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https://www.readbyqxmd.com/read/28101655/percutaneous-vertebral-augmentation-in-fragility-fractures-indications-and-limitations
#1
O Gonschorek, S Hauck, T Weiß, V Bühren
INTRODUCTION: There is still no general consensus about the management of osteoporotic vertebral fractures. Recommendations depend on type of fracture, grade of instability, bone quality, and general conditions of the patient. Spontaneous fractures may be considered to be treated different compared to cases with high-velocity trauma. METHODS: According to the DVO, patients without trauma should first be treated conservatively. However, there is no more strict time protocol of 3 or 6 week conservative treatment before operations may be indicated...
January 18, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28093624/osteoporotic-vertebral-body-fractures-of-the-thoracolumbar-spine-indications-and-techniques-of-a-360%C3%A2-stabilization
#2
Ulrich Spiegl, J-S Jarvers, C-E Heyde, C Josten
Unstable vertebral body fragility fractures of the thoracolumbar spine can occur with or without relevant trauma. Initially, a standardized diagnostic algorithm including magnetic resonance tomography is recommended to detect accompanied further vertebral body fractures, to interpret the individual fracture stability, and to screen for relevant traumatic intervertebral disc lesions. Aim of the therapy is to assure fast mobilization and to maintain spinal alignment. Unstable fracture morphology is defined by vertebral body fractures including a relevant defect of the posterior vertebral cortex as well as type B or C fractures...
January 16, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28090452/classifying-thoracolumbar-fractures-role-of-quantitative-imaging
#3
REVIEW
Fernando Ruiz Santiago, Pablo Tomás Muñoz, Elena Moya Sánchez, Marta Revelles Paniza, Alberto Martínez Martínez, Antonio Luis Pérez Abela
This article describes different types of vertebral fractures that affect the thoracolumbar spine and the most relevant contributions of the different classification systems to vertebral fracture management. The vertebral fractures types are based on the three columns model of Denis that includes compression, burst, flexion-distraction and fracture-dislocation types. The most recent classifications systems of these types of fractures are reviewed, including the Thoracolumbar Injury Classification and Severity score (TLICS) and the Arbeitsgemeinschaft für Osteosynthesefragen Spine Thoracolumbar Injury Classification and Severity score (AOSpine-TLICS)...
December 2016: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/28089837/direct-midline-posterior-corpectomy-and-fusion-of-a-lumbar-burst-fracture-with-retrospondyloptosis-a-case-report
#4
Arthur Carminucci, Rachid Assina, R Nick Hernandez, Ira M Goldstein
BACKGROUND: Traumatic burst fractures of the lumbar spine can result in significant neurological injury and mechanical instability. The ideal surgical approach for the treatment of unstable lumbar spine burst fractures remains debatable. CASE DESCRIPTION: A 37 year-old male presented with severe neurological injury including loss of motor function below the level of the iliopsoas muscles bilaterally, saddle anesthesia, and absent rectal tone, following a fall from 60 ft...
January 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28050455/outcomes-of-short-segment-posterior-instrumentation-in-unstable-thoracolumbar-fractures
#5
Sharvil H Gajjar, Hari J Menon, Nitin Chaudhari, Vipul Chaudhari
INTRODUCTION: The spinal traumas are common and leading problem in orthopaedics practice. The individuals are at a risk of high energy trauma in modern era. Unstable thoracolumbar burst fractures are serious injuries of concern, if left untreated may result in marked morbidity and disability to the patient. Thoracolumbar is the second most common segment involved in the spinal cord following spinal injuries followed by cervical segment. The goal of treatment of any spinal injury is restoration of the patient to maximum possible function with disability free life...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28043420/two-additional-augmenting-screws-with-posterior-short-segment-instrumentation-without-fusion-for-unstable-thoracolumbar-burst-fracture-comparisons-with-transpedicular-grafting-techniques
#6
Yu-Chih Lin, Kuo-Fon Fan, Jen-Chung Liao
BACKGROUND: Transpedicular grafting techniques with posterior short-segment instrumentation have demonstrated to prevent high implant failure in unstable thoracolumbar burst fractures. We tested our hypothesis that short-segment instrumentation with two additional augmenting screws in the injured vertebra could provide stability and was similar to those of the transpedicular grafting technique. METHODS: Twenty patients belonged to group A; treated with short-segment pedicle screw fixation and reinforced by two augmenting screws at the fractured vertebra...
