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vertebral burst fracture

Jae-Kwang Kim, Bong Ju Moon, Sang-Deok Kim, Jung-Kil Lee
RATIONALE: In the treatment of noncontiguous lumbar burst fractures, there still remains controversy over proper surgical procedures. PATIENT CONCERNS: A 19-year-old female patient visited our hospital after fall down from 3 m high. DIAGNOSES: Initial neurologic examination revealed an incomplete spinal cord injury characterized by hypoesthesia and motor grade of 2 below the L2 segment. Lumbar computed tomography and magnetic resonance imaging demonstrated L2 and L5 burst fractures severely obliterating the spinal canal...
March 2018: Medicine (Baltimore)
Hsi-Hsien Lin, Ming-Chau Chang, Shih-Tien Wang, Chien-Lin Liu, Po-Hsin Chou
PURPOSE: Polymethylmethacrylate (PMMA) augmentation is a common method to increase pullout strength fixed for osteoporotic spines. However, few papers evaluated whether these pedicle screws migrated with time and functional outcome in these geriatrics following PMMA-augmented pedicle screw fixation. METHODS: From March 2006 to September 2008, consecutive 64 patients were retrospectively enrolled. VAS and ODI were used to evaluate functional outcomes. Kyphotic angle at instrumented levels and horizontal and vertical distances (HD and VD) between screw tip and anterior and upper cortexes were evaluated...
February 11, 2018: International Orthopaedics
Chester J Donnally, Gil Metser, Eric S Roth, Justin P Moo Young, Augustus J Rush, Motasem A Al Maaieh
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To identify patient characteristics and associated injuries in those sustaining a spine fracture from personal watercraft (PWC) usage. SUMMARY OF BACKGROUND DATA: There are few studies regarding PWC use and injuries, and even more scarce are studies evaluating PWC usage and spine injuries. Identifying high risk actions and individuals can help to effectively treat them, reduce mortality, and possibly avoid certain spine fractures...
February 6, 2018: Spine
Chi Li, Jing Wang, Hong-Lin Teng, Ming-Yu Zhu, Yang Zhou
OBJECTIVE: To compare the clinical effects and multifidus muscle injury of different approaches, including unilateral Wiltse intermuscular approach and intramuscular approach combined with contralateral decompression, in treating thoracolumbar burst fracture. METHODS: Forty-three patients with thoracolumbar burst fracture were enrolled in the study from January 2010 to December 2014, including 29 males and 14 females with an average age of 42.3 years old(ranged from 21 to 64 years old)...
May 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Giuseppe Salvatore, Alessandra Berton, Hugo Giambini, Mauro Ciuffreda, Pino Florio, Umile Giuseppe Longo, Vincenzo Denaro, Andrew Thoreson, Kai-Nan An
BACKGROUND: Cancer patients are likely to undergo osteoporosis as consequence of hormone manipulation and/or chemotherapy. Little is known about possible increased risk of fracture in this population. The aim of this study was to describe the biomechanical effect of a metastatic lesion in an osteoporotic lumbar spine model. METHODS: A finite element model of two spinal motion segments (L3-L5) was extracted from a previously developed L3-Sacrum model and used to analyze the effect of metastasis size and bone mineral density (BMD) on Vertebral bulge (VB) and Vertebral height (VH)...
February 5, 2018: BMC Musculoskeletal Disorders
Shady Elmasry, Shihab Asfour, Francesco Travascio
Percutaneous pedicle screw fixation (PPSF) is a minimally invasive surgery (MIS) employed in the treatment of thoracolumbar burst fractures (TBF). However, hardware failure and loss of angular correction are common limitations caused by the poor support of the anterior column of the spine. Balloon Kyphoplasty (KP) is another MIS successfully used in the treatment of compression fractures by augmenting the injured vertebral body with cement. To overcome its limitations as a stand-alone procedure, it was suggested to augment PPSF with KP when treating TBF...
February 1, 2018: Journal of Biomechanical Engineering
Jie Mi, Xiao-Jiang Sun, Kai Zhang, Chang-Qing Zhao, Jie Zhao
OBJECTIVE: To formulate radiological indexes based on CT for further MRI examination to detect posterior ligamentous complex injury (PLC) or disc injury in thoracolumbar burst fractures without neurological deficit in the emergent setting. MATERIALS AND METHODS: Patients with a single thoracolumbar burst fracture and no neurological deficit were included into this study. Radiological indexes on CT included canal compromise (CC), anterior and posterior vertebral height ratio (PVH and AVH ratio), local kyphosis (LK) and regional kyphosis (RK)...
December 15, 2017: Injury
Yip-Kan Yeung, Sheung-Tung Ho
Study Design: Retrospective cohort. Purpose: To review the clinical presentation of operated patients with delayed neurological deficits after osteoporotic vertebral fractures (OVFs). Overview of Literature: Delayed neurological deficits can occur from 1 week to 5.7 months after OVFs. Baba has reported 78% good-to-excellent improvement (i.e., ≥50%) after 20 posterior (Cotrel-Dubousset) and 7 anterior (Kaneda in 4, Zielke ventral derotational spondylodesis in 2, and un-instrumented anterior fusion in 1) fusions...
December 2017: Asian Spine Journal
M K Ahsan, A A Mamun, Z Zahangiri, M A Awwal, S I Khan, N Zaman, M H Haque
The treatment of unstable thoracolumbar junction burst fractures remains a controversial issue. We evaluate the efficacy of short segment (SS) compared with that of long-segment (LS) stabilization in terms of clinical and the radiological outcomes. Records of 88 patients with thoracolumbar burst fracture underwent posterior pedicle screw fixation from January 2004 to December 2015, studied retrospectively. These patients were divided into two groups: SS and the LS-group. Clinical parameters: back pain, disability, neurological deficit and radiologic parameters: Cobb angle, sagittal index, the kyphotic deformation of vertebral body, vertebral height and canal compromise were measured before surgery and immediately after surgery and at 3, 6 and 12 months postoperatively...
October 2017: Mymensingh Medical Journal: MMJ
Kyu Yeol Lee, Min-Woo Kim, Sang Yun Seok, Dong Ryul Kim, Chul Soon Im
Background: To determine the relationship between superior disc-endplate complex injury and correction loss after surgery in a group of young adult patients with a stable thoracolumbar burst fracture. Methods: The study group was comprised of young adult patients who had undergone short-segment posterior fixation and bone grafting under the diagnosis of a stable thoracolumbar burst fracture from March 2008 to February 2014. Follow-up was available for more than 1 year...
December 2017: Clinics in Orthopedic Surgery
Yong Fan, JiaNan Zhang, Xin He, YunFei Huang, QiNing Wu, DingJun Hao
BACKGROUND The thoracolumbar AO type A3 fracture is an incomplete burst fracture, which affects one vertebral body endplate. The objective of this study was to determine which of two minimal invasive techniques was more suitable for A3 fractures based on clinical and radiographic results. MATERIAL AND METHODS We studied 112 patients with A3 subtype fractures without neurological deficits. A total of 63 patients received percutaneous pedicle screw fixation (PPSF), and 49 patients were treated using mini-open Wiltse approach with pedicle screw fixation (MWPSF)...
November 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Kalliopi Alpantaki, Michael Dohm, Panagiotis Korovessis, Alexander G Hadjipavlou
INTRODUCTION: This paper describes surgical options for Osteoporotic vertebral compression fracture (OVCF) with acute flexible or chronic rigid kyphosis, and pseudarthrosis complicated with pain and neurologic deficit. METHODS: This study has two components. a) A prospective clinical study of surgical treatment of 31 patients (age: 69±11 years) with either acute flexible or progressive pseudarthrotic kyphosis manifested with severe pain or neurological deficit between 2010 and 2014...
November 12, 2017: Injury
Federico De Iure, Giorgio Lofrese, Pasquale De Bonis, Francesco Cultrera, Michele Cappuccio, Sofia Battisti
BACKGROUND CONTEXT: The load sharing classification (LSC) laid foundations for a scoring system able to indicate which thoracolumbar fractures, after short-segment posterior-only fixations, would need longer instrumentations or additional anterior supports. PURPOSE: We analyzed surgically treated thoracolumbar fractures, quantifying the vertebral body's fragment displacement with the aim of identifying a new parameter that could predict the posterior-only construct failure...
October 23, 2017: Spine Journal: Official Journal of the North American Spine Society
Joep Kitzen, Martijn G M Schotanus, Herbert S W Plasschaert, Frans-Jan H Hulsmans, Pieter B J Tilman
BACKGROUND: Short-segment pedicle-screw instrumentation is frequently used to stabilize thoracolumbar burst fractures. A recognized disadvantage of this procedure is recurrent kyphosis from intervertebral disc creep into the fractured central endplate. Balloon Assisted Endplate Reduction (BAER) using Tricalcium Phosphate bone cement (TCP) enables elevation of the centrally depressed endplate. Our objective was to evaluate the bone-tissue response to TCP and to analyse whether BAER using TCP can prevent recurrent kyphosis after removal of the instrumentation...
October 10, 2017: BMC Musculoskeletal Disorders
A Germaneau, T Vendeuvre, M Saget, P Doumalin, J C Dupré, F Brémand, F Hesser, C Brèque, P Maxy, M Roulaud, O Monlezun, P Rigoard
BACKGROUND: Burst fractures represent a significant proportion of fractures of the thoracolumbar junction. The recent advent of minimally invasive techniques has revolutionized the surgical treatment of this type of fracture. However mechanical behaviour and primary stability offered by these solutions have to be proved from experimental validation tests on cadaveric specimens. Therefore, the aim of this study was to develop an original and reproducible model of burst fracture under dynamic impact...
September 13, 2017: Clinical Biomechanics
Ping-Jui Tsai, Ming-Kai Hsieh, Kuo-Feng Fan, Lih-Huei Chen, Chia-Wei Yu, Po-Liang Lai, Chi-Chien Niu, Tsung-Ting Tsai, Wen-Jer Chen
BACKGROUND: Burst fracture is a common thoracolumbar injury that is treated using posterior pedicle instrumentation and fusion combined with transpedicular intracorporeal grafting after reduction. In this study, we compared the outcome of these two techniques by using radiologic imaging and functional outcome. METHODS: Sixty-one patients with acute thoracolumbar burst fracture were operated with kyphoplasty (n = 31) or vertebroplasty (n = 30) and retrospectively reviewed in our institution between 2011 and 2014...
September 11, 2017: BMC Musculoskeletal Disorders
Y W Li, H J Wang, Y S Wang, W Cui
Objective: To evaluate the value of intraoperative CT scanning in the treatment of fresh thoracolumbar burst fractures. Methods: From January 2008 to January 2015 , 161 patients with thoracolumbar fractures in Department of Orthopedics, Luohe City Central Hospital, were divided into two groups: 79 cases were treatment group which were treated with intraoperative CT scan and decompression mode was determined according to CT scan results during the period from October 2012 to January 2015. 82 patients as the observation group were treated without intraoperative CT scan and direct laminectomy were performed during the period...
September 5, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
S De la Cruz-Álvarez, J A Canales-Nájera, A Hurtado-Padilla, F Guevara-Villazón, J Ledezma-Ledezma
OBJECTIVE: The objective is to evaluate the outcome of vertebral corpectomy and placement of an expandable cage in patients with thoracolumbar fractures, using a posterior-only approach. MATERIAL AND METHODS: A retrospective, case series study in the period from May 2011 to May 2014, in which eight patients with thoracolumbar burst fractures were treated surgically with corpectomy of fractured spinal body, placement of expandable box and fixation with transpedicular system, via posterior-only approach...
March 2017: Acta Ortopédica Mexicana
Aymeric Amelot, Joseph Cristini, Alexis Moles, Celine Salaud, Olivier Hamel, Eric Bord, Kevin Buffenoir
STUDY DESIGN: Burst fractures not associated with any neurological deficits are frequent but not therapeutic agreement on their management is available to date. This case-control study was conducted to try to help guide therapeutic decision in the treatment of such fractures. MATERIALS AND METHODS: This case-control study includes consecutive retrospective evaluation of 25 case-patients treated by posterior short-segment fixation associated with kyphoplasty (SFK) in the treatment of A3 thoracolumbar unstable fractures, as compared to a control-group composed of 82 patients treated by long-segment (LF) pedicle screws...
October 2017: Injury
Zühtü Özbek, Emre Özkara, Hasan Önner, Gültekin Baş, İpek Canan Erman, Hülya Özen, Emre Entok, Ali Arslantaş
OBJECTIVE: To investigate the effect of fusion on short segment including fractured level (SSIFL) and long segment (LS) transpedicular fixation after acute thoracolumbar junction burst fractures. The 2-year clinical and radiologic follow-up results of the 2 groups also were compared. METHODS: Seventy-four patients were randomized into one of 2 groups: SSIFL (n = 39) or LS (n = 35). The SSIFL group included one level above and one level below, including the fracture level, whereas the LS group included 2 levels above and 2 levels below, excluding the fracture level, for the transpedicular fixation...
November 2017: World Neurosurgery
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