Fractures spinal

Growth factors lnductOS /Dibotermin a Bone morphogenetic protein-2 Tibia fracture, spinal surgery... 

Oi5 = the number of intracranial hemorrhage, extraclavicular fracture, spinal injury, nerve injury (other than facial and brachial plexus), and other birth trauma. 

The spinal cord emerges from the brain stem at the base of the skull and terminates at the second lumbar vertebra. The thoracic spine is most vulnerable to cord compression because of natural kyphosis and because the width of the thoracic spinal canal is the smallest among the vertebrae. Most spinal cord compression is due to adjacent vertebral metastases that compress the spinal cord or from pathologic compression fracture of the vertebra. This results in significant edema and inflammation in the affected area. 

Bisphosphonates such as pamidronate and zoledronic acid may prevent skeletal morbidity, such as pathologic fractures and spinal code compression, when used for hormone-refractory prostate cancer in patients with clinically significant bone loss. Usual dosages are pamidronate, 90 mg every month, and zoledronic acid, 4 mg every 3 to 4 weeks. 

In the Breast Cancer Prevention Trial (Fisher et al. 1998) a clinical survey aimed at determining the potential of tamoxifen for breast cancer prevention in women at increased risk, 13,338 pre- or postmenopausal women were monitored over 5 years. After randomization, women in the treatment group (n = 6681) were given a 20-mg daily dose of tamoxifen, while the remaining (n = 6707) received a placebo. Although the overall rate of fractures was about the same in both groups, tamoxifen-treated women sustained fewer hip, spine, and Colles fractures. Nevertheless, relevant data may have been biased, since in this trial there was an indiscriminate inclusion of pre- and postmenopausal women and no spinal radiographs were carried out. 

One in four postmenopausal women have osteoporosis. Osteoporosis, a decrease in bone mass, constitutes the most serious effect of menopause. It has been estimated that following cessation of ovarian function, the loss of bone mass proceeds at a rate of 2 to 5% per year. As a result of osteoporosis, as many as 50% of women develop spinal compression fractures by age 75, and 20% will have hip fractures by age 90. 

There have been repeated reports of epidural lipomatosis, which can lead to spinal cord compression (48,49) or spinal fracture (50) in one instance, the excised lipomata contained brown fat, a phenomenon that may prove to be not unusual in glucocorticoid-induced lipomata (SEDA-16, 451). 

Roy-Camille R, Mazel C, Husson JL, Saillant G. Symptomatic spinal epidural hpomatosis induced by a long-term steroid treatment. Review of the literature and report of two additional cases. Spine 1991 16(12) 1365-71. Andress HJ, Schurmann M, Heuck A, Schmand J, Lob G. A rare case of osteoporotic spine fracture associated with epidural lipomatosis causing paraplegia following longterm cortisone therapy. Arch Orthop Trauma Surg 2000 120(7-8) 484-6. 

Diamond TH, Bucci J, Kersley JH, Aslan P, Lynch WB, Bryant C. Osteoporosis and spinal fractures in men with prostate cancer risk factors and effects of androgen deprivation therapy. J Urol 2004 172 529-32. 

Oxygen is used for the correction of hypoxia and as a diluent or carrier gas for vapors and gases, primarily anesthetic agents. The use of oxygen at increased pressure is termed hyperbaric oxygen therapy. This therapy is used in diverse conditions such as multiple sclerosis, traumatic spinal cord injury, cerebrovascular accidents, bone graft, fractures, and leprosy. However, there are no available authentic data, as there are no well-controlled clinical trials. 

Bone graft/Cage (rBMP with metal cage) Infuse Bone Graft/LT-Cage (Medtronic/Wyeth) Low back pain from spinal disc degen tibia shaft fracture... 

Haldeman S, Rubinstein SM. Compression fractures iu patients undergoing spinal manipulative therapy. J Manipulative Physiol Ther 1992 15(7) 450-4. 

Women scheduled for cesarean section (n = 32) were given spinal bupivacaine 10 mg (0.5%) or spinal bupivacaine 5 mg (0.5%) plus fentanyl 25 pg (28). Those given fentanyl had adequate spinal anesthesia for cesarean section with fewer adverse effects (nausea and hjrpotension). This observation was reproduced by spinal anesthesia with bupivacaine 4 mg plus fentanyl 20 pg, which provided adequate spinal anesthesia for surgical repair of hip fracture in elderly patients, with fewer adverse effects than bupivacaine 10 mg (29). 

Ben-David B, Frankel R, Arzumonov T, Marchevsky Y, Volpin G. Minidose bupivacaine-fentanyl spinal anesthesia for surgical repair of hip fracture in the aged. Anesthesiology 2000 92(1) 6-10. 

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