far, In view of the favorable prognosis of osteoporotic vertebral compression fractures with noninvasive management, we emphasize the need for clear and individual indications and adequate technical settings. AD - Klinikum Fulda, Unfallchirurg Orthopad Klin, D-36043 Fulda, Germany. Klinikum Fulda, Klin Diagnost & Interventionelle Radiol, Fulda, Germany. Pleser, M (corresponding author), Klinikum Fulda, Unfallchirurg Orthopad Klin, Pacelliallee 4, D-36043 Fulda, Germany. mpleser@web.de AN - WOS:000224502400010 AU - Pleser, M. AU - Roth, R. AU - Worsdorfer, O. AU - Manke, C. DA - Sep DO - 10.1007/s00113-004-0763-5 J2 - Unfallchirurg KW - percutaneous vertebroplasty polymethylmethacrylate pulmonary embolism complication osteoporosis CEMENT HYPOTENSION MANAGEMENT Emergency Medicine Surgery LA - German M1 - 9 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2004 SN - 0177-5537 SP - 807-811 ST - Pulmonary embolism caused by PMMA in percutaneous vertebroplasty. Case report and review of the literature T2 - Unfallchirurg TI - Pulmonary embolism caused by PMMA in percutaneous vertebroplasty. Case report and review of the literature UR - ://WOS:000224502400010 VL - 107 ID - 830436 ER - TY - JOUR AB - We report on an 80-year-old female patient with osteoporotic collapse of the L1 vertebra who developed absolute stenosis of the spinal canal. During preoperative vertebra augmentation with PMMA (polymethylmethacrylate), pulmonary embolism developed due to perivertebral leakage of acrylic cement. According to the literature, leakage of PMMA during (percutaneous) vertebroplasty is a more frequent complication than assumed so far. In view of the favorable prognosis of osteoporotic vertebral compression fractures with noninvasive management, we emphasize the need for clear and individual indications and adequate technical settings. AD - Unfallchirurgisch-Orthopädische Klinik, Klinikum Fulda. mpleser@web.de AN - 15083278 AU - Pleser, M. AU - Roth, R. AU - Wörsdörfer, O. AU - Manke, C. DA - Sep DO - 10.1007/s00113-004-0763-5 DP - NLM ET - 2004/04/15 J2 - Der Unfallchirurg KW - Aged Aged, 80 and over Bone Cements/adverse effects/therapeutic use Diskectomy, Percutaneous/*adverse effects/methods Extravasation of Diagnostic and Therapeutic Materials/*complications/*diagnosis/prevention & control Female Humans Osteoporosis/complications/diagnosis/therapy Polymethyl Methacrylate/*adverse effects/therapeutic use Pulmonary Embolism/*chemically induced/*diagnosis/etiology Review Literature as Topic Spinal Fractures/diagnosis/etiology/*therapy Spinal Stenosis/diagnosis/etiology/therapy Treatment Outcome LA - ger M1 - 9 N1 - PubMed NLM literature search January 5, 2021 OP - Lungenembolie durch PMMA bei perkutaner Vertebroplastie. Fallbericht und Literaturübersicht. PY - 2004 SN - 0177-5537 (Print) 0177-5537 SP - 807-11 ST - [Pulmonary embolism caused by PMMA in percutaneous vertebroplasty. Case report and review of the literature] T2 - Unfallchirurg TI - [Pulmonary embolism caused by PMMA in percutaneous vertebroplasty. Case report and review of the literature] VL - 107 ID - 828924 ER - TY - JOUR AD - Neurosurgery, Neuroscienze Salute Mentale e Organi di Senso (NESMOS) Department, Faculty of Medicine and Psychology, "Sapienza" University of Rome, via di Grottarossa 1035-1039, 00189 Rome, Italy. Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza" University of Rome, Corso della Repubblica 79, 04100 Latina, Italy. Institute of Public Health, Section of Legal Medicine, Catholic University, L.go F. Vito 1, 00168 Rome, Italy. AN - 25463979 AU - Polli, F. M. AU - Marongiu, A. AU - Miscusi, M. AU - De-Giorgio, F. AU - Raco, A. DA - Feb 1 DO - 10.1016/j.spinee.2014.10.029 DP - NLM ET - 2014/12/03 J2 - The spine journal : official journal of the North American Spine Society KW - Aged Bone Cements/*adverse effects/therapeutic use Embolism/*diagnostic imaging/etiology Female Humans Radiography Vertebroplasty/*adverse effects LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 1529-9430 SP - 376 ST - Cardiopulmonary cement embolism after vertebroplasty T2 - Spine J TI - Cardiopulmonary cement embolism after vertebroplasty VL - 15 ID - 828823 ER - TY - JOUR AB - The article describes a fatal case of endoprothesis operation of the hip joint; autopsy showed a massive fat embolism of all parenchymatous organs. A discussion is presented of possible causes for the development of this phenomenon in relation to the implantation of bone cement in the organism. In this context, fat embolism occurs in a matter of seconds which particularly in the more aged patients with already impaired circulatory deficiencies appears to be of an irreparable nature. AD - Chir. Abt., Krankenh. Porz a. Rhein AU - Posth, H. E. DB - Embase KW - bone cement fat embolism major clinical study therapy total hip prosthesis LA - German M1 - 3 N1 - Embase Elsevier literature search January 5, 2021 PY - 1977 SN - 0009-4846 SP - 519-524 ST - Massive fat embolism following implantation of bone cement; a matter of seconds? T2 - Chirurgische Praxis TI - Massive fat embolism following implantation of bone cement; a matter of seconds? UR - https://www.embase.com/search/results?subaction=viewrecord&id=L8183597&from=export VL - 22 ID - 829971 ER - TY - JOUR AB - PURPOSE: To prospectively evaluate the incidence of pulmonary cement embolism (PCE) after vertebroplasty in procedures performed under real-time computed tomographic (CT) fluoroscopy guidance. MATERIALS AND METHODS: A total of 85 vertebroplasties were performed in 51 consecutive patients (31 women, 20 men; mean age, 71.9 y; range, 48-92 y) in 51 sessions. The needle was inserted with guidance from intermittent single-shot CT scans, and intermittent CT fluoroscopy was used during cement injection only. To reduce the risk of extravertebral or extraosseous leakage, several procedures (cement injection stopping/slowing, needle position changes) were employed. The chest and treated bone were scanned immediately after vertebroplasty. These CT images included the entire thorax as well as the treated vertebrae. RESULTS: No cement emboli were observed on CT after vertebroplasty. After 85 vertebroplasty procedures, 44 extravertebral leaks were detected. Epidural leaks were observed on CT in six treated vertebrae (7%), in 12 cases in the anterior external venous plexus (14.1%), in five in the azygos vein (5.8%), in 19 in the disc space (22%), and in two in the foraminal space (2.3%). On a per-patient basis, the odds of leaks increased with the number of vertebroplasties (P = .05) and the volume of cement used (P = .0412). There was also a higher probability of leak (P < .05) for osteoporotic vertebral compression fractures (67.9%; 95% confidence interval, 47.7%-84.1%) than osteolytic spinal metastases (34.8%; 16.4%-57.3%). CONCLUSIONS: PCE did not occur after vertebroplasty under CT fluoroscopy guidance. Further larger prospective vertebroplasty studies are needed to compare the rates of PCE for CT versus conventional fluoroscopic guidance. AD - Radiology Department, Percy Military Hospital, Avenue Henri Barbusse, 92140 Clamart, France. Electronic address: potet_julien@yahoo.fr. AN - 23958047 AU - Potet, J. AU - Weber-Donat, G. AU - Curis, E. AU - Arnaud, F. X. AU - Thome, A. AU - Valbousquet, L. AU - Peroux, E. AU - Geffroy, Y. AU - Bouzad, C. AU - Kervella, Y. AU - Lahutte, M. AU - Ukkola-Pons, E. AU - Baccialone, J. AU - Teriitehau, C. A. DA - Dec DO - 10.1016/j.jvir.2013.05.048 DP - NLM ET - 2013/08/21 J2 - Journal of vascular and interventional radiology : JVIR KW - Aged Aged, 80 and over Bone Cements/*adverse effects Chi-Square Distribution Female Fluoroscopy Foreign-Body Migration/diagnosis/*epidemiology France/epidemiology Humans Incidence Linear Models Logistic Models Male Middle Aged *Multidetector Computed Tomography Odds Ratio Prospective Studies Pulmonary Embolism/diagnosis/*epidemiology Radiography, Interventional/*methods Risk Factors Treatment Outcome Vertebroplasty/*adverse effects Ci Ovcf Pce Pmma Vas confidence interval osteoporotic vertebral compression fracture polymethylmethacrylate pulmonary cement embolism visual analog scale LA - eng M1 - 12 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1051-0443 SP - 1853-60 ST - Incidence of pulmonary cement embolism after real-time CT fluoroscopy-guided vertebroplasty T2 - J Vasc Interv Radiol TI - Incidence of pulmonary cement embolism after real-time CT fluoroscopy-guided vertebroplasty VL - 24 ID - 828661 ER - TY - JOUR AD - Radiology Department, Percy Military Hospital, Avenue Henri Barbusse, 92140 Clamart, France. Electronic address: potet_julien@yahoo.fr. AN - 104119222. Language: English. Entry Date: 20140725. Revision Date: 20150710. Publication Type: Journal Article AU - Potet, Julien AU - Weber-Donat, Gabrielle AU - Curis, Emmanuel AU - Arnaud, François-Xavier AU - Thome, Alphonse AU - Valbousquet, Laura AU - Peroux, Evelyne AU - Geffroy, Yann AU - Bouzad, Caroline AU - Kervella, Yann AU - Lahutte, Marion AU - Ukkola-Pons, Elsa AU - Baccialone, Jacques AU - Teriitehau, Christophe A. DB - cin20 DO - 10.1016/j.jvir.2013.05.048 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Foreign-Body Migration -- Epidemiology Multidetector Computed Tomography Pulmonary Embolism -- Epidemiology Radiography, Interventional -- Methods Kyphoplasty -- Adverse Effects Aged Aged, 80 and Over Chi Square Test Female Fluoroscopy Foreign-Body Migration -- Diagnosis France Human Incidence Linear Regression Logistic Regression Male Middle Age Odds Ratio Prospective Studies Pulmonary Embolism -- Diagnosis Risk Factors Treatment Outcomes M1 - 12 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2013 SN - 1051-0443 SP - 1853-1860 ST - Incidence of Pulmonary Cement Embolism after Real-Time CT Fluoroscopy-guided Vertebroplasty T2 - Journal of Vascular & Interventional Radiology TI - Incidence of Pulmonary Cement Embolism after Real-Time CT Fluoroscopy-guided Vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104119222&site=ehost-live&scope=site VL - 24 ID - 830647 ER - TY - JOUR AB - A 78-year old woman with osteoporotic collapse of the Th12 and L4 vertebrae was treated by percutaneous vertebroplasty (pVp) with PMMA (polymethylmethacrylate). Postoperatively, the Th11 and L1 vertebrae collapsed so that a second vertebroplasty was performed. Postoperatively, the patient developed a severe pulmonary embolism which was treated conservatively. In this report, the complications of pulmonary embolism, perivertebral leakage of PMMA and of additional vertebral collapses after pVp are discussed. AD - Unfallchirurgische Klinik, Klinikum Hildesheim GmbH. AN - 15856167 AU - Pott, L. AU - Wippermann, B. AU - Hussein, S. AU - Günther, T. AU - Brüsch, U. AU - Fremerey, R. DA - Jul DO - 10.1007/s00132-005-0785-x DP - NLM ET - 2005/04/28 J2 - Der Orthopade KW - Aged Extravasation of Diagnostic and Therapeutic Materials/*complications Female Humans Laminectomy/*adverse effects Polymethyl Methacrylate/*adverse effects/*therapeutic use Pulmonary Embolism/*chemically induced Spinal Fractures/complications/*etiology Thoracic Vertebrae/drug effects/*surgery Treatment Failure LA - ger M1 - 7 N1 - PubMed NLM literature search January 5, 2021 OP - PMMA Lungenembolisation und postinterventionelle Anschlussfrakturen nach perkutaner Vertebroplastie. PY - 2005 SN - 0085-4530 (Print) 0085-4530 SP - 698-700, 702 ST - [PMMA pulmonary embolism and post interventional associated fractures after percutaneous vertebroplasty] T2 - Orthopade TI - [PMMA pulmonary embolism and post interventional associated fractures after percutaneous vertebroplasty] VL - 34 ID - 828915 ER - TY - JOUR AB - Objectives: In long bones, cementoplasty alone does not provide sufficient stability, which may cause secondary fractures. This study reviewed the safety and efficacy of reinforced cementoplasty (RC) (percutaneous internal fixation using dedicated spindles combined with cementoplasty) for unstable malignant lesions of the cervicotrochanteric region (CTR) of the proximal femur.Methods: Eighteen consecutive patients (nine women [50%] and nine men [50%]; mean age 55.1 ± 16.2 years; range 22-85) underwent RC for 19 unstable lesions of the CTR (16/19 [84.2%] bone metastases, 3/19 [15.8%] multiple myeloma lesions). All the patients were considered unsuitable for surgery. Clinical outcome was judged with a mean follow-up of 8.8 ± 7.2 months (range 1-27). The primary endpoints were occurrence of secondary fractures during the follow-up period and local pain relief measured by a visual analogue scale (VAS).Results: No secondary fracture occurred. Mean VAS improved from 5.9 ± 3.1 (range 0-10) to 2.3 ± 2.4 (range 0-7) at 1 month (p = 0.001) to 1.6 ± 1.7 (range 0-5) at final follow-up (p = 0.0002). One symptomatic cement pulmonary embolism was recorded.Conclusion: RC is an original minimally invasive technique providing pain relief and effective bone stability for unstable malignant lesions of the cervicotrochanteric region in patients unsuitable for open surgery.Key Points: • Reinforced cementoplasty (RC) combines intralesional spindling with cementoplasty. • RC provides effective bone stability and pain relief. • RC is a suitable minimally invasive option for patients in poor general condition. AD - Department of Interventional Neuroradiology , Pitié-Salpêtrière Hospital , 47-83 Boulevard de l'Hôpital 75013 Paris France Department of Orthopaedic Surgery , Pitié-Salpêtrière Hospital , Paris France Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France Paris VI University Pierre et Marie Curie, Paris, France AN - 124485404. Language: English. Entry Date: 20180330. Revision Date: 20200402. Publication Type: journal article AU - Premat, Kévin AU - Clarençon, Frédéric AU - Bonaccorsi, Raphael AU - Degos, Vincent AU - Cormier, Évelyne AU - Chiras, Jacques AU - Premat, Kévin AU - Clarençon, Frédéric AU - Cormier, Évelyne DB - cin20 DO - 10.1007/s00330-017-4774-3 DP - EBSCOhost KW - Femoral Neoplasms -- Therapy Cementoplasty -- Methods Methylmethacrylates -- Therapeutic Use Bone Cements -- Therapeutic Use Human Adult Young Adult Retrospective Design Tomography, X-Ray Computed -- Methods Hip Fractures Fracture Fixation -- Methods Pain -- Therapy Hip Fractures -- Therapy Pain Measurement -- Methods Middle Age Visual Analog Scaling Female Aged Femoral Neoplasms Aged, 80 and Over Male Treatment Outcomes Validation Studies Comparative Studies Evaluation Research Multicenter Studies Scales M1 - 9 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 0938-7994 SP - 3973-3982 ST - Reinforced cementoplasty using dedicated spindles in the management of unstable malignant lesions of the cervicotrochanteric region T2 - European Radiology TI - Reinforced cementoplasty using dedicated spindles in the management of unstable malignant lesions of the cervicotrochanteric region UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=124485404&site=ehost-live&scope=site VL - 27 ID - 830564 ER - TY - JOUR AB - Objectives: To evaluate, on a long-term basis, the safety and effectiveness of percutaneous alcohol embolization (PAE) combined with percutaneous vertebroplasty (PVP) as a sole treatment for aggressive vertebral haemangiomas (AVHs) with epidural extension.Methods: From 1996 to 2015, 26 consecutive patients (15 women [58%] and 11 men; mean age 51.8 years [range: 19-75 years]) underwent PAE combined with PVP (performed at day 15) for the treatment of 27 AVHs with epidural extension. Clinical outcome was evaluated with a mean delay of 88.3 ± 53.3 months (range: 22-217 months). The primary endpoint was pain relief evaluated with a visual analogue scale (VAS).Results: Pre-procedure mean VAS score was 7.23 ± 1.3 and significantly improved at last follow-up (m = 3.11 ± 1.9; p < 0.001). Ten patients (38.5%) remained asymptomatic. Eighty-eight percent of the patients with neurosensory disorders had complete regression of these symptoms. Two of the three patients with motor deficit did not show any improvement. No major complication was recorded.Conclusions: PAE combined with PVP is a minimally invasive safe and effective therapeutic approach for AVH with epidural involvement, even on long-term clinical outcome. This technique appears mainly effective for pain and neurosensory symptoms, but seems less effective for motor deficit relief.Key Points: • Combination of PAE with PVP is a safe technique. • PAE combined with PVP is an effective treatment for sensory symptoms. • This strategy seems less effective in patients with motor deficits. AD - Department of Interventional Neuroradiology , Pitié-Salpêtrière Hospital , 47-83 Boulevard de l'Hôpital 75013 Paris France Department of Anaesthesiology , Pitié-Salpêtrière Hospital , Paris France Department of Orthopaedic Surgery , Pitié-Salpêtrière Hospital , Paris France Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l'Hôpital, 75013, Paris, France Paris VI University Pierre et Marie Curie, Paris, France Department of Orthopaedic Surgery, Pitié-Salpêtrière Hospital, Paris, France AN - 123476737. Language: English. Entry Date: 20180228. Revision Date: 20200402. Publication Type: journal article. Journal Subset: Biomedical AU - Premat, Kévin AU - Clarençon, Frédéric AU - Cormier, Évelyne AU - Mahtout, Jugurtha AU - Bonaccorsi, Raphaël AU - Degos, Vincent AU - Chiras, Jacques AU - Premat, Kévin AU - Clarençon, Frédéric AU - Cormier, Évelyne AU - Bonaccorsi, Raphaël DB - cin20 DO - 10.1007/s00330-016-4664-0 DP - EBSCOhost KW - Spinal Cord Neoplasms -- Therapy Hemangioma -- Therapy Thoracic Vertebrae Embolization, Therapeutic -- Methods Chemoembolization, Therapeutic -- Methods Spinal Neoplasms -- Therapy Vertebroplasty -- Methods Combined Modality Therapy Treatment Outcomes Hemangioma -- Diagnosis Spinal Neoplasms -- Complications Pain -- Etiology Ethanol -- Administration and Dosage Aged Adult Time Factors Neoplasm Invasiveness Pain -- Therapy Retrospective Design Middle Age Male Angiography, Digital Subtraction -- Methods Spinal Cord Neoplasms -- Complications Young Adult Pain Measurement Spinal Neoplasms -- Diagnosis Female Hemangioma -- Complications Prospective Studies Spinal Cord Neoplasms -- Diagnosis Scales M1 - 7 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 0938-7994 SP - 2860-2867 ST - Long-term outcome of percutaneous alcohol embolization combined with percutaneous vertebroplasty in aggressive vertebral hemangiomas with epidural extension T2 - European Radiology TI - Long-term outcome of percutaneous alcohol embolization combined with percutaneous vertebroplasty in aggressive vertebral hemangiomas with epidural extension UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=123476737&site=ehost-live&scope=site VL - 27 ID - 830566 ER - TY - JOUR AB - Objectives: Osteoporotic vertebral compression fractures (OVCFs) are an important health issue for which minimally invasive techniques are a feasible treatment. The SpineJack® (Vexim) is an intravertebral expandable system designed to improve the correction of the structural modifications caused by OVCFs. Its ability to stabilise and reduce OVCFs at the acute phase being already well established, we sought to evaluate the feasibility of vertebral augmentation with the SpineJack® in chronic kyphotic OVCFs. Methods: All consecutive patients treated with the SpineJack® were prospectively included if they met the following criteria: (1) OVCF considered unstable (grade A3 according to Magerl’s classification). (2) Local kyphotic angle ≥ 20°. (3) OVCF older than 6 weeks. (4) Back pain with visual analogue scale (VAS) ≥ 4. Results: Nineteen consecutive patients (16 women [84.2%] and 3 men [15.8%]; mean age 73.2 ± 8.2 years) were included. Treatment was performed after a mean delay of 5.8 months ± 2.9 (range 1.5–12). Median visual analogue scale significantly improved from 7 preoperatively (IQR 6–9) to 2 (IQR 1–5) at 6 months (p < 0.01). Significant kyphosis reduction (i.e. ≥ 30%) was obtained in 94.7% of cases. Secondary adjacent level fractures (SALFs) were noted in 21.1% of cases and were correlated with the importance of the kyphosis reduction. Conclusions: Vertebral augmentation with the SpineJack® is feasible and seems able to correct major structural deformities in chronic OVCFs. SALFs were noted in a substantial amount of cases. Preventive adjacent vertebroplasty might be useful in patients with several risk factors for SALFs. Key Points: • Vertebral augmentation with SpineJack® is effective to correct major structural deformities e.g. height loss and kyphosis. • Successful reduction is reachable with SpineJack® in chronic (older than 6 weeks) OVCFs. • Aggressive reduction of major kyphosis might promote SALFs and complementary adjacent vertebroplasties prevent their occurrence. AD - F. Clarençon, Department of Neuroradiology, Pitié-Salpêtrière Hospital, 47-83 Boulevard de l’Hôpital, Paris, France AU - Premat, K. AU - Vande Perre, S. AU - Cormier, É AU - Shotar, E. AU - Degos, V. AU - Morardet, L. AU - Fargeot, C. AU - Clarençon, F. AU - Chiras, J. DB - Embase Medline DO - 10.1007/s00330-018-5544-6 KW - bone cement device orthopedic surgical equipment spinejack adult aged article backache body height chronic disease clinical article compression fracture female follow up fracture human kyphosis lung embolism male postoperative period priority journal spine fracture spine surgery vertebral augmentation very elderly visual analog scale LA - English M1 - 12 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1432-1084 0938-7994 SP - 4985-4991 ST - Vertebral augmentation with the SpineJack® in chronic vertebral compression fractures with major kyphosis T2 - European Radiology TI - Vertebral augmentation with the SpineJack® in chronic vertebral compression fractures with major kyphosis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L622556553&from=export http://dx.doi.org/10.1007/s00330-018-5544-6 VL - 28 ID - 829172 ER - TY - JOUR AB - Background: The literature suggests that a cemented long-stem femoral arthroplasty is associated with increased intraoperative and perioperative risks. Embolic events may precipitate cardiopulmonary complications and even death; by contrast, others have reported that the use of a cemented long-stem femoral arthroplasty in patients with metastatic bone disease is a safe procedure.Questions/purposes: Specifically, in this study, we sought to identify (1) intraoperative complications potentially attributable to the use of cemented long-stem femoral components, and (2) early postoperative complications potentially attributable to the use of cemented long-stem femoral components in patients having an arthroplasty for metastatic bone disease.Methods: In this study, we performed a retrospective chart review of 42 patients (44 arthroplasties), in which the same surgical technique was used. The primary outcome measure was perioperative complications, including intraoperative cement-associated desaturation, cement-associated hypotension, sympathomimetic administration, postoperative hypotension/desaturation, and death.Results: In this series, 19% of the patients had cement-associated hypotension and sympathomimetics were administered to 48%. Two patients required prolonged intubation. One death occurred during hospitalization but there were no cardiopulmonary events.Conclusions: This study showed that some patients experienced postoperative desaturation, prolonged intubation, and increased use of sympathomimetics, however, these events were short-lived and did not result in patient mortality. Although there are significant risks to cemented long-stem femoral arthroplasty, it can be performed with a low risk of fatal cardiopulmonary complications and remains a surgical option when treating patients with metastatic bone disease.Level Of Evidence: Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence. AD - Department of Orthopaedics Sarcoma Services, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive Salt Lake City 84112 USA University of Utah School of Medicine, Salt Lake City USA Department of Orthopaedic Surgery, University of Utah, Salt Lake City USA Department of Orthopaedics Sarcoma Services, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope Drive, Salt Lake City, UT, 84112, USA AN - 90244831. Language: English. Entry Date: 20140606. Revision Date: 20180508. Publication Type: journal article. Journal Subset: Biomedical AU - Price, Shawn AU - Farukhi, M. AU - Jones, Kevin AU - Aoki, Stephen AU - Randall, R. AU - Price, Shawn L. AU - Farukhi, M. Aabid AU - Jones, Kevin B. AU - Aoki, Stephen K. AU - Randall, R. Lor DB - cin20 DO - 10.1007/s11999-013-3113-5 DP - EBSCOhost KW - Hip Joint -- Surgery Arthroplasty, Replacement, Hip -- Adverse Effects Postoperative Complications -- Etiology Bone Neoplasms -- Surgery Carcinoma -- Surgery Bone Cements Prosthesis Failure Hip Joint -- Pathology Treatment Outcomes Female Retrospective Design Middle Age Male Bone Neoplasms Arthroplasty, Replacement, Hip -- Mortality Carcinoma Short Portable Mental Status Questionnaire M1 - 10 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2013 SN - 0009-921X SP - 3303-3307 ST - Complications of cemented long-stem hip arthroplasty in metastatic bone disease revisited T2 - Clinical Orthopaedics & Related Research TI - Complications of cemented long-stem hip arthroplasty in metastatic bone disease revisited UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=90244831&site=ehost-live&scope=site VL - 471 ID - 830649 ER - TY - JOUR AB - Indroduction: Kyphoplasty has been established as treatment for painful osteoporotic vertebral compression fractures for over ten years. Not only is prompt pain reduction achieved, but according to a new, large, long-term study, long-term survival is also increased. Material and Methods: Balloon kyphoplasty was performed for 564 patients from 2008-1-1 until 2011-7-31. In all cases, pain was rated more than 6/10 points, and recent fracture was evident on cross-sectional imaging (CT or MRT STIR T2) performed to supplement spine x-rays.Average patient age was 75.3 years. 71.3% of patients were female. Treated fracture levels ranged from T3 to L5. Results: A single level was treated in 372 cases, with two levels treated simultaneously in 128 cases, three levels in 48 cases, and four levels in 22 cases. Average operative time for all patients was 36 minutes. 8 different surgeons performed the procedures. Average convalescence time was 8 days which decreased progressively over the years. Pain was reduced from 8 preoperative 8 to 2.4 points postoperative in visual analogue scale. Six major complications (1.06%) occurred. In 2 cases, neurologic compromise occurred after dorsal extravasation of the cement. In one case there was incomplete hemiparesis at the T8 level with spontaneous complete remission after 3 months. The other case at L3 showed persistent grade 4 hip flexor paresis after mispuncture. There were 2 patient mortalities during hospital admission (a 93 year-old female of heart failure 4 days postoperatively after complaint-free mobilization, and a 78 yearold female of cardiopulmonary failure 26 days post-operation). There was one case of painful lateral stent protrusion (61 yearold female, L1). It was retrieved using transthoracic endoscopy. During thorascopy, there was diaphragmatic rupture with gastric herniation, requiring emergent laparotomy and diaphragm repair. The patient is now free of complaints. One patient experienced extensive cement extravasation into the lungs and large veins, which was initially asymptomatic. After 2.5 years, a cement embolus led to acute cardiac perforation requiring emergent thoracotomy. The pericardium was sutured. This patient survived and is currently symptom-free. Conclusion: Kyphoplasty is good procedure in treating painful osteoporotic fractures from lumbal to thoracal spine. Major complications occur seldom after kyphoplasty; however, they must be considered and clarified. AD - A. Prokop, Kliniken Sindelfingen, Klinikverbund Südwest, Unfallchirurgie, Sindelfingen, Germany AU - Prokop, A. AU - Dolezych, R. AU - Chmielnicki, M. DB - Embase DO - 10.1007/s00586-012-2522-6 KW - cement spine kyphoplasty society human patient female pain fracture extravasation procedures thoracotomy visual analog scale long term survival convalescence surgeon diaphragm rupture diaphragm vein embolism pericardium compression fracture operation duration mobilization hospital admission mortality imaging heart failure stent endoscopy paresis hernia laparotomy hip lung remission perforation fragility fracture hemiparesis LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 0940-6719 SP - 2338 ST - Major complications after kyphoplasty-analysis of 564 cases in 3.5 years T2 - European Spine Journal TI - Major complications after kyphoplasty-analysis of 564 cases in 3.5 years UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70969430&from=export http://dx.doi.org/10.1007/s00586-012-2522-6 VL - 21 ID - 829531 ER - TY - JOUR AB - Indroduction: Kyphoplasty has been established as treatment for painful osteoporotic vertebral compression fractures for over 15 years. Not only is prompt pain reduction achieved, but according to a new, large, long-term study, long-term survival is also increased. Methods: Balloon kyphoplasty was performed for 1167 patients from 2008-1-1 until 2016-5-31. In all cases, pain was rated more than 6/10 points, and recent fracture was evident on cross-sectional imaging (CT or MRI) performed to supplement spine x-rays. Average patient age was 77.4 years. 72.3% of patients were female. Treated fracture levels ranged from T3 to L5. Results: A single level was treated in 797 cases, with two levels treated simultaneously in 242 cases, three levels in 87 cases, and four levels in 43 cases. Average operative time for all patients was 26 minutes. 23 different surgeons performed the procedures. Average convalescence time was 8 days. Pain was reduced from preoperative 8.1 to 2.4 points postoperative in visual analogue scale. 11 major complications (0.9%) occurred. In 3 cases, neurologic compromise occurred after dorsal extravasation of the cement. In one case there was incomplete hemiparesis at the T8 level with spontaneous complete remission after 3 months. The other cases at L3 and L5 showed persistent hyposthesia after mispuncture and cemet leckage. There were 6 patients (0.5%) mortalities during hospital admission (87y. female heart failure 1. day, 93y. female heart failure 4 days postoperatively after complaint-free mobilization, a 78 year-old female of cardiopulmonary failure 26 days post-operation, 80y. female pulmonary embolism 5 days postoperatively, 84y female perforated bowl with peritonitis 26 days postop.). In one case (80y female) there was a subdural haematoma 2 days postoperatively after using cumarine with complette remission by conservativ treatment. There was one case of painful lateral cement protrusion (61 year-old female, L1). It was retrieved using transthoracic endoscopy. One patient experienced extensive cement extravasation into the lungs and large veins, which was initially asymptomatic. After 2.5 years, a cement embolus led to acute cardiac perforation requiring emergent thoracotomy. The pericardium was sutured. This patient survived and is currently symptom-free. Summary: Kyphoplasty is good procedure in treating painful osteoporotic fractures from lumbal to thoracal spine. Major complications occur seldom after kyphoplasty; however, they must be considered and clarified. AD - A. Prokop, Kliniken Sindelfingen, Klinikverbund-Südwest, Unfallchirurgie, Sindelfingen, Germany AU - Prokop, A. AU - Dolezych, R. AU - Chmielnicki, M. DB - Embase DO - 10.1007/s00586-016-4801-0 KW - cement coumarin adult aged complication controlled study convalescence dorsal region endoscopy extravasation female fragility fracture heart failure heart perforation hemiparesis hospital admission human hypesthesia kyphoplasty lung embolism major clinical study male middle aged mortality nervous system nuclear magnetic resonance imaging pain pericardium peritonitis remission spine subdural hematoma surgeon surgery symptom thoracotomy vein visual analog scale X ray LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 0940-6719 SP - 3826 ST - Complications after kyphoplasty in elderly - Analysis of 1167 cases in 8.5 years T2 - European Spine Journal TI - Complications after kyphoplasty in elderly - Analysis of 1167 cases in 8.5 years UR - https://www.embase.com/search/results?subaction=viewrecord&id=L613451489&from=export http://dx.doi.org/10.1007/s00586-016-4801-0 VL - 25 ID - 829300 ER - TY - JOUR AB - Kyphoplasty is an established method in the treatment of osteoporotic spine fractures. In 10-15% of cases cement extravasation and leakage into veins occur. We report about the rare course of an extravasation. In 2008 an osteoporotic compression fracture of L-4 and L-5 in a 62-year-old female patient was treated by kyphoplasty. In the treated vertebra filling of an outgoing vein towards the proximal right side occurred. Postoperatively the patient was free of complaints (VAS preoperative 9/10, postoperative 1/10). In the chest X-ray a small asymptomatic filling of a lung vessel on the left side was present. The patient arrived as an emergency case 2.5 years later with decompensated heart failure. In the chest CT and angiography cement emboli in the lung were seen as well as a perforation of the pericardium with beginning tamponade. A thoracotomy was performed. Intraoperatively two 4 cm long sharp cement pieces were removed from the heart, which had perforated the right ventricle. Leakages were closed by suture. The patient survived the operation and was dismissed after 2 weeks of intensive care for rehabilitation and from there dismissed home. Six months later she had no more problems. When filling vertebra in several levels one must pay attention to introducing cement with a thick consistency, otherwise venous emboli and lung emboli may occur. These are as a rule asymptomatic, but may result in exceptional life-threatening complications. AD - [Prokop, A.] Klin Verbund SW Sindelfingen, Radiol Klin, Klin Unfallchirurg, D-71065 Sindelfingen, Germany. Klin Verbund SW Sindelfingen, Radiol Klin, Kardiol Klin, D-71065 Sindelfingen, Germany. Prokop, A (corresponding author), Klin Verbund SW Sindelfingen, Radiol Klin, Klin Unfallchirurg, Arthur Gruberstr 70, D-71065 Sindelfingen, Germany. verletzt@klinikverbund-suedwest.de AN - WOS:000313710100014 AU - Prokop, A. AU - Hagele, M. AU - Pfeilsticker, U. AU - Koll, S. AU - Chmielnicki, M. DA - Jan DO - 10.1007/s00113-011-2136-1 J2 - Unfallchirurg KW - Kyphoplasty Embolism Cardiac perforation Complications VERTEBROPLASTY Emergency Medicine Surgery LA - German M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2013 SN - 0177-5537 SP - 80-84 ST - Pericardial perforation 2.5 years after kyphoplasty. A rare complication after cement extravasation T2 - Unfallchirurg TI - Pericardial perforation 2.5 years after kyphoplasty. A rare complication after cement extravasation UR - ://WOS:000313710100014 VL - 116 ID - 830290 ER - TY - JOUR AB - Kyphoplasty is an established method in the treatment of osteoporotic spine fractures. In 10-15% of cases cement extravasation and leakage into veins occur. We report about the rare course of an extravasation. In 2008 an osteoporotic compression fracture of L(4) and L(5) in a 62-year-old female patient was treated by kyphoplasty. In the treated vertebra filling of an outgoing vein towards the proximal right side occurred. Postoperatively the patient was free of complaints (VAS preoperative 9/10, postoperative 1/10). In the chest X-ray a small asymptomatic filling of a lung vessel on the left side was present. The patient arrived as an emergency case 2.5 years later with decompensated heart failure. In the chest CT and angiography cement emboli in the lung were seen as well as a perforation of the pericardium with beginning tamponade. A thoracotomy was performed. Intraoperatively two 4 cm long sharp cement pieces were removed from the heart, which had perforated the right ventricle. Leakages were closed by suture. The patient survived the operation and was dismissed after 2 weeks of intensive care for rehabilitation and from there dismissed home. Six months later she had no more problems. When filling vertebra in several levels one must pay attention to introducing cement with a thick consistency, otherwise venous emboli and lung emboli may occur. These are as a rule asymptomatic, but may result in exceptional life-threatening complications. AD - Klinik für Unfallchirurgie und Klinik für Kardiologie, Klinik für Radiologie, Klinikverbund Südwest Sindelfingen, Arthur-Gruberstraße 70, 71065 Sindelfingen. verletzt@klinikverbund-suedwest.de AN - 22367516 AU - Prokop, A. AU - Hägele, M. AU - Pfeilsticker, U. AU - Koll, S. AU - Chmielnicki, M. DA - Jan DO - 10.1007/s00113-011-2136-1 DP - NLM ET - 2012/03/01 J2 - Der Unfallchirurg KW - Bone Cements/*adverse effects Extravasation of Diagnostic and Therapeutic Materials/*complications Female Heart Injuries/*etiology/*surgery Humans Kyphoplasty/*adverse effects Middle Aged Spinal Fractures/complications/*therapy LA - ger M1 - 1 N1 - PubMed NLM literature search January 5, 2021 OP - Herzperforation 2,5 Jahre nach Kyphoplastie. Eine seltene Komplikation nach Zementaustritt. PY - 2013 SN - 0177-5537 SP - 80-4 ST - [Pericardial perforation 2.5 years after kyphoplasty. A rare complication after cement extravasation] T2 - Unfallchirurg TI - [Pericardial perforation 2.5 years after kyphoplasty. A rare complication after cement extravasation] VL - 116 ID - 828851 ER - TY - JOUR AB - Cement-augmented pedicle screws can increase the stability of fixators for unstable vertebral fractures in the elderly. Fixators can be inserted quickly and with minimally invasive techniques, reducing surgical risks. From March 2012 until July 2014, we treated 40 patients with percutaneous augmented fixators for unstable vertebral fractures. Average age was 77.5 years. During the six month observation period, no patients died. There were no neurological deficits. On VAS, average pain decreased from 8.5 to 4.1 points postoperatively. The average Cobb angle of 4.1° was improved after surgery. After 6 months, bony consolidation yielded angles of 1 to 4°, average 2.6°. There was often venous extravasation of cement leaking from the augmented vertebrae, even extending to pulmonary embolism. The emboli were usually asymptomatic. We report a case where the patient required resuscitation immediately after cement application because of pulmonary emboli. The patient survived because of the immediately implemented critical care measures. Little has been published about this risk, which is underestimated despite increasing numbers of augmented fixator operations. The risk can be reduced with slower cement injection, smaller cement applicators, and short term positive pressure ventilation with PEEP. AD - Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Kliniken Sindelfingen, Klinikverbund Südwest. Medizinische Klinik II - Kardiologie, Kliniken Sindelfingen, Klinikverbund Südwest. AN - 28666290 AU - Prokop, A. AU - Sagerer, M. AU - Rupp, W. AU - Chmielnicki, M. DA - Oct DO - 10.1055/s-0043-111594 DP - NLM ET - 2017/07/01 J2 - Zeitschrift fur Orthopadie und Unfallchirurgie KW - Aged *Bone Cements Extravasation of Diagnostic and Therapeutic Materials/diagnostic imaging/etiology Fractures, Compression/diagnostic imaging/*surgery Humans Kyphoplasty/instrumentation Lumbar Vertebrae/diagnostic imaging/*injuries/surgery Male Pedicle Screws/*adverse effects Postoperative Complications/diagnostic imaging/*etiology Pulmonary Embolism/etiology Pulmonary Veins/diagnostic imaging Resuscitation Spinal Fractures/diagnostic imaging/*surgery Spinal Fusion/*instrumentation Tomography, X-Ray Computed LA - ger M1 - 5 N1 - PubMed NLM literature search January 5, 2021 OP - Venöse Paravasate nach Augmentation von Pedikelschrauben – ein unterschätztes Risiko. PY - 2017 SN - 1864-6697 SP - 587-591 ST - [Venous Paravasation After Augmentation of Pedicle Screws - An Underestimated Risk] T2 - Z Orthop Unfall TI - [Venous Paravasation After Augmentation of Pedicle Screws - An Underestimated Risk] VL - 155 ID - 828687 ER - TY - JOUR AB - Cement-augmented pedicle screws can increase the stability of fixators for unstable vertebral fractures in the elderly. Fixators can be inserted quickly and with minimally invasive techniques, reducing surgical risks. From March 2012 until July 2014, we treated 40 patients with percutaneous augmented fixators for unstable vertebral fractures. Average age was 77.5 years. During the six month observation period, no patients died. There were no neurological deficits. On VAS, average pain decreased from 8.5 to 4.1 points postoperatively. The average Cobb angle of 4.1 degrees was improved after surgery. After 6 months, bony consolidation yielded angles of 1 to 4 degrees, average 2.6 degrees. There was often venous extravasation of cement leaking from the augmented vertebrae, even extending to pulmonary embolism. The emboli were usually asymptomatic. We report a case where the patient required resuscitation immediately after cement application because of pulmonary emboli. The patient survived because of the immediately implemented critical care measures. Little has been published about this risk, which is underestimated despite increasing numbers of augmented fixator operations. The risk can be reduced with slower cement injection, smaller cement applicators, and short term positive pressure ventilation with PEEP. AD - [Prokop, Axel; Sagerer, Manuela; Chmielnicki, Marc] Kliniken Sindelfingen, Klin Verbund Sudwest, Klin Unfall Hand & Wiederherstellungschirurg, Arthur Gruber Str 70, D-71065 Sindelfingen, Germany. [Rupp, Wolfgang] Kliniken Sindelfingen, Klin Verbund Sudwest, Med Klin Kardiol 2, Sindelfingen, Germany. Prokop, A (corresponding author), Kliniken Sindelfingen, Klin Verbund Sudwest, Klin Unfall Hand & Wiederherstellungschirurg, Arthur Gruber Str 70, D-71065 Sindelfingen, Germany. a.prokop@klinikverbund-suedwest.de AN - WOS:000413576200018 AU - Prokop, A. AU - Sagerer, M. AU - Rupp, W. AU - Chmielnicki, M. DA - Oct DO - 10.1055/s-0043-111594 J2 - Z. Orthop. Unfallchir. KW - cement leakage osteoporosis instable spine fracture augmented pedicle screws CEMENT LEAKAGE KYPHOPLASTY FRACTURES Orthopedics LA - German M1 - 5 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2017 SN - 1864-6697 SP - 587-591 ST - Venous Paravasation After Augmentation of Pedicle Screws An Underestimated Risk T2 - Zeitschrift Fur Orthopadie Und Unfallchirurgie TI - Venous Paravasation After Augmentation of Pedicle Screws An Underestimated Risk UR - ://WOS:000413576200018 VL - 155 ID - 830187 ER - TY - JOUR AB - Introduction: Kyphoplasty is an established method in the treatment of osteoporotic spine fractures. In 10-15 % paravasates and cement fillings of veins occur. We report about the rare course of a paravasate. Material: In 2008 an osteoporotic compression fracture of L 4 and L 5 with a 62 year old female patient was treated by kyphoplasty. In the treated vertebra filling of an outgoing vein towards proximal right side occurred. Postoperatively the patient was free of complaints (VAS preoperative 9/10, postoperative 1/10). In the chest X ray a small asymptomatic filling of a lung vessel at the left side was present. 2,5 years later the patient arrived as an emergency case with decompensated heart insufficiency. In the chest CT and angiography cement emboli in the lung were seen as well as a perforation of pericard with beginning tamponade. A thoracotomy was performed. Intraoperatively two 4 cm long sharp cement pieces were removed from the heart which had perforated the right ventricle. Results: Leakages were closed by suture. The patient survived the operation and was dismissed after two weeks intensive care in Reha and from there dismissed home. 6 month later she had no more problems. Conclusion: When filling vertebra in several levels one must pay attention to introduce cement at thickened consistency otherwise venous emboli and lung emboli may occur. These are as a rule asymptomatic but may result in exceptional life threatening complications. (Figure Presented). AD - A. Prokop, Kliniken Sindelfingen, Klinikverbund-Südwest, Unfallchirurgie, Sindelfingen, Germany AU - Prokop, A. AU - Stenz, R. AU - Pfeilsticker, U. AU - Chmielnicki, M. DB - Embase DO - 10.1007/s00586-011-2033-x KW - cement spine kyphoplasty society perforation human patient embolism vein vertebra lung blood vessel thorax radiography lung embolism intensive care spine fracture female compression fracture lung thoracotomy heart heart right ventricle suture angiography thorax heart failure emergency patient LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 0940-6719 SP - 2055 ST - Pericard perforation 2,5 years after kyphoplasty T2 - European Spine Journal TI - Pericard perforation 2,5 years after kyphoplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71314077&from=export http://dx.doi.org/10.1007/s00586-011-2033-x VL - 20 ID - 829603 ER - TY - JOUR AB - Purpose: The interventional oncologist can have a significant impact on the quality of life of cancer patients through palliative pain management procedures. The utilization of advanced imaging and thermal ablation techniques to control pain in cancer patients will be an important component of effective interventional oncology services as our subspecialty evolves. Materials and Methods: Following Institutional Review Board approval, our group retrospectively collected and analyzed the documented pain relief parameters and subsequent complications recorded as part of the medical record during our performance of percutaneous image-guided palliative ablative procedures during the past year. We chose 2 cases from each of the following categories in order to demonstrate the scope and efficacy of this service: head and neck neoplasms, palliative nerve ablations, osseous metastases, soft tissue masses, thoracic masses, vertebral body neoplasms, and lesions requiring combination interventional therapies (embolization plus ablation). Results: For purposes of this presentation, 13 cases were chosen: one retropharyngeal mass, one mass in the pterygopalatine fossa, one celiac plexus cryoablation, one pudendal nerve microwave ablation, one metastatic renal cell carcinoma lesion in the proximal humerus, one lung cancer metastases to the sternum, one refractory malignant fibrous histiocytoma about the elbow, cryoablation of two painful neoplastic chest wall lesions, two neoplastic thoracic vertebral body fractures treated with ablative cavity creation and cementoplasty, and two cases of pelvic metastsases treated with transcatheter arterial particle embolization followed by CT-guided microwave ablation and cementoplasty. All patients had significant pain relief (>5 points on a 1-10 pain scale) following their procedure. One patient was treated with antibiotics for a presumed puncture site infection 3 days following the procedure. Conclusions: The application of interventional radiological techniques, including embolization and thermal ablation, are powerful tools for palliation in the setting of cancer pain. AD - J.D. Prologo AU - Prologo, J. D. AU - Hsu, D. P. AU - Robbin, M. R. AU - Passalacqua, M. DB - Embase DO - 10.1016/j.jvir.2011.11.001 KW - antibiotic agent oncology cancer patient human ablation therapy pain artificial embolization analgesia patient microwave thermotherapy vertebra body cryoablation elbow fracture pelvis pain assessment puncture infection palliative therapy cancer pain quality of life imaging institutional review medical record head and neck tumor nerve soft tissue thorax wall therapy pterygopalatine fossa bone metastasis pudendal nerve kidney carcinoma celiac plexus humerus lung cancer metastasis sternum malignant fibrous histiocytoma neoplasm LA - English M1 - 12 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 1051-0443 SP - 1785.e15-1785.e16 ST - Percutaneous image-guided palliative ablative therapy for pain control in cancer patients T2 - Journal of Vascular and Interventional Radiology TI - Percutaneous image-guided palliative ablative therapy for pain control in cancer patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70611106&from=export http://dx.doi.org/10.1016/j.jvir.2011.11.001 VL - 22 ID - 829599 ER - TY - JOUR AB - We report a 75-year-old male patient with an aneurysm of the left femoral artery after cemented total hip arthroplasty. Two months after the operation, the patient showed a spherical resistance and pain in the left groin. Examination showed a big false aneurysm of the left femoral artery. After resection of the aneurysm, an endovascular stent graft vessel prosthesis was implanted. The aneurysm originated from a punctual lesion of the artery caused by a screw. Since the first description of vessel lesions in orthopaedic surgery in 1964, a total of 24 cases of aneurysm in hip surgery have been described. Therefore, a review of literature tries to explain causes and mechanisms of vessel injuries in hip surgery and the possibilities of repair. © Springer-Verlag 2006. AD - D. Proschek, Department of Orthopedic Surgery, University Hospital Frankfurt, Marienburgstraße 2, 60528 Frankfurt am Main, Germany AU - Proschek, D. AU - Proschek, P. AU - Hochmuth, K. AU - Balzer, J. O. AU - Mack, M. G. AU - Vogl, T. J. DB - Embase Medline DO - 10.1007/s00402-006-0166-x KW - anticoagulant agent aged anastomosis aneurysm surgery angiography anticoagulant therapy bone atrophy bone screw case report clinical examination clinical feature computer assisted tomography conservative treatment deep vein thrombosis echography false aneurysm femoral artery femoral vein hip osteoarthritis human lung embolism male phlebography postoperative period priority journal radiography review stent surgical technique thrombectomy total hip prosthesis treatment failure treatment outcome vein occlusion LA - English M1 - 7 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 0936-8051 SP - 493-497 ST - False aneurysm of the left femoral artery and thrombosis of the left femoral vein after total hip arthroplasty T2 - Archives of Orthopaedic and Trauma Surgery TI - False aneurysm of the left femoral artery and thrombosis of the left femoral vein after total hip arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L44194515&from=export http://dx.doi.org/10.1007/s00402-006-0166-x VL - 126 ID - 829784 ER - TY - JOUR AB - Introduction: In 1979, in his first book dealing with low-friction arthroplasty (LFA), Charnley highlighted the use of a cement restrictor. Breusch and Malchau described in 2005 the "second-generation cementing technique." The main objective of this study was to report on the clinical survival of 100 cases of Charnley femoral component implanted in 2007 and 2008 using a permeable and resorbable cement restrictor and a low-viscosity antibiotic-loaded cement. The secondary objectives were to analyze the complications and side effects and the accuracy of the device positioning. Material and methods: This was a monocentric retrospective review of a prospectively compiled database. Diaphyseal restrictor was biodegradable and permeable to gas, blood, and fluids to avoid intramedullary over pression during cementation. The cement was a low-viscosity antibiotic-loaded cement. Among 3555 patients, we selected the first continuous 100 cases of patients where we implanted the device. Survival probability was computed according to Kaplan-Meier method. Results: Mean follow-up was 6.55 2.6 (range 1-11). Considering femoral component revision as the endpoint, survival rate was 100%. No patients died intraoperatively, none in the first month and the first year after surgery. No early periprosthetic fractures have been reported. Discussion: As described initially by Charnley, the use of a cement restrictor was highly recommended through the different generations of cementing techniques. Hypotensive episodes and cardiac arrest have been reported during cement insertion. In our series, we did not deplore any adverse effect related to the cementation. Conclusion: Our study demonstrates a 100% survival rate of a cemented femoral component without adverse effects when using routinely a resorbable and permeable cement restrictor and a low-viscosity cement. Bone cement is still a fantastic ally for the surgeon and the patients. AD - [Prudhon, Jean-Louis] Ctr Osteo Articulaire, 5 Rue Raoul Blanchard, F-38000 Grenoble, France. [Caton, Jacques H.] Inst Orthopedie, 103 Rue Coste, F-69300 Caluire Et Cuire, France. [Aslanian, Thierry] 25 Chemin Jan Baptiste Gillard, F-69300 Caluire Et Cuire, France. Prudhon, JL (corresponding author), Ctr Osteo Articulaire, 5 Rue Raoul Blanchard, F-38000 Grenoble, France. jean-louis.prudhon@wanadoo.fr AN - WOS:000495038500002 AU - Prudhon, J. L. AU - Caton, J. H. AU - Aslanian, T. C7 - 39 DA - Nov DO - 10.1051/sicotj/2019034 J2 - Sicot-J KW - Resorbable and permeable cement restrictor Cementation Cardiovascular side effects TOTAL HIP-ARTHROPLASTY LOW-FRICTION ARTHROPLASTY PREVENTION COMPONENT REVISION EMBOLISM FAT Orthopedics LA - English M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 2426-8887 SP - 7 ST - Charnley femoral cemented stem with a permeable and resorbable cement restrictor and low-viscosity cement Clinical and radiographical evaluation of 100 cases at a mean follow-up of 6.55 years T2 - Sicot-J TI - Charnley femoral cemented stem with a permeable and resorbable cement restrictor and low-viscosity cement Clinical and radiographical evaluation of 100 cases at a mean follow-up of 6.55 years UR - ://WOS:000495038500002 VL - 5 ID - 830116 ER - TY - JOUR AB - This paper presents the case report of an 88 year old female who came to hospital suffering from a severe lower back pain. Ten days before, she had undergone a vertebroplasty with injection of cement into lumbar vetebra 3 because of an osteoporotic fracture. This treatment did not result in a reduction of the lower back pain, which was the main reason for the procedure. However, the patient claimed to have increasing pain radiating to her left leg. Furthermore, she suffered from numbness of her left leg. Clinical examination showed a lack of power in this leg according to hip flexion with a degree of 3/5. X-ray examinations showed paravertebral cement particles and led to the suspicion that the paravertebral cement had caused nerve root compression. MRI and CT myelography showed that the cement had drained into the intraspinal, extradural venous plexus (Batson's plexus). The plexus was filled out with cement between L2 and L5 on both sides. There was nearly no cement in the fractured vertebra L3, but cement had also run onto the paravertebral veins up to the vena cava, which was also involved. The cemented veins had led to a stenosis of the neuroforamina L2 and L3 on the left side. The result was compression of left L3 nerve root. After consulting with our vascular surgeons, we decided on a non-operative treatment. We prescribed a lumbar brace as external stabilisation and as an antithrombotic treatment we gave the patient weight adapted low molecular weight heparin. AD - Univ Klinikum Kiel, Orthopad Klin, Kiel, Germany. Univ Klinikum Kiel, Gefasschirurg Klin, Kiel, Germany. Prymka, M (corresponding author), Orthopad Univ Klinikum Kiel, Michaelisstr 1, D-24105 Kiel, Germany. AN - WOS:000186694400009 AU - Prymka, M. AU - Puhler, T. AU - Hirt, S. AU - Ulrich, H. W. DA - Oct DO - 10.1007/s00113-003-0644-3 J2 - Unfallchirurg KW - percutaneous vertebroplasty back pain nerve root compression cement complication OSTEOPOROTIC VERTEBRAL COMPRESSION PERCUTANEOUS VERTEBROPLASTY ACRYLIC CEMENT PULMONARY-EMBOLISM FRACTURES POLYMETHYLMETHACRYLATE COMPLICATION KYPHOPLASTY VENOGRAPHY Emergency Medicine Surgery LA - German M1 - 10 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2003 SN - 0177-5537 SP - 860-864 ST - Extracorporeal cement drainage with filling from the extradural venous plexus to the vena cava after vertebroplasty. Case report and review of the literature T2 - Unfallchirurg TI - Extracorporeal cement drainage with filling from the extradural venous plexus to the vena cava after vertebroplasty. Case report and review of the literature UR - ://WOS:000186694400009 VL - 106 ID - 830446 ER - TY - JOUR AB - Objectives 1. Understand how various neurointerventional radiology procedures are done and the advantages they hold for pain control. 2. Develop a better understanding of when to call a neurointerventional radiologist and what their procedures can accomplish. 3. Learn about a model for how palliative care clinicians can work together with a neurointerventional radiologist for more rapid and improved pain control for patients. A palliative care patient in severe pain is an emergency and needs to be evaluated and treated quickly. Palliative care clinicians usually try to avoid invasive procedures and so large doses of opioids and adjuvants are the mainstay of treatment. Sometimes, though, these are not very effective. Severe incident pain (chronic or malignant) is one area in which it can be very challenging to make the patient comfortable without a procedure. There are also patients with neuropathic pain, in whom the usual medications are not effective enough. There are other situations when the usual treatment of radiation takes far longer to relieve pain than a procedure. Providing the procedure first can mean that the radiation is better tolerated and more likely to be completed. A neurointerventional radiologist performs various procedures that can drastically reduce pain in certain situations. These procedures include vertebral augmentation (vertebral plasty and kyphoplasty), epidural steroid injections, nerve root blocks and facet injections, sacral plasty, celiac blocks, trigger point injections, palliative embolization's, and other procedures tailored to the patient's needs. Palliative care clinicians frequently order these procedures without full knowledge of what they are ordering or what the patient can expect. Being familiar with what they are and when they can be effective can mean the patient may require far fewer narcotics and so also experience fewer side effects after a relatively noninvasive procedure. In this presentation, we will present clinical cases when the palliative care clinician worked closely with neurointerventional radiology to provide greatly improved pain relief than what was otherwise possible. The procedures themselves and the equipment will be described so that these activities can be better understood and so more easily used. Case histories and diagnostic images will be presented for each case. AD - A. Putnam, Yale University, New Haven, CT, United States AU - Putnam, A. AU - Johnson, M. DB - Embase DO - 10.1016/j.jpainsymman.2013.12.059 KW - narcotic agent adjuvant steroid hospice human radiologist analgesia nurse palliative therapy procedures patient pain injection radiation radiology trigger point invasive procedure nerve root emergency epidural drug administration kyphoplasty drug therapy artificial embolization side effect non invasive procedure diagnosis neuropathic pain model LA - English M1 - 2 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 0885-3924 SP - 407 ST - Reducing the need for narcotics: The role of the neurointerventional radiologist in pain management T2 - Journal of Pain and Symptom Management TI - Reducing the need for narcotics: The role of the neurointerventional radiologist in pain management UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71370411&from=export http://dx.doi.org/10.1016/j.jpainsymman.2013.12.059 VL - 47 ID - 829430 ER - TY - JOUR AB - This study was to investigate the influence of bone cement implantation on haemodynamics and the preventive effect of epinephrine hydrochloride on pulmonary embolism in elderly patients with cemented semihip replacement. 128 patients were retrospectively analyzed. The patients were treated with (group A, 64 cases) or without (group B, 64 cases) epinephrine hydrochloride saline. The monitoring indicators included systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and pulse oxygen saturation (SPO2). The indicators of the two groups were compared before and 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10 minutes after bone cement implantation. Analysis of variance and SNK-q test were used for the statistical analysis. Blood pressure and SPO2 of group B decreased with statistical difference (P < 0.05) and HR increased without statistical significance, comparing with those of group A. In group A, SBP, DBP, MAP, HR, and SPO2 after bone cement implantation did not change significantly at each time point comparing with before implantation (P > 0.05). Bone cement implantation has significant influence on hemodynamics in elderly patients with hemiarthroplasty. Flushing the bone marrow cavity with saline epinephrine hydrochloride is an effective measure to reduce the incidence of bone cement pulmonary embolism. AD - Department of Emergency Orthopaedics, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, China. AN - 26413535 AU - Qi, X. AU - Zhang, Y. AU - Pan, J. AU - Ma, L. AU - Wang, L. AU - Wang, J. C2 - Pmc4568059 DO - 10.1155/2015/568019 DP - NLM ET - 2015/09/29 J2 - BioMed research international KW - Aged Aged, 80 and over Blood Pressure/*drug effects Bone Cements/*adverse effects/therapeutic use Epinephrine/administration & dosage/pharmacology/therapeutic use Female Heart Rate/*drug effects Hemiarthroplasty/*adverse effects/methods Humans Male Prostheses and Implants Pulmonary Embolism/drug therapy/*prevention & control Retrospective Studies LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 2314-6133 (Print) SP - 568019 ST - Effect of Bone Cement Implantation on Haemodynamics in Elderly Patients and Preventive Measure in Cemented Hemiarthroplasty T2 - Biomed Res Int TI - Effect of Bone Cement Implantation on Haemodynamics in Elderly Patients and Preventive Measure in Cemented Hemiarthroplasty VL - 2015 ID - 828636 ER - TY - JOUR AB - This study was to investigate the influence of bone cement implantation on haemodynamics and the preventive effect of epinephrine hydrochloride on pulmonary embolism in elderly patients with cemented semihip replacement. 128 patients were retrospectively analyzed. The patients were treated with (group A, 64 cases) or without (group B, 64 cases) epinephrine hydrochloride saline. The monitoring indicators included systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and pulse oxygen saturation (SPO2). The indicators of the two groups were compared before and 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10 minutes after bone cement implantation. Analysis of variance and SNK-q test were used for the statistical analysis. Blood pressure and SPO2 of group B decreased with statistical difference (P < 0.05) and HR increased without statistical significance, comparing with those of group A. In group A, SBP, DBP, MAP, HR, and SPO2 after bone cement implantation did not change significantly at each time point comparing with before implantation (P > 0.05). Bone cement implantation has significant influence on hemodynamics in elderly patients with hemiarthroplasty. Flushing the bone marrow cavity with saline epinephrine hydrochloride is an effective measure to reduce the incidence of bone cement pulmonary embolism. AD - [Qi, Xiangbei; Zhang, Yingze; Pan, Jinshe; Ma, Lijie; Wang, Lin; Wang, Jianzhao] Hebei Med Univ, Dept Emergency Orthopaed, Hosp 3, Shijiazhuang 050051, Hebei, Peoples R China. Zhang, YZ (corresponding author), Hebei Med Univ, Dept Emergency Orthopaed, Hosp 3, Shijiazhuang 050051, Hebei, Peoples R China. yingzezhang77@163.com AN - WOS:000361207700001 AU - Qi, X. B. AU - Zhang, Y. Z. AU - Pan, J. S. AU - Ma, L. J. AU - Wang, L. AU - Wang, J. Z. C7 - 568019 DO - 10.1155/2015/568019 J2 - Biomed Res. Int. KW - PULMONARY-EMBOLISM HIP Biotechnology & Applied Microbiology Medicine, Research & Experimental LA - English M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2015 SN - 2314-6133 SP - 6 ST - Effect of Bone Cement Implantation on Haemodynamics in Elderly Patients and Preventive Measure in Cemented Hemiarthroplasty T2 - Biomed Research International TI - Effect of Bone Cement Implantation on Haemodynamics in Elderly Patients and Preventive Measure in Cemented Hemiarthroplasty UR - ://WOS:000361207700001 VL - 2015 ID - 830248 ER - TY - JOUR AB - HISTORY AND ADMISSION FINDINGS: We report on a patient with acute dyspnea after several vertebral body interventions, among others a kyphoplasty, that was performed a few days earlier. INVESTIGATIONS: In the computed tomography we prove a bilateral pulmonary embolism (cement and thrombus). There is no right heart failure. A deep vein thrombosis can be excluded by color-coded vascular ultrasound. DIAGNOSIS, TREATMENT AND COURSE: The pulmonary embolism is due to bone cement. The cement material is also found paravertebral, intraspinal and intraneuroforaminal. By conservative treatment using therapeutic anticoagulation and analgesic medication, the patient showed a rapid clinical improvement. CONCLUSIONS: In patients with cardiopulmonary symptoms after vertebroplasty and kyphoplasty, pulmonary embolism due to bone cement should be considered as a possible cause. The therapy depends on the extent of the cement embolism and the symptoms of the patient. AN - 27598920 AU - Qiu, H. J. AU - Rietig, R. AU - Steger, V. AU - Lehn-Stefan, A. AU - Ketelsen, D. AU - Balletshofer, B. AU - Randrianarisoa, E. DA - Sep DO - 10.1055/s-0042-101913 DP - NLM ET - 2016/09/07 J2 - Deutsche medizinische Wochenschrift (1946) KW - Bone Cements/*adverse effects Dyspnea Humans Kyphoplasty/*adverse effects *Pulmonary Embolism/diagnosis/diagnostic imaging/etiology Tomography, X-Ray Computed Vertebroplasty/*adverse effects LA - ger M1 - 18 N1 - PubMed NLM literature search January 5, 2021 OP - Seltene Ursache einer Lungenarterienembolie - Fall 8 / 2016. PY - 2016 SN - 0012-0472 SP - 1324 ST - [A rare cause of pulmonary embolism] T2 - Dtsch Med Wochenschr TI - [A rare cause of pulmonary embolism] VL - 141 ID - 828652 ER - TY - JOUR AB - OBJECTIVE: To observe the early clinical effect of perfusion bone cement screw for lumbar degenerative diseases with osteoporosis. METHODS: The clinical data of 28 patients with lumbar degenerative diseases combined with moderate to severe osteoporosis treated by posterior lateral graft fusion with perfusion of bone cement screws from June 2015 to June 2017 were retrospectively analyzed. There were 9 males and 19 females, aged from 55 to 86 years old with an average of 76 years. Anteroposterior, oblique, and dynamic radiography were performed before operation, and the diagnosis was confirmed by CT, MRI and dual energy X-ray absorptionmetry(DXA). All the patients had moderate to severe lumbar spinal stenosis, including 16 cases with degenerative scoliosis, 12 cases with degenerative lumbar spondylolisthesis, and 16 cases with lumbar disc herniation. According to Jikei grade of osteoporosis, 9 cases were grade II and 19 cases were grade III. Visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score were used to assess the improvement of lumbar leg pain, and neurological function. Imaging data were used to observe the circumstance of pedicle loosening, prolapse, breakage and bone cement leakage, and comprehensively evaluate the fusion. RESULTS: The hospital stay was from 10 to 14 days with an average of 12 days; the operative time was 100 to 150 min with an average of 120 min;the blood loss was 200 to 600 ml with an average of 350 ml (for operations more than 3 vertebral segments, blood filtration recovery was intraoperatively used);the postoperative drainage volume was 150 to 600 ml with an average of 300 ml, no allogeneic blood was used in all the patients. Bone cement of 2 to 3 ml were injected into each vertebral body, and bone cement leakage occurred in 2 cases during injection, both of which were paravertebral vessel leakage, and there was no evidence of intravertebral leakage. The injection of bone cement was terminated in a timely manner without serious complications such as nerve injury, bone cement toxicity, and vascular embolization and pulmonary embolism. According to the fusion criteria by X-ray, 18 cases achieved strong bone fusion, and 10 cases were inaccurate fusion, but no pseudarthrosis occurred in the fusion segment. No screw loosening, prolapse or fracture were found, and postoperative VAS, JOA scores were significantly improved. CONCLUSIONS: Perfusion bone cement screw technique can obtain satisfactory effect in treating lumbar degenerative diseases with osteoporosis. AD - Department of Orthopaedics, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing 100700, China; Yuxing34@sina.com. AN - 32512964 AU - Qu, Y. AU - Yu, X. AU - Wang, F. X. AU - Yang, J. Z. AU - Yang, Y. D. AU - Zhao, D. Y. AU - Wang, H. J. AU - Chen, S. X. DA - Oct 25 DO - 10.3969/j.issn.1003-0034.2019.10.011 DP - NLM ET - 2020/06/10 J2 - Zhongguo gu shang = China journal of orthopaedics and traumatology KW - Aged Aged, 80 and over Bone Cements Bone Screws Female Humans Lumbar Vertebrae Male Middle Aged *Osteoporosis/surgery *Pedicle Screws Retrospective Studies *Spinal Fusion Treatment Outcome Bone cement Lumbar degeneration Osteoporosis Pedicle screw Spinal stenosis relevant financial relationships with commercial interests to disclose. LA - chi M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 1003-0034 (Print) 1003-0034 SP - 928-932 ST - [Application of perfusion bone cement screw in lumbar degenerative disease with osteoporosis] T2 - Zhongguo Gu Shang TI - [Application of perfusion bone cement screw in lumbar degenerative disease with osteoporosis] VL - 32 ID - 828554 ER - TY - JOUR AD - Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA. AN - 16505181 AU - Quesada, N. AU - Mutlu, G. M. DA - Feb 28 DO - 10.1161/circulationaha.105.557017 DP - NLM ET - 2006/03/01 J2 - Circulation KW - Aged Atrial Fibrillation Barium Sulfate Bone Cements/*adverse effects Fever/etiology Humans Low Back Pain Male Osteoporosis/*complications/therapy Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/diagnosis/*etiology Spine/surgery Tomography, X-Ray Computed Ventricular Dysfunction, Left LA - eng M1 - 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0009-7322 SP - e295-6 ST - Images in cardiovascular medicine. Pulmonary embolization of acrylic cement during vertebroplasty T2 - Circulation TI - Images in cardiovascular medicine. Pulmonary embolization of acrylic cement during vertebroplasty VL - 113 ID - 828958 ER - TY - JOUR AD - G.M. Mutlu, Northwestern University Feinberg School of Medicine, Pulmonary and Critical Care Medicine, 240 E Huron St, McGaw 2342, Chicago, IL 60611, United States AU - Quesada, N. AU - Mutlu, G. M. DB - Embase DO - 10.1161/CIRCULATIONAHA.105.557017 KW - acrylic cement barium sulfate poly(methyl methacrylate) aged article case report computer assisted tomography fever atrial fibrillation heart left ventricle failure human leg edema low back pain lung embolism male percutaneous vertebroplasty priority journal thorax radiography LA - English M1 - 8 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 0009-7322 SP - e295-e296 ST - Pulmonary embolization of acrylic cement during vertebroplasty T2 - Circulation TI - Pulmonary embolization of acrylic cement during vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L43754261&from=export http://dx.doi.org/10.1161/CIRCULATIONAHA.105.557017 VL - 113 ID - 829799 ER - TY - JOUR AB - Purpose: To present the results of the surgical management of metastatic renal cell tumours of the spine with cord compression who underwent pre-operative embolisation. Methods: We conducted a retrospective cohort study of all embolised vascular metastatic renal cell tumours of the spine that underwent urgent surgical intervention over a 7-year period (2005-2011). All medical notes, images and angiography/embolisation details were studied. We recorded the timing (immediate vs. delayed) and grade of embolisation and compared this to the estimated blood loss (EBL); extent of metastatic spinal cord compression (using the Tomita score and Bilsky scores) was also compared to EBL. Finally, neurological (Frankel grade), surgical outcome and complications were reviewed in all patients. Results: During the study period, we operated on 25 emergency patients with metastatic renal cell carcinoma causing spinal cord compression who had received pre-operative embolisation (mean age 59.6 (24-78) years; 8 females, 17 males). All but one of our patients had hypervascularisation/arterio-venous fistulae on angiography. We were able to achieve greater than 90 % embolisation in the majority (17/25, 68 %) The estimated blood loss was 1,696 (400-5,000) ml; mean operating time was 276 (90-690) min and an average of 2.3 (0-7) units of whole blood was transfused. Nine patients had a posterior only decompression/stabilisation, nine patients had a posterior decompression ± cement augmentation, six had combined anterior/posterior procedures and one had anterior corpectomy/reconstruction alone. There was no statistical difference in the EBL between immediate versus delayed surgery after embolisation or the grade of embolisation. Immediate surgery after embolisation and interestingly less complete embolisation showed a trend towards less EBL. The extent of the tumour as graded by the Bilsky score correlated with increased EBL (p = 0.042). No complications occurred during the embolisation procedure. The surgical complication rate was 32 % (8/25) including two major complications (septicaemia (1) and metal work failure (2)) and five minor complications. Postoperatively, 52 % (13/25) had no change in neurological status, 36 % (9/25) improved by at least one Frankel grade and 12 % (3/25) had neurological deterioration by one Frankel grade. The average survival following surgery was 14.1 (0.5-72) months. Conclusion: Blood loss (mean 1,696 ml) and complications (32 %) remain a concern in the operative treatment of vascular metastatic spinal cord compression. Most patients remained the same neurologically or improved by at least 1 grade (22/25, 88 %). Paradoxically, greater embolisation showed a trend to more blood loss which could be due to more extensive surgery in this group, a rebound 'reperfusion' phenomena or even the presence of arterio-venous fistulae. Interestingly, we also found that the extent of the tumour, as graded by the Bilsky score, correlated with increased blood loss suggesting that more extensive cord compression by metastases could lead to more blood loss intra-operatively. AD - Centre for Spine Studies and Surgery, Queens Medical Centre, West Block, D Floor, Derby Road, Nottingham, NG7 2UH, UK, nasquraishi@hotmail.com. AN - 104239187. Language: English. Entry Date: 20130906. Revision Date: 20200708. Publication Type: journal article AU - Quraishi, N. A. AU - Purushothamdas, S. AU - Manoharan, S. R. AU - Arealis, G. AU - Lenthall, R. AU - Grevitt, M. P. DB - cin20 DO - 10.1007/s00586-012-2648-6 DP - EBSCOhost KW - Carcinoma, Renal Cell Embolization, Therapeutic Spinal Cord Compression -- Etiology Spinal Cord Compression -- Surgery Spinal Neoplasms Adult Aged Angiography Carcinoma, Renal Cell -- Radiography Female Great Britain Human Kidney Neoplasms -- Pathology Male Middle Age Retrospective Design Spinal Cord Compression -- Mortality Spinal Neoplasms -- Radiography Young Adult N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2013 SN - 0940-6719 SP - 27-32 ST - Outcome of embolised vascular metastatic renal cell tumours causing spinal cord compression T2 - European Spine Journal TI - Outcome of embolised vascular metastatic renal cell tumours causing spinal cord compression UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104239187&site=ehost-live&scope=site VL - 22 ID - 830661 ER - TY - JOUR AB - BACKGROUND CONTEXT: Kyphoplasty is performed for the treatment of osteoporotic compression fractures. A theoretical advantage of this technique is the reduced risk of embolization of cement. STUDY DESIGN/SETTING: Case report of an incidental finding of cement pulmonary embolization after kyphoplasty of an osteoporotic vertebral compression fracture. METHODS/RESULTS: Here we report a patient who presented with an incidental finding of pulmonary embolization after kyphoplasty and review the relevant literature. CONCLUSIONS: Patients who present with symptoms of respiratory distress after kyphoplasty should undergo workup for pulmonary embolism. Clinicians may consider routine postoperative chest radiographs after kyphoplasty to screen for embolic disease. Further research is necessary to identify the risk factors and possible long-term sequelae of cement embolization. AD - Department of Orthopaedic Surgery, Thomas Jefferson University Hospital and Rothman Institute, Philadelphia, PA 19107, USA. radcliffk@gmail.com AN - 20868999 AU - Radcliff, K. E. AU - Reitman, C. A. AU - Delasotta, L. A. AU - Hong, J. AU - DiIorio, T. AU - Zaslavsky, J. AU - Vaccaro, A. R. AU - Hipp, J. A. DA - Oct DO - 10.1016/j.spinee.2010.07.394 DP - NLM ET - 2010/09/28 J2 - The spine journal : official journal of the North American Spine Society KW - Aged Bone Cements/*adverse effects Coronary Artery Disease/complications Female Fractures, Compression/surgery Heart Failure/complications Humans Hypertension/complications Kyphoplasty/*adverse effects Lumbar Vertebrae/injuries/surgery Pulmonary Disease, Chronic Obstructive/complications Pulmonary Embolism/*etiology Spinal Fractures/surgery LA - eng M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 1529-9430 SP - e1-5 ST - Pulmonary cement embolization after kyphoplasty: a case report and review of the literature T2 - Spine J TI - Pulmonary cement embolization after kyphoplasty: a case report and review of the literature VL - 10 ID - 828736 ER - TY - JOUR AB - The aim of minimally invasive surgery is to minimise tissue damage, in order to reduce blood loss and postoperative pain and thus shorten rehabilitation, without compromising the high standards of safety and longevity of the implants. The skin incision should be as short as possible, but in particular structural damage to the muscles by splitting, crushing or tearing and functional damage through detachment of muscle origins should be avoided. The objective of our study was to examine the clinical results after hip arthroplasty using an anterior minimally invasive approach. In a prospective study, a cementless, hybrid or cemented total hip prosthesis was implanted in 1000 consecutive patients (mean age 73.6 [32-91] years). Surgery was performed in the supine position, access was via an anterior approach, using the space between the tensor fasciae latae, gluteus medius and minimus lateral muscles and the sartorius and rectus femoris medial muscles. Specially curved retractor hooks and an angled reamers were used intraoperatively. All patients were examined preoperatively, at the day of admission, 6 and 12 weeks as well as 1 and 2 years postoperatively, using the Merle d'Aubignéscore. In addition, conventional X-rays were performed immediately postoperatively, on discharge and 1 year postoperatively. Pain was assessed daily up to the 7th postoperative day using a visual analogue scale (VAS). It was possible to perform the surgical technique on all patients, the mean incision length being 7.8 (6-12) cm. The mean operating time was 52 (45-130) minutes, and mean blood loss over 24 hours was 295 (120-1200) ml. The mean pain score on the VAS was 8.1 (5-10) preoperatively, 2.3 (0-7) 3 days postoperatively and 1.4 (0-6) 7 days postoperatively. The mean Merle d'Aubignéscore was 9.8 (5-14) preoperatively. Postoperatively, the mean scores were 15.6 (9-18) at the day of admission, 16.8 (12-18) after 6 weeks, 17.2 (13-18) after 12 weeks, 17.3 (13-18) after 1 year and 16.9 (12-18) after 2 years. A total of 71 complications occurred: 4 prosthesis infections, 5 periprosthetic fractures, 4 fractures of the greater trochanter, 12 wound healing disorders, 4 deep vein thrombosis, 1 pulmonary embolism, 5 dislocations, and 37 irritations of the lateral femoral cutaneous nerve. Radiology revealed no signs of loosening. Total hip arthroplasty using the minimally invasive anterior approach is a safe and conservative method that enables correct positioning of the cup and stem components as well as the use of cementless and cemented prosthesis models. Muscular or obese patients do not represent contraindications. © Schattauer 2011. AD - S. Radmer, Zentrum für Bewegungsheilkunde, Orthopädische Facharztpraxis, Bozener Str. 17, 10825 Berlin, Germany AU - Radmer, S. AU - Andresen, R. AU - Sparmann, M. DB - Embase DO - 10.1055/s-0037-1619999 KW - adult aged article deep vein thrombosis device infection fracture hip arthroplasty hip surgery human implant lung embolism major clinical study minimally invasive surgery operation duration pain assessment patient positioning postoperative complication postoperative hemorrhage postoperative pain prospective study supine position surgical approach surgical technique total hip prosthesis treatment outcome visual analog scale wound healing wound healing impairment LA - German M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 1019-1291 SP - 233-238 ST - Minimally invasive hip replacement using an anterior approach - Medium-term results in 1000 consecutive cases T2 - Osteologie TI - Minimally invasive hip replacement using an anterior approach - Medium-term results in 1000 consecutive cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L364123739&from=export http://dx.doi.org/10.1055/s-0037-1619999 VL - 20 ID - 829630 ER - TY - JOUR AB - Internal fixation of unstable thoracolumbar spine fractures requires correction of the lacking anterior column support. This usually entails insertion of a vertebral body replacement strut through an anterior approach, or a long posterior construct spanning at least two vertebrae above and two vertebrae below the fracture. Posterior short-segment pedicle instrumentation (SSPI)-one vertebra above and below-is suitable for approximately 40% of fractures, but not for all. A total of 52 patients with unstable thoracolumbar burst fractures meeting our inclusion criteria were instrumented using a novel approach, combining percutaneous SSPI, pedicle screw augmentation with polymethyl methacrylate (PMMA) and fractured vertebra kyphoplasty. We retrospectively reviewed patient and fracture data, operative results and 1 year radiographic follow-up postoperatively in 40 of the patients. We reviewed operative complications of all 52 patients. Most fractures were AO/Magerl type A3.1, A3.2 and A3.3. They were instrumented within 72 h and ambulated without additional external bracing. Operative time averaged 2 h and blood loss was less than 50 cc in most cases. Complications were mostly related to PMMA leakage. On average, 3.3A degrees (0-13) of correction was lost after 3 months, but remained constant afterward. Percutaneous augmented short-segment pedicle instrumentation of unstable thoracolumbar fractures can be done with short operative times, minimal blood loss and a low complication rate. The radiographical results at 1 year are equal to anterior stabilization and are better than other posterior-only techniques. AD - [Rahamimov, Nimrod; Mulla, Hani; Freiman, Shay] Western Galilee Hosp, Spine Surg Unit, Nahariyya, Israel. [Shani, Adi] Western Galilee Hosp, Dept Surg B, Nahariyya, Israel. Rahamimov, N (corresponding author), Western Galilee Hosp, Spine Surg Unit, POB 21, Nahariyya, Israel. nim205@gmail.com; hani.mulla@naharia.health.gov.il; a_eilat@walla.com; shay.freiman@naharia.health.gov.il AN - WOS:000303513600006 AU - Rahamimov, N. AU - Mulla, H. AU - Shani, A. AU - Freiman, S. DA - May DO - 10.1007/s00586-011-2106-x J2 - Eur. Spine J. KW - Spine Fracture Kyphoplasty Pedicle Trauma Percutaneous instrumentation PEDICLE SCREW INSTRUMENTATION THORACIC SPINE STABILIZATION POSTERIOR INSTRUMENTATION BALLOON KYPHOPLASTY CALCIUM-PHOSPHATE TRAUMA PATIENTS CLINICAL-COURSE VERTEBROPLASTY FIXATION EMBOLISM Clinical Neurology Orthopedics LA - English M1 - 5 M3 - Article; Proceedings Paper N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2012 SN - 0940-6719 SP - 850-854 ST - Percutaneous augmented instrumentation of unstable thoracolumbar burst fractures T2 - European Spine Journal TI - Percutaneous augmented instrumentation of unstable thoracolumbar burst fractures UR - ://WOS:000303513600006 VL - 21 ID - 830307 ER - TY - JOUR AB - BACKGROUND: Vertebroplasty is a procedure most commonly used for vertebral compression fractures. Although it is a relatively safe procedure, complications have been reported. Cement embolism is seen in 2.1%-26% of patients after percutaneous vertebroplasty. CASE PRESENTATION: a 38-year-old male who was diagnosed with cushing's syndrome, underwent percutaneous vertebroplasty for his thoracic osteoporotic compression fractures. 24-hours following vertebroplasty, he presented to emergency department with acute-onset dyspnea and chest pain. Chest radiography showed an opaque linear lesion in left pulmonary artery which was suggestive of cement embolism. Pulmonary spiral CT-scan further confirmed the diagnosis. The patient's symptoms improved over time, and warfarin was started with close cardiopulmonary assessments for indicators of cement embolus removal. CONCLUSION: in patients with pulmonary cement embolism, conservative treatment may be recommended rather than a surgical removal except when the obstruction is extensive enough to cause hemodynamic changes. Given that all the related studies have suggested that pulmonary thromboembolism can occur as a complication due to bone cement leakage, discovering new cement alternatives and/or injection devices, seems beneficial. AD - Pulmonology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Internal Medicine Department, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran. AN - 30073141 AU - Rahimi, B. AU - Boroofeh, B. AU - Dinparastisaleh, R. AU - Nazifi, H. C2 - Pmc6068333 DO - 10.1016/j.rmcr.2018.06.009 DP - NLM ET - 2018/08/04 J2 - Respiratory medicine case reports KW - Cement embolism Complications Percutaneous vertebroplasty cushing's syndrome LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 2213-0071 (Print) 2213-0071 SP - 78-85 ST - Cement pulmonary embolism after percutaneous vertebroplasty in a patient with cushing's syndrome: A case report T2 - Respir Med Case Rep TI - Cement pulmonary embolism after percutaneous vertebroplasty in a patient with cushing's syndrome: A case report VL - 25 ID - 828621 ER - TY - JOUR AB - BACKGROUND: In osteoporotic patients, a useful technique for significantly enhancing the strength of a pedicle screw is augmentation with polymethylmethacrylate cement. However, a rare complication of this procedure is a symptomatic pulmonary cement embolism. CASE DESCRIPTION: A pedicle screw cement augmentation was performed in a middle-aged female for the failed back syndrome. When she developed symptomatic pulmonary cement emboli, she was successfully managed with conservative measures, including anticoagulation. CONCLUSION: Despite the increased use of cement augmentation for pedicle screw placement and the relatively high incidence of cement leakage into the prevertebral venous system, symptomatic cement pulmonary embolism remains rare. The management of such symptomatic CPE should be evaluated and treated based on both the size and location of the embolism. Here, we presented this case while reviewing three symptomatic and four asymptomatic cases from the literature. AD - Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran. AN - 32123606 AU - Rahimizadeh, A. AU - Hassani, V. AU - Soufiani, H. AU - Rahimizadeh, A. AU - Karimi, M. AU - Asgari, N. C2 - Pmc7049880 DO - 10.25259/sni_592_2019 DP - NLM ET - 2020/03/04 J2 - Surgical neurology international KW - Cement augmentation Cement pulmonary emboli Complication Failed back syndrome Pedicle screw Polymethylmethacrylate LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 2229-5097 (Print) 2152-7806 SP - 18 ST - Symptomatic pulmonary cement embolism after pedicle screw polymethylmethacrylate cement augmentation: A case report and review T2 - Surg Neurol Int TI - Symptomatic pulmonary cement embolism after pedicle screw polymethylmethacrylate cement augmentation: A case report and review VL - 11 ID - 828608 ER - TY - JOUR AB - INTRODUCTION: Asymptomatic vertebral hemangiomas are common, but extension into the spinal canal causing cord compression with neurologic symptoms is rare. CASE REPORTS: Case 1:A 20-year-old male patient presented with difficulty in walking for 6 months with gradually progressive weakness of both the lower limbs. On examination, upper motor neuron signs were present in both the lower limbs with a sensory level below T8 and no bladder involvement. Magnetic resonance imaging (MRI) showed a vascular tumor arising from T6 lamina and pedicle and compressing the cord. Pre-operative computerized tomogram angiography and embolization of the tumor was done, followed by decompression, stabilization of the spine, and vertebroplasty. Postoperatively, the patient received radiotherapy. Case 2: A 71-year-old male patient presented with the recurrence of vertebral hemangioma and cord compression. He had a history of hemangioma with cord compression 13 years back, which was treated by embolization, followed by decompression and fixation. The patient had gradually improved neurologically to normal activities. He was asymptomatic till 7 months back when he noticed difficulty in walking. On examination, pyramidal signs were found to be positive. MRI revealed an expansile lesion at T7 vertebra which was causing compression of the spinal cord. Pre-operative embolization, followed by decompression, stabilization, and vertebroplasty was performed. He also received radiotherapy postoperatively. The diagnosis of benign capillary hemangioma was made after histopathological examination. Neurological recovery was almost complete in both the cases. At6-month follow-up after surgery, both the patients were able to perform all the activities of daily living. CONCLUSION: Aggressive vertebral hemangiomas causing progressive neurological deficit should be treated with surgical decompression, stabilization, and vertebroplasty. Pre-operative angiography, embolization, and post-operative low-dose radiation therapy are recommended. AD - Department of Orthopaedics, P D Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra. India. AN - 30167409 AU - Rai, R. R. AU - Shah, S. AU - Deogaonkar, K. AU - Dalvie, S. C2 - Pmc6114208 DA - Mar-Apr DO - 10.13107/jocr.2250-0685.1038 DP - NLM ET - 2018/09/01 J2 - Journal of orthopaedic case reports KW - Hemangioma radiotherapy thoracic cord compression vertebroplasty LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 2250-0685 (Print) 2250-0685 SP - 33-37 ST - Aggressive Vertebral Hemangioma Causing Spinal Cord Compression: Presenting a Study of Two Cases and Review of Literature T2 - J Orthop Case Rep TI - Aggressive Vertebral Hemangioma Causing Spinal Cord Compression: Presenting a Study of Two Cases and Review of Literature VL - 8 ID - 828677 ER - TY - JOUR AB - Introduction-Percutaneous vertebral augmentation procedures are minimally invasive procedures commonly performed for vertebral compression fractures secondary to osteoporosis or malignancy. These include vertebroplasty, kyphoplasty, and skyphoplasty. Although these are relatively safe procedures and have become a standard of care, complications have been reported. We report a case of cement pulmonary embolism (PE) in a patient who underwent kyphoplasty. Presentation-A 75 year-old female with multiple comorbidities including morbid obesity, hypothyroidism, osteoporosis, osteoarthritis and rheumatoid arthritis underwent multilevel kyphoplasty for thoracolumbar vertebral compression fractures. Post-procedure patient was stable and recovering well. A routine chest X-ray (CXR) was performed on day four post procedure which in addition to multilevel kyphoplasty revealed linear branching radiopacity overlying the right mid to upper lung field. Computed Tomography (CT) scan of the chest with contrast showed multiple small branching tubular hyperdensities within the right upper lobe pulmonary vasculature compatible with polymethylmethacrylate (PMMA) cement emboli from the recent kyphoplasty. The patient denied any chest pain or shortness of breath. She was hemodynamically stable with normal oxygenation on room air. Echocardiogram showed normal ejection fraction with no evidence of right heart strain. Based on the current guidelines, our patient was not started on anticoagulation as she was asymptomatic and cement PE was peripheral. She was closely followed up as an outpatient and remained stable from pulmonary standpoint. Discussion-PMMA cement PE is a complication of vertebral augmentation procedures. It is seen less commonly with kyphoplasty compared to vertebroplasty due to difference in the technique which creates lower pressures while injecting the cement. The amount of cement injected and the viscosity of cement have also been studied as risk factors for cement PE. Most patients of cement PE remain asymptomatic. Some practitioners recommend routine use of CXR or CT scan to look for cement PE, however, it is not a routine screening practice post-procedure. Cement PE can be identified on the imaging as single or multiple tubular or branching, radio-graphically dense opacities in the lung field. There are no clear guidelines for treatment of this entity. Based on the review of literature, in asymptomatic patients with peripheral cement PE, clinical follow-up without anti-coagulation is recommended. A 3-6 month course of coumadin therapy is currently a commonly followed approach for symptomatic or central cement PE. This is believed to minimize the risk of thrombus formation on the cement PE. However, it will not improve the ventilation/perfusion ratio in symptomatic patients. (Figure Presented) . AD - K. Rajdev, Internal Medicine, Northwell Health Staten Island University Hospital, Staten Island, NY, United States AU - Rajdev, K. AU - Habib, S. AU - Sharma, D. AU - Siddiqui, A. H. AU - Pervaiz, S. AU - Ahmed, S. DB - Embase KW - cement warfarin aged ambient air anticoagulation blood clotting cancer patient clinical trial (topic) comorbidity complication compression fracture computer assisted tomography conference abstract dyspnea echocardiography female follow up heart ejection fraction human hypothyroidism kyphoplasty literature lung blood vessel lung embolism lung ventilation perfusion ratio malignant neoplasm morbid obesity osteoporosis outpatient oxygenation physician practice guideline rheumatoid arthritis risk factor systematic review thorax pain thorax radiography viscosity LA - English M1 - 9 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1535-4970 ST - Cement pulmonary embolism as a complication of percutaneous kyphoplasty: A case report T2 - American Journal of Respiratory and Critical Care Medicine TI - Cement pulmonary embolism as a complication of percutaneous kyphoplasty: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L630355408&from=export VL - 199 ID - 829142 ER - TY - JOUR AB - Introduction/objectives: Dislocation of hemiarthoplasty in elderly patients is associated with significant morbidity and mortality. The aim of our study is to assess the short term clinical results of the use of constrained acetabular cup in dislocation of hemiarthroplasty of hip. Methods: A retrospective review of dislocated hemiarthroplasty of hip for a period from 2009 to 2013 is carried out using coding data base, theatre records and case notes. We identified cases with dislocation of hemiarthroplasty who underwent revision surgery using constrained acetabular cup. Cemented cups were used in all the cases. Results: There were a total of 672 patients had hemiarthroplasty during this period. Twenty-five (3.72%) patients had dislocation of hemiarthropalsty. Seventeen patients had Thompsons and eight patients had ETS hemiarthroplasty. Six patients had revision of hemiarthroplasty to a total hip replacement using constrained acetabular cup and 44 offset CDH Exeter stem with cement to cement fixation. All the patients had a good postoperative recovery. All patients were mobilised and discharged early. There were no complications including infections, deep vein thrombosis, pulmonary embolism or further dislocation at one year follow-up. Conclusions: The advantages of using constrained acetabular cups are it avoids prolonged bed rest and also the use of an abduction brace and also allows rapid rehabilitation. We conclude that the revision of a dislocated hemiarthroplasty using constrained acetabular cup and cement to cement Exeter stem is a good option in selected group of patients with good clinical outcomes. AD - A. Rajeev, Queen Elizabeth Hospital, Gateshead Health NHS Trust, Gateshead, United Kingdom AU - Rajeev, A. AU - Banaszkiewicz, P. DB - Embase DO - 10.5301/hipint.5000450 KW - cement abduction acetabulum aged bed rest brace clinical outcome complication data base deep vein thrombosis dislocation follow up hemiarthroplasty human infection information processing lung embolism major clinical study rehabilitation remission retrospective study surgery total hip prosthesis LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1120-7000 SP - S66-S67 ST - Short term results of the use of constrained acetabular cup for dislocation of hemiarthroplasty of the hip in elderly patients T2 - HIP International TI - Short term results of the use of constrained acetabular cup for dislocation of hemiarthroplasty of the hip in elderly patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L613187664&from=export http://dx.doi.org/10.5301/hipint.5000450 VL - 26 ID - 829308 ER - TY - JOUR AB - Introduction Hemiarthroplasty of the hip is one of the commonest procedures done for intracapsular fractures of the neck of femur in elderly. Dislocation of the hemiarthroplasty is a recognised and significant complication. This is associated with considerable morbidity and mortality. The treatment options include closed manipulation, skin and skeletal traction, conversion to total hip replacement, exploration and open reduction and leaving it out of the acetabulum. Presentation of case A retrospective review of ten patients with recurrent and failed closed manipulative reduction of hemiarthroplasty who underwent revision using a cemented captive acetabular cup and cement to cement revision of femoral component with Exeter CDH stem was carried out. The follow up period was two years and the functional outcomes were assessed using Harris hip scores. Discussion The management of recurrent dislocations of hemiarthroplasty in elderly patient are very challenging. Even though various treatment options are described most of them are associated with increased morbidity and mortality and prevent these patients from early mobilisation. The use of captive acetabular avoid repeated dislocations, prolonged bed rest, wearing of a brace and all the complications associated with sustained immobilization. The drawbacks of using constrained cups are hip pain, limited hip movements and loosening. Conclusion We describe a new method of treatment of this difficult condition with a cemented constrained acetabular captive cup and cement to cement revision using a CDH femoral stem. This method prevents further dislocations and will give good functional outcomes thus reducing the high morbidity and mortality. AD - A. Rajeev, Trauma and Orthopaedics, Queen Elizabeth Hospital, Gateshead Health Foundation NHS Trust, Sheriff Hill, Gateshead, United Kingdom AU - Rajeev, A. AU - Banaszkiewicz, P. DB - Embase DO - 10.1016/j.ijscr.2016.04.030 KW - cement acetabulum aged article deep vein thrombosis female follow up Harris hip score hip hemiarthroplasty human infection lung embolism major clinical study outcome assessment priority journal recurrent dislocation retrospective study total hip prosthesis LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 2210-2612 SP - 141-145 ST - Constrained captive acetabular cup for recurrent dislocation of hemiarthroplasty in elderly: A case series T2 - International Journal of Surgery Case Reports TI - Constrained captive acetabular cup for recurrent dislocation of hemiarthroplasty in elderly: A case series UR - https://www.embase.com/search/results?subaction=viewrecord&id=L610065664&from=export http://dx.doi.org/10.1016/j.ijscr.2016.04.030 VL - 23 ID - 829338 ER - TY - JOUR AB - Background Context The incidence of proximal junctional kyphosis (PJK) ranges from 5% to 46% following adult spinal deformity surgery. Approximately 66% to 76% of PJK occurs within 3 months of surgery. A subset of these patients, reportedly 26% to 47%, develop proximal junctional failure (PJF) within 6 months postoperatively. To date, there are no studies evaluating the impact of prophylactic vertebroplasty on PJK and PJF incidence at long-term follow-up. Purpose The purpose of this study is to evaluate the long-term radiographic and clinical outcomes, and incidence of PJK and PJF, after prophylactic vertebroplasty for long-segment thoracolumbar posterior spinal fusion (PSF). Study Design This is a prospective cohort study. Patient Sample Thirty-nine patients, of whom 87% were female, who underwent two-level prophylactic vertebroplasty at the upper instrumented and supra-adjacent vertebrae at the time of index PSF were included in this study. Outcome Measures Clinical outcomes were assessed using the Scoliosis Research Society-22 (SRS-22), and Short-Form (SF) 36 questionnaires, and the Oswestry Disability Index (ODI). Radiographic parameters including PJK angle, and coronal and sagittal alignment, were calculated, along with relevant perioperative complications and revision rates. Methods Of the 41 patients who received two-level prophylactic vertebroplasty at the upper instrumented and supra-adjacent vertebrae at the time of index PSF, and comprised a cohort with previously published 2-year follow-up data, 39 (95%) completed 5-year follow-up (average: 67.6 months). Proximal junctional kyphosis was defined as a change in the PJK angle ≥10° between the immediate postoperative and final follow-up radiograph. Proximal junctional failure was defined as acute proximal junctional fracture, fixation failure, or kyphosis requiring extension of fusion within the first 6 months postoperatively. Results Thirty-nine patients with a mean age of 65.6 (41–87) years were included in this study. Of the 39 patients, 28.2% developed PJK (11: 7.7% at 2 years, 20.5% between 2 and 5 years), and 5.1% developed acute PJF. Two of the 11 PJK patients required revision for progressive worsening of the PJK. There were no proximal junctional fractures. There was no significant difference in preoperative, immediate postoperative, and final follow-up measurements of thoracic kyphosis, lumbar lordosis, and coronal or sagittal alignment between patients who developed PJK, PJF, or neither (p>.05). There was no significant difference in ODI, SRS-22, or SF-36 scores between those with and without PJK or PJF (p>.05). Conclusions This long-term follow-up demonstrates that prophylactic vertebroplasty may minimize the risk for junctional failure in the early postoperative period. However, it does not appear to decrease the incidence of PJK at 5 years. AD - T. Raman, Department of Orthopaedic Surgery, The Johns Hopkins University, 601 N Caroline St, Baltimore, MD, United States AU - Raman, T. AU - Miller, E. AU - Martin, C. T. AU - Kebaish, K. M. DB - Embase Medline DO - 10.1016/j.spinee.2017.05.017 KW - bone cement device pedicle screw fixation device bone cement steroid adult aged anterior spine fusion article bone cement leakage case report clinical article clinical outcome cohort analysis compression fracture controlled study debridement female fixation failure follow up heart arrhythmia human kyphosis lordosis lung embolism male medical device complication middle aged operative blood loss Oswestry Disability Index percutaneous vertebroplasty peroperative complication posterior spine fusion postoperative complication postoperative infection priority journal prophylactic surgical procedure prospective study proximal junctional failure proximal junctional kyphosis reoperation rheumatic polymyalgia rheumatoid arthritis screw loosening Short Form 36 spine injury spine malformation spine radiography steroid therapy surgical infection thoracolumbar spine urinary tract infection wound irrigation LA - English M1 - 10 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1878-1632 1529-9430 SP - 1489-1498 ST - The effect of prophylactic vertebroplasty on the incidence of proximal junctional kyphosis and proximal junctional failure following posterior spinal fusion in adult spinal deformity: a 5-year follow-up study T2 - Spine Journal TI - The effect of prophylactic vertebroplasty on the incidence of proximal junctional kyphosis and proximal junctional failure following posterior spinal fusion in adult spinal deformity: a 5-year follow-up study UR - https://www.embase.com/search/results?subaction=viewrecord&id=L616631456&from=export http://dx.doi.org/10.1016/j.spinee.2017.05.017 VL - 17 ID - 829235 ER - TY - JOUR AB - Pulmonary bone cement embolism (PCE) is an uncommon event occurring after implantation of polymethylmethacrylate (PMMA) in orthopaedic surgeries involving adult patients, more so in the elderly. Its incidence in the paediatric population is extremely rare. We herein describe a case of PCE in a 15-year-old girl, 9 days after she underwent total elbow replacement with PMMA placement for a primitive neuroectodermal tumour (PNET) of the distal humerus. This report describes the occurrence of a common post-operative complication of bone cement embolism in an uncommon scenario of total elbow replacement for a bone tumour in a child, which masqueraded initially as acute pneumonitis. AD - Department of Medical Oncology (Paediatric), Tata Memorial Hospital, Dr. E. Borges Road Parel, Mumbai, 400012, India. ped.doc.subbu@gmail.com. Department of Medical Oncology (Paediatric), Tata Memorial Hospital, Dr. E. Borges Road Parel, Mumbai, 400012, India. Department of Surgical Oncology (Orthopaedic), Tata Memorial Hospital, Mumbai, India. Department of Radio-Diagnosis, Tata Memorial Hospital, Mumbai, India. AN - 28233027 AU - Ramanathan, S. AU - Vora, T. AU - Gulia, A. AU - Mahajan, A. AU - Desai, S. DA - May DO - 10.1007/s00256-017-2602-0 DP - NLM ET - 2017/02/25 J2 - Skeletal radiology KW - Adolescent Adrenal Cortex Hormones/therapeutic use *Arthroplasty, Replacement, Elbow Bone Cements/*adverse effects Diagnosis, Differential Female Humans Humerus/surgery Neuroectodermal Tumors, Primitive/*surgery Oxygen/therapeutic use Polymethyl Methacrylate/adverse effects Postoperative Complications/*diagnostic imaging/therapy Pulmonary Embolism/*diagnostic imaging/*etiology Radiography Tomography, X-Ray Computed Child Primitive neuroectodermal tumour (PNET) Pulmonary cement embolism Total elbow replacement LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 0364-2348 SP - 715-718 ST - Pulmonary cement embolism in a child following total elbow replacement for primitive neuroectodermal tumour (PNET) of the humerus T2 - Skeletal Radiol TI - Pulmonary cement embolism in a child following total elbow replacement for primitive neuroectodermal tumour (PNET) of the humerus VL - 46 ID - 828703 ER - TY - JOUR AB - The risk of osteoporotic hip fractures may be reduced by augmenting susceptible femora with high-and low-viscosity cement. As the injection of excessive amounts of cement may result in thermal necrosis of bone tissue or even embolism, the minimum cement volume required to achieve a predefined level of augmentation should be determined. To this end, the present work introduces a novel efficient generalized augmentation strategy combining a strain-based fracture criterion with experimental results of bone augmentation previously obtained. The proposed methodology aims to estimate the fracture load improvement with two cement types (high-or low-viscosity). In total, 18 healthy and 17 osteoporotic ex vivo femora were numerically studied using the Finite Element Method and considering a typical lateral fall on the greater trochanter. In all cases, both a nonaugmented and an augmented state with injected bone cement were simulated. All augmented models of femora exhibited enhanced fracture loads regardless of the cement viscosity used. Low viscosity cement showed a higher fracture load improvement than high-viscosity cement. Furthermore, augmentation of osteoporotic femora estimated a larger improvement in the fracture load (10.32 +/- 3.22% with high-viscosity cement and 28.93 +/- 7.04% with low-viscosity cement) with respect to healthy femora (9.41 +/- 3.66% with high-viscosity cement and 25.19 +/- 6.00% with low-viscosity cement). The results suggest that low-viscosity cement can be a powerful candidate for use in femoroplasty. Furthemore, the proposed methodology can be efficiently used for preoperative planning of bone augmentation surgery. AD - [Ramos-Infante, S. J.; Perez, M. A.] Univ Zaragoza, I3A, M2BE, Campus Rio Ebro,Ebro,C Maria de Luna S-N, Zaragoza 50018, Spain. Perez, MA (corresponding author), Univ Zaragoza, Mech Engn, Ed Betancourt,Campus Rio Ebro,C Maria de Luna, Zaragoza 50018, Spain. angeles@unizar.es AN - WOS:000487812100020 AU - Ramos-Infante, S. J. AU - Perez, M. A. C7 - 106647 DA - Oct DO - 10.1016/j.engfracmech.2019.106647 J2 - Eng. Fract. Mech. KW - High- and low viscosity cement Femoroplasty Healthy and osteoporotic models of femora Finite element analyses Fracture load FINITE-ELEMENT MODELS HUMAN PROXIMAL FEMUR FRACTURE LOAD IN-VITRO PROPHYLACTIC AUGMENTATION EVOLUTIONARY OPTIMIZATION SIDEWAYS FALL FEMOROPLASTY BONE PREDICTION Mechanics LA - English M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 0013-7944 SP - 10 ST - High- and low-viscosity cement for osteoporotic femoral augmentation: A computational subject-specific approach T2 - Engineering Fracture Mechanics TI - High- and low-viscosity cement for osteoporotic femoral augmentation: A computational subject-specific approach UR - ://WOS:000487812100020 VL - 219 ID - 830123 ER - TY - JOUR AB - Giant cell tumor (GCT) is a locally highly aggressive tumor of bone comprising 5 to 10% of all benign bone tumors. The sacrum is the third most common site of involvement. Patients with sacral GCTs present with localized pain in the lower back that may radiate to one or both lower limbs. Vague abdominal complaints and bowel and bladder symptoms may also be present. Neuroimaging workup should include advanced modalities, preferably magnetic resonance imaging, prior to obtaining a biopsy specimen. Giant cell tumor has a 1 to 5% rate of metastasizing to the lung and may convert to a fulminate malignant variant, which has a very poor prognosis. The standard treatment for GCT is curettage combined with adjuvant bone grafting or cement-augmented stabilization. In appropriately selected cases, sacral resection is a valuable procedure to effect local tumor control and overall survival. Embolization may also prove palliative and/or curative in cases in which the tumor is unresectable or refractory to treatment. AD - Sarcoma Services, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA. AN - 15350044 AU - Randall, R. L. DA - Aug 15 DO - 10.3171/foc.2003.15.2.13 DP - NLM ET - 2004/09/08 J2 - Neurosurgical focus KW - Biopsy Bone Transplantation Curettage Disease Progression Embolization, Therapeutic Female Giant Cell Tumor of Bone/diagnosis/*pathology/secondary/surgery/therapy Humans Low Back Pain/etiology Lung Neoplasms/secondary Magnetic Resonance Imaging Male Neoplasm Invasiveness Sacrum/*pathology/surgery Spinal Neoplasms/diagnosis/*pathology/surgery/therapy LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2003 SN - 1092-0684 SP - E13 ST - Giant cell tumor of the sacrum T2 - Neurosurg Focus TI - Giant cell tumor of the sacrum VL - 15 ID - 829030 ER - TY - JOUR AB - It is controversial whether a cemented long-stem femoral arthroplasty is a safe surgical option for patients with meta-static bone disease of the hip. Cemented long stems increase the risk of embolic cascades and may cause subsequent cardiopulmonary complications, particularly in patients with metastatic disease. We retrospectively reviewed results of 29 long-stem cemented femoral arthroplasties in 27 patients in which surgical techniques that minimized intramedullary debris and canal pressurization were used. The surgical techniques minimized intraoperative cement-related emboli with aggressive medullary lavage, intraoperative canal suctioning during cementation, use of early low-viscosity polymethylmethacrylate, and slow, controlled insertion of the long-stem prosthesis. Cement-associated hypotension occurred in four (14%) patients, sympathomimetics were administered in nine (31%) patients, and a worsening mental status occurred postoperatively in one (3%) patient. There were no cement-associated desaturation events, cardiac arrests, or intraoperative deaths. No patients required prolonged intubation, and there were no postoperative cardiopulmonary events. Cemented long-stem femoral arthroplasty is a safe procedure for patients with high-risk metastatic disease. Increased awareness of cement-related cardiopulmonary pathophysiology, and modifying conventional surgical techniques can minimize cement-associated complications. LEVEL OF EVIDENCE: Therapeutic study, Level IV (case series). See the Guidelines for Authors for a complete description of levels of evidence. AD - Huntsman Cancer Institute, Department of Orthopaedics, Salt Lake City, UT 84112, USA. r.lor.randall@hsc.utah.ed AN - 16462453 AU - Randall, R. L. AU - Aoki, S. K. AU - Olson, P. R. AU - Bott, S. I. DA - Feb DO - 10.1097/01.blo.0000191270.50033.3a DP - NLM ET - 2006/02/08 J2 - Clinical orthopaedics and related research KW - Adult Aged Aged, 80 and over Arthroplasty, Replacement, Hip/*adverse effects/instrumentation Bone Cements/adverse effects Bone Neoplasms/*secondary/surgery Cementation/adverse effects Female Follow-Up Studies *Hip Prosthesis Humans Hypotension/drug therapy/*etiology Male Middle Aged Postoperative Complications Prosthesis Design Retrospective Studies Risk Factors Sympathomimetics/therapeutic use LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0009-921X (Print) 0009-921x SP - 287-95 ST - Complications of cemented long-stem hip arthroplasties in metastatic bone disease T2 - Clin Orthop Relat Res TI - Complications of cemented long-stem hip arthroplasties in metastatic bone disease VL - 443 ID - 828799 ER - TY - JOUR AB - Highly hydrophilic, perfectly smooth and spherical microspheres have been synthetized. These non-biodegradable microspheres absorb water in varying degrees and can be injected easily through microcatheters due to their slippery and compressible characteristics. The material was successfully used for embolization of 4 vascular intracranial tumours and 2 spinal vascular lesions in the cervical region, by superselective delivery. Histopathology confirmed absolute inertness of the microspheres. AD - Department of radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India. AN - 1880562 AU - Rao, V. R. AU - Ravimandalam, K. AU - Jayakrishnan, A. AU - Thanoo, B. C. AU - Radhakrishnan, V. V. AU - Gupta, A. K. AU - Kumar, S. AU - Joseph, S. AU - Unni, M. AU - Rao, A. S. DP - NLM ET - 1991/01/01 J2 - Journal of neuroradiology = Journal de neuroradiologie KW - Adult Angiography, Digital Subtraction Arteriovenous Malformations/therapy Brain Neoplasms/therapy Catheterization Child Embolization, Therapeutic/*instrumentation/methods Female Humans Hydrolysis Male Meningioma/blood supply/therapy *Methylmethacrylates/chemical synthesis/chemistry *Microspheres Middle Aged *Radiology, Interventional Spine/blood supply Vertebral Artery/abnormalities LA - eng fre M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 1991 SN - 0150-9861 (Print) 0150-9861 SP - 61-9 ST - Hydrolysed microspheres from cross-linked polymethyl methacrylate (Hydrogel). A new embolic material for interventional neuroradiology T2 - J Neuroradiol TI - Hydrolysed microspheres from cross-linked polymethyl methacrylate (Hydrogel). A new embolic material for interventional neuroradiology VL - 18 ID - 828985 ER - TY - JOUR AB - Instrumentation with cement-augmented pedicle screws has expanded the therapeutic spectrum. This technique is useful for the palliation of bone metastases and in generalized osteoporosis. Serious complications such as pulmonary embolism have been described following percutaneous vertebroplasty, a frequently used technique. We report the case of a 55-year-old patient with a large central Palacos embolism of the right pulmonary artery after corporectomy of the lumbar vertebrae 3 and 4 and reconstruction using autologous pelvic bone. The large Palacos embolism was removed successfully from the right pulmonary artery with extracorporeal circulation. AD - Department of Thoracic and Cardiovascular Surgery, University Hospital, Westfälische Wilhelms-University, Münster, Germany. AN - 20922632 AU - Rasch, A. AU - Sindermann, J. AU - Scheld, H. H. AU - Hoffmeier, A. DA - Oct DO - 10.1055/s-0029-1240847 DP - NLM ET - 2010/10/06 J2 - The Thoracic and cardiovascular surgeon KW - Anti-Bacterial Agents/therapeutic use Antihypertensive Agents/therapeutic use Bone Cements/*adverse effects Embolectomy Extracorporeal Circulation Foreign-Body Migration/diagnostic imaging/*etiology/therapy Fracture Fixation/*adverse effects Humans Lumbar Vertebrae/diagnostic imaging/injuries/*surgery Male Middle Aged Pulmonary Embolism/diagnostic imaging/*etiology/therapy Spinal Fractures/diagnostic imaging/*surgery Tomography, X-Ray Computed Treatment Outcome LA - eng M1 - 7 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 0171-6425 SP - 437-9 ST - Pulmonary Palacos embolism: a case report T2 - Thorac Cardiovasc Surg TI - Pulmonary Palacos embolism: a case report VL - 58 ID - 828794 ER - TY - JOUR AB - This prospective randomized double‐blind study aims to evaluate the effect of surface finish of the cemented femoral stem in primary total hip arthroplasty. Between January 1996 and May 1997, a single surgeon prospectively implanted 244 primary THAs (237 patients) using cemented femoral stems with modified third‐generation cement technique in selected patients. Patients were randomized to receive the Ranawat‐Burstein prosthesis (Biomet, Warsaw, IN) with 1 of 2 finishes (smooth‐Ra 17 or rough‐Ra 170). At a minimum 5‐year follow‐up, no statistical differences were found between the 2 groups. One patient with a smooth stem underwent revision of the femoral component at 2 years secondary to aseptic loosening. There was no other evidence of radiographic loosening or osteolysis. As an isolated variable, surface finish does not appear to significantly influence results at mean follow‐up of 6.5 years. AN - CN-00504485 AU - Rasquinha, V. J. AU - Ranawat, C. S. AU - Dua, V. AU - Ranawat, A. S. AU - Rodriguez, J. A. DO - 10.1016/j.arth.2004.06.005 KW - *cement *hip arthroplasty *prosthesis fixation Adult Aged Aged, 80 and over Arthroplasty, Replacement, Hip [*methods] Asepsis Bone necrosis/su [Surgery] Bone radiography Cefazolin/dt [Drug Therapy] Cefazolin/pa [Parenteral Drug Administration] Cementation Chi‐Square Distribution Clinical trial Coated Materials, Biocompatible Conference paper Controlled clinical trial Controlled study Coxitis/su [Surgery] Deep vein thrombosis/co [Complication] Deep vein thrombosis/dt [Drug Therapy] Deep vein thrombosis/pc [Prevention] Device infection/co [Complication] Device infection/dt [Drug Therapy] Device infection/pc [Prevention] Double blind procedure Double‐Blind Method Female Femur Follow up Follow‐Up Studies Hip Joint [diagnostic imaging] Hip Prosthesis Hip dysplasia/su [Surgery] Human Humans Implantation Low drug dose Lung embolism/co [Complication] Lung embolism/dt [Drug Therapy] Lung embolism/pc [Prevention] Major clinical study Male Middle Aged Osteoarthritis/su [Surgery] Osteolysis Prospective Studies Prosthesis Design Prosthesis Failure Prosthesis failure/co [Complication] Prosthesis loosening/co [Complication] Radiography Randomized controlled trial Surface Properties Surface property Thromboembolism/co [Complication] Thromboembolism/dt [Drug Therapy] Thromboembolism/pc [Prevention] Treatment Outcome Warfarin/do [Drug Dose] Warfarin/dt [Drug Therapy] M1 - 7 Suppl 2 M3 - Clinical Trial; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2004 SP - 2‐9 ST - A prospective, randomized, double-blind study of smooth versus rough stems using cement fixation: minimum 5-year follow-up T2 - Journal of arthroplasty TI - A prospective, randomized, double-blind study of smooth versus rough stems using cement fixation: minimum 5-year follow-up UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00504485/full VL - 19 ID - 830044 ER - TY - JOUR AN - 5579518 AU - Ratliff, A. H. AU - Clement, J. A. C2 - Pmc1796024 DA - May 29 DO - 10.1136/bmj.2.5760.532 DP - NLM ET - 1971/05/29 J2 - British medical journal KW - Aged Female Heart Arrest/chemically induced Humans Hypotension/chemically induced Pulmonary Embolism/*chemically induced Tissue Adhesives/*adverse effects LA - eng M1 - 5760 N1 - PubMed NLM literature search January 5, 2021 PY - 1971 SN - 0007-1447 (Print) 0007-1447 SP - 532 ST - Pulmonary embolism and bone cement T2 - Br Med J TI - Pulmonary embolism and bone cement VL - 2 ID - 828892 ER - TY - JOUR AB - BACKGROUND CONTEXT: Fenestrated pedicle screw cement augmentation (FPSCA) in spine surgery has recently been FDA approved in 2016. Although numerous biomechanical studies support its use to increase pull-out strength, few studies report its safety and efficacy in a broad scope of indications. PURPOSE: Our goal was to report our practice pattern, perioperative outcomes and complications with a new FPSCA system. STUDY DESIGN/SETTING: Retrospective cohort study. PATIENT SAMPLE: Forty-three consecutive patients over 14 months. OUTCOME MEASURES: Occurrence of hardware failure, cement leaks, cement embolism, fat embolism, mortality METHODS: Forty-three patients underwent FPSCA (2.5mL of high viscosity polymethylmetacrylate per screw) between September 2017 and November 2018 by six surgeons at our institution for degenerative disease, tumor, trauma or deformity correction. Baseline demographics, bone density, operative data, perioperative outcome (failure rate), complications (cement embolus, pulmonary embolism, perivertebral cement leaks, mortality) and postoperative X-rays or computed tomography were reported. Our practice pattern was also reported (regional distribution and indications). RESULTS: Average age was 64.9±17.6 years. Mean follow-up was 15.5±12.3 weeks. Twenty-three patients (53.5%) had osteoporosis or osteopenia; 175 cement-augmented pedicle screws were used in constructs totaling 276 screws (63.4%). Regional distribution was: thoracic (18%), lumbar (58.1%) and thoracolumbar (23.2%). Indication were: deformity (36.2%), tumor (24.9%), trauma (7%) and degenerative conditions (31.9%). Most augmentations were performed at a combination of the UIV, UIV –1 and LIV. Systematic verification of screw depth before injection prevented rod insertion difficulties. Complications comprised cement leakage (22 patients, 51.1%), hardware failure (4 patients, 9.3%) and non-cement related pulmonary embolism (two patients). Fifty-six leaks occurred and concerned segmental veins (38 leaks, 67.8%), basivertebral veins (8 leaks, 14.2%), a cortical defect (4 leaks, 9.3%) or the spinal canal (6 patients, 13.9%). None of the patients developed acute respiratory distress syndrome from fat embolism. No symptomatic cement embolism or perioperative cement-related death occurred. CONCLUSIONS: This is the largest mixed-indication case-series on record in North America. Fenestrated pedicle screw augmentation in spine surgery can be a safe and effective method of increasing fixation in osteopenic bone. FDA DEVICE/DRUG STATUS: This abstract does not discuss or include any applicable devices or drugs. AU - Ratnayake, R. AU - Bouloussa, H. AU - Majid, K. AU - Kuo, C. C. AU - Bains, R. S. DB - Embase DO - 10.1016/j.spinee.2019.05.576 KW - cement poly(methyl methacrylate) adult adult respiratory distress syndrome bone density case report case study clinical article cohort analysis complication computer assisted tomography conference abstract death deformity degenerative disease drug safety fat embolism female follow up human injection injury lung embolism male middle aged mortality neoplasm North America osteopenia osteoporosis pedicle screw pharmacokinetics retrospective study spine surgery surgeon surgery treatment failure vein vertebral canal viscosity X ray LA - English M1 - 9 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1878-1632 1529-9430 SP - S228 ST - P151. Two-year experience with fenestrated pedicle screw cement augmentation in spine surgery: a safety and efficacy study T2 - Spine Journal TI - P151. Two-year experience with fenestrated pedicle screw cement augmentation in spine surgery: a safety and efficacy study UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2002164061&from=export http://dx.doi.org/10.1016/j.spinee.2019.05.576 VL - 19 ID - 829117 ER - TY - JOUR AB - Percutaneous vertebroplasty was first introduced in 1984 by Galibert et al. for the treatment of hemangiomas in the spine. The current indications for vertebroplasty also include compression fractures due to osteoporosis as well as osteolytic metastases and spinal myeloma lesions. With the numbers of percutaneous vertebroplasty performed by orthopedic and trauma surgeons, neurosurgeons, and radiologists steadily increasing, complications have also risen. Over the last 3 years an increasing number of cases with varying complications, their genesis, and their management have been reported in the literature. Complications include asymptomatic cement leakage, cardiovascular effects, embolism with lethal outcome as well as severe neurological deficits. This article presents a review of the complications reported in the literature, strategies for preventing possible complications as well as current concepts in therapy management. Several of our cases with cement leakages are presented. AD - Orthopädische Universitätsklinik, Stiftung Friedrichsheim, Frankfurt/M. M.Rauschmann@friedrichsheim.de AN - 14747909 AU - Rauschmann, M. A. AU - von Stechow, D. AU - Thomann, K. D. AU - Scale, D. DA - Jan DO - 10.1007/s00132-003-0573-4 DP - NLM ET - 2004/01/30 J2 - Der Orthopade KW - Bone Cements/adverse effects Embolism/etiology Humans Minimally Invasive Surgical Procedures Orthopedic Procedures/*adverse effects Osteoporosis/*complications/diagnostic imaging Phlebography Spinal Canal Spinal Fractures/diagnostic imaging/etiology/*surgery Spine/blood supply/diagnostic imaging/innervation/*surgery Tomography, X-Ray Computed LA - ger M1 - 1 N1 - PubMed NLM literature search January 5, 2021 OP - Komplikationen in der Vertebroplastie. PY - 2004 SN - 0085-4530 (Print) 0085-4530 SP - 40-7 ST - [Complications of vertebroplasty] T2 - Orthopade TI - [Complications of vertebroplasty] VL - 33 ID - 828609 ER - TY - JOUR AB - Vertebral haemangiomas constitute an infrequently encounterd entity in clinical practice. Although x-ray, computerised tomography scan and magnetic resonance Imaging scan provide a pathognomic picture confirming the diagnosis of vertebral haemangiomas, angiography constitutes an important tool for diagnosis and helps in deciding and execution of treatment. Various treatment modalities like surgery, radiotherapy, pre-operative embolisation, percutaneous vertebroplasty and intralesional ethanol have been discussed in the setting of asymptomatic vertebral haemangiomas to those presenting with features of cord compression. AD - Department of Oncology, Batra Hospital and Medical Research Centre, New Delhi 10062 AN - 17802977 AU - Rawat, S. AU - Nangia, S. AU - Ezhilalan, R. B. AU - Bansal, A. K. AU - Ghosh, D. DA - Jan DP - NLM ET - 2007/09/07 J2 - Journal of the Indian Medical Association KW - Adult *Angiography Female Hemangioma/diagnostic imaging/*radiotherapy Humans Low Back Pain/diagnosis/etiology Lumbar Vertebrae/diagnostic imaging/*pathology Spinal Neoplasms/diagnostic imaging/*radiotherapy LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 0019-5847 (Print) 0019-5847 SP - 42, 44-5, 48 ST - Variance in the treatment of vertebral haemangiomas T2 - J Indian Med Assoc TI - Variance in the treatment of vertebral haemangiomas VL - 105 ID - 829025 ER - TY - JOUR AB - Bone cement implantation syndrome (BCIS) is characterized by hypoxia, hypotension, cardiac arrhythmias, increased pulmonary vascular resistance and cardiac arrest. It is a known cause of morbidity and mortality in patients undergoing cemented orthopaedic surgeries. The rarity of the condition as well as absence of a proper definition has contributed to under-reporting of cases. We report a 59-year-old woman who sustained fracture of the neck of her left femur and underwent an elective hybrid total hip replacement surgery. She collapsed during surgery and was revived only to succumb to death twelve hours later. Post mortem findings showed multiorgan disseminated microembolization of bone marrow and amorphous cement material. AD - University Technology MARA, Faculty of Medicine, Selangor, Malaysia. dr_razuin@salam.uitm.edu.my AN - 23817399 AU - Razuin, R. AU - Effat, O. AU - Shahidan, M. N. AU - Shama, D. V. AU - Miswan, M. F. DA - Jun DP - NLM ET - 2013/07/03 J2 - The Malaysian journal of pathology KW - Arthroplasty, Replacement, Hip/*adverse effects Bone Cements/*adverse effects Cementation/*adverse effects Embolism/*etiology/physiopathology Fatal Outcome Female Humans Middle Aged Postoperative Complications/*etiology/physiopathology Syndrome LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 0126-8635 (Print) 0126-8635 SP - 87-90 ST - Bone cement implantation syndrome T2 - Malays J Pathol TI - Bone cement implantation syndrome VL - 35 ID - 828727 ER - TY - JOUR AB - Bone cement implantation syndrome (BCIS) is characterized by hypoxia, hypotension, cardiac arrhythmias, increased pulmonary vascular resistance and cardiac arrest. It is a known cause of morbidity and mortality in patients undergoing cemented orthopaedic surgeries. The rarity of the condition as well as absence of a proper definition has contributed to under-reporting of cases. We report a 59-year-old woman who sustained fracture of the neck of her left femur and underwent an elective hybrid total hip replacement surgery. She collapsed during surgery and was revived only to succumb to death twelve hours later. Post mortem findings showed multiorgan disseminated microembolization of bone marrow and amorphous cement material. AD - R. Razuin, University Technology MARA, Jalan Hospital, Sg. Buloh Campus, 40700 Sg Buloh, Selangor, Malaysia AU - Razuin, R. AU - Effat, O. AU - Shahidan, M. N. AU - Shama, D. V. AU - Miswan, M. F. M. DB - Embase Medline KW - epinephrine atropine bone cement acute kidney tubule necrosis adult article autopsy bone cement implantation syndrome bradycardia case report collapse coronary artery atherosclerosis death drug response elective surgery embolism female femoral neck fracture histopathology human human tissue hypotension microembolism pancreas hemorrhage pancreatitis peroperative complication resuscitation total hip prosthesis L1 - http://www.mjpath.org.my/2013.1/bone-cement-implantation-syndrome.pdf LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0126-8635 SP - 87-90 ST - Bone cement implantation syndrome T2 - Malaysian Journal of Pathology TI - Bone cement implantation syndrome UR - https://www.embase.com/search/results?subaction=viewrecord&id=L369217732&from=export VL - 35 ID - 829490 ER - TY - JOUR AB - SESSION TITLE: Medical Student/Resident Pulmonary Vascular Disease Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Vertebral compression fractures (VCFs) are commonly seen in elderly people as a result of osteoporosis and malignancy. Vertebral augmentation procedures (VAPs) like kyphoplasty and vertebroplasty can be used in the management of VCFs. Pulmonary cement embolism (PCE) is a relatively rare complication of these procedures and is usually asymptomatic and diagnosed incidentally on imaging studies. CASE PRESENTATION: A 57-year-old white woman presented with shortness of breath with exertion for 6 weeks, and pleuritic chest pain for 2 weeks. She has stage 4 lung adenocarcinoma status post resection and chemotherapy, and chronic obstructive lung disease. She underwent kyphoplasty with polymethylmethacrylate for fractured L3-L4 two months ago. Her vital signs were normal at the time of current presentation and physical examination showed diminished breath sounds at bases. Laboratory workup was normal. Chest radiograph showed tubular densities in the mid and right lower lungs and chest CT angiogram showed high-density material in bilateral peripheral pulmonary arteries. These densities represented cement embolization. She refused anticoagulation and was symptomatically treated with ibuprofen for pleuritic chest pain with resolution of symptoms during close follow-up. DISCUSSION: VAPs are minimally invasive, relatively safe procedures that introduce a cement polymer into the vertebral body. PCE is a potentially serious complication of VAPs with an incidence of 2-25%. It occurs as a result of extravasation of cement to the vertebral venous plexus and its embolization to inferior renal vein and then to inferior vena cava and right atrium and ultimately reaching pulmonary arteries. Maintaining a prone position and elevated intrathoracic pressure during the procedure can help to prevent PCE. Although most cases are asymptomatic and diagnosed incidentally on radiographic images, patients can have dyspnea, chest pain, cough, hemoptysis, syncope, and hypoxic respiratory failure. Most of the time, symptoms begin days to weeks after the procedure. Characteristic chest x-ray shows high-density tubular or branching opacities correlating with the branching pattern of the pulmonary arteries. Diagnosis should be confirmed with chest CT angiogram. Prognosis is usually good and there are no standard guidelines for management. Anticoagulation is recommended for symptomatic PCE in peripheral arteries and asymptomatic PCE in central pulmonary arteries for 6 months. Life-threatening massive central PCEs can be managed with surgical embolectomy. Interestingly, this patient had complete resolution of symptomatic PCE without anticoagulation. CONCLUSIONS: With the increasing use of VAPs, it is important to be aware of PCE as a rare complication from these procedures. A high index of suspicion and the use of imaging studies are crucial for early diagnosis and in preventing serious complications. Reference #1: Idiculla PS, Rajdev K, Pervaiz S, et al. Cement pulmonary embolism after balloon kyphoplasty. Respir Med Case Rep. 2019;28:100887. Published 2019 Jun 20. doi:10.1016/j.rmcr.2019.100887 Reference #2: Ignacio JMF, Ignacio KHD. Pulmonary Embolism from Cement Augmentation of the Vertebral Body. Asian Spine J. 2018;12(2):380-387. doi:10.4184/asj.2018.12.2.380 Reference #3: Nooh A, Abduljabbar FH, Abduljabbar AH, Jarzem P. Pulmonary Artery Cement Embolism after a Vertebroplasty. Case Rep Orthop. 