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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_6046_Библиотеки_им_академика_М_И_Перельмана.pdf
Index
231
World Health Organization (WHO), 21
Osteoporotic vertebral compression fractures (OVCFs)
adjacent segment disease, 188
advantages and disadvantages, 59
anti-osteoporotic drugs, 60
body mass index (BMI), 59
bracing, 104, 105
chronic oral glucocorticoid therapy, 58
complications, 187
cost, 57
DEXA scores, 58
epidural steroid injections, 58
frailty, 58
FRAX, 60
incidence and prevalence, 57
initial management, 101
injections, 103
lumbar decompression surgery, 59
medical managament, 184–186
medication, 58
minimally invasive techniques, 187
multidisciplinary care, 57
neurological manifestations, 59
pharmacologic treatment, 101, 102, 187
physical activity, 60
pre-operative and post-operative interventions, 187
prevention and treatment, 221, 223, 224, 225
prophylactic vertebral cement augmentation, 188
proximal junctional fracture, 183
biomechancial, 183, 184
cellular level, 184
psychological treatment, 101, 105
radiographic studies, 58
risk factor, 58–60, 184
sagittal spinal alignment, 183
screening, 58, 221–223
surgical managament, 186, 187
symptoms, 58
systemic corticosteroids, 58
T-score, 58, 60
type I, 57
type II, 57
type III, 57
United States Preventative Services Task Force
(USPSTF), 58
vertebroplasty, 59
vitamin D deciency, 60
Z-score, 58
Osteoprotegrin (OPG) functions, 2
Oswestry Disability Index (ODI), 26, 200, 225
Oswestry Low Back Disability Index scores, 215
P
Pathologic vertebral compression fracture (pVCF)
diagnosis, 63
etiologies, 63
history, 64
imaging, 65, 66
management, 63, 66, 67
physical examination, 64, 65
R
Raloxifene (Evista
®
), 42
Roland-Morris Disability Questionnaire, 26
S
Sacral insufciency fractures (SIF)
anatomy and biomechanics, 206–208
bone scintigraphy, 213
clinical presentation and evaluation, 209
conservative management, 213, 214
CT, 210, 211
fatigue fractures, 205
incidence, 205, 206
insufciency fracture, 205
medical management, 214
MRI, 210, 212
plain radiographs, 209, 210
risk factors, 205, 208, 209
surgical management
long-axis technique (90), 216, 217
minimally invasive augmentation, 214
morbidity, 214
posterior (short-axis) technique, 215, 216
sacroplasty, 215
screw xation, 214, 215
vertebroplasty, 214
Secreted protein acid which is rich in cysteine (SPARC), 4
Sphingosine-1 phosphate (S1P), 5
Spinal column tumors
after SRS, 154–158
cement augmentation, 154
cervicothoracic junction (CTJ), 160
clinical characteristics, 158
clinical signicance, 154
cranio-vertebral junction (CVJ), 158, 159
imaging studies, 154
incidence, 153, 154
management, 154
NOMS algorithm, 158
pathological fractures, 153
radiographic diagnosis, 160–162
spinal instability neoplastic score (SINS), 162, 163
subaxial cervical spine, 160
surgical management
cervical spine and cervico-thoracic
junction, 164, 165
chemotherapy and radiation, 164
fenestrated pedicle screws (FPS), 171, 172
indications and contraindications, 164
less invasive approaches, 164
minimally invasive surgery (MIS), 172, 175
personalized treatment, 164
pre-operative evaluation, 164
surgical CVJ stabilization, 165–169
thoracic and lumbar spine metastases, 168,
170–174
vertebroplasty and kyphoplasty, 165
surgical optimization, 158
symptoms, 158, 159
thoracic and lumbar spine, 160
232
Index
Spinal deformity management
evaluation, 145, 146
medical management, 147, 148
postoperative care, 151, 152
radiographic examination, 146–148
surgical management
anterior and posterior thoracolumbar approaches,
149
anterior column reconstruction, 149
bicortical placement, 149
bone mineral density, 149
cement augmentation, 151
complications, 149
dorsal and posterolateral fusion, 150
goals, 149
hemilaminectomy, 149
iliac instrumentation, 150
lower instrumented vertebra (LIV), 151
patient factors, 148, 149
short segment xation, 150
spinal stenosis, 149
