Domino Effect: mechanic factors role

Nardi, Alfredo and Tarantino, Umberto and Ventura, Lorenzo and Armotti, Pierantonio and Resmini, Giuseppina and Cozzi, Luisella and Tonini, Greta and Ramazzina, Emilio and Rossini, Maurizio (2011) Domino Effect: mechanic factors role. Clinical cases in mineral and bone metabolism, 8 (2). pp. 38-42. ISSN 1971-3266

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Abstract

The rapid onset of the Domino Effect following the first Vertebral Compression Fracture is a direct consequence of the mechanical variations that affect the spine when physiological curves are modified. The degree of kyphosis influences the intensity of the Flexor Moment; this is greater on vertebrae D7, D8 and on vertebrae D12, L1 when the spine flexes. Fractures of D7, D8, D12 and L1 are, by far, the most frequent and also the main cause of the mechanical alterations that can trigger the Domino Effect. For these considerations vertebrae D7, D8, D12 and L1 have to be taken in consideration as “critical". In the case of critical clinical vertebral fractures it is useful to provide an indication for minimally invasive surgical reduction or intrasomatic stabilization. When occurs a fracture of a “critical vertebra”, prompt restoration of the heights leads to a reduction in the Kyphosis Index and therefore in the Flexor Moment, not only of the fractured vertebra but also, in turn, of all the other metameres which, even if morphologically still intact, are structurally fragile; so, through the restoration of the mechanical vertebral proprieties, we can reduce the risk of the Domino Effect. At the same time the prompt implementation of osteoinductive therapy is indispensable in order to achieve rapid and intense reconstruction of the trabecular bone, the strength of which increases significantly in a short period of time. Clinical studies are necessary to confirm the reduction of the domino effect following a fragility fracture of "critical vertebrae" with the restoration of the mechanical properties together with anabolic therapy

Item Type:	Article
Uncontrolled Keywords:	Vertebral Compression Fracture (VCF); Vertebral Compression Fractures (VCFs); Domino Effect (DE); Flexor Moment (FM); Kyphosis Index(KI); Vertebral Deformity Degree (VDD); Vertebral Deformity Exacerbation Rate(VDER); Vertebral Deformity Gain (VDG); Polymethylmethacrylate (PMMA)
Subjects:	600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 611 Anatomia; Citologia; Istologia umana > 611.7 Sistema muscoloscheletrico, tegumento
Depositing User:	Danilo Dezzi
Date Deposited:	09 Jan 2014 12:52
Last Modified:	09 Jan 2014 12:52
URI:	http://eprints.bice.rm.cnr.it/id/eprint/5998

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