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  • 1
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    Influence of Hyponatremia on Spinal Bone Quality and Fractures Due to Low-Energy Trauma
    MDPI AG ; 2021
    In:  Medicina Vol. 57, No. 11 ( 2021-11-10), p. 1224-
    Details
    In: Medicina, MDPI AG, Vol. 57, No. 11 ( 2021-11-10), p. 1224-
    Abstract: Background and Objectives: Hyponatremia is the most common electrolyte disorder in elderly and associated with increased risk of falls. Clinical studies as well as small animal experiments suggested an association between chronic hyponatremia and osteoporosis. Furthermore, it has been assumed that subtle hyponatremia may be an independent fracture risk in the elderly. Therefore, this study was designed to evaluate the possible influence of chronic hyponatremia on osteoporosis and low-energy fractures of the spine. Materials and Methods: 144 patients with a vertebral body fracture (mean age: 69.15 ± 16.08; 73 females and 71 males) due to low-energy trauma were treated in a level one trauma center within one year and were included in the study. Chronic hyponatremia was defined as serum sodium 〈 135 mmol/L at admission. Bone mineral density (BMD) of the spine was measured using quantitative computed tomography in each patient. Results: Overall, 19.44% (n = 28) of patients in the low-energy trauma group had hyponatremia. In the group with fractures caused by low-energy trauma, the proportion of hyponatremia of patients older than 65 years was significantly increased as compared to younger patients (p** = 0.0016). Furthermore, there was no significant gender difference in the hyponatremia group. Of 28 patients with chronic hyponatremia, all patients had decreased bone quality. Four patients showed osteopenia and the other 24 patients even showed osteoporosis. In the low-energy trauma group, the BMD correlated significantly with serum sodium (r = 0.396; p*** 〈 0.001). Conclusions: The results suggest that chronic hyponatremia affects bone quality. Patients with chronic hyponatremia have an increased prevalence of fractures after low-energy trauma due to a decreased bone quality. Therefore, physicians from different specialties should focus on the treatment of chronic hyponatremia to reduce the fracture rate after low-energy trauma, particularly with elderly patients.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina57111224
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2088820-X
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  • 2
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    Cage or Pelvic Graft—Study on Bony Fusion of the Ventral Thoracic and Lumbar Spine in Traumatic Vertebral Fractures
    MDPI AG ; 2021
    In:  Medicina Vol. 57, No. 8 ( 2021-07-31), p. 786-
    Details
    In: Medicina, MDPI AG, Vol. 57, No. 8 ( 2021-07-31), p. 786-
    Abstract: Background and Objectives: Stabilization of the spine by cage implantation or autologous pelvic bone graft are surgical methods for the treatment of traumatic spine fractures. These methods serve to stably re-adjust the spine and to prevent late detrimental effects such as pain or increasing kyphosis. They both involve ventral interventions using interbody fusion to replace the intervertebral disc space between the vertebral bodies either by cages or autologous pelvic bone grafts. We examined which of these methods serves the patients better in terms of bone fusion and the long-term clinical outcome. Materials and Methods: Forty-six patients with traumatic fractures (12 cages; mean age: 54.08/34 pelvic bone grafts; mean age: 42.18) who received an anterior fusion in the thoracic or lumbar spine were included in the study. Postoperative X-ray images were evaluated, and fusion of the stabilized segment was inspected by two experienced spine surgeons. The time to discharge from hospital and gender differences were evaluated. Results: There was a significant difference of the bone fusion rate of patients with autologous pelvic bone grafts in favor of cage implantation (p = 0.0216). Also, the stationary phase of patients who received cage implantations was clearly shorter (17.50 days vs. 23.85 days; p = 0.0089). In addition, we observed a significant gender difference with respect to the bony fusion rate in favor of females treated with cage implantations (p 〈 0.0001). Conclusions: Cage implantations after spinal fractures result in better bony fusion rates as compared to autologous pelvic bone grafts and a shorter stay of the patients in the hospital. Thus, we conclude that cage implantations rather than autologous pelvic bone grafts should be the preferred surgical treatment for stabilizing the spine after fracture.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina57080786
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2088820-X
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  • 3
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    Combination of vertebral bone quality scores from different magnetic resonance imaging sequences improves prognostic value for the estimation of osteoporosis
    Elsevier BV ; 2023
    In:  The Spine Journal Vol. 23, No. 2 ( 2023-02), p. 305-311
    Details
    In: The Spine Journal, Elsevier BV, Vol. 23, No. 2 ( 2023-02), p. 305-311
    Type of Medium: Online Resource
    ISSN: 1529-9430
    URL: Article
    DOI: 10.1016/j.spinee.2022.10.013
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2023
    detail.hit.zdb_id: 2057875-1
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  • 4
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    Can You Feel it? – Correlation Between Intraoperatively Perceived Bone Quality and Objectively Measured Bone Mineral Density
    SAGE Publications ; 2022
    In:  Global Spine Journal
    Details
    In: Global Spine Journal, SAGE Publications
