Outcome after Posterior Vertebral Column Resection in Patients with Severe Osteoporotic Fractures—A Retrospective Analysis from Two Centers

<i<Background and Objectives:</i< In osteoporotic fractures of the spine with resulting kyphosis and threatening compression of neural structures, therapeutic decisions are difficult. The posterior vertebral column resection (pVCR) has been described by different authors as a surgical tr...
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Gespeichert in:

Autor*in:	Leon-Gordian Koepke [verfasserIn] Lukas Weiser [verfasserIn] Martin Stangenberg [verfasserIn] Marc Dreimann [verfasserIn] Annika Heuer [verfasserIn] André Strahl [verfasserIn] Lennart Viezens [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	osteoporotic fractures spine spinal fusion kyphosis osteoporosis geriatrics

Übergeordnetes Werk:	In: Medicina - MDPI AG, 2016, 58(2022), 2, p 277
Übergeordnetes Werk:	volume:58 ; year:2022 ; number:2, p 277

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.3390/medicina58020277

Katalog-ID:	DOAJ01636273X

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520			\|a <i<Background and Objectives:</i< In osteoporotic fractures of the spine with resulting kyphosis and threatening compression of neural structures, therapeutic decisions are difficult. The posterior vertebral column resection (pVCR) has been described by different authors as a surgical treatment in a single-stage posterior procedure. The aim of this study is to evaluate midterm outcomes of patients treated by pVCR due to severe osteoporotic fractures. <i<Materials and Methods:</i< Retrospective data analysis of all the patients treated for osteoporotic fractures by pVCR from 2012–2020 at two centers was performed. Demographic data, visual analog scale (VAS), Frankel scale (FS), Karnofsky performance status (KPS), radiological result and spinal fusion rates were evaluated. <i<Results:</i< A total of 17 patients were included. The mean age was 70 ± 10.2 y. The mean VAS decreased significantly from 7.7 ± 2.8 preoperatively to 3.0 ± 1.6 at last follow-up (<i<p</i< < 0.001) and the segmental kyphosis decreased from 29.4 ± 14.1° to 7.9 ± 8.0° (<i<p</i< < 0.001). The neurologic function on the FS did not worsen in any and improved in four of the patients. The median KPS remained stable over the whole observation period (70% vs. 70%). Spinal fusion was observed in nine out of nine patients who received CT follow-up <120 days after index surgery. <i<Conclusions:</i< This study showed that pVCR is a safe surgical technique with few surgical complications and no neurological deterioration considering the cohort. The patients’ segmental kyphosis and VAS improved significantly, while the KPS remained stable.
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spelling	10.3390/medicina58020277 doi (DE-627)DOAJ01636273X (DE-599)DOAJ272349ba6865487cbccd20088377822f DE-627 ger DE-627 rakwb eng R5-920 Leon-Gordian Koepke verfasserin aut Outcome after Posterior Vertebral Column Resection in Patients with Severe Osteoporotic Fractures—A Retrospective Analysis from Two Centers 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives:</i< In osteoporotic fractures of the spine with resulting kyphosis and threatening compression of neural structures, therapeutic decisions are difficult. The posterior vertebral column resection (pVCR) has been described by different authors as a surgical treatment in a single-stage posterior procedure. The aim of this study is to evaluate midterm outcomes of patients treated by pVCR due to severe osteoporotic fractures. <i<Materials and Methods:</i< Retrospective data analysis of all the patients treated for osteoporotic fractures by pVCR from 2012–2020 at two centers was performed. Demographic data, visual analog scale (VAS), Frankel scale (FS), Karnofsky performance status (KPS), radiological result and spinal fusion rates were evaluated. <i<Results:</i< A total of 17 patients were included. The mean age was 70 ± 10.2 y. The mean VAS decreased significantly from 7.7 ± 2.8 preoperatively to 3.0 ± 1.6 at last follow-up (<i<p</i< < 0.001) and the segmental kyphosis decreased from 29.4 ± 14.1° to 7.9 ± 8.0° (<i<p</i< < 0.001). The neurologic function on the FS did not worsen in any and improved in four of the patients. The median KPS remained stable over the whole observation period (70% vs. 70%). Spinal fusion was observed in nine out of nine patients who received CT follow-up <120 days after index surgery. <i<Conclusions:</i< This study showed that pVCR is a safe surgical technique with few surgical complications and no neurological deterioration considering the cohort. The patients’ segmental kyphosis and VAS improved significantly, while the KPS remained stable. osteoporotic fractures spine spinal fusion kyphosis osteoporosis geriatrics Medicine (General) Lukas Weiser verfasserin aut Martin Stangenberg verfasserin aut Marc Dreimann verfasserin aut Annika Heuer verfasserin aut André Strahl verfasserin aut Lennart Viezens verfasserin aut In Medicina MDPI AG, 2016 58(2022), 2, p 277 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:58 year:2022 number:2, p 277 https://doi.org/10.3390/medicina58020277 kostenfrei https://doaj.org/article/272349ba6865487cbccd20088377822f kostenfrei https://www.mdpi.com/1648-9144/58/2/277 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 58 2022 2, p 277