2015;2015:582769. doi:10.1155/2015/582769 DISCLOSURES: No relevant relationships by Prudhvi Regula, source=Web Response No relevant relationships by Praful Schroff, source=Web Response No relevant relationships by KRISHNA VASIPALLI, source=Web Response No relevant relationships by Krishna Venkata, source=Web Response AU - Regula, P. AU - Schroff, P. AU - Vasipalli, K. AU - Venkata, K. DB - Embase DO - 10.1016/j.chest.2020.08.1832 KW - cement endogenous compound ibuprofen poly(methyl methacrylate) protein c jun abnormal respiratory sound adult adverse drug reaction aged anticoagulation astronomy cancer chemotherapy cancer patient cancer prognosis cancer staging cancer surgery case report chronic obstructive lung disease clinical article complication conference abstract coughing diagnosis dyspnea early diagnosis embolectomy exercise extravasation faintness female follow up heart right atrium hemoptysis human incidence inferior cava vein kidney vein kyphoplasty lung adenocarcinoma lung embolism middle aged physical examination practice guideline prevention prognosis prone position pulmonary artery remission respiratory failure side effect thorax pain thorax pressure thorax radiography vertebra body vital sign LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1931-3543 0012-3692 SP - A2125 ST - “METEORITE SHOWERS IN THE LUNGS”: A CASE OF PULMONARY CEMENT EMBOLISM T2 - Chest TI - “METEORITE SHOWERS IN THE LUNGS”: A CASE OF PULMONARY CEMENT EMBOLISM UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2008026103&from=export http://dx.doi.org/10.1016/j.chest.2020.08.1832 VL - 158 ID - 829052 ER - TY - JOUR AB - Trans-oesophageal echocardiography and continuous monitoring of the partial pressure of carbon dioxide at end expiration (PETCO2) were performed in 63 dogs during total hip replacement and in three dogs during femoral stem revision. The PETCO2 usually did not change during insertion of the acetabular prosthesis, but in 17.5% of the cases, it decreased by more than 10 mmHg after insertion of the femoral prosthesis. In all of the cases, transoesophageal echocardiography revealed echogenic structures in the right side of the heart, immediately after insertion of the acetabular and of the femoral prostheses. These appeared as either numerous pinpoint echoes, which passed through the right side of the heart in a "snow flurry" like fashion or more echogenic particles. The embolaemia, seen ultrasonographically, was categorized into one of six grades of severity. Statistical analysis showed significant positive correlations between the severity of the embolaemia and the extent of the decrease in PETCO2 (rs = 0.405; P = 0.001; n = 60), and between the severity of the embolaemia and the duration of the decrease in PETCO2 before it returned to baseline values (rs = 0.345; P = 0.007; n = 60). Trans-oesophageal echocardiography demonstrated that embolaemia was induced during cemented prosthesis insertion. It was proposed that an increase in intramedullary pressure, during insertion, forces bone marrow into the venous circulation. Bone marrow itself can constitute an embolus, but also it may activate intravascular coagulation, thus leading to thromboembolism, in addition to bone marrow embolism. Elongated particulate emboli, up to several centimetres in length, were seen on ultrasonogrammes and were thought to be, at least in part, products of intravascular coagulation. A significant decrease in the platelet concentration in peripheral venous blood, after insertion of the femoral prosthesis, was also indicative of intravascular coagulation. The extent of the impairment of gas exchange was documented by means of capnography. The significant positive correlation between the embolaemia, seen via ultrasonography, and the decrease in PETCO2 strongly suggest a causal relationship between the two variables. The rapid recovery, that occurred in most patients, is attributed to the enormous lytic ability of pulmonary tissue. Prophylactic measures include the maintenance of normovolaemia during the operations, thorough lavage of the intramedullary cavity before prosthesis insertion and steps to prevent an increase in intramedullary pressure during implantation. AD - Univ Munich, Fac Vet, Dept Surg, D-80539 Munich, Germany. Reindl, S (corresponding author), Univ Munich, Fac Vet, Dept Surg, Vet Str 13, D-80539 Munich, Germany. AN - WOS:000074159400003 AU - Reindl, S. AU - Matis, U. DA - May J2 - Vet. Comp. Orthop. Traumatol. KW - total hip replacement trans-oesophageal echocardiography capnometry embolism-fat embolism bone marrow TWO-DIMENSIONAL ECHOCARDIOGRAPHY CEMENTED ARTHROPLASTY FAT-EMBOLISM ARTERIAL OXYGENATION DOGS HYPOTENSION HYPOXEMIA PRESSURE MODEL Veterinary Sciences Zoology LA - English M1 - 2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1998 SN - 0932-0814 SP - 68-75 ST - Detection of embolic events by capnography and transoesophageal echocardiography during total hip replacement T2 - Veterinary and Comparative Orthopaedics and Traumatology TI - Detection of embolic events by capnography and transoesophageal echocardiography during total hip replacement UR - ://WOS:000074159400003 VL - 11 ID - 830476 ER - TY - JOUR AB - Study Design: Review of literature and case series. Objectives: Update and review of current treatment concepts for spine fractures in patients with ankylosing spinal disorders. Methods: Case presentation and description of a diagnostic and therapeutic algorithm for unstable spinal injuries with an underlying ankylosing spinal disorder (ASD) of the cervical and thoracolumbar spine. Results: Nondisplaced fractures can be missed easily using conventional X-rays. Thus, computed tomography (CT) scans are recommended for all trauma patients with ASD. In doubt or presence of any neurologic involvement additional magnetic resonance imaging (MRI) scans should be obtained. Spine precautions should be maintained all times and until definitive treatment (<24 h). Nonoperative fracture treatment is not recommended given the mechanical instability of the most commonly seen fracture patterns (AOSpine B- and C-type, M2) in patients with ASD and inherent high risk of secondary neurologic deterioration. For patients with ankylosing spondylitis (AS) or diffuse idiopathic hyperostosis (DISH) sustaining cervical spine fractures, a combined anterior-posterior instrumentation for fracture fixation is recommended. Closed reduction and patient positioning can be challenging in presence of preexisting kyphotic deformities. In the thoracolumbar (TL) spine, a posterior instrumentation extending 2 to 3 levels above and below the fracture level is recommended to maintain adequate reduction and stability until fracture healing. Minimally invasive percutaneous pedicle screws and cement augmentation can help to minimize the surgical trauma and strengthen the construct stability in patients with diminished minor bone quality (osteopenia, osteoporosis). Conclusions: Current concepts, treatment options, and recommendations of the German Orthopedic Trauma Society–Spine Section for spinal fractures in the ankylosed spine have been outlined. AD - M. Reinhold, Klinikum Südstadt Rostock, Department of Orthopaedic, Trauma and Hand Surgery, Sudring 81, Rostock, Germany AU - Reinhold, M. AU - Knop, C. AU - Kneitz, C. AU - Disch, A. DB - Embase DO - 10.1177/2192568217736268 KW - ankylosing spinal disorder ankylosing spondylitis article cervical spine cervical spine fracture comorbidity computer assisted tomography fibrocartilage fracture healing Glasgow coma scale human hyperostosis inflammation lung embolism morbidity nuclear magnetic resonance imaging ossification pneumonia prevalence priority journal radiculopathy radiography spine disease spine fracture thoracolumbar spine vein thrombosis wound healing LA - English M1 - 2_suppl M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 2192-5690 2192-5682 SP - 56S-68S ST - Spine Fractures in Ankylosing Diseases: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) T2 - Global Spine Journal TI - Spine Fractures in Ankylosing Diseases: Recommendations of the Spine Section of the German Society for Orthopaedics and Trauma (DGOU) UR - https://www.embase.com/search/results?subaction=viewrecord&id=L623958529&from=export http://dx.doi.org/10.1177/2192568217736268 VL - 8 ID - 829182 ER - TY - JOUR AB - Malignant epidural spinal cord compression (MESCC) remains a common neuro-oncologic emergency with high associated morbidity. Despite widespread availability of MRI, the diagnosis frequently goes unmade until myelopathy supervenes, which is unfortunate because the strongest predictor of neurologic outcome with treatment is the neurologic status when treatment is initiated. Once the diagnosis of MESCC is suspected, patients with neurologic deficits should be started on high-dose corticosteroids (eg, dexamethasone, 10-100 mg intravenously, followed by 16 to 100 mg/d in divided doses). Definitive therapy of MESCC almost always includes radiation therapy and in some cases surgical intervention; factors considered include the patient's performance status and extent of visceral and skeletal disease, spinal stability, the tumor's underlying radiosensitivity, and the degree of spinal cord compression. Patients with spinal instability or radioresistant tumors are likely to have a much better neurologic outcome with tumor resection and spinal stabilization prior to radiation; the same may also pertain to patients with moderately radiosensitive tumors who have good life expectancy in terms of their systemic tumor. Conventional radiation has historically been beneficial after surgery and in patients who are not surgical candidates. Recent studies suggest a role for stereotactic body radiation therapy in patients with spinal metastasis from radioresistant tumors and in patients who have received prior standard radiotherapy, so long as the spinal cord has been decompressed. AD - [Ribas, Eduardo Santamaria Carvalhal; Schiff, David] Univ Virginia, Neurooncol Ctr, Charlottesville, VA 22908 USA. Ribas, ESC (corresponding author), Univ Virginia, Neurooncol Ctr, Box 800432, Charlottesville, VA 22908 USA. ds4jd@virginia.edu AN - WOS:000306695900009 AU - Ribas, E. S. C. AU - Schiff, D. DA - Aug DO - 10.1007/s11940-012-0176-7 J2 - Curr. Treat. Options Neurol. KW - Epidural spinal cord compression Radiosurgery Radiation therapy Neoplasm Spinal cord Treatment Stereotactic body radiation therapy Corticosteroids Fractionated radiotherapy Percutaneous radiofrequency ablation Embolization Vertebroplasty Kyphoplasty POSTEROLATERAL TRANSPEDICULAR APPROACH RADIOFREQUENCY ABLATION DECOMPRESSIVE SURGERY PROGNOSTIC-FACTORS CEMENT AUGMENTATION COURSE RADIOTHERAPY METASTATIC TUMORS CLINICAL ARTICLE VERTEBRAL BODY LOCAL-CONTROL Clinical Neurology LA - English M1 - 4 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2012 SN - 1092-8480 SP - 391-401 ST - Spinal Cord Compression T2 - Current Treatment Options in Neurology TI - Spinal Cord Compression UR - ://WOS:000306695900009 VL - 14 ID - 830304 ER - TY - JOUR AD - Hospital Cárdio Pulmonar, Salvador, BR. AN - 26398761 AU - Ribeiro Neto, M. L. AU - Albuquerque, M. L. AU - Cavalcante, D. B. AU - Almeida, J. R. C2 - Pmc4635961 DA - Jul-Aug DO - 10.1590/s1806-37132015000000061 DP - NLM ET - 2015/09/24 J2 - Jornal brasileiro de pneumologia : publicacao oficial da Sociedade Brasileira de Pneumologia e Tisilogia KW - Aged Bone Cements/*adverse effects Female Humans Polymethyl Methacrylate/adverse effects Pulmonary Embolism/*diagnostic imaging/etiology Radiography Vertebroplasty/*adverse effects LA - eng por M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 1806-3713 (Print) 1806-3713 SP - 395-6 ST - Pulmonary cement embolism T2 - J Bras Pneumol TI - Pulmonary cement embolism VL - 41 ID - 828641 ER - TY - JOUR AB - A 68-year-old man was referred to your outpatient clinic following a cemented right hip arthroplasty procedure 3 weeks before your examination. He reports that he has had pain in his right calf and thigh since being discharged from the hospital and that these symptoms limit his ability to ambulate. He also reports difficulty getting in and out of bed. You find that he has a swollen right lower extremity and that he complains of pain when you palpate his right posterior calf and knee. You suspect that he may have a deep vein thrombosis (DVT), but you also consider that it is likely that the lower-extremity symptoms are attributable to the recent surgical procedure. Do you contact the patient's physician? The diagnosis of DVT in patients who are hospitalized is well recognized, but DVT associated with outpatient care is less frequently discussed. The purpose of this update is to summarize evidence-based approaches to the clinical examination of outpatients who are at risk for DVT. We also review radiological and laboratory-based diagnostic tests used to confirm or refute the diagnosis of DVT. Venous thromboembolism (VTE) is a vascular disease that manifests as DVT or pulmonary embolism (PE). Both DVT and PE can be symptomatic or asymptomatic. Newly diagnosed cases of symptomatic VTE are estimated to occur in approximately 250,000 Americans per year, and DVT accounts for approximately two thirds of these cases. Deep vein thrombosis most commonly appears in the lower extremity and is typically classified as being either proximal (affecting the popliteal and thigh veins) or distal (affecting the calf veins). Proximal deep vein thrombosis (PDVT) is the more dangerous form of lower-extremity DVT because it is more likely to cause life-threatening PE and may result in a greater risk of postthrombotic syndrome. Calf DVT, although less serious than PDVT, must be considered because the thrombus extends proximally in approximately 30% of cases. AD - D.L. Riddle, Department of Physical Therapy, Medical College of Virginia Campus, Virginia Commonwealth University, Richmond, VA 23298-0224, United States AU - Riddle, D. L. AU - Wells, P. S. DB - Embase Medline KW - aged algorithm anticoagulant therapy case report clinical examination clinical feature consensus deep vein thrombosis diagnostic imaging evidence based medicine high risk patient hip arthroplasty human laboratory test leg edema leg pain leg thrombosis male medical decision making outpatient care patient care physician physiotherapist practice guideline probability professional practice review risk factor skill symptom LA - English M1 - 8 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2004 SN - 0031-9023 SP - 729-735 ST - Diagnosis of lower-extremity deep vein thrombosis in outpatients T2 - Physical Therapy TI - Diagnosis of lower-extremity deep vein thrombosis in outpatients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L38989543&from=export VL - 84 ID - 829834 ER - TY - JOUR AB - Background: Cement leakage is regarded as a typical complication of cement-based augmentation of vertebral fractures. The gold standard is balloon kyphoplasty (BK). Recent methods, such as radiofrequency kyphoplasty (RFK), must be compared with BK in terms of therapeutic success and complication rates. It is unclear whether the cement leakage rate in RFK is lower than with BK and whether this has any clinical relevance. Therefore, the aim of our prospective clinical study was to compare RFK with BK with respect to cement leakage rates and associated clinical complications. Patients and Methods: After prospective randomisation, 100 patients (76 women and 24 men with an average age of 78.5 years) or 162 vertebral bodies were treated by BK (n = 79) or RFK (n = 83). We evaluated the parameters "localisation of cement leakage" (epidural, intradiscal, extracorporal, intravascular) and "clinical relevance". Results: More cement is used in BK (5.2 ml) than in RFK (4.0 ml, p = 0.001). Cement leakage was found in 48/79 patients (60.8%) with BK and 53/83 patients (63.9%) with RFK (p = 0.420). Even subanalysis by location showed no significant difference between the two methods. Despite the high leakage rates, we experienced only two cases (1x BK, 1x RFK) with intravascular leakage in the inferior vena cava, with interventional endovascular salvage. Conclusion: The two examined kyphoplasty methods (BK vs. RFK) have the same high rates of cement leakage, but are rarely associated with clinically manifest complications. Clinically relevant differences between the two compared kyphoplasty methods could not be found. AD - [Riesner, H. -J.; Kiupel, K.; Lang, P.; Friemert, B.; Palm, H. -G.] Ulm Army Hosp, Dept Trauma Surg & Orthopaed, Oberer Eselsberg 40, D-89081 Ulm, Germany. [Stuby, F.] Univ Tubingen Hosp, Dept Trauma & Reconstruct Surg, Tubingen, Germany. Palm, HG (corresponding author), Ulm Army Hosp, Dept Trauma Surg & Orthopaed, Oberer Eselsberg 40, D-89081 Ulm, Germany. hg_palm@yahoo.de AN - WOS:000383273200017 AU - Riesner, H. J. AU - Kiupel, K. AU - Lang, P. AU - Stuby, F. AU - Friemert, B. AU - Palm, H. G. DA - Aug DO - 10.1055/s-0042-104069 J2 - Z. Orthop. Unfallchir. KW - vertebral body balloon kyphoplasty radiofrequency kyphoplasty cement augmentation cement leakage OSTEOPOROTIC VERTEBRAL FRACTURES PERCUTANEOUS VERTEBROPLASTY PULMONARY-EMBOLISM COMPRESSION FRACTURES VENA-CAVA POLYMETHYLMETHACRYLATE COMPLICATIONS METHACRYLATE MANAGEMENT SPINE Orthopedics LA - English M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2016 SN - 1864-6697 SP - 370-376 ST - Clinical Relevance of Cement Leakage after Radiofrequency Kyphoplasty vs. Balloon Kyphoplasty: A Prospective Randomised Study T2 - Zeitschrift Fur Orthopadie Und Unfallchirurgie TI - Clinical Relevance of Cement Leakage after Radiofrequency Kyphoplasty vs. Balloon Kyphoplasty: A Prospective Randomised Study UR - ://WOS:000383273200017 VL - 154 ID - 830210 ER - TY - JOUR AD - Division of Angiology and Hemostasis, Geneva University Hospital, 24 rue Micheli-du-Crest, 1211 Geneva 14, Switzerland. Marc.Righini@hcuge.ch AN - 16502563 AU - Righini, M. AU - Sekoranja, L. AU - Le Gal, G. AU - Favre, I. AU - Bounameaux, H. AU - Janssens, J. P. DA - Feb DP - NLM ET - 2006/03/01 J2 - Thrombosis and haemostasis KW - Bone Cements/*adverse effects Extravasation of Diagnostic and Therapeutic Materials/*complications Female Fractures, Bone/complications/therapy Humans Lumbar Vertebrae Middle Aged Pulmonary Embolism/diagnosis/*etiology Tomography, X-Ray Computed LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0340-6245 (Print) 0340-6245 SP - 388-9 ST - Pulmonary cement embolism after vertebroplasty T2 - Thromb Haemost TI - Pulmonary cement embolism after vertebroplasty VL - 95 ID - 828953 ER - TY - JOUR AB - We describe the first case of clinically significant neurological manifestations of the fat embolism syndrome in the absence of both patent foramen ovale and cardiopulmonary resuscitation during hip hemiarthroplasty. This is an important differential diagnosis in postoperative neurological dysfunction requiring high index of suspicion. Management is supportive. © 2014 Wichtig Publishing. AD - S. T. Roberts, John Hunter Hospital, 6/22 Patrick St Mewewether, New Lambton, NSW 2299, Australia AU - Roberts, S. T. AU - Nicholson, D. J. AU - Oakley, P. W. DB - Embase Medline DO - 10.5301/hipint.5000122 KW - antibiotic agent bone cement aged article atelectasis brain disease brain embolism case report dementia differential diagnosis diffusion coefficient diffusion weighted imaging facial nerve paralysis fat embolism female femur head prosthesis femoral neck fracture Glasgow coma scale hemiparesis hip hemiarthroplasty human imaging Mini Mental State Examination nuclear magnetic resonance imaging patent foramen ovale periprosthetic joint infection respiratory failure resuscitation spinal anesthesia thorax radiography transthoracic echocardiography weakness LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1120-7000 SP - 306-309 ST - Cerebral fat embolism following hip hemiarthroplasty in the absence of a patent foramen ovale with almost complete resolution T2 - HIP International TI - Cerebral fat embolism following hip hemiarthroplasty in the absence of a patent foramen ovale with almost complete resolution UR - https://www.embase.com/search/results?subaction=viewrecord&id=L373225376&from=export http://dx.doi.org/10.5301/hipint.5000122 VL - 24 ID - 829437 ER - TY - JOUR AB - Osteoporotic vertebral compression fractures are a menace to the elderly generation causing diminished quality of life due to pain and deformity. At first, conservative treatment still is the method of choice. In case of resulting deformity, sintering and persistent pain vertebral cement augmentation techniques today are widely used. Open correction of resulting deformity by different types of osteotomies addresses sagittal balance, but has comparably high morbidity. Besides conventional vertebral cement augmentation techniques balloon kyphoplasty has become a popular tool to address painful thoracic and lumbar compression fractures. It showed improved pain reduction and lower complication rates compared to standard vertebroplasty. Interestingly the results of two placebo-controlled vertebroplasty studies question the value of cement augmentation, if compared to a sham operation. Even though there exists now favourable data for kyphoplasty from one randomised controlled trial, the absence of a sham group leaves the placebo effect unaddressed. Technically kyphoplasty can be performed with a transpedicular or extrapedicular access. Polymethyl methacrylate (PMMA)-cement should be favoured, since calcium phosphate cement showed inferior biomechanical properties and less effect on pain reduction especially in less stable burst fractures. Common complications of kyphoplasty are cement leakage and adjacent segment fractures. Rare complications are toxic PMMA-monomer reactions, cement embolisation, and infection. AD - [Robinson, Yohan; Forsth, Peter; Olerud, Claes] Univ Uppsala Hosp, Inst Surg Sci, Dept Orthopaed, Uppsala, Sweden. [Heyde, Christoph E.] Leipzig Univ Hosp, Dept Orthopaed Surg, Leipzig, Germany. Robinson, Y (corresponding author), Univ Uppsala Hosp, Inst Surg Sci, Dept Orthopaed, Uppsala, Sweden. yohan.robinson@surgsci.uu.se AN - WOS:000306231600001 AU - Robinson, Y. AU - Heyde, C. E. AU - Forsth, P. AU - Olerud, C. C7 - 43 DA - Aug DO - 10.1186/1749-799x-6-43 J2 - J. Orthop. Surg. Res. KW - Kyphoplasty vertebroplasty osteoporosis spinal fractures FIXED SAGITTAL IMBALANCE CALCIUM-PHOSPHATE CEMENT PERCUTANEOUS VERTEBROPLASTY BALLOON KYPHOPLASTY RANDOMIZED-TRIAL AUGMENTATION STABILIZATION COMPLICATIONS WOMEN POLYMETHYLMETHACRYLATE Orthopedics LA - English M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2011 SN - 1749-799X SP - 8 ST - Kyphoplasty in osteoporotic vertebral compression fractures - Guidelines and technical considerations T2 - Journal of Orthopaedic Surgery and Research TI - Kyphoplasty in osteoporotic vertebral compression fractures - Guidelines and technical considerations UR - ://WOS:000306231600001 VL - 6 ID - 830321 ER - TY - JOUR AB - Osteoporotic vertebral compression fractures are a menace to the elderly generation causing diminished quality of life due to pain and deformity. At first, conservative treatment still is the method of choice. In case of resulting deformity, sintering and persistent pain vertebral cement augmentation techniques today are widely used. Open correction of resulting deformity by different types of osteotomies addresses sagittal balance, but has comparably high morbidity. Besides conventional vertebral cement augmentation techniques balloon kyphoplasty has become a popular tool to address painful thoracic and lumbar compression fractures. It showed improved pain reduction and lower complication rates compared to standard vertebroplasty. Interestingly the results of two placebo-controlled vertebroplasty studies question the value of cement augmentation, if compared to a sham operation. Even though there exists now favourable data for kyphoplasty from one randomised controlled trial, the absence of a sham group leaves the placebo effect unaddressed. Technically kyphoplasty can be performed with a transpedicular or extrapedicular access. Polymethyl methacrylate (PMMA)-cement should be favoured, since calcium phosphate cement showed inferior biomechanical properties and less effect on pain reduction especially in less stable burst fractures. Common complications of kyphoplasty are cement leakage and adjacent segment fractures. Rare complications are toxic PMMA-monomer reactions, cement embolisation, and infection. AD - Uppsala University Hospital, Institute for Surgical Sciences, Department of Orthopaedics, Uppsala, Sweden. yohan.robinson@surgsci.uu.se AN - 21854577 AU - Robinson, Y. AU - Heyde, C. E. AU - Försth, P. AU - Olerud, C. C2 - Pmc3170323 DA - Aug 19 DO - 10.1186/1749-799x-6-43 DP - NLM ET - 2011/08/23 J2 - Journal of orthopaedic surgery and research KW - Bone Cements Female Fractures, Compression/*surgery Humans Kyphoplasty/*methods Lumbar Vertebrae/surgery Male Osteoporotic Fractures/*surgery Practice Guidelines as Topic Spinal Fractures/*surgery Thoracic Vertebrae/surgery LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2011 SN - 1749-799x SP - 43 ST - Kyphoplasty in osteoporotic vertebral compression fractures--guidelines and technical considerations T2 - J Orthop Surg Res TI - Kyphoplasty in osteoporotic vertebral compression fractures--guidelines and technical considerations VL - 6 ID - 828629 ER - TY - JOUR AB - Twelve arteriovenous malformations of the dental arcades (AVMDAs) (seven mandibular and five maxillary) were seen in our institution between 1977 and 1997. All these lesions consisted of true arteriovenous shunts (of either nidus or fistulous type) involving the bone, with or without soft tissue extension. Haemorrhage was present in eight patients (67%); either torrential, necessitating emergency embolization, or recurrent and progressive. Teeth instability was detected in all patients and was the origin of the bleeding. All lesions were embolized. Lesions in nine patients were embolized with Polyvinyl Alcohol Particles (PVA): this helped to stabilize the situation but could not avoid recurrences in all patients, necessitating complementary embolizations and or surgery. The use of acrylic glue (N-Butyl-Cyano-Acrylate [NBCA] Histoacryl) as the embolic agent has changed the results obtained tremendously. Eight patients have been treated with NBCA (five as complementary therapy to PVA during later sessions and three at the first attempt); injection either via the transarterial route or direct transcutaneous puncture (four patients) achieved a cure in four of these lesions (34%) with stability at long-term follow-up of all the other AVMs. Embolization with glue represents the therapy of choice in these sometimes life-threatening lesions, achieving a cure if directed towards the osseous venous lakes. Surgery, often leading to facial mutilation and necessitating massive reconstruction should be avoided nowadays, at least as the initial therapy. AD - G. Rodesch, Neuroradiologie Vasculaire, Hopital Bicetre, 78 rue du General Leclerc, 94275 Le Kremlin Bicetre, France AU - Rodesch, G. AU - Soupre, V. AU - Vazquez, M. P. AU - Alvarez, H. AU - Lasjaunias, P. DB - Embase Medline DO - 10.1016/S1010-5182(98)80059-0 KW - acrylic cement enbucrilate glue polyvinyl alcohol arteriovenous malformation article artificial embolization bleeding clinical article emergency treatment female fistula human intraarterial drug administration jaw disease male mandible recurrent disease soft tissue defect tooth arch tooth injury transdermal drug administration LA - English M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1998 SN - 0301-0503 SP - 306-313 ST - Arteriovenous malformations of the dental arcades. The place of endovascular therapy: Results in 12 cases are presented T2 - Journal of Cranio-Maxillo-Facial Surgery TI - Arteriovenous malformations of the dental arcades. The place of endovascular therapy: Results in 12 cases are presented UR - https://www.embase.com/search/results?subaction=viewrecord&id=L28499907&from=export http://dx.doi.org/10.1016/S1010-5182(98)80059-0 VL - 26 ID - 829905 ER - TY - JOUR AB - BACKGROUND CONTEXT: The XLIF procedure allows for minimally invasive placement of a large anterior graft, disk height and alignment restoration, and indirect decompression. PURPOSE: The peri- and post-operative complications associated with the XLIF procedure are reported to demonstrate the feasibility, safety, and effectiveness of the approach. STUDY DESIGN/SETTING: Prospective, nonrandomized safety assessment. PATIENT SAMPLE: Data were collected for our single-site consecutive series of 775 XLIF patients. OUTCOME MEASURES: Peri- and post-operative complications and their relation to clinical and radiographic outcomes were evaluated to assess comorbidities, surgical details, hospital stay, complications, pain scores, reoperation rate, and fusion. METHODS: Our single-site consecutive series of 775 XLIF outcomes were reviewed. Surgical and postoperative complications were documented. RESULTS: 775 cases included patients aged 22-89 years (average 66 years). Diagnoses included stenosis (52%), spondylolisthesis (15%), DDD (12%), HNP (8%), post-laminectomy instability (6%), and scoliosis (8%). 77% had one or more pre-existing comorbidities, including diabetes, CAD, COPD, smoking, and chronic steroid use. 42% had prior lumbar surgery. 379 (49%) were obese or morbidly obese. 966 levels were treated: 80% single-level; 61% at L4-5. All but 5 included supplemental instrumentation. Hospital stay averaged 1.2 days. 57 complications were reported: (7.4% complication rate): 3 wound (herniamsubcutaneous hematoma, and infection); 3 hematologic (1 transfusion, 1 DVT, 1 FUO); 7 GI (6 ileus, 1 gastric volvulus); 5 renal (2 urinary retention, 1 peritoneal catheter occlusion, 1 UTI, 1 kidney stone); 1 mental status (delirium); 8 respiratory (5 pneumonia, 2 pulmonary embolism, 1 re-intubation); 7 cardiac (6 atrial fibrillations, 1 MI at 6 wks post-op); 4 neural (3 quad weakness, 1 anterior tibialis weakness); 12 vertebral body fractures (1 endplate fracture, 1 osteophyte fracture requiring reoperation, 1 subsidence requiring reoperation, 2 sacral fractures (1 requiring reoperation), 6 compression fractures at an adjacent level requiring vertebroplasty, 1 hnp at an adjacent level); 1 iatrogenic HNP (requiring laminectomy at 4 wks); 1 hnp at an adjacent level (requiring discectomy), and 6 hardware failures (3 cage fractures on insertion, 1 screw that penetrated the endplate, 1 fractured rod at 6 months, 1 fractured screw at 1 year). Reoperation rate was 72/775 (9.3%) (8 vertebroplasty, 8 axiaLIF, 24 XLIF, 12 PLIF, 2 ALIF, 15 laminectomy, 1 hardware revision, 1 hematoma drainage, and 1 stimulator implant,). Average VAS scores, radiographic measures, and fusion scores were not different between the complications group and the total series. CONCLUSIONS: XLIF is a safe, effective treatment for multiple thoracolumbar degenerative conditions. XLIF surgery can be performed in many conditions with a low complication rate. AD - W.B. Rodgers, Spine Midwest, Jefferson City, MO, United States AU - Rodgers, W. B. AU - Gerber, E. J. DB - Embase DO - 10.1016/j.spinee.2010.07.252 KW - steroid 1,1 dichloro 2,2 bis(4 chlorophenyl)ethane surgery society spine reoperation fracture postoperative complication laminectomy patient hospitalization percutaneous vertebroplasty hematoma nerve ending weakness computer height decompression safety risk assessment pain diagnosis stenosis spondylolisthesis scoliosis diabetes mellitus smoking devices wound infection transfusion ileus stomach volvulus urine retention peritoneal catheter catheter occlusion nephrolithiasis mental health pneumonia lung embolism intubation atrial fibrillation vertebra body osteophyte compression fracture discectomy implant delirium LA - English M1 - 9 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 1529-9430 SP - 95S ST - Complications in 775 XLIF surgeries T2 - Spine Journal TI - Complications in 775 XLIF surgeries UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70265349&from=export http://dx.doi.org/10.1016/j.spinee.2010.07.252 VL - 10 ID - 829651 ER - TY - JOUR AB - Pulmonary cement embolism (PCE) is a recognized complication of balloon kyphoplasty, a vertebral augmentation technique that stabilizes vertebral compression fractures, alleviating associated pain. Balloon kyphoplasty is particularly relevant when patients with advanced stages of cancer present with longer survival times, and therefore benefit from such augmentation techniques to improve pain and prevent additional complications. The embolization of cement to pulmonary vasculature may be unnoticed given the frequent absence of symptoms and routine imaging tests following the procedure. The present study reports the case of a 58-year-old female with stage IV lung cancer with a painful compression L3 fracture who underwent balloon kyphoplasty with no initially reported complications. The patient maintained the usual respiratory symptoms; therefore, the diagnosis was only made in a routine CT scan 3 months after the surgery. A literature review of PCE is performed, integrating the current evidence regarding diagnosis, therapeutics, prognosis and prevention. Certain poorly clarified aspects are identified as potential investigation starting points. AD - Department of Pulmonology, Hospital Pedro Hispano, São Mamede de Infesta, 4465-120 Matosinhos, Portugal. Multidisciplinary Unit of Thoracic Tumors, Department of Pulmonology, Centro Hospitalar Vila Nova de Gaia/Espinho, 4434-502 Vila Nova de Gaia, Portugal. AN - 30680211 AU - Rodrigues, D. M. AU - Cunha Machado, D. P. AU - Campainha Fernandes, S. A. AU - Paixão Barroso, A. M. C2 - Pmc6327216 DA - Feb DO - 10.3892/mco.2018.1782 DP - NLM ET - 2019/01/27 J2 - Molecular and clinical oncology KW - cancer cement embolism kyphoplasty pulmonary LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 2049-9450 (Print) 2049-9450 SP - 299-303 ST - Pulmonary cement embolism following balloon kyphoplasty: The impact of a procedural complication in a new era for lung cancer management T2 - Mol Clin Oncol TI - Pulmonary cement embolism following balloon kyphoplasty: The impact of a procedural complication in a new era for lung cancer management VL - 10 ID - 828611 ER - TY - JOUR AB - Pulmonary cement embolism (PCE) is a recognized complication of balloon kyphoplasty, a vertebral augmentation technique that stabilizes vertebral compression fractures, alleviating associated pain. Balloon kyphoplasty is particularly relevant when patients with advanced stages of cancer present with longer survival times, and therefore benefit from such augmentation techniques to improve pain and prevent additional complications. The embolization of cement to pulmonary vasculature may be unnoticed given the frequent absence of symptoms and routine imaging tests following the procedure. The present study reports the case of a 58-year-old female with stage IV lung cancer with a painful compression L3 fracture who underwent balloon kyphoplasty with no initially reported complications. The patient maintained the usual respiratory symptoms; therefore, the diagnosis was only made in a routine CT scan 3 months after the surgery. A literature review of PCE is performed, integrating the current evidence regarding diagnosis, therapeutics, prognosis and prevention. Certain poorly clarified aspects are identified as potential investigation starting points. AD - D.M. Rodrigues, Department of Pulmonology, Hospital Pedro Hispano, São Mamede de Infesta, Matosinhos, Portugal AU - Rodrigues, D. M. AU - Machado, D. P. C. AU - Fernandes, S. A. C. AU - Barroso, A. M. P. DB - Embase DO - 10.3892/mco.2018.1782 KW - cisplatin enoxaparin erlotinib gemcitabine nivolumab pemetrexed vinorelbine tartrate adult article bone metastasis bronchoscopy cancer staging case report chemoradiotherapy clinical article computer assisted tomography disease exacerbation echocardiography human human tissue immunohistochemistry kyphoplasty lobectomy lumbar spine lung biopsy lung cancer male middle aged multiple cycle treatment nuclear magnetic resonance imaging palliative therapy phlebography positron emission tomography postoperative complication pulmonary cement embolism LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 2049-9469 2049-9450 SP - 299-303 ST - Pulmonary cement embolism following balloon kyphoplasty: The impact of a procedural complication in a new era for lung cancer management T2 - Molecular and Clinical Oncology TI - Pulmonary cement embolism following balloon kyphoplasty: The impact of a procedural complication in a new era for lung cancer management UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2004851991&from=export http://dx.doi.org/10.3892/mco.2018.1782 VL - 10 ID - 829155 ER - TY - JOUR AB - Introduction and objectives: Cementation of vertebral bodies has been linked with pulmonary alterations, which, according to some authors, has led to a restricted use of this technique when there is involvement of more than three vertebrae. However, there are no clinical data correlating vertebral cementation with pulmonary damage. The purpose of the study is to determine if the injection of polymethyl methacrylate (PMMA) in the vertebral body is related to pulmonary alterations. Materials and methods: Prospective non-randomized observational study with two groups (cemented and not cemented, mean age 77.4 and 58.5 years, respectively) of 25 patients each and instrumentation at one level. Arterial gasometry was performed in the course of the intervention, as well as pre- and post-instrumentation transesophageal echocardiography. Elisa for basal urinary desmosine (marker for lung injury) was done post-instrumentation and at 24 and 72, as well as chest X-ray at 24 and 72 hours; results were compared with comparison with pre-operative data. Results: In both groups, low urinary desmosine levels were determined in pre-instrumentation samples, with progressive increase for up to 24 hours after the surgery and subsequent decrease at 72 hours, with no statistically significant differences between groups. There were no cases of pulmonary thromboembolism, although in the postoperative chest X-ray of two patients, cement residues were seen but without increase of desmosine levels nor associated gasometric changes. We did no detect any relationship between intraoperative urinary desmosine levels and gasometric changes. Regarding the echocardiogram, there was an increase in the passage of particles during cementation, greater than in control cases, without relationship with the increase of desmosine levels. Conclusions: Although the comparison was made against a younger group, no clinical, analytical, or gasometric data indicating lung injury was found in the group of cemented patients. Further studies should be carried out, with the inclusion of more extensive fusions to assess the risk of pulmonary lesion when this technique is used. AD - M.G. Rodriguez Arguisjuela, Fundación Jiménez Diaz, Unidad De Patologia De Columna, Madrid, Spain AU - Rodriguez Arguisjuela, M. G. AU - Castelbon Calvo, I. AU - Piñera Parrilla, A. R. AU - Gallego Bustos, J. AU - Mengis Palleck, C. L. R. AU - Martin Piñeiro, B. AU - Leal Caramazana, V. AU - Cuellar Bobadilla, C. AU - Bravo Álvarez, N. AU - Garzón Márquez, F. M. AU - Sanz Aguilera, S. AU - Moya Diaz, A. B. AU - Tomé Bermejo, F. AU - Benito Gallo, M. AU - López Herradón, A. AU - Heili Frades, S. AU - Álvarez Galovich, L. DB - Embase DO - 10.1007/s00586-018-5769-8 KW - desmosine poly(methyl methacrylate) aged cementation clinical article conference abstract controlled study enzyme linked immunosorbent assay female human injection lung embolism lung injury lung lesion male observational study preoperative evaluation prospective study risk assessment surgery thorax radiography transesophageal echocardiography vertebra body LA - English M1 - 10 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1432-0932 SP - 2665 ST - Alterations of lung tissue after spinal instrumented fusion with injection of polymethyl methacrylate T2 - European Spine Journal TI - Alterations of lung tissue after spinal instrumented fusion with injection of polymethyl methacrylate UR - https://www.embase.com/search/results?subaction=viewrecord&id=L624693649&from=export http://dx.doi.org/10.1007/s00586-018-5769-8 VL - 27 ID - 829179 ER - TY - JOUR AB - BACKGROUND CONTEXT: Pulmonary complications in patients age 75 years and older who undergo spinal fusion may have catastrophic consequences. The use of augmentation techniques with polymethylmethacrylate (PMMA) have been associated with pulmonary damage. The use of fenestrated pedicle screws augmented with PMMA may increase the risk of lung injury in this population. PURPOSE: To investigate whether the use of PMMA-augmented screws is correlated with increased lung injury in patients undergoing instrumented lumbar spinal fusion. STUDY DESIGN: A nonrandomized, prospective, case-controlled clinical study was carried out. PATIENT SAMPLE: We included 50 consecutive patients: 25 classifieds as patients who required PMMA-augmented screws in lumbar spinal fusion, and 25 classifieds as control participants because they underwent uncemented instrumented spinal fusion. OUTCOME MEASURES: We compare the incidence of the event, lung damage, in both groups by measuring a series of parameters: arterial blood gas, transesophageal echocardiography, urinary desmosine, and chest radiograph. The epidemiological parameters analyzed were age, sex, body mass index, status as a smoker, and number of cement leaks. METHODS: Changes in pulmonary damage markers were described in both groups of patients, comparing postsurgery values with baseline values. In control participants, each change was evaluated for the total number of patients. All changes are indicated in this report by mean differences for quantitative variables and by differing proportions for qualitative variables, with 95% confidence intervals provided for all values. RESULTS: There was an increase in postinstrumentation PaO2 (arterial partial pressure of oxygen) in both groups, probably related to the use of mechanical ventilation and recruitment maneuvers. Even though the group that required augmentation had lower baseline levels, the difference between groups was not statistically significant. On transesophageal echocardiographs, we observed scattered small, snowflake-like emboli, and bright echo signals appeared in the right atrium during PMMA injection. Signal density was constant but gradually faded away when PMMA injection ended. No participants in the group without augmentation had radiological complications. Overall, desmosine levels increased in both groups, and the rise was similar in both. There was a slight average increase in urine desmosine levels after instrumentation and progressively continues to rise until 24 hours after instrumentation, with a subsequent decrease at 72 hours. Comparing the two groups, we found no statistically significant differences at any time. CONCLUSIONS: We were not able to identify a significant difference in urine desmosine levels associated with the augmentation of with fenestrated pedicle screws with PMMA. Despite comparing patients age 75 years or older with a younger group, we found no clinical, analytical, or gasometric data indicating lung damage in patients who had augmentation. AD - Spine Unit, Av Reyes Catolicos 2, 28040 Madrid, Spain. Department of Anesthesiology, Av Reyes Catolicos 2, 28040 Madrid, Spain. Pulmonary Department, Av Reyes Catolicos 2, 28040 Madrid, Spain. Department of Statistics Fundación Jiménez Diaz, Av Reyes Catolicos 2, 28040 Madrid, Spain. Hospital General de Villalba, Orthopedic Department, Collado Villalba, 28400 Madrid, Spain. Spine Unit, Av Reyes Catolicos 2, 28040 Madrid, Spain. Electronic address: lalvarez@fjd.es. AN - 33259968 AU - Rodriguez-Arguisjuela, M. AU - Martin-Piñeiro, B. AU - Cuéllar-Bobadilla, C. AU - Leal-Caramanzana, V. AU - Heili-Frades, S. AU - Mahíllo-Fernandez, I. AU - Mengis, C. L. AU - Gallego-Bustos, J. AU - Peiro, A. AU - Garzon-Márquez, F. M. AU - Tomé-Bermejo, F. AU - Alvarez-Galovich, L. DA - Nov 28 DO - 10.1016/j.spinee.2020.11.006 DP - NLM ET - 2020/12/02 J2 - The spine journal : official journal of the North American Spine Society KW - Elderly population Fenestrated augmented pedicle screws Osteoporosis Pmma Pulmonary embolism Spine surgery complication LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 1529-9430 ST - Lung injury in patients age 75 years and older with the use of polymethylmethacrylate fenestrated pedicle screws T2 - Spine J TI - Lung injury in patients age 75 years and older with the use of polymethylmethacrylate fenestrated pedicle screws ID - 828602 ER - TY - JOUR AB - The results of primary total knee replacement performed on a group of haemophiliac patients in a single institution by the same surgeon using the same surgical technique and prosthesis are reported. A total of 35 primary replacements in 30 patients were carried out between 1996 and 2005 and were reviewed retrospectively. The mean age of the patients was 31 years (24 to 42) and the mean follow-up was for 7.5 years (1 to 10). There were 25 patients with haemophilia A and five with haemophilia B. The HIV status and CD4 count were recorded, and Knee Society scores determined. Two patients had inhibitors to the deficient coagulation factor. There were no early wound infections and only one late deep infection which required a two-stage revision arthroplasty, with a good final result. The incidence of infection in HIV-positive and negative patients was thus similar. One knee in a patient with inhibitor had excessive bleeding due to a pseudoaneurysm which required embolisation. The results were excellent in 27 knees (77%), good in six (17%) and fair in two (6%). The survival rate at 7.5 years taking removal of the prosthesis for loosening or infection as the end-point was 97%. The mechanical survival of total knee replacements in haemophiliacs is very good. Our results confirm that this is a reproducible procedure in haemophilia, even in HIV-positive patients with a CD4 count > 200 mm(3) and those with inhibitors. Our rate of infection was lower than previously reported. This could be due to better control of the HIV status with highly active anti-retroviral therapy and the use of antibiotic-loaded cement. AD - Associate Professor, Department of Orthopaedics and Haemophilia Unit, La Paz University Hospital, Paseo de la Castellana 261, 28046 Madrid, Spain; rmerchan@arrakis.es AN - 105997388. Language: English. Entry Date: 20080222. Revision Date: 20200708. Publication Type: Journal Article AU - Rodriguez-Merchan, E. C. DB - cin20 DO - 10.1302/0301-620x.89b2.18682 DP - EBSCOhost KW - Arthroplasty, Replacement, Knee -- Methods Hemophilia -- Complications Joint Diseases -- Surgery Adult Hemarthrosis -- Etiology HIV Infections -- Complications Joint Diseases -- Etiology Joint Diseases -- Radiography Knee Joint -- Radiography Male Prospective Studies Retrospective Design Treatment Outcomes Human M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2007 SN - 0301-620X SP - 186-188 ST - Total knee replacement in haemophilic arthropathy T2 - Journal of Bone & Joint Surgery, British Volume TI - Total knee replacement in haemophilic arthropathy UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105997388&site=ehost-live&scope=site VL - 89 ID - 830766 ER - TY - JOUR AB - Cerebral embolism poses one of the most perplexing problems in cerebrovascular disease; fat emboli and marantic air emboli occur occasionally. However, the most common cause for a cerebral embolism is degenerative changes in the central arteries. The authors report the case of a 75-year-old female suffering from ischemic cerebrovascular disease of the left dominant hemisphere during a revision arthroplasty of the right hip (cementless Austin Moore hemiarthroplasty to a cemented Charnley total hip replacement); a cement gun was used to introduce the cement; both the induction of anesthesia and the surgical procedure were uneventful. The patient awoke slowly, and when awake she showed a combination of contralateral hemiplegia, and right hemianesthesia with global aphasia; the CT scan showed an ischemic lesion in the territory of the middle cerebral artery; during the following two weeks the patient showed complete recovery from the clinical syndrome. This complication must be recognized by every orthopedic surgeon, and a high clinical index of suspicion remains essential to early diagnosis. AD - Traumatology Service, La Paz Hospital, Madrid, Spain. AN - 8571770 AU - Rodriguez-Merchan, E. C. AU - Comin-Gomez, J. A. AU - Martinez-Chacon, J. L. DP - NLM ET - 1995/01/01 J2 - Acta orthopaedica Belgica KW - Aged Anesthesia, General/methods Female Hip Prosthesis/*methods Humans Intracranial Embolism and Thrombosis/diagnostic imaging/*etiology Intraoperative Complications/*etiology Radiography Remission, Spontaneous LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 1995 SN - 0001-6462 (Print) 0001-6462 SP - 319-22 ST - Cerebral embolism during revision arthroplasty of the hip T2 - Acta Orthop Belg TI - Cerebral embolism during revision arthroplasty of the hip VL - 61 ID - 828994 ER - TY - JOUR AB - The clinical case of a 34-year-old patient is presented who was diagnosed with Ewing sarcoma in the right pedicle of the L5 vertebral body on the basis of persisting dorsolumbar pain. Staging examinations including CT scan of the thorax and abdomen as well as bone scintigraphy were inconspicuous. The patient underwent 6 cycles of neoadjuvant chemotherapy (VIDE, similar to Euro Ewing 99). Presurgically, embolisation of the L4 and L5 vertebral bodies was performed on both sides. The tumour was removed via a dorsal approach with corporectomy of L5 and resection of the right nerve root of L5. The defect was bridged by a titanium cage filled with bone cement; a dorsal L4-S1 instrumentation was performed. Early postoperative X-rays showed a screw dislocation in S1, making a revision intervention and screw replacement necessary. For additional fixation, S2 was instrumented. Histopathology classified the tissue samples as containing no active tumour cells. Surgery was followed by additional chemotherapy. The patient has remained free of recurrence until now. The aim of this case report is to call attention to the unusual site of the Ewing sarcoma as well as to discuss therapy options, especially dorsal corporectomy, and the prognosis together with a review of the most current literature. AD - [Roellinghoff, M.; Koriller, M.; Sobottke, R.; Delank, K. -S.; Eysel, P.] Univ Cologne, Dept Orthoped Surg, D-50924 Cologne, Germany. Rollinghoff, M (corresponding author), Univ Cologne, Dept Orthoped Surg, Joseph Stelzmannstr 9, D-50924 Cologne, Germany. marc.roellinghoff@gmx.de AN - WOS:000261311700008 AU - Rollinghoff, M. AU - Koriller, M. AU - Sobottke, R. AU - Delank, K. S. AU - Eysel, P. DA - Nov DO - 10.1055/s-2008-1080938 J2 - Zent.bl. Neurochir. KW - Ewing sarcoma spine corporectomy tumor instrumentation SURGICAL TECHNIQUE TUMORS SPINE SPONDYLECTOMY EXPERIENCE BONE Neurosciences Surgery LA - English M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2008 SN - 0044-4251 SP - 200-203 ST - Dorsal Corporectomy in a Ewing Sarcoma Situated in the Pedicle of the L5 Vertebral Body T2 - Zentralblatt Fur Neurochirurgie TI - Dorsal Corporectomy in a Ewing Sarcoma Situated in the Pedicle of the L5 Vertebral Body UR - ://WOS:000261311700008 VL - 69 ID - 830370 ER - TY - JOUR AB - The clinical case of a 34-year-old patient is presented who was diagnosed with Ewing sarcoma in the right pedicle of the L5 vertebral body on the basis of persisting dorsolumbar pain. Staging examinations including CT scan of the thorax and abdomen as well as bone scintigraphy were inconspicuous. The patient underwent 6 cycles of neoadjuvant chemotherapy (VIDE, similar to Euro Ewing 99). Presurgically, embolisation of the L4 and L5 vertebral bodies was performed on both sides. The tumour was removed via a dorsal approach with corporectomy of L5 and resection of the right nerve root of L5. The defect was bridged by a titanium cage filled with bone cement; a dorsal L4-S1 instrumentation was performed. Early postoperative X-rays showed a screw dislocation in S1, making a revision intervention and screw replacement necessary. For additional fixation, S2 was instrumented. Histopathology classified the tissue samples as containing no active tumour cells. Surgery was followed by additional chemotherapy. The patient has remained free of recurrence until now. The aim of this case report is to call attention to the unusual site of the Ewing sarcoma as well as to discuss therapy options, especially dorsal corporectomy, and the prognosis together with a review of the most current literature. AD - Department of Orthopedic Surgery, Universitiy of Cologne, Köln, Germany. marc.roellinghoff@gmx.de AN - 18949684 AU - Röllinghoff, M. AU - Koriller, M. AU - Sobottke, R. AU - Delank, K. S. AU - Eysel, P. DA - Nov DO - 10.1055/s-2008-1080938 DP - NLM ET - 2008/10/25 J2 - Zentralblatt fur Neurochirurgie KW - Adult Bone Screws Combined Modality Therapy Embolization, Therapeutic Humans Low Back Pain/etiology Magnetic Resonance Imaging Male *Neurosurgical Procedures Radiotherapy Sarcoma, Ewing/*surgery/therapy Spinal Neoplasms/*surgery/therapy Spinal Nerve Roots/surgery Spine/*surgery Tomography, X-Ray Computed LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 0044-4251 (Print) 0044-4251 SP - 200-3 ST - Dorsal corporectomy in a Ewing sarcoma situated in the pedicle of the L5 vertebral body T2 - Zentralbl Neurochir TI - Dorsal corporectomy in a Ewing sarcoma situated in the pedicle of the L5 vertebral body VL - 69 ID - 828905 ER - TY - JOUR AB - The authors present the very rare complication of widespread pulmonary artery cement embolism after pedicle screw augmentation with bone cement for multilevel spine fusion. A 69-year-old woman with severe osteoporosis underwent a posterior T12S1fusion because of lumbar scoliosis. After two months the superior pedicle screws loosened, and a revision spondylodesis T8L1 was performed with bone cement augmentation of the pedicle screws. Although cement leakage was seen paravertebrally, the patient was asymptomatic and reported distinct pain relief, so that no further investigations were initiated. Three months later, instability was identified in the adjacent superior segment. A CT-scan of the chest now revealed multiple pulmonary cement embolisms. Corpectomy T7 and extension spondylodesis T6T9 with an anterior single rod were performed. The pulmonary embolisms remained clinically silent and lung function was normal 18 months after surgery. The risk for cement embolism after pedicle screw augmentation has been established at 1/119 or 0.8%. After vertebroplasty and kyphoplasty it ranges from 3 to 23%. The existing literature offers no clear strategy for prevention or treatment of pulmonary cement embolism. The authors feel, as far as prevention is concerned, that creating a cavity by means of balloon distention before pedicle screw augmentation allows to inject the cement under lower pressure, so that the incidence of cement embolism might be reduced. Treatment options include, besides surgical removal in symptomatic embolism, heparin or warfarin treatment for 3 to 6 months. AD - Department of Orthopaedic and Trauma Surgery, University of Cologne, Cologne, Germany. marc.roellinghoff@gmx.de AN - 20503956 AU - Röllinghoff, M. AU - Siewe, J. AU - Eysel, P. AU - Delank, K. S. DA - Apr DP - NLM ET - 2010/05/28 J2 - Acta orthopaedica Belgica KW - Aged *Bone Cements Bone Screws Cementation/*adverse effects Female Humans Internal Fixators Osteoporosis/complications Pulmonary Embolism/*etiology Scoliosis/*surgery Spinal Fusion/*adverse effects/methods Spinal Stenosis/surgery Vertebroplasty/adverse effects/*methods LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 0001-6462 (Print) 0001-6462 SP - 269-73 ST - Pulmonary cement embolism after augmentation of pedicle screws with bone cement T2 - Acta Orthop Belg TI - Pulmonary cement embolism after augmentation of pedicle screws with bone cement VL - 76 ID - 828724 ER - TY - JOUR AB - Introduction: Vertebrae with lytic metastasis have an high risk of burst fracture with neurologic complications. The gold standard for treatment of solitary metastases confined into the vertebral body is vertebrectomy. However many patients are not eligible for such an invasive procedure. Nevertheless, prevention of vertebral collapse plays a meaningful role in conserving and improving the quality of life in these patients. The prophylactic vertebroplasty may reduce pain and risk of fractures in metastatic vertebrae. The purpose of this study is to verify the effectiveness of vertebroplasty for treatment of vertebral metastases. Methods: In the last eighteen months we have treated ten patients with vertebral metastasis from larynx, breast, lung, kidney and uterus. Vertebral localizations were mainly at lumbar level and in few cased at dorso-lumbar level. The mean age of patients was 62.4 years. Our series included 8 women and 2 men. All the patients were studied with standard X-Ray projections both pre- and post surgery and at follow-up. TC scan, NMR and scintigraphy were performed in all patients pre-operatively whereas CT scan was routinely performed at 4 months after surgery. Clinical follow-up was performed using the VAS and the SF-36 scale. The procedure included a trans-pedicular bony biopsy followed by Vessel-X Vertebroplasty. Results: Cement leakage was detected into the inter-vertebral disc and in the vertebral venous system in 2 cases. Nevertheless there were no cases of pulmonary embolism or neurologic complications after the procedure. Trans-pedicular biopsy could confirm presence of neoplastic tissue in seven patients. Low back pain was significantly decreased at the VAS scale 1 month after surgery. Such an improvement remained stable at 4 months follow-up. No fracture of the vertebral body nor local progression of disease were detected at CT-scan at 4 month follow-up. Conclusions: The treatment of metastatic spinal tumours with modified Vessel-X vertebroplasty came out to be a safe and repeatable treatment. Injection of bone-cement into the anterior column with integrity of the posterior column leads to a good stability to the vertebra. Our preliminary data confirm the usefullness of this procedure in preventing vertebral body fracture and relieving pain at an average follow-up of 4 months. It is not possible by now to completely estimate the role of the vertebroplasty in controlling the neoplastic progression in the vertebral body, due to the small number of cases in our series. AD - F. Romanò, Department of Orthopaedic and Traumatology, Italy AU - Romanò, F. AU - Ragni, P. AU - Bertocco, P. AU - Corradini, G. AU - Mercalli, M. DB - Embase DO - 10.1007/s00586-010-1375-0 KW - cement bone cement percutaneous vertebroplasty spine society human female patient follow up vertebra body fracture procedures vertebra surgery metastasis computer assisted tomography bone filler neurological complication biopsy spine metastasis pain risk lung embolism venous circulation intervertebral disk quality of life prevention gold standard scintigraphy invasive procedure male X ray uterus kidney low back pain tissues lung injection breast larynx nuclear magnetic resonance LA - English M1 - 5 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0940-6719 SP - 864-865 ST - The role of vertebroplasty in lytic metastatic lesions: Preliminary report T2 - European Spine Journal TI - The role of vertebroplasty in lytic metastatic lesions: Preliminary report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71562108&from=export http://dx.doi.org/10.1007/s00586-010-1375-0 VL - 19 ID - 829671 ER - TY - JOUR AB - Prostate-related metastatic spinal cord compression (MSCC) accounts for 50% of all MSCC cases and constitute an oncological emergency. Metastatic spread has a detrimental impact on patient quality of life and the whole management strategy. We sought to identify the prognostic factors influencing the survival rate of patients operated for prostate-related MSCC. Sixty medical records of patients operated for prostate-related MSCC were selected from January 2002 to December 2014 in the Neurosurgery Department, Yopougon Teaching Hospital, Abidjan, Ivory Coast. Tokuhashi and Karnofsky scales were used to assess prognostic scores. Survival curves were generated using the Kaplan-Meier, and we used the log rank analysis for statistical comparison with a statistical significance threshold p < 0.05. The mean age was 57.16 ± 9.3 years (41–80) with an average of 57 years. The mean survival of the population was 27 ± 5 months (1–55 months), and the overall survival curve showed that 50% survival rate was seen in 31 months. The following parameters were associated with a poor overall survival rate: Tokuhashi score between 0 and 8 and Karnofsky score ≤ 50%. Poor overall survival rate was also observed in patient over 60 years of age, WHO score > 3, Frankel scale A-B, presence of metastasis, Gleason score > 5, PSA levels > 100 ng/ml, LH-RH analogue (decapeptyl LP 11.25) and anterior corpectomy and fusion. All analysis failed to show any significant difference. The management of prostate-related MSCC requires a multidisciplinary approach. Surgery has an unequivocal impact on patient quality of life if their combined prognostic scores are satisfactory. AD - K. Romuald, Neurosurgery Department, Yopougon Teaching Hospital, Abidjan, Cote d'Ivoire AU - Romuald, K. AU - Cédric, B. AU - Alban, M. AU - Ismael, D. AU - Dominique, N. D. O. AU - Guy, V. DB - Embase DO - 10.1007/s13193-020-01155-x KW - bicalutamide carboplatin cisplatin clodronic acid cyclophosphamide cyproterone acetate docetaxel estramustine phosphate ibandronic acid prostate specific antigen zoledronic acid adult aged article cancer chemotherapy cancer hormone therapy cancer prognosis cancer specific survival cancer survival cervical spinal cord external beam radiotherapy Frankel grade Gleason score histology human human tissue hypercalcemia Kaplan Meier method Karnofsky Performance Status laminectomy lung embolism major clinical study male medical record review monotherapy neurosurgery overall survival percutaneous vertebroplasty primary tumor priority journal progression free survival prophylaxis prostate cancer sepsis spinal cord compression spine fusion spine metastasis survival rate urinary tract infection LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 0976-6952 0975-7651 SP - 498-508 ST - Prognostic Factors Influencing Survival Rate of Patients Operated for Prostate-Related Metastatic Spinal Cord Compression (MSCC) T2 - Indian Journal of Surgical Oncology TI - Prognostic Factors Influencing Survival Rate of Patients Operated for Prostate-Related Metastatic Spinal Cord Compression (MSCC) UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2005593203&from=export http://dx.doi.org/10.1007/s13193-020-01155-x VL - 11 ID - 829058 ER - TY - JOUR AB - Vascular anomalies are mainly divided into two groups: vasoproliferative/vascular neoplasms (e.g., hemangioma), and vascular malformations (VMs). The main difference between the two resides in the histopathological assessment, while vascular tumors are true neoplasm, typically congenital with rapid postnatal growth, and eventual slow regression; VMs have a single endothelial cell lining, tend to be regarded as acquired despite being congenital in nature, can undergo sudden and massive growth, miming neoplastic proliferation. Arteriovenous malformation (AVMs) are one type of fast flow VMs, with a four-stage natural history, and potentially disruptive evolution. Magnetic resonance is the gold-standard for diagnosis and pre-operative planning while computer tomography is particularly valuable for AVMs involving bones, and selective angiography can define source / draining vessels for sclerotherapy and surgical planning. Given their unpredictable evolution, AVMs shouldn’t be treated until symptomatic, complicated, or aesthetically unacceptable. Surgical resection should be preceded by arterial embolization from 24 to 72 hours, which must be extensive in order to reduce the risk of recurrence. Pain due to ischemic condition is one of the most common and debilitating symptoms of AVM, while gassosus gangrene is the most feared complication as they can become pabulum for bacteria overgrowth eventually resulting in necrotizing fasciitis. Given their clinical evolution, VMs pose physicians at great challenge in identifying the best-suited treatment for each case. It is of paramount importance to be able to make accurate diagnosis, understand the basic physiology, and use appropriate diagnostic and treatment modalities to optimize outcome. Proper multidisciplinary approach along with constant psychological support is the basis for a successful final outcome. Aim of this work was to provide a deeper insight into these relatively uncommon pathology and related hardship that afflicts both patients and their families. (www. actabiomedica.it). AD - N.D. Rosa, O.U. of Hand Surgery and Microsurgery, Azienda Ospedaliera Policlinico of Modena, Modena, Italy AU - Rosa, N. D. AU - Bertozzi, N. AU - Adani, R. DB - Embase Medline DO - 10.23750/abm.v91i3.8298 KW - antibiotic agent bone cement adult angiography arterial embolization arteriography arteriovenous fistula artery blood flow article bleeding bone erosion case report cell proliferation clinical article computer assisted tomography congenital blood vessel malformation dermatitis dermoipodermitis echography female fever fracture nonunion hemangioma hormonal therapy human hyperplasia limb pain muscle atrophy necrotizing fasciitis nuclear magnetic resonance imaging osteochondroma physician prevalence resuscitation sclerotherapy septic shock soft tissue swelling vascular tumor young adult LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 2531-6745 0392-4203 SP - 1-6 ST - Vascular malformation and their unpredictable evolution: A true challenge for physicians T2 - Acta Biomedica TI - Vascular malformation and their unpredictable evolution: A true challenge for physicians UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2005086625&from=export http://dx.doi.org/10.23750/abm.v91i3.8298 VL - 91 ID - 829057 ER - TY - JOUR AB - Background: Blood loss during total knee arthroplasty (TKA) may require blood transfusions that are associated with increased risk, morbidity, and cost. Multiple techniques exist to reduce blood loss in TKA, including the use of a tourniquet and tranexamic acid (TXA). While multiple studies suggest that TXA is effective in reducing blood loss, the use of a tourniquet is more controversial. We studied the combined effect of TXA with a limited‐use tourniquet on blood loss and complications in the setting of primary TKA. Methods: A retrospective review of a prospectively gathered arthroplasty database from a single institution was performed. We compared our limited‐use cohort data with the published results of randomized controlled trials evaluating the effectiveness of tourniquets used during the entire TKA procedure. Results: Fifty‐one procedures from our institution’s database met the inclusion criteria. TXA (administered in a single 15‐mg/kg dose) with limited tourniquet use (a mean duration of 26.3 minutes) resulted in an average intraoperative estimated blood loss of 94.7 mL. The mean decrease in hemoglobin from the preprocedure baseline to postoperative day 1 was 2.6±0.9 g/dL (P<0.001), and only 2 of the 51 procedures required a blood transfusion. When compared to recent randomized controlled trials, the 51 procedures demonstrated lower levels of blood loss, similar operative time, and no increase in morbidity or mortality. Conclusion: Our study results suggest that using TXA in combination with a tourniquet during the cementation portion only of a TKA provides a reasonable operative time and low intraoperative blood loss without increasing perioperative morbidity or complications. AN - CN-01299411 AU - Rosenstein, A. D. AU - Michelov, Y. A. AU - Thompson, S. AU - Kaye, A. D. KW - *operative blood loss /drug therapy /complication /drug therapy /therapy *total knee arthroplasty *tourniquet Adult Aged Article Blood transfusion Clinical article Cohort analysis Controlled study Deep vein thrombosis /complication Female Hemoglobin blood level Hospital readmission Human Intraoperative period Lung embolism /complication Male Operation duration Postoperative period Prospective study Randomized controlled trial Retrospective study Single drug dose Surgical infection Wound healing impairment /complication M1 - 4 M3 - Journal: Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2016 SP - 443‐449 ST - Benefits of limited use of a tourniquet combined with intravenous tranexamic acid during total knee arthroplasty T2 - Ochsner journal TI - Benefits of limited use of a tourniquet combined with intravenous tranexamic acid during total knee arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01299411/full VL - 16 ID - 830052 ER - TY - JOUR AN - 24855772 AU - Rosman, J. AU - Graftieaux, J. P. AU - Eap, C. DA - Apr DP - NLM ET - 2014/05/27 J2 - La Revue du praticien KW - Aged *Cementoplasty Female Humans Kyphoplasty *Postoperative Complications Pulmonary Embolism/*diagnostic imaging/*etiology Radiography LA - fre M1 - 4 N1 - PubMed NLM literature search January 5, 2021 OP - Embolie pulmonaire post-cimentoplastie. PY - 2014 SN - 0035-2640 (Print) 0035-2640 SP - 461 ST - [Post-cementoplasty pulmonary embolism] T2 - Rev Prat TI - [Post-cementoplasty pulmonary embolism] VL - 64 ID - 828514 ER - TY - JOUR AD - I. B. Ross, Huntington Memorial Hospital, 630 South Raymond Avenue #330, Pasadena, CA 91105, United States AU - Ross, I. B. AU - Fineman, I. DB - Embase Medline DO - 10.1017/S0317167100009781 KW - bone cement narcotic analgesic agent poly(methyl methacrylate) steroid aged arthrodesis article case report cementation compression fracture computer assisted tomography delayed neurotoxicity female fracture fixation fragility fracture general condition improvement human kyphoplasty kyphosis laminectomy leg pain limb weakness lumbar spine lung embolism male nerve root compression neurological complication nuclear magnetic resonance imaging osteoporosis pain paresthesia pedicle screw percutaneous vertebroplasty priority journal spinal cord compression spinal cord decompression spine fracture spine radiography spine stabilization steroid therapy thorax pain LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0317-1671 SP - 125-127 ST - Delayed neurologic complications of vertebral bone cement injections T2 - Canadian Journal of Neurological Sciences TI - Delayed neurologic complications of vertebral bone cement injections UR - https://www.embase.com/search/results?subaction=viewrecord&id=L358292155&from=export http://dx.doi.org/10.1017/S0317167100009781 VL - 37 ID - 829681 ER - TY - JOUR AB - Fat embolism (FE) occurs frequently after trauma and during orthopaedic procedures involving manipulation of intramedullary contents. Classically characterized as a triad of pulmonary distress, neurologic symptoms, and petechial rash, the clinical entity of FE syndrome is much less common. Both mechanical and biochemical pathophysiologic theories have been proposed with contributions of vascular obstruction and the inflammatory response to embolized fat and trauma. Recent studies have described the relationship of embolized marrow fat with deep venous thrombosis and postsurgical cognitive decline, but without clear treatment strategies. Because treatment is primarily supportive, our focus must be on prevention. In trauma, early fracture stabilization decreases the rate of FE syndrome; however, questions remain regarding the effect of reaming and management of bilateral femur fractures. In arthroplasty, computer navigation and alternative cementation techniques decrease fat embolization, although the clinical implications of these techniques are currently unclear, illustrating the need for ongoing education and research with an aim toward prevention. AD - From the Department of Orthopaedics, University of Utah, Salt Lake City, UT. AN - 139197266. Language: English. Entry Date: 20191031. Revision Date: 20200803. Publication Type: journal article AU - Rothberg, David L. AU - Makarewich, Christopher A. DB - cin20 DO - 10.5435/JAAOS-D-17-00571 DP - EBSCOhost KW - Embolism, Fat -- Diagnosis Embolism, Fat -- Therapy Embolism, Fat -- Epidemiology Embolism, Fat -- Etiology Sex Factors Male Adult Female Age Factors Postoperative Complications -- Etiology Magnetic Resonance Imaging Wounds and Injuries -- Complications Orthopedic Surgery -- Adverse Effects Young Adult Child Tomography, X-Ray Computed M1 - 8 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2019 SN - 1067-151X SP - e346-e355 ST - Fat Embolism and Fat Embolism Syndrome T2 - Journal of the American Academy of Orthopaedic Surgeons TI - Fat Embolism and Fat Embolism Syndrome UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=139197266&site=ehost-live&scope=site VL - 27 ID - 830534 ER - TY - JOUR AB - BACKGROUND: Pulmonary cement embolization after vertebroplasty is a well-known complication but typically presents with minimal respiratory symptoms. Although this rare complication has been reported, the current literature does not address the need for awareness of symptoms of potentially devastating respiratory compromise. CASE DESCRIPTION: We present the case of a 29-year-old man who underwent T11 vertebroplasty and subsequently had chest pain develop several days later. His right lower lung lobe had infarcted owing to massive cement embolization to his pulmonary arterial circulation. Open pulmonary wedge resection and embolectomy were performed. The patient recovered from the embolectomy but had chronic, persistent respiratory symptoms after surgery. LITERATURE REVIEW: Operative management of vertebral compression fractures has included percutaneous vertebroplasty for the past 25 years. The reported incidence of pulmonary cement emboli after vertebroplasty ranges from 2.1% to 26% with much of this variation resulting from which radiographic technique is used to detect embolization. Symptoms of pulmonary cement embolism can occur during the procedure, but more commonly begin days to weeks, even months, after vertebroplasty. At least six deaths from cement embolization after vertebroplasty have been reported. Most cases of pulmonary cement emboli with cardiovascular and pulmonary complications are treated nonoperatively with anticoagulation. Endovascular removal of large cement emboli from the pulmonary arteries is not without risk and sometimes requires open surgery for complete removal of cement pieces. CLINICAL RELEVANCE: Pulmonary cement embolism is a potentially serious complication of vertebroplasty. If a patient has chest pain or respiratory difficulty after the procedure, chest radiography and possibly advanced chest imaging studies should be performed immediately. AD - Department of Orthopaedic Surgery, Washington University in St Louis, 660 S Euclid Avenue, Campus Box 8233, St Louis, MO, 63110, USA. AN - 24532433 AU - Rothermich, M. A. AU - Buchowski, J. M. AU - Bumpass, D. B. AU - Patterson, G. A. C2 - Pmc3971236 DA - May DO - 10.1007/s11999-014-3506-0 DP - NLM ET - 2014/02/18 J2 - Clinical orthopaedics and related research KW - Adult Bone Cements *Embolectomy Foreign-Body Migration/diagnosis/etiology/*surgery Humans Male *Pneumonectomy Pulmonary Embolism/diagnosis/etiology/*surgery Reoperation Thoracic Vertebrae/*surgery Tomography, X-Ray Computed Treatment Outcome Vertebroplasty/*adverse effects LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 0009-921X (Print) 0009-921x SP - 1652-7 ST - Pulmonary cement embolization after vertebroplasty requiring pulmonary wedge resection T2 - Clin Orthop Relat Res TI - Pulmonary cement embolization after vertebroplasty requiring pulmonary wedge resection VL - 472 ID - 828673 ER - TY - JOUR AB - CONCLUSION: It's uncommon complication except bone cement leakge in treatment of osteoporotic thoracolumbar vertebral compression fractures with percutaneous kyphoplasty. The complication of cardiopulmonary system is a high risk in surgery; and cytotoxicity of bone cement,nervous reflex,fat embolism and alteration of intravertebral pressure may be main reasons. OBJECTIVE: To analyze the complications of percutaneous kyphoplasty except bone leakge for the treatment of osteoporotic thoracolumbar vertebral compression fractures. METHODS: From October 2008 to October 2012,178 patients with 224 osteoporotic vertebral compression fractures were treated with percutaneous kyphoplasty under local anethsia. There were 72 males and 106 females,ranging in age from 58 to 92 years old,with an average of 75.3 years,including 93 thoracic vertebrae and 131 lumbar vertebrae. The complications except bone cement leakage were analyzed during operation and after operation. RESULTS: All operations were successful and all patients were followed up from 12 to 60 months with an average of 26.2 months. No death was found. Bone cement leakage occurred in 27 cases, about 15.1% in 178 cases; and complications except bone cement leakage occurred in 15 cases. There was 1 case with cardiac arrest,was completely recovery by cardiopulmonary resuscitation (CPR) immediately; and 1 case with temporary absence of breathing,was recovery after treatment. There were 3 cases with fall of blood pressure and slower of heart rate; 1 case with intestinal obstruction; 2 cases with local hematoma and 1 case with intercostal neuralgia. Vertebral body fractures of 2 cases were split by bone cement and the fractures of adjacent body occurred in 4 cases. AU - Ru, X. AU - Jiang, Z. AU - Gui, X. AU - Sun, Q. AU - Song, B. S. AU - Lin, H. AU - He, J. DB - Medline KW - adverse event aged female compression fracture human injury kyphoplasty lumbar vertebra male middle aged fragility fracture postoperative complication spine fracture thoracic vertebra vertebra very elderly LA - Chinese M1 - 8 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1003-0034 SP - 763-767 ST - Complications of percutaneous kyphoplasty non-related with bone leakage in treating osteoporotic thoracolumbar vertebral compression fractures T2 - Zhongguo gu shang = China journal of orthopaedics and traumatology TI - Complications of percutaneous kyphoplasty non-related with bone leakage in treating osteoporotic thoracolumbar vertebral compression fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L607544047&from=export VL - 28 ID - 829368 ER - TY - JOUR AB - OBJECTIVE: To analyze the complications of percutaneous kyphoplasty except bone leakge for the treatment of osteoporotic thoracolumbar vertebral compression fractures. METHODS: From October 2008 to October 2012,178 patients with 224 osteoporotic vertebral compression fractures were treated with percutaneous kyphoplasty under local anethsia. There were 72 males and 106 females,ranging in age from 58 to 92 years old,with an average of 75.3 years,including 93 thoracic vertebrae and 131 lumbar vertebrae. The complications except bone cement leakage were analyzed during operation and after operation. RESULTS: All operations were successful and all patients were followed up from 12 to 60 months with an average of 26.2 months. No death was found. Bone cement leakage occurred in 27 cases, about 15.1% in 178 cases; and complications except bone cement leakage occurred in 15 cases. There was 1 case with cardiac arrest,was completely recovery by cardiopulmonary resuscitation (CPR) immediately; and 1 case with temporary absence of breathing,was recovery after treatment. There were 3 cases with fall of blood pressure and slower of heart rate; 1 case with intestinal obstruction; 2 cases with local hematoma and 1 case with intercostal neuralgia. Vertebral body fractures of 2 cases were split by bone cement and the fractures of adjacent body occurred in 4 cases. CONCLUSION: It's uncommon complication except bone cement leakge in treatment of osteoporotic thoracolumbar vertebral compression fractures with percutaneous kyphoplasty. The complication of cardiopulmonary system is a high risk in surgery; and cytotoxicity of bone cement,nervous reflex,fat embolism and alteration of intravertebral pressure may be main reasons. AN - 26502533 AU - Ru, X. L. AU - Jiang, Z. H. AU - Gui, X. G. AU - Sun, Q. C. AU - Song, B. S. AU - Lin, H. AU - He, J. DA - Aug DP - NLM ET - 2015/10/28 J2 - Zhongguo gu shang = China journal of orthopaedics and traumatology KW - Aged Aged, 80 and over Female Fractures, Compression/*surgery Humans Kyphoplasty/*adverse effects Lumbar Vertebrae/*injuries/surgery Male Middle Aged Osteoporotic Fractures/*surgery Postoperative Complications/etiology Spinal Fractures/*surgery Thoracic Vertebrae/*injuries/surgery LA - chi M1 - 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 1003-0034 (Print) 1003-0034 SP - 763-7 ST - [Complications of percutaneous kyphoplasty non-related with bone leakage in treating osteoporotic thoracolumbar vertebral compression fractures] T2 - Zhongguo Gu Shang TI - [Complications of percutaneous kyphoplasty non-related with bone leakage in treating osteoporotic thoracolumbar vertebral compression fractures] VL - 28 ID - 828693 ER - TY - JOUR AB - We report the pathological findings in cases of acrylic implants obtained by direct intratumoral injection of polymethyl-methacrylate (PMMA) and N-butyl-cyano-acrylate (NBCA), Direct intratumoral injection of acrylic implants was performed for a variety of primary and secondary bone lesions. These types of treatments have been used at our institution in the last 4 years for 40 vertebroplasty (PMMA) procedures and for nine bone lesions of other locations (PMMA, NBCA). Postmortem histology became available for 1 case of PMMA and for 5 cases with NBCA intratumoral acrylic implants. The pathological findings associated with PMMA and NBCA were evaluated and compared. PMMA exhibited a macroscopic and microscopic rim of tumor necrosis, 6 months after implantation. NBCA exhibited compressive effects on the nearby tumor tissue, however, without signs of significant necrosis outside the acrylic tumor cast, Tumor captured inside the acrylic cast showed extensive to near complete necrosis, Acrylic implants mag lead to necrosis when injected directly in tumors. The necrotizing effect may extend beyond the limits of an implant in the case of PMMA, Such an extended effect of PR IMA, when compared with NBCA, may be due to the variable toxicity of acrylic implants, including the different degrees of the exothermic reaction during polymerization. (Bone 25:85S-90S; 1999) (C) 1999 by Elsevier Science Inc. All rights reserved. AD - Univ Geneva, Ctr Med, Dept Morphol, Div Anat, CH-1211 Geneva 4, Switzerland. Univ Geneva, Dept Pathol, CH-1211 Geneva, Switzerland. Univ Geneva, Dept Neuroradiol, Geneva, Switzerland. Ruiz, DS (corresponding author), Univ Geneva, Ctr Med, Dept Morphol, Div Anat, CH-1211 Geneva 4, Switzerland. San@cmu.unige.ch AN - WOS:000081937400018 AU - Ruiz, D. S. AU - Burkhardt, K. AU - Jean, B. AU - Muster, M. AU - Martin, J. B. AU - Bouvier, J. AU - Fasel, J. H. D. AU - Rufenacht, D. A. AU - Kurt, A. M. DA - Aug DO - 10.1016/s8756-3282(99)00140-4 J2 - Bone KW - histology NBCA PMMA vertebroplasty PERCUTANEOUS VERTEBROPLASTY INTRATUMORAL EMBOLIZATION CRANIOFACIAL TUMORS CEMENT POLYMETHYLMETHACRYLATE INJECTION Endocrinology & Metabolism LA - English M1 - 2 M3 - Article; Proceedings Paper N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1999 SN - 8756-3282 SP - 85S-90S ST - Pathology findings with acrylic implants T2 - Bone TI - Pathology findings with acrylic implants UR - ://WOS:000081937400018 VL - 25 ID - 830467 ER - TY - JOUR AB - A female white-naped crane (Grus vipio) was presented with an open, oblique fracture of the distal right tarsometatarsus and concomitant vascular and nerve damage. Conventional fracture fixation repairs failed, which led to implantation of a custom titanium limb prosthesis. After subsequent revisions with 2 different prosthetic devices, limb function was ultimately restored but a later yolk embolism caused a circulatory compromise in the opposite leg, which necessitated euthanasia. Histopathologic results revealed limited ingrowth of bone into the porous coated implant, which indicated that a limb prosthesis may provide salvage for long-legged, heavy-bodied birds with fractures of the tarsometatarsus. AD - Birmingham Zoo Inc, 2630 Cahaba Rd, Birmingham, AL 35223, USA. AN - 23156979 AU - Rush, E. M. AU - Turner, T. M. AU - Montgomery, R. AU - Ogburn, A. L. AU - Urban, R. M. AU - Sidebothum, C. AU - LaVasser, A. DA - Sep DO - 10.1647/2009-012r2.1 DP - NLM ET - 2012/11/20 J2 - Journal of avian medicine and surgery KW - Animals Animals, Zoo Artificial Limbs/*veterinary Bird Diseases/*surgery Birds/*injuries Bone Cements Female Fractures, Open/surgery/veterinary Hindlimb/*injuries/surgery LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 1082-6742 (Print) 1082-6742 SP - 167-75 ST - Implantation of a titanium partial limb prosthesis in a white-naped crane (Grus vipio) T2 - J Avian Med Surg TI - Implantation of a titanium partial limb prosthesis in a white-naped crane (Grus vipio) VL - 26 ID - 828524 ER - TY - JOUR AN - 25882981 AU - Rybak-Bąk, M. AU - Wolnicka, M. AU - Ziętek, A. AU - Kiszka, K. DO - 10.20452/pamw.2844 DP - NLM ET - 2015/04/18 J2 - Polskie Archiwum Medycyny Wewnetrznej KW - Adult Female Foreign-Body Migration/*surgery Humans Pulmonary Embolism/etiology/*surgery Thoracic Vertebrae/*surgery Vertebroplasty/*adverse effects LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SP - 383-5 ST - Symptomatic segmental pulmonary thromboembolism secondary to acrylic embolization after vertebroplasty T2 - Pol Arch Med Wewn TI - Symptomatic segmental pulmonary thromboembolism secondary to acrylic embolization after vertebroplasty VL - 125 ID - 828511 ER - TY - JOUR AB - Background: Percutaneous vertebroplasty is a minimally invasive method based on the percutaneous injection of polymethylmetacrylate cement into the affected vertebral body. It is used to relieve the pain and improve mechanical functions of the spine. Authors present their experience with clinically or graphicaily aggressive vertebral body hemangiomas treated with percutaneous vertebroplasty. Materials and methods: From September 2003 to April 2005, 4 procedures in 4 patients (2 female, 2 males, age range 30-51 years) were performed in authors' department. During each procedure, one vertebral body at levels T5, T12, T12 and L4 was filled with polymethylmethacrylate. All procedures were performed under fluoroscopy using transpedicular technique. In 3 patients, the bone cement powder had to be inserted bipedicularly, in one patient monopedicular access was sufficient. In one patient laminectomy, surgical removal of epidural tumor portion and radiotherapy followed our procedure. In 3 patients, angiography was performed before vertebroplasty, with following tumor embolization in one case. Results: All procedures were technically successful and all patients became better clinically till 72 hours after the procedure. There were no symptomatic complications. In one case PMMA cement leaked to spinal canal and in one case to paravertebral soft tissues were noted. All these complications were without clinical manifestation. Conclusion: According to authors' experience, percutaneous vertebroplasty seems to be effective in treatment of aggressive vertebral body hemangiomas. Compared to intraarterial embolisation, ethanol ablation or radiotherapy, vertebroplasty (and surgical therapy) are the only methods providing also stabilisation of the damaged vertebra. Compared to surgical therapy, vertebroplasty is less invasive for the patient. AD - P. Ryška, Radiologická Klinika LF a FN, 500 05 Hradec Králové, Czech Republic AU - Ryška, P. AU - Eliáš, P. AU - Málek, V. AU - Klzo, L. AU - Ungermann, L. AU - Kaltofen, K. AU - Adamkov, J. AU - Renc, O. AU - Řehák, S. DB - Embase KW - alcohol poly(methyl methacrylate) adult angiography article artificial embolization case report catheter ablation computer assisted surgery disease activity female fluoroscopy hemangioma human intermethod comparison laminectomy lumbar vertebra male minimally invasive surgery percutaneous vertebroplasty postoperative complication spinal cord tumor spine stabilization surgical approach surgical technique thoracic spine treatment outcome vertebra body vertebral canal LA - Czech M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 1210-7883 SP - 446-452 ST - Percutaneous vertebroplasty for the treatment of vertebral hemangiomas T2 - Ceska Radiologie TI - Percutaneous vertebroplasty for the treatment of vertebral hemangiomas UR - https://www.embase.com/search/results?subaction=viewrecord&id=L44794878&from=export VL - 60 ID - 829780 ER - TY - JOUR AB - We report the case of a 52-year-old man who died of massive fat emboli 39 h after undergoing elective total knee replacement. His past medical history included hypertension, obesity and diabetes (most of the clusters of the metabolic syndrome). Post-mortem pathological examination showed fat embolism in the kidneys and the brain. This is the first reported case of fat emboli as the cause of death in an association with metabolic syndrome, and the case suggests that the fat embolism should be anticipated in over weight and obese individuals with three or more of the risk factors of the metabolic syndrome. AD - The Wessex Cardiothoracic Unit, Southampton General Hospital, Southampton, UK. AN - 17180678 AU - Saad, R. A. AU - Fahmy, A. A. AU - Ahmed, M. H. DA - Jul DO - 10.1007/s00402-006-0268-5 DP - NLM ET - 2006/12/21 J2 - Archives of orthopaedic and trauma surgery KW - Arthroplasty, Replacement, Knee/*adverse effects Brain/pathology Diabetes Mellitus, Type 1/complications Embolism, Fat/*etiology/pathology Fatal Outcome Humans Hypertension/complications Kidney/pathology Male Metabolic Syndrome/*complications Middle Aged Obesity/complications LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2007 SN - 0936-8051 (Print) 0936-8051 SP - 387-9 ST - Fatal fat embolism complicating cemented total knee replacement: another manifestation of the metabolic syndrome? T2 - Arch Orthop Trauma Surg TI - Fatal fat embolism complicating cemented total knee replacement: another manifestation of the metabolic syndrome? VL - 127 ID - 828923 ER - TY - JOUR AB - Objective: To determine the prevalence and variation of inferior vena cava filter (IVCF) use in the spine trauma population and evaluate patient and facility level factors associated with their use. Study Design: Retrospective cohort. Participants/Outcome Measures: Patients with spinal injuries were identified by ICD-9 codes from the National Trauma Data Bank (NTDB), the best validated national trauma database. Patients whose spine injuries were operatively treated and those who received IVCF were identified from procedure description fields. Additional information compiled included patient demographics, injury severity score (ISS), time until surgery, concomitant fractures, and facility level information. Multivariate logistic regression analyses were conducted to examine the relationship of associated factors for IVCF use. Results: Of the 120,920 patients identified with spinal injuries, 2.4% received prophylactic IVCF. Of the 13,273 patients with operatively treated spinal injuries, 8.2% received prophylactic IVCF. Of the 7,770 patients with spinal cord injury (SCI), 10.8% received prophylactic IVCF. The interquartile ranges of placement rates among centers demonstrated greater than 10 fold variation. Based on multivariate logistic regression, ISS score >12 demonstrated the strongest association with prophylactic IVCF (adjusted OR = 4.908). Concomitant pelvic and lower extremity fractures (adj OR 2.573 and 2.522) were also associated with their use. Conclusions: Currently the only data regarding existing IVCF use in the spine trauma population amounts to surveys. The present study provides the most detailed and objective information regarding their use in this setting. Even in the operatively treated and SCI subgroups, prophylactic filters were used in only a small percentage of cases but placement rates varied widely among centers. More severely injured patients (ISS >12) had highest odds of receiving prophylactic IVCF. Further study is needed to clarify their role in this vulnerable population. AD - M.J. Vives, Dept. of Orthopaedics, Rutgers University-New Jersey Medical School, 140 Bergen Street, Suite D1610, Newark, NJ, United States AU - Sabharwal, S. AU - Fox, A. D. AU - Vives, M. J. DB - Embase Medline DO - 10.1080/10790268.2018.1465284 KW - vena cava filter adult age article clinical evaluation coccyx cohort analysis emergency health service female human ICD-9 injury injury scale insurance kyphoplasty limb fracture lung embolism major clinical study male medicaid middle aged pelvis fracture percutaneous vertebroplasty prevalence prophylaxis retrospective study sacroiliac joint sex spinal cord injury spine injury surgery thoracolumbar spine thromboembolism LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 2045-7723 1079-0268 SP - 228-235 ST - The use of inferior vena cava filters in spine trauma: A nationwide study using the National Trauma Data Bank T2 - Journal of Spinal Cord Medicine TI - The use of inferior vena cava filters in spine trauma: A nationwide study using the National Trauma Data Bank UR - https://www.embase.com/search/results?subaction=viewrecord&id=L622076808&from=export http://dx.doi.org/10.1080/10790268.2018.1465284 VL - 42 ID - 829149 ER - TY - JOUR AB - The treatment of patients who have malignancies of bone often require multidisciplinary care. The aim of this review is to outline percutaneous techniques that may be useful for the diagnosis and treatment of these patients. In particular, the existing procedures of percutaneous biopsy, alcoholization (ethanol ablation), vertebroplasty, kyphoplasty, osteoplasty, radiofrequency ablation, laser photocoagulation, and vascular embolization are reviewed. Aspects of each technique, including mechanism of action, patient selection, treatment technique, and recent patient outcome are presented. Copyright © 2006 by Elsevier Inc. AD - Department of Radiology, Guy's and St. Thomas' Hospital, London, UK. AN - 106346379. Language: English. Entry Date: 20061013. Revision Date: 20150711. Publication Type: Journal Article AU - Sabharwal, T. AU - Salter, R. AU - Adam, A. AU - Gangi, A. DB - cin20 DP - EBSCOhost KW - Bone Neoplasms -- Diagnosis Bone Neoplasms -- Therapy Ethanol -- Therapeutic Use Biopsy, Needle Catheter Ablation Diagnostic Imaging Lasers -- Therapeutic Use Orthopedic Surgery M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2006 SN - 0030-5898 SP - 105-112 ST - Image-guided therapies in orthopedic oncology T2 - Orthopedic Clinics of North America TI - Image-guided therapies in orthopedic oncology UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=106346379&site=ehost-live&scope=site VL - 37 ID - 830775 ER - TY - JOUR AB - Percutaneous vertebroplasty (PV) is one of the alternative treatments for vertebral fractures. Reported significant complications include pain, radiculopathy, spinal cord compression, pulmonary embolism, infection and rib fractures. In this report, we highlight intradural cement leakage which is a rare complication of the procedure. A 49 year old man with a T12 compression fracture due to multiple myeloma was referred to the neurosurgery department from the orthopaedics and traumatology clinic after developing a right lower limb weakness following percutaneous vertebroplasty with polymethylmethacrylate. An urgent thoraco-lumbar magnetic resonance imaging was performed. The T1 and T2-weighted images demonstrated intradural extramedullary and epidural cement leakages which were hypointense on both sequences. Total laminectomy was performed at T12 and L1 and two epidural cement collections were excised on the right. Then, a dural incision from T12 to the body of L1 was done and cement material seen in front of the rootlets excised without any nerve injury. The patient was discharged after a week and referred to the haematology clinic for additional therapy of multiple myeloma. Although the cement leakage was extensive, the right leg weakness improved significantly and he began to walk with assistance 3 months later. Good quality image monitoring and clear visualisation of cement are essential requirements for PV using polymethylmethacrylate to prevent this complication from the treatment. © 2008 Springer-Verlag. AD - H. Sabuncuoǧlu, Koza Sokak No: 72/36, Ikizler Sitesi 06700, Gaziosmanpaşa, Ankara, Turkey AU - Sabuncuoǧlu, H. AU - Dinçer, D. AU - Güçlü, B. AU - Erdoǧan, E. AU - Hatipoǧlu, H. G. AU - Özdoǧan, S. AU - Timurkaynak, E. DB - Embase Medline DO - 10.1007/s00701-008-1503-3 KW - poly(methyl methacrylate) adult case report human intradural cement leakage laminectomy limb weakness male multiple myeloma nuclear magnetic resonance imaging percutaneous vertebroplasty postoperative complication priority journal short survey spine fracture LA - English M1 - 8 M3 - Short Survey N1 - Embase Elsevier literature search January 5, 2021 PY - 2008 SN - 0001-6268 0942-0940 SP - 811-815 ST - Intradural cement leakage: A rare complication of percutaneous vertebroplasty T2 - Acta Neurochirurgica TI - Intradural cement leakage: A rare complication of percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L50160758&from=export http://dx.doi.org/10.1007/s00701-008-1503-3 VL - 150 ID - 829739 ER - TY - JOUR AB - Percutaneous vertebroplasty (PV) is one of the alternative treatments for vertebral fractures. Reported significant complications include pain, radiculopathy, spinal cord compression, pulmonary embolism, infection and rib fractures. In this report, we highlight intradural cement leakage which is a rare complication of the procedure. A 49 year old man with a T12 compression fracture due to multiple myeloma was referred to the neurosurgery department from the orthopaedics and traumatology clinic after developing a right lower limb weakness following percutaneous vertebroplasty with polymethylmethacrylate. An urgent thoraco-lumbar magnetic resonance imaging was performed. The T1 and T2-weighted images demonstrated intradural extramedullary and epidural cement leakages which were hypointense on both sequences. Total laminectomy was performed at T12 and L1 and two epidural cement collections were excised on the right. Then, a dural incision from T12 to the body of L1 was done and cement material seen in front of the rootlets excised without any nerve injury. The patient was discharged after a week and referred to the haematology clinic for additional therapy of multiple myeloma. Although the cement leakage was extensive, the right leg weakness improved significantly and he began to walk with assistance 3 months later. Good quality image monitoring and clear visualisation of cement are essential requirements for PV using polymethylmethacrylate to prevent this complication from the treatment. AD - Neurosurgery Department of Ufuk University School of Medicine, Ankara, Turkey. hsabuncuoglu@hotmail.com AN - 18509588 AU - Sabuncuoğlu, H. AU - Dinçer, D. AU - Güçlü, B. AU - Erdoğan, E. AU - Hatipoğlu, H. G. AU - Ozdoğan, S. AU - Timurkaynak, E. DA - Aug DO - 10.1007/s00701-008-1503-3 DP - NLM ET - 2008/05/30 J2 - Acta neurochirurgica KW - Bone Cements/*adverse effects/therapeutic use Dura Mater/*drug effects/pathology/surgery Fractures, Compression/diagnosis/*surgery Humans Lumbar Vertebrae/pathology/surgery Magnetic Resonance Imaging Male Middle Aged Multiple Myeloma/complications Polymethyl Methacrylate/administration & dosage/*adverse effects Postoperative Complications/*chemically induced/diagnosis/surgery Reoperation Spinal Cord Compression/*chemically induced/diagnosis/surgery Spinal Fractures/diagnosis/*surgery Thoracic Vertebrae/pathology/*surgery Vertebroplasty/*adverse effects/methods LA - eng M1 - 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 0001-6268 SP - 811-5 ST - Intradural cement leakage: a rare complication of percutaneous vertebroplasty T2 - Acta Neurochir (Wien) TI - Intradural cement leakage: a rare complication of percutaneous vertebroplasty VL - 150 ID - 828845 ER - TY - JOUR AB - OBJECTIVE: Postpartum hemorrhage (PPH) is the leading cause of obstetric morbidity and mortality around the world. Prophylactic administration of tranexamic acid in patients at risk for PPH is aimed at reducingestimated blood loss (EBL). This is a novel method of administering TXA STUDY DESIGN: A scoring criterion was devised based on the RR of certain maternal characteristics . Patients scoring >3 were included in the study. 101 patient were chosen; 51 patients were given 1000mg of tranexamic acid (TXA) at cord clamping after delivery of the baby, 50 patients who had similar criteria were used as a control. Pre and post hematocrit (HCT) was used to calculate the estimated blood loss for patients. Both C-sections (CS) and vaginal deliveries (VD) were included in the study RESULTS: Between January 2017, and May 2017 101 women were enrolled in the study fifty-one patient's received tranexamic acid (n=51) and fifty patients were matched to control (n=50). There was a total of fifty-one (50.5%) cases of PPH, twenty (39%) women received TXA, while thirty-one (61%) women did not. The relative risk of PPH in a patient who received TXA was 0.7 with a CI-0.19 ≤ 0.20. The numbers needed to treat in order to prevent 1 PPH was 5 women. The average EBL for VD who received TXA was 562ml, which was significantly less than those who did not 841ml (p=0.0006). The average EBL for C/S who received TXA was 672ml which was significantly less than those who did not 1072ml (p=0.0007). There were no reported cases of pulmonary embolism or deep vein thrombosis in either arm. CONCLUSION: TXA can be used as a prophylactic intervention to prevent blood loss, morbidity, and mortality in obstetric patients who are at risk for post-partum hemorrhage. A randomized control trial is recommended to further cement these results. AD - S. Sadek, East Virginia Medical School, Norfolk, VA, United States AU - Sadek, S. AU - Kayaalp, E. AU - Movva, V. AU - Dad, N. DB - Embase KW - cement tranexamic acid conference abstract controlled study deep vein thrombosis drug therapy female hematocrit human infant lung embolism major clinical study male morbidity mortality numbers needed to treat obstetric patient pilot study postpartum hemorrhage prevention randomized controlled trial risk assessment risk factor study design vaginal delivery LA - English M1 - 1 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1097-6868 SP - S244 ST - Prophylactic tranexamic acid usage in prevention of postpartum hemorrhage a pilot study T2 - American Journal of Obstetrics and Gynecology TI - Prophylactic tranexamic acid usage in prevention of postpartum hemorrhage a pilot study UR - https://www.embase.com/search/results?subaction=viewrecord&id=L620310113&from=export VL - 218 ID - 829211 ER - TY - JOUR AB - Purpose: To assess the readability of online education materials offered by hospitals describing commonly performed interventional radiology (IR) procedures.Materials and Methods: Online patient education materials from 402 hospitals selected from the Medicare Hospital Compare database were assessed. The presence of an IR service was determined by representation in the Society of Interventional Radiology physician finder directory. Patient online education materials about (i) uterine artery embolization for fibroid tumors, (ii) liver cancer embolization, (iii) varicose vein treatment, (iv) central venous access, (v) inferior vena cava (IVC) filter placement, (vi) nephrostomy tube insertion, (vii) gastrostomy tube placement, and (viii) vertebral augmentation were targeted and assessed by using six validated readability scoring systems.Results: Of 402 hospitals sampled, 156 (39%) were presumed to offer IR services. Of these, 119 (76%) offered online patient education material for one or more of the eight service lines. The average readability scores corresponding to grade varied between the ninth- and 12th-grade levels. All were higher than the recommended seventh-grade level (P < .05) except for nephrostomy and gastrostomy tube placement. Average Flesch-Kincaid Reading Ease scores ranged from 42 to 69, corresponding with fairly difficult to difficult readability for all service lines except IVC filter and gastrostomy tube placement, which corresponded with standard readability.Conclusions: A majority of hospitals offering IR services provide at least some online patient education material. Most, however, are written significantly above the reading comprehension level of most Americans. More attention to health literacy by hospitals and IR physicians is warranted. AD - Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd., Room 125 D, Atlanta, GA 30322 Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd., Room 125 D, Atlanta, GA 30322.. Electronic address: gsadigh@emory.edu. Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Rd., Room 125 D, Atlanta, GA 30322. AN - 109607594. Language: English. Entry Date: 20150923. Revision Date: 20160525. Publication Type: journal article. Journal Subset: Biomedical AU - Sadigh, Gelareh AU - Hawkins, C. Matthew AU - O'Keefe, John J. AU - Khan, Ramsha AU - Duszak Jr, Richard AU - Duszak, Richard, Jr. DB - cin20 DO - 10.1016/j.jvir.2015.04.029 DP - EBSCOhost M1 - 8 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2015 SN - 1051-0443 SP - 1156-1161 ST - Can Patients Comprehend the Educational Materials that Hospitals Provide about Common IR Procedures? T2 - Journal of Vascular & Interventional Radiology TI - Can Patients Comprehend the Educational Materials that Hospitals Provide about Common IR Procedures? UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=109607594&site=ehost-live&scope=site VL - 26 ID - 830611 ER - TY - JOUR AB - Introduction: We report the results of a titanium acetabular reinforcement ring with a hook (ARRH) in primary total hip arthroplasty (THA), which was introduced in 1987 and continues to be used routinely in our center. The favorable results of this device in arthroplasty for developmental dysplasia and difficult revisions motivated its use in primary THA. With this implant only minimal acetabular reaming is necessary, anatomic positioning is achieved by placing the hook around the teardrop and a homogenous base for cementing the polyethylene cup is provided. Materials and methods: Between April 1987 and December 1991, 241 THAs with insertion of an ARRH were performed in 178 unselected, consecutive patients (average age 58 years; range 30-84 years) with a secondary osteoarthrosis in 41% of the cases. Results: At the time of the latest follow-up, 33 patients (39 hips) had died and 17 cases had been lost to follow-up. The median follow-up was 122 months with a minimum of 10 years. Eight hips had been revised, leaving 177 hips in 120 living patients without revision. Six cups were revised because of aseptic loosening. Two hips were revised for sepsis. The mean Merle d'Aubigné score for the remaining hips was 16 (range 7-18) at the latest follow-up. For aseptic loosening, the probability of survival of the cup was 0.97 (95% confidence interval, 0.94-0.99). However, analysis of radiographs implied loosening in seven other cups without clinical symptoms. Conclusions: The results of primary THA using an acetabular reinforcement ring parallel the excellent results of these implants often observed in difficult primary and revision arthroplasty at a minimum of 10 years. Survivorship is comparable to modern cementless implants. Medial migration that occurs with loosening of the acetabular component seems to be prevented with this implant. Radiographic loosening signs can exist without clinical symptoms. © Springer-Verlag 2008. AD - M. Tannast, Department of Orthopaedic Surgery, Inselspital, University of Bern, Bern 3010, Switzerland AU - Sadri, H. AU - Pfander, G. AU - Siebenrock, K. A. AU - Tannast, M. AU - Koch, P. AU - Fujita, H. AU - Ballmer, P. AU - Ganz, R. DB - Embase Medline DO - 10.1007/s00402-008-0612-z KW - antibiotic agent heparin titanium warfarin adult aged article bone necrosis confidence interval conservative treatment controlled study death deep vein thrombosis endoprosthesis loosening female femoral nerve femur osteotomy femur trochanteric fracture follow up fracture reduction hip disease hip dislocation hip dysplasia hip osteoarthritis hip radiography human immobilization lung embolism major clinical study male nerve lesion nerve surgery neuroma postoperative infection priority journal probability reoperation rheumatoid arthritis sciatic nerve scoring system sepsis survival rate total hip prosthesis Protema LA - English M1 - 8 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2008 SN - 0936-8051 SP - 869-877 ST - Acetabular reinforcement ring in primary total hip arthroplasty: A minimum 10-year follow-up T2 - Archives of Orthopaedic and Trauma Surgery TI - Acetabular reinforcement ring in primary total hip arthroplasty: A minimum 10-year follow-up UR - https://www.embase.com/search/results?subaction=viewrecord&id=L50095318&from=export http://dx.doi.org/10.1007/s00402-008-0612-z VL - 128 ID - 829738 ER - TY - JOUR AB - PURPOSE Percutaneous vertebroplasty (PV) is a relatively simple and minimally invasive technique for the treatment of vertebral pathology providing early vertebral stabilization and pain relief. In some cases, complicated by spinal cord compression, PV alone cannot be performed free of risks. We describe a double approach in which decompressive laminectomy and intraoperative vertebroplasty (IV) are performed during a single session. MATERIALS AND METHODS Among the 252 vertebroplasties performed in our center in the past 3 years, 15 (5 symptomatic haemangiomas, 6 metastatic fractures, 4 osteoporotic fractures) were done in association with surgery in patients with pain and spinal cord compression at a dorsal level. All were treated with decompressive laminectomy and IV (mono/bipeduncular or median- posterior trans-somatic access). Four patients with symptomatic haemangiomas were treated with endovascular embolization prior to the combined approach. In one of these, with a paravertebral mass, a thoracotomy was performed to remove the pathologic tissue. Four cases required posterior segmental fixation. A VAS (visual analog scale) was applied to assess pain intensity before and after surgery. RESULTS In all cases benefit from pain and neurological deficits was observed. The mean VAS score decreased from 7 to 3 after operation. No clinical complications were observed. In one case a CT showed a foraminal accumulation of PMMA, but the patient referred no symptoms. CONCLUSIONS According to our short term results, we observed that the association of surgical approach with IV is beneficial. This technique allows to perform decompression of dural sac and vertebral body stabilization, possibly avoiding segmental fixation. AD - L. Saitta, Department Of Diagnostic And Interventional Neuroradiology, San Martino Hospital, Genoa, Italy AU - Saitta, L. AU - Allegretti, L. AU - Mavilio, N. AU - Silvestro, C. AU - Spaziante, R. AU - Castellan, L. DB - Embase DO - 10.1007/s00234-009-0561-4 KW - percutaneous vertebroplasty neuroradiology decompression society pain patient laminectomy surgery spinal cord compression fracture fragility fracture thoracotomy tissues visual analog scale surgical approach vertebra body minimally invasive procedure pathology analgesia risk artificial embolization LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 0028-3940 SP - S92-S93 ST - Intraoperative vertebroplasty combined with posterior cord decompression: Report of fifteen cases T2 - Neuroradiology TI - Intraoperative vertebroplasty combined with posterior cord decompression: Report of fifteen cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70007097&from=export http://dx.doi.org/10.1007/s00234-009-0561-4 VL - 51 ID - 829700 ER - TY - JOUR AB - We describe a comprehensive, multidisciplinary treatment approach for lumbar vertebral hemangiomas (VHs) with spinal stenosis and radiculopathy. A 59-year-old female presented with 1 year of pain predominantly in the lower back, with pain in the left buttock and proximal left anterior thigh as well and magnetic resonance imaging of the lumbar spine demonstrated lumbar scoliosis and an L3 vertebral lesion suspicious for hemangioma. A computed tomography guided biopsy was done, which supported the diagnosis. Definitive treatment entailed preoperative angiography and embolization, followed by L3 laminectomy, right L3 pedicle resection, partial L3 corpectomy, L3 vertebral cement augmentation, and L1 to L5 instrumented fusion. By 1-year postoperatively, the patient reported no radicular pain and only mild groin pain attributed to left hip degenerative joint disease. Radiographs 1-year postoperatively confirmed the stability of the instrumented posterior fusion and a magnetic resonance imaging with and without contrast confirmed no VH recurrence. A comprehensive and multidisciplinary approach for the treatment of VHs with neurological symptoms or signs is presented. This approach is recommended to maximize lesion removal, ensure biomechanical stability, and minimize recurrence. AD - E. Yu, Department of Orthopaedics, Ohio State University Wexner Medical Center, 725 Prior Hall, Columbus, OH, United States AU - Samade, R. AU - Malik, A. AU - Jain, N. AU - Scharschmidt, T. AU - Yu, E. DB - Embase DO - 10.4103/jcvjs.JCVJS_106_19 KW - analgesic agent adult artificial embolization case report clinical article computer assisted tomography conservative treatment decompression surgery disease duration female human human tissue image guided biopsy inguinal pain laminectomy low back pain lumbar spinal stenosis lumbar vertebral hemangioma medical history middle aged neuromodulation nuclear magnetic resonance imaging physiotherapy postoperative period preoperative period priority journal radiculopathy review scoliosis spinal angiography spinal cord decompression spine fusion surgical approach vertebra hemangioma visual analog scale LA - English M1 - 4 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 0976-9285 0974-8237 SP - 259-262 ST - Integrated treatment of a lumbar vertebral hemangioma with spinal stenosis and radiculopathy: A case report and a review of the literature T2 - Journal of Craniovertebral Junction and Spine TI - Integrated treatment of a lumbar vertebral hemangioma with spinal stenosis and radiculopathy: A case report and a review of the literature UR - https://www.embase.com/search/results?subaction=viewrecord&id=L630808836&from=export http://dx.doi.org/10.4103/jcvjs.JCVJS_106_19 VL - 10 ID - 829116 ER - TY - JOUR AB - We describe a comprehensive, multidisciplinary treatment approach for lumbar vertebral hemangiomas (VHs) with spinal stenosis and radiculopathy. A 59-year-old female presented with 1 year of pain predominantly in the lower back, with pain in the left buttock and proximal left anterior thigh as well and magnetic resonance imaging of the lumbar spine demonstrated lumbar scoliosis and an L3 vertebral lesion suspicious for hemangioma. A computed tomography guided biopsy was done, which supported the diagnosis. Definitive treatment entailed preoperative angiography and embolization, followed by L3 laminectomy, right L3 pedicle resection, partial L3 corpectomy, L3 vertebral cement augmentation, and L1 to L5 instrumented fusion. By 1-year postoperatively, the patient reported no radicular pain and only mild groin pain attributed to left hip degenerative joint disease. Radiographs 1-year postoperatively confirmed the stability of the instrumented posterior fusion and a magnetic resonance imaging with and without contrast confirmed no VH recurrence. A comprehensive and multidisciplinary approach for the treatment of VHs with neurological symptoms or signs is presented. This approach is recommended to maximize lesion removal, ensure biomechanical stability, and minimize recurrence. AD - Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. AN - 32089622 AU - Samade, R. AU - Malik, A. T. AU - Jain, N. AU - Scharschmidt, T. J. AU - Yu, E. C2 - Pmc7008654 DA - Oct-Dec DO - 10.4103/jcvjs.JCVJS_106_19 DP - NLM ET - 2020/02/25 J2 - Journal of craniovertebral junction & spine KW - Lumbar spine neoplasm vertebral hemangioma LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 0974-8237 (Print) 0974-8237 SP - 259-262 ST - Integrated treatment of a lumbar vertebral hemangioma with spinal stenosis and radiculopathy: A case report and a review of the literature T2 - J Craniovertebr Junction Spine TI - Integrated treatment of a lumbar vertebral hemangioma with spinal stenosis and radiculopathy: A case report and a review of the literature VL - 10 ID - 828645 ER - TY - JOUR AB - Cement (polymethylmethacrylat) is frequently and increasingly used in vertebral surgery. Complications can occur by spillage of this material; however the vast majority of the patients remain free of symptoms and do not require any specific therapy. Internists, gastroenterologists and radiologists regularly performing abdominal ultrasound and computed tomography should be aware of this complication. A case of spillage of cement in the right hepatic vein is presented AD - [Samie, A. Abdel; Maier, B.; Sun, R.; Bachmann, K.; Theilmann, L.] Helios Kliniken Pforzheim, Gastroenterol, Kanzlerstr 2-6, D-75175 Pforzheim, Germany. Samie, AA (corresponding author), Helios Kliniken Pforzheim, Gastroenterol, Kanzlerstr 2-6, D-75175 Pforzheim, Germany. abdelsamie@ngi.de AN - WOS:000378730400018 AU - Samie, A. A. AU - Maier, B. AU - Sun, R. AU - Bachmann, K. AU - Theilmann, L. DA - Jun DO - 10.1055/s-0042-106211 J2 - Z. Gastroent. KW - cement embolism hepatic vein abdominal ultrasound PULMONARY CEMENT EMBOLISM Gastroenterology & Hepatology LA - English M1 - 6 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2016 SN - 0044-2771 SP - 566-568 ST - A patient with a hyperechoic band-shaped structure in the right hepatic vein T2 - Zeitschrift Fur Gastroenterologie TI - A patient with a hyperechoic band-shaped structure in the right hepatic vein UR - ://WOS:000378730400018 VL - 54 ID - 830215 ER - TY - JOUR AB - Objective Few cases of muscle arteriovenous malformations have been reported in literature to date. Case report We report the case of a 32-year-old man presenting a muscle arteriovenous malformation involving the vastus lateralis muscle with recurrent episodes of pain. The patient was treated by transcatheter embolization with Glubran 2 acrylic glue. There were no periprocedural or subsequent clinical complications, the glue resulted in successful selective occlusion and the patient showed resolution of symptoms at the six-months follow-up. Conclusions Endovascular therapy has been shown to be beneficial in patients with high surgical risks and is the treatment of choice for arteriovenous malformation lesions that extend beyond the deep fascia and involve muscle, tendon, and bone. Glubran 2 constitutes a useful tool to attempt embolization of the muscle arteriovenous malformation nidus, with easier handling and promising results. AD - E.M. San Norberto, Division of Vascular Surgery, Valladolid University Hospital, C/ Ramón y Cajal n°3, Valladolid, Spain AU - San Norberto, E. M. AU - Brizuela, J. A. AU - Revilla, Á AU - Taylor, J. H. AU - Vaquero, C. DB - Embase Medline DO - 10.1177/1708538114550736 KW - acrylic cement glubran 2 acrylic glue iodinated poppyseed oil unclassified drug adult arteriovenous malformation article artificial embolization case report computer assisted tomography deep femoral artery devascularization digital subtraction angiography femoral artery human male muscle arteriovenous malformation priority journal vastus lateralis muscle LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1708-539X 1708-5381 SP - 432-435 ST - Endovascular embolization of a muscular symptomatic arteriovenous malformation with Glubran 2 acrylic glue T2 - Vascular TI - Endovascular embolization of a muscular symptomatic arteriovenous malformation with Glubran 2 acrylic glue UR - https://www.embase.com/search/results?subaction=viewrecord&id=L605171644&from=export http://dx.doi.org/10.1177/1708538114550736 VL - 23 ID - 829366 ER - TY - JOUR AB - Encouraging clinical results have been reported with the use of femoral head structural allografts and, more recently, trabecular metal cones for the management of large structural defects of the femur and tibia during revision total knee arthroplasty (TKA). However, to our knowledge, there are no published studies comparing these two techniques. Compared with bulk allografts, do trabecular metal cones result in (1) better validated outcomes scores; (2) a lower risk of loosening or revision at 5 years; and (3) fewer surgical complications when used for the management of bone loss in revision TKA? Between 2002 and 2008, three surgeons performed 450 TKA revisions, 45 (10%) of which were performed using augmentation of host bone; in those, femoral head allograft was used in 30 (75%) and trabecular metal cones in 15 (25%). From 2002 to 2007, femoral head allografts were used in all patients (28 patients); from 2007 to 2008, trabecular metal augments were used in all patients. There was a period of 1 year (16 knees) in which there was some overlap; during that time, femoral head structural allografts were used in cases in which we were unable to fit the defect or achieve adequate stability with trabecular metal cones. Followup was at a mean of 9 years (range, 5-12 years). No patients were lost to followup. Knee function and quality of life were assessed using the Oxford Knee Score, WOMAC, SF-12, and the UCLA activity score. Radiographs were assessed for signs of loosening. Surgical complications included superficial or deep infections, iatrogenic fractures, symptomatic deep venous thromboses or pulmonary emboli, and blood loss requiring transfusion; these were obtained from our database and from review of patients' charts. The mean Oxford Knee Score in the allograft and trabecular metal cone groups was 91 (SD 10) and 91 (SD 14), respectively (95% confidence interval [CI], 88-94; p = 0.29). Mean WOMAC scores were 94 (SD 10) and 92 (SD 14), respectively (95% CI, 80-105; p = 0.52) and mean UCLA scores were 6 (SD 1.2) and 6 (SD 1.5), respectively (95% CI, 4-8; p = 0.49). Five- and 10-year survivorship of the allografts was 93% (95% CI, 77-98) and 93% (95% CI, 77-99), respectively. Survivorship at a mean of 5 years in the trabecular metal cones group was 91% (95% CI, 56-98). With the numbers available, there were no differences between the groups in terms of the frequency of surgical complications (3% [one of 30] versus 7% [one of 15]; odds ratio, 0.5; p = 0.632). With the numbers available, we found no difference in pain, function, or repeat revision when comparing femoral head allografts and trabecular metal cones for severe bone defects during revision TKA. However, we used allografts for the larger bone defects. Based on these results, we believe that femoral head allografts and trabecular metal cones can both be used for the management of Anderson Orthopaedic Research Institute Types 2 and 3 defects. Future multicenter studies are required with larger numbers, cost analyses, and a longer duration of followup. Level III, therapeutic study. AD - [Sandiford, Nemandra A.; Misur, Peter; Garbuz, Donald S.; Greidanus, Nelson V.; Masri, Bassam A.] Univ British Columbia, Dept Orthopaed, Reconstruct Orthopaed, 3rd Floor,910 West 10th Ave, Vancouver, BC V5Z 4E3, Canada. Sandiford, NA (corresponding author), Univ British Columbia, Dept Orthopaed, Reconstruct Orthopaed, 3rd Floor,910 West 10th Ave, Vancouver, BC V5Z 4E3, Canada. nemsandiford@hotmail.com AN - WOS:000391386700022 AU - Sandiford, N. A. AU - Misur, P. AU - Garbuz, D. S. AU - Greidanus, N. V. AU - Masri, B. A. DA - Jan DO - 10.1007/s11999-016-4898-9 J2 - Clin. Orthop. Rel. Res. KW - TOTAL KNEE ARTHROPLASTY TANTALUM METAPHYSEAL CONES TIBIAL BONE LOSS STRUCTURAL ALLOGRAFT DEFECTS SLEEVES REPLACEMENT HIP RECONSTRUCTION CEMENTLESS Orthopedics Surgery LA - English M1 - 1 M3 - Article; Proceedings Paper N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2017 SN - 0009-921X SP - 118-124 ST - No Difference Between Trabecular Metal Cones and Femoral Head Allografts in Revision TKA: Minimum 5-year Followup T2 - Clinical Orthopaedics and Related Research TI - No Difference Between Trabecular Metal Cones and Femoral Head Allografts in Revision TKA: Minimum 5-year Followup UR - ://WOS:000391386700022 VL - 475 ID - 830200 ER - TY - JOUR AB - Arterial injuries following total hip arthroplasty (THA) are uncommon and are usually related to revision THA. Deep external pudendal artery injury and delayed bleeding due to percutaneous adductor tenotomy during THA has not been reported.A 62-year-old man with bilateral hip osteoarthritis and ankylosing spondylitis was treated with right cementless THA. Persistent severely limited hip abduction after prosthetic implantation required a percutaneous adductor tenotomy, which was performed bilaterally. No clinical signs of bleeding existed postoperatively. On postoperative day 3, the patient had a hypotensive attack, his right anteromedial thigh at the tenotomy site was distended, and the hemoglobin was 5.9 g/dL. Computed tomography angiography of the iliac and femoral vessels showed a right hematoma medial to the common femoral artery, with active contrast extravasation. Volumetric data reconstruction revealed active bleeding from the right external pudendal artery into an inguinal collection. Angiography was performed by the standard Seldinger technique via the contralateral femoral artery. A guiding catheter was placed as near to the lesion as possible. A microcatheter system and microguidewire were used for superselective catheterization, and 2 embolization coils were used to control the bleeding. The patient remained hemodynamically stable and was discharged 12 days later. Two-year follow-up was uneventful.The deep external pudendal artery may be injured during percutaneous adductor tenotomy, especially in patients with fragile arterial walls, and life-threatening complications may occur. Angiography and embolization are the best treatment options. AD - Department of Orthopaedic Surgery and Traumatology, Azienda Ospedaliera Universitaria Integrata, Policlinico GB Rossi, Verona, Italy. andrea.sandri@ospedaleuniverona.it AN - 22495861 AU - Sandri, A. AU - Regis, D. AU - Marino, M. A. AU - Perandini, S. AU - Bonetti, I. AU - Toso, M. DA - Apr DO - 10.3928/01477447-20120327-35 DP - NLM ET - 2012/04/13 J2 - Orthopedics KW - Arteries/*injuries/*surgery Arthroplasty, Replacement, Hip/*adverse effects Humans Male Middle Aged Spondylitis, Ankylosing/*complications/*surgery Tenotomy/*adverse effects Treatment Outcome LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0147-7447 SP - e566-9 ST - Deep external pudendal artery injury after percutaneous adductor tenotomy during THA in ankylosing spondylitis T2 - Orthopedics TI - Deep external pudendal artery injury after percutaneous adductor tenotomy during THA in ankylosing spondylitis VL - 35 ID - 828882 ER - TY - JOUR AB - A pulmonary embolism is a rare, but well described complication of percutaneous vertebroplasty; the majority of cases are caused by acrylic cement. Here, for the first time, we report a case of pulmonary embolism due to a thrombus in the right atrium, which was caused by an acrylic cement foreign body in the right atrium and central veins 6 years after percutaneous vertebroplasty. This case suggests that an acrylic cement foreign body should be considered as a potential source of thrombus formation in patients that develop a pulmonary embolism following percutaneous vertebroplasty. © 2006, The Korean Society of Circulation. AD - K.-H. Kim, Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, 28 Yonqon-dong, Chongno-gu, Seoul 110-744, South Korea AU - Sang, E. L. AU - Chang, S. A. AU - Kim, M. S. AU - Kim, S. Y. AU - Han, J. K. AU - Jang, H. J. AU - Kim, Y. J. AU - Sohn, D. W. AU - Oh, B. H. AU - Kim, K. H. DB - Embase DO - 10.4070/kcj.2006.36.10.713 KW - acrylic cement adult anamnesis article case report computed tomographic angiography female foreign body heart arrest heart atrium thrombosis heart catheter heart right atrium heart tumor liver vein human hypothermia inferior cava vein lung embolism lung perfusion open heart surgery percutaneous vertebroplasty pulmonary artery thorax radiography transesophageal echocardiography transthoracic echocardiography spine fracture LA - English M1 - 10 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 1738-5555 1738-5520 SP - 713-715 ST - Acrylic cement foreign body and thrombus in right atrium causing pulmonary embolism after percutaneous vertebroplasty T2 - Korean Circulation Journal TI - Acrylic cement foreign body and thrombus in right atrium causing pulmonary embolism after percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L44885377&from=export http://dx.doi.org/10.4070/kcj.2006.36.10.713 VL - 36 ID - 829806 ER - TY - JOUR AB - INTRODUCTION: Cement pulmonary artery emboli are a known complication following vertebral kyphoplasty with incidence thought to occur between 2.1 to 26% of patients undergoing this procedure. We present a case of cement pulmonary artery emboli and review of current preventative and treatment guidelines. CASE PRESENTATION: A 39-year-old woman with a history of asthma and degenerative joint disease with a resultant L4-S1 vertebral kyphoplasty four years prior presented with complaints of dyspnea. Her dyspnea was sudden onset and occurred at rest following extensive travel. She also experienced diffuse pleuritic chest pain that was accompanied by a dry cough. She had tried her albuterol inhaler at home without relief and was also given an albuterol nebulizer in the Emergency Room without improvement in her dyspnea. Her vital signs were within normal limits including her oxygen saturation. She was in mild distress and wheezing, without crackles on auscultation of her respiratory system. There was no lower extremity edema or erythema. On laboratory examination she was noted to have a mildly elevated D-dimer of 0.62mcg/mL. An electrocardiogram was normal and a chest radiograph had no acute cardiopulmonary disease process. Since her symptoms did not respond to therapy and she had an elevated D-dimer, a helical computerized tomography of the chest was performed that demonstrated multiple bilateral cement pulmonary artery emboli. She improved with therapy for obstructive lung disease and was initated on enoxaparin for anticoagulation. DISCUSSION: Cement emboli occurs during a vertebral kyphoplasty, as there is an injection of polymethylmethacrylate into the vertebral bodies that can result in extravasations into the paravertebral veins resulting in pulmonary emboli. It can also extravasate into the paravertebral veins as a result of too much pressure being applied to the vertebral bodies during the kyphoplasty. Importantly ensuring the injected material is of toothpaste like texture can decrease embolization. CONCLUSIONS: Current treatment guidelines recommend the use of anticoagulation with warfarin for six months. There have been reports of endothelialization after six months of warfarin therapy is completed to prevent the progression of the embolus. However if the cement pulmonary emboli are found incidentally or the patient is asymptomatic, no further treatment is indicated. AD - P. Sanghera, University of Oklahoma, Tulsa School of Community Medicine, Tulsa, OK, United States AU - Sanghera, P. AU - Andrews, S. AU - Sambhara, V. AU - Garfinkel, F. AU - Test, V. DB - Embase DO - 10.1378/chest.1704569 KW - cement D dimer salbutamol warfarin toothpaste poly(methyl methacrylate) enoxaparin pulmonary artery artery embolism human case report kyphoplasty dyspnea therapy anticoagulation embolism lung embolism vein vertebra body patient thorax thorax pain electrocardiogram laboratory test travel erythema edema leg respiratory system osteoarthritis auscultation artificial embolization thorax radiography crackle wheezing female oxygen saturation vital sign emergency ward extravasation nebulizer injection inhaler asthma chronic obstructive lung disease computer assisted tomography coughing procedures L1 - http://journal.publications.chestnet.org/article.aspx?articleid=1740359 LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0012-3692 ST - Cement pulmonary artery emboli: A case report and literature review T2 - Chest TI - Cement pulmonary artery emboli: A case report and literature review UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71269229&from=export http://dx.doi.org/10.1378/chest.1704569 VL - 144 ID - 829480 ER - TY - JOUR AB - Bone augmentation is a preventative osteoporosis intervention, comprising the injection of bone cement into an osteoporotic bone. As injection of excessive amounts of bone cement may result into thermal necrosis of bone tissue or even embolism, the minimum cement volume required to achieve a predefined level of augmentation must be sought. To this end, the present paper introduces a new evolutionary optimization method, applicable to any osteoporotic bone. The method was numerically evaluated through a typical case of femoral augmentation and compared to another powerful optimization method. The results demonstrate the efficiency and low computational cost of the proposed method. AD - a School of Mechanical and Automotive Engineering , Kingston University , London , UK . AN - 28271716 AU - Santana Artiles, M. E. AU - Venetsanos, D. T. DA - May DO - 10.1080/10255842.2017.1291805 DP - NLM ET - 2017/03/09 J2 - Computer methods in biomechanics and biomedical engineering KW - *Algorithms Biomechanical Phenomena/drug effects Bone Cements/pharmacology Elastic Modulus/drug effects Femur/drug effects/*pathology Humans Necrosis Numerical Analysis, Computer-Assisted Osteoporosis/*pathology Bone augmentation evolutionary method femoroplasty optimization osteoporosis LA - eng M1 - 7 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 1025-5842 SP - 691-700 ST - A new evolutionary optimization method for osteoporotic bone augmentation T2 - Comput Methods Biomech Biomed Engin TI - A new evolutionary optimization method for osteoporotic bone augmentation VL - 20 ID - 828567 ER - TY - JOUR AB - Introduction: An irregular craniofacial contour along the temporal fossa, known commonly as "temporal hollowing deformity," (THD) can arise from multiple etiologies. In fact, up to half of all patients who undergo neurosurgical pterional dissections develop some form of temporal contour deformities. Unfortunately, temporal hollowing correction remains surgically challenging with many techniques resulting in high rates of failure and/or morbidity. Methods: Herein, we describe anatomy contributing to postsurgical temporal deformity as well as time-tested prevention and surgical correction techniques. In addition, a review of 25 articles summarizing various techniques and complication profiles associated with temporal hollowing correction are presented. Results: Complications included infection, implant malposition, revision surgery, pain, and implant removal because of implantrelated complications Augmentation with either autologous fat or dermal filler is associated with the highest number of reported complications, including catastrophic events such as stroke, pulmonary embolism, and death. No such complications were reported with use of alloplastic material, use of autologous bone, or free tissue transfer. Furthermore, careful attention to adequate temporalis muscle resuspension and position remain paramount for stable restoration of craniofacial symmetry. Conclusions: Catastrophic complications were associated with injection augmentation of both fat and dermal filler in the temporal region. In contrast, use of alloplastic materials was not found to be associated with any catastrophic complications. As such, for the most severe cases of THD, we prefer to employ alloplastic reconstruction. AD - [Santiago, Gabriel F.; Wolff, Amir; Gordon, Chad R.] Johns Hopkins Univ, Sch Med, Dept Plast & Reconstruct Surg, Neuroplast & Reconstruct Surg,Johns Hopkins Hosp, Baltimore, MD USA. [Terner, Jordan] Albert Einstein Coll Med, Div Plast & Reconstruct Surg, Bronx, NY 10467 USA. [Teixeira, Jeffrey] Walter Reed Natl Mil Med Ctr, Dept Otolaryngol Head & Neck Surg, Bethesda, MD USA. [Santiago, Gabriel F.; Wolff, Amir; Brem, Henry; Huang, Judy; Gordon, Chad R.] Johns Hopkins Univ, Sch Med, Dept Neurosurg, Johns Hopkins Hosp, Baltimore, MD 21205 USA. Santiago, GF (corresponding author), Johns Hopkins Univ, Neuroplast & Reconstruct Surg, Dept Plast & Reconstruct Surg, Sch Med,JHOC, 8th Floor,601 N Caroline St, Baltimore, MD 21287 USA.; Santiago, GF (corresponding author), Johns Hopkins Univ, Plast & Reconstruct Surg, Dept Plast & Reconstruct Surg, Sch Med,JHOC, 8th Floor,601 N Caroline St, Baltimore, MD 21287 USA. gsantia2@jhmi.edu AN - WOS:000452441400053 AU - Santiago, G. F. AU - Terner, J. AU - Wolff, A. AU - Teixeira, J. AU - Brem, H. AU - Huang, J. AU - Gordon, C. R. DA - Oct DO - 10.1097/scs.0000000000004639 J2 - J. Craniofac. Surg. KW - Complication contour deformity craniofacial neurosurgery plastic surgery technique review temporal hollowing HYDROXYAPATITE CEMENT CRANIAL DEFECTS RECONSTRUCTION AUGMENTATION CRANIOPLASTY IMPLANT BONE INJECTION BLINDNESS SURGERY Surgery LA - English M1 - 7 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 1049-2275 SP - 1723-1729 ST - Post-Neurosurgical Temporal Deformities: Various Techniques for Correction and Associated Complications T2 - Journal of Craniofacial Surgery TI - Post-Neurosurgical Temporal Deformities: Various Techniques for Correction and Associated Complications UR - ://WOS:000452441400053 VL - 29 ID - 830153 ER - TY - JOUR AB - Purpose: Tranexamic acid has been shown to be effective in reducing blood loss after total hip replacement. The purpose of this study was to prospectively assess the effectiveness of topical TXA use to reduce blood loss after primary total hip replacement and to compare these outcomes with those of a matched control group from a similar cohort that did not have received tranexamic acid.Methods: This is a prospective matched control study to assess the effect of a 2 g topical tranexamic acid in 50 mL physiological saline solution in total hip replacement. Primary outcomes were hemoglobin and hematocrit drop, and total blood loss. Secondary outcomes were transfusion rates, length of hospital stay, deep vein thrombosis, and pulmonary embolism events.Results: We could match 100 patients to a control group. There were no statistical significantly differences between the two groups. The hemoglobin and hematocrit postoperative values were significantly higher in topical tranexamic acid group than in control group (P < 0.001). The mean total blood loss was 769 in topical tranexamic acid group and 1163 in control group with significant differences (P = 0.001), which meant 34% reduction in total blood loss. Length of stay was lower in topical tranexamic acid group. The risk of deep vein thrombosis and pulmonary events did not increase.Conclusions: A single dose of 2 g tranexamic acid in 50 mL physiological saline solution topical administration was effective and safe in reducing bleeding in patients undergoing unilateral primary non-cemented total hip replacement compared to a matched control group. AD - Hip Unit, Department of Orthopedic Surgery, HLA Clinica Vistahermosa, Av de Denia 76, 03016, Alicante, Spain AN - 131705478. Language: English. Entry Date: 20180919. Revision Date: 20191029. Publication Type: Article AU - Sanz-Reig, Javier AU - Mas Martinez, Jesus AU - Verdu Román, Carmen AU - Morales Santias, Manuel AU - Martínez Gimenez, Enrique AU - Bustamante Suarez de Puga, David DB - cin20 DO - 10.1007/s00590-018-2192-0 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Adverse Effects Postoperative Hemorrhage -- Prevention and Control Tranexamic Acid -- Therapeutic Use Tranexamic Acid -- Administration and Dosage Administration, Topical Bone Cements Human Prospective Studies Treatment Outcomes Normal Saline Hemoglobins Hematocrit Blood Transfusion Length of Stay Venous Thrombosis -- Risk Factors Pulmonary Embolism -- Risk Factors M1 - 7 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2018 SN - 1633-8065 SP - 1335-1339 ST - Matched cohort study of topical tranexamic acid in cementless primary total hip replacement T2 - European Journal of Orthopaedic Surgery & Traumatology TI - Matched cohort study of topical tranexamic acid in cementless primary total hip replacement UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=131705478&site=ehost-live&scope=site VL - 28 ID - 830543 ER - TY - JOUR AB - Percutaneous vertebroplasty (PVP) is a minimally invasive procedure widely used for the treatment of pain due to vertebral fractures of different origins-osteoporotic, traumatic, or neoplastic. PVP is minimally invasive, but the complications are not rare; however, they are in most cases not significant clinically. The most frequent is cement leakage, which can occur onto veins, paravertebral soft tissue, into the intervertebral disk, or to the spinal canal, affecting foraminal area or epidural space. We analyzed results of treatment and complications of vertebroplasty performed with the use of polimethylomethylacrylate cement (PMMA) on 1100 vertebrae, with a special regard to the severity of complication and eventual clinical manifestation. One thousand one hundred PVP were analyzed, performed in 616 patients. There were 468 (76%) women and 148 men (24%), 24 to 94-year old, mean age 68 years. From 1100 procedures, 794 treated osteporotic and 137 fractures due to malignant disease, 69 PVP were made in traumatic fractures. One hundred patients had painful vertebral hemangiomas. Seven hundred twenty-six (66%) lesions were in thoracic, and 374 (34%) in lumbar area. Results of treatment were assessed using 10 cm Visual Analogue Scale (VAS) 12 hours after surgery, 7 days, 30 days, and then each 6 months, up to 3 years. Before surgery all patients had significant pain 7 to 10 in VAS scale, mean 8.9 cm. Twelve  hours after surgery 602 (97.7%) reported significant relief of pain, with mean VAS of 2,3 cm. Local complications occurred in 50% of osteoporotic, 34% of neoplastic, 16% of traumatic fractures, and 2% of vertebral hemangiomas. The most common was PMMA leakage into surrounding tissues-20%; paravertebral vein embolism-13%; intradiscal leakage-8%; and PMMA leakage into the spinal canal-0.8%. Results of treatment did not differ between patients with and without any complications. From 104 patients who had chest X-ray or CT study performed after surgery, pulmonary embolism was noted in 2 patients, but without any clinical symptoms. Only 1 patient-with PMMA leakage into the spinal canal required surgical decompression In conclusion, PVP is effective in decreasing the level of pain in compression vertebral fractures. Complications occur in almost half of the patients but in more than 95% of them do not produce any clinical symptoms. AD - Faculty of Health Sciences and Physical Education, Kazimierz Pulaski University of Technology and Humanities, Radom, Poland. AN - 27310966 AU - Saracen, A. AU - Kotwica, Z. C2 - Pmc4998452 DA - Jun DO - 10.1097/md.0000000000003850 DP - NLM ET - 2016/06/17 J2 - Medicine KW - Adult Aged Aged, 80 and over Female Fluoroscopy Follow-Up Studies Fractures, Compression/diagnosis/*surgery Humans Lumbar Vertebrae/*injuries Male Middle Aged Retrospective Studies Spinal Fractures/diagnosis/*surgery Surgery, Computer-Assisted Thoracic Vertebrae/*injuries Treatment Outcome Vertebroplasty/*methods Young Adult LA - eng M1 - 24 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 0025-7974 (Print) 0025-7974 SP - e3850 ST - Complications of percutaneous vertebroplasty: An analysis of 1100 procedures performed in 616 patients T2 - Medicine (Baltimore) TI - Complications of percutaneous vertebroplasty: An analysis of 1100 procedures performed in 616 patients VL - 95 ID - 828591 ER - TY - JOUR AB - Bone cement implantation syndrome is associated with hypoxia, hypotension, cardiac arrhythmias, increase in pulmonary vascular resistance and cardiac arrest and is a cause of mortality and morbidity in orthopedic patients when cement is used. Because it is rare and isn't well identified, literature is limited to case reports. In this article, bone cement implatation syndrome developed in a patient who had undergone surgery for hip replacement is reported with literature. AD - [Sargin, Mehmet; Borazan, Hale; Otelcioglu, Seref] Necmettin Erbakan Univ, Tip Fak, Anesteziyol & Reanimasyon Anabilim Dali, Konya, Turkey. Sargin, M (corresponding author), Necmettin Erbakan Univ, Tip Fak, Anesteziyol & Reanimasyon Anabilim Dali, Konya, Turkey. mehmet21sargin@yahoo.com AN - WOS:000417444800010 AU - Sargin, M. AU - Borazan, H. AU - Otelcioglu, S. DO - 10.5350/btdmjb201713310 J2 - Med. J. Bakirkoy KW - Bone cement implantation syndrome regional anesthesia hip replacement TOTAL HIP-ARTHROPLASTY FAT-EMBOLISM CARDIAC-OUTPUT HYPOTENSION COLLAPSE SURGERY DEATH Medicine, General & Internal LA - Turkish M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2017 SN - 1305-9319 SP - 156-158 ST - Developing bone cement implantation syndrome under regional anesthesia: case report T2 - Medical Journal of Bakirkoy TI - Developing bone cement implantation syndrome under regional anesthesia: case report UR - ://WOS:000417444800010 VL - 13 ID - 830198 ER - TY - JOUR AB - Vertebral hemangiomas (VHs) are common lesions in the adult population. They are usually asymptomatic and found incidentally on radiological imaging. New-onset back pain followed by subacute progression of thoracal myelopathy is the most common presentation in patients with neurological deficit. Differential diagnoses would include metastasis, multiple myeloma, lymphoma, Paget disease, osseous tumors such as Ewing sarcoma or hemangioblastoma and blood dyscrasia. We present a 41 year-old-male patient with thoracal VH causing myelopathy that completely improved after rehabilitation program with embolization and vertebroplasty procedures. AD - Department of Physical Medicine and Rehabilitation, Medical Faculty, Istanbul University Cerrahpaşa, Istanbul, Turkey. Department of Interventional Radiology, Medical Faculty, Istanbul University Cerrahpaşa, Istanbul, Turkey. AN - 23948851 AU - Sari, H. AU - Uludag, M. AU - Akarirmak, U. AU - Ornek, N. I. AU - Gun, K. AU - Gulsen, F. DO - 10.3233/bmr-130425 DP - NLM ET - 2013/08/21 J2 - Journal of back and musculoskeletal rehabilitation KW - Adult Embolization, Therapeutic Hemangioma/*complications/rehabilitation/therapy Humans Magnetic Resonance Imaging Male Spinal Cord Compression/*etiology/surgery/therapy Thoracic Vertebrae/pathology/surgery Treatment Outcome Vascular Neoplasms/*complications/rehabilitation/therapy Vertebrobasilar Insufficiency/*etiology/rehabilitation/therapy Vertebroplasty Aggressive hemangioma embolization myelopathy thoracal vertebra LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1053-8127 SP - 125-9 ST - Aggressive vertebral hemangioma as a rare cause of myelopathy T2 - J Back Musculoskelet Rehabil TI - Aggressive vertebral hemangioma as a rare cause of myelopathy VL - 27 ID - 828908 ER - TY - JOUR AB - Background: Metastatic bone disease affects more than 1.2 million new patients annually. The femur is the most common long bone affected, with 25% involving the proximal third of the femur. For cases involving the femoral head, neck, and intertrochanteric area, the long stem cemented hip replacement is an important surgical option for fracture management and management of impending fractures. An important complication of this technique is the development of cardiopulmonary embolism. This study was conducted to evaluate the effectiveness of distal femoral canal decompression in reducing the risk of cardiopulmonary events. Method: A total of 32 patients with metastatic disease of the proximal femur who underwent long stem hip replacement were recruited in a randomized study. A conventional technique was used in 16 cases (without decompressing the medullary canal). Another 16 patients had the medullary canal decompressed distally. This was done via a trocar which was connected to a vacuum suction which was inserted into the distal femoral canal. A four Chambers Transesophageal Echocardiography was performed for all patients intraoperatively to detect the quantity of emboli passing through the heart. Results: Patients who were operated on with the vacuum technique were haemodynamically more stable and developed significantly less cardiopulmonary events during reaming of the femoral canal, insertion of the femoral stem and relocation of the hip joint. Conclusion: Distal femoral decompression of the femoral canal is effective in reducing embolism to the heart and reducing the incidence of cardiopulmonary events. AD - S. Sarrafan, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia AU - Sarrafan, S. AU - Singh, V. A. AU - Veriah, R. S. DB - Embase KW - hip arthroplasty long bone bone metastasis Malaysian decompression human patient embolism femur fracture heart vacuum transesophageal echocardiography suction femoral head metastasis risk trocar neck hip bone disease L1 - http://morthoj.org/supplements/v6-sA/abstracts-meniscus-cartilage-oncology.pdf LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1985-2533 SP - 32 ST - The study of medullarly canal decompression in reducing cardiopulmonary complications in long stem hip replacement of long bone metastases T2 - Malaysian Orthopaedic Journal TI - The study of medullarly canal decompression in reducing cardiopulmonary complications in long stem hip replacement of long bone metastases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71991660&from=export VL - 6 ID - 829567 ER - TY - JOUR AB - Background and aims: Bone cement implantation syndrome is characterized by hypotension, hypoxemia, cardiac arrhythmias, cardiac arrest comlications which may be fatal in 0,6-1% of all cases. Intramedullary hypertension in the femur during the prothesis placement in patients undergoing cemented hip arthroplasty leads to microemboli formation and venous embolization. Early signs include severe dyspnoea, hypoxaemia, hypotension, dizzyness, loss of consciousness which may lead to respiratory or cardiac arrest. General anaesthesia may mask these early symptoms, on the other hand, central blocks like spinal or epidural anaesthesia keep the patient awake and alert and communication with the patient helps early recognition. We investigated a retrospective study involving these cases. Method: In the period between April 2009 until January 2011, 1036 cases of total hip arthroplasty and hemiarthroplasty and 28 cases of revision were recorded. Patients were aged 81±24 years, 61,2% female and 38,8% male. All of them were performed under regional anaesthesia. Results: There were 15 cases involving major complications of BCIS, four of them leading to death (3 intra-operatively and one after three-month stay in the ICU). From the rest, 11 cases were treated successfully and 3 involved cardiac arrest which needed resuscitation and performance of ALS algorithm and requested postoperative care with monitoring in the ward. Two cases were associated with severe hypoxemia, which leaded to cardiorespiratory arrest. In all these cases, early recognition, due to regional anaesthesia, was the key for early resuscitation which was successful in most of them. Conclusions: Bone cement syndrome may often appear after cement placement in many forms, related to cardiovascular dysfunction and respiratory distress, but its severe complications seemed to appear in a relative low incidence in our hospital with six Orthopaedic Departments. Early suspicion and diagnosis with careful intraoperative monitoring can minimize morbidity and mortality. AD - D. Sarridou, Aslepieio Voulas General Hospital, Voula, Greece AU - Sarridou, D. AU - Moustaka, A. AU - Papadopoulos, P. AU - Rozakis, D. AU - Konstantopoulos, K. AU - Mela, A. DB - Embase DO - 10.1097/AAP.0b013e31826a8366 KW - bone cement cement regional anesthesia hip arthroplasty implantation human retrospective study society patient heart arrest hypoxemia resuscitation heart arrhythmia hypotension consciousness cardiopulmonary insufficiency hospital patient monitoring general anesthesia dyspnea monitoring postoperative care artificial embolization female prosthesis death male arthroplasty femur algorithm total hip prosthesis ward mortality respiratory distress morbidity diagnosis interpersonal communication epidural anesthesia hypertension LA - English M1 - 5 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1098-7339 SP - E237 ST - Regional anaesthesia promotes early recognition of bone cement implantation syndrome after hip arthroplasty. A retrospective study T2 - Regional Anesthesia and Pain Medicine TI - Regional anaesthesia promotes early recognition of bone cement implantation syndrome after hip arthroplasty. A retrospective study UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70880983&from=export http://dx.doi.org/10.1097/AAP.0b013e31826a8366 VL - 37 ID - 829550 ER - TY - JOUR AB - PURPOSE: To describe cardiovascular collapse during a cemented hip hemiarthroplasty in a patient who, despite a successful cardiopulmonary resuscitation, remained in a persistent vegetative state due to cerebral fat embolism diagnosed by magnetic resonance imaging (MRI). CLINICAL FEATURES: A 75-yr-old woman with no medical history underwent cemented hip hemiarthroplasty under spinal anesthesia for a right femoral neck fracture. Shortly after insertion of the prosthesis, a sudden oxygen desaturation, hypotension, bradycardia, and cardiac arrest occurred. The patient was successfully resuscitated, but did not regain consciousness. The patient developed high-grade fever, thrombocytopenia, anemia, and oliguria. MRI scans of the brain revealed multiple high intensity signals throughout the white matter, the basal ganglia, the cerebellum, and the brain stem. The diagnosis of fat embolism was made on the basis of clinical findings and MRI images. Although her cardiorespiratory status improved over the next week, the patient remained in a persistent vegetative state. CONCLUSION: When fat embolism is suspected, serial MRI scans of the brain should be performed to diagnose the etiology of cerebral embolism as well as to evaluate the severity of brain damage. AD - Department of Anesthesiology and Medical Crisis Management, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho-cho Mizuho-ku, Nagoya 467-8601, Japan. nobusasano@aol.com AN - 15525611 AU - Sasano, N. AU - Ishida, S. AU - Tetsu, S. AU - Takasu, H. AU - Ishikawa, K. AU - Sasano, H. AU - Katsuya, H. DA - Nov DO - 10.1007/bf03018883 DP - NLM ET - 2004/11/05 J2 - Canadian journal of anaesthesia = Journal canadien d'anesthesie KW - Aged Arthroplasty, Replacement, Hip/*adverse effects Embolism, Fat/*diagnosis/etiology Female Femoral Neck Fractures/surgery Follow-Up Studies Humans Intracranial Embolism/*diagnosis/etiology Intraoperative Complications *Magnetic Resonance Imaging Persistent Vegetative State/etiology Shock, Surgical/etiology LA - eng M1 - 9 N1 - PubMed NLM literature search January 5, 2021 PY - 2004 SN - 0832-610X (Print) 0832-610x SP - 875-9 ST - Cerebral fat embolism diagnosed by magnetic resonance imaging at one, eight, and 50 days after hip arthroplasty: a case report T2 - Can J Anaesth TI - Cerebral fat embolism diagnosed by magnetic resonance imaging at one, eight, and 50 days after hip arthroplasty: a case report VL - 51 ID - 828899 ER - TY - JOUR AB - During a posterior segmental spinal fusion procedure, a 71-year-old woman developed cardiac and pulmonary embolism characterized by nonsustained ventricular tachycardia during cement injection, rapid and severe hypoxemia, and hemodynamic instability. Management included exploratory cardiotomy under cardiopulmonary bypass and removal of the emboli from the pulmonary vessels. Postoperative recovery was successful, and the patient was discharged without sequelae. We discuss the pathophysiology of bone cement implantation syndrome during spinal fusion, possible causative factors, and treatment alternatives. (A&A Case Reports 2013;1:82-5). Copyright © 2013 International Anesthesia Research Society. AD - J.A. Sastre, Department of Anesthesiology, Complejo Asistencial Universitario de Salamanca, Paseo de San Vicente, 58-182, Salamanca 37007, Spain AU - Sastre, J. A. AU - López, T. AU - Dalmau, M. J. AU - Cuello, R. E. DB - Embase DO - 10.1097/ACC.0b013e31829e42ad KW - bone cement poly(methyl methacrylate) aged article cardiopulmonary bypass case report computer assisted tomography female fluoroscopy general anesthesia heart hemodynamics cardiac index heart stroke volume heart surgery heart ventricle extrasystole heart ventricle tachycardia human lung embolism priority journal spine surgery transesophageal echocardiography Spine Fix LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 2325-7237 SP - 82-85 ST - Bone cement implantation syndrome during spinal surgery requiring cardiac surgery T2 - A and A Case Reports TI - Bone cement implantation syndrome during spinal surgery requiring cardiac surgery UR - https://www.embase.com/search/results?subaction=viewrecord&id=L373618110&from=export http://dx.doi.org/10.1097/ACC.0b013e31829e42ad VL - 1 ID - 829463 ER - TY - JOUR AD - Department of Orthopaedic Surgery, Konan Kosei Hospital, 137 Takayamachi Ohmatsubara, Konan, Japan 483-8704. Department of Orthopaedic Surgery, Nagoya University, 56 Tsurumacho Showa-ku, Nagoya, Japan 466-8550. AN - 29252288 AU - Satake, K. AU - Kanemura, T. AU - Yamaguchi, H. AU - Matsumoto, A. DA - Dec 24 DO - 10.2106/jbjs.cc.m.00159 DP - NLM ET - 2013/12/24 J2 - JBJS case connector LA - eng M1 - 4 Suppl 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 2160-3251 SP - e132-e3 ST - Pulmonary Embolism After Vertebroplasty with Use of Hydroxyapatite Blocks: A Case Report T2 - JBJS Case Connect TI - Pulmonary Embolism After Vertebroplasty with Use of Hydroxyapatite Blocks: A Case Report VL - 3 ID - 828723 ER - TY - JOUR AB - Introduction: Gastric variceal bleeding due to splenic vein thrombosis is a life-threatening situation and is often difficult to manage by endoscopy. In the worst cases, an emergency splenectomy may be required to stop variceal bleeding. Case presentation: We report the case of a 60-year-old Caucasian woman with bleeding gastric varices secondary to splenic vein thrombosis treated by splenic artery embolization. Successful embolization was performed by depositing coils into the splenic artery resulting in cessation of variceal bleeding. After embolization there was no recurrence of bleeding. Conclusion: Splenic artery embolization can be an effective and definite treatment for variceal bleeding secondary to splenic vein thrombosis. AD - B. Saugel, II. Medizinische Klinik und Poliklinik, Klinikum Rechts der Isar der Technischen Universitat Munchen, Munchen, Germany AU - Saugel, B. AU - Gaa, J. AU - Phillip, V. AU - Schmid, R. M. AU - Huber, W. DB - Embase DO - 10.1186/1752-1947-4-247 KW - embolization coil acrylic cement analgesic agent terlipressin abdominal discomfort abdominal radiography adult arterial embolization article case report Caucasian clinical article coil embolization computer assisted tomography disease severity elevated blood pressure erythrocyte transfusion esophagogastroduodenoscopy female hospital admission hospital discharge human intensive care unit liver function test magnetic resonance angiography middle aged patient referral patient transport plasma transfusion portal vein blood flow portal vein blood pressure priority journal recurrent disease shock spleen artery splenic vein splenomegaly stomach hemorrhage stomach varices vein thrombosis LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 1752-1947 ST - Splenic artery embolization in a woman with bleeding gastric varices and splenic vein thrombosis: A case report T2 - Journal of Medical Case Reports TI - Splenic artery embolization in a woman with bleeding gastric varices and splenic vein thrombosis: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L51021822&from=export http://dx.doi.org/10.1186/1752-1947-4-247 VL - 4 ID - 829654 ER - TY - JOUR AB - Personal clinical experience with Genesis total knee prostheses is reported. This prosthesis is highly modular and flexible and permits very accurate adaptation to the most varied anatomo-pathological situations. The cases treated totalled 39 knees in 37 patients, with a maximum follow-up of 20 months. Surgery consisted of applying a non-cemented femoral component, a cemented tibial component in 21 with a pin in 18 cases, without ever applying a prosthesis to the patella. Complications included 3 thrombophlebitis, 1 pulmonary embolism with non-fatal outcome, 3 cases of rigidity, 2 of which required arthrolysis. The results have been assessed according to clinical and radiographic knee Society parameters. In many cases, the non-cemented tibial components showed the presence of radiolucent lines that were, however, never evolutive, except for one case subjected to prolonged, forced passive mobilisation. The femoral component never showed significant radiolucence lines. The preliminary results of Genesis total knee prosthesis are very favourable but a longer follow-up will be needed for a more conclusive assessment. AD - A. Savarese, Via Matteotti, 56, 26013 Crema, Italy AU - Savarese, A. DB - Embase KW - adult aged clinical article clinical trial complication conference paper female femoral shaft follow up genesis implant human knee instability lung embolism male radiography rigidity thrombophlebitis tibia total knee arthroplasty LA - Italian M1 - 10 M3 - Conference Paper N1 - Embase Elsevier literature search January 5, 2021 PY - 1994 SN - 0026-4911 SP - 457-463 ST - Genesis knee prosthesis. Technique and preliminary results T2 - Minerva Ortopedica e Traumatologica TI - Genesis knee prosthesis. Technique and preliminary results UR - https://www.embase.com/search/results?subaction=viewrecord&id=L25077196&from=export VL - 45 ID - 829934 ER - TY - JOUR AB - Background and Aims: Minimally invasive augmentation techniques of vertebral bodies have been widely used in the treatment of painful osteoporotic vertebral compression fractures (VBCFs). Kyphoplasty seems to achieve pain relief and contributes to improvement in quality of the patients' life. The present study reports our experience and the 3-year follow-up in kyphoplasty procedures for osteoporotic VBCF's. Methods: A total of 117 VBCF (46 thoracic and 71 lumbar vertebrae) in 60 patients (mean age: 69 years, range 38-84 years) were treated with kyphoplasty during 2002 and 2005. All patients were preoperatively evaluated with radiographs, MRI, bone scintigraphy, and Oswestry Disability Index questionnaire. Eight patients were treated within a week from their injury (new fractures). All patients completed the Oswestry Disability Index Questionnaire preoperatively, the 1st day postoperatively and 6 months after surgery. All procedures