    Abstract: clinical study. Objectives Loosening of pedicle screws is a frequent complication in patients with osteoporosis. The indication for additional stabilization, such as cement augmentation, is more often based on the subjective intraoperative feeling of the surgeon than on a preoperative bone mineral density (BMD) measurement. Aim was to evaluate the correlation of the intraoperative perceived bone quality in comparison to the objectively measured BMD. Methods A total of 62 patients undergoing dorsal stabilization using pedicle screws at a level-1 trauma center were analyzed. The preoperative CT scan measured each instrumented vertebra's pedicle size and BMD. During the surgery, the perceived screw stability was graded by the respective surgeon for each screw. Results 204 vertebral bodies were evaluated. Looking at all implanted screws a significant correlation between the measured BMD and the perceived screw stability was found (Resident r = .450; R 2 = .202; P 〈 .001/Attending r = .364; R 2 = .133; P 〈 .001), but there was no significant correlation in the osteoporotic patients (Resident P = .148 / Attending P = .907). The evaluation of the screws implanted in osteoporotic vertebrae showed that the surgeons considered a total of 31% of these screws to be sufficiently stable. Conclusions There was no significant correlation between the measured BMD and the perceived pedicle screw stability in the group with osteopenic / osteoporotic bone ( 〈 100 mg/cm³). The results indicate that it is not possible to reliably determine the bone quality and the resulting screw stability in patients with reduced BMD. The preoperative measurement of the BMD should become a crucial part of preoperative planning.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/21925682221120398
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2648287-3
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  • 5
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    Effect of a Contrast Agent on Bone Mineral Density Measurement in the Spine and Hip Using QCT-Conversion Factor Recommendation
    MDPI AG ; 2023
    In:  Journal of Clinical Medicine Vol. 12, No. 4 ( 2023-02-12), p. 1456-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 12, No. 4 ( 2023-02-12), p. 1456-
    Abstract: Background: Osteoporosis causes an increased fracture risk. Clinically, osteoporosis is diagnosed late, usually after the first fracture occurs. This emphasizes the need for an early diagnosis of osteoporosis. However, computed tomography (CT) as routinely used for polytrauma scans cannot be used in the form of quantitative computed tomography (QCT) diagnosis because QCT can only be applied natively, i.e., without any contrast agent application. Here, we tested whether and how contrast agent application could be used for bone densitometry measurements. Methods: Bone mineral density (BMD) was determined by QCT in the spine region of patients with and without the contrast agent Imeron 350. Corresponding scans were performed in the hip region to evaluate possible location-specific differences. Results: Measurements with and without contrast agent administration between spine and hip bones indicate that the corresponding BMD values were reproducibly different between spine and hips, indicating that Imeron 350 application has a location-specific effect. We determined location-specific conversion factors that allow us then to determine the BMD values relevant for osteoporosis diagnosis. Conclusions: Results show that contrast administration cannot be used directly for CT diagnostics because the agent significantly alters BMD values. However, location-specific conversion factors can be established, which are likely to depend on additional parameters such as the weight and corresponding BMI of the patient.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm12041456
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662592-1
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  • 6
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    Cervical Disc Arthroplasties Fail to Maintain Physiological Kinematics Under Lateral Eccentric Loads
    SAGE Publications ; 2023
    In:  Global Spine Journal
    Details
    In: Global Spine Journal, SAGE Publications
    Abstract: In vitro human cadaveric biomechanical analysis. Objectives Optimization of prostheses for cervical disc arthroplasties (CDA) reduces the risk of complications. The instantaneous helical axis (IHA) is a superior parameter for examining the kinematics of functional spinal units. There is no comprehensive study about the IHA after CDA considering all 3 motion dimensions. Methods Ten human functional spinal units C4-5 (83.2 ± 7.9 yrs.) were examined with an established measuring apparatus in intact conditions (IC), and after CDA, with 2 different types of prostheses during axial rotation, lateral bending, and flexion/extension. Eccentric preloads simulated strains. The IHA orientation and its position at the point of rest (IHA 0 -position) were analyzed. Results The results confirmed the existing data for IHA in IC. Lateral preloads showed structural alterations of kinematics after CDA: During axial rotation and lateral bending, the shift of the IHA 0 -position was corresponding with the lateral preloads’ applied site in IC, while after CDAs, it was vice versa. During lateral bending, the lateral IHA orientation was inclined, corresponding with the lateral preloads’ applied site in the IC and oppositely after the CDAs. During flexion/extension, the lateral IHA orientation was nearly vertical in the IC, while after CDA, it inclined, corresponding with the lateral preloads’ applied site. The axial IHA orientation rotated to the lateral preloads’ corresponding site in the IC; after CDA, it was vice versa. Conclusion Both CDAs failed to maintain physiological IHA characteristics under lateral preloads, revealing a new aspect for improving prostheses’ design and optimizing their kinematics.
