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Lumbar burst fracture

Jingmin Li, Lihua Guo, Yuancheng Li, Zhenkun Lei, Yuanchang Liu, Weiping Shi, Tao Li, Weikang Li, Chong Liu
Open surgery is currently the main treatment method for the lumbar burst fracture with neurological deficit but may irreversibly disrupt the lumbar anatomy. The minimally invasive surgery (MIS) techniques have recently gained increasing attention. However, their use is still limited to lumbar burst fractures mainly due to their difficulties in burst fracture reduction and decompression. Here we present a novel bio-inspired MIS device which can be used with an endoscope to reset the bone fragments retropulsed into the spinal canal within the wounded vertebral body...
2016: Bioinspiration & Biomimetics
Yu Qian, Zhen Lin, Cong Jin, Xing Zhao, Minghao Zheng
STUDY DESIGN: Surgical approach development in an animal model, and a prospective study comparing clinical outcomes between novel and conventional approaches in thoracolumbar burst fracture fixation. OBJECTIVE: To investigate the feasibility of a less-invasive retroperitoneal approach to the lumbar spine in a sheep model and to compare the clinical outcomes of anterior reconstruction in the treatment of thoracolumbar burst fractures using novel and conventional approaches...
June 28, 2016: Clinical Spine Surgery
Azad Sait, Nadipi Reddy Prabhav, Vijay Sekharappa, Reshma Rajan, N Arunai Nambi Raj, Kenny Samuel David
OBJECTIVE There has been a transition from long- to short-segment instrumentation for unstable burst fractures to preserve motion segments. Circumferential fixation allows a stable short-segment construct, but the associated morbidity and complications are high. Posterior short-segment fixation spanning one level above and below the fractured vertebra has led to clinical failures. Augmentation of this method by including the fractured level in the posterior instrumentation has given promising clinical results...
June 10, 2016: Journal of Neurosurgery. Spine
Vaner Koksal, Selcuk Coskun, Pinar Koksal Coskun
Patients with vertebral fractures are frequently encountered and those with thoracic and lumbar spine fractures are likely to have associated injuries. Detection of a widened mediastinum after trauma is very nonspecific and most of the time it is related to aortic injury or mediastinal hematoma. Vertebral or sternal fractures can also be the cause of mediastinal hematoma with or without aortic injury. This report reviews an unusual case of rapid onset mediastinal hematoma due to vertebral fracture after a fall...
December 2015: Turkish Journal of Emergency Medicine
Tayfun Hakan, Ajlan Çerçi, Serkan Gürcan, Serkan Akçay
BACKGROUND: Uncertainty still exists regarding the treatment of the patients presenting with gunshot wounds to the spine. Neurological insults, cerebrospinal fluid fistula, infection, lead or copper toxicity, migration of bullets, and spinal instability are included among the common challenging issues. CASE DESCRIPTION: An 18-year-old woman was admitted with low back pain following a gunshot injury five days ago. She was neurologically intact. Radiological examinations showed that a bullet was settled in L4-5 disc space...
2016: Surgical Neurology International
Jin Hyuk Bang, Keun-Tae Cho
Cauda equina syndrome (CES) is often defined as a complex of symptoms and signs consisting of low back pain, bilateral sciatica, lower extremity weakness, saddle anesthesia, and bowel and bladder dysfunction. CES is considered to be neurosurgical emergency. Delayed or missed diagnosis of CES can result in serious morbidity and neurological sequelae. However, the diagnosis of CES is often difficult when one or more of these symptoms are absent or when these symptoms develop asymmetrically or incompletely. We report a case of urinary retention and sphincter dysfunction without sciatica or motor weakness following an L3 burst fracture in a 52-year-old male and discuss the atypical presentation of CES and treatment of traumatic CES...
October 2015: Korean Journal of Neurotrauma
Christina Ble, Parmenion P Tsitsopoulos, Dimitrios M Anestis, Sofia Hadjileontiadou, Triantafyllia Koletsa, Maria Papaioannou, Christos Tsonidis
Osteoporotic vertebral fractures are uncommon in young adults and usually indicate an underlying disease. Systemic mastocytosis is a myeloproliferative neoplasm, which can be associated with osteoporosis. A previously healthy 30-year-old man presented with an L4 burst fracture after lifting a heavy object. He was operated with laminectomy and posterior lumbar instrumentation. During surgery, abnormally soft bone was noted. Postoperatively, osteoporosis was confirmed with measurement of bone mineral density...
