Perioperative prevalence of deep vein thrombosis in patients with percutaneous kyphoplasty: A retrospective study with routine ultrasonography

Vertebroplasty in geriatric patients with osteoporotic vertebral fractures: single-center cohort study at a level 1 center for spinal surgery

Study design

Retrospective single-center cohort study.

Background

The spine is the most common anatomic site for osteoporotic fractures. Osteoporotic vertebral fractures play an increasingly important role in geriatric patients and percutaneous vertebroplasty (PVP) constitutes a common treatment option. The aim of this study was to evaluate the safety and efficacy of PVP in geriatric patients with cardiovascular comorbidities at our center.

Methods

In this retrospective single-center study, 49 patients aged ≥ 65 with a total of 88 vertebral fractures underwent vertebroplasty. MRI and CT scans of the spine were performed in all patients prior to surgery. All patients were evaluated 4 weeks after surgery as part of their clinical follow-up. VAS scores were recorded before and after the operation. Postoperative complications within 30 days of the initial surgery were analyzed.

Results

The mean age of patients was 77 years (± 6.4). Of the 49 patients, 39 (80%) were female, and 36 (76%) had cardiovascular comorbidities. The most frequent postoperative complications were cement leakage with no new neurological postoperative deficits (14.3%). The in-hospital mortality rate was 1 out of 49 patients (2%). VAS scores revealed an overall pain reduction of > 97%. None of the following affected patient safety: ASA, BMI, duration of surgery, or the level or localization of vertebroplasty.

Conclusions

Our data demonstrate that vertebroplasty was a feasible and effective treatment for pain reduction in geriatric patients with osteoporotic fractures despite cardiovascular comorbidities.

Level of evidence

3.

The Best Evidence for the Prevention and Management of Lower Extremity Deep Venous Thrombosis After Gynecological Malignant Tumor Surgery: A Systematic Review and Network Meta-Analysis

Background:

To search and obtain the relevant evidence of prevention and management of lower extremity deep venous thrombosis (DVT) after gynecological malignant tumor operation and to summarize the relevant evidence.

Methods

We searched the JBI evidence summary, up to date, the national comprehensive cancer network of the United States, the guide library of the National Institute of clinical medicine of the United Kingdom, PubMed, the Chinese biomedical literature database, CNKI, Wanfang, and other relevant evidence on the prevention and management of DVT in patients with gynecological malignant tumors. It includes clinical practice guidelines, best practice information book, expert consensus, evidence summary, original research, etc. The retrieval time limit is from database establishment till August 20, 2021. Two researchers independently evaluated the literature quality, combined with professional judgment, and extracted the literature that met the standards.

Results

Finally, 18 literatures were included, including eight guidelines, three evidence summaries, four systematic evaluations, two expert consensuses, and one best practice information volume. A total of 26 pieces of the best evidence on the prevention and management of postoperative venous thrombosis in gynecological malignant tumors were summarized. It includes risk assessment, drug prevention, mechanical prevention, management strategy, and health education.

Conclusion

This study summarized the best evidence of risk, prevention, and health management of DVT in postoperative patients with gynecological malignant tumors to provide evidence-based basis for clinical nurses and to improve the nursing level.