Suitability of the WHOQOL-BREF for community-dwelling older people in Taiwan

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Title:	Suitability of the WHOQOL-BREF for community-dwelling older people in Taiwan
Authors:	Hwang, HF;Liang, WM;Chiu, YN;Lin, MR
Contributors:	公共衛生學院公衛系;Taipei Med Univ, Inst Injury Prevent & Control, Coll Publ Hlth & Nutr, Taipei 110, Taiwan;Natl Taipei Coll Nursing, Dept Nursing, Taipei, Taiwan;China Med Coll, Dept Publ Hlth, Taichung, Taiwan
Date:	2003
Issue Date:	2010-09-24 13:55:13 (UTC+8)
Publisher:	OXFORD UNIV PRESS
Abstract:	OBJECTIVES: We aimed to evaluate the efficacy of reinforcing short-segment pedicle screw fixation with polymethyl methacrylate (PMMA) vertebroplasty in patients with thoracolumbar burst fractures. METHODS: We enrolled 70 patients with thoracolumbar burst fractures for treatment with short-segment pedicle screw fixation. Fractures in Group A (n = 20) were reinforced with PMMA vertebroplasty during surgery. Group B patients (n = 50) were not treated with PMMA vertebroplasty. Kyphotic deformity, anterior vertebral height, instrument failure rates, and neurological function outcomes were compared between the two groups. RESULTS: Kyphosis correction was achieved in Group A (PMMA vertebroplasty) and Group B (Group A, 6.4 degrees; Group B, 5.4 degrees). At the end of the follow-up period, kyphosis correction was maintained in Group A but lost in Group B (Group A, 0.33-degree loss; Group B, 6.20-degree loss) (P = 0.0001). After surgery, greater anterior vertebral height was achieved in Group A than in Group B (Group A, 12.9%; Group B, 2.3%) (P < 0.001). During follow-up, anterior vertebral height was maintained only in Group A (Group A, 0.13 +/- 4.06%; Group B, -6.17 +/- 1.21 %) (P < 0.001). Patients in both Groups A and B demonstrated good postoperative Denis Pain Scale grades (P1 and P2), but Group A had better results than Group Bin terms of the control of severe and constant pain (P4 and P5) (P < 0.001). The Frankel Performance Scale scores increased by nearly 1 in both Groups A and B. Group B was subdivided into Group B1 and B2. Group 131 consisted of patients who experienced instrument failure, including screw pullout, breakage, disconnection, and dislodgement (n = 11). Group 132 comprised patients from Group B who did not experience instrument failure (n = 39). There were no instrument failures among patients in Group A. Preoperative kyphotic deformity was greater in Group 131 (23.5 +/- 7.9 degrees) than in Group B2 (16.8 +/- 8.40 degrees), P < 0.05. Severe and constant pain (P4 and P5) was noted in 36% of Group B1 patients (P < 0.001), and three of these patients required removal of their implants. CONCLUSION: Reinforcement of short-segment pedicle fixation with PMMA vertebroplasty for the treatment of patients with thoracolumbar burst fracture may achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Good Denis Pain Scale grades and improvement in Frankel Performance Scale scores were found in patients without instrument failure (Groups A and B2). Patients with greater preoperative kyphotic deformity had a higher risk of instrument failure if they did not undergo reinforcement with vertebroplasty. PMMA vertebroplasty offers immediate spinal stability in patients with thoracolumbar burst fractures, decreases the instrument failure rate, and provides better postoperative pain control than without vertebroplasty.
Relation:	AGE AND AGEING 32(6):593-600
Appears in Collections:	[Department of Public Health] Journal articles

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