were performed under general anaesthesia and fluoroscopy guidance. Results: All patients experienced pain relief following the procedure and the mean Oswestry Disability Index score from 78% preoperatively decreased to 4.39% immediately postoperatively (P <0.0001). Pain results remained satisfactory 6 months after the kyphoplasty as demonstrated by the repeat of questionnaire (mean value 4.32%). There were no cases ofpulmonary embolism nor were any significant cement leakages noted. Conclusion: The treatment of painful osteoporotic VBCF's with kyphoplasty is safe and reduces pain and disability, contributing in a better quality of living in osteoporotic patients, immediately postoperatively as well as long-term. AD - C. Savvidou, Second Orthopaedic Department, University of Athens, Athens, Greece AU - Savvidou, C. AU - Zoumboulis, P. AU - Chatziioannou, S. AU - Pneumaticos, S. DB - Embase DO - 10.1111/j.1533-2500.2009.00266.x KW - cement kyphoplasty analgesia pain patient Oswestry Disability Index questionnaire fracture general anesthesia fluoroscopy embolism surgery disability vertebra body compression fracture follow up lumbar vertebra X ray film bone scintiscanning injury nuclear magnetic resonance imaging LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 1530-7085 SP - 74-75 ST - Pain relief and improvement of quality living after kyphoplasty T2 - Pain Practice TI - Pain relief and improvement of quality living after kyphoplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70207142&from=export http://dx.doi.org/10.1111/j.1533-2500.2009.00266.x VL - 9 ID - 829718 ER - TY - JOUR AB - Background: Incidence of vertebral compression fractures (VCFs) is increasing due to increase in human life expectancy and prevalence of osteoporosis. Vertebroplasty had been traditional treatment for pain, but it neither attempts to restore vertebral body height nor eliminates spinal deformity and is associated with a high rate of cement leakage. Balloon kyphoplasty involves introduction of inflatable balloon into the fractured body of vertebra for elevation of the end-plates prior to fixation of the fracture with bone cement. This study evaluates short term functional and radiological outcomes of balloon kyphoplasty. The secondary aim is to explore short-term complications of the procedure. Materials and Methods: A retrospective study of 199 kyphoplasty procedures in 135 patients from March 2009 to March 2012 were evaluated with short form-36 (SF-36) score, visual analogue scale (VAS), detailed neurological and radiological evaluations. The mean followup was 18 months (range 12-20 months). Statistical analysis including paired sample t-test was done with statistical package for social sciences. Results: Statistically significant improvements in SF-36 (from 34.29 to 48.53, an improvement of 14.24, standard deviation (SD) - 20.08 P < 0.0001), VAS (drop of 4.49, from 6.74 to 2.24, SD - 1.44, P < 0.0001), percentage restoration of lost vertebral height (from 30.62% to 16.19%, improvement of 14.43%, SD - 15.37, P < 0.0001) and kyphotic angle correction (from 17.41° to 10.59°, improvement of 6.82, SD - 7.26°, P < 0.0001) were noted postoperatively. Six patients had cement embolism, 65 had cement leak and three had adjacent level fracture which required repeat kyphoplasty later. One patient with history of ischemic heart disease had cardiac arrest during the procedure. No patients had neurological deterioration in the followup period. Conclusions: Kyphoplasty is a safe and effective treatment for VCFs. It improves physical function, reduces pain and corrects kyphotic deformity. AD - Department of Orthopaedic Surgery, The Spine Clinic, Shalby Hospitals, Ahmedabad, Gujarat, India AN - 109816793. Language: English. Entry Date: 20150709. Revision Date: 20200708. Publication Type: Journal Article AU - Saxena, B. Praveen AU - Shah, B. Viral AU - Joshi, S. Prateek DB - cin20 DO - 10.4103/0019-5413.159673 DP - EBSCOhost KW - Kyphoplasty -- Methods Fractures, Vertebral Compression -- Surgery Treatment Outcomes -- Evaluation Human Retrospective Design Osteoporosis Visual Analog Scaling Time Factors Paired T-Tests Magnetic Resonance Imaging Algorithms Tomography, X-Ray Computed Short Form-36 Health Survey (SF-36) Questionnaires M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2015 SN - 0019-5413 SP - 458-464 ST - Outcome of percutaneous balloon kyphoplasty in vertebral compression fractures T2 - Indian Journal of Orthopaedics TI - Outcome of percutaneous balloon kyphoplasty in vertebral compression fractures UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=109816793&site=ehost-live&scope=site VL - 49 ID - 830615 ER - TY - JOUR AB - OBJECTIVE: Intraoperative blood loss constitutes a major cause of perioperative morbidity in surgical decompression and reconstruction of highly vascular spinal metastatic tumors. We propose a technique for embolization of highly vascular vertebral metastases using percutaneous direct injection using n-butyl cyanoacrylate (NBCA) instead of polymethylmethacrylate to complement preoperative transarterial embolization and to minimize operative blood loss. METHODS: Five patients with renal cell carcinoma metastases to the spine (one cervical, one thoracic, and three lumbar) underwent embolization by percutaneous direct injection of the affected vertebrae with a mixture of NBCA and iodized oil to supplement transarterial embolization with polyvinyl alcohol particles and fibered platinum coils. This was achieved via a transpedicular approach in four cases and by direct vertebral body puncture in one case. RESULTS: The percutaneous NBCA direct injection procedure was technically successful in all cases and was not associated with neurological or medical complications. All patients underwent subsequent vertebrectomy and spinal instrumentation. Surgical resection was performed with lower than expected blood loss and with a subjective improvement in tumor tissue handling and dissection. CONCLUSION: The extent of tumor devascularization can be improved by supplementing transarterial embolization with NBCA direct injection to decrease operative blood loss and increase the safety of surgical resection and stabilization of highly vascular spinal metastases. Copyright © Congress of Neurological Surgeons. AD - A.M. Malek, Cerebrovascular and Endovascular Division, Department of Neurosurgery, Tufts-New England Medical Center, 750 Washington Street, #178, Boston, MA 02111, United States AU - Schirmer, C. M. AU - Malek, A. M. AU - Kwan, E. S. AU - Hoit, D. A. AU - Weller, S. J. DB - Embase Medline DO - 10.1227/01.NEU.0000223503.92392.CE KW - enbucrilate iodinated poppyseed oil platinum derivative polyvinyl alcohol adult aged article artificial embolization bleeding cancer surgery clinical article female human kidney carcinoma male outcome assessment percutaneous vertebroplasty priority journal puncture spine metastasis spine stabilization surgical approach treatment outcome vertebra body LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 0148-396X SP - E431-E432.6 ST - Preoperative embolization of hypervascular spinal metastases using percutaneous direct injection with N-butyl cyanoacrylate: Technical case report T2 - Neurosurgery TI - Preoperative embolization of hypervascular spinal metastases using percutaneous direct injection with N-butyl cyanoacrylate: Technical case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L44325837&from=export http://dx.doi.org/10.1227/01.NEU.0000223503.92392.CE VL - 59 ID - 829788 ER - TY - JOUR AB - Introduction: The euphoria about vertebroplasty (VP) and kyphoplasty (KP) after promising experiences in the 1990s and the first Decade of this century, especially after the studies by Kallmes et al and Buchbinder et al in 2009, receded somewhat. But new and thoroughly analyzed data and meta-analyzes have been shown a clear benefit and an extremely low risk profile (Klazen et al 2010, Papanastassiou et al 2012) especially for the KP. But they also reported about at least occasional complications with complex and complicated patient histories. The first objective of this follow-up examination was to determine the cause, nature and scope of revision surgery after VP, KP, and augmentation. Material and Methods: Patient data of two German spinal centers from 11/2000 to 05/2012 have been analyzed and mainly the externally assigned patients to revisions after VP, KP and augmentation were covered. A total of 57 patients could be detected. The revisions were divided arbitrarily into early (up to 4 weeks postoperatively) and late revisions (from 5th week after surgery up to years) and being subsumed in relation to their cause, indication for revision, and the nature and extent of the revision surgery. Results: There was the indication for revision in 22 cases, according to VP, 17 times after KP and 18 times after augmentation, over all in 57 patients. There were 22 early revisions e.g. with cement leakage into the spinal canal with neurological failure, cement embolism and infection, and 35 late revisions were necessary for vertebral necrosis, connection fractures and kyphosis. A total of 9 of the late revisions were required in possibly exaggerated indication and implementation of VP or KP for underestimated fractures (type A supposedly, but type B in real) or with undetected tumors or metastases. The majority of operations were vertebra resection and replacement with dorsal spinal instrumentation / fusion (30) and decompression with posterior instrumentation / fusion (20). With significantly fewer patients reached a sole decompression (4) or another KP or VP (2). One patient had to be a sternotomy done for embolectomy. Conclusion: For revision surgery after VP, KP and augmentation there is little literature to find. The frequency of revision surgery after KP or VP is not statistically proven, but overall they seem rarely to be indexed. There are usually complex operations with corresponding potential complication and high demands on the surgical and anesthesia team. Already an extensive preoperative surgical planning and a strategy are required. In these cases especially the following is to be considered: invasiveness, a necessary correction amount, access (anteriorly, posteriorly combined?), decompression of the spinal canal, anterior, posterior, anchor bolts?. AD - O. Schlonski, SRH Zentralklinikum, Suhl, Germany AU - Schlonski, O. AU - Matis, N. AU - Ruf, M. DB - Embase DO - 10.1007/s00586-012-2522-6 KW - cement spine percutaneous vertebroplasty kyphoplasty society surgery human patient decompression vertebral canal devices fracture follow up embolism infection necrosis medical history planning anesthesia embolectomy sternotomy risk vertebra patient coding metastasis neoplasm examination kyphosis euphoria LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 0940-6719 SP - 2338 ST - Revision surgery after vertebroplasty, kyphoplasty and augmentation T2 - European Spine Journal TI - Revision surgery after vertebroplasty, kyphoplasty and augmentation UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70969431&from=export http://dx.doi.org/10.1007/s00586-012-2522-6 VL - 21 ID - 829532 ER - TY - JOUR AB - Purpose: Spondylitis is a rare complication of vertebroplasty with only one case report having been published to date. We report a further case of spondylitis after vertebroplasty that was managed successfully with conservative therapy. Methods: The clinical course of a 55-year-old patient with secondary osteoporosis due to liver cirrhosis from alcohol abuse is reported, in whom percutaneous vertebroplasty of three fractured vertebral bodies (L3-L5) was complicated by spondylitis at these levels. Results: Spondylitis of L3-L5 with paravertebral abscess formation and progressive collapse of L5 was detected by magnetic resonance imaging (MRI). Treatment consisted of percutaneous aspiration of the paravertebral abscess and antibiotic therapy. No bacteria was identified despite cultures have been taken before antibiotic treatment. The patient was treated with intravenous ciprofloxacin and consecutive clindamycin for a total of 3 months. One year after the infection the MRI signs of spondylitis have resolved without further collapse of L5. Painlevels have improved significantly, allowing the patient to return to work, but are still higher than immediately after vertebroplasty. Conclusion: Spondylitis is a rare complication of vertebroplasty. In the presented case a satisfactory result could be achieved through conservative antibiotic therapy and restriction of movement. AD - Berufsgenossenschaftliche Unfallklin Murnau, Dept Neurosurg, D-82418 Murnau, Germany. Univ Spital Bern, Dept Orthopaed Surg, Bern, Switzerland. Berufsgenossenschaftliche Unfallklin Murnau, Dept Radiol, Murnau, Germany. Schmid, KE (corresponding author), Berufsgenossenschaftliche Unfallklin Murnau, Dept Neurosurg, Prof Kuntscherstr 8, D-82418 Murnau, Germany. katharina.schmid@bgu-murnau.de AN - WOS:000233776300011 AU - Schmid, K. E. AU - Boszczyk, B. M. AU - Bierschneider, M. AU - Zarfl, A. AU - Robert, B. AU - Jaksche, H. DA - Nov DO - 10.1007/s00586-005-0905-7 J2 - Eur. Spine J. KW - vertebroplasty complications spondylitis conservative therapy further vertebral collapse PERCUTANEOUS VERTEBROPLASTY PULMONARY-EMBOLISM COMPRESSION FRACTURES METHYL-METHACRYLATE ACRYLIC CEMENT POLYMETHYLMETHACRYLATE COMPLICATION METASTASES MANAGEMENT LEAKAGE Clinical Neurology Orthopedics LA - English M1 - 9 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2005 SN - 0940-6719 SP - 895-899 ST - Spondylitis following vertebroplasty: a case report T2 - European Spine Journal TI - Spondylitis following vertebroplasty: a case report UR - ://WOS:000233776300011 VL - 14 ID - 830421 ER - TY - JOUR AB - For patients suffering from vertebral metastases vertebroplasty and kyphoplasty offer two relatively new treatment options for the stabilization of vertebral compression fractures. This can help to reduce the fracture-associated symptoms and can improve the quality of life. Cement extravasation is a specific complication of this therapy. This article reports a case of multiple cement paravasations in the paravertebral veins, the vena cava inferior and peripheral segmental and subsegmental pumonary arteries after kyphoplasty of an extensive pathological vertebral body fracture in a 64-year-old man suffering from metastatic urothelial cancer. AD - Abteilung für Urologie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland, robinschmid@bundeswehr.org. AN - 24113993 AU - Schmid, R. AU - Efinger, K. AU - Schulz, C. AU - Sparwasser, C. AU - Martinschek, A. DA - Jan DO - 10.1007/s00120-013-3315-1 DP - NLM ET - 2013/10/12 J2 - Der Urologe. Ausg. A KW - Bone Cements/adverse effects Embolism/diagnostic imaging/*etiology/surgery Extravasation of Diagnostic and Therapeutic Materials/diagnostic imaging/*etiology/*surgery Humans Kyphoplasty/*adverse effects Male Middle Aged Radiography, Interventional/methods Spinal Fractures/complications/*therapy Spinal Neoplasms/complications/*secondary/therapy Treatment Outcome Urologic Neoplasms/complications/diagnostic imaging/surgery Vena Cava, Inferior/*diagnostic imaging LA - ger M1 - 1 N1 - PubMed NLM literature search January 5, 2021 OP - Intracavaler Zementzapfen nach Kyphoplastie. Interventionell-radiologische Bergung bei metastasiertem Urothelkarzinom. PY - 2014 SN - 0340-2592 SP - 62-6 ST - [Vena cava cement embolism after percutaneous kyphoplasty. Interventional radiological recovery in metastasized urothelial cancer] T2 - Urologe A TI - [Vena cava cement embolism after percutaneous kyphoplasty. Interventional radiological recovery in metastasized urothelial cancer] VL - 53 ID - 828776 ER - TY - JOUR AB - For patients suffering from vertebral metastases vertebroplasty and kyphoplasty offer two relatively new treatment options for the stabilization of vertebral compression fractures. This can help to reduce the fracture-associated symptoms and can improve the quality of life. Cement extravasation is a specific complication of this therapy. This article reports a case of multiple cement paravasations in the paravertebral veins, the vena cava inferior and peripheral segmental and subsegmental pumonary arteries after kyphoplasty of an extensive pathological vertebral body fracture in a 64-year-old man suffering from metastatic urothelial cancer. © Springer-Verlag Berlin Heidelberg 2013. AD - R. Schmid, Abteilung für Urologie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany AU - Schmid, R. AU - Efinger, K. AU - Schulz, C. AU - Sparwasser, C. AU - Martinschek, A. DB - Embase DO - 10.1007/s00120-013-3315-1 KW - cement adult article case report extravasation human inferior cava vein interventional radiology kyphoplasty male metastatic urothelial cancer middle aged percutaneous kyphoplasty pulmonary artery spine fracture spine metastasis urinary tract cancer vena cava cement extravasation LA - German M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1433-0563 0340-2592 SP - 62-66 ST - Vena cava cement embolism after percutaneous kyphoplasty. Interventional radiological recovery of a due to metastasized urothelial cancer T2 - Urologe - Ausgabe A TI - Vena cava cement embolism after percutaneous kyphoplasty. Interventional radiological recovery of a due to metastasized urothelial cancer UR - https://www.embase.com/search/results?subaction=viewrecord&id=L372813464&from=export http://dx.doi.org/10.1007/s00120-013-3315-1 VL - 53 ID - 829436 ER - TY - JOUR AB - For patients suffering from vertebral metastases vertebroplasty and kyphoplasty offer two relatively new treatment options for the stabilization of vertebral compression fractures. This can help to reduce the fracture-associated symptoms and can improve the quality of life. Cement extravasation is a specific complication of this therapy. This article reports a case of multiple cement paravasations in the paravertebral veins, the vena cava inferior and peripheral segmental and subsegmental pumonary arteries after kyphoplasty of an extensive pathological vertebral body fracture in a 64-year-old man suffering from metastatic urothelial cancer. AD - Abteilung für Urologie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland, robinschmid@bundeswehr.org. AN - 104011016. Language: German. Entry Date: 20141107. Revision Date: 20170919. Publication Type: journal article AU - Schmid, R. AU - Efinger, K. AU - Schulz, C. AU - Sparwasser, C. AU - Martinschek, A. DB - cin20 DO - 10.1007/s00120-013-3315-1 DP - EBSCOhost KW - Embolism -- Etiology Extravasation of Diagnostic and Therapeutic Materials -- Etiology Extravasation of Diagnostic and Therapeutic Materials -- Surgery Kyphoplasty -- Adverse Effects Spinal Fractures -- Therapy Spinal Neoplasms Vena Cava, Inferior -- Radiography Bone Cements -- Adverse Effects Embolism -- Radiography Embolism -- Surgery Extravasation of Diagnostic and Therapeutic Materials -- Radiography Extravasation of Diagnostic and Therapeutic Materials -- Radiotherapy Male Middle Age Radiography, Interventional -- Methods Spinal Fractures -- Complications Spinal Neoplasms -- Complications Spinal Neoplasms -- Therapy Treatment Outcomes Urologic Neoplasms -- Complications Urologic Neoplasms -- Radiography Urologic Neoplasms -- Surgery M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2014 SN - 0340-2592 SP - 62-66 ST - Intracavaler Zementzapfen nach Kyphoplastie. Interventionell-radiologische Bergung bei metastasiertem Urothelkarzinom T2 - Der Urologe A TI - Intracavaler Zementzapfen nach Kyphoplastie. Interventionell-radiologische Bergung bei metastasiertem Urothelkarzinom UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104011016&site=ehost-live&scope=site VL - 53 ID - 830645 ER - TY - JOUR AB - Introduction: Vertebroplasty is a relatively new procedure for the treatment of vertebral body fractures of different origin. Due to early promising results the rate of performed procedures increases constantly. Indeed an increasing number of partially severe complications are reported. A summary of the existing findings seems therefore necessary. Methods: On the basis of a medline inquiry important aspects of vertebroplasty in the fields of basic science, diagnostics, indications, contraindications, technique, results and complications were compiled. Results: Especially for the field of indications, possible longterm effects and for the "ideal" technique open questions exist, mainly due to missing prospective, randomized long-term clinical trials. Conclusions: A final assessment of the significance of vertebroplasty for osteoporotic fractures in comparison to conservative treatment is actually not possible. In contrast vertebroplasty is a therapeutical option for malignomas in selected cases. AD - Univ Ulm, Orthopad Klin, Querschnittgelahmtenzentrum, D-89081 Ulm, Germany. Schmidt, R (corresponding author), Univ Ulm, Orthopad Klin, Querschnittgelahmtenzentrum, Oberer Eselsberg 45, D-89081 Ulm, Germany. rene.schmidt@gmx.de AN - WOS:000232731600018 AU - Schmidt, R. AU - Richter, M. AU - Puhl, W. AU - Cakir, B. DA - Oct DO - 10.1055/s-2005-836875 J2 - Zent.bl. Chir. KW - vertebroplasty indications technique complications VERTEBRAL COMPRESSION FRACTURES INTRAVERTEBRAL VACUUM CLEFT QUALITY-OF-LIFE PERCUTANEOUS VERTEBROPLASTY METHYL-METHACRYLATE PULMONARY-EMBOLISM PAIN RELIEF POLYMETHYLMETHACRYLATE VERTEBROPLASTY BIOMECHANICAL EVALUATION POLYMETHYL METHACRYLATE Surgery LA - German M1 - 5 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2005 SN - 0044-409X SP - 476-484 ST - Vertebroplasty - Bask science, indications and technique T2 - Zentralblatt Fur Chirurgie TI - Vertebroplasty - Bask science, indications and technique UR - ://WOS:000232731600018 VL - 130 ID - 830424 ER - TY - JOUR AB - PURPOSE: Cardio‐pulmonary damage due to embolism is a feared complication of cemented hip arthroplasty and can be fatal. Embolic events result from an increased intramedullary pressure during cement and stem insertion and can lead to extrusion of bone‐marrow elements into the circulation. To reduce embolism and at the same time achieve an ideal cement mantle, the cement injection stem has been designed. In contrast to conventional stems where cement applied before stem insertion (primary cementing technique), the cement injection stem is positioned first and only then is the cement injected via the stem in a volume‐ and pressure‐controlled fashion (secondary cementing technique). METHODS: A randomised trial with 30 patients was performed to evaluate whether this technique is able to reduce embolic events. Patients either received a conventional cemented stem (primary cementing technique) or a cement injection stem (secondary cementing technique). Embolic events were recorded by transesophageal echocardiography at six specific points during the operation and classified from grade 0 to grade 3. RESULTS: Significantly fewer grade 2 and 3 embolic events were observed in patients receiving the cement injection stem using the secondary cementing technique. Moreover, in the conventional group all patients (100 %) had at least one grade 3 embolus whereas only 20 % with the secondary cementing technique had an embolic event of grade 3. CONCLUSION: Secondary cement insertion via the cement injection stem is able to reduce severe embolic events significantly. The technique offers a more gentle cementing technique and therefore appears especially beneficial for patients of advanced age and/or with pre‐existing cardio‐pulmonary comorbidities. AN - CN-00854205 AU - Schmidutz, F. AU - Düll, T. AU - Voges, O. AU - Grupp, T. AU - Müller, P. AU - Jansson, V. DO - 10.1007/s00264-012-1537-2 KW - Aged Aged, 80 and over Arthroplasty, Replacement, Hip [*methods] Bone Cements [*therapeutic use] Echocardiography, Transesophageal Female Hip Joint [diagnostic imaging, surgery] Humans Incidence Injections Male Middle Aged Pulmonary Embolism [diagnostic imaging, epidemiology, *prevention & control] Radiography M1 - 8 M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2012 SP - 1575‐1581 ST - Secondary cement injection technique reduces pulmonary embolism in total hip arthroplasty T2 - International orthopaedics TI - Secondary cement injection technique reduces pulmonary embolism in total hip arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00854205/full VL - 36 ID - 830047 ER - TY - JOUR AB - Purpose: Cardio-pulmonary damage due to embolism is a feared complication of cemented hip arthroplasty and can be fatal. Embolic events result from an increased intramedullary pressure during cement and stem insertion and can lead to extrusion of bone-marrow elements into the circulation. To reduce embolism and at the same time achieve an ideal cement mantle, the cement injection stem has been designed. In contrast to conventional stems where cement applied before stem insertion (primary cementing technique), the cement injection stem is positioned first and only then is the cement injected via the stem in a volume- and pressure-controlled fashion (secondary cementing technique). Methods: A randomised trial with 30 patients was performed to evaluate whether this technique is able to reduce embolic events. Patients either received a conventional cemented stem (primary cementing technique) or a cement injection stem (secondary cementing technique). Embolic events were recorded by transesophageal echocardiography at six specific points during the operation and classified from grade 0 to grade 3. Results: Significantly fewer grade 2 and 3 embolic events were observed in patients receiving the cement injection stem using the secondary cementing technique. Moreover, in the conventional group all patients (100 %) had at least one grade 3 embolus whereas only 20 % with the secondary cementing technique had an embolic event of grade 3. Conclusion: Secondary cement insertion via the cement injection stem is able to reduce severe embolic events significantly. The technique offers a more gentle cementing technique and therefore appears especially beneficial for patients of advanced age and/or with pre-existing cardio-pulmonary comorbidities. AD - Department of Orthopaedic Surgery, University Hospital of Munich (LMU), Campus Grosshadern, Munich, Germany Department of Orthopaedic Surgery, University Hospital of Munich (LMU), Campus Grosshadern, Munich, Germany, florian.schmidutz@med.uni-muenchen.de. AN - 104358836. Language: English. Entry Date: 20130208. Revision Date: 20200708. Publication Type: journal article AU - Schmidutz, F. AU - Düll, T. AU - Voges, O. AU - Grupp, T. AU - Müller, P. AU - Jansson, V. AU - Schmidutz, Florian AU - Düll, Tobias AU - Voges, Ole AU - Grupp, Thomas AU - Müller, Peter AU - Jansson, Volkmar DB - cin20 DO - 10.1007/s00264-012-1537-2 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Methods Bone Cements -- Therapeutic Use Pulmonary Embolism -- Prevention and Control Aged Aged, 80 and Over Echocardiography, Transesophageal Female Hip Joint -- Radiography Hip Joint -- Surgery Human Incidence Injections Male Middle Age Pulmonary Embolism -- Epidemiology Pulmonary Embolism -- Radiography Randomized Controlled Trials M1 - 8 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2012 SN - 0341-2695 SP - 1575-1581 ST - Secondary cement injection technique reduces pulmonary embolism in total hip arthroplasty T2 - International Orthopaedics TI - Secondary cement injection technique reduces pulmonary embolism in total hip arthroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104358836&site=ehost-live&scope=site VL - 36 ID - 830675 ER - TY - JOUR AD - L. Schneider, Department of Cardiology, St. Vincents Hospital, Sydney, NSW, Australia AU - Schneider, L. AU - Plit, M. DB - Embase Medline DO - 10.1111/j.1445-5994.2007.01377.x KW - acrylic cement adult backache blood gas analysis blood pressure case report computed tomographic angiography fluoroscopy heart rate human letter lung embolism lung function test male percutaneous vertebroplasty postoperative complication priority journal spine fracture thoracic spine thorax radiography vertebra body LA - English M1 - 6 M3 - Letter N1 - Embase Elsevier literature search January 5, 2021 PY - 2007 SN - 1444-0903 1445-5994 SP - 423-425 ST - Pulmonary embolization of acrylic cement during percutaneous vertebroplasty [3] T2 - Internal Medicine Journal TI - Pulmonary embolization of acrylic cement during percutaneous vertebroplasty [3] UR - https://www.embase.com/search/results?subaction=viewrecord&id=L47029895&from=export http://dx.doi.org/10.1111/j.1445-5994.2007.01377.x VL - 37 ID - 829768 ER - TY - JOUR AN - 105991333. Language: English. Entry Date: 20080222. Revision Date: 20200708. Publication Type: Journal Article AU - Schneider, L. AU - Plit, M. DB - cin20 DO - 10.1111/j.1445-5994.2007.01377.x DP - EBSCOhost KW - Methylmethacrylates -- Adverse Effects Pulmonary Embolism -- Etiology Pulmonary Embolism -- Radiography Spinal Fusion -- Adverse Effects Male Middle Age Spinal Fusion -- Methods Thoracic Vertebrae -- Radiography Thoracic Vertebrae -- Surgery M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2007 SN - 1444-0903 SP - 423-425 ST - Pulmonary embolization of acrylic cement during percutaneous vertebroplasty T2 - Internal Medicine Journal TI - Pulmonary embolization of acrylic cement during percutaneous vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105991333&site=ehost-live&scope=site VL - 37 ID - 830763 ER - TY - JOUR AB - Various radiographic and scintigraphic methods are used to supplement clinical findings in the evaluation of total knee arthroplasty and its complications. Serial roentgenograms offer reliable information for diagnosing mechanical loosening. Wide and extensive radiolucency at the cement-bone interface and shift in position and alignment of prosthetic components can be seen in almost all cases by the time revision is necessary. Radiographic abnormalities are usually not present in acute infection, but are often present in chronic infection. Bone scanning has a high sensitivity for diagnosis of infection or loosening, but is nonspecific because increased uptake is often present around asymptomatic total knee arthroplasties with normal radiographs. Differential bone and Gallium scanning and scanning with Indium 111-labeled leukocytes have a greater specificity for diagnosis of infection than does bone or Gallium scanning alone. Routine radiographic and scintigraphic studies have shown a high incidence of deep vein thrombosis in the calf after total knee arthroplasty. Clinically significant pulmonary embolization is infrequent. AN - 3698369 AU - Schneider, R. AU - Soudry, M. DA - Apr DP - NLM ET - 1986/04/01 J2 - Clinical orthopaedics and related research KW - Gallium Radioisotopes Humans Indium Knee Joint/*diagnostic imaging *Knee Prosthesis Postoperative Complications/*diagnostic imaging Prosthesis Failure Pulmonary Embolism/diagnostic imaging Radiography Radioisotopes Radionuclide Imaging Surgical Wound Infection/diagnostic imaging Technetium LA - eng M1 - 205 N1 - PubMed NLM literature search January 5, 2021 PY - 1986 SN - 0009-921X (Print) 0009-921x SP - 108-20 ST - Radiographic and scintigraphic evaluation of total knee arthroplasty T2 - Clin Orthop Relat Res TI - Radiographic and scintigraphic evaluation of total knee arthroplasty ID - 828832 ER - TY - JOUR AB - For more than 20 years percutaneous vertebroplasty has been used in the minimally invasive treatment of vertebral fractures. We report on a patient with embolisation of bone cement into the pulmonary artery and the right ventricle, which was perforated. The final diagnosis was delayed due to a combination of complications, previous disorders as well as a second embolisation. AD - Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Klinikum der Johann Wolfgang- Goethe Universität Frankfurt a.M., Theodor-Stern-Kai 7, 60590 Frankfurt a.M. AN - 17928974 AU - Schoenes, B. AU - Bremerich, D. H. AU - Risteski, P. S. AU - Thalhammer, A. AU - Meininger, D. DA - Feb DO - 10.1007/s00101-007-1276-8 DP - NLM ET - 2007/10/12 J2 - Der Anaesthesist KW - Anesthesia Bone Cements/adverse effects Diagnosis, Differential Electrocardiography Heart Injuries/diagnosis/*etiology Humans Magnetic Resonance Imaging Male Middle Aged Postoperative Complications/diagnosis/*etiology Pulmonary Embolism/diagnosis/*etiology/therapy Respiratory Function Tests Spinal Fractures/surgery Spirometry Tomography, X-Ray Computed Ventricular Dysfunction, Right/diagnosis/*etiology/therapy Vertebroplasty/*adverse effects LA - ger M1 - 2 N1 - PubMed NLM literature search January 5, 2021 OP - Palacos im Herzen. PY - 2008 SN - 0003-2417 (Print) 0003-2417 SP - 147-50 ST - [Cardiac perforation after vertebroplasty] T2 - Anaesthesist TI - [Cardiac perforation after vertebroplasty] VL - 57 ID - 828914 ER - TY - JOUR AB - For more than 20 years percutaneous vertebroplasty has been used in the minimally invasive treatment of vertebral fractures. We report on a patient with embolisation of bone cement into the pulmonary artery and the right ventricle, which was perforated. The final diagnosis was delayed due to a combination of complications, previous disorders as well as a second embolisation. AD - Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Klinikum der Johann Wolfgang- Goethe Universität Frankfurt a.M., Theodor-Stern-Kai 7, 60590 Frankfurt a.M Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Klinikum der Johann Wolfgang- Goethe Universität Frankfurt a.M., Theodor-Stern-Kai 7, 60590, Frankfurt a.M., Deutschland. AN - 105690580. Language: German. Entry Date: 20081114. Revision Date: 20200619. Publication Type: journal article AU - Schoenes, B. AU - Bremerich, D. H. AU - Risteski, P. S. AU - Thalhammer, A. AU - Meininger, D. AU - Schoenes, B. AU - Bremerich, D. H. AU - Risteski, P. S. AU - Thalhammer, A. AU - Meininger, D. DB - cin20 DO - 10.1007/s00101-007-1276-8 DP - EBSCOhost KW - Heart Injuries -- Etiology Kyphoplasty -- Adverse Effects Postoperative Complications -- Etiology Pulmonary Embolism -- Etiology Ventricular Dysfunction, Right -- Etiology Anesthesia Bone Cements -- Adverse Effects Diagnosis, Differential Electrocardiography Heart Injuries -- Diagnosis Magnetic Resonance Imaging Male Middle Age Postoperative Complications -- Diagnosis Pulmonary Embolism -- Diagnosis Pulmonary Embolism -- Therapy Respiratory Function Tests Spinal Fractures -- Surgery Spirometry Tomography, X-Ray Computed Ventricular Dysfunction, Right -- Diagnosis Ventricular Dysfunction, Right -- Therapy M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2008 SN - 0003-2417 SP - 147-150 ST - Palacos im Herzen T2 - Anaesthesist TI - Palacos im Herzen UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105690580&site=ehost-live&scope=site VL - 57 ID - 830754 ER - TY - JOUR AD - Department of Internal Medicine/Cardiology, University of Leipzig, Heart Center Leipzig, Struempellstrasse 39, Leipzig D-04289, Germany. Department of Cardiac Surgery, University of Leipzig, Heart Center Leipzig, Leipzig, Germany. Department of Internal Medicine/Cardiology, University of Leipzig, Heart Center Leipzig, Struempellstrasse 39, Leipzig D-04289, Germany norman.mangner@med.uni-leipzig.de. AN - 25157112 AU - Schuerer, S. AU - Misfeld, M. AU - Schuler, G. AU - Mangner, N. DA - Apr 1 DO - 10.1093/eurheartj/ehu300 DP - NLM ET - 2014/08/27 J2 - European heart journal KW - Aged Back Pain/surgery Bone Cements/*adverse effects Chronic Pain/surgery Coronary Angiography Echocardiography Embolism/diagnosis/*etiology Foreign-Body Migration/*diagnosis Heart Diseases/diagnosis/*etiology Heart Ventricles Humans Male Multimodal Imaging Spinal Fusion/*adverse effects Tomography, X-Ray Computed LA - eng M1 - 13 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 0195-668x SP - 783 ST - Intracardiac cement embolization in a 65-year-old man four months after multilevel spine fusion T2 - Eur Heart J TI - Intracardiac cement embolization in a 65-year-old man four months after multilevel spine fusion VL - 36 ID - 828520 ER - TY - JOUR AB - Background Cement augmentation of the proximal femur nail antirotation (PFNA; Fa. DePuy Synthes) showed good biomechanical and clinical results regarding increased stability and functional outcome [Linden et al. in J Orthop Res 24:2230-2237, 2006;Kammerlander et al. in Injury 49:1436-1444, 2018;]. Cement-associated complications are well known in orthopedic procedures like hip arthroplasty, vertebra- and kyphoplasty. This study investigates outcome and safety of augmentation of the proximal femur nail blade. Materials and methods The retrospective review of the 299 patients (mean age 80 +/- 13 years; 205 women and 94 men) focused on perioperative complications after augmentation which was performed with Traumacem V+ Cement (Fa. DePuy Synthes) in 152 cases. The decision for augmentation of the blade was made by the attending surgeon and based on the factors age, bone quality, and fracture pattern. Primary outcome measures were changes in blood pressure, heart rate or oxygen saturation, and the number of needed vasoactive drugs during augmentation. Secondary outcome measures where the rate of cement leakage into the joint, mechanical failure, and perioperative complications like pulmonary embolism, stroke, or heart attack. Results In 152 augmented cases, no leakage of cement into the joint could be detected. No signs of mechanical failure like cut-out of the blade were seen after 6 weeks and 3 months. Also, augmentation did not show a higher rate of mortality or postoperative complications like stroke, heart attack, embolism, or infection. 57 of 152 augmented cases received an intraoperative intervention with vasoactive medication at the time of augmentation either prophylactically or because of a blood pressure fall. Out of the non-augmented cases, 21 of 147 needed vasoactive medication in the second half of the operation. The difference between these groups was significant (p < 0.05). In the cases without an intervention, there was a significant blood pressure fall of about 8 +/- 7.4 mmHg during the augmentation (p < 0.001). Still, none of the augmented cases showed a change in heart rate or oxygen saturation. Conclusion The augmentation of the PFNA blade proved to be a safe procedure. Cement augmentation will not increase postoperative complications or mortality. The risk for leakage of cement into the joint is low and mechanical cut-out might be prevented. The decision for augmentation should be made carefully and always be declared loud and in advance to allow the anesthetist to prepare, because blood pressure changes can occur. AD - [Schuetze, Konrad; Eickhoff, A.; Dehner, C.; Gebhard, F.; Richter, P. H.] Ulm Univ, Dept Trauma Hand & Reconstruct Surg, Albert Einstein Allee 23, D-89081 Ulm, Germany. [Ehinger, S.] Univ Hosp Ulm, Dept Anesthesiol, Ulm, Germany. Schuetze, K (corresponding author), Ulm Univ, Dept Trauma Hand & Reconstruct Surg, Albert Einstein Allee 23, D-89081 Ulm, Germany. konrad.schuetze@uniklinik-ulm.de; Sebastian.ehinger@uniklinik-ulm.de; alexander.eickhoff@uniklinik-ulm.de; Christoph.dehner@uniklinik-ulm.de; Florian.gebhard@uniklinik-ulm.de; Peter.richter@uniklinik-ulm.de AN - WOS:000552153500001 AU - Schuetze, K. AU - Ehinger, S. AU - Eickhoff, A. AU - Dehner, C. AU - Gebhard, F. AU - Richter, P. H. DO - 10.1007/s00402-020-03531-2 J2 - Arch. Orthop. Trauma Surg. KW - Hip fracture Augmentation Bone cement syndrome Osteoporosis FEMORAL-NECK FRACTURE BONE-CEMENT IMPLANTATION SYNDROME PERTROCHANTERIC FRACTURES BLOOD-PRESSURE GAMMA-NAIL HIP HEMIARTHROPLASTY COMPLICATIONS ARTHROPLASTY Orthopedics Surgery LA - English M3 - Article; Early Access N1 - Web of Science Clarivate Analytics literature search January 5, 2021 SN - 0936-8051 SP - 9 ST - Cement augmentation of the proximal femur nail antirotation: is it safe? T2 - Archives of Orthopaedic and Trauma Surgery TI - Cement augmentation of the proximal femur nail antirotation: is it safe? UR - ://WOS:000552153500001 ID - 830102 ER - TY - JOUR AB - BACKGROUND: Cement augmentation of the proximal femur nail antirotation (PFNA; Fa. DePuy Synthes) showed good biomechanical and clinical results regarding increased stability and functional outcome [Linden et al. in J Orthop Res 24:2230-2237, 2006;Kammerlander et al. in Injury 49:1436-1444, 2018;]. Cement-associated complications are well known in orthopedic procedures like hip arthroplasty, vertebra- and kyphoplasty. This study investigates outcome and safety of augmentation of the proximal femur nail blade. MATERIALS AND METHODS: The retrospective review of the 299 patients (mean age 80 ± 13 years; 205 women and 94 men) focused on perioperative complications after augmentation which was performed with Traumacem V+ Cement (Fa. DePuy Synthes) in 152 cases. The decision for augmentation of the blade was made by the attending surgeon and based on the factors age, bone quality, and fracture pattern. Primary outcome measures were changes in blood pressure, heart rate or oxygen saturation, and the number of needed vasoactive drugs during augmentation. Secondary outcome measures where the rate of cement leakage into the joint, mechanical failure, and perioperative complications like pulmonary embolism, stroke, or heart attack. RESULTS: In 152 augmented cases, no leakage of cement into the joint could be detected. No signs of mechanical failure like cut-out of the blade were seen after 6 weeks and 3 months. Also, augmentation did not show a higher rate of mortality or postoperative complications like stroke, heart attack, embolism, or infection. 57 of 152 augmented cases received an intraoperative intervention with vasoactive medication at the time of augmentation either prophylactically or because of a blood pressure fall. Out of the non-augmented cases, 21 of 147 needed vasoactive medication in the second half of the operation. The difference between these groups was significant (p < 0.05). In the cases without an intervention, there was a significant blood pressure fall of about 8 ± 7.4 mmHg during the augmentation (p < 0.001). Still, none of the augmented cases showed a change in heart rate or oxygen saturation. CONCLUSION: The augmentation of the PFNA blade proved to be a safe procedure. Cement augmentation will not increase postoperative complications or mortality. The risk for leakage of cement into the joint is low and mechanical cut-out might be prevented. The decision for augmentation should be made carefully and always be declared loud and in advance to allow the anesthetist to prepare, because blood pressure changes can occur. AD - Department of Trauma-, Hand-, and Reconstructive Surgery, Ulm University, Albert-Einstein-Allee 23, 89081, Ulm, Germany. konrad.schuetze@uniklinik-ulm.de. Department of Anesthesiology, University Hospital Ulm, Ulm, Germany. Department of Trauma-, Hand-, and Reconstructive Surgery, Ulm University, Albert-Einstein-Allee 23, 89081, Ulm, Germany. AN - 32710347 AU - Schuetze, K. AU - Ehinger, S. AU - Eickhoff, A. AU - Dehner, C. AU - Gebhard, F. AU - Richter, P. H. DA - Jul 25 DO - 10.1007/s00402-020-03531-2 DP - NLM ET - 2020/07/28 J2 - Archives of orthopaedic and trauma surgery KW - Augmentation Bone cement syndrome Hip fracture Osteoporosis LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 0936-8051 ST - Cement augmentation of the proximal femur nail antirotation: is it safe? T2 - Arch Orthop Trauma Surg TI - Cement augmentation of the proximal femur nail antirotation: is it safe? ID - 828568 ER - TY - JOUR AB - INTRODUCTION: Cementless THR is a well established, and a widely accepted optimal procedure for younger patients. The cementless Vektor-Titan stem is made of Ti6AI7Nb, has got the shape of a three-dimensional cone, and an optimal proximal anchoring property. MATERIALS AND METHODS: The aim of this prospective study was to scrutinise the outcome of 250 Vektor-Titan stems in cementless THRs with an average follow-up time of 3.0 years (Min: 1, Max: 6). The average age of the patients including 148 women and 102 men was calculated with 54.6 years (Min: 22.5, Max: 77.7). RESULTS: The score according to Merle d'Aubigné improved from preoperative 9.3 (Min: 7, Max: 13) to postoperative 17.0 (Min: 14, Max: 18). Distal cortical hypertrophy and proximal atrophy was detected in 4 cases. Single atrophy of the proximal femur was found in additional 3 cases. Progressive radiolucent lines in zone 1 and 7 according to Gruen were observed in one case. Postoperative local and general complications were seen as two subfascial hematomas, two single dislocations, two recurrent dislocations of the hip prosthesis, 6 lesions of the sciatic nerve (one persisting), two deep venous thrombosis, two pneumonias, and one lethal pulmonary embolism. A stable proximal fixation was achieved in 242 of 250 cases (96.8%). CONCLUSION: The results of this study using the Vektor-Titan stem in cementless total hip arthroplasty showed that the principle of proximal fixation was optimized. Long term follow-up studies are needed to confirm these good results. AD - Orthopädische Klinik Rummelsberg, Rummelsberg 71, 90592 Schwarzenbruck. AN - 15792199 AU - Schuh, A. AU - Ebert, A. AU - Holzwarth, U. AU - Zeiler, G. DA - Jan-Feb DO - 10.1515/bmt.2005.006 DP - NLM ET - 2005/03/29 J2 - Biomedizinische Technik. Biomedical engineering KW - Adult Aged Arthroplasty, Replacement, Hip/*instrumentation/methods/*statistics & numerical data Cementation Comorbidity *Equipment Failure Analysis Female Hip Prosthesis/*statistics & numerical data Humans Male Middle Aged Postoperative Complications/diagnosis/*epidemiology Prognosis Prosthesis Failure Risk Assessment/*methods Risk Factors Treatment Outcome LA - eng M1 - 1-2 N1 - PubMed NLM literature search January 5, 2021 PY - 2005 SN - 0013-5585 (Print) 0013-5585 SP - 30-4 ST - Cementless Vektor-titan stem in total hip arthroplasty T2 - Biomed Tech (Berl) TI - Cementless Vektor-titan stem in total hip arthroplasty VL - 50 ID - 829014 ER - TY - JOUR AB - Alloarthroplastic replacement of the hip comprises certain risks. Therefore good apparative and instrumental equipment and biological understanding of the post operative phase are necessary. Our rate of operative complications was 1.3% of all cases. In this number fat embolism after implantation of acrylic cement is of special interest. Reference is made of animal experiments on the pathogenesis of this phenomenon. Early complications comprise luxation of the prosthesis, bleeding and hematoma formation, iliotibial-nerve syndrome, phlebothrombosis, embolism, early infection. Late complications comprise infection and loosening of the prosthesis. In a total of 1200 implantations we had early complications in 1.8% and late complications in 0.9%. Reference is made of clinical and X-ray signs of loosening of the implant. Arthrography proved to be the most dependable method. We found periarticular calcifications in 30% of all cases. Fractures of the prosthesis were extremely rare: in few cases we found fractures of the polyestercup. In all cases the aggressive granuloma will leed to rarefication of bone sooner or later going along with loosening of the implant. AN - 938312 AU - Schulitz, K. P. AU - Dustmann, H. O. DA - Jun 18 DO - 10.1007/bf00416331 DP - NLM ET - 1976/06/18 J2 - Archiv fur orthopadische und Unfall-Chirurgie KW - Blood Pressure/drug effects Bone Cements/adverse effects/pharmacology Calcinosis Embolism, Fat/etiology Female Hematoma/etiology *Hip Joint Humans Joint Prosthesis/*adverse effects Middle Aged Osteolysis Postoperative Complications Surgical Wound Infection Synovial Membrane/pathology Thrombosis/etiology LA - ger M1 - 1 N1 - PubMed NLM literature search January 5, 2021 OP - Komplikationen der Totalendoprothese. PY - 1976 SN - 0003-9330 (Print) 0003-9330 SP - 33-50 ST - [Complications after total hip replacement (author's transl)] T2 - Arch Orthop Unfallchir TI - [Complications after total hip replacement (author's transl)] VL - 85 ID - 828887 ER - TY - JOUR AB - Alloarthroplastic replacement of the hip comprises certain risks. Therefore good apparative and instrumental equipment and biological understanding of the postoperative phase are necessary. The authors' rate of operative complications was 1.3% of all cases. In this number fat embolism after implantation of acrylic cement is of special interest. Reference is made of animal experiments on the pathogenesis of this phenomenon. Early complications comprise luxation of the prosthesis, bleeding and hematoma formation, iliotibial nerve syndrome, phlebothrombosis, embolism, early infection. Late complications comprise infection and loosening of the prosthesis. In a total of 1200 implantations there were early complications in 1.8% and late complications in 0.9%. Reference is made of clinical and X ray signs of loosening of the implant. Arthrography proved to be the most dependable method. Periarticular calcifications were found in 30% of all cases. Fractures of the prosthesis were extremely rare: in few cases fractures of the polyestercup were found. In all cases the aggressive granuloma will lead to rarefication of bone sooner or later, along with loosening of the implant. AD - Orthop. Klin., Univ. Heidelberg/Schlierbach AU - Schulitz, K. P. AU - Dustmann, H. O. DB - Embase Medline KW - arthroplasty bleeding diagnosis dislocation etiology fat embolism hip infection major clinical study methodology prosthesis therapy total hip prosthesis vein thrombosis LA - German M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1976 SN - 0344-8444 SP - 33-50 ST - Complications after total hip replacement T2 - Archives of Orthopaedic and Traumatic Surgery TI - Complications after total hip replacement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L7093516&from=export VL - 85 ID - 829974 ER - TY - JOUR AD - Assistant Professor, Department of Orthopaedic Surgery, George Washington University, Washington, District of Columbia. leahmschulte@gmail.com. AN - 107954349. Language: English. Entry Date: 20131101. Revision Date: 20150712. Publication Type: Journal Article AU - Schulte, Leah M. AU - O'Brien, Joseph R. AU - Bean, Matthew C. AU - Pierce, Todd P. AU - Yu, Warren D. AU - Meals, Clifton DB - cin20 DP - EBSCOhost KW - Arthroplasty Postoperative Complications -- Epidemiology Pulmonary Embolism -- Epidemiology Spinal Fusion -- Methods Venous Thrombosis -- Epidemiology Anticoagulants -- Therapeutic Use Human Incidence Kyphoplasty Multivariate Analysis Pulmonary Embolism -- Prevention and Control Retrospective Design Risk Factors Spine -- Surgery Venous Thrombosis -- Prevention and Control M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2013 SN - 1078-4519 SP - 267-270 ST - Deep vein thrombosis and pulmonary embolism after spine surgery: incidence and patient risk factors T2 - American Journal of Orthopedics TI - Deep vein thrombosis and pulmonary embolism after spine surgery: incidence and patient risk factors UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=107954349&site=ehost-live&scope=site VL - 42 ID - 830656 ER - TY - JOUR AB - BACKGROUND: Kyphoplasty is associated with a low incidence of cement leakage and this usually tends to be clinically asymptomatic. However, there is a potential for life-threatening complications from extraspinal leakage resulting in vascular, cardiac and pulmonary embolisms. A total of eight cases of open surgical thrombectomy for cardiopulmonary cement leakage have been published in the current literature to date. Besides the description of a consecutive series with special reference to extraspinal cement leakage this article presents the results after successful endovascular removal of intravenous cement fragments following kyphoplasty in two patients. MATERIALS AND METHODS: In 46 cases following balloon kyphoplasty the number and amount of extraspinal venous cement leakage was retrospectively determined using computed tomography (CT). The number of cement embolisms into the pulmonary venous system was differently revealed for patients showing no extravertebral leakage or leakage only into the external vertebral venous plexus compared to leakage into the major venous vessels, azygos and hemiazygos vein or inferior vena cava. RESULTS: In 8 out of 046 cases (17.4 %) leakage into the external vertebral venous plexus was detected. In 5 out of 8 cases without involvement of the azygos/hemiazygos vein or inferior vena cava no pulmonary cement embolism was detected. In 3 out of 8 cases the inferior vena cava or azygos/hemiazygos vein was reached and additionally asymptomatic peripheral pulmonary cement embolism was induced in these cases. In two cases harboring residual intravasal cement fragments treatment was successful using endovascular extraction techniques. CONCLUSIONS: A computed tomography scan after kyphoplasty is recommended for all cases. If there is involvement of the inferior vena cava or the azygos/hemiazygos vein an additional CT scan of the chest should follow, even in asymptomatic cases. Residual intravasal cement fragments are safely extractable using endovascular techniques. AD - Abteilung Neurochirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081 Ulm, Deutschland. chr74@gmx.de AN - 23096261 AU - Schulz, C. AU - Efinger, K. AU - Schwarz, W. AU - Mauer, U. M. DA - Nov DO - 10.1007/s00132-012-1964-1 DP - NLM ET - 2012/10/26 J2 - Der Orthopade KW - Adult Bone Cements/*adverse effects Embolism/diagnosis/*etiology/*therapy Extravasation of Diagnostic and Therapeutic Materials/*diagnosis/etiology/*prevention & control Female Humans Kyphoplasty/*adverse effects Male Middle Aged Young Adult LA - ger M1 - 11 N1 - PubMed NLM literature search January 5, 2021 OP - Erfahrungen mit intravasalen Zementaustritten nach Ballonkyphoplastie. PY - 2012 SN - 0085-4530 SP - 881-8 ST - [Experiences with cement leakage after balloon kyphoplasty] T2 - Orthopade TI - [Experiences with cement leakage after balloon kyphoplasty] VL - 41 ID - 828839 ER - TY - JOUR AD - B. Schulze, Department of Cardiovascular Surgery, Heart and Cardiovascular Centre North Rhine-Westphalia, Ruhr University Bochum, Georgstr. 11, Bad Oeynhausen, Germany AU - Schulze, B. AU - Hoffmann, R. AU - Scholtz, W. AU - Gummert, J. AU - Paluszkiewicz, L. DB - Embase Medline DO - 10.1093/ehjci/jeu303 KW - adult cardiac imaging case report computer assisted tomography heart right atrium heart right ventricle heart transplantation human lung embolism male middle aged note osteoporosis pacemaker electrode pallacos embolism percutaneous vertebroplasty priority journal pulmonary artery steroid therapy superior cava vein thorax radiography transesophageal echocardiography transthoracic echocardiography tricuspid valve LA - English M1 - 5 M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 2047-2412 2047-2404 SP - 571 ST - Uncommon intracardiac finding after cardiac transplantation mimicking pacemaker leads T2 - European Heart Journal Cardiovascular Imaging TI - Uncommon intracardiac finding after cardiac transplantation mimicking pacemaker leads UR - https://www.embase.com/search/results?subaction=viewrecord&id=L606125892&from=export http://dx.doi.org/10.1093/ehjci/jeu303 VL - 16 ID - 829395 ER - TY - GEN AD - Jena, Germany. AU - Schummer, W. CY - New York, New York DB - cin20 DO - 10.1093/bja/aeu426 DP - EBSCOhost J2 - BJA: The British Journal of Anaesthesia KW - Bone Cements -- Adverse Effects Central Venous Catheters Methylmethacrylates -- Adverse Effects Pulmonary Embolism -- Etiology Vertebroplasty -- Adverse Effects Female N1 - CINAHL (EbscoHost) literature search January 5, 2021 PB - Elsevier B.V. PY - 2015 SN - 0007-0912 SP - 351-352 ST - Reply from the author...Br J Anaesth. 2014 Apr;112(4):672-4; Br J Anaesth. 2015 Feb;114(2):351 TI - Reply from the author...Br J Anaesth. 2014 Apr;112(4):672-4; Br J Anaesth. 2015 Feb;114(2):351 UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=103875781&site=ehost-live&scope=site VL - 114 ID - 830621 ER - TY - JOUR AB - We report on a rare complication of poly(methyl methacrylate) (PMMA), injected into the spine, which then inadvertently leaked into the venous system. This resulted in an embolism of PMMA and produced a mass surrounding a triple lumen central venous catheter located in the superior vena cava. The catheter as well as the attached mass of PMMA was retrieved safely by cardiothoracic surgery. This case emphasizes the importance of prompt diagnosis and treatment and illustrates the need for close monitoring of patients undergoing any spinal surgery that includes vertebroplasty. AD - Clinic for Anaesthesiology and Intensive Care Medicine, Friedrich Schiller University Jena, Erlanger Allee 103, Jena 07747, Germany. AN - 24318858 AU - Schummer, W. AU - Schlonski, O. AU - Breuer, M. DA - Apr DO - 10.1093/bja/aet413 DP - NLM ET - 2013/12/10 J2 - British journal of anaesthesia KW - Bone Cements/*adverse effects *Central Venous Catheters Female Humans Middle Aged Osteoporosis, Postmenopausal/complications Osteoporotic Fractures/etiology/surgery Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/diagnostic imaging/*etiology Spinal Fractures/etiology/surgery Tomography, X-Ray Computed Vertebroplasty/*adverse effects/methods bone cements central venous catheters complication pulmonary embolism shock vertebroplasty LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 0007-0912 SP - 672-4 ST - Bone cement embolism attached to central venous catheter T2 - Br J Anaesth TI - Bone cement embolism attached to central venous catheter VL - 112 ID - 828817 ER - TY - JOUR AN - 21174260 AU - Schwarz, M. AU - Reimer, P. AU - Schulte, B. DA - Feb DO - 10.1055/s-0029-1245782 DP - NLM ET - 2010/12/22 J2 - RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin KW - *Bone Cements Breast Neoplasms/diagnostic imaging/*surgery Epidural Space/blood supply Extravasation of Diagnostic and Therapeutic Materials/*complications/diagnostic imaging Female Humans Image Processing, Computer-Assisted Kyphoplasty/*adverse effects Lumbar Vertebrae/diagnostic imaging/*surgery Middle Aged Osteolysis/diagnostic imaging/*surgery Phlebography Postoperative Complications/diagnostic imaging/*etiology Pulmonary Embolism/diagnostic imaging/*etiology Spinal Neoplasms/diagnostic imaging/*secondary/*surgery Thoracic Vertebrae/diagnostic imaging/*surgery Tomography, X-Ray Computed LA - ger M1 - 2 N1 - PubMed NLM literature search January 5, 2021 OP - Die pulmonalarterielle Zementembolie - eine mögliche Komplikation nach Kyphoplastie. PY - 2011 SN - 1438-9010 SP - 172-3 ST - [Pulmonary artery cement embolism - a possible complication after kyphoplasty] T2 - Rofo TI - [Pulmonary artery cement embolism - a possible complication after kyphoplasty] VL - 183 ID - 828988 ER - TY - JOUR AB - Introduction Intralesional curettage of benign aggressive tumors or metastatic lesions in the pelvis and sacrum can be a challenging procedure when dealing with wide lesions or with tumors at high risk for massive bleeding. To reduce bleeding, we began to use cryosurgery as an aid during removal of the lesion, which is progressively freezed and curetted, and as an adjuvant treatment after curettage on the remaining walls of the cavity. A retrospective evaluation of 10 cases was performed to verify efficacy and safeness of this technique. Materials and methods In the last 5 years we performed 10 surgical procedures of intralesional excision of bone tumors in the sacrum and pelvis with the intraoperative aid of cryosurgery. Histology of the tumour was: metastatic lesion from renal cell adenocarcinoma in 4 cases and from hemangiopericytoma in 1, giant cell tumour 1, aneurysmal bone cyst 1, schwannoma 1, chondrosarcoma 2 cases. Location of the tumour was: sacrum 3 cases, sacroiliac area 2, periacetabular 3, ileopubic ramus 1, ischium 1. Age of the patients ranged from 19 to 77 years (average 56). Freezing was performed using cryoprobes; size and number of probes varied according to characteristics of the lesion. The defect was filled with cement or left empty. Preoperative selective arterial embolization was used in 7 cases. Results Average duration of surgery was 3.6 h (2.15-6). Cumulative number (intraoperative and postoperative) of blood transfusions per patient ranged from 0 to 15 (average 3.8). In one patient control of bleeding was particularly difficult and the patient received 15 blood units; in the remaining 9 patients average number of blood transfusions was 2.5. No skin necrosis was encountered. No deep infection and no neurovascular damage occurred. Follow-up ranged from 1 to 47 months (average 19.9). Two patients affected by metastatic disease died 14 and 15 months after surgery for systemic disease. In the 7 patients with follow-up longer than 1 year no local recurrence or progression was observed. Discussion In our experience, use of cryoprobes to freeze tumoral tissue in high risk lesions resulted in limited bleeding. The absence of complications showed the safeness of the technique. Effect of cryosurgery on surgical margins in intra-lesional excisions needs a longer follow-up and wider series to be evaluated. Conclusions Cryosurgery as an aid during curettage of bone tumors of the sacrum and pelvis is a useful tool to decrease bleeding in a high-risk surgery. AD - G. Scoccianti, Ortopedia Oncologica, AOU Careggi, Florence, Italy AU - Scoccianti, G. AU - Campanacci, D. A. AU - Beltrami, G. AU - Frenos, F. AU - Capanna, R. DB - Embase DO - 10.1007/s10195-012-0209-8 KW - cement curettage neoplasm pelvis sacrum cryosurgery blood adjuvant therapy society orthopedics traumatology patient human bleeding follow up surgery risk blood transfusion intralesional drug administration cryoprobe bone tumor excision tissues neurilemoma systemic disease metastasis aneurysmal bone cyst giant cell tumor infection hemangiopericytoma skin necrosis surgical technique adenocarcinoma artificial embolization freezing kidney cell ischium chondrosarcoma histology procedures LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1590-9921 SP - S34 ST - Curettage of tumour lesions of the pelvis and sacrum with the aid of cryosurgery for blood sparing and adjuvant effect T2 - Journal of Orthopaedics and Traumatology TI - Curettage of tumour lesions of the pelvis and sacrum with the aid of cryosurgery for blood sparing and adjuvant effect UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70936669&from=export http://dx.doi.org/10.1007/s10195-012-0209-8 VL - 13 ID - 829530 ER - TY - JOUR AB - Paradoxical cerebral embolism of cement occurred in a 78-year-old woman after cement-assisted transpedicular spinal fixation surgery. Multiple pulmonary emboli of polymethylmethacrylate precipitated pulmonary hypertension and right-to-left shunting into the systemic circulation through a patent foramen ovale. This rare complication occurred because of failure to recognize venous migration of cement during the procedure and the injection of multiple levels in one setting. Although this was an open procedure, the technical aspects were the same as for vertebroplasty and the precautions should be applied to percutaneous vertebroplasty. AD - Department of Neuroradiology, Flinders Medical Center, Flinders Drive, Bedford Park, SA, Australia. AN - 12006295 AU - Scroop, R. AU - Eskridge, J. AU - Britz, G. W. DA - May DP - NLM ET - 2002/05/15 J2 - AJNR. American journal of neuroradiology KW - Aged Bone Cements/*adverse effects/therapeutic use Device Removal Female Humans Hypertension, Pulmonary/etiology Injections, Spinal Intracranial Embolism/*chemically induced/diagnostic imaging *Intraoperative Complications Orthopedic Fixation Devices Polymethyl Methacrylate/administration & dosage/*adverse effects Pulmonary Embolism/chemically induced/complications/diagnostic imaging Radiography, Thoracic Spinal Fusion Spine/*surgery Tomography, X-Ray Computed LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2002 SN - 0195-6108 (Print) 0195-6108 SP - 868-70 ST - Paradoxical cerebral arterial embolization of cement during intraoperative vertebroplasty: case report T2 - AJNR Am J Neuroradiol TI - Paradoxical cerebral arterial embolization of cement during intraoperative vertebroplasty: case report VL - 23 ID - 828841 ER - TY - JOUR AB - Paradoxical cerebral embolism of cement occurred in a 78-year-old woman after cement-assisted transpedicular spinal fixation surgery. Multiple pulmonary emboli of polymethylmethacrylate precipitated pulmonary hypertension and right-to-left shunting into the systemic circulation through a patent foramen ovale. This rare complication occurred because of failure to recognize venous migration of cement during the procedure and the injection of multiple levels in one setting. Although this was an open procedure, the technical aspects were the same as for vertebroplasty and the precautions should be applied to percutaneous vertebroplasty. AD - Flinders Med Ctr, Dept Neuroradiol, Bedford Pk, SA, Australia. Flinders Med Ctr, Dept Neurol Surg, Bedford Pk, SA, Australia. Scroop, R (corresponding author), Flinders Med Ctr, Dept Radiol, Flinders Dr, Bedford Pk, SA, Australia. AN - WOS:000175599300027 AU - Scroop, R. AU - Eskridge, J. AU - Britz, G. W. DA - May J2 - Am. J. Neuroradiol. KW - PERCUTANEOUS VERTEBROPLASTY ARTHROPLASTY Clinical Neurology Neuroimaging Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 5 M3 - Article; Retracted Publication N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2002 SN - 0195-6108 SP - 868-870 ST - RETRACTED: Paradoxical cerebral arterial embolization of cement during intraoperative vertebroplasty: Case report (Retracted Article. See vol 25, pg B1, 2004) T2 - American Journal of Neuroradiology TI - RETRACTED: Paradoxical cerebral arterial embolization of cement during intraoperative vertebroplasty: Case report (Retracted Article. See vol 25, pg B1, 2004) UR - ://WOS:000175599300027 VL - 23 ID - 830453 ER - TY - JOUR AB - Over 4.5 years, 32 patients with spinal epidural metastases were decompressed and stabilized. Median survival was 9.5 months. Myelopathy was the predominant indication (41%) for the operation, intractable pain (microinstability) the second most important. The type of tumor spreading and biomechanics necessitated ventral decompression and stabilization in 65%. Corporectomy or extensive laminectomy was always combined with internal fixation and bone cement. With the exception of six patients (5 early deaths), all patients were able to walk after surgery. The Karnofsky index was improved significantly from 35 to 66%. The longest survival time was found in breast carcinomas and myelomas. Preoperative radiological embolization was a keystone in the treatment. Indication for surgery in spinal metastases is critical and needs an interdisciplinary approach. When the patient is suffering from higher degrees of paresis or even paralysis, he/she is no longer an ideal candidate for the operation. The same applies in the presence of uncontrolled primary tumors and neoplastic disease of the GI tract and the bronchus. AD - Klinik für Unfall-,Hand- und Plastiche Chirurgie, Zentralkrankenhaus Reinkenheide, Bremerhaven. AN - 9229780 AU - Seiler, H. AU - Graf, L. AU - von Pawel-Rammingen, U. DA - Apr DO - 10.1007/s001130050122 DP - NLM ET - 1997/04/01 J2 - Der Unfallchirurg KW - Adult Aged Aged, 80 and over Breast Neoplasms/diagnostic imaging/mortality/*surgery Decompression, Surgical/*methods Female Humans Male Middle Aged Multiple Myeloma/diagnostic imaging/mortality/*surgery Palliative Care Postoperative Complications/diagnostic imaging/mortality Spinal Cord Compression/diagnostic imaging/mortality/*surgery Spinal Fusion/*methods Spinal Neoplasms/diagnostic imaging/mortality/*secondary/surgery Survival Rate Tomography, X-Ray Computed LA - ger M1 - 4 N1 - PubMed NLM literature search January 5, 2021 OP - Wirbelsäulenstabilisierung bei extraduraler Metastasenkrankheit Indikation und Verläufe bei 32 Patienten. PY - 1997 SN - 0177-5537 (Print) 0177-5537 SP - 294-300 ST - [Spinal stabilization in extradural metastatic disease. Indications and follow-up of 32 cases] T2 - Unfallchirurg TI - [Spinal stabilization in extradural metastatic disease. Indications and follow-up of 32 cases] VL - 100 ID - 829010 ER - TY - JOUR AB - Background: Injection of cement during vertebroplasty and kyphoplasty can leak into surrounding structures and could be symptomatic. Purpose: To identify the sites and incidence of cement extravasation after kyphoplasty and vertebroplasty, and to evaluate their impacts on clinical outcomes. Material and Methods: A retrospective review of 316 patients treated with kyphoplasty and vertebroplasty; 411 cases were included (223 kyphoplasty and 188 vertebroplasty). Cement extravasation was evaluated postoperatively by computed tomography (CT) scan of the spine. Clinical outcomes were assessed by visual analog scale (VAS) and Oswestry Disability Index (ODI). Results: There was a statistically significant difference in the incidence rate of cement extravasation between vertebroplasty and kyphoplasty groups (P < 0.04). The most common site of cement extravasation was in paravertebral soft tissues for vertebroplasty (n = 33, 40.7%) and for kyphoplasty (n = 30, 30%). In the subgroup where cement leaked into the intradiscal space, adjacent vertebral body fractures occurred in 3/26 vertebrae (11.5%) in the vertebroplasty group and in 2/18 vertebrae (11.1%) in the kyphoplasty group. Both groups showed a statistically significant decrease in both VAS (P < 0.001) and ODI scores (P < 0.001). There was no significantly difference in patient satisfaction between those who had cement extravasation and those who did not, in both groups. Conclusion: Kyphoplasty has an advantage in terms of less risk of cement extravasation. However, this factor did not reflect on subsequent sequelae or final clinical outcomes. This study did not find a distinct correlation between intradiscal cement extravasation and increased risk of adjacent vertebral fractures. AD - [Semaan, Hassan; Obri, Tawfik; Bazerbashi, Mohamad] Univ Toledo, Med Ctr, Dept Radiol, 2801 W Bancroft St, Toledo, OH 43606 USA. [Paull, Daniel; Elgafy, Hossein] Univ Toledo, Med Ctr, Dept Orthoped Surg, Toledo, OH 43614 USA. [Liu, Xiaochen; Sarrouj, Marah] Univ Toledo, Coll Med, 2801 W Bancroft St, Toledo, OH 43606 USA. Elgafy, H (corresponding author), Univ Toledo, Med Ctr, Dept Orthoped Surg, Toledo, OH 43614 USA. Hossein.Elgafy@utoledo.edu AN - WOS:000433906400016 AU - Semaan, H. AU - Obri, T. AU - Bazerbashi, M. AU - Paull, D. AU - Liu, X. C. AU - Sarrouj, M. AU - Elgafy, H. DA - Jul DO - 10.1177/0284185117732599 J2 - Acta Radiol. KW - Cement extravasation kyphoplasty vertebroplasty clinical outcome VERTEBRAL COMPRESSION FRACTURES OSTEOPOROTIC SPINAL FRACTURES BALLOON KYPHOPLASTY PULMONARY-EMBOLISM RANDOMIZED-TRIAL BODY RISK METAANALYSIS EFFICACY LEAKAGE Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 7 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 0284-1851 SP - 861-868 ST - Clinical outcome and subsequent sequelae of cement extravasation after percutaneous kyphoplasty and vertebroplasty: a comparative review T2 - Acta Radiologica TI - Clinical outcome and subsequent sequelae of cement extravasation after percutaneous kyphoplasty and vertebroplasty: a comparative review UR - ://WOS:000433906400016 VL - 59 ID - 830165 ER - TY - JOUR AD - Yonsei University College of Medicine, Seoul 120-572, South Korea. AN - 15788629 AU - Seo, J. S. AU - Kim, Y. J. AU - Choi, B. W. AU - Kim, T. H. AU - Choe, K. O. DA - Apr DO - 10.2214/ajr.184.4.01841364 DP - NLM ET - 2005/03/25 J2 - AJR. American journal of roentgenology KW - Aged Humans Male Pulmonary Embolism/*diagnostic imaging/etiology Spinal Fractures/surgery Spinal Fusion/*adverse effects Tomography, X-Ray Computed/*methods LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2005 SN - 0361-803X (Print) 0361-803x SP - 1364-5 ST - MDCT of pulmonary embolism after percutaneous vertebroplasty T2 - AJR Am J Roentgenol TI - MDCT of pulmonary embolism after percutaneous vertebroplasty VL - 184 ID - 828977 ER - TY - JOUR AB - The cervical spine is a less common site for metastatic disease than is the thoracolumbar spine. Percutaneous vertebroplasty (PVP) in the cervical spine can be performed using an anteromedial or lateral approach. A 51-yearold woman with breast cancer had been experiencing severe weight-bearing neck pain for 2 months, even after undergoing radiation therapy. Imaging studies revealed an osteolytic compression fracture in the C7 vertebra. For performing PVP at C7 using the anteromedial approach, a needle was inserted from the left side of the patient's neck. The needle was advanced to the anterior 1/3 anterior 1/3 or 1/2 of the vertebral body by hammering, and approximately 2 ml of cement was injected. Immediately after the operation, the patient could move her neck without pain. In conclusion, PVP using an anterolateral approach may be an option for treating metastatic osteolytic vertebral lesions in the cervical spine for alleviating intractable axial neck pain. © the Korean Society of Anesthesiologists, 2013. AD - K.-H. Kim, Department of Anesthesia and Pain Medicine, School of Medicine, Yangsan Busan National University Hospital, Beomeo-ri, Mulgeum-eup, Yangsan 626-770, South Korea AU - Seo, S. S. AU - Lee, D. H. AU - Kim, H. J. AU - Yoon, J. W. AU - Kwon, O. S. AU - Kim, K. H. DB - Embase DO - 10.4097/kjae.2013.64.3.276 KW - cefazolin fentanyl ketorolac adult article biopsy needle bleeding bone scintiscanning case report compression fracture embolism epidural space female follow up human metastasis neck pain nerve injury nuclear magnetic resonance imaging percutaneous vertebroplasty vertebra body wound infection L1 - http://ekja.org/Synapse/Data/PDFData/0011KJAE/kjae-64-276.pdf LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 2005-6419 2005-7563 SP - 276-279 ST - Percutaneous vertebroplasty at C7 for the treatment of painful metastases - A case report T2 - Korean Journal of Anesthesiology TI - Percutaneous vertebroplasty at C7 for the treatment of painful metastases - A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L368648265&from=export http://dx.doi.org/10.4097/kjae.2013.64.3.276 VL - 64 ID - 829507 ER - TY - JOUR AB - Fat embolism was assessed at necropsy and correlated with clinical findings in the patients who died among 854 with fractured hips admitted to hospital between 1967 and August 1971. Sixteen cases of clinical importance were found, eight of which were judged to have been fatal or to have seriously contributed to death. Frequencies were as follows: 2.4 to 3.3% among 424 patients with subcapital fractures; 0.7 to 0.8% in the 405 with trochanteric fractures; 4.1 to 7% among subjects treated without operation, representing 30% of those who died within seven days; and 0.9 to 1.1% among patients treated by pinning, nailing, or nail-plating. The higher frequency in the conservatively treated group is probably related to selection of poor-risk subjects. Fat embolism was found in 6.8 to 8.0% of those with subcapital fractures treated by primary Thompson's arthroplasty which utilizes acrylic cement, and in none of those given Moore's prostheses for which cement is not used. Study of a larger group after Moore's prosthesis is required to establish its lack of special risk. Fat embolism accounted for all the deaths within seven days of Thompson's arthroplasty and for most within 14 days; it was clearly related to surgery in some cases.A possible explanation of the hazard of Thompson's arthroplasty is that fat globule entry is enhanced by a rise of intramedullary pressure due to proximal occlusion of the reamed marrow cavity. A controlled trial of the effect of venting the marrow cavity on the frequency of fat embolism is warranted. It is possible that the acrylic monomer may also contribute to venous entry of medullary fat. The higher-age group of those with subcapital fractures and associated chronic cardiac and pulmonary disease might make them more susceptible to fat embolization than those in whom arthroplasty is also carried out for chronic hip disease. AN - 5022012 AU - Sevitt, S. C2 - Pmc1788947 DA - Apr 29 DO - 10.1136/bmj.2.5808.257 DP - NLM ET - 1972/04/29 J2 - British medical journal KW - Acrylates/adverse effects Aged Arthroplasty/adverse effects Autopsy Bone Cements/adverse effects Bone Marrow/surgery *Embolism, Fat/complications/etiology/mortality Female Femoral Fractures/*complications/mortality/surgery Fracture Fixation Humans Joint Prosthesis Male Prospective Studies Retrospective Studies LA - eng M1 - 5808 N1 - PubMed NLM literature search January 5, 2021 PY - 1972 SN - 0007-1447 (Print) 0007-1447 SP - 257-62 ST - Fat embolism in patients with fractured hips T2 - Br Med J TI - Fat embolism in patients with fractured hips VL - 2 ID - 828828 ER - TY - JOUR AB - BACKGROUND: Cervical spine metastases with circumferential spinal cord compression often are treated with combined anteroposterior decompression and stabilization. In patients with large anterior neck masses, previous radiotherapy to the neck, or previous anterior neck surgery, however, anterior approaches may pose additional risk. In such cases, posterior-only approaches that allow for circumferential decompression and anterior column reconstruction may be beneficial. CASE DESCRIPTION: We present the case of a 70-year-old man with follicular thyroid carcinoma metastatic to the cervical spine causing spinal cord compression. We used a posterior-only approach for a C6-C7 partial corpectomy and posterior decompression and fusion from C2 to T2. Our technique involved preoperative embolization of the right vertebral artery to safely gain access to the ventral surface of the spinal cord and vertebral bodies. Anterior column support was provided by a chest tube/polymethylmethacrylate construct, allowing the implant to be placed within the anterior column from a posterior approach without nerve root sacrifice. The patient tolerated the procedure well. He had no postoperative neurologic deficits. Two months later, he underwent a total thyroidectomy followed by stereotactic radiotherapy to the tumor bed (2700 cGy total, 3 fractions). At 1-year follow-up, he was active and without significant pain or focal neurologic deficits. CONCLUSIONS: We propose a novel approach to ventral/circumferential cervical spine tumors that combines epidural decompression and cervical stabilization via a posterior-only approach. By using a chest tube/polymethylmethacrylate construct, anterior column support can be achieved through a posterior approach without nerve root sacrifice. AD - Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA. Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, Rhode Island, USA. Electronic address: ziya_gokaslan@brown.edu. AN - 30447451 AU - Shaaya, E. AU - Fridley, J. AU - Barber, S. M. AU - Syed, S. AU - Xia, J. AU - Galgano, M. AU - Oyelese, A. AU - Telfeian, A. AU - Gokaslan, Z. DA - Feb DO - 10.1016/j.wneu.2018.11.010 DP - NLM ET - 2018/11/18 J2 - World neurosurgery KW - Adenocarcinoma, Follicular/secondary/*surgery Aged Bone Cements/therapeutic use Cervical Vertebrae/*surgery Humans Male Organ Sparing Treatments/methods Polymethyl Methacrylate/therapeutic use Spinal Cord Compression/etiology/surgery Spinal Neoplasms/secondary/*surgery *Thyroid Neoplasms Trauma, Nervous System/prevention & control Cervical spine reconstruction Polymethylmethacrylate Posterior cervical corpectomy Spine metastasis Spine tumor Thyroid carcinoma LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 1878-8750 SP - 298-302 ST - Posterior Nerve-Sparing Multilevel Cervical Corpectomy and Reconstruction for Metastatic Cervical Spine Tumors: Case Report and Literature Review T2 - World Neurosurg TI - Posterior Nerve-Sparing Multilevel Cervical Corpectomy and Reconstruction for Metastatic Cervical Spine Tumors: Case Report and Literature Review VL - 122 ID - 828726 ER - TY - JOUR AB - Background: Cervical spine metastases with circumferential spinal cord compression often are treated with combined anteroposterior decompression and stabilization. In patients with large anterior neck masses, previous radiotherapy to the neck, or previous anterior neck surgery, however, anterior approaches may pose additional risk. In such cases, posterior-only approaches that allow for circumferential decompression and anterior column reconstruction may be beneficial. Case Description: We present the case of a 70-year-old man with follicular thyroid carcinoma metastatic to the cervical spine causing spinal cord compression. We used a posterior-only approach for a C6–C7 partial corpectomy and posterior decompression and fusion from C2 to T2. Our technique involved preoperative embolization of the right vertebral artery to safely gain access to the ventral surface of the spinal cord and vertebral bodies. Anterior column support was provided by a chest tube/polymethylmethacrylate construct, allowing the implant to be placed within the anterior column from a posterior approach without nerve root sacrifice. The patient tolerated the procedure well. He had no postoperative neurologic deficits. Two months later, he underwent a total thyroidectomy followed by stereotactic radiotherapy to the tumor bed (2700 cGy total, 3 fractions). At 1-year follow-up, he was active and without significant pain or focal neurologic deficits. Conclusions: We propose a novel approach to ventral/circumferential cervical spine tumors that combines epidural decompression and cervical stabilization via a posterior-only approach. By using a chest tube/polymethylmethacrylate construct, anterior column support can be achieved through a posterior approach without nerve root sacrifice. AD - Z. Gokaslan, Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School at Brown University, Providence, RI, United States AU - Shaaya, E. AU - Fridley, J. AU - Barber, S. M. AU - Syed, S. AU - Xia, J. AU - Galgano, M. AU - Oyelese, A. AU - Telfeian, A. AU - Gokaslan, Z. DB - Embase Medline DO - 10.1016/j.wneu.2018.11.010 KW - chest tube cytokeratin 7 homeobox protein Nkx 2.1 poly(methyl methacrylate) thyroglobulin aged arterial embolization article cancer radiotherapy case report clinical article coil embolization follow up foraminotomy human male nerve reconstruction nerve root nuclear magnetic resonance imaging posterior nerve sparing multilevel cervical corpectomy radiation dose fractionation spinal cord compression spinal cord decompression spine surgery spine tumor thyroid follicular carcinoma thyroidectomy LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1878-8769 1878-8750 SP - 298-302 ST - Posterior Nerve–Sparing Multilevel Cervical Corpectomy and Reconstruction for Metastatic Cervical Spine Tumors: Case Report and Literature Review T2 - World Neurosurgery TI - Posterior Nerve–Sparing Multilevel Cervical Corpectomy and Reconstruction for Metastatic Cervical Spine Tumors: Case Report and Literature Review UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2001347227&from=export http://dx.doi.org/10.1016/j.wneu.2018.11.010 VL - 122 ID - 829153 ER - TY - JOUR AB - SESSION TITLE: Medical Student/Resident Pulmonary Vascular Disease Posters SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Vertebral augmentation procedures, such as percutaneous vertebroplasty (PVP) and balloon kyphoplasty (BKP), are minimally invasive surgeries used in management of vertebral compression fractures (VCF). It is well known that there is no difference in clinical outcomes between these two procedures (1). Varying studies, however, show that cement leakage into surrounding tissue is significantly decreased in patients that undergo BKP (8.7-37.5%) over PVP (25.2-90%) (2) (3). Here, we present a case of a symptomatic pulmonary cement embolism (PCE) despite a BKP, which only occurs in 0.4% of patients undergoing this procedure (2). CASE PRESENTATION: A 56-year-old female with medical history of CAD, recurrent respiratory failure due to COPD exacerbations, DM, and HTN underwent BKP for VCFs of T7-T9 attributed to prolonged steroid use. One week later, she revisited the ED with complaints of shortness of breath and severe, pleuritic, left sided back pain radiating to the lateral left side of her chest. On arrival, she was tachycardic, tachypneic, and hypoxic with a normal blood pressure. Physical examination revealed mild diffuse wheezing and decreased breath sounds. EKG showed sinus tachycardia. A CTA revealed a small hyperdensity within a few segmental and subsegmental pulmonary arteries which suggested cement from her prior BKP procedure. Her symptoms were consistent with PCE and COPD exacerbation. She was intubated for four days and started on therapeutic anticoagulation with heparin. Later, her anticoagulation was held for intrathecal morphine pump placement. She was eventually discharged on her baseline oxygen of 3-4 L with a tapering dose of steroids and no further anticoagulation. DISCUSSION: BKP consists of inflating a balloon inside a VCF to create a cavity for the insertion of polymethylmethacrylate cement under low pressures. Unlike PVP, this localized injection approach helps prevent cement leakage into the paravertebral veins, which eventually empty into the pulmonary circulation. Although there are no established treatment guidelines for PCE, conservative management with close follow-up is recommended for asymptomatic patients with small and peripheral emboli. Acute symptomatic patients with central or peripheral emboli should receive treatment with heparin followed by warfarin for 3–6 months. In those with hemodynamic instability, severe respiratory failure, or large central emboli, emergent surgical treatment with embolectomy is suggested (3). CONCLUSIONS: Although vascular cement leak is lower in BKP compared to PVP, there is no statistically significant data regarding PCE rates between both surgeries (2). Specific imaging measures, such as fluoroscopy and post-procedural x-rays, should be established to monitor for this complication. Additional studies are required to establish standard management guidelines for PCE and to assess PCE risk rates between BKP and PVP. Reference #1: Wang, B., Zhao, C., Song, L. et al. Balloon kyphoplasty versus percutaneous vertebroplasty for osteoporotic vertebral compression fracture: a meta-analysis and systematic review. J Orthop Surg Res 13, 264 (2018). https://doi.org/10.1186/s13018-018-0952-5 Reference #2: Eck, J., Nachtigall, D., Humphreys, S. C., & Hodges, S. (2007). P1. Comparison of Vertebroplasty and Balloon Kyphoplasty for Treatment of Vertebral Compression Fractures: A Meta-Analysis of the Literature. The Spine Journal, 7(5), 83S. doi:10.1016/j.spinee.2007.07.205 Reference #3: Krueger, A., Bliemel, C., Zettl, R., & Ruchholtz, S. (2009). Management of pulmonary cement embolism after percutaneous vertebroplasty and kyphoplasty: a systematic review of the literature. European Spine Journal, 18(9), 1257–1265. doi:10.1007/s00586-009-1073-y DISCLOSURES: No relevant relationships by Subarna Gautam, source=Web Response No relevant relationships by Ritha Kartan, source=Web Response No relevant relationsh ps by Parth Shah, source=Web Response No relevant relationships by Krupa Solanki, source=Web Response AU - Shah, P. AU - Solanki, K. AU - Gautam, S. AU - Kartan, R. DB - Embase DO - 10.1016/j.chest.2020.08.1853 KW - cement fluvalinate heparin morphine oxygen steroid warfarin adult anticoagulation backache blood pressure monitoring chronic obstructive lung disease complication compression fracture conference abstract conservative treatment disease exacerbation drug therapy dyspnea electrocardiogram embolectomy female fluoroscopy follow up hemodynamics human human tissue hypobarism kyphoplasty lung circulation lung embolism medical history meta analysis middle aged osteoporosis physical examination pulmonary artery respiratory failure risk assessment sinus tachycardia spine surgery systematic review thorax vein wheezing X ray LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1931-3543 0012-3692 SP - A2150-A2151 ST - A RARE CASE OF CEMENT PULMONARY EMBOLISM AFTER BALLOON KYPHOPLASTY T2 - Chest TI - A RARE CASE OF CEMENT PULMONARY EMBOLISM AFTER BALLOON KYPHOPLASTY UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2008024784&from=export http://dx.doi.org/10.1016/j.chest.2020.08.1853 VL - 158 ID - 829050 ER - TY - JOUR AB - INTRODUCTION: Percutaneous vertebroplasty and Kyphoplasty are procedures done for compression fractures. Polymethylmethacrylate cement mixed with opacifying agent is injected under radiological guidance as a liquid and it quickly hardens and stabilizes the collapsed vertebra. Some degree of local leakage of cement during the procedure is very common. We report a case of a cement pulmonary embolism following kyphoplasty procedure. CASE PRESENTATION: 62-yr-old female with L2 compression fracture was admitted for Kyphoplasty. Polymethylmethacryate was injected under fluoroscopic guidance. Extravasation of the cement was noted. CT scan of Lumbar Spine was performed which confirmed extravasation of cement reaching border of Inferior vena cava. Subsequent CT of the chest showed cement in right upper and middle lobe pulmonary arteries. Physical exam was unremarkable. Patient remained hemodynamically stable. She had no complains of chest pain, shortness of breath, hemoptysis etc. and ABG showed no hypoxia. Patient was subsequently started on therapeutic enoxaparin. She was discharged home later without anticoagulation. DISCUSSIONS: Complications due to kyphoplasty and vertebroplasty are low and include infection, hypotension and leakage of cement outside the vertebral body. Occasionally, polymethylmethacrylate extravasates outside the vertebral body and extends into epidural and paraspinal veins, extending into inferior vena cava and may result in pulmonary embolism. Factors determining risk of pulmonary embolism are insufficient polymerization of cement, needle position with respect to vertebral vein and overfill of vertebral body. Most leaks are asymptomatic. In patients with clinical evidence of pulmonary embolism, management mainly consists of anticoagulation because there is risk of thrombus formation on the cement embolus. CONCLUSION: Physicians should be aware of possibility of cement pulmonary embolism. It could potentially be fatal. Few cases have been reported. It is recommended that this procedure should be done under fluoroscopic/CT guidance. As soon as leakage into perivertebral veins is seen, procedure should be discontinued. AD - N. Brar, Winthrop University Hospital, Mineola, NY, United States AU - Shalshin, A. AU - Brar, N. AU - Chawla, S. AU - Islam, T. DB - Embase DO - 10.1378/chest.10723 KW - cement poly(methyl methacrylate) enoxaparin kyphoplasty embolism lung embolism patient vein vertebra body percutaneous vertebroplasty compression fracture extravasation anticoagulation risk inferior cava vein liquid epidural drug administration computer assisted tomography lumbar spine thorax needle female pulmonary artery thorax pain dyspnea hemoptysis hypoxia physician blood clotting hypotension infection vertebra polymerization L1 - http://chestjournal.chestpubs.org/cgi/content/meeting_abstract/138/4_MeetingAbstracts/13A?sid=e5680a46-5eda-44bc-821b-532fd298fb50 LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0012-3692 ST - Pulmonary cement embolism: Rare complication of Kyphoplasty T2 - Chest TI - Pulmonary cement embolism: Rare complication of Kyphoplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70361261&from=export http://dx.doi.org/10.1378/chest.10723 VL - 138 ID - 829647 ER - TY - JOUR AD - Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. Department of Radiology, University Hospital Bonn, Bonn, Germany. Heart Center, Department of Medicine II, University Hospital Bonn, Bonn, Germany. Electronic address: jan-malte.sinning@ukbonn.de. AN - 31838105 AU - Shamekhi, J. AU - Düsing, P. AU - Sedaghat, A. AU - Kütting, D. AU - Nickenig, G. AU - Sinning, J. M. DA - Feb 24 DO - 10.1016/j.jcin.2019.09.044 DP - NLM ET - 2019/12/16 J2 - JACC. Cardiovascular interventions KW - Aged, 80 and over Bone Cements/*adverse effects *Cardiac Catheterization Foreign-Body Migration/diagnostic imaging/etiology/*therapy Humans Kyphoplasty/*adverse effects Male Pulmonary Embolism/diagnostic imaging/etiology/*therapy Spinal Fractures/*therapy Treatment Outcome Tricuspid Valve Insufficiency/diagnostic imaging/etiology/*therapy *cement embolism *heart failure *tricuspid regurgitation LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 1936-8798 SP - 532-533 ST - Healing a Heart of Stone: Percutaneous Extraction of Cardiopulmonary Cement Embolism T2 - JACC Cardiovasc Interv TI - Healing a Heart of Stone: Percutaneous Extraction of Cardiopulmonary Cement Embolism VL - 13 ID - 828508 ER - TY - JOUR AB - The activation of the clotting cascade leading to deep venous thrombosis begins during total hip arthroplasty, but few studies have assessed changes in coagulation during surgery. A better understanding of thrombogenesis during total hip arthroplasty may provide a more rational basis for treatment. In 3 separate studies, the following observations were made. Circulating indices of thrombosis and fibrinolysis: prothrombin F1.2, thrombin‐antithrombin complexes, fibrinopeptide A, and D‐dimer, did not increase during osteotomy of the neck of the femur or during insertion of the acetabular component, but rose significantly during insertion of the femoral component. Thrombin‐antithrombin complexes, fibrinopeptide A, and D‐dimer were higher after insertion of a cemented component than insertion of a noncemented femoral component. A significant decline in central venous oxygen tension was observed after relocation of the hip joint and after insertions of cemented and noncemented femoral components, providing evidence of femoral venous occlusion during insertion of the femoral component. In patients receiving a cemented femoral component, mean pulmonary artery pressure increased after relocation of the hip joint, indicating intraoperative pulmonary embolism. No changes in mean pulmonary artery pressure were noted with noncemented total hip arthroplasty. Administration of 1000 units of unfractionated heparin before insertion of a cemented femoral component blunted the rise of fibrinopeptide A. The results of these studies suggest that (1) the greatest risk of activation of the clotting cascade during total hip arthroplasty occurs during insertion of the femoral component; (2) femoral venous occlusion and use of cemented components are factors in thrombogenesis during total hip arthroplasty; and (3) measures to prevent deep venous thrombosis during total hip arthroplasty (such as intraoperative anticoagulation) should begin during surgery rather than during the postoperative period and be applied during insertion of the femoral component. AN - CN-00119099 AU - Sharrock, N. E. AU - Go, G. AU - Harpel, P. C. AU - Ranawat, C. S. AU - Sculco, T. P. AU - Salvati, E. A. KW - Aged Antithrombin III [analysis] Blood Coagulation Factors Bone Cements Female Fibrin Fibrinogen Degradation Products [analysis] Fibrinolysis Fibrinopeptide A [analysis] Heparin [pharmacology] Hip Prosthesis Humans Intraoperative Period Male Middle Aged Oximetry Peptide Fragments [analysis] Peptide Hydrolases [analysis] Prothrombin [analysis] Pulmonary Wedge Pressure Thrombosis [*blood] M1 - 319 M3 - Clinical Trial; Controlled Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1995 SP - 16‐27 ST - The John Charnley Award. Thrombogenesis during total hip arthroplasty T2 - Clinical orthopaedics and related research TI - The John Charnley Award. Thrombogenesis during total hip arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00119099/full ID - 830074 ER - TY - JOUR AB - BACKGROUND: To solve the complications such as screw cut-out, loosening, and insufficient holding force that may occur during internal fixation of osteoporotic fractures, a new cement-reinforced screw combined with PHILOS plate is currently used to treat osteoporotic fracture of the proximal humerus. However, there are few reports on the clinical efficacy of this technique in the treatment of osteoporotic fractures of the proximal humerus in China. OBJECTIVE: To compare the clinical efficacy of a novel cement-reinforced screw combined with locking plate fixation and artificial humeral head replacement in the treatment of osteoporotic fractures of the proximal humerus. METHODS: Twenty-two patients with osteoporotic fractures of the proximal humerus admitted to at Guizhou Provincial People’s Hospital from February 2017 to March 2019 were enrolled, including 8 males and 14 females, aged 68-88 years. Ten patients underwent open reduction using new cement-reinforced screws combined with locking plate internal fixation (internal fixation group), and 12 patients underwent humeral head arthroplasty (humeral head arthroplasty group). The operation time, intraoperative blood loss, and intraoperative and postoperative complications were compared. The Visual Analogue Scale and Constant scores of the shoulder joint were detected at 6 months after surgery. All patients received a postoperative anti-osteoporosis treatment. The study was approved by the Ethics Committee of Guizhou Provincial People’s Hospital, approval No. 2017(02). RESULTS AND CONCLUSION: (1) Twenty-two patients were followed up for 6-15 months, an average of (9.0±1.6) months. (2) No toxicity reaction of bone cement or embolism occurred in both groups. One case of postoperative shoulder stiffness occurred in the internal fixation group. There were no complications in both groups, such as incision infection, heterotopic ossification, delayed healing, and screw cut-out. (3) The operation time and intraoperative blood loss in the internal fixation group were significantly less than those in the humeral head arthroplasty group (P < 0.05). (4) The Visual Analogue Scale and the excellent and good rate of Constant scores of the shoulder joint at 6 months after surgery showed no significant differences between two groups (P > 0.05). (5) In summary, the novel cement-reinforced screw technique combined with locking plate internal fixation has similar clinical efficacy with humeral head arthroplasty. Therefore, this new technique is an alternative internal fixation method for some patients scheduled for shoulder joint arthroplasty. AD - Y. Zhang, Guizhou Provincial People’s Hospital, Guiyang, Guizhou Province, China AU - She, R. AU - Zhang, Y. AU - Wang, Y. AU - Zhang, B. AU - Chen, P. AU - Huang, Q. DB - Embase DO - 10.3969/j.issn.2095-4344.2627 KW - bone screw cement reinforced screw bone cement adult arthroplasty article clinical article embolism female fragility fracture heterotopic ossification human humeral head humeral head arthroplasty male open fracture reduction osteosynthesis peroperative complication plate fixation postoperative complication proximal humerus fracture shoulder visual analog scale LA - Chinese M1 - 15 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 2095-4344 SP - 2335-2341 ST - A novel cement-reinforced screw combined with locking plate fixation versus humeral head arthroplasty in the treatment of osteoporotic fractures of the proximal humerus T2 - Chinese Journal of Tissue Engineering Research TI - A novel cement-reinforced screw combined with locking plate fixation versus humeral head arthroplasty in the treatment of osteoporotic fractures of the proximal humerus UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2003446195&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.2627 VL - 24 ID - 829065 ER - TY - JOUR AB - Percutaneous vertebroplasty is a minimally invasive technique for treating vertebral compression fractures and tumors. Although percutaneous vertebroplasty is considered a relatively safe and technically simple procedure, it is also associated with life-threatening complications as a result of cement leakage, including cardiac perforation and pulmonary embolism. A 63-year-old woman underwent percutaneous vertebroplasty for an L3 vertebral fracture and had cement leaks into the inferior vena cava, pulmonary arteries, and right heart chambers, with a free wall perforation. Surgical removal of the cement emboli was recommended as a result of apparent penetration of the ventricle and the fragile nature of polymethyl methacrylate. A cardiopulmonary bypass was immediately performed via a right atriotomy. A foreign body 10 cm in length was removed from the right atrium and ventricle. Arteriotomies were then performed, and 4 cement filaments were retrieved from the pulmonary arteries. The inferior vena cava was also surgically opened, allowing extraction of a cement fragment that was 12 cm long. The postoperative course was uneventful, and the patient fully recovered. This is the first report of the migration of a cement fragment larger than 10 cm that had migrated and embedded in the heart chamber. This report showed that imaging analysis is valuable when cement leakage is detected during percutaneous vertebroplasty and can be used to avoid serious complications and improve patient outcomes. AN - 26488794 AU - Shen, C. AU - Liu, G. AU - Hu, J. Z. AU - Yang, X. H. DA - Oct DO - 10.3928/01477447-20151002-93 DP - NLM ET - 2015/10/22 J2 - Orthopedics KW - *Bone Cements Female Foreign-Body Migration/*surgery Fractures, Compression/surgery Heart Atria/surgery Heart Injuries/*surgery Heart Ventricles/surgery Humans Lumbar Vertebrae/injuries/surgery Middle Aged *Polymethyl Methacrylate Postoperative Complications/*surgery Pulmonary Embolism/*surgery Spinal Fractures/surgery Vena Cava, Inferior/*surgery *Vertebroplasty LA - eng M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 0147-7447 SP - e947-50 ST - Cardiac Perforation and Multiple Emboli After Percutaneous Vertebroplasty T2 - Orthopedics TI - Cardiac Perforation and Multiple Emboli After Percutaneous Vertebroplasty VL - 38 ID - 828658 ER - TY - JOUR AB - Percutaneous vertebroplasty is a minimally invasive technique for treating vertebral compression fractures and tumors. Although percutaneous vertebroplasty is considered a relatively safe and technically simple procedure, it is also associated with life-threatening complications as a result of cement leakage, including cardiac perforation and pulmonary embolism. A 63-year-old woman underwent percutaneous vertebroplasty for an L3 vertebral fracture and had cement leaks into the inferior vena cava, pulmonary arteries, and right heart chambers, with a free wall perforation. Surgical removal of the cement emboli was recommended as a result of apparent penetration of the ventricle and the fragile nature of polymethyl methacrylate. A cardiopulmonary bypass was immediately performed via a right atriotomy. A foreign body 10 cm in length was removed from the right atrium and ventricle. Arteriotomies were then performed, and 4 cement filaments were retrieved from the pulmonary arteries. The inferior vena cava was also surgically opened, allowing extraction of a cement fragment that was 12 cm long. The postoperative course was uneventful, and the patient fully recovered. This is the first report of the migration of a cement fragment larger than 10 cm that had migrated and embedded in the heart chamber. This report showed that imaging analysis is valuable when cement leakage is detected during percutaneous vertebroplasty and can be used to avoid serious complications and improve patient outcomes. AD - Department of Orthopedics Department of Orthopedics , Guangxi Brain Hospital, Guangxi, China. Department of Cardiology , The Affiliated Hospital of Guilin Medical College AN - 110579242. Language: English. Entry Date: 20160624. Revision Date: 20160624. Publication Type: journal article AU - Shen, Chong AU - Liu, Gang AU - Hu, Jun-Zu AU - Yang, Xl-Heng AU - Yang, Xi-Heng DB - cin20 DO - 10.3928/01477447-20151002-93 DP - EBSCOhost KW - Methylmethacrylates Bone Cements Vena Cava, Inferior -- Surgery Vertebroplasty Foreign-Body Migration -- Surgery Pulmonary Embolism -- Surgery Heart Injuries -- Surgery Postoperative Complications -- Surgery Middle Age Lumbar Vertebrae -- Injuries Fractures, Compression -- Surgery Spinal Fractures -- Surgery Heart Ventricle -- Surgery Heart Atrium -- Surgery Female Lumbar Vertebrae -- Surgery M1 - 10 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2015 SN - 0147-7447 SP - e947-e950 ST - Cardiac Perforation and Multiple Emboli After Percutaneous Vertebroplasty T2 - Orthopedics TI - Cardiac Perforation and Multiple Emboli After Percutaneous Vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=110579242&site=ehost-live&scope=site VL - 38 ID - 830606 ER - TY - JOUR AB - Aim: To observe the efficacy of active regular exercises as early as possible in the prevention of deep venous thrombosis (DVT) after total hip replacement. Methods: Eighty-one patients undergoing total hip replacement from February 2000 to April 2004 were selected in the Department of Orthopedics, the Second Affiliated Hospital of Sun Yat-sen University, including 34 cases of aseptic necrosis of femoral head, 29 of femoral neck fracture, 8 of osteoarthritis, 4 of coax rebuild, 2 of old coxotuberculosis, 2 of ankylosing spondylitis, and 2 of malignant tumor; otherwise, there were 66 hips of bio-fixation type, 17 hips of mixed type, and 9 hips of bone cement type. Pre-operative color Doppler showed that there was no DVT in both lower limbs. Active regular exercise was performed at 2-5 hours after operation, including flexion and extension of metatarsophalangeal joints, inversion, eversion, flexion and extension of bilateral ankle joints; Circumduction of bilateral ankle joint was performed at 1-2 days after operation; Circumduction of ankle joint and isometric contraction of quadriceps femoris were performed at 3-7 days after operation; According to the individual condition, amount of motion was increased based on those mentioned above. No anticoagulant drugs were used in patients after operation. 1 Whether there were symptoms related to DVT or not was detected every day after operation, and color Doppler of bilateral lower limbs was performed at 12 days after operation. The results were compared with those before treatment. Incidence of thrombosis was measured. 2 Whether there were any changes in bleeding of patients without administration of anticoagulant drug was observed after operation. Results: According to the intention-to-treat analysis, 81 patients were all involved in the result analysis. 1 Incidence of lower-limb DVT: Incidence of DVT was 4.94%(4/81) after operation. Four days after operation, 1 case was found having swelling of affect lower limb, and emboli in popliteal vein and superficial femoral vein detected with color Doppler. Twelve days after operation, 3 cases of non-symptoms were found having DVT forming, including 1 in popliteal vein and 2 in middle segment of superficial femoral vein. Among the four above-mentioned cases, there were 2 cases of femoral neck fracture of bone cement type, 1 of non-cement type femoral neck fracture, and 1 of mixed type osteoarthritis. There were 10.34%(3/29) DVT due to femoral neck fracture and 11.54% (3/26) DVT due to intraoperative usage of bone cement. 2 Amount of bleeding during and after operation: The total amount was (779.6±207.4) mL. Sixty-seven percent of patients (54/81) did not need blood transfusion. Conclusion: Active regular exercises as early as possible can significantly reduce the incidence rate of deep venous thrombosis after total hip replacement, which is less than 40% reported in 1999. Incidence of complication, such as bleeding, is decreased as a result of non-usage of anticoagulant drugs. AD - H.-Y. Shen, Department of Orthopedics, Hospital of Sun Yat-sen University, Guangzhou 510120 Guangdong Province, China AU - Shen, H. Y. AU - Yang, R. AU - Tang, Y. AU - Cheng, Z. A. AU - Huang, L. AU - Huang, J. R. AU - Lin, D. X. DB - Embase KW - adult aged ankylosing spondylitis article aseptic necrosis bleeding China color Doppler flowmetry controlled study deep vein thrombosis female femoral vein femur fracture femur head necrosis hip osteoarthritis human incidence kinesiotherapy major clinical study male malignant neoplasm metatarsophalangeal joint muscle isometric contraction popliteal vein postoperative period preoperative evaluation quadriceps femoris muscle statistical analysis total hip prosthesis LA - Chinese M1 - 26 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2005 SN - 1671-5926 SP - 4-6 ST - Active regular exercises as early as possible in the prevention of deep venous thrombosis after total hip replacement: An incidence rate of 4.94% in 81 cases (92 hip joints) T2 - Chinese Journal of Clinical Rehabilitation TI - Active regular exercises as early as possible in the prevention of deep venous thrombosis after total hip replacement: An incidence rate of 4.94% in 81 cases (92 hip joints) UR - https://www.embase.com/search/results?subaction=viewrecord&id=L41575083&from=export VL - 9 ID - 829813 ER - TY - JOUR AB - OBJECTIVE: To study the clinical efficacy of modified percutaneous vertebroplasty (PVP) in the treatment of painful old osteoporosis vertebral compression fractures (OVCF). METHODS: From April 2007 to October 2009, 16 cases (23 vertebrae) of symptomic old OVCF were treated with a modified PVP. Before operation, all the patients were examined by standing anteroposterior and lateral X-Ray and MRI. The pain level of each patient was assessed before operation and 1 week, 6, 12 months after the operation using visual analogue scale (VAS) and Oswestry disability index (ODI). The middle line vertebral body height and local sagittal Cobb's angle were also measured. RESULTS: Postoperative average VAS, Oswestry disability index (ODI), the local sagittal Cobb's angle decreased from 7.8, 72.3%, and 38.2° to 3.1, 26.8%, and 21.5° respectively before and after surgery (p<0.05). The mean midline vertebral height increased from 13.8mm to 26.6mm before and after surgery (p<0.05). There was no infection, nerve injury, pulmonary embolism, or death after operation. CONCLUSIONS: The modified PVP can increase the space for bone cement filling and is good for the restoration of vertebral body height. It is an optimal procedure for the treatment of painful old OVCF. AD - Department of Spinal Surgery, The Second Hospital of Shandong University, 247 Beiyuan Road, Jinan Shandong, China. AN - 22236367 AU - Shengzhong, M. AU - Dongjin, W. AU - Shiqing, W. AU - Yang, S. AU - Peng, R. AU - Wanli, M. AU - Chunzheng, G. DA - Apr DO - 10.1016/j.injury.2011.12.021 DP - NLM ET - 2012/01/13 J2 - Injury KW - Aged Aged, 80 and over Bone Cements Fractures, Compression/diagnostic imaging/*surgery Humans Middle Aged Osteoporosis/complications/surgery Pain/*surgery Pain Measurement Radiography Spinal Fractures/*surgery Treatment Outcome Vertebroplasty/*methods LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0020-1383 SP - 486-9 ST - Modification of percutaneous vertebroplasty for painful old osteoporotic vertebral compression fracture in the elderly: preliminary report T2 - Injury TI - Modification of percutaneous vertebroplasty for painful old osteoporotic vertebral compression fracture in the elderly: preliminary report VL - 43 ID - 828731 ER - TY - JOUR AB - Objective: To study the clinical efficacy of modified percutaneous vertebroplasty (PVP) in the treatment of painful old osteoporosis vertebral compression fractures (OVCF). Methods: From April 2007 to October 2009, 16 cases (23 vertebrae) of symptomic old OVCF were treated with a modified PVP. Before operation, all the patients were examined by standing anteroposterior and lateral X-Ray and MRI. The pain level of each patient was assessed before operation and 1 week, 6, 12 months after the operation using visual analogue scale (VAS) and Oswestry disability index (ODI). The middle line vertebral body height and local sagittal Cobb's angle were also measured. Results: Postoperative average VAS, Oswestry disability index (ODI), the local sagittal Cobb's angle decreased from 7.8, 72.3%, and 38.2° to 3.1, 26.8%, and 21.5° respectively before and after surgery (p<0.05). The mean midline vertebral height increased from 13.8mm to 26.6mm before and after surgery (p<0.05). There was no infection, nerve injury, pulmonary embolism, or death after operation. Conclusions: The modified PVP can increase the space for bone cement filling and is good for the restoration of vertebral body height. It is an optimal procedure for the treatment of painful old OVCF. AD - Department of Spinal Surgery, The Second Hospital of Shandong University, 247 Beiyuan Road, Jinan Shandong, China Department of Spinal Surgery, The Second Hospital of Shandong University, 247 Beiyuan Road, Jinan Shandong 250033, China. AN - 104545648. Language: English. Entry Date: 20120629. Revision Date: 20200708. Publication Type: journal article AU - Shengzhong, M. AU - Dongjin, W. AU - Shiqing, W. AU - Yang, S. AU - Peng, R. AU - Wanli, M. AU - Chunzheng, G. AU - Shengzhong, Ma AU - Dongjin, Wu AU - Shiqing, Wu AU - Yang, Song AU - Peng, Ren AU - Wanli, Ma AU - Chunzheng, Gao DB - cin20 DO - 10.1016/j.injury.2011.12.021 DP - EBSCOhost KW - Fractures, Compression -- Surgery Kyphoplasty -- Methods Pain -- Surgery Spinal Fractures -- Surgery Aged Aged, 80 and Over Bone Cements Clinical Assessment Tools Fractures, Compression -- Radiography Human Middle Age Osteoporosis -- Complications Osteoporosis -- Surgery Pain Measurement Treatment Outcomes M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2012 SN - 0020-1383 SP - 486-489 ST - Modification of percutaneous vertebroplasty for painful old osteoporotic vertebral compression fracture in the elderly: preliminary report T2 - Injury TI - Modification of percutaneous vertebroplasty for painful old osteoporotic vertebral compression fracture in the elderly: preliminary report UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104545648&site=ehost-live&scope=site VL - 43 ID - 830681 ER - TY - JOUR AB - Percutaneous vertebroplasty (PVP) is a minimally invasive treatment that has been widely used for the treatment of osteoporotic vertebral compression fractures and vertebral tumors. However, the maximum number of vertebral segments treated in a single PVP remains controversial. Furthermore, PVP may cause complications, including cement leakage, pulmonary embolism, bone cement toxicity, and spinal nerve-puncture injury. We report the rare case of a patient who underwent multilevel PVP for vertebral metastases, with no bone cement leakage or spinal cord injury, but who developed temporary paraparesis. AD - H. Tang, Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China AU - Shi, G. AU - Feng, F. AU - Hao, C. AU - Pu, J. AU - Li, B. AU - Tang, H. DB - Embase Medline DO - 10.1177/0300060519835084 KW - kyphoplasty system lidocaine poly(methyl methacrylate) ropivacaine adult article backache bone biopsy bone scintiscanning cancer chemotherapy case report clinical article computer assisted tomography daily life activity electrocardiography female follow up human human tissue lung cancer middle aged motor dysfunction muscle strength nuclear magnetic resonance imaging pain severity paraplegia percutaneous vertebroplasty physical examination pleura effusion postoperative period sensory dysfunction sleep quality spine metastasis thoracolumbar spine visual analog scale Kyphon LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1473-2300 0300-0605 ST - A case of multilevel percutaneous vertebroplasty for vertebral metastases resulting in temporary paraparesis T2 - Journal of International Medical Research TI - A case of multilevel percutaneous vertebroplasty for vertebral metastases resulting in temporary paraparesis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2006989187&from=export http://dx.doi.org/10.1177/0300060519835084 VL - 48 ID - 829165 ER - TY - JOUR AB - Background: Percutaneous vertebral augmentation (PVA) under local anesthesia has been widely used to treat osteoporotic vertebral compression fractures and vertebral body tumors. However, the occurrence of spinal cord or nerve root dysfunction may result in poor prognosis for patients. The aim of this study was to analyze the causes of transient paraplegia in 12 patients undergoing PVA. Methods: The medical records of 12 patients with transient paraplegia during PVA in our hospital were analyzed. Data, including operation, vertebral, anesthetic dose, operation time, recovery time, and follow-up, were extracted. Results: Among the 12 patients, ranging in age from 62 years to 83 years, with a mean age of 74 years, 8 were females and 4 were males. The average anesthetic dose injected per vertebral body was 6.38 ml. Patients required an average of 218.75 min to recover sensation and movement completely. However, the amount of anesthetic injected into each vertebral body was not related to the time required for complete recovery. Follow-up showed that all patients had regained normal bilateral sensation and motor function. Postoperative visual analog scale and Oswestry Disability Index values of the 12 patients were significantly improved compared with preoperative values. Conclusion: The complication of transient paraplegia was caused by local anesthetic drugs infiltrating into the spinal canal and inhibiting nerve conduction in the spinal cord. AD - [Shi, Guan; Feng, Fei; Hao, Chen; Pu, Jia; Li, Bao; Tang, Hai] Capital Med Univ, Beijing Friendship Hosp, Dept Orthoped, 95 Yong An Rd, Beijing 100050, Peoples R China. Tang, H (corresponding author), Capital Med Univ, Beijing Friendship Hosp, Dept Orthoped, 95 Yong An Rd, Beijing 100050, Peoples R China. tanghai2187@126.com AN - WOS:000477888400001 AU - Shi, G. AU - Feng, F. AU - Hao, C. AU - Pu, J. AU - Li, B. AU - Tang, H. C7 - 2309499019861879 DA - Jul DO - 10.1177/2309499019861879 J2 - J. Orthop. Surg. KW - local anesthesia percutaneous vertebral augmentation transient paraplegia SPINAL-CORD CONCUSSION PULMONARY-EMBOLISM SCIWORA Orthopedics Surgery LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 1022-5536 SP - 6 ST - An analysis of the causes of transient paraplegia during percutaneous vertebral augmentation under local anesthesia: A case series of 12 patients T2 - Journal of Orthopaedic Surgery TI - An analysis of the causes of transient paraplegia during percutaneous vertebral augmentation under local anesthesia: A case series of 12 patients UR - ://WOS:000477888400001 VL - 27 ID - 830133 ER - TY - JOUR AB - Percutaneous vertebroplasty (PVP) is a minimally invasive treatment that has been widely used for the treatment of osteoporotic vertebral compression fractures and vertebral tumors. However, the maximum number of vertebral segments treated in a single PVP remains controversial. Furthermore, PVP may cause complications, including cement leakage, pulmonary embolism, bone cement toxicity, and spinal nerve-puncture injury. We report the rare case of a patient who underwent multilevel PVP for vertebral metastases, with no bone cement leakage or spinal cord injury, but who developed temporary paraparesis. AD - Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China. AN - 30880529 AU - Shi, G. AU - Feng, F. AU - Hao, C. AU - Pu, J. AU - Li, B. AU - Tang, H. C2 - Pmc7581983 DA - Feb DO - 10.1177/0300060519835084 DP - NLM ET - 2019/03/19 J2 - The Journal of international medical research KW - Vertebral metastasis bone cement local anesthetic multilevel percutaneous vertebroplasty temporary paraparesis LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 0300-0605 (Print) 0300-0605 SP - 300060519835084 ST - A case of multilevel percutaneous vertebroplasty for vertebral metastases resulting in temporary paraparesis T2 - J Int Med Res TI - A case of multilevel percutaneous vertebroplasty for vertebral metastases resulting in temporary paraparesis VL - 48 ID - 828571 ER - TY - JOUR AB - RATIONALE: Percutaneous osteoplasty (POP) has been proved effective to relieve pain in metastases of vertebral, pelvis, and femur. Nevertheless, there are few reports about the effectiveness of POP in the humeral head metastases. In this study, we described 2 patients with humeral head metastases treated with POP in our hospital. PATIENT CONCERNS: Case 1 was a 79-year-old man with vertebral and right humeral head metastasis after radical surgery or and periods of chemotherapy for bladder cancer. He suffered constant severe back and right shoulder joint pain even if taking much non-steroidal anti-inflammatory drugs. Case 2 was a 59-year-old woman with vertebral and right humeral head metastasis from lung cancer. She received regular radiotherapy and took much painkillers to relieve pain. However, the pain could not be relieved any more after 1 month and severely affects sleeping and daily activities. DIAGNOSIS: Both 2 patients were diagnosed as vertebral metastases and right proximal humeral head metastases. INTERVENTIONS: POP was performed to treat the right humeral head metastases. Percutaneous vertebroplasty (PVP) was performed to treat vertebral metastases. OUTCOMES: After surgery, the patients experienced significant decrease in pain and better motor function. Both patients did not suffer from pulmonary embolism, infection, nerve injury, and bone cement syndrome. LESSONS: For the pain that cannot be relieved by radiotherapy and analgesic drugs, POP is a safe and beneficial minimally invasive procedure that provides immediate and substantial relief from pain for humerus head metastases. AD - Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing. Department of Orthopedics, The First People's Hospital Of Longquanyi District, Chengdu, China. AN - 31096529 AU - Shi, G. AU - Liu, Q. AU - Chen, H. AU - Feng, F. AU - Jia, P. AU - Bao, L. AU - Tang, H. C2 - Pmc6531151 DA - May DO - 10.1097/md.0000000000015727 DP - NLM ET - 2019/05/18 J2 - Medicine KW - Aged Bone Neoplasms/secondary/*surgery Cancer Pain/surgery Cementoplasty/*methods Female Humans Humeral Head/pathology/*surgery Lung Neoplasms/radiotherapy/surgery Male Middle Aged Minimally Invasive Surgical Procedures/methods Spinal Neoplasms/secondary/*surgery Treatment Outcome Urinary Bladder Neoplasms/drug therapy/surgery Vertebroplasty/*methods LA - eng M1 - 20 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 0025-7974 (Print) 0025-7974 SP - e15727 ST - Percutaneous osteoplasty for the management of a humeral head metastasis: Two case reports T2 - Medicine (Baltimore) TI - Percutaneous osteoplasty for the management of a humeral head metastasis: Two case reports VL - 98 ID - 828619 ER - TY - JOUR AB - Rationale: Percutaneous osteoplasty (POP) has been proved effective to relieve pain in metastases of vertebral, pelvis, and femur. Nevertheless, there are few reports about the effectiveness of POP in the humeral head metastases. In this study, we described 2 patients with humeral head metastases treated with POP in our hospital.Patient Concerns: Case 1 was a 79-year-old man with vertebral and right humeral head metastasis after radical surgery or and periods of chemotherapy for bladder cancer. He suffered constant severe back and right shoulder joint pain even if taking much non-steroidal anti-inflammatory drugs. Case 2 was a 59-year-old woman with vertebral and right humeral head metastasis from lung cancer. She received regular radiotherapy and took much painkillers to relieve pain. However, the pain could not be relieved any more after 1 month and severely affects sleeping and daily activities.Diagnosis: Both 2 patients were diagnosed as vertebral metastases and right proximal humeral head metastases.Interventions: POP was performed to treat the right humeral head metastases. Percutaneous vertebroplasty (PVP) was performed to treat vertebral metastases.Outcomes: After surgery, the patients experienced significant decrease in pain and better motor function. Both patients did not suffer from pulmonary embolism, infection, nerve injury, and bone cement syndrome.Lessons: For the pain that cannot be relieved by radiotherapy and analgesic drugs, POP is a safe and beneficial minimally invasive procedure that provides immediate and substantial relief from pain for humerus head metastases. AD - Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing Department of Orthopedics, The First People's Hospital Of Longquanyi District, Chengdu, China. AN - 138773889. Language: English. Entry Date: 20190930. Revision Date: 20190930. Publication Type: journal article AU - Shi, Guan AU - Liu, Qingshan AU - Chen, Hao AU - Feng, Fei AU - Jia, Pu AU - Bao, Li AU - Tang, Hai AU - Na DB - cin20 DO - 10.1097/MD.0000000000015727 DP - EBSCOhost KW - Cementoplasty -- Methods Vertebroplasty -- Methods Bone Neoplasms -- Surgery Humerus -- Surgery Spinal Neoplasms -- Surgery Middle Age Bladder Neoplasms -- Drug Therapy Humerus -- Pathology Aged Lung Neoplasms -- Surgery Lung Neoplasms -- Radiotherapy Treatment Outcomes Spinal Neoplasms Bladder Neoplasms -- Surgery Male Female Bone Neoplasms Minimally Invasive Procedures -- Methods Clinical Assessment Tools M1 - 20 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2019 SN - 0025-7974 SP - e15727-e15727 ST - Percutaneous osteoplasty for the management of a humeral head metastasis: Two case reports T2 - Medicine TI - Percutaneous osteoplasty for the management of a humeral head metastasis: Two case reports UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=138773889&site=ehost-live&scope=site VL - 98 ID - 830530 ER - TY - JOUR AB - Rationale: Percutaneous osteoplasty (POP) has been proved effective to relieve pain in metastases of vertebral, pelvis, and femur. Nevertheless, there are few reports about the effectiveness of POP in the humeral head metastases. In this study, we described 2 patients with humeral head metastases treated with POP in our hospital. Patient concerns: Case 1 was a 79-year-old man with vertebral and right humeral head metastasis after radical surgery or and periods of chemotherapy for bladder cancer. He suffered constant severe back and right shoulder joint pain even if taking much nonsteroidal anti-inflammatory drugs. Case 2 was a 59-year-old woman with vertebral and right humeral head metastasis from lung cancer. She received regular radiotherapy and took much painkillers to relieve pain. However, the pain could not be relieved any more after 1 month and severely affects sleeping and daily activities. Diagnosis: Both 2 patients were diagnosed as vertebral metastases and right proximal humeral head metastases. Interventions: POP was performed to treat the right humeral head metastases. Percutaneous vertebroplasty (PVP) was performed to treat vertebral metastases. Outcomes: After surgery, the patients experienced significant decrease in pain and better motor function. Both patients did not suffer from pulmonary embolism, infection, nerve injury, and bone cement syndrome. Lessons: For the pain that cannot be relieved by radiotherapy and analgesic drugs, POP is a safe and beneficial minimally invasive procedure that provides immediate and substantial relief from pain for humerus head metastases. AD - [Shi, Guan; Chen, Hao; Feng, Fei; Jia, Pu; Bao, Li; Tang, Hai] Capital Med Univ, Beijing Friendship Hosp, Dept Orthoped, 95 Yong An Rd, Beijing 100050, Peoples R China. [Liu, Qingshan] First Peoples Hosp Longquanyi Dist, Dept Orthoped, Chengdu, Sichuan, Peoples R China. Tang, H (corresponding author), Capital Med Univ, Beijing Friendship Hosp, Dept Orthoped, 95 Yong An Rd, Beijing 100050, Peoples R China. tanghai2187@126.com AN - WOS:000473676000100 AU - Shi, G. AU - Liu, Q. S. AU - Chen, H. AU - Feng, F. AU - Jia, P. AU - Bao, L. AU - Tang, H. C7 - e15727 DA - May DO - 10.1097/md.0000000000015727 J2 - Medicine KW - case report humeral head metastasis percutaneous osteoplasty PAIN Medicine, General & Internal LA - English M1 - 20 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 0025-7974 SP - 5 ST - Percutaneous osteoplasty for the management of a humeral head metastasis Two case reports T2 - Medicine TI - Percutaneous osteoplasty for the management of a humeral head metastasis Two case reports UR - ://WOS:000473676000100 VL - 98 ID - 830141 ER - TY - JOUR AB - Demographic trends make it incumbent on spine surgeons to recognize the special challenges involved in caring for older patients. The aim of this study was to identify variables that may predict early mortality in geriatric patients over the age of 90 following elective hospitalization for various spinal pathologies. Retrospective analyses of all patients over the age of 90 years, which were electively treated between 2006 and 2016 at out department for various spinal conditions, were performed. Patient characteristics, type of treatment, and comorbidities were analyzed with regard to the 30-day mortality rate. Twenty-six patients were identified. Mean age was 93 years (range 91–97), 19 (73%) were female. Eighteen (69%) patients were treated operatively. Mean hospital stay was 13 days (range 2–51). Seventeen (65%) patients were on anticoagulation therapy. Mean Charlson Comorbidity Index (CCI) was 5.3 (range 1–11); mean diagnosis count (DC) was 8.3 (range 2–17); mean Geriatric Index of Comorbidity (GIC) was 2.8 (range 1–4); and mean comorbidity-polypharmacy score (GPS) was 13.3 (range 5–23). The 30-day mortality rate was 16.7% in the surgically treated group compared with 12.5% in the conservatively treated group (p = 0.9), anticoagulation therapy (p = 0.91), gender (p = 0.49), length of hospital stay (p = 0.33), GIC (p = 0.54), CCI (p = 0.74), GPS (p = 0.82), and DC (p = 0.65) did not correlate with the 30-day mortality rate. Cause of death was pulmonary embolism in two cases and unknown in one case. Thirty-day mortality rate in patients over 90 years old with degenerative spinal diseases is relatively high regardless of the treatment modality. Standard geriatric prognostic scores seem less reliable for these patients. AD - N. Lange, Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Ismaninger Str. 22, Munich, Germany AU - Shiban, E. AU - Lange, N. AU - Rothlauf, P. AU - Jörger, A. K. AU - Wagner, A. AU - Ryang, Y. M. AU - Lehmberg, J. AU - Meyer, B. DB - Embase Medline DO - 10.1007/s10143-019-01122-3 KW - aged anterior cervical discectomy anticoagulant therapy article Barthel index Charlson Comorbidity Index chi square test clinical article comorbidity comorbidity polypharmacy score controlled study decompression degenerative disease discectomy female geriatric assessment Geriatric Index of Comorbidity score geriatric prognostic score glomerulus filtration rate hospitalization human kyphoplasty length of stay lumbar spinal stenosis lung embolism male osteochondrosis outcome assessment priority journal retrospective study risk factor scoring system spinal cord disease spine disease spine fusion spondylolisthesis vertebral canal stenosis very elderly LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1437-2320 0344-5607 SP - 807-812 ST - Inaccuracy of standard geriatric scores in nonagenarians following hospitalization for various spinal pathologies T2 - Neurosurgical Review TI - Inaccuracy of standard geriatric scores in nonagenarians following hospitalization for various spinal pathologies UR - https://www.embase.com/search/results?subaction=viewrecord&id=L627966864&from=export http://dx.doi.org/10.1007/s10143-019-01122-3 VL - 43 ID - 829073 ER - TY - JOUR AB - BACKGROUND: Percutaneous injection of bone cement into the vertebral body can enhance the vertebral strength and vertebral stability, and obtain pain relief. But the bone cement may leakage into the paravertebral vessels during injection, and may back to the right ventricle and flow into the pulmonary artery through vena cave and thus causing pulmonary embolism. OBJECTIVE: To evaluate the relationship between cement paravertebral vascular leakage and pulmonary cement embolism during percutaneous vertebroplasty. METHODS: Totally 134 cases of osteoporotic compression fractures treated with vertebroplasty were retrospectively analyzed. Among them, 23 cases of cement paravertebral vascular leakage were considered as the experimental group, and the 43 cases without cement paravertebral vascular leakage and had the complete imaging data were considered as the control group. The spine and chest X-ray films were taken before and after vertebroplasty to detect whether there were cement paravertebral vascular leakage and pulmonary cement embolism in the patients of two groups. RESULTS AND CONCLUSION: Among the 134 patients, 23 patients had cement paravertebral vascular leakage, and accounted for 17.2%. Among the 23 patients with cement paravertebral vascular leakage, three cases had pulmonary cement embolism without chest symptoms, and accounted for 13%. No pulmonary cement embolism occurred in the 43 patients without paravertebral vascular leakage of the control group, and there was no significant difference between two groups (P=0.039). Although the patients with cement pulmonary embolism remained asymptomatic, pulmonary cement embolism remained possible if cement paravertebral vascular leakage was detected during vertebroplasty. AD - Y. Xiao-Dong, Department of Orthopedics, Peking University First Hospital, Beijing, China AU - Shi-Jun, W. AU - Xiao-Dong, Y. AU - Chun-De, L. AU - Xian-Yi, L. AU - Hai-Lin, L. AU - Hong, L. AU - Hong, L. AU - Zheng-Rong, Y. AU - Hao-Lin, S. DB - Embase DO - 10.3969/j.issn.2095-4344.2013.47.021 KW - bone cement article clinical evaluation compression fracture controlled study disease association fragility fracture human lung embolism major clinical study paravertebral vascular leakage percutaneous vertebroplasty pulmonary cement embolism spine disease thorax radiography vascular disease LA - Chinese M1 - 47 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1673-8225 SP - 8275-8281 ST - Relationship between paravertebral vascular leakage and pulmonary cement embolism during percutaneous vertebroplasty T2 - Chinese Journal of Tissue Engineering Research TI - Relationship between paravertebral vascular leakage and pulmonary cement embolism during percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L611771064&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.2013.47.021 VL - 17 ID - 829521 ER - TY - JOUR AB - Only 6 cases of pyogenic spondylitis following vertebroplasty or kyphoplasty have been reported, and their causes remained unclear. The authors report on 4 cases of delayed pyogenic spondylitis (DPS) following vertebroplasty or kyphoplasty for osteoporotic compression fractures and metastatic disease. Four patients presented with DPS after vertebroplasty or kyphoplasty and underwent surgical treatment. Clinical history, laboratory examination, and MR imaging confirmed the diagnosis of DPS. Anterior debridement, reconstruction, and posterior instrumented fusion were performed. The mean interval for the delayed occurrence of pyogenic spondylitis after surgery was 12.3 months. The infections were primarily bacterial in origin, but most patients also suffered diverse medical comorbidities. Despite successful treatment of the infections, comorbidity was and is a factor that compromises good results. Medical comorbidities associated with compromised immunity may increase susceptibility to DPS after vertebroplasty or kyphoplasty. In cases of incapacitating back pain after a pain-free period following either of these surgeries, evaluation of the erythrocyte sedimentation rate and C-reactive protein level and examination of contrast-enhanced MR imaging studies are essential to rule out delayed vertebral infection. Surgical treatment requires cement removal and anterior reconstruction with or without additional posterior instrumented fusion. AD - [Ha, Kee-Yong; Kim, Ki-Won; Joo, Min-Wook] Catholic Univ, Dept Orthopaed Surg, Kang Nam St Marys Hosp, Coll Med, Seoul 137040, South Korea. [Shin, Jae-Hyuk] Hallym Univ, Hangang Sacred Heart Hosp, Int Spine Ctr, Coll Med, Chunchon, South Korea. [Lee, Jun-Seok] Dongshin Gen Hosp, Dept Orthopaed Surg, Seoul, South Korea. Ha, KY (corresponding author), Catholic Univ, Dept Orthopaed Surg, Kang Nam St Marys Hosp, Coll Med, 505 Ban Po Dong, Seoul 137040, South Korea. kyh@catholic.ac.kr AN - WOS:000258903900007 AU - Shin, J. H. AU - Ha, K. Y. AU - Kim, K. W. AU - Lee, J. S. AU - Joo, M. W. DA - Sep DO - 10.3171/spi/2008/9/9/265 J2 - J. Neurosurg.-Spine KW - delayed spondylitis kyphoplasty vertebroplasty OSTEOPOROTIC COMPRESSION FRACTURES TITANIUM MESH CAGES ACRYLIC CEMENT PULMONARY-EMBOLISM VERTEBRAL OSTEOMYELITIS SPINAL INSTRUMENTATION IDIOPATHIC SCOLIOSIS SEPTIC SPONDYLITIS WOUND INFECTIONS SURGERY Clinical Neurology Surgery LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2008 SN - 1547-5654 SP - 265-272 ST - Surgical treatment for delayed pyogenic spondylitis after percutaneous vertebroplasty and kyphoplasty T2 - Journal of Neurosurgery-Spine TI - Surgical treatment for delayed pyogenic spondylitis after percutaneous vertebroplasty and kyphoplasty UR - ://WOS:000258903900007 VL - 9 ID - 830374 ER - TY - JOUR AB - Fat embolus has been known to occur during major orthopedic surgery. In many cases, fat embolus syndrome is a postoperative complication of long bone orthopedic surgery, particularly femoral fractures occurring after trauma. Changes in intraoperative cardiopulmonary function have been reported in a subset of these patients, and they are associated with the degree of embolization occurring with manipulation or cementing of prostheses in the fractured femur. Intraoperative cardiovascular collapse has been reported, and this cardiac event is temporally associated with intramedullary manipulations such as reaming or cementing. We present a rare case of fatal intraoperative fat embolization diagnosed with trans-esophageal echocardiography. AD - Division of Anesthesia Services, Mayo Clinic, Jacksonville, Florida 32224, USA. AN - 21046001 AU - Shine, T. S. AU - Feinglass, N. G. AU - Leone, B. J. AU - Murray, P. M. C2 - Pmc2958300 DP - NLM ET - 2010/11/04 J2 - The Iowa orthopaedic journal KW - Aged, 80 and over *Arthroplasty, Replacement, Hip Echocardiography, Transesophageal Embolism, Fat/*diagnostic imaging Fatal Outcome Female Hip Fractures/*surgery Humans Intraoperative Period LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 1541-5457 (Print) 1541-5457 SP - 211-4 ST - Transesophageal echocardiography for detection of propagating, massive emboli during prosthetic hip fracture surgery T2 - Iowa Orthop J TI - Transesophageal echocardiography for detection of propagating, massive emboli during prosthetic hip fracture surgery VL - 30 ID - 828950 ER - TY - JOUR AB - We report three cases of percutaneous osteoplasty for the treatment of hypervascular bone metastasis. Four hypervascular bone metastases were treated in three consecutive patients by percutaneous osteoplasty under fluoroscopic or computed tomographic guidance. Primary malignant tumors included pheochromocytoma and renal cell carcinoma. Pain relief after osteoplasty was achieved in all three patients. There was no major complication. Projectile bleeding and subcutaneous hematoma were noted during or after osteoplasty but were easily controlled conservatively. Percutaneous osteoplasty for hypervascular bone metastases is not only a highly effective but also a minimally invasive technique that provides immediate pain relief without major complication. AD - [Shinoto, Makoto; Hasuo, Kanehiro; Aibe, Hitoshi; Shida, Yoshitaka; Kinjo, Maya; Kubo, Yuko; Terashima, Kotaro] Int Med Ctr Japan, Dept Radiol, Shinjuku Ku, Tokyo 1628655, Japan. Shinoto, M (corresponding author), Int Med Ctr Japan, Dept Radiol, Shinjuku Ku, 1-21-1 Toyama, Tokyo 1628655, Japan. shinotou.m@nk-cc.go.jp AN - WOS:000262408100005 AU - Shinoto, M. AU - Hasuo, K. AU - Aibe, H. AU - Shida, Y. AU - Kinjo, M. AU - Kubo, Y. AU - Terashima, K. DA - Dec DO - 10.1007/s11604-008-0277-0 J2 - Radiat. Med. KW - Hypervascular bone metastasis Percutaneous osteoplasty Vertebroplasty SPINAL METASTASES OSTEOLYTIC METASTASES VERTEBROPLASTY EMBOLIZATION CARCINOMA INJECTION Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 10 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2008 SN - 1862-5274 SP - 603-608 ST - Percutaneous osteoplasty for hypervascular bone metastasis T2 - Radiation Medicine TI - Percutaneous osteoplasty for hypervascular bone metastasis UR - ://WOS:000262408100005 VL - 26 ID - 830366 ER - TY - JOUR AB - Approximately 100,000 total hip reconstructions are done annually in the United States. The nature of the surgical technique in a field close to the iliac and femoral vessels makes the occurrence of vascular injury an occasional but serious complications. We have reviewed retrospectively our experience of five cases of vascular injuries with total hip replacement and an additional 63 cases in the literature to identify those patients at risk and to define the management of these injuries. For the entire group of 68 patients, most injuries were sustained on the left side (66%), and 39% were seen in revisions. Complications were related to cement incorporation of the iliac vessels (44%), aggressive medial retraction (17%), excessive traction on atherosclerotic vessels (10%), and improper technique in preparation of the acetabulum. The most commonly injured vessels were the external iliac artery (36), common femoral artery (17), and external iliac vein (6). Twenty-seven of these injuries required emergent surgery, most for hemorrhage (66%). Injuries consisted of thromboembolic complications leading to distal ischemia (46%), vessel lacerations (26%), pseudoaneurysms (25%), and arteriovenous fistulas (3%). Vascular repair was individualized and included suture repair, thrombectomy and patch angioplasty, embolectomy, and arterial and venous bypass procedures. There was an overall 7% mortality and a 15% incidence of limb loss. Risk factors include (1) revision procedures, (2) left-sided procedures, and (3) intrapelvic migration of the acetabular component of the hip prosthesis. Elective vascular workup and preliminary retroperitoneal exposure of the iliac vessels at time of hip arthroplasty is recommended for patients at risk. AD - Division of Vascular Surgery, Beth Israel Medical Center, Mount Sinai School of Medicine, City University of New York, NY 10003. AN - 2182915 AU - Shoenfeld, N. A. AU - Stuchin, S. A. AU - Pearl, R. AU - Haveson, S. DA - Apr DP - NLM ET - 1990/04/01 J2 - Journal of vascular surgery KW - Aged Aged, 80 and over Arteries/injuries/surgery Female Femoral Artery/injuries Femoral Vein/injuries Hip Prosthesis/*adverse effects Humans Iliac Artery/injuries Iliac Vein/injuries Leg/*blood supply Male Reoperation Retrospective Studies Veins/injuries/surgery LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 1990 SN - 0741-5214 (Print) 0741-5214 SP - 549-55 ST - The management of vascular injuries associated with total hip arthroplasty T2 - J Vasc Surg TI - The management of vascular injuries associated with total hip arthroplasty VL - 11 ID - 829019 ER - TY - JOUR AB - Percutaneous vertebroplasty procedure is of major importance, given the significantly increasing aging population and the higher number of orthopedic procedures related to vertebral compression fractures. Vertebroplasty is a complex technique involving the injection of polymethylmethacrylate (PMMA) into the compressed vertebral body for mechanical stabilization of the fracture. Our understanding and ability to modify these mechanisms through alterations in cement material is rapidly evolving. However, the rate of cardiac complications secondary to PMMA injection and subsequent cement leakage has increased with time. The following review considers the main effects of PMMA bone cement on the heart, and the extent of influence of the materials on cardiac embolism. Clinically, cement leakage results in life-threatening cardiac injury. The convolution of this outcome through an appropriate balance of complex material properties is highlighted via clinical case reports. AD - Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA. pus8@pitt.edu. Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA 15213, USA. yanfeichen@pitt.edu. Division of Cardiology, Allegheny General Hospital, Pittsburgh, PA 15212, USA. rkhalil@ahn.org. Bone and Joint Center at Magee-Women's Hospital of UPMC, Pittsburgh, PA 15213, USA. plakap@upmc.edu. Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA 15213, USA. skcho@pitt.edu. Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, 15213 USA. tillmanbw@pitt.edu. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA. skcho@pitt.edu. McGowan Institute for Regenerative Medicine, Pittsburgh, PA 15219, USA. skcho@pitt.edu. Department of Chemical and Petroleum Engineering, University of Pittsburgh, Pittsburgh, PA 15213, USA. skcho@pitt.edu. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA. yjchun@pitt.edu. Department of Industrial Engineering, University of Pittsburgh, Pittsburgh, PA 15213, USA. yjchun@pitt.edu. McGowan Institute for Regenerative Medicine, Pittsburgh, PA 15219, USA. yjchun@pitt.edu. AN - 28773942 AU - Shridhar, P. AU - Chen, Y. AU - Khalil, R. AU - Plakseychuk, A. AU - Cho, S. K. AU - Tillman, B. AU - Kumta, P. N. AU - Chun, Y. C2 - Pmc5456584 DA - Oct 6 DO - 10.3390/ma9100821 DP - NLM ET - 2017/08/05 J2 - Materials (Basel, Switzerland) KW - Pmma  bone cement  cardiac embolism  cement leakage  viscosity LA - eng M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1996-1944 (Print) 1996-1944 ST - A Review of PMMA Bone Cement and Intra-Cardiac Embolism T2 - Materials (Basel) TI - A Review of PMMA Bone Cement and Intra-Cardiac Embolism VL - 9 ID - 828559 ER - TY - JOUR AB - Percutaneous vertebroplasty procedure is of major importance, given the significantly increasing aging population and the higher number of orthopedic procedures related to vertebral compression fractures. Vertebroplasty is a complex technique involving the injection of polymethylmethacrylate (PMMA) into the compressed vertebral body for mechanical stabilization of the fracture. Our understanding and ability to modify these mechanisms through alterations in cement material is rapidly evolving. However, the rate of cardiac complications secondary to PMMA injection and subsequent cement leakage has increased with time. The following review considers the main effects of PMMA bone cement on the heart, and the extent of influence of the materials on cardiac embolism. Clinically, cement leakage results in life-threatening cardiac injury. The convolution of this outcome through an appropriate balance of complex material properties is highlighted via clinical case reports. AD - [Shridhar, Puneeth; Kumta, Prashant N.; Chun, YoungJae] Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA 15213 USA. [Chen, Yanfei; Chun, YoungJae] Univ Pittsburgh, Dept Ind Engn, Pittsburgh, PA 15213 USA. [Khalil, Ramzi] Allegheny Gen Hosp, Div Cardiol, Pittsburgh, PA 15212 USA. [Plakseychuk, Anton] UPMC, Magee Womens Hosp, Ctr Bone & Joint, Pittsburgh, PA 15213 USA. [Cho, Sung Kwon; Kumta, Prashant N.] Univ Pittsburgh, Dept Mech Engn & Mat Sci, Pittsburgh, PA 15213 USA. [Tillman, Bryan] Univ Pittsburgh, Med Ctr, Div Vasc Surg, Pittsburgh, PA 15213 USA. [Kumta, Prashant N.; Chun, YoungJae] McGowan Inst Regenerat Med, Pittsburgh, PA 15219 USA. [Kumta, Prashant N.] Univ Pittsburgh, Dept Chem & Petr Engn, Pittsburgh, PA 15213 USA. Chun, Y (corresponding author), Univ Pittsburgh, Dept Bioengn, Pittsburgh, PA 15213 USA.; Chun, Y (corresponding author), Univ Pittsburgh, Dept Ind Engn, Pittsburgh, PA 15213 USA.; Chun, Y (corresponding author), McGowan Inst Regenerat Med, Pittsburgh, PA 15219 USA. pus8@pitt.edu; yanfeichen@pitt.edu; rkhalil@ahn.org; plakap@upmc.edu; skcho@pitt.edu; tillmanbw@pitt.edu; pkumta@pitt.edu; yjchun@pitt.edu AN - WOS:000384670800028 AU - Shridhar, P. AU - Chen, Y. F. AU - Khalil, R. AU - Plakseychuk, A. AU - Cho, S. K. AU - Tillman, B. AU - Kumta, P. N. AU - Chun, Y. C7 - 821 DA - Oct DO - 10.3390/ma9100821 J2 - Materials KW - PMMA bone cement cardiac embolism cement leakage viscosity CALCIUM-PHOSPHATE CEMENT HIGH-VISCOSITY CEMENT PERCUTANEOUS VERTEBROPLASTY PULMONARY-EMBOLISM CARDIAC PERFORATION RHEOLOGICAL PROPERTIES CARDIOVASCULAR CHANGES COMPRESSION FRACTURES EXPERIMENTAL-MODEL LATE COMPLICATION Materials Science, Multidisciplinary LA - English M1 - 10 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2016 SP - 14 ST - A Review of PMMA Bone Cement and Intra-Cardiac Embolism T2 - Materials TI - A Review of PMMA Bone Cement and Intra-Cardiac Embolism UR - ://WOS:000384670800028 VL - 9 ID - 830209 ER - TY - JOUR AD - Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: GShroff@mdanderson.org. Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX. AN - 26002243 AU - Shroff, G. S. AU - Okwandu, E. AU - Viswanathan, C. AU - Truong, M. T. DA - Jul DO - 10.1053/j.ro.2015.01.005 DP - NLM ET - 2015/05/24 J2 - Seminars in roentgenology KW - Aged Anticoagulants/therapeutic use Bone Cements/*adverse effects Diagnosis, Differential Dyspnea/drug therapy/*etiology Enoxaparin/therapeutic use Humans Male Pulmonary Artery/diagnostic imaging Pulmonary Embolism/*diagnostic imaging/drug therapy/*etiology Tomography, X-Ray Computed Warfarin/therapeutic use LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 0037-198x SP - 226-8 ST - Pulmonary cement embolism presenting with dyspnea T2 - Semin Roentgenol TI - Pulmonary cement embolism presenting with dyspnea VL - 50 ID - 828883 ER - TY - JOUR AB - Pulmonary cement embolism (PCE) is a complication of percutaneous vertebral augmentation techniques. PCE in lung transplant patient population has not been reported. We report a case 57-year-old male patient with double lung transplant secondary to idiopathic pulmonary fibrosis presented with shortness of breath after vertebroplasty. CTA chest showed thin dense opacities within the bilateral pulmonary arteries consistent with pulmonary cement embolism. The patient was treated with therapeutic enoxaparin and remained stable at one year follow up. AD - Division of Pulmonary and Critical Care, Houston Methodist Hospital, Houston, TX 6565 Fannin St, Houston, TX 77030, USA. Division of Pulmonary Transplant, Houston Methodist Hospital, Houston, TX, USA. AN - 29977762 AU - Siddiqui, A. S. AU - Goodarzi, A. AU - Majumdar, T. AU - Kaleekal, T. C2 - Pmc6010605 DO - 10.1016/j.rmcr.2018.04.011 DP - NLM ET - 2018/07/07 J2 - Respiratory medicine case reports LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 2213-0071 (Print) 2213-0071 SP - 63-64 ST - A rare case of pulmonary cement embolism in a lung transplant patient T2 - Respir Med Case Rep TI - A rare case of pulmonary cement embolism in a lung transplant patient VL - 24 ID - 828644 ER - TY - JOUR AB - In recent years, the use of vertebral cementing techniques for vertebroplasty and kyphoplasty has spread for the treatment of pain associated with osteoporotic vertebral compression fractures. This is also associated with the increased incidence of complications related with these procedures, the most frequent being originated by leakage of cementation material. Cement can escape into the vertebral venous system and reach the pulmonary circulation through the azygous system and cava vein, producing a cement embolism. This is a frequent complication, occurring in up to 26% of patients undergoing vertebroplasty but, since most patients have no clinical or hemodynamical repercussion, this event usually goes unnoticed. However, some serious, and even fatal cases, have been reported. We report the case of a 74-year-old male patient who underwent vertebroplasty for persistent pain associated with osteoporotic L3 vertebral fracture and who developed a cement leak into the cava vein and right pulmonary artery during the procedure. Although he developed a pulmonary cement embolism, the patient remained asymptomatic and did not present complications during follow-up. AD - Servicio de Reumatología, Hospital Universitario Ramón y Cajal, Madrid, España. albertosifuentesg@gmail.com AN - 23481509 AU - Sifuentes Giraldo, W. A. AU - Lamúa Riazuelo, J. R. AU - Gallego Rivera, J. I. AU - Vázquez Díaz, M. DA - Jul-Aug DO - 10.1016/j.reuma.2012.07.005 DP - NLM ET - 2013/03/14 J2 - Reumatologia clinica KW - Aged Bone Cements/*adverse effects Humans Male Postoperative Complications/*etiology Pulmonary Embolism/*etiology *Vertebroplasty Cement pulmonary embolism Embolismo pulmonar por cemento Fractura vertebral Osteoporosis Vertebral compression fracture Vertebroplastia Vertebroplasty LA - eng spa M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1699-258x SP - 239-42 ST - Cement pulmonary embolism after vertebroplasty T2 - Reumatol Clin TI - Cement pulmonary embolism after vertebroplasty VL - 9 ID - 828708 ER - TY - JOUR AB - Vertebroplasty is commonly contraindicated for severe vertebral fractures, or vertebra plana. However, we decided after multidisciplinary staff decision to perform vertebroplasty for few severe vertebral fractures which were still painful after optimal medical treatment. We retrospectively studied the charts of patients who benefited from vertebroplasty for severe vertebral body compression fracture between May 2006 and January 2012 in a rheumatology department. Clinical and biological data were collected and patients were consulted to assess effectiveness of that technique. We performed vertebroplasty of 12 severe vertebral fractures in 10 patients (nine women and one man). Mean age was 74.9±10.7 years. Mean VAS score was 9/10±1.15 before vertebroplasty and 2.4±2 after. Global improvement was 80% and patient satisfaction was 7/10. After vertebroplasty, use of drugs was significantly reduced or even stopped. The complications observed were: three infraclinical cement leakages, one haematoma at the site of the puncture, one atrial fibrillation and one classic pulmonary embolism. Mean follow-up was 28.6±22.3 months. Vertebroplasty is indeed a delicate procedure for severe vertebral fracture but quickly and sustainably effective. AD - Service de Rhumatologie, Hôpital Henri-Mondor, AP-HP, 51, avenue Maréchal-de-Lattre-de-Tassigny, 94010 Créteil, France. johanna.sigaux@gmail.com AN - 23639594 AU - Sigaux, J. AU - Guignard, S. AU - Tuilier, T. AU - Eymard, C. AU - Gaston, A. AU - Chevalier, X. DA - May DO - 10.1016/j.jbspin.2012.12.004 DP - NLM ET - 2013/05/04 J2 - Joint bone spine KW - Aged Aged, 80 and over Feasibility Studies Female Fractures, Compression/diagnostic imaging/etiology/*surgery Humans Male Middle Aged Osteoporosis/complications/diagnostic imaging/*surgery Radiography Retrospective Studies Severity of Illness Index Spinal Fractures/diagnostic imaging/etiology/*surgery Treatment Outcome Vertebroplasty/*methods LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1297-319x SP - 328-31 ST - Efficacity and feasibility of vertebroplasty for severe vertebral fracture: a retrospective study of 12 vertebroplasties T2 - Joint Bone Spine TI - Efficacity and feasibility of vertebroplasty for severe vertebral fracture: a retrospective study of 12 vertebroplasties VL - 80 ID - 828721 ER - TY - JOUR AN - 3683629 AU - Simon, M. A. AU - Crul, J. F. DA - Nov 7 DP - NLM ET - 1987/11/07 J2 - Nederlands tijdschrift voor geneeskunde KW - Adult Blood Pressure Bone Nails/*adverse effects Female Femur/*surgery Heart Rate Humans Methylmethacrylate Methylmethacrylates/*adverse effects Pulmonary Embolism/*etiology Respiratory Distress Syndrome/etiology LA - dut M1 - 45 N1 - PubMed NLM literature search January 5, 2021 OP - Hemodynamische complicaties bij het gebruik van botcement. PY - 1987 SN - 0028-2162 (Print) 0028-2162 SP - 2034-7 ST - [Hemodynamic complications following the use of bone cement] T2 - Ned Tijdschr Geneeskd TI - [Hemodynamic complications following the use of bone cement] VL - 131 ID - 828538 ER - TY - JOUR AD - St. Radboudziekenhuis, Instituut voor Anesthesiologie, 6500 HB Nijmegen AU - Simon, M. A. M. AU - Crul, J. F. DB - Embase Medline KW - bone cement methacrylic acid methyl ester case report Ewing sarcoma human lung embolism resuscitation LA - Dutch M1 - 45 N1 - Embase Elsevier literature search January 5, 2021 PY - 1987 SN - 0028-2162 SP - 2034-2037 ST - Hemodynamic complications after use of bone cement T2 - Nederlands Tijdschrift voor Geneeskunde TI - Hemodynamic complications after use of bone cement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L18044202&from=export VL - 131 ID - 829955 ER - TY - JOUR AB - OBJECTIVE: To evaluate the effect of important trials on the practice of neurosurgery. METHODS: We hypothesized that evidence from trials addressing the management of intracranial aneurysms (International Subarachnoid Aneurysm Trial [ISAT]) and nontraumatic intracerebral hemorrhages (Surgical Trial in Intracerebral Hemorrhage [STICH]) and vertebral augmentation for osteoporotic vertebral body fractures had a significant impact on the frequency of the corresponding neurosurgical procedures. A Medicare administrative database was queried for corresponding Common Procedural Terminology codes and units billed per calendar year. The effects of ISAT and STICH were evaluated using a generalized linear model. The effect of the vertebral augmentation study was evaluated using a t test. RESULTS: After publication of ISAT in 2002, the rate of increase in proportion of cerebral aneurysms that were treated with embolization (Common Procedural Terminology code 61624) per year increased from 3.9% to 5.5% (P = 0.01). After publication of STICH in 2005, the number of craniotomies performed for intracerebral hematoma decreased from 2341 in 2002 to 1646 in 2011 (P = 0.03). After 2 publications in 2009, performance of vertebral augmentation decreased from a high of 99,961 in 2009 per year to 77,108 in 2013 (P = 0.002). CONCLUSIONS: Randomized clinical trials remain the gold standard in the medical community to demonstrate efficacy, but their true impact relies on rapid and extensive assimilation into everyday medical practice. However, the described methodology establishes a temporal relationship only and does not prove causation. Nonetheless, trends in procedural volume suggest that the results of these select randomized clinical trials had a significant effect on neurosurgical practice affecting Medicare patients within an interval of a few years. AD - Department of Neurosurgery, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA. Electronic address: ssimon@hmc.psu.edu. Center for Quantitative Sciences, Vanderbilt University, Nashville, Tennessee, USA. Department of Neurological Surgery, Columbia University, New York, New York, USA. Department of Neurosurgery, Geisinger Health System, Danville, Pennsylvania, USA. Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee, USA. AN - 25655690 AU - Simon, S. D. AU - Koyama, T. AU - Zacharia, B. E. AU - Schirmer, C. M. AU - Cheng, J. S. DA - Apr DO - 10.1016/j.wneu.2015.01.011 DP - NLM ET - 2015/02/07 J2 - World neurosurgery KW - Aged Aged, 80 and over Craniotomy/statistics & numerical data Databases, Factual Embolization, Therapeutic/statistics & numerical data Female Humans Intracranial Aneurysm/epidemiology/surgery Intracranial Hemorrhages/epidemiology/surgery Male Medicare Neurosurgery/*statistics & numerical data Osteoporosis/complications/epidemiology Practice Patterns, Physicians'/*statistics & numerical data Randomized Controlled Trials as Topic/*statistics & numerical data Retrospective Studies Spinal Fractures/epidemiology/etiology/surgery United States/epidemiology Aneurysm Cerebellar hematoma Neurosurgery Randomized trial Vertebral augmentation LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 1878-8750 SP - 431-7 ST - Impact of clinical trials on neurosurgical practice: an assessment of case volume T2 - World Neurosurg TI - Impact of clinical trials on neurosurgical practice: an assessment of case volume VL - 83 ID - 828744 ER - TY - JOUR AB - This study aimed to define the indications, technique and results of presurgical embolization of intracranial extra-axial tumours using Glubran 2® a new acrylic glue with the CE mark, suitable for permanent embolization of the pathological circulation of tumours. Embolization was performed prior to surgery in seven patients with benign tumours and three patients with malignant lesions. All the procedures were technically feasible and achieved partial or complete embolization of the vascularized lesion without periprocedural complications. Glubran 2® proved easy to use with excellent intravascular penetration achieving permanent embolization. The degree of presurgical embolization in terms of surgical field haemostasis was satisfactory in all cases and correlated to the degree of vascular occlusion achieved. AD - L. Simonetti, Servizio di Neuroradiologia, Ospedale Bellaria, Via Altura 3, 40139 Bologna, Italy AU - Simonetti, L. AU - Raffi, L. AU - Cenni, P. AU - Andreoli, A. AU - Calbucci, F. AU - Leonardi, M. DB - Embase DO - 10.1177/197140090401700502 KW - acrylic cement cyanoacrylate adult aged angiography article artificial embolization blood vessel occlusion brain metastasis chordoma clinical article computer assisted tomography female hemostasis human intracranial tumor male meningioma paraganglioma preoperative treatment sarcoma tumor blood flow glubran 2 LA - English M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2004 SN - 1120-9976 SP - 645-658 ST - Presurgical embolization of intracranial extra-axial tumours using Glubran 2®: Our experience in 14 patients T2 - Rivista di Neuroradiologia TI - Presurgical embolization of intracranial extra-axial tumours using Glubran 2®: Our experience in 14 patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L40221476&from=export http://dx.doi.org/10.1177/197140090401700502 VL - 17 ID - 829830 ER - TY - JOUR AB - Background: Percutaneous procedures using Polymethylmethacrylate (PMMA) cement are successfully used to treat vertebral compression fractures. Although it is a minimally invasive procedure, complications can occur. Cement embolism is a serious adverse event, and migration of PMMA most often occurs in the pulmonary arterial system, resulting in cement pulmonary embolism. However, intracardiac cement embolism migration is a rare and life-threatening complication that has been described in few case reports1. To the best of our knowledge, differences in migration patterns between pulmonary and intracardiac cement embolism have not been described. Methods: We report two cases of cement embolism after percutaneous cementoplasty using Spine Jack® device and PMMA cement. The first case was a 49-year-old female known for a T cell Lymphoma operated for T10 and L5 vertebral compression fractures. The second case was a 66-year-old female operated for an L1 osteoporotic fracture. Clinical and radiological presentation of both cases are compared, and intracardiac cement embolism case reports are reviewed. Results: In both cases, cement leakage was identified in a paravertebral vein during the procedure, and injection was immediately aborted. However, post-operative clinical course differed. In the first case, the patient was immediately transferred to the radiology unit after the procedure. A transesophageal echocardiography (TEE), followed by angiography, revealed an inferior lobar artery cement embolism. In the second case, presentation consisted of insidious chest pain and discomfort, several hours after the end of the procedure. Echocardiography revealed an intracardiac cement embolism, anchored to the tricuspid valve. In the literature as well, most of the case reports concerning intracardiac cement embolism describe a delayed clinical presentation. Of note, the risk of an asymptomatic cement embolism ranges from 3.5 to 23%. Symptomatic cement embolism is much more rare. In our institution, there were only two cases over around 1700 procedures. Conclusion: We present two different cases of cement embolism following percutaneous cementoplasty procedures. We believe that clinical presentation differs between intracardiac and pulmonary cement migration. Intracardiac cement embolism is rare, and presentation is often delayed. It is important to keep a high level of suspicion, especially when paravertebral venous cement leakage is identified during the procedure. AD - A. Simonin, Hôpital Cantonal Fribourg HFR, Fribourg, Switzerland AU - Simonin, A. AU - Rusconi, A. AU - Maestretti, G. DB - Embase DO - 10.1055/s-0037-1603867 KW - cement adult adverse drug reaction aged angiography artery cancer surgery case report cell migration cementoplasty clinical article complication compression fracture conference abstract disease course embolism female fragility fracture human injection lung middle aged radiology side effect spine T cell lymphoma thorax pain transesophageal echocardiography tricuspid valve vein LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 2193-6323 ST - Differences between pulmonary and intracardiac cement embolism migration after percutaneous cementoplasty: Report of two cases and review of the literature T2 - Journal of Neurological Surgery, Part A: Central European Neurosurgery TI - Differences between pulmonary and intracardiac cement embolism migration after percutaneous cementoplasty: Report of two cases and review of the literature UR - https://www.embase.com/search/results?subaction=viewrecord&id=L620956707&from=export http://dx.doi.org/10.1055/s-0037-1603867 VL - 78 ID - 829250 ER - TY - JOUR AB - INTRODUCTION: Localized cement leakage is known complications of kyphoplasty but cement embolization in pulmonary vasculature is a rare. We report a case of chronic pulmonary thromboembolism (PTE) secondary to cement embolization after kyphoplasty. CASE PRESENTATION: A 80-year-old female with past medical history significant for osteoporosis was referred by primary care physician to pulmonary clinic due to dyspnea on exertion for last 4 years. Her vitals were stable, with saturation of 95% at rest which dropped down to 89% while climbing stairs. Physical examination was non-significant. EKG showed sinus tachycardia. Arterial blood gas was normal with no acid base imbalance. Lateral chest X ray showed hyperdense lesion in L2 vertebra. The recent chest computed tomography angiogram (CTA) revealed hyperdense opacities in bilateral distal pulmonary arteries. Previous CTA also revealed similar filling defects. Hence, she was diagnosed with chronic pulmonary thromboembolism (PTE) with unknown etiology. She gave history of kyphoplasty 4 years back after vertebra fracture. She developed dyspnea after the procedure and was treated with coumadin for total of 6 months for presumptive pulmonary embolism. She continued to have dyspnea on exertion despite initial treatment with coumadin. Diagnosis of pulmonary cement embolism (PCE) leading to chronic thromboembolism was entertained due to history of kyphoplasty preceding dyspnea in the past. Hence, this condition remained undiagnosed and existed in our patient for long time. We offered her lifelong anticoagulation but she declined. DISCUSSION: Chronic PTE secondary to foreign bodies are very rare and usually missed. To the best of our knowledge, pulmonary thromboembolism secondary implantable devices and fractured venous catheter have been described but cement embolism has never been described as etiology for chronic PTE. Detailed history of kyphoplasty in the past and its correlation with dyspnea is key for the diagnosis of PCE as etiology for chronic thromboembolism. Asymptomatic PCE requires close monitoring but symptomatic or central PCE needs initial heparinization followed by coumadin for 6 month. Role of life long anticoagulation in case of persistent symptoms is not clear. CONCLUSIONS: PCE secondary to kyphoplasty can be one of the rare etiology for chronic PTE leading to pulmonary hypertension. Physicians should be aware that detailed history and review of radiology from the past are keys for this rare diagnosis. AD - A. Singh, North Shore Long Island Jewish Health System, New Hyde Park, New York, NY, United States AU - Singh, A. AU - Verma, S. AU - Patel, P. AU - Shah, R. AU - Talwar, A. DB - Embase DO - 10.1378/chest.1693486 KW - cement warfarin lung embolism artificial embolization kyphoplasty dyspnea human etiology diagnosis embolism exercise anticoagulation thromboembolism thorax procedures spine fracture hospital general practitioner pulmonary artery computer assisted tomography osteoporosis lung blood vessel thorax radiography physician pulmonary hypertension heparinization medical history disorders of acid base balance intravenous catheter arterial gas devices foreign body sinus tachycardia patient monitoring physical examination climbing radiology vertebra female L1 - http://journal.publications.chestnet.org/article.aspx?articleid=1739709 LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0012-3692 ST - Chronic pulmonary thromboembolism as a consequence of cement embolization T2 - Chest TI - Chronic pulmonary thromboembolism as a consequence of cement embolization UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71269225&from=export http://dx.doi.org/10.1378/chest.1693486 VL - 144 ID - 829479 ER - TY - JOUR AB - PURPOSE: To assess the effects of tranexamic acid (TA) in patients undergoing total hip arthroplasty (THA) for osteoarthritis. METHODS: 42 patients underwent primary THA for osteoarthritis by a single surgeon. 10 men and 11 women who did not receive TA were controls, whereas 9 men and 12 women who received TA constituted the treatment group. Both groups were matched for age, gender, body mass index, and American Society of Anesthesiologists grading. The type of prosthesis used (cemented or uncemented) was based on the surgeon's preference and patient age, activity level and demands. No hybrid prosthesis was used. 10 minutes prior to incision, a single dose of intravenous TA (10 mg per kg body weight) was given to patients in the treatment group. Comparison was made between both groups with regard to intra‐operative blood loss, postoperative reduction in haemoglobin and haematocrit levels, blood transfusion, incidence of deep vein thrombosis, and the length of hospital stay. RESULTS: The mean intra‐operative blood loss (489 [SD, 281] vs. 339 [SD, 184] ml, p = 0.048) and the decrease in haemoglobin level (38 [SD, 12] vs. 29 [SD, 10] g/l, p=0.014) were significantly higher in the control than the treatment group. Two patients among the controls received a transfusion, compared to none in the TA group (p = 0.49, Fisher's exact test). The 2 patients who needed blood transfusion had blood losses of 600 and 690 ml, compared to a mean of 489 ml in the whole group. No patient in either group developed deep vein thrombosis or pulmonary embolism up to 3 months. CONCLUSION: A single dose of intravenous TA (10 mg per kg body weight) given 10 minutes prior to THA is a cost‐effective and safe means of minimising blood loss and reduction in haemoglobin concentrations as well as the need for allogenic blood transfusion, without increasing the risk of thromboembolic events. AN - CN-00785795 AU - Singh, J. AU - Ballal, M. S. AU - Mitchell, P. AU - Denn, P. G. DO - 10.1177/230949901001800305 KW - Aged Aged, 80 and over Antifibrinolytic Agents [*therapeutic use] Arthroplasty, Replacement, Hip [*adverse effects] Blood Loss, Surgical [*prevention & control] Blood Transfusion Female Hematocrit Hemoglobins [metabolism] Humans Length of Stay Male Middle Aged Osteoarthritis, Hip [blood, complications, *surgery] Tranexamic Acid [*therapeutic use] Treatment Outcome Venous Thrombosis [epidemiology] M1 - 3 M3 - Controlled Clinical Trial; Journal Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2010 SP - 282‐286 ST - Effects of tranexamic acid on blood loss during total hip arthroplasty T2 - Journal of orthopaedic surgery (hong kong) TI - Effects of tranexamic acid on blood loss during total hip arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00785795/full VL - 18 ID - 830037 ER - TY - JOUR AB - Purpose: To assess the effects of tranexamic acid (TA) in patients undergoing total hip arthroplasty (THA) for osteoarthritis. Methods: 42 patients underwent primary THA for osteoarthritis by a single surgeon. 10 men and 11 women who did not receive TA were controls, whereas 9 men and 12 women who received TA constituted the treatment group. Both groups were matched for age, gender, body mass index, and American Society of Anesthesiologists grading. The type of prosthesis used (cemented or uncemented) was based on the surgeon's preference and patient age, activity level and demands. No hybrid prosthesis was used. 10 minutes prior to incision, a single dose of intravenous TA (10 mg per kg body weight) was given to patients in the treatment group. Comparison was made between both groups with regard to intra-operative blood loss, postoperative reduction in haemoglobin and haematocrit levels, blood transfusion, incidence of deep vein thrombosis, and the length of hospital stay. Results: The mean intra-operative blood loss (489 [SD, 281] vs. 339 [SD, 184] ml, p = 0.048) and the decrease in haemoglobin level (38 [SD, 12] vs. 29 [SD, 10] g/l, p=0.014) were significantly higher in the control than the treatment group. Two patients among the controls received a transfusion, compared to none in the TA group (p = 0.49, Fisher's exact test). The 2 patients who needed blood transfusion had blood losses of 600 and 690 ml, compared to a mean of 489 ml in the whole group. No patient in either group developed deep vein thrombosis or pulmonary embolism up to 3 months. Conclusion: A single dose of intravenous TA (10 mg per kg body weight) given 10 minutes prior to THA is a cost-effective and safe means of minimising blood loss and reduction in haemoglobin concentrations as well as the need for allogenic blood transfusion, without increasing the risk of thromboembolic events. AD - Macclesfield District General Hospital, Cheshire, United Kingdom Macclesfield District General Hospital, Cheshire, United Kingdom. AN - 105001622. Language: English. Entry Date: 20110708. Revision Date: 20200708. Publication Type: journal article AU - Singh, J. AU - Ballal, M. S. AU - Mitchell, P. AU - Denn, P. G. AU - Singh, Jagwant AU - Ballal, Moez S. AU - Mitchell, P. AU - Denn, P. G. DB - cin20 DO - 10.1177/230949901001800305 DP - EBSCOhost KW - Antifibrinolytic Agents -- Therapeutic Use Arthroplasty, Replacement, Hip -- Adverse Effects Blood Loss, Surgical -- Prevention and Control Osteoarthritis, Hip -- Surgery Acids, Carbocyclic -- Therapeutic Use Aged Aged, 80 and Over Blood Transfusion Female Hematocrit Hemoglobins -- Metabolism Human Length of Stay Male Middle Age Osteoarthritis, Hip -- Blood Osteoarthritis, Hip -- Complications Treatment Outcomes Venous Thrombosis -- Epidemiology Clinical Trials M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2010 SN - 1022-5536 SP - 282-286 ST - Effects of tranexamic acid on blood loss during total hip arthroplasty T2 - Journal of Orthopaedic Surgery (10225536) TI - Effects of tranexamic acid on blood loss during total hip arthroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105001622&site=ehost-live&scope=site VL - 18 ID - 830696 ER - TY - JOUR AB - STUDY DESIGN: Systematic review. OBJECTIVES: (1) Study indications for cement-augmented pedicle screws (CAPS) in patients with osteoporosis. Have they changed over the years (2000-2017)? Are there any differences in usage of CAPS based on the geographical region? (2) What were the outcome of the studies? (3) What are the complications associated with this technique? METHODS: Electronic database and reference list of desired articles were searched from the database (2000-2017). Articles were selected discussing indications, clinical and radiological outcomes, and complications in cases of preexistent osteoporosis treated surgically using CAPS. RESULTS: Seventeen studies were identified; 3 were comparative studies and had a control arm (cemented vs noncemented screws). Most studies originated from Europe (10) or Asia (7). Painful vertebral fracture with or without neurological deficit, Kummell's lesion, deformity and failure to respond to conservative treatment are the common indications for cement augmentation. Visual analogue scale score was the most commonly used to assess pain and average improvement after surgery was 6.1. Average improvement in kyphosis was 13.21° and average loss of correction at the end of the study was 3°. Cement leak was the most common complication observed and pulmonary cement embolism was the most dreaded complication. Nevertheless, majority of cement leaks discussed in studies were asymptomatic. CONCLUSION: CAPS are being increasingly used in osteoporotic spine. Pain scores, functional quality of life, and neurological function indices were studied. CAPS improved anchorage in osteoporotic vertebra and helped improve/maintain clinical and radiological improvement. Common risks of cement leak were observed. AD - Indian Spinal Injuries Center, New Delhi, India. AN - 31552160 AU - Singh, V. AU - Mahajan, R. AU - Das, K. AU - Chhabra, H. S. AU - Rustagi, T. C2 - Pmc6745638 DA - Oct DO - 10.1177/2192568218801570 DP - NLM ET - 2019/09/26 J2 - Global spine journal KW - Pmma cement osteoporosis vertebral fracture of interest with respect to the research, authorship, and/or publication of this article. LA - eng M1 - 7 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 2192-5682 (Print) 2192-5682 SP - 783-795 ST - Surgical Trend Analysis for Use of Cement Augmented Pedicle Screws in Osteoporosis of Spine: A Systematic Review (2000-2017) T2 - Global Spine J TI - Surgical Trend Analysis for Use of Cement Augmented Pedicle Screws in Osteoporosis of Spine: A Systematic Review (2000-2017) VL - 9 ID - 828576 ER - TY - JOUR AB - BACKGROUND: The femur is the most common long bone affected by metastatic bone disease, with 25% involving the proximal third of the femur. Long stem cemented hip replacement (LHR) is an important option for cases of impending fracture. Pulmonary embolism is a critical complication that can occur. This study evaluates the effectiveness of distal femoral canal decompression in reducing the risk of cardiopulmonary events. MATERIALS AND METHODS: Thirty two patients with metastatic bone disease of the proximal femur undergoing LHR were recruited and randomized. Conventional technique was used in 16 cases and distal decompression of the medullary canal was carried out for the other 16 patients. The decompression was carried out through a trocar inserted into the distal medullary canal, connected to a vacuum suction. Quantity of emboli was detected through A4 chambers transesophageal echocardiography; the blood pressure and oxygen saturation readings were also recorded. RESULTS: The decompression group experienced significantly lower Grade 2 and Grade 3 embolic events compared to the conventional group (11 vs. 26), and the duration of the embolic phenomena was shorter. Insertion of the stem and relocating the hip gave the highest amount embolic events. There was a significant drop in systolic blood pressure (SBP) in 12 out of 16 patients (75.0%) in the conventional group and 5 out of 16 patients in the decompression group (31.3%). This is statically significant (P = 0.0124). The average drop in SBP for the conventional group is 45.8 mmHg and the decompression group was 32.9 mmHg. Oxygen saturation remained at above 96% in the decompression group. However, in the conventional group, 25% of the patients had their oxygen saturation drop to below 96% during the insertion of stem and relocation of hip joint. CONCLUSION: Distal femoral canal decompression is an effective method in reducing the risk of cardiopulmonary embolic events associated with LHR. AD - Department of Orthopaedics (Noceral), University Malaya Medical Center, Kuala Lumpur, Malaysia. Department of Cardiology, University Malaya Medical Center, Kuala Lumpur, Malaysia. AN - 29416165 AU - Singh, V. A. AU - Sarrafan, S. AU - Veriah, R. S. C2 - Pmc5791226 DA - Jan-Feb DO - 10.4103/ortho.IJOrtho_101_17 DP - NLM ET - 2018/02/09 J2 - Indian journal of orthopaedics KW - Bone metastasis Metastasis distal canal decompression hip joint arthroplasty hip prosthesis long stem hip replacement pulmonary embolism LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 0019-5413 (Print) 0019-5413 SP - 15-21 ST - Distal Medullary Canal Decompression in Long Stem Hip Replacement in Long Bone Metastasis: Does it Reduce Cardiopulmonary Complications? T2 - Indian J Orthop TI - Distal Medullary Canal Decompression in Long Stem Hip Replacement in Long Bone Metastasis: Does it Reduce Cardiopulmonary Complications? VL - 52 ID - 829005 ER - TY - JOUR AB - Background: The femur is the most common long bone affected by metastatic bone disease, with 25% involving the proximal third of the femur. Long stem cemented hip replacement (LHR) is an important option for cases of impending fracture. Pulmonary embolism is a critical complication that can occur. This study evaluates the effectiveness of distal femoral canal decompression in reducing the risk of cardiopulmonary events. Materials and Methods: Thirty two patients with metastatic bone disease of the proximal femur undergoing LHR were recruited and randomized. Conventional technique was used in 16 cases and distal decompression of the medullary canal was carried out for the other 16 patients. The decompression was carried out through a trocar inserted into the distal medullary canal, connected to a vacuum suction. Quantity of emboli was detected through A4 chambers transesophageal echocardiography; the blood pressure and oxygen saturation readings were also recorded. Results: The decompression group experienced significantly lower Grade 2 and Grade 3 embolic events compared to the conventional group (11 vs. 26), and the duration of the embolic phenomena was shorter. Insertion of the stem and relocating the hip gave the highest amount embolic events. There was a significant drop in systolic blood pressure (SBP) in 12 out of 16 patients (75.0%) in the conventional group and 5 out of 16 patients in the decompression group (31.3%). This is statically significant (P = 0.0124). The average drop in SBP for the conventional group is 45.8 mmHg and the decompression group was 32.9 mmHg. Oxygen saturation remained at above 96% in the decompression group. However, in the conventional group, 25% of the patients had their oxygen saturation drop to below 96% during the insertion of stem and relocation of hip joint. Conclusion: Distal femoral canal decompression is an effective method in reducing the risk of cardiopulmonary embolic events associated with LHR. AD - Departments of Orthopaedics (Noceral), University Malaya Medical Center, Kuala Lumpur, Malaysia Department of Cardiology, University Malaya Medical Center, Kuala Lumpur, Malaysia AN - 142838763. Language: English. Entry Date: 20180202. Revision Date: 20200423. Publication Type: Article. Journal Subset: Asia AU - Singh, Vivek Ajit AU - Sarrafan, Siamak AU - Veriah, Ramesh Singh DB - cin20 DO - 10.4103/ortho.IJOrtho_101_17 DP - EBSCOhost M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2018 SN - 0019-5413 SP - 15-21 ST - Distal Medullary Canal Decompression in Long Stem Hip Replacement in Long Bone Metastasis T2 - Indian Journal of Orthopaedics TI - Distal Medullary Canal Decompression in Long Stem Hip Replacement in Long Bone Metastasis UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=142838763&site=ehost-live&scope=site VL - 52 ID - 830556 ER - TY - JOUR AB - Bone cement implantation syndrome (BCIS) is a poorly understood entity. It is an important cause of intraoperative mortality and morbidity in patients undergoing cemented hip arthroplasty and may also be seen in the postoperative period in a milder form causing hypoxia and confusion. Hip arthroplasty is being increasingly resorted to in the ageing population. We here report a severe hemodynamic derangement and transient hypoxemia observed during cemented arthro-plasty of hip in a 65 years old lady. Peripheral vasodilatory effects of the cement monomer, fat and marrow embolism and activation of the clotting cascade in the lungs, all contribute to bone cement implantation syndrome(BCIS). Early and aggressive resuscitation using vasopressors, establishment of invasive hemodynamic monitoring and surgical operative modifications are the key to prevention of this catastrophic syndrome. AD - A. Singia, Department of Anaesthesiology and Critical Care, Rural Medical College, Loni, Tal. Rahata, District-Ahmednagar, Maharashtra, India AU - Singia, A. AU - Divekar, D. S. AU - Kumar, N. DB - Embase KW - cemented prosthesis hypertensive factor methacrylic acid methyl ester aged article blood pressure monitoring bone cement implantation syndrome bone radiography case report disease severity early diagnosis early intervention end tidal carbon dioxide tension fat embolism female femur fracture fracture fixation hemodynamic derangement hip hemiarthroplasty hip pain human hypertension hypoxemia intermittent mandatory ventilation medical device complication morbidity oxygen saturation patient monitoring peroperative complication risk factor surgical mortality thrombocyte aggregation vasodilatation walking difficulty LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 0976-0164 0975-0533 SP - 17-20 ST - Bone cement implantation syndrome (BCIS) T2 - Pravara Medical Review TI - Bone cement implantation syndrome (BCIS) UR - https://www.embase.com/search/results?subaction=viewrecord&id=L602122420&from=export VL - 6 ID - 829457 ER - TY - JOUR AB - Pulmonary Cement Embolization (PCE) is a rare complication of vertebroplasty surgery. There is no clear guideline for management of this entity. There is no definite protocol for anticoagulation in PCE. This is a case report of our patient who was diagnosed to have Pulmonary Cement Embolization, which was quite significant involving both lungs. She was successfully managed without long term anticoagulation. AD - Department of Respiratory Medicine, Fortis Hospitals, Bangaluru, Karnataka, India. Department of Neurosurgery, Fortis Hospitals, Bangaluru, Karnataka, India. Department of Radiology, Fortis Hospitals, Bangaluru, Karnataka, India. AN - 26664167 AU - Sinha, N. AU - Padegal, V. AU - Satyanarayana, S. AU - Santosh, H. K. C2 - Pmc4663864 DA - Nov-Dec DO - 10.4103/0970-2113.168119 DP - NLM ET - 2015/12/15 J2 - Lung India : official organ of Indian Chest Society KW - Anticoagulation pulmonary cement embolization vertebroplasty LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 0970-2113 (Print) 0970-2113 SP - 602-5 ST - Pulmonary cement embolization after vertebroplasty, an uncommon presentation of pulmonary embolism: A case report and literature review T2 - Lung India TI - Pulmonary cement embolization after vertebroplasty, an uncommon presentation of pulmonary embolism: A case report and literature review VL - 32 ID - 828688 ER - TY - JOUR AB - We report on two cases of fatal non-thrombotic pulmonary embolism with bone fragments and bone cement, respectively, as well as a case of thrombotic pulmonary embolism with a 70-cm long thrombus showing signs of advanced organization. Although the clinical diagnosis of pulmonary embolism was confirmed in each case by postmortem examination, the true nature and origin of the emboli would have remained undetected without autopsy and histological examinations. Thus, the autopsy continues to be an important procedure with substantial, if largely underused potential to advance medical knowledge and improve clinical practice. AD - [Sinicina, I.; Pankratz, H.; Schoepfer, J.] Ludwig Maximilians Univ Munchen, Inst Rechtsmed, Nussbaumstr 26, D-80336 Munich, Germany. Sinicina, I (corresponding author), Ludwig Maximilians Univ Munchen, Inst Rechtsmed, Nussbaumstr 26, D-80336 Munich, Germany. inga.sinicina@med.uni-muenchen.de AN - WOS:000433195300007 AU - Sinicina, I. AU - Pankratz, H. AU - Schopfer, J. DA - Jun DO - 10.1007/s00194-017-0219-1 J2 - Rechtsmedizin KW - Bone cement embolism Bone fragment embolism Skrew augmentation Vertebral fracture Cement leakage PERCUTANEOUS VERTEBROPLASTY CEMENT EMBOLISM BONE EMBOLISM KYPHOPLASTY AUTOPSY Medicine, Legal LA - German M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 0937-9819 SP - 214-218 ST - Unusual cases of pulmonary embolism T2 - Rechtsmedizin TI - Unusual cases of pulmonary embolism UR - ://WOS:000433195300007 VL - 28 ID - 830168 ER - TY - JOUR AB - We report on two cases of fatal non-thrombotic pulmonary embolism with bone fragments and bone cement, respectively, as well as a case of thrombotic pulmonary embolism with a 70-cm long thrombus showing signs of advanced organization. Although the clinical diagnosis of pulmonary embolism was confirmed in each case by postmortem examination, the true nature and origin of the emboli would have remained undetected without autopsy and histological examinations. Thus, the autopsy continues to be an important procedure with substantial, if largely underused potential to advance medical knowledge and improve clinical practice. AD - I. Sinicina, Institut für Rechtsmedizin, Ludwig-Maximilians-Universität, Nußbaumstr. 26, München, Germany AU - Sinicina, I. AU - Pankratz, H. AU - Schöpfer, J. DB - Embase KW - bone cement device bone cement article autopsy bone case report clinical article clinical practice diagnostic procedure histopathology human lung embolism professional knowledge risk factor LA - German M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1434-5196 0937-9819 SP - 214-218 ST - Unusual cases of pulmonary embolism T2 - Rechtsmedizin TI - Unusual cases of pulmonary embolism UR - https://www.embase.com/search/results?subaction=viewrecord&id=L619601325&from=export VL - 28 ID - 829191 ER - TY - JOUR AB - Percutaneous vertebroplasty (PVP) is a minimally invasive intervention widely used for relief of pain caused by osteoporotic, traumatic, or neoplastic vertebral fractures. During PVP, polymethyl methacrylate (bone cement) is injected directly into the vertebral body via a vertebral pedicle to partially restore the vertebral body height, to stabilize bone trabeculae and to alleviate pain. Though the procedure is minimally invasive, complications are not rare; however, mostly, they are not clinically significant. Potentially serious complications of PVP include pulmonary embolism with polymethyl methacrylate with variety of manifestations ranging from asymptomatic postoperative x-ray findings to life-threatening extravasation (cement "leakage") which is quite rare and fatal. Epidemiology, pathogenesis, clinical and radiological signs of pulmonary embolism in PVP and approaches to treatment are discussed in this review of literature. The article also describes two clinical cases of pulmonary embolism in patients underwent PVP for hemangioma of the vertebral body with severe pain syndrome are also described. AU - Sinopal’nikov, A. I. AU - Tyurin, I. E. AU - Shvayko, S. N. AU - Sheykh, Z. V. AU - Morozova, L. V. AU - Smirnov, I. P. DB - Embase DO - 10.18093/0869-0189-2019-29-3-353-359 KW - bone cement poly(methyl methacrylate) article hemangioma human lung embolism pain severity percutaneous vertebroplasty vertebra body LA - Russian M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 0869-0189 SP - 353-359 ST - Pulmonary embolism with polymethyl methacrylate (bone cement) after percutaneous vertebroplasty (a review of literature and case reports) T2 - Pulmonologiya TI - Pulmonary embolism with polymethyl methacrylate (bone cement) after percutaneous vertebroplasty (a review of literature and case reports) UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2002632189&from=export http://dx.doi.org/10.18093/0869-0189-2019-29-3-353-359 VL - 29 ID - 829163 ER - TY - JOUR AB - Purpose: Management of intertrochanteric fractures in elderly osteoporotic patients continues to be a challenging problem for orthopedic surgeons. Cutting out of implant from the femoral head and varus malpositioning of fragments is often seen in such cases if early ambulation is allowed. Prolonged bed rest in elderly patients leads to higher risk of complications such as bed sores, pneumonia and deep vein thrombosis not uncommonly leading to fatal pulmonary embolism. The purpose of this case series study was to assess the role of hemiarthroplasty in the treatment of intertrochanteric fractures in elderly patients and study the complications. Materials and methods: Twenty-five patients were treated at a tertiary care center with hip hemiarthroplasty in intertrochanteric fractures. Mean age of the patients in the study was 77.8 years. Young patients with stable fractures and patients with active infection were excluded from study. Seventy-two percent of patients in the study were osteoporotic and associated comorbidity was present in 18 patients. Preoperative ambulatory status of all patients was noted for comparison. If calcar was deWcient, calcar was reconstructed with a cut autograft from the femoral neck. Results: All Patients were followed for 1 year and evaluated using ModiWed Harris Hip Score except one patient who expired in postoperative period probably due to embolism. He had poor cardiopulmonary reserve preoperatively and cement was used in this case. Average period of initiation of full weight bearing in the present study was 5.5 days. Excellent/good results were seen in 20 patients (80%). One of the patients, who remained bedridden even after surgery, developed decubitus ulcer on the back and was labeled as failure. This patient expired 9 months after surgery. Dislocation of prosthesis was not seen in any case. One patient had shortening more than 1.5 cm due to sinking of prosthesis. Conclusion: Although majority of patients with intertrochanteric fractures can be successfully managed with osteosynthesis, older patients with severe osteoporosis and associated comorbidity may beneWt from prosthetic replacement. However, large scale studies are required to prove it conclusively. © Springer-Verlag 2011. AD - H. Jain, Agrawal Farm, Mansarovar, 5/284, S.F.S., Jaipur, Rajasthan, India AU - Siwach, R. AU - Jain, H. AU - Singh, R. AU - Sangwan, K. DB - Embase DO - 10.1007/s00590-011-0870-2 KW - adult aged article cardiopulmonary insufficiency cementoplasty clinical article comorbidity decubitus disease association embolism femur intertrochanteric fracture follow up hip hemiarthroplasty human lung function lung reserve mobilization Modified Harris Hip Score osteoporosis outcome assessment peroperative complication postoperative period preoperative period priority journal prosthesis loosening prosthesis sinking rating scale surgical mortality surgical technique tertiary health care treatment failure weight bearing LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1633-8065 1432-1068 SP - 467-472 ST - Role of hemiarthroplasty in intertrochanteric fractures in elderly osteoporotic patients: A case series T2 - European Journal of Orthopaedic Surgery and Traumatology TI - Role of hemiarthroplasty in intertrochanteric fractures in elderly osteoporotic patients: A case series UR - https://www.embase.com/search/results?subaction=viewrecord&id=L365496076&from=export http://dx.doi.org/10.1007/s00590-011-0870-2 VL - 22 ID - 829552 ER - TY - JOUR AD - From Departments of Cardiology (E.T.S., O.D.-E., P.I.L.), Thoracic Surgery (T.S.), and Pathology (L.U.-H.), University Hospital of Northern Norway, Tromsø. Eystein.Skjolsvik@unn.no. From Departments of Cardiology (E.T.S., O.D.-E., P.I.L.), Thoracic Surgery (T.S.), and Pathology (L.U.-H.), University Hospital of Northern Norway, Tromsø. AN - 26371238 AU - Skjølsvik, E. T. AU - Steensrud, T. AU - Dahl-Eriksen, Ø AU - Uhlin-Hansen, L. AU - Lunde, P. I. DA - Sep 15 DO - 10.1161/circulationaha.115.017141 DP - NLM ET - 2015/09/16 J2 - Circulation KW - Aged Arthroplasty, Replacement, Hip/adverse effects/*instrumentation Bone Cements/*adverse effects Cardiac Surgical Procedures Embolism/*complications Female Foreign-Body Migration/*complications Heart Injuries/diagnostic imaging/*etiology Hip Prosthesis Humans Tomography, X-Ray Computed Treatment Outcome Wounds, Penetrating/diagnostic imaging/*etiology LA - eng M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 0009-7322 SP - 1047-8 ST - Cardiac Perforation Caused by Cement Embolus After Total Hip Replacement T2 - Circulation TI - Cardiac Perforation Caused by Cement Embolus After Total Hip Replacement VL - 132 ID - 828513 ER - TY - JOUR AD - E.T.E. Skjølsvik, Universitetssykehuset Nord-Norge, Hjerte Og Lungeklinikken, Hansine Hansens Vei 67, Tromsø, Norway AU - Skjølsvik, E. T. E. AU - Steensrud, T. AU - Dahl-Eriksen, Ø AU - Uhlin-Hansen, L. AU - Lunde, P. I. DB - Embase Medline DO - 10.1161/CIRCULATIONAHA.115.017141 KW - cement palacos troponin aged angiocardiography aortic dissection case report cemented prosthesis disease course echocardiography embolism female field emission scanning electron microscopy fluoroscopy heart perforation heart right atrium heart tamponade hip arthroplasty hospital admission human note observational study open heart surgery pericarditis priority journal ST segment elevation thorax pain total hip prosthesis LA - English M1 - 11 M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1524-4539 0009-7322 SP - 1047-1048 ST - Cardiac perforation caused by cement embolus after total hip replacement T2 - Circulation TI - Cardiac perforation caused by cement embolus after total hip replacement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L606060951&from=export http://dx.doi.org/10.1161/CIRCULATIONAHA.115.017141 VL - 132 ID - 829394 ER - TY - JOUR AB - LEARNING OBJECTIVE 1: Recognize and diagnose a potentially clinically significant sequela of vertebroplasty. CASE: Our patient is a 53 year old man presenting with dyspnea and cough. He had a complicated medical course since receiving kyphoplasty 6 months prior to admission, and was intermittently hospitalized for recurrent pneumonia and COPD exacerbation. Due to high suspicion of pulmonary embolism at presentation, contrast CT of the chest was obtained which revealed multiple nonocclusive densities in the right pulmonary artery system as well as opacities in the right middle and lower lobe. Patient later corroborated a history of bone cement embolism following his procedure. He was admitted to the intensive care unit and treated for multifactorial respiratory failure with antibiotics, diuretics, steroids and nebulizers. Despite aggressive treatment, on the ninth day of his admission he developed sudden bradycardia and expired. Autopsy was performed with final pathology results pending. DISCUSSION: Kyphoplasty and vertebroplasty are common procedures in the treatment of vertebral compression fracture in which bone cement is injected percutaneously into a vertebral body to restore height and integrity. While the incidence of local leakage of cement into adjacent spaces can be high (up to 80-90 %), intravasation is less common (24 %) and embolization of cement less common still (4.6-6.8 %). The vast majority of cement emboli are asymptomatic and long term or serious sequelae, including death, are rarely reported. In our patient, the exact role of his cement emboli thus far remains uncertain. While our patient demonstrated no peripheral eosinophilia, he did have persistent bronchospasm which was resistant to steroids and nebulizers; we hypothesize that the long term presence of foreign material in the lungs may have caused a chronic hypersensitivity reaction. Though he had right sided opacities on imaging, he was afebrile and the differential for this finding could include pulmonary hemorrhage. Unfortunately, the patient expired before bronchoscopy could be performed. At this time, autopsy has been performed and initial pathology did demonstrate cement material in the right pulmonary artery system. The vast majority of reported cement emboli were asymptomatic, but our patient's clinical course clearly deteriorated significantly following his kyphoplasty. Currently no consensus exists in the treatment of this condition, with attempted therapies ranging from antibiotics to anticoagulation to mechanical extraction. The exact effect of bone cement on vascular or lung tissue remains to be determined and to our knowledge no pathologic examination of cement pulmonary embolus exists in the literature. Identifying this effect as well as the true incidence of cement embolization may help in reducing morbidity and mortality for kyphoplasty and vertebroplasty in the future. AD - J. Skrzynski, William Beaumont Hospital, Royal Oak, MI, United States AU - Skrzynski, J. AU - Sahi, S. AU - Kelekar, A. K. DB - Embase KW - cement bone cement steroid antibiotic agent diuretic agent lung embolism society internal medicine breathing human patient kyphoplasty embolism percutaneous vertebroplasty nebulizer pathology autopsy artificial embolization procedures pulmonary artery density vertebra body thorax compression fracture pneumonia bradycardia dyspnea male intensive care unit mortality height morbidity examination extraction anticoagulation coughing consensus disease course bronchoscopy lung hemorrhage imaging therapy allergic reaction lung foreign body lung parenchyma bronchospasm eosinophilia death respiratory failure LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 0884-8734 SP - S262 ST - “Heavy” breathing: A case of cement pulmonary embolism T2 - Journal of General Internal Medicine TI - “Heavy” breathing: A case of cement pulmonary embolism UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71495281&from=export VL - 29 ID - 829421 ER - TY - JOUR AB - Dislocation after total hip arthroplasty (THA) remains a problem despite many advances in technique and prosthetic design over the 5 decades since the introduction of total joint replacement. This article reports the short-term results (1 year of follow-up) of THA in 235 patients who received a large, anatomically sized femoral head (BFH Technology; Wright Medical Technology, Inc, Arlington, Tennessee) with modular necks for hip stability. The prosthesis allows a 6-mm differential between the size of the acetabular component and femoral head size. Patients also received a Conserve monoblock acetabular cup and a Profemur femoral stem (Wright Medical Technology, Inc) implanted without cement. Postoperative clinical evaluations included measurements of Harris Hip Scores and range of motion, along with assessments of pain and function and radiological evaluations. There were no complications (deep venous thrombosis, pulmonary embolism, infection, reoperations) and no dislocations. All clinical evaluations showed statistically significant improvement (P<.001) at 1-year follow-up, and radiographic evaluation has shown no evidence of osteolysis or implant loosening. This study indicates that using a large femoral head may reduce the incidence of dislocation and may enable early return to activities postoperatively. Future evaluations of this patient group will elicit longer-term follow-up data. AN - 105392429. Language: English. Entry Date: 20090911. Revision Date: 20200708. Publication Type: Journal Article AU - Smit, M. J. DB - cin20 DO - 10.3928/01477447-20090527-09 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip Joint Instability Prosthesis Design Adult Aged Aged, 80 and Over Clinical Assessment Tools Descriptive Statistics Female Functional Assessment Hip -- Radiography Male Middle Age Prospective Studies Treatment Outcomes Human M1 - 7 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0147-7447 SP - 489-489 ST - Hip stability in primary total hip arthroplasty using an anatomically sized femoral head T2 - Orthopedics TI - Hip stability in primary total hip arthroplasty using an anatomically sized femoral head UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105392429&site=ehost-live&scope=site VL - 32 ID - 830728 ER - TY - JOUR AN - 4754207 AU - Smith, R. E. AU - Turner, R. J. DA - Sep DP - NLM ET - 1973/09/01 J2 - Clinical orthopaedics and related research KW - Adolescent Adult Age Factors *Bone Cements/adverse effects Child Evaluation Studies as Topic Follow-Up Studies Hip/*surgery Humans Hypotension/etiology *Joint Prosthesis/adverse effects/mortality *Methylmethacrylates Middle Aged Myocardial Infarction/etiology Osteoarthritis/surgery Postoperative Complications/mortality Pulmonary Embolism/etiology Surgical Wound Infection/etiology United States LA - eng M1 - 95 N1 - PubMed NLM literature search January 5, 2021 PY - 1973 SN - 0009-921X (Print) 0009-921x SP - 231-8 ST - Total hip replacement using methylmethacrylate cement. An analysis of data from 3,482 cases T2 - Clin Orthop Relat Res TI - Total hip replacement using methylmethacrylate cement. An analysis of data from 3,482 cases ID - 828543 ER - TY - JOUR AD - Hospital Mater Dei, Departamento de Clínica Médica, Rua Goncalves Dias 2700, Belo Horizonte, MG, Brazil. hortasoares@gmail.com AN - 23090217 AU - Soares, T. H. AU - Bastos, Md AU - Moreira, W. AU - Rezende, S. M. DA - Sep-Oct DP - NLM ET - 2012/10/24 J2 - Revista da Associacao Medica Brasileira (1992) KW - Aged Angiography Bone Cements/adverse effects Female Humans Incidental Findings Pulmonary Embolism/*diagnostic imaging/etiology Tomography, X-Ray Computed Vertebroplasty/*adverse effects LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0104-4230 SP - 516 ST - Unexpected finding in computed tomographic pulmonary angiography T2 - Rev Assoc Med Bras (1992) TI - Unexpected finding in computed tomographic pulmonary angiography VL - 58 ID - 828532 ER - TY - JOUR AD - T. H. Soares, Hospital Mater Dei, Departamento de Clínica Médica, Rua Goncalves Dias, 2700, Belo Horizonte, MG, CEP: 30140-092, Brazil AU - Soares, T. H. AU - de Bastos, M. AU - Moreira, W. AU - Rezende, S. M. DB - Medline KW - bone cement aged angiography article case report computer assisted tomography female human incidental finding lung embolism percutaneous vertebroplasty radiography L1 - http://www.scielo.br/pdf/ramb/v58n5/v58n5a03.pdf LA - English M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 0104-4230 SP - 516 ST - Unexpected finding in computed tomographic pulmonary angiography T2 - Revista da Associacao Medica Brasileira TI - Unexpected finding in computed tomographic pulmonary angiography UR - https://www.embase.com/search/results?subaction=viewrecord&id=L368610556&from=export VL - 58 ID - 829547 ER - TY - JOUR AB - Introduction: Traditionally the use of small diameter femoral heads (22 mm) and the posterior approach have been associated with higher reported rates of dislocation. We present the results of a consecutive series of 400 total hip replacements performed using a 22mm femoral head and a standard posterior approach, with prospective data collection. Objective: To determine the outcome of total hip replacement using small diameter heads via a standard posterior approach. Methods: Between March 2000 and November 2005 364 patients underwent 400 total hip replacements with a small diameter 22mm head under the care of four different consultants, using a standard posterior approach. All patients underwent annual clinical and radiological review. All of the femoral implants were cemented modular polished triple-tapered C-stems (Depuy Ltd.) and all of the acetabular components were cemented flanged monobloc all-polyethylene components with long posterior walls. Palacos-R cement (Heraeus GMBH) containing gentamicin was used in all cases with a third generation cementing technique. A standard posterior approach was used in all cases, with direct repair of the short external rotators, but without the use of transosseous sutures. Results: There were 252 female and 112 male patients, with 175 right-sided operations, 225 left and 36 patients underwent staged bilateral operations. The average age at the time of surgery was 71.3 years (range 25-92) and the average duration of follow-up for surviving patients is 107 months (76-144). Osteoarthritis was the most common pathology (348 cases - 87%) and postoperative complications occurred in 19 cases. There were 4 greater trochanter fractures, 1 periprosthetic fracture, 2 cases of acetabular osteolysis, 2 temporary nerve palsies (1 Femoral and 1 Sciatic), 1 case of chronic venous congestion, 1 nonfatal pulmonary embolism, 1 deep infection, 2 leg length discrepancies and 5 dislocations. There were 6 re-operations, 3 revision for aseptic loosening of the acetabulum, 1 for internal fixation of a peri-prosthetic femoral fracture, 1 washout and debridement of an infected hip (MRSA), and 1 PLAD (Posterior Lip Augmentation Device) for recurrent dislocation. Two acetabular components currently appear radiologically loose, but remain asymptomatic, and there are imporno loose femoral components. The average acetabular abduction angle was 43.2 degrees (30-62) and the average femoral offset was 46 mm (35-54). Five patients suffered dislocations, 3 female and 2 male, 3 right-sided and 2 left. Average age was 70 (60-85), average offset was 44.6 mm (40-48). Four occurred on a single occasion only and were stable on reduction and only one required further surgery for recurrent dislocations. Extended, skirted femoral heads had been used in four of these cases, reducing the head/neck ratio (p<0.5). Conclusions: Total hip replacement using small diameter femoral heads and a posterior approach has provided excellent results and implant longevity, with a low complication rate. Dislocation was the most common complication, occurring in only 1.25% of cases and was associated with the use of an extended head. When using this approach the use of extended heads should be avoided, with high offset stems and standard heads being used in preference to achieve the correct length and offset whilst maintaining the maximum head/neck ratio. AD - D. Sochart, Department of Orthopaedic Surgery, North Manchester General Hospital, Manchester, United Kingdom AU - Sochart, D. DB - Embase DO - 10.5301/HIP.2012.9524 KW - gentamicin cement palacos polyethylene total hip prosthesis femoral head European hip society human patient male recurrent dislocation female implant surgery suture periprosthetic fracture osteolysis venous congestion lung embolism fracture postoperative complication debridement pathology osteoarthritis femur fracture devices greater trochanter nerve paralysis prosthesis loosening infection follow up leg length inequality acetabulum osteosynthesis lip consultation information processing abduction longevity L1 - http://www.hip-int.com/article/-abstracts-from-the-10th-congress-of-the-european-hip-society LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1120-7000 SP - 422-423 ST - Low dislocation rates in total hip replacement with the use of a small diameter (22 mm) femoral head implanted using a standard posterior approach T2 - HIP International TI - Low dislocation rates in total hip replacement with the use of a small diameter (22 mm) femoral head implanted using a standard posterior approach UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71960092&from=export http://dx.doi.org/10.5301/HIP.2012.9524 VL - 22 ID - 829560 ER - TY - JOUR AB - The results of cemented Charnley low-friction arthroplasty in patients aged less than 30 years are presented. Eighty-three arthroplasties were performed on 55 patients with an average age of 24.9 years (range, 17-29 years) and an average follow-up period of 240 months (20 years; range, 62-360 months). There were 2 nonfatal pulmonary emboli, 2 cases of deep sepsis, and 3 fractured femoral implants. Twenty-eight acetabular components migrated (34%), 25 have been revised (30%), and the average annual acetabular wear rate was 0.12 mm. Sixteen femoral implants subsided (19%), and fracture of the tip of the cement mantle occurred in 8 hips (10%). Nineteen femoral components (23%) were revised; femoral osteolysis was seen in 15 hips (18%) and changes in the calcar in 33 (38%). Acetabular component survivorship was 92% (95% confidence interval, 85-98%) at 10 years, 70% (60-81%) at 20 years, and 68% (57-79%) at 25 years, with the figures for the femoral implant being 93% (87-98%), 76% (66-86%), and 73% (62-85%), respectively. AD - Centre for Hip Surgery, Wrightington Hospital, Wigan, Lancashire, United Kingdom. AN - 9526204 AU - Sochart, D. H. AU - Porter, M. L. DA - Feb DO - 10.1016/s0883-5403(98)90089-4 DP - NLM ET - 1998/04/04 J2 - The Journal of arthroplasty KW - Adolescent Adult Age Factors *Arthroplasty, Replacement, Hip Cementation Female Humans Life Tables Male Reoperation Treatment Outcome LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 1998 SN - 0883-5403 (Print) 0883-5403 SP - 123-31 ST - Long-term results of cemented Charnley low-friction arthroplasty in patients aged less than 30 years T2 - J Arthroplasty TI - Long-term results of cemented Charnley low-friction arthroplasty in patients aged less than 30 years VL - 13 ID - 828891 ER - TY - JOUR AB - Introduction: The technique of selective embolization has been applied for years in the treatment of vascular anomalies, severe hemorrhage, and for benign and malignant tumors. Some hypervascular skeletal metastases are prone to massive hemorrhage. Case presentation: We describe the cases of two patients with thyroid carcinoma presenting with neuromuscular symptoms due to large skeletal metastases in the shoulder and sternum respectively. Pre-operative percutaneous selective catheterizations of the arteries feeding the metastatic tumors were performed, followed by infusion of gelfoam. The procedures were technically successful in both patients without adverse effects or bleeding. Complete resections of the skeletal metastases were then performed without substantial bleeding. Conclusion: Selective embolization is an effective treatment for bony metastases from thyroid cancer. AD - H.Y. Son, Department of Otorhinolaryngology, Thyroid/Head and Neck Cancer Center, Dongnam Institution of Radiological and Medical Sciences, 40 Jwadong-gil, Jangan-eup, Gijang-gun, Busan, South Korea AU - Son, H. Y. AU - An, S. Y. AU - Kim, E. Y. AU - Ahn, S. B. AU - Lee, B. C. DB - Embase Medline DO - 10.1186/1752-1947-8-405 KW - bone cement gelatin sponge gelfoam iodine 131 radioactive iodine adult aged angiography artery article artificial embolization bleeding bone metastasis cancer adjuvant therapy case report catheterization clavicle computer assisted emission tomography differentiated thyroid cancer distant metastasis echography excision female human hypervascular metastasis male middle aged priority journal shoulder sternum subclavian artery surgical mesh thyroid carcinoma thyroid follicular carcinoma thyroidectomy treatment outcome cutanplast LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1752-1947 ST - Selective embolization for hypervascular metastasis from differentiated thyroid cancer: A case series T2 - Journal of Medical Case Reports TI - Selective embolization for hypervascular metastasis from differentiated thyroid cancer: A case series UR - https://www.embase.com/search/results?subaction=viewrecord&id=L602677465&from=export http://dx.doi.org/10.1186/1752-1947-8-405 VL - 8 ID - 829458 ER - TY - JOUR AB - Percutaneous vertebroplasty is a minimally invasive technique that is used to treat vertebral fractures, tumors and osteolytic vertebral metastases. However, cement leakage to the venous system is a potential source of serious complications after percutaneous vertebroplasty. We report a 65-year-old female patient who demonstrated cardiac perforation, pulmonary cement embolism, and tricuspid regurgitation, and these were all caused by venous leakage of polymethylmethacrylate as a complication of the procedure. AD - Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center, Seoul, Republic of Korea. AN - 18249556 AU - Son, K. H. AU - Chung, J. H. AU - Sun, K. AU - Son, H. S. DA - Mar DO - 10.1016/j.ejcts.2007.11.027 DP - NLM ET - 2008/02/06 J2 - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery KW - Aged Bone Cements/*adverse effects Female Heart Injuries/diagnostic imaging/*etiology Humans Lumbar Vertebrae/surgery Medical Errors Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/etiology Spinal Diseases/*surgery Tomography, X-Ray Computed Treatment Outcome Tricuspid Valve Insufficiency/*etiology LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 1010-7940 (Print) 1010-7940 SP - 508-9 ST - Cardiac perforation and tricuspid regurgitation as a complication of percutaneous vertebroplasty T2 - Eur J Cardiothorac Surg TI - Cardiac perforation and tricuspid regurgitation as a complication of percutaneous vertebroplasty VL - 33 ID - 828931 ER - TY - JOUR AB - BACKGROUND: Percutaneous vertebroplasty (PVP) is usually used for osteoporotic thoracolumbar fractures, which has various advantages such as easy to operate, short operation time, less trauma, rapid recovery, analgesic effect and so on. But its application is restricted due to nerve compression symptoms and pulmonary embolism caused by bone cement leakage. Thereafter, how to reduce the leakage of bone cement is an issue of concern. OBJECTIVE: To investigate the relationship between the lumbar quantitative computed tomography (QCT) values and contrast agent dispersion in osteoporotic thoracolumbar fractures. METHODS: Sixty cases of osteoporotic thoracolumbar fractures undergoing PVP were enrolled, and received QCT examination before surgery, and contrast agent was injected intraoperatively. X-ray examination was conducted to detect the bone mineral density, contrast agent dispersion and leakage of bone cement, and the relationship between the lumbar QCT values and contrast agent dispersion as well as leakage of bone cement. RESULTS AND CONCLUSION: (1) There were 110 vertebral fractures, and 74 vertebrae with contrast agent diffusing more than vertebral midline, accounting for 67.3%. There was significant difference in the contrast agent dispersion among groups (P < 0.05). (2) The bone cement leakage showed no significant difference among groups after injected with bone cement by unilateral or bilateral approach (P > 0.05). (3) These results suggest that contrast agent dispersion in osteoporotic thoracolumbar fractures has a certain relationship with the lumbar QCT values, and lumbar QCT values with more contrast agent dispersion, but the lumbar QCT values have no correlation with bone cement leakage. Therefore, choosing a appropriate approach based on the QCT values and contrast agent dispersion can reduce leakage and improve the safety of PVP. AD - J.-W. Xu, Department of Rehabilitation, The First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, China AU - Song, Q. S. AU - Tang, F. B. AU - Wang, X. H. AU - Zhang, J. L. AU - Li, Z. F. AU - Rao, Y. S. AU - Wu, L. AU - Tai, Z. H. AU - Qin, H. B. AU - Xu, J. W. DB - Embase DO - 10.3969/j.issn.2095-4344.2017.19.016 KW - orthopedic surgical equipment bone cement contrast medium article bone cement leakage bone density computer assisted tomography fragility fracture human major clinical study patient safety percutaneous vertebroplasty preoperative evaluation quantitative analysis radiodiagnosis spine fracture surgical approach thoracolumbar spine LA - Chinese M1 - 19 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1673-8225 SP - 3051-3056 ST - Relationship between the lumbar quantitative computed tomography values and contrast agent dispersion in osteoporotic thoracolumbar fractures T2 - Chinese Journal of Tissue Engineering Research TI - Relationship between the lumbar quantitative computed tomography values and contrast agent dispersion in osteoporotic thoracolumbar fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L618949777&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.2017.19.016 VL - 21 ID - 829283 ER - TY - JOUR AB - RATIONALE: Leakage of bone cement is a common complication after percutaneous kyphoplasty. In rare cases, bone cement can leak into the venous system, which can be life threatening, especially when it causes an embolism in the heart. PATIENT CONCERNS: A 79-year-old female patient developed chest pain with chest tightness 3 weeks after the percutaneous kyphoplasty. DIAGNOSES: Initially, negative fluoroscopy results and elevated myocardial enzymes suggested that the patient's chest pain and chest tightness symptoms were manifestations of coronary heart disease. However, in the subsequent computed tomography (CT) examination, foreign bodies in the heart and pulmonary vessels were found. INTERVENTIONS: The patient underwent emergency surgery to remove the bone cement and repair the tricuspid valve. OUTCOMES: The postoperative course was uneventful and the patient was discharged on the 13th day after surgery. LESSONS: If a patient develops chest pain with chest tightness after percutaneous kyphoplasty, the clinicians must be vigilant and take into account the limited sensitivity of fluoroscopy and use chest computer tomography and echocardiogram as the first choice and thereby prevent serious consequences. AD - Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. AN - 32176057 AU - Song, Y. AU - Huang, X. AU - Wu, L. C2 - Pmc7220056 DA - Mar DO - 10.1097/md.0000000000019354 DP - NLM ET - 2020/03/17 J2 - Medicine KW - Aged Bone Cements/*adverse effects/therapeutic use Echocardiography/methods Embolism/diagnostic imaging/*etiology/*surgery Female Fluoroscopy/methods Follow-Up Studies Foreign Bodies/*diagnostic imaging/surgery Heart Ventricles/diagnostic imaging/surgery Humans Kyphoplasty/*adverse effects/methods Lumbar Vertebrae/surgery Spinal Fractures/diagnostic imaging/*surgery Treatment Outcome LA - eng M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 0025-7974 (Print) 0025-7974 SP - e19354 ST - Removal of intracardiac bone cement embolism after percutaneous kyphoplasty: A case report T2 - Medicine (Baltimore) TI - Removal of intracardiac bone cement embolism after percutaneous kyphoplasty: A case report VL - 99 ID - 828599 ER - TY - JOUR AB - Rationale: Leakage of bone cement is a common complication after percutaneous kyphoplasty. In rare cases, bone cement can leak into the venous system, which can be life threatening, especially when it causes an embolism in the heart. Patient concerns: A 79-year-old female patient developed chest pain with chest tightness 3 weeks after the percutaneous kyphoplasty. Diagnoses: Initially, negative fluoroscopy results and elevated myocardial enzymes suggested that the patient's chest pain and chest tightness symptoms were manifestations of coronary heart disease. However, in the subsequent computed tomography (CT) examination, foreign bodies in the heart and pulmonary vessels were found. Interventions: The patient underwent emergency surgery to remove the bone cement and repair the tricuspid valve. Outcomes: The postoperative course was uneventful and the patient was discharged on the 13th day after surgery. Lessons: If a patient develops chest pain with chest tightness after percutaneous kyphoplasty, the clinicians must be vigilant and take into account the limited sensitivity of fluoroscopy and use chest computer tomography and echocardiogram as the first choice and thereby prevent serious consequences. AD - [Song, Yu; Huang, Xiaofan; Wu, Long] Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Cardiovasc Surg, 1277 Jiefang Rd, Wuhan 430022, Peoples R China. Wu, L (corresponding author), Huazhong Univ Sci & Technol, Union Hosp, Tongji Med Coll, Dept Cardiovasc Surg, 1277 Jiefang Rd, Wuhan 430022, Peoples R China. 1136908070@qq.com AN - WOS:000525195500034 AU - Song, Y. AU - Huang, X. F. AU - Wu, L. C7 - 19354 DA - Mar DO - 10.1097/md.0000000000019354 J2 - Medicine KW - bone cements cardiac foreign bodies kyphoplasty tricuspid valve LEAKAGE VERTEBROPLASTY COMPLICATION PREVENTION Medicine, General & Internal LA - English M1 - 11 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2020 SN - 0025-7974 SP - 3 ST - Removal of intracardiac bone cement embolism after percutaneous kyphoplasty A case report T2 - Medicine TI - Removal of intracardiac bone cement embolism after percutaneous kyphoplasty A case report UR - ://WOS:000525195500034 VL - 99 ID - 830109 ER - TY - JOUR AB - Aims: Instrumentation of the osteoporotic spine occasionally brings about complications due to pedicle screw loosening and/ or pull-out. Excessive usage of PMMA carries disadvantages like: allergic reactions, pulmonary embolism, leakage into epidural space, adjacent vertebral failure due to changes in mechanical properties of the augmented vertebrae, PMMA remaining in the vertebral body after screw removal in case of infection. To reduce the number of disadvantages of PMMA augmentation in treatment of osteoporotic patients, we designed a new screw with side holes and performed a pull-out test to evaluate its applicability. Methods: Six osteoporotic lumbar vertebrae were obtained from fresh cadavers. The newly designed screws were inserted into the pedicles and 0.5∼0.7 ml of PMMA was injected into the screws. Then, 0.3∼0.5 ml of PMMA was push out into the vertebral body through the side holes and afterwards, the pull-out force was measured. In addition, forces required to detach the PMMA from the screws axially or rotationally were also measured. Results: The mean pull-out force of the designed screw was 853.4N (1.74 times compared to conventional screws). The average force needed to detach PMMA from the screw was 1569N/1.5Nm (torque) (axially/ rotationally). (Image presented). Conclusions: The pull-out strength of the newly designed screws with PMMA was increased about twofold above the mean. These results are more favorable than those previously reported including our study (Soshi et al, Spine, 1991). Additionally, less PMMA with this newly designed screw was needed for augmentation and therefore: (1) complications associated with PMMA were reduced, (2) PMMA was easily detached with a lower rotational force, (3) following screw removal, PMMA remaining in the vertebral body was minimized. Therefore we concluded that the newly designed screw with side-holes for PMMA injection can be very useful for augmentation of osteoporotic vertebrae. AD - S. Soshi, Orthopaedic Surgery, Jikei University, School of Medicine, Tokyo, Japan AU - Soshi, S. AU - Kida, Y. AU - Ushiku, C. AU - Marumo, K. AU - Spengler, D. DB - Embase DO - 10.1007/s00198-010-1247-9 KW - osteoporosis economic aspect spine pedicle screw osteoarthritis vertebra body vertebra injection epidural space lung embolism allergic reaction devices infection patient lumbar vertebra cadaver torque LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0937-941X SP - S367 ST - A novel pedicle screw for PMMA augmentation: A preliminary study of pull-out test in osteoporotic spine T2 - Osteoporosis International TI - A novel pedicle screw for PMMA augmentation: A preliminary study of pull-out test in osteoporotic spine UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70226396&from=export http://dx.doi.org/10.1007/s00198-010-1247-9 VL - 21 ID - 829667 ER - TY - JOUR AB - Background:Vertebroplasty and kyphoplasty are minimally invasive treatments for vertebral compression fractures. Although infrequent, both transitory and persistent adverse effects have been reported. They range from asymptomatic to severe neurological deficits that are caused directly by polymethylmethacrylate (PMMA) leakage or may be related to local or general reactions not due to PMMA leakage. Transitory hypotension after the procedure has been observed, but the characteristics and etiology of this phenomenon are not defined.Objective:To describe a case of prolonged hypotension after kyphoplasty and suggest a possible mechanism.Methods:Six months after L2 kyphoplasty, a 63-year-old woman with severe osteoporosis developed a new back pain due to compression fracture of L1 and compression deformity of the superior L3 endplate. The patient underwent bilateral kyphoplasty at the L1 and L3 levels. She developed persistent hypotension for approximately 46 hours immediately after the procedure. Common causes of hypotension were ruled out and the event resolved spontaneously.Results:On the basis of needle placement, the temporal relationship between the procedure and blood pressure change, and the lack of other identifiable causes, thermal sympathectomy from heating of the PMMA adjacent to the paravertebral sympathetic chain is proposed as a potential mechanism.Limitations:Single case report based on clinical observation.Discussion:Prolonged hypotension can complicate kyphoplasty at upper lumbar levels. Two days of severe hypotension has not been described as a complication of kyphoplasty. Although the mechanism is unknown, a transient thermal sympathectomy may be the cause. AD - [Soto, Eliezer; Galperin, Mark; Portenoy, Russell K.] Beth Israel Deaconess Med Ctr, Dept Pain Med & Palliat Care, New York, NY 10003 USA. Soto, E (corresponding author), Beth Israel Deaconess Med Ctr, Dept Pain Med & Palliat Care, First Ave & 16th St, New York, NY 10003 USA. esoto2001@gmail.com AN - WOS:000329937400005 AU - Soto, E. AU - Galperin, M. AU - Portenoy, R. K. DA - Dec DO - 10.1097/ajp.0000000000000031 J2 - Clin. J. Pain KW - kyphoplasty polymethylmethacrylate thermal sympathectomy vertebral compression fracture hypotension VERTEBRAL COMPRESSION FRACTURES PERCUTANEOUS VERTEBROPLASTY BONE-CEMENT PULMONARY-EMBOLISM POLYMETHYLMETHACRYLATE METHACRYLATE MANAGEMENT COLLAPSE SAFETY DEATH Anesthesiology Clinical Neurology LA - English M1 - 12 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2013 SN - 0749-8047 SP - E49-E53 ST - Transient Thermal Sympathectomy as a Possible Mechanism for Hypotension After Kyphoplasty A Case Report T2 - Clinical Journal of Pain TI - Transient Thermal Sympathectomy as a Possible Mechanism for Hypotension After Kyphoplasty A Case Report UR - ://WOS:000329937400005 VL - 29 ID - 830274 ER - TY - JOUR AB - Cement embolism of the pulmonary arteries is a well-known complication of percutaneous vertebroplasty as well as orthopedic procedures involving instrumentation of the medullary canal. A few cases of paradoxical cement embolism have also been described. Herein, we report a case of cortical bone void filler embolism to the infragenicular arteries during revision spine surgery. The cement had entered the aorta via the left L3 lumbar artery. To the best of our knowledge, this is the first report of embolism due to direct arterial migration of cement during an orthopedic procedure. AD - 1st Department of Orthopedics, Athens University Medical School, Attikon Hospital, Athens, Greece. AN - 18834702 AU - Soultanis, K. AU - Kakisis, J. D. AU - Pyrovolou, N. AU - Lazaris, A. M. AU - Vasdekis, S. AU - Soukakos, P. DA - May-Jun DO - 10.1016/j.avsg.2008.08.027 DP - NLM ET - 2008/10/07 J2 - Annals of vascular surgery KW - Arterial Occlusive Diseases/diagnostic imaging/*etiology/surgery Bone Cements/*adverse effects Embolectomy Embolism, Paradoxical/diagnostic imaging/*etiology/surgery Humans Ischemia/etiology Lower Extremity/*blood supply Male Middle Aged Reoperation Sacrum/*surgery Spondylitis, Ankylosing/*surgery Thoracic Vertebrae/*surgery Tomography, X-Ray Computed Treatment Outcome Vertebroplasty/*adverse effects LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0890-5096 SP - 413.e9-12 ST - Peripheral arterial embolization of cement during revision spine surgery T2 - Ann Vasc Surg TI - Peripheral arterial embolization of cement during revision spine surgery VL - 23 ID - 828913 ER - TY - JOUR AD - Department of Anaesthesiology University Hospital of Heraklion, Greece Department of Orthopaedics and Traumatology University Hospital of Heraklion, Greece Department of Orthopedics Asklepieon Hospital Heraklion, Greece. AN - 107885718. Language: English. Entry Date: 20141107. Revision Date: 20200708. Publication Type: Journal Article AU - Souvatzis, Xenia AU - Alpantaki, Kalliopi AU - Hadjipavlou, Alexander DB - cin20 DO - 10.1097/BRS.0b013e3182a02381 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Cardiac Tamponade -- Etiology Embolism -- Etiology Heart Injuries -- Etiology Kyphoplasty -- Adverse Effects Lumbar Vertebrae -- Injuries Lumbar Vertebrae -- Surgery Spinal Fractures -- Surgery Female M1 - 19 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2013 SN - 0362-2436 SP - 1709-1709 ST - Letters...Spine (Phila Pa 1976). 2013 Mar 1;38(5):E316-8 T2 - Spine (03622436) TI - Letters...Spine (Phila Pa 1976). 2013 Mar 1;38(5):E316-8 UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=107885718&site=ehost-live&scope=site VL - 38 ID - 830651 ER - TY - JOUR AB - Venous air embolism has been reported to occur during total hip arthroplasty. The incidence of venous air embolism, however, has not been previously studied in a large series using Doppler ultrasound and mass spectrometry. Seventy patients undergoing total hip arthroplasty were monitored for venous air embolism with precordial Doppler ultrasound, central venous catheter, end-tidal N2 and CO2 (mass spectrometry), and arterial blood gases (ABG). Changes in the monitored variables consistent with venous air embolism were noted in 57% by Doppler ultrasound, 9% by mass spectrometry, 4% by central venous catheter and 3% of the cases by ABG. A total of 77 Doppler ultrasound events were detected in 40 of the 70 patients studied. Hemodynamic changes consisting of either hypotension, defined as a greater than or equal to 20% decrease in mean arterial pressure (MAP), or cardiac dysrhythmia occurred during 43% of these events. The Doppler ultrasound was the only monitor that detected all cases of venous air embolism with concomitant hemodynamic changes. Air was aspirated from the central venous catheter during 10% of the detections of venous air embolism by Doppler ultrasound. Venous air embolism in total hip arthroplasty is a common event and may be responsible for hemodynamic changes previously ascribed to the use of methylmethacrylate cement. Routine monitoring with Doppler ultrasound appears warranted. The routine use of central venous catheterization may also be warranted. AD - Department of Anesthesiology, Rush Medical College, Chicago, II. AN - 3078522 AU - Spiess, B. D. AU - Sloan, M. S. AU - McCarthy, R. J. AU - Lubenow, T. R. AU - Tuman, K. J. AU - Matz, S. D. AU - Ivankovich, A. D. DO - 10.1016/0952-8180(88)90007-4 DP - NLM ET - 1988/01/01 J2 - Journal of clinical anesthesia KW - Blood Gas Monitoring, Transcutaneous Embolism, Air/diagnosis/*epidemiology/physiopathology Hemodynamics Hip Joint/surgery *Hip Prosthesis Humans Incidence Mass Spectrometry Postoperative Complications Ultrasonography Veins/physiopathology LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 1988 SN - 0952-8180 (Print) 0952-8180 SP - 25-30 ST - The incidence of venous air embolism during total hip arthroplasty T2 - J Clin Anesth TI - The incidence of venous air embolism during total hip arthroplasty VL - 1 ID - 828837 ER - TY - JOUR AB - Aims A fracture of the hip is the most common serious orthopaedic injury, and surgical site infection (SSI) is one of the most significant complications, resulting in increased mortality, prolonged hospital stay and often the need for further surgery. Our aim was to determine whether high dose dual antibiotic impregnated bone cement decreases the rate of infection. Patients and Methods A quasi‐randomised study of 848 patients with an intracapsular fracture of the hip was conducted in one large teaching hospital on two sites. All were treated with a hemiarthroplasty. A total of 448 patients received low dose single‐antibiotic impregnated cement (control group) and 400 patients received high dose dual‐antibiotic impregnated cement (intervention group). The primary outcome measure was deep SSI at one year after surgery. Results The rate of deep SSI was 3.5% in the control group and 1.1% in the intervention group (p = 0.041; logistic regression adjusting for age and gender). The overall rate of non‐infective surgical complications did not differ between the two groups (unadjusted chi‐squared test; p > 0.999). Conclusion The use of high dose dual‐antibiotic impregnated cement in these patients significantly reduces the rate of SSI compared with standard low dose single antibiotic loaded bone cement. Copyright © 2016 The British Editorial Society of Bone & Joint Surgery. AN - CN-01373489 AU - Sprowson, A. P. AU - Jensen, C. AU - Chambers, S. AU - Parsons, N. R. AU - Aradhyula, N. M. AU - Carluke, I. AU - Inman, D. AU - Reed, M. R. DO - 10.1302/0301-620X.98B11.34693 KW - *antibiotic bone cement/dt [Drug Therapy] *clindamycin/do [Drug Dose] *clindamycin/dt [Drug Therapy] *dual antibiotic laden cement/dt [Drug Therapy] *gentamicin/cb [Drug Combination] *gentamicin/do [Drug Dose] *gentamicin/dt [Drug Therapy] *hip fracture/su [Surgery] *hip hemiarthroplasty *surgical infection/co [Complication] *surgical infection/dt [Drug Therapy] *surgical infection/pc [Prevention] Age Aged Article Aspiration pneumonia/co [Complication] Cerebrovascular accident/co [Complication] Chi square test Clinical effectiveness Clostridium difficile infection/co [Complication] Controlled study Deep vein thrombosis/co [Complication] Drug megadose Female Gastrointestinal hemorrhage/co [Complication] Gender Heart infarction/co [Complication] Hospital readmission Human Hyponatremia/co [Complication] Ischemia/co [Complication] Kidney failure/co [Complication] Logistic regression analysis Low drug dose Lung embolism/co [Complication] Major clinical study Male Outcome assessment Pneumonia/co [Complication] Postoperative complication/co [Complication] Priority journal Randomized controlled trial Single drug dose Surgical infection/dt [Drug Therapy] Teicoplanin/cb [Drug Combination] Treatment outcome Unclassified drug Urinary tract infection/co [Complication] Very elderly M1 - 11 M3 - Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2016 SP - 1534‐1541 ST - The use of high-dose dual-impregnated antibiotic-laden cement with hemiarthroplasty for the treatment of a fracture of the hip the fractured hip infection trial T2 - Bone and joint journal TI - The use of high-dose dual-impregnated antibiotic-laden cement with hemiarthroplasty for the treatment of a fracture of the hip the fractured hip infection trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01373489/full VL - 98‐B ID - 830007 ER - TY - JOUR AB - Purpose: We aimed to report approach, safety, technical success, and clinical outcomes of prone trans- radial access (PTRA) and demonstrate feasibility for procedures requiring simultaneous arterial intervention and prone percutaneous access.Methods: Fifteen patients underwent PTRA, seven females (47%) and eight males (53%), mean age of 55 years (range, 19-78 years). All patients underwent PTRA for combined transarterial and posterior-approach percutaneous interventions. Variables included sheath size (French, F), type of anesthesia, arterial intervention technical success, posterior-approach percutaneous intervention technical success, estimated blood loss (mL), fluoroscopy and procedure time, complications, and follow-up.Results: Mean sheath size was 4 F (range, 4-6 F; SD = 0.5). Arterial interventions included transarterial embolization of renal (n=6), hepatic (n=2), and pelvic vessels (n=2), diagnostic arteriography (n=4), and embolization of an arteriovenous malformation (n=1). Posterior-approach intervention technical success was 100% (15/15). PTRA technical success was 100% (15/15). Posterior-approach percutaneous interventions included retroperitoneal (n=5) and pelvic (n=1) mass biopsies, nephrostomy tube placement (n=2), cryoablation of pelvic (n=2) and renal (n=1) masses, sclerotherapy of arteriovenous malformations (n=2), foreign body removal from the renal collecting system (n=2), ablation of a renal tumor (n=1), intracavitary injection of pulmonary mycetoma (n=1), and ablation and cementoplasty of a vertebral body tumor (n=1). The biopsies were diagnostic (6/6). There were no minor or major access-site complications.Conclusion: PTRA is a safe and feasible method for performing combined arterial and posterior approach percutaneous interventions without the need for repositioning. AD - From the Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health Systems, Ann Arbor, Michigan, USA Department of Radiology, University of Michigan Medical School, Ann Arbor, Michigan, USA Division of Vascular and Interventional Radiology, Department of Radiology, University of Michigan Health Systems, Ann Arbor, Michigan, USA AN - 131800085. Language: English. Entry Date: In Process. Revision Date: 20190111. Publication Type: journal article. Journal Subset: Biomedical AU - Srinivasa, Rajiv N. AU - Beecham Chick, Jeffrey Forris AU - Gemmete, Joseph J. AU - Majdalany, Bill S. AU - Hage, Anthony AU - Jo, Alex AU - Srinivasa, Ravi N. AU - Chick, Jeffrey Forris Beecham DB - cin20 DO - 10.5152/dir.2018.18050 DP - EBSCOhost KW - Radial Artery -- Surgery Catheterization, Peripheral -- Equipment and Supplies Sclerotherapy -- Methods Embolization, Therapeutic -- Methods Angiography -- Methods Arteriovenous Malformations -- Surgery Blood Loss, Surgical Female Catheterization, Peripheral -- Statistics and Numerical Data Retrospective Design Male Treatment Outcomes Adult Catheterization, Peripheral -- Methods Embolization, Therapeutic -- Equipment and Supplies Urinary Diversion -- Methods Angiography -- Equipment and Supplies Aged Cryosurgery -- Methods Middle Age Scales M1 - 5 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2018 SN - 1305-3825 SP - 276-282 ST - Prone transradial catheterization for combined single-session endovascular and percutaneous interventions: approach, technical success, safety, and outcomes in 15 patients T2 - Diagnostic & Interventional Radiology TI - Prone transradial catheterization for combined single-session endovascular and percutaneous interventions: approach, technical success, safety, and outcomes in 15 patients UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=131800085&site=ehost-live&scope=site VL - 24 ID - 830548 ER - TY - JOUR AB - Background: Tranexamic acid (TXA) is efficiently used to control blood loss during total knee arthroplasty (TKA). The role of intraarticular epinephrine needs further clarification. Limited data exist, concerning the combined use of intravenous and intraarticular TXA plus epinephrine in the intraoperative management of blood loss in patients undergoing TKA. Methods: This study aimed to evaluate the safety and efficacy of intravenous and intraarticular TXA plus epinephrine in the intraoperative blood management in primary TKA. In this case-control study, 204 patients undergoing primary cemented TKA were enrolled. One hundred two patients received one gr TXA intravenously and intraarticular injection of a mixture containing 500 mg TXA and 0.6 mg epinephrine. They compared to a historical control group comprised of 102 patients that received the same drug combination without epinephrine. The two groups were comparable concerning age, sex, the grade of osteoarthritis, and preoperative hemoglobin and hematocrit. Results: The epinephrine group had significantly higher postoperative hemoglobin (11.70 vs 10.75, p <0.001) and hematocrit (35.70 vs 32.25, p <0.001) compared to the control group at the first postoperative day. The epinephrine group received fewer transfusions, not reaching statistical significance (p =0.110), compared to the control group during hospitalization. The rate of complications was similar between the groups. The combined use of TXA and epinephrine was positively associated with a smaller postoperative hemoglobin drop. Conclusion: The combination of intravenous and intraarticular TXA plus epinephrine was safe and reduced the drop of hemoglobin at the first postop day but not significantly the rate of transfusions, in patients undergoing primary TKA. Future higher-level of evidence studies are needed to validate these results. AD - E. Kenanidis, Pontou str., Panorama, Thessaloniki, Greece AU - Stamatopoulos, A. AU - Stamatopoulos, T. AU - Kenanidis, E. AU - Potoupnis, M. AU - Sayegh, F. AU - Tsiridis, E. DB - Embase KW - compression stocking creatine epinephrine hemoglobin rivaroxaban tranexamic acid aged anticoagulant therapy article blood analysis blood transfusion case control study controlled study deep vein thrombosis dizziness drug efficacy drug safety female hematocrit hematoma human hypotension knee osteoarthritis lung embolism major clinical study operative blood loss preoperative period total knee arthroplasty treatment outcome wound closure wound infection LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1790-8019 1108-4189 SP - 86-90 ST - Intravenous and intraarticular tranexamic acid plus epinephrine for the management of blood loss after cemented total knee arthroplasty: A case-control study T2 - Hippokratia TI - Intravenous and intraarticular tranexamic acid plus epinephrine for the management of blood loss after cemented total knee arthroplasty: A case-control study UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2002062249&from=export VL - 22 ID - 829208 ER - TY - JOUR AD - Department of Diagnostic Radiology, University of Heidelberg Medical Center, INF 110, 69120 Heidelberg, Germany. AN - 105808773. Language: English. Entry Date: 20080905. Revision Date: 20150711. Publication Type: Journal Article. Journal Subset: Biomedical AU - Stampfl, S. AU - Bellemann, N. AU - Stampfl, U. AU - Radeleff, B. AU - Lopez-Benitez, R. AU - Sommer, C. M. AU - Thierjung, H. AU - Berger, I. AU - Richter, G. M. DB - cin20 DP - EBSCOhost KW - Embolization, Therapeutic Acrylic Resins Angiography Animals Gels Inflammation Methylmethacrylates Models, Biological Nonparametric Statistics Polyvinyls Proteins Swine M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2008 SN - 1051-0443 SP - 577-586 ST - Inflammation and recanalization of four different spherical embolization agents in the porcine kidney model T2 - Journal of Vascular & Interventional Radiology TI - Inflammation and recanalization of four different spherical embolization agents in the porcine kidney model UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105808773&site=ehost-live&scope=site VL - 19 ID - 830753 ER - TY - JOUR AB - The objective of this study was to evaluate inflammatory response and recanalization after embolization with a new spherical embolic agent based on a core and shell design with a hydrogel core of polymethylmethacrylate (PMMA) and a Polyzene-F nanoscale coating in a porcine kidney model. Thirty-six minipigs were enrolled for superselective renal embolization. Polyzene-F-coated PMMA particles and uncoated PMMA particles with a diameter of 300-600 mum were used. Either 4 or 12 weeks post-embolization, arteriography of the embolized kidneys was performed and then compared with pre- and immediate post-embolization arteriograms using a specific recanalization score to determine the extent of recanalization. Using a microscopic inflammation score (Banff classification), the embolized organs were examined for local inflammatory effects which occurred in response to the embolic agent. In Polyzene-F-coated particles, the Banff classification showed an average inflammation score of 0.26 +/- 0.58 at 4 weeks and of 0.08 +/- 0.28 at 12 weeks. In uncoated particles, the Banff score measured 0.37 +/- 0.6 at 4 weeks, which was higher, but without a statistically significant difference. According to the recanalization score used in this study, mild angiographic recanalization was evident in all groups, without statistically significant differences (3.0 +/- 0.71 in coated particles, 3.09 +/- 0.81 in uncoated particles; p = 0.74). We conclude that both uncoated hydrogel particles and Polyzene-F-coated embolic agents triggered virtually no inflammatory response and effectively occluded target arteries. This study demonstrates good biocompatibility of the new embolic material. As in other spherical embolic agents, recanalization can occur to some degree. AD - Department of Diagnostic Radiology, University of Heidelberg Medical Center, Heidelberg, Germany AN - 105701347. Language: English. Entry Date: 20081128. Revision Date: 20200708. Publication Type: journal article AU - Stampfl, S. AU - Stampfl, U. AU - Bellemann, N. AU - Sommer, C. M. AU - Thierjung, H. AU - Radeleff, B. AU - Lopez-Benitez, R. AU - Berger, I. AU - Kauffmann, G. W. AU - Richter, G. M. AU - Stampfl, Sibylle AU - Stampfl, Ulrike AU - Bellemann, Nadine AU - Sommer, Christof M. AU - Thierjung, Heidi AU - Radeleff, Boris AU - Lopez-Benitez, Ruben AU - Berger, Irina AU - Kauffmann, Guenter W. AU - Richter, Goetz M. DB - cin20 DO - 10.1007/s00270-007-9268-2 DP - EBSCOhost KW - Arteritis -- Pathology Biocompatible Materials Embolization, Therapeutic -- Methods Methylmethacrylates -- Pharmacodynamics Renal Artery -- Pathology Acrylic Resins Angiography -- Methods Animals Arteritis -- Radiography Gels -- Pharmacodynamics Kidney -- Blood Supply Kidney -- Pathology Kidney -- Radiography Models, Biological Nonparametric Statistics Particle Size Polymers -- Pharmacodynamics Probability Proteins Random Assignment Renal Artery -- Radiography Renal Circulation -- Physiology Risk Assessment Sensitivity and Specificity Swine Animal Studies M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2008 SN - 0174-1551 SP - 799-806 ST - Biocompatibility and recanalization characteristics of hydrogel microspheres with polyzene-F as polymer coating T2 - CardioVascular & Interventional Radiology TI - Biocompatibility and recanalization characteristics of hydrogel microspheres with polyzene-F as polymer coating UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105701347&site=ehost-live&scope=site VL - 31 ID - 830749 ER - TY - JOUR AB - OBJECTIVE The treatment of cervical spinal metastases represents a controversial issue regarding the type, extent, and invasiveness of interventions. In the lumbar and thoracic spine, kypho-and vertebroplasties have been established as minimally invasive procedures for patients with metastases to the vertebral bodies and without neurological deficit. These procedures show good results with respect to pain reduction and low complication rates. However, limited data are available for kypho- and vertebroplasties for cervical spinal metastases. In an effort to add to existing data, the authors here present a case series of 14 patients who were treated for osteolytic metastases of the cervical spine using vertebroplasty alone or in addition to another surgical procedure involving the cervical spine in a palliative setting to reduce pain and restore stability. METHODS Fourteen patients consisting of 8 males and 6 females, with a mean age of 64.7 years (range 44-85 years), were treated with vertebroplasty at the authors' clinic between January 2015 and November 2016. In total, 25 vertebrae were treated with vertebroplasty: 10 C-2, 5 C-3, 2 C-4, 2 C-5, 3 C-6, and 3 C-7. Two patients had an additional posterior stabilization and 5 patients an additional anterior stabilization. In 13 cases, the surgical approach was a modified Smith-Robinson approach; in 1 case, the cement was injected into the corpus axis from posteriorly. Patients with osteolytic defects of the posterior wall of the vertebral body did not undergo surgery, nor did patients with neurological deficits. Pre-operatively, on the 2nd day after surgery, and at the follow-up, neck pain was rated using the visual analog scale (VAS). RESULTS Twelve patients were examined at follow-up (mean 9 months). Neck pain was rated as a mean of 6.0 (range 3-8) preoperatively, 2.9 on Day 2 after surgery (range 0-5), and 0.5 at the follow-up (range 0-4), according to the VAS. The mean Neck Disability Index at follow-up was 3.6% (range 0%-18%). CONCLUSIONS Anterior vertebroplasty of the cervical spine via an anterolateral approach represents a safe and minimally invasive procedure with a low complication rate and appears suitable for reducing pain and restoring stability in cases of cervical spinal metastases. Vertebroplasties can be combined with other anterior and posterior operations of the cervical spine and, in the axis vertebra, can be performed transpedicularly from posteriorly. Thus, in cases in which the posterior wall of the vertebral body is intact, vertebroplasty represents a less invasive alternative to vertebral replacement in oncological surgery. Prospective randomized trials with a longer follow-up period and a larger patient cohort are needed to confirm the encouraging results of this case series. AD - [Stangenberg, Martin; Dreimann, Marc] Univ Hosp Hamburg Eppendorf, Dept Trauma Hand & Reconstruct Surg, Hamburg, Germany. [Viezens, Lennart] Univ Hosp Hamburg Eppendorf, Dept Neurosurg, Hamburg, Germany. [Eicker, Sven O.; Mohme, Malte; Mende, Klaus C.] Univ Hosp Gottingen, Dept Trauma Surg Orthoped & Plast Surg, Gottingen, Germany. Stangenberg, M (corresponding author), Univ Hosp Hamburg Eppendorf, Martinistr 52, D-20246 Hamburg, Germany. m.stangenberg@uke.de AN - WOS:000408714300004 AU - Stangenberg, M. AU - Viezens, L. AU - Eicker, S. O. AU - Mohme, M. AU - Mende, K. C. AU - Dreimann, M. C7 - E3 DA - Aug DO - 10.3171/2017.5.focus17175 J2 - Neurosurg. Focus KW - vertebroplasty cervical metastasis osteolysis tumor minimally invasive surgery PULMONARY CEMENT EMBOLISM NECK-DISABILITY-INDEX QUALITY-OF-LIFE PERCUTANEOUS VERTEBROPLASTY BONE-CEMENT VERTEBRAL AUGMENTATION SPINAL METASTASES KYPHOPLASTY SYSTEM PAIN Clinical Neurology Surgery LA - English M1 - 2 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2017 SN - 1092-0684 SP - 8 ST - Cervical vertebroplasty for osteolytic metastases as a minimally invasive therapeutic option in oncological surgery: outcome in 14 cases T2 - Neurosurgical Focus TI - Cervical vertebroplasty for osteolytic metastases as a minimally invasive therapeutic option in oncological surgery: outcome in 14 cases UR - ://WOS:000408714300004 VL - 43 ID - 830189 ER - TY - JOUR AB - Percutaneous vertebroplasty consists of percutaneous injection of polymethylmethacrylate (PMMA) via a transpedicular approach for the treatment of collapsed osteoporotic or metastatic vertebrae. Even if percutaneous vertebroplasty is considered to be minimally invasive, threatening complications can occur. Cement leakage is the most common complication of percutaneous vertebroplasty. Rigorous patient selection and individual therapeutic strategy may reduce the occurrence of leakage, in particular the risk of cement entry into the venous system and the spinal canal is the potent major hazard of this technique. Cement pulmonary and cardiac embolism are reported in literature as a cause of unexpected death after percutaneous vertebroplasty. Authors report a fatal case of pulmonary cement embolization occurred after vertebroplasty with haemopericardium, due to the perforation of the right atrium wall from a cement solidified fragment. A complete post mortem examination documented the presence of multiple cement fragments in the pulmonary arteries and transmural perforation of the wall of the right atrium by a whitish needle-like foreign body. Pulmonary microembolization was observed under polarized light. AD - [Stefano, D'Errico; Sara, Niballi; Diana, Bonuccelli] Azienda USL Toscana Nordovest, Dept Legal Med, Lucca, Italy. Stefano, D (corresponding author), Azienda USL Toscana Nordovest, Dept Legal Med, Lucca, Italy. stefano.derrico@uslnordovest.toscana.it AN - WOS:000461349700009 AU - Stefano, D. AU - Sara, N. AU - Diana, B. DA - Apr DO - 10.1016/j.jflm.2019.03.004 J2 - J. Forensic Leg. Med. KW - Percutaneous vertebroplasty Cement leakage Cardiac perforation RIGHT-VENTRICULAR PERFORATION INTRACARDIAC BONE-CEMENT RARE COMPLICATION POLYMETHYLMETHACRYLATE KYPHOPLASTY MANAGEMENT LEAKAGE Medicine, Legal LA - English M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 1752-928X SP - 48-51 ST - Fatal cardiac perforation and pulmonary embolism of leaked cement after percutaneous vertebroplasty T2 - Journal of Forensic and Legal Medicine TI - Fatal cardiac perforation and pulmonary embolism of leaked cement after percutaneous vertebroplasty UR - ://WOS:000461349700009 VL - 63 ID - 830142 ER - TY - JOUR AB - Percutaneous vertebroplasty consists of percutaneous injection of polymethylmethacrylate (PMMA) via a transpedicular approach for the treatment of collapsed osteoporotic or metastatic vertebrae. Even if percutaneous vertebroplasty is considered to be minimally invasive, threatening complications can occur. Cement leakage is the most common complication of percutaneous vertebroplasty. Rigorous patient selection and individual therapeutic strategy may reduce the occurrence of leakage, in particular the risk of cement entry into the venous system and the spinal canal is the potent major hazard of this technique. Cement pulmonary and cardiac embolism are reported in literature as a cause of unexpected death after percutaneous vertebroplasty. Authors report a fatal case of pulmonary cement embolization occurred after vertebroplasty with haemopericardium, due to the perforation of the right atrium wall from a cement solidified fragment. A complete post mortem examination documented the presence of multiple cement fragments in the pulmonary arteries and transmural perforation of the wall of the right atrium by a whitish needle-like foreign body. Pulmonary microembolization was observed under polarized light. AD - D.E. Stefano, Department of Legal Medicine, Azienda USL Toscana Nordovest, Lucca, Italy AU - Stefano, D. E. AU - Sara, N. AU - Diana, B. DB - Embase Medline DO - 10.1016/j.jflm.2019.03.004 KW - bone cement device poly(methyl methacrylate) aged arteriolosclerosis article autopsy backache bone cement leakage case report clinical article emphysema fatality female foreign body heart perforation heart tamponade human lung embolism osteoporosis percutaneous vertebroplasty resuscitation spine fracture sudden cardiac death thoracic spine LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1878-7487 1752-928X SP - 48-51 ST - Fatal cardiac perforation and pulmonary embolism of leaked cement after percutaneous vertebroplasty T2 - Journal of Forensic and Legal Medicine TI - Fatal cardiac perforation and pulmonary embolism of leaked cement after percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2001675111&from=export http://dx.doi.org/10.1016/j.jflm.2019.03.004 VL - 63 ID - 829146 ER - TY - JOUR AB - Percutaneous vertebroplasty consists of percutaneous injection of polymethylmethacrylate (PMMA) via a transpedicular approach for the treatment of collapsed osteoporotic or metastatic vertebrae. Even if percutaneous vertebroplasty is considered to be minimally invasive, threatening complications can occur. Cement leakage is the most common complication of percutaneous vertebroplasty. Rigorous patient selection and individual therapeutic strategy may reduce the occurrence of leakage, in particular the risk of cement entry into the venous system and the spinal canal is the potent major hazard of this technique. Cement pulmonary and cardiac embolism are reported in literature as a cause of unexpected death after percutaneous vertebroplasty. Authors report a fatal case of pulmonary cement embolization occurred after vertebroplasty with haemopericardium, due to the perforation of the right atrium wall from a cement solidified fragment. A complete post mortem examination documented the presence of multiple cement fragments in the pulmonary arteries and transmural perforation of the wall of the right atrium by a whitish needle-like foreign body. Pulmonary microembolization was observed under polarized light. AD - Department of Legal Medicine, Azienda USL Toscana Nordovest, Lucca, Italy AN - 135491645. Language: English. Entry Date: In Process. Revision Date: 20190424. Publication Type: journal article AU - Stefano, D'Errico AU - Sara, Niballi AU - Diana, Bonuccelli AU - D'Errico, Stefano AU - Niballi, Sara AU - Bonuccelli, Diana DB - cin20 DO - 10.1016/j.jflm.2019.03.004 DP - EBSCOhost KW - Pulmonary Embolism -- Pathology Extravasation of Diagnostic and Therapeutic Materials -- Complications Death, Sudden -- Etiology Bone Cements -- Adverse Effects Vertebroplasty -- Adverse Effects Heart Atrium -- Injuries Foreign Bodies -- Pathology Aged Methylmethacrylates -- Adverse Effects Forensic Pathology Fractures, Compression -- Surgery Female Heart Atrium -- Pathology Spinal Fractures -- Surgery N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2019 SN - 1752-928X SP - 48-51 ST - Fatal cardiac perforation and pulmonary embolism of leaked cement after percutaneous vertebroplasty T2 - Journal of Forensic & Legal Medicine TI - Fatal cardiac perforation and pulmonary embolism of leaked cement after percutaneous vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=135491645&site=ehost-live&scope=site VL - 63 ID - 830535 ER - TY - JOUR AB - Objectives: Balloon Kyphoplasty (BKP) for vertebral compression fractures (VCFs) in cancer patients is more challenging than for osteoporotic ones. Cord compressions are frequent and the incidence of complications tenfold greater. Polymethylmetacrylate (PMMA) is the gold standard material for BKP but has disadvantages: exothermic reaction, short working time, rapid solidification, absence of osteoconduction. VK100 is a mixture of Dimethyl Methylvinyl siloxane and Barium Sulphate. It is elastic, adhesive to bone, leaves 30 min before solidification without exothermic reaction, and shows a stiffness close to the intact vertebrae. The surgical procedure, called elastoplasty, is similar to a BKP. Clinical results obtained with this new silicone in pathological VCFs have been investigated. Patients and Methods: 41 cancer patients with symptomatic VCFs (70 vertebral bodies), underwent percutaneous and open elastoplasties. Post-operative leakages, pulmonary embolism (PE) and adjacent fractures were carefully evaluated with neuroimaging. KPS, VAS and Dennis Pain Score were calculated pre- post-operatively and at the last follow-up. Results: The mean volume of silicone inserted in each vertebra was 3.8 cc. Complications included seven leakages (17%), two asymptomatic PE (4.3%) and 3 post-operative adjacent fractures (7.3%). Median follow-up was 29 months. A significant improvement was observed in KPS, VAS and Dennis Pain Score (p < .0001). The 1yr survival rate was 76.9%. Conclusions: Elastoplasty appears a safe and effective palliative treatment of VCFs in oncologic patients. Useful qualities of VK100 are the lack of exothermic reaction and the wider working window. The influence of biomechanical properties of silicone on reduction of adjacent level fractures requires further investigations. AD - [Stefano, Telera; Mfredo, Pompili; Francesco, Crispo; Laura, Raus] IRCSS Natl Canc Inst Regina Elena, Dept Neurosurg, Via Elio Chianesi 53, I-00144 Rome, Italy. [Maddalena, Giovannetti] IRCSS Natl Canc Inst Regina Elena, Dept Anesthesiol, Rome, Italy. [Andrea, Pace; Veronica, Villani] IRCSS Natl Canc Inst Regina Elena, Dept Neurol, Rome, Italy. [Alessandra, Fabi] IRCSS Natl Canc Inst Regina Elena, Dept Oncol A, Rome, Italy. [Isabella, Sperduti] IRCSS Natl Canc Inst Regina Elena, Dept Biostat, Rome, Italy. Stefano, T (corresponding author), Regina Elena Inst Canc Res, Dept Neurosurg, Via Elio Chianesi 53, I-00144 Rome, Italy. stefano.telera@ifo.gov.it AN - WOS:000439673100030 AU - Stefano, T. AU - Mfredo, P. AU - Francesco, C. AU - Maddalena, G. AU - Andrea, P. AU - Veronica, V. AU - Alessandra, F. AU - Isabella, S. AU - Laura, R. DA - Aug DO - 10.1016/j.clineuro.2018.06.018 J2 - Clin. Neurol. Neurosurg. KW - Elastoplasty Ballon Kyphoplasty Silicone Spinal metastases VK 100 VERTEBRAL AUGMENTATION PMMA CEMENT VERTEBROPLASTY FRACTURE POLYMETHYLMETHACRYLATE EXPERIENCE Clinical Neurology Surgery LA - English M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 0303-8467 SP - 184-189 ST - Kyphoplasty with purified silicone VK100 (Elastoplasty) to treat spinal lytic lesions in cancer patients: A retrospective evaluation of 41 cases T2 - Clinical Neurology and Neurosurgery TI - Kyphoplasty with purified silicone VK100 (Elastoplasty) to treat spinal lytic lesions in cancer patients: A retrospective evaluation of 41 cases UR - ://WOS:000439673100030 VL - 171 ID - 830161 ER - TY - JOUR AB - Spinal metastases are a common and morbid condition in America. Of the 1.6 million new cases of cancer estimated to be diagnosed in the USA in 2015, approximately 5–10 % will develop spinal metastases. This number is expected to increase as the life expectancy of cancer patients increases. Patients with osteolytic spinal metastases experience severe and often debilitating pain, which significantly reduces quality of life. Due to the morbidity of open surgery, particularly in oncologic patients, the treatment paradigm has shifted towards minimally invasive therapy. The advent and evolution of percutaneous treatments of spinal metastases has shown progressive success in reducing pain, improving function, and providing mechanical stability. There are various currently available interventions including vertebroplasty, vertebral augmentation, and coblation and radiofrequency ablation systems. For more complex spinal metastases, combined treatments including vertebral augmentation in conjunction with radiofrequency ablation, external beam radiation, and the novel treatment of intraoperative radiotherapy are also available. Ultimately, the goal of treatment in this patient population is palliative with the intention of improving the remaining quality of life. There is no established algorithm or specific technique that has proved best for the many variations of vertebral compression fractures (VCFs), so treatment tends to be dependent on the operator and/or based on institution preference or bias. Each technique provides its own unique value in the various types of metastatic VCFs encountered, and understanding the uses, advantages, and safety profile of each specific treatment is imperative in providing the best patient care. Percutaneous treatment of metastatic spinal disease is an excellent alternative to medical and surgical management in carefully selected patients. We believe that a multidisciplinary approach and combination therapy allows for optimal pain reduction and improvement of function. AD - M.B. Stephenson, Department of Vascular and Interventional Radiology, Loyola University Medical Center, 2160 South 1st Avenue, Maywood, IL, United States AU - Stephenson, M. B. AU - Glaenzer, B. AU - Malamis, A. DB - Embase Medline DO - 10.1007/s11864-016-0433-1 KW - bone cement poly(methyl methacrylate) backache bone cement leakage compression fracture external beam radiotherapy human intraoperative radiotherapy kyphoplasty lung embolism minimally invasive procedure musculoskeletal system parameters percutaneous vertebroplasty plasma mediated radiofrequency ablation quality of life radiofrequency ablation review spinal cord metastasis vertebra body vertebral height LA - English M1 - 11 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1534-6277 1527-2729 ST - Percutaneous Minimally Invasive Techniques in the Treatment of Spinal Metastases T2 - Current Treatment Options in Oncology TI - Percutaneous Minimally Invasive Techniques in the Treatment of Spinal Metastases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L612205970&from=export http://dx.doi.org/10.1007/s11864-016-0433-1 VL - 17 ID - 829299 ER - TY - JOUR AN - 23513234 AU - Stevens, A. C. DA - Mar DO - 10.1136/emermed-2013-202432 DP - NLM ET - 2013/03/21 J2 - Emergency medicine journal : EMJ KW - Aged Bone Cements/*adverse effects Humans Male Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/*diagnostic imaging/etiology Pulmonary Infarction/*diagnostic imaging/etiology Radiography Vertebroplasty/*adverse effects chest imaging, x-ray respiratory, pulmonary embolism spinal thrombo-embolic disease LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1472-0205 SP - 257 ST - Polymethylmethacrylate cement pulmonary embolism and infarct T2 - Emerg Med J TI - Polymethylmethacrylate cement pulmonary embolism and infarct VL - 31 ID - 828848 ER - TY - JOUR AN - 22619836 AU - Stiefelhagen, P. DA - Mar 8 DO - 10.1007/s15006-012-0237-6 DP - NLM ET - 2012/05/25 J2 - MMW Fortschritte der Medizin KW - *Bone Cements Cardiopulmonary Bypass Foreign-Body Migration/*diagnosis/surgery Humans Lumbar Vertebrae/*surgery Male Middle Aged Postoperative Complications/*etiology/surgery *Pulmonary Artery/surgery Pulmonary Embolism/*etiology/surgery Reoperation Spinal Fusion/*adverse effects Spondylolisthesis/*surgery Tomography, X-Ray Computed LA - ger M1 - 4 N1 - PubMed NLM literature search January 5, 2021 OP - Lungenembolie nach Wirbelsäulenoperation: Was steckt denn da in der Pulmonalarterie? PY - 2012 SN - 1438-3276 (Print) 1438-3276 SP - 34 ST - [Pulmonary embolism after spinal operation: what lies in the pulmonary artery?] T2 - MMW Fortschr Med TI - [Pulmonary embolism after spinal operation: what lies in the pulmonary artery?] VL - 154 ID - 828989 ER - TY - JOUR AN - 27668464 AU - Streithoff, F. AU - Tacke, J. DA - Feb DO - 10.1055/s-0042-116948 DP - NLM ET - 2016/09/27 J2 - RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin KW - Aged Bone Cements/*adverse effects Catheter Ablation/*adverse effects Diagnosis, Differential Extravasation of Diagnostic and Therapeutic Materials/*complications/diagnosis Humans Kyphoplasty/*adverse effects Male Osteoporotic Fractures/complications/diagnostic imaging/*therapy Pulmonary Embolism/diagnostic imaging/*etiology Treatment Outcome LA - ger M1 - 2 N1 - PubMed NLM literature search January 5, 2021 OP - Ungewöhnlich konfigurierte pulmonalarterielle Zementembolie durch Radiofrequenz-Kyphoplastie. PY - 2017 SN - 1438-9010 SP - 157-158 ST - [Not Available] T2 - Rofo TI - [Not Available] VL - 189 ID - 828992 ER - TY - JOUR AB - Pulmonary polymethylmethacrylate embolism is a rare but potentially fatal complication of percutaneous vertebroplasty. Clinical signs are typical for pulmonary embolism: they include respiratory distress, hypotension, and decreases in end-tidal CO,. We report a case of fatal pulmonary polymethylinethacrylate embolism during percutaneous vertebroplasty that initially presented with hypertension (arterial blood pressure 190/90 mm Hg), normocardia, and hypercapnia (Paco(2) 96 mm Hg), along with loss of consciousness. Several pieces of polymethylmethacrylate were found in the pulmonary vasculature at autopsy. AD - Univ Hosp Bern, Dept Anesthesiol, CH-3010 Bern, Switzerland. Univ Hosp Bern, Dept Orthoped Surg, CH-3010 Bern, Switzerland. Univ Bern, Inst Legal Med, Bern, Switzerland. Univ Bern, Dept Intens Care Med, Bern, Switzerland. Stricker, K (corresponding author), Univ Hosp Bern, Dept Anesthesiol, CH-3010 Bern, Switzerland. Kay.Stricker@insel.ch AN - WOS:000220491700058 AU - Stricker, K. AU - Orler, R. AU - Yen, K. AU - Takala, J. AU - Luginbuhl, M. DA - Apr DO - 10.1213/01.ane.0000104585.83801.c5 J2 - Anesth. Analg. KW - PERCUTANEOUS VERTEBROPLASTY Anesthesiology LA - English M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2004 SN - 0003-2999 SP - 1184-1186 ST - Severe hypercapnia due to pulmonary embolism of polymethylmethacrylate during vertebroplasty T2 - Anesthesia and Analgesia TI - Severe hypercapnia due to pulmonary embolism of polymethylmethacrylate during vertebroplasty UR - ://WOS:000220491700058 VL - 98 ID - 830439 ER - TY - JOUR AB - Pulmonary polymethylmethacrylate embolism is a rare but potentially fatal complication of percutaneous vertebroplasty. Clinical signs are typical for pulmonary embolism: they include respiratory distress, hypotension, and decreases in end-tidal CO(2). We report a case of fatal pulmonary polymethylmethacrylate embolism during percutaneous vertebroplasty that initially presented with hypertension (arterial blood pressure 190/90 mm Hg), normocardia, and hypercapnia (PaCO(2) 96 mm Hg), along with loss of consciousness. Several pieces of polymethylmethacrylate were found in the pulmonary vasculature at autopsy. IMPLICATIONS: Osteoporotic spine fractures are increasingly treated by injection of bone cement into the vertebral body. Polymethylmethacrylate embolism is a rare but potentially fatal complication. We report on a case of polymethylmethacrylate embolism that was at first unrecognized because of uncharacteristic signs and symptoms. AD - Department of Anesthesiology, University Hospital of Bern, Switzerland. Kay.Stricker@insel.ch AN - 15041623 AU - Stricker, K. AU - Orler, R. AU - Yen, K. AU - Takala, J. AU - Luginbühl, M. DA - Apr DO - 10.1213/01.ane.0000104585.83801.c5 DP - NLM ET - 2004/03/26 J2 - Anesthesia and analgesia KW - Aged Bone Cements/*adverse effects Echocardiography Fatal Outcome Female Humans Hypercapnia/diagnostic imaging/*etiology/physiopathology Lumbar Vertebrae/*surgery Osteoporosis/complications Polymethyl Methacrylate/*adverse effects Pulmonary Embolism/*complications/diagnostic imaging/etiology Spinal Fractures/*surgery LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2004 SN - 0003-2999 (Print) 0003-2999 SP - 1184-6, table of contents ST - Severe hypercapnia due to pulmonary embolism of polymethylmethacrylate during vertebroplasty T2 - Anesth Analg TI - Severe hypercapnia due to pulmonary embolism of polymethylmethacrylate during vertebroplasty VL - 98 ID - 828911 ER - TY - JOUR AB - Pulmonary polymethylmethacrylate embolism is a rare but potentially fatal complication of percutaneous vertebroplasty. Clinical signs are typical for pulmonary embolism: they include respiratory distress, hypotension, and decreases in end-tidal CO2. We report a case of fatal pulmonary polymethylmethacrylate embolism during percutaneous vertebroplasty that initially presented with hypertension (arterial blood pressure 190/90 mm Hg), normocardia, and hypercapnia (PaCO2 96 mm Hg), along with loss of consciousness. Several pieces of polymethylmethacrylate were found in the pulmonary vasculature at autopsy. AD - K. Stricker, Department of Anesthesiology, University Hospital, CH-3010 Bern, Switzerland AU - Stricker, K. AU - Orler, R. AU - Yen, K. AU - Takala, J. AU - Luginbühl, M. DB - Embase Medline DO - 10.1213/01.ANE.0000104585.83801.C5 KW - acetylsalicylic acid alfentanil amiloride anesthetic agent hydrochlorothiazide ipratropium bromide poly(methyl methacrylate) prednisone salbutamol aged article autopsy case report chronic obstructive lung disease coma congestive heart failure end tidal carbon dioxide tension female general anesthesia geriatric patient high resolution computer tomography human hypercapnia iatrogenic disease injection low back pain lung dead space lung embolism osteoporosis percutaneous vertebroplasty priority journal spine fracture spine surgery transthoracic echocardiography vertebra body LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2004 SN - 0003-2999 SP - 1184-1186 ST - Severe Hypercapnia Due to Pulmonary Embolism of Polymethylinethacrylate during Vertebroplasty T2 - Anesthesia and Analgesia TI - Severe Hypercapnia Due to Pulmonary Embolism of Polymethylinethacrylate during Vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L38405445&from=export http://dx.doi.org/10.1213/01.ANE.0000104585.83801.C5 VL - 98 ID - 829841 ER - TY - JOUR AB - Purpose: To evaluate technical success, complications, and effective dose in patients undergoing CT fluoroscopy-guided iliosacral screw placement for the fixation of unstable posterior pelvic ring injuries. Materials and methods: Our retrospective analysis includes all consecutive patients with vertical sacral fractures and/or injury of the iliosacral joint treated with CT fluoroscopy-guided screw placement in our department from 11/2005 to 03/2013. Interventions were carried out under general anesthesia and CT fluoroscopy (10-20 mAs; 120 kV; 16- or 128-row scanner, Siemens Healthcare, Erlangen, Germany). Technical outcome, major and minor complications, and effective patient dose were analyzed. Results: We treated 99 consecutive patients (mean age 53.1∈±∈21.7 years, 50 male, 49 female) with posterior pelvic ring instability with CT fluoroscopy-guided screw placement. Intervention was technically successful in all patients (n∈=∈99). No major and one minor local complication occurred (1 %, secondary screw dislocation). General complications included three cases of death (3 %) due to pulmonary embolism (n∈=∈1), hemorrhagic shock (n∈=∈1), or cardiac event (n∈=∈1) during a follow-up period of 30 days. General complications were not related to the intervention. Mean effective patient radiation dose per intervention was 12.28 mSv∈±∈7.25 mSv. Mean procedural time was 72.1∈±∈37.4 min. Conclusions: CT fluoroscopy-guided screw placement for the treatment of posterior pelvic ring instabilities can be performed with high technical success and a low complication rate. This method provides excellent intrainterventional visualization of iliac and sacral bones, as well as the sacral neuroforamina for precise screw placement by applying an acceptable effective patient dose. © 2014 ISS. AD - F.F. Strobl, Institute for Clinical Radiology, Marchioninistr. 15, 81377 Munich, Germany AU - Strobl, F. F. AU - Haeussler, S. M. AU - Paprottka, P. M. AU - Hoffmann, R. T. AU - Pieske, O. AU - Reiser, M. F. AU - Trumm, C. G. DB - Embase Medline DO - 10.1007/s00256-014-1890-x KW - poly(methyl methacrylate) adult article bone screw cannula computed tomography scanner computer assisted tomography dislocation female fluoroscopy human iliac bone iliosacral screw imaging system interventional radiology Kirschner wire major clinical study male morbidity mortality operation duration pelvis fracture pelvis injury percutaneous vertebroplasty posterior pelvic ring injury priority journal radiation dose radiologist retrospective study sacrum treatment outcome vertebra body ACE DePuy Biomet Osteopal V CARE Vision CT Definition AS Somatom Definition Edge Somatom Sensation 16 LA - English M1 - 8 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1432-2161 0364-2348 SP - 1093-1100 ST - Technical and clinical outcome of percutaneous CT fluoroscopy-guided screw placement in unstable injuries of the posterior pelvic ring T2 - Skeletal Radiology TI - Technical and clinical outcome of percutaneous CT fluoroscopy-guided screw placement in unstable injuries of the posterior pelvic ring UR - https://www.embase.com/search/results?subaction=viewrecord&id=L53157055&from=export http://dx.doi.org/10.1007/s00256-014-1890-x VL - 43 ID - 829451 ER - TY - JOUR AB - In this study the results of the use of Austin Moore's and Monk's protheses in displaced subcapital femoral neck fractures have been compared. Patients treated with Monk's prosthesis did better. The relief of pain and sense of security in the early postoperative days were noteworthy findings in patients with Monk's prosthesis. No cases of fat embolism or cardiac arrest were reported with the use of cemented Monk's prosthesis. AN - 7409880 AU - Suman, R. K. DA - May DO - 10.1016/0020-1383(80)90103-5 DP - NLM ET - 1980/05/01 J2 - Injury KW - Aged Female Femoral Neck Fractures/*surgery Hip Joint/diagnostic imaging *Hip Prosthesis/mortality Humans Male Middle Aged Postoperative Complications Radiography LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 1980 SN - 0020-1383 (Print) 0020-1383 SP - 309-16 ST - Prosthetic replacement of the femoral head for fractures of the neck of the femur: a comparative study T2 - Injury TI - Prosthetic replacement of the femoral head for fractures of the neck of the femur: a comparative study VL - 11 ID - 829034 ER - TY - JOUR AD - E.M. Lindley, Department of Orthopedics, Anschutz Medical Campus, University of Colorado, 13001 E. 17th Pl., Aurora, CO, United States AU - Sun, D. AU - Burger, E. L. AU - Weyant, M. J. AU - Lindley, E. M. AU - Patel, V. V. DB - Embase DO - 10.1097/BCO.0000000000000274 KW - pedicle screw bone cement warfarin adult aged bladder function case report conservative treatment electrocardiogram feces incontinence female follow up gastrocnemius muscle heart ventricle function hip pain human international normalized ratio intestine function intramedullary nail lung embolism medical device complication middle aged mobile x ray unit muscle muscle weakness perineum physical examination postoperative period priority journal pulmonary cement embolism quadriceps femoris muscle review rheumatoid arthritis spinal cord compression spine tumor spondylolisthesis thoracic spine urine incontinence vertebral canal stenosis LA - English M1 - 5 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1941-7551 1940-7041 SP - 553-558 ST - Pulmonary cement embolism after navigated pedicle screw placement: A report of two cases and review of the literature T2 - Current Orthopaedic Practice TI - Pulmonary cement embolism after navigated pedicle screw placement: A report of two cases and review of the literature UR - https://www.embase.com/search/results?subaction=viewrecord&id=L606013253&from=export http://dx.doi.org/10.1097/BCO.0000000000000274 VL - 26 ID - 829393 ER - TY - JOUR AB - OBJECTIVE: To describe the application of polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar diseases with osteoporosis. METHODS: Observation group included 14 cases of degenerative lumbar diseases with osteoporosis received polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws from November 2014 to July 2015, control group included 12 cases of degenerative lumbar diseases with osteoporosis received polymethylmethacrylate augmentation with traditional pedicle screws.The operation time, blood loss, number of pedicle screws and number of augmented pedicle screws in the two groups were compared. The bone cement leakage and pulmonary bone cement embolism in the two groups were also compared. The fusion rate and pedicle screws loosening by lumbar X ray and dynamic X ray were evaluated. The clinical results were assessed by visual analog scale (VAS) of pain on lumbar and lower limbers, lumbar Japanese Orthopaedic Association scores (JOA), Prolo functional scores and Oswestry disability (ODI) scores. RESULTS: Differences of operation time and blood loss in the two groups were not statistically significant. The average number of pedicle screws was 9.9±4.7 and the average number of augmented pedicle screws was 5.9±2.6 in observation group while the average number of pedicle screws was 7.1±2.8 and the average number of augmented pedicle screws was 3.0±1.9 in control group. The ratio of augmented pedicle screws was higher in observation group than in control group (0.69±0.30 vs.0.47±0.30,P<0.05). The bone cement leakage rate was lower in observation group than in control group (5/83 vs. 12/42, P<0.01). All the cases in observation group were without leakage to the interspinal canal while one case in control group suffered from bone cement leakage to the interspinal canal with augmentation of 3 pedicle screws. The follow up period was (10.6±2.3) months in observation group and (36.5±7.2) months in control group. In final follow up, no case with non-fusion or pedicle screws loosening was found in both groups. Lumbar VAS, lower limbers VAS, lumbar JOA scores, Prolo functional scores and ODI scores were all better than pre-operation (P<0.01). CONCLUSION: Polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar diseases with osteoporosis was effective, with simple working processes and lower risk of bone cement leakage. The short-term clinical result was good. AD - Department of Orthopedics, Peking University First Hospital, Beijing 100034,China. AN - 27987507 AU - Sun, H. L. AU - Li, C. D. AU - Yang, Z. C. AU - Yi, X. D. AU - Liu, H. AU - Lu, H. L. AU - Li, H. AU - Wang, Y. DA - Dec 18 DP - NLM ET - 2016/12/18 J2 - Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences KW - Blood Loss, Surgical Bone Cements/*adverse effects/*therapeutic use Comparative Effectiveness Research Humans Low Back Pain/*surgery Lumbar Vertebrae/*surgery Operative Time Osteoporosis/*surgery Pain Measurement Pedicle Screws/*adverse effects Polymethyl Methacrylate/*adverse effects/*therapeutic use Pulmonary Embolism/etiology Spinal Diseases/*surgery Spinal Fusion/*methods LA - chi M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1671-167X (Print) 1671-167x SP - 1019-1025 ST - [Polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar diseases with osteoporosis] T2 - Beijing Da Xue Xue Bao Yi Xue Ban TI - [Polymethylmethacrylate augmentation of bone cement-injectable cannulated pedicle screws for the treatment of degenerative lumbar diseases with osteoporosis] VL - 48 ID - 828605 ER - TY - JOUR AB - Complete or partial thrombosis of the inferior vena cava is usually due to pre-existing malformation of the vessel, malignant tumors, ascending thrombosis, or thrombophilic disorders. We report the case of an 81-year-old woman, in whom a partial thrombosis of the vena cava was observed in the CT scan when re-staging was performed after six cycles of R-CHOP because of high-grade malignant non-Hodgkin lymphoma. Before chemotherapy was started, the patient had undergone an operation of the lumbar spine using cement augmentation. Retrospective analysis showed that cement had penetrated a segmental vein and spilled into the vena cava leading to formation of an adhering blood thrombus. The patient was free of symptoms and anticoagulation was started. Spillage of cement frequently occurs in the process of vertebroplasty and kyphoplasty and may result in serious sequelae. As these procedures are increasingly being used, physicians should be aware of these complications if a patient presents with thrombosis of the caval vein or signs of pulmonary embolism. AD - Medizinische Klinik II, Klinikum Pforzheim GmbH, Kanzlerstraße 2-6, 75175, Pforzheim. rsunrsun@hotmail.com AN - 22274303 AU - Sun, R. AU - Maier, B. AU - Theilmann, L. AU - Abdel Samie, A. DA - Apr DO - 10.1007/s00108-011-2991-4 DP - NLM ET - 2012/01/26 J2 - Der Internist KW - Aged, 80 and over Bone Cements/*adverse effects Extravasation of Diagnostic and Therapeutic Materials/*etiology/*therapy Female Humans Lumbar Vertebrae/*surgery Lymphoma, Non-Hodgkin/complications/*surgery Treatment Outcome Vena Cava, Inferior Venous Thrombosis/*etiology/*therapy Vertebroplasty/adverse effects LA - ger M1 - 4 N1 - PubMed NLM literature search January 5, 2021 OP - V.-cava-inferior-Thrombose bei Patientin mit Non-Hodgkin-Lymphom und stattgefundener Wirbelsäulenoperation. PY - 2012 SN - 0020-9554 SP - 474-7 ST - [Partial thrombosis of the inferior vena cava in a patient with non-Hodgkin lymphoma and history of lumbar spine surgery] T2 - Internist (Berl) TI - [Partial thrombosis of the inferior vena cava in a patient with non-Hodgkin lymphoma and history of lumbar spine surgery] VL - 53 ID - 828921 ER - TY - JOUR AB - Complete or partial thrombosis of the inferior vena cava is usually due to pre-existing malformation of the vessel, malignant tumors, ascending thrombosis, or thrombophilic disorders. We report the case of an 81-year-old woman, in whom a partial thrombosis of the vena cava was observed in the CT scan when re-staging was performed after six cycles of R-CHOP because of high-grade malignant non-Hodgkin lymphoma. Before chemotherapy was started, the patient had undergone an operation of the lumbar spine using cement augmentation. Retrospective analysis showed that cement had penetrated a segmental vein and spilled into the vena cava leading to formation of an adhering blood thrombus. The patient was free of symptoms and anticoagulation was started. Spillage of cement frequently occurs in the process of vertebroplasty and kyphoplasty and may result in serious sequelae. As these procedures are increasingly being used, physicians should be aware of these complications if a patient presents with thrombosis of the caval vein or signs of pulmonary embolism. AD - [Sun, R.; Theilmann, L.; Samie, A. Abdel] Klinikum Pforzheim GmbH, Med Klin 2, D-75175 Pforzheim, Germany. [Maier, B.] Klinikum Pforzheim GmbH, Klin Unfallchirurg & Orthopadie, D-75175 Pforzheim, Germany. Sun, R (corresponding author), Klinikum Pforzheim GmbH, Med Klin 2, Kanzlerstr 2-6, D-75175 Pforzheim, Germany. rsunrsun@hotmail.com AN - WOS:000302285800010 AU - Sun, R. AU - Maier, B. AU - Theilmann, L. AU - Samie, A. A. DA - Apr DO - 10.1007/s00108-011-2991-4 J2 - Internist KW - Inferior vena cava Thrombosis Cement dislocation Vertebroplasty Kyphoplasty PULMONARY CEMENT EMBOLISM VERTEBROPLASTY Medicine, General & Internal LA - German M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2012 SN - 0020-9554 SP - 474-477 ST - Partial thrombosis of the inferior vena cava in a patient with non-Hodgkin lymphoma and history of lumbar spine surgery T2 - Internist TI - Partial thrombosis of the inferior vena cava in a patient with non-Hodgkin lymphoma and history of lumbar spine surgery UR - ://WOS:000302285800010 VL - 53 ID - 830309 ER - TY - JOUR AB - OBJECTIVE: To compare the effectiveness between unilateral and bilateral percutaneous kyphoplasty (PKP) in the treatment of Kümmell disease. METHODS: The clinical data of 45 patients with Kümmell disease that met the criteria between January 2014 and February 2016 were analyzed retrospectively. Among them, 26 cases were treated by unilateral PKP (unilateral group), 19 cases were treated by bilateral PKP (bilateral group). There was no significant difference in gender, age, disease duration, injured vertebral segment, bone mineral density (T value), and the preoperative visual analogue scale (VAS) score, Oswestry disability index (ODI), anterior vertebral height, and kyphosis Cobb angle between 2 groups ( P>0.05). The operation time, intraoperative fluoroscopy times, amount of injected bone cement, and hospitalization time were recorded, and the situation of bone cement leakage was observed. The VAS score, ODI, anterior vertebral height, and kyphosis Cobb angle were evaluated before operation, at 1 day after operation, and at last follow-up. RESULTS: Bone cement leakage during the operation were found in 4 cases (15.38%) of unilateral group and 3 cases (15.79%) of bilateral group without obvious neurological symptoms; there was no significant difference in the incidence of bone cement leakage between 2 groups ( χ(2)=0.000, P=1.000). The operation time, intraoperative fluoroscopy times, and amount of injected bone cement in the unilateral group were significantly lower than those in the bilateral group ( P<0.05); but there was no significant difference in the hospitalization time between 2 groups ( P>0.05). The X-ray film examination showed that there was no pulmonary embolism in all patients at 1 day after operation. All the patients were followed up 12-24 months, with an average of 16.4 months. There was no complication such as vertebral re-fracture or cement block displacement in the injured vertebra. The VAS score, ODI, anterior vertebral height, and kyphosis Cobb angle at 1 day after operation and at last follow-up were significantly improved when compared with preoperative values in 2 groups ( P<0.05); the VAS score and ODI in 2 groups were further reduced at last follow-up when compared with the value at 1 day after operation ( P<0.05), but the anterior vertebral height and kyphosis Cobb angle in 2 groups at last follow-up did not change significantly ( P>0.05). There was no significant difference in above indexes at 1 day after operation and at last follow-up between 2 groups ( P>0.05). CONCLUSION: Both unilateral and bilateral PKP can achieve good effectiveness in treatment of Kümmell disease. But the unilateral puncture technique possesses advantages such as shorter operation time, less radiation dose, and less amount of injected bone cement. AD - Department of Spine Surgery, Sichuan Province Orthopedics Hospital, Chengdu Sichuan, 610041, P.R.China. Department of Spine Surgery, Sichuan Province Orthopedics Hospital, Chengdu Sichuan, 610041, P.R.China.2841710476@qq.com. AN - 29798566 AU - Sun, Y. AU - Xiong, X. AU - Wan, D. AU - Deng, X. AU - Shi, H. AU - Song, S. AU - Wu, X. AU - Zhou, J. AU - Yang, M. DA - Sep 15 DO - 10.7507/1002-1892.201704055 DP - NLM ET - 2018/05/26 J2 - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery KW - *Bone Cements Bone Diseases/*surgery Fractures, Compression Humans *Kyphoplasty Spinal Fractures Treatment Outcome *Vertebroplasty *Kümmell disease *Percutaneous kyphoplasty *bilateral puncture *osteoporosis *unilateral puncture LA - chi M1 - 9 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 1002-1892 (Print) 1002-1892 SP - 1086-1091 ST - [Effectiveness comparison between unilateral and bilateral percutaneous kyphoplasty for Kümmell disease] T2 - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi TI - [Effectiveness comparison between unilateral and bilateral percutaneous kyphoplasty for Kümmell disease] VL - 31 ID - 828597 ER - TY - JOUR AB - BACKGROUND CONTEXT: Metastatic cancer is the most common malignant disease of the skeletal system, which is the third most common site after the lung and liver. Metastases to the spine are most likely to occur, in 56% of patients with skeletal metastases, the spine is affected. The incidence of spinal metastases has been reported to range from 30% to 70% depending on the primary tumour. Metastatic spinal lesions are commonly associated with bony lesions and skeletal destruction, however, they are usually asymptomatic, and pain is only caused by further vertebral body collapse. Approximately, 10% of cancer patients will present with symptoms and of these, 40-70% will have involvement at multiple levels. Acute the posterior margin of the vertebral body. In case of intravascular, epidural, or foraminal leakage, injection is immediately and definitively stopped. Following completion of the procedure, patients are monitored for up to six hours post-operatively. All patients received additional radiation therapy 1 to 2 weeks postintervention. RESULTS: We were able to perform 2-year follow-up for 39 out of 48 patients. Of the 48 patients, 9 had no follow-up visits and were consequently excluded from the study. Of those 9 patients, 7 had died within the 2-year follow-up period due to progression of primary cancer. None of the deaths occurred within the first 2 months after the procedure. Therefore, our study group comprised 39 patients (97 kyphoplasty procedures) with complete preoperative and postoperative data. Significant improvements in all of the outcome measures were observed postoperatively and throughout the duration of follow-up. Safety and EfficacyAll procedures were performed by one orthopedic surgeon (Qian Z.-L., M.D., Ph.D.). The surgical procedure took a mean of 28.3 min for each level. The fluoroscopy time was 4.2161.45 min for one level. All patients in the study group tolerated the kyphoplasty procedure well. We found no local recurrence of metastatic tumors after kyphoplasty. There were no injuries to spinal or extraspinal tissues as a result of guide pin, obturator, or cannula placement. There were no complications from infection, bleeding, pulmonary embolism, stroke, or cardiac arrest. Furthermore, our patients showed no local or systemic reactions with PMMA. (Fig. 2) Radiographic EvaluationAnterior and middle vertebral height improvement are achieved in all cases, based on comparison of preoperative and postoperative data (Table I). The mean anterior VB height variation changed from (52.7616.8 %) preoperatively to (85.3613.2 %) postoperatively (p<.001). The mean postoperative mid-vertebral height variation was (82.4±9.6 %), which also represented a statistical increase (p<.001). Significant improvements in VB height variation were observed postoperatively and throughout the duration of follow-up. Kyphotic angle corrected from (16.4°64.7°) preoperatively to (8.4°62.5°) postoperatively, and maintained (8.8°62.1°) until the final follow-up. Statistically significant differences were observed between the preoperative and every follow-up assessment (Table II). Clinical EvaluationAverage preoperativeVAS score for all patients was reported to be 7.4±2.1, decreased to 3.8±1.6 after operation, and it was maintained at 3.5±1.2 at 2-year follow up. Improvement in pain level was statistically significant between the preoperative and every follow-up assessment (p<.001). Similar results were seen in ODI scores (Table III). At a mean follow-up of 2 years, the SF-36 scores for Bodily Pain (BF), Physical Function (PF), Vitality (VT), and Social Functioning (SF) all showed significant improvement (p<.05). Statistically significant differences were seen between the preoperative and every follow-up assessment (Table IV). Cement ExtravasationIn our collective, the standard postoperative CT of the kyphoplasty-treated vertebrae revealed a cement leakage in a total of 18 vertebrae, representing 18.6% of all levels. Leaks were located in the venous plexus (11 leaks), paravertebral tissues (4 leaks) and adjacent disks (3 leaks). Despite the leakage of PMMA detected, none of the patients developed any clinical or neurological symptoms. CONCLUSIONS: In conclusion, kyphoplasty is an effective, minimally invasive procedure for the stabilization of pathological vertebral fractures caused by metastatic disease, even in levels with vertebral wall deficiency, leading to a statistically significant reduction of pain, improvement in function and preventing further kyphotic deformity of the spine. AD - Z. Sun, Suzhou, China AU - Sun, Z. DB - Embase DO - 10.1016/j.spinee.2011.08.026 KW - cement society kyphoplasty spine metastasis compression fracture human follow up patient height pain tissues primary tumor vertebra vertebra body spine fracture deformity skeleton lung liver bone metastasis spinal cord metastasis cancer patient epidural drug administration injection social interaction death safety surgeon surgical technique spinal cord lesion injury cannula infection bleeding lung embolism cerebrovascular accident heart arrest fluoroscopy neurologic disease minimally invasive procedure radiotherapy LA - English M1 - 10 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 1529-9430 SP - 5S-7S ST - Kyphoplasty for the treatment of malignant vertebral compression fractures caused by metastases T2 - Spine Journal TI - Kyphoplasty for the treatment of malignant vertebral compression fractures caused by metastases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70558101&from=export http://dx.doi.org/10.1016/j.spinee.2011.08.026 VL - 11 ID - 829606 ER - TY - JOUR AD - Orthopedics Department, People's Hospital Affiliated, Soochow University AN - 126911180. Language: English. Entry Date: 20171222. Revision Date: 20171222. Publication Type: journal article AU - Sun, Zhenzhong AU - Wei, Xuming DB - cin20 DP - EBSCOhost KW - Spine Vertebroplasty Spinal Fractures -- Surgery Treatment Outcomes M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 1533-3159 SP - E207-E208 ST - Transarterial Embolization Followed by Percutaneous Vertebroplasty in Treating Vertebral Metastases with Paravetebral Extension T2 - Pain Physician TI - Transarterial Embolization Followed by Percutaneous Vertebroplasty in Treating Vertebral Metastases with Paravetebral Extension UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=126911180&site=ehost-live&scope=site VL - 20 ID - 830577 ER - TY - JOUR AB - Background: The definition of a vertebral fracture is usually based on the presence of a deformation of the vertebral body and this can be misleading in the presence of a fracture without radiologic collapse with the definition of occult osteoporotic vertebral fractures (OOVFs). STIR sequence of MRI images showing hyperintensity signal was the most confirmative screening examination used to determine the presence of painful OOVFs. To date, clinical management of OOVFs has been rarely discussed. Material/Methods: Between 2011 and 2013, 89 patients suffering from painful OOVFs underwent 142 percutaneous balloon kyphoplasty (PKP) procedures. Outcome data (mean variation of anterior and middle vertebral body height, visual analog scale [VAS] scores, Oswestry Disability Index [ODI] scores, and SF-36 scores) were recorded preoperatively, postoperatively, and at 1 month, 6 months, and 2 year after treatment, to evaluate the results. Results: We successfully treated 89 patients (142 vertebral bodies) with PKP. Cement leakages were observed in 12 (8.45%) treated vertebral bodies and there were 5 new adjacent vertebral fractures during the follow-up period. The mean variation of anterior and middle vertebral body height changed from 96.5±3.4% preoperatively to 97.2±2.5% postoperatively (p>0.05) and from 96.3±2.8% preoperatively to 97.9±3.1% postoperatively (p>0.05), respectively. The mean VAS scores were reduced significantly from pre-surgery to post-surgery (8.3±1.2 to 2.9±0.7; p<0.05), as was the ODI score (76.4±12.5 to 26.7±5.6; p<0.05). The SF-36 scores, including Bodily Pain (BF), Vitality (VT), Physical Function (PF), and Social Functioning (SF), all showed notable improvement (P<0.05). These variations were maintained during the 2-year follow-up period. Conclusions: PKP is a safe and effective method in the treatment of painful OOVFs. AD - Z.