allfields_unstemmed	10.3390/medicina58020277 doi (DE-627)DOAJ01636273X (DE-599)DOAJ272349ba6865487cbccd20088377822f DE-627 ger DE-627 rakwb eng R5-920 Leon-Gordian Koepke verfasserin aut Outcome after Posterior Vertebral Column Resection in Patients with Severe Osteoporotic Fractures—A Retrospective Analysis from Two Centers 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives:</i< In osteoporotic fractures of the spine with resulting kyphosis and threatening compression of neural structures, therapeutic decisions are difficult. The posterior vertebral column resection (pVCR) has been described by different authors as a surgical treatment in a single-stage posterior procedure. The aim of this study is to evaluate midterm outcomes of patients treated by pVCR due to severe osteoporotic fractures. <i<Materials and Methods:</i< Retrospective data analysis of all the patients treated for osteoporotic fractures by pVCR from 2012–2020 at two centers was performed. Demographic data, visual analog scale (VAS), Frankel scale (FS), Karnofsky performance status (KPS), radiological result and spinal fusion rates were evaluated. <i<Results:</i< A total of 17 patients were included. The mean age was 70 ± 10.2 y. The mean VAS decreased significantly from 7.7 ± 2.8 preoperatively to 3.0 ± 1.6 at last follow-up (<i<p</i< < 0.001) and the segmental kyphosis decreased from 29.4 ± 14.1° to 7.9 ± 8.0° (<i<p</i< < 0.001). The neurologic function on the FS did not worsen in any and improved in four of the patients. The median KPS remained stable over the whole observation period (70% vs. 70%). Spinal fusion was observed in nine out of nine patients who received CT follow-up <120 days after index surgery. <i<Conclusions:</i< This study showed that pVCR is a safe surgical technique with few surgical complications and no neurological deterioration considering the cohort. The patients’ segmental kyphosis and VAS improved significantly, while the KPS remained stable. osteoporotic fractures spine spinal fusion kyphosis osteoporosis geriatrics Medicine (General) Lukas Weiser verfasserin aut Martin Stangenberg verfasserin aut Marc Dreimann verfasserin aut Annika Heuer verfasserin aut André Strahl verfasserin aut Lennart Viezens verfasserin aut In Medicina MDPI AG, 2016 58(2022), 2, p 277 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:58 year:2022 number:2, p 277 https://doi.org/10.3390/medicina58020277 kostenfrei https://doaj.org/article/272349ba6865487cbccd20088377822f kostenfrei https://www.mdpi.com/1648-9144/58/2/277 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 58 2022 2, p 277
allfieldsGer	10.3390/medicina58020277 doi (DE-627)DOAJ01636273X (DE-599)DOAJ272349ba6865487cbccd20088377822f DE-627 ger DE-627 rakwb eng R5-920 Leon-Gordian Koepke verfasserin aut Outcome after Posterior Vertebral Column Resection in Patients with Severe Osteoporotic Fractures—A Retrospective Analysis from Two Centers 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives:</i< In osteoporotic fractures of the spine with resulting kyphosis and threatening compression of neural structures, therapeutic decisions are difficult. The posterior vertebral column resection (pVCR) has been described by different authors as a surgical treatment in a single-stage posterior procedure. The aim of this study is to evaluate midterm outcomes of patients treated by pVCR due to severe osteoporotic fractures. <i<Materials and Methods:</i< Retrospective data analysis of all the patients treated for osteoporotic fractures by pVCR from 2012–2020 at two centers was performed. Demographic data, visual analog scale (VAS), Frankel scale (FS), Karnofsky performance status (KPS), radiological result and spinal fusion rates were evaluated. <i<Results:</i< A total of 17 patients were included. The mean age was 70 ± 10.2 y. The mean VAS decreased significantly from 7.7 ± 2.8 preoperatively to 3.0 ± 1.6 at last follow-up (<i<p</i< < 0.001) and the segmental kyphosis decreased from 29.4 ± 14.1° to 7.9 ± 8.0° (<i<p</i< < 0.001). The neurologic function on the FS did not worsen in any and improved in four of the patients. The median KPS remained stable over the whole observation period (70% vs. 70%). Spinal fusion was observed in nine out of nine patients who received CT follow-up <120 days after index surgery. <i<Conclusions:</i< This study showed that pVCR is a safe surgical technique with few surgical complications and no neurological deterioration considering the cohort. The patients’ segmental kyphosis and VAS improved significantly, while the KPS remained stable. osteoporotic fractures spine spinal fusion kyphosis osteoporosis geriatrics Medicine (General) Lukas Weiser verfasserin aut Martin Stangenberg verfasserin aut Marc Dreimann verfasserin aut Annika Heuer verfasserin aut André Strahl verfasserin aut Lennart Viezens verfasserin aut In Medicina MDPI AG, 2016 58(2022), 2, p 277 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:58 year:2022 number:2, p 277 https://doi.org/10.3390/medicina58020277 kostenfrei https://doaj.org/article/272349ba6865487cbccd20088377822f kostenfrei https://www.mdpi.com/1648-9144/58/2/277 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 58 2022 2, p 277
