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vertebral burst fracture

Jing Xiao, Xiaobin Wang, Xiaoju Tan
OBJECTIVE: To verify whether the procedure of posterior instrumentation and vertebroplasty for treatment of thoracolumbar burst fracture in youth and middle-aged patients is safe, practical and effective in short- and long-term.
 METHODS: A total of 50 patients aged 30-55 years old who suffered from thoracolumbar burst fracture complicated with incomplete paralysis or without neurologic symptom received surgery by using pedicle-screw implantation, reduction and bone cement filling through the unilateral or bilateral pedicles...
August 2016: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Mauro Dobran, Davide Nasi, Denise Brunozzi, Lucia di Somma, Maurizio Gladi, Maurizio Iacoangeli, Massimo Scerrati
BACKGROUND: The surgical management of thoracolumbar burst fractures frequently involves posterior pedicle screw fixation. However, the application of short- or long-segment instrumentation is still controversial. The aim of this study was to compare the outcome of the short-segment fixation with inclusion of the fracture level (SSFIFL) versus the traditional long-segment fixation (LSF) for the treatment of unstable thoracolumbar junction fractures. METHODS: From December 2009 to February 2014, 60 patients with unstable thoracolumbar junction fractures (T11-L2) were divided into two groups according to the number of instrumented levels...
October 2016: Acta Neurochirurgica
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
Linli Li, Youhai Dong, Yiqun He, Xiangsheng Liu, Wenqing Tong
Purpose To evaluate the efficacy of percutaneous pedicle screw fixation technique combined with three-step reduction in the treatment of thoracolumbar fracture. Methods This is a retrospective study, based on medical records from the archives of the Fifth People's Hospital of Fudan University, from January 2012 to January 2015. The 49 patients with thoracolumbar fracture were treated with percutaneous pedicle screw fixation technique combined with three-step reduction. The treatment plan was determined by the AO classification and the Thoracolumbar Injury Classification and Severity classification...
July 26, 2016: Journal of Neurological Surgery. Part A, Central European Neurosurgery
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
Pan Tang, Ren Zhu, Wei-Ping Ji, Ji-Ying Wang, Shuai Chen, Shun-Wu Fan, Zhi-Jun Hu
BACKGROUND: Modic changes are the MRI signal changes of degenerative lumbar vertebral endplate and which lead to or accelerate intervertebral disc degeneration. NLRP3, caspase-1, and interleukin-1β (IL-1β) play a pivotal role in the pathogenesis of many inflammatory diseases, such as osteoarthritis. However, the roles of IL-1β and its activators caspase-1 and NLRP3 are unclear in the degenerative endplate. QUESTIONS/PURPOSES: We asked: (1) What are the degenerative changes of the histologic features and chondrogenic markers' gene expressions between the cartilaginous endplates of patients with Modic changes and trauma (control)? (2) How does the NLRP3/caspase-1/IL-1β axis in the cartilaginous endplates of patients with Modic changes compare with control (trauma) specimens? METHODS: Surgical specimens of cartilaginous endplates were divided into Modic changes (n = 56) and the trauma control (n = 16) groups...
August 2016: Clinical Orthopaedics and related Research
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
Ilsoo Koh, Yvonne Gombert, Cecilia Persson, Håkan Engqvist, Benedikt Helgason, Stephen J Ferguson
BACKGROUND: A vertebral burst fracture (VBF) treated with vertebroplasty using a ceramic cement consists of four regions; native bone fragments, native ceramic cement, ceramic cement-trabecular bone (ceramic-bone) composite and ceramic-bone interface. Although the mechanical properties of native bone and native ceramic cements have been well investigated, the mechanical properties of ceramic-bone composite and ceramic-bone interface remain unknown. Therefore, the aim of this study was to determine the mechanical properties of ceramic-bone composites and ceramic-bone interfaces...
August 2016: Journal of the Mechanical Behavior of Biomedical Materials
Jiao-Xiang Chen, Dao-Liang Xu, Sun-Ren Sheng, Amit Goswami, Jun Xuan, Hai-Ming Jin, Jian Chen, Yu Chen, Zeng-Ming Zheng, Xi-Bang Chen, Xiang-Yang Wang
PURPOSE: Our aim was to evaluate the results of short-segment pedicle instrumentation with screw insertion in the fracture level and find factors predicting kyphosis recurrence in thoracolumbar burst fractures. METHODS: We retrospectively analysed 122 patients with thoracolumbar burst fracture who were divided into two groups: kyphosis recurrence and no kyphosis recurrence. Pre-operative radiographic data comprising Cobb angle (CA), regional angle, anterior vertebra height (AVH), upper intervertebral angle, vertebral wedge angle (VWA), pre-anteroposterior A/P approach, superior endplate fracture, load-sharing classification (LSC) score and clinical data including age, visual analogue scale (VAS) score, thoracolumbar injury classification and severity score were compared between groups...