2016: Journal of Surgical Case Reports
Jonathan N Sellin, William J Steele, Lauren Simpson, Wei X Huff, Brandon C Lane, Joshua J Chern, Daniel H Fulkerson, Christina M Sayama, Andrew Jea
OBJECTIVE The Thoracolumbar Injury Classification and Severity Score (TLICS) system was developed to streamline injury assessment and guide surgical decision making. To the best of the authors' knowledge, external validation in the pediatric age group has not been undertaken prior to this report. METHODS This study evaluated the use of the TLICS in a large retrospective series of children and adolescents treated at 4 pediatric medical centers (Texas Children's Hospital, Children's Healthcare of Atlanta, Riley Children's Hospital, and Doernbecher Children's Hospital)...
August 2016: Journal of Neurosurgery. Pediatrics
Yong-jun Hua, Ren-yan Wang, Zhi-hui Guo, Cun-hong Shu, Chao-hua Li
OBJECTIVE: To compare the clinical curative effect of thoracolumbar burst fracture treated by the posterior unilateral approach corpectomy fusion screw-rod fixation and anterior corpectomy bone fusion screw plate fixation. METHODS: From January 2008 to May 2014,36 cases of thoracolumbar burst fracture underwent operation of decompression, fusion, and internal fixation was retrospective analyzed. Among them, 16 patients were treated through posterior approach as posterior group, including 13 males and 3 females aged from 37 to 62 years old; 9 cases caused by falling injury, 3 cases by traffic accident injury,4 cases by heavy aboved;the injury segment was on T₁₂ in 2 cases, L₁ in 5 cases, L₂ in 7 cases, L₃ in 2 cases; according ASIA grade, 3 cases were grade A, 2 cases were grade B, 2 cases were grade C, 5 cases were grade D, 4 cases were grade E; the time between injury and operation ranged from 5 to 15 days...
January 2016: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Anica Eschler, Paula Roepenack, Jan Roesner, Philipp Karl Ewald Herlyn, Heiner Martin, Martin Reichel, Robert Rotter, Brigitte Vollmar, Thomas Mittlmeier, Georg Gradl
INTRODUCTION: Current treatment strategies for osteoporotic vertebral compression fractures (VCFs) focus on cement-associated solutions. Complications associated with cement application are leakage, embolism, adjacent fractures, and compromise in bony healing. This study comprises a validated VCF model in osteoporotic sheep in order to (1) evaluate a new cementless fracture fixation technique using titanium mesh implants (TMIs) and (2) demonstrate the healing capabilities in osteoporotic VCFs...
2016: BioMed Research International
Shirzad Azhari, Parisa Azimi, Sohrab Shahzadi, Hassan Reza Mohammadi, Hamid Reza Khayat Kashani
STUDY DESIGN: Cross-sectional. PURPOSE: To develop a strategy to determine a sound method for decision-making based on postoperative clinical outcome satisfaction. OVERVIEW OF LITERATURE: The ideal management of thoracolumbar and lumbar burst fractures (TLBF) without neurological compromise remains controversial. METHODS: This was a prospective study. Patients with thoracolumbar injury severity and classification score (TLICS) <4 were treated nonoperatively, with bed rest and bracing until the pain decreased sufficiently to allow mobilization...
February 2016: Asian Spine Journal
Mao-sheng Zhou, Jia-bing Xie, Guo-zheng Ding, Qiang Wang, Zhu-jun Xu, Chao Fang, Min Yang
OBJECTIVE: To observe clinical effects of posterior short-segment fixation with undermining decompress by posterior ligament complex for the treatment of upper lumbar burst fractures. METHODS: From October 2010 to March 2013,23 patients with upper lumbar burst fractures (Denis B type) were treated by posterior short-segment fixation with undermining decompress by posterior ligament complex. There were 18 males and 5 females aged from 26 to 64 years old with an average of 45...
December 2015: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Yvan Petit, Dominic Boisclair, Stefan Parent, Jean-Marc Mac-Thiong
This work presents a novel method creating high energy vertebral fractures on complete swine specimens to investigate realistic vertebral fracture mechanisms. An apparatus was developed to maintain a porcine specimen in an upright position and apply a caudal impact simulating a fall. Five mature minipigs were impacted with varying impact magnitude. Computed tomography scans were used to assess the resulting fracture type, fracture level, spinal canal encroachment and fractures of adjacent bony structures. Lumbar fractures were produced on four specimens: three inferior endplate burst fractures (L2) and one superior endplate burst fracture (L5)...