allfieldsSound	10.3390/medicina58020277 doi (DE-627)DOAJ01636273X (DE-599)DOAJ272349ba6865487cbccd20088377822f DE-627 ger DE-627 rakwb eng R5-920 Leon-Gordian Koepke verfasserin aut Outcome after Posterior Vertebral Column Resection in Patients with Severe Osteoporotic Fractures—A Retrospective Analysis from Two Centers 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives:</i< In osteoporotic fractures of the spine with resulting kyphosis and threatening compression of neural structures, therapeutic decisions are difficult. The posterior vertebral column resection (pVCR) has been described by different authors as a surgical treatment in a single-stage posterior procedure. The aim of this study is to evaluate midterm outcomes of patients treated by pVCR due to severe osteoporotic fractures. <i<Materials and Methods:</i< Retrospective data analysis of all the patients treated for osteoporotic fractures by pVCR from 2012–2020 at two centers was performed. Demographic data, visual analog scale (VAS), Frankel scale (FS), Karnofsky performance status (KPS), radiological result and spinal fusion rates were evaluated. <i<Results:</i< A total of 17 patients were included. The mean age was 70 ± 10.2 y. The mean VAS decreased significantly from 7.7 ± 2.8 preoperatively to 3.0 ± 1.6 at last follow-up (<i<p</i< < 0.001) and the segmental kyphosis decreased from 29.4 ± 14.1° to 7.9 ± 8.0° (<i<p</i< < 0.001). The neurologic function on the FS did not worsen in any and improved in four of the patients. The median KPS remained stable over the whole observation period (70% vs. 70%). Spinal fusion was observed in nine out of nine patients who received CT follow-up <120 days after index surgery. <i<Conclusions:</i< This study showed that pVCR is a safe surgical technique with few surgical complications and no neurological deterioration considering the cohort. The patients’ segmental kyphosis and VAS improved significantly, while the KPS remained stable. osteoporotic fractures spine spinal fusion kyphosis osteoporosis geriatrics Medicine (General) Lukas Weiser verfasserin aut Martin Stangenberg verfasserin aut Marc Dreimann verfasserin aut Annika Heuer verfasserin aut André Strahl verfasserin aut Lennart Viezens verfasserin aut In Medicina MDPI AG, 2016 58(2022), 2, p 277 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:58 year:2022 number:2, p 277 https://doi.org/10.3390/medicina58020277 kostenfrei https://doaj.org/article/272349ba6865487cbccd20088377822f kostenfrei https://www.mdpi.com/1648-9144/58/2/277 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 58 2022 2, p 277
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author	Leon-Gordian Koepke
spellingShingle	Leon-Gordian Koepke misc R5-920 misc osteoporotic fractures misc spine misc spinal fusion misc kyphosis misc osteoporosis misc geriatrics misc Medicine (General) Outcome after Posterior Vertebral Column Resection in Patients with Severe Osteoporotic Fractures—A Retrospective Analysis from Two Centers
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topic_title	R5-920 Outcome after Posterior Vertebral Column Resection in Patients with Severe Osteoporotic Fractures—A Retrospective Analysis from Two Centers osteoporotic fractures spine spinal fusion kyphosis osteoporosis geriatrics
topic	misc R5-920 misc osteoporotic fractures misc spine misc spinal fusion misc kyphosis misc osteoporosis misc geriatrics misc Medicine (General)
topic_unstemmed	misc R5-920 misc osteoporotic fractures misc spine misc spinal fusion misc kyphosis misc osteoporosis misc geriatrics misc Medicine (General)
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title	Outcome after Posterior Vertebral Column Resection in Patients with Severe Osteoporotic Fractures—A Retrospective Analysis from Two Centers
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title_full	Outcome after Posterior Vertebral Column Resection in Patients with Severe Osteoporotic Fractures—A Retrospective Analysis from Two Centers
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title_sort	outcome after posterior vertebral column resection in patients with severe osteoporotic fractures—a retrospective analysis from two centers
callnumber	R5-920
title_auth	Outcome after Posterior Vertebral Column Resection in Patients with Severe Osteoporotic Fractures—A Retrospective Analysis from Two Centers