-M. Zhang, Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China AU - Sun, Z. Y. AU - Li, X. F. AU - Zhao, H. AU - Lin, J. AU - Qian, Z. L. AU - Zhang, Z. M. AU - Yang, H. L. DB - Embase Medline DO - 10.12659/MSM.903997 KW - adult aged article backache bleeding bone density cerebrovascular accident clinical assessment clinical evaluation clinical outcome female fragility fracture heart arrest human infection kyphoplasty lung embolism major clinical study male middle aged multidetector computed tomography nuclear magnetic resonance imaging osteoporosis osteoporotic occult vertebral fracture Oswestry Disability Index pain percutaneous vertebroplasty postoperative complication quality of life questionnaire retrospective study scoring system screening spinal pain spine fracture visual analog scale X ray spectroscopy LA - English M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1643-3750 1234-1010 SP - 1682-1690 ST - Percutaneous balloon kyphoplasty in treatment of painful osteoporotic occult vertebral fracture: A retrospective study of 89 cases T2 - Medical Science Monitor TI - Percutaneous balloon kyphoplasty in treatment of painful osteoporotic occult vertebral fracture: A retrospective study of 89 cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L615416845&from=export http://dx.doi.org/10.12659/MSM.903997 VL - 23 ID - 829262 ER - TY - JOUR AB - BACKGROUND: Kyphoplasty with bone cement has achieved good therapeutic efficacy on osteoporotic thoracolumbar fractures; however, there is little report about its application in the repair of vertebral fractures associated with vertebral body wall damage, due to the risks of bone cement leakage and puncture. OBJECTIVE: To evaluate the treatment outcomes of kyphoplasty with bone cement on osteoporotic thoracolumbar fractures associated with peripheral wall damage and to assess its short-term clinical effect. METHODS: Sixty-five patients (42 females and 23 males, mean age=71.5 years) with osteoporotic thoracolumbar fractures associated with peripheral wall damage were enrolled and treated with kyphoplasty. The anterior and mid-vertebral body height, complications, visual analog scale scores and Oswestry disability index were observed before, immediately and 1, 6 and 24 months postoperatively. RESULTS AND CONCLUSION: The visual analog scale scores, Oswestry disability index and Cobb angle were decreased significantly, and the anterior and mid-vertebral body height were increased significantly from pre- to post-operation (P < 0.05). All above improvements appeared to have no significant changes from post-operation to 2-year follow-up (P > 0.05). Cement leakage was detected in 7 cases (10 vertebrae), but did not cause severe clinical symptoms. There were no injuries to spinal nerve root and no complications of infection, bleeding, pulmonary embolism, stroke, or cardiac cerebral arrest. These findings indicate that kyphoplasty with bone cement is safe and feasible to treat osteoporotic thoracolumbar fractures associated with peripheral wall damage, leading to restoration of the vertebral height, reduction in pain, correction of the kyphotic deformity and satisfaction with the short-term curative effect. AD - H.-L. Yang, Department of Orthopaedics, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China AU - Sun, Z. Y. AU - Qian, Z. L. AU - Zhu, X. Y. AU - Chen, K. W. AU - Pi, B. AU - Yang, H. L. DB - Embase DO - 10.3969/j.issn.2095-4344.2016.47.012 KW - bone cement aged article Cobb angle female follow up human kyphoplasty major clinical study male osteoporosis Oswestry Disability Index spine fracture thoracolumbar vertebral fracture treatment outcome vertebra body visual analog scale LA - Chinese M1 - 47 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1673-8225 SP - 7076-7082 ST - Kyphoplasty with bone cement repairs osteoporotic thoracolumbar vertebral fractures associated with peripheral wall damage: A 2-year follow-up T2 - Chinese Journal of Tissue Engineering Research TI - Kyphoplasty with bone cement repairs osteoporotic thoracolumbar vertebral fractures associated with peripheral wall damage: A 2-year follow-up UR - https://www.embase.com/search/results?subaction=viewrecord&id=L617472304&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.2016.47.012 VL - 20 ID - 829347 ER - TY - JOUR AB - Learning Objectives: Several drugs that are not FDA approved in the US are used worldwide for cosmetic soft tissue augmentation. Young women often travel outside of the US to have procedures performed by non-medical lay practitioners and end up with fatal complications. We describe the case of hemorrhagic pneumonitis causing acute respiratory failure in a young healthy female due to Anicoll injection. Methods: A healthy 29-year-old woman was admitted with history of sudden onset of shortness of breath, cough productive of blood tinged sputum, chest pain, headache and altered mental status for 2 days. She was febrile and hypotensive. She was intubated, resuscitated and started on vasopressors, antimicrobials and hydrocortisone. Labs showed elevated WBC count, anemia and thrombocytopenia. Toxicology screen was negative. CT chest showed extensive infiltrates, predominantly in bilateral lower lobes and ground glass opacities within the middle and upper lobes. Bilateral breast implants were noted to be intact. CT pelvis showed dense infiltration within the subcutaneous fat of bilateral buttocks. Diagnostic bronchoscopy was suggestive of diffuse alveolar hemorrhage. Lumbar puncture was negative for infection. Upon obtaining further history from family, it was revealed that she had received injections in her gluteal region at a local beauty salon in Mexico 1 day prior to her symptoms. The salon in Mexico was contacted which revealed that she received Anicoll injection for gluteal enhancement. The composition of Anicoll was found to be polymethyl methacrylate (PMMA) microspheres suspended in purified collagen (30%) and silicone (70%). Extensive workup for infection and autoimmune conditions was negative. Bronchoalveolar fluid showed reactive alveolar macrophages, blood, inflammatory cells and negative cytology. Antimicrobials were discontinued and the patient received high dose intravenous methylprednisolone. Her hemodynamic and respiratory status gradually improved. Results: Silicone, more commonly than PMMA, enters the blood stream when inappropriately injected and can cause pneumonitis and an emboli syndrome. AD - A. Sunkara AU - Sunkara, A. AU - Zimmerman, J. AU - Uppalapati, A. DB - Embase DO - 10.1097/01.ccm.0000510556.02004.1b KW - antihypertensive agent collagen endogenous compound glass hydrocortisone methylprednisolone microsphere poly(methyl methacrylate) silicone acute respiratory failure adult anemia blood flow breast endoprosthesis bronchoscopy buttock case report coughing cytology diagnosis dyspnea embolism esthetics family study female headache human infection inflammatory cell injection leukocyte count liquid lumbar puncture lung alveolus macrophage lung hemorrhage mental health Mexico normal human pelvis pneumonia population based case control study sputum subcutaneous fat symptom thorax pain thrombocytopenia toxicology LA - English M1 - 12 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1530-0293 SP - 546 ST - Acute hemorrhagic pneumonitis from illegal anicoll injection T2 - Critical Care Medicine TI - Acute hemorrhagic pneumonitis from illegal anicoll injection UR - https://www.embase.com/search/results?subaction=viewrecord&id=L613522328&from=export http://dx.doi.org/10.1097/01.ccm.0000510556.02004.1b VL - 44 ID - 829294 ER - TY - JOUR AU - Sutherland, T. R. AU - Lynch, M. J. AU - O'Donnell, C. DB - Embase Medline DO - 10.1111/1754-9485.12886 KW - bone cement aged autopsy case report clinical article clinical feature computer assisted tomography disease association fat embolism female general anesthesia heart arrest human image analysis letter priority journal prosthetic femoral neck replacement replacement arthroplasty resuscitation retroperitoneal fat subcutaneous fat total hip replacement very elderly LA - English M1 - 3 M3 - Letter N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1754-9485 1754-9477 SP - 353-354 ST - Post-mortem CT features of fulminant fatal fat embolisation associated with prosthetic femoral neck replacement T2 - Journal of Medical Imaging and Radiation Oncology TI - Post-mortem CT features of fulminant fatal fat embolisation associated with prosthetic femoral neck replacement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L627496195&from=export http://dx.doi.org/10.1111/1754-9485.12886 VL - 63 ID - 829134 ER - TY - JOUR AD - Municipial Hospital Karlsruhe, Medical Clinic IV: Cardiology, Moltkestraße 90, Karlsruhe, Germany. Helios Clinic for Cardiac Surgery Karlsruhe, Department for Cardiac Surgery, Franz-Lust-Straße 30, Karlsruhe, Germany. AN - 29718318 AU - Swojanowsky, P. AU - Brinkmeier-Theofanopoulou, M. AU - Schmitt, C. AU - Mehlhorn, U. DA - Aug 21 DO - 10.1093/eurheartj/ehy208 DP - NLM ET - 2018/05/03 J2 - European heart journal KW - Bone Cements/*adverse effects Embolism/*complications/diagnostic imaging/*etiology/surgery Female Heart Ventricles/diagnostic imaging/*injuries/surgery Humans Kyphoplasty/*adverse effects/methods Lumbar Vertebrae/injuries Middle Aged Pericardial Effusion/diagnostic imaging/*etiology Polymethyl Methacrylate Postoperative Complications Spinal Fractures/surgery LA - eng M1 - 32 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 0195-668x SP - 3001 ST - A rare cause of pericardial effusion due to intracardiac cement embolism T2 - Eur Heart J TI - A rare cause of pericardial effusion due to intracardiac cement embolism VL - 39 ID - 828515 ER - TY - JOUR AB - We report a rare complication of autopsy-proven fat and bone marrow embolization following percutaneous vertebroplasty in a patient who had no evidence of cement leakage. Cement injection was done during one patient encounter, covering 3 vertebral levels by using a unipedicular approach. Patients may have complications even without polymethylmethacrylate leakage. AD - Department of Radiology, Mercy Medical Center, Springfield, Ohio 45501-1308, USA. AN - 16484407 AU - Syed, M. I. AU - Jan, S. AU - Patel, N. A. AU - Shaikh, A. AU - Marsh, R. A. AU - Stewart, R. V. DA - Feb DP - NLM ET - 2006/02/18 J2 - AJNR. American journal of neuroradiology KW - Aged *Ambulatory Surgical Procedures Embolism, Fat/*pathology Fatal Outcome Female Fractures, Compression/*surgery Humans Hypertension, Pulmonary/pathology Methylmethacrylate/adverse effects/*therapeutic use Postoperative Complications/*pathology Pulmonary Artery/pathology Pulmonary Embolism/*pathology Pulmonary Emphysema/pathology Risk Factors Spinal Fractures/*surgery Thoracic Vertebrae/*injuries/surgery LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0195-6108 (Print) 0195-6108 SP - 343-5 ST - Fatal fat embolism after vertebroplasty: identification of the high-risk patient T2 - AJNR Am J Neuroradiol TI - Fatal fat embolism after vertebroplasty: identification of the high-risk patient VL - 27 ID - 828949 ER - TY - JOUR AB - Context: Hemangiomas are the commonest benign tumors of the spine. Most occur in the thoracolumbar spine and the majority are asymptomatic. Rarely, hemangiomas cause symptoms through epidural expansion of the involved vertebra, resulting in spinal canal stenosis, spontaneous epidural hemorrhage, and pathological burst fracture. Findings: We report a rare case of a 73-year-old woman, who had been treated for two months for degenerative neurogenic claudication. On admission, magnetic resonance imaging and computed tomographic scans revealed a hemangioma of the third lumbar vertebra protruding to the epidural space producing lateral spinal stenosis and ipsilateral nerve root compression. The patient underwent successful right hemilaminectomy for decompression of the nerve root, balloon kyphoplasty with poly- methyl methacrylate (PMMA) and pedicle screw segmental stabilization. Postoperative course was uneventful. Conclusion: In the elderly, this rare presentation of spinal stenosis due to hemangiomas may be encountered. Decompression and vertebral augmentation by means balloon kyphoplasty with PMMA plus segmental pedicle screw fixation is recommended. AD - [Syrimpeis, Vasileios; Vitsas, Vasileios; Korovessis, Panagiotis] Gen Hosp Patras O Agios Andreas, Dept Orthopaed, Patras 26335, Greece. Syrimpeis, V (corresponding author), Gen Hosp Patras O Agios Andreas, Dept Orthopaed, Patras 26335, Greece. siva@upatras.gr AN - WOS:000337132700016 AU - Syrimpeis, V. AU - Vitsas, V. AU - Korovessis, P. DA - Mar DO - 10.1179/2045772313y.0000000135 J2 - J. Spinal Cord. Med. KW - Vertebra hemangioma Spinal canal stenosis Root compression Balloon Kyphoplasty CORD COMPRESSION METHYL-METHACRYLATE ETHANOL INJECTION EMBOLIZATION VERTEBROPLASTY RADIOTHERAPY MANAGEMENT ALCOHOL Clinical Neurology LA - English M1 - 2 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2014 SN - 1079-0268 SP - 237-242 ST - Lumbar vertebral hemangioma mimicking lateral spinal canal stenosis: Case report and review of literature T2 - Journal of Spinal Cord Medicine TI - Lumbar vertebral hemangioma mimicking lateral spinal canal stenosis: Case report and review of literature UR - ://WOS:000337132700016 VL - 37 ID - 830267 ER - TY - JOUR AB - Goals: To evaluate safety & efficacy of loco regional interventional therapy in the management of inoperable locally advanced and metastatic breast cancer. Methods: Between March 2013 and March 2018 patients with inoperable locally advanced and metastatic breast cancer were included in this study. They were referred from the medical and/or surgical oncology departments for the interventional unit of the Radiology Department in the National Cancer Institute, Cairo University. Patients failed to respond to standard systemic chemotherapy (at least more than 3 regimens). Three patients suffered from active bleeding from locally advanced disease and one had acute massive bleeding from radiation necrosis ulcer. Ten patients were referred for local control of hepatic deposits. One patient had a single pulmonary deposit. Three patients were referred for local control of bone deposits. Clinicopathological data as well as safety and outcome of the intervention were recorded. Results: Median patients” age was 41 years (range, 25–65). The median follow up period was 169 days (range, 30–1074 days). Local control and stoppage of bleeding was achieved in the 4 patients with locally advanced disease by embolization. In 10 patients with hepatic deposits 8 radiofrequency ablation (RFA) sessions and 5 transarterial chemoembolization (TACE) were applied on 20 hepatic deposits. Complete response or PR was achieved in 6/10 (60%) or 3/10(30%) respectively with overall response rate (ORR: CR+PR) of 90%. Complete ablation and CR was achieved by RFA for one patient with single lung metastases. The 3 patients with bone deposits achieved pain control and mobility improvement by combined RFA & cementoplasty in 2 patients while by cementoplasty only in the third patient. No major complications were encountered in the 18 patients and only one minor complication in the form of fracture in one patient 2 months after RFA and cementoplasty. Conclusions: The interventional radiology may actively participate in the modern management of locally advanced and metastatic breast cancer patients. Further studies on large number of patients are warranted for more verification. AD - A. Darwish, Medical Oncology, National Cancer Institute, Cairo, Egypt AU - Tabashy, R. AU - Darwish, A. AU - Hamed, A. DB - Embase DO - 10.1016/S0960-9776(19)30250-4 KW - endogenous compound adult advanced cancer aged bleeding cancer patient cancer surgery case report cementoplasty chemoembolization clinical article complication conference abstract female follow up fracture human interventional radiology liver lung deposit lung metastasis metastatic breast cancer national health organization pain radiation necrosis radiofrequency ablation radiology department remission surgical oncology treatment failure ulcer LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1532-3080 0960-9776 SP - S66 ST - Locally advanced and metastatic breast cancer: the interventional radiology add-on T2 - Breast TI - Locally advanced and metastatic breast cancer: the interventional radiology add-on UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2001765978&from=export http://dx.doi.org/10.1016/S0960-9776(19)30250-4 VL - 44 ID - 829147 ER - TY - JOUR AB - We carried out a prospective study of 118 hydroxyapatite-coated, cementless total knee replacements in patients who were ≤ 55 years of age and who had primary (92; 78%) or post-traumatic (26; 22%) osteoarthritis. The mean period of follow-up was 7.9 years (5 to 12.5). The Knee Society clinical scores improved from a pre-operative mean of 98 (0 to 137) to a mean of 185 (135 to 200) at five years, and 173 (137 to 200) at ten years. There were two revisions of the tibial component because of aseptic loosening, and one case of polyethylene wear requiring further surgery. There was no osteolysis or progressive radiological loosening of any other component. At 12 years, the overall rate of implant survival was 97.5% (excluding exchange of spacer) and 92.1% (including exchange of spacer). Cementless total knee replacement can achieve excellent long-term results in young, active patients with osteoarthritis. In contrast to total hip replacement, polyethylene wear, osteolysis and loosening of the prosthesis were not major problems for these patients, although it is possible that this observation could change with longer periods of follow-up. © 2006 British Editorial Society of Bone and Joint Surgery. AD - C.C. Tai, Department of Orthopaedic Surgery, University Malaya Medical Centre, 50603 Kuala Lumpur, Malaysia AU - Tai, C. C. AU - Cross, M. J. DB - Embase Medline DO - 10.1302/0301-620X.88B9.17789 KW - antibiotic agent hydroxyapatite polyethylene warfarin adult article clinical trial decubitus deep vein thrombosis female follow up human knee osteoarthritis lung embolism major clinical study male osteolysis pneumonia preoperative period priority journal prospective study prosthesis loosening prosthesis material reoperation scoring system survival tibia total knee arthroplasty unstable angina pectoris wound infection Active LA - English M1 - 9 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 0301-620X SP - 1153-1163 ST - Five- to 12-year follow-up of a hydroxyapatite-coated, cementless total knee replacement in young, active patients T2 - Journal of Bone and Joint Surgery - Series B TI - Five- to 12-year follow-up of a hydroxyapatite-coated, cementless total knee replacement in young, active patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L44417943&from=export http://dx.doi.org/10.1302/0301-620X.88B9.17789 VL - 88 ID - 829785 ER - TY - JOUR AB - 1420 primary cementless THRs with a minimum follow-up of 10-years were stratified according to BMI: nonobese (BMI < 30 kg/m2) and obese (BMI ≥ 30 kg/m2). Median age at surgery was younger in obese patients (P < 0.001). We case-matched 82 THRs in obese patients with 162 THRs in non-obese patients. No difference between groups was found in improvement in HHS (P = 0.668), satisfaction with surgery (P = 0.644), range of movement, prosthesis orientation, or radiological loosening. The obese cohort was further separated into those with a BMI below and above 35. No difference was found between groups in improvement in HHS, satisfaction with surgery, component orientation, or radiological loosening. There was no difference in the incidence of post-operative complications between obese and non-obese patients. After 10-years, the results of THR are not compromised by obesity. AD - S.M. Tai, Specialist Orthopaedic Group, Mater Clinic, Suite 1.08, 3-9 Gillies Street, North Sydney, NSW, Australia AU - Tai, S. M. AU - Imbuldeniya, A. M. AU - Munir, S. AU - Walter, W. L. AU - Walter, W. K. AU - Zicat, B. A. DB - Embase Medline DO - 10.1016/j.arth.2014.04.033 KW - adult aged article body mass cementless prosthesis clinical assessment controlled study dislocation female follow up Harris hip score heart infarction human incidence lung embolism major clinical study male obesity outcome assessment patient satisfaction periprosthetic fracture postoperative infection postoperative period prosthesis loosening range of motion scoring system total hip prosthesis treatment outcome LA - English M1 - 9 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1532-8406 0883-5403 SP - 1758-1762 ST - The effect of obesity on the clinical, functional and radiological outcome of cementless total hip replacement: A case-matched study with a minimum 10-year follow-up T2 - Journal of Arthroplasty TI - The effect of obesity on the clinical, functional and radiological outcome of cementless total hip replacement: A case-matched study with a minimum 10-year follow-up UR - https://www.embase.com/search/results?subaction=viewrecord&id=L53150437&from=export http://dx.doi.org/10.1016/j.arth.2014.04.033 VL - 29 ID - 829450 ER - TY - JOUR AB - A 59-year-old female fractured her left femoral neck by fall. Four days after trauma, her hip arthroplasty was performed with bone cement. She was conscious and well oriented with no neurological and respiratory problems immediately after operation. But following morning, she was found to be in the state of coma and respiratory depression. A brain CT did not show significant findings. However, MRI revealed diffuse high intensity area on T2-weighted image, which was unrelated to vascular territories. From the MRI findings, she was suspected to be fat embolism syndrome. After hyperbaric oxygen therapy, her consciousness level improved significantly. About one month later, she had a GCS score of 15, with no neurologic signs. MRI seems to be useful for detecting lesions in fat embolism. AD - K. Takehana, Department of Intensive Care Unit, Toyama Med./Pharmaceut. University, Toyama, Japan AU - Takehana, K. AU - Shibuya, N. AU - Yamazaki, M. AU - Ito, Y. DB - Embase KW - bone cement adult article case report fat embolism female femoral neck fracture hip arthroplasty human hyperbaric oxygen therapy image analysis nuclear magnetic resonance imaging oxygen therapy unconsciousness LA - Japanese M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1998 SN - 0367-5947 SP - 55-58 ST - A case of consciousness disturbance after hip arthroplasty T2 - Hokuriku Journal of Anesthesiology TI - A case of consciousness disturbance after hip arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L29057844&from=export VL - 32 ID - 829904 ER - TY - JOUR AD - Centre hospitalier Cochin, AP-GP, 75014 Paris, France. Electronic address: patrice.Talec@hotmail.fr. Centre hospitalier Cochin, AP-GP, 75014 Paris, France. AN - 27671978 AU - Talec, P. AU - Fromentin, M. AU - Samama, C. M. DA - Feb DO - 10.1016/j.accpm.2016.05.011 DP - NLM ET - 2016/09/28 J2 - Anaesthesia, critical care & pain medicine KW - Aged, 80 and over *Arthroplasty, Replacement, Knee Bone Cements/*adverse effects Female Humans Knee Prosthesis Obesity, Morbid/complications Oxygen/blood Postoperative Complications/diagnostic imaging/*therapy Pulmonary Embolism/diagnostic imaging/*etiology/*therapy *Cement *Knee prosthesis replacement *Pulmonary embolism LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 2352-5568 SP - 71-72 ST - Pulmonary embolism of cement after knee prosthesis replacement T2 - Anaesth Crit Care Pain Med TI - Pulmonary embolism of cement after knee prosthesis replacement VL - 36 ID - 828738 ER - TY - JOUR AB - Laboratory and human mechanical studies indicated that chemical substances in bone cement had toxic and prothrombotic effects. Impaction of cement added a mechanical trauma to the reaming and broaching procedure and contributed to a substantial local and systemic thrombin generation. Case reports and materials have indicated bone cement as the immediate trigger of cardiorespiratory and vascular dysfunction, occasionally fatal, and described as the bone cement implantation syndrome. In spite of this knowledge, bone cement has gained popularity and is widely used for prosthesis fixation, possibly due to a lack of clinical evidence supporting the basic science indicating bone cement as a mortality risk factor. This is a prospective, randomized study comparing cemented and non cemented hemiprosthesis on patients suffering a dislocated cervical hip fracture. Perioperative characteristics and 1 year mortality differences between the groups were estimated. Hundred and thirty-four patients over 75 years were enrolled from two hospitals in Norway. Average age was 84 years, 75 % were female and 60 % had symptomatic comorbidities. We find no difference in mortality between cemented and uncemented hemiprosthesis up to 1 year (HR 0.77, 95 % CI 0.51-1.18, p = 0.233). However, statistically significant reduced operation time and blood loss were found in the non-cemented group. (mean difference of 13 min, 95 % CI 4-22, p = 0.004 and 92 ml 95 % CI 3-181, p = 0.043, respectively). Installation of non-cemented hemiprostheses in elderly with hip fracture may have benefits perioperatively regarding operation time and bleeding, and do not seem to influence 1 year mortality relative to cemented implants. AD - [Talsnes, O.; Dahl, O. E.] Innlandet Hosp Trust, N-2418 Elverum, Norway. [Hjelmstedt, F.] Vestre Viken Hosp Trust, Drammen, Norway. [Pripp, A. H.; Reikeras, O.] Univ Oslo, Rikshosp, Oslo Univ Hosp, N-0027 Oslo, Norway. [Pripp, A. H.; Reikeras, O.] Ulleval Hosp, Oslo, Norway. [Dahl, O. E.] Thrombosis Res Inst, London SW3 6LR, England. Talsnes, O (corresponding author), Innlandet Hosp Trust, N-2418 Elverum, Norway. ove.talsnes@sykehuset-innlandet.no AN - WOS:000319269700010 AU - Talsnes, O. AU - Hjelmstedt, F. AU - Pripp, A. H. AU - Reikeras, O. AU - Dahl, O. E. DA - Jun DO - 10.1007/s00402-013-1726-5 J2 - Arch. Orthop. Trauma Surg. KW - Bone cement Mortality Hip fracture Elderly Comorbidity PERIOPERATIVE MORTALITY FEMORAL-NECK PULMONARY-HYPERTENSION FAT-EMBOLISM BONE-CEMENT HEMIARTHROPLASTY SURGERY DEATH THROMBOPROPHYLAXIS ARTHROPLASTY Orthopedics Surgery LA - English M1 - 6 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2013 SN - 0936-8051 SP - 805-809 ST - No difference in mortality between cemented and uncemented hemiprosthesis for elderly patients with cervical hip fracture.A prospective randomized study on 334 patients over 75 years T2 - Archives of Orthopaedic and Trauma Surgery TI - No difference in mortality between cemented and uncemented hemiprosthesis for elderly patients with cervical hip fracture.A prospective randomized study on 334 patients over 75 years UR - ://WOS:000319269700010 VL - 133 ID - 830283 ER - TY - JOUR AB - Background: To review on-table, day 0, day 1, day 7, and day 30 mortality after hemiarthroplasty or total hip arthroplasty (THA) using cemented femoral stems for femoral neck fractures in order to evaluate risk factors for perioperative and short-term mortality. Methods: The medical records of 751 consecutive cases with neck of femur fractures who underwent hemiarthroplasty (n = 602) or THA (n = 149) with cemented stems between January 2011 and December 2016 were retrospectively reviewed from a prospectively gathered database. The primary outcome measures were on-table, day 0, day 1, day 7, and day 30 mortality. Univariate and multivariate analyses were performed in order to identify various contributing patient and surgical variables. Results: There were 2 on-table deaths (0.27%): one patient had a cardiorespiratory arrest at the time of inserting the femoral stem and the other had a cardiorespiratory arrest at the end of wound closure some 20 minutes after cementing. There were 3 further day 0 deaths meaning the day 0 mortality rate was 0.67% (5/751). All 5 patients were older than 80 years and had an American Society of Anesthesiologists grade 3 or more. The 1-day, 7-day, and 30-day mortality rates were 0.93% (7 patients), 2.7% (20 patients), and 6.8% (51 patients), respectively. There is significantly higher 30-day mortality risk associated with increasing American Society of Anesthesiologists grade (P <.001) when adjusted for age, gender, and type of surgery (hemiarthroplasty compared with THA). Conclusion: In our neck of femur fracture patients who were operated with cemented stems, 7-day and 30-day mortality rates were 2.7% and 6.8%, respectively. Cemented stems should be used with caution in elderly hip fracture patients with multiple comorbidities who are at high risk of perioperative mortality. AD - R.W. Crawford, Orthopaedic Research Unit, Level 5, Clinical Sciences Building, Rode Road, Chermside, Queensland, Australia AU - Tan, K. G. AU - Whitehouse, S. L. AU - Crawford, R. W. DB - Embase Medline DO - 10.1016/j.arth.2019.11.027 KW - acute heart infarction adult age aged article aspiration pneumonia cardiogenic shock cardiopulmonary insufficiency comorbidity elderly care fat embolism female femoral neck fracture gender hip hemiarthroplasty human intermethod comparison intraoperative period lung embolism major clinical study male medical record review middle aged mortality rate mortality risk retrospective study risk factor surgical mortality surgical technique total hip replacement treatment outcome very elderly wound closure LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1532-8406 0883-5403 SP - 1095-1100 ST - On-Table and Short-Term Mortality: A Single-Institution Experience With Cementing All Hip Arthroplasties for Neck of Femur Fractures T2 - Journal of Arthroplasty TI - On-Table and Short-Term Mortality: A Single-Institution Experience With Cementing All Hip Arthroplasties for Neck of Femur Fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2004321837&from=export http://dx.doi.org/10.1016/j.arth.2019.11.027 VL - 35 ID - 829070 ER - TY - JOUR AB - Improvements in diagnosis and treatment have prolonged cancer survival, with a consequent increase in the incidence of spinal metastases and vertebral compression fractures with associated axial pain, progressive radiculomyelopathy, and mechanical instability. Pain relief in malignant vertebral compression fractures is key to achieving a better quality of life in patients under palliative care. The gold standard for pain relief is nonsteroidal anti-inflammatory drugs and opioids. Nonresponsive cases are then treated with radiotherapy, which may require 2-4 weeks to take effect and in most cases does not provide complete pain relief. Percutaneous vertebroplasty and percutaneous kyphoplasty can in particular give relief in patients with vertebral body compression fractures that do not cause neurological deficits but severely compromise quality of life because of intractable pain. © 2011. AD - M.A. Lorenzetti, Istituto Clinico Humanitas (ICH), Via Manzoni 56, Rozzano, Milan 20089, Italy AU - Tancioni, F. AU - Lorenzetti, M. A. AU - Navarria, P. AU - Pessina, F. AU - Draghi, R. AU - Pedrazzoli, P. AU - Scorsetti, M. AU - Alloisio, M. AU - Santoro, A. AU - Rodriguez y Baena, R. DB - Embase Medline DO - 10.1016/j.suponc.2011.01.001 KW - narcotic analgesic agent nonsteroid antiinflammatory agent poly(methyl methacrylate) cement leakage compression fracture computer assisted tomography human intractable pain kyphoplasty lung embolism neurologic disease nuclear magnetic resonance imaging osteolysis osteoporosis pain percutaneous kyphoplasty percutaneous vertebroplasty postoperative complication postoperative infection quality of life review spine metastasis spine mobility spine radiography spine scintiscanning spine stabilization stent surgical technique treatment indication vertebra compression LA - English M1 - 1 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2011 SN - 1544-6794 SP - 4-10 ST - Percutaneous Vertebral Augmentation in Metastatic Disease: State of the Art T2 - Journal of Supportive Oncology TI - Percutaneous Vertebral Augmentation in Metastatic Disease: State of the Art UR - https://www.embase.com/search/results?subaction=viewrecord&id=L361764603&from=export http://dx.doi.org/10.1016/j.suponc.2011.01.001 VL - 9 ID - 829629 ER - TY - JOUR AB - BACKGROUND: The increase of augmented level and bone cement dose are accompanied by the rising incidence of cement leakage (CL) of cement-augmented pedicle screw instrumentation (CAPSI). But the effect and potential risks of the application of CAPSI to osteoporotic lumbar degenerative disease (LDD) have not been studied in the case of multilevel fixation. This study aimed to investigate the effectiveness and potential complications of using multilevel CAPSI for patients with osteoporotic LDD. METHODS: A total of 93 patients with multilevel LDD were divided into the CAPSI group (46 subjects) and the conventional pedicle screw (CPS) group (47 subjects), including 75 cases for three levels and 18 cases for four levels. Relevant data were compared between two groups, including baseline data, clinical results, and complications. RESULTS: In the CAPSI group, a total of 336 augmented screws was placed bilaterally. The CL was observed in 116 screws (34.52%). Three cemented screws (0.89%) were found loosened during the follow-up and the overall fusion rate was 93.47%. For perioperative complications, two patients (4.35%) experienced pulmonary cement embolism (PCE), one patient augmented vertebral fracture, and three patients (6.52%) wound infection. And in the CPS group, thirty-three screws (8.46%) suffered loosening in cranial and caudal vertebra with a fusion rate of 91.49%. The operation time and hospital stay of CAPSI group were longer than the CPS group, but CAPSI group has a lower screw loosening percentage (P<0. 05). And in terms of blood loss, perioperative complications, fusion rate, and VAS and ODI scores at the follow-up times, there were no significant differences between the two groups. CONCLUSIONS: Patients with osteoporotic LDD underwent multilevel CPS fixation have a higher rate of screw loosening in the cranial and caudal vertebra. The application of cemented pedicle screws for multilevel LDD can achieve better stability and less screw loosening, but it also accompanied by longer operating time, higher incidence of CL, PCE and wound infections. Selective cement augmentation of cranial and caudal pedicle screws may be a worthy strategy to decrease the complications. AD - Spine Surgery Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510407, China. The 1st Institute of Clinical Medicine, Guangzhou University of Chinese Medicine, 12 Airport Road, Baiyun District, Guangzhou, 510405, Guangdong, People's Republic of China. Spine Surgery Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, 510407, China. 18122436960@163.com. The 1st Institute of Clinical Medicine, Guangzhou University of Chinese Medicine, 12 Airport Road, Baiyun District, Guangzhou, 510405, Guangdong, People's Republic of China. 18122436960@163.com. AN - 32345282 AU - Tang, Y. C. AU - Guo, H. Z. AU - Guo, D. Q. AU - Luo, P. J. AU - Li, Y. X. AU - Mo, G. Y. AU - Ma, Y. H. AU - Peng, J. C. AU - Liang, D. AU - Zhang, S. C. C2 - Pmc7189525 DA - Apr 28 DO - 10.1186/s12891-020-03309-y DP - NLM ET - 2020/04/30 J2 - BMC musculoskeletal disorders KW - Cement-augmented pedicle screw instrumentation Lumbar degenerative disease Multilevel fixation LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 1471-2474 SP - 274 ST - Effect and potential risks of using multilevel cement-augmented pedicle screw fixation in osteoporotic spine with lumbar degenerative disease T2 - BMC Musculoskelet Disord TI - Effect and potential risks of using multilevel cement-augmented pedicle screw fixation in osteoporotic spine with lumbar degenerative disease VL - 21 ID - 828996 ER - TY - JOUR AB - Background: The increase of augmented level and bone cement dose are accompanied by the rising incidence of cement leakage (CL) of cement-augmented pedicle screw instrumentation (CAPSI). But the effect and potential risks of the application of CAPSI to osteoporotic lumbar degenerative disease (LDD) have not been studied in the case of multilevel fixation. This study aimed to investigate the effectiveness and potential complications of using multilevel CAPSI for patients with osteoporotic LDD.Methods: A total of 93 patients with multilevel LDD were divided into the CAPSI group (46 subjects) and the conventional pedicle screw (CPS) group (47 subjects), including 75 cases for three levels and 18 cases for four levels. Relevant data were compared between two groups, including baseline data, clinical results, and complications.Results: In the CAPSI group, a total of 336 augmented screws was placed bilaterally. The CL was observed in 116 screws (34.52%). Three cemented screws (0.89%) were found loosened during the follow-up and the overall fusion rate was 93.47%. For perioperative complications, two patients (4.35%) experienced pulmonary cement embolism (PCE), one patient augmented vertebral fracture, and three patients (6.52%) wound infection. And in the CPS group, thirty-three screws (8.46%) suffered loosening in cranial and caudal vertebra with a fusion rate of 91.49%. The operation time and hospital stay of CAPSI group were longer than the CPS group, but CAPSI group has a lower screw loosening percentage (P<0. 05). And in terms of blood loss, perioperative complications, fusion rate, and VAS and ODI scores at the follow-up times, there were no significant differences between the two groups.Conclusions: Patients with osteoporotic LDD underwent multilevel CPS fixation have a higher rate of screw loosening in the cranial and caudal vertebra. The application of cemented pedicle screws for multilevel LDD can achieve better stability and less screw loosening, but it also accompanied by longer operating time, higher incidence of CL, PCE and wound infections. Selective cement augmentation of cranial and caudal pedicle screws may be a worthy strategy to decrease the complications. AD - Spine Surgery Department, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, 510407, Guangzhou, China The 1st Institute of Clinical Medicine, Guangzhou University of Chinese Medicine, 12 Airport Road, Baiyun District, 510405, Guangzhou, Guangdong, People's Republic of China AN - 142942404. Language: English. Entry Date: In Process. Revision Date: 20200718. Publication Type: journal article. Journal Subset: Biomedical AU - Tang, Yong-chao AU - Guo, Hui-zhi AU - Guo, Dan-qing AU - Luo, Pei-jie AU - Li, Yong-xian AU - Mo, Guo-ye AU - Ma, Yan-huai AU - Peng, Jian-cheng AU - Liang, De AU - Zhang, Shun-cong DB - cin20 DO - 10.1186/s12891-020-03309-y DP - EBSCOhost M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2020 SN - 1471-2474 SP - 1-12 ST - Effect and potential risks of using multilevel cement-augmented pedicle screw fixation in osteoporotic spine with lumbar degenerative disease T2 - BMC Musculoskeletal Disorders TI - Effect and potential risks of using multilevel cement-augmented pedicle screw fixation in osteoporotic spine with lumbar degenerative disease UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=142942404&site=ehost-live&scope=site VL - 21 ID - 830511 ER - TY - JOUR AB - Introduction: Vertebroplasty is a minimally invasive method for the treatment of painful vertebrae fractures. Sementembolism, a rare complication of this method, is usually asymptomatic and does not require treatment. Anticoagulant therapy or surgical embolectomy is recommended when symptomatic. Case Presentation: A 41-year-old man applied to our clinic with chest pain and shortness of breath 3 days after percutaneous vertebroplasty that was performed for the fracture of thoracic 12 (Th12) vertebra due to a traffic accident. There were no pathological findings in his physical examination. He was normotensive, and room air oxygen saturation (SaO2) was 98%. A left lung lower zone branching radio-opacity was detected in postero anterior (PA) chest radiography. His hematological, biochemical and cardiac laboratory parameters were in normal values. There was no electrocardiographic abnormality. With suspicion of cement embolism, thorax CT-angiography was performed. The Th12 vertebrae had a compression fracture in the corpus and a hyperdense view of cement approximately 2.2 cm in diameter. In the right paravertebral space, the linear hyperdense line in the hemiazigos vein was noteworthy at the distance between Th 11, Th 12 and L1 vertebrae corpus (compatible with cement embolism). In addition, high density areas were observed in both lung parenchyma in right middle lobe, upper lobe in left lung and subsegmental branches in lower lobe medial area (cement embolism). There were no pathological findings or pleural effusion in the lung parenchyma. The patient was symptomatic for pulmonary embolism but he was hemodynamically stable. Echocardiography (Echo) revealed an ejection fraction of 60% and a mean pulmonary arterial pressure of 25mmHg. The removal of cement embolus was not considerated since the patient was hemodynamically stable, Echo was normal and there was not any sign of cement in the main pulmonary arteries. He started to the treatment with subcutaneus anticoagulant therapy and his respiratory symptoms were recovered quickly. After treatment during 3 months, we ended the anticoagulant therapy. Since then, the patient has been under control and has no complaints. Conclusion: Cement embolism may not be a mortal clinical situation if it is diagnosed early and treated appropriately to the location of mechanical occlusion in the pulmonary arteries. Another important point is that all patients should be controlled with routine chest X-ray after vertebroplasty, before discharging from hospital. There is not any consensus algorithm about the treatment of pulmonary cement embolism, but case reports and case series show some outcomes. AD - Ö.O. Tapan, Department of Chest Diseases, Muǧla Sitki Koçman University School of Medicine, Muǧla, Turkey AU - Tapan, Ö O. AU - Tapan, U. AU - Elibol, F. D. DB - Embase DO - 10.5152/TurkThoracJ.2019.352 KW - cement adult algorithm ambient air anticoagulant therapy arterial oxygen saturation case report case study clinical article complication compression fracture computed tomographic angiography conference abstract consensus dyspnea ECG abnormality echocardiography heart ejection fraction human left lung lung artery pressure lung embolism lung parenchyma male normal value occlusion percutaneous vertebroplasty physical examination pleura effusion surgery thorax pain thorax radiography traffic accident vein vertebra LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 2149-2530 SP - S352 ST - A rare presentation of pulmonary embolism: Cement embolism after vertebroplasty T2 - Turkish Thoracic Journal TI - A rare presentation of pulmonary embolism: Cement embolism after vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L632344845&from=export http://dx.doi.org/10.5152/TurkThoracJ.2019.352 VL - 20 ID - 829148 ER - TY - JOUR AB - STUDY DESIGN: Systematic review and meta-regression. OBJECTIVES: To compare the efficacy and safety of balloon kyphoplasty and vertebroplasty for the treatment of vertebral compression fractures, and to examine the prognostic factors that predict outcome. SUMMARY OF BACKGROUND DATA: A previous systematic review of vertebroplasty by Levine et al in 2000 identified seven case series studies and no controlled studies. METHODS: A number of electronic databases were searched through March 1, 2004. Citation searches of included studies were undertaken and contact was made with experts in the field. No language restrictions were applied. All controlled and uncontrolled studies were included with the exception of case reports. Prognostic factors responsible for pain relief and cement leakage were examined using meta-regression. RESULTS: The following studies were included: balloon kyphoplasty (three nonrandomized comparative studies against conventional medical therapy and 13 case series), vertebroplasty (one nonrandomized comparative study against conventional medical care and 57 cases series), balloon kyphoplasty versus vertebroplasty (one nonrandomized comparative study). The majority of studies were undertaken in older women with osteoporotic vertebral compression fractures with long-term pain that was refractory to medical treatment. At this time, there is no good quality direct comparative evidence of balloon kyphoplasty versus vertebroplasty. From indirect comparison of case series evidence, the procedures appear to provide similar gains in pain relief while for balloon kyphoplasty there is better documentation of gains in patient functionality and quality of life. The level of cement leakage and number of reported adverse events (pulmonary emboli and neurologic injury) in balloon kyphoplasty was significantly lower than for vertebroplasty. These findings were confirmed by meta-regression analysis. CONCLUSIONS: There is Level III evidence to support balloon kyphoplasty and vertebroplasty as effective therapies in the management of patients with symptomatic osteoporotic vertebral compression fractures refractory to conventional medical therapy. Although there was a good ratio of benefit to harm for both procedures, balloon kyphoplasty appears to offer the better adverse event profile. These conclusions need to be updated on the basis of the findings of ongoing randomized controlled trials. AD - Department of Public Health & Epidemiology, University of Birmingham, Edgbaston, United Kingdom. r.s.taylor@bham.ac.uk AN - 17077747 AU - Taylor, R. S. AU - Taylor, R. J. AU - Fritzell, P. DA - Nov 1 DO - 10.1097/01.brs.0000244639.71656.7d DP - NLM ET - 2006/11/02 J2 - Spine KW - Aged Bone Cements/therapeutic use *Catheterization Female Fractures, Compression/*surgery Humans Injections Kyphosis/*surgery Male Middle Aged Minimally Invasive Surgical Procedures Orthopedic Procedures/adverse effects/*methods Palliative Care Polymethyl Methacrylate/administration & dosage/therapeutic use Safety Spinal Fractures/*surgery Treatment Outcome LA - eng M1 - 23 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0362-2436 SP - 2747-55 ST - Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety T2 - Spine (Phila Pa 1976) TI - Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety VL - 31 ID - 828633 ER - TY - JOUR AB - Study Design. Systematic review and meta-regression. Objectives. To compare the efficacy and safety of balloon kyphoplasty and vertebroplasty for the treatment of vertebral compression fractures, and to examine the prognostic factors that predict outcome. Summary of Background Data. A previous systematic review of vertebroplasty by Levine et al in 2000 identified seven case series studies and no controlled studies. Methods. A number of electronic databases were searched through March 1, 2004. Citation searches of included studies were undertaken and contact was made with experts in the field. No language restrictions were applied. All controlled and uncontrolled studies were included with the exception of case reports. Prognostic factors responsible for pain relief and cement leakage were examined using meta-regression. Results. The following studies were included: balloon kyphoplasty ( three nonrandomized comparative studies against conventional medical therapy and 13 case series), vertebroplasty ( one nonrandomized comparative study against conventional medical care and 57 cases series), balloon kyphoplasty versus vertebroplasty ( one nonrandomized comparative study). The majority of studies were undertaken in older women with osteoporotic vertebral compression fractures with long-term pain that was refractory to medical treatment. At this time, there is no good quality direct comparative evidence of balloon kyphoplasty versus vertebroplasty. From indirect comparison of case series evidence, the procedures appear to provide similar gains in pain relief while for balloon kyphoplasty there is better documentation of gains in patient functionality and quality of life. The level of cement leakage and number of reported adverse events ( pulmonary emboli and neurologic injury) in balloon kyphoplasty was significantly lower than for vertebroplasty. These findings were confirmed by meta-regression analysis. Conclusions. There is Level III evidence to support balloon kyphoplasty and vertebroplasty as effective therapies in the management of patients with symptomatic osteoporotic vertebral compression fractures refractory to conventional medical therapy. Although there was a good ratio of benefit to harm for both procedures, balloon kyphoplasty appears to offer the better adverse event profile. These conclusions need to be updated on the basis of the findings of ongoing randomized controlled trials. AD - Univ Birmingham, Dept Publ Hlth & Epidemiol, Birmingham B15 2TT, W Midlands, England. Univ Birmingham, Hlth Econ Facil, Birmingham, W Midlands, England. Falun Cent Hosp, Dept Orthopaed Surg, Falun, Sweden. Taylor, RS (corresponding author), Univ Birmingham, Dept Publ Hlth & Epidemiol, Birmingham B15 2TT, W Midlands, England. r.s.taylor@bham.ac.uk AN - WOS:000241857900018 AU - Taylor, R. S. AU - Taylor, R. J. AU - Fritzell, P. DA - Nov DO - 10.1097/01.brs.0000244639.71656.7d J2 - Spine KW - spinal fracture osteoporosis systematic review meta-analysis FIXATION WOMEN Clinical Neurology Orthopedics LA - English M1 - 23 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2006 SN - 0362-2436 SP - 2747-2755 ST - Balloon kyphoplasty and vertebroplasty for vertebral compression fractures - A comparative systematic review of efficacy and safety T2 - Spine TI - Balloon kyphoplasty and vertebroplasty for vertebral compression fractures - A comparative systematic review of efficacy and safety UR - ://WOS:000241857900018 VL - 31 ID - 830404 ER - TY - JOUR AB - Introduction: Balloon Kyphoplasty (BKP) for vertebral compression fractures (VCFs) in cancer patients is more challenging than for osteoporotic ones. Cord compressions are frequent and the incidence of complications is reported to be ten-fold greater. PMMA is the gold standard for BKP. However, PMMA has also some disadvantages: exothermic reaction, short working time, rapid solidification, absence of osteoconductive properties. A new purified silicon material has been recently introduced for BKP. It is a mixture of Dimethyl methylvinyl siloxane, Barium Sulphate and Platinum catalyst, it is adhesive to bone, it has no exothermic reaction leaving up to 30 minutes before solidification and is more elastic than PMMA. The surgical procedure called elastoplasty, is similar to a BKP. Material and Methods: To investigate the clinical results obtained with this new silicon material in pathological VCFs, we treated 46 cancer patients (80 vertebral bodies) with purified silicon, through percutaneous BKP, open BKP and augmentation procedures to implement dorso-lumbar stabilizations. Leakages and pulmonary embolism (PE) were evaluated with CT scans. Median follow-up was 14 months. Results: The average working time allowed by VK 100 was 30 minutes. The mean volume of silicon inserted in each vertebra was 3.8 cc. Complications included seven cases of leakages in 41 patients treated with BKP (17%), two asymptomatic PE (4.3%) and 3 postoperative adjacent fractures (7.3%). A significant improvement was observed in KPS, VAS and Dennis Pain Score (p < 0.0001). The 1-yr survival rate was 77.5 Conclusion: Elastoplasty appears a safe and effective palliative treatment of VCFs in oncologic patients. Major advantages over PMMA are the lack of exothermic reaction and the wider working window. The influence of biomechanical properties of silicon on reduction of adjacent level fractures requires further investigations. AD - S. Telera, Deparment of Neurosurgery, National Cancer Institute Regina Elena, Rome, Italy AU - Telera, S. AU - Crispo, F. AU - Giovannetti, M. AU - Carapella, C. AU - Sperduti, I. AU - Raus, L. DB - Embase DO - 10.1177/2192568218771030 KW - adhesive agent barium sulfate platinum silicon adult cancer patient catalyst clinical article clinical evaluation complication compression fracture conference abstract controlled study drug therapy female follow up human kyphoplasty lumbar region lung embolism male pain palliative therapy retrospective study surgery surgical technique survival rate vertebra body working time x-ray computed tomography LA - English M1 - 1 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 2192-5690 SP - 68S ST - Elastoplasty with syilicone purified for the treatment of spinal lytic lesions in cancer patients: A retrospective evaluation of 46 cases T2 - Global Spine Journal TI - Elastoplasty with syilicone purified for the treatment of spinal lytic lesions in cancer patients: A retrospective evaluation of 46 cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L622331165&from=export http://dx.doi.org/10.1177/2192568218771030 VL - 8 ID - 829196 ER - TY - JOUR AB - OBJECTIVE: Symptomatic metastatic spine disease (MSD), is a challenging disease involving 3%-20% of patients with bone metastases. Different surgical options are available and must be tailored to the general and neurologic conditions of the patients. Open kyphoplasty (OKP) refers to decompressive hemilaminectomy, associated with a contralateral percutaneous kyphoplasty, and in some cases, to a posterior stabilization. The aim of the study was to critically review our experience during the last decade with OKP in patients with cancer. METHODS: Fifty-three patients with cancer underwent OKP for symptomatic MSD. The Tokuhashi score and Spinal Instability Neoplastic Score were calculated for each patient. Length of hospital stay, perioperative complications, incidence of adjacent-level fractures, and median survival after surgery were evaluated. Karnofsky Performance Status, visual analog scale, and Dennis Pain Score were calculated preoperatively, postoperatively, and at last follow-up. RESULTS: Median Tokuhashi score and Spinal Instability Neoplastic Score were 10 and 10, respectively. The mean volume of filling material inserted was 3.6 mL. Median operative time was 180 minutes. Complications included 8 leakages (15%), 2 permanent motor deficits (3.8%), and 2 asymptomatic pulmonary embolisms (3.8%). Mean length of hospital stay was 7 days. A significant improvement was observed in Karnofsky Performance Status, visual analog scale score, and Dennis Pain Score (P < 0.0001). Median follow-up was 16 months and overall survival 22 months. CONCLUSIONS: OKP was an effective treatment of symptomatic MSDs in selected oncologic patients with low Tokuhashi scores. It relieved lateral epidural compressions, expanded indications of palliative surgery in patients who were not otherwise surgical candidates, and rapidly dealt with cement leakages. AD - Department of Neurosurgery, IRCSS National Cancer Institute "Regina Elena", Rome, Italy. Electronic address: stefano.telera@ifo.gov.it. Division of Neurosurgery, Messina University, Messina, Italy. Department of Neurosurgery, IRCSS National Cancer Institute "Regina Elena", Rome, Italy. Department of Radiology, IRCSS National Cancer Institute "Regina Elena", Rome, Italy. Department of Neurology, IRCSS National Cancer Institute "Regina Elena", Rome, Italy. Department of Clinical Oncology A, IRCSS National Cancer Institute "Regina Elena", Rome, Italy. Department of Biostatistics, IRCSS National Cancer Institute "Regina Elena", Rome, Italy. AN - 30951918 AU - Telera, S. AU - Gorgoglione, N. AU - Raus, L. AU - Vidiri, A. AU - Villani, V. AU - Pace, A. AU - Fabi, A. AU - Crispo, F. AU - Castiglione, M. AU - Sperduti, I. AU - Boccaletti, R. DA - Jul DO - 10.1016/j.wneu.2019.03.258 DP - NLM ET - 2019/04/06 J2 - World neurosurgery KW - Adult Aged Aged, 80 and over Female Humans Kyphoplasty/*methods Lumbar Vertebrae/diagnostic imaging/surgery Male Middle Aged Minimally Invasive Surgical Procedures/*methods Retrospective Studies Spinal Neoplasms/diagnostic imaging/*secondary/*surgery Thoracic Vertebrae/diagnostic imaging/surgery Young Adult Epidural compression Metastatic spine disease Mini-invasive approach Open kyphoplasty Pmma Vk100 LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 1878-8750 SP - e751-e760 ST - Open Kyphoplasty for Metastatic Spine Disease: A Retrospective Clinical Series T2 - World Neurosurg TI - Open Kyphoplasty for Metastatic Spine Disease: A Retrospective Clinical Series VL - 127 ID - 828570 ER - TY - JOUR AB - OBJECTIVES: Balloon Kyphoplasty (BKP) for vertebral compression fractures (VCFs) in cancer patients is more challenging than for osteoporotic ones. Cord compressions are frequent and the incidence of complications ten-fold greater. Polymethylmetacrylate (PMMA) is the gold standard material for BKP but has disadvantages: exothermic reaction, short working time, rapid solidification, absence of osteoconduction. VK100 is a mixture of Dimethyl Methylvinyl siloxane and Barium Sulphate. It is elastic, adhesive to bone, leaves 30 min before solidification without exothermic reaction, and shows a stiffness close to the intact vertebrae. The surgical procedure, called elastoplasty, is similar to a BKP. Clinical results obtained with this new silicone in pathological VCFs have been investigated. PATIENTS AND METHODS: 41 cancer patients with symptomatic VCFs (70 vertebral bodies), underwent percutaneous and open elastoplasties. Post-operative leakages, pulmonary embolism (PE) and adjacent fractures were carefully evaluated with neuroimaging. KPS, VAS and Dennis Pain Score were calculated pre- post-operatively and at the last follow-up. RESULTS: The mean volume of silicone inserted in each vertebra was 3.8 cc. Complications included seven leakages (17%), two asymptomatic PE (4.3%) and 3 post-operative adjacent fractures (7.3%). Median follow-up was 29 months. A significant improvement was observed in KPS, VAS and Dennis Pain Score (p < .0001). The 1-yr survival rate was 76.9%. CONCLUSIONS: Elastoplasty appears a safe and effective palliative treatment of VCFs in oncologic patients. Useful qualities of VK100 are the lack of exothermic reaction and the wider working window. The influence of biomechanical properties of silicone on reduction of adjacent level fractures requires further investigations. AD - Department of Neurosurgery, IRCSS National Cancer Institute "Regina Elena", Rome, Italy. Electronic address: stefano.telera@ifo.gov.it. Department of Neurosurgery, IRCSS National Cancer Institute "Regina Elena", Rome, Italy. Department of Anesthesiology, IRCSS National Cancer Institute "Regina Elena", Rome, Italy. Department of Neurology, IRCSS National Cancer Institute "Regina Elena", Rome, Italy. Department of Oncology A, IRCSS National Cancer Institute "Regina Elena", Rome, Italy. Department of Biostatistics, IRCSS National Cancer Institute "Regina Elena", Rome, Italy. AN - 29929175 AU - Telera, S. AU - Pompili, A. AU - Crispo, F. AU - Giovannetti, M. AU - Pace, A. AU - Villani, V. AU - Fabi, A. AU - Sperduti, I. AU - Raus, L. DA - Aug DO - 10.1016/j.clineuro.2018.06.018 DP - NLM ET - 2018/06/22 J2 - Clinical neurology and neurosurgery KW - Adult Aged Aged, 80 and over Bone Cements Female Fractures, Compression/*surgery Humans *Kyphoplasty/methods Male Middle Aged Neoplasms/*surgery Osteoporotic Fractures/surgery Retrospective Studies Silicones Spinal Fractures/*surgery Spine/surgery Treatment Outcome Vertebroplasty/methods *Ballon Kyphoplasty *Elastoplasty *Silicone *Spinal metastases *Vk 100 LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 0303-8467 SP - 184-189 ST - Kyphoplasty with purified silicone VK100 (Elastoplasty) to treat spinal lytic lesions in cancer patients: A retrospective evaluation of 41 cases T2 - Clin Neurol Neurosurg TI - Kyphoplasty with purified silicone VK100 (Elastoplasty) to treat spinal lytic lesions in cancer patients: A retrospective evaluation of 41 cases VL - 171 ID - 828620 ER - TY - JOUR AB - Case Reports: Now-a-days, percutaneous vertebroplasty is increasingly being used to treat osteoporotic compression fractures as well as bone loss due to malignancy. It is relatively safe procedure with some possible complications. We describe a case of vertebroplasty cement serving as a potential nidus for pulmonary embolism (PE). Case: An 87 year old female with PMH of myocardial infarction s/p stent placement in 2010, presented to ER with 10/10 right upper quadrant abdominal pain and lower back pain aggravated by standing and relieved by rest. Vital signs revealed hypotension and oxygen saturation of >95 %. Physical examination was remarkable for RUQ tenderness and diffuse lumbar para-spinal tenderness. Six weeks prior to admission, she had compression fractures of L1, L2 and L5 vertebrae and underwent L2 vertebroplasty. Abdominal CT at that time was normal.Chest CT now showed extensive bilateral pulmonary filling defects affecting right main pulmonary artery, all three lobar arteries and left lower lobar branches and multiple segmental branches. Work-up for PE included a negative lower limb Doppler, cardiac enzymes and CHF peptide. CT abdomen showed a 9 cm cement fragment in the Inferior Vena Cava (IVC) extending proximally from the level of the right superior renal vein. This appeared to be secondary to cement leak from the vertebral plexus into the IVC. She was started on Heparin and Warfarin and responded well. Patient refused aggressive management and discharged home on medical management. Discussion: Although vertebroplasty is considered a relatively safe procedure, cement leaks are reported in 73% cases, 24% of which are venous leaks. There is an incidence of 6.2 % with IVC foreign bodies serving as a nidus for PE. There are about 51 reported cases of cement pulmonary embolism. We believe, this is the first reported case of vertebroplasty cement serving as a nidus for PE. Treatment includes anticoagulation and supportive management. Preventive measures include better cement composition and low threshold for detecting venous cement leak. With the increasing use of this procedure, more attention is needed regarding potential complications and their prevention. AD - S.H. Tella, Creighton University Medical Center, United States AU - Tella, S. H. AU - Chilluru, V. AU - Bansal, O. AU - Townley, T. DB - Embase DO - 10.1097/01.ccm.0000425605.04623.4b KW - cement warfarin heparin peptide enzyme intensive care lung embolism percutaneous vertebroplasty society procedures human compression fracture heart infarction kidney vein inferior cava vein abdomen female leg artery pulmonary artery vertebra physical examination oxygen saturation osteolysis hypotension vital sign low back pain abdominal pain patient disease management foreign body prevention anticoagulation stent case report LA - English M1 - 12 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 0090-3493 SP - 99 ST - Pulmonary embolism and vertebroplasty: The sinister link T2 - Critical Care Medicine TI - Pulmonary embolism and vertebroplasty: The sinister link UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71065550&from=export http://dx.doi.org/10.1097/01.ccm.0000425605.04623.4b VL - 40 ID - 829527 ER - TY - JOUR AD - Department of Orthopaedics and Rehabilitation, Milton S. Hershey Medical Center, Pennsylvania State University School of Medicine, Hershey 17033, USA. jtemple@psu.edu AN - 11940629 AU - Temple, J. D. AU - Ludwig, S. C. AU - Ross, W. K. AU - Marshall, W. K. AU - Larsen, L. AU - Gelb, D. E. DA - Apr DO - 10.2106/00004623-200204000-00023 DP - NLM ET - 2002/04/10 J2 - The Journal of bone and joint surgery. American volume KW - *Bone Cements *Bone Screws Embolism, Fat/*etiology Fatal Outcome Female Humans Intraoperative Complications/*etiology Middle Aged Spinal Fusion/*adverse effects LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2002 SN - 0021-9355 (Print) 0021-9355 SP - 639-42 ST - Catastrophic fat embolism following augmentation of pedicle screws with bone cement : a case report T2 - J Bone Joint Surg Am TI - Catastrophic fat embolism following augmentation of pedicle screws with bone cement : a case report VL - 84 ID - 828937 ER - TY - JOUR AD - Penn State Univ, Milton S Hershey Med Ctr, Sch Med, Dept Orthopaed & Rehabil, Hershey, PA 17033 USA. Penn State Univ, Milton S Hershey Med Ctr, Sch Med, Dept Anesthesiol, Hershey, PA 17033 USA. Temple, JD (corresponding author), Penn State Univ, Milton S Hershey Med Ctr, Sch Med, Dept Orthopaed & Rehabil, 500 Univ Dr, Hershey, PA 17033 USA. AN - WOS:000174803500024 AU - Temple, J. D. AU - Ludwig, S. C. AU - Ross, W. K. AU - Marshall, W. K. AU - Larsen, L. AU - Gelb, D. E. DA - Apr DO - 10.2106/00004623-200204000-00023 J2 - J. Bone Joint Surg.-Am. Vol. KW - SPINE Orthopedics Surgery LA - English M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2002 SN - 0021-9355 SP - 639-642 ST - Catastrophic fat embolism following augmentation of pedicle screws with bone cement - A case report T2 - Journal of Bone and Joint Surgery-American Volume TI - Catastrophic fat embolism following augmentation of pedicle screws with bone cement - A case report UR - ://WOS:000174803500024 VL - 84A ID - 830454 ER - TY - JOUR AB - BACKGROUND: Cemented total hip arthroplasty (THA) is a safe and common procedure. In rare cases life threatening bone cement implantation syndrome (BCIS) may occur, which is commonly caused by pulmonary embolism (PE). CASE PRESENTATION: We describe the rare case of a 70-year old patient who underwent an elective total hip replacement. Before surgery he was diagnosed with underlying systemic indolent mastocytosis, a rare pathological disorder that may result in anaphylaxis after massive systemic mast cell activation. Triggers may be IgE-mediated, direct mast cell activation, or unclear. Some patients may be at risk for severe non IgE-mediated reactions, such as those experienced with nonsteroidal anti-inflammatory drugs, or with perioperative muscle relaxants. During cementing of the acetabular component, our patient developed acute hypotension (blood pressure dropped from 90/50 to 60/40 mmHg, and saturation dropped from 95 to 80 %). The differential diagnosis of acute PE was excluded (no signs of breathing abnormalities during physical examination, normal arterial blood sample, and no electrocardiography or cardiac ultrasound abnormalities). The patient was diagnosed with acute anaphylactic shock, which was successfully managed by 100 % oxygen administration, rapid fluid induction, and vasoconstrictive drug therapy. He recovered hemodynamically within 15 min, did not lose consciousness, and did not develop angioedema or an urticarial rash. Forty-five minutes after onset of the symptoms, the surgical procedure was completed after inserting a press fitted uncemented femoral stem component. The patient was transported to the Intensive Care Unit (ICU) for optimal monitoring. Our patient had an uneventful recovery. Within six hours after surgery he started to ambulate following our standard fast-track rehabilitation regime. Post-operative day one he was discharged to the specialized Orthopedic Department, and after five hospital days discharged to his home. Twelve months after THA surgery our patient was satisfied with an optimal functional status of his hip joint replacement. CONCLUSION: The differential diagnosis of anaphylactic shock must be taken into consideration in patients with acute hypotension during cementing of total hip arthroplasty components. Patients with underlying mastocytosis are at particular risk of this potential life-threatening intra-operative complication. This rare entity should be taken into consideration during the pre-operative risk stratification and shared decision-making process for elective cemented joint replacement. AD - Department of Anesthesiology, Martini Hospital Groningen, Van Swietenplein 1, 9728 NT Groningen, The Netherlands. Department of Orthopaedic Surgery, Martini Hospital Groningen, van Swietenplein 1, 9728 NT Groningen, The Netherlands. AN - 27822310 AU - Ten Hagen, A. AU - Doldersum, P. AU - van Raaij, T. C2 - Pmc5097346 DO - 10.1186/s13037-016-0113-x DP - NLM ET - 2016/11/09 J2 - Patient safety in surgery KW - Anaphylaxis Bone cement Case report Hip surgery Implantation syndrome Mastocytosis LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1754-9493 (Print) 1754-9493 SP - 25 ST - Anaphylactic shock during cement implantation of a total hip arthroplasty in a patient with underlying mastocytosis: case report of a rare intraoperative complication T2 - Patient Saf Surg TI - Anaphylactic shock during cement implantation of a total hip arthroplasty in a patient with underlying mastocytosis: case report of a rare intraoperative complication VL - 10 ID - 828770 ER - TY - JOUR AD - Q. Liu, Department of Radiology, Shandong Medical Imaging Research Institute Affiliated to Shandong University, No 324, Warp 5 Weft 7 Street, Huaiyin District, Ji'nan, Shandong Province, China AU - Teng, F. AU - Xu, X. J. AU - Liu, Q. DB - Embase DO - 10.1016/j.jimed.2019.05.010 KW - ablation catheter bone cement device catheter sheath guide wire TIG catheter bone cement poly(methyl methacrylate) aged article bone cement leakage cardiac cement embolism case report clinical article computer assisted tomography embolism fluoroscopy heart right atrium heart right ventricle human inferior cava vein lung angiography lung artery male medical device complication outcome assessment paravertebral vein percutaneous vertebroplasty spine fracture spine radiography tricuspid valve vein LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 2096-3602 SP - 38-41 ST - A modified wire-loop snare technique for the retrieval of a large cardiac cement embolus caused by cement leakage after percutaneous vertebroplasty T2 - Journal of Interventional Medicine TI - A modified wire-loop snare technique for the retrieval of a large cardiac cement embolus caused by cement leakage after percutaneous vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2001969420&from=export http://dx.doi.org/10.1016/j.jimed.2019.05.010 VL - 2 ID - 829154 ER - TY - JOUR AB - A 3-year-old, German shepherd dog died suddenly during cemented total hip arthroplasty. Gross necropsy findings included severe pulmonary edema and congestion as well as congestion of the liver and kidneys. Acute pulmonary embolism was suspected as the cause of death. Microscopic examination of hematoxylin and eosin-stained, formalin-fixed, and oil red O-stained frozen tissue sections confirmed the presence of large numbers of fat globules in blood vessels in the lungs, liver, and kidneys. Fat embolism during total hip arthroplasty is a common surgical complication in humans, but it is uncommon in veterinary cases and is rarely a cause of death. © 2004 American Animal Hospital Association. AD - S.P. Terrell, Department of Pathobiology, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610, United States AU - Terrel, S. P. AU - Chandra, A. M. S. AU - Pablo, L. S. AU - Lewis, D. D. DB - Embase Medline KW - eosin fat formaldehyde hematoxylin acute disease animal tissue article autopsy blood vessel breed cause of death disease severity dog fat embolism frozen section intraoperative period kidney disease liver congestion lung congestion lung edema lung embolism male microscopy nonhuman osteoarthritis total hip prosthesis L1 - http://www.jaaha.org/cgi/content/full/40/4/345 LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2004 SN - 1547-3317 SP - 345-348 ST - Fatal intraoperative pulmonary fat embolism during cemented total hip arthroplasty in a dog T2 - Journal of the American Animal Hospital Association TI - Fatal intraoperative pulmonary fat embolism during cemented total hip arthroplasty in a dog UR - https://www.embase.com/search/results?subaction=viewrecord&id=L43180255&from=export VL - 40 ID - 829838 ER - TY - JOUR AB - A 3-year-old, German shepherd dog died suddenly during cemented total hip arthroplasty. Gross necropsy findings included severe pulmonary edema and congestion as well as congestion of the liver and kidneys. Acute pulmonary embolism was suspected as the cause of death. Microscopic examination of hematoxylin and eosin-stained, formalin-fixed, and oil red O-stained frozen tissue sections confirmed the presence of large numbers of fat globules in blood vessels in the lungs, liver, and kidneys. Fat embolism during total hip arthroplasty is a common surgical complication in humans, but it is uncommon in veterinary cases and is rarely a cause of death. AD - Univ Florida, Coll Vet Med, Dept Pathobiol, Gainesville, FL 32610 USA. Univ Florida, Coll Vet Med, Dept Large Anim Clin Sci, Gainesville, FL 32610 USA. Univ Florida, Coll Vet Med, Dept Small Anim Clin Sci, Gainesville, FL 32610 USA. Terrell, SP (corresponding author), Disneys Anim Programs, Vet Serv, 1200 N Savannah Circle, Bay Lake, FL 33844 USA. AN - WOS:000238365300013 AU - Terrell, S. P. AU - Chandra, A. M. S. AU - Pablo, L. S. AU - Lewis, D. D. DA - Jul-Aug DO - 10.5326/0400345 J2 - J. Am. Anim. Hosp. Assoc. KW - METHYLMETHACRYLATE CEMENT BONE CEMENT REPLACEMENT HYPOTENSION PROSTHESIS PRESSURE Veterinary Sciences LA - English M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2004 SN - 0587-2871 SP - 345-348 ST - Fatal intraoperative pulmonary fat embolism during cemented total hip arthroplasty in a dog T2 - Journal of the American Animal Hospital Association TI - Fatal intraoperative pulmonary fat embolism during cemented total hip arthroplasty in a dog UR - ://WOS:000238365300013 VL - 40 ID - 830438 ER - TY - JOUR AB - A 3-year-old, German shepherd dog died suddenly during cemented total hip arthroplasty. Gross necropsy findings included severe pulmonary edema and congestion as well as congestion of the liver and kidneys. Acute pulmonary embolism was suspected as the cause of death. Microscopic examination of hematoxylin and eosin-stained, formalin-fixed, and oil red O-stained frozen tissue sections confirmed the presence of large numbers of fat globules in blood vessels in the lungs, liver, and kidneys. Fat embolism during total hip arthroplasty is a common surgical complication in humans, but it is uncommon in veterinary cases and is rarely a cause of death. AD - Department of Pathobiology, College of Veterinary Medicine, University of Florida, Gainesville, Florida 32610, USA. AN - 15238566 AU - Terrell, S. P. AU - Sundeep Chandra, A. M. AU - Pablo, L. S. AU - Lewis, D. D. DA - Jul-Aug DO - 10.5326/0400345 DP - NLM ET - 2004/07/09 J2 - Journal of the American Animal Hospital Association KW - Animals Arthroplasty, Replacement, Knee/veterinary Dogs Embolism, Fat/etiology/pathology/*veterinary Fatal Outcome Hip Dysplasia, Canine/surgery Intraoperative Complications/epidemiology/*veterinary Male Pulmonary Embolism/etiology/pathology/*veterinary LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2004 SN - 0587-2871 SP - 345-8 ST - Fatal intraoperative pulmonary fat embolism during cemented total hip arthroplasty in a dog T2 - J Am Anim Hosp Assoc TI - Fatal intraoperative pulmonary fat embolism during cemented total hip arthroplasty in a dog VL - 40 ID - 828846 ER - TY - JOUR AB - Aims Metaphyseal fixation during revision total knee arthroplasty (TKA) is important, but potentially difficult when using historical designs of cone. Material and manufacturing innovations have improved the size and shape of the cones which are available, and simplified the required bone preparation. In a large series, we assessed the implant survivorship, radiological results, and clinical outcomes of new porous 3D-printed titanium metaphyseal cones featuring a reamer-based system. Methods We reviewed 142 revision TKAs in 139 patients using 202 cones (134 tibial, 68 femoral) which were undertaken between 2015 and 2016. A total of 60 involved tibial and femoral cones. Most cones (149 of 202; 74%) were used for Type 2B or 3 bone loss. The mean age of the patients was 66 years (44 to 88), and 76 (55 %) were female. The mean body mass index (BMI) was 34 kg/m2 (18 to 60). The patients had a mean of 2.4 (1 to 8) previous operations on the knee, and 68 (48%) had a history of prosthetic infection. The mean follow-up was 2.4 years (2 to 3.6). Results Survivorship free of cone revision for aseptic loosening was 10 0% and survivorship free of any cone revision was 98%. Survivorships free of any revisio n and any reoperation were 90% and 83%, respectively. Five cones were revised: Three for infection, one for periprosthetic fracture, and one for aseptic tibial loosening. Radiologically, three unrevised femoral cones appeared loose in the presence of hinged implants, while the remaining cones appeared stable. All cases of cone loosening oc curred in patients with Type 2B or 3 defects. The mean Knee Society score (KSS) improve d significantly from 50 (0 to 94) preoperatively to 87 (72 to 94) (p < 0.001). Three in traoperative fractures with cone impaction (two femoral, one tibial) healed uneventfully. Conclusion Novel 3D-printed titanium cones, with a reamer-based system, yielded excellent early survivorship and few complications in patients with severe bone loss undergoing difficult revision TKA. The diversity of cone options, relative ease of preparation, and outcomes rivalling those of previous designs of cone support their continued use. AD - M.P. Abdel, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, United States AU - Tetreault, M. W. AU - Perry, K. I. AU - Pagnano, M. W. AU - Hanssen, A. D. AU - Abdel, M. P. DB - Embase Medline DO - 10.1302/0301-620X.102B6.BJJ-2019-1544.R1 KW - hip stem total knee prosthesis acrylic cement gentamicin bone cement marlex titanium vancomycin adult aged article body mass clinical outcome debridement female femur fracture femur metaphysis follow up human knee radiography Knee Society Score lung embolism major clinical study male metaphysis middle aged osteolysis periprosthetic fracture peroperative complication preoperative evaluation priority journal prosthesis infection prosthesis loosening reoperation survivorship three dimensional printing tibial metaphysis total knee arthroplasty wound dehiscence LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 2049-4408 2049-4394 SP - 107-115 ST - Excellent two-year survivorship of 3D-printed metaphyseal cones in revision total knee arthroplasty: A reliable and safe reamer-based system T2 - Bone and Joint Journal TI - Excellent two-year survivorship of 3D-printed metaphyseal cones in revision total knee arthroplasty: A reliable and safe reamer-based system UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2006990243&from=export http://dx.doi.org/10.1302/0301-620X.102B6.BJJ-2019-1544.R1 VL - 102-B ID - 829066 ER - TY - JOUR AB - Objective: In lower-extremity surgery there are significant risks associated with the use of tourniquets. This prospective study was done to assess to what extent these risks may be offset by the potential advantages of tourniquets, namely reductions in blood loss, length of hospital stay and complication rates. Design: A prospective case study. Setting: A major urban hospital. Patients: Sixty-three consecutive patients scheduled for primary cemented total knee arthroplasty (TI(A)were blindly randomized into tourniqet (n = 33) and non-tourniquet (n = 30) groups. Intervention: TI(A. during which a pneumatic tourniquet was applied or not applied to control blood loss. Main outcome measures: Perioperative blood loss, operating time, complication rates, hospital stay and transfusion needs. Results: Differences in the total measured blood loss, intraoperative blood loss and the Hemovac drainage blood loss between the 2 groups were not significantly different (p > 0.25). The calculated total blood loss was actually lower in the non-tourniquet group (p = 0.02). Between the groups there were no statistical differences in surgical time, length of hospital stay, transfusion requirements or rate of complications (although there was a trend to more complications in the tourniquet group (P = 0.06)). Conclusion: The effectiveness of a pneumatic tourniquet to control blood loss in TKA is questionable. AD - Queens Univ, Dept Surg, Kingston, ON K7L 3N6, Canada. Rudan, JF (corresponding author), Queens Univ, Dept Surg, Kingston, ON K7L 3N6, Canada. AN - WOS:000166950800010 AU - Tetro, A. M. AU - Rudan, J. F. DA - Feb J2 - Can. J. Surg. KW - MASSIVE PULMONARY-EMBOLISM DEFLATION Surgery LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2001 SN - 0008-428X SP - 33-38 ST - The effects of a pneumatic tourniquet on blood loss in total knee arthroplasty T2 - Canadian Journal of Surgery TI - The effects of a pneumatic tourniquet on blood loss in total knee arthroplasty UR - ://WOS:000166950800010 VL - 44 ID - 830461 ER - TY - JOUR AB - Introduction: We conducted a prospective, single-center, continuous study of patients operated for fractures urelated to osteoporosis at the thoracolumbar junction level using percutaneous techniques. The aim of this study was to investigate the clinical and radiological outcomes of percutaneous techniques for these indications. Patients and methods: This study included patients who underwent standalone balloon kyphoplasty surgery or combined with percutaneous posterior osteosynthesis in cases of associated distraction. The fractures were classified according to the Magerl classification. The patients were evaluated clinically (visual analog scale [VAS], the Oswestry Disability Index, and autonomy) and radiologically (vertebral kyphosis and height variations of the vertebral body) for 12 months. Results: Sixty-five patients were included. The mean age at the time of the surgery was 45.4 years (range, 19-72 years). The main indications were A.1 fractures of L1. We noted 22% cement leakages, none having a clinical impact. In the overall series, the VAS at the lesional level improved from 5.5 (range, 3-8) preoperatively to 0.6 (range, 1-3) at 12 months. In all, 95% of the workers resumed their occupation. Traumatic kyphosis improved from 13.3° (range, 5-23°) before the surgery to 8.3° (range, 1-20°). Discussion: The complication rate was low. The radiological results are comparable to those reported in the literature for other series with percutaneous surgery. Only the loss of the correction observed in the group undergoing standalone kyphoplasty with calcium phosphate cement led us to propose another type of treatment for these indications. This study must be continued over the long term to detect the appearance of discopathy related to cement leakage and to answer questions as to how cement evolves. Level of evidence: III, prospective study with low statistical power. © 2011 Elsevier Masson SAS. AD - S. Teyssédou, Department of Orthopaedic Surgery and Traumatology, La Milétrie Teaching Hospital, Center, 2, rue de la Milétrie, 86000 Poitiers, France AU - Teyssédou, S. AU - Saget, M. AU - Prébet, R. AU - Leclercq, N. AU - Vendeuvre, T. AU - Pries, P. DB - Embase Medline DO - 10.1016/j.otsr.2011.08.009 KW - adult aged article body height case study clinical evaluation disease classification female human kyphoplasty kyphosis leg pain lung embolism major clinical study male osteosynthesis Oswestry Disability Index patient autonomy percutaneous posterior osteosynthesis postoperative complication postoperative hemorrhage postoperative infection postoperative pain postoperative thrombosis preoperative evaluation priority journal prospective study spinal hematoma spine fracture spine radiography thoracolumbar spine fracture treatment indication treatment outcome vein thrombosis vertebra body vertebral spine kyphosis visual analog scale work resumption Sextant LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1877-0568 SP - 39-47 ST - Evaluation of percutaneous surgery in the treatment of thoracolumbar fractures. Preliminary results of a prospective study on 65 patients T2 - Orthopaedics and Traumatology: Surgery and Research TI - Evaluation of percutaneous surgery in the treatment of thoracolumbar fractures. Preliminary results of a prospective study on 65 patients UR - https://www.embase.com/search/results?subaction=viewrecord&id=L364198190&from=export http://dx.doi.org/10.1016/j.otsr.2011.08.009 VL - 98 ID - 829582 ER - TY - JOUR AB - Introduction: The introduction of a new knee arthroplasty model, even if it differs from a validated implant by only a few details, should be followed by rigorous assessment. The Optetrak™ cemented posterior stabilized knee prosthesis evolved from the Insall prosthesis with a smaller tibial keel associated with a higher tibial cam and increased femorotibial congruency as well as a more posterior-stabilized trochlea. Hypothesis: We hypothesized that this implant with only minor modifications to the Insall prosthesis would provide as favorable results as the Insall prosthesis. Materials and methods: A continuous series of 110 prostheses (106 patients) implanted between 2005 and 2007 was retrospectively analyzed with a mean follow-up of 25 months (range, 12-42 months) by an independent observer. The follow-up was based on the IKS score and the radiological assessment was conducted by three senior surgeons. Results: The mean IKS score was 83.7 (range, 13-100) points at the last follow-up, the mean function score was 82.6 (range, 30-100 points), and mean flexion was 120° (range, 80-140°). Seventeen patients (15%) were disappointed or dissatisfied, 25 knees (22%) were painful, requiring regular painkillers. The prostheses had a satisfactory mechanical axis, with a mean HKA angle of 177.4 ± 4°, but 25 prostheses (22%) presented rims evolving toward tibial implant loosening, and 24 (21%) developed signs of patellofemoral conflict. With follow-up less than 5 years, nine cases were revised for tibial loosening, three for patellofemoral instability, and one for patellofemoral pain. The cases of tibial loosening were particular because they occurred at the cement-tibial-implant interface. The cumulated survival rate at 36 months was 80.97 ± 9.1% and 76.74 ± 12% at 45 months. Discussion: This tibial implant with a small keel does not resist the stresses applied by posterior stabilization, with notably a higher level of stress than the Insall prosthesis from which it was derived. In cases of centering defect, the design of the trochlea can lead to impingement between the edges of the patella and the prominent edges of the prosthetic trochlea. We have suspended implantation of this prosthesis and continue to monitor the progression of patients having received these implants. Level of evidence: Level IV, retrospective study. © 2012 . AD - G. Pasquier, Faculté de médecine, Lille Nord-de-France University, 59045 Lille cedex, France AU - Thelu, C. E. AU - Pasquier, G. AU - Maynou, C. AU - Migaud, H. DB - Embase Medline DO - 10.1016/j.otsr.2012.04.008 KW - analgesic agent bone cement adult aged article aseptic necrosis female follow up functional assessment hematoma human knee arthroplasty knee function knee instability knee osteoarthritis knee pain knee prosthesis knee radiography lung embolism major clinical study male patellofemoral pain syndrome patient assessment patient satisfaction phlebitis postoperative infection priority journal prosthesis loosening retrospective study rheumatic disease surgeon survival rate tibia treatment failure Optetrak LA - English M1 - 4 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1877-0568 SP - 413-420 ST - Poor results of the Optetrak™ cemented posterior stabilized knee prosthesis after a mean 25-month follow-up: Analysis of 110 prostheses T2 - Orthopaedics and Traumatology: Surgery and Research TI - Poor results of the Optetrak™ cemented posterior stabilized knee prosthesis after a mean 25-month follow-up: Analysis of 110 prostheses UR - https://www.embase.com/search/results?subaction=viewrecord&id=L364933671&from=export http://dx.doi.org/10.1016/j.otsr.2012.04.008 VL - 98 ID - 829561 ER - TY - JOUR AB - Glucocorticosteroid-induced osteoporosis is the most frequent of all secondary types of osteoporosis, and can increase the risk of vertebral compression fractures (VCFs). There are promising additions to current medical treatment for appropriately selected osteoporotic patients. Few studies have reported on the efficiency of percutaneous vertebroplasty (PVP) or kyphoplasty for whole thoracic and Lumbar glucocorticosteroid-induced osteoporotic vertebral compression fractures. We report a case of a 67-year-old man with intractable pain caused by successional VCFs treated by PVP. AD - [Tian, Qing-Hua; Wu, Chun-Gen; Xiao, Quan-Ping; He, Cheng-Jian; Gu, Yi-Feng; Wang, Tao; Li, Ming-Hua] Shanghai Jiao Tong Univ, Affiliated Peoples Hosp 6, Dept Diagnost & Intervent Radiol, Shanghai 200233, Peoples R China. Wu, CG (corresponding author), Shanghai Jiao Tong Univ, Affiliated Peoples Hosp 6, Dept Diagnost & Intervent Radiol, 600 Yishan Rd, Shanghai 200233, Peoples R China. 649514608@qq.com AN - WOS:000345949600015 AU - Tian, Q. H. AU - Wu, C. G. AU - Xiao, Q. P. AU - He, C. J. AU - Gu, Y. F. AU - Wang, T. AU - Li, M. H. DA - Nov-Dec DO - 10.3348/kjr.2014.15.6.797 J2 - Korean J. Radiol. KW - Percutaneous vertebroplasty Entire thoracic and lumber vertebra Osteoporotic vertebral compression fractures Steroids RISK COMPLICATIONS OSTEOPOROSIS KYPHOPLASTY REFRACTURES EMBOLISM PATIENT Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 6 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2014 SN - 1229-6929 SP - 797-801 ST - Percutaneous Vertebroplasty of the Entire Thoracic and Lumbar Vertebrae for Vertebral Compression Fractures Related to Chronic Glucocorticosteriod Use: Case Report and Review of Literature T2 - Korean Journal of Radiology TI - Percutaneous Vertebroplasty of the Entire Thoracic and Lumbar Vertebrae for Vertebral Compression Fractures Related to Chronic Glucocorticosteriod Use: Case Report and Review of Literature UR - ://WOS:000345949600015 VL - 15 ID - 830253 ER - TY - JOUR AB - Background: Our experience with direct anterior approach total hip arthroplasty (THA) suggests that it can be performed successfully with a morphometrically optimized metaphyseal-diaphyseal engaging femoral stem (NOT a short stem), a regular operating room table (NOT a special custom table), and WITHOUT intraoperative fluoroscopy. We report our minimum 2-year results.Methods: A retrospective review of a single-surgeon series of primary direct anterior approach THAs was performed. All procedures were performed on a regular table, without fluoroscopy, using a cementless tapered femoral stem. Clinical, functional, and radiographic outcomes were evaluated at a minimum of 2 years.Results: In total, 1017 primary THAs were performed. The preoperative Harris Hip Score was 40.7 ± 5.1 and improved to 95.3 ± 4.2 at minimum 2-year follow-up. There were 3 dislocations (0.3%) and 15 revisions (1.5%): 7 for infection (0.7%), 4 for periprosthetic fractures (0.4%), 2 for instability (0.2%), 1 for loosening (0.1%), and 1 for pain (0.1%). Five patients (0.5%) required blood transfusion. One patient developed deep vein thrombosis and pulmonary embolism. No intraoperative fractures, perforation, or THA-related mortality occurred. Neutral stem alignment was confirmed in 98.3%. Mean cup inclination was 38.8° ± 5.1° and anteversion was 16.2° ± 3.5°. The mean leg-length discrepancy was corrected from 1.2 ± 0.2 cm preoperatively to 0.2 ± 0.1 cm postoperatively.Conclusion: Using a morphometrically optimized metaphyseal-diaphyseal engaging tapered femoral stem instead of a short stem reduces component malposition and minimizes risk of loosening. Combining the use of this implant design and the technique and elements described in our cohort demonstrated to have excellent results at 2 years. The patients will need continued follow-up to demonstrate further durability of this device and technique compared to others performing direct anterior THA. AD - Rothman Institute, Thomas Jefferson University, Philadelphia, PA Affiliated Hospital of Qingdao University, Qingdao, China Department of Orthopaedics & Sports Medicine, University of Washington, Seattle, WA AN - 134067715. Language: English. Entry Date: 20190403. Revision Date: 20200605. Publication Type: journal article AU - Tian, Shaoqi AU - Goswami, Karan AU - Manrique, Jorge AU - Blevins, Kier AU - Azboy, Ibrahim AU - Hozack, William J. DB - cin20 DO - 10.1016/j.arth.2018.10.023 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Equipment and Supplies Joint Prosthesis Arthroplasty, Replacement, Hip -- Adverse Effects Femur -- Surgery Fluoroscopy Adult Aged, 80 and Over Young Adult Aged Diaphyses -- Surgery Male Arthroplasty, Replacement, Hip -- Methods Surgical Equipment and Supplies Middle Age Fractures Female Prosthesis Design Retrospective Design Arthroplasty, Replacement, Hip -- Statistics and Numerical Data Postoperative Period Human M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2019 SN - 0883-5403 SP - 327-332 ST - Direct Anterior Approach Total Hip Arthroplasty Using a Morphometrically Optimized Femoral Stem, a Conventional Operating Table, Without Fluoroscopy T2 - Journal of Arthroplasty TI - Direct Anterior Approach Total Hip Arthroplasty Using a Morphometrically Optimized Femoral Stem, a Conventional Operating Table, Without Fluoroscopy UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=134067715&site=ehost-live&scope=site VL - 34 ID - 830539 ER - TY - JOUR AB - OBJECTIVE: We noted a large amount of intravenous gas during balloon kyphoplasty on CT imaging. Formal assessment to understand the extent, possible causes and implications was undertaken. MATERIALS AND METHODS: Ten consecutive cases of balloon kyphoplasty were performed under general anaesthesia in the prone position, on a single vertebral level using a two-step technique under combined fluoroscopic and CT guidance. CT of the affected vertebra was performed before, after, and intermittently during the procedure. In 2 cases delayed CT was carried out in the supine position. RESULTS: Gas was seen on CT imaging, but not on conventional fluoroscopy. The gas is most likely to be air introduced during the procedure and was seen in the epidural and paravertebral venous plexus, posterior intercostal veins, renal veins, IVC and azygos vein. The average measured volume of gas seen on the post-procedure CT imaging was 1.07 mL, range 0.16-3.97 mL. There was no correlation of the measured amount of gas to the procedure duration or location, the use of a curette or the injected cement volume. Delayed CT in the supine position no longer showed air in the local venous system. CONCLUSIONS: Balloon kyphoplasty is associated with the fluoroscopically invisible introduction of air into the vertebral and paravertebral veins and deep systemic veins and is likely to be much more extensive than identified on CT imaging. There is potential for serious air embolism in kyphoplasty and if there is a sudden deterioration in patient condition during the procedure the possibility of this complication needs to be considered. AD - Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Twmpath Lane, Oswestry, Shropshire, SY10 7AG, UK. Bernhard.Tins@rjah.nhs.uk AN - 22252292 AU - Tins, B. J. AU - Cassar-Pullicino, V. N. AU - Lalam, R. AU - Haddaway, M. DA - Sep DO - 10.1007/s00256-011-1348-3 DP - NLM ET - 2012/01/19 J2 - Skeletal radiology KW - Aged Embolism, Air/*diagnostic imaging/*etiology Female Humans Kyphoplasty/*adverse effects Male Middle Aged Phlebography/*methods Tomography, X-Ray Computed/*methods Treatment Outcome LA - eng M1 - 9 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0364-2348 SP - 1093-8 ST - Venous air embolism in consecutive balloon kyphoplasties visualised on CT imaging T2 - Skeletal Radiol TI - Venous air embolism in consecutive balloon kyphoplasties visualised on CT imaging VL - 41 ID - 828768 ER - TY - JOUR AB - Objective: We noted a large amount of intravenous gas during balloon kyphoplasty on CT imaging. Formal assessment to understand the extent, possible causes and implications was undertaken.Materials and Methods: Ten consecutive cases of balloon kyphoplasty were performed under general anaesthesia in the prone position, on a single vertebral level using a two-step technique under combined fluoroscopic and CT guidance. CT of the affected vertebra was performed before, after, and intermittently during the procedure. In 2 cases delayed CT was carried out in the supine position.Results: Gas was seen on CT imaging, but not on conventional fluoroscopy. The gas is most likely to be air introduced during the procedure and was seen in the epidural and paravertebral venous plexus, posterior intercostal veins, renal veins, IVC and azygos vein. The average measured volume of gas seen on the post-procedure CT imaging was 1.07 mL, range 0.16-3.97 mL. There was no correlation of the measured amount of gas to the procedure duration or location, the use of a curette or the injected cement volume. Delayed CT in the supine position no longer showed air in the local venous system.Conclusions: Balloon kyphoplasty is associated with the fluoroscopically invisible introduction of air into the vertebral and paravertebral veins and deep systemic veins and is likely to be much more extensive than identified on CT imaging. There is potential for serious air embolism in kyphoplasty and if there is a sudden deterioration in patient condition during the procedure the possibility of this complication needs to be considered. AD - Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Twmpath Lane, Oswestry, Shropshire, SY10 7AG, UK Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital, Twmpath Lane, Oswestry, Shropshire, SY10 7AG, UK. Bernhard.Tins@rjah.nhs.uk AN - 104383076. Language: English. Entry Date: 20130208. Revision Date: 20200708. Publication Type: journal article AU - Tins, B. J. AU - Cassar-Pullicino, V. N. AU - Lalam, R. AU - Haddaway, M. AU - Tins, Bernhard J. AU - Cassar-Pullicino, Victor N. AU - Lalam, Radhesh AU - Haddaway, Mike DB - cin20 DO - 10.1007/s00256-011-1348-3 DP - EBSCOhost KW - Embolism, Air -- Etiology Embolism, Air -- Radiography Kyphoplasty -- Adverse Effects Phlebography -- Methods Tomography, X-Ray Computed -- Methods Aged Female Human Male Middle Age Treatment Outcomes M1 - 9 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2012 SN - 0364-2348 SP - 1093-1098 ST - Venous air embolism in consecutive balloon kyphoplasties visualised on CT imaging T2 - Skeletal Radiology TI - Venous air embolism in consecutive balloon kyphoplasties visualised on CT imaging UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104383076&site=ehost-live&scope=site VL - 41 ID - 830672 ER - TY - JOUR AB - Hip arthroplasty is associated with a high incidence of embolic events that, although usually not relevant at a clinical level, may be an important cause of morbidity and mortality in certain situations. Extreme caution should be taken in patients with cardiac defects that favor communication between the pulmonary and systemic circulation, due to their greater risk of complications. We present the case of a 72-year-old patient who suffered a paradoxical embolism during the intervention, with devastating consequences. AD - Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen de la Nieves, Granada, España. Electronic address: joseluistomeroca@gmail.com. Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen de la Nieves, Granada, España. AN - 31327534 AU - Tomé Roca, J. L. AU - López Martín, R. AU - Baca Morilla, Y. AU - de la Linde Valverde, C. DA - Oct DO - 10.1016/j.redar.2019.03.014 DP - NLM ET - 2019/07/23 J2 - Revista espanola de anestesiologia y reanimacion KW - Aged Anesthetics/adverse effects/pharmacology Arthroplasty/*adverse effects/methods Blood Gas Monitoring, Transcutaneous Bone Cements/*adverse effects Brain Ischemia/etiology/physiopathology Bundle-Branch Block/complications Carbon Dioxide/blood Coma/etiology Diagnosis, Differential Eisenmenger Complex/*complications Embolism, Paradoxical/blood/*etiology/physiopathology Fatal Outcome Female Hip Fractures/*surgery Humans Infarction, Posterior Cerebral Artery/blood/*etiology/physiopathology Intraoperative Complications/blood/*etiology/physiopathology Lactates/blood Monitoring, Intraoperative Oxygen/blood Stroke/diagnosis Vascular Resistance/drug effects Eisenmenger syndrome Embolismo paradójico Hemiartroplastia cadera Hip arthroplasty Paradoxical embolism Síndrome Eisenmenger LA - eng spa M1 - 8 N1 - PubMed NLM literature search January 5, 2021 OP - Embolismo paradójico intraoperatorio en paciente con síndrome de Eisenmenger sometida a hemiartroplastia de cadera. PY - 2019 SN - 0034-9356 SP - 439-442 ST - Paradoxical intraoperative embolism in a patient with Eisenmenger syndrome undergoing hip arthroplasty T2 - Rev Esp Anestesiol Reanim TI - Paradoxical intraoperative embolism in a patient with Eisenmenger syndrome undergoing hip arthroplasty VL - 66 ID - 828504 ER - TY - JOUR AB - [Background] Recently, the incidences of pulmonary embolism (PE) and/or deep vein thrombosis (DVT) after orthopedic operation increased in Japan. However the effective prevention methods have not been established yet. To make the effective prevention of PE and/or DVT after total hip arthroplasty (THA), we investigated the time‐dependent changes of serum thrombin‐antithrombin III complex (TAT) and D‐dimer levels after THA. [Subjects & Methods] We measured changes of serum TAT, and D‐dimer levels (before, on day 1, day 5, week 2 and week 4 after operation). Twenty‐six women (mean age 64.5 years old), who had undergone THA for osteoarthritis of the hip joint were enrolled and divided into two groups at random. One group had been intravenously injected with 1,000 units of heparin during THA (IH Group, 14 patients), and the other group had not been injected (NH Group, 12 patients). [Results] No patients showed clinical PE and/or, DVT. The levels of TAT and D‐dimer in IH group significantly reduced compared with these in NH group on the fifth and first postoperative day, respectively (p < 0.05). There were no severe complications clinically. [Conclusion] Our data suggests that intravenous heparin injection during THA might be a potentially effective and safe strategy for prophylaxis of PE after THA. AN - CN-00707818 AU - Tomita, M. AU - Motokawa, S. KW - *D dimer/ec [Endogenous Compound] *deep vein thrombosis/dt [Drug Therapy] *deep vein thrombosis/pc [Prevention] *heparin/cr [Drug Concentration] *heparin/dt [Drug Therapy] *heparin/iv [Intravenous Drug Administration] *heparin/pk [Pharmacokinetics] *lung embolism/dt [Drug Therapy] *lung embolism/pc [Prevention] *thrombin antithrombin complex *total hip prosthesis Acetylsalicylic acid Adult Article Bafferin Blood autotransfusion Bone cement Clinical article Controlled study Enzyme immunoassay Female Human Osteoarthritis Patient monitoring Protein blood level Recombinant erythropoietin Thrombosis prevention Ticlopidine M1 - 1 M3 - Journal: Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2008 SP - 9‐13 ST - Intraoperative heparin injection reduced D-dimer and TAT levels after total hip arthroplasty T2 - Acta medica nagasakiensia TI - Intraoperative heparin injection reduced D-dimer and TAT levels after total hip arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00707818/full VL - 53 ID - 830000 ER - TY - JOUR AB - In order to establish effective prevention of PE and/or DVT after THA, we measured serum TAT and D-Dimer, time dependently, in 26 cases that THA for osteoarthritis of hip joint was performed. We divided these 26 cases into two groups, one was injected with 1000 units of heparin intravenously during THA (IH, 14 cases), and the other was not injected (NH, 12 cases). We compared the amount of blood loss as a complication of intravenous heparin injection during THA. Furthermore, we studied the influence of bone cement, auto blood transfusion, and epoetin alfa (erythropoietin derivatives) on TAT and/or D-Dimer. In these 26 cases, there were no cases that suffered from clinical PE and DVT, and we were not able to detect any other complications after THA. Intravenous heparin injection during THA decreased the value of TAT and D-Dimer on the fifth and first postoperative day respectively (P<0.05). Blood losses due to operation in the IH group were more than those in the NH group, but there were no severe complications in any cases in the IH group after operation. The use of bone cement, auto blood transfusion, and epoetin alfa did not show significant effects on TAT and D-Dimer. Our data suggest that intravenous heparin injection during THA is one of the effective and safe means of prevention of PE soon after THA. The dose of heparin we used in this study was effective and safe. AD - S. Motokawa, Department of Orthopedic Surgery, 2-1001-1 Kubara, Ohmura-city, Nagasaki, 856-8562, Japan AU - Tomita, M. AU - Motokawa, S. AU - Fujimoto, K. DB - Embase KW - bone cement D dimer heparin recombinant erythropoietin thrombin antithrombin complex article bleeding blood autotransfusion clinical article controlled study deep vein thrombosis drug efficacy drug safety human lung embolism osteoarthritis protein blood level total hip prosthesis LA - Japanese M1 - 8 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2003 SN - 0021-1699 SP - 530-534 ST - Efficacy of intravenous heparin injection during operation for prevention of pulmonary embolism after total hip arthroplasty T2 - IRYO - Japanese Journal of National Medical Services TI - Efficacy of intravenous heparin injection during operation for prevention of pulmonary embolism after total hip arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L37236841&from=export VL - 57 ID - 829852 ER - TY - JOUR AB - Pulmonary arterial embolization of polymethylmethacrylate cement, most usually occurring after vertebroplasty or kyphoplasty, is very uncommon following vertebral stabilization procedures. Unenhanced CT scans viewed at lung window settings allow confident identification of cement emboli in the pulmonary circulation along with possible associate parenchymal changes, whereas hyperdense emboli may be less conspicuous on CT-angiographic studies with high-flow contrast medium injection. Although clinical manifestations are largely variable from asymptomatic cases to severe respiratory distress, most cases are treated with anticoagulation. AD - Department of Radiology, "Luigi Sacco" University Hospital, Via G. B. Grassi 74, 20157 Milan, Italy. AN - 22988411 AU - Tonolini, M. AU - Bianco, R. C2 - Pmc3440899 DA - Jul DO - 10.4103/0974-2700.99710 DP - NLM ET - 2012/09/19 J2 - Journal of emergencies, trauma, and shock KW - Vertebral stabilization polymethylmethacrylate bone cement pulmonary embolism vertebroplasty LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0974-2700 (Print) 0974-2700 SP - 272-3 ST - Pulmonary cement embolism after pedicle screw vertebral stabilization T2 - J Emerg Trauma Shock TI - Pulmonary cement embolism after pedicle screw vertebral stabilization VL - 5 ID - 828859 ER - TY - JOUR AB - Objective: Spine fractures often occur in patients with ankylosing spondylitis caused by minor trauma. Due to the low prevalence of the pathology, only few series are published and treatment guidelines are missing. Methods: We retrospectively reviewed our clinical database for pats. suffering from ankylosing spondylitis who underwent surgical treatment for spine fractures between 03/2008 and 05/2013. Surgical time, hospital-/ICU-stay, pre- and postop. neurological symptoms, co-morbidities, perioperative complications and surgical strategy were assessed. Results: 17 pts (10 m /1 f; mean age 74 yrs, range 47 - 90) were operated for traumatic Bechterew fractures (10 cervical, 6 thoracic, 1 lumbar) in a total of 34 surgeries with a mean operation time of 155 ± 58 min (60 - 309). 14 (82%) pats. suffered from more than 1 relevant co-morbidity prior to trauma. Mean hospital stay was 26 ± 17 d (6 - 70). 10 (59 %) pats. needed ICU treatment (mean stay 13 ± 17 d, range 1 - 51) due to medical deterioration (6 x pneumonia, 2 x cardiac arrest 1 x cement embolism, 2x sepsis, 2 x kidney failure,1 x postoperative agitation). There were different operating strategies for cervical spine fractures: In 9/10 cases a 360 ° fusion was applied (5 x anterior - posterior, 4 x post. - ant.). In 2 cases surgery was realized 1-staged, in 7 cases 2-staged with a mean interval of 5 ± 3 d (1 - 10). 1 pat. received mere dorsal instrumentation. Preexisting poor medical condition and clinical deterioration obviated a secondary ventral procedure. 5/7 (71 %) of the pats. with thoracic / lumbar fractures received a 360° fusion with primary posterior stabilization with or w/o laminectomy and secondary ventral corpectomy during the same hospital stay. 2 pats. received mere percutaneous posterior instrumentation. 8 pats. (47 %) had preoperative neurological deficits of whom 2/8 pats. improved, 6/8 pats. were unchanged postop. 3 severe intraop. complications occurred (1 successful reanimation, 1 cement embolism, 1 VA-dissection w/o neurological sequelae). There were 2 mild / moderate intraop. complications (1 durotomy, 1 rod malposition). 3 pats. had revision surgeries for superficial wound infection, screw-loosening 3 months after the first operation and for early implant failure 24 hrs after ACDF with secondary fracture dislocation and permanent neurological deterioration. This pat. was immediately revised anteriorly and received dorsal instrumentation during the same surgical procedure. 7 (41%) pats. experienced medical complications (4 pats.: i.e. pneumonia, kidney failure), or neurological deterioration (3 pats.) prior to surgery. These pats. had significantly longer hospital- (40 ± 18 d vs. 18 ± 8 d, p < 0.05) and ICU-stays (30 ± 16 d vs. 2 ± 3 d, p < 0.05). 27 medical complications occurred in 10 pts (59 %): 7 pneumonias, 6 tracheotomy, 5 renal failures, 2 venous thromboses, 2 pleural effusions, 2 sepsis, 2 cardiac arrest, 1 urinary tract infection, 1 pneumothorax, 1 stroke, 1 GI-bleeding with laparatomy and wound infection. 2 of these pats. (12 %) died during hospital stay from severe medical complications. Conclusion: Dorso-ventral spine instrumentation for ankylosing spondylitis fractures seem to be the surgical strategy of choice in these patients. The interval between trauma and surgery and in between 2-staged surgeries should be as brief as possible, as the patients are at high risk for neurological or medical deterioration prior to surgery resulting in significantly longer hospital- and ICU-stays. Surgery-associated complications were rare but the rate of medical complications was high in this patient group. AD - E. Török, Klinikum Rechts der Isar, Neurochirurgische Klinik und Poliklinik, München, Germany AU - Török, E. AU - Gempt, J. AU - Meyer, B. AU - Ryang, Y. M. DB - Embase DO - 10.1007/s00586-013-3050-8 KW - cement peroperative complication patient human ankylosing spondylitis spine fracture surgery deterioration devices kidney failure hospital injury pneumonia fracture hospitalization sepsis embolism wound infection heart arrest morbidity cervical spine fracture neurologic disease agitation data base ant pathology prevalence spine bleeding cerebrovascular accident pneumothorax urinary tract infection pleura effusion vein thrombosis tracheotomy surgical technique fracture dislocation implant dissection resuscitation laminectomy procedures operation duration risk LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0940-6719 SP - 2619-2620 ST - Surgical treatment and perioperative complications in patients with ankylosing spondylitis spine fractures T2 - European Spine Journal TI - Surgical treatment and perioperative complications in patients with ankylosing spondylitis spine fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71283652&from=export http://dx.doi.org/10.1007/s00586-013-3050-8 VL - 22 ID - 829469 ER - TY - JOUR AD - Goldfarb School of Nursing, Barnes-Jewish College AN - 104222490. Language: English. Entry Date: 20130920. Revision Date: 20150819. Publication Type: Journal Article AU - Torres, Brian A. DA - Summer2013 DB - cin20 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Arthroplasty, Replacement, Hip Pulmonary Embolism -- Etiology Anesthesia Intraoperative Complications -- Prevention and Control Middle Age Female Reoperation Epidural Catheters Blood Loss, Surgical M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2013 SP - 18-22 ST - 5-HT3 Receptor Antagonism following Suspected Bone Cement Implantation Syndrome T2 - International Student Journal of Nurse Anesthesia TI - 5-HT3 Receptor Antagonism following Suspected Bone Cement Implantation Syndrome UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104222490&site=ehost-live&scope=site VL - 12 ID - 830654 ER - TY - JOUR AN - 14753147 AU - Torres Machí, M. L. AU - Suárez Romero, V. AU - Medina Ramírez, C. AU - Gil Bedia, F. AU - Ojeda Betancor, N. AU - Rodríguez-Pérez, A. DA - Nov DP - NLM ET - 2004/02/03 J2 - Revista espanola de anestesiologia y reanimacion KW - Bone Cements/*adverse effects Female Humans Middle Aged Pulmonary Embolism/*etiology *Spinal Fusion LA - spa M1 - 9 N1 - PubMed NLM literature search January 5, 2021 OP - Embolismo pulmonar por cemento tras vertebroplastia. PY - 2003 SN - 0034-9356 (Print) 0034-9356 SP - 489-91 ST - [Pulmonary embolism caused by cement following vertebroplasty] T2 - Rev Esp Anestesiol Reanim TI - [Pulmonary embolism caused by cement following vertebroplasty] VL - 50 ID - 828968 ER - TY - JOUR AD - Military Hospital Val-de-Grâce, Paris, France. AN - 22256808 AU - Tourtier, J. P. AU - Cottez, S. DA - Jan 19 DO - 10.1056/NEJMicm1010341 DP - NLM ET - 2012/01/20 J2 - The New England journal of medicine KW - Bone Cements Humans Lung/diagnostic imaging Male Middle Aged Polymethyl Methacrylate Postoperative Complications/*diagnostic imaging Pulmonary Embolism/*diagnostic imaging/etiology Radiography *Vertebroplasty LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0028-4793 SP - 258 ST - Images in clinical medicine. Pulmonary cement embolism after vertebroplasty T2 - N Engl J Med TI - Images in clinical medicine. Pulmonary cement embolism after vertebroplasty VL - 366 ID - 828917 ER - TY - JOUR AD - J.-P. Tourtier, Military Hospital Val-de-Grâce, Paris, France AU - Tourtier, J. P. AU - Cottez, S. DB - Embase Medline DO - 10.1056/NEJMicm1010341 KW - bone cement oxygen poly(methyl methacrylate) adult article asymptomatic disease case report clinical observation computer assisted tomography follow up hemangioma hospital discharge human hypoxemia laminectomy lung artery pressure lung embolism lung perfusion lung scintiscanning male percutaneous vertebroplasty priority journal pulmonary hypertension recovery room spinal cord compression thorax radiography transthoracic echocardiography L1 - http://www.nejm.org/doi/pdf/10.1056/NEJMicm1010341 LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 0028-4793 1533-4406 SP - 258 ST - Pulmonary cement embolism after vertebroplasty T2 - New England Journal of Medicine TI - Pulmonary cement embolism after vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L364132704&from=export http://dx.doi.org/10.1056/NEJMicm1010341 VL - 366 ID - 829584 ER - TY - JOUR AD - Military Hospital Val-de-Grâce, Paris, France Military Hospital Val-de-Grâce, Paris, France. AN - 104629867. Language: English. Entry Date: 20120323. Revision Date: 20170411. Publication Type: journal article AU - Tourtier, J. P. AU - Cottez, S. AU - Tourtier, Jean-Pierre AU - Cottez, Sophie DB - cin20 DO - 10.1056/NEJMicm1010341 DP - EBSCOhost KW - Postoperative Complications -- Radiography Pulmonary Embolism -- Radiography Kyphoplasty Bone Cements Lung -- Radiography Male Middle Age Methylmethacrylates Pulmonary Embolism -- Etiology M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2012 SN - 0028-4793 SP - 258-258 ST - Images in clinical medicine. Pulmonary cement embolism after vertebroplasty T2 - New England Journal of Medicine TI - Images in clinical medicine. Pulmonary cement embolism after vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104629867&site=ehost-live&scope=site VL - 366 ID - 830686 ER - TY - JOUR AB - Objective: To determine the influence of stem sizing and positioning with early subsidence and stem complications with cementless (BFX) total hip arthroplasty (THA). Study design: Retrospective case series. Animals: Fifty-five dogs; 58 THAs. Methods: Eighty cobalt-chromium BFX THAs were reviewed, 58 met inclusion criteria. Implant size, positioning, and major complications within 12 months of surgery were recorded. Femoral canal flare (FCF), canal fill, stem angle, and subsidence at 3 months were measured from postoperative radiographs. Appropriateness of final stem size was assessed with digital templates. Odds ratios for associations were calculated. Results: Mean+/-SD coronal canal fill (Fillcor) was 75% +/- 6, FCF was 2.0+/-0.3, and subsidence was 1.7 mm+/-2.6. Stem angulation ranged from 7 degrees varus to 6 degrees valgus, and 78 cranial to 38 caudal. Appropriately sized stems (n=45) had a mean Fillcor of 78%. Major stem complications occurred in 12% of THAs. Femora with subsidence> 3 mm were 45.3 times more likely to develop postoperative stem complications (P=.02). Stems with varus angulation >= 5 degrees were 12.5 times more likely to sustain intraoperative fissures (P=.03). Stems considered undersized based on postoperative digital templating were 5.6 times more likely to develop stem complications (P=.04) and 5.7 times more likely to subside >3 mm(P=.03). Conclusion: Varus stem angulation should be avoided to prevent fissures. Canal fill is a poor indicator of optimal stem size and the current recommendation of >85% is unnecessarily high. Postoperative templating may be useful for assessing appropriateness of stem size. AD - [Townsend, Sarah; Kim, Stanley E.] Univ Florida, Coll Vet Med, Dept Small Anim Clin Sci, Gainesville, FL 32610 USA. [Pozzi, Antonio] Univ Zurich, Dept Small Anim Surg, Vetsuisse Fac, Zurich, Switzerland. Kim, SE (corresponding author), Univ Florida, Coll Vet Med, Dept Small Anim Clin Sci, Gainesville, FL 32610 USA. stankim@ufl.edu AN - WOS:000406723400007 AU - Townsend, S. AU - Kim, S. E. AU - Pozzi, A. DA - Aug DO - 10.1111/vsu.12666 J2 - Vet. Surg. KW - TRANSCATHETER ARTERIAL EMBOLIZATION DIFFERENT EMBOLIC AGENTS HEPATOCELLULAR-CARCINOMA TRANSARTERIAL CHEMOEMBOLIZATION DOGS THERAPY TUMORS CYANOACRYLATE SURVIVAL LIPIODOL Veterinary Sciences LA - English M1 - 6 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2017 SN - 0161-3499 SP - 803-811 ST - Effect of stem sizing and position on short-term complications with canine press fit cementless total hip arthroplasty T2 - Veterinary Surgery TI - Effect of stem sizing and position on short-term complications with canine press fit cementless total hip arthroplasty UR - ://WOS:000406723400007 VL - 46 ID - 830190 ER - TY - JOUR AB - A 55-year-old man diagnosed with osteogenesis imperfecta had multiple pulmonary embolism from acrylic cement during vertebroplasty. The patient immediately developed respiratory distress, renal failure, and right cardiac failure. A computed tomographic scan showed the presence of cement in the right and left pulmonary arteries, and in both lungs. Cardiac and respiratory functions did not improve with medical treatment, therefore the patient underwent pulmonary artery embolectomy. Cement was easily removed from both pulmonary arteries. The patient quickly recovered from respiratory and cardiac failure. We believe pulmonary embolectomy is a reliable and effective procedure to treat this rare and dreadful complication of acrylic vertebroplasty. AD - Department of Cardiovascular Surgery, Centre Hĵspitalier Universitaire Vaudois-CHUV, Lausanne, Switzerland. tozzig@hotmail.com AN - 12440642 AU - Tozzi, P. AU - Abdelmoumene, Y. AU - Corno, A. F. AU - Gersbach, P. A. AU - Hoogewoud, H. M. AU - von Segesser, L. K. DA - Nov DO - 10.1016/s0003-4975(02)03962-0 DP - NLM ET - 2002/11/21 J2 - The Annals of thoracic surgery KW - Embolectomy Fractures, Spontaneous/diagnostic imaging/*surgery Humans Injections Intraoperative Complications/*chemically induced/diagnostic imaging/surgery Lumbar Vertebrae/diagnostic imaging/surgery Male Middle Aged Osteogenesis Imperfecta/diagnostic imaging/*surgery Polymethyl Methacrylate/administration & dosage/*adverse effects Postoperative Complications/chemically induced/diagnostic imaging/surgery Pulmonary Embolism/*chemically induced/diagnostic imaging/surgery Radiography Reoperation Spinal Fractures/diagnostic imaging/*surgery Thoracic Vertebrae/diagnostic imaging/*injuries/surgery LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2002 SN - 0003-4975 (Print) 0003-4975 SP - 1706-8 ST - Management of pulmonary embolism during acrylic vertebroplasty T2 - Ann Thorac Surg TI - Management of pulmonary embolism during acrylic vertebroplasty VL - 74 ID - 828871 ER - TY - JOUR AD - Service d'Anesthésie-réanimation, CHU de Liège, Belgique. Service de Neurochirurgie, CHU de Liège, Belgique. Service de Radiologie, CHU de Liège, Belgique. AN - 28628282 AU - Tran, G. AU - Dewandre, Q. AU - Boulanger, Y. AU - Racaru, T. AU - Fanssen, C. DA - Jun DP - NLM ET - 2017/06/20 J2 - Revue medicale de Liege KW - Aged Bone Cements/*adverse effects Female Humans Laminectomy/adverse effects Pulmonary Embolism/*diagnostic imaging/etiology LA - fre M1 - 6 N1 - PubMed NLM literature search January 5, 2021 OP - L'image du mois. Un cas d’embolie pulmonaire de ciment après chirurgie du rachis. PY - 2017 SN - 0370-629X (Print) 0370-629x SP - 273-274 ST - [Image of the month. A case of cement pulmonary embolism.] T2 - Rev Med Liege TI - [Image of the month. A case of cement pulmonary embolism.] VL - 72 ID - 828690 ER - TY - JOUR AD - G. Tran, Service d'Anesthésie-Réanimation, CHU de Liège, Site Sart Tilman, Belgium AU - Tran, G. AU - Dewandre, Q. AU - Boulanger, Y. AU - Racaru, T. AU - Franssen, C. DB - Embase Medline KW - cement case report human kyphoplasty lung embolism short survey thorax radiography LA - English French M1 - 6 M3 - Short Survey N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 0370-629X SP - 273-274 ST - Image of the month: A case of pulmonary cement embolism after kyphoplasty T2 - Revue Medicale de Liege TI - Image of the month: A case of pulmonary cement embolism after kyphoplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L616840647&from=export VL - 72 ID - 829249 ER - TY - JOUR AB - STUDY DESIGN: We report the first case of life-threatening cardiac tamponade after percutaneous balloon kyphoplasty and its treatment with pericardiac drainage and percutaneous retrieval of cement embolus. OBJECTIVE: To sensitize clinicians to the occurrence of perforation on the right side of the heart, with intracavity cement leakage as a potential complication after balloon kyphoplasty. SUMMARY OF BACKGROUND DATA: Balloon kyphoplasty is a minimal invasive technique for symptomatic vertebral fractures. Cement leakage after kyphoplasty is a rare complication compared with vertebroplasty. METHODS: A 68-year-old female patient underwent balloon kyphoplasty after a recent third and fourth lumbar verlebral fracture was diagnosed. RESULTS: The day after balloon kyphoplasty, the patient complained of dyspnea and chest pain. Her hemodynamic status rapidly deteriorated. Acute occlusion of coronary vessels was excluded by coronary angiography. Pericardial tamponade was documented by echocardiography, and pericardial effusion was urgently drained. Computed tomographic scan revealed the presence of cement embolus inside the right ventricle due to right ventricle perforation during the kyphoplasty procedure. The cement embolus was successfully retrieved percutaneously with a snare catheter. CONCLUSION: Balloon kyphoplasty is a minimal invasive technique with low rate of complications. In case of postprocedural chest symptoms, it is mandatory to exclude right ventricle perforation, cardiac tamponade, and embolism into pulmonary vessels because of cement embolism. LEVEL OF EVIDENCE: 5. AD - Department of Cardiology, Maria Hilf Hospital, Bad Neuenahr, Germany. I.Tran@maw.marienhaus-gmbh.de AN - 23232213 AU - Tran, I. AU - Gerckens, U. AU - Remig, J. AU - Zintl, G. AU - Textor, J. DA - Mar 1 DO - 10.1097/BRS.0b013e318281507a DP - NLM ET - 2012/12/13 J2 - Spine KW - Aged Bone Cements/*adverse effects Cardiac Catheterization Cardiac Tamponade/diagnosis/*etiology/therapy Coronary Angiography Drainage Embolism/diagnosis/*etiology/therapy Female Heart Injuries/diagnosis/*etiology/therapy Heart Ventricles/injuries Humans Kyphoplasty/*adverse effects/methods Lumbar Vertebrae/*injuries/*surgery Pericardial Effusion/etiology Spinal Fractures/diagnosis/*surgery Tomography, X-Ray Computed Treatment Outcome LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 0362-2436 SP - E316-8 ST - First report of a life-threatening cardiac complication after percutaneous balloon kyphoplasty T2 - Spine (Phila Pa 1976) TI - First report of a life-threatening cardiac complication after percutaneous balloon kyphoplasty VL - 38 ID - 828787 ER - TY - JOUR AD - Servicio de Medicina Interna, Hospital General Universitario Morales Meseguer, Murcia, España. Electronic address: c_trasancos@hotmail.com. Servicio de Medicina Interna, Hospital General Universitario Morales Meseguer, Murcia, España. AN - 26706996 AU - Trasancos-Escura, C. AU - Pinos-Blanco, A. DA - Oct DO - 10.1016/j.arbres.2015.11.003 DP - NLM ET - 2015/12/29 J2 - Archivos de bronconeumologia KW - Aged Bone Cements/*adverse effects Female Humans Lumbar Vertebrae/surgery Polymethyl Methacrylate Postoperative Complications/diagnostic imaging/*etiology Pulmonary Embolism/diagnostic imaging/*etiology Sacrum/surgery Spinal Stenosis/surgery Thoracic Vertebrae/surgery *Vertebroplasty LA - eng spa M1 - 10 N1 - PubMed NLM literature search January 5, 2021 OP - Una causa infrecuente de embolismo pulmonar. PY - 2016 SN - 0300-2896 SP - 528-9 ST - An unusual cause of pulmonary embolism T2 - Arch Bronconeumol TI - An unusual cause of pulmonary embolism VL - 52 ID - 828507 ER - TY - JOUR AB - Objective: To retrospectively evaluate the incidence and clinical impact of local polymethylmethacrylate (PMMA) leaks and pulmonary cement embolisms occurring under CT fluoroscopy-guided vertebroplasty of symptomatic malignant vertebral osteolyses.Materials and Methods: From December 2001 to June 2009, 202 cancer patients (116 women, 86 men; age 63.2±8.6 years) with painful malignant vertebral osteolyses underwent vertebroplasty, with or without vertebral compression fracture. A total of 331 vertebrae were treated in 231 sessions under CT fluoroscopy guidance (120 kV; 10–25 mA; single slice, 4-, 16-, and 128-row CT). In the pre-vertebroplasty CT, the following items were assessed: osteolytic destruction (0, ≤25, ≤50, ≤75, or ≤100%) of vertebral cross-sectional area, posterior wall, and circumference; presence of perivertebral and degree of epidural (no, mild, moderate) soft tissue involvement. Local PMMA leaks were analyzed using the post-vertebroplasty CT. Pulmonary cement embolisms were evaluated in all patients having undergone radiography (CR; n053) or CT (n088) of the chest after vertebroplasty due to their underlying disease. Patient charts were reviewed regarding adverse events.Results: Of 331 treated vertebrae, 32, 20.2, and 15.7% showed more than 50% osteolytic involvement of the vertebral cross-sectional area, posterior wall, and circumference, respectively. Mild or moderate epidural involvement was seen in 13.0 and 8.4%. Local PMMA leakage rate was 58.6% (194 of 331 vertebrae). Pulmonary cement embolisms (segmental, n010; central, n01) were seen after 7.8% of the procedures with follow-up imaging of the chest. No major complications occurred within a 30-day period after vertebroplasty.Conclusion: Vertebroplasty of spinal malignancy can be safely performed under CT fluoroscopy guidance even in patients with substantial osteolytic involvement. In our patient collective, PMMA leaks and pulmonary cement embolisms visualized in post-procedural radiography and CT images had no clinical impact. AD - Department of Clinical Radiology, Klinikum der Ludwig-Maximilians-Universität München-Großhadern, Marchioninistrasse 15, 81377 Munich, Germany AN - 104384770. Language: English. Entry Date: 20130322. Revision Date: 20200708. Publication Type: journal article AU - Trumm, C. G. AU - Pahl, A. AU - Helmberger, T. K. AU - Jakobs, T. F. AU - Zech, C. J. AU - Stahl, R. AU - Paprottka, P. M. AU - Sandner, T. A. AU - Reiser, M. F. AU - Hoffmann, R. T. AU - Trumm, Christoph G. AU - Pahl, Anne AU - Helmberger, Thomas K. AU - Jakobs, Tobias F. AU - Zech, Christoph J. AU - Stahl, Robert AU - Paprottka, Philipp M. AU - Sandner, Torleif A. AU - Reiser, Maximilian F. AU - Hoffmann, Ralf-Thorsten DB - cin20 DO - 10.1007/s00256-012-1365-x DP - EBSCOhost KW - Extravasation of Diagnostic and Therapeutic Materials -- Epidemiology Osteolysis -- Epidemiology Methylmethacrylates -- Adverse Effects Postoperative Complications -- Epidemiology Pulmonary Embolism -- Epidemiology Pulmonary Embolism -- Etiology Radiography, Interventional Spinal Neoplasms -- Surgery Tomography, X-Ray Computed Kyphoplasty -- Methods Adult Aged Aged, 80 and Over Chi Square Test Female Fluoroscopy Human Incidence Male Middle Age Retrospective Design Nonparametric Statistics Treatment Outcomes M1 - 11 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2012 SN - 0364-2348 SP - 1391-1400 ST - CT fluoroscopy-guided percutaneous vertebroplasty in spinal malignancy: technical results, PMMA leakages, and complications in 202 patients T2 - Skeletal Radiology TI - CT fluoroscopy-guided percutaneous vertebroplasty in spinal malignancy: technical results, PMMA leakages, and complications in 202 patients UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104384770&site=ehost-live&scope=site VL - 41 ID - 830668 ER - TY - JOUR AB - We present a case of combined surgical screw placement and osteoplasty guided by computed tomography-fluoroscopy (CTF) in a 68-year-old man with unilateral osteolytic destruction and a pathological fracture of the iliosacral joint due to a metastasis from renal cell carcinoma. The patient experienced intractable lower back pain that was refractory to analgesia. After transarterial particle and coil embolization of the tumor-feeding vessels in the angiography unit, the procedure was performed under general anesthesia by an interdisciplinary team of interventional radiologists and trauma surgeons. Under intermittent single-shot CTF, two K wires were inserted into the left iliosacral joint from a lateral transiliac approach at the S1 level followed by two self-tapping surgical screws. Continuous CTF was used for monitoring of the subsequent polymethylmethacrylate injection through two vertebroplasty cannulas for further stabilization of the screw threads within the osteolytic sacral ala. Both the screw placement and cement injection were successful, with no complications occurring during or after the procedure. With additional nonsteroidal anti-inflammatory and opioid medication, the patient reported a marked decrease in his lower back pain and was able to move independently again at the 3-month follow-up assessment. In our patient with intolerable back pain due to tumor destruction and consequent pathological fracture of the iliosacral joint, CTF-guided iliosacral screw placement combined with osteoplasty was successful with respect to joint stabilization and a reduction in the need for analgesic therapy. AD - Department of Clinical Radiology, University of Munich, Campus Großhadern, Marchioninistrasse 15, 81377 Munich, Germany. christoph.trumm@med.lmu.de AN - 19795167 AU - Trumm, C. G. AU - Rubenbauer, B. AU - Piltz, S. AU - Reiser, M. F. AU - Hoffmann, R. T. DA - Feb DO - 10.1007/s00270-009-9716-2 DP - NLM ET - 2009/10/02 J2 - Cardiovascular and interventional radiology KW - Aged Angiography, Digital Subtraction Bone Cements Bone Neoplasms/diagnosis/*secondary/*surgery *Bone Screws Carcinoma, Renal Cell/diagnosis/*secondary/*surgery Combined Modality Therapy Embolization, Therapeutic Fluoroscopy/*methods Fracture Fixation, Internal/*methods Fractures, Spontaneous/diagnosis/*surgery Humans Intra-Articular Fractures/diagnosis/*surgery Kidney Neoplasms/diagnosis/*surgery Male Pain, Intractable/surgery Polymethyl Methacrylate/administration & dosage Radiography, Interventional/*methods Sacroiliac Joint/*injuries/*surgery Tomography, X-Ray Computed/*methods LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2011 SN - 0174-1551 SP - S288-93 ST - Screw placement and osteoplasty under computed tomographic-fluoroscopic guidance in a case of advanced metastatic destruction of the iliosacral joint T2 - Cardiovasc Intervent Radiol TI - Screw placement and osteoplasty under computed tomographic-fluoroscopic guidance in a case of advanced metastatic destruction of the iliosacral joint VL - 34 Suppl 2 ID - 828810 ER - TY - JOUR AB - Purpose: To compare radiation dose estimates and image quality between state-of-the-art interventional fluoroscopy systems in phantom and clinical cases. Materials: Phantom study used acrylic sheets simulating different patient sizes to compare air kerma rates (AKRs) for different dose modes on Philips Allura-ClarityIQ and Siemens ArtisQ systems (4 systems). After IRB approval, cumulative air kerma (CAK) at the interventional reference point and kerma-area product (KAP) were extracted for cases performed over a 16-month period and compared by procedure type between the two types of systems. Next, CAK and KAP for patients with metastatic uveal melanoma receiving repeat chemo/immuno-embolization of the same liver lobe by the same physician on both types of systems were compared, accounting for differences in patient positioning, reference locations and digital acquisitions. For these cases, image quality was scored by 2 CAQ certified interventional radiologists using a five-point scale for 5 parameters. Interclass correlation coefficient (ICC) was computed and the scores were compared between the two types of systems. IBM's SPSS Statistics was used for analysis (with Bonferroni corrections for multiple comparisons). Results: Phantom study revealed a significant lower AKR (p<0.05) with Allura-ClarityIQ for acrylic thicknesses of 30-40cm. Clinical data contained 5113 cases; significant differences for CAK and KAP were seen in 9/16 and 3/16 procedure-types (p<0.05), respectively, with lower values for Allura-ClarityIQ systems. Subset analysis of 61 patients receiving identical treatment on both systems showed CAK and KAP were significantly lower for Allura-ClarityIQ systems (p<0.02; median for CAK lower by 44% and for KAP by 27%). Good reliability and absolute agreement was noted between readers for 5 parameters (ICC≥0.75). Image quality review scores were significantly higher for images obtained with Allura-ClarityIQ systems across all parameters (p<0.05; mean difference in scores between systems for each parameter ranging from 1.3 to 1.6). Conclusions: Allura-ClarityIQ systems utilized lower radiation dose and were associated with superior image quality compared with ArtisQ. AU - Trunz, L. AU - Eschelman, D. AU - Gonsalves, C. AU - Adamo, R. AU - Dave, J. DB - Embase DO - 10.1016/j.jvir.2018.12.355 KW - poly(methyl methacrylate) adult artificial embolization cancer patient conference abstract controlled study correlation coefficient data analysis software female fluoroscopy system human image quality interventional radiologist liver lobe major clinical study male metastatic uvea melanoma patient positioning phantom radiation dose reliability statistics LA - English M1 - 3 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1535-7732 1051-0443 SP - S129-S130 ST - 03:36 PM Abstract No. 290 Phantom and in vivo comparison of radiation dose estimates and image quality between state-of-the-art interventional fluoroscopy systems T2 - Journal of Vascular and Interventional Radiology TI - 03:36 PM Abstract No. 290 Phantom and in vivo comparison of radiation dose estimates and image quality between state-of-the-art interventional fluoroscopy systems UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2001612405&from=export http://dx.doi.org/10.1016/j.jvir.2018.12.355 VL - 30 ID - 829151 ER - TY - JOUR AB - Cardiovascular reactions to acrylic bone cement in patients with total hip replacement are a common complication. Hypotension and arrhythmias are the most frequently observed symptoms. Elderly patients with fractures of the femoral neck constitute a special risk group. In some patients these reactions can be fatal. The mechanisms suggested to explain these reactions are embolism of air, polymer or fat, reaction to the heat, and toxic or vasodilating effects of the acrylic monomer. In a pilot study and in a case report a significant rise of the plasma histamine was described following cementation of the femur. We therefore performed an investigation to find whether application of bone cement to the femur caused histamine release in elective hip surgery, and, independently of this, also investigated whether premedication with H1- + H2-antagonists had any effect on the cardiovascular reactions due to bone cement implantation into the femoral shaft in elderly patients with hip fracture. METHODS. Part I. In all, 40 patients, scheduled for elective surgical hip replacement were anesthetized by general or epidural anesthesia. Patients were continuously monitored by ECG. Blood pressure was recorded noninvasively at 2-min intervals during the study. Blood samples for the determination of the plasma histamine were taken immediately before implantation of the bone cement into the femur, and 2, 5, and 10 min after. Part II. A further group of 20 patients aged greater than or equal to 70 years with fractures of the femoral neck and in whom total hip replacement was planned were included in the study. In this group, 10 patients were randomly assigned to receive 4 mg clemastine + 400 mg cimetidine i.v. about 15 min before implantation of the bone cement. All patients were operated on under general anesthesia. ECG was monitored continuously and blood pressure was monitored at 2-min intervals during the study. Changes of the blood pressure and heart rate and therapeutic interventions following the implantation of the bone cement were documented. RESULTS. Part I. In 11 of the 40 patients (27.5%) plasma histamine increased by greater than 0.5 ng/ml (9 patients greater than 1 ng/ml). In comparable groups (patients with a control systolic blood pressure less than or equal to 130 mmHg) the histamine responders showed a significantly greater reduction in systolic blood pressure (-5.7 +/- 14.7 vs -17.7 +/- 8.6 mmHg). Part II. In the control group we observed a significantly greater fall in systolic blood pressure than in premedicated patients (41.5 +/- 25.4 vs 11.0 +/- 13.4 mmHg). In the control group 7 of the 10 patients required therapeutic interventions, while in the premedicated group only one therapeutic intervention was necessary (P less than 0.05). DISCUSSION. We have demonstrated that the implantation of acrylic bone cement into the femur may increase plasma histamine by greater than 1 ng/ml. In elderly patients with preexisting cardiac diseases or/and hypovolemia even moderate histamine release can cause serious, sometimes potentially fatal, cardiovascular complications. In this special risk group with hip fractures we found a significant reduction in the frequency of cardiovascular reactions to bone cement implantation in patients premedicated with H1 + H2 antagonists. Because we also observed significant falls in systolic blood pressure in premedicated patients, we assume that the pathogenesis of cardiovascular reactions to bone cement implantation is multifactorial. It may be that potentially lethal complications only occur if two or more of the predisposing factors (hypovolemia, myocardial insufficiency, arrhythmia, embolism, histamine release) are present simultaneously. Pre- and intraoperative measures therefore have to be instituted to eliminate all possible risk factors. AD - Universitätsklinik für Anaesthesiologie, Intensiv- und Schmerztherapie Bergmannsheil, Bochum. AN - 1706562 AU - Tryba, M. AU - Linde, I. AU - Voshage, G. AU - Zenz, M. DA - Jan DP - NLM ET - 1991/01/01 J2 - Der Anaesthesist KW - Aged Aged, 80 and over Arrhythmias, Cardiac/*etiology/prevention & control Bone Cements/*adverse effects Cimetidine/*therapeutic use Clemastine/*therapeutic use Female *Hip Prosthesis Histamine Release/drug effects/*physiology Humans Hypotension/*etiology/prevention & control Male Middle Aged LA - ger M1 - 1 N1 - PubMed NLM literature search January 5, 2021 OP - Histaminfreisetzung und kardiovaskuläre Reaktionen nach Implantation von Knochenzement bei totalem Hüftgelenkersatz. PY - 1991 SN - 0003-2417 (Print) 0003-2417 SP - 25-32 ST - [Histamine release and cardiovascular reactions to implantation of bone cement during total hip replacement] T2 - Anaesthesist TI - [Histamine release and cardiovascular reactions to implantation of bone cement during total hip replacement] VL - 40 ID - 828805 ER - TY - JOUR AB - Cardiovascular reactions to acrylic bone cement in patients with total hip replacement are a common complication. Hypotension and arrhythmias are the most frequently observed symptoms. Elderly patients with fractures of the femoral neck constitute a special risk group. In some patients these reactions can be fatal. The mechanisms suggested to explain these reactions are embolism of air, polymer or fat, reaction to the heat, and toxic or vasodilating effects of the acrylic monomer. In a pilot study and in a case report a significant rise of the plasma histamine was described following cementation of the femur. We therefore performed an investigation to find whether application of bone cement to the femur caused histamine release in elective hip surgery, and, independently of this, also investigated whether premedication with H1 + H2-antagonists had any effect on the cardiovascular reactions due to bone cement implantation into the femoral shaft in elderly patients with hip fracture. Methods. Part I. In all, 40 patients, scheduled for elective surgical hip replacement were anesthetized by general or epidural anesthesia. Patients were continuously monitored by ECG. Blood pressure was recorded noninvasively at 2-min intervals during the study. Blood samples for the determination of the plasma histamine were taken immediately before implantation of the bone cement into the femur, and 2, 5, and 10 min after. Part II. A further group of 20 patients aged ≥70 years with fractures of the femoral neck and in whom total hip replacement was planned were included in the study. In this group, 10 patients were randomly assigned to receive 4 mg clemastin + 400 mg cimetidine i.v. about 15 min before implantation of the bone cement. All patients were operated on under general anesthesia. ECG was monitored continuously and blood pressure was monitored at 2-min intervals during the study. Changes of the blood pressure and heart rate and therapeutic interventions following the implantation of the bone cement were documented. Results. Part I. In 11 of the 40 patients (27.5%) plasma histamine increased by >0.5 ng/ml (9 patients >1 ng/ml). In comparable groups (patients with a control systolic blood pressure ≤130 mmHg) the histamine responders showed a significantly greater reduction in systolic blood pressure (-5.7 ± 14.7 vs -17.7 ± 8.6 mmHg). Part II. In the control group we observed a significantly greater fall in systolic blood pressure than in premedicated patients (41.5 ± 25.4 vs 11.0 ± 13.4 mmHg). In the control group 7 of the 10 patients required therapeutic interventions, while in the premedicated group only one therapeutic intervention was necessary (P < 0.05). Discussion. We have demonstrated that the implantation of acrylic bone cement into the femur may increase plasma histamine by >1 ng/ml. In elderly patients with pre-existing cardiac diseases or/and hypovolemia even moderate histamine release can cause serious, sometimes potentially fatal, cardiovascular complications. In this special risk group with hip fractures we found a significant reduction in the frequency of cardiovascular reactions to bone cement implantation in patients premedicated with H1 + H2 antagonists. Because we also observed significant falls in systolic blood pressure in premedicated patients, we assume that the pathogenesis of cardiovascular reactions to bone cement implantation is multifactorial. It may be that potentially lethal complications only occur if two or more of the predisposing factors (hypovolemia, myocardial insufficiency, arrhythmia, embolism, histamine release) are present simultaneously. Pre- and intraoperative measures therefore have to be instituted to eliminate all possible risk factors. AD - M. Tryba, Univ.