5/15 of the patients were smokers. The surgical procedure consisted of percutaneous stabilisation using the augmented fenestrated screws in www.selleckchem.com/products/Enzastaurin.html 6 cases and an unilateral percutaneous stabilisation associated with a contralateral TLIF or bone graft placement through a miniaccess approach in 9 patients. The mean operative time was 165min ��54.4 (range, 80�C275min), and the mean perioperative blood loss was 261.4mL �� 195 (range, 30�C600mL). The mean cement injection per pedicle was 2.02mL �� 0.56 (range, 1.5�C3.0mL). The injection of PMMA was done in a minimum of 5 minutes after mixing to obtain a high viscosity consistency of the cement. Despite this waiting time, PMMA asymptomatic extravasations were observed in 5/15 patients.
PMMA extravasations were posterior towards the spinal canal (n = 2), in the intervertebral disc (n = 1), and into the external venous plexus (n = 2). PMMA extravasations were noted in 4 of the 78 fenestrated screws placed (5% of screws). There were no cases of severe morbidity post-operatively (no death, no myocardial infarction, no pulmonary emboli, or intraoperative hypotension). Two postoperative complications related to the procedure were noted: and one S1 screw misplacement associated with a nerve radiculitis (no cement injected through this screw), one subcutaneous infection with multisensible staphylococcus epidermidis treated with 2 weeks of antibiotherapy. Patients were observed at regular intervals for a maximum of 2 years. The mean follow-up period in this study was 13.3 months (range, 6�C24 months).
At the end of follow-up period we noted no construct failure, no screw fractures, no loss of correction, or screw pullout. Based on the VAS for back pain and leg pain, pain intensity was significantly improved at discharge, 6 months and 1-year followup (Table 2), The back function evaluated by ODI score showed significantly improvement when compared between preoperative and discharge period including 6-month and 1-year followup (Figure 7). Based on the 1-year follow-up Rx control, the fusion was considered as completed in all cases where TLIF or posterolateral bone graft were placed (7 patients). In fracture cases, no bone graft was placed. Nevertheless, the burst fracture was consolidated in all patients. In patients 7 and 10, despite the absence of interbody bone grafting, a spontaneous progressive interbody fusion was noted.
Figure 7 Clinical outcomes preoperatively and over 1 year postoperative followup. Results AV-951 are expressed as mean scores ��Standard deviation at each time point. LVAS: Low back visual analogue score (1�C10) of pain, RVAS: radicular VAS. Table 2 Means LVAS, RVAS, and ODI scores at preoperative, discharge, 6 months and 1-year postoperative. 3.1. Illustrative Case 3.1.1. Presentation and Examination This 83-year-old woman presented with more than 5-year history of low back pain, more significant left buttock, lateral calf, and foot pain, as well as intermittent claudication.
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