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Surgical techniques for patients with cancer-related neuropathic pain.

In this manuscript, we discuss the use of neuromodulatory techniques such as intrathecal therapy (IT) and spinal cord stimulation (SCS) for cancer pain in neuro-oncology patients. Currently, cancer pain management relies on oral opioids, which have a number of systemic side effects particularly in a chronic setting. An escalation of pain therapy for pain relief, such as neuromodulation, is necessary to improve neuro-oncology patients' quality of life. The paper highlights the need for more comprehensive pain management for patients during and after receiving cancer therapies. IT allows analges

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… indicated with an Ommaya reservoir or high cervical catheter 18 , 32 Pain associated with vertebral and sacral metastases | Pathologic fracture or to damage of structures surrounding the metastases | IT with morphine, bupivacaine, and clonidine in combination with injections, radiofrequency ablations, and kyphoplasty-sacroplasty …

Development of a Multimodal Machine Learning Model for Predicting Second Osteoporotic Vertebral Compression Fractures.

PURPOSE: Osteoporosis increases the probability of osteoporotic vertebral compression fractures (OVCF), and the resultant pain severely limits physical activity and increases mortality and morbidity. This study aimed to develop a high-precision multimodal prediction model to forecast the risk of a second OVCF. MATERIALS AND METHODS: This retrospective study included 178 patients from a single institution with a first OVCF between January 1, 2000, and December 31, 2019. The study dataset included 18 preoperative clinical variables, including demographics, medications, comorbidities, bone miner

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… Patients who underwent vertebral augmentation (vertebroplasty or kyphoplasty) at the index level remained eligible for inclusion; however, imaging or morphological changes confined to the treated vertebra were not considered second OVCF. …

Bisphosphonate-loaded bone cement: Background, clinical indications and future perspectives.

Bisphosphonates represent an established treatment against bone resorption and osseous loss. Local application could help increase bone mineral density while minimizing their systemic use side-effects. Bone cement, used on a large scale in orthopedic surgery and a historically successful drug carrier, could represent an effective scaffold. The aim of this review was to investigate the alterations produced on the cement's structure and properties by this mixture, as well as its antiosteoporotic and antitumor effect. After a thorough research of articles, title screening and duplicate removal we

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… A commercially available BP-loaded bone cement could be used for injection in osteoporotic vertebrae in order to improve bone quality before arriving to a compression fracture or function as a supplementary for already existing procedures such as vertebroplasty and balloon kyphoplasty in order to upgrade …

Myeloma Bone Disease: A Comprehensive Review.

Multiple myeloma (MM) is a neoplastic clonal proliferation of plasma cells in the bone marrow microenvironment, characterized by overproduction of heavy- and light-chain monoclonal proteins (M-protein). These proteins are mainly found in the serum and/or urine. Reduction in normal gammaglobulins (immunoparesis) leads to an increased risk of infection. The primary site of origin is the bone marrow for nearly all patients affected by MM with disseminated marrow involvement in most cases. MM is known to involve bones and result in myeloma bone disease. Osteolytic lesions are seen in 80% of patien

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… Vertebroplasty or Kyphoplasty These are minimal invasive procedures that include percutaneous injection of bone cement into fractured vertebral body for stabilization. … Kyphoplasty in the Treatment of Osteolytic Vertebral Compression Fractures as a Result of Multiple Myeloma J. Clin. Oncol. 2002 20 2382 2387 10.1200/JCO.2002.09.097 11981012 114. Raje N. Roodman G.D. Advances in the Biology and Treatment of Bone Disease in Multiple Myeloma Clin. …

Comprehensive Insights into Metastasis-Associated Spinal Cord Compression: Pathophysiology, Diagnosis, Treatment, and Prognosis: A State-of-the-Art Systematic Review

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… Other methods include laminectomy, minimally invasive endoscopic procedures, and kyphoplasty [ 53 , 54 ]. These techniques offer improved pain relief and functional recovery, especially when combined with stabilization procedures like pedicle screws. …

Pain in blood cancers.

