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Thoracolumbar fractures

Xiang-Yao Sun, Xi-Nuo Zhang, Yong Hai
PURPOSE: This study evaluated differences in outcome variables between percutaneous, traditional, and paraspinal posterior open approaches for traumatic thoracolumbar fractures without neurologic deficit. METHODS: A systematic review of PubMed, Cochrane, and Embase was performed. In this meta-analysis, we conducted online searches of PubMed, Cochrane, Embase using the search terms "thoracolumbar fractures", "lumbar fractures", ''percutaneous'', "minimally invasive", ''open", "traditional", "posterior", "conventional", "pedicle screw", "sextant", and "clinical trial"...
October 18, 2016: European Spine Journal
Qinliang Li, Cai Yun, Shichun Li
BACKGROUND: Complications in posterior pedicle screw fixation using a conventional posterior approach for thoracolumbar fractures include vertebral height loss, kyphosis relapse and breakage, or loosening of instrumentation. The purpose of this study was to evaluate the clinical effects of transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach for thoracolumbar fractures. METHODS: We retrospectively analyzed 50 patients with thoracolumbar fractures treated with transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach...
October 17, 2016: Journal of Orthopaedic Surgery and Research
Wenhao Hu, Bin Wang, Hongyu Run, Xuesong Zhang, Yan Wang
BACKGROUND: It is estimated that upwards of 50,000 individuals suffer traumatic fracture of the spine each year, and the instability of the fractured vertebra and/or the local deformity results in pain and, if kyphosis increases, neurological impairment can occur. There is a significant controversy over the ideal management. The purpose of the study is to present clinical and radiographic results of pedicle subtraction osteotomy and disc resection with cage placement in correcting post-traumatic thoracolumbar kyphosis...
October 12, 2016: Journal of Orthopaedic Surgery and Research
Jan Kocis, Martin Kelbl, Peter Wendsche, Radek Vesely
AIMS: A retrospective analysis of patients with thoracolumbar junction fractures who underwent video-assisted thoracoscopic surgery via a minimally invasive approach (minithoracotomy) for reconstruction of the anterior spinal column. METHODS: Between 2002 and 2014, a total of 176 patients were treated by this technique. The patients received either posterior stabilization and, at the second stage, the minimally invasive technique via an anterior approach, or the minimally invasive anterior procedure alone...
October 3, 2016: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Ahmad Jabir Rahyussalim, Ifran Saleh, M Fajrin Armin, Tri Kurniawati, Ahmad Yanuar Safri
INTRODUCTION: Intraoperative neurophysiologic monitoring (IONM) had important role related to the complications in spinal surgery. Somatosensory Evoked Potential (SