exudates and Spinal-Fractures

This study aimed to determine the prevalence of vertebral fractures (VF) in a selected urban population in Malaysia and to explore possible variables associated with VF in the study population.. A cross-sectional study involving community-living, healthy subjects aged between 45-90 years from the state of Selangor, Malaysia, were invited to attend a bone health check-up. Subjects with diseases known to affect bone metabolism or were on treatment for osteoporosis (OP) were excluded. Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry (DXA). Lateral and antero-posterior view lumbar spine x-rays were performed and VF was determined by the semi-quantitative Genant method.. A total of 386 subjects were studied. Asymptomatic morphometric VF were found in 44 (11.4%) subjects. T12 was the most common vertebrae to be fractured. The prevalence of VF was significantly higher in menopausal women (12.4%) compared to non-menopausal women, in those above the age of 60 (18.5%), in those of Chinese ethnicity (16.5%), in those with a low body fat percentage (17.1%) and among those with OP (27.0%). The mean (standard deviation) 25-hydroxyvitamin D [25(OH)D] levels were significantly higher in those with VF compared to those without VF, 67.64 (23.50) and 57.47 (21.71) nmol/L, respectively. However, after multiple regression analysis, age over 60 years and OP on DXA BMD measurement were the only significant associated factors for VF.. Overall, 11.4% of a selected Malaysian urban population had asymptomatic morphometric VF. Age over 60 years and OP on DXA BMD measurement, but not 25(OH)D levels, were associated with VF.

Topics: Absorptiometry, Photon; Adult; Aged; Aged, 80 and over; Bone Density; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Middle Aged; Osteoporosis; Osteoporotic Fractures; Prevalence; Risk Factors; Spinal Fractures

To measure the cervical pedicles and assess the feasibility of transpedicular fixation in a Malay population.. 960 computed tomography (CT) scans of bilateral C2 to C7 pedicles of 80 Malays were compared. 22 men and 24 women aged <60 (mean, 37.3; range, 18-56) years were defined as young patients, whereas 18 men and 16 women aged 60 or over (mean, 63.9; range, 60-76) years as elderly patients. An inner diameter of <3.0 mm (85% of a 3.5-mm screw) was defined as 'unfeasible' and a medial or lateral wall thickness of <1.0 mm as 'unsafe' for cervical pedicle screw fixation.. In the respective young versus elderly groups, the inner diameters ranged from 1.94 to 2.80 mm versus 2.51 to 3.37 mm in men, and from 1.52 to 2.31 mm versus 1.64 to 2.46 mm in women. Medial wall thickness ranged from 1.25 to 1.46 mm versus 1.13 to 1.48 mm in men, and from 1.28 to 1.72 mm versus 1.10 to 1.24 mm in women. Lateral wall thickness ranged from 0.80 to 0.90 mm versus 0.66 to 0.88 mm in men, and from 0.85 to 0.99 mm versus 0.59 to 0.86 mm in women.. The cervical spine of Malays may not be adequate to accommodate a 3.5-mm pedicle screw for transpedicular fixation, as this procedure may risk adjacent vital structures.

Topics: Adolescent; Adult; Aged; Bone Screws; Cervical Vertebrae; Feasibility Studies; Female; Follow-Up Studies; Fracture Fixation, Internal; Humans; Malaysia; Male; Middle Aged; Retrospective Studies; Spinal Fractures; Tomography, X-Ray Computed; Treatment Outcome

To measure the diameter of the odontoid process in a Malaysian population using computed tomographic (CT) scan and determine the feasibility of treating type-II odontoid fractures using 2 cortical screws.. CT images of the odontoid process of 85 patients aged 18 to 80 years were analysed; 69 (81%) were male (mean age, 44 years) and 16 (19%) were female (mean age, 48 years). Both anteroposterior (AP) and transverse diameters of the odontoid process were measured via axial CT images at 3 different levels: the base of the odontoid process and 1.2 mm and 2.4 mm above the base.. The mean AP and transverse diameters of the odontoid process in men were 11.3 (range, 10.0-12.6; standard deviation [SD], 0.7) mm and 10.2 (range, 8.5-12.3; SD, 0.8) mm respectively, whereas in women were 10.9 (range, 9.4-13.2; SD, 0.8) mm and 10.1 (range, 7.9-11.6; SD, 0.9) mm respectively. The difference in corresponding mean dimensions between men and women was not statistically significant. The mean AP diameter was significantly larger than the mean transverse diameter. At the base and 1.2 mm and 2.4 mm above the base, the respective transverse diameters of 4 (5%), 13 (15%), and 24 (28%) of the patients were <9.0 mm. None had an odontoid AP diameter of <9.0 mm at any level.. Two 3.5-mm cortical screws appear too big for fixation in one third of our sample presenting with type-II odontoid fracture. Fixation by two 2.7-mm screws is recommended for Malaysians and other Asian populations.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anthropometry; Asian People; Bone Screws; Equipment Design; Female; Humans; Malaysia; Male; Middle Aged; Odontoid Process; Spinal Fractures; Tomography, X-Ray Computed

Topics: Aged; Femoral Fractures; Health Services for the Aged; Humans; Malaysia; Osteoarthritis; Osteoporosis; Spinal Fractures