December 2016: Biomedical Journal
https://www.readbyqxmd.com/read/28027506/posterior-short-segment-fixation-in-thoracolumbar-unstable-burst-fractures-transpedicular-grafting-or-six-screw-construct
#7
Jen-Chung Liao, Kuo-Fon Fan
OBJECTIVES: Early implant failure and donor-site complication remain a concern in patients with thoracolumbar burst fracture underwent one-above and-below short-segment posterior pedicle screw fixation with fusion. Our aim was to evaluate the results of short-segment pedicle instrumentation enforced by two augmenting screws or injectable artificial bone cement in the fractured vertebra, and compare the differences between these two PATIENTS AND METHODS: We conducted a retrospective clinical and radiographic study...
December 21, 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28027145/chance-fractures-in-the-pediatric-population-are-often-misdiagnosed
#8
Lindsay M Andras, Kira F Skaggs, Haleh Badkoobehi, Paul D Choi, David L Skaggs
BACKGROUND: Flexion injuries of the spine range from mild compression fractures to severe flexion-distraction injuries, that is, Chance fractures. Chance fractures are often unstable and Arkader and colleagues demonstrated improved outcomes when Chance fractures are treated operatively compared with those managed nonoperatively. METHODS: A retrospective review was conducted of all patients treated over a 5-year period (2008 to 2013) for a flexion injury, either a Chance or a compression fracture, of the thoracolumbar spine at our tertiary pediatric level I trauma center...
December 23, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27943230/is-thoracolumbar-injury-classification-and-severity-score-tlics-superior-to-ao-thoracolumbar-injury-classification-system-for-guiding-the-surgical-management-of-unstable-thoracolumbar-burst-fractures-without-neurologic-deficit
#9
Mehmet Onur Yüksel, Mehmet Sabri Gürbüz, Merih Iş, Hakan Somay
AIM: The aim of this study was to determine whether Thoracolumbar Injury Classification and Severity Score (TLICS) and AOSpine Thoracolumbar Injury Classification System have any superiority to each other regarding the reliability of their recommendations in the surgical management of unstable thoracolumbar burst fractures. MATERIAL AND METHODS: Fifty-five consecutive patients with thoracolumbar burst fractures undergoing instrumentation between 2010 and 2015 were analyzed retrospectively...
November 18, 2016: Turkish Neurosurgery
https://www.readbyqxmd.com/read/27886875/the-role-of-a-miniopen-thoracoscopic-assisted-approach-in-the-management-of-burst-fractures-involving-the-thoracolumbar-junction
#10
REVIEW
Ricky Raj S Kalra, Meic H Schmidt
Thoracoscopic spinal surgery is a minimally invasive open endoscopic approach to the anterior thoracolumbar spine for decompression and stabilization. It offers an alternative to open thoracotomy for thoracolumbar burst fractures, anterior spinal cord decompression, and spinal reconstruction with interbody and anterolateral plate instrumentation for restoration of biomechanical stability and alignment. Posterior instrumentation may not sufficiently stabilize a significantly disrupted anterior load-bearing spinal column, and the high access morbidity of open procedures is of significant concern...
January 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/27879575/cost-utility-analysis-of-pedicle-screw-removal-after-successful-posterior-instrumented-fusion-in-thoracolumbar-burst-fractures
#11
Han-Dong Lee, Chang-Hoon Jeon, Nam-Su Chung, Young-Wook Seo
STUDY DESIGN: Cost-utility analysis (CUA). OBJECTIVE: Determine the cost-effectiveness of pedicle screw removal after posterior fusion in thoracolumbar burst fractures. SUMMARY OF BACKGROUND DATA: Pedicle screw instrumentation is a standard fixation method for unstable thoracolumbar burst fracture. However, removal of the pedicle screw after successful fusion remains controversial because the clinical benefits remain unclear. CUA can help clinicians make appropriate decisions about optimal healthcare for pedicle screw removal after successful fusion in thoracolumbar burst fractures...
November 22, 2016: Spine
https://www.readbyqxmd.com/read/27867025/comparison-of-short-segment-pedicle-fixation-with-versus-without-inclusion-of-the-fracture-level-in-the-treatment-of-mild-thoracolumbar-burst-fractures
#12
Chao Sun, Guoping Guan, Xinhui Liu, Hailong Zhang, Bin Wang
BACKGROUND: A review of the literature showed that posterior short-segment fixation including the fractured vertebra (PSFFV) has better outcomes in the treatment of thoracolumbar burst fractures(TBFs) than patients with short-segment pedicle screw fixation(SSPF) alone. However, its efficacy in mild TBFs with load-sharing scores of 3 and 4 points has not been specifically analyzed. The aim of this study was to compare the clinical, functional and radiologic results of PSFFV with SSPF for mild TBFs and to determine whether the screws in the fractured vetebra were necessary for these patients...
December 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27830346/acute-traumatic-intraosseous-fluid-sign-predisposes-to-dynamic-fracture-mobility
#13
Troy A Hutchins, Richard H Wiggins, Jill M Stein, Lubdha M Shah
The intraosseous fluid sign (IFS) in chronic osteoporotic vertebral fractures is attributed to fluid accumulation within non-healing intervertebral clefts. IFS can also be seen in acute traumatic fractures, not previously described. We hypothesize a pathophysiological mechanism for the acute traumatic intraosseous fluid sign (ATIFS) and its predisposition to dynamic fracture mobility with axial loading on upright radiographs. Retrospective analysis was performed of 41 acute thoracic and lumbar compression or stable burst fractures with both supine CT and upright plain films completed within 1 week of each other...
November 10, 2016: Emergency Radiology
https://www.readbyqxmd.com/read/27828664/surgical-treatment-of-denis-type-b-thoracolumbar-burst-fracture-with-neurological-deficiency-by-paraspinal-approach
#14
H Wu, D-X Zhao, R Jiang, X-Y Zhou
We aimed to describe the surgical technique and clinical outcomes of paraspinal-approach reduction and fixation (PARF) in a group of patients with Denis type B thoracolumbar burst fracture (TLBF) with neurological deficiencies. A total of 62 patients with Denis B TLBF with neurological deficiencies were included in this study between January 2009 and December 2011. Clinical evaluations including the Frankel scale, pain visual analog scale (VAS) and radiological assessment (CT scans for fragment reduction and X-ray for the Cobb angle, adjacent superior and inferior intervertebral disc height, and vertebral canal diameter) were performed preoperatively and at 3 days, 6 months, and 1 and 2 years postoperatively...
2016: Brazilian Journal of Medical and Biological Research, Revista Brasileira de Pesquisas Médicas e Biológicas
https://www.readbyqxmd.com/read/27816708/minimally-invasive-pedicle-screw-fixation-combined-with-percutaneous-vertebroplasty-for-the-treatment-of-thoracolumbar-burst-fracture
#15
Chunbo Li, Jianfeng Pan, Yutong Gu, Jian Dong
INTRODUCTION: To evaluate the feasibility, efficacy and safety of minimally invasive pedicle screw fixation (MIPS) combined with percutaneous vertebroplasty (PVP) using calcium phosphate for the treatment of thoracolumbar burst fracture without neurologic deficits. METHODS: Between September 2011 and April 2013, a total of thirty-seven patients with a mean age of 50.73 years (range 40-63 years), who suffered from thoracic or lumbar burst fracture without neurologic deficits underwent the procedure of MIPS combined with PVP using calcium phosphate...
December 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27807770/modified-one-stage-posterior-anterior-combined-surgery-with-posterior-pedicle-instrumentation-and-anterior-monosegmental-reconstruction-for-unstable-denis-type-b-thoracolumbar-burst-fracture
#16
Oujie Lai, Yong Hu, Zhenshan Yuan, Xiaoyang Sun, Weixin Dong, Jiao Zhang, Binke Zhu
PURPOSE: This study aimed to evaluate the clinical and radiological results in patients with unstable Denis type B thoracolumbar burst fractures treated by modified one-stage posterior/anterior combined surgery. METHODS: Thirty-one patients with unstable Denis type B thoracolumbar burst fractures were enrolled in this study. The patients underwent one-stage posterior/anterior combined surgery with posterior instrumentation using pedicle screws and anterior monosegmental reconstruction utilizing titanium mesh cages...
November 2, 2016: European Spine Journal
https://www.readbyqxmd.com/read/27790321/c2-body-fracture-report-of-cases-managed-conservatively-by-philadelphia-collar
#17
Rouzbeh Motiei-Langroudi, Homa Sadeghian
STUDY DESIGN: Case series. PURPOSE: To present results of conservative management in patients with pure C2 body fractures. OVERVIEW OF LITERATURE: Axis body fractures, a less common subgroup of C2 fractures, are commonly classified as vertical coronal, vertical sagittal, and transverse subtypes. While the treatment paradigm for other C2 fractures is clear, there is insufficient evidence to support treatment guidelines for C2 body fractures...
October 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27788683/analysis-of-the-independent-risk-factors-of-neurologic-deficit-after-thoracolumbar-burst-fracture
#18
Peifu Tang, Anhua Long, Tao Shi, Licheng Zhang, Lihai Zhang
BACKGROUND: The objective of this study is to identify the independent risk factors of neurologic deficit after thoracolumbar burst fracture. Traumatic fractures of the thoracolumbar spine are the most common type of spinal column fractures. Many studies have attempted to determine whether neurologic deficit in such fractures is related to spinal canal stenosis or other parameters observed on axial computed tomography. However, this relationship remains controversial. METHODS: A review of the clinical data and axial computed tomography (CT) for 105 patients was performed...
October 24, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27666140/the-new-intra-articular-calcaneal-fracture-classification-system-in-term-of-sustentacular-fragment-configurations-and-incorporation-of-posterior-calcaneal-facet-fractures-with-fracture-components-of-the-calcaneal-body
#19
Thossart Harnroongroj, Thos Harnroongroj, Thongchai Suntharapa, Marut Arunakul
OBJECTIVE: The aim of this study was to develop a new calcaneal fracture classification system which will consider sustentacular fragment configuration and relation of posterior calcaneal facet to calcaneal body. METHODS: The new classification system used sustentacular fragment configuration and relation of posterior calcaneal facet fracture with fracture components of calcaneal body as key aspects of main types and subtypes. Between 2000 and 2014, 126 intraarticular calcaneal fractures were classified according to the new classification system by using computed tomography images...
October 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27624223/how-safe-is-bubble-soccer
#20
Sameer H Halani, Jonathan P Riley, Gustavo Pradilla, Faiz U Ahmad
Traumatic neurologic injury in contact sports is a rare but serious consequence for its players. These injuries are most commonly associated with high-impact collisions, for example in football, but are found in a wide variety of sports. In an attempt to minimize these injuries, sports are trying to increase safety by adding protection for participants. Most recently is the seemingly 'safe' sport of Bubble Soccer, which attempts to protect its players with inflatable plastic bubbles. We report a case of a 16-year-old male sustaining a cervical spine burst fracture with incomplete spinal cord injury while playing Bubble Soccer...
December 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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