Patients with blood-related cancers (BRC) suffer from a substantial symptom burden, including several pain syndromes sustained by different causes and pathogenetic mechanisms. So, with regard to pain, a multifaceted clinical scenario may be observed in this setting. Indeed, pain may be correlated to disease itself, to disease-associated complications, to iatrogenic causes or may be due to unrelated clinical conditions. A close diagnostic procedure for the assessment of the underlying causes of the pain and of its pathogenetic mechanisms may direct the treatment approach which should be based o

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… In recent years, percutaneous cementoplasty, vertebroplasty and kyphoplasty have been developed to repair spinal fractures and to provide pain relief in patients with multiple myeloma (MM)[ 14 46 ]. …

Rapid Fire Presentations

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Multiple myeloma: an overview of management.

Multiple myeloma represents 2% of all new cancer diagnoses in the United Kingdom and accounts for 2% of all cancer deaths. In the past few decades, there have been huge improvements in life expectancy which have been driven by novel therapeutic agents, autologous stem cell transplants and intensified supportive care. This review will discuss the pathogenesis of multiple myeloma, current management approaches and the direction of future treatments. In addition, this review will highlight the high burden of symptoms that patients experience and therefore the great benefits that can be gained fro

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… All patients with significant spinal disease should be referred to a specialist spinal surgery team for assessment as they may benefit from bracing, vertebroplasty or kyphoplasty. 5 Patients with MM have a weakened immune system and infection is a common cause of presentation and of death, especially …

Prognostic Value of Perioperative Anemia in Neurosurgical-Oncological Treatment of Spinal Metastases.

Neurosurgical resection of spinal metastases is an established treatment option for selected patients with advanced malignancies. However, high perioperative morbidity and mortality may further compromise outcomes in this vulnerable population, emphasizing the need to identify modifiable prognostic factors. Perioperative anemia is common and clinically relevant, yet its impact in this setting remains insufficiently studied. This retrospective, single-center study included 279 patients who underwent surgical treatment for spinal metastases between 2013 and 2025. Patients were stratified into th

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… Surgical options for managing spinal metastases encompass a spectrum, from transpedicular biopsy combined with vertebroplasty/kyphoplasty [ 9 , 10 ], to neurosurgical decompression of the spinal canal [ 11 ], and/or combined with minimally invasive percutaneous surgical procedures [ 12 ], open dorsal …

Анализ боли в скелете, общих симптомов и показателей результатов, сообщаемых пациентами, а также их значения для выявления симптоматического развития - междисциплинарное перспективное исследование у пациентов с множественной миеломой.

Задержка с диагностированием множественной миеломы (ММ) и прогрессирующего заболевания (ПД) может как увеличить риск осложнений в скелете, так и повлиять на качество жизни пациентов (QoL). В этом перспективном исследовании мы проанализировали боль в скелете, общие симптомы и описанные пациентом итоговые показатели (ПРОМ) у пациентов с MM и их значение для выявления симптоматического развития. Мы провели оценку 502 пациенты, 47 с первоначальным диагнозом (ID) MM и 455 Пациенты-последовательницы. В ID, 74% Сообщили о боли в костях, главным образом в позвоночнике. Общие симптомы, особенно усталос

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… The role of cement augmentation with percutaneous vertebroplasty and balloon kyphoplasty for the treatment of vertebral compression fractures in multiple myeloma: a consensus statement from the International Myeloma Working Group (IMWG) Blood Cancer J. 9 2019 27 10.1038/s41408-019-0187-7 30808868 PMC6391474 …

Opportunistic CT for Prediction of Adverse Postoperative Events in Patients with Spinal Metastases.