abstract	<i<Background and Objectives:</i< In osteoporotic fractures of the spine with resulting kyphosis and threatening compression of neural structures, therapeutic decisions are difficult. The posterior vertebral column resection (pVCR) has been described by different authors as a surgical treatment in a single-stage posterior procedure. The aim of this study is to evaluate midterm outcomes of patients treated by pVCR due to severe osteoporotic fractures. <i<Materials and Methods:</i< Retrospective data analysis of all the patients treated for osteoporotic fractures by pVCR from 2012–2020 at two centers was performed. Demographic data, visual analog scale (VAS), Frankel scale (FS), Karnofsky performance status (KPS), radiological result and spinal fusion rates were evaluated. <i<Results:</i< A total of 17 patients were included. The mean age was 70 ± 10.2 y. The mean VAS decreased significantly from 7.7 ± 2.8 preoperatively to 3.0 ± 1.6 at last follow-up (<i<p</i< < 0.001) and the segmental kyphosis decreased from 29.4 ± 14.1° to 7.9 ± 8.0° (<i<p</i< < 0.001). The neurologic function on the FS did not worsen in any and improved in four of the patients. The median KPS remained stable over the whole observation period (70% vs. 70%). Spinal fusion was observed in nine out of nine patients who received CT follow-up <120 days after index surgery. <i<Conclusions:</i< This study showed that pVCR is a safe surgical technique with few surgical complications and no neurological deterioration considering the cohort. The patients’ segmental kyphosis and VAS improved significantly, while the KPS remained stable.
abstractGer	<i<Background and Objectives:</i< In osteoporotic fractures of the spine with resulting kyphosis and threatening compression of neural structures, therapeutic decisions are difficult. The posterior vertebral column resection (pVCR) has been described by different authors as a surgical treatment in a single-stage posterior procedure. The aim of this study is to evaluate midterm outcomes of patients treated by pVCR due to severe osteoporotic fractures. <i<Materials and Methods:</i< Retrospective data analysis of all the patients treated for osteoporotic fractures by pVCR from 2012–2020 at two centers was performed. Demographic data, visual analog scale (VAS), Frankel scale (FS), Karnofsky performance status (KPS), radiological result and spinal fusion rates were evaluated. <i<Results:</i< A total of 17 patients were included. The mean age was 70 ± 10.2 y. The mean VAS decreased significantly from 7.7 ± 2.8 preoperatively to 3.0 ± 1.6 at last follow-up (<i<p</i< < 0.001) and the segmental kyphosis decreased from 29.4 ± 14.1° to 7.9 ± 8.0° (<i<p</i< < 0.001). The neurologic function on the FS did not worsen in any and improved in four of the patients. The median KPS remained stable over the whole observation period (70% vs. 70%). Spinal fusion was observed in nine out of nine patients who received CT follow-up <120 days after index surgery. <i<Conclusions:</i< This study showed that pVCR is a safe surgical technique with few surgical complications and no neurological deterioration considering the cohort. The patients’ segmental kyphosis and VAS improved significantly, while the KPS remained stable.
abstract_unstemmed	<i<Background and Objectives:</i< In osteoporotic fractures of the spine with resulting kyphosis and threatening compression of neural structures, therapeutic decisions are difficult. The posterior vertebral column resection (pVCR) has been described by different authors as a surgical treatment in a single-stage posterior procedure. The aim of this study is to evaluate midterm outcomes of patients treated by pVCR due to severe osteoporotic fractures. <i<Materials and Methods:</i< Retrospective data analysis of all the patients treated for osteoporotic fractures by pVCR from 2012–2020 at two centers was performed. Demographic data, visual analog scale (VAS), Frankel scale (FS), Karnofsky performance status (KPS), radiological result and spinal fusion rates were evaluated. <i<Results:</i< A total of 17 patients were included. The mean age was 70 ± 10.2 y. The mean VAS decreased significantly from 7.7 ± 2.8 preoperatively to 3.0 ± 1.6 at last follow-up (<i<p</i< < 0.001) and the segmental kyphosis decreased from 29.4 ± 14.1° to 7.9 ± 8.0° (<i<p</i< < 0.001). The neurologic function on the FS did not worsen in any and improved in four of the patients. The median KPS remained stable over the whole observation period (70% vs. 70%). Spinal fusion was observed in nine out of nine patients who received CT follow-up <120 days after index surgery. <i<Conclusions:</i< This study showed that pVCR is a safe surgical technique with few surgical complications and no neurological deterioration considering the cohort. The patients’ segmental kyphosis and VAS improved significantly, while the KPS remained stable.
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title_short	Outcome after Posterior Vertebral Column Resection in Patients with Severe Osteoporotic Fractures—A Retrospective Analysis from Two Centers
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Outcome after Posterior Vertebral Column Resection in Patients with Severe Osteoporotic Fractures—A Retrospective Analysis from Two Centers

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