-Klin. Anaesthesiologie, Intensiv- und Schmerztherapie, Bergmannsheil Bochum, Gilsingstrasse 14, W-4630 Bochum, Germany AU - Tryba, M. AU - Linde, I. AU - Voshage, G. AU - Zenz, M. C1 - refobacin palacos tagamet tavegil DB - Embase Medline KW - bone cement cimetidine clemastine clemastine fumarate gentamicin bone cement histamine histamine H1 receptor refobacin palacos unclassified drug adult aged article clinical article clinical trial controlled study female heart arrhythmia hip fracture human hypotension intravenous drug administration male randomized controlled trial vasodilatation tagamet tavegil LA - German M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1991 SN - 0003-2417 SP - 25-32 ST - Histamine release and cardiovascular reactions to bone cement used in total hip replacement T2 - Anaesthesist TI - Histamine release and cardiovascular reactions to bone cement used in total hip replacement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L21066327&from=export VL - 40 ID - 829946 ER - TY - JOUR AB - Cardiovascular reactions to acrylic bone cement in patients with total hip replacement are a common complication. Hypotension and arrhythmias are the most frequently observed symptoms. Elderly patients with fractures of the femoral neck constitute a special risk group. In some patients these reactions can be fatal. The mechanisms suggested to explain these reactions are embolism of air, polymer or fat, reaction to the heat, and toxic or vasodilating effects of the acrylic monomer. In a pilot study and in a case report a significant rise of the plasma histamine was described following cementation of the femur. We therefore performed an investigation to find whether application of bone cement to the femur caused histamine release in elective hip surgery, and, independently of this, also investigated whether premedication with H1-+H-2-antagonists had any effect on the cardiovascular reactions due to bone cement implantation into the femoral shaft in elderly patients with hip fracture. AD - ORTHOPAD REHABIL ZENTRUM ANNASTIFT HANNOVER, ZENT ANAESTHESIEABT, HANNOVER, GERMANY. TRYBA, M (corresponding author), RUHR UNIV BOCHUM, ANAESTHESIOL INTENS & SCHMERZTHERAPIE KLIN, BERGMANNSHEIL BOCHUM, W-4630 BOCHUM, GERMANY. AN - WOS:A1991EV00100005 AU - Tryba, M. AU - Linde, I. AU - Voshage, G. AU - Zenz, M. DA - Jan J2 - Anaesthesist KW - FAT-EMBOLISM AIR-EMBOLISM BLOOD ARTHROPLASTY PLASMA Anesthesiology LA - German M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1991 SN - 0003-2417 SP - 25-32 ST - HISTAMINE-RELEASE AND CARDIOVASCULAR REACTIONS TO BONE-CEMENT USED IN TOTAL HIP-REPLACEMENT T2 - Anaesthesist TI - HISTAMINE-RELEASE AND CARDIOVASCULAR REACTIONS TO BONE-CEMENT USED IN TOTAL HIP-REPLACEMENT UR - ://WOS:A1991EV00100005 VL - 40 ID - 830497 ER - TY - JOUR AD - S.H. Tryfon, Pulmonary Department of NHS, Geneneral Hospital “G. Papanikolaou”, Thessaloniki, Greece AU - Tryfon, S. H. AU - Moyseos, M. AU - Babalis, G. AU - Serasli, E. AU - Ditsios, K. AU - Tryfon, S. DB - Embase KW - poly(methyl methacrylate) adult bone density case report clinical article computer assisted tomography female follow up fragility fracture human lung embolism middle aged note percutaneous vertebroplasty thorax radiography LA - English M1 - 2 M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 1105-848X SP - 95 ST - Incidental finding of multiple pulmonary embolisms on chest x-ray T2 - Pneumon TI - Incidental finding of multiple pulmonary embolisms on chest x-ray UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2005102516&from=export VL - 33 ID - 829071 ER - TY - JOUR AB - An hypervascular and lytic thoracic (Th10) vertebral metastasis from kidney neoplasm causing cord compression was successfully resected after embolization. Because the anterior spinal artery arose at the same level, arterial embolization was only partial and completed by percutaneous vertebroplasty using Nbutyl cyanoacrylate. AD - Département d'imagerie morphologique et fonctionnelle, Centre hospitalier Sainte-Anne, Paris Cedex 14, France. AN - 10740077 AU - Trystram, D. AU - Aymard, A. AU - Godon Hardy, S. AU - Cioloca, C. AU - Frédy, D. AU - Meder, J. DA - Mar DP - NLM ET - 2000/03/31 J2 - Journal de radiologie KW - Embolization, Therapeutic/*methods Enbucrilate/therapeutic use Female Humans Kidney Neoplasms/*pathology Magnetic Resonance Imaging Polyvinyls/therapeutic use Preoperative Care/*methods Spinal Cord Compression/etiology Spinal Neoplasms/complications/diagnosis/*secondary/*therapy *Thoracic Vertebrae Tomography, X-Ray Computed *Vertebral Artery LA - fre M1 - 3 N1 - PubMed NLM literature search January 5, 2021 OP - Dévascularisation préopératoire d'une métastase vertébrale avec artère médullaire naissant au même étage. PY - 2000 SN - 0221-0363 (Print) 0221-0363 SP - 250-3 ST - [Preoperative devascularization of a vertebral metastasis with a spinal artery at the same level] T2 - J Radiol TI - [Preoperative devascularization of a vertebral metastasis with a spinal artery at the same level] VL - 81 ID - 828970 ER - TY - JOUR AB - An hypervascular and lytic thoracic (Th10) vertebral metastasis from kidney neoplasm causing cord compression was successfully resected after embolization. Because the anterior spinal artery arose at the same level, arterial embolization was only partial and completed by percutaneous vertebroplasty using N-butyl cyanoacrylate. AD - D. Trystram, Dept. d'Imagerie Morphol./Fonction., Centre Hospitalier Sainte-Anne, 1, rue Cabanis, 75674 Paris Cedex 14, France AU - Trystram, D. AU - Aymard, A. AU - Godon Hardy, S. AU - Cioloca, C. AU - Frédy, D. AU - Meder, J. F. DB - Embase Medline KW - enbucrilate adult article artificial embolization bone atrophy case report computer assisted tomography devascularization female human kidney tumor preoperative treatment spinal angiography spinal cord compression spine metastasis tumor vascularization LA - French M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2000 SN - 0221-0363 SP - 250-253 ST - Preoperative devascularization of an hypervascular vertebral metastasis with spinal artery at the same level T2 - Journal de Radiologie TI - Preoperative devascularization of an hypervascular vertebral metastasis with spinal artery at the same level UR - https://www.embase.com/search/results?subaction=viewrecord&id=L30211882&from=export VL - 81 ID - 829890 ER - TY - JOUR AB - STUDY DESIGN: Case report. OBJECTIVE: To report a rare case of anterior spinal cord syndrome caused by a cement embolism in the anterior spinal artery after vertebroplasty. SUMMARY OF BACKGROUND DATA: Vertebroplasty is commonly performed for the management of pain associated with benign compression fractures, multiple myelomas, lymphomas, vertebral metastatic lesions, and hemangiomas. Here, we describe a severe complication associated with this procedure; a similar complication has not been reported previously. METHODS: A 63-year-old woman suffered from persistent severe back pain that radiated to both sides of the chest wall 1 week before medical consultation. Magnetic resonance imaging analysis of the thoracolumbar spine revealed a pathologic fracture in the body of the T9 and T10 vertebrae, with retropulsion into the spinal canal and compression of the spinal cord at the T10 level. We performed decompressive laminectomy of the T9-10 vertebrae with tumor biopsy and vertebroplasty. RESULTS: Immediately after the operation, the patient experienced paraplegia and loss of sensitivity to pain/temperature; however, deep pressure sensation and 2-point discrimination below the umbilicus (T10 level) were preserved. Computed tomography scans showed the presence of PMMA in T9 and T10, with opacification of the paravertebral vessels, the left intercostal artery at the T10 level, and a segment of the anterior spinal artery at the T10-11 level. CONCLUSION: We present the first report describing a case of anterior spinal cord syndrome caused by a cement embolism in the anterior spinal artery after vertebroplasty. The severity of this complication warrants that surgeons should inform patients of the same while obtaining their consent for vertebroplasty. AD - Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. AN - 20110843 AU - Tsai, Y. D. AU - Liliang, P. C. AU - Chen, H. J. AU - Lu, K. AU - Liang, C. L. AU - Wang, K. W. DA - Feb 15 DO - 10.1097/BRS.0b013e3181b52221 DP - NLM ET - 2010/01/30 J2 - Spine KW - Arterial Occlusive Diseases/diagnostic imaging/*etiology/physiopathology Back Pain/etiology/surgery Bone Cements/*adverse effects Embolism/diagnostic imaging/*etiology/physiopathology Fatal Outcome Female Humans Middle Aged Pain Threshold Paraplegia/etiology Polymethyl Methacrylate/*adverse effects Spinal Cord/*blood supply Spinal Neoplasms/complications/secondary/surgery Syndrome Thermosensing Tomography, X-Ray Computed Vertebroplasty/*adverse effects LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2010 SN - 0362-2436 SP - E134-6 ST - Anterior spinal artery syndrome following vertebroplasty: a case report T2 - Spine (Phila Pa 1976) TI - Anterior spinal artery syndrome following vertebroplasty: a case report VL - 35 ID - 828814 ER - TY - JOUR AB - Study Design: Case report. Objective: To report a rare case of anterior spinal cord syndrome caused by a cement embolism in the anterior spinal artery after vertebroplasty. Summary Of Background Data: Vertebroplasty is commonly performed for the management of pain associated with benign compression fractures, multiple myelomas, lymphomas, vertebral metastatic lesions, and hemangiomas. Here, we describe a severe complication associated with this procedure; a similar complication has not been reported previously. Methods: A 63-year-old woman suffered from persistent severe back pain that radiated to both sides of the chest wall 1 week before medical consultation. Magnetic resonance imaging analysis of the thoracolumbar spine revealed a pathologic fracture in the body of the T9 and T10 vertebrae, with retropulsion into the spinal canal and compression of the spinal cord at the T10 level. We performed decompressive laminectomy of the T9-10 vertebrae with tumor biopsy and vertebroplasty. Results: Immediately after the operation, the patient experienced paraplegia and loss of sensitivity to pain/temperature; however, deep pressure sensation and 2-point discrimination below the umbilicus (T10 level) were preserved. Computed tomography scans showed the presence of PMMA in T9 and T10, with opacification of the paravertebral vessels, the left intercostal artery at the T10 level, and a segment of the anterior spinal artery at the T10-11 level. Conclusion: We present the first report describing a case of anterior spinal cord syndrome caused by a cement embolism in the anterior spinal artery after vertebroplasty. The severity of this complication warrants that surgeons should inform patients of the same while obtaining their consent for vertebroplasty. AD - Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan From the Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. AN - 105128431. Language: English. Entry Date: 20100521. Revision Date: 20170411. Publication Type: journal article AU - Tsai, Y. D. AU - Liliang, P. C. AU - Chen, H. J. AU - Lu, K. AU - Liang, C. L. AU - Wang, K. W. AU - Tsai, Yu-Duan AU - Liliang, Po-Chau AU - Chen, Han-Jung AU - Lu, Kang AU - Liang, Cheng-Loong AU - Wang, Kuo-Wei DB - cin20 DO - 10.1097/BRS.0b013e3181b52221 DP - EBSCOhost KW - Arterial Occlusive Diseases -- Etiology Bone Cements -- Adverse Effects Embolism -- Etiology Methylmethacrylates -- Adverse Effects Spinal Cord -- Blood Supply Kyphoplasty -- Adverse Effects Arterial Occlusive Diseases -- Physiopathology Arterial Occlusive Diseases -- Radiography Back Pain -- Etiology Back Pain -- Surgery Embolism -- Physiopathology Embolism -- Radiography Fatal Outcome Female Human Middle Age Pain Threshold Paraplegia -- Etiology Spinal Neoplasms -- Complications Spinal Neoplasms Spinal Neoplasms -- Surgery Syndrome Sensation Tomography, X-Ray Computed M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2010 SN - 0362-2436 SP - E134-6 ST - Anterior spinal artery syndrome following vertebroplasty: a case report T2 - Spine (03622436) TI - Anterior spinal artery syndrome following vertebroplasty: a case report UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105128431&site=ehost-live&scope=site VL - 35 ID - 830713 ER - TY - JOUR AB - Background: we have considered as challenging when the risk of complication was high: large rupture of the posterior wall, extension in the spinal canal, tumour close to neurological structures or adjacent organs, and hypervascular lesions. Clinical findings and procedure details: we have reviewed retrospectively the challenging spinal tumour cases of the last 16 years treated in our department. In order to offer a curative or palliative treatment option to the patient, different percutaneous methods (vertebroplasty, alcoholisation, laser-, RF-, cryo-ablation, and RF cavitation) have been applied. To overcome difficulties, a number of techniques were used: tumour cavitation before vertebroplasty, thermal monitoring and insulation during ablation (thermosensors, fluid and/or CO2 injection). During the last 16 years, the progress of the technique allowed the approach and treatment of the majority of spinal tumours. We are reporting and commenting each complication we have encountered including an accidental ablation of S2 to S4 nerve roots, an L5 paresis, reversible cauda equina syndrome, cement leaks with pulmonary embolism or foraminal compression. Conclusion: percutaneous management of the challenging spinal tumours requires a thorough knowledge of the different percutaneous techniques and the anatomy. Determining the therapeutic intention (curative or palliative) is mandatory in order to choose the most adapted and less disabling technique offering the patient the optimum treatment option. AD - G. Tsoumakidou, Dept. of Non Vascular Interventional Radiology, Hôpital Civil, Strasbourg, France AU - Tsoumakidou, G. AU - Buy, X. AU - Enescu, I. AU - Bierry, G. AU - Host, P. AU - Gangi, A. DB - Embase KW - cement society Europe neoplasm percutaneous vertebroplasty patient cauda equina syndrome injection lung embolism nerve root risk rupture vertebral canal laser palliative therapy monitoring liquid paresis compression LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 0174-1551 SP - 333 ST - Percutaneous management of challenging spinal tumours: How to deal with T2 - CardioVascular and Interventional Radiology TI - Percutaneous management of challenging spinal tumours: How to deal with UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70339447&from=export VL - 32 ID - 829704 ER - TY - JOUR AB - Three patients with nontraumatic arteriovenous fistulas (AVFs) of the scalp were treated with embolization using acrylate glue via the transarterial route or by direct percutaneous puncture of the lesion and surgical excision. Complete cure was achieved in all 3. No major morbidity or blood loss occurred during the treatment of these patients. Selective angiography is essential for the diagnosis of scalp AVFs for which a combination of embolization and surgical excision is the treatment of choice. AD - K. Tsujiguchi, Plastic/Reconstructive Surgery Dept., Osaka City General Hospital, Osaka 534, Japan AU - Tsujiguchi, K. AU - Imai, K. AU - Toda, C. AU - Sung, K. C. DB - Embase KW - acrylic cement adult angiography arteriovenous fistula article artificial embolization case report female human scalp treatment outcome vascular surgery LA - Japanese M1 - 7 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1997 SN - 0021-5228 SP - 681-685 ST - Nontraumatic arteriovenous fistulas of the scalp: Three cases treated with a combination of embolization and surgical excision T2 - Japanese Journal of Plastic and Reconstructive Surgery TI - Nontraumatic arteriovenous fistulas of the scalp: Three cases treated with a combination of embolization and surgical excision UR - https://www.embase.com/search/results?subaction=viewrecord&id=L27327832&from=export VL - 40 ID - 829912 ER - TY - JOUR AB - Two patients had fatal fat pulmonary embolism during bipolar hip endoprosthesis. Two women, 71-year-old and 76-year-old, with femoral neck fracture underwent bipolar hip endoprosthesis under combined lumbar epidural/general anesthesia. Soon after the placement of bone cement and a femoral stem with a bipolar endoprosthesis in the femoral shaft, the patients developed circulatory collapse. Immediate cardiopulmonary resuscitation did not restore adequate circulation and the patients died 3.5 hours and 1 hour thereafter, respectively. Pathological examination revealed the presence of fat particles within the entire pulmonary arteries, arterioles and capillaries. Main cause of the present pulmonary fat embolism may be an increase in the intramedullary pressure during cement pressurization and femoral stem placement. Anesthetists have to be aware of occurrence of this serious syndrome during bipolar hip endoprosthesis. For earlier detection of this serious complication we recommend to monitor central venous pressure and pulmonary artery pressure in patients undergoing bipolar hip endoprosthesis. AD - Department of Anesthesia, Gifu Social Insurance Hospital, Kani. AN - 9852698 AU - Tsujitou, T. AU - Ishiyama, T. AU - Dohi, S. DA - Nov DP - NLM ET - 1998/12/16 J2 - Masui. The Japanese journal of anesthesiology KW - Aged Anesthesia, Epidural Anesthesia, General Arthroplasty, Replacement, Hip/*adverse effects Blood Pressure Bone Cements/adverse effects Embolism, Fat/*etiology/pathology Female Femoral Neck Fractures/surgery Humans Intraoperative Complications/*etiology Monitoring, Intraoperative Pulmonary Embolism/*etiology/pathology LA - jpn M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 1998 SN - 0021-4892 (Print) 0021-4892 SP - 1338-43 ST - [Pulmonary fat embolism during bipolar hip endoprosthesis] T2 - Masui TI - [Pulmonary fat embolism during bipolar hip endoprosthesis] VL - 47 ID - 828918 ER - TY - JOUR AB - Background: For total hip arthroplasty (THA), minimally invasive surgery (MIS) has been developed to reduce incision length, muscle damage, and a shorter hospital stay. However, reduced exposure of anatomical landmarks may result in technical errors and inferior implant survivorships. The aim of this study was to report the short-term results and clinical complications of primary MIS THA in the supine position. Methods: A consecutive series of 103 patients who underwent MIS cementless THA with a modified Watson-Jones anterolateral approach (AL) were enrolled. Outcomes data were reviewed at a minimum of 12 months following the procedure. Clinical evaluations were made using the Merle d'Aubigne and Postel hip score. The results of these procedures were retrospectively compared with those of a historical series of 98 total hip arthroplasties that had been performed by the same surgeon with use of a posterolateral approach (PL). Results: In the MIS AL THA group, intraoperative fracture was observed in 6 hips; 3 in greater trochanter and 3 in calcar femoral. One hip was subjected to irrigation because of postoperative infection was suspected. In the PL group, intraoperative fracture was demonstrated in 4 hips in calcar femoral. No postoperative dislocation and no pulmonary embolism or nerve paralysis was observed in both groups. Conclusions: The MIS AL THA did not show a clinically relevant superior outcome compared with the PL THA. When performing MIS AL THA, special attention should pay for prevention of greater trochanter fracture. AD - Department of Orthopaedic Surgery, Itami City Hospital, Itami 664-8540, Japan Department of Orthopaedic Surgery, Osaka Police Hospital, Osaka 543-0035, Japan AN - 117063559. Language: English. Entry Date: 20160916. Revision Date: 20160916. Publication Type: Article AU - Tsuyoshi, Nakai AU - Naxin, Liu AU - Kazumasa, Fudo AU - Toshikazu, Mohri AU - Masaaki, Kakiuchi DB - cin20 DO - 10.1016/j.jor.2014.08.005 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Methods Supine Position Treatment Outcomes Patient Positioning -- Methods Arthroplasty, Replacement, Hip -- Adverse Effects Human Minimally Invasive Procedures Retrospective Design Comparative Studies Intraoperative Complications Length of Stay Postoperative Complications Clinical Assessment Tools Functional Assessment -- Methods M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2014 SN - 0972-978X SP - 166-169 ST - Early complications of primary total hip arthroplasty in the supine position with a modified Watson-Jones anterolateral approach T2 - Journal of Orthopaedics TI - Early complications of primary total hip arthroplasty in the supine position with a modified Watson-Jones anterolateral approach UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=117063559&site=ehost-live&scope=site VL - 11 ID - 830626 ER - TY - JOUR AB - Vertebral hemangiomas are benign vascular lesions of the vertebral column; only 0.9-1.2% of all vertebral hemangiomas cause spinal cord compression. We report a 34-year-old female who was admitted to the neurosurgery clinic with a history of back pain, poor quality of life and easy fatigability for 1.5 years. Her medical history revealed a fall from a height of 2 meters 1.5 years ago. Neurology examination revealed bilateral hypoesthesia below the T8 level and hyperactive deep tendon reflexes in her left leg. Computed tomography scan of the thoracic spine showed T8 vertebral hemangioma, and magnetic resonance imaging showed a T8 hemangioma compressing the spinal cord. Surgical intervention was planned and T8 total laminectomy was performed. The tumor extending into the anterior spinal cord was resected, and T8 vertebroplasty with short segment posterior stabilization and fusion was performed. We aimed to present a new treatment approach for symptomatic vertebral hemangiomas and reviewed the relevant literature. AD - [Tucer, Bulent; Menku, Ahmet; Koc, Rahmi Kemal] Erciyes Univ, Fac Med, Dept Neurosurg, Kayseri, Turkey. [Ekici, Mehmet Ali; Guclu, Bulent] Sevket Yilmaz Training & Res Hosp, Dept Neurosurg, Bursa, Turkey. Ekici, MA (corresponding author), Sevket Yilmaz Training & Res Hosp, Dept Neurosurg, Bursa, Turkey. mehmetali.ekici@gmail.com AN - WOS:000327575300017 AU - Tucer, B. AU - Ekici, M. A. AU - Menku, A. AU - Koc, R. K. AU - Guclu, B. DA - Sep DO - 10.5137/1019-5149.jtn.6371-12.1 J2 - Turk. Neurosurg. KW - Vertebral hemangioma Posterior stabilization Vertebroplasty Total laminectomy SPINAL-CORD COMPRESSION METHYL-METHACRYLATE VERTEBROPLASTY EMBOLIZATION RADIOTHERAPY INJECTION RESECTION ETHANOL ALCOHOL Clinical Neurology Surgery LA - English M1 - 5 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2013 SN - 1019-5149 SP - 680-684 ST - Surgical Management of Symptomatic T8 Vertebral Hemangioma: Case Report and Review of the Literature T2 - Turkish Neurosurgery TI - Surgical Management of Symptomatic T8 Vertebral Hemangioma: Case Report and Review of the Literature UR - ://WOS:000327575300017 VL - 23 ID - 830280 ER - TY - JOUR AB - Introduction/objectives: Primary total hip replacements performed for femoral neck fractures have a much higher incidence of complications, particularly dislocation, which in turn is linked to higher mortality figures. Methods: This was a retrospective review of clinical and radiological records of patients identified from prospectively collected database specifically looking at dislocations and other complications from January 2009 to December 2015. Results: 87 patients with acute femoral neck fractures (female:male 69:18; mean age 70.48 years) deemed to be suitable for primary total hip replacement as per NICE recommendations underwent 84 cemented and 3 uncemented arthroplasty procedures using the posterior approach. All surgeries were performed by specialist hip surgeons. All except 7 cases had a 28 mm metal head. No patient had a constrained or dual mobility bearing. The 30 day mortality was 0%. 9 deaths occurred at more than 12 months (10.34%). There was 1 superficial wound infection, no deep infection and no nerve injury. 3 patients had symptomatic DVT and 1 patient had symptomatic pulmonary embolism 4 weeks postoperatively. There was one revision required for a femoral periprosthetic fracture. One patient with recurrent dislocation despite revision surgery ultimately underwent excision arthroplasty. There was no mechanical failure of any arthroplasty. Conclusions: THR in this patient group is shown to have better functional outcomes and survivorship compared to hemiarthroplasty but is associated with higher dislocation rates. We found only 1 (1.14%) dislocation despite using posterior approaches in all patients, and without utilising any form of anti-dislocation device. AD - A. Turaev, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, United Kingdom AU - Turaev, A. AU - Cockburn, H. J. AU - Fadulemola, A. AU - Radhakrishnan, A. AU - Shah, N. AU - Wynn Jones, H. DB - Embase DO - 10.5301/hipint.5000450 KW - aged complication data base death deep vein thrombosis excision female femoral neck fracture head hemiarthroplasty human information processing lung embolism major clinical study male mortality nerve injury periprosthetic fracture recurrent dislocation retrospective study surgeon surgery total hip prosthesis wound infection LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1120-7000 SP - S65-S66 ST - Dislocation and complications after THR for acute femoral neck fractures T2 - HIP International TI - Dislocation and complications after THR for acute femoral neck fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L613187511&from=export http://dx.doi.org/10.5301/hipint.5000450 VL - 26 ID - 829307 ER - TY - JOUR AB - Introduction: NICE recommends THR for patients with displaced intracapsular femoral neck fractures who were able to walk independently with no more a stick, are not cognitively impaired and are medically fit for surgery. High complication rates, particularly dislocations, (10-22% - almost 4 times higher than THA for osteoarthritis) are reported in literature in this cohort resulting in current use of larger heads and constrained bearings routinely which have their own problems, failure mechanisms and additional expense. A dislocation in this patient group is linked to higher mortality figures. Aim: We report our results and complications after THR using standard 28 and 32 mm heads and standard acetabulum components for acute femoral neck fractures. Methods: This was a Retrospective review of clinical and radiological records of patients identified from prospectively collected data for the National Hip Fracture Database specifically looking at dislocation rates and other complications in patients treated over a 5 year period. Results: 65 patients (female: male 50:15) with mean age 71.5 years underwent primary THR from 2009-2014 by surgeons routinely performing hip replacement surgery. 56 patients had ASA grade 2 or 3. 62 had all-cemented THR. Suitability was determined by the on-call consultant and the operating surgeon. All had posterior approach with formal soft tissue repair. Antibiotic and VTE prophylaxis was as per trust guidelines. All except 4 cases had a 28 mm metal head. No patient had a constrained or dual mobility bearing. The 30 day mortality was 0%. There were 9 deaths at more than 12 months (14%). There were no early wound problems and no deep infections. There was no nerve injury. 3 patients had symptomatic deep DVT and 1 patient had symptomatic pulmonary embolism 4 weeks postoperatively. One periprosthetic femoral fracture in a cemented hip required revision. There was 1(1.5%) revision surgery performed for recurrent dislocation (28 mm metal head). There were no other readmissions within one year. There was no mechanical failure. Conclusions: THR in this particular cohort was shown to have good functional outcomes and quality of life with low dislocation rates. In our study we found 1(1.5%) dislocation and all patients had posterior approaches. Our overall percentage of patients suitable for THR is lower than the expected national average despite being a specialist hip centre. Even after introduction of NICE guidelines we have not seen the expected increase in this number. This may reflect unique patient characteristics of the local population or stringent selection criteria. AD - A. Turaev, Department of Trauma and Orthopaedic Surgery, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, United Kingdom AU - Turaev, A. AU - Radhakrishnan, A. AU - Shah, N. DB - Embase DO - 10.5301/hipint.5000333 KW - neutrophil cytoplasmic antibody metal antibiotic agent femoral neck fracture hip society human patient surgery surgeon mortality osteoarthritis prophylaxis tissue repair soft tissue hip arthroplasty data base hip fracture medical specialist quality of life hospital readmission consultation recurrent dislocation femur fracture death lung embolism nerve injury infection wound population acetabulum male female L1 - http://www.hip-int.com/Attach/3fd3478c-a11d-462c-883f-b672128a7ff9/5deedb29-a7c4-4612-adb4-d35bb3765fd9 LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1120-7000 SP - S52 ST - Dislocation and complications after THR for acute femoral neck fractures T2 - HIP International TI - Dislocation and complications after THR for acute femoral neck fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L72166443&from=export http://dx.doi.org/10.5301/hipint.5000333 VL - 25 ID - 829355 ER - TY - JOUR AB - Introduction Pulmonary embolism (PE) is a potentially life threatening condition present in the differential diagnosis for dyspnea. Despite the frequency at which it is clinically encountered, controversy exists regarding assessment and management. One particular grey area lies in the management of right heart thrombi (RHT). As echocardiography cements itself as a key tool in the assessment of PE severity, concomitant discovery of RHT in transit and its subsequent management is bound to become another area of controversy. Case Report A 55-year-old man with no past medical history presented to the emergency department (ED) from his internists office with complaints of leg pain. A duplex ultrasound performed in the office had revealed a deep vein thrombosis (DVT) in the left lower extremity. In the ED, the patient mentioned a two week history of dyspnea with associated pleuritic chest pain and left lower extremity swelling. His vital signs in the ED were: a blood pressure of 157/79 mm Hg, heart rate of 104 beats per minute, temperature of 97.9 o F, respiratory rate of 18 breaths per minute and an oxygen saturation of 98 % on ambient air. Laboratory investigations in the ED noted both a negative troponin and brain natriuretic peptide. A 12 lead electrocardiogram (ECG) showed a normal sinus rhythm and an incomplete right bundle branch block. A CT angiogram of the chest demonstrated bilateral pulmonary emboli, pulmonary infarctions in the right upper and lower lobes and right ventricular (RV) enlargement. A goal directed transthoracic echocardiogram (TTE) revealed a right atrial thrombus measuring 4.2cm which was prolapsing into the RV. Additionally, the echocardiogram demonstrated intra-ventricular septal flattening and RV enlargement consistent with RV dysfunction. After an interdisciplinary discussion with interventional radiology and cardiovascular surgery, the decision was made to give thrombolytics and the patient was subsequently monitored in the intensive care unit. The patient remained hemodynamically stable and a repeat echocardiogram two hours after thrombolytics showed resolution of the clot. He was placed on a heparin drip and eventually discharged on warfarin. Discussion This case highlights the importance of recognizing RHT, as they may not be seen on a CT scan. In addition, as the overall mortality rate for patients with RHT has been reported at 28% and it is associated with high early mortality, early recognition is key. This should escalate treatment options to include thrombolytics, catheter based interventions or possible surgical intervention. AD - N. Tyagi, Winthrop University Hospital, Mineola, NY, United States AU - Tyagi, N. AU - Osahan, D. AU - Desai, A. AU - Desouza, S. DB - Embase DO - 10.1164/ajrccm-conference.2017.B70 KW - brain natriuretic peptide endogenous compound fibrinolytic agent troponin warfarin adult ambient air blood pressure breathing rate cardiovascular surgery case report catheter chemical binding deep vein thrombosis duplex Doppler ultrasonography dyspnea emergency ward heart right atrium heart right bundle branch block heart right ventricle failure heart right ventricle hypertrophy human intensive care unit internist interventional radiology intracardiac thrombosis leg pain lower limb lung embolism lung infarction male medical history middle aged mortality rate oxygen saturation sinus rhythm surgery swelling thorax pain transthoracic echocardiography vital sign x-ray computed tomography LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1535-4970 ST - Thrombus in transit complicating pulmonary embolism T2 - American Journal of Respiratory and Critical Care Medicine TI - Thrombus in transit complicating pulmonary embolism UR - https://www.embase.com/search/results?subaction=viewrecord&id=L617709521&from=export http://dx.doi.org/10.1164/ajrccm-conference.2017.B70 VL - 195 ID - 829281 ER - TY - JOUR AB - We treated a 73-year-old man with a dural arteriovenous fistula (AVF) with cortical venous drainage of the left mastoid region using transarterial embolization of the middle meningeal and occipital arteries with n-butyl 2-cyanoacrylate (NBCA). The patient's clinical symptoms improved dramatically. Three months after the procedure, follow-up CT showed resolution of white matter edema and follow-up angiograms showed no evidence of a recurrent AVF. This report indicates that dural AVFs without sinus drainage can be cured solely with transarterial NBCA embolization. AD - Department of Radiology, Saga Medical School, Japan. AN - 9929150 AU - Uchino, A. AU - Numaguchi, Y. AU - Holloway, R. G. AU - Cherian, N. DA - Nov-Dec DP - NLM ET - 1999/02/03 J2 - Radiation medicine KW - Aged Arteriovenous Fistula/diagnostic imaging/*therapy Bone Cements/*adverse effects Brain Edema/diagnostic imaging/*etiology Cerebral Angiography Cerebral Arteries Cerebral Veins/*abnormalities/diagnostic imaging Dura Mater/*blood supply Embolization, Therapeutic/*adverse effects Enbucrilate/adverse effects/*analogs & derivatives Follow-Up Studies Humans Male Tissue Adhesives/*adverse effects Tomography, X-Ray Computed LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 1998 SN - 0288-2043 (Print) 0288-2043 SP - 477-81 ST - Reversible symptomatic venous congestion after treatment of dural arteriovenous fistula using NBCA T2 - Radiat Med TI - Reversible symptomatic venous congestion after treatment of dural arteriovenous fistula using NBCA VL - 16 ID - 828528 ER - TY - JOUR AB - Total hip replacement is a frequently practised operation. Depending on age, circumstances and individual assessment, cemented, non-cemented and hybrid forms are used. Apart from general risks, such as vascular and/or neural injuries, thrombosis and infections, there are specific risks, depending on the surgical technique. If cemented systems are used, the anesthesiologist must be on the alert in respect of a possible multi-causal cardiopulmonary depression during the implantation of the prosthesis. Incidents may be reduced or moderated by measures such as reduction of pressure from the femoral cavity or anesthetic measures such as avoidance of N2O during or after cementation, use of anti-histamines, etc., but there is no absolute protection from severe reactions by the cardiopulmonary system. In these cases it is imperative to recognise and treat hypoxic conditions immediately, whatever the cause, such as cardiac or pulmonary depression. If a non-cemented hip replacement is used or a revision is necessary the main problem is usually a higher blood loss. Especially in such cases it is necessary to apply a well-organised sequence of blood-saving methods to protect patients from the general risks of homologous blood transfusion. Even though the main concern of the public is the possibility of contamination of donor blood with the AIDS virus, transmission of hepatitis C virus is a much more common problem. Depending on the diagnostic methods the occurrence of thrombosis after total hip replacement has been reported to be as much as 55%. To minimise this high incidence, sufficient prophylaxis, adequate fluid therapy, suitable anesthetic techniques and cutting down on the duration of the operation should be taken into account. The use of low molecular weight heparins has certain advantages. If deep vein thrombosis has occurred, therapy consists of anticoagulation with intravenous heparin and immobilisation. A rare but severe complication is a deep hip prosthetic infection. More than 50% of infections are caused by coagulase-negative staphylococci and anaerobic bacteria. To avoid sepsis it is imperative to employ adequate high-dosage antibiotics, revisional surgery and, if necessary, even excision arthroplasty. There is no "ideal" anesthesiological method for total hip replacement. Regional techniques as well as general anesthesia have their specific pros and cons which are controversially discussed in respect of their priority. To achieve early diagnosis of embolism, especially in the case of high risk patients, the exigency of extensive haemodynamic monitoring as well as Doppler-ultrasound is discussed.(ABSTRACT TRUNCATED AT 400 WORDS) AD - Klinik für Anästhesiologie und operative Intensivmedizin, Katharinenhospital Stuttgart. AN - 7819464 AU - Ullrich, W. AU - Holz, U. AU - Krier, C. DA - Nov DO - 10.1055/s-2007-996769 DP - NLM ET - 1994/11/01 J2 - Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS KW - Aged *Anesthesia, Epidural *Anesthesia, General Blood Loss, Surgical/physiopathology Femoral Neck Fractures/*surgery Hemodynamics/physiology *Hip Prosthesis Humans Intraoperative Complications/etiology/*prevention & control Middle Aged Monitoring, Intraoperative Osteoarthritis, Hip/*surgery Postoperative Complications/etiology/*prevention & control Risk Factors LA - ger M1 - 7 N1 - PubMed NLM literature search January 5, 2021 OP - Hüfttotalendoprothesen--Besonderheiten aus anästhesiologischer Sict. PY - 1994 SN - 0939-2661 (Print) 0939-2661 SP - 385-99 ST - [Total hip endoprostheses--characteristic aspects from the anesthesiologic viewpoint] T2 - Anasthesiol Intensivmed Notfallmed Schmerzther TI - [Total hip endoprostheses--characteristic aspects from the anesthesiologic viewpoint] VL - 29 ID - 829028 ER - TY - JOUR AB - Total hip replacement is a frequently practised operation. Depending on age, circumstances and individual assessment, cemented, non-cemented and hybrid forms are used. Apart from general risks, such as vascular and/or neural injuries, thrombosis and infections, there are specific risks, depending on the surgical technique. If cemented systems are used, the anesthesiologist must be on the alert in respect of a possible multi-causal cardiopulmonary depression during the implantation of the prosthesis. Incidents may be reduced or moderated by measures such as reduction of pressure from the femoral cavity or anesthetic measures such as avoidance of N2O during or after cementation, use of anti-histamins, etc., but there is no absolute protection from severe reactions by the cardiopulmonary system. In these cases it is imperative to recognise and treat hypoxic conditions immediately, whatever the cause, such as cardiac or pulmonary depression. If a non-cemented hip replacement is used or a revision is necessary the main problem is usually a higher blood loss. Especially in such cases it is necessary to apply a well-organised sequence of blood-saving methods to protect patients from the general risks of homologous blood transfusion. Even though the main concern of the public is the possibility of contamination of donor blood with the AIDS virus, transmission of hepatitis C virus is a much more common problem. Depending on the diagnostic methods the occurrence of thrombosis after total hip replacement has been reported to be as much as 55%. To minimise this high incidence, sufficient prophylaxis, adequate fluid therapy, suitable anesthetic techniques and cutting down on the duration of the operation should be taken into account. The use of low molecular weight heparins has certain advantages. If deep vein thrombosis has occurred, therapy consists of anticoagulation with intravenous heparin and immobilisation. A rare but severe complication is a deep hip prosthetic infection. More than 50% of infections are caused by coagulase-negative staphylococci and anaerobic bacteria. To avoid sepsis it is imperative to employ adequate high-dosage antibiotics, revisional surgery and, if necessary, even excision arthroplasty. There is no 'ideal' anesthesiological method for total hip replacement. Regional techniques as well as general anesthesia have their specific pros and cons which are controversially discussed in respect of their priority. To achieve early diagnosis of embolism, especially in the case of high risk patients, the exigency of extensive haemodynamic monitoring as well as Doppler-ultrasound is discussed. Postoperative treatment in an intensive-care unit should be guaranteed after total hip replacement with high blood loss or in high-risk patients. AD - W. Ullrich, Klin. Anasthesiol./Op. Intensivmed., Katharinenhospital, Kriegsbergstrasse 60, 70174 Stuttgart, Germany AU - Ullrich, W. AU - Holz, U. AU - Krier, C. DB - Embase Medline KW - antibiotic agent antihistaminic agent low molecular weight heparin anesthesiology human review sepsis thrombosis total hip prosthesis LA - German M1 - 7 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 1994 SN - 0939-2661 SP - 385-399 ST - Total hip replacement - The anaesthesiological point of view T2 - Anasthesiologie Intensivmedizin Notfallmedizin Schmerztherapie TI - Total hip replacement - The anaesthesiological point of view UR - https://www.embase.com/search/results?subaction=viewrecord&id=L24362341&from=export VL - 29 ID - 829933 ER - TY - JOUR AB - A rise in intrafemoral pressure during the implantation of a cemented hip replacement seems to have been proven in experimental and clinical studies. The biological system of the femur equalizes this pressure by means of its venous drainage system, which is located at the linea aspera and distal metaphysis. The intravasation of bone marrow, fat and debris that follows leads to characteristic clinical signs of a more or less distinct embolism of the lung, which is indicated by an intraoperative drop in blood pressure and end expiratory pCO2. The logical therapeutic measure to avoid biological self‐drainage of the femur is to create sufficient extrafemoral drainage via a unicortical venting hole distal from the expected tip of the prosthesis, which must be combined with an intramedullary plug to preserve the desired effect of the high‐pressure technique for cement‐bone interlocking. If it is also possible to install a vacuum in the medullar cavity of the femur to draw the cement into the cancelleous bone, an optimal cementing result in combination with minimal patient risk can be promised. AN - CN-00114227 AU - Ulrich, C. KW - Bone Cements [therapeutic use] Bone Marrow [physiology] Embolism, Fat [diagnosis, *prevention & control] Hip Prosthesis [*methods] Humans Pressure Prospective Studies M1 - 2 M3 - Clinical Trial; Comparative Study; English Abstract; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1995 SP - 138‐143 ST - Value of venting drilling for reduction of bone marrow spilling in cemented hip endoprosthesis T2 - Der orthopade TI - Value of venting drilling for reduction of bone marrow spilling in cemented hip endoprosthesis UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00114227/full VL - 24 ID - 830072 ER - TY - JOUR AB - Introduction: There is very limited information about pulmonary cement embolism (PCE) following cement-augmented fenestrated pedicle screw (CAFPS) fixation in the literature. The aim of this study to report the incidence of PCE following CAFPS fixation in adult deformity patients with severe osteoporosis and to identify risk factors such as; the number of levels, number of screws, and the cement volume used.Methods: 281 patients (204F, 77M) in whom CAFPS fixation was used during deformity surgery were included. All patients' routine postop 2 day chest X-rays and any available CT scans were reviewed by two radiologists. In patients with PCE, preop, early postop, and latest echocardiography studies were compared in terms of changes in pulmonary artery pressure (PAP) and right ventricular dilatation. Estimated cement volume used was calculated as: 2 cc (1 cc + 1 cc) per thoracic and 3 cc (1.5 cc + 1.5 cc) per lumbar levels, which are our routine protocol. Statistical analysis for risk factors was assessed with point biserial correlation test.Results: Average age is 70.5 (51-89) and average follow-up is 3.2 years (2-5). A total of 2978 CAFPS were instrumented with a mean of 10.5 levels (2-16) in 281 patients. PCE was diagnosed radiologically in 46 patients (16.3%). Among these 46 patients, PCE was clinically symptomatic in only 4 patients. Overall incidence of symptomatic PCE was 1.4% (4 of 281). Symptomatic PCE was statistically significant: when CAFPS fixation was performed > 7 levels; > 14 screws were used, and > 20-25 cc cement was used for augmentation (r = 0.378). In PCE group, mean preop PAP values of 27.40 (20-37) mm/Hg increased to 32.34 (20-50) mm/Hg in early postop and decreased to 28.29 (18-49) mm/Hg at final follow-up. In symptomatic PCE patients, mean preop PAP values of 30.75 (28-36) mm/Hg increased to 45.74 (40-50) mm/Hg in early postop and decreased to 38.75 (37-40) mm/Hg at final follow-up.Conclusion: This study showed an overall 16.3% radiological PCE and 1.4% symptomatic PCE incidence when CAFPS were used due to severe osteoporosis. The symptomatic PCE risk was significant when CAFPS were > 7 levels; > 14 fenestrated screws; and > 20-25 cc cement volume is used and this may cause PAP increase and right ventricular dilatation. AD - Department of Radiology, Istanbul Florence Nightingale Hospital, Abide-i Hurriyet Cad. No:166 Sisli, 34381, Istanbul, Turkey Department of Orthopaedics and Traumatology, Istanbul Bilim University Faculty of Medicine, Abide-i Hurriyet Cad. No:166 Sisli 34381, Istanbul, Turkey Department of Radiology, Istanbul Bilim University Faculty of Medicine, Abide-i Hurriyet Cad. No:166 Sisli 34381, Istanbul, Turkey Istanbul Spine Center at Florence Nightingale Hospital, Abide-i Hurriyet Cad. No:160 Sisli, 34381, Istanbul, Turkey AN - 131406623. Language: English. Entry Date: 20191116. Revision Date: 20191116. Publication Type: journal article. Journal Subset: Biomedical AU - Ulusoy, Onur Levent AU - Kahraman, Sinan AU - Abay, Burak AU - Karalok, Isik AU - Kaya, Emel AU - Enercan, Meric AU - Sever, Cem AU - Karadereler, Selhan AU - Hamzaoglu, Azmi DB - cin20 DO - 10.1007/s00586-018-5593-1 DP - EBSCOhost KW - Osteoporosis -- Surgery Pedicle Screws -- Adverse Effects Embolism -- Etiology Spinal Diseases -- Surgery Spinal Diseases -- Complications Bone Cements -- Adverse Effects Osteoporosis -- Complications Postoperative Complications -- Etiology Bone Cements -- Therapeutic Use Lumbar Vertebrae -- Surgery Spinal Fusion -- Adverse Effects Spinal Fusion -- Equipment and Supplies M1 - 9 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2018 SN - 0940-6719 SP - 2348-2356 ST - Pulmonary cement embolism following cement-augmented fenestrated pedicle screw fixation in adult spinal deformity patients with severe osteoporosis (analysis of 2978 fenestrated screws) T2 - European Spine Journal TI - Pulmonary cement embolism following cement-augmented fenestrated pedicle screw fixation in adult spinal deformity patients with severe osteoporosis (analysis of 2978 fenestrated screws) UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=131406623&site=ehost-live&scope=site VL - 27 ID - 830549 ER - TY - JOUR AB - Purpose: Percutaneous vertebroplasty with polymethylmethacrylate (PMMA) is used increasingly for pain relief in symptomatic neoplastic or osteoporotic compression fractures. However, restoration of the stiffness of the treated vertebrae might propagate secondary fracture of adjacent vertebrae. Elastoplasty might prevent these secondary fractures. We assessed retrospectively our experience with elastoplasty in 12 patients, focusing on silicone migration. Methods: During the period from July 2011 to January 2012, all patients with an indication for vertebroplasty were treated with elastoplasty. The exclusion criterion was the presence of posterior wall defects. Chest computed tomography (CT) scans were performed to evaluate the presence of perivertebral leakage and pulmonary embolism. The prevalence of leakage was compared with the results obtained for vertebroplasty with PMMA reported in the literature. Other complications during the postprocedural period were recorded. Results: Twenty-one vertebral bodies in 12 patients were treated with elastoplasty. Silicone pulmonary emboli were detected on the postprocedural chest CT in 60 % (6/10) of the patients. Leakage to the perivertebral venous plexus was seen in 67 % (14/21) of the treated vertebrae. One major complication occurred: severe, medication-resistant dyspnea developed in one patient with multiple peripheral silicone emboli. Conclusions: This preliminary evidence suggests that VK100 silicone cement should not be used in elastoplasty because of the increased risk of silicone pulmonary embolism, when compared with the use of PMMA, which occurs worldwide. The major technical disadvantage is that the time taken for the VK100 silicone material to achieve its final strength is too long for practical application. AD - Department of Radiology, Medical Center Westeinde, Postbus 432, 2501, CK, Den Haag, The Netherlands, t_urlings@hotmail.com. AN - 104251243. Language: English. Entry Date: 20131004. Revision Date: 20200708. Publication Type: journal article AU - Urlings, Thijs A. J. AU - van der Linden, Edwin DB - cin20 DO - 10.1007/s00270-012-0409-x DP - EBSCOhost KW - Fractures, Compression -- Surgery Spinal Fractures -- Surgery Kyphoplasty -- Methods Aged Aged, 80 and Over Extravasation of Diagnostic and Therapeutic Materials -- Radiography Extravasation of Diagnostic and Therapeutic Materials -- Radiotherapy Female Fluoroscopy Fractures, Compression -- Radiography Human Male Middle Age Pain Measurement Postoperative Complications -- Radiography Radiography, Interventional Retrospective Design Silicones -- Administration and Dosage Spinal Fractures -- Radiography Tomography, X-Ray Computed Treatment Outcomes M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2013 SN - 0174-1551 SP - 479-483 ST - Elastoplasty: first experience in 12 patients T2 - CardioVascular & Interventional Radiology TI - Elastoplasty: first experience in 12 patients UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104251243&site=ehost-live&scope=site VL - 36 ID - 830659 ER - TY - JOUR AB - INTRODUCTION: Vertebral hemangioma (VH) is an exceedingly rare neoplasm in pediatric population with less than 10 cases reported in the literature. It is usually asymptomatic in adults and diagnosed incidentally at radiographic investigations of other medical conditions. In this report, we describe two children who presented to our institution with severe back pain and were diagnosed with VH. CASE REPORTS: Case 1 was an 8-year-old male with a pain score of 10 out of 10 at presentation. Clinical investigations eliminated the possibility of a neoplasm or infectious process and MRI findings were highly suggestive of an aggressive vertebral hemangioma. Case 2 was a 17-year-old female who presented with back pain radiating to shoulders. Her pain score was 4 out of 10 and she was diagnosed with vertebral hemangioma due to the specific findings on MRI studies. DISCUSSION: Both patients received propranolol with a dose of 20 and 40 mg per day, respectively. They were free of pain at 2 months follow-up. There are different invasive treatment modalities for the management of VH, including vertebroplasty, kyphoplasty, radiotherapy, alcohol injection, embolization, and surgery. These methods have been used in adult patients for several years, but each of them has potential risks which make these options unsuitable for children. CONCLUSION: Propranolol is a beta blocker which is safely used in the management of infantile hemangiomas. This is the first report demonstrating its efficacy in symptomatic treatment of childhood VH. The lesions did not show any regression, but the pain relief obtained was very significant under propranolol therapy. AD - Cerrahpasa Medical School, Istanbul University, Istanbul, Turkey. AN - 23306960 AU - Uzunaslan, D. AU - Saygin, C. AU - Gungor, S. AU - Hasiloglu, Z. AU - Ozdemir, N. AU - Celkan, T. DA - May DO - 10.1007/s00381-012-2012-5 DP - NLM ET - 2013/01/12 J2 - Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery KW - Adolescent Adrenergic beta-Antagonists/administration & dosage/*pharmacology Back Pain/*drug therapy/etiology Child Female Follow-Up Studies Hemangioma/complications/*diagnosis/pathology Humans Magnetic Resonance Imaging Male Propranolol/administration & dosage/*pharmacology Spinal Neoplasms/complications/*diagnosis/pathology Thoracic Vertebrae/*pathology Treatment Outcome LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 0256-7040 SP - 855-60 ST - Novel use of propranolol for management of pain in children with vertebral hemangioma: report of two cases T2 - Childs Nerv Syst TI - Novel use of propranolol for management of pain in children with vertebral hemangioma: report of two cases VL - 29 ID - 828747 ER - TY - JOUR AB - The eye lens is one of the most sensitive organs for radiation injury and exposure might lead to radiation induced cataract. Eye lens dosimetry in anesthesiology has been published in few clinical trials and an active debate about the causality of radiation induced cataract is still ongoing. Recently, the International Commission on Radiological Protection (ICRP) recommended a reduction in the annual dose limit for occupational exposure for the lens of the eye from 150 to 20 mSv, averaged over a period of 5 years, with the dose in a single year not exceeding 50 mSv. This prospective study investigated eye lens dosimetry in anesthesiology practice during a routine year of professional activity. The radiation exposure measured represented the exposure in a normal working schedule of a random anesthesiologist during 1 month and this cumulative eye lens dose was extrapolated to 1 year. Next, eye lens doses were measured in anesthesiology during neuro-embolisation procedures, radiofrequency ablations or vertebroplasty/kyphoplasty procedures. The eye lens doses are measured in terms of the dose equivalent H p(3) with the Eye-D dosimeter (Radcard, Poland) close to the right eye (on the temple). In 16 anesthesiologists, the estimated annual eye lens doses range from a minimum of 0.4 mSv to a maximum of 3.5 mSv with an average dose of 1.33 mSv. Next, eye lens doses were measured for nine neuro-embolisation procedures, ten radiofrequency ablations and six vertebroplasty/kyphoplasty procedures. Average eye lens doses of 77 ± 76 µSv for neuro-embolisations, 38 ± 34 µSv for cardiac ablations and 40 ± 44 µSv for vertebro-/kyphoplasty procedures were recorded. The maximum doses were respectively 264, 97 and 122 µSv. This study demonstrated that the estimated annual eye lens dose is well below the revised ICRP's limit of 20 mSv/year. However, we demonstrated high maximum and average doses during neuro-embolisation, cardiac ablation and vertebro-/kyphoplasty procedures. With radiation induced cataract being explained as a possible stochastic effect, without a threshold dose, anesthesiologists who regularly work in a radiological environment should remain vigilant and maintain radiation safety standards at all times. This includes adequately protective equipment (protection shields, apron, thyroid shield and leaded eye wear), keeping distance, routine monitoring and appropriate education. AD - Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy , Ziekenhuis Oost-Limburg , Genk Belgium Department of Ophthalmology , University Hospitals Leuven , Leuven Belgium Radiation Protection Dosimetry and Calibration , Belgian Nuclear Research Centre (SCK·CEN) , Mol Belgium Department of Ophthalmology , Ziekenhuis Oost-Limburg , Genk Belgium Department of Radiology , Ziekenhuis Oost-Limburg , Genk Belgium AN - 121743096. Language: English. Entry Date: 20170930. Revision Date: 20190708. Publication Type: journal article AU - Vaes, Bart AU - Van Keer, Karel AU - Struelens, Lara AU - Schoonjans, Werner AU - Nijs, Ivo AU - Vandevenne, Jan AU - Van Poucke, Sven DB - cin20 DO - 10.1007/s10877-016-9857-1 DP - EBSCOhost KW - Radiometry -- Equipment and Supplies Lens, Crystalline -- Radiation Effects Anesthesiology -- Manpower Occupational Exposure -- Prevention and Control Radiologic Health -- Methods Catheter Ablation Cataract Extraction Vertebroplasty Radio Waves Embolization, Therapeutic Prospective Studies Radiometry -- Methods Radiologic Health -- Equipment and Supplies Kyphoplasty Human M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 1387-1307 SP - 303-308 ST - Eye lens dosimetry in anesthesiology: a prospective study T2 - Journal of Clinical Monitoring & Computing TI - Eye lens dosimetry in anesthesiology: a prospective study UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=121743096&site=ehost-live&scope=site VL - 31 ID - 830570 ER - TY - JOUR AB - INTRODUCTION: A tourniquet is used during the total knee replacement surgery to improve the visibility, to reduce the blood loss and for better cementation. Indirectly it decreases the duration of surgery and enhances the recovery of the patient. Their use however is controversial due to some side effects associated with the use of tourniquet. They may increase the risk of deep vein thrombosis and pulmonary embolism by causing venous stasis, endothelial damage and increased platelet adhesion secondary to distal limb ischemia. MATERIAL AND METHODS: We conducted a randomized controlled trial (RCT) to examine the benefits and risks associated with the use of long duration over short duration tourniquets during TKA. The study was a prospective randomised control trial with a total of 80 knees (40 knees in each group) included in the study. The knees selected for surgery were randomly allocated to one of the two groups: Group A - long duration tourniquet (LT-group) or Group B - short duration tourniquet (ST-group). RESULT: The average operating time in Group A (43.53±3.11 minutes) was statistically less significant than that of Group B (51.7±2.56 minutes). Intra-operative blood loss in Group B, was significantly more than that of Group A. Post-operative blood loss in the drain was more in long duration tourniquet group. Total blood loss (intra-operative + post-operative) was more in short duration tourniquet group. Pain score (using VAS scale) was comparable in both the groups at the end of the second and sixth week. At sixth weeks there was no significant difference in the range of motion in both the groups. The KSS score was not significantly different in both the groups in post operative period at first, second, and six weeks. There were no events of thrombo-embolism and deep vein thrombosis in either groups. In 11 patients (27.5%) of long duration tourniquet group, swelling, and redness of knee was seen post operatively as compared to three patients (7.5%) of short duration tourniquet group. CONCLUSION: The use of a short duration tourniquet during TKA gives better symptomatic pain relief in the early postoperative period as compared to long duration use of tourniquet. However, this is associated with increased blood loss, more operating time and not having a clear operative field. We suggest that a rational thinking and reconsidering the practice of routine use of long duration tourniquet in each and every case of TKA is required. AD - Department of Orthopaedics & Joint Replacement Surgery, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India. AN - 29628683 AU - Vaishya, R. AU - Agarwal, A. K. AU - Vijay, V. AU - Tiwari, M. K. C2 - Pmc5884052 DA - Jan-Mar DO - 10.1016/j.jcot.2017.11.016 DP - NLM ET - 2018/04/10 J2 - Journal of clinical orthopaedics and trauma KW - Complications Functional outcomes Pain Total Knee Arthroplasty Tourniquet LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 0976-5662 (Print) 0976-5662 SP - 46-50 ST - Short term outcomes of long duration versus short duration tourniquet in primary total knee arthroplasty: A randomized controlled trial T2 - J Clin Orthop Trauma TI - Short term outcomes of long duration versus short duration tourniquet in primary total knee arthroplasty: A randomized controlled trial VL - 9 ID - 829011 ER - TY - JOUR AB - Percutaneous vertebroplasty is used to treat osteoporotic compression fractures and bone loss due to malignancy. The cement used can serve as a potential nidus for pulmonary thromboembolism (PTE). An 87-year-old woman with recent L2 vertebroplasty presented with abdominal pain and shortness of breath. Thoracoabdominal CT scan revealed extensive bilateral pulmonary emboli associated with a 9 cm cement fragment in the inferior vena cava (IVC) extending proximally from the level of the right superior renal vein, likely secondary to cement leak from the vertebral plexus into the IVC. She refused catheter extraction was managed conservatively. There are 51 reported cases of cement pulmonary embolism. IVC foreign bodies serving as a nidus for PTE have been reported with IVC filters with an incidence of 6.2%. This is the second reported case of vertebroplasty cement serving as a nidus for PTE. Treatment depends on time interval between the procedure and the symptom onset. AD - Department of Internal Medicine, Alegent-Creighton University Medical Center, Omaha, Nebraska, USA. AN - 24154998 AU - Vallabhajosyula, S. AU - Sundaragiri, P. R. AU - Bansal, O. AU - Townley, T. A. C2 - Pmc3822182 DA - Oct 23 DO - 10.1136/bcr-2013-200763 DP - NLM ET - 2013/10/25 J2 - BMJ case reports KW - Aged, 80 and over Bone Cements/adverse effects Female Humans Polymethyl Methacrylate/adverse effects Pulmonary Embolism/diagnostic imaging/*etiology Tomography, X-Ray Computed Vena Cava, Inferior/diagnostic imaging Vertebroplasty/*adverse effects LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1757-790x ST - A rare nidus for pulmonary thromboembolism after vertebroplasty T2 - BMJ Case Rep TI - A rare nidus for pulmonary thromboembolism after vertebroplasty VL - 2013 ID - 828800 ER - TY - JOUR AB - Vertebral augmentation techniques have become enormously popular procedures in the United States and abroad for the treatment of painful vertebral compression fractures. This minimally invasive procedure avoids or mitigates the direct and indirect adverse effects of pharmacologic and conventional pain treatment modalities while providing pain relief and improved function in an expedited fashion. Vertebral augmentation procedures include percutaneous vertebroplasty, the injection of bone cement directly into a fractured vertebral body, and balloon kyphoplasty, in which an inflatable bone tamp is employed to create a cavity in the bone prior to cement injection. These procedures are performed on fractures of thoracolumbar vertebrae and the sacral vertebrae (sacroplasty). Until recently, the efficacy of vertebral augmentation procedures had been supported in numerous case reports, case series, and nonrandomized trials. Practitioners valued the procedures, and patients seemed to prefer the active intervention as opposed to medical therapy. However, the level of evidence of these early reports was fair to poor because of the lack of randomized, controlled trials. Recent prospective, randomized, and controlled trials have done little to confirm or deny the efficacy of the techniques. In general, they have found percutaneous vertebroplasty or balloon kyphoplasty either beneficial or not different compared with conservative therapy with regards to primary (pain and disability) and secondary outcome indexes (quality of life, analgesic usage, etc.). The direction of future studies should be directed at endpoints, such as short-term benefits, cost-effectiveness, and longer-term prognosis, and should include adequate sample sizes to allow stratification of patients according to history and physical findings. © 2010 Elsevier Inc. AD - R. Vallejo, Millennium Pain Center, 1015 South Mercer Avenue, Bloomington, IL 61701, United States AU - Vallejo, R. AU - Benyamin, R. M. DB - Embase DO - 10.1053/j.trap.2010.06.004 KW - lidocaine nonsteroid antiinflammatory agent opiate derivative paracetamol poly(methyl methacrylate) analgesia article backache bed rest bleeding brace cast application clinical trial compression fracture conservative treatment death fracture external fixation human infection kidney injury kyphoplasty lumbar vertebra lung embolism metal implantation minimally invasive procedure nerve compression nerve injury neuromonitoring percutaneous vertebroplasty rehabilitation rib fracture sacral spinal cord spinal cord compression spinal cord decompression spinal cord injury spine stabilization surgical technique thoracolumbar spine treatment outcome vertebra body spine fracture vertebral canal stenosis LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 1084-208X SP - 133-141 ST - Vertebral augmentation techniques for the treatment of vertebral compression fractures: A review T2 - Techniques in Regional Anesthesia and Pain Management TI - Vertebral augmentation techniques for the treatment of vertebral compression fractures: A review UR - https://www.embase.com/search/results?subaction=viewrecord&id=L359452565&from=export http://dx.doi.org/10.1053/j.trap.2010.06.004 VL - 14 ID - 829660 ER - TY - JOUR AB - Introduction and aim: In B2 glomus tympanicum tumors, the default strategy (following the algorithm as proposed by Mario Sanna) is a canal-wall up mastoidectomy with extended facial recess opening combined with subfacial recess tympanotomy without embolisation. This requires extensive retrofacial drilling and does not provide excellent exposure of the hypotympanum. In primary inner ear schwannomas the choice of the approach depends on tumor location, ranging from the transcanal to the transotic approach. As an alternative the temporary canal wall removal technique can be used. This technique involves creating a wide facial recess approach and cutting the canal wall with an oscillating saw. After tumor resection the canal wall can be repositioned and fixated using hydroxyapatite bone cement. The aim of this study is to report our experience with temporary canal wall removal in intracochlear schwannomas and B2 glomus tympanicum tumors. Material and methods: We performed a retrospective review on 7 consecutive cases with an intracochlear schwannoma (n = 1) and B2 glomus tympanicum (n = 6) who underwent canal wall up mastoidectomy with temporary canal wall removal. We reviewed audiometric data and complications such as cholesteatoma, recurrence, facial nerve palsy, etc. Results: Total resection was achieved in all cases. In B2 glomus tympanicum cases minimal bleeding was observed during surgery, which was easily controlled by bipolar cautery. None of the patients had any facial palsy. No complications were observed such as sensorineural deafness, perforation of the tympanic membrane, granulation formation, extrusion of the canal wall or formation of cholesteatoma. Air conduction improved from 43 dBHL pure tone average to 29 dBHL after surgery. Conclusion: The temporary canal wall removal technique is a safe strategy to easily approach the hypotympanum and promontory. It avoids the need for the retrofacial approach when accessing the hypotympanum and the need for the transotic approach. In case of intact cochlear function it enables preservation of the ossicular chain. AD - K. Van Der Gucht, Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium AU - Van Der Gucht, K. AU - Van Rompaey, V. AU - Forton, G. AU - Van De Heyning, P. DB - Embase KW - bone cement hydroxyapatite adult air conduction auditory ossicle bleeding cancer surgery cauterization cholesteatoma clinical article complication conference abstract controlled study eardrum perforation face facial nerve paralysis female glomus tympanicum tumor human inner ear male mastoidectomy neurilemoma perception deafness pure tone audiometry relapse retrospective study surgery LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1781-782X SP - 26 ST - Temporary canal wall removal in primary inner ear schwannomas and B2 glomus tympanicum tumors T2 - B-ENT TI - Temporary canal wall removal in primary inner ear schwannomas and B2 glomus tympanicum tumors UR - https://www.embase.com/search/results?subaction=viewrecord&id=L625697551&from=export VL - 12 ID - 829350 ER - TY - JOUR AD - Dept of Pneumology, Sint-Jan General Hospital, Brugge, Belgium. AN - 15684308 AU - Vandooren, B. AU - Haenebalcke, C. AU - Bogaerts, Y. DA - Feb DO - 10.1183/09031936.05.00040904 DP - NLM ET - 2005/02/03 J2 - The European respiratory journal KW - Aged Bone Cements/*adverse effects Female Humans *Iatrogenic Disease Postoperative Complications/*diagnostic imaging Pulmonary Embolism/*diagnostic imaging/*etiology Spinal Fractures/*surgery Tomography, X-Ray Computed LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2005 SN - 0903-1936 (Print) 0903-1936 SP - 389-91 ST - Two patients with the same type of iatrogenic disease T2 - Eur Respir J TI - Two patients with the same type of iatrogenic disease VL - 25 ID - 828540 ER - TY - JOUR AB - Introduction The city of Passo Fundo, in the north of the Rio Grande do Sul state, has been standing out in the health care field for many years. The state has become a reference in endovascular interventional neuroradiology. We will cover 10 years of experience in this area and divide our observations in 3 parts: cerebral angiograms (part I), carotid angioplasties (part II) and intracranial aneurysms (part III). The goal of part I is to statistically assess the cerebral angiograms, their indications, risks and complications, as well as to do a technical review. Materials and Methods A retrospective study from 2005 to 2015 with a total of 5,567 interventional neuroradiology procedures performed. A total of 4,114 angiograms, 639 embolizations of intracranial aneurysms, 414 carotid angioplasties, 143 embolizations of cerebral arteriovenous malformations, 32 embolizations of dural arteriovenous fistulas, 102 cerebral vasospasm treatments, 21 treatments of epistaxis, 36 embolizations of craniocervical tumor, 25 thrombolysis of ischemic stroke, 18 vertebroplasties and 13 embolizations of arteriovenous malformations of the face. Results A total of 4,084 procedures performed, 21,811 vessels studied, average vase 7.62/2.82 vessel and patient/procedure. Of these, 2,536 were diagnostic procedures and 1,548 angiographic controls. Of the total, 1,188 patients received only an angiogram, 27.14% of which were therapeutic procedures. We obtained a total of 3.89% complications: 2.33% reflection vasovagal, 0.56% allergic skin reaction, anaphylactic shock 0.07%, 0.27% femoral hematoma, 0.26% transient neurological deficit, 0.12% permanent neurological deficit and no case of death. Conclusion Cerebral angiography in adults, children and infants is a safe procedure with low risk of permanent neurological complications. AD - J.R. Vanzin, Interventional Neuroradiology Service of Passo Fundo, Rua Teixeira Soares, 640, Passo Fundo, RS, Brazil AU - Vanzin, J. R. AU - Azambuja, N. D. AU - Frighetto, L. AU - Frohlich, A. C. AU - Varela, D. L. AU - Filho, P. M. AU - Roman, A. AU - Manzato, L. B. DB - Embase DO - 10.1055/s-0036-1584685 KW - fentanyl midazolam anaphylaxis anesthesia anxiety arteriovenous malformation article atheromatosis bradycardia brain angiography brain arteriovenous malformation brain embolism brain ischemia brain radiography brain vasospasm carotid angioplasty computed tomographic angiography dural arteriovenous fistula endovascular neurosurgery epistaxis faintness hematoma hospitalization human intracranial aneurysm magnetic resonance angiography major clinical study neurosurgery pain percutaneous vertebroplasty priority journal prospective study retrospective study Rio Grande do Sul sedation skin allergy transient global amnesia LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 0103-5355 2359-5922 SP - 167-173 ST - Endovascular neurosurgery in the northern Macro-region of Rio Grande do Sul: Part i T2 - Brazilian Neurosurgery TI - Endovascular neurosurgery in the northern Macro-region of Rio Grande do Sul: Part i UR - https://www.embase.com/search/results?subaction=viewrecord&id=L612953281&from=export http://dx.doi.org/10.1055/s-0036-1584685 VL - 37 ID - 829209 ER - TY - JOUR AB - Introduction The city of Passo Fundo, in the north of the Rio Grande do Sul state, has been standing out in the health care field for many years. The state has become a reference in endovascular interventional neuroradiology. We will cover 10 years of experience in this area and divide our observations in 3 parts: cerebral angiograms (part I), carotid angioplasties (part II) and intracranial aneurysms (part III). The goal of part I is to statistically assess the cerebral angiograms, their indications, risks and complications, as well as to do a technical review. Materials and Methods A retrospective study from 2005 to 2015 with a total of 5,567 interventional neuroradiology procedures performed. A total of 4,114 angiograms, 639 embolizations of intracranial aneurysms, 414 carotid angioplasties, 143 embolizations of cerebral arteriovenous malformations, 32 embolizations of dural arteriovenous fistulas, 102 cerebral vasospasm treatments, 21 treatments of epistaxis, 36 embolizations of craniocervical tumor, 25 thrombolysis of ischemic stroke, 18 vertebroplasties and 13 embolizations of arteriovenous malformations of the face. Results A total of 4,084 procedures performed, 21,811 vessels studied, average vase 7.62/2.82 vessel and patient/procedure. Of these, 2,536 were diagnostic procedures and 1,548 angiographic controls. Of the total, 1,188 patients received only an angiogram, 27.14% of which were therapeutic procedures. We obtained a total of 3.89% complications: 2.33% reflection vasovagal, 0.56% allergic skin reaction, anaphylactic shock 0.07%, 0.27% femoral hematoma, 0.26% transient neurological deficit, 0.12% permanent neurological deficit and no case of death. Conclusion Cerebral angiography in adults, children and infants is a safe procedure with low risk of permanent neurological complications. AD - [Vanzin, Jose Ricardo; Azambuja, Nerio Dutra, Jr.; Frighetto, Leonardo; Frohlich, Alan Christmann; Varela, Daniel Lima; Mesquita Filho, Paulo; Roman, Alex; Manzato, Luciano Bambini] Intervent Neuroradiol Serv Passo Fundo, Passo Fundo, RS, Brazil. Vanzin, JR (corresponding author), Serv Neurorradiol Intervencionista Passo Fundo, Rua Teixeira Soares 640, BR-99010080 Passo Fundo, RS, Brazil. vanzin@neurosnn.com.br AN - WOS:000447800600002 AU - Vanzin, J. R. AU - Azambuja, N. D. AU - Frighetto, L. AU - Frohlich, A. C. AU - Varela, D. L. AU - Mesquita, P. AU - Roman, A. AU - Manzato, L. B. DA - Sep DO - 10.1055/s-0036-1584685 J2 - Braz. Neurosurg. KW - arteriography interventional radiology neuroangiography endovascular technique PERCUTANEOUS CORONARY INTERVENTION INTERNAL CAROTID-ARTERY CEREBRAL-ANGIOGRAPHY SUBARACHNOID HEMORRHAGE VERTEBRAL ARTERY DIRECT PUNCTURE ANEURYSM COMPLICATIONS ACCESS NEUROANGIOGRAPHY Surgery LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 0103-5355 SP - 167-173 ST - Endovascular Neurosurgery in the Northern Macro- region of Rio Grande do Sul: Part I T2 - Brazilian Neurosurgery-Arquivos Brasileiros De Neurocirurgia TI - Endovascular Neurosurgery in the Northern Macro- region of Rio Grande do Sul: Part I UR - ://WOS:000447800600002 VL - 37 ID - 830158 ER - TY - JOUR AB - Vertebroplasty is a therapeutic procedure that is used to repair spinal lesions. For its part, methyl acrylate is a bone cement that is injected into the spongy bone of the vertebral body during this procedure. The case is presented of a 59 year-old woman with a history of a lumbar arthrodesis, who consulted due stabbing-type lower back pain, after a fall from her own height. On physical examination, she had pain in the thoracic region with no clinical signs of radiculopathy, and impossibility for movement. The imaging studies reported a fracture due to wedging of vertebral bodies T12-L1. A change was made in the arthrodesis material, which required the additional use of methyl acrylate to fix the cannulated screws. Two hours after the surgical procedure, she referred to chest pain, dyspnoea and tachypnoea, for which further studies were requested. Due to the findings in the chest x-ray, a pulmonary embolism induced by methyl acrylate was suspected, for which a computed tomography scan of the chest was requested. She was transferred to the Intensive Care Unit. After 72 hours of admission there, an echocardiogram was performed that showed dilated right cavities, hypokinesis of the right ventricle with systolic dysfunction, tricuspid insufficiency, and moderate pulmonary hypertension. Thromboprophylaxis was prescribed for three months and follow-up by the Internal Medicine and Neurosurgery departments. AD - L.J. Vargas Rodríguez, Hospital San Rafael - Universidad de Boyacá, Tunja, Colombia AU - Vargas Rodríguez, L. J. AU - Agudelo Sanabria, M. B. AU - Rozo Ortiz, E. J. DB - Embase DO - 10.1016/j.rccar.2017.08.015 KW - cannulated screw fusion implant anticoagulant agent methacrylic acid methyl ester adult arthrodesis article case report clinical article computer assisted tomography device removal dyspnea echocardiography falling female follow up heart right ventricle failure hospital admission human intensive care unit low back pain lumbar spine lung embolism medical history middle aged physical examination postoperative period prescription spine fracture systolic dysfunction tachypnea thoracic spine thorax pain thorax radiography treatment duration tricuspid valve regurgitation LA - English Spanish M1 - 5 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 0120-5633 SP - 341.e1-341.e5 ST - Pulmonary embolism due to methyl methacrylate T2 - Revista Colombiana de Cardiologia TI - Pulmonary embolism due to methyl methacrylate UR - https://www.embase.com/search/results?subaction=viewrecord&id=L619455704&from=export http://dx.doi.org/10.1016/j.rccar.2017.08.015 VL - 25 ID - 829181 ER - TY - JOUR AB - Background: Dural arteriovenous fistulas are uncommon lesions in children, with traumatic lesions suspected to arise from incomplete arterial injury in proximity to a vein or draining sinus. Management of symptomatic acquired lesions requires evaluation of patient presentation, neurological status, and pathoanatomic configuration, with special consideration required for surgery secondary to failed endovascular technique. Case Report: A 12-year-old male sustained a bicycle fall causing a right temporo-parietal skull fracture associated with non-surgical right epidural hematoma and left contre-coup parietal contusion. Six-weeks later, he complained of a right temporal bruit with subsequent cerebral angiography demonstrating a dural-based fistula between the right middle meningeal artery and a dural vein draining into the sigmoid sinus. Intervention: Endovascular treatment of this lesion with glue embolization and coiling was unsuccessful, with angiographic illustration of previously unobserved collateral vessels and coils occupying the sigmoid sinus. A right temporo-parietal craniectomy was required to excise the dural-based fistula, followed by dural defect repair with bovine pericardium and subsequent cranioplasty. Six years later the patient remains neurologically intact with no headaches or bruit. Conclusions: Dural arteriovenous fistula can uncommonly occur following traumatic injury in children. Partial injury to the middle mengineal artery may have established arterial communication with the draining vein that became ectatic and tortuous under high pressure. Failure of primary endovascular treatment may complicate secondary surgical intervention. AD - M. Vassilyadi, Division of Neurosurgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada AU - Vassilyadi, M. AU - Mehrotra, N. AU - Shamji, M. F. AU - Michaud, J. DB - Embase Medline DO - 10.1017/S0317167100008386 KW - bone cement bucrilate hydroxyapatite iodinated poppyseed oil arteriovenous fistula article bicycle brain angiography brain arteriovenous malformation brain vein carotid arteriography bovine childhood injury coil embolization computer assisted tomography contusion craniectomy cranioplasty dura mater dural arteriovenous fistula epidural hematoma falling head injury meningeal artery pericardium priority journal sigmoid sinus skull fracture treatment outcome DuraGuard Mimix Vortx fibered coil LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 0317-1671 SP - 751-756 ST - Pediatric traumatic dural arteriovenous fistula T2 - Canadian Journal of Neurological Sciences TI - Pediatric traumatic dural arteriovenous fistula UR - https://www.embase.com/search/results?subaction=viewrecord&id=L355474196&from=export http://dx.doi.org/10.1017/S0317167100008386 VL - 36 ID - 829690 ER - TY - JOUR AB - Extensive bone loss raises formidable challenges in total hip revision. The aim of this study was to evaluate the results of reconstruction using a cemented long-stem and massive structural allograft implanted in a filleted proximal femur, with and without the use of a trochanteric claw plate. Between 1988 and 2001, 44 revisions were performed in 42 patients. After a transtrochanteric approach, the femur was cut longitudinally. A long, cemented Charnley-type prosthesis was used, and flaps of the residual femur were folded around the allograft. The greater trochanter was reinserted with wires in all revisions, and with both wires and a claw plate in 20 revisions. Mean follow-up was 7.15 years (range: 3-16); seven patients, died and four were lost to follow-up. The follow-up exceeded five years in 34 patients. The major complication was nonunion of the greater trochanter, which occurred in 25 cases. Six dislocations, one recurrence of infection, two mechanical loosening, and two fractures below the stem were also recorded. The use of a trochanteric claw plate significantly improved final hip stability, even in patients with nonunion. Femoral reconstruction with a massive structural allograft is reliable and long-lived, and serious complications and long-term resorption are uncommon. The use of a trochanteric claw plate significantly improves final hip stability. Level of evidence: Therapeutic study, level III (retrospective comparative study). © 2007 Springer-Verlag. AD - L. Vastel, Department of Orthopedic Surgery, Hôpital Cochin, Paris V University, 27 rue du Faubourg St Jacques, Paris 75014, France AU - Vastel, L. AU - Lemoine, C. T. AU - Kerboull, M. AU - Courpied, J. P. DB - Embase Medline DO - 10.1007/s00264-006-0275-8 KW - bone cement adult aged article bone allograft bone plate bone remodeling clinical article fat embolism female femur follow up fracture fracture healing hip arthroplasty hip dislocation hip prosthesis human long term care male postoperative complication priority journal prosthesis complication prosthesis loosening pseudarthrosis cerebrovascular accident surgical technique treatment outcome LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2007 SN - 0341-2695 SP - 851-857 ST - Structural allograft and cemented long-stem prosthesis for complex revision hip arthroplasty: Use of a trochanteric claw plate improves final hip function T2 - International Orthopaedics TI - Structural allograft and cemented long-stem prosthesis for complex revision hip arthroplasty: Use of a trochanteric claw plate improves final hip function UR - https://www.embase.com/search/results?subaction=viewrecord&id=L350160303&from=export http://dx.doi.org/10.1007/s00264-006-0275-8 VL - 31 ID - 829755 ER - TY - JOUR AB - OBJECTIVE Vertebral hemangiomas are common tumors that are benign and generally asymptomatic. Occasionally these lesions can exhibit aggressive features such as bony expansion and erosion into the epidural space resulting in neurological symptoms. Surgery is often recommended in these cases, especially if symptoms are severe or rapidly progressive. Some surgeons perform decompression alone, others perform gross-total resection, while others perform en bloc resection. Radiation, embolization, vertebroplasty, and ethanol injection have also been used in combination with surgery. Despite the variety of available treatment options, the optimal management strategy is unclear because aggressive vertebral hemangiomas are uncommon lesions, making it difficult to perform large trials. For this reason, the authors chose instead to report their institutional experience along with a comprehensive review of the literature. METHODS A departmental database was searched for patients with a pathological diagnosis of "hemangioma" between 2008 and 2015. Medical records were reviewed to identify patients with aggressive vertebral hemangiomas, and these cases were reviewed in detail. RESULTS Five patients were identified who underwent surgery for treatment of aggressive vertebral hemangiomas during the specified time period. There were 2 lumbar and 3 thoracic lesions. One patient underwent en bloc spondylectomy, 2 patients had piecemeal gross-total resection, and the remaining 2 had subtotal tumor resection. Intraoperative vertebroplasty was used in 3 cases to augment the anterior column or to obliterate residual tumor. Adjuvant radiation was used in 1 case where there was residual tumor as well. The patient who underwent en bloc spondylectomy experienced several postoperative complications requiring additional medical care and reoperation. At an average follow-up of 31 months (range 3-65 months), no patient had any recurrence of disease and all were clinically asymptomatic, except the patient who underwent en bloc resection who continued to have back pain. CONCLUSIONS Gross-total resection or subtotal resection in combination with vertebroplasty or adjuvant radiation therapy to treat residual tumor seems sufficient in the treatment of aggressive vertebral hemangiomas. En bloc resection appears to provide a similar oncological benefit, but it carries higher morbidity to the patient. AD - Brigham and Women's Hospital, Harvard Medical School; and. Center for Neuro-Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts. AN - 27476849 AU - Vasudeva, V. S. AU - Chi, J. H. AU - Groff, M. W. DA - Aug DO - 10.3171/2016.5.focus16169 DP - NLM ET - 2016/08/02 J2 - Neurosurgical focus KW - Adult Aged Female Follow-Up Studies Hemangioma/*diagnostic imaging/*surgery Humans Male Middle Aged Retrospective Studies Spinal Neoplasms/*diagnostic imaging/*surgery Thoracic Vertebrae/*diagnostic imaging/*surgery Treatment Outcome *EBL = estimated blood loss *NBCA = N-butyl cyanoacrylate *aggressive vertebral hemangioma *cavernous hemangioma *primary spinal column tumor *vertebral angioma *vertebral hemangioma LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1092-0684 SP - E7 ST - Surgical treatment of aggressive vertebral hemangiomas T2 - Neurosurg Focus TI - Surgical treatment of aggressive vertebral hemangiomas VL - 41 ID - 828622 ER - TY - JOUR AD - K. Venkatnarayan, Department of Pulmonary Medicine, St John's National Academy of Health Sciences, Bengaluru, Karnataka, India AU - Venkatnarayan, K. AU - Krishnaswamy, U. AU - Devaraj, U. AU - Ramachandran, P. DB - Embase DO - 10.4103/lungindia.lungindia_309_19 KW - bone cement aged case report clinical article female human lung artery pressure lung embolism note pulmonary artery pulmonary hypertension thorax radiography transthoracic echocardiography x-ray computed tomography LA - English M1 - 2 M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2020 SN - 0974-598X 0970-2113 SP - 167-168 ST - Pulmonary arteries in a fix T2 - Lung India TI - Pulmonary arteries in a fix UR - https://www.embase.com/search/results?subaction=viewrecord&id=L631195013&from=export http://dx.doi.org/10.4103/lungindia.lungindia_309_19 VL - 37 ID - 829076 ER - TY - JOUR AB - BACKGROUND AND PURPOSE: The reported incidence of PCE during PV varies, depending on the sensitivity of diagnostic tests used. To assess the true incidence of PCE, we performed native chest CT during follow‐up in a large proportion of patients from the VERTOS II trial. MATERIALS AND METHODS: VERTOS II is a prospective multicenter randomized controlled trial comparing PV with conservative therapy in 202 patients. After a mean follow‐up of 22 months (median, 21 months; range, 6‐42 months), 54 of 78 patients (69%) with 80 vertebrae treated with PV underwent native chest CT to detect possible PCE. The presence, location, number, and size of PCE were recorded. In addition, the presence of pulmonary parenchymal changes adjacent to PCE was noted. Possible risk factors for PCE, such as age, sex, number of treated vertebrae, cement volume per vertebra, and presence and location of perivertebral cement leakage, were evaluated. RESULTS: PCE was detected in 14 of 54 patients (26%; 95% CI, 16%‐39%). All patients were asymptomatic. Cement emboli were small and randomly distributed in peripheral small vessels. There were no reactive pulmonary changes. Cement leakage in the azygos vein was the only risk factor for the occurrence of PCE (OR, 43; 95% CI, 5‐396). CONCLUSIONS: Small and clinically silent PCE occurred in a quarter of patients treated with PV. Cement leakage into the azygos vein was the only risk factor. With time, these small cement emboli remained inert, without inflammatory pulmonary response. Standard postprocedural CT or chest radiographs are not necessary. AN - CN-00773037 AU - Venmans, A. AU - Klazen, C. A. AU - Lohle, P. N. AU - van Rooij, W. J. AU - Verhaar, H. J. AU - de Vries, J. AU - Mali, W. P. DO - 10.3174/ajnr.A2127 KW - Aged Aged, 80 and over Azygos Vein Bone Cements [*adverse effects] Female Follow‐Up Studies Fractures, Compression [epidemiology, therapy] Humans Incidence Male Middle Aged Osteoporosis [epidemiology, *therapy] Pulmonary Embolism [diagnostic imaging, epidemiology, *etiology] Risk Factors Spinal Fractures [epidemiology, *therapy] Tomography, Spiral Computed Vertebroplasty [adverse effects, methods, statistics & numerical data] M1 - 8 M3 - Journal Article; Multicenter Study; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2010 SP - 1451‐1453 ST - Percutaneous vertebroplasty and pulmonary cement embolism: results from VERTOS II T2 - AJNR. American journal of neuroradiology TI - Percutaneous vertebroplasty and pulmonary cement embolism: results from VERTOS II UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00773037/full VL - 31 ID - 830020 ER - TY - JOUR AB - A vertebral fracture, whether originating from osteoporosis or trauma, can be the cause of pain, disability, deformation and neurological deficit. The treatment of vertebral compression fractures has, for many years until the advent of vertebroplasty, consisted of bedrest and analgesics. Vertebroplasty is a percutaneous technique during which bone cement is injected in a vertebral body to provide immediate pain relief by stabilization. Inflatable bone tamps can, prior to the injection of cement, be used to create a void in the vertebral body, in which case the technique is known as balloon vertebroplasty (or kyphoplasty). The chance of extracorporal cement leakage is smaller for balloon vertebroplasty than for vertebroplasty. Some authors also claim to have gained some correction in vertebral body height or angulation. Both interventions can be used for several indications, including osteoporotic compression fractures and osteolytic lesions of the vertebral body such as myeloma, hemangioma or metastasis, and also for traumatic burst fractures in combination with pedicle screw instrumentation. Polymethyl methacrylate cement is the bone void filler that is used most frequently, although the application of calcium phosphate cements has been studied widely in vitro, in vivo and also in small-scale clinical series. The clinical results of (balloon-) vertebroplasty are favorable with 85-95% of all patients experiencing immediate and long-lasting relief of pain. Serious complications are relatively rare but include neurological deficit and pulmonary embolism. In this paper, both vertebroplasty and balloon vertebroplasty and their respective indications, techniques and results are described in relation with the application and limitations of permanent and resorbable injectable bone cements. AD - Department of Orthopaedics, University Medical Center Utrecht, Heidelberglaan 100, 3584CX Utrecht, The Netherlands. j.j.verlaan@chir.azu.nl AN - 16102818 AU - Verlaan, J. J. AU - Oner, F. C. AU - Dhert, W. J. DA - Jan DO - 10.1016/j.biomaterials.2005.07.028 DP - NLM ET - 2005/08/17 J2 - Biomaterials KW - Absorbable Implants/adverse effects Bone Cements/*therapeutic use Calcium Phosphates/therapeutic use Humans Injections, Spinal Orthopedic Procedures/instrumentation/methods/trends Osteoporosis/complications Pain/etiology *Pain Management Polymethyl Methacrylate/therapeutic use Spinal Fractures/complications/etiology/*therapy Treatment Outcome LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2006 SN - 0142-9612 (Print) 0142-9612 SP - 290-301 ST - Anterior spinal column augmentation with injectable bone cements T2 - Biomaterials TI - Anterior spinal column augmentation with injectable bone cements VL - 27 ID - 828635 ER - TY - JOUR AB - A vertebral fracture, whether originating from osteoporosis or trauma, can be the cause of pain, disability, deformation and neurological deficit. The treatment of vertebral compression fractures has, for many years until the advent of vertebroplasty, consisted of bedrest and analgesics. Vertebroplasty is a percutaneous technique during which bone cement is injected in a vertebral body to provide immediate pain relief by stabilization. Inflatable bone tamps can, prior to the injection of cement, be used to create a void in the vertebral body, in which case the technique is known as balloon vertebroplasty (or kyphoplasty). The chance of extracorporal cement leakage is smaller for balloon vertebroplasty than for vertebroplasty. Some authors also claim to have gained some correction in vertebral body height or angulation. Both interventions can be used for several indications, including osteoporotic compression fractures and osteolytic lesions of the vertebral body such as myeloma, hemangioma or metastasis, and also for traumatic burst fractures in combination with pedicle screw instrumentation. Polymethyl methacrylate cement is the bone void filler that is used most frequently, although the application of calcium phosphate cements has been studied widely in vitro, in vivo and also in small-scale clinical series. The clinical results of (balloon-) vertebroplasty are favorable with 85-95% of all patients experiencing immediate and long-lasting relief of pain. Serious complications are relatively rare but include neurological deficit and pulmonary embolism. In this paper, both vertebroplasty and balloon vertebroplasty and their respective indications, techniques and results are described in relation with the application and limitations of permanent and resorbable injectable bone cements. © 2005 Elsevier Ltd. All rights reserved. AD - J.-J. Verlaan, Department of Orthopaedics, University Medical Center Utrecht, Heidelberglaan 100, 3584CX Utrecht, Netherlands AU - Verlaan, J. J. AU - Oner, F. C. AU - Dhert, W. J. A. DB - Embase Medline DO - 10.1016/j.biomaterials.2005.07.028 KW - bone cement calcium phosphate dibasic filler methacrylic acid methyl ester poly(methyl methacrylate) analgesia arthroplasty bed rest bleeding body height bone atrophy bone metastasis fragility fracture hemangioma human hypersensitivity in vitro study infection kyphoplasty lung embolism medical device myeloma neurologic disease pain percutaneous vertebroplasty postoperative complication priority journal review spinal cord surgery spinal cord ventral horn surgical technique vertebra body spine fracture LA - English M1 - 3 M3 - Review N1 - Embase Elsevier literature search January 5, 2021 PY - 2006 SN - 0142-9612 SP - 290-301 ST - Anterior spinal column augmentation with injectable bone cements T2 - Biomaterials TI - Anterior spinal column augmentation with injectable bone cements UR - https://www.embase.com/search/results?subaction=viewrecord&id=L41457232&from=export http://dx.doi.org/10.1016/j.biomaterials.2005.07.028 VL - 27 ID - 829802 ER - TY - JOUR AB - The aim of this prospective randomized clinical study was to evaluate the magnitude of bone mineral changes as well as the clinical results after cemented and cementless haemiarthroplasty (HA) for femoral neck fracture. The study was comprised of 60 patients (mean age 85.2 years); 30 of them underwent cemented HA and 30 cementless HA. All patients underwent osteodensitometry for the purpose of Bone Mineral Density (BMD) evaluation. BMD was measured with dual‐energy X‐ray absorptiometry test (DEXA scans), which was scheduled at 1 month, 6 months and 1 year after surgery. BMD was evaluated at each of the seven Gruen zones. Harris Hip Score (HHS) at 3 months, 6 months and 12 months was used for evaluation of functional outcome. No difference was found between the two groups of patients in terms hospital stay, morbidity and mortality. The procedure took longer time in group A (cemented HA) compared to group B (cementless HA) (79.03 ± 3.59 vs 68.02 ± 5.97 minutes; p = 0.00). The Harris hip score averaged 76.97 ± 7.49 one year after surgery. At each follow ‐ up examination the HHS was significantly higher in patients with cemented HA. We noted a trend of less intensive BMD reduction in all Gruen zones in group A compared to group B. However, the difference in BMD reduction between these two groups was significant only in zones 2, 3 and 4. Our results support the view that cemented hemiarthroplasty should be used for the management of displaced femoral neck fractures providing better functional outcomes and lower periprosthetic bone loss. AN - CN-01067189 AU - Vidovic, D. AU - Matejcic, A. AU - Punda, M. AU - Ivica, M. AU - Tomljenovic, M. AU - Bekavac-Beslin, M. AU - Mijic, A. AU - Bakota, B. DO - 10.1016/S0020-1383(13)70201-8 KW - *bone disease *cemented hip prosthesis *cementless hip prosthesis *cementless prosthesis *hip hemiarthroplasty *hip prosthesis *periprosthetic bone loss Aged Aged, 80 and over Arthroplasty, Replacement, Hip [*methods] Article Bone Cements Bone Density Bone cement Bone densitometry Bone mineral Cementation Controlled study Deep vein thrombosis/co [Complication] Dual energy X ray absorptiometry Female Femoral Neck Fractures [diagnostic imaging, physiopathology, *surgery] Femur neck fracture/su [Surgery] Follow up Gastrointestinal hemorrhage/co [Complication] Harris hip score Hemiarthroplasty [*adverse effects] Hip Prosthesis Human Humans Lung embolism/co [Complication] Major clinical study Mortality Pneumonia/co [Complication] Postoperative hemorrhage/co [Complication] Postoperative infection/co [Complication] Postoperative period Priority journal Prospective Studies Prospective study Radiography Randomized controlled trial Treatment Outcome Treatment duration Urinary tract infection/co [Complication] M3 - Comparative Study; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2013 SP - S62‐6 ST - Periprosthetic bone loss following hemiarthroplasty: a comparison between cemented and cementless hip prosthesis T2 - Injury TI - Periprosthetic bone loss following hemiarthroplasty: a comparison between cemented and cementless hip prosthesis UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01067189/full VL - 44 Suppl 3 ID - 830001 ER - TY - JOUR AB - Pulmonary embolism is a frequent condition for which multidetector computed tomography (MDCT) plays an important role in its detection. Occasionally, on MDCT studies, dense linear branching opacities may be found within the pulmonary vessels. They represent dense emboli within the pulmonary arteries (DEPA). These may occur in oncologic patients that undergo specific treatments or interventional procedures, such as cement embolus from vertebroplasty, catheter or coil migration after embolization procedures, radioactive seed embolus in patients treated with local brachytherapy for prostate, lung, or liver cancer, and also in chronic pulmonary embolism. Usually DEPA does not have any clinical significance but may be fatal when massive or when in patients with impaired cardiopulmonary function. Being familiar with their radiologic appearance and knowing about the good clinical outcome of these patients will avoid unnecessary imaging testing. In this article, we describe some examples of DEPA. Based on the MDCT imaging findings, these emboli have very few or no side effects on the underlying lung parenchyma. We would like to stress the need for using bone window values for identifying these emboli. We provide examples of dense linear nonvascular images (pulmonary calcification secondary to tuberculosis (TBC) or radiotherapy, calcified mucous plugs, lung sutures, etc) that may mimic DEPA. AD - Department of Radiology, Clínica Universitaria de Navarra, Universidad de Navarra, Pamplona, Spain Department of Radiology, Clínica Universitaria de Navarra, Universidad de Navarra, Pamplona, Spain. avillanueva@unav.es AN - 105226993. Language: English. Entry Date: 20100312. Revision Date: 20200708. Publication Type: journal article AU - Villanueva, A. AU - Díaz, M. L. AU - Sánchez, A. AU - Castañer, E. AU - Bastarrika, G. AU - Broncano, J. AU - del Barrio, L. G. AU - Villanueva, Alberto AU - Díaz, Maria Lourdes AU - Sánchez, Armando AU - Castañer, Eva AU - Bastarrika, Gorka AU - Broncano, Jordi AU - del Barrio, Loreto Garcia DB - cin20 DO - 10.1067/j.cpradiol.2008.12.001 DP - EBSCOhost KW - Pulmonary Embolism -- Radiography Tomography, X-Ray Computed Brachytherapy -- Adverse Effects Catheterization -- Adverse Effects Diagnosis, Differential Pulmonary Embolism -- Etiology Pulmonary Embolism -- Therapy Risk Factors Kyphoplasty -- Adverse Effects M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0363-0188 SP - 251-263 ST - Multidetector computed tomography findings of dense pulmonary emboli in oncologic patients T2 - Current Problems in Diagnostic Radiology TI - Multidetector computed tomography findings of dense pulmonary emboli in oncologic patients UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105226993&site=ehost-live&scope=site VL - 38 ID - 830717 ER - TY - JOUR AB - Introduction: Over the last few years there has been a growing evidence to support the use of uncemented total hip prostheses even in patients with osteoporotic bone1. Several designs HA coated have demonstrated results that are certainly as good as any published contemporary, cemented stem series, with survivorships over 95% at 15 years, even in patients younger than 55 years2-4. In addition uncemented stems may also reduce fat embolism, thromboembolic disease, and particularly, reduced operative time without increasing the cost of the procedure5. Methods: 350 uncemented arthroplasties were performed in our institution during the past 10 years with an HA coated stem HA. In none of these cases an HA coated cup was used. The diagnosis was osteoarthritis, mainly in the older group (55-78 years): 280 patients. In patients younger than 50 years the main diagnoses were congenital dislocations, dysplasia, sequelae of fracture, infection, Calve-Legg-Perthes disease, avascular necrosis or femoroacetabular impingment. In most cases we used an uncemented straight stem fully coated with hydroxyapatite (HA) (Corail, De Puy). In cases of severe dysplasia, previous femoral osteotomy or proximal deformity our first choice was a proximally coated with HA, modular metaphyseal stem (S-ROM, De Puy). We used a porous cup without HA in these patients. Metal on poly and ceramic on ceramic were the most frequently used bearings. Metal on metal was used in the last 4 years, monoblock cups rather than modular ones for young and active patients. Results: Six of the stems were revised at latest follow up. Three patients becomed infected and were finally revised with a two stage protocol. Two patients had an early dislocation requiring revision with a modular stem and one patient suffered a periprosthetic fracture requiring revision with a Wagner stem. The rest of the stems were classified as well integrated, with no signs of radiological loosening or subsidence at latest follow-up (1-10 years, mean 7.5 years). Radiolucent lines or bone atrophy around proximal Gruen zones 1 and 7 were observed in 10% of the stems, all well osseointegrated. Discussion: The promising results produced by HA-coated femoral prostheses have been repeated in the younger patient. Cemented hip arthroplasty may not be the “gold standard” for patients younger than 55 years6. Several studies with uncemented prostheses report survivorships over 95% at 15 years2,7. Some of the theoretical problems remain unsolved but have not demonstrated, so far, any deleterious influence in the performance of the implants8. These are HA resorption and long-term stability, osteolísis and granuloma that are occasionally observed in the proximal zones, and difficulty removing a well integrated HA-coated stem. Our experience only allows us to assure that extraction of a fully HA coated stem requires a transfemoral approach. The rest of the problems are not expected to occur before the second decade of implant life and are not a major concern in the literature. An additional advantage of HA coatings is that bioactive fixation may seal the whole interface and block the migration of wear debris, limiting osteolísis or granuloma formation derived from particle disease to proximal areas. AD - M. Villanueva, University Hospital Gregorio Marañon, Spain AU - Villanueva, M. DB - Embase KW - metal hydroxyapatite personal experience human total hip prosthesis biomechanics surgery patient follow up granuloma ceramics dysplasia diagnosis fat embolism osteoarthritis periprosthetic fracture bone atrophy fracture deformity arthroplasty avascular necrosis operation duration Perthes disease femur osteotomy thromboembolism extraction cementless prosthesis infection gold standard prosthesis hip arthroplasty implant LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0021-9290 SP - S50-S51 ST - Personal experience with HA-coated total hip arthroplasty T2 - Journal of Biomechanics TI - Personal experience with HA-coated total hip arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71828025&from=export VL - 43 ID - 829665 ER - TY - JOUR AB - Context: Vertebral haemangiomas are recognized to be one of the commonest benign tumours of the vertebral column, occurring mostly in the thoracic spine. The vast majority of these are asymptomatic. Infrequently, these can turn symptomatic and cause neurological deficit (cord compression) through any of four reported mechanisms: (1) epidural extension; (2) expansion of the involved vertebra(e) causing spinal canal stenosis; (3) spontaneous epidural haemorrhage; (4) pathological burst fracture. Thoracic haemangiomas have been reported to be more likely to produce cord compression than lumbar haemangiomas. Findings: A forty-nine year old male with acute onset spinal cord compression from a pathological fracture in a first lumbar vertebral haemangioma. An MRI delineated the haemangioma and extent of bleeding that caused the cord compression. These were confirmed during surgery and the haematoma was evacuated. The spine was instrumented from T12 to L2, and a cement vertebroplasty was performed intra-operatively. Written consent for publication was obtained from the patient. Clinical Relevance: The junctional location of the first lumbar vertebra, and the structural weakness from normal bone being replaced by the haemangioma, probably caused it to fracture under axial loading. This pathological fracture caused bleeding from the vascularized bone, resulting in cord compression. AD - [Vinay, S.; Khan, S. K.; Braybrooke, J. R.] Univ Hosp Leicester NHS Trust, Dept Trauma & Orthopaed, Leicester, Leics, England. Khan, SK (corresponding author), 103 Kildale House,Marton Rd, Middlesbrough TS4 3TG, Cleveland, England. Sameer.khan@doctors.net.uk AN - WOS:000290851400014 AU - Vinay, S. AU - Khan, S. K. AU - Braybrooke, J. R. DA - May DO - 10.1179/2045772311y.0000000004 J2 - J. Spinal Cord. Med. KW - Vertebral haemangioma Pathological fracture Spinal cord compression Vertebroplasty Paralysis Paraparesis METHYL-METHACRYLATE RETROGRADE EMBOLIZATION ETHANOL INJECTION VERTEBROPLASTY MANAGEMENT STABILIZATION RADIOTHERAPY ALCOHOL Clinical Neurology LA - English M1 - 3 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2011 SN - 1079-0268 SP - 335-339 ST - Lumbar vertebral haemangioma causing pathological fracture, epidural haemorrhage, and cord compression: a case report and review of literature T2 - Journal of Spinal Cord Medicine TI - Lumbar vertebral haemangioma causing pathological fracture, epidural haemorrhage, and cord compression: a case report and review of literature UR - ://WOS:000290851400014 VL - 34 ID - 830326 ER - TY - JOUR AB - Introduction: Thromboembolism is a known complication after orthopedic surgery but rarely occurs intraoperatively. Cement embolism during the procedure is less common but can be fatal. While the diagnosis is readily made, management may be controversial as there is no current consensus regarding optimal treatment. We present such a case requiring emergent embolectomy assisted by cardiopulmonary bypass. CASE PRESENTATION: A 64-year old man with a history of COPD and alcohol abuse presented with streptococcus pneumonia and a complex fracture of the hip, necessitating total artificial hip replacement. After initial medical management and conservative treatment of the fracture the patient was scheduled for elective surgery. During that procedure, at the time of bone cement injection, the patient abruptly developed hemodynamic instability and PEA. CPR was initiated, while thromboembolism was confirmed by TEE. An emergency sternotomy was performed and the patient was placed on cardiopulmonary bypass for removal of massive clot extending from the IVC through the RV into the pulmonary arteries (Fig. 1). An IVC filter was also placed to prevent further thromboembolism. DISCUSSION: Massive thromboembolism was provoked by cement leak into circulation in this patient who had other risk factors including a recent infection and prolonged immobilization. Particles of bone cement were found in the removed clot on surgical pathology. Conclusions: The incident of massive and fatal thromboembolism in perioperative patients is reported as 0.1-2% after most procedures, but as high as 13% after hip replacement[1]. This case illustrates diagnosis and treatment, including emergent pulmonary embolectomy, in patients presenting with major intraoperative thromboembolism, which is a rare but often fatal complication during surgery. Patients undergoing bone cement injection are particularly at risk for this entity. AD - M.W. Von Ballmoos, Medical College of Wisconsin/Milwaukee, WI, Milwaukee, WI, United States AU - Von Ballmoos, M. W. AU - Almassi, G. AU - Gandhi, S. DB - Embase DO - 10.1378/chest.2280176 KW - bone cement cement embolectomy thromboembolism hip arthroplasty human patient procedures diagnosis cardiopulmonary bypass fracture injection orthopedic surgery embolism Streptococcus pneumonia surgery risk factor pulmonary artery sternotomy alcohol abuse male emergency elective surgery consensus conservative treatment disease management hip filter infection immobilization pathology risk L1 - http://journal.publications.chestnet.org/article.aspx?articleID=2457115 LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 0012-3692 ST - Emergent embolectomy for massive intraoperative thromboembolism during total artificial hip replacement T2 - Chest TI - Emergent embolectomy for massive intraoperative thromboembolism during total artificial hip replacement UR - https://www.embase.com/search/results?subaction=viewrecord&id=L72120058&from=export http://dx.doi.org/10.1378/chest.2280176 VL - 148 ID - 829360 ER - TY - JOUR AB - OBJECTIVE: To describe the technique of percutaneous vertebroplasty and the short-term results in patients with symptomatic, osteoporotic vertebral compression fractures. DESIGN: Prospective follow-up study. METHOD: In a pilot-study to evaluate the short-term safety and effectiveness of percutaneous vertebroplasty, 18 consecutive patients with a total of 33 osteoporotic thoracic or lumbar vertebral compression fractures were treated from October 2001 to June 2002 with a follow-up of 3-6 months. The indication for treatment was a symptomatic, therapy-resistant osteoporotic vertebral compression fracture. Percutaneous vertebroplasty was performed under radiographic control, after previous intraossal venography, using bone cement mixed with barium sulphate. Post-procedural follow-up consisted of radiological evaluation with conventional thoracolumbar X-rays and MRI scans, and interviews of the patients. RESULTS: Percutaneous vertebroplasty was technically successful in 31 of 33 vertebral fractures (94%), and in 16 of 18 patients (89%). One patient with extreme venous contrast leakage could not be treated. Sixteen patients had less or no pain after treatment. One patient retained thoracolumbar back pain after inadequate cementations and refused further treatment. None of the patients reported aggravation of symptoms following the procedure. Contrast leakage was absent in 18 vertebrae. In 8 vertebrae there was contrast leakage to paravertebral veins. In three of these cases the leakage was so severe that embolisation was performed, with success in one case. In 13 vertebrae, cement leakage to intervertebral and paravertebral spaces and pedicular cement spurs were seen, without clinical consequences. Immediately after the procedure and during follow-up there were no clinically relevant complications. CONCLUSION: Percutaneous vertebroplasty was a technically feasible treatment in these patients with symptomatic, therapy-resistant, osteoporotic vertebral fractures. The first short-term results were comparable with results in the literature. A prospective randomised intervention study will be needed to compare percutaneous vertebroplasty with optimal conservative treatment. AD - Sint Elisabeth Ziekenhuis, Postbus 90.151, 5000 LC Tilburg. mhjvoorm@tiscali.nl AN - 12942845 AU - Voormolen, M. H. AU - Lohle, P. N. AU - Fransen, H. AU - Juttmann, J. R. AU - de Waal Malefijt, J. AU - Lampmann, L. E. DA - Aug 9 DP - NLM ET - 2003/08/29 J2 - Nederlands tijdschrift voor geneeskunde KW - Aged Aged, 80 and over Back Pain/surgery Cementation Female Follow-Up Studies Fractures, Spontaneous/etiology/*surgery Humans Lumbar Vertebrae/*injuries/surgery Male Middle Aged Osteoporosis/*complications Pilot Projects Postoperative Complications/epidemiology Prospective Studies Safety Spinal Fractures/etiology/*surgery Thoracic Vertebrae/*injuries/surgery Treatment Outcome LA - dut M1 - 32 N1 - PubMed NLM literature search January 5, 2021 OP - Percutane vertebroplastiek bij osteoporotische wervelinzakkingsfracturen: eerste kortetermijnresultaten. PY - 2003 SN - 0028-2162 (Print) 0028-2162 SP - 1549-53 ST - [Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: first short term results] T2 - Ned Tijdschr Geneeskd TI - [Percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures: first short term results] VL - 147 ID - 828771 ER - TY - JOUR AB - Objective. To describe the technique of percutaneous vertebroplasty and the short-term results in patients with symptomatic, osteoporotic vertebral compression fractures. Design. Prospective follow-up study. Method. In a pilot-study to evaluate the short-term safety and effectiveness of percutaneous vertebroplasty, 18 consecutive patients with a total of 33 osteoporotic thoracic or lumbar vertebral compression fractures were treated from October 2001 to June 2002 with a follow-up of 3-6 months. The indication for treatment was a symptomatic, therapy-resistant osteoporotic vertebral compression fracture. Percutaneous vertebroplasty was performed under radiographic control, after previous intraossal venography, using bone cement mixed with barium sulphate. Post-procedural follow-up consisted of radiological evaluation with conventional thoracolumbar X-rays and MRI scans, and interviews of the patients. Results. Percutaneous vertebroplasty was technically successful in 31 of 33 vertebral fractures (94%), and in 16 of 18 patients (89%). One patient with extreme venous contrast leakage could not be treated. Sixteen patients had less or no pain after treatment. One patient retained thoracolumbar back pain after inadequate cementations and refused further treatment. None of the patients reported aggravation of symptoms following the procedure. Contrast leakage was absent in 18 vertebrae. In 8 vertebrae there was contrast leakage to paravertebral veins. In three of these cases the leakage was so severe that embolisation was performed, with success in one case. In 13 vertebrae, cement leakage to intervertebral and paravertebral spaces and pedicular cement spurs were seen, without clinical consequences. Immediately after the procedure and during follow-up there were no clinically relevant complications. Conclusion. Percutaneous vertebroplasty was a technically feasible treatment in these patients with symptomatic, therapy-resistant, osteoporotic vertebral fractures. The first short-term results were comparable with results in the literature. A prospective randomised intervention study will be needed to compare percutaneous vertebroplasty with optimal conservative treatment. AD - M.H.J. Voormolen, Sint Elisabeth Ziekenhuis, Postbus 90.151, 5000 LC Tilburg, Netherlands AU - Voormolen, M. H. J. AU - Lohle, P. N. M. AU - Fransen, H. AU - Juttmann, J. R. AU - De Waal Malefijt, J. AU - Lampmann, L. E. H. DB - Embase Medline KW - barium sulfate bone cement article backache clinical article follow up fragility fracture human nuclear magnetic resonance imaging osteoporosis percutaneous vertebroplasty phlebography pilot study postoperative complication spine radiography surgical technique treatment indication spine fracture LA - Dutch M1 - 32 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2003 SN - 0028-2162 SP - 1549-1553 ST - Percutaneous vertebroplasty in osteoporotic vertebral compression fractures: First short-term results T2 - Nederlands Tijdschrift voor Geneeskunde TI - Percutaneous vertebroplasty in osteoporotic vertebral compression fractures: First short-term results UR - https://www.embase.com/search/results?subaction=viewrecord&id=L37069935&from=export VL - 147 ID - 829851 ER - TY - JOUR AB - Introduction: For the treatment of stable symptomatic vertebral fractures of osteoporotic, tumorous or traumatic origin, vertebroplasty and kyphoplasty are established as two safe minimally invasive surgical procedures. In 2008 an alternative procedure was introduced for the treatment of vertebral fractures of the thoracic and lumbar spine by Alphatec called Osseofix Spinal Fractures Reduction System. In this case a titanium cage is positioned into the fractured vertebra, subsequently expanded and filled with bone cement. The aim of this study was to evaluate the early outcome with view to pain reduction, extent of vertebral reconstruction and peri- and postoperative complications. Material and Methods: From September 2009 to March 2010, 30 patients (22 women, 8 men, average age 74.2 years, 58 to 93) with 47 acute fractures diagnosed by MRI (38 osteoporotic, 5 traumatic, 4 tumorous) and CT scan who did not respond to nonoperative treatment, were operated with the Osseofix System by bipedicular approach. AO classification: 27 A1.1, 5 A1.2, 9 A1.3, 6 A3.1. 28 patients were followed up clinically and by x-rays after an average of 8 weeks (4-12) postoperatively. Results: The back pain during motion determined by the VAS decreased significantly from pre-OP 8,2 ± 0,59 to 2,4 ± 0,95 at the 3.-5.postop.day and further to 1,7 ± 1,27 at the time of follow-up. The comparison of the pre- and postop. CT scan showed a reduction of the kyphotic angle by an average of 2,1°. The anterior vertebral body height showed an average increase of 1,0 mm in the sagittal CT scan, the middle vertebral body height increased by 1,4 mm. Both results were not significant. The mean operation time was 28min / vertebral body (vb) with a fluoroscopy time of 240s / vb. The average volume of cement applied / vb was 1,97ml (1,0 to 2,6ml). In 17% of all treated vertebral bodies a minimal asymptomatic cement leakage was found in the postoperative CT scan, without being visible on plain radiographs. No patient had surgery-related complications such as infection, bleeding, pulmonary embolism or neurological deficits. Nine (19%) of the operated vertebrae showed a height loss from 1 to 3mm in the radiological follow-up control; one of those was clinically symptomatic (VAS 5). In 4 cases this loss of reduction occurred in A1.1 and A3.1 fractures, once in A1.3 fracture. Two patients developed adjacent fractures above the initial treated vertebral body, two patients showed a more distant fracture. There was no neurological deterioration after the operation or during follow-up. Conclusion: The Osseofix System of intravertebral augmentation is a new effective, very safe and quick procedure for minimally invasive treatment of stable vertebral fractures. The handling of the expandable cage seems to be more precise than established, comparable methods. The patient safety is improved since the volume of cement used per vertebral body is much smaller and adverse cement leakage is reduced. With view to pain reduction, frequency of adjacent fractures and postoperative loss of reduction the procedure appears to be at least equivalent to the established procedures. AD - O. Waitz, Sana Klinikum Hof, Unfallchirurgie und Orthopädische Chirurgie, Hof, Germany AU - Waitz, O. AU - Schürmann, M. AU - Drexel, L. AU - Högemeier, U. DB - Embase DO - 10.1007/s00586-010-1601-9 KW - cement bone cement spine spine fracture inflatable penis prosthesis society minimally invasive procedure human fracture vertebra body patient computer assisted tomography procedures follow up vertebra body height pain kyphoplasty operation duration percutaneous vertebroplasty titanium cage backache classification conservative treatment lumbar spine deterioration height fluoroscopy minimally invasive surgery male lung embolism X ray film female postoperative complication bleeding infection patient safety surgery nuclear magnetic resonance imaging X ray LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0940-6719 SP - 2030 ST - Preliminary results of the minimally invasive treatment of stable vertebral fractures with expandable titan cages T2 - European Spine Journal TI - Preliminary results of the minimally invasive treatment of stable vertebral fractures with expandable titan cages UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71558006&from=export http://dx.doi.org/10.1007/s00586-010-1601-9 VL - 19 ID - 829641 ER - TY - JOUR AB - OBJECTIVE: This case describes symptomatic pulmonary cement embolism as a rare postvertebroplasty complication and highlights its critical yet ill-defined management. BACKGROUND: Pulmonary cement embolism (PCE) is a feared complication of vertebroplasty in the treatment of vertebral fractures. While the majority of PCEs are asymptomatic, symptomatic PCEs often present with chest pain, tachycardia, signs of severe respiratory distress, and death. Computer tomography angiogram (CTA) allows visualization of cement within the pulmonary vasculature. Despite the well-established risk of PCE, clinical management is unclear with limited research on treatment options. Reported treatments include anticoagulation, embolectomy, CPR, and supportive care and observation. Report. We report the case of a 75-year-old woman who experienced shortness of breath, tachypnea, tachycardia, hypertension, and hypoxemia five days following a corrective surgery for a compression fracture of L3 with pedicle screw fixation, fusion of L2 through L4, and L2 vertebral body cement augmentation with polymethyl methacrylate. RESULTS: Breath sounds were diminished bilaterally with respiratory alkalosis and hypoxemia evident on arterial blood gas. CTA revealed intravasated cement throughout the right lung, including the pulmonary artery and upper and middle lobar arteries. The proposed mechanism is embolization of cement particles from the lumbar veins, which also showed intravasation. Due to the inorganic nature of the occluding material, the use of a thrombolytic agent was ruled against. Treatment included bronchodilators, 3 L of oxygen via nasal cannula, and prophylactic antibiotics, pulmonary toilet, and incentive spirometry. Symptomatic management was continued until she was discharged from the hospital in a stable condition. CONCLUSIONS: Postvertebroplasty pulmonary cement embolisms can be managed conservatively, without the use of anticoagulant or thrombolytic agents. This case illustrates a variation of care for this rare presentation and adds to the sparse literature on the management of PCEs. AD - University of Central Florida College of Medicine, Orlando, FL, USA. Advent Health, Orlando, FL, USA. AN - 32566322 AU - Waler, A. R. AU - Sanchez, K. J. AU - Parikh, A. A. AU - Okorie, O. N. C2 - Pmc7293736 DO - 10.1155/2020/2425973 DP - NLM ET - 2020/06/23 J2 - Case reports in critical care LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 2090-6420 (Print) 2090-6420 SP - 2425973 ST - A Case of Pulmonary Cement Embolism Managed through Symptomatic Treatment T2 - Case Rep Crit Care TI - A Case of Pulmonary Cement Embolism Managed through Symptomatic Treatment VL - 2020 ID - 828598 ER - TY - JOUR AB - Background: For cement augmentation of pedicle screws there is a variety of different types of screws and cement variants. Cement leakage into segmental veins is a well known problem, which often leads to, mostly inapparent pulmonary embolisms, mainly when using the standard-PMMA cement. We describe a major complication during cement augmentation of pedicle screws with highly viscous cement (Confidence®), which lead to a continuous transvenous cement leakage from the segmental vein of L1, passing the caval vein into the right atrium. Case Report: The 62-year-old woman was transferred to our department for treatment of a complex Th12 fracture. This fracture was alread pre-treated in a different hospital with transpedicular kyphoplasty and a dorsal screw-rod instrumentation Th11 to L1. Due to a severe osteoporosis, there was dislocation of the internal osteosynthesis, which made an operative removal of the complete system necessary. In the following course, a further sintering of the augmented Th12 fracture could be seen, that lead to a fragment dislocation into the spinal canal and consecutive compression of the spinal cord. Finally, we saw the indication for a dorsal instrumentation Th10/11 to L1/2 with cement augmented pedicle screws and laminectomy of Th12 for decompression of the spinal cord. During the operative procedure, we saw a clear cement leakage into the segmental vein of L1 and an instant drainage into the inferior caval vein. In the thoracic CT, a continuous cement string, leading into the right atrium and causing a myocardial injury could be confirmed. This cement string had to be removed by our cardiac surgeons, using a minimal invasive, endoscopically-assisted transatrial approach under heart-lung machine. The patient revcovered from these procedures completely cardio-pulmonal compensated without any neurological deficit and could already be transferred to a further rehabilitation treatment. Discussion: In contrast to the more liquid PMMA-cement, the application of highly viscous cement types during augmentation of pedicle screws, is thought to be connected with an increase in safety referring to complications due to cement leakage. This case shows impressively the possibility of major complications, which are, despite the higher cement viscosity, inherent to the procedure. The theoretically postulated lower frequency of pulmonary embolisms, due to smaller cement leakages, is offset by the possibility of a massive irritation of the cardio-pulmonary system, which may be caused by the higher application pressure, followed by major cement leakages. To the best of our knowledge, this is the first presentation of a dramatic complication with transvenous cement leakage into the right atrium and consecutive myocardial injury during augmentation of pedicle screws using highly viscous cement. AD - J. Walter, Friedrich-Schiller-Universität, Klinik für Neurochirurgie, Jena, Germany AU - Walter, J. AU - Waschke, A. AU - Reichart, R. AU - Kalff, R. AU - Ewald, C. DB - Embase DO - 10.1007/s00586-010-1601-9 KW - cement spine heart muscle injury fracture intramedullary nailing society heart right atrium pedicle screw human vein procedures spinal cord lung embolism devices rehabilitation patient female heart lung machine case report cardiac surgeon inferior cava vein cava vein decompression laminectomy compression vertebral canal osteosynthesis osteoporosis kyphoplasty liquid viscosity safety hospital LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0940-6719 SP - 1993-1994 ST - Transvenous cement leakage into the right atrium and consecutive myocardial injury during cement augmented dorsal screw-rod fixation of a Th12 fracture T2 - European Spine Journal TI - Transvenous cement leakage into the right atrium and consecutive myocardial injury during cement augmented dorsal screw-rod fixation of a Th12 fracture UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71557913&from=export http://dx.doi.org/10.1007/s00586-010-1601-9 VL - 19 ID - 829638 ER - TY - JOUR AB - OBJECTIVE In this case series, the authors evaluated the safety of balloon kyphoplasty at 4 or more vertebral levels in a single anesthetic session. The current standard is that no more than 3 levels should be cemented at one time because of a perceived risk of increased complications. METHODS A retrospective chart review was performed for 19 consecutive patients who underwent ≥ 4-level balloon kyphoplasty between July 1, 2011, and December 31, 2015. Outcomes documented included kyphoplasty-associated complications and incidences of subsequent vertebral fracture. RESULTS Nineteen patients aged 22 to 95 years (mean 66.1 years, median 66 years; 53% male, 47% female) had 4 or more vertebrae cemented during the same procedure (mean 4.6 levels [62 thoracic, 29 lumbar]). No postoperative anesthetic complication, infection, extensive blood loss, symptomatic cement leakage, pneumothorax, or new-onset anemia was observed. Five patients experienced new compression fracture within a mean of 278 days postoperatively. One patient with metastatic cancer suffered bilateral pulmonary embolism 19 days after surgery, but no evidence of cement in the pulmonary vasculature was found. CONCLUSIONS In this case series, kyphoplasty performed on 4 or more vertebral levels was not found to increase risk to patient safety, and it might decrease unnecessary risks associated with multiple operations. Also, morbidity associated with leaving some fractures untreated because of an unfounded fear of increased risk of complications might be decreased by treating 4 or more levels in the same anesthetic session. AD - 1Department of Neurosurgery, Oakland University William Beaumont School of Medicine, Rochester; and. 2Michigan Head & Spine Institute, Southfield, Michigan. AN - 29372861 AU - Wang, A. C. AU - Fahim, D. K. DA - Apr DO - 10.3171/2017.8.spine17358 DP - NLM ET - 2018/01/27 J2 - Journal of neurosurgery. Spine KW - Adult Aged Aged, 80 and over Anesthetics Female Fractures, Compression/*surgery Humans *Kyphoplasty/adverse effects/methods Lumbar Vertebrae/surgery Male Middle Aged Osteoporotic Fractures/*surgery Retrospective Studies Spinal Fractures/*surgery Thoracic Vertebrae/surgery Treatment Outcome Vertebroplasty/adverse effects/methods Young Adult *4 or more levels *BMI = body mass index *DVT = deep vein thrombosis *ME = morphine equivalent *PE = pulmonary embolism *VNRS = verbal numerical rating scale *kyphoplasty *safety *surgical technique *vertebral compression fractures LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 1547-5646 SP - 372-378 ST - Safety and efficacy of balloon kyphoplasty at 4 or more levels in a single anesthetic session T2 - J Neurosurg Spine TI - Safety and efficacy of balloon kyphoplasty at 4 or more levels in a single anesthetic session VL - 28 ID - 828594 ER - TY - JOUR AB - BACKGROUND CONTEXT: Aggressive (Enneking stage 3, S3) vertebral hemangiomas (VHs) are rare, which might require surgery. However, the choice of surgery for S3 VHs remains controversial because of the rarity of these lesions. PURPOSE: We reported our experience of treating S3 VHs, and evaluated the effectiveness and safety of intraoperative vertebroplasty during decompression surgery for S3 VHs. STUDY DESIGN: This is a retrospective study. PATIENT SAMPLE: Thirty-nine patients with a definitive pathologic diagnosis of aggressive VHs who underwent primary decompression surgery in our department were included in this study. OUTCOME MEASURES: Basic data such as surgical procedure, surgical duration, estimated blood loss during surgery, and pathology were collected. The modified Frankel grade was used to evaluate neurologic function. Enneking staging was based on radiological findings. METHODS: We retrospectively examined aggressive VHs with neurologic deficits. Surgery was indicated if the neurologic deficit was severe or developed quickly or if radiotherapy was ineffective. Decompression surgery was performed. Intraoperative vertebroplasty during posterior decompression has been used since 2009. If contrast-enhanced computed tomography (CT) revealed a residual lesion, we recommended adjuvant radiotherapy with 40-50 Gy to prevent recurrence. Patients' basic and surgical information was collected. The minimum follow-up duration was 18 months. This study was partially funded by Peking University Third Hospital, Grant no. Y71508-01. RESULTS: Average age of the 39 patients with S3 VHs who underwent primary decompression surgery was 46.2 (range, 10-69) years. All patients had neurologic deficits caused by aggressive VHs. Aggressive VH lesions were located in the cervical, thoracic, and lumbar spine in 2, 32, and 5 patients, respectively. The decompression-alone group had 17 patients, and the decompression plus intraoperative vertebroplasty group had 22. There were no statistically significant intergroup differences in preoperative information (p>. 05). The average estimated blood losses were 1,764.7 mL (range, 500-4,000 mL) and 1,068.2 mL (range, 300-3,000 mL) in the decompression-alone group and decompression plus vertebroplasty group, respectively (p=. 017). One patient who underwent primary decompression alone without adjuvant radiotherapy experienced recurrence after the first decompression. The average follow-up was 50.2 (range, 18-134) months, and no cases of recurrence were observed at the last follow-up. CONCLUSIONS: Our results suggest that posterior decompression effectively provides symptom relief in patients with aggressive (S3)VHs with severe spinal cord compression. Intraoperative vertebroplasty is a safe and effective method for minimizing blood loss during surgery, whereas adjuvant radiotherapy or vertebroplasty helps in minimizing recurrence after decompression. (C) 2017 Elsevier Inc. All rights reserved. AD - [Wang, Ben; Liu, Xiao Guang; Wei, Feng; Liu, Zhong Jun] Peking Univ, Hosp 3, Orthopaed Dept, 49 North Garden Rd, Beijing 100191, Peoples R China. [Wang, Ben] Peking Univ, Hlth & Sci Ctr, 38 Xueyuan Rd, Beijing 100191, Peoples R China. [Han, Song Bo; Jiang, Liang] Peking Univ, Hosp 3, Dept Radiol, 49 North Garden Rd, Beijing 100191, Peoples R China. [Yang, Shao Min] Peking Univ, Hlth Ctr, Dept Pathol, 38 Xueyuan Rd, Beijing 100191, Peoples R China. [Meng, Na] Peking Univ, Hosp 3, Dept Radiotherapy, 49 North Garden Rd, Beijing 100191, Peoples R China. Jiang, L (corresponding author), Peking Univ, Hosp 3, Orthopaed Dept, 49 North Garden Rd, Beijing 100191, Peoples R China.; Jiang, L (corresponding author), Peking Univ, Hosp 3, Dept Radiol, 49 North Garden Rd, Beijing 100191, Peoples R China. jiangliang@bjmu.edu.cn AN - WOS:000438471500004 AU - Wang, B. AU - Han, S. B. AU - Jiang, L. AU - Liu, X. G. AU - Yang, S. M. AU - Meng, N. AU - Wei, F. AU - Liu, Z. J. DA - Jul DO - 10.1016/j.spinee.2017.11.003 J2 - Spine Journal KW - Aggressive vertebral hemangioma Blood loss Decompression surgery Enneking stage Intraoperative vertebroplasty Surgical management SPINAL-CORD COMPRESSION NATURAL-HISTORY FOLLOW-UP MANAGEMENT ALCOHOL EMBOLIZATION RADIOTHERAPY DIAGNOSIS ETHANOL Clinical Neurology Orthopedics LA - English M1 - 7 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 1529-9430 SP - 1128-1135 ST - Intraoperative vertebroplasty during surgical decompression and instrumentation for aggressive vertebral hemangiomas: a retrospective study of 39 patients and review of the literature T2 - Spine Journal TI - Intraoperative vertebroplasty during surgical decompression and instrumentation for aggressive vertebral hemangiomas: a retrospective study of 39 patients and review of the literature UR - ://WOS:000438471500004 VL - 18 ID - 830162 ER - TY - JOUR AB - Background: Vertebral hemangioma (VH) is one of the most common benign spinal tumors and can be aggressive in some cases. While most aggressive VHs have typical radiographic features, including vertical striations, a honeycomb appearance, and/or a "polka-dot sign" in computed tomography (CT) scans, cases with atypical features might complicate diagnosis. This study aimed to determine the range and frequency of these features. Methods: In this retrospective study, to identify the typical and atypical features of aggressive VH, pretreatment CT and magnetic resonance imaging (MRI) were reviewed retrospectively by 1 radiologist and 1 orthopaedic surgeon. Percutaneous biopsies were performed to confirm the VH in atypical cases. Results: A total of 95 patients with aggressive VHs were treated in our hospital from January 2005 to December 2017. Thirty-four (36%) of the lesions showed at least 1 atypical radiographic feature: 16 patients (17%) had a vertebral compression fracture, 11 patients (12%) had expansive and/or osteolytic bone destruction without a honeycomb appearance and/or "polka-dot sign", 11 patients (12%) had obvious epidural osseous compression of the spinal cord, 12 patients (13%) had involvement of >1 segment, 9 patients (10%) had a VH centered in the pedicle and/or lamina, and 8 patients (8%) had atypical MRI signals. Forty-three patients underwent percutaneous biopsies, which had an accuracy of 86%. Conclusions: Based on radiographic analysis, aggressive VH can be classified as typical or atypical. More than one-third of aggressive VH lesions may have at least 1 atypical feature. CT-guided biopsies are indicated for these atypical cases. AD - [Wang, Ben; Zhang, Lihua; Yang, Shaomin; Han, Songbo; Jiang, Liang; Wei, Feng; Yuan, Huishu; Liu, Xiaoguang; Liu, Zhongjun] Peking Univ, Hosp 3, Beijing, Peoples R China. [Wang, Ben; Jiang, Liang; Wei, Feng; Liu, Xiaoguang; Liu, Zhongjun] Peking Univ, Hosp 3, Orthopaed Dept, Beijing, Peoples R China. [Zhang, Lihua; Han, Songbo; Yuan, Huishu] Peking Univ, Hosp 3, Dept Radiol, Beijing, Peoples R China. [Yang, Shaomin] Peking Univ, Hlth & Sci Ctr, Dept Pathol, Beijing, Peoples R China. [Wang, Ben] Peking Univ, Hlth & Sci Ctr, Beijing, Peoples R China. Jiang, L (corresponding author), Peking Univ, Hosp 3, Orthopaed Dept, Beijing, Peoples R China.; Jiang, L (corresponding author), Peking Univ, Hosp 3, Dept Radiol, Beijing, Peoples R China. jiangliang@bjmu.edu.cn; liuzj@bjmu.edu.cn AN - WOS:000474366000010 AU - Wang, B. AU - Zhang, L. H. AU - Yang, S. M. AU - Han, S. B. AU - Jiang, L. AU - Wei, F. AU - Yuan, H. S. AU - Liu, X. G. AU - Liu, Z. J. DA - Jun DO - 10.2106/jbjs.18.00746 J2 - J. Bone Joint Surg.