The purpose of this study was to assess the value of body composition measures obtained from opportunistic abdominal computed tomography (CT) in order to predict hospital length of stay (LOS), 30-day postoperative complications, and reoperations in patients undergoing surgery for spinal metastases. 196 patients underwent CT of the abdomen within three months of surgery for spinal metastases. Automated body composition segmentation and quantifications of the cross-sectional areas (CSA) of abdominal visceral and subcutaneous adipose tissue and abdominal skeletal muscle was performed. From this,

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… Exclusion criteria comprised (1) revision procedures, (2) vertebroplasty or kyphoplasty, (3) absence of L4 level coverage on the CT scan, and (4) metal artifacts on CT scans hindering analysis. …

Oral Presentations

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… ID: AGS26/841 A006: Ultra-early intervention with percutaneous kyphoplasty for acute osteoporotic vertebral compression fractures: efficacy and safety outcomes from a high-volume county hospital center Wenjie Wu 1 , Li Huo 1 , Chuanqi Zou 1 , Junxiong Cao 1 , Boxing Wang 1 , Qian Cheng 1 1 The People's … Hospital of Banan District, Chongqing, China Introduction: The optimal timing for performing percutaneous kyphoplasty (PKP) in acute osteoporotic vertebral compression fractures (OVCFs) remains controversial, particularly regarding the risk of cement leakage in hyperacute cases. …

Факторы риска и клиническое воздействие боли в костях у пациентов с множественной миеломой - перспективное междисциплинарное исследование.

Боль в костях доходит до 80% :: количество пациентов с множественными миеломами (ММ) и значительно ухудшает качество жизни (КОЛ), однако его конкретные прогнозы по-прежнему плохо характеризуются. Определение факторов риска имеет важнейшее значение для раннего вмешательства и индивидуального лечения. МЕТОДЫ: Это перспективное исследование, рассчитанное на один центр 352 Пациенты. Боль в костях регистрируется с использованием стандартного вопросника. Для выявления независимых прогнозов боли в костях использовалась многовариантная логистическая регрессия с поэтапным отбором. QoL и состояние здоро

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… The role of cement augmentation with percutaneous vertebroplasty and balloon kyphoplasty for the treatment of vertebral compression fractures in multiple myeloma: a consensus statement from the international myeloma working group (IMWG) Blood Cancer J. 9 2019 27 10.1038/s41408-019-0187-7 30808868 PMC6391474 …

Outcomes and Complications of Surgery for Symptomatic Spinal Metastases; a Comparison Between Patients Aged ≥ 70 and <70.

Study designRetrospective cohort study.ObjectivePhysicians may be deterred from operating on elderly patients due to fears of poorer outcomes and complications. We aimed to compare the outcomes of surgical treatment of spinal metastases patients aged ≥70-yrs and Materials and methodsThis is a retrospective study of patients surgically treated for metastatic epidural spinal cord compression and spinal instability between January-2005 to December-2021. Follow-up was till death or minimum 1-year post-surgery. Outcomes included post-operative neurological status, ambulatory status, medical and sur

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… Patients <18-yrs, with intradural tumors, primary spinal tumors, previous spine surgery or radiotherapy procedures or who had undergone en-bloc spondylectomy or vertebroplasty/kyphoplasty only were excluded. Patients were operated for spinal instability if the SINS score was 7-18. …

The reporting quality and transparency of orthopaedic studies using Bayesian analysis requires improvement: A systematic review.

BackgroundBayesian methods are being used more frequently in orthopaedics. To advance the use and transparent reporting of Bayesian studies, reporting guidelines have been recommended. There is currently little known about the use or applications of Bayesian analysis in orthopedics including adherence to recommended reporting guidelines. The objective is to investigate the reporting of Bayesian analysis in orthopedic surgery studies; specifically, to evaluate if these papers adhere to reporting guidelines.MethodsWe searched PUBMED to December 2nd, 2020. Two reviewers independently identified s

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… Clin Spine Surg. https://doi.org/10.1097/BSD.0000000000001094 Zhu R–S, Kan S-L, Ning G-Z et al. (2019) Which is the best treatment of osteoporotic vertebral compression fractures: balloon kyphoplasty, percutaneous vertebroplasty, or non-surgical treatment? A Bayesian network meta-analysis. …

Trends in surgical management of spinal metastases in a Singaporean tertiary referral center: a 17-year retrospective review.

