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Pharmacological options for pain control in patients with vertebral fragility fractures
Nuttan Kantilal Tanna,Terence Ong 대한골다공증학회 2022 Osteoporosis and Sarcopenia Vol.8 No.3
This review considers the evidence base and current knowledge for pharmacological treatment options that are available for pain control in patients with vertebral fractures sustained after a low trauma incident. Due care needs to be taken when considering prescribed options for pain control. The decision should be based on first establishing whether the presentation is one of acute severe pain at the time of a new vertebral fragility fracture incident or whether the complaint is one of the debilitating, longer term chronic back pain syndrome, accompanied by a clinical suspicion of a possible new fracture. The article also presents currently debated questions in this important area of clinical and patient care and will be of interest to the readership worldwide.
Chaitanya Baban Chikhale,Ketan Shripad Khurjekar,Ashok Kumar Shyam,Parag Kantilal Sancheti 대한척추외과학회 2017 Asian Spine Journal Vol.11 No.2
Study Design: This was a single surgeon, single center-based retrospective study with prospective data collection. Purpose: To assess the correlation between T2-weighted magnetic resonance imaging (MRI) signal intensity (SI) changes and factors such as age, duration of symptoms, baseline modified Japanese Orthopedic Association (mJOA) score and to determine its prognostic value in predicting recovery after surgery. Overview of Literature: Whether intramedullary cord T2-weighted MRI SI changes can predict operative outcomes of cervical myeloradiculopathy remains debatable, with only a few prospective studies analyzing the same. Methods: Forty-six consecutive patients who underwent cervical myeloradiculopathy were included and were followed up for an average of 1 year. Preoperative T2-weighted MRI SI grading was performed for all patients. The correlation between MRI SI changes and age, duration of symptoms, preoperative mJOA score, and mJOA score at 1-year follow-up were analyzed. Results: Fifteen patients had single-level (21.73%) or double-level (10.86%) prolapsed discs; 54.34% had degenerative cervical spondylosis with canal stenosis or multilevel disc prolapse and 13.07% had ossified posterior longitudinal ligaments. The mean age was 56.17±9.53 years (range, 35–81 years). The mean baseline mJOA score was 10.83±2.58 (range, 6–16), which postoperatively improved to 13.59±2.28 (range, 8–17; p <0.001). There was a statistically significant correlation between mJOA score at 1 year and MRI T2 SI grading (p =0.017). Conclusions: Patients with longer symptom durations had high grades of intramedullary cord T2-weighted MRI SI changes. Age and preoperative neurological status were not significantly correlated with the existence of intramedullary cord SI changes. However, patients without or with mild and diffuse intramedullary cord T2-weighted MRI SI changes had better postoperative neurological recovery than those with sharp and focal SI changes.
Shailesh Ramakant Hadgaonkar,Ashok Kumar Shyam,Kunal Chandrakant Shah,Ketan Shripad Khurjekar,Parag Kantilal Sancheti 대한척추외과학회 2014 Asian Spine Journal Vol.8 No.5
Osteoblastomas are bone forming lesions arising mainly from posterior elements of the vertebra. They are commonly encountered in the cervical and lumbar regions. We present a case of a thoracic osteoblastoma which is extra osseous and is not communicating with any part of the vertebra present intraforaminally. This is a rare presentation of an osteoblastoma. Imaging studies do not accurately diagnose the osteiod lesion. The size of the lesion and cortical erosion seen on the computed tomography scan help in differentiating the osteoid osteoma and osteoblastoma, but they are less sensitive and specific. Thus a histopathology is the investigation of choice to diagnose the osteoblastoma. Early and adequate removal of mass prevents malignant transformation, metastasis, and recurrence. In our case we excised the pars interarticularis unilaterally, removed the osteoid mass intact, and performed unilateral instrumented fusion. There was no recurrence and solid fusion was seen at 3 years follow up.
Baek, Myung Ju,Park, Ja Young,Xu, Wenlong,Kattel, Krishna,Kim, Han Gyeol,Lee, Eun Jung,Patel, Anilkumar Kantilal,Lee, Jae Jun,Chang, Yongmin,Kim, Tae Jeong,Bae, Ji Eun,Chae, Kwon Seok,Lee, Gang Ho American Chemical Society 2010 ACS APPLIED MATERIALS & INTERFACES Vol.2 No.10
<P>A facile one-pot synthesis of a water-soluble MnO nanocolloid (i.e., <SMALL>d</SMALL>-glucuronic acid-coated MnO nanoparticle) is presented. The MnO nanoparticle in the MnO nanocolloid was coated with a biocompatible and hydrophilic <SMALL>d</SMALL>-glucuronic acid, and its particle diameter was nearly monodisperse and ranged from 2 to 3 nm. The average hydrodynamic diameter of the MnO nanocolloid was estimated to be 5 nm. The MnO nanoparticle was nearly paramagnetic down to <I>T</I> = 3 K. The MnO nanocolloid showed a high longitudinal water proton relaxivity of <I>r</I><SUB>1</SUB> = 7.02 s<SUP>−1</SUP> mM<SUP>−1</SUP> with the <I>r</I><SUB>2</SUB>/<I>r</I><SUB>1</SUB> ratio of 6.83 due to five unpaired <I>S</I>-state electrons of Mn(II) ion (<I>S</I> = 5/2) as well as a high surface to volume ratio of the MnO nanoparticle. High contrast in vivo <I>T</I><SUB>1</SUB> MR images were obtained for various organs, showing the capability of the MnO nanocolloid as a sensitive <I>T</I><SUB>1</SUB> MRI contrast agent. The suggested three key-parameters which control the <I>r</I><SUB>1</SUB> and <I>r</I><SUB>2</SUB> relaxivities of nanocolloids (i.e., the <I>S</I> value of a metal ion, the spin structure, and the surface to volume ratio of a nanoparticle) successfully accounted for the observed <I>r</I><SUB>1</SUB> and <I>r</I><SUB>2</SUB> relaxivities of the MnO nanocolloid.</P><P><B>Graphic Abstract</B> <IMG SRC='http://pubs.acs.org/appl/literatum/publisher/achs/journals/content/aamick/2010/aamick.2010.2.issue-10/am100641z/production/images/medium/am-2010-00641z_0012.gif'></P>