-Am. Vol. KW - SPINAL-CORD COMPRESSION FOLLOW-UP SURGICAL-MANAGEMENT THORACIC HEMANGIOMA NATURAL-HISTORY CASE SERIES ACUTE ONSET VERTEBROPLASTY EMBOLIZATION RADIOTHERAPY Orthopedics Surgery LA - English M1 - 11 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2019 SN - 0021-9355 SP - 979-986 ST - Atypical Radiographic Features of Aggressive Vertebral Hemangiomas T2 - Journal of Bone and Joint Surgery-American Volume TI - Atypical Radiographic Features of Aggressive Vertebral Hemangiomas UR - ://WOS:000474366000010 VL - 101 ID - 830137 ER - TY - JOUR AB - BACKGROUND: Major blood loss is unavoidable after primary total knee arthroplasty (TKA). The aim of this study was to determine if tranexamic acid (TXA) can reduce major blood loss following TKA. METHODS: In this double‐blind, randomized, placebo‐control trial, 60 patients treated with unilateral primary cement TKA between August 1st 2013 and September 30th 2013 were randomized into TXA 500 mg intra‐articular injection without drainage (test group, 30 knees) and 30 patients with saline intra‐articular injection (control group, 30 knees). RESULTS: There was a significant reduction in mean blood loss (560.55 mL) between the groups at postoperative day (POD) 5 (999.22 mL vs. 1559.77 mL, P = 0.001). The maximum hemoglobin drop was identified at POD 3 (10.51 g/dL vs. 9.10 g/dL, mean difference = 1.41 g/dL). Also, there was a significant reduction in red blood cell and hematocrit loss (P = 0.001). The transfusion rates (0% vs. 23.3%, P = 0.011) and average amount transfused (0.00 ± 0.00 units vs. 0.53 ± 1.04 units, P = 0.009) were significantly lower in the TXA group compared with control group. No significant difference in coagulation marker changes were found between TXA and control groups (P > 0.05), but the D‐dimer levels at 3 and 5 days post‐TKA were statistically lower in the TXA group (P < 0.05). No significant changes in the rate of symptomatic deep venous thrombosis, pulmonary embolism, or wound healing problems were noted. CONCLUSIONS: TXA treatment without drainage during TKA reduces the amount of blood transfusions required without increasing the rate of adverse events. AN - CN-01257749 AU - Wang, C. G. AU - Sun, Z. H. AU - Liu, J. AU - Cao, J. G. AU - Li, Z. J. DO - 10.1016/j.ijsu.2015.05.045 KW - Aged Antifibrinolytic Agents [*administration & dosage] Arthroplasty, Replacement, Knee [adverse effects] Blood Loss, Surgical Blood Transfusion Double‐Blind Method Drainage Female Fibrin Fibrinogen Degradation Products Humans Injections, Intra‐Articular Male Middle Aged Osteoarthritis, Knee [surgery] Postoperative Hemorrhage [prevention & control] Tranexamic Acid [*administration & dosage] M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2015 SP - 1‐7 ST - Safety and efficacy of intra-articular tranexamic acid injection without drainage on blood loss in total knee arthroplasty: a randomized clinical trial T2 - International journal of surgery (london, england) TI - Safety and efficacy of intra-articular tranexamic acid injection without drainage on blood loss in total knee arthroplasty: a randomized clinical trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01257749/full VL - 20 ID - 830028 ER - TY - JOUR AB - Background: Major blood loss is unavoidable after primary total knee arthroplasty (TKA). The aim of this study was to determine if tranexamic acid (TXA) can reduce major blood loss following TKA.Methods: In this double-blind, randomized, placebo-control trial, 60 patients treated with unilateral primary cement TKA between August 1st 2013 and September 30th 2013 were randomized into TXA 500 mg intra-articular injection without drainage (test group, 30 knees) and 30 patients with saline intra-articular injection (control group, 30 knees).Results: There was a significant reduction in mean blood loss (560.55 mL) between the groups at postoperative day (POD) 5 (999.22 mL vs. 1559.77 mL, P = 0.001). The maximum hemoglobin drop was identified at POD 3 (10.51 g/dL vs. 9.10 g/dL, mean difference = 1.41 g/dL). Also, there was a significant reduction in red blood cell and hematocrit loss (P = 0.001). The transfusion rates (0% vs. 23.3%, P = 0.011) and average amount transfused (0.00 ± 0.00 units vs. 0.53 ± 1.04 units, P = 0.009) were significantly lower in the TXA group compared with control group. No significant difference in coagulation marker changes were found between TXA and control groups (P > 0.05), but the D-dimer levels at 3 and 5 days post-TKA were statistically lower in the TXA group (P < 0.05). No significant changes in the rate of symptomatic deep venous thrombosis, pulmonary embolism, or wound healing problems were noted.Conclusions: TXA treatment without drainage during TKA reduces the amount of blood transfusions required without increasing the rate of adverse events. AN - 109621521. Language: English. Entry Date: 20150923. Revision Date: 20200708. Publication Type: journal article AU - Wang, Chen-Guang AU - Sun, Zhen-Hui AU - Liu, Jun AU - Cao, Jian-Gang AU - Li, Zhi-Jun DB - cin20 DO - 10.1016/j.ijsu.2015.05.045 DP - EBSCOhost N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2015 SN - 1743-9191 SP - 1-7 ST - Safety and efficacy of intra-articular tranexamic acid injection without drainage on blood loss in total knee arthroplasty: A randomized clinical trial T2 - International Journal of Surgery TI - Safety and efficacy of intra-articular tranexamic acid injection without drainage on blood loss in total knee arthroplasty: A randomized clinical trial UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=109621521&site=ehost-live&scope=site VL - 20 ID - 830610 ER - TY - JOUR AB - BACKGROUND: Percutaneous vertebroplasty is a widely used vertebral augmentation procedure for treating osteoporotic vertebral compression fractures (OVCFs). But high cement leakage rate caused by a low-viscosity cement and high injection pressure has limited its general use. Balloon kyphoplasty (BKP) and high-viscosity cement vertebroplasty (HVCV) are 2 modifications of vertebroplasty designed to decrease cement leakage. OBJECTIVE: To assess the safety and efficacy of HVCV compared with BKP. STUDY DESIGN: A prospective cohort study. SETTING: Department of Spine Surgery, an affiliated hospital of a medical university. METHOD: One hundred seven patients suffering from painful OVCFs were randomly assigned into HVCV or BKP groups. Visual Analog Scale (VAS), Oswestry Disability Index (ODI), cement leakage, and vertebral height restoration were evaluated. All occurring complications and injected cement volumes were recorded. The follow-up time was one year. RESULTS: VAS and ODI scores improved in both groups, and did not differ significantly between the 2 groups. More cement was used in the BKP group than in HVCV group (4.22 vs. 3.31 mL, P < 0.0001). The incidence of cement leakage in the HVCV group was lower than that of the BKP group (13.24% vs 30.56%, P < 0.05). No symptomatic cement leakages occurred in the HVCV group. In the BKP group, one patient experienced discogenic back pain related to a disc leak, and another patient had asymptomatic cement emboli in the lung related to venous leakage. The mean compression rate before the procedure was 29.98% in the HVCV group and 28.67% in the BKP group (P = 0.94). The vertebral height was improved significantly and maintained at one-year follow-up in both groups. BKP was more effective in vertebral height restoration than HVCV (44.87% vs. 23.93%, P < 0.0001). There was one case of a new adjacent vertebral fracture in the HVCV group (2%), and 4 cases of new nonadjacent vertebral fractures in the BKP group (7.84%) (P = 0.18). LIMITATIONS: A single-center and relatively small-sample size study. CONCLUSION: HVCV and BKP are safe and effective in improving quality of life and relieving pain. HVCV has a lower cement leakage rate, whereas BKP is more effective in vertebral height restoration. Subsequent fractures are not different between the 2 groups. AD - Department of Spine Surgery, Qilu Hospital, Shandong University, P.R. China; Department of Orthopedics, Liaocheng People's Hospital, P.R. China; Department of Radiology, Liaocheng People's Hospital, Liaocheng, P.R. China. AN - 25794218 AU - Wang, C. H. AU - Ma, J. Z. AU - Zhang, C. C. AU - Nie, L. DA - Mar-Apr DP - NLM ET - 2015/03/21 J2 - Pain physician KW - Aged Aged, 80 and over Bone Cements/chemistry/*standards Cohort Studies Female Follow-Up Studies Fractures, Compression/diagnostic imaging/*surgery Humans Kyphoplasty/methods/*standards Male Middle Aged Osteoporotic Fractures/diagnostic imaging/*surgery Pain/diagnostic imaging/surgery Pain Measurement/methods Prospective Studies Radiography Spinal Fractures/diagnostic imaging/*surgery Treatment Outcome Vertebroplasty/methods/*standards Viscosity LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 1533-3159 SP - E187-94 ST - Comparison of high-viscosity cement vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures T2 - Pain Physician TI - Comparison of high-viscosity cement vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures VL - 18 ID - 828657 ER - TY - JOUR AB - Background: Percutaneous vertebroplasty is a widely used vertebral augmentation procedure for treating osteoporotic vertebral compression fractures (OVCFs). But high cement leakage rate caused by a low-viscosity cement and high injection pressure has limited its general use. Balloon kyphoplasty (BKP) and high-viscosity cement vertebroplasty (HVCV) are 2 modifications of vertebroplasty designed to decrease cement leakage.Objective: To assess the safety and efficacy of HVCV compared with BKP.Study Design: A prospective cohort study.Setting: Department of Spine Surgery, an affiliated hospital of a medical university.Method: One hundred seven patients suffering from painful OVCFs were randomly assigned into HVCV or BKP groups. Visual Analog Scale (VAS), Oswestry Disability Index (ODI), cement leakage, and vertebral height restoration were evaluated. All occurring complications and injected cement volumes were recorded. The follow-up time was one year.Results: VAS and ODI scores improved in both groups, and did not differ significantly between the 2 groups. More cement was used in the BKP group than in HVCV group (4.22 vs. 3.31 mL, P < 0.0001). The incidence of cement leakage in the HVCV group was lower than that of the BKP group (13.24% vs 30.56%, P < 0.05). No symptomatic cement leakages occurred in the HVCV group. In the BKP group, one patient experienced discogenic back pain related to a disc leak, and another patient had asymptomatic cement emboli in the lung related to venous leakage. The mean compression rate before the procedure was 29.98% in the HVCV group and 28.67% in the BKP group (P = 0.94). The vertebral height was improved significantly and maintained at one-year follow-up in both groups. BKP was more effective in vertebral height restoration than HVCV (44.87% vs. 23.93%, P < 0.0001). There was one case of a new adjacent vertebral fracture in the HVCV group (2%), and 4 cases of new nonadjacent vertebral fractures in the BKP group (7.84%) (P = 0.18).Limitations: A single-center and relatively small-sample size study.Conclusion: HVCV and BKP are safe and effective in improving quality of life and relieving pain. HVCV has a lower cement leakage rate, whereas BKP is more effective in vertebral height restoration. Subsequent fractures are not different between the 2 groups. AN - 109713483. Language: English. Entry Date: 20150923. Revision Date: 20151028. Publication Type: journal article. Journal Subset: Biomedical AU - Wang, Cheng-Hu AU - Ma, Jin-Zhu AU - Zhang, Chuan-Chen AU - Nie, Lin DB - cin20 DP - EBSCOhost M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2015 SN - 1533-3159 SP - E187-94 ST - Comparison of high-viscosity cement vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures T2 - Pain Physician TI - Comparison of high-viscosity cement vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=109713483&site=ehost-live&scope=site VL - 18 ID - 830619 ER - TY - JOUR AB - BACKGROUND AND PURPOSE: The incidence of deep vein thrombosis (DVT) after total knee arthroplasty (TKA) in the Asian population is probably higher than is commonly assumed by clinicians. The purpose of this study was to investigate the incidence of DVT after TKA in a southern Taiwanese population and to determine whether routine prophylaxis against DVT is indicated. MATERIALS AND METHODS: The incidence of DVT was investigated in 107 ascending venograms performed in 105 knees in 102 patients after TKA. Observations were made and interpreted by orthopedic radiologists blinded to the clinical condition of the patients. The correlation of DVT with the medical conditions, anesthesia type, and local physical findings were analyzed. RESULTS: The overall incidence of DVT after TKA was 63.6% (68/107); 95.6% (63/68) of cases involved the distal veins in the calf and only 4.4% (3/68) involved the proximal vein at the popliteal level. There was no higher incidence of thrombosis in the femoral and iliac veins, and no pulmonary embolism. Approximately 70% of patients with DVT were symptomatic and required treatment. There was no statistically significant correlation of DVT with medical condition, including diabetes mellitus, hypertension, body weight, varicosity, history of thromboembolic disorder and congestive heart failure, or the type of anesthesia or bone cement used. There was a positive correlation of DVT with local physical findings including calf girth enlargement, leg edema, and skin discoloration, and a negative correlation with findings including Homans' sign, cord induration, venous engorgement, and knee effusion. CONCLUSION: The incidence of DVT after TKA in this southern Taiwanese cohort was similar to that in Western populations, and higher than is commonly assumed by clinicians at this facility. However, the rate of proximal thrombosis and pulmonary embolism was much lower than in previous studies from Western populations. The majority of cases of DVT involved the veins in the calf; approximately 70% of patients were symptomatic and required treatment. AD - Department of Orthopedic Surgery, Chang Gung Memorial Hospital at Kaohsiung, 123 Ta-Pei Road, Niao Sung Hsiang, Kaohsiung, Taiwan. AN - 11155775 AU - Wang, C. J. AU - Wang, J. W. AU - Chen, L. M. AU - Chen, H. S. AU - Yang, B. Y. AU - Cheng, S. M. DA - Nov DP - NLM ET - 2001/01/13 J2 - Journal of the Formosan Medical Association = Taiwan yi zhi KW - Aged Aged, 80 and over Arthroplasty, Replacement, Knee/*adverse effects Female Humans Incidence Leg/blood supply Male Middle Aged Risk Factors Taiwan/epidemiology Venous Thrombosis/epidemiology/*etiology/prevention & control LA - eng M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 2000 SN - 0929-6646 (Print) 0929-6646 SP - 848-53 ST - Deep vein thrombosis after total knee arthroplasty T2 - J Formos Med Assoc TI - Deep vein thrombosis after total knee arthroplasty VL - 99 ID - 828866 ER - TY - JOUR AB - OBJECTIVE: To study the effectiveness of tibial transverse transport combined with the antibiotics embedded bone cement in the treatment of chronic infection of foot and ankle with lower extremity ischemic diseases. METHODS: A retrospective analysis was performed on 28 patients with ischemic diseases of lower extremities associated with chronic foot and ankle infection who were treated with tibial transverse transport combined with antibiotic bone cement between August 2015 and October 2019. There were 22 males and 6 females, with an average age of 65.6 years (range, 41-86 years). There were 25 cases of diabetic foot, 2 cases of arteriosclerosis obliterans, and 1 case of thromboangiitis obliterans. The course of infection ranged from 1 to 27 years, with an average of 14.9 years. The healing condition and time of foot and ankle in all patients were recorded and compared, and the Wagner grading and WIFi (W: lower extremity wound classification; I: ischemic classification; Fi: foot infection classification) grading were compared before and at last follow-up. RESULTS: The wound surface of 1 diabetic foot patient improved at 111 days after operation, without purulent secretion, and lost follow-up. The remaining 27 cases were followed up 5 to 21 months (mean, 8.4 months). There was no necrosis in the tibial osteotomy incision and the local flap. After operation, 21 cases showed needle reaction of external fixator, but the needle infection gradually improved after the corresponding treatment. Among the 24 patients with diabetic foot, 1 died of multiple organ failure due to pulmonary infection. Acute lower extremity vascular embolism occurred in 1 case, and the foot was amputated due to acute gangrene. In the remaining 22 cases, the wound healing time of foot and ankle was 2.5-11.0 months (mean, 4.6 months). At last follow-up, Wagner grading and WIFi grading of the patients were significantly improved when compared with those before operation ( P<0.05). One patient with thromboangiitis obliterans had foot and ankle healing at 6 months after operation. Two patients with lower extremity arteriosclerosis obliterans had foot and ankle healing at 16 and 18 months after operation, respectively. CONCLUSION: Tibial transverse transport combined with the antibiotics embedded bone cement is effective in treating chronic infection of foot and ankle with lower extremity ischemic diseases. AD - Department of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan Shanxi, 030001, P.R.China. Department of Orthopaedics, Rehabilitation Hospital of the National Research Center for Rehabilitation Technical Aids, Beijing, 100176, P.R.China. AN - 32794665 AU - Wang, D. AU - Zhang, Y. AU - He, G. AU - Zhang, X. AU - Qin, S. DA - Aug 15 DO - 10.7507/1002-1892.202003098 DP - NLM ET - 2020/08/15 J2 - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery KW - Adult Aged Aged, 80 and over *Ankle Anti-Bacterial Agents Bone Cements Female Humans *Infections Lower Extremity Male Middle Aged Retrospective Studies Treatment Outcome Tibial transverse transport arteriosclerosis obliterans chronic infection of foot and ankle diabetic foot thromboangiitis obliterans LA - chi M1 - 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 1002-1892 (Print) 1002-1892 SP - 979-984 ST - [Clinical study on treatment of chronic infection of foot and ankle with lower extremity ischemic diseases by tibial transverse transport combined with antibiotic embedded bone cement] T2 - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi TI - [Clinical study on treatment of chronic infection of foot and ankle with lower extremity ischemic diseases by tibial transverse transport combined with antibiotic embedded bone cement] VL - 34 ID - 828637 ER - TY - JOUR AB - The incidence of osteoporotic vertebral compression fracture (OVCF) is increased recently. Percutaneous kyphoplasty (PKP) has recently been shown to have a curative effect on OVCF. Unfortunately, related complications arising from PKP cannot be ignored, such as cement leaks, fever, and intercostal neuralgia. This study aimed to investigate the common complications of PKP in the treatment of OVCF patients and analyze the causes and assess prevention and control measures. A total of 196 patients (204 vertebrae) underwent PKP procedures at the Department of Spine Surgery, Shenzhen Sixth People's Hospital, Guangdong, China, from June 2004 to August 2010. The data on incidence rates of the various complications were compiled. All patients were successfully operated without death, paraplegia, or pulmonary embolism. Incidence of various complications resulting from different types of bone cement leakage was 27.45 %, including 0.51 % for postoperative elevated fever, 4.08 % for intercostal neuralgia, 2.55 % for trailing of bone cement, 0.51 % for refracture at adjacent vertebrae, and 0.51 % for cerebrospinal fluid leakage. These results suggest that PKP is an effective surgical technique for the treatment of OVCF, resulting in limited trauma with satisfactory curative effects. Skillful mastery of this technology will help reduce the incidence rate of complications. AD - Department of Spine Surgery, Shenzhen Sixth People's Hospital, 89 Taoyuan Road, Shenzhen, 518052, Guangdong, China. ertianwang@126.com AN - 23417109 AU - Wang, E. AU - Yi, H. AU - Wang, M. AU - Huang, C. DA - Jul DO - 10.1007/s00590-013-1187-0 DP - NLM ET - 2013/02/19 J2 - European journal of orthopaedic surgery & traumatology : orthopedie traumatologie KW - Aged Aged, 80 and over Cementation/*adverse effects China/epidemiology Female *Fever/epidemiology/etiology/prevention & control Fractures, Compression/surgery Humans Incidence Intercostal Nerves/*physiopathology Kyphoplasty/*adverse effects/methods/statistics & numerical data Male Middle Aged *Neuralgia/epidemiology/etiology/physiopathology/prevention & control Osteoporotic Fractures/*surgery Outcome and Process Assessment, Health Care *Postoperative Complications/epidemiology/etiology/physiopathology/prevention & control Severity of Illness Index Spinal Fractures/surgery LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1633-8065 (Print) 1633-8065 SP - S71-5 ST - Treatment of osteoporotic vertebral compression fractures with percutaneous kyphoplasty: a report of 196 cases T2 - Eur J Orthop Surg Traumatol TI - Treatment of osteoporotic vertebral compression fractures with percutaneous kyphoplasty: a report of 196 cases VL - 23 Suppl 1 ID - 828712 ER - TY - JOUR AB - BACKGROUND: Vertebral metastases are the most frequent vertebral tumor. Transarterial embolization (TAE) devascularizes the tumor, resulting in tumor necrosis. Percutaneous vertebroplasty (PVP), a minimally invasive procedure, can effectively relieve tumor-related pain and improve spine stability. Unfortunately, the PVP technique is of limited use in controlling the progression of vertebral tumor, especially for paravertebral metastases. TAE combined with PVP may achieve a better control on vertebral metastases with paravertebral extension, but little information regarding the combination is available. OBJECTIVES: The present study is intended to assess the safety and effectiveness of the combination of TAE and PVP in patients suffering from vertebral metastases with paravertebral extension. STUDY DESIGN: Sequential TAE followed by PVP was used in 25 patients with symptomatic vertebral metastases. The safety and effectiveness of the sequential therapy were evaluated. SETTING: Three hospitals' clinical research centers. METHODS: This retrospective study was conducted with 25 consecutive patients (11 women and 14 men; mean age 59.3 years, range 38 - 80 years) with vertebral and paravertebral metastases from March 2009 to March 2014. The patients were treated with TAE, and 5 - 7 days later with the PVP procedure. The clinical outcomes were assessed by the control of pain using visual analog scale (VAS) scores, and computed tomography (CT) imaging. X2 or Fisher exact testing was performed for univariate analysis of variables. The VAS scores between groups were compared using ONE-WAY ANOVA, with a P-value of less than 0.05 considered statistically significant. RESULTS: All the TAE and PVP procedures were successfully done. Mean VAS scores decreased after TAE (from 8.64 ± 0.58 to 5.32 ± 1.46, P < 0.05) and further decreased after PVP (from 5.32 ± 1.46 to 2.36 ± 0.54, P < 0.05), and the decrease in VAS lasted until the third month (3.08 ± 1.52, P > 0.05) follow-up. However, VAS scores at the sixth month were statistically higher than those at the third month (4.8 ± 1.24 versus 3.08 ± 1.52, P < 0.05), VAS scores at the twelfth month were statistically higher than those at the sixth month (6.29 ± 1.07 versus 4.8 ± 1.24, P < 0.05). We found paravertebral cement leakage in 6 cases. No clinical or symptomatic complications were observed. In the follow-up, no patient showed further vertebral compression or spinal canal compromise. LIMITATIONS: This is a retrospective clinical study of a small number of patients. CONCLUSION: The sequential TAE followed by PVP is safe and effective in treating vertebral metastases with paravertebral extension. KEY WORDS: Spine, metastases, pain, embolization, vertebroplasty, interventional radiology, PVP, TAE. AD - Department of Interventional Radiology, Subei People's Hospital of Jiangsu Province (Clinical Medical College of Yangzhou University), Yangzhou, JiangSu Province, China. Department of Radiology, Zhong-da Hospital, Medical School, Southeast University, Nanjing 210009, China. Department of Radiology, the Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China. AN - 27228522 AU - Wang, F. A. AU - He, S. C. AU - Xiao, E. H. AU - Wang, S. X. AU - Sun, L. AU - Lv, P. H. AU - Huang, W. N. DA - May DP - NLM ET - 2016/05/27 J2 - Pain physician KW - Adult Aged Aged, 80 and over Female Follow-Up Studies Fractures, Compression/diagnostic imaging/surgery Humans Lumbar Vertebrae/diagnostic imaging/*injuries Male Middle Aged Pain/diagnostic imaging/etiology Pain Management/adverse effects/*methods Pain Measurement/methods Radiology, Interventional Retrospective Studies Spinal Fractures/diagnostic imaging/etiology/*therapy Spinal Neoplasms/complications/diagnostic imaging/*therapy Thoracic Vertebrae/diagnostic imaging/*injuries Tomography, X-Ray Computed Treatment Outcome Vertebroplasty/adverse effects/*methods LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 1533-3159 SP - E559-67 ST - Sequential Transarterial Embolization Followed by Percutaneous Vertebroplasty Is Safe and Effective in Pain Management in Vertebral Metastases T2 - Pain Physician TI - Sequential Transarterial Embolization Followed by Percutaneous Vertebroplasty Is Safe and Effective in Pain Management in Vertebral Metastases VL - 19 ID - 828660 ER - TY - JOUR AB - Background: Vertebral metastases are the most frequent vertebral tumor. Transarterial embolization (TAE) devascularizes the tumor, resulting in tumor necrosis. Percutaneous vertebroplasty (PVP), a minimally invasive procedure, can effectively relieve tumor-related pain and improve spine stability. Unfortunately, the PVP technique is of limited use in controlling the progression of vertebral tumor, especially for paravertebral metastases. TAE combined with PVP may achieve a better control on vertebral metastases with paravertebral extension, but little information regarding the combination is available.Objectives: The present study is intended to assess the safety and effectiveness of the combination of TAE and PVP in patients suffering from vertebral metastases with paravertebral extension.Study Design: Sequential TAE followed by PVP was used in 25 patients with symptomatic vertebral metastases. The safety and effectiveness of the sequential therapy were evaluated.Setting: Three hospitals' clinical research centers.Methods: This retrospective study was conducted with 25 consecutive patients (11 women and 14 men; mean age 59.3 years, range 38 - 80 years) with vertebral and paravertebral metastases from March 2009 to March 2014. The patients were treated with TAE, and 5 - 7 days later with the PVP procedure. The clinical outcomes were assessed by the control of pain using visual analog scale (VAS) scores, and computed tomography (CT) imaging. X2 or Fisher exact testing was performed for univariate analysis of variables. The VAS scores between groups were compared using ONE-WAY ANOVA, with a P-value of less than 0.05 considered statistically significant.Results: All the TAE and PVP procedures were successfully done. Mean VAS scores decreased after TAE (from 8.64 ± 0.58 to 5.32 ± 1.46, P < 0.05) and further decreased after PVP (from 5.32 ± 1.46 to 2.36 ± 0.54, P < 0.05), and the decrease in VAS lasted until the third month (3.08 ± 1.52, P > 0.05) follow-up. However, VAS scores at the sixth month were statistically higher than those at the third month (4.8 ± 1.24 versus 3.08 ± 1.52, P < 0.05), VAS scores at the twelfth month were statistically higher than those at the sixth month (6.29 ± 1.07 versus 4.8 ± 1.24, P < 0.05). We found paravertebral cement leakage in 6 cases. No clinical or symptomatic complications were observed. In the follow-up, no patient showed further vertebral compression or spinal canal compromise.Limitations: This is a retrospective clinical study of a small number of patients.Conclusion: The sequential TAE followed by PVP is safe and effective in treating vertebral metastases with paravertebral extension.Key Words: Spine, metastases, pain, embolization, vertebroplasty, interventional radiology, PVP, TAE. AD - Department of Interventional Radiology, Subei People's Hospital of Jiangsu Province (Clinical Medical College of Yangzhou University), Yangzhou, JiangSu Province, China Department of Radiology, Zhong-da Hospital, Medical School, Southeast University, Nanjing 210009, China Department of Radiology, the Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China AN - 120950119. Language: English. Entry Date: 20170129. Revision Date: 20191106. Publication Type: journal article AU - Wang, Fu-An AU - He, Shi-Cheng AU - Xiao, En-Hua AU - Wang, Shu-Xiang AU - Sun, Ling AU - Lv, Peng-Hua AU - Huang, Wen-Nuo DB - cin20 DP - EBSCOhost KW - Spinal Fractures -- Therapy Spinal Neoplasms -- Therapy Pain -- Therapy Thoracic Vertebrae -- Injuries Lumbar Vertebrae -- Injuries Vertebroplasty -- Methods Adult Female Aged Retrospective Design Tomography, X-Ray Computed Fractures, Compression -- Surgery Spinal Fractures Prospective Studies Treatment Outcomes Thoracic Vertebrae Male Human Pain Measurement -- Methods Middle Age Pain -- Etiology Vertebroplasty -- Adverse Effects Pain Aged, 80 and Over Fractures, Compression Spinal Neoplasms Spinal Neoplasms -- Complications Lumbar Vertebrae Specialties, Medical Spinal Fractures -- Etiology Validation Studies Comparative Studies Evaluation Research Multicenter Studies M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2016 SN - 1533-3159 SP - E559-E567 ST - Sequential Transarterial Embolization Followed by Percutaneous Vertebroplasty Is Safe and Effective in Pain Management in Vertebral Metastases T2 - Pain Physician TI - Sequential Transarterial Embolization Followed by Percutaneous Vertebroplasty Is Safe and Effective in Pain Management in Vertebral Metastases UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=120950119&site=ehost-live&scope=site VL - 19 ID - 830594 ER - TY - JOUR AD - Department of Interventional Radiology Subei People's Hospital of Jiangsu Province (Clinical Medical College of Yangzhou University), Yangzhou, JiangSu Province, China Department of Radiology, the Second Xiangya Hospital, Central South University, Changsha, Hunan Province, China AN - 126911181. Language: English. Entry Date: 20171222. Revision Date: 20171222. Publication Type: journal article AU - Wang, Fu-An AU - Xiao, En-Hua DB - cin20 DP - EBSCOhost KW - Fractures, Compression -- Surgery Vertebroplasty Spinal Fractures -- Surgery M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 1533-3159 SP - E207-E208 ST - Author's Reply to the Letter to Editor, "Transarterial Embolization Followed by Percutaneous Vertebroplasty in Treating Vertebral Metastases with Paravetebral Extension" T2 - Pain Physician TI - Author's Reply to the Letter to Editor, "Transarterial Embolization Followed by Percutaneous Vertebroplasty in Treating Vertebral Metastases with Paravetebral Extension" UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=126911181&site=ehost-live&scope=site VL - 20 ID - 830575 ER - TY - JOUR AB - Retrograde cement extrusion into the nutrient vessels of the femur is a rare phenomenon in uncomplicated cemented hemiarthroplasty of the hip; this is a report on three cases. Routine postoperative radiographs showed a continuous dense linear opacity arising from the posterior medial region of the femur. Computed tomography (CT) scans revealed no evidence of a cortical break in the femur and confirmed our suspicion of retrograde cement extrusion into the nutrient vessels of the femur. Post-operative recovery was uneventful with no complications of cement thromboembolism. Our findings in three cases suggest that cement retrograde extrusion into nutrient vessels following hemiarthroplasty is a benign complication of modern cementing techniques involving pressurisation. The site of cement extrusion into the nutrient foramina displays a constant topography. We recommend that a CT scan of the femur be done on detection of a radio-opaque density on postoperative radiographs to differentiate an extraosseous breach from an intra-vascular extrusion of cement. The theoretical complications of cement embolism and thrombosis should be kept in mind and looked for clinically. AD - Department of Orthopaedics, Tan Tock Seng Hospital, Singapore. kaedetod@gmail.com AN - 23019773 AU - Wang, L. AU - Gardner, A. W. AU - Kwek, E. B. AU - Naidu, G. R. DA - Aug DP - NLM ET - 2012/10/02 J2 - Acta orthopaedica Belgica KW - Aged Aged, 80 and over Arthroplasty, Replacement, Hip/*adverse effects/methods Bone Cements/*adverse effects Cementation/*adverse effects/methods *Extravasation of Diagnostic and Therapeutic Materials Female Femur/blood supply/diagnostic imaging Hip/blood supply/diagnostic imaging Humans Radiography LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0001-6462 (Print) 0001-6462 SP - 431-5 ST - Retrograde cement arteriovenogram of nutrient vessels following hemiarthroplasty of the hip T2 - Acta Orthop Belg TI - Retrograde cement arteriovenogram of nutrient vessels following hemiarthroplasty of the hip VL - 78 ID - 828902 ER - TY - JOUR AB - Retrograde cement extrusion into the nutrient vessels of the femur is a rare phenomenon in uncomplicated cemented hemiarthroplasty of the hip; this is a report on three cases. Routine postoperative radiographs showed a continuous dense linear opacity arising from the posterior medial region of the femur. Computed tomography (CT) scans revealed no evidence of a cortical break in the femur and confirmed our suspicion of retrograde cement extrusion into the nutrient vessels of the femur. Post-operative recovery was uneventful with no complications of cement thromboembolism. Our findings in three cases suggest that cement retrograde extrusion into nutrient vessels following hemiarthroplasty is a benign complication of modern cementing techniques involving pressurisation. The site of cement extrusion into the nutrient foramina displays a constant topography. We recommend that a CT scan of the femur be done on detection of a radio-opaque density on postoperative radiographs to differentiate an extra-osseous breach from an intra-vascular extrusion of cement. The theoretical. complications of cement embolism and thrombosis should be kept in mind and looked for clinically. AD - [Wang, Lushun; Gardner, Antony Westwood; Kwek, Ernest Beng Kee; Naidu, Ganesan Rajamoney] Tan Tock Seng Hosp, Dept Orthopaed, Singapore 308433, Singapore. Wang, LS (corresponding author), Tan Tock Seng Hosp, Dept Orthopaed, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore. kaedetod@gmail.com AN - WOS:000308453500002 AU - Wang, L. S. AU - Gardner, A. W. AU - Kwek, E. B. K. AU - Naidu, G. R. DA - Aug J2 - Acta Orthop. Belg. KW - hemiarthroplasty total hip arthroplasty polymethylmethacrylate cement nutrient artery nutrient vein Orthopedics LA - English M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2012 SN - 0001-6462 SP - 431-435 ST - Retrograde cement arteriovenogram of nutrient vessels following hemiarthroplasty of the hip T2 - Acta Orthopaedica Belgica TI - Retrograde cement arteriovenogram of nutrient vessels following hemiarthroplasty of the hip UR - ://WOS:000308453500002 VL - 78 ID - 830303 ER - TY - JOUR AB - Introduction: Intrahepatic cholangiocarcinoma is the second most common primary tumors of the liver. It is usually fatal due to lack of effective non-operative therapy. The rate and site of bone metastasis from intrahepatic cholangiocarcinoma are unclear. Currently, there is no established therapy once the diagnosis is made. Besides curative resection, the benefit of other treatment in survival is still controversial. Case description: A 58-year-old woman presented to our hospital complaining painful of the left hip for 2 months. The clinical examination at admission showed a tender palpable abdominal mass at the epigastric area. X-ray of Pelvic revealed an osteolytic lesion of the up margin of the left acetabulum and ischium, which confirmed by radionuclide bone scanning. The bioptic specimens showed a metastatic moderately differentiated adenocarcinoma of unknown origin. Then, diagnosis was made based on computed tomography and ultrasound. After ultrasound-guided fine-needle aspiration and core biopsy was performed, immunohistologic revealed the tumor cells were strongly positive for CK7 and CK19 while negative for CK20. Thus, intrahepatic cholangiocarcinoma with bone metastases was diagnosised. TACE was made to control primary lesion, at the same time, iliac arteriography and embolization was done to control the metastatic tumor of bone. Three weeks later, the patient felt difficulty in walking, then, screw osteosynthesis and bone cement filling was operated. She could walk by herself soon after our operation. One month after TACE, the patient subsequently commenced gemcitabine- based Chemotherapy. Nine months after diagnosised the patient died. Conclusions: Despite their infrequency, intrahepatic cholangiocarcinoma with bone metastases should be considered seriously. Our experience suggested that an early diagnosis together with positive comprehensive treatments may show promising efficacy in respect to survival and quality of life. Patients with a bad prognosis will potentially benefit from shorter treatment duration because of a limited life expectancy. AD - Q. Wang, Department of General Surgery, Guangzhou, China AU - Wang, Q. AU - Ye, X. AU - Li, X. AU - Chen, W. AU - Huang, P. AU - Yao, Z. AU - Huang, H. AU - Chen, X. AU - Yang, P. AU - Liu, B. DB - Embase DO - 10.1007/s12072-013-9429-0 KW - radioisotope gemcitabine bone cement bile duct carcinoma bone metastasis human case report Asian liver patient therapy ultrasound diagnosis survival walking hospital metastasis artificial embolization arteriography female tumor cell biopsy fine needle aspiration biopsy computer assisted tomography surgery adenocarcinoma bone scintiscanning life expectancy treatment duration prognosis ischium acetabulum bone atrophy bone chemotherapy osteosynthesis pelvis X ray abdominal mass clinical examination early diagnosis quality of life hip primary tumor LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1936-0533 SP - S712-S713 ST - Intrahepatic cholangiocarcinoma with bone metastases after comprehensive treatments: A case report T2 - Hepatology International TI - Intrahepatic cholangiocarcinoma with bone metastases after comprehensive treatments: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71309424&from=export http://dx.doi.org/10.1007/s12072-013-9429-0 VL - 7 ID - 829493 ER - TY - JOUR AB - OBJECTIVES: : Intramedullary reaming of long bones before nail insertion has been known to cause an increase in fat emboli introduction into the bloodstream, which is a potentially fatal phenomenon. The goal of this study was to assess whether the reamer irrigator aspirator (RIA) reamer can reduce fat embolic load compared with the standard AO reamer. METHODS: : Fifteen pigs were prepared using an intravenous catheter inserted into the marginal ear vein for fluid balance and drug administration. One third of the pig's blood volume was withdrawn to simulate hemorrhagic shock. Each animal underwent bilateral retrograde femoral reaming, cementing, and nailing using either an RIA or AO reamer. Assignment of a reamer type to the left or right side was done randomly and allowed for direct comparison of matching femur results. Outcome measures were obtained, namely, pulmonary arterial pressure, mean arterial pressure, partial pressure of arterial oxygen, and cardiac output. Staining techniques were used to ascertain fat emboli counts from lung tissue samples. RESULTS: : For mean arterial pressure, partial pressure of arterial oxygen, and cardiac output after cement injection, the RIA reamer group showed statistically higher values than the AO reamer group. In corollary, the RIA showed statistically lower pulmonary arterial pressure levels. No differences were noted at baseline, during hypovolemia, and post resuscitation. With the Student t test, no statistical differences were found between reamers regarding fat emboli counts for both staining methods. With the Mann-Whitney test, the RIA reamer showed statistically fewer emboli (7.0 versus 74.5) (P = 0.02, Z = 2.33) using Oil Red 'O' staining. CONCLUSIONS: : The RIA reamer demonstrated superior results with respect to physiologic measures and fat emboli counts and may provide optimal results compared with the AO reamer. AD - Sports Medicine and Arthroscopic Shoulder & Knee Surgery, Pinnacle Health Sciences Center, Richmond Hill, Ontario, Canada tMusculoskeletal Research Laboratory tMartin Orthopaedic Biomechanics Laboratory, St. Michael's Hospital, Toronto, Canada §Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, Canada Department of Laboratory Medicine, St. Michael's Hospital, Toronto, Canada ¶Faculty of Medicine, Department of Surgery, University of Toronto, Toronto, Canada. AN - 107972971. Language: English. Entry Date: 20130927. Revision Date: 20150712. Publication Type: Journal Article AU - Wang, R. Y. AU - Li, R. AU - Zdero, R. AU - Bell, D. AU - Blankstein, M. AU - Schemitsch, E. H. DB - cin20 DO - 10.1097/BOT.0b013e318238b22b DP - EBSCOhost KW - Embolism, Fat -- Prevention and Control Femur -- Surgery Orthopedic Fixation Devices Animals Bone Cements Models, Biological Embolism, Fat -- Etiology Embolism, Fat -- Physiopathology Female Femur -- Physiopathology Suction -- Equipment and Supplies Swine Therapeutic Irrigation -- Equipment and Supplies M1 - 9 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2012 SN - 0890-5339 SP - e132-7 ST - The physiologic and pathologic effects of the reamer irrigator aspirator on fat embolism outcome: an animal study T2 - Journal of Orthopaedic Trauma TI - The physiologic and pathologic effects of the reamer irrigator aspirator on fat embolism outcome: an animal study UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=107972971&site=ehost-live&scope=site VL - 26 ID - 830671 ER - TY - JOUR AB - Background: Percutaneous vertebroplasty (PV) is a therapeutic procedure for osteoporosis vertebral compression fracture. Venous thrombo-embolisms (VTE) have been reported as procedure complications. The relationship between PVand the risk of VTE is unclear. Methods: We conducted a retrospective, population-based case-control study using the National Health Insurance Research Database (NHIRD) to investigate the relationship between osteoporosis vertebral compression fracture patients receiving PV and risk of VTE. We identified 1639 patients with receiving PV and 14,887 subjects without receiving PV from 2000-2013. After development of 1:1 propensity score-matched cohort study, 1639 PV patients and 1639 control patients were followed up for more than 12 y. Using the application of PV as the exposure factor, cause-specified Cox's proportional hazard model was performed to examine the association between PV and VTE. We used three different adjusted models, including covariate adjustment using the propensity score, traditional measured con-founders and confounder selection model using backward elimination procedure. Results: The incidence and risk of VTE between patients receiving PV and matched participants were insignificantly different after propensity matching and using three different adjusted models. In the subgroup analyses, age, sex, comorbidity and cancer were not to increase the risk of VTE between the two cohorts. However, osteoporosis vertebral compression fracture patients with the history of heart failure, arrhythmia, cancer, with using antihypertension medications, and aged were significantly increase the risk of VTE regardless receiving PV or not, and patients receiving analgesic drugs decreased the risk of VTE. Conclusion: Osteoporosis vertebral compression fracture patients who received PV seems not to increase the risk of VTE but should be monitored cautiously in subgroup prone to developing VTE. AD - W.-H. Wang, Department of Orthopedic, Changhua Christian Hospital, Taichung, Taiwan AU - Wang, W. H. AU - Huang, C. H. AU - Kor, C. T. DB - Embase DO - 10.1007/s00198-018-04815-5 KW - analgesic agent adult cancer patient case control study cohort analysis comorbidity compression fracture conference abstract controlled study drug therapy embolism female heart arrhythmia heart failure human hypertension incidence major clinical study male multicenter study national health insurance osteoporosis percutaneous vertebroplasty propensity score retrospective study risk assessment venous thromboembolism LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1433-2965 SP - S90-S91 ST - The relationship between the osteoporosis vertebral compression fracture patients and the risk of venous thromboembolism: A nationwide, population-based case-control study T2 - Osteoporosis International TI - The relationship between the osteoporosis vertebral compression fracture patients and the risk of venous thromboembolism: A nationwide, population-based case-control study UR - https://www.embase.com/search/results?subaction=viewrecord&id=L628597224&from=export http://dx.doi.org/10.1007/s00198-018-04815-5 VL - 30 ID - 829138 ER - TY - JOUR AB - INTRODUCTION: POEMS syndrome is a group of multi-system disease with abnormalities of monoclonal plasma cell. The clinical manifestations of the disease are complex, the system damage is often heterogeneous, and is easy to misdiagnosis. The lung damage of POEMS is rarely mentioned in the literature. CASE PRESENTATION: A 68-year-old man was hospitalized for recurrent cough for 10 years, dyspnea for 7 months. During the past 10 years, the patient had cough when he inhaled dust, cold air or irritant gas. The symptoms alleviated after antibiotic treatment. 7 months ago, the cough aggravated, accompanied by shortness of breath, lower extremity weakness and his activity tolerance decreased gradually. He was diagnosed as chronic obstructive pulmonary disease (COPD) with Cor Pulmonale in the local hospital. His weight lost 5 kg during the 7 months period. Past history: 10 years ago, he was diagnosed as melanosis due to skin pigmentation. He felt numbness in fingers during the cold season in the past 10 years. Dust, asphalt and cement contact history for 30 years. Smoking history for more than 10 years, 3-4/day. He quitted smoking 19 years ago. Physical examination findings and diagnostic studies: Black pigmentation in skin, cyanosis, and neck vein engorgement. Barrel chest, no rales. Heart rate 70/ min, P2 > A2. The liver and spleen impalpable. The distal interphalangeal joint deformity in both hands, lower extremity edema. Chest CT showed emphysema with bilateral pleural effusion. CTPA had no evidence of pulmonary embolism. Pulmonary function demonstrated obstructive dysfunction (FEV1/FVC 58%, FEV1 83%pred, RV/TLC 31% DLCO 32%pred). Transthoracic echocardiogram showed enlargement of right heart, PASP 75mmHg, LVEF 67%. Blood gas analysis result was PH 7.491, PaCO2 28.1mmHg, PaO2 53.7mmHg (on room air). Primary diagnosis was COPD, Cor pulmonale. He was treated with tiotropium, Salmeterol/Fluticasone and diuretics, but had no effect Further lab studies showed serum autoimmune antibodies, ANCA, dsDNA were all negative. Bone marrow aspiration showed bone marrow hyperplasia, plasma cell account for 8%, where the plasmablast cells accounted for 6%; electromyography found that the left peroneal nerve, the right peroneal nerve and tibial nerve CMAP latency prolonged. Immunoglobulin electrophoresis showed that IgG monoclonal, blood λlight chain 180mg/dl, urine λlight chain 12.7mg/dl, blood κlight chain 1910mg/dl; skin biopsy demonstrated pigment cell hyperplasia, mild chronic inflammatory cell infiltration around small vascular. The final diagnosis: plasma cell disorders, POEMS syndrome with pulmonary hypertension (PH). DISCUSSION: COPD is one of the most common causes of PH. PH often means that the course of COPD is at the end stage. This patient had mild COPD, PH could not be caused by COPD. POEMS syndrome is a group of monoclonal plasma cell hyperplasia as the main performance of the clinical syndrome including peripheral polyneuropathy, organomegaly, skin damage, endocrine dysfunction and M protein. The M protein is the most important clinical characteristics. Respiratory involvement of POEMS syndrome is relatively rare. The main manifestations are respiratory muscle fatigue, decreased diffusion capacity, restrictive ventilation dysfunction and PH. POEMS with PH had bad clinical outcome. The average survival period of POEM syndrome 14.7 years. Therapies include glucocorticoid and chemotherapy. Some patients might get benefit from operation and radiation therapy, plasmapheresis, autologous stem cell transplantation and cell factor antagonist therapy. CONCLUSIONS: There are many causes of PH. For those patients who have history of smoking and dust exposure, COPD is one of the most important reasons. However, for those patients who had no effect to COPD treatment and HP was not paralleled to the disease severity, we need to consider other conditions. POEMS is a rare clinical disease and can cause HP. AD - X.H. Wang, Peking University, Third Hospital, Beijing, China AU - Wang, X. H. DB - Embase DO - 10.1378/chest.1991384 KW - M protein irritant agent cement autoantibody immunoglobulin asphalt tiotropium bromide glucocorticoid diuretic agent immunoglobulin G POEMS syndrome pulmonary hypertension pH human chronic obstructive lung disease patient plasma cell light chain coughing smoking diagnosis thorax peroneus nerve leg cell hyperplasia dyspnea dust cor pulmonale therapy blood cyanosis skin pigmentation electromyography bone marrow physical examination bone marrow biopsy hyperplasia tibial nerve jugular vein serum season paresthesia ambient air blood gas analysis skin pigmentation cold air echocardiography melanosis male diagnostic error weight lung embolism hospital plasmapheresis lung function heart lung injury survival time pleura effusion lung diffusion capacity emphysema muscle fatigue edema latent period arthropathy interphalangeal joint electrophoresis endocrine disease spleen skin defect polyneuropathy weakness liver inflammatory cell heart rate pigment cell cell infiltration diseases skin biopsy antibiotic therapy breathing muscle urine crackle air conditioning gas chemotherapy radiotherapy autologous stem cell transplantation dust exposure disease severity L1 - http://journal.publications.chestnet.org/article.aspx?articleID=1912906 LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 0012-3692 ST - Poems syndrome associated with pulmonary arterial hypertension T2 - Chest TI - Poems syndrome associated with pulmonary arterial hypertension UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71780554&from=export http://dx.doi.org/10.1378/chest.1991384 VL - 146 ID - 829405 ER - TY - JOUR AB - The aim of this study was to evaluate the safety and efficacy of percutaneous vertebroplasty (PVP) in Kambin triangle approach for the treatment of osteoporotic vertebral compression fractures (OVCFs).Between November 2017 and September 2018, 109 patients (144 vertebral bodies) with OVCFs, with a mean age of 76.7 ± 9.9 years (55-96 years), underwent PVP in Kambin triangle approach. The time of operation, the volume of bone cement, the incidence of complication, the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) score, the position of puncture needles, and the spread of polymethylmethacrylate (PMMA) in vertebral body (VB) were recorded.All patients had been completed the operation successfully and were followed up 9.1 ± 2.9 months. The average operation time of each VB was 24.0 ± 3.5 minutes. The average volume of cement was 4.8 ± 0.6 ml. The mean VAS scores were 8.4 ± 0.7 preoperatively, 1.6 ± 0.6 at the first day postoperatively, and 1.2 ± 0.6 at the last follow-up. The mean ODI scores were 70.97 ± 7.73 preoperatively, 27.99 ± 4.12 at the first day postoperatively, and 19.65 ± 3.49 at the last follow-up. The position of puncture needles in the VB was: 119 vertebral puncture needles reached the midline, 15 were close to the midline, and 10 exceeded the midline. The spread of PMMA in the VB was: type 1 in 81 levels (56.3%), type 2 in 37 (25.7%), type 3 in 18 (12.5%), type 5 in 8 (5.5%), and no case in type 4. One case developed pneumothorax after operation. No other complications (hematoma, cement embolism, spinal cord, and nerve injury) occurred.Kambin triangle approach in PVP, which can deliver the puncture needle to the midline of VB easily and with excellent cement distribution, is a safe and effective method. AD - Department of Orthopedics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Jiangsu Province, China. AN - 31689878 AU - Wang, Y. F. AU - Shen, J. AU - Li, S. Y. AU - Yu, X. AU - Zou, T. M. C2 - Pmc6946336 DA - Nov DO - 10.1097/md.0000000000017857 DP - NLM ET - 2019/11/07 J2 - Medicine KW - Aged Aged, 80 and over Bone Cements Female Fractures, Compression/*surgery Humans Male Middle Aged Operative Time Osteoporotic Fractures/*surgery Polymethyl Methacrylate Postoperative Complications Retrospective Studies Spinal Fractures/*surgery Vertebroplasty/adverse effects/*methods LA - eng M1 - 44 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 0025-7974 (Print) 0025-7974 SP - e17857 ST - Kambin triangle approach in percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures T2 - Medicine (Baltimore) TI - Kambin triangle approach in percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures VL - 98 ID - 828553 ER - TY - JOUR AB - Objective: To evaluate percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in treating malignant tumors of thoracolumbar spine, and to compared the advantages and disadvantages of PVP and PKP. Methods: During the period from Dec. 2007 to July 2011, PVP or PKP was carried out in 45 patients with thoracolumbar tumors in authors' hospital. PVP group included 30 cases with 46 diseased vertebrae, and PKP group had 15 cases with 20 diseased vertebrae. The hospitalization days, hospitalization cost and the incidence of complications were recorded, and the visual analogue pain scale (VAS) and the activities of daily living scale (BI) were measured before operation as well as at one week, one and 3 months after operation. The results were analyzed and the therapeutic effects were evaluated. Results: Statistically significant difference in VAS scores and BI scores existed between preoperative data and postoperative ones in both groups (P < 0.05), although no significant differences in VAS scores and BI scores existed between PVP group and PKP group (P > 0.05). Also statistically significant differences in hospitalization days and hospitalization cost were present between the two groups. The hospitalization time and hospitalization cost of PVP group were significantly shorter and less than those of PKP group (P < 0.05). The incidence of bone cement leakage in PVP group and PKP group was 30% (n = 9) and 13.3% (n = 4) respectively, and the difference between the two groups was statistically significant (P < 0.05). No severe complications such as pulmonary embolism occurred in both groups. Conclusion: In treating malignant tumors of thoracolumbar spine, PVP and PKP can quickly relieve the pain and enhance the vertebral stability. PKP has lower incidence of bone cement leakage, but it costs more and needs longer hospitalization time. PVP is easy to be performed and has reliable effectiveness with lower cost, although it carries relatively higher incidence of bone cement leakage. AD - C.-F. Ni, Department of Interventional Radiology, Soochow University, Suzhou 215006, China AU - Wang, Y. W. AU - Ni, C. F. AU - Chen, L. AU - Li, Z. AU - Yang, C. DB - Embase DO - 10.3969/j.issn.1008-794X.2012.06.009 KW - bone cement article clinical article controlled study daily life activity hospitalization hospitalization cost human kyphoplasty morbidity pain assessment percutaneous vertebroplasty postoperative complication rating scale spine cancer spine surgery spine tumor statistical significance thoracolumbar spine visual analog scale LA - Chinese M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1008-794X SP - 478-481 ST - Clinical application of percutaneous vertebroplasty and kyphoplasty in treating malignant tumors of spine T2 - Journal of Interventional Radiology (China) TI - Clinical application of percutaneous vertebroplasty and kyphoplasty in treating malignant tumors of spine UR - https://www.embase.com/search/results?subaction=viewrecord&id=L365496860&from=export http://dx.doi.org/10.3969/j.issn.1008-794X.2012.06.009 VL - 21 ID - 829563 ER - TY - JOUR AB - BACKGROUND: Balloon kyphoplasty is a minimally invasive procedure for the treatment of painful vertebral fractures, which is intended to reduce pain and improve quality of life. We assessed the efficacy and safety of the procedure. METHODS: Adults with one to three acute vertebral fractures were eligible for enrolment in this randomised controlled trial at 21 sites in eight countries. We randomly assigned 300 patients by a computer‐generated sequence to receive kyphoplasty treatment (n=149) or non‐surgical care (n=151). The primary outcome was the difference in change from baseline to 1 month in the short‐form (SF)‐36 physical component summary (PCS) score (scale 0‐100) between the kyphoplasty and control groups. Quality of life and other efficacy measurements and safety were assessed up to 12 months. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00211211. FINDINGS: 138 participants in the kyphoplasty group and 128 controls completed follow‐up at 1 month. By use of repeated measures mixed effects modelling, all 300 randomised participants were included in the analysis. Mean SF‐36 PCS score improved by 7.2 points (95% CI 5.7‐8.8), from 26.0 at baseline to 33.4 at 1 month, in the kyphoplasty group, and by 2.0 points (0.4‐3.6), from 25.5 to 27.4, in the non‐surgical group (difference between groups 5.2 points, 2.9‐7.4; p<0.0001). The frequency of adverse events did not differ between groups. There were two serious adverse events related to kyphoplasty (haematoma and urinary tract infection); other serious adverse events (such as myocardial infarction and pulmonary embolism) did not occur perioperatively and were not related to procedure. INTERPRETATION: Our findings suggest that balloon kyphoplasty is an effective and safe procedure for patients with acute vertebral fractures and will help to inform decisions regarding its use as an early treatment option. AN - CN-00682286 AU - Wardlaw, D. AU - Cummings, S. R. AU - Van Meirhaeghe, J. AU - Bastian, L. AU - Tillman, J. B. AU - Ranstam, J. AU - Eastell, R. AU - Shabe, P. AU - Talmadge, K. AU - Boonen, S. DO - 10.1016/S0140-6736(09)60010-6 KW - Aged Back Pain [etiology, prevention & control] Bone Cements [therapeutic use] Female Follow‐Up Studies Fractures, Compression [complications, *therapy] Hematoma [etiology] Humans Male Minimally Invasive Surgical Procedures [methods] Quality of Life Radiography Reconstructive Surgical Procedures [adverse effects, *methods] Spinal Fractures [complications, diagnostic imaging, *therapy] Urinary Tract Infections [etiology] Vertebroplasty [adverse effects, *methods] M1 - 9668 M3 - Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2009 SP - 1016‐1024 ST - Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial T2 - Lancet (london, england) TI - Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00682286/full VL - 373 ID - 830019 ER - TY - JOUR AB - Background: Balloon kyphoplasty is a minimally invasive procedure for the treatment of painful vertebral fractures, which is intended to reduce pain and improve quality of life. We assessed the efficacy and safety of the procedure. Methods: Adults with one to three acute vertebral fractures were eligible for enrolment in this randomised controlled trial at 21 sites in eight countries. We randomly assigned 300 patients by a computer-generated sequence to receive kyphoplasty treatment (n=149) or non-surgical care (n=151). The primary outcome was the difference in change from baseline to 1 month in the short-form (SF)-36 physical component summary (PCS) score (scale 0-100) between the kyphoplasty and control groups. Quality of life and other efficacy measurements and safety were assessed up to 12 months. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00211211. Findings: 138 participants in the kyphoplasty group and 128 controls completed follow-up at 1 month. By use of repeated measures mixed effects modelling, all 300 randomised participants were included in the analysis. Mean SF-36 PCS score improved by 7.2 points (95% CI 5.7-8.8), from 26.0 at baseline to 33.4 at 1 month, in the kyphoplasty group, and by 2.0 points (0.4-3.6), from 25.5 to 27.4, in the non-surgical group (difference between groups 5.2 points, 2.9-7.4; p<0.0001). The frequency of adverse events did not differ between groups. There were two serious adverse events related to kyphoplasty (haematoma and urinary tract infection); other serious adverse events (such as myocardial infarction and pulmonary embolism) did not occur perioperatively and were not related to procedure. Interpretation: Our findings suggest that balloon kyphoplasty is an effective and safe procedure for patients with acute vertebral fractures and will help to inform decisions regarding its use as an early treatment option. AD - Orthopaedic Department, Woodend Hospital, NHS Grampian, Aberdeen, UK AN - 105489620. Language: English. Entry Date: 20090424. Revision Date: 20200708. Publication Type: journal article AU - Wardlaw, D. AU - Cummings, S. R. AU - Van Meirhaeghe, J. AU - Bastian, L. AU - Tillman, J. B. AU - Ranstam, J. AU - Eastell, R. AU - Shabe, P. AU - Talmadge, K. AU - Boonen, S. AU - Wardlaw, Douglas AU - Cummings, Steven R. AU - Van Meirhaeghe, Jan AU - Bastian, Leonard AU - Tillman, John B. AU - Ranstam, Jonas AU - Eastell, Richard AU - Shabe, Peter AU - Talmadge, Karen AU - Boonen, Steven DB - cin20 DO - 10.1016/S0140-6736(09)60010-6 DP - EBSCOhost KW - Fractures, Vertebral Compression -- Surgery Kyphoplasty -- Methods Quality of Life Surgery, Reconstructive -- Methods Aged Back Pain -- Etiology Back Pain -- Prevention and Control Bone Cements -- Therapeutic Use Randomized Controlled Trials Female Fractures, Vertebral Compression -- Complications Fractures, Vertebral Compression -- Radiography Hematoma -- Etiology Kyphoplasty -- Adverse Effects Male Minimally Invasive Procedures -- Methods Prospective Studies Research Instruments Surgery, Reconstructive -- Adverse Effects Urinary Tract Infections -- Etiology Human M1 - 9668 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 0099-5355 SP - 1016-1024 ST - Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial T2 - Lancet TI - Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105489620&site=ehost-live&scope=site VL - 373 North American Edition ID - 830734 ER - TY - JOUR AB - A 72-year-old woman who presented with a unilateral oculomotor nerve palsy was shown to have a very rare condition: multiple dural arteriovenous fistulae (DAVF) involving the cavernous and sphenoparietal sinuses. The sphenoparietal DAVF was cured completely by transarterial embolisation. Symptomatic relief was accomplished by this procedure. The cavernous sinus DAVF progressed to acquire cortical venous drainage, and was obliterated completely by transvenous embolisation. AD - T. Watanabe, Biomedizinische NMR Forschungs GmbH, Max-Planck-Inst. Biophysikal. Chemie, Am Fassberg 11, 37077 Gottingen, Germany AU - Watanabe, T. AU - Matsumaru, Y. AU - Sonobe, M. AU - Asahi, T. AU - Onitsuka, K. AU - Sugita, K. AU - Takahashi, S. AU - Nose, T. DB - Embase Medline KW - copolymer poly(methyl methacrylate) aged arteriovenous fistula artery blood flow article artificial embolization brain angiography brain vein carotid arteriography case report cavernous sinus dura mater exophthalmos external carotid artery female human ophthalmoplegia priority journal sphenoid sinus surgical technique symptomatology treatment outcome LA - English M1 - 10 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2000 SN - 0028-3940 SP - 771-774 ST - Multiple dural arteriovenous fistulae involving the cavernous and sphenoparietal sinuses T2 - Neuroradiology TI - Multiple dural arteriovenous fistulae involving the cavernous and sphenoparietal sinuses UR - https://www.embase.com/search/results?subaction=viewrecord&id=L30814545&from=export VL - 42 ID - 829887 ER - TY - JOUR AB - The authors report four cases of fat embolism syndrome following total hip arthroplasty using cementless acetabular press-fit components and cemented press-fit femoral components. Factors implicated in the production of this syndrome following "hybrid" total hip arthroplasty include increased canal pressure during femoral reaming and prosthetic insertion, retained marrow elements and reaming debris, and the use of lumbar epidural anesthesia. This potentially fatal syndrome must be a recognized complication following the use of cemented press-fit femoral stems. Specific recommendations for decreasing the incidence of this complication are reviewed. AD - Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Ohio 44106. AN - 2746245 AU - Watson, J. T. AU - Stulberg, B. N. DO - 10.1016/s0883-5403(89)80065-8 DP - NLM ET - 1989/01/01 J2 - The Journal of arthroplasty KW - Aged Cementation/adverse effects/*methods Embolism, Fat/*etiology Female Hip Prosthesis/*adverse effects Humans Male Methylmethacrylates/adverse effects Respiratory Distress Syndrome/etiology Risk Factors LA - eng M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 1989 SN - 0883-5403 (Print) 0883-5403 SP - 133-7 ST - Fat embolism associated with cementing of femoral stems designed for press-fit application T2 - J Arthroplasty TI - Fat embolism associated with cementing of femoral stems designed for press-fit application VL - 4 ID - 828967 ER - TY - JOUR AB - This study aimed to investigate the application valuable of percutaneous vertebroplasty (PVP) with unilateral multiple channels approach in osteoporotic vertebral fractures patients. A retrospective review was conducted on 685 consecutive patients with osteoporotic vertebral fracture from March 2003 to October 2012. Among them, 82 cases were given PVP procedure by unilateral multiple channels approach. The timing of surgery, bone cements injection, and complications were analyzed. By using the X-ray film, the distribution of cement was detected and scored. The visual analogue scale (VAS) score and Oswestry disability index (ODI) system were used to evaluate the pain relief and improvement of daily activity function after operation. The excellent and good rate of cement distribution was 98.8% (98/99). Before surgery, the VAS score was 2.5±0.43. After surgery, the VAS score was significantly decreased to 2.0±0.33 at 1 h. Before surgery, ODI was 40.94±2.72. ODI was significantly decreased at 1 month after surgery (9.64±2.60) and at the final follow-up (7.77±2.15).  No spine or nerve injury, bone cement leakage, pulmonary embolism, pneumothorax, bleeding or infection occurred intraoperatively. Thus, the PVP with unilateral multiple channels approach effectively relieve the pain and improve the functional activity, without occurrence of complications. AD - Department of Spinal surgery, China-Japan Friendship Hospital, Beijing, China. Department of Traditional Chinese Medicine (TCM) Rheumatism, China-Japan Friendship Hospital, Beijing, China. AN - 29096745 AU - Wei, H. AU - Ma, X. DA - Oct 31 DO - 10.14715/cmb/2017.63.10.11 DP - NLM ET - 2017/11/04 J2 - Cellular and molecular biology (Noisy-le-Grand, France) KW - Activities of Daily Living Aged Aged, 80 and over Bone Cements Electrocardiography Female Humans Magnetic Resonance Imaging Male Osteoporotic Fractures/diagnostic imaging/*surgery Pain Management Retrospective Studies Treatment Outcome Vertebroplasty/*methods Multiple channels. Percutaneous vertebroplasty Unilateral approach LA - eng M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 0145-5680 SP - 69-73 ST - Application of unilateral multiple channels approach in percutaneous vertebroplasty for osteoporotic vertebral fractures T2 - Cell Mol Biol (Noisy-le-grand) TI - Application of unilateral multiple channels approach in percutaneous vertebroplasty for osteoporotic vertebral fractures VL - 63 ID - 828612 ER - TY - JOUR AB - OBJECTIVE: To explore the therapeutic efficacy of manual reduction combined with percutaneous vertebroplasty in treating osteoporotic vertebral compression fractures(OVCFs) with intravertebral clefts. METHODS: The clinical data of 94 patients with osteoporotic vertebral compression fractures with intravertebral clefts treated from January 2014 to January 2017 were retrospectively analyzed. The patients were divided into group A and group B according to different operative methods. In group A, 45 patients were treated with unilateral approach PVP, including 17 males and 28 females, aged (75.35±11.82) years old, with a bone density T-value of (-4.28±0.65) g/cm³; in group B, 49 patients treated with manual reduction combined with unilateral approach PVP, including 19 males and 30 females, aged (76.79±9.64) years old, with a bone density T-value of (-4.33±0.72) g/cm³. The operation time, bone cement injection volume and postoperative complications of two groups were recorded. The VAS and ODI scores of two groups were analyzed respectively at 1, 12, 18 months after operation. Vertebral height and kyphosis Cobb angle of two groups were compared immediately after surgery and 12, 18 months after operation. The distribution of bone cement in the vertebral body was observed and its distribution excellent rate was calculated. RESULTS: There was no significant difference in operation time between two groups. The amount of bone cement injection was(8.42±1.24) ml in group A and(9.19±1.09) ml in group B, and the difference between two groups was statistically significant(P<0.05). No spinal nerve root injury during operation and no complications including pulmonary embolism, bone cement toxicity and infection were found in two groups. There were 5 cases of bone cement leakage in group A and 4 cases in group B, which did not cause corresponding clinical symptoms and were not treated additionally. The distribution of bone cement in group A was excellent in 25 cases, good in 19 cases, poor in 1 case and in group B was excellent in 45 cases, good in 4 cases. The distribution excellent rate of bone cement was higher in group B than in group A (P<0.05). The VAS and ODI scores before operation and 1, 12, 18 months after operation were 8.29±0.74, 2.59±0.14, 3.75±0.38, 3.84±0.88 and 40.04±3.16, 9.24±2.82, 12.27±2.64, 15.83±2.58 in group A, 8.22±0.82, 2.54±0.19, 2.81±0.23, 2.82±0.45 and 39.98±2.05, 9.16±2.10, 9.46±2.41, 9.76±2.46 in group B. There was no significant difference in VAS and ODI scores at 1 month after operation between two groups (P>0.05), but group A was higher than group B at 12 and 18 months after operation (P<0.05). The vertebral height and Cobb angle before surgery, immediately after surgery, and 12, 18 months after surgery in group A were(59.17±1.42)%, (85.95±2.19)%, (75.27±3.45)%, (68.34±2.24)% and(23.83±3.37)°, (15.26±2.61)°, (17.63±2.16)°, (19.46±2.54)°, and in group B were(59.31±1.87)%, (89.19±2.53)%, (88.62±2.51)%, (88.59±2.62)% and(24.72±3.78)°, (14.91±2.28)°, (15.48±2.55)°, (15.86±2.81)°. Vertebral height Immediately after surgery was greater in group B than in group A and Cobb angle in group B was smaller than in group A (P<0.05). During follow-up, there was no significant change in vertebral height in group B, while vertebral body recollapse in group A(P<0.05). CONCLUSIONS: In the treatment of osteoporotic vertebral compression fractures with intravertebral clefts, the manual reduction combined with PVP is more effective than single PVP, which can effectively prevent vertebral body recollapse and improve the long-term efficacy of patients. AD - Department of Orthopaedics, China-Japan Friendship Hospital, Beijing 100029, China; zrtanms@sina.com. AN - 31382714 AU - Wei, H. Y. AU - Dong, C. K. AU - Zhou, J. AU - Wang, Y. L. AU - Tang, X. S. AU - Tan, M. S. DA - Jul 25 DO - 10.3969/j.issn.1003-0034.2019.07.002 DP - NLM ET - 2019/08/07 J2 - Zhongguo gu shang = China journal of orthopaedics and traumatology KW - Aged Aged, 80 and over Bone Cements Female *Fractures, Compression Humans Male Middle Aged *Osteoporotic Fractures Retrospective Studies *Spinal Fractures Treatment Outcome *Vertebroplasty Intravertebral clefts Manual reduction Osteoporotic vertebral compression fractures Percutaneous vertebroplasty relevant financial relationships with commercial interests to disclose. LA - chi M1 - 7 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 1003-0034 (Print) 1003-0034 SP - 591-597 ST - [Manual reduction combined with percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures with intravertebral clefts] T2 - Zhongguo Gu Shang TI - [Manual reduction combined with percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures with intravertebral clefts] VL - 32 ID - 828601 ER - TY - JOUR AD - Department of General Internal Medicine, University Hospital Bern, Bern 3010, Switzerland AU - Weiler, S. AU - Basedow, J. AU - Isenegger, J. AU - Heverhagen, J. AU - Meier, B. AU - Exadaktylos, A. DB - Embase DO - 10.1136/bmj.f6920 KW - bone cement D dimer aged case report computer assisted tomography faintness female heart catheterization human lung artery pressure lung embolism mitral valve stenosis note priority journal transthoracic echocardiography L1 - http://www.bmj.com/highwire/filestream/674717/field_highwire_article_pdf/0/bmj.f6920.full.pdf LA - English M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1756-1833 ST - Cementing the lungs T2 - BMJ (Online) TI - Cementing the lungs UR - https://www.embase.com/search/results?subaction=viewrecord&id=L370397193&from=export http://dx.doi.org/10.1136/bmj.f6920 VL - 347 ID - 829465 ER - TY - JOUR AB - The aim of our study was to describe the technique of percutaneous injection of acrylic surgical cement into acetabulum malignancies [percutaneous acetabuloplasty (PCA)] and determine its efficiency in relieving pain. Eighteen patients (8 men, 10 women; aged 40-81 years) with painful acetabular malignancies (18 lesions; 17 metastases, 1 multifocal bone sarcoma) were treated with PCA. Procedures were done using lateral approach with fluoroscopic guidance. The 18 procedures were evaluated and resulted in 4 (22 %) total improvement, 7 (39 %) clear improvement, 4 (22 %) moderate improvement, 1 (6 %) no improvement, and 2 (11 %) worsening in keeping with a cement leak in contact with the sciatic nerve and a leak towards the joint. Follow-up ranged from 2 to 48 months (average 9.4 months). We observed 2 cases of recurrence of pain at 6 and 39 months, both in keeping with local tumoral progression. PCA of malignancies is a minimally invasive and low-cost procedure that provides immediate and long-term pain relief. AD - Hop La Pitie Salpetriere, Neuroradiol Charcot, F-75013 Paris, France. Weill, A (corresponding author), Fdn Ophthalmol Adolphe de Rothschild, Serv Neuroradiol Intervent, 25-29 Rue Manin, F-75940 Paris, France. AN - WOS:000072067700024 AU - Weill, A. AU - Kobaiter, H. AU - Chiras, J. DO - 10.1007/s003300050351 J2 - Eur. Radiol. KW - acetabulum interventional radiology neoplasms surgery hip METASTASES EMBOLIZATION LESIONS Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 1998 SN - 0938-7994 SP - 123-129 ST - Acetabulum malignancies: technique and impact on pain of percutaneous injection of acrylic surgical cement T2 - European Radiology TI - Acetabulum malignancies: technique and impact on pain of percutaneous injection of acrylic surgical cement UR - ://WOS:000072067700024 VL - 8 ID - 830478 ER - TY - JOUR AN - 104852622. Language: English. Entry Date: 20110527. Revision Date: 20150711. Publication Type: Journal Article AU - Weinstein, Jason S. DB - cin20 DO - 10.3928/01477447-20110124-21 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Methods Bone Cements -- Therapeutic Use Embolism, Fat -- Prevention and Control M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2011 SN - 0147-7447 SP - 208-209 ST - Comparison of bone-vacuum cement vs no cement for the prevention of fat embolism during THA T2 - Orthopedics TI - Comparison of bone-vacuum cement vs no cement for the prevention of fat embolism during THA UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104852622&site=ehost-live&scope=site VL - 34 ID - 830694 ER - TY - JOUR AB - In recent years, deep venous thrombosis (DVT) after spine surgery has received extensive attention, but perioperative prevalence of DVT in patients undergoing percutaneous kyphoplasty (PKP) is lacking.To assess the perioperative prevalence of deep vein thrombosis (DVT) in patients undergoing PKP with routinely applied ultrasonography.We reviewed 1113 consecutive patients undergoing PKP from January 2014 to August 2017. The surgical procedure was bilateral PKP. All patients were routinely examined with ultrasonography when admitted to the hospital and on the first post-operative day. Clinical signs of DVT were checked and recorded before examination.Forty (3.6%) out of 1113 patients were diagnosed with DVT by ultrasonography. Of the 40 detected cases of DVT, only six (0.54%) patients presented with clinical signs of DVT, demonstrating that there were 34 (3.05%) asymptomatic cases. No patient presenting with clinically suspected pulmonary embolism (PE) was observed. Gender, body mass index (BMI), operative time, hypertension, diabetes, heart disease, and lower limb fracture were not significant risk factors for DVT (P > .05). In contrast, patient age, oncologic conditions, DVT history, and paraplegia appeared to be significant risk factors for DVT (P < .01). There was no significant difference in the incidence of DVT found between the three PKP surgical levels (P > .05).The total incidence of perioperative DVT diagnosed with ultrasonography in patients undergoing PKP was 3.6%, of which only 0.54% was symptomatic cases. It is necessary to assess DVT using ultrasonography during the perioperative procedure of PKP, especially for high-risk patients.Level of evidence: Level IV. AD - Department of Orthopaedic Surgery, Daqing Oilfield General Hospital, Heilongjiang 163001 Department of Nephrology, Affiliated Hospital of Nanjing Medical University, North District of Suzhou Municipal Hospital, Suzhou Department of Orthopedics, The First Affiliated Hospital of Soochow University, 188, Shizi Road, Suzhou 215006 Department of Orthopaedic Surgery, Shengzhou People's Hospital, The First Affiliated Hospital of Zhejiang University Shengzhou Branch, Zhejiang, China AN - 143885408. Language: English. Entry Date: 20200625. Revision Date: 20200929. Publication Type: journal article. Journal Subset: Biomedical AU - Wencan, Fan AU - Tianzhu, Qiao AU - Yongqing, You AU - Jun, Zhang AU - Jijian, Gao AU - Fan, Wencan AU - Qiao, Tianzhu AU - You, Yongqing AU - Zhang, Jun AU - Gao, Jijian DB - cin20 DO - 10.1097/MD.0000000000019402 DP - EBSCOhost KW - Venous Thrombosis -- Etiology Intraoperative Period Kyphoplasty -- Adverse Effects Male Venous Thrombosis -- Physiopathology Venous Thrombosis -- Epidemiology China Retrospective Design Risk Factors Aged Postoperative Complications -- Etiology Adult Prevalence Middle Age Ultrasonography -- Statistics and Numerical Data Postoperative Complications -- Physiopathology Kyphoplasty -- Methods Postoperative Complications -- Epidemiology Female Scales M1 - 10 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2020 SN - 0025-7974 SP - 1-4 ST - Perioperative prevalence of deep vein thrombosis in patients with percutaneous kyphoplasty: A retrospective study with routine ultrasonography T2 - Medicine TI - Perioperative prevalence of deep vein thrombosis in patients with percutaneous kyphoplasty: A retrospective study with routine ultrasonography UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=143885408&site=ehost-live&scope=site VL - 99 ID - 830515 ER - TY - JOUR AN - CN-00460072 AU - Werner, L. DO - 10.1111/j.1365-2044.2003.03622.x KW - Arthroplasty, Replacement, Hip [*adverse effects] Bone Cements [*adverse effects] Death, Sudden, Cardiac [*etiology] Humans Polymethyl Methacrylate [*adverse effects] Prospective Studies Pulmonary Embolism [etiology] M1 - 2 M3 - Clinical Trial; Comment; Letter; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2004 SP - 200 ST - A response to 'Sudden deaths during hip hemi-arthroplasty', Parry G, Anaesthesia 2003; 58: 922-23 T2 - Anaesthesia TI - A response to 'Sudden deaths during hip hemi-arthroplasty', Parry G, Anaesthesia 2003; 58: 922-23 UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00460072/full VL - 59 ID - 830009 ER - TY - JOUR AB - STUDY DESIGN: Technical note. OBJECTIVE: To describe a technique for performing percutaneous vertebroplasty of C1 for treatment of osteolytic metastatic disease involving the lateral portions of the atlas in which precautions are taken to protect the vertebrobasilar arterial supply and a posterior access route is used for cement delivery. SUMMARY OF BACKGROUND DATA: Percutaneous vertebroplasty (PVP) has proved to be efficient for the treatment of painful osteolytic vertebral disease. Good clinical experience with this technique suggested its extension to stabilize a painful osteolytic lesion of the atlas. METHODS: A patient with known parotid cancer presented with neck pain refractory to conservative treatment. On computed tomography, osteolytic destruction of the atlas that mainly involved the right lateral mass and surrounded the vertebral artery was found. On digital subtraction angiography, the lesion was shown to be highly vascularized and supplied mainly by direct branches of the ipsilateral vertebral artery. To avoid the risk of cement reflux from the tumor vascular bed to the involved vertebral artery, coil occlusion of the involved V3 segment was performed before vertebroplasty. Percutaneous vertebroplasty was then carried out using a percutaneous posteroanterior direction access route. RESULTS: Satisfactory filling of the osteolytic lesion with cement was achieved radiologically. Three days after the intervention and at a 9-month follow-up examination, the patient was free of pain. CONCLUSIONS: Vertebroplasty used to treat an osteolytic lesion of the atlas involving the lateral mass was performed by a posterior percutaneous approach. To prevent vertebrobasilar embolism, the involved vertebral artery was occluded before polymer injection. AD - Department of Radiology at the University Hospital of Geneva, Geneva, Switzerland. stephanwetzel@yahoo.de AN - 12436010 AU - Wetzel, S. G. AU - Martin, J. B. AU - Somon, T. AU - Wilhelm, K. AU - Rufenacht, D. A. DA - Nov 15 DO - 10.1097/00007632-200211150-00022 DP - NLM ET - 2002/11/19 J2 - Spine KW - Aged Angiography, Digital Subtraction Carcinoma/*complications Cervical Atlas/diagnostic imaging/pathology/*surgery Humans Male Minimally Invasive Surgical Procedures Neck Pain/etiology Osteolysis/diagnosis/*etiology/surgery Parotid Neoplasms/*complications Spinal Neoplasms/diagnosis/secondary/*surgery Tomography, X-Ray Computed Treatment Outcome LA - eng M1 - 22 N1 - PubMed NLM literature search January 5, 2021 PY - 2002 SN - 0362-2436 SP - E493-5 ST - Painful osteolytic metastasis of the atlas: treatment with percutaneous vertebroplasty T2 - Spine (Phila Pa 1976) TI - Painful osteolytic metastasis of the atlas: treatment with percutaneous vertebroplasty VL - 27 ID - 828935 ER - TY - JOUR AB - Study Design: Technical note.Objective: To describe a technique for performing percutaneous vertebroplasty of C1 for treatment of osteolytic metastatic disease involving the lateral portions of the atlas in which precautions are taken to protect the vertebrobasilar arterial supply and a posterior access route is used for cement delivery.Summary Of Background Data: Percutaneous vertebroplasty (PVP) has proved to be efficient for the treatment of painful osteolytic vertebral disease. Good clinical experience with this technique suggested its extension to stabilize a painful osteolytic lesion of the atlas.Methods: A patient with known parotid cancer presented with neck pain refractory to conservative treatment. On computed tomography, osteolytic destruction of the atlas that mainly involved the right lateral mass and surrounded the vertebral artery was found. On digital subtraction angiography, the lesion was shown to be highly vascularized and supplied mainly by direct branches of the ipsilateral vertebral artery. To avoid the risk of cement reflux from the tumor vascular bed to the involved vertebral artery, coil occlusion of the involved V3 segment was performed before vertebroplasty. Percutaneous vertebroplasty was then carried out using a percutaneous posteroanterior direction access route.Results: Satisfactory filling of the osteolytic lesion with cement was achieved radiologically. Three days after the intervention and at a 9-month follow-up examination, the patient was free of pain.Conclusions: Vertebroplasty used to treat an osteolytic lesion of the atlas involving the lateral mass was performed by a posterior percutaneous approach. To prevent vertebrobasilar embolism, the involved vertebral artery was occluded before polymer injection. AD - Department of Radiology at the University Hospital of Geneva, Geneva, Switzerland AN - 138086498. Language: English. Entry Date: 20030418. Revision Date: 20190819. Publication Type: journal article AU - Wetzel, Stephan G. AU - Martin, Jean-Baptiste AU - Somon, Thierry AU - Wilhelm, Kai AU - Rufenacht, Daniel A. DB - cin20 DP - EBSCOhost KW - Cervical Atlas -- Surgery Parotid Neoplasms -- Complications Spinal Neoplasms -- Surgery Carcinoma -- Complications Osteolysis -- Etiology Aged Angiography, Digital Subtraction Spinal Neoplasms -- Diagnosis Cervical Atlas -- Pathology Cervical Atlas Male Osteolysis -- Surgery Treatment Outcomes Neck Pain -- Etiology Osteolysis -- Diagnosis Minimally Invasive Procedures Tomography, X-Ray Computed Spinal Neoplasms Scales M1 - 22 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2002 SN - 0362-2436 SP - E493-E495 ST - Painful osteolytic metastasis of the atlas: treatment with percutaneous vertebroplasty T2 - Spine (03622436) TI - Painful osteolytic metastasis of the atlas: treatment with percutaneous vertebroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=138086498&site=ehost-live&scope=site VL - 27 ID - 830791 ER - TY - JOUR AB - BACKGROUND: The objective was to investigate changes in pulmonary blood flow after lung contusion and fat embolism. METHODS: Eighteen mongrel dogs were randomly assigned to three groups: fat embolism alone (n = 7); moderate unilateral pulmonary contusion followed by fat embolism (n = 6); and severe unilateral pulmonary contusion followed by fat embolism (n = 5). Fat embolism was produced by intramedullary reaming of left femur and tibia followed by canal pressurization using bone cement. Outcome measures were systemic blood pressure, pulmonary artery pressure, pulmonary artery occluded pressure, cardiac output (CO), and partial pressures of arterial and mixed venous oxygen (Pao2, PvO2). Samples were taken from contused and noncontused contralateral lung to calculate regional pulmonary blood flow. RESULTS: After the fat embolism, pulmonary artery pressure and pulmonary vascular resistance increased significantly (p < 0.05) in all groups, whereas Pao2 decreased in groups 2 and 3 and at 30 minutes in group 1. CO decreased significantly in group 3. Group 3 also demonstrated a greater initial decrease in Pao2 and PvO2 from baseline and a larger increase in pulmonary vascular resistance. In those animals that underwent contusion, regional pulmonary blood flow was not found to be different between contused and noncontused lung segments. After contusion, flow decreased significantly in contused and noncontused segments in group 3 only. CONCLUSIONS: Gas exchange deteriorates because of decreased CO. For any preexisting intrapulmonary shunt, the decrease of PvO2 will cause worsening of Pao2. AD - Division of Orthopaedic Surgery, Department of Surgery, St. Michael's Hospital, Toronto, Ontario, Canada. AN - 105104657. Language: English. Entry Date: 20101015. Revision Date: 20200708. Publication Type: Journal Article AU - Whelan, D. B. AU - Byrick, R. J. AU - Mazer, C. D. AU - Kay, C. AU - Richards, R. R. AU - Zdero, R. AU - Schemitsch, E. H. DB - cin20 DO - 10.1097/TA.0b013e3181ec484f DP - EBSCOhost KW - Contusions and Abrasions -- Physiopathology Embolism, Fat -- Physiopathology Lung Injury -- Physiopathology Pulmonary Gas Exchange -- Physiology Animal Studies Blood Pressure -- Physiology Carbon Dioxide -- Blood Cardiac Output -- Physiology Dogs Female Lung -- Blood Supply Lung -- Physiopathology Male Models, Biological Oxygen -- Blood Partial Pressure Pulmonary Circulation -- Physiology Pulmonary Wedge Pressure -- Physiology M1 - 3 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2010 SN - 0022-5282 SP - 512-518 ST - Posttraumatic lung injury after pulmonary contusion and fat embolism: factors determining abnormal gas exchange T2 - Journal of Trauma TI - Posttraumatic lung injury after pulmonary contusion and fat embolism: factors determining abnormal gas exchange UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105104657&site=ehost-live&scope=site VL - 69 ID - 830705 ER - TY - JOUR AB - STUDY DESIGN: Technical report. OBJECTIVE: To convey the mechanism of venous air embolism (VAE) during percutaneous spinal procedures and its proper identification and management. SUMMARY OF BACKGROUND DATA: Percutaneous spinal procedures such as vertebroplasty and kyphoplasty are commonplace techniques employed to alleviate back pain for compression fractures. VAE is a real and likely underappreciated phenomenon that is important to recognize. METHODS: A case report is used to illustrate the clinical scenario of VAE during vertebroplasty performed for a T9 compression fracture. RESULTS: The rapid sumping of fluid and air was identified during the procedure and believed to be due to a large air/venous interface within the trabecular bone. The needle was capped and no undue harm occurred to the patient. CONCLUSION: VAE is a complication with associated morbidity and mortality from percutaneous procedures for the treatment of compression fractures. An understanding of the causes, prevention, identification, and management when it occurs will serve to improve patient care and reduce morbidity. AD - Department of Neuroscience and Experimental Therapeutics, Texas A&M University, College Station, TX, USA. AN - 19483666 AU - White, J. B. AU - Thielen, K. R. AU - Kallmes, D. F. DA - Jun 15 DO - 10.1097/BRS.0b013e3181a90b44 DP - NLM ET - 2009/06/02 J2 - Spine KW - Aged Embolism, Air/*diagnosis/etiology Female Humans Intraoperative Complications/*diagnosis/etiology Monitoring, Intraoperative/methods Osteoporosis, Postmenopausal/complications Risk Factors Spinal Fractures/etiology/surgery Veins/pathology Vertebroplasty/adverse effects/instrumentation/*methods LA - eng M1 - 14 N1 - PubMed NLM literature search January 5, 2021 PY - 2009 SN - 0362-2436 SP - 1526-8 ST - Putative risk of substantial venous air embolism during vertebroplasty: a technical observation T2 - Spine (Phila Pa 1976) TI - Putative risk of substantial venous air embolism during vertebroplasty: a technical observation VL - 34 ID - 828826 ER - TY - JOUR AB - Case Description: The patient presented to the emergency room for insidious back pain; imaging showed T5 lytic lesion with pathologic fracture. No neurologic deficits at presentation, and he was treated conservatively. T5 vertebral biopsy confirmed metastatic lung adenocarcinoma and he was discharged with outpatient follow up. He returned for intractable pain in the same area and underwent T5 radiofrequency tumor ablation and kyphoplasty. Small amount of cement extrusion noted from the posterior aspect of the vertebral body during the procedure. Post-op, he was neurologically intact, but developed worsening lower extremity weakness and sensory loss 48 hours later. Imaging showed cement extrusion into the central canal and neural foramen causing mass effect on the spinal cord and nerve roots. He underwent emergent T4-5 laminectomy and cement evacuation. Exam showed T5 AIS B incomplete paraplegia. He was also treated with corticosteroid taper and palliative radiation therapy. Post-op course notable for bowel incontinence, urinary retention, andmultiple pressure injuries. He was transferred to inpatient rehabilitation (IPR) shortly after surgery. Despite initial progress, transfers and mobility were limited by poor trunk control and impaired sensation. He was discharged to subacute rehabilitation. Setting: Tertiary care hospital Patient: A 78-year-old male with recently diagnosed lung adenocarcinoma with bony metastases. Assessment/Results: Patient had several readmissions for morbidities related to his spinal cord injury including infected pressure injury and pulmonary embolism. His functional status continued to decline despite continued subacute rehabilitation. Repeat imaging showed advancing metastases and he was ultimately discharged to hospice. Discussion: Kyphoplasty is generally a well-tolerated procedure, and patients report successful pain relief. Cement extrusion is a known and accepted risk during vertebral kyphoplasty, however there are few reported cases of resultant spinal cord injury. Conclusion: While rare, cement extrusion during kyphoplasty can cause permanent spinal cord injury despite cement evacuation and decompression. AD - L.A. White, Beaumont Health (Royal Oak), PMandR Program, Royal Oak, MI, United States AU - White, L. A. DB - Embase DO - 10.1002/pmrj.12271 KW - cement corticosteroid adverse drug reaction aged analgesia backache bone biopsy cancer patient cancer radiotherapy cancer surgery case report clinical article conference abstract decompression embolism emergency ward feces incontinence follow up functional status hospice hospital patient hospital readmission human hypesthesia intractable pain kyphoplasty laminectomy lower limb lung adenocarcinoma lung injury lung metastasis male morbidity nerve root outpatient paraplegia pathologic fracture radiofrequency radiotherapy rehabilitation side effect spinal cord injury tertiary care center trunk tumor ablation urine retention vertebra body weakness LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1934-1482 SP - S166-S167 ST - Evolving spinal cord injury due to cement extrusion during vertebral kyphoplasty: A case report T2 - PM and R TI - Evolving spinal cord injury due to cement extrusion during vertebral kyphoplasty: A case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L631855243&from=export http://dx.doi.org/10.1002/pmrj.12271 VL - 11 ID - 829106 ER - TY - JOUR AD - From the Department of Internal Medicine and Cardiology, Technische Universität Dresden, Herzzentrum Dresden University Hospital, Dresden, Germany. stephan.wiedemann@mailbox.tu-dresden.de. From the Department of Internal Medicine and Cardiology, Technische Universität Dresden, Herzzentrum Dresden University Hospital, Dresden, Germany. AN - 24944304 AU - Wiedemann, S. AU - Ebner, B. AU - Ibrahim, K. AU - Scherf, L. AU - Heidrich, F. M. AU - Strasser, R. H. DA - Jun DO - 10.1161/circinterventions.113.001128 DP - NLM ET - 2014/06/20 J2 - Circulation. Cardiovascular interventions KW - Aged Bone Cements/*adverse effects Cardiac Catheterization/*methods Coronary Angiography Echocardiography, Transesophageal Female Foreign-Body Migration/*complications Humans *Jugular Veins Lumbar Vertebrae/surgery Pulmonary Embolism/diagnosis/*etiology/*therapy Spinal Fusion/*adverse effects/methods Treatment Outcome embolism intervention right ventricular involvement LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1941-7640 SP - 410-3 ST - Percutaneous transjugular removal of an intracardial bone cement fragment after dorsal stabilization T2 - Circ Cardiovasc Interv TI - Percutaneous transjugular removal of an intracardial bone cement fragment after dorsal stabilization VL - 7 ID - 828525 ER - TY - JOUR AB - Introduction: Percutaneous vertebroplasty is the injection of polymethylmethacrylate (PMMA) bone cement into a painful vertebra, with the aim of providing stability. Complications are rare, and most are related to the leakage of bone cement into the spinal canal or the perivertebral venous system. Pulmonary cement embolism caused by cement migration during this procedure may be asymptomatic, but fatal cardiopulmonary complications have been reported. Cement leakage is not considered as a complication unless related with neurological or pulmonary morbidities. Material and Methods: Aim of this study: Prospective randomized comparison of the incidence of leakage of two cement types after percutaneous vertebroplasty in vertebral osteoporotic fractures, and to compare the results of two different viscosities of cement regarding localisation and frequency of leakage using the same intraoperative technique. Forty patients (25 females, 15 males; mean age 67.4 years) with osteoporotic single level fractures from Th9 to L3 without posterior cortex involvement or neurological deficit, devided randomly and prospective into 2 groups; * Group A with high viscosity bone cement (Depuy;Confidence), * Group B with low viscosity bone cement (Biomet; Bone Cement V) X‐ray and CT (only in cases with suspected leakage in intra operative X‐ray) was done to detect cement leakage. Results: In Group A (high viscosity) 4 patients (20%) had total of 5 cement leakages. Three perivertebral venous leakages; 2 disc space leakage. One of these patients had both disc space and venous leakage. No pulmonary venous involvement and no spinal canal leakage. In Group B (low viscosity) 8 patients (40%) had 11 cement leakages. Seven perivertebral venous leakages, 2 of them basal lung venous involvement, one with spinal canal involvement. Four disc space leakages. We had no patient with postoperative neurological deficit or pulmonary distress. Venous cement leakage was significantly less in cases managed with low viscosity cement (P<0.04) whereas this difference was statistically insignificant regarding disk space leakage (P=0.14). Conclusion: In vertebroplasty the use of high viscosity bone cement in treatment of osteoporotic vertebral fractures is significantly effective to reduce the risk of venous cement leakage and consequently increases the safety of this procedure. AN - CN-01065724 AU - Wiese, D. AU - Alhashash, M. AU - Bohm, H. DO - 10.1007/s00586-010-1601-9 KW - *bone cement *cement *percutaneous vertebroplasty *society *spine *spine fracture *viscosity Cimetidine Embolism Female Fracture Fragility fracture Human Injection Lung Male Morbidity Patient Poly(methyl methacrylate) Procedures Risk Safety Venous circulation Vertebra Vertebral canal X ray M1 - 11 M3 - Journal: Conference Abstract N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2010 SP - 1994 ST - Prospective randomised study about the influence of bone cement viscosity on cement leakage comparing high with low viscosity bone cement in thoracolumbar osteoporotic vertebral fractures treated with percutaneous Vertebroplasty T2 - European spine journal. TI - Prospective randomised study about the influence of bone cement viscosity on cement leakage comparing high with low viscosity bone cement in thoracolumbar osteoporotic vertebral fractures treated with percutaneous Vertebroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01065724/full VL - 19 ID - 829981 ER - TY - JOUR AB - Introduction: Percutaneous vertebroplasty is the injection of polymethylmethacrylate (PMMA) bone cement into a painful vertebra, with the aim of providing stability. Complications are rare, and most are related to the leakage of bone cement into the spinal canal or the perivertebral venous system. Pulmonary cement embolism caused by cement migration during this procedure may be asymptomatic, but fatal cardiopulmonary complications have been reported. Cement leakage is not considered as a complication unless related with neurological or pulmonary morbidities. Material and Methods: Aim of this study: Prospective randomized comparison of the incidence of leakage of two cement types after percutaneous vertebroplasty in vertebral osteoporotic fractures, and to compare the results of two different viscosities of cement regarding localisation and frequency of leakage using the same intraoperative technique. Forty patients (25 females, 15 males; mean age 67.4 years) with osteoporotic single level fractures from Th9 to L3 without posterior cortex involvement or neurological deficit, devided randomly and prospective into 2 groups; • Group A with high viscosity bone cement (Depuy;Confidence), • Group B with low viscosity bone cement (Biomet; Bone Cement V) X-ray and CT (only in cases with suspected leakage in intra operative X-ray) was done to detect cement leakage. Results: In Group A (high viscosity) 4 patients (20%) had total of 5 cement leakages. Three perivertebral venous leakages; 2 disc space leakage. One of these patients had both disc space and venous leakage. No pulmonary venous involvement and no spinal canal leakage. In Group B (low viscosity) 8 patients (40%) had 11 cement leakages. Seven perivertebral venous leakages, 2 of them basal lung venous involvement, one with spinal canal involvement. Four disc space leakages. We had no patient with postoperative neurological deficit or pulmonary distress. Venous cement leakage was significantly less in cases managed with low viscosity cement (P<0.04) whereas this difference was statistically insignificant regarding disk space leakage (P=0.14). Conclusion: In vertebroplasty the use of high viscosity bone cement in treatment of osteoporotic vertebral fractures is significantly effective to reduce the risk of venous cement leakage and consequently increases the safety of this procedure. AD - D. Wiese, Zentralklinik Bad Berka, Klinik für Wirbeläulenchrurgie und Querschnittgelähmte, Bad Berka, Germany AU - Wiese, D. AU - Alhashash, M. AU - Böhm, H. DB - Embase DO - 10.1007/s00586-010-1601-9 KW - bone cement cement cimetidine poly(methyl methacrylate) viscosity spine spine fracture percutaneous vertebroplasty society human patient vertebral canal X ray procedures embolism venous circulation safety lung vertebra fracture male female fragility fracture risk morbidity injection LA - English M1 - 11 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2010 SN - 0940-6719 SP - 1994 ST - Prospective randomised study about the influence of bone cement viscosity on cement leakage comparing high with low viscosity bone cement in thoracolumbar osteoporotic vertebral fractures treated with percutaneous Vertebroplasty T2 - European Spine Journal TI - Prospective randomised study about the influence of bone cement viscosity on cement leakage comparing high with low viscosity bone cement in thoracolumbar osteoporotic vertebral fractures treated with percutaneous Vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71557914&from=export http://dx.doi.org/10.1007/s00586-010-1601-9 VL - 19 ID - 829639 ER - TY - JOUR AB - We describe a 59-year-old woman, who came to the Emergency Room with fever, dyspnoea and lung abnormalities on chest x-ray. The X-ray abnormalities were not related to the clinical symptoms and could be explained by the patient's medical history, which included rib fractures and spinal compression fractures. The confined spherical structures visible on chest X-ray were indicative of previous rib fractures. The linear hyperdense branching structures represent diffuse pulmonary cement embolisms after percutaneous vertebroplasty. AD - Spaarne Gasthuis, afd. Longziekten, Haarlem/Hoofddorp. Contact: P.C. Wijsman (pietawijsman@live.nl). Spaarne Gasthuis, afd. Radiologie, Haarlem/Hoofddorp. AN - 30875157 AU - Wijsman, P. C. AU - de Monyé, W. DA - Mar 11 DP - NLM ET - 2019/03/16 J2 - Nederlands tijdschrift voor geneeskunde KW - Bone Cements/*adverse effects Dyspnea/etiology Female Fever/etiology Fractures, Compression/surgery Humans Middle Aged Pulmonary Embolism/*diagnostic imaging/*etiology Radiography Spinal Fractures/surgery Vertebroplasty/*adverse effects LA - dut N1 - PubMed NLM literature search January 5, 2021 OP - Afwijkingen op een thoraxfoto. PY - 2019 SN - 0028-2162 ST - [Unusual findings on chest x-ray] T2 - Ned Tijdschr Geneeskd TI - [Unusual findings on chest x-ray] VL - 163 ID - 828494 ER - TY - JOUR AB - Deep‐vein thrombosis (DVT) and pulmonary embolism (PE) represent life‐threatening postoperative complications frequently responsible for in‐hospital mortality following total knee arthroplasty (TKA). Mechanical prophylaxis in the form of a foot pump offers an alternative to pharmacological and physical therapy. The aim of this prospective and randomised study was to examine the clinical efficacy of the A‐V Impulse (AVI) system in reduction of soft‐tissue swelling of the lower limb following a TKA. A total of 80 patients undergoing cemented TKA between September 2005 and December 2006 were randomised into two groups of 40 patients (n¹ = 40, n² = 40) during the 16‐month study period. All patients received a subcutaneous dose of low molecular weight heparin (LMWH) (Enoxaparin/Clexane® 40 mg) once daily beginning 24 hours prior to the operation. The mean age for the groups n¹ and n² were 68.93 and 68.15 years, respectively. The reduction of soft‐tissue swelling in the n¹ group was significantly higher (p < 0.05) compared with n². Evaluation of body mass index (BMI) with regard to the average reduction of soft‐tissue swelling showed no significant influence (p < 0.05). The better function of the operated knee in group AVI was a significant predictor for improved agility and mobility (p < 0.01). No complications were reported for the application of the AVI. No ultrasonographic evidence of DVT or PE was found in any of the 80 patients during the investigative time period of eight days. After three months, there was no evidence of a symptomatic DVT. AN - CN-00813261 AU - Windisch, C. AU - Kolb, W. AU - Kolb, K. AU - Grützner, P. AU - Venbrocks, R. AU - Anders, J. DO - 10.1007/s00264-010-1091-8 KW - Aged Anticoagulants [therapeutic use] Arthroplasty, Replacement, Knee [adverse effects, *rehabilitation] Assisted Circulation [*instrumentation, methods] Foot [blood supply] Heparin, Low‐Molecular‐Weight [therapeutic use] Hospital Mortality Humans Postoperative Care Postoperative Complications [*prevention & control] Pressure Prospective Studies Pulmonary Embolism [etiology, pathology, prevention & control] Regional Blood Flow Stockings, Compression Thromboembolism [etiology, pathology, *prevention & control] Venous Thrombosis [etiology, pathology, prevention & control] M1 - 7 M3 - Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2011 SP - 995‐1000 ST - Pneumatic compression with foot pumps facilitates early postoperative mobilisation in total knee arthroplasty T2 - International orthopaedics TI - Pneumatic compression with foot pumps facilitates early postoperative mobilisation in total knee arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00813261/full VL - 35 ID - 830069 ER - TY - JOUR AB - We encountered a case of apparent progressive femoral osteolysis around a well-fixed cementless implant in a young patient. At the time of revision arthroplasty, massive hemorrhaging occurred during exposure and attempted femoral component extraction. Urgent packing of the exposed endosteum with polymethyl methacrylate controlled the bone bleeding. Emergent angiography confirmed an arteriovenous malformation with extensive proximal diaphyseal involvement directly at the site of osteolysis. This arteriovenous malformation was treated successfully with selective arterial embolization and second-stage resection. In retrospect, the index arthroplasty operative note indicated an excessive amount of blood loss, and prerevision radiographs showed osteolysis with uncharacteristic vascular markings. The presence of an osteolytic lesion in total hip arthroplasty should not be assumed to be attributed to polyethylene granuloma, and any atypical radiographic features should prompt further preoperative investigations. AD - M.J. Winemaker, Hamilton Arthroplasty Group, Hamilton Health Sciences Corporation, Henderson General Hospital, 711 Concession Street, Hamilton, Ont. L8V 1C3, Canada AU - Winemaker, M. J. AU - Boucher, M. A. AU - De V. DeBeer, J. AU - Colterjohn, N. AU - Petruccelli, D. DB - Embase Medline DO - 10.1054/arth.2001.20544 KW - adult angiography arteriovenous malformation artery embolism article bleeding case report clinical feature diaphysis disease course femur granuloma human male osteolysis preoperative period prosthesis radiography total hip prosthesis LA - English M1 - 3 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2001 SN - 0883-5403 SP - 394-399 ST - Arteriovenous malformation mimicking femoral osteolysis after total hip arthroplasty T2 - Journal of Arthroplasty TI - Arteriovenous malformation mimicking femoral osteolysis after total hip arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L32303863&from=export http://dx.doi.org/10.1054/arth.2001.20544 VL - 16 ID - 829883 ER - TY - JOUR AB - We encountered a case of apparent progressive femoral osteolysis around a well-fixed cementless implant in a young patient. At the time of revision arthroplasty, massive hemorrhaging occurred during exposure and attempted femoral component extraction. Urgent packing of the exposed endosteum with polymethyl methacrylate controlled the bone bleeding. Emergent angiography confirmed an arteriovenous malformation with extensive proximal diaphyseal involvement directly at the site of osteolysis. This arteriovenous malformation was treated successfully with selective arterial embolization and second-stage resection. In retrospect, the index arthroplasty operative note indicated an excessive amount of blood loss, and prerevision radiographs showed osteolysis with uncharacteristic vascular markings. The presence of an osteolytic lesion in total hip arthroplasty should not be assumed to be attributed to polyethylene granuloma, and any atypical radiographic features should prompt further preoperative investigations. AD - Hamilton Arthroplasty Group, Hamilton Health Sciences Corporation, Henderson General Hospital, Hamilton, Ontario, Canada. AN - 11307141 AU - Winemaker, M. J. AU - Boucher, M. A. AU - de, V. deBeer J. AU - Colterjohn, N. AU - Petruccelli, D. DA - Apr DO - 10.1054/arth.2001.20544 DP - NLM ET - 2001/04/18 J2 - The Journal of arthroplasty KW - Adult Arteriovenous Malformations/*diagnosis/therapy *Arthroplasty, Replacement, Hip Diagnosis, Differential Humans Male Osteolysis/*diagnosis/etiology Reoperation LA - eng M1 - 3 N1 - PubMed NLM literature search January 5, 2021 PY - 2001 SN - 0883-5403 (Print) 0883-5403 SP - 394-9 ST - Arteriovenous malformation mimicking femoral osteolysis after total hip arthroplasty T2 - J Arthroplasty TI - Arteriovenous malformation mimicking femoral osteolysis after total hip arthroplasty VL - 16 ID - 828974 ER - TY - JOUR AB - We encountered a case of apparent progressive femoral osteolysis around a well-fixed cementless implant in a young patient. At the time of revision arthroplasty, massive hemorrhaging occurred during exposure and attempted femoral component extraction. Urgent packing of the exposed endosteum with polymethyl methacrylate controlled the hone bleeding. Emergent angiography confirmed an arteriovenous malformation with extensive proximal diaphyseal involvement directly at the site of osteolysis. This arteriovenous malformation was treated successfully with selective arterial embolization and second-stage resection. In retrospect, the index arthroplasty operative note indicated an excessive amount of blued loss, and prerevision radiographs showed osteolysis with uncharacteristic vascular markings. The presence of an osteolytic lesion in total hip arthroplasty should not bs assumed to be attributed to polyethylene granuloma, and any atypical radiographic features should prompt further preoperative investigations. AD - Henderson Gen Hosp, Hamilton Hlth Sci Corp, Hamilton Arthroplasty Grp, Hamilton, ON L8V 1C3, Canada. Winemaker, MJ (corresponding author), Henderson Gen Hosp, Hamilton Hlth Sci Corp, Hamilton Arthroplasty Grp, 711 Concess St, Hamilton, ON L8V 1C3, Canada. AN - WOS:000168113500020 AU - Winemaker, M. J. AU - Boucher, M. A. AU - deBeer, J. D. AU - Colterjohn, N. AU - Petruccelli, D. DA - Apr DO - 10.1054/arth.2001.20544 J2 - J. Arthroplast. KW - total hip arthroplasty arteriovenous malformation osteolysis angiography embolization Orthopedics LA - English M1 - 3 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2001 SN - 0883-5403 SP - 394-399 ST - Arteriovenous malformation mimicking femoral osteolysis after total hip arthroplasty T2 - Journal of Arthroplasty TI - Arteriovenous malformation mimicking femoral osteolysis after total hip arthroplasty UR - ://WOS:000168113500020 VL - 16 ID - 830460 ER - TY - JOUR AB - Purpose: This study investigated whether etoricoxib (COX‐II blocker) has a superior efficacy of preventing heterotopic ossification (HO) after total hip arthroplasty (THA) compared to diclofenac (non‐selective NSAID). Methods: One hundred patients were included (50 in each group) in this single centre, prospective, double‐blinded, randomized, controlled trial. Etoricoxib (90 mg) was administered once and diclofenac (75 mg) twice per day for a perioperative period of nine days. The incidence of HO was evaluated on radiographs of the pelvis six months after surgery. Results: Eighty nine of 100 (89 %) patients could be analysed. The overall HO incidence was 37.8 %. There was no significant difference between both study groups. Twelve patients (27.3 %) of the DIC group and 13 patients (28.9 %) of the ETO group showed Brooker grade I ossifications. Five patients (11.4 %) of the DIC and four patients of the ETO (8.9 %) group showed grade II HO formations. No class III or IV HO formations occured in both groups. Ad hoc analysis detected a negative correlation between HO incidence and limited abduction and internal rotation of the hip. Conclusions: Etoricoxib and diclofenac are equally effective for oral HO prophylaxis after primary cementless THA when given for nine peri‐operative days to ensure a full recovery and high patient satisfaction. AN - CN-01141332 AU - Winkler, S. AU - Springorum, H. R. AU - Vaitl, T. AU - Handel, M. AU - Barta, S. AU - Kehl, V. AU - Craiovan, B. AU - Grifka, J. DO - 10.1007/s00264-015-3077-z KW - *cementless prosthesis *diclofenac/ae [Adverse Drug Reaction] *diclofenac/cm [Drug Comparison] *diclofenac/ct [Clinical Trial] *diclofenac/dt [Drug Therapy] *drug efficacy *etoricoxib/ae [Adverse Drug Reaction] *etoricoxib/cm [Drug Comparison] *etoricoxib/ct [Clinical Trial] *etoricoxib/dt [Drug Therapy] *heterotopic ossification/co [Complication] *heterotopic ossification/dt [Drug Therapy] *heterotopic ossification/pc [Prevention] *total hip prosthesis Abduction Adolescent Adult Aged Aged, 80 and over Anti‐Inflammatory Agents, Non‐Steroidal [adverse effects, *therapeutic use] Arthroplasty, Replacement, Hip [*adverse effects] Article Certoparin/sc [Subcutaneous Drug Administration] Comparative study Controlled study Correlation analysis Cyclooxygenase 2 Inhibitors [adverse effects, *therapeutic use] Diarrhea/si [Side Effect] Diclofenac [adverse effects, *therapeutic use] Dizziness/si [Side Effect] Double blind procedure Double‐Blind Method Drug withdrawal Etoricoxib Evening dosage Female Femur fracture/co [Complication] Hemorrhoid hemorrhage/co [Complication] Hip osteoarthritis/th [Therapy] Human Humans Incidence Joint mobility Lung embolism/co [Complication] Lymph node dissection Major clinical study Male Middle Aged Morning dosage Morphine Ossification, Heterotopic [etiology, *prevention & control] Pain/si [Side Effect] Patient compliance Pelvis [diagnostic imaging, pathology] Pelvis radiography Perioperative Period Phase 3 clinical trial Postoperative pain/co [Complication] Priority journal Prospective Studies Prospective study Prosthesis loosening/co [Complication] Pyridines [adverse effects, *therapeutic use] Randomized controlled trial Rib fracture/co [Complication] Rotation Seroma/co [Complication] Sulfones [adverse effects, *therapeutic use] Thrombosis/co [Complication] Treatment duration Vomiting/si [Side Effect] M1 - 4 M3 - Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2016 SP - 673‐680 ST - Comparative clinical study of the prophylaxis of heterotopic ossifications after total hip arthroplasty using etoricoxib or diclofenac T2 - International orthopaedics TI - Comparative clinical study of the prophylaxis of heterotopic ossifications after total hip arthroplasty using etoricoxib or diclofenac UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01141332/full VL - 40 ID - 830084 ER - TY - JOUR AB - Case Presentation: A 73-year-old man with atrial fibrillation, and multiple myeloma was admitted with severe back pain secondary to multiple lumbar osteoporotic vertebral compression fractures (VCF). Four kyphoplasties (KP) were performed, providing significant pain relief. He presented 8 months later with pneumonia, and was incidentally found on a contrast-enhanced computed tomography scan of the chest to have a linear mass in the right atrium and extending into the right ventricle. A transthoracic echocardiogram confirmed the location of the linear mass and showed movement with systole. It was evident that he had suffered (Figure presented) a venous embolism of PMMA from his prior KP. A 63-yearold woman with atrial fibrillation and a prior unprovoked pulmonary embolism presented after a fall with back pain secondary to an acute T12 fracture. She failed inpatient pain management, developing encephalopathy before achieving adequate pain control. Her warfarin was held for vertebroplasty (VP), which was done without incident. She was bridged with enoxaparin and discharged to a skilled facility where her warfarin titration was problematic. She was readmitted on full dose enoxaparin and warfarin, INR 2.7, with hypovolemic shock and a 25 × 5 × 13 cm hematoma in the posterior right chest wall, along the track of the prior VP. Discussion: Two blinded randomized trials in 2009 compared VP to a sham procedure in patients with painful vertebral fractures. Patients in either group had equivalent results regarding pain control and degree of disability, questioning the true efficacy of VP. This contrasts prior studies, including meta-analyses, all supporting VP and KP over medical management in the short term. However- none of these studies involved a sham procedure, including a randomized controlled trial comparing KP favorably to medical management. Conclusions: The patients in these two case reports survived, with the first person never displaying any symptoms. The second patient presented critically ill, and required a 10 day hospitalization. Patients with multiple myeloma and those on warfarin are at higher risk for complications. Hospitalists should carefully consider whether the risks in patients with multiple co-morbidities outweigh the potential benefits of a procedure possibly equivalent to placebo. AD - M. Wolff, Nova Southeastern University, College of Osteopathic Medicine, Fort Lauderdale, FL, United States AU - Wolff, M. AU - Cohen, J. AU - Scott, G. DB - Embase DO - 10.1002/jhm.1927 KW - warfarin enoxaparin placebo hospital percutaneous vertebroplasty society kyphoplasty human patient multiple myeloma backache sham procedure analgesia disease management randomized controlled trial case report atrial fibrillation pain risk meta analysis pneumonia computer assisted tomography thorax heart right atrium heart right ventricle echocardiography vein embolism female lung embolism systole fracture hospital patient brain disease titrimetry hypovolemic shock hematoma thorax wall spine fracture disability critically ill patient hospitalization medical staff morbidity procedures compression fracture male international normalized ratio LA - English M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1553-5592 SP - S176-S177 ST - Time to back up? Two cases highlighting the potential dangers of kyphoplasty and vertebroplasty T2 - Journal of Hospital Medicine TI - Time to back up? Two cases highlighting the potential dangers of kyphoplasty and vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L70698279&from=export http://dx.doi.org/10.1002/jhm.1927 VL - 7 ID - 829579 ER - TY - JOUR AB - BACKGROUND: Topical application of tranexamic acid to bleeding wound surfaces reduces blood loss in patients undergoing some major surgeries, without systemic complications. The objective of the present trial was to assess the efficacy and safety of the topical application of tranexamic acid on postoperative blood loss in patients undergoing primary unilateral total knee arthroplasty with cement. METHODS: In a prospective, double‐blind, placebo‐controlled trial, 124 patients were randomized to receive 1.5 or 3.0 g of tranexamic acid in 100 mL of normal saline solution or an equivalent volume of placebo (normal saline solution) applied into the joint for five minutes at the end of surgery. The primary outcome was blood loss calculated from the difference between the preoperative hemoglobin level and the corresponding lowest postoperative value or hemoglobin level prior to transfusion. The safety outcomes included Doppler ultrasound in all patients and measurement of plasma levels of tranexamic acid one hour after release of the tourniquet. RESULTS: Twenty‐five patients were withdrawn for various reasons; therefore, ninety‐nine patients were included in the intention‐to‐treat analysis. The postoperative blood loss was reduced in the 1.5 and 3‐g tranexamic acid groups (1295 mL [95% confidence interval, 1167 to 1422 mL] and 1208 mL [95% confidence interval, 1078 to 1339 mL], respectively) in comparison with the placebo group (1610 mL [95% confidence interval, 1480 to 1738 mL]) (p < 0.017). The postoperative hemoglobin levels were higher in the 1.5 and 3.0‐g tranexamic acid groups (10.0 g/dL [95% confidence interval, 9.5 to 10.4 g/dL] and 10.1 g/dL [95% confidence interval, 9.8 to 10.5 g/dL], respectively) in comparison with the placebo group (8.6 g/dL [95% confidence interval, 8.2 to 9 g/dL]) (p < 0.017). With the numbers studied, there was no difference in the rates of deep‐vein thrombosis or pulmonary embolism between the three groups. Minimal systemic absorption of tranexamic acid was observed. CONCLUSIONS: At the conclusion of a total knee arthroplasty with cement, topical application of tranexamic acid directly into the surgical wound reduced postoperative bleeding by 20% to 25%, or 300 to 400 mL, resulting in 16% to 17% higher postoperative hemoglobin levels compared with placebo, with no clinically important increase in complications being identified in the treatment groups. AN - CN-00770851 AU - Wong, J. AU - Abrishami, A. AU - El Beheiry, H. AU - Mahomed, N. N. AU - Roderick Davey, J. AU - Gandhi, R. AU - Syed, K. A. AU - Muhammad Ovais Hasan, S. AU - De Silva, Y. AU - Chung, F. DO - 10.2106/JBJS.I.01518 KW - Administration, Topical Aged Antifibrinolytic Agents [*administration & dosage, therapeutic use] Arthroplasty, Replacement, Knee Bone Cements Chi‐Square Distribution Double‐Blind Method Female Humans Male Placebos Postoperative Hemorrhage [*drug therapy] Prospective Studies Tranexamic Acid [*administration & dosage, therapeutic use] Treatment Outcome M1 - 15 M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2010 SP - 2503‐2513 ST - Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty: a randomized, controlled trial T2 - Journal of bone and joint surgery. American volume TI - Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty: a randomized, controlled trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00770851/full VL - 92 ID - 830040 ER - TY - JOUR AB - Background: Topical application of tranexamic acid to bleeding wound surfaces reduces blood loss in patients undergoing some major surgeries, without systemic complications. The objective of the present trial was to assess the efficacy and safety of the topical application of tranexamic acid on postoperative blood loss in patients undergoing primary unilateral total knee arthroplasty with cement.Methods: In a prospective, double-blind, placebo-controlled trial, 124 patients were randomized to receive 1.5 or 3.0 g of tranexamic acid in 100 mL of normal saline solution or an equivalent volume of placebo (normal saline solution) applied into the joint for five minutes at the end of surgery. The primary outcome was blood loss calculated from the difference between the preoperative hemoglobin level and the corresponding lowest postoperative value or hemoglobin level prior to transfusion. The safety outcomes included Doppler ultrasound in all patients and measurement of plasma levels of tranexamic acid one hour after release of the tourniquet.Results: Twenty-five patients were withdrawn for various reasons; therefore, ninety-nine patients were included in the intention-to-treat analysis. The postoperative blood loss was reduced in the 1.5 and 3-g tranexamic acid groups (1295 mL [95% confidence interval, 1167 to 1422 mL] and 1208 mL [95% confidence interval, 1078 to 1339 mL], respectively) in comparison with the placebo group (1610 mL [95% confidence interval, 1480 to 1738 mL]) (p < 0.017). The postoperative hemoglobin levels were higher in the 1.5 and 3.0-g tranexamic acid groups (10.0 g/dL [95% confidence interval, 9.5 to 10.4 g/dL] and 10.1 g/dL [95% confidence interval, 9.8 to 10.5 g/dL], respectively) in comparison with the placebo group (8.6 g/dL [95% confidence interval, 8.2 to 9 g/dL]) (p < 0.017). With the numbers studied, there was no difference in the rates of deep-vein thrombosis or pulmonary embolism between the three groups. Minimal systemic absorption of tranexamic acid was observed.Conclusions: At the conclusion of a total knee arthroplasty with cement, topical application of tranexamic acid directly into the surgical wound reduced postoperative bleeding by 20% to 25%, or 300 to 400 mL, resulting in 16% to 17% higher postoperative hemoglobin levels compared with placebo, with no clinically important increase in complications being identified in the treatment groups. AD - Department of Anesthesia, Toronto Western Hospital, University of Toronto, 2MC-434, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada AN - 104939301. Language: English. Entry Date: 20110107. Revision Date: 20160517. Publication Type: journal article AU - Wong, J. AU - Abrishami, A. AU - El Beheiry, H. AU - Mahomed, N. N. AU - Roderick Davey, J. AU - Gandhi, R. AU - Syed, K. A. AU - Muhammad Ovais Hasan, S. AU - De Silva, Y. AU - Chung, F. AU - Wong, Jean AU - Abrishami, Amir AU - El Beheiry, Hossam AU - Mahomed, Nizar N. AU - Roderick Davey, J. AU - Gandhi, Rajiv AU - Syed, Khalid A. AU - Muhammad Ovais Hasan, Syed AU - De Silva, Yoshani AU - Chung, Frances DB - cin20 DO - 10.2106/JBJS.I.01518 DP - EBSCOhost KW - Acids, Carbocyclic -- Administration and Dosage Antifibrinolytic Agents -- Administration and Dosage Arthroplasty, Replacement, Knee Postoperative Hemorrhage -- Drug Therapy Acids, Carbocyclic -- Therapeutic Use Administration, Topical Aged Antifibrinolytic Agents -- Therapeutic Use Bone Cements Chi Square Test Double-Blind Studies Female Human Male Placebos Prospective Studies Randomized Controlled Trials Treatment Outcomes M1 - 15 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2010 SN - 0021-9355 SP - 2503-2513 ST - Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty: a randomized, controlled trial T2 - Journal of Bone & Joint Surgery, American Volume TI - Topical application of tranexamic acid reduces postoperative blood loss in total knee arthroplasty: a randomized, controlled trial UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104939301&site=ehost-live&scope=site VL - 92 ID - 830699 ER - TY - JOUR AB - This study was done to demonstrate the computed tomography (CT) and pathologic findings of the sequential changes for experimental pulmonary fat embolism (PFE), and to correlate the CT and pathologic findings of rabbit lung. PFE was induced by an intravenous injection of 0.2 mL linoleic acid in 24 rabbits. The rabbits were divided into 4 groups of 6 rabbits each. CT scans were obtained sequentially at 2 hr (n=24), day 1 (n=18), day 3 (n=12) and day 7 (n=6) after fat embolization. The pathologic findings were analyzed and CT-pathologic correlation was done. CT scans showed bilateral ground-glass opacity (GGO), consolidation and nodule in all cases. The findings of PFE at 2 hr after fat embolization were areas of decreased attenuation, GGO, consolidation and nodule. These findings were aggravated on the follow-up CT after 1 day and 3 days. The follow-up CT revealed linear density in the subpleural lungs after 7 days. On CT-pathology correlation, wedge-shaped ischemic necrosis in, the subpleural lungs correlated with nodule at 2 hr. GGO and consolidation at day 1 on CT correlated with congestion and edema, and these findings at day 3 were correlated with inflammation and hemorrhagic edema. The linear density in the subpleural lungs correlated with interstitial fibrosis and pleural contraction at day 7. In conclusion, PFE was caused by using linoleic acid which is kind of free fatty acid and this study served as one model of the occurrence of nontraumatic PFE. CT accurately depicted the natural evolution of PFE in the serial followup, and this correlated well with the pathologic findings. AD - [Woo, Ok Hee; Yong, Hwan Seok; Oh, Yu-Whan; Kang, Eun-Young] Korea Univ, Guro Hosp, Dept Radiol, Coll Med,Korea Lung Tissue Bank, Seoul 152703, South Korea. [Shin, Bong Kyung; Kim, Han Kyeom] Korea Univ, Guro Hosp, Dept Pathol, Coll Med,Korea Lung Tissue Bank, Seoul 152703, South Korea. Kang, EY (corresponding author), Korea Univ, Guro Hosp, Dept Radiol, Coll Med,Korea Lung Tissue Bank, 97 Guro Dong, Seoul 152703, South Korea. keyrad@korea.ac.kr AN - WOS:000258936600020 AU - Woo, O. H. AU - Yong, H. S. AU - Oh, Y. W. AU - Shin, B. K. AU - Kim, H. K. AU - Kang, E. Y. DA - Aug DO - 10.3346/jkms.2008.23.4.691 J2 - J. Korean Med. Sci. KW - embolism experimental studies embolism fat pulmonary embolism lung computed tomography MICROVASCULAR PERMEABILITY CEMENTED ARTHROPLASTY MARROW EMBOLISM CT FINDINGS OLEIC-ACID LUNGS DOGS Medicine, General & Internal LA - English M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2008 SN - 1011-8934 SP - 691-699 ST - Experimental pulmonary fat embolism: Computed tomography and Pathologic findings of the sequential changes T2 - Journal of Korean Medical Science TI - Experimental pulmonary fat embolism: Computed tomography and Pathologic findings of the sequential changes UR - ://WOS:000258936600020 VL - 23 ID - 830375 ER - TY - JOUR AB - Vesselplasty is a novel technique for treatment of vertebral osteoporotic compression fractures. It characterizes a PET balloon which acts as a not only a expander but also a bone cement container. Although there were reports about balloon rupture during coronary angioplasty or kyphoplasty, no reports regarding balloon rupture during Vesselplasty was found. We report a case suffered from balloon rupture during Vesselplasty complicated with neurological compromise. Vesselplasty was first performed in 2004 by Darwono. It uses a polyethylene terephthalate (PET) balloon container (Vessel-X, A-Spine Holding Group Corporation) to restore the height of the vertebral body. [1] The balloon acts as both a vertebral body expander and a bone cement container. Because of the porous structure, it also allows cement interdigitation into cancellous bone to increase the stability. Theoretically, this technique would prevent cement leakage that might cause neural compression or venous embolism. There was no searchable reports on PubMed regarding neurological complications caused by cement leakage with the use of Vesselplasty. We report a case with T6 compression fracture who received Vesselplasty treatment suffered from cement leakage and paraplegia. Case report: A 77-year-old female presented herself with middle back pain since a fall one month ago. The pain was aggravated by standing and walking, and relieved by rest. Physical examination showed middle back knocking pain. There was no neurological deficit. Plain X-rays showed T6 and T11 compression fracture. MRI study was arranged which showed T6 vertebral body recent compression fracture and T11 vertebral body old compression fracture without spinal canal compromise. BMD study over lumbar spine showed T-score-2.02, which indicated osteopenia. We arranged admission for her for Vesselplasty treatment. Vesselplasty was performed through bilateral pedicle tracts. However, cement leakage after balloon rupture was found intra-operatively. Fluoroscopy was checked and spinal canal compromise was found. Emergent open laminectomy was performed. A cement block was removed. Fluoroscopy was checked again and no visible cement in the spinal canal was noticed. However, paraplegia was found postoperatively. Megadose steroid was prescribed. Rehabilitation was conducted and physical therapy was initiated. Paralytic ileus with abdominal pain, nausea, poor appetite was also found. Discussion: There are many reports of balloon ruptures during cardiovascular procedures. Intraaortic balloon (IAB) ruptures was reported with the incidence of 2.4% (382 insertions over 75 months).[2-4] However, there were no complications as a consequence of IAB rupture. [2] Jahollari reported a case of IAB rupture and entrapment in the right femoral artery which was solved by surgical extraction under local anesthesia. [5] Schrader, R reported a case of rupture and fragmentation of a PET-balloon catheter during percutaneous transluminal coronary angioplasty of a calcified LAD-obstruction. The balloon ruptured when the insufflation pressure increased to 12atm.[6] Emergent operation for fragments removal was done to prevent a large myocardial infarction. [6-8] Rothschild, R also reported 3 cases of coronary angioplasty balloon rupture complicated by coronary artery dissection. [9] Kussmaul, W G 3rd demonstrated a circumferential tear of a ruptured angioplasty balloon. The fluoroscopic appearance of impending balloon rupture is also demonstrated. [10] It is also reported that liquid embolic materials such as lipiodol or a 33% NBCA-Lipiodol mixture should not be performed with 3 kinds of balloon catheter owing to the likelihood of causing rupture of the balloons.[11] In kyphoplasty, there was also some reports about balloon ruptures during the procedure. Balloon rupture was observed during 5 vertebrae among 137 kyphoplasties. [12] 1 balloon rupture was found in 22 kyphoplasty using in multiple myeloma patients with spinal compression fractures. [13, 14] Despite of the ruptured balloons during kyphoplasty, ruptured balloons we e easily withdrawn without clinical consequences. [15-17] Despite of the many reports mentioned above, there were few reports describing balloon ruptures during Vesselplasty procedure. Due to the basic difference of clinical scenario, the materials contained in the balloon during Vesselplasty were different from other procedures using balloons. In the balloons used in IABP, balloons were inflated and deflated with air. In balloon angioplasty, contrast media such as lipiodol was used and contained in the balloons. In contrast, during Vesselplasty, PMMA was contained and act as a spacer. The major difference between PMMA and air or contrast media is the heat generated during polymerization. Whether the heat generated from PMMA during polymerization would increase the possibility of balloon rupture or not need further investigation. Viscosity is another concern. During injection, the viscosity of PMMA is greater than water or contrast media. If the injection is done too quickly, it will elevate the pressure inside the inserter and cause the system to fail, including the possibility of breaking the delivery system. [18] On the other hand, the rough surface of the cancellous bone in vertebral body may also enhance the possibility of balloon rupture, comparing to the balloons used in IABP or angioplasty. Krishnan reported a series of patients receiving Vesselplasty. According to his report, Vesselplasty balloon rupture rate was as high as 33%, and the rate would be decreased to 8% if preceding kyphoplasty balloon was combined. [19] Most of the ruptures resulted in intravertebral cement spill, despite 2 cases with asymptomatic extravertebral cement leakage. No neurological complications was reported in the series. As to our knowledge, this case is the first report of neurological complication caused by Vesselplasty balloon rupture during cement injection. In this case, neurological complication may be caused not only by leaked cement block compression, but also thermal damage from the heat generated during cement polymerization. Despite of emergent decompression by laminectomy and removing cement block, the injury caused by compression and thermal damage may be irreversible. Some technical pitfalls, such as gentle delivery of the balloon, proper positioning of the balloon inside the vertebral body, and slowly injection of PMMA, should be emphasized.[18] Besides, more detailed explanation to the patients before the procedures should be taken during clinical practice in the future. AD - S.W. Wu, Taipei Veterans General Hospital, Taipei, Taiwan AU - Wu, S. W. DB - Embase DO - 10.1007/s00198-018-4465-1 KW - bone cement iodinated poppyseed oil steroid water abdominal pain adverse drug reaction aeration aged aortic balloon appetite backache bone density bone filler cancer patient cancer surgery case report clinical article clinical practice complication compression fracture conference abstract container coronary artery dissection decompression drug megadose drug therapy drug withdrawal extraction female femoral artery fluoroscopy heart infarction heat height human incidence injection kyphoplasty laminectomy local anesthesia lumbar spine male Medline multiple myeloma nausea neurologic disease neurological complication nuclear magnetic resonance imaging osteopenia paralytic ileus paraplegia physical examination physiotherapy polymerization prevention rehabilitation rest rupture side effect spinal cord injury surgery thermal injury trabecular bone transluminal coronary angioplasty vein embolism vertebra body vertebral canal viscosity walking X ray LA - English M1 - 1 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 1433-2965 SP - S203-S204 ST - Acute spinal cord injury following cement leakage from ruptured balloon of vesselplasty T2 - Osteoporosis International TI - Acute spinal cord injury following cement leakage from ruptured balloon of vesselplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L623596356&from=export http://dx.doi.org/10.1007/s00198-018-4465-1 VL - 29 ID - 829219 ER - TY - JOUR AB - BACKGROUND: A large number of literatures have confirmed that the use of tranexamic acid in total knee arthroplasty can effectively reduce perioperative bleeding, but there is no consensus on which tranexamic acid is most used. Little is reported on the changes of related inflammatory factors in blood after tranexamic acid is given. OBJECTIVE: To investigate the effects of different tranexamic acid administration methods on perioperative blood loss and inflammatory response in total knee arthroplasty. METHODS: Ninety patients who underwent unilateral total knee arthroplasty due to knee osteoarthritis from June 2016 to June 2018 were included in this study. They were randomly divided into three groups, 30 in each group using the envelope lottery method. All of them received cemented posterior cruciate ligament-retaining unilateral total knee arthroplasty. In group A, patients were treated by intravenous infusion of tranexamic acid. In group B, intraarticular injection of tranexamic acid was performed. In group C, both intravenous and intraarticular administration of tranexamic acid was used. Perioperative total blood loss and occult blood loss were calculated, and the number of patients receiving blood transfusion and the volume of blood transfused were recorded. Fibrinogen level, prothrombin time, activated partial thromboplastin time, and the levels of inflammatory factors C-reactive protein and interleukin-6 were measured before and 1, 3 and 7 days after surgery. Deep vein thrombosis was examined at 1 week after surgery. All patients were followed up for 6 months to determine the occurrence of deep vein thrombosis and pulmonary embolism. This study was approved by the Medical Ethics Committee of the Third People’s Hospital of Hainan Province, China. RESULTS AND CONCLUSION: (1) Total perioperative blood loss in groups A and B was significantly higher than that in group C (P < 0.05). There were no significant differences in occult blood loss and blood transfusion rate among the three groups (P > 0.05). (2) There were no significant differences in fibrinogen level, prothrombin time and activated partial thromboplastin time among three groups before surgery and at 1, 3 and 7 days after surgery (P > 0.05). (3) In each group, C-reactive protein and interleukin-6 levels at 1 and 3 days after surgery were significantly higher than those before surgery (P < 0.05), and there were no significant differences in C-reactive protein and interleukin-6 levels among three groups (P > 0.05). (4) At 7 days after surgery, the levels of C-reactive protein and interleukin-6 in each group decreased to the levels before surgery, and there were no significant differences among three groups (P > 0.05). Vascular ultrasound examination of the both lower limbs showed no deep vein thrombosis at 1 week after surgery. After 6 months of follow-up, there were no cases of deep venous thrombosis and pulmonary embolism in the lower limbs. (5) The results suggest that compared with simple intravenous or intraarticular administration of tranexamic acid, combined intravenous and intraarticular administration of tranexamic acid can greatly reduce total perioperative blood loss and does not increase the risk of developing deep vein thrombosis after total knee arthroplasty. Different administration methods of tranexamic acid have no obvious effects on inflammatory response. AD - G.R. Zhang, Department of Bone and Joint Surgery, Third People’s Hospital of Hainan Province, Sanya, Hainan Province, China AU - Wu, X. Y. AU - Zhang, G. R. AU - Liu, T. AU - Zhou, C. H. DB - Embase DO - 10.3969/j.issn.2095-4344.1962 KW - C reactive protein fibrinogen tranexamic acid activated partial thromboplastin time article blood transfusion blood volume deep vein thrombosis human inflammation knee osteoarthritis lung embolism major clinical study operative blood loss posterior cruciate ligament retaining total knee arthroplasty prothrombin time total knee arthroplasty LA - Chinese M1 - 36 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 2095-4344 SP - 5753-5759 ST - Intravenous and intraarticular tranexamic acid can reduce blood loss and inflammatory response during cemented posterior cruciate ligament-retaining unilateral total knee arthroplasty T2 - Chinese Journal of Tissue Engineering Research TI - Intravenous and intraarticular tranexamic acid can reduce blood loss and inflammatory response during cemented posterior cruciate ligament-retaining unilateral total knee arthroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L2004210761&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.1962 VL - 23 ID - 829164 ER - TY - JOUR AD - C.-M. Chao, Department of Intensive Care Medicine, Chi Mei Medical Center, Taikang Vil., Liuying Dist. NO. 201, Taikang, Tainan, Taiwan AU - Wu, Y. F. AU - Lai, C. C. AU - Chao, C. M. DB - Embase Medline DO - 10.1016/j.jemermed.2017.08.035 KW - bone cement enoxaparin adult article case report clinical article dyspnea human lung embolism male middle aged percutaneous vertebroplasty priority journal pulmonary cement embolism thoracolumbar spine thorax pain thorax radiography x-ray computed tomography LA - English M1 - 6 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 0736-4679 SP - e139-e140 ST - Severe Pulmonary Cement Embolism T2 - Journal of Emergency Medicine TI - Severe Pulmonary Cement Embolism UR - https://www.embase.com/search/results?subaction=viewrecord&id=L618692537&from=export http://dx.doi.org/10.1016/j.jemermed.2017.08.035 VL - 53 ID - 829227 ER - TY - JOUR AD - Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan AN - 126945243. Language: English. Entry Date: 20180524. Revision Date: 20181003. Publication Type: journal article. Journal Subset: Biomedical AU - Wu, Ya-Fang AU - Lai, Chih-Cheng AU - Chao, Chien-Ming DB - cin20 DO - 10.1016/j.jemermed.2017.08.035 DP - EBSCOhost KW - Bone Cements -- Adverse Effects Pulmonary Embolism -- Diagnosis Heparin, Low-Molecular-Weight -- Therapeutic Use Anticoagulants -- Therapeutic Use Middle Age Male Pulmonary Embolism Chest Pain -- Etiology Radiography -- Methods Pulmonary Embolism -- Surgery Dyspnea -- Etiology M1 - 6 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 0736-4679 SP - e139-e140 ST - Severe Pulmonary Cement Embolism T2 - Journal of Emergency Medicine (0736-4679) TI - Severe Pulmonary Cement Embolism UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=126945243&site=ehost-live&scope=site VL - 53 ID - 830560 ER - TY - JOUR AB - PURPOSE: This study was designed to compare the efficacy and safety of the combined use of tranexamic acid (TXA) with the intravenous (IV) or local use alone in total hip arthroplasty (THA). METHODS: 210 patients were randomised to a IV group, a local group or a combined group. Participants received 1.5 g IV‐TXA in the IV group, 3 g local TXA in the local group, or 1 g IV‐TXA combined with 2 g local TXA in the combined group. The primary outcomes were total blood loss (TBL), maximum haemoglobin drop, and the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE). RESULTS: TBL was (776.75 ± 188.95) ml in the combined group, which was significantly lower than in the IV group or the local group (p = 0.015, p = 0.001 respectively). Likewise, the mean values of maximum hemoglobin drop in the combined, IV, and local groups were 2.98 ± 0.78, 3.36 ± 0.78, and 3.89 ± 0.72 g/dL, respectively, with a significant intergroup difference (p<0.001 for all). Asymptomatic DVT was detected in 1 patient of the IV group, and 2 patients of the combined group with the use of ultrasound. There were no episodes of PE, and no significant differences were seen between groups in terms of complications. CONCLUSIONS: Combined use of intravenous TXA and local TXA in primary unilateral THA can effectively decrease total blood loss and increase postoperative haemoglobin levels without influencing complication rates. It is suggested that this combined TXA regimen is more effective in decreasing blood loss in cementeless THA than intravenous or local administration alone. AN - CN-01138965 AU - Xie, J. AU - Ma, J. AU - Yue, C. AU - Kang, P. AU - Pei, F. DO - 10.5301/hipint.5000291 KW - *comparative effectiveness *total hip prosthesis *tranexamic acid/ct [Clinical Trial] *tranexamic acid/iv [Intravenous Drug Administration] *tranexamic acid/tp [Topical Drug Administration] Administration, Topical Adult Aged Antifibrinolytic Agents [*administration & dosage] Arthroplasty, Replacement, Hip [adverse effects, *methods] Article Blood Loss, Surgical [*prevention & control] Blood transfusion Bone necrosis Cementation Cementless prosthesis Computer assisted tomography Controlled study Deep vein thrombosis/co [Complication] Doppler flowmetry Drug Therapy, Combination Drug efficacy Drug safety Enoxaparin Female Femur Head Necrosis [*surgery] Hematocrit Hemoglobin/ec [Endogenous Compound] Hemoglobins [metabolism] Hip osteoarthritis Human Humans Incidence Injections, Intravenous International normalized ratio Length of stay Lung embolism/co [Complication] Major clinical study Male Middle Aged Operation duration Operative blood loss/co [Complication] Osteoarthritis, Hip [*surgery] Partial thromboplastin time Postoperative complication Prospective Studies Prospective study Prothrombin time Pulmonary Embolism [epidemiology] Randomized controlled trial Rivaroxaban/po [Oral Drug Administration] Surgical infection/co [Complication] Thrombocyte count Tranexamic Acid [*administration & dosage] Treatment Outcome Ultrasound Venous Thrombosis [epidemiology] M1 - 1 M3 - Journal Article; Randomized Controlled Trial; Research Support, Non‐U.S. Gov't N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2016 SP - 36‐42 ST - Combined use of intravenous and topical tranexamic acid following cementless total hip arthroplasty: a randomised clinical trial T2 - Hip international TI - Combined use of intravenous and topical tranexamic acid following cementless total hip arthroplasty: a randomised clinical trial UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01138965/full VL - 26 ID - 830075 ER - TY - JOUR AB - Background Context: Vertebroplasty or kyphoplasty of osteoporotic vertebral fractures bears the risk of pulmonary cement embolism (3.5%-23%) caused by leakage of commonly applied acrylic polymethylmethacrylate (PMMA) cement to spongious bone marrow or outside of the vertebrae. Ultraviscous cement and specific augmentation systems have been developed to reduce such adverse effects. Rapidly setting, resorbable, physiological calcium phosphate cement (CPC) may also represent a suitable alternative.Purpose: This study aimed to compare the intravertebral extrusion of CPC and PMMA cement in an ex vivo and in vivo study in sheep.Study Design/setting: A prospective experimental animal study was carried out.Methods: Defects (diameter 5 mm; 15 mm depth) were created by a ventrolateral percutaneous approach in lumbar vertebrae of female Merino sheep (2-4 years) either ex vivo (n=17) or in vivo (n=6), and injected with: (1) CPC (L3); (2) CPC reinforced with 10% poly(l-lactide-co-glycolide) (PLGA) fibers (L4); or (3) PMMA cement (L5; Kyphon HV-R). Controls were untouched (L1) or empty defects (L2). The effects of the cement injections were assessed in vivo by blood gas analysis and ex vivo by computed tomography (CT), micro-CT (voxel size: 67 µm), histology, and biomechanical testing.Results: Following ex vivo injection, micro-CT documented significantly increased extrusion of PMMA cement in comparison to CPC (+/- fibers) starting at a distance of 1 mm from the edge of the defect (confirmed by histology); this was also demonstrated by micro-CT following in vivo cement injection. In addition, blood gas analysis showed consistently significantly lower values for the fraction of oxygenized hemoglobin/total hemoglobin (FO2Hb) in the arterial blood until 25 minutes following injection of the PMMA cement (p ≤ .05 vs. CPC; 7, 15 minutes). Biomechanical testing following ex vivo injection showed significantly lower compressive strength and Young modulus than untouched controls for the empty defect (40% and 34% reduction, respectively) and all three cement-injected defects (21%-27% and 29%-32% reduction, respectively), without significant differences among the cements.Conclusions: Because of comparable compressive strength, but significantly lower cement extrusion into spongious bone marrow than PMMA cement, physiological CPC (+/- PLGA fibers) may represent an attractive alternative to PMMA for vertebroplasty or kyphoplasty of osteoporotic vertebral fractures to reduce the frequency or severity of adverse effects. AD - Experimental Rheumatology Unit, Department of Orthopedics, Waldkrankenhaus “Rudolf Elle”, Klosterlausnitzer Str. 81, Jena University Hospital, 07607, Eisenberg, Germany Department of Orthopedics, Tongde Hospital of Zhejiang Province, No. 234 Gucui Road, 310012 Hangzhou, Zhejiang, China Chair of Orthopedics, Department of Orthopedics, Waldkrankenhaus “Rudolf Elle”, Jena University Hospital, Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller, University Jena, Löbdergraben 32, 07743 Jena, Germany BAM, Federal Institute for Materials Research and Testing, Unter den Eichen 87, 12205 Berlin, Germany Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Dornburger Str. 23, 07743 Jena, Germany AN - 119929048. Language: English. Entry Date: 20170710. Revision Date: 20180528. Publication Type: journal article AU - Xin, Long AU - Bungartz, Matthias AU - Maenz, Stefan AU - Horbert, Victoria AU - Hennig, Max AU - Illerhaus, Bernhard AU - Günster, Jens AU - Bossert, Jörg AU - Bischoff, Sabine AU - Borowski, Juliane AU - Schubert, Harald AU - Jandt, Klaus D. AU - Kunisch, Elke AU - Kinne, Raimund W. AU - Brinkmann, Olaf DB - cin20 DO - 10.1016/j.spinee.2016.07.529 DP - EBSCOhost KW - Phosphates -- Pharmacokinetics Methylmethacrylates -- Pharmacokinetics Viscosity Bone Marrow -- Drug Effects Bone Cements -- Pharmacokinetics Pulmonary Embolism -- Etiology Compressive Strength Bone Cements Methylmethacrylates -- Adverse Effects Sheep Vertebroplasty -- Methods Female Bone Cements -- Adverse Effects Phosphates -- Adverse Effects Lumbar Vertebrae -- Drug Effects Animal Studies Validation Studies Comparative Studies Evaluation Research Multicenter Studies M1 - 12 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2016 SN - 1529-9430 SP - 1468-1477 ST - Decreased extrusion of calcium phosphate cement versus high viscosity PMMA cement into spongious bone marrow-an ex vivo and in vivo study in sheep vertebrae T2 - Spine Journal TI - Decreased extrusion of calcium phosphate cement versus high viscosity PMMA cement into spongious bone marrow-an ex vivo and in vivo study in sheep vertebrae UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=119929048&site=ehost-live&scope=site VL - 16 ID - 830581 ER - TY - JOUR AB - BACKGROUND: The researches on the treatment of osteoporotic vertebral fractures by percutaneous vertebroplasty are mainly based on the fresh osteoporotic compression vertebral fractures, and the reports on the treatment of old symptomatic osteoporotic vertebral fractures are rare. OBJECTIVE: To investigate the effect of percutaneous vertebroplasty in the treatment of old symptomatic osteoporotic vertebral fractures in elderly. METHODS: The patients with old symptomatic osteoporotic vertebral fractures in elderly were selected from Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine during January 2007 to December 2010, and all the 12 patients (14 vertebras) were treated with percutaneous vertebroplasty. The Visual Analogue Scale score, Oswestry disability index and local sagittal Cobb's angles were measured before percutaneous vertebroplasty, and 1 month and 1 year after percutaneous vertebroplasty. RESULTS AND CONCLUSION: There was no infection, toxic effect of bone cement, pulmonary embolism or leakage of bone cement in the patients with old symptomatic osteoporotic vertebral fractures. After percutaneous vertebroplasty, there was one case with loss of follow-up, one case of death, and the death has nothing to do with the surgery. The Visual Analogue Scale score and Oswestry disability index of the patients with old symptomatic osteoporotic vertebral fractures after percutaneous vertebroplasty were significantly lower than those before percutaneous vertebroplasty (P <0.01), and there was no significant difference of local sagittal Cobb's angles before and after percutaneous vertebroplasty (P > 0.05). It suggests that percutaneous vertebroplasty can relieve the pain and improve the life quality of the patients with old symptomatic osteoporotic vertebral fractures. AD - G.-Q. Cheng, Department of Orthopedics, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China AU - Xin, W. W. AU - Cheng, G. Q. AU - Feng, Y. AU - Chen, B. DB - Embase DO - 10.3969/j.issn.2095-4344.2012.52.033 KW - radioisotope article bone radiography computer assisted tomography diagnostic error differential diagnosis human joint prosthesis nuclear magnetic resonance imaging prognosis prosthesis infection prosthesis loosening X ray LA - Chinese M1 - 52 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 1673-8225 SP - 9873-9880 ST - Percutaneous vertebroplasty for the treatment of old symptomatic osteoporotic vertebral fracture in the elderly T2 - Chinese Journal of Tissue Engineering Research TI - Percutaneous vertebroplasty for the treatment of old symptomatic osteoporotic vertebral fracture in the elderly UR - https://www.embase.com/search/results?subaction=viewrecord&id=L373887973&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.2012.52.033 VL - 16 ID - 829594 ER - TY - JOUR AB - Background: With the advanced progress of prostheses manufacture and surgical technique, early loosening of hip articulation prostheses and femoral neck fracture tend to reduce after hip surface arthroplasty. Meanwhile hip articulation activity has been improved. Objective: To discuss the biocompatibility between the implants and the hosts in patients underwent hip surface arthroplasty and observe the functional recovery of hip articulations. Design, Time and Setting: Retrospective case analysis was carried out in the Department of Orthopaedics, Changhai Hospital Affiliated to the Second Military Medical University of Chinese PLA (Shanghai, China) from January 2006 to August 2007. Participants: Fifty-two patients with hip articulation diseases, including 25 females and 27 males, underwent sixty-three hip surface arthroplasties, and eleven cases of them were subjected to bilateral arthroplasty. Their average age was 47.6 years. Methods: Hip resurfacing prostheses were offered by Zimmerm Company (Huntington, Indiana, USA). Hip resurfacing was performed using 4-mm-thick cement-less acetabular bone (metal acetabular cup of 3.7-mm thickness was coated with 0.3-mm plasma titanium). Acetabular cup exhibits large diameter and arch shape (165°), is coated with 0.3-mm plasma titanium and fixed with cement less. By means of posterolateral approach, acetabular prostheses were implanted to the central position of hip articulation with regards to anatomy. Acetabular prostheses were covered more than 90% area. Main Outcome Measures: Subsequent to the arthroplasty, biocompatibility between the implant materials and the hosts was recorded, such as dislocation and infection. Functional recovery of the patients was assessed with Harris hip score at 1, 3, 6 and 12 months after operation and annually thereafter. Radiological evaluation was conducted to record radioactive permeability in the areas of 1 mm around acetabular cup in the DeLee and Charnley zone. Results: All patients were involved in the follow-up. There were no cases of dislocation, deep venous embolism, deep infection or neurovascular complications that required further treatment. The mean Harris score was 38 points before operation and significantly increased to 90 points after operation. Two patients appeared a 2-mm crevice below acetabular prostheses, which disappeared 6 months after arthroplasty. Acetabular or femoral prostheses removal, or local osteolysis was detectable. Conclusion: Metal-on-metal hip surface arthroplasty has excellent early effects on young and active patients. The arthroplasty potentially offers the ultimate bone preservation and better restoration of hip articulation function in patients, without specific biocompatibility. AD - W.-D. Xu, Department of Orthopaedics, Changhai Hospital, Second Military Medical University of Chinese PLA, Shanghai 200433, China AU - Xu, W. D. AU - Chen, G. AU - Li, J. AU - Xu, L. AU - Liang, Z. M. DB - Embase KW - metal titanium acetabuloplasty adolescent adult aged article biocompatibility China controlled study convalescence female femoral neck fracture follow up Harris hip score hip arthroplasty hip dislocation hip prosthesis hip radiography hospital department human infection joint function major clinical study male osteolysis postoperative period prosthesis loosening retrospective study surgical approach surgical technique university hospital Durom hip prosthesis LA - English M1 - 22 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2008 SN - 1673-8225 SP - 4373-4376 ST - Metal-to-metal hip surface arthroplasty in 63 cases: A follow-up assessment T2 - Journal of Clinical Rehabilitative Tissue Engineering Research TI - Metal-to-metal hip surface arthroplasty in 63 cases: A follow-up assessment UR - https://www.embase.com/search/results?subaction=viewrecord&id=L351982299&from=export VL - 12 ID - 829745 ER - TY - JOUR AB - BackgroundElderly patients with vertebral hemangiomas are rare and might require surgery. Thus, the choice of surgery for these lesions remains controversial because of the rarity of these lesions. This study aimed to analyze the clinical efficacy of the intraoperative injection of absorbable gelatin sponge mixed with cement followed by spinal decompression to treat the elderly with typical vertebral hemangiomas. The risk factors for hemangioma recurrence were investigated through a literature review.MethodsWe retrospectively analyzed 13 patients with typical aggressive hemangiomas between January 2009 and January 2016. Of these patients, 7 were treated with spinal decompression combined with intraoperative vertebroplasty (Group A), and 6 patients were treated with decompression with intraoperative vertebroplasty and absorbable gelatin sponge (Group B). The general data and perioperative data of the patients were compared. Patients were followed up for at least 3years, and postoperative complications and recurrence rates were recorded and compared.ResultsAll patients had typical aggressive hemangiomas. The average age of all patients was 64.43.3years. The preoperative data did not differ significantly between the two groups (P>0.05). The blood loss of groups A and B was 707.1 +/- 109.7ml and 416.7 +/- 103.3ml, respectively (P=0.003) (P=0.003), and the average surgery durations were 222 +/- 47.8min and 162 +/- 30.2min, respectively (P=0.022). The average follow-up duration was 62 +/- 19months, and no cases of recurrence were found at the final follow-up assessment.Conclusions Multimodal treatment significantly alleviated the clinical symptoms of elderly patients with typical aggressive vertebral hemangiomas. Intraoperative absorbable gelatin sponge injection is a safe and effective way to reduce blood loss and surgery duration. AD - [Xu, Weihong] Fujian Med Univ, Affiliated Hosp 1, Dept Spine Surg, Fuzhou 350004, Fujian, Peoples R China. [Lan, Zhibin] Fujian Tradit Chinese Med Univ, Quanzhou Orthoped Traumatol Hosp, Dept Spine Surg, Quanzhou 362000, Fujian, Peoples R China. [Huang, Yuming] Xiamen Univ, Fuzhou Hosp 2, Dept Orthoped, Fuzhou 350007, Fujian, Peoples R China. Huang, YM (corresponding author), Xiamen Univ, Fuzhou Hosp 2, Dept Orthoped, Fuzhou 350007, Fujian, Peoples R China. 