2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
P-H Chou, H-L Ma, C-L Liu, S-T Wang, O K Lee, M-C Chang, W-K Yu
METHODS: In this study of patients who underwent internal fixation without fusion for a burst thoracolumbar or lumbar fracture, we compared the serial changes in the injured disc height (DH), and the fractured vertebral body height (VBH) and kyphotic angle between patients in whom the implants were removed and those in whom they were not. Radiological parameters such as injured DH, fractured VBH and kyphotic angle were measured. Functional outcomes were evaluated using the Greenough low back outcome scale and a VAS scale for pain...
January 2016: Bone & Joint Journal
D C Jaffray, S M Eisenstein, B Balain, J M Trivedi, M Newton Ede
AIMS: The authors present the results of a cohort study of 60 adult patients presenting sequentially over a period of 15 years from 1997 to 2012 to our hospital for treatment of thoracic and/or lumbar vertebral burst fractures, but without neurological deficit. METHOD: All patients were treated by early mobilisation within the limits of pain, early bracing for patient confidence and all progress in mobilisation was recorded on video. Initial hospital stay was one week...
January 2016: Bone & Joint Journal
Can Yaldiz, Kıyasettin Asil, Birol Özkal, Davut Ceylan, Tibet Kacira
BACKGROUND: Thoracolumbar burst fractures are common clinical entity encountered in neurosurgical practice, accounting for 10-20% of all spinal fractures. Clinical picture could be devastating due to severe neurological deficits which lead the patients dependent both socially and emotionally. MATERIALS AND METHODS: This study compared two groups of patients who were operated because of thoracolumbar burst fracture secondary to spinal trauma in terms of neurologic deficits, degree of improvement, and radiologic measurements at one-year follow-up...
2015: Neurologia i Neurochirurgia Polska
Remi M Ajiboye, Scott D Nelson, Arya N Shamie
BACKGROUND: Yolk sac tumors (YST) are malignant neoplasms. They are a subtype of germ cell tumors and typically originate in the gonads although extragonadal origins of such tumors have been described. Yolk sac tumors are commonly found in the gonads of infants and children and are extremely rare in adults. The goal of this case report is to describe the clinical presentation of a rare case of metastatic extragonadal yolk sac tumor originating from the mediastinum and causing an acute conus medullaris syndrome in an adult male...
2015: International Journal of Spine Surgery
Markus Loibl, Mariya Korsun, Julian Reiss, Boyko Gueorguiev, Michael Nerlich, Carsten Neumann, Florian Baumann
INTRODUCTION: Surgical management of thoracolumbar trauma involves correction of posttraumatic deformity and placement of transpedicular instrumentation. The aim of this prospective cohort study was to generate first results reflecting the clinical and radiological outcome of patients treated with percutaneous dorsal instrumentation for fractures of the thoracic and lumbar spine with the use of a transpedicular new Schanz Screw system (USS Fracture MIS, DePuy Synthes). METHODS: A total of 26 patients with fractures of the thoracic and lumbar spine were operatively treated with bi-segmental dorsal instrumentation between January and December 2012...
October 2015: Injury
Anica Eschler, Paula Röpenack, Philipp K E Herlyn, Jan Roesner, Kristin Pille, Kirsten Büsing, Brigitte Vollmar, Thomas Mittlmeier, Georg Gradl
INTRODUCTION: Vertebral compression fractures (VCFs) are one of the most common injuries in the aging population presenting with an annual incidence of 1.4 million new cases in Europe. Current treatment strategies focus on cement-associated solutions (kyphoplasty/vertebroplasty techniques). Specific cement-associated problems as leakage, embolism and the adjacent fracture disease are reported adding to open questions like general fracture healing properties of the osteoporotic spine. In order to analyze those queries animal models are of great interest; however, both technical difficulties in the induction of experimental osteoporosis in animal as well as the lack of a standardized fracture model impede current and future in vivo studies...
October 2015: Injury
Bryan M Saltzman, David M Levy, Venus Vakhshori, Christopher J DeWald
This case report presents two patients who underwent fibular strut grafting for complex revisions of previous lumbar spine arthrodeses. A case review of the Electronic Medical Record at the index institution was performed to evaluate the timeline of events of the two patients who underwent fibular strut grafting for complex revisions of previous lumbar spine arthrodesis, including imaging studies, progress notes, and laboratory results. One patient had developed chronic L3 vertebral body osteomyelitis from a prior fibular allograft and instrumentation placed for a traumatic burst fracture...
September 2015: Korean Journal of Spine
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