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Background: Percutaneous vertebroplasty (PVP) has been gradually used for osteoporotic vertebral compression fracture (OVCF) treatment, but severe osteoporotic vertebral body compression fractures (sOVCFs) due to the difficulty in performing a puncture and the characteristics of the fractured vertebrae, it has been considered as a contraindication to PVP. The aim of the following study was to evaluate the feasibility of a unilateral, three-dimensional (3D), accurate puncture in percutaneous vertebroplasty (PVP) for a single, severely osteoporotic vertebral body compression fracture (ssOVCFs). Materials and Methods: 57 patients received PVP in the current study. Feasibility of a unilateral approach was judged before surgery using the 64-slice helical computed tomography (CT) multiplanar reconstruction technique, a 3D accurate puncture plan was then determined. The skin bone distance, puncture angle and needle insertion depth were recorded during surgery. 2D CT rechecking was performed for any complication at day 1 after operation. Preoperative and postoperative numerical data were compared. Results: The procedure was completed smoothly in all patients. 2D CT scanning at day 1 after operation did not show any puncture related complications. Visual analog scoring (VAS) showed that the score at day 3 after surgery was reduced to 1.7 ± 0.4 (0-2.9 scale) from the preoperative 7.9 ± 2.1 (6.1-9.5 scale). No significant differences in measure numerical data were found before and after the surgery. At 12 months followup three patients presented with nonadjacent level fractures, VAS for other patients were 1.2 ± 0.3 (0-2.1 scale). Conclusions: Application of CT scanning for a unilateral 3D puncture design helps realize an accurate puncture in PVP. It is a safe and effective method for ssOVCFs treatment. [ABSTRACT FROM AUTHOR]

The present retrospective study aimed to investigate the mid-term safety and efficacy of hepatectomy combined with microwave ablation of the partial spleen for treatment of liver cancer complicated with hypersplenism. A retrospective analysis was performed on 23 patients who underwent hepatectomy combined with microwave ablation of the partial spleen for liver cancer, complicated with hypersplenism that was secondary to cirrhosis. The splenic and ablated volumes were calculated according to a contrast-enhanced computed tomography scan prior to and 2 weeks after the operation. Complete blood count and liver function tests were examined prior to and following the surgery, and complications and changes in the blood tests were monitored for 6 months. Over this period of investigation, the splenic volume was reduced by a mean value of 34.0%. The levels of serum alanine aminotransferase and aspartate aminotransferase were increased on the first day after the operation (P<0.05), although they recovered to the normal level within 1 week (P<0.05). The total level of bilirubin increased slightly, along with moderately decreased levels of albumin and cholinesterase on the first day, although these changes were not significant compared with the baseline (P>0.05). The white blood cell count was persistently significantly higher compared with the baseline over the course of the 6 months (P>0.05). The platelet count did not increase significantly for the first week after the operation (P>0.05); however, it was revealed to be significantly increased 1 month after the surgery (P<0.05). No significant complications were occurred during the follow-up period. In conclusion, hepatectomy combined with microwave ablation of the spleen was demonstrated to be a safe and effective procedure for patients with liver cancer and hypersplenism in the mid-term. [ABSTRACT FROM AUTHOR]