1143810401@qq.com AN - WOS:000521117000007 AU - Xu, W. H. AU - Lan, Z. B. AU - Huang, Y. M. DA - Feb DO - 10.1186/s12891-020-3143-6 J2 - BMC Musculoskelet. Disord. KW - Aggressive vertebral hemangiomas Pain Multimodal surgery Absorbable gelatin sponge CORD COMPRESSION PERCUTANEOUS VERTEBROPLASTY SURGICAL-MANAGEMENT SURGERY EMBOLIZATION Orthopedics Rheumatology LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2020 SP - 9 ST - Intraoperative injection of absorbable gelatin sponge (AGS) mixed with cement followed by spinal decompression to treat elderly with vertebral hemangiomas T2 - Bmc Musculoskeletal Disorders TI - Intraoperative injection of absorbable gelatin sponge (AGS) mixed with cement followed by spinal decompression to treat elderly with vertebral hemangiomas UR - ://WOS:000521117000007 VL - 21 ID - 830111 ER - TY - JOUR AB - OBJECTIVE: To study the effectiveness of long segment fixation combined with vertebroplasty (LSF-VP) for severe osteoporotic thoracolumbar compressive fractures with kyphosis deformity. METHODS: Between March 2006 and May 2012, a retrospective analysis was made on the clinical data of 48 cases of severe osteoporotic thoracolumbar compressive fractures with more than 50% collapse of the anterior vertebral body or more than 400 of sagittal angulation, which were treated by LSF-VP in 27 cases (LSF-VP group) or percutaneous kyphoplasty (PKP) in 21 cases (PKP group). All patients suffered from single thoracolumbar vertebral compressive fracture at T11 to L2. There was no significant difference in gender, age, spinal segment, and T values of bone mineral density between 2 groups (P > 0.05). The effectiveness of the treatment was appraised by visual analogue scale (VAS), Cobb angle of thoracolumbar kyphosis, height of anterior/posterior vertebral body, and compressive ratio of vertebrae before and after operations. RESULTS: The LSF-VP group had longer operation time, hospitalization days, and more bone cement injection volume than the PKP group, showing significant differences (P < 0.05). Intraoperative blood loss in LSF-VP group ranged from 220 to 1,050 mL (mean, 517 mL). No pulmonaryor cerebral embolism or cerebrospinal fluid leakage was found in both groups. Asymptomatic bone cement leakage was found in 3 cases of LSF-VP group and 2 cases of PKP group. The patients were followed up for 16-78 months (mean, 41.1 months) in LSF-VP group, and 12-71 months (mean, 42.1 months) in PKP group. No fixation failure such as loosened or broken pedicle screw was found in LSF-VP group during the follow-up, and no re-fracture or adjacent vertebral body fracture was found. Two cases in PKP group at 39 and 56 months after operation respectively were found to have poor maintenance of vertebral height and loss of rectification (Cobb angle was more than 40 degrees) with recurrence of pain, which were treated by second surgery of LSF-VP; another case had compressive fracture of the adjacent segment and thoracolumbar kyphosis at 16 months after operation, which was treated by second surgery of LSF-VP. There were significant differences in the other indexes between each pair of the three time points (P < 0.05), except the Cobb angle of thoracolumbar kyphosis, and the height of posterior vertebral body between discharge and last follow-up in LSF-VP group, and except the Cobb angle of thoracolumbar kyphosis and compressive ratio of bertebrae between discharge and last follow-up in PKP group (P > 0.05). After operation, the other indexes of LSF-VP group were significantly better than those of PKP group at each time point (P < 0.05), except the VAS score and the height of posterior vertebral body at discharge (P > 0.05). CONCLUSION: The effectiveness of LSF-VP is satisfactory in treating severe osteoporotic thoracolumbar compressive fractures with kyphosis deformity. LSF-VP can acquire better rectification of kyphosis and recovery of vertebral body height than PKP. AD - Department of Spine and Orthopedics, the First Affiliated Hospital of Fujian Medical University, Fuzhou Fujian, 350005, P.R.China. AN - 24501892 AU - Xu, Z. AU - Xu, W. AU - Wang, C. AU - Luo, H. AU - Li, G. AU - Chen, R. DA - Nov DP - NLM ET - 2014/02/08 J2 - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery KW - Aged Aged, 80 and over Biomechanical Phenomena Bone Cements/therapeutic use Bone Screws Female Fracture Fixation, Internal/instrumentation/*methods Fractures, Compression/complications/diagnostic imaging/*surgery Humans Kyphosis/diagnostic imaging/etiology/surgery Lumbar Vertebrae/diagnostic imaging/injuries/surgery Male Middle Aged Osteoporotic Fractures/complications/diagnostic imaging/*surgery Pain Measurement Radiography Retrospective Studies Spinal Fractures/complications/diagnostic imaging/*surgery Thoracic Vertebrae/diagnostic imaging/injuries/surgery Treatment Outcome Vertebroplasty/*methods LA - chi M1 - 11 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1002-1892 (Print) 1002-1892 SP - 1331-7 ST - [Effectiveness of long segment fixation combined with vertebroplasty for severe osteoporotic thoracolumbar compressive fractures] T2 - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi TI - [Effectiveness of long segment fixation combined with vertebroplasty for severe osteoporotic thoracolumbar compressive fractures] VL - 27 ID - 828720 ER - TY - JOUR AB - BACKGROUND: Percutaneous vertebroplasty with bone cement injection for osteoporotic vertebral compression fractures can quickly relieve pain and increase vertebral strength, but vertebral re-fractures often occur because of osteoporosis. OBJECTIVE: To investigate the therapeutic effect of percutaneous vertebroplasty with bone cement injection combined with zoledronic acid in the treatment of osteoporotic vertebral compression fractures. METHODS: Six patients with osteoporotic vertebral compression fractures were enrolled, including two males and four females, aged 60-86 years. These patients with T12-L4 vertebral fractures underwent percutaneous vertebroplasty with polymethyl methacrylate acrylate bone cement treatment. At 4 weeks after bone cement injection, all patients were administrated with intravenous injection of zoledronic acid (100 mL: 5 mg) as anti-osteoporosis treatment, 30 drops per minute, once a year, for consecutive 2 years. The 2-year periodic imaging was performed to observe the clinical efficacy on vertebral compression fractures, bone density and adjacent vertebral fractures. RESULTS AND CONCLUSION: At 48 hours after bone cement injection, pain symptoms were relieved in the six cases. At the end of 2-year follow-up, fractures healed in all the six cases without delayed union or nonunion, and there was no bone cement leakage, nerve root compression, dural involvement, needle opening or wound infection and pulmonary embolism; the bone density was significantly higher than that before treatment (P < 0.05), and no adjacent vertebral fractures occurred. These findings indicate that the percutaneous vertebroplasty with bone cement injection combined with zoledronic acid can significantly relieve pain, improve vertebral stability and bone density, and reduce the incidence of adjacent vertebral fractures in patients with osteoporotic vertebral compression fractures. AD - F. Xue, Department of General Surgery, Fuqing Municipal Hospital, Fuqing, Fujian Province, China AU - Xue, F. AU - Ye, Y. S. DB - Embase DO - 10.3969/j.issn.2095-4344.2015.25.001 KW - acrylic acid bone cement poly(methyl methacrylate) zoledronic acid adult aged article bone density bone pain clinical article clinical assessment compression fracture drug efficacy female follow up fracture healing fracture nonunion human image analysis incidence joint stability male osteoporosis osteoporotic vertebral compression fracture percutaneous vertebroplasty pseudarthrosis spine fracture therapy effect LA - Chinese M1 - 25 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1673-8225 SP - 3937-3941 ST - Bone cement combined with zoledronic acid to repair osteoporotic vertebral compression fractures T2 - Chinese Journal of Tissue Engineering Research TI - Bone cement combined with zoledronic acid to repair osteoporotic vertebral compression fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L606147641&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.2015.25.001 VL - 19 ID - 829370 ER - TY - JOUR AB - Background: Since percutaneous injection of bone cement vertebroplasty has been successfully used in treatment of spine fracture, percutaneous vertebroplasty is trying to be utilized in the treatment of vertebral hemangiomas. Objective: To evaluate the safety and effectiveness of percutaneous injection of bone cement vertebroplasty in the treatment of symptomatic vertebral hemangiomas. Methods: Totally nine patients with symptomatic thoracic vertebral hemangioma patients, including two males and seven females, had back pain. Of them, two cases suffered from nerve root irritation. Percutaneous vertebroplasty with bone cement was used alone. Postoperative clinical and radiographic follow-up was conducted. Results and Conclusion: The success rate was 100%, and no pulmonary embolism or nerve injury appeared. Postoperative imaging showed no leakage of spinal canal or foramen. At 24 hours after treatment, the symptoms had eased; nine cases were followed up for 3 to 36 months, showing that the original symptoms and signs disappeared or almost disappeared, no recurrence of vascular tumors. Results indicated that the percutaneous injection of bone cement vertebroplasty for the treatment of symptomatic vertebral hemangiomas is a safe and effective treatment; it can not only relieve symptoms, but also can increase the stability of the vertebral body, and prevent compression fracture and recurrence. AD - H.-Y. Zhang, Xiangyang Central Hospital, Xiangyang 441021, Hubei Province, China AU - Yan, X. W. AU - Zhang, H. Y. DB - Embase DO - 10.3969/j.issn.2095-4344.2013.52.009 KW - bone cement article backache clinical article compression fracture female follow up human joint stability male nerve root injury percutaneous vertebroplasty postoperative period spine radiography thoracic vertebral hemangioma tumor recurrence vertebra body vertebra hemangioma LA - Chinese M1 - 52 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1673-8225 SP - 8993-8998 ST - Bone cement vertebroplasty for symptomatic thoracic vertebral hemangioma T2 - Chinese Journal of Tissue Engineering Research TI - Bone cement vertebroplasty for symptomatic thoracic vertebral hemangioma UR - https://www.embase.com/search/results?subaction=viewrecord&id=L373888270&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.2013.52.009 VL - 17 ID - 829517 ER - TY - JOUR AB - Background: Balloon kyphoplasty is a new technique of microtraumatic surgery of spine developed in recent years, and brings a new pathway for the treatment of osteoporotic vertebral fracture in the elderly. Objective: To investigate the therapeutic effect of percutaneous balloon kyphoplasty on osteoporotic vertebral fracture, and to explore the main point of injecting bone cement. Methods: A total of 22 patients with osteoporotic vertebral fracture at the age of 60-78 years underwent percutaneous balloon kyphoplasty under C-arm fluoroscopy. In accordance with the standards of WHO, antalgic effects were evaluated. The injection time, manner and dose of bone cement were analyzed. Results and Conclusion: All patients were followed up for 1-12 months. Postoperative pain was completely lessened in 15 patients, and partially relieved in 7 cases, with an effective rate of 100%. Spinal mobility increased. No incision surgery was needed in all patients. No complications such as pulmonary embolism or nerve injury appeared. These results indicate that percutaneous balloon kyphoplasty for treatment of osteoporotic vertebral fractures is minimally invasive and simple, has less complication and effectively reconstructs vertebral body strength, and can better alleviate the pain, is an effective minimally invasive spinal treatment technology. To strictly understand the main treatment point can obtain satisfactory clinical curative effects, including precise diagnosis of the disease, identification whether patient's pain is induced by fractures, preoperative intraoperative exact localization of the affected vertebra, perfect puncturing technique, suitable postoperative treatment and nursing. It is also important to strictly master the time of injecting bone cement and the dose of bone cement. Bone cement injection was commonly done in drawing-wire stage. Too early injection easily induced leakage and toxic reaction. Too late injection affected the expansion of bone cement and therapeutic effects. The injection of bone cement should be finished under a perspective environment, which can effectively avoid bone cement leakage. AD - H.-Y. Zhang, Xiangyang Municipal Central Hospital, Xiangyang 441021, Hubei Province, China AU - Yan, X. W. AU - Zhang, H. Y. DB - Embase DO - 10.3969/j.issn.2095-4344.2014.09.027 KW - bone cement adult aged article clinical article fluoroscopy human kyphoplasty minimally invasive surgery osteoporotic vertebral fracture percutaneous balloon kyphoplasty postoperative pain spine fracture spine mobility strength therapy effect LA - Chinese M1 - 9 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1673-8225 SP - 1471-1476 ST - Balloon kyphoplasty for osteoporotic vertebral fracture: Key point of bone cement injection T2 - Chinese Journal of Tissue Engineering Research TI - Balloon kyphoplasty for osteoporotic vertebral fracture: Key point of bone cement injection UR - https://www.embase.com/search/results?subaction=viewrecord&id=L373859642&from=export http://dx.doi.org/10.3969/j.issn.2095-4344.2014.09.027 VL - 18 ID - 829442 ER - TY - JOUR AB - Objective: To evaluate the clinical outcomes of cemented bipolar hemiarthroplasty in elderly patients with osteoporotic intertrochanteric femur fractures. Method: This is a retrospective study included sixty-nine patients with osteoporotic type A2.2, A2.3, or A3 intertrochanteric femur fractures. Cemented bipolar hemiarthroplasty was performed in these patients. Clinical data were evaluated, including time of operation, volume of intraoperative blood loss, postoperative drainage volume, blood transfusion volume, complications, time to attain full weight bearing, VAS assessment of hip pain, JOA assessment of recovery. At the post-surgery follow-up visits, the location of the prosthesis and the healing of the fracture were assessed by imaging. Results: The mean age of the patients included in this study was 79.3 years old. The mean operation time was 78.5±15.3 min, with blood loss during surgery at 240.2±15.6 ml. The post-operative drainage volume was 70.8±12.2 ml, whereas the blood transfusion volume was 1.5±0.3 u. The mean time to attain weight bearing was 0.5± 0.1 day. None of the patients had bone cement implantation syndrome or infections at the incision site/prosthetic joint. Deep vein thrombosis was found in 8 cases, while pulmonary embolism was not observed. The mean VAS score was 2.1±1.2 (ranged from 1 to 4). The JOA score levels on recovery were: not satisfactory = 2 cases, moderate = 4 cases, good = 15 cases, excellent = 48 cases. Majority of the patients (91.3%) had good or excellent recovery. The X-ray examination at the follow-up visit showed that all prostheses were well positioned with no obvious sinking or loose, and all fractures were healed. Conclusion: The cemented bipolar hemiarthroplasty for osteoporotic intertrochanteric femur fractures provided satisfactory functional outcomes. Patients had stable pain free joint and early ambulation with minimal complications. AD - S.-Y. Fang, Department of Traumatic Orthopaedics, Anhui Provincial Hospital, Anhui Medical University, Hefei, Anhui, China AU - Yang, J. Z. AU - Xie, K. AU - Xu, L. AU - Xia, R. AU - Xu, W. AU - Yao, G. AU - Wang, X. J. AU - Sun, J. W. AU - Fang, S. Y. DB - Embase DO - 10.1166/jbt.2018.1708 KW - Kirschner wire prosthesis stainless steel wire bone cement aged article blood transfusion cemented bipolar hemiarthroplasty clinical outcome deep vein thrombosis female femur intertrochanteric fracture follow up fracture healing hemiarthroplasty human Japanese Orthopaedic Association score major clinical study male operation duration operative blood loss osteoporosis postoperative care retrospective study very elderly visual analog scale weight bearing X ray analysis x-ray computed tomography LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2018 SN - 2157-9091 2157-9083 SP - 132-135 ST - Evaluation of cemented bipolar hemiarthroplasty treatment for elderly patients with femoral intertrochanteric fractures T2 - Journal of Biomaterials and Tissue Engineering TI - Evaluation of cemented bipolar hemiarthroplasty treatment for elderly patients with femoral intertrochanteric fractures UR - https://www.embase.com/search/results?subaction=viewrecord&id=L620746442&from=export http://dx.doi.org/10.1166/jbt.2018.1708 VL - 8 ID - 829212 ER - TY - JOUR AB - We reviewed the effectiveness of balloon kyphoplasty in the treatment of acute symptomatic vertebral compression fractures. We assessed radiographic and functional outcome in 11 patients with a 24.3 month follow-up from a retrospectively monitored series of 11 patients who underwent balloon kyphoplasty (BKP). A visual analogue scale (VAS) and the short McGill questionnaire (MPQ) were used to assess average symptoms. Eleven patients with 19 treated vertebrae completed the study. The VAS showed significant improvement after treatment: the initial score was 9.1 +/- 0.6 (mean +/- SD), falling to 2.7 +/- 1.07 by 24.3 months (P<0.001). The MPQ also showed a significant improvement (P<0.001) at follow-up. A new fracture was seen in one patient affecting two vertebrae adjacent to the treated level. On CT following the procedure, there was cement leakage in the disc in 9% of cases. BKP is a minimally invasive procedure that has been shown to be effective in the treatment of acute symptomatic vertebral compression fractures. It appears that BKP is associated with a low incidence of procedure-related complications and cement extravasation. AD - [Lv, X.; Wu, Z.] Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, Beijing 100050, Peoples R China. [Yang, T.; Liu, S.] Changchun Univ Chinese Med, Hosp Affiliated, Changchun, Peoples R China. Lv, X (corresponding author), Capital Med Univ, Beijing Tiantan Hosp, Beijing Neurosurg Inst, 6 Tiantan Xili, Beijing 100050, Peoples R China. lvxianli000@163.com AN - WOS:000281008700008 AU - Yang, T. AU - Liu, S. AU - Lv, X. AU - Wu, Z. DA - Mar DO - 10.1177/159101991001600108 J2 - Interv. Neuroradiol. KW - compression fractures methylmethacrylate kyphoplasty PERCUTANEOUS VERTEBROPLASTY CLINICAL-OUTCOMES POLYMETHYLMETHACRYLATE EMBOLISM CEMENT REDUCTION PAIN Clinical Neurology Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2010 SN - 1591-0199 SP - 65-70 ST - Balloon Kyphoplasty for Acute Osteoporotic Compression Fractures T2 - Interventional Neuroradiology TI - Balloon Kyphoplasty for Acute Osteoporotic Compression Fractures UR - ://WOS:000281008700008 VL - 16 ID - 830343 ER - TY - JOUR AB - Hydrogen peroxide (H(2)O(2)) is commonly used in orthopaedic surgery during cemented arthroplasty and wound washouts. Its purported roles include antisepsis, haemostasis, mechanical debridement, and optimising the cement-bone interface during cementing. However, despite its apparent harmless mechanism of action, H(2)O(2) has been implicated in fatal and near fatal complications caused through oxygen emboli. We present a case of oxygen embolism and review the existing literature to highlight its potential risks and its lack of therapeutic value. We believe there is little role for its use in orthopaedic surgery. AD - a Department of Orthopaedics , Launceston General Hospital , Tasmania , Australia. b Department of Anaesthetics , Launceston General Hospital , Tasmania , Australia. c Department of Surgery (RMH) , The University of Melbourne , Victoria , Australia. AN - 27426669 AU - Yang, Y. AU - Reid, C. AU - Nambiar, M. AU - Penn, D. DA - Aug DO - 10.1080/00015458.2016.1147235 DP - NLM ET - 2016/07/19 J2 - Acta chirurgica Belgica KW - Anti-Infective Agents/*adverse effects Arthroplasty, Replacement, Hip/*adverse effects/methods Embolism, Air/*chemically induced/physiopathology/therapy Female Follow-Up Studies Humans Hydrogen Peroxide/*adverse effects Middle Aged Orthopedics/methods Patient Positioning Prosthesis Failure Risk Assessment Surgical Wound Infection/diagnosis/*therapy Therapeutic Irrigation/adverse effects Arthroplasty cement hydrogen peroxide oxygen embolism LA - eng M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2016 SN - 0001-5458 (Print) 0001-5458 SP - 247-250 ST - Hydrogen peroxide in orthopaedic surgery - is it worth the risk? T2 - Acta Chir Belg TI - Hydrogen peroxide in orthopaedic surgery - is it worth the risk? VL - 116 ID - 828668 ER - TY - JOUR AB - Sacral giant cell tumour of bone has an insidious onset and slow growth rate, making early diagnosis difficult. The tumour has a high recurrence rate and is often fatal. Magnetic resonance imaging and computed tomography (CT), including CT-guided fine-needle biopsy, are useful for early diagnosis. Although therapy for sacral giant cell tumour often involves surgical resection and reconstruction challenges, improvements in various treatment modalities, including arterial embolization and radiotherapy, have widened the effective treatment options. The current surgical and adjuvant treatment modalities available for the management of sacral giant cell tumour are systematically reviewed and a suggested treatment algorithm is provided. En bloc excision remains the surgical procedure of choice, with functional reconstruction important in cases where the lesion is high in the sacrum. The use of adjuvant radiotherapy and chemotherapy remains controversial and should be studied further. Determination of the optimum treatment for sacral giant cell tumour will require randomized controlled trials. Early diagnosis, complete surgical resection with tumour-free margins and comprehensive treatment are important for local tumour control and improved outcome. © 2012 Field House Publishing LLP. AD - Z. M. Yang, Department of Orthopaedics, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, China AU - Yang, Z. M. AU - Shen, C. C. AU - Li, H. AU - Shi, Z. L. AU - Tao, H. M. DB - Embase Medline DO - 10.1177/147323001204000203 KW - cyclophosphamide doxorubicin liquid nitrogen methotrexate phenol poly(methyl methacrylate) adjuvant chemoradiotherapy adjuvant therapy article artificial embolization computer assisted tomography cryosurgery cryotherapy early diagnosis human intensity modulated radiation therapy medical decision making needle biopsy nuclear magnetic resonance imaging osteoclastoma recurrence risk sacral osteoclastoma spine surgery surgical approach treatment outcome tumor growth tumor localization LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 0300-0605 SP - 415-425 ST - Current treatment of sacral giant cell tumour of bone: A review T2 - Journal of International Medical Research TI - Current treatment of sacral giant cell tumour of bone: A review UR - https://www.embase.com/search/results?subaction=viewrecord&id=L364721272&from=export http://dx.doi.org/10.1177/147323001204000203 VL - 40 ID - 829587 ER - TY - JOUR AB - BACKGROUND CONTEXT: Vertebroplasty is commonly performed for the management of pain associated with benign compression fractures, multiple myelomas, lymphomas, vertebral metastatic lesions, and hemangiomas. We describe a severe complication associated with this procedure; only one previous case has been reported in the literature. OBJECTIVE: To report a case of anterior spinal cord syndrome caused by a direct cement leakage in the arterial vessels after vertebroplasty. METHODS: A 20-year-old man who has been diagnosed with multifocal Ewing sarcoma for 5 months suffered from severe and chronic inflammatory polyarthralgia in the left knee, pelvis, and the low back. The imaging studies, X-ray and computed tomography scan, showed the presence of pathologic fractures of T8 and L1 vertebrae. There was no retropulsion of bony fragment in the vertebral canal. A percutaneous vertebroplasty of T8 and L1 level was performed. RESULTS: Immediately after the procedure, the patient experienced a total paralysis and loss of sensitivity to pain and temperature in both lower limbs; however, deep pressure sensation and two-point discrimination below the umbilicus were preserved. Computed tomography scans showed no leakage of polymethylmethacrylate of T8 and L1 vertebral bodies, with opacification of the right intercostal artery at the L1 level and a segment of the anterior spinal artery at the T10-L1 level. C ONCLUSIONS: Although percutaneous vertebroplasty has many benefits, including its simplicity and relative safety, it could lead to serious complications. The current case demonstrates the direct leakage of cement within the anterior spinal artery leading to an irreversible paralysis. The clinicians should be aware of such complications to happen and explain it to their patients. (C) 2011 Elsevier Inc. All rights reserved. AD - [Yazbeck, Paul G.; Kreichati, Gaby E.; Kharrat, Khalil E.] Hotel Dieu France Univ Hosp, Dept Orthoped Surg, Beirut 96100, Lebanon. [Al Rouhban, Rana B.; Slaba, Sami G.] Hotel Dieu France Univ Hosp, Dept Radiol, Beirut 96100, Lebanon. Yazbeck, PG (corresponding author), Hotel Dieu France Univ Hosp, Dept Orthoped Surg, Alfred Naccach St, Beirut 96100, Lebanon. paul.yazbeck@hotmail.com AN - WOS:000295772900002 AU - Yazbeck, P. G. AU - Al Rouhban, R. B. AU - Slaba, S. G. AU - Kreichati, G. E. AU - Kharrat, K. E. DA - Aug DO - 10.1016/j.spinee.2011.06.020 J2 - Spine Journal KW - Vertebroplasty Cement leakage Anterior spinal artery syndrome Vertebral fracture PULMONARY-EMBOLISM ACRYLIC CEMENT RARE COMPLICATION POLYMETHYLMETHACRYLATE Clinical Neurology Orthopedics LA - English M1 - 8 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2011 SN - 1529-9430 SP - E5-E8 ST - Anterior spinal artery syndrome after percutaneous vertebroplasty T2 - Spine Journal TI - Anterior spinal artery syndrome after percutaneous vertebroplasty UR - ://WOS:000295772900002 VL - 11 ID - 830322 ER - TY - JOUR AB - The aim of this study was to evaluate the safety and efficacy of percutaneous vertebroplasty (PVP) in Kambin triangle approach for the treatment of osteoporotic vertebral compression fractures (OVCFs).Between November 2017 and September 2018, 109 patients (144 vertebral bodies) with OVCFs, with a mean age of 76.7 ± 9.9 years (55-96 years), underwent PVP in Kambin triangle approach. The time of operation, the volume of bone cement, the incidence of complication, the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) score, the position of puncture needles, and the spread of polymethylmethacrylate (PMMA) in vertebral body (VB) were recorded.All patients had been completed the operation successfully and were followed up 9.1 ± 2.9 months. The average operation time of each VB was 24.0 ± 3.5 minutes. The average volume of cement was 4.8 ± 0.6 ml. The mean VAS scores were 8.4 ± 0.7 preoperatively, 1.6 ± 0.6 at the first day postoperatively, and 1.2 ± 0.6 at the last follow-up. The mean ODI scores were 70.97 ± 7.73 preoperatively, 27.99 ± 4.12 at the first day postoperatively, and 19.65 ± 3.49 at the last follow-up. The position of puncture needles in the VB was: 119 vertebral puncture needles reached the midline, 15 were close to the midline, and 10 exceeded the midline. The spread of PMMA in the VB was: type 1 in 81 levels (56.3%), type 2 in 37 (25.7%), type 3 in 18 (12.5%), type 5 in 8 (5.5%), and no case in type 4. One case developed pneumothorax after operation. No other complications (hematoma, cement embolism, spinal cord, and nerve injury) occurred.Kambin triangle approach in PVP, which can deliver the puncture needle to the midline of VB easily and with excellent cement distribution, is a safe and effective method. AD - Department of Orthopedics, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Jiangsu Province, China AN - 143865227. Language: English. Entry Date: 20200623. Revision Date: 20200623. Publication Type: journal article. Journal Subset: Biomedical AU - Ye-Feng, Wang AU - Jun, Shen AU - Suo-Yuan, Li AU - Xiao, Yu AU - Tian-Ming, Zou AU - Wang, Ye-Feng AU - Shen, Jun AU - Li, Suo-Yuan AU - Yu, Xiao AU - Zou, Tian-Ming DB - cin20 DO - 10.1097/MD.0000000000017857 DP - EBSCOhost KW - Vertebroplasty -- Methods Spinal Fractures -- Surgery Fractures, Compression -- Surgery Male Methylmethacrylates Postoperative Complications Aged, 80 and Over Aged Bone Cements Vertebroplasty -- Adverse Effects Female Middle Age Retrospective Design M1 - 44 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2019 SN - 0025-7974 SP - 1-8 ST - Kambin triangle approach in percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures T2 - Medicine TI - Kambin triangle approach in percutaneous vertebroplasty for the treatment of osteoporotic vertebral compression fractures UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=143865227&site=ehost-live&scope=site VL - 98 ID - 830521 ER - TY - JOUR AB - Background: This study investigates the outcomes of cemented sockets in young patients (<50 years) requiring a total hip replacement (THR) compared to older patients (>50 years) having the same procedure, under the same surgeon between June 2005 and May 2009. Methods: Prosthesis survivorship rates, patient outcomes and radiological findings were compared between a consecutive series of 56 young patients (mean 42, range 25-49) and 56 older patients (mean 69, range 53-81) that underwent a primary THR using a cemented Stryker® Exeter™ Contemporary™ flanged cup. The minimum follow-up was 5 years. Results: No significant difference was observed between the groups’ Oxford Hip Scores (p = 0.078) or satisfaction scores (p = 0.67). Worst case scenario analysis for revision, failure or lost to follow-up showed 94.6% survival in the <50 year olds and 92.9% survival in the >50 year olds at 5 years. This study demonstrates no significant difference in patient outcomes, survivorship or radiographic findings at a minimum of 5 years between patients <50 years old and those >50 years old undergoing THR with a cemented socket. Conclusions: We believe the current trend towards uncemented cups may be driven by marketing rather than by evidence of improved outcomes. Cemented sockets provide very good outcomes for patients of all ages. AD - T.F.M. Yeoman, Department of Orthopaedics, Royal Infirmary of Edinburgh, 51 Little France Cres, Edinburgh, United Kingdom AU - Yeoman, T. F. M. AU - Smy, W. AU - Gaston, P. DB - Embase Medline DO - 10.5301/hipint.5000445 KW - total hip prosthesis acetabulum adult aged article case control study controlled study deep vein thrombosis follow up hip dislocation human infection lung embolism major clinical study middle aged outcome assessment Oxford Hip Score patient satisfaction questionnaire radiography reproducibility treatment outcome very elderly LA - English M1 - 2 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2017 SN - 1120-7000 SP - 122-127 ST - A case control study of cemented acetabular total hip arthroplasty components in patients less than 50 with 5-year minimum follow-up T2 - HIP International TI - A case control study of cemented acetabular total hip arthroplasty components in patients less than 50 with 5-year minimum follow-up UR - https://www.embase.com/search/results?subaction=viewrecord&id=L615223704&from=export http://dx.doi.org/10.5301/hipint.5000445 VL - 27 ID - 829267 ER - TY - JOUR AB - Major orthopaedic procedures that involve instrumentation of the medullary canal are well known to produce showers of embolic debris including fat, bone fragments, marrow constituents, and cement. A growing literature has identified paradoxic cerebral embolism as a rare but serious consequence of the passage of these emboli through an intracardiac right-to-left shunt to the cerebral arterial circulation. We report 2 cases of paradoxic cerebral embolism after cemented total knee arthroplasty and propose a novel treatment plan to prevent recurrent stroke during subsequent surgery. AD - Harvard Medical School, Boston, Massachusetts, USA. AN - 12555195 AU - Yeon, H. B. AU - Ramappa, A. AU - Landzberg, M. J. AU - Thornhill, T. S. DA - Jan DO - 10.1054/arth.2003.50003 DP - NLM ET - 2003/01/30 J2 - The Journal of arthroplasty KW - Aged Arthroplasty, Replacement, Knee/*adverse effects Cementation Echocardiography Female Heart Septal Defects, Atrial/diagnostic imaging Humans Intracranial Embolism/diagnosis/*etiology/prevention & control Magnetic Resonance Imaging Male Middle Aged LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2003 SN - 0883-5403 (Print) 0883-5403 SP - 113-20 ST - Paradoxic cerebral embolism after cemented knee arthroplasty: a report of 2 cases and prophylactic option for subsequent arthroplasty T2 - J Arthroplasty TI - Paradoxic cerebral embolism after cemented knee arthroplasty: a report of 2 cases and prophylactic option for subsequent arthroplasty VL - 18 ID - 828894 ER - TY - JOUR AB - Integrated CT-fluoroscopy equipment augments the comprehensive approach to the treatment of musculoskeletal (MSK) malignancy by interventional radiology techniques. As the role of minimally invasive treatment expands to meet the highly variable presentation of MSK malignancy, creative solutions to treatment challenges are required to improve locoregional tumor control and durability of pain palliation. Challenges to effective treatment can often be attributed to a combination of aggressive tumor biology, large size, forbidding location, and adverse vascularity. In these cases, a tailored treatment approach may necessitate the application of multiple interventional radiology (IR) techniques that require different image guidance capabilities. Integrated CT-fluoroscopy equipment provides the means to leverage both imaging modalities within the same procedural setting to facilitate the simultaneous application of multiple synergistic treatments and protective measures. This article examines the potential role of hybrid units in the IR treatment of challenging MSK malignancies as a means to empower a paradigm transition for a more comprehensive and patient-tailored approach. AD - [Yevich, Steven; Odisio, Bruno C.; Sheth, Rahul] Univ Texas MD Anderson Canc Ctr, Dept Intervent Radiol, Div Diagnost Imaging, Houston, TX 77030 USA. [Tselikas, Lambros; de Baere, Thierry; Deschamps, Frederic] Gustave Roussy Canc Campus Grand Paris, Dept Intervent Radiol, Villejuif, France. Yevich, S (corresponding author), Univ Texas MD Anderson Canc Ctr, 1400 Pressler St,FCT14-6024, Houston, TX 77030 USA. syevich@mdanderson.org AN - WOS:000449278700003 AU - Yevich, S. AU - Odisio, B. C. AU - Sheth, R. AU - Tselikas, L. AU - de Baere, T. AU - Deschamps, F. DA - Oct DO - 10.1055/s-0038-1669962 J2 - Semin. Interv. Radiol. KW - integrated hybrid musculoskeletal malignancy interventional radiology PERCUTANEOUS THERMAL ABLATION BONE METASTASES RADIOFREQUENCY ABLATION SCREW FIXATION DISEASE TUMORS EMBOLIZATION CANCER CEMENTOPLASTY CRYOABLATION Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 4 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 0739-9529 SP - 229-237 ST - Integrated CT-Fluoroscopy Equipment: Improving the Interventional Radiology Approach and Patient Experience for Treatment of Musculoskeletal Malignancies T2 - Seminars in Interventional Radiology TI - Integrated CT-Fluoroscopy Equipment: Improving the Interventional Radiology Approach and Patient Experience for Treatment of Musculoskeletal Malignancies UR - ://WOS:000449278700003 VL - 35 ID - 830154 ER - TY - JOUR AB - Metastatic cancer to the osseous structures can result in significant pain that can often be difficult to control with narcotic medication. Multiple interventional radiology treatments can be applied for palliative relief and improvement in patient quality of life. The most commonly used interventional radiology techniques include embolization, thermal ablation, vertebral augmentation, cementoplasty, and percutaneous internal fixation. These procedures are associated with unique considerations for the radiology nurse. We review the most common palliative techniques performed by the radiology team for patients with musculoskeletal metastases and focus on the salient nursing implications for preprocedural, intraprocedural, and postprocedural care. AD - Division of Diagnostic Imaging, Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX AN - 129791023. Language: English. Entry Date: 20180605. Revision Date: 20180605. Publication Type: Article AU - Yevich, Steven AU - Sheth, Rahul AU - Ojeshina, Olalekan AU - Tam, Alda DB - cin20 DO - 10.1016/j.jradnu.2017.12.006 DP - EBSCOhost KW - Neoplasm Metastasis Cancer Pain -- Therapy Radiography, Interventional Palliative Care Quality of Life Bone Neoplasms M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2018 SN - 1546-0843 SP - 90-97 ST - Interventional Radiology Techniques for the Management of Painful Bone Metastases T2 - Journal of Radiology Nursing TI - Interventional Radiology Techniques for the Management of Painful Bone Metastases UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=129791023&site=ehost-live&scope=site VL - 37 ID - 830551 ER - TY - JOUR AB - The technical art to percutaneous injection of polymethyl methacrylate (PMMA) cement for the palliative treatment of osseous metastases is not without pitfalls. Pathologic fracture, cortical bone erosion, large lytic tumor, aggressive tumor biology, and tumor vascularity may increase the risk of cement leakage or limit complete consolidation. A calculated and determined approach is often necessary to achieve satisfactory patient-tailored results. This article reviews the challenges and potential complications during the consolidation of osseous metastases. Case examples are presented to facilitate early detection of impending cement leakage, minimize procedural risks, and provide management suggestions for complications. Technical pearls are provided to refine consolidative techniques and improve the comprehensive treatment of painful osseous metastases. AD - [Yevich, Steven] Univ Texas MD Anderson Canc Ctr, Dept Intervent Radiol, Div Diagnost Imaging, Houston, TX 77030 USA. [Tselikas, Lambros; Gravel, Guillaume; de Baere, Thierry; Deschamps, Frederic] Gustave Roussy Canc Campus Grand Paris, Dept Intervent Radiol, Villejuif, France. Yevich, S (corresponding author), Univ Texas MD Anderson Canc Ctr, 1400 Pressler St,FCT14-6024, Houston, TX 77030 USA. syevich@mdanderson.org AN - WOS:000449278700008 AU - Yevich, S. AU - Tselikas, L. AU - Gravel, G. AU - de Baere, T. AU - Deschamps, F. DA - Oct DO - 10.1055/s-0038-1673418 J2 - Semin. Interv. Radiol. KW - cement leakage cementoplasty polymethyl methacrylate complication interventional radiology SKELETAL-RELATED EVENTS VERTEBRAL AUGMENTATION PULMONARY-EMBOLISM RARE COMPLICATION FAT-EMBOLISM RADIOFREQUENCY ABLATION SPINAL METASTASES ACRYLIC CEMENT BONE-CEMENT VERTEBROPLASTY Radiology, Nuclear Medicine & Medical Imaging LA - English M1 - 4 M3 - Review N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 0739-9529 SP - 268-280 ST - Percutaneous Cement Injection for the Palliative Treatment of Osseous Metastases: A Technical Review T2 - Seminars in Interventional Radiology TI - Percutaneous Cement Injection for the Palliative Treatment of Osseous Metastases: A Technical Review UR - ://WOS:000449278700008 VL - 35 ID - 830155 ER - TY - JOUR AB - Metastases to the bone represent the third most common site of metastatic disease. More than 50% of patients with metastatic cancer will develop bone metastases. Associated morbidity is related to local tumor progression that destroys bone to result in pain, pathologic fracture, hypercalcemia, and neurologic deficits. Depending on the tumor biology, systemic chemotherapy or radiation therapy may not provide complete local control and may not adequately relieve associated pain. While surgical intervention may be beneficial in many patients, surgical options may also provide incomplete locoregional cure or palliation, and moreover may require extensive healing that can delay systemic therapy. Interventional oncology treatments can provide appealing alternative therapies for osseous metastases. These minimally-invasive therapies can augment existing conventional treatments and even provide a viable option for patients that have exhausted, or are not suitable candidates, for conventional treatments. Interventional oncology treatments are applied for either pain palliation, local tumor control, or both. The goals of treatment can include tumor remission or cure, as well as improved quality of life and mobility. An effective and durable interventional oncology treatment requires a tailored approach that considers the high variability in disease presentation. Osseous metastases may present throughout the skeleton, with low to high vascularity, and undulant to rapidly aggressive tumor biology. This article reviews the main percutaneous treatment for osseous metastases that include embolization, thermal ablation, vertebral augmentation, cementoplasty, and fixation by internal cemented screw (FICS). AD - Department of Interventional Radiology, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. syevich@mdanderson.org. Department of Interventional Radiology, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France. 2nd Department of Radiology, General University Hospital "ATTIKON", National and Kapodistrian University of Athens, Athens, Greece. AN - 31735050 AU - Yevich, S. AU - Tselikas, L. AU - Kelekis, A. AU - Filippiadis, D. AU - de Baere, T. AU - Deschamps, F. DA - Dec DO - 10.21037/cco.2019.10.02 DP - NLM ET - 2019/11/19 J2 - Chinese clinical oncology KW - Aged, 80 and over Bone Neoplasms/pathology/*therapy Female Humans Neoplasm Metastasis Bone ablation fixation malignancy metastasis osseous LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2019 SN - 2304-3865 SP - 62 ST - Percutaneous management of metastatic osseous disease T2 - Chin Clin Oncol TI - Percutaneous management of metastatic osseous disease VL - 8 ID - 828627 ER - TY - JOUR AB - Background and purpose - Cemented hemiarthroplasty is preferred in treating displaced fractures of the femoral neck in the elderly. The cementing process may cause a fat embolism, leading to serious complications or death. In this study, we wanted to determine whether use of uncemented hemiarthroplasty (HA) would lead to reduced mortality and whether there are differences in the complications associated with these different types of arthroplasty. Patients and methods - From the PERFECT database, which combines information from various treatment registries, we identified 25,174 patients who were treated with hemiarthroplasty for a femoral neck fracture in the years 1999-2009. The primary outcome was mortality. Secondary outcomes were reoperations, complications, re-admissions, and treatment times. Results - Mortality was lower in the first postoperative days when uncemented HA was used. At 1 week, there was no significant difference in mortality (3.9% for cemented HA and 3.4% for uncemented HA; p = 0.09). This was also true after one year (26% for cemented HA and 27% for uncemented HA; p = 0.1). In patients treated with uncemented HA, there were significantly more mechanical complications (3.7% vs. 2.8%; p < 0.001), hip re-arthroplasties (1.7% vs. 0.95; p < 0.001), and femoral fracture operations (1.2% vs. 0.52%; p < 0.001) during the first 90 days after hip fracture surgery. Interpretation - From registry data, mortality appears to be similar for cemented and uncemented HA. However, uncemented HA is associated with more frequent mechanical complications and reoperations. AD - Department of Orthopedics, Traumatology and Hand Surgery, Kuopio University Hospital and University of Eastern Finland, Kuopio National Institute for Health and Welfare, Helsinki, Finland and University of Eastern Finland, Kuopio Department of Orthopedics and Traumatology, Töölö Hospital, Helsinki University Central Hospital, Helsinki, Finland. AN - 104033180. Language: English. Entry Date: 20140304. Revision Date: 20200708. Publication Type: Journal Article AU - Yli-Kyyny, Tero AU - Sund, Reijo AU - Heinänen, Mikko AU - Venesmaa, Petri AU - Kröger, Heikki DB - cin20 DO - 10.3109/17453674.2013.878827 DP - EBSCOhost KW - Hemiarthroplasty -- Mortality Femoral Fractures -- Surgery Femur Neck Fat Embolism Syndrome Human Finland Male Female Aged Aged, 80 and Over Cox Proportional Hazards Model Data Analysis Software Descriptive Statistics Odds Ratio Registries, Implant Reoperation M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2014 SN - 1745-3674 SP - 49-53 ST - Cemented or uncemented hemiarthroplasty for the treatment of femoral neck fractures? T2 - Acta Orthopaedica TI - Cemented or uncemented hemiarthroplasty for the treatment of femoral neck fractures? UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=104033180&site=ehost-live&scope=site VL - 85 ID - 830643 ER - TY - JOUR AB - Fat Embolism is a complication of long bone fractures, intramedullary fixation and joint arthroplasty. It may progress to fat embolism syndrome, which is rare but involves significant morbidity and can occasionally be fatal. Fat Embolism can be detected at the time of embolization by transoesophageal echocardiography or atrial blood sampling. Later, a combination of clinical signs and symptoms will point towards fat embolism but there is no specific test to confirm the diagnosis. We investigated serum Interleukin-6 (IL-6) as a possible early marker for fat embolism.~Background~Background~An animal study was conducted to simulate a hip replacement in 31 adult male Sprague Dawley rats. The procedure was performed under general anesthesia and the animals divided into 3 groups: control, uncemented and cemented. Following surgery and recovery from anaesthesia, the rats allowed to freely mobilize in their cages. Blood was taken before surgery and at 6 hours, 12 hours and 24 hours to measure serum IL-6 levels. The rats were euthanized at 24 hours and lungs removed and stained for fat. The amount of fat seen was then correlated with serum IL-6 levels.~Methods~Methods~No rats in the control group had fat emboli. Numerous fat emboli were seen in both the uncemented and cemented implant groups. The interleukin levels were raised in all groups reaching a peak at 12 hours after surgery reaching 100 pg/ml in the control group and around 250 pg/ml in the uncemented and cemented implant groups. The IL-6 levels in the control group were significantly lower than any of the implant groups at 12 and 24 hours. At these time points, the serum IL-6 correlated with the amount of fat seen on lung histology.~Results~Results~Serum IL-6 is a possible early marker of fat embolism.~Conclusion~Conclusions AD - Department of Orthopaedic Surgery, University of Otago, Dunedin, New Zealand. yoga.raj@me.com. AN - 105437859. Language: English. Entry Date: 20100903. Revision Date: 20200708. Publication Type: Journal Article AU - Yoga, R. AU - Theis, J. C. AU - Walton, M. AU - Sutherland, W. DB - cin20 DO - 10.1186/1749-799X-4-18 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip Embolism, Fat -- Diagnosis Fractures -- Complications Interleukins -- Blood Interleukins -- Diagnostic Use Adult Analysis of Variance Animal Studies Biological Markers -- Diagnostic Use Data Analysis Software Fisher's Exact Test Interleukins -- Classification Male Post Hoc Analysis Rats Spearman's Rank Correlation Coefficient Time Factors N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2009 SN - 1749-799X SP - 7p-7p ST - Interleukin-6 as an early marker for fat embolism T2 - Journal of Orthopaedic Surgery & Research TI - Interleukin-6 as an early marker for fat embolism UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105437859&site=ehost-live&scope=site VL - 4 ID - 830742 ER - TY - JOUR AB - Prophylaxis against venous thromboembolism after elective total hip replacement is routinely recommended. Our preference has been to use mechanical prophylaxis without anticoagulant drugs. A randomised controlled trial was performed to evaluate whether the incidence of post‐operative venous thromboembolism was reduced by using pharmacological anticoagulation with either fondaparinux or enoxaparin in addition to our prophylactic mechanical regimen. A total of 255 Japanese patients who underwent primary unilateral cementless total hip replacement were randomly assigned to one of three postoperative regimens, namely injection of placebo (saline), fondaparinux or enoxaparin. There were 85 patients in each group. All also received the same mechanical prophylaxis during and after the operation, regardless of their assigned group. The primary measurement of efficacy was the presence of a venous thromboembolic event by day 11, defined as deep‐vein thrombosis detected by ultrasonography, documented symptomatic deep‐vein thrombosis or documented symptomatic pulmonary embolism. The duration of follow‐up was 12 weeks. The rate of venous thromboembolism was 7.2% with the placebo, 7.1% with fondaparinux and 6.0% with enoxaparin (p = 0.95 for the comparison of all three groups). Our study confirmed the effectiveness and safety of mechanical thromboprophylaxis without the use of anticoagulant drugs after total hip replacement in Japanese patients. AN - CN-00778432 AU - Yokote, R. AU - Matsubara, M. AU - Hirasawa, N. AU - Hagio, S. AU - Ishii, K. AU - Takata, C. DO - 10.1302/0301-620X.93B2.25795 KW - Aged Anticoagulants [*therapeutic use] Arthroplasty, Replacement, Hip Combined Modality Therapy Compression Bandages Enoxaparin [therapeutic use] Female Fondaparinux Humans Intermittent Pneumatic Compression Devices Male Middle Aged Polysaccharides [therapeutic use] Postoperative Care [methods] Postoperative Complications [diagnostic imaging, *prevention & control] Ultrasonography, Doppler, Duplex Unnecessary Procedures Venous Thromboembolism [diagnostic imaging, *prevention & control] M1 - 2 M3 - Comparative Study; Journal Article; Randomized Controlled Trial N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2011 SP - 251‐256 ST - Is routine chemical thromboprophylaxis after total hip replacement really necessary in a Japanese population? T2 - Journal of bone and joint surgery. British volume TI - Is routine chemical thromboprophylaxis after total hip replacement really necessary in a Japanese population? UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-00778432/full VL - 93 ID - 830089 ER - TY - JOUR AB - Purpose: To present midterm results of Duracon total knee arthroplasty (TKA) performed between 1991 and 2001. Methods: One man and 43 women (65 knees) aged 46 to 84 (mean, 63) years who underwent primary TKAs using the Duracon prosthesis performed by a single surgeon were followed up for a mean of 8.5 (range, 5-11) years. All TKAs were cruciate-retaining and cemented, with only 9 of the patellae resurfaced. The diagnosis was osteoarthritis in 42 patients (61 knees), and rheumatoid arthritis in 2 patients (4 knees). Patients were assessed using the Knee Society Clinical Rating System, the Oxford Knee Score, and the Knee Society Total Knee Arthroplasty Roentgenographic Evaluation and Scoring System. Results: The mean Knee Society knee score was 86 (range, 43-100) and the function score was 68 (0- 100). 94% of patients reported no or only mild pain. The mean Oxford Knee Score was 19. There was no patellofemoral complication, deep vein thrombosis or pulmonary embolism. Complications included a superficial infection and an uncontrolled deep infection. One patient had the insert exchanged for wear at the 11-year follow-up, and another had the polyethylene insert and tibial tray revised after a motorcycle accident. Conclusion: The Duracon TKA had good midterm clinical results with absence of patellofemoral complications. AD - Department of Orthopaedic Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia Department of Orthopaedic Surgery, University Malaya Medical Centre, Kuala Lumpur, Malaysia. AN - 105570004. Language: English. Entry Date: 20090220. Revision Date: 20200619. Publication Type: journal article AU - Yong, C. K. AU - Choon, D. S. AU - Soon, H. C. AU - Yong, C. K. AU - Choon, D. S. K. AU - Soon, H. C. DB - cin20 DO - 10.1177/230949900801600214 DP - EBSCOhost KW - Arthroplasty, Replacement, Knee -- Methods Joint Prosthesis Aged Aged, 80 and Over Arthritis, Rheumatoid -- Surgery Chi Square Test Female Male Middle Age Osteoarthritis, Knee -- Surgery Postoperative Complications -- Epidemiology Postoperative Complications -- Prevention and Control Prosthesis Design Prosthesis Failure Questionnaires Range of Motion Treatment Outcomes Human M1 - 2 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2008 SN - 1022-5536 SP - 197-200 ST - Midterm outcome of the Duracon total knee arthroplasty T2 - Journal of Orthopaedic Surgery (10225536) TI - Midterm outcome of the Duracon total knee arthroplasty UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=105570004&site=ehost-live&scope=site VL - 16 ID - 830748 ER - TY - JOUR AB - STUDY DESIGN: A case of acute respiratory distress syndrome following percutaneous vertebroplasty is described. OBJECTIVE: To alert clinicians to the potential occurrence of acute respiratory distress syndrome following use of polymethylmethacrylate bone cement. SUMMARY OF BACKGROUND DATA: Noncardiogenic pulmonary edema has not been reported following intravertebral injection of polymethylmethacrylate. METHODS: A 68-year-old woman underwent percutaneous vertebroplasty for a painful L5 compression fracture under local anesthesia. A contralateral transpedicular approach was made to inject polymethylmethacrylate. RESULTS: On the third postoperative day, she developed arthralgia, myalgia, fever, and frequent coughing. Chest radiography revealed bilateral, multifocal, patchy consolidations, suggestive of acute respiratory distress syndrome, and a 5-cm-long tubular radiopacity in the right pulmonary artery. She died 20 days after the vertebroplasty. CONCLUSION: This case illustrates that clinicians must be aware of the potential occurrence of acute respiratory distress syndrome in patients who received percutaneous vertebroplasty. AD - Department of Anesthesiology, Chonnam National University Medical School, Gwangju, South Korea. AN - 15247590 AU - Yoo, K. Y. AU - Jeong, S. W. AU - Yoon, W. AU - Lee, J. DA - Jul 15 DO - 10.1097/01.brs.0000131211.87594.b0 DP - NLM ET - 2004/07/13 J2 - Spine KW - Aged Bone Cements/*adverse effects Embolectomy Fatal Outcome Female Fractures, Spontaneous/etiology/*therapy Humans Injections, Intralesional Multiple Organ Failure/etiology Osteoporosis/complications Polymethyl Methacrylate/administration & dosage/*adverse effects Pulmonary Artery Pulmonary Embolism/*chemically induced/complications/diagnosis/surgery Respiratory Distress Syndrome/*etiology Spinal Fractures/etiology/*therapy Treatment Failure LA - eng M1 - 14 N1 - PubMed NLM literature search January 5, 2021 PY - 2004 SN - 0362-2436 SP - E294-7 ST - Acute respiratory distress syndrome associated with pulmonary cement embolism following percutaneous vertebroplasty with polymethylmethacrylate T2 - Spine (Phila Pa 1976) TI - Acute respiratory distress syndrome associated with pulmonary cement embolism following percutaneous vertebroplasty with polymethylmethacrylate VL - 29 ID - 828850 ER - TY - JOUR AB - Thromboembolism is the most common serious complication following total hip arthroplasty and most common cause of death after total hip arthroplasty. A prospective randomized study in 170 cases of elective cementless total hip arthroplasty was carried out to examine the incidence of deep vein thrombosis and pulmonary embolism after cementless total hip arthroplasty from Aug. 1993 to May 1995. Laboratory study, clinical symptoms and signs, chest roentgenograph and precipitating factors were analysed. Venography and lung perfusion scan using radionuclide scan were used for this study. The weight, height, sex, habitus of alcohol and smoking, hypertension, diabetes mellitus, previous operation history of ipsilateral lower extremity, etiology of hip joint disease, and transfusion of blood were not precipitating factors, but the age over 40 and previous history of pulmonary embolism had a significant effect on the incidence of deep vein thrombosis. There was no significant relationship between the incidence of deep vein thrombosis and the laboratory assay, clinical symptoms and signs. Deep vein thrombosis was detected in 29 cases (17.0%), pulmonary embolism in 22 cases (12.9%), and fatal pulmonary embolism in 1 case (0.6%). The most common location of deep vein thrombosis was the popliteal area. [By kind permission, KoreaMed, Korean Association of Medical Journal Editors.] AN - CN-01046665 AU - Yoo, M. C. AU - Cho, Y. J. AU - Yim, C. M. AU - Hong, G. P. AU - Kim, J. M. M1 - 7 N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 1998 SP - 1672‐1680 ST - Deep Vein Thrombosis and Pulmonary Embolism after Cementless Total Hip Arthroplasty T2 - Journal of the korean orthopaedic association TI - Deep Vein Thrombosis and Pulmonary Embolism after Cementless Total Hip Arthroplasty UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01046665/full VL - 33 ID - 830065 ER - TY - JOUR AB - A report is presented of circulatory changes during total hip joint and knee joint surgery with methylmethacrylate bone cement in 18 patients. Average systolic blood pressure fall of total hip replacement was 14 mmHg and maximal fall, 40 mmHg. Also the authors could find a blood pressure fall in 50 mmHg in total knee joint surgery. 15 cases out of 18 cases had in some degree a change in blood pressure. The authors must be attentive to cement monomer's direct effects on the cardiovascular and pulmonary systems, and embolism by pressure rise in bone marrow cavity. The authors never had the case with severe complications during operations. The authors consider that cardiac arrest during operation is induced by more than one mechanism. A schedule of experimental research concerning the movement of the peripheral artery at hypotension induced by acrylic monomer is described. AD - Dept. I Oral Surg., Hiroshima Univ., Sch. Dent., Hiroshima AU - Yoshiga, K. AU - Fujii, K. AU - Kawahara, M. DB - Embase KW - acrylic acid bone cement methacrylic acid methyl ester blood pressure heart arrest hypotension knee arthroplasty lung embolism major clinical study total hip prosthesis total knee arthroplasty LA - Japanese M1 - 3 N1 - Embase Elsevier literature search January 5, 2021 PY - 1975 SP - 139-145 ST - Circulatory changes following implantation of bone cement (Japanese) T2 - Hiroshima Journal of Anesthesia TI - Circulatory changes following implantation of bone cement (Japanese) UR - https://www.embase.com/search/results?subaction=viewrecord&id=L7053164&from=export VL - 11 ID - 829975 ER - TY - JOUR AB - Percutaneous kyphoplasty is a commonly used procedure for management of compression fractures and cement pulmonary embolism (CPE) is a documented complication of this procedure. Different incidence rates (2.1%-28.6%) of CPE have been reported depending on imaging modality used for the diagnosis. Her we present an interesting case of symptomatic peripheral CPE. Description:A 33 years-old Afro-American woman with history of morbid obesity, tobacco abuse, OSA and HTN presented to ER with right sided chest pain and SOB that started two days ago. T-11 Kyphoplasty was performed three days ago for wedge compression fracture of T-11 and T-12 vertebrae secondary to fall three months ago. On examination, she was tachycardic, tachypneic, hypertensive with oxygen saturation of 90%. Other exams were unremarkable.Initial EKG, cardiac enzymes, BNP, CMP and CBC were WNL. Chest X-ray revealed Linear metallic densities in the right lower lobe. CT scan of the chest with pulmonary embolism protocol (CT-PE) was performed which showed hyperdense emboli involving the right lower lobe pulmonary artery as well as multiple subsegmental branches on the right. History and imaging data were suggestive of symptomatic peripheral CPE. Heparin was started with bridging to warfarin. Currently patient is taking warfarin with regular visits to our coumadin clinic. Her symptoms have improved, she has stopped smoking and patient is actively losing weight. She will continue treatment for 6 months. Repeat CT-PE will be performed in 6 months. Discussion:1. CPE is not a rare complication of vertebral kyphoplasty. Incidence rate varies with the sensitivity of imaging modality.2. Extravasation of cement into nutrient vessels, azygous vein and inferior vena-cava subsequently leads to CPE.3. CPE is divided into 4 groups (Central CPE involves main pulmonary trunk, right or left main PA): (1) asymptomatic peripheral, (2) symptomatic peripheral, (3) asymptomatic central, (4) symptomatic central.4. Group 1 is managed conservatively with close observation, for group 2 and group 3 it is recommended to follow CHEST guidelines for VTE management i.e. anticoagulation for 3-6 months. For group 4 surgical embolectomy is recommended.5. There is limited literature on monitoring or follow up of these patients.Conclusion:Our patient was appropriately managed based on the available literature and shared decision making. AD - H. Yousaf, Internal Medicine, Memorial Univerity Medical Center, Savannah, GA, United States AU - Yousaf, H. AU - Robinson, E. AU - Goodman, L. DB - Embase KW - cement cytidine phosphate heart enzyme heparin warfarin adult African American anticoagulation azygos vein body weight case report clinical article complication compression fracture conference abstract drug therapy electrocardiogram embolectomy extravasation female follow up human incidence inferior cava vein kyphoplasty lung embolism morbid obesity nutrient oxygen saturation practice guideline pulmonary artery shared decision making smoking tachycardia thorax pain thorax radiography tobacco dependence vertebra x-ray computed tomography LA - English M1 - 9 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2019 SN - 1535-4970 ST - Cement pulmonary embolism after percutaneous kyphoplasty T2 - American Journal of Respiratory and Critical Care Medicine TI - Cement pulmonary embolism after percutaneous kyphoplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L630348483&from=export VL - 199 ID - 829139 ER - TY - JOUR AB - OBJECTIVE: Aseptic prosthetic loosening is a primary problem of total hip arthroplasty. For this reason, several prosthesis interfaces with different characteristics have been studied, such as ceramic-on-ceramic prosthesis. The purpose of this study was to investigate the mid- and short-term curative effects of ceramic-on-ceramic total hip arthroplasty in treatment of avascular necrosis of the femoral head (ANFH) and to evaluate its clinical application value. METHODS: A total of 23 patients (28 hips) with ANFH who received ceramic-on-ceramic non-cement hip prosthesis replacement were followed up. All hip prostheses were BiCONTACT® ceramic-on-ceramic hip prostheses. Functional evaluation was assessed according to the Harris hip score. Radiographic analysis was performed using the Gruen's zonal method for the stem and the zonal classification of Delee-Charnley for the cup implants. RESULTS: All patients were followed up for an average of 28 months. The mean Harris hip scores ranged from 39.45 points prior to surgery to 88.57 points after surgery, with a difference which was significant (P < 0.05). Radiographically, no obvious prosthesis loosening or subsidence was observed. CONCLUSION: The ceramic-on-ceramic total hip arthroplasty can produce good short-term curative effects in treatment of ANFH. Radiographic findings do not show obvious prosthesis loosening. AD - B. Yu, Department of Orthopedics, Shandong University of Traditional Chinese Medicine, Jinan 250011, Shandong Province, China AU - Yu, B. DB - Embase DO - 10.3969/j.issn.1673-8225.2009.39.041 KW - adult article avascular necrosis ceramic prosthesis clinical article deep vein thrombosis female femoral head follow up functional assessment Harris hip score hip arthroplasty hip dislocation hip radiography human lung embolism male prosthesis loosening range of motion retrospective study total hip prosthesis BiCONTACT LA - English M1 - 39 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2009 SN - 1673-8225 SP - 7780-7784 ST - Ceramic-on-ceramic total hip arthroplasty for treating avascular necrosis of the femoral head in 23 cases T2 - Journal of Clinical Rehabilitative Tissue Engineering Research TI - Ceramic-on-ceramic total hip arthroplasty for treating avascular necrosis of the femoral head in 23 cases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L355654867&from=export http://dx.doi.org/10.3969/j.issn.1673-8225.2009.39.041 VL - 13 ID - 829697 ER - TY - JOUR AB - Vertebral hemangiomas are benign lesions and are often asymptomatic. Most vertebral hemangiomas that cause cord compression and neurological symptoms are located in the thoracic spine and involve a single vertebra. The authors report the rare case of lumbar hemangiomas in a 60-year-old woman presenting with severe back pain and rapidly progressive neurological signs attributable to 2 noncontiguous lesions. After embolization of the feeding arteries, no improvement was noted. Thus, the authors performed open surgery using a combination of posterior decompression, intraoperative kyphoplasty, and segmental fixation. The patient experienced relief from back and leg pain immediately after surgery. At 3 months postoperatively, her symptoms and neurological deficits had improved completely. To the authors' knowledge, this is the first description of 2 noncontiguous extensive lumbar hemangiomas presenting with neurological symptoms managed by such combined treatment. The combined management seems to be an effective method for treating symptomatic vertebral hemangiomas. AD - Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China. AN - 24236666 AU - Yu, B. AU - Wu, D. AU - Shen, B. AU - Zhao, W. AU - Huang, Y. AU - Zhu, J. AU - Qi, D. DA - Jan DO - 10.3171/2013.10.spine13499 DP - NLM ET - 2013/11/19 J2 - Journal of neurosurgery. Spine KW - Combined Modality Therapy *Decompression, Surgical Embolization, Therapeutic Female Hemangioma/complications/pathology/*surgery Humans *Kyphoplasty Lumbar Vertebrae/*surgery Middle Aged Spinal Cord Compression/etiology/pathology/surgery *Spinal Fusion Spinal Neoplasms/complications/pathology/*surgery Treatment Outcome LA - eng M1 - 1 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 1547-5646 SP - 60-6 ST - Noncontiguous lumbar vertebral hemangiomas treated by posterior decompression, intraoperative kyphoplasty, and segmental fixation T2 - J Neurosurg Spine TI - Noncontiguous lumbar vertebral hemangiomas treated by posterior decompression, intraoperative kyphoplasty, and segmental fixation VL - 20 ID - 828785 ER - TY - JOUR AB - Vertebral hemangiomas are benign lesions and are often asymptomatic. Most vertebral hemangiomas that cause cord compression and neurological symptoms are located in the thoracic spine and involve a single vertebra. The authors report the rare case of lumbar hemangiomas in a 60-year-old woman presenting with severe back pain and rapidly progressive neurological signs attributable to 2 noncontiguous lesions. After embolization of the feeding arteries, no improvement was noted. Thus, the authors performed open surgery using a combination of posterior decompression, intraoperative kyphoplasty, and segmental fixation. The patient experienced relief from back and leg pain immediately after surgery. At 3 months postoperatively, her symptoms and neurological deficits had improved completely. To the authors' knowledge, this is the first description of 2 noncontiguous extensive lumbar hemangiomas presenting with neurological symptoms managed by such combined treatment. The combined management seems to be an effective method for treating symptomatic vertebral hemangiomas. ©AANS, 2014. AD - D. Wu, Department of Spine Surgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200120, China AU - Yu, B. AU - Wu, D. AU - Shen, B. AU - Zhao, W. AU - Huang, Y. AU - Zhu, J. AU - Qi, D. DB - Embase Medline DO - 10.3171/2013.10.SPINE13499 KW - gelfoam nonsteroid antiinflammatory agent poly(methyl methacrylate) adult analgesia article artificial embolization backache case report computer assisted tomography conservative treatment constipation electrostimulation female follow up hospital admission human kyphoplasty leg pain limb weakness middle aged myelography noncontiguous lumbar vertebral hemangiomas nuclear magnetic resonance imaging paresthesia pedicle screw postoperative period rare disease spinal cord decompression spine stabilization vertebra hemangioma walking difficulty L1 - http://thejns.org/doi/pdf/10.3171/2013.10.SPINE13499 LA - English M1 - 1 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2014 SN - 1547-5654 1547-5646 SP - 60-66 ST - Noncontiguous lumbar vertebral hemangiomas treated by posterior decompression, intraoperative kyphoplasty, and segmental fixation: Case report T2 - Journal of Neurosurgery: Spine TI - Noncontiguous lumbar vertebral hemangiomas treated by posterior decompression, intraoperative kyphoplasty, and segmental fixation: Case report UR - https://www.embase.com/search/results?subaction=viewrecord&id=L372111831&from=export http://dx.doi.org/10.3171/2013.10.SPINE13499 VL - 20 ID - 829433 ER - TY - JOUR AB - Vertebral hemangiomas are benign lesions and are often asymptomatic. Most vertebral hemangiomas that cause cord compression and neurological symptoms are located in the thoracic spine and involve a single vertebra. The authors report the rare case of lumbar hemangiomas in a 60-year-old woman presenting with severe back pain and rapidly progressive neurological signs attributable to 2 noncontiguous lesions. After embolization of the feeding arteries, no improvement was noted. Thus, the authors performed open surgery using a combination of posterior decompression, intraoperative kyphoplasty, and segmental fixation. The patient experienced relief from back and leg pain immediately after surgery. At 3 months postoperatively, her symptoms and neurological deficits had improved completely. To the authors' knowledge, this is the first description of 2 noncontiguous extensive lumbar hemangiomas presenting with neurological symptoms managed by such combined treatment. The combined management seems to be an effective method for treating symptomatic vertebral hemangiomas. AD - [Yu, Bin; Wu, Desheng; Shen, Bin; Zhao, Weidong; Huang, Yufeng; Zhu, Jianguang; Qi, Dongduo] Tongji Univ, Sch Med, Shanghai East Hosp, Dept Spine Surg, Shanghai 200120, Peoples R China. Wu, DS (corresponding author), Tongji Univ, Sch Med, Shanghai East Hosp, Dept Spine Surg, Shanghai 200120, Peoples R China. eastspine@yahoo.com AN - WOS:000329088100010 AU - Yu, B. AU - Wu, D. S. AU - Shen, B. AU - Zhao, W. D. AU - Huang, Y. F. AU - Zhu, J. G. AU - Qi, D. D. DA - Jan DO - 10.3171/2013.10.spine13499 J2 - J. Neurosurg.-Spine KW - noncontiguous extensive symptomatic lumbar vertebral hemangioma kyphoplasty BALLOON KYPHOPLASTY PERCUTANEOUS VERTEBROPLASTY NATURAL-HISTORY MANAGEMENT COMPRESSION CEMENT FRACTURE Clinical Neurology Surgery LA - English M1 - 1 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2014 SN - 1547-5654 SP - 60-66 ST - Noncontiguous lumbar vertebral hemangiomas treated by posterior decompression, intraoperative kyphoplasty, and segmental fixation Case report T2 - Journal of Neurosurgery-Spine TI - Noncontiguous lumbar vertebral hemangiomas treated by posterior decompression, intraoperative kyphoplasty, and segmental fixation Case report UR - ://WOS:000329088100010 VL - 20 ID - 830273 ER - TY - JOUR AN - 23043151 AU - Yu, C. H. AU - Yang, S. C. AU - Chen, W. DA - Oct DO - 10.1093/qjmed/hcs181 DP - NLM ET - 2012/10/09 J2 - QJM : monthly journal of the Association of Physicians KW - Aged Bone Cements/*adverse effects Female Fractures, Bone/surgery Humans Lumbar Vertebrae/surgery Pulmonary Embolism/diagnosis/*diagnostic imaging/*etiology Tomography, X-Ray Computed Vertebroplasty/*adverse effects LA - eng M1 - 10 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 1460-2393 SP - 967-8 ST - Pulmonary cement embolism T2 - Qjm TI - Pulmonary cement embolism VL - 106 ID - 828927 ER - TY - JOUR AB - Rationale: Leakage of bone cement is a common complication after percutaneous kyphoplasty. In rare cases, bone cement can leak into the venous system, which can be life threatening, especially when it causes an embolism in the heart.Patient Concerns: A 79-year-old female patient developed chest pain with chest tightness 3 weeks after the percutaneous kyphoplasty.Diagnoses: Initially, negative fluoroscopy results and elevated myocardial enzymes suggested that the patient's chest pain and chest tightness symptoms were manifestations of coronary heart disease. However, in the subsequent computed tomography (CT) examination, foreign bodies in the heart and pulmonary vessels were found.Interventions: The patient underwent emergency surgery to remove the bone cement and repair the tricuspid valve.Outcomes: The postoperative course was uneventful and the patient was discharged on the 13th day after surgery.Lessons: If a patient develops chest pain with chest tightness after percutaneous kyphoplasty, the clinicians must be vigilant and take into account the limited sensitivity of fluoroscopy and use chest computer tomography and echocardiogram as the first choice and thereby prevent serious consequences. AD - Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China AN - 144230503. Language: English. Entry Date: 20200627. Revision Date: 20200627. Publication Type: journal article AU - Yu, Song AU - Xiaofan, Huang AU - Long, Wu AU - Song, Yu AU - Huang, Xiaofan AU - Wu, Long DB - cin20 DO - 10.1097/MD.0000000000019354 DP - EBSCOhost KW - Kyphoplasty -- Adverse Effects Bone Cements -- Adverse Effects Embolism -- Etiology Foreign Bodies Embolism -- Surgery Spinal Fractures -- Surgery Heart Ventricle Spinal Fractures Foreign Bodies -- Surgery Bone Cements -- Therapeutic Use Prospective Studies Echocardiography -- Methods Treatment Outcomes Heart Ventricle -- Surgery Aged Lumbar Vertebrae -- Surgery Kyphoplasty -- Methods Fluoroscopy -- Methods Embolism Female M1 - 11 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2020 SN - 0025-7974 SP - 1-3 ST - Removal of intracardiac bone cement embolism after percutaneous kyphoplasty: A case report T2 - Medicine TI - Removal of intracardiac bone cement embolism after percutaneous kyphoplasty: A case report UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=144230503&site=ehost-live&scope=site VL - 99 ID - 830513 ER - TY - JOUR AB - Purpose: To evaluate the safety and efficacy of three-dimensional (3D) navigation-guided polymethylmethacrylate (PMMA)-augmented thoracic and lumbar pedicle screw fixation for the osteoporotic patients.Methods: 27 consecutive osteoporosis patients with a variety of spinal disorders who underwent 3D navigation-guided PMMA-augmented pedicle screw fixation were evaluated clinically and radiologically in the perioperative and 1-year follow-up period. The improvement of Japanese Orthopaedic Association (JOA) scores was analyzed. PMMA leakage and other complications were inspected intraoperatively and postoperatively. Screw loosening and bone fusion were evaluated radiographically during follow-up.Results: 8 patients had thoracic and lumbar fractures; 18 patients had degenerative spinal disorders; one patient had revision surgery. One patient died of postoperative pneumonia. Each of the other 26 patients was followed up regularly at 3, 6, 12 and 18 months postoperatively. The mean therapeutic improvement rate is 39.6% evaluated by JOA scores. 2 patients (7.4%) had leakage into the spinal canal in front of the posterior longitudinal ligament and two patients (7.4%) had leakage into the prevertebral soft tissue inspected by the postoperative CT scans. No pedicle cortex breach and cement leakage surrounding pedicle cortex were observed. None of patients complained of dyspnoea and showed evidence of pulmonary embolism. Bone fusions were found in 20 patients (bony fusion rate 76.9%) at the 12-month follow-up and no screw loosening occurs.Conclusion: The results show favorable outcome using 3D navigation-guided PMMA-augmented thoracic and lumbar pedicle screw fixation for the osteoporosis patients both clinically and radiologically. AN - 109729163. Language: English. Entry Date: 20150923. Revision Date: 20171020. Publication Type: journal article. Journal Subset: Biomedical AU - Yuan, Qiang AU - Zhang, Guilin AU - Wu, Jingye AU - Xing, Yonggang AU - Sun, Yuqing AU - Tian, Wei DB - cin20 DO - 10.1007/s00586-013-3131-8 DP - EBSCOhost M1 - 5 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2015 SN - 0940-6719 SP - 1043-1050 ST - Clinical evaluation of the polymethylmethacrylate-augmented thoracic and lumbar pedicle screw fixation guided by the three-dimensional navigation for the osteoporosis patients T2 - European Spine Journal TI - Clinical evaluation of the polymethylmethacrylate-augmented thoracic and lumbar pedicle screw fixation guided by the three-dimensional navigation for the osteoporosis patients UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=109729163&site=ehost-live&scope=site VL - 24 ID - 830618 ER - TY - JOUR AB - Cement pulmonary embolism (cPE) and inferior vena cava embolism (cIE) are rare but potentially life-threatening complications of percutaneous vertebroplasty (PVP). Most cPE and cIE occurred simultaneously. In this case, a 65-year-old woman complained of dyspnea after PVP for 4 days. Patient's symptom and image tests manifest that the cPE was secondary to cIE. Although cIE was found at the first day after PVP, the local surgeons treat the patient with a regular anticoagulant without another more effective therapeutic measure. Eventually, the long cement inferior vena cava embolus was broken and result in left pulmonary embolism via the systemic circulation. She was admitted to our hospital and performed with embolectomy surgery by cardiopulmonary bypass and discharged after 7 days. We report this case to show that cIE embolism is still underestimated by some spine surgeons in China, and cIE may be developed to severe cPE during conservation management with anticoagulation. AD - Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China. Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China. Electronic address: xiaoboliaoxiangya@csu.edu.cn. AN - 29428532 AU - Yuan, Z. AU - Zhou, Y. AU - Zhou, X. AU - Liao, X. DA - Apr DO - 10.1016/j.avsg.2018.01.003 DP - NLM ET - 2018/02/13 J2 - Annals of vascular surgery KW - Aged Bone Cements/*adverse effects Cardiopulmonary Bypass Cementoplasty/*adverse effects Computed Tomography Angiography Embolectomy Embolism/diagnostic imaging/*etiology/surgery Female Foreign-Body Migration/diagnostic imaging/*etiology/surgery Humans Phlebography/methods Pulmonary Embolism/diagnostic imaging/*etiology/surgery Severity of Illness Index Treatment Outcome *Vena Cava, Inferior/diagnostic imaging/surgery LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2018 SN - 0890-5096 SP - 255.e1-255.e3 ST - Severe Pulmonary Embolism was Secondary to Cement Inferior Vena Cava Embolism after Percutaneous Vertebroplasty T2 - Ann Vasc Surg TI - Severe Pulmonary Embolism was Secondary to Cement Inferior Vena Cava Embolism after Percutaneous Vertebroplasty VL - 48 ID - 828628 ER - TY - JOUR AB - Cement pulmonary embolism (cPE) and inferior vena cava embolism (cIE) are rare but potentially life-threatening complications of percutaneous vertebroplasty (PVP). Most cPE and cIE occurred simultaneously. In this case, a 65-year-old woman complained of dyspnea after PVP for 4 days. Patient's symptom and image tests manifest that the cPE was secondary to cIE. Although cIE was found at the first day after PVP, the local surgeons treat the patient with a regular anticoagulant without another more effective therapeutic measure. Eventually, the long cement inferior vena cava embolus was broken and result in left pulmonary embolism via the systemic circulation. She was admitted to our hospital and performed with embolectomy surgery by cardiopulmonary bypass and discharged after 7 days. We report this case to show that cIE embolism is still underestimated by some spine surgeons in China, and cIE may be developed to severe cPE during conservation management with anticoagulation. AD - [Yuan, Zhaoshun; Zhou, Yangzhao; Zhou, Xinmin; Liao, Xiaobo] Cent S Univ, Xiangya Hosp 2, Dept Cardiovasc Surg, Changsha 410011, Hunan, Peoples R China. Liao, XB (corresponding author), Cent S Univ, Xiangya Hosp 2, Dept Cardiovasc Surg, Changsha 410011, Hunan, Peoples R China. xiaoboliaoxiangya@csu.edu.cn AN - WOS:000427574700040 AU - Yuan, Z. S. AU - Zhou, Y. Z. AU - Zhou, X. M. AU - Liao, X. B. C7 - 255.e1 DA - Apr DO - 10.1016/j.avsg.2018.01.003 J2 - Ann. Vasc. Surg. KW - Surgery Peripheral Vascular Disease LA - English M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2018 SN - 0890-5096 SP - 3 ST - Severe Pulmonary Embolism was Secondary to Cement Inferior Vena Cava Embolism after Percutaneous Vertebroplasty T2 - Annals of Vascular Surgery TI - Severe Pulmonary Embolism was Secondary to Cement Inferior Vena Cava Embolism after Percutaneous Vertebroplasty UR - ://WOS:000427574700040 VL - 48 ID - 830175 ER - TY - JOUR AB - We report a case of symptomatic polymethyl methacrylate pulmonary emboli after percutaneous vertebroplasty to alert clinicians to this potential cause of pulmonary emboli. A 77-year-old woman developed acute respiratory failure after multilevel percutaneous vertebroplasty. She received mechanical ventilatory support and anticoagulation with low-molecular-weight heparin and warfarin. Multiple pulmonary polymethyl methacrylate cement emboli were identified by computed tomography angiogram. Polymethyl methacrylate cement extravasation into the vertebral venous circulation is common during vertebroplasty. Pulmonary embolism caused by cement migration after this procedure is extremely rare, as reported in the literature to date. However, the frequency of this complication may increase secondary to the widespread use of percutaneous vertebroplasty and kyphoplasty for osteoporotic compression fractures. AD - Division of Hospitalist Medicine/Pulmonary and Critical Care Medicine, Hamot Medical Center Erie, PA 16550, USA. mmzaccheo@yahoo.com AN - 18534316 AU - Zaccheo, M. V. AU - Rowane, J. E. AU - Costello, E. M. DA - Jun DO - 10.1016/j.ajem.2007.10.013 DP - NLM ET - 2008/06/07 J2 - The American journal of emergency medicine KW - Acute Disease Aged *Bone Cements Female Foreign-Body Migration/*complications Humans Osteoporosis, Postmenopausal/complications *Polymethyl Methacrylate/adverse effects Respiratory Insufficiency/*etiology Spinal Fractures/etiology/*surgery Vertebroplasty/*adverse effects LA - eng M1 - 5 N1 - PubMed NLM literature search January 5, 2021 PY - 2008 SN - 0735-6757 SP - 636.e5-7 ST - Acute respiratory failure associated with polymethyl methacrylate pulmonary emboli after percutaneous vertebroplasty T2 - Am J Emerg Med TI - Acute respiratory failure associated with polymethyl methacrylate pulmonary emboli after percutaneous vertebroplasty VL - 26 ID - 828767 ER - TY - JOUR AB - Introduction: The metastatic lesions of the vertebrae have a high risk fracture by the axial compression, with possible neurological involvement. The vertebrectomy is the best treatment of solitary metastases that are located inside the vertebral body. However, many patients are not able to withstand this method. Nevertheless, the prevention of vertebral collapse plays a significant role in maintaining or improving the quality of life in these patients. The use of prophylactic vertebroplasty has the potential benefit of reducing the pain and the risk of fractures in the vertebrae. The purpose of this study is to test the efficacy of vertebroplasty in the treatment of vertebral metastases. Materials and methods: In the last 2 years we have treated 36 patients with vertebral metastases primitiveness breast, lung, kidney and prostate. The vertebrae involved were all located in the lumbar and dorsal column. Patients had a mean age of 65 years and it was 24 women and 12 men. All patients underwent radiography in two projections in the pre and post surgery and subsequent clinical evaluations. The instrumental evaluation was performed preoperatively with CT, MRI and bone scan. All patients underwent a CT scan at follow-up to 4 months. The clinical evaluation has made use of the VAS and SF-36. Results: We had extravasation of cement through the vertebral lytic areas in two cases. However we hadn't cases of pulmonary embolism or neurological injuries. The treatment has allowed us to decrease the back pain at follow-up to a month, while maintaining constant values for VAS also at follow-up to 4 months. In none of the patients has occurred the fracture of the vertebral body and was not detectable in the study TC a local progression of the disease. Discussion and conclusions: The treatment of metastatic lesions with vertebroplasty has proved safe and repeatable. The introduction of cement in the front column and the integrity of the posterior column makes it possible to confer a good stability to the vertebra. Preliminary data in our possession confirm the usefulness of this method in preventing the collapse of vertebrae and improvement of the lumbar vertebral pain. AD - A. Zachos, Division of Orthopedics and Traumatology, San Martino Hospital, Oristano, Italy AU - Zachos, A. AU - Meloni, C. AU - Muresu, F. AU - Ruggiu, A. AU - Doria, C. DB - Embase DO - 10.1007/s00586-012-2290-3 KW - cement percutaneous vertebroplasty vertebra body metastasis spine society male human patient vertebra fracture follow up clinical evaluation spine metastasis risk prostate injury kidney lung embolism lung breast extravasation computer assisted tomography pain quality of life bone scintiscanning surgery radiography prevention female backache spinal pain compression nuclear magnetic resonance imaging LA - English M1 - 4 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2012 SN - 0940-6719 SP - 779-780 ST - The importance of vertebroplasty in the treatment of vertebral body metastases T2 - European Spine Journal TI - The importance of vertebroplasty in the treatment of vertebral body metastases UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71314479&from=export http://dx.doi.org/10.1007/s00586-012-2290-3 VL - 21 ID - 829566 ER - TY - JOUR AB - Purpose: Studies using intraoperative trans-esophageal echocardiography (TEE) have observed the presence of multiple emboli during long bone surgery, especially during reaming or cementing. However, emboli imaged were rarely associated with hemodynamic instability. We describe the perioperative use of point of care ultrasound examination of the inferior Vena-Cava (IVC) to identify pulmonary emboli (PE) associated with significant cardiovascular collapse. Clinical Features: A 58 year-old caucasian woman with a pathological fracture of right femur underwent insertion of an intramedullary nail. She was diagnosed with non-small cell carcinoma of the lung 2 years prior, and was treated for brain and bone metastases. Her platelet count and INR were normal. Standard ASA monitoring was applied and supplemental oxygen via a face-mask was started. An ultrasound-guided fascia iliaca block with 35ml of 0.375% bupivacaine, and a spinal anesthetic with 2.6ml of plain 0.5% bupivacaine and 10mcg of fentanyl were administered uneventfully. Moderate sedation was achieved with propofol infusion. Intraoperative hemodynamics remained stable until the wound closure, at which time the patient became unresponsive with an unrecordable blood pressure and a sudden drop in end-tidal Carbon Dioxide and Oxygen saturation accompanied with tachypnea. Following resuscitation with ephedrine (50mg), phenylephrine (400mcg) and 1,5L crystalloid, trans-abdominal ultrasound examination of the IVC showed multiple emboli in the IVC measuring 2-4 mm. Subsequent TTE -performed immediately by a second anesthesiologist- demonstrated normovolemic heart chambers with normal valve function and wall motion. This was associated with return of normal circulation. Due to concerns for pulmonary embolus, unfractionated heparin was administered, as was IV steroids given her history of IV contrast hypersensitivity. Interestingly, CT-PA performed 11 hours post-op did not identify any PE, so in consultation with the medical team only prophylactic anticoagulation was commenced. The patient made full recovery and was discharged home two days later. The patient's consent was obtained. Conclusion: Numerous studies have detailed the benefits of perioperative TEE for the detection of PE; however, its availability is limited by its cost and the expertise required. Point of care TTE of the inferior vena cava to assess fluid responsiveness has become common practice at our institution. Its intraoperative use is less invasive than TEE and the skills required for diagnosis are easily acquired. Indeed, since the prediction by the Symington report that point of care ultrasound will change how medicine is practiced and taught, PoCUS has become part of the medical curricula worldwide to various degrees. Furthermore, we highlight the possibility that previously reported incidence of intraoperative PE may be an underestimation as they relied on postmortem examination to confirm the embolus. Our case demonstrates that hemodynamically significant PE can occur transiently without subsequent physical evidence. The increasing availability of portable ultrasound and skill in its use of during the perioperative period has enabled us to make this prompt bedside diagnosis and target therapy in a timely fashion. AD - M.T. Zadeh, Anesthesia, Sunnybrook Hospital, Toronto, ON, Canada AU - Zadeh, M. T. AU - Wang, J. J. AU - Nix, C. AU - Hockmann, E. DB - Embase DO - 10.1007/s12630-013-0063-z KW - bupivacaine propofol fentanyl oxygen phenylephrine steroid ephedrine heparin inferior cava vein lung embolism anesthesist human society ultrasound embolism patient skill examination diagnosis pathologic fracture conscious sedation hemodynamics Caucasian fascia face mask transesophageal echocardiography monitoring clinical feature platelet count anticoagulation prediction perioperative period female shock bone metastasis infusion wound closure brain orthopedic surgery lung resuscitation small cell carcinoma tachypnea oxygen saturation intramedullary nail end tidal carbon dioxide tension crystalloid heart femur hypersensitivity consultation blood pressure liquid curriculum autopsy long bone therapy spinal anesthesia international normalized ratio LA - English M1 - 1 M3 - Conference Abstract N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 0832-610X SP - S36 ST - Use of point of care ultrasound (PoCUS) of the inferior vena cava in the perioperative management of a life threatening pulmonary embolus T2 - Canadian Journal of Anesthesia TI - Use of point of care ultrasound (PoCUS) of the inferior vena cava in the perioperative management of a life threatening pulmonary embolus UR - https://www.embase.com/search/results?subaction=viewrecord&id=L71350563&from=export http://dx.doi.org/10.1007/s12630-013-0063-z VL - 60 ID - 829494 ER - TY - JOUR AB - Introduction: In contrast to cemented hip prostheses, the effect of washing the bone bed with jet‐lavage prior to insertion of cementless stem components in primary hip arthroplasty (THA) is unclear. Jet‐lavage potentially decreases the risk of fat embolisation during rasping and stem insertion and might help in avoiding bacterial contamination. An earlier animal study has shown less debris and better‐organised trabecular structure of new bone when jet‐lavage was used. We hypothesised that the primary stability of cementless femoral stems implanted after jet‐lavage of the femoral canal prior to stem insertion would improve with earlier stabilisation, as measured with Radiostereometry (RSA), compared with insertion without prior jet‐lavage. Methods: 40 patients with primary osteoarthritis operated on with a cementless titanium grit blasted stem are included in the study. The patients were randomised to either jet‐lavage or control without any lavage of the femoral canal prior to insertion of the prosthesis. The stem migration pattern was measured with RSA at 0, 3, 12, 24 and 72 months. Results: At 6 years, 19 patients remained for analysis in the jet‐lavage and 18 in the control group. We found no difference in extent or pattern of migration as measured with RSA. Both groups seemed to have stabilised within 3 months after a slight subsidence and retroversion. No stem was revised or considered loose as measured with RSA. Conclusions: Washing the bone bed with jet‐lavage prior to insertion of cementless stems does not affect the stability of cementless femoral components. No adverse effects were observed. AN - CN-01943494 AU - Zampelis, V. AU - Flivik, G. AU - Kesteris, U. DO - 10.1177/1120700019843123 KW - *follow up *hip arthroplasty *lavage *radiostereometric analysis Absence of side effects Adult Article Bone Clinical article Controlled study Female Human Male Osteoarthritis Prosthesis Randomized controlled trial M3 - Journal: Article in Press N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2019 ST - No effect of femoral canal jet-lavage on the stability of cementless stems in primary hip arthroplasty: a randomised RSA study with 6 years follow-up T2 - Hip international TI - No effect of femoral canal jet-lavage on the stability of cementless stems in primary hip arthroplasty: a randomised RSA study with 6 years follow-up UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01943494/full ID - 830042 ER - TY - JOUR AB - Introduction: In contrast to cemented hip prostheses, the effect of washing the bone bed with jet-lavage prior to insertion of cementless stem components in primary hip arthroplasty (THA) is unclear. Jet-lavage potentially decreases the risk of fat embolisation during rasping and stem insertion and might help in avoiding bacterial contamination. An earlier animal study has shown less debris and better-organised trabecular structure of new bone when jet-lavage was used. We hypothesised that the primary stability of cementless femoral stems implanted after jet-lavage of the femoral canal prior to stem insertion would improve with earlier stabilisation, as measured with Radiostereometry (RSA), compared with insertion without prior jet-lavage. Methods: 40 patients with primary osteoarthritis operated on with a cementless titanium grit blasted stem are included in the study. The patients were randomised to either jet-lavage or control without any lavage of the femoral canal prior to insertion of the prosthesis. The stem migration pattern was measured with RSA at 0, 3, 12, 24 and 72 months. Results: At 6 years, 19 patients remained for analysis in the jet-lavage and 18 in the control group. We found no difference in extent or pattern of migration as measured with RSA. Both groups seemed to have stabilised within 3 months after a slight subsidence and retroversion. No stem was revised or considered loose as measured with RSA. Conclusions: Washing the bone bed with jet-lavage prior to insertion of cementless stems does not affect the stability of cementless femoral components. No adverse effects were observed. AD - Department of Orthopaedics, Skåne University Hospital, Clinical Sciences, Lund University, Lund, Sweden AN - 144200334. Language: English. Entry Date: 20200626. Revision Date: 20200626. Publication Type: Article AU - Zampelis, Vasileios AU - Flivik, Gunnar AU - Kesteris, Uldis DB - cin20 DO - 10.1177/1120700019843123 DP - EBSCOhost KW - Arthroplasty, Replacement, Hip -- Methods Femur Therapeutic Irrigation -- Methods Bone Cements Joint Prosthesis Materials Testing -- Methods Radiostereometric Analysis Treatment Outcomes -- Evaluation After Care Human Randomized Controlled Trials Random Assignment Comparative Studies Embolism, Fat -- Prevention and Control Bacterial Contamination -- Prevention and Control Osteoarthritis -- Surgery Titanium Prosthesis Failure Time Factors M1 - 4 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2020 SN - 1120-7000 SP - 417-422 ST - No effect of femoral canal jet-lavage on the stability of cementless stems in primary hip arthroplasty: a randomised RSA study with 6 years follow-up T2 - Hip International TI - No effect of femoral canal jet-lavage on the stability of cementless stems in primary hip arthroplasty: a randomised RSA study with 6 years follow-up UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=144200334&site=ehost-live&scope=site VL - 30 ID - 830508 ER - TY - JOUR AB - Disseminated intravascular coagulation (DIC) is an extremely serious hemorrhagic disorder and one that is potentially lethal. DIC is more frequently observed as a complication of obstetric pathologies, diffused neoplasms, bacterial sepsis, blood transfusions, traumas and adipose embolias. The literature reports very few cases occurring after total hip replacement, two of which the cause of death. In all of the cases described one or boh prosthetic components are cemented. The authors report a case observed after total hip replacement in a patient submitted one year previously to contralateral hip replacement. Severe hypotension, bradychardia and profuse bleeding of the wound and from the drainages one hour after suturing constituted the initial symptom. Recognition of the clinical findings, after exclusion of a iatrogenic lesion, and subsequent treatment in intensive therapy allowed us to save the patient. The syndrome must be suspected and immediately diagnosed when profuse bleeding that cannot be related to vascular lesion is observed immediately postsurgery after cemented or hybrid hip replacement. Confirmation through hematological tests and timely treatment in a specialized center are indispensable requirements to save the life of the patient. AD - Divisione di Ortopedia e Traumatologia, Policlinico S. Orsola-Malpighi, Bologna. AN - 12508712 AU - Zappoli, F. A. AU - Brizio, L. AU - Alfonso, C. AU - Laus, M. DA - Apr-Jun DP - NLM ET - 2003/01/02 J2 - La Chirurgia degli organi di movimento KW - Aged *Arthroplasty, Replacement, Hip/adverse effects/methods Blood Transfusion *Disseminated Intravascular Coagulation/diagnosis/etiology/therapy Follow-Up Studies Humans Intensive Care Units Intraoperative Complications Male Time Factors LA - eng ita M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2002 SN - 0009-4749 (Print) 0009-4749 SP - 125-31 ST - Disseminated intravascular coagulation during total hip replacement T2 - Chir Organi Mov TI - Disseminated intravascular coagulation during total hip replacement VL - 87 ID - 828957 ER - TY - JOUR AB - Objective: To investigate the clinical effect of high and low viscosity bone cement in vertebroplasty for treatment of osteoporotic vertebral compression fractures. Methods: 40 cases of patients with osteoporotic thoracolumbar compression fractures admitted into department of orthopeadics in our hospital were reviewed. All patients were divided into high viscosity bone cement group (20 cases) and low viscosity bone cement group (20 cases). Visual Analog Score (VAS), Oswestry Dability Index (ODI), injured vertebral height restoration (Cobb Angle) and bone cement leakage rate, subsequent fracture rate of vertebrae body with or without surgical treatment were measured. Results: Compared with the low viscosity bone cement group, the VAS score, ODI score and Cobb angle of high viscosity bone cement group had a statistical difference (P<0.05). The postoperative complications in high viscosity bone cement group were lower than those in low viscosity bone cement group (P<0.05). Conclusion: Compared with low viscosity bone cement, bone cement leakage rate reduced obviously in high viscosity bone cement with good clinical effect and prognosis in vertebroplasty for treatment of osteoporotic thoracolumbar compression fractures. AD - X.-J. Yang, Shenzhen Second People’s Hospital, No. 3002, West Sungang Road, Shenzhen, Guangdong, China AU - Zeng, T. H. AU - Wang, Y. M. AU - Yang, X. J. AU - Xiong, J. Y. AU - Guo, D. Q. DB - Embase KW - bone cement adult aged article bone cement leakage clinical article Cobb angle compression fracture female fluoroscopy follow up human lung embolism male Oswestry Disability Index percutaneous vertebroplasty postoperative complication surgical technique very elderly viscosity visual analog scale LA - English M1 - 10 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2015 SN - 1940-5901 SP - 18855-18860 ST - The clinical comparative study on high and low viscosity bone cement application in vertebroplasty T2 - International Journal of Clinical and Experimental Medicine TI - The clinical comparative study on high and low viscosity bone cement application in vertebroplasty UR - https://www.embase.com/search/results?subaction=viewrecord&id=L607201554&from=export VL - 8 ID - 829357 ER - TY - JOUR AB - This study aimed to investigate the clinical effect of percutaneous kyphoplasty and the precautions against adjacent vertebral refractures in the treatment of multiple osteoporotic vertebral compression fractures. 54 cases (128 vertebrae) with multiple osteoporotic vertebral compression fractures from July 2007 to December 2013 treated with percutaneous kyphoplasty were retrospectively reviewed. 36 cases of them suffered from bi-segment vertebral fractures, 16 cases with tri-segment vertebral fractures and 2 cases with quadri-segment vertebral fractures. The operative effect was evaluated by visual analogue scale (VAS) score and oswestry disability index (ODI) score. Then the reasons for adjacent vertebral refractures were analyzed and the precautions were proposed. 54 cases (128 vertebrae) were admitted with percutaneous kyphoplasty successfully. No pulmonary embolism, spinal cord injury and other serious complications were found. The follow-up took 3-33 months with the average of 12 months. There was significant difference of VAS scores and ODI scores between pre-operation and post-operation (P<0.05). Bone cement leakage occurred in 23 vertebrae, and the incidence rate was 18.0%. 8 cases sustained adjacent vertebral refractures including 3 cases in the contiguous vertebral bodies and 5 cases in the interval vertebral bodies, and the incidence rate was 14.8%. 5 cases gained fracture healing after additional percutaneous kyphoplasty procedures while the other 3 cases were healed basically after conservative treatment for three months. In conclusion, percutaneous kyphoplasty is safe and effective to treat multiple osteoporotic vertebral compression fractures. However, the risk of new adjacent vertebral fractures in the multiple osteoporotic vertebral compression fractures is higher than that in the single osteoporotic vertebral compression fracture. Timely and proper treatment can reduce refractures. AD - Department of Spine Surgery, Tongji Hospital, Tongji University Shanghai 200065, China. AN - 26550284 AU - Zhai, W. AU - Jia, Y. AU - Wang, J. AU - Cheng, L. AU - Zeng, Z. AU - Yu, Y. AU - Chen, L. C2 - Pmc4612969 DP - NLM ET - 2015/11/10 J2 - International journal of clinical and experimental medicine KW - Percutaneous kyphoplasty multiple osteoporotic vertebral compression fractures new vertebral fractures LA - eng M1 - 8 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 1940-5901 (Print) 1940-5901 SP - 13473-81 ST - The clinical effect of percutaneous kyphoplasty for the treatment of multiple osteoporotic vertebral compression fractures and the prevention of new vertebral fractures T2 - Int J Clin Exp Med TI - The clinical effect of percutaneous kyphoplasty for the treatment of multiple osteoporotic vertebral compression fractures and the prevention of new vertebral fractures VL - 8 ID - 828733 ER - TY - JOUR AB - This study aimed to investigate the clinical effect of percutaneous kyphoplasty and the precautions against adjacent vertebral refractures in the treatment of multiple osteoporotic vertebral compression fractures. 54 cases (128 vertebrae) with multiple osteoporotic vertebral compression fractures from July 2007 to December 2013 treated with percutaneous kyphoplasty were retrospectively reviewed. 36 cases of them suffered from bi-segment vertebral fractures, 16 cases with tri-segment vertebral fractures and 2 cases with quadri-segment vertebral fractures. The operative effect was evaluated by visual analogue scale (VAS) score and oswestry disability index (ODI) score. Then the reasons for adjacent vertebral refractures were analyzed and the precautions were proposed. 54 cases (128 vertebrae) were admitted with percutaneous kyphoplasty successfully. No pulmonary embolism, spinal cord injury and other serious complications were found. The follow-up took 3-33 months with the average of 12 months. There was significant difference of VAS scores and ODI scores between pre-operation and post-operation (P<0.05). Bone cement leakage occurred in 23 vertebrae, and the incidence rate was 18.0%. 8 cases sustained adjacent vertebral refractures including 3 cases in the contiguous vertebral bodies and 5 cases in the interval vertebral bodies, and the incidence rate was 14.8%. 5 cases gained fracture healing after additional percutaneous kyphoplasty procedures while the other 3 cases were healed basically after conservative treatment for three months. In conclusion, percutaneous kyphoplasty is safe and effective to treat multiple osteoporotic vertebral compression fractures. However, the risk of new adjacent vertebral fractures in the multiple osteoporotic vertebral compression fractures is higher than that in the single osteoporotic vertebral compression fracture. Timely and proper treatment can reduce refractures. AD - [Zhai, Weifeng; Jia, Yongwei; Wang, Jianjie; Cheng, Liming; Zeng, Zhili; Yu, Yan; Chen, Lei] Tongji Univ, Tongji Hosp, Dept Spine Surg, Shanghai 200065, Peoples R China. Jia, YW (corresponding author), Tongji Univ, Tongji Hosp, Dept Spine Surg, 389 Xincun Rd, Shanghai 200065, Peoples R China. yongweijiacn@163.com AN - WOS:000365271900186 AU - Zhai, W. F. AU - Jia, Y. W. AU - Wang, J. J. AU - Cheng, L. M. AU - Zeng, Z. L. AU - Yu, Y. AU - Chen, L. J2 - Int. J. Clin. Exp. Med. KW - Percutaneous kyphoplasty multiple osteoporotic vertebral compression fractures new vertebral fractures CEMENT AUGMENTATION BALLOON KYPHOPLASTY RISK-FACTORS RETROSPECTIVE ANALYSIS FINITE-ELEMENT VERTEBROPLASTY ADJACENT PREDICTORS LEAKAGE IMPACT Medicine, Research & Experimental LA - English M1 - 8 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2015 SN - 1940-5901 SP - 13473-13481 ST - The clinical effect of percutaneous kyphoplasty for the treatment of multiple osteoporotic vertebral compression fractures and the prevention of new vertebral fractures T2 - International Journal of Clinical and Experimental Medicine TI - The clinical effect of percutaneous kyphoplasty for the treatment of multiple osteoporotic vertebral compression fractures and the prevention of new vertebral fractures UR - ://WOS:000365271900186 VL - 8 ID - 830247 ER - TY - JOUR AB - Background: Spinal metastases can cause metastatic epidural spinal cord compression (MESCC), which can result in neurological dysfunction and impaired quality of life. This study investigated the safety and effectiveness of posterior decompression surgery and radiofrequency ablation followed by vertebroplasty in spinal metastasis from lung cancer. Material/Methods: From June 2008 to September 2015, a retrospective analysis was conducted in 15 patients with spinal metastasis from lung cancer. All cases suffered MESCC and underwent posterior decompression surgery to relieve the compression of spinal cord, and had radiofrequency ablation followed by vertebroplasty. All patients received postoperative multidisciplinary therapy. The operative time, blood loss, complications, pain, neurologic deficit, quality of life, and survival were assessed preoperatively and postoperatively. Results: Patients were followed from 6 to 56 months. The mean time of operation was 154 +/- 50 minutes and the mean blood loss was 210 +/- 90 mL. In the pre-operation analysis found the mean visual analogue scale (VAS) was 7.86 +/- 0.86. In the post-operation analysis at 3 months, the mean VAS score was 3.51 +/- 1.32. The VAS improved significantly (t=7.95, P<0.01). The Frankel grade was improved 1 grade or 2 grades in 14 patients when preoperation was compared to post-operation. Only 1 patient kept Frankel grade D after surgery. Eight patients with sphincteric dysfunction preoperatively were improved after surgery. The EORTC QLQ-C30 score was 86.13 +/- 8.51 preoperatively and 52.21 +/- 13.28 postoperatively. The quality of life was improved significantly (t=11.8, P<0.01). The median survival time was 11 months. Conclusions: Through posterior decompression surgery and radiofrequency ablation followed by vertebroplasty, the quality of life was improved significantly. This palliative treatment was effective and safe in spinal metastasis from lung cancer. AD - [Zhang, Chao; Han, Xiuxin; Li, Lili; Ma, Yulin; Wang, Guowen] Tianjin Med Univ Canc Inst & Hosp, Natl Clin Res Ctr Canc, Tianjins Clin Res Ctr Canc, Dept Bone & Soft Tissue Tumor,Key Lab Canc Preven, Tianjin, Peoples R China. Ma, YL; Wang, GW (corresponding author), Tianjin Med Univ Canc Inst & Hosp, Natl Clin Res Ctr Canc, Tianjins Clin Res Ctr Canc, Dept Bone & Soft Tissue Tumor,Key Lab Canc Preven, Tianjin, Peoples R China. 1442331086@qq.com; wangguowenhrbe@163.com AN - WOS:000552227900001 AU - Zhang, C. AU - Han, X. X. AU - Li, L. L. AU - Ma, Y. L. AU - Wang, G. W. C7 - e925169 DA - Jul DO - 10.12659/msm.925169 J2 - Med. Sci. Monitor KW - Lung Neoplasms Pulsed Radiofrequency Treatment Spinal Cord Compression Vertebroplasty QUALITY-OF-LIFE PERCUTANEOUS VERTEBROPLASTY CEMENT INJECTION STABILIZATION EMBOLISM Medicine, Research & Experimental LA - English M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2020 SN - 1643-3750 SP - 7 ST - Posterior Decompression Surgery and Radiofrequency Ablation Followed by Vertebroplasty in Spinal Metastases from Lung Cancer T2 - Medical Science Monitor TI - Posterior Decompression Surgery and Radiofrequency Ablation Followed by Vertebroplasty in Spinal Metastases from Lung Cancer UR - ://WOS:000552227900001 VL - 26 ID - 830103 ER - TY - JOUR AB - OBJECTIVE: A retrospective evaluation of the clinical outcome and technical feasibility of kyphoplasty for the treatment of very severe osteoporotic vertebral compression fracture (vsOVCF). METHODS: Patients with vsOVCF were treated with kyphoplasty and followed-up for 1 year. Vertebral body height variation, kyphotic angle, back pain (visual analogue scale [VAS]) and Oswestry disability index (ODI) were evaluated preoperatively, postoperatively, 1 month, 3 months and 1 year after treatment. RESULTS: In total, 35 patients (49 vertebrae) were treated with kyphoplasty. There were no cases of spinal or extraspinal injury, infection, bleeding, pulmonary embolism, epidural cement leakage, stroke or cardiac arrest as a result of treatment. There were significant postoperative improvements in all outcome measures (vertebral body height variation, kyphotic angle, VAS and ODI); these improvements were maintained during the follow-up period. CONCLUSION: Kyphoplasty is an effective and minimally invasive procedure for the treatment of vsOVCF. AD - Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China. AN - 23321197 AU - Zhang, H. T. AU - Sun, Z. Y. AU - Zhu, X. Y. AU - Chen, K. W. AU - Qian, Z. L. AU - Yang, H. L. DO - 10.1177/030006051204000638 DP - NLM ET - 2013/01/17 J2 - The Journal of international medical research KW - Aged Aged, 80 and over Back Pain/surgery Body Height *Bone Cements Female Fractures, Compression/*surgery Humans *Kyphoplasty/adverse effects Lumbar Vertebrae/injuries/surgery Male Middle Aged Osteoporosis Osteoporotic Fractures/*surgery Pain Measurement Retrospective Studies Spinal Fractures/surgery Thoracic Vertebrae/injuries/surgery Treatment Outcome LA - eng M1 - 6 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 0300-0605 SP - 2394-400 ST - Kyphoplasty for the treatment of very severe osteoporotic vertebral compression fracture T2 - J Int Med Res TI - Kyphoplasty for the treatment of very severe osteoporotic vertebral compression fracture VL - 40 ID - 828745 ER - TY - JOUR AB - OBJECTIVE: A retrospective evaluation of the clinical outcome and technical feasibility of kyphoplasty for the treatment of very severe osteoporotic vertebral compression fracture (vsOVCF). METHODS: Patients with vsOVCF were treated with kyphoplasty and followed-up for 1 year. Vertebral body height variation, kyphotic angle, back pain (visual analogue scale [VAS]) and Oswestry disability index (ODI) were evaluated preoperatively, postoperatively, 1 month, 3 months and 1 year after treatment. RESULTS: In total, 35 patients (49 vertebrae) were treated with kyphoplasty. There were no cases of spinal or extraspinal injury, infection, bleeding, pulmonary embolism, epidural cement leakage, stroke or cardiac arrest as a result of treatment. There were significant postoperative improvements in all outcome measures (vertebral body height variation, kyphotic angle, VAS and ODI); these improvements were maintained during the follow-up period. CONCLUSION: Kyphoplasty is an effective and minimally invasive procedure for the treatment of vsOVCF. AD - [Zhang, H. T.; Sun, Z. Y.; Zhu, X. Y.; Chen, K. W.; Qian, Z. L.; Yang, H. L.] Soochow Univ, Affiliated Hosp 1, Dept Orthopaed Surg, Suzhou 215006, Jiangsu, Peoples R China. Qian, ZL (corresponding author), Soochow Univ, Affiliated Hosp 1, Dept Orthopaed Surg, 188 Shizi St, Suzhou 215006, Jiangsu, Peoples R China. soochowspine@139.com AN - WOS:000313538300038 AU - Zhang, H. T. AU - Sun, Z. Y. AU - Zhu, X. Y. AU - Chen, K. W. AU - Qian, Z. L. AU - Yang, H. L. DA - Nov-Dec DO - 10.1177/030006051204000638 J2 - J. Int. Med. Res. KW - KYPHOPLASTY KYPHOTIC ANGLE OSTEOPOROSIS VERTEBRAL BODY HEIGHT VARIATION VERY SEVERE OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURE BALLOON KYPHOPLASTY MANAGEMENT VERTEBROPLASTY Medicine, Research & Experimental Pharmacology & Pharmacy LA - English M1 - 6 M3 - Article; Retracted Publication N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2012 SN - 0300-0605 SP - 2394-2400 ST - RETRACTED: Kyphoplasty for the Treatment of Very Severe Osteoporotic Vertebral Compression Fracture (Retracted article. See vol. 55, pg. 759, 2013) T2 - Journal of International Medical Research TI - RETRACTED: Kyphoplasty for the Treatment of Very Severe Osteoporotic Vertebral Compression Fracture (Retracted article. See vol. 55, pg. 759, 2013) UR - ://WOS:000313538300038 VL - 40 ID - 830294 ER - TY - JOUR AB - BACKGROUND: Percutaneous vertebroplasty has been gradually used to treat Kümmell disease because of less trauma and quick pain relief, but there is still a high rate of bone cement leakage. OBJECTIVE: To investigate the clinical efficacy of percutaneous vertebroplasty with high-viscosity bone cement plus hyperextension position reset for treatment of Kümmell’s disease. METHODS: The clinical data of 17 patients with Kümmell’s disease were retrospectively analyzed, including 5 males and 12 females, aged 55-83 years, and all underwent percutaneous vertebroplasty with high-viscosity bone cement plus hyperextension position reset. The visual analog scale, Oswestry disability index score, vertebral body height and vertebral kyphosis angle were determined. The bone cement leakage, pulmonary embolism, adjacent vertebral fractures and other complications were recorded. RESULTS AND CONCLUSION: At the 12th month of follow-up, the visual analog scale scores, Oswestry disability index scores and vertebral kyphosis angle of patients were significantly lower than those before treatment (P < 0.05), the vertebral body height was significantly higher than that before treatment (P < 0.05). After treatment, there were three cases of bone cement leakage, which had no special discomfort and neurological symptoms, and one case of new fractures. These results demonstrate that hyperextension position reset combined with percutaneous vertebroplasty with high-viscosity bone cement in treatment of Kümmell’s disease can effectively relieve back pain, improve function of the lower back, partially restore vertebral height and reduce kyphosis angle. AD - X.-M. Feng, Northern Jiangsu People’s Hospital, Yangzhou, Jiangsu Province, China AU - Zhang, L. AU - Feng, X. M. AU - Wang, J. C. AU - Tao, Y. P. AU - Yang, J. D. AU - Zhang, S. F. AU - Huang, J. J. AU - Cai, J. AU - Zhang, Z. Q. DB - Embase DO - 10.3969/j.Issn.2095-4344.2016.08.001 KW - bone cement adult aged article backache bone cement leakage clinical article clinical effectiveness female follow up human Kummell disease kyphosis lung embolism male Oswestry Disability Index percutaneous vertebroplasty postoperative complication retrospective study spine disease spine fracture vertebra body viscosity visual analog scale LA - Chinese M1 - 8 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 2016 SN - 1673-8225 SP - 1069-1074 ST - Percutaneous vertebroplasty with high-viscosity bone cement treats kümmell disease T2 - Chinese Journal of Tissue Engineering Research TI - Percutaneous vertebroplasty with high-viscosity bone cement treats kümmell disease UR - https://www.embase.com/search/results?subaction=viewrecord&id=L617554434&from=export http://dx.doi.org/10.3969/j.Issn.2095-4344.2016.08.001 VL - 20 ID - 829348 ER - TY - JOUR AB - OBJECTIVE: To discuss the safety and effectiveness of the improved technique by comparing the effects of low temperature bone cement infusion before and after the improvement in the percutaneous vertebroplasty (PVP). METHODS: The clinical data of 170 patients (184 vertebrae) with osteoporotic vertebral compression fracture who met the selection criteria between January 2016 and January 2018 were retrospectively analyzed. All patients were treated with PVP by low-temperature bone cement perfusion technology. According to the technical improvement or not, the patients were divided into two groups: the group before the technical improvement (group A, 95 cases) and the group after the technical improvement (group B, 75 cases). In group A, the patients were treated by keeping the temperature of bone cement at 0℃ and parallel puncture; in group B, the patients were treated by increasing the temperature of bone cement or reducing the time of bone cement in ice salt water and cross puncture. There was no significant difference in gender, age, disease duration, T value of bone mineral density, operative segment, and preoperative vertebral compression rate, visual analogue scale (VAS) score between the two groups ( P>0.05). CT examination was performed immediately after operation, and the leakage rate of bone cement was calculated. The amount of bone cement perfusion and the proportion of bone cement in contact with the upper and lower endplates at the same time were compared between the two groups. The vertebral compression rate was calculated and the VAS score was used to evaluate the pain before operation, at immediate after operation, and last follow-up. RESULTS: There was no complication such as incision infection, spinal nerve injury, or pulmonary embolism in both groups. There was no significant difference in the amount of bone cement perfusion between groups A and B ( t=0.175, P=0.861). There were 38 vertebral bodies (36.89%) in group A and 49 vertebral bodies (60.49%) in group B exposed to bone cement contacting with the upper and lower endplates at the same time, showing significant difference ( χ (2)=10.132, P=0.001). Bone cement leakage occurred in 19 vertebral bodies (18.45%) in group A and 6 vertebral bodies (7.41%) in group B, also showing significant difference ( χ (2)=4.706, P=0.030). The patients in group A and group B were followed up (13.3±1.2) months and (11.5±1.1) months, respectively. The vertebral compression rates of the two groups at immediate after operation were significantly lower than those before operation ( P<0.05), but the vertebral compression rate of group A at last follow-up was significantly higher than that at immediate after operation ( P<0.05), and there was no significant difference in group B between at immediate after operation and at last follow-up ( P>0.05). The VAS scores of the two groups at immediate after operation were significantly lower than those before operation ( P<0.05); but the VAS scores of group A at last follow-up were significantly higher than those at immediate after operation ( P<0.05) and there was no siginificant difference in group B ( P>0.05). There was no significant difference in VAS scores between the two groups at immediate after operation ( t=0.380, P=0.705); but at last follow-up, VAS score in group B was significantly lower than that in group A ( t=3.627, P=0.000). CONCLUSION: The improved advanced low-temperature bone cement perfusion technology during PVP by increasing the viscosity of bone cement combined with cross-puncture technology, can reduce bone cement leakage, improve the distribution of bone cement in the vertebral body, and reduce the risk of vertebral collapse, and achieve better effectiveness. AD - Department of Spine Surgery, the Fourth People's Hospital of Guiyang City, Guiyang Guizhou, 550002, P.R.China. AN - 32291976 AU - Zhang, Y. AU - Long, H. AU - Xiao, J. AU - Zou, W. AU - Zhou, C. AU - Liu, J. AU - Wang, G. DA - Apr 15 DO - 10.7507/1002-1892.201905013 DP - NLM ET - 2020/04/16 J2 - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery KW - *Bone Cements *Cold Temperature Fractures, Compression/*surgery Humans Osteoporotic Fractures/*surgery Retrospective Studies Spinal Fractures/*surgery Treatment Outcome Vertebroplasty/*methods Percutaneous vertebroplasty bone cement leakage low-temperature cement perfusion osteoporotic vertebral compression fracture LA - chi M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2020 SN - 1002-1892 (Print) 1002-1892 SP - 428-434 ST - [Effectiveness comparison of low-temperature bone cement perfusion before and after improvement in percutaneous vertebroplasty] T2 - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi TI - [Effectiveness comparison of low-temperature bone cement perfusion before and after improvement in percutaneous vertebroplasty] VL - 34 ID - 828577 ER - TY - JOUR AB - OBJECTIVE: To evaluate the feasibility and effectiveness of percutaneous kyphoplasty in hyperextension position for treatment of stage II or III Kümmell disease. METHODS: Between May 2003 and February 2009, 17 patients with Kümmell disease (6 at stage II, 11 at stage III) were treated with percutaneous kyphoplasty in hyperextension position. There were 5 males and 12 females with an average age of 71 years (range, 55-85 years). The involved vertebral bodies were T10 in 1 case, T11 in 3 cases, T12 in 7 cases, L1 in 4 cases, L2 in 1 case, and T12, L1 in 1 case by X-ray, CT, and MRI examinations. The effectiveness was determined by the visual analogue scale (VAS) and the Oswestry Disability Index (ODI). The height and the kyphotic Cobb angle of the involved vertebral body were measured pre- and postoperatively. RESULTS: The operation was successfully completed in all the patients, and the incisions healed by first intention. Pain was alleviated or eliminated within 48 hours after operation; no spinal nerves injury or pulmonary embolism occurred. One patient had cement leakage to the adjacent disc, who did not manifest any clinical symptoms. Thirteen patients were followed up 24 to 56 months (mean, 32 months). The VAS score, ODI, anterior and medial vertebral height, kyphotic Cobb angle of involved vertebral body were improved significantly at 1 week after operation and at last follow-up (P < 0.05), there was no significant difference between at 1 week after operation and at last follow-up (P > 0.05). Adjacent vertebral fracture occurred in 1 patient at 6 months after operation and was cured after percutaneous kyphoplasty. CONCLUSION: Percutaneous kyphoplasty in hyperextension position for treatment of stage II or III Kümmell disease can relieve back pain, improve viability, decrease Cobb angle, and retain the vertebral body height and spinal alignment. The general condition of the patient is needed to be evaluated and the operation indication should be controlled strictly. AD - Department of Orthopedic Surgery, Jiangyin Hospital, Southeast University, Jiangyin Jiangsu, 214400, P.R. China. AN - 22568318 AU - Zhang, Y. AU - Yang, H. AU - Liu, Y. AU - Zhou, F. AU - Deng, X. AU - Luo, W. AU - Chen, L. DA - Apr DP - NLM ET - 2012/05/10 J2 - Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery KW - Aged Aged, 80 and over Arthroplasty/*methods Female Follow-Up Studies Fractures, Compression/pathology/*surgery Humans Kyphoplasty/*methods Lumbar Vertebrae/injuries/surgery Male Middle Aged Osteoporosis/complications Pain Measurement Severity of Illness Index Spinal Diseases/pathology/*surgery Spinal Fractures/pathology/*surgery Thoracic Vertebrae/injuries/surgery Treatment Outcome LA - chi M1 - 4 N1 - PubMed NLM literature search January 5, 2021 PY - 2012 SN - 1002-1892 (Print) 1002-1892 SP - 411-5 ST - [Percutaneous kyphoplasty in hyperextension position for treatment of middle and late period Kümmell disease] T2 - Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi TI - [Percutaneous kyphoplasty in hyperextension position for treatment of middle and late period Kümmell disease] VL - 26 ID - 828765 ER - TY - JOUR AB - BACKGROUND: Studies have reported that patients with human immunodeficiency virus (HIV) have a high incidence of osteonecrosis of the femoral head (ONFH). Total hip arthroplasty (THA) is an effective management of ONFH. However, little data exist regarding the use of THA for the HIV patients with ONFH in China. This study reviewed the outcomes of HIV-positive patients who underwent THA for ONFH, compared with HIV-negative individuals. METHODS: The patients who underwent THA for ONFH from September 2012 to September 2014 in Beijing Ditan Hospital, Capital Medical University were retrospectively studied. Twenty-eight HIV-positive patients and 35 HIV-negative patients underwent 48 THAs and 45 THAs with cementless components, respectively. Medical records and follow-up data were reviewed. Harris Hip Score (HHS) was applied to evaluate the pain and function of the hips before and after THA. Complications such as wound healing, surgical site infection, deep venous thrombosis, pulmonary embolism, sepsis, mortality, and complications from the prosthesis were reviewed. The operation time, blood loss, and hospital stay were compared between the two groups. RESULTS: The mean follow-up period was 19.5 ± 5.8 months (ranging from 6 to 30 months). The mean age of the HIV-positive patients with osteonecrosis at the time of surgery was 35 years old, which was significantly lower than that of the HIV-negative group (42 years old) (P < 0.05). The HIV-positive patients underwent surgery a mean of 2.5 years after their original symptoms, which was significantly shorter than the HIV-negatives' (mean 4 years) (P < 0.05). Among HIV-positive patients, the prevalence of being male and rate of bilateral procedures were significantly higher than those in the HIV-negative group (P < 0.05). The operation time in HIV-positive patients was significantly longer than that in HIV-negative patients (P < 0.05). There were no significant differences in blood loss or hospital stay between the two groups (P > 0.05). The HHSs of two groups significantly improved after THAs (P < 0.05), without significant difference between two groups. No wound complication, sepsis, mortality, prosthesis complication, and occupational exposure occurred, except for two cases of heterotopic ossification and one case of humeral head necrosis. CONCLUSIONS: ONFH is more likely to occur bilaterally in younger HIV-positive males. The development of osteonecrosis seems faster in HIV-positive patients than in HIV-negative patients. This should be cautionary for asymptomatic HIV-positive patients with low viral RNA level and in the primary HIV stage. Despite longer operation times in the HIV-positive patients than in the HIV-negative patients, THA is still a safe and efficient approach to treat ONFH in HIV-positive patients. The incidence of complications is much lower than previously reported. However, the long-term follow-up is needed. AD - Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China. AN - 26228219 AU - Zhao, C. S. AU - Li, X. AU - Zhang, Q. AU - Sun, S. AU - Zhao, R. G. AU - Cai, J. C2 - Pmc4717963 DA - Aug 5 DO - 10.4103/0366-6999.161364 DP - NLM ET - 2015/08/01 J2 - Chinese medical journal KW - Adult Arthroplasty, Replacement, Hip/*methods China Female Femur Head Necrosis/pathology/*surgery HIV Infections/*surgery Humans Magnetic Resonance Imaging Male Retrospective Studies Treatment Outcome LA - eng M1 - 15 N1 - PubMed NLM literature search January 5, 2021 PY - 2015 SN - 0366-6999 (Print) 0366-6999 SP - 2059-64 ST - Early Outcomes of Primary Total Hip Arthroplasty for Osteonecrosis of the Femoral Head in Patients with Human Immunodeficiency Virus in China T2 - Chin Med J (Engl) TI - Early Outcomes of Primary Total Hip Arthroplasty for Osteonecrosis of the Femoral Head in Patients with Human Immunodeficiency Virus in China VL - 128 ID - 829013 ER - TY - JOUR AB - OBJECTIVE: To explore the clinical application and therapeutic effect of percutaneous vertebroplasty(PVP) and open vertebroplasty for metastatic spinal tumor. METHODS: The clinical data of 126 patients with metastatic spinal tumor underwent surgery and obtained follow-up from January 2012 to March 2016 were retrospectively analyzed. These 126 cases were divided into two groups according to different operative methods. The metastatic tumor of 43 cases encroached vertebral canal oppressing spinal cord and nerve root, they were treated with open operation(open vertebroplasty group);and other 83 cases without obviously spinal cord or nerve root compression, or unfit for open operation, were treated with PVP (percutaneous vertebroplasty group) . VAS score, ECOG and Frankel grade were used to evaluate the pain and neurofunction in two groups.All out-hospital patients were followed up every 3 months for 1 time. X-ray, CT, MRI were examined in follow-up. RESULTS: A total of 112 vertebrae underwent PVP with the median surgical time of 50 min;VAS scores decreased significantly at 2 days after operation, which maintained till 1 month later; ECOG grade at 1 month decreased significantly;44 of 112 vertebrae suffered from asymptomatic bone cement leakage, no complications such as nerve injury or pulmonary embolism was found; the median survival time was 16 months. While for open vertebroplasty group, the median surgical time was 160 min and blood loss was 1 000 ml; postoperative VAS scores and ECOG grade at 1 month decreased significantly. Postoperative Frankel grade of 36 patients got improvement in 41 patients with spinal cord functional disturbance(87.8%); and 29 of 40 patients with incompleteness out of motor function were full recovery(76.3%); 12 cases (27.9%) occurred complications and the median survival time was 11 months. CONCLUSIONS: The different vertebroplasty treatments can be selected for patients with metastatic spinal tumor, which can relieve the pain, improve the nerve function, reconstruct the spinal stabilization, maintain the local control and raise the life quality. AD - Department of Orthopaedics, the Affiliated Hospital of Jiangnan University, the 4th People's Hospital of Wuxi, Wuxi 214062, Jiangsu, China; zhaoxijiangruilet@aliyun.com. Department of Orthopaedics, the Affiliated Hospital of Jiangnan University, the 4th People's Hospital of Wuxi, Wuxi 214062, Jiangsu, China. AN - 29350000 AU - Zhao, X. J. AU - Qi, X. S. AU - Mao, Z. X. AU - Wang, Q. M. AU - Gao, X. B. AU - Zhang, X. J. DA - Feb 25 DO - 10.3969/j.issn.1003-0034.2017.02.005 DP - NLM ET - 2018/01/20 J2 - Zhongguo gu shang = China journal of orthopaedics and traumatology KW - Bone Cements/adverse effects Humans Pain Measurement Retrospective Studies Spinal Neoplasms/*secondary/*surgery Spine Treatment Outcome Vertebroplasty/*methods Neoplasm metastasis Percutaneous vertebroplasty Spine relevant financial relationships with commercial interests to disclose. LA - chi M1 - 2 N1 - PubMed NLM literature search January 5, 2021 PY - 2017 SN - 1003-0034 (Print) 1003-0034 SP - 115-120 ST - [Percutaneous vertebroplasty and open vertebroplasty for metastatic spinal tumor] T2 - Zhongguo Gu Shang TI - [Percutaneous vertebroplasty and open vertebroplasty for metastatic spinal tumor] VL - 30 ID - 828589 ER - TY - JOUR AB - STUDY DESIGN: A case report and literature review. OBJECTIVE: To present a case of dynamic detection of a large pulmonary cement embolus as it formed and migrated during percutaneous vertebroplasty, which was successfully managed by percutaneous endovascular retrieval. SUMMARY OF BACKGROUND DATA: Pulmonary embolism resulting from cement leakage after percutaneous vertebroplasty to treat osteoporotic vertebral compression fracture has been described rarely; however, the frequency of this complication may increase secondary to the expanding use of percutaneous vertebral augmentation techniques. METHODS: The formation of a large embolus of acrylic cement and its migration into the pulmonary artery was observed in real time in a 55-year-old female with osteoporotic vertebral compression fracture of L4 during percutaneous vertebroplasty. RESULTS: Pulmonary arteriography confirmed the presence of the cement embolism in the right pulmonary artery during the operation. Percutaneous endovascular retrieval of the cement fragments was performed successfully via an interventional catheter procedure and subsequent incision of the femoral vein. The patient made an uneventful recovery. CONCLUSION: As illustrated by our case, large cement emboli may be primarily associated with technical aspects of the surgery. When considering the appropriate treatment strategy, percutaneous endovascular retrieval may be considered first. However, risks and benefits should be carefully evaluated on a case-by-case basis. LEVEL OF EVIDENCE: N/A. AD - From the Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, China. AN - 25271513 AU - Zhao, Y. AU - Liu, T. AU - Zheng, Y. AU - Wang, L. AU - Hao, D. DA - Dec 15 DO - 10.1097/brs.0000000000000613 DP - NLM ET - 2014/10/02 J2 - Spine KW - Bone Cements/*adverse effects Female Fractures, Compression/surgery Humans Lumbar Vertebrae/injuries/*surgery Middle Aged Osteoporotic Fractures/surgery Pulmonary Embolism/*etiology/*surgery Treatment Outcome Vertebroplasty/*adverse effects LA - eng M1 - 26 N1 - PubMed NLM literature search January 5, 2021 PY - 2014 SN - 0362-2436 SP - E1616-21 ST - Successful percutaneous retrieval of a large pulmonary cement embolus caused by cement leakage during percutaneous vertebroplasty: case report and literature review T2 - Spine (Phila Pa 1976) TI - Successful percutaneous retrieval of a large pulmonary cement embolus caused by cement leakage during percutaneous vertebroplasty: case report and literature review VL - 39 ID - 828739 ER - TY - JOUR AB - Study Design. A case report and literature review. Objective. To present a case of dynamic detection of a large pulmonary cement embolus as it formed and migrated during percutaneous vertebroplasty, which was successfully managed by percutaneous endovascular retrieval. Summary of Background Data. Pulmonary embolism resulting from cement leakage after percutaneous vertebroplasty to treat osteoporotic vertebral compression fracture has been described rarely; however, the frequency of this complication may increase secondary to the expanding use of percutaneous vertebral augmentation techniques. Methods. The formation of a large embolus of acrylic cement and its migration into the pulmonary artery was observed in real time in a 55-year-old female with osteoporotic vertebral compression fracture of L4 during percutaneous vertebroplasty. Results. Pulmonary arteriography confirmed the presence of the cement embolism in the right pulmonary artery during the operation. Percutaneous endovascular retrieval of the cement fragments was performed successfully via an interventional catheter procedure and subsequent incision of the femoral vein. The patient made an uneventful recovery. Conclusion. As illustrated by our case, large cement emboli may be primarily associated with technical aspects of the surgery. When considering the appropriate treatment strategy, percutaneous endovascular retrieval may be considered first. However, risks and benefits should be carefully evaluated on a case-by-case basis. AD - [Zhao, Yuanting; Liu, Tuanjiang; Zheng, Yonghong; Wang, Liping; Hao, Dingjun] Xi An Jiao Tong Univ, Honghui Hosp, Coll Med, Dept Spine Surg, Xian 710054, Peoples R China. Hao, DJ (corresponding author), Xi An Jiao Tong Univ, Honghui Hosp, Coll Med, Dept Spine Surg, 555 Friendship Rd, Xian 710054, Peoples R China. zytqy@163.com AN - WOS:000346480500009 AU - Zhao, Y. T. AU - Liu, T. J. AU - Zheng, Y. H. AU - Wang, L. P. AU - Hao, D. J. DA - Dec DO - 10.1097/brs.0000000000000613 J2 - Spine KW - percutaneous vertebroplasty osteoporotic vertebral compression fracture pulmonary embolism bone cement surgery conservative treatment inferior vena cava pulmonary artery embolectomy recovery VERTEBRAL COMPRESSION FRACTURES ACRYLIC CEMENT RARE COMPLICATION POLYMETHYLMETHACRYLATE METHACRYLATE PERFORATION MANAGEMENT Clinical Neurology Orthopedics LA - English M1 - 26 M3 - Article N1 - Web of Science Clarivate Analytics literature search January 5, 2021 PY - 2014 SN - 0362-2436 SP - E1616-E1621 ST - Successful Percutaneous Retrieval of a Large Pulmonary Cement Embolus Caused by Cement Leakage During Percutaneous Vertebroplasty Case Report and Literature Review T2 - Spine TI - Successful Percutaneous Retrieval of a Large Pulmonary Cement Embolus Caused by Cement Leakage During Percutaneous Vertebroplasty Case Report and Literature Review UR - ://WOS:000346480500009 VL - 39 ID - 830250 ER - TY - JOUR AB - We herein report the first case of fatal extensive bone cement embolism appearing in pulmonary arterioles following surgical vertebral screw augmentation, which histological evidence of bone cement emboli was confirmed by Fourier transform infrared spectroscopy. A 47-year-old woman has accepted multilevel spine fusion and pedicle screw augmentation with totally 4 ml bone cement infusion. She suddenly developed low blood pressure, dyspnoea, and unconsciousness approximately 1 h post anaesthetic recovery, and then she was dead. It was shown both lungs were edematous in autopsy, and bluish emboli were appeared in extensive pulmonary arterioles in H&E stained sections. Negative information was shown in Molybdenum target X-ray imaging, but the emboli were confirmed to be PMMA bone cement by Fourier transform infrared spectroscopy. The present case indicated it might be effective to confirm the dubious trace component in histology by FTIR. AD - Key Laboratory of Evidence Science(China University of Political Science and Law), Ministry of Education, Beijing, PR China. AN - 23821787 AU - Zheng, N. AU - Liang, M. AU - Zhang, H. D. AU - Zhu, S. H. AU - Yang, T. T. AU - Zhuo, L. AU - Wang, G. F. AU - Liu, H. X. AU - Liu, L. DA - Jun 10 DO - 10.1016/j.forsciint.2013.03.031 DP - NLM ET - 2013/07/04 J2 - Forensic science international KW - Bone Cements/*adverse effects Female Forensic Pathology Humans Middle Aged Polymethyl Methacrylate/*adverse effects Pulmonary Edema/pathology Pulmonary Embolism/*pathology *Spectroscopy, Fourier Transform Infrared Spinal Fusion/adverse effects LA - eng M1 - 1-3 N1 - PubMed NLM literature search January 5, 2021 PY - 2013 SN - 0379-0738 SP - e23-5 ST - Fatal extensive bone cement embolism: histological findings confirmed by Fourier transform infrared spectroscopy T2 - Forensic Sci Int TI - Fatal extensive bone cement embolism: histological findings confirmed by Fourier transform infrared spectroscopy VL - 229 ID - 828773 ER - TY - JOUR AD - Orthopedics Department Wuxi Number 9 People's Hospital Affiliated Soochow University 999 Liangxi Road, Wuxi 214062, China AN - 120687532. Language: English. Entry Date: 20171222. Revision Date: 20170113. Publication Type: Article. Journal Subset: Biomedical AU - Zhenzhong, Sun AU - Xuming, Wei DB - cin20 DP - EBSCOhost M1 - 1 N1 - CINAHL (EbscoHost) literature search January 5, 2021 PY - 2017 SN - 1533-3159 SP - E207-E207 ST - Transarterial Embolization Followed by Percutaneous Vertebroplasty in Treating Vertebral Metastases with Paravertebral Extension T2 - Pain Physician TI - Transarterial Embolization Followed by Percutaneous Vertebroplasty in Treating Vertebral Metastases with Paravertebral Extension UR - http://libproxy.temple.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=cin20&AN=120687532&site=ehost-live&scope=site VL - 20 ID - 830576 ER - TY - JOUR AB - BACKGROUND: Because it can reduce the risk of postoperative bone cement leakage, percutaneous kyphoplasty is increasingly used for treatment of severe osteoporotic thoracolumbar vertebral compression fractures. Studies have found that injection of mixed bone cement with high viscosity can significantly reduce the leakage of bone cement. OBJECTIVE: To compare the therapeutic efficacy of percutaneous vertebroplasty with high viscosity bone cement and percutaneous kyphoplasty with standard viscosity bone cement in the treatment of severe osteoporotic thoracolumbar vertebral compression fractures. METHODS: Eighty patients with severe osteoporotic thoracolumbar vertebral compression fractures were enrolled and randomized into vertebroplasty group and kyphoplasty group, 40 patients in each group. Visual analog sc score and Oswestry disability index score were compared between groups before and after treatment. Incidence rate of bone cement leakage and other complications were also compared between two groups after treatment. RESULTS AND CONCLUSION: No significant difference was found between the visual analog scale scores of two groups after treatment (P > 0.05). Patients in the two groups all presented with good recovery of spinal function after treatment, and there was no difference in the Oswestry disability index scores between groups at 3 months after treatment (P > 0.05). The incidence rate of bone cement leakage was 45% in the vertebroplasty group and 30% in the kyphoplasty group, with a significant difference (P < 0.05). But the patients in both gro ps showed no obvious clinical symptoms and underwent no treatment. After treatment, all patients had no pulmonary embolism, bone cement toxicity, spinal cord and nerve root injury. These findings show that there is no significant difference between percutaneous vertebroplasty and kyphoplasty with high‐viscosity bone cement in the following aspects: pain improvement, recovery of the spinal function, incidence rate of bone cement leakage and clinical efficacy. AN - CN-01370931 AU - Zhou, W. DO - 10.3969/j.issn.2095-4344.2015.46.028 KW - *compression fracture /surgery *fragility fracture /surgery *osteoporotic thoracolumbar vertebral compression fracture /surgery *percutaneous vertebroplasty Analgesia Article Bone cement leakage /complication Clinical effectiveness Comparative effectiveness Controlled study Human Major clinical study Oswestry Disability Index Randomized controlled trial Treatment outcome Visual analog scale M1 - 46 M3 - Journal: Article N1 - Cochrane Library (Wiley) literature search January 5, 2021 PY - 2015 SP - 7534‐7538 ST - Percutaneous vertebroplasty with high-viscosity bone cement for treatment of severe osteoporotic thoracolumbar vertebral compression fractures T2 - Chinese journal of tissue engineering research TI - Percutaneous vertebroplasty with high-viscosity bone cement for treatment of severe osteoporotic thoracolumbar vertebral compression fractures UR - https://www.cochranelibrary.com/central/doi/10.1002/central/CN-01370931/full VL - 19 ID - 829984 ER - TY - JOUR AB - The limits of the indication for compound osteosynthesis combined with filling up of bone defects by bone cement are shown from examples in the literature and on patients. The indication for compound osteosynthesis should be thought over carefully, especially in cases of juvenile growing bones and fresh fractures. We recommend compound osteosynthesis within three ranges of indications only: fractures in bones destroyed by malignant tumors; fractures in highly osteoporotic bones of old persons; and fractures in the region of cemented allo-arthroplasties. In pathologic fractures, compound osteosynthesis offer the advantages of: freedom from pain by stabilization and therefore economizing on analgesics; facilitation of nursing and of therapy, e.g., radiotherapy of tumors; prophylaxis of complications, e.g., embolism or decubitus; avoidance of confinement to bed, which encourages the patient and raises his hope for recovery; restoration of mobility or even capacity to bear weight; prolongation of survival time (only in cases of osteoporosis); and shortening of hospital treatment. AD - Orthop. Univ. Klin., Koln AU - Zilkens, J. AU - Leger, W. AU - Schneider, I. DB - Embase Medline KW - bone cement bone cyst injury major clinical study osteoporosis osteosynthesis pathologic fracture therapy LA - German M1 - 8 M3 - Article N1 - Embase Elsevier literature search January 5, 2021 PY - 1977 SP - 353-357 ST - Indication limits of compound osteosynthesis T2 - Unfallheilkunde/Traumatology TI - Indication limits of compound osteosynthesis UR - https://www.embase.com/search/results?subaction=viewrecord&id=L8151283&from=export VL - 80 ID - 829973 ER - TY - JOUR AB - BACKGROUND: Bone cement is uncommon cause of foreign-body pulmonary embolism. DISCUSSION: 65-year-old woman with a wheeze presented with multiple linear opacities with bone density on chest x-ray. She reported a percutaneous vertebroplasty 4 months ago. Non-contrast chest computerized tomography showed peripheral cement emboli in pulmonary arteries. The patient received conservative treatment. CONCLUSION: Clinicians should be aware of this potential complication following vertebroplasty. It is necessary to perform a chest x-ray after procedure. AD - Trakya University, School of Medicine, Department of Chest Diseases, Edirne. Turkey. Onsekiz Mart University, School of Medicine, Department of Chest Diseases, Canakkale. Turkey. AN - 32964825 AU - Zohra, A. AU - Gonlugur, U. DA - Sep 23 DO - 10.2174/1573405616666200923161922 DP - NLM ET - 2020/09/24 J2 - Current medical imaging KW - Vertebroplasty bone cements foreign bodies polymethyl methacrylate prognosis pulmonary embolism LA - eng N1 - PubMed NLM literature search January 5, 2021 PY - 2020 ST - Cement pulmonary embolism due to percutaneous vertebroplasty T2 - Curr Med Imaging TI - Cement pulmonary embolism due to percutaneous vertebroplasty ID - 828616 ER - TY - JOUR AD - F. Zumstein, Leitender Arzt Kardiologie, Medizinische Klinik, Kantonsspital Münsterlingen, CH-8596 Münsterlingen, Switzerland AU - Zumstein, D. AU - Widmer, F. AU - Blay, M. DB - Embase KW - acrylic cement aged backache case report computer assisted tomography Doppler echocardiography echocardiography female fluoroscopy fragility fracture human kyphoplasty lung embolism note percutaneous vertebroplasty thorax radiography L1 - http://www.cardiovascmed.ch/docs/cvm/2013/03/en/cvm-00118.pdf LA - English M1 - 3 M3 - Note N1 - Embase Elsevier literature search January 5, 2021 PY - 2013 SN - 1423-5528 1662-629X SP - 95-96 ST - Acrylcement pulmonary embolism T2 - Kardiovaskulare Medizin TI - Acrylcement pulmonary embolism UR - https://www.embase.com/search/results?subaction=viewrecord&id=L368900948&from=export VL - 16 ID - 829508 ER -