June 2016: International Orthopaedics
Eleftherios Archavlis, Eike Schwandt, Michael Kosterhon, Angelika Gutenberg, Peter Ulrich, Amr Nimer, Alf Giese, Sven Rainer Kantelhardt
BACKGROUND AND OBJECTIVE: The main difficulties of transpedicular corpectomies are lack of space for vertebral body replacement in the neighborhood of critical structures, the necessity for sacrifice of nerve roots in the thoracic spine. and the extent of hemorrhage due to venous epidural bleeding. We present a modified technique of transpedicular corpectomy by using an endoscopic-assisted microsurgical technique performed through a single posterior approach. A 3-dimensional (3D) preoperative reconstruction could be helpful in the planning for this complex anatomic region...
July 2016: World Neurosurgery
Ilsoo Koh, Giacomo Marini, René P Widmer, Nicola Brandolini, Benedikt Helgason, Stephen J Ferguson
BACKGROUND: The use of percutaneous vertebroplasty as a stand-alone treatment for stable vertebral burst fractures has been investigated in vitro and in clinical studies. These studies present inconsistent results on the mechanical response of vertebroplasty-treated burst fractures. In addition, observations of the loss of sagittal alignment after vertebroplasty raise questions on the applicability of vertebroplasty for burst fractures. Therefore, the aim of this study was to investigate the mechanical stability of burst fractures after stand-alone treatment by vertebroplasty...
May 2016: Clinical Biomechanics
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
Sub-Ri Park, Hwa-Yeop Na, Jung-Mook Kim, Dong-Chan Eun, Eui-Young Son
BACKGROUND: The development of pedicle screw-based posterior spinal instrumentation is recognized as one of the major surgical treatment methods for thoracolumbar burst fractures. However, the appropriate level in posterior segment instrumentation is still a point of debate. To assesses the long-term results of two-level and three-level posterior fixations of thoracolumbar burst fractures that have load-sharing scores of 7 and 8 points. METHODS: From January 1998 to May 2009, we retrospectively analyzed clinical and radiologic outcomes of 45 patients with thoracolumbar burst fractures of 7 and 8 points in load-sharing classification who were operated on using two-level posterior fixation (one segment above and one segment below: 28 patients, group I) or three-level posterior fixation (two segments above and one segment below: 17 patients, group II)...
March 2016: Clinics in Orthopedic Surgery
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
Young Jae Moon, Kwang-Bok Lee
OBJECTIVES: To analyze the relationship between clinical factors and spontaneous canal remodeling. METHODS: We evaluated computed tomography scans, before surgery, within a week after surgery, 6 months after surgery, and 12 months after surgery. Thirty-eight consecutive patients who underwent posterior fixation and fusion after thoracolumbar burst fractures were included in. Factors potentially affecting the postoperative degree of reduction and spontaneous spinal remodeling were defined as age, location, degree of change of anterior vertebral compression ratio, fracture type of the retropulse bone, presence of injury to the posterior longitudinal ligament, and posterolateral complex fracture...
May 2016: World Neurosurgery
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
Tae Seong Im, Joon Woo Lee, Eugene Lee, Yusuhn Kang, Joong Mo Ahn, Heung Sik Kang
OBJECTIVE: To evaluate the effects of facet joint injection (FJI) reducing the need for percutaneous vertebroplasty (PVP) in cases of vertebral compression fracture (VCF). MATERIALS AND METHODS: A total of 169 patients who were referred to the radiology department of our institution for PVP between January 2011 and December 2014 were retrospectively evaluated. The effectiveness of FJI was evaluated by the proportion of patients who cancelled PVP and who experienced reduced pain...
May 2016: Cardiovascular and Interventional Radiology
Ludwig Oberkircher, Maya Schmuck, Martin Bergmann, Philipp Lechler, Steffen Ruchholtz, Antonio Krüger
OBJECT: The treatment of traumatic burst fractures unaccompanied by neurological impairment remains controversial and ranges from conservative management to 360° fusion. Because of the heterogeneity of fracture types, classification systems, and treatment options, comparative biomechanical studies might help to improve our knowledge. The aim of the current study was to create a standardized fracture model to investigate burst fractures in a multisegmental setting. METHODS: A total of 28 thoracolumbar fresh-frozen human cadaveric spines were used...
April 2016: Journal of Neurosurgery. Spine
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
Guang-Dong Chen, Qi Lu, Gen-Lin Wang, Jun Zou, Hui-Lin Yang, Yan Yang, Zong-Ping Luo
BACKGROUND: Percutaneous kyphoplasty (PKP) has been proven as an effective, minimally invasive procedure for the treatment of Kummell's disease in the early stages. However, a risk of cement leakage and further neurological damage remains during and after PKP, especially in chronic osteoporotic stage III Kummell's disease with severe spinal canal stenosis. OBJECTIVE: To evaluate the feasibility and efficacy of PKP for the treatment of chronic osteoporotic stage III Kummell's disease with severe spinal canal stenosis...
November 2015: Pain Physician
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