three-column osteotomies, 149
vacuum phenomenon, 150
Spinal Instability in Neoplasm Score (SINS), 66
Spinal Proprioception Extension Exercise Dynamic
(SPEED) program, 186
SpineJack
®
device, 225
Spine Oncology Study Group (SOSG), 162
Stereotactic spine radiosurgery (SRS), 154–158
T
Teriparatide, 147
Thoracolumbarsacaral orthosis (TLSO), 104
U
United States Preventative Services Task Force
(USPSTF), 58
U.S. healthcare, 21
V
Vertebral compression fractures (VCF)
acute radiculopathy, 71
anabolic agents, 42, 43
anterior wedge fractures, 50, 51
benign and pathologic VCFs, 80, 81
biconcave fracture patterns, 51, 52
biochemical bone turnover markers (BTMs), 73
BMD testing, 34
bone biopsy, 73
calcium, 37
chemical shift imaging, 88
chronicity, 77–80
classication system, 51
clinical consequences, 95
clinical presentation, 95
conventional radiography and scintigraphy, 80
cortex, 82
creep deformity and fatigue failure, 50
crush type fracture patterns, 52
DEXA scan, 69
diagnosis, 34–36
diagnostic evaluation, 70
diet, 37
differential diagnosis, 69, 72
diffusion weighted imaging, 86–88
discogenic/spondylotic pain, 70
dynamic contrast enhanced MRI, 88, 89
18F FDG PET/CT, 89–91
epidemiology, 31, 32
estrogen agonist/antagonist, 42
etiology, 70
excessive kyphosis, 71
extravertebral features
distant osseous ndings, 86
paraspinal soft tissue, 84, 86
®
FRAX
tool, 35
initial radiologic evaluation, 76
intervertebral disc, 50
laboratory evaluation, 72, 73
malignant features, 86
marrow signal intensity
contrast enhancement, 84
marrow edema and inammation, 83–85
morphologic features, 86
mechanism of pain, 52, 53
medical management, 38, 39
medication, 73
microstructure, 49, 50
morphologic features, 86
morphologic imaging, 89
morphology, 80
MRI, 77, 80
multidetector computed tomography (MDCT), 77
muscular/spondylotic pain, 70
NOF guidelines, 73
oral bisphosphonates, 40, 41
pain, 96
patient history, 70, 71
pharmacologic management, 39, 40
physical consequences, 97, 98
physical examination, 71, 72
positron emission tomography (PET)/CT, 80
qualitative evaluation, 86
qualitative/semi-quantitative imaging assessment, 77
rank ligand inhibition, 41, 42
red ag symptoms, 70
risk factors, 32, 33, 36, 37, 69, 70, 98
societal impact, 33, 34
symptoms, 71
Technetium 99m hydroxymethylene diphosphonate
(Tc-99m HMDP), 89
trabecula, 82
treatment, 69
vacuum cleft/uid sign, 83
Vertebral Fracture Assessment (VFA) software, 35
vertebral imaging, 35
VERT trial, 98
Index
233
vertebral body contour, 81
vitamin D, 37, 38
Vertebral Efcacy with Risedronate
Therapy (VERT) trial, 98
Vertebroplasty, 53
Vertebroplasty cement augmentation technique
advantages, 120
analgesics, 116
aseptic technique, 121
bone cements, 126, 127
bone demineralization, 116
bone density test, 117
bone needles, 124
cement augmentation, 120, 121
cement injection, 127–129
clinical feature, 117
complications, 129–133
CT, 118, 119
description, 121
early intervention, 117
uoroscopy, 119, 120
goal, 120
heating pads, 116
image-guided percutaneous vertebroplasty, 117
image-guided vertebroplasty procedures, 115
imaging, 117
indications and contraindications, 117, 120
informed consent, 121
intravenous antibiotics, 121
invasive treatment strategies, 117
kyphotic deformity, 116
laboratory parameters, 121
medical management, 116
Medicare database, 115
MRI, 118
multilevel vertebroplasty, 128
needle placement, 122, 124–126
non-invasive treatments, 116
osteoporosis therapy, 129
pain relief and mobility improvement, 128
patient co-morbidities, 121
patient outcomes, 122
patient positioning, 122
patient selection, 117, 121
patient’s pain diagram, 117
physical examination, 117
physical therapy, 116
radiographic evaluation, 118
for rotatory scoliosis, 129
spine brace, 129
temporary balloon tamp ination, 120
treatment decision, 129
for vertebra plana deformity, 129
Vitamin D deciency, 12, 13
Vitamin D receptor (VDR), 13
Z
Zoledronic acid (Reclast
®
), 41