IntroductionSurgical treatment is increasingly the treatment of choice in cancer patients with epidural spinal cord compression and spinal instability. There has also been an evolution in surgical treatment with the advent of minimally invasive surgical (MIS) techniques and separation surgery. This paper aims to investigate the changes in epidemiology, surgical technique, outcomes and complications in the last 17 years in a tertiary referral center in Singapore.MethodsThis is a retrospective study of 383 patients with surgically treated spinal metastases treated between January 2005 to January

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… We excluded patients who had primary spine tumors, patients who had previous spinal surgery for spinal metastases and other spinal conditions, and patients who have undergone vertebroplasty, kyphoplasty or other interventional procedures. …

Management of patients with multiple myeloma in the era of COVID-19 pandemic: a consensus paper from the European Myeloma Network (EMN).

Patients with multiple myeloma (MM) seem to be at increased risk for more severe COVID-19 infection and associated complications due to their immunocompromised state, the older age and comorbidities. The European Myeloma Network has provided an expert consensus statement in order to guide therapeutic decisions in the era of the COVID-19 pandemic. Patient education for personal hygiene and social distancing measures, along with treatment individualization, telemedicine and continuous surveillance for early diagnosis of COVID-19 are essential. In countries or local communities where COVID-19 inf

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… The role of cement augmentation with percutaneous vertebroplasty and balloon kyphoplasty for the treatment of vertebral compression fractures in multiple myeloma: a consensus statement from the International Myeloma Working Group (IMWG) Blood Cancer J. 2019;9:27. doi: 10.1038/s41408-019-0187-7. 42. …

Gram-Negative Taxa and Antimicrobial Susceptibility after Fecal Microbiota Transplantation for Recurrent Clostridioides difficile Infection.

Fecal microbiota transplantation (FMT) has promising applications in reducing multidrug-resistant organism (MDRO) colonization and antibiotic resistance (AR) gene abundance. However, data on clinical microbiology results after FMT are limited. We examined the changes in antimicrobial susceptibility profiles in patients with Gram-negative infections in the year before and the year after treatment with FMT for recurrent Clostridioides difficile infection (RCDI). We also examined whether a history of FMT changed health care provider behavior with respect to culture ordering and antibiotic prescri

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… metronidazole, oral vancomycin, oral + rectal vancomycin | Colonoscopy/1 | Fecal DON 2014-2 | Remission | Transient constipation | Until 7 mo post-FMT | | | | | | | | | | | | 202 | 50 | F | Caucasian | Seizures, irritable bowel syndrome, self-reported Crohn’s disease and celiac sprue | Kyphoplasty …

European guidance for the diagnosis and management of osteoporosis in postmenopausal women.

UnlabelledGuidance is provided in a European setting on the assessment and treatment of postmenopausal women at risk of fractures due to osteoporosis.IntroductionThe International Osteoporosis Foundation and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis published guidance for the diagnosis and management of osteoporosis in 2008. This manuscript updates these in a European setting.MethodsSystematic literature reviews.ResultsThe following areas are reviewed: the role of bone mineral density measurement for the diagnosis of osteoporosis and assessment of fr

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… Vertebroplasty and kyphoplasty In patients with recent vertebral fracture in whom pain persists for 2 to 3 weeks despite a well-conducted analgesic programme, injection of cement in the fractured vertebral body without (vertebroplasty) or with preceding balloon inflation (kyphoplasty) may lead to short-term …

National guidelines for diagnosis and treatment of osteoporosis in Slovakia.

BACKGROUND: Osteoporosis is a chronic, systemic skeletal disease characterized by decreased bone mass and microarchitectural deterioration, leading to increased fracture risk. In Slovakia, its prevalence is estimated at 6%, with substantial health, social, and economic burdens. OBJECTIVE: The Slovak national guideline provides an overview for the diagnosis, prevention, and treatment of osteoporosis in Slovakia, reflecting recent scientific advances and recommendations from international bodies. METHODS: The guidelines were developed by a multidisciplinary expert panel and officially adopted

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… Fig. 1 Denosumab treatment algorithm In patients with multiple vertebral fractures due to the rebound phenomenon, based on the data published so far, vertebroplasty or kyphoplasty is not appropriate. …