    Type of Medium: Online Resource
    ISSN: 2192-5682 , 2192-5690
    URL: Article
    DOI: 10.1177/21925682231193642
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2648287-3
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  • 7
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    Psychostimulants Modafinil, Atomoxetine and Guanfacine Impair Bone Cell Differentiation and MSC Migration
    MDPI AG ; 2022
    In:  International Journal of Molecular Sciences Vol. 23, No. 18 ( 2022-09-06), p. 10257-
    Details
    In: International Journal of Molecular Sciences, MDPI AG, Vol. 23, No. 18 ( 2022-09-06), p. 10257-
    Abstract: Attention deficit hyperactivity disorder (ADHD) is one of the most common worldwide mental disorders in children, young and adults. If left untreated, the disorder can continue into adulthood. The abuse of ADHD-related drugs to improve mental performance for studying, working and everyday life is also rising. The potentially high number of subjects with controlled or uncontrolled use of such substances increases the impact of possible side effects. It has been shown before that the early ADHD drug methylphenidate influences bone metabolism negatively. This study focused on the influence of three more recent cognitive enhancers, modafinil, atomoxetine and guanfacine, on the differentiation of mesenchymal stem cells to osteoblasts and on their cell functions, including migration. Human mesenchymal stem cells (hMSCs) were incubated with a therapeutic plasma dosage of modafinil, atomoxetine and guanfacine. Gene expression analyses revealed a high beta-2 adrenoreceptor expression in hMSC, suggesting it as a possible pathway to stimulate action. In bone formation assays, all three cognitive enhancers caused a significant decrease in the mineralized matrix and an early slight reduction of cell viability without triggering apoptosis or necrosis. While there was no effect of the three substances on early differentiation, they showed differing effects on the expression of osterix (OSX), receptor activator of NF-κB ligand (RANKL) and osteoprotegerin (OPG) in the later stages of osteoblast development, suggesting alternative modes of action. All three substances significantly inhibited hMSC migration. This effect could be rescued by a selective beta-blocker (Imperial Chemical Industries ICI-118,551) in modafinil and atomoxetine, suggesting mediation via beta-2 receptor stimulation. In conclusion, modafinil, atomoxetine and guanfacine negatively influence hMSC differentiation to bone-forming osteoblasts and cell migration through different intracellular pathways.
    Type of Medium: Online Resource
    ISSN: 1422-0067
    URL: Article
    DOI: 10.3390/ijms231810257
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2019364-6
    SSG: 12
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  • 8
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    Long-term Quality of Life after Fusion of the Ventral Thoracic and Lumbar Spine
    Georg Thieme Verlag KG ; 2022
    In:  Journal of Neurological Surgery Part A: Central European Neurosurgery Vol. 83, No. 02 ( 2022-03), p. 153-160
    Details
    In: Journal of Neurological Surgery Part A: Central European Neurosurgery, Georg Thieme Verlag KG, Vol. 83, No. 02 ( 2022-03), p. 153-160
    Abstract: Background Cage implantations and autologous pelvic bone grafts are common surgical procedures to fuse the spine in cases of spinal disorders such as traumatic fractures or degenerative diseases. These surgical methods are designed to stably readjust the spine and to prevent late detrimental effects such as pain or increasing kyphosis. Benefits of these surgical interventions have been evaluated, but the long-term well-being of patients after the respective treatments has not yet been examined. This study was designed to evaluate the clinical outcome for patients who received iliac crest or cage implantations. Material and Methods Forty-six patients with traumatic fractures after they obtained an anterior fusion in the thoracic or lumbar spine (12 cages; mean age: 54.08 years; 34 pelvic bone grafts; mean age: 42.18 years) were asked to participate in the survey using a precast questionnaire according the Visual Analog Scale (VAS) Spine Score. Twenty-nine of them provided the data requested. Results Evaluation of the VAS scores of the patients, reporting at least 1 year after the surgery, revealed that cage implantations led to significantly better results with respect to all aspects of their daily life such as pain sensing, capability to undertake physical activities and exercise as compared with patients with autologous pelvic bone graft. Patients with autologous pelvic bone graft treatment reported a particularly poor overall satisfaction level concerning their long-term well-being. Conclusions Patients with cage implantation reported a higher degree of long-term well-being. The data provide evidence for a positive impact on the postsurgery quality of life after cage implantation.
    Type of Medium: Online Resource
    ISSN: 2193-6315 , 2193-6323
    URL: Article
    DOI: 10.1055/s-0041-1736324
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
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  • 9
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    Surgical management of acute traumatic spinal cord injury : Stability vs. functionality
    Springer Science and Business Media LLC ; 2023
    In:  Die Unfallchirurgie Vol. 126, No. 10 ( 2023-10), p. 756-763
    Details
    In: Die Unfallchirurgie, Springer Science and Business Media LLC, Vol. 126, No. 10 ( 2023-10), p. 756-763
    Type of Medium: Online Resource
    ISSN: 2731-7021 , 2731-703X
    URL: Article
    DOI: 10.1007/s00113-023-01341-w
    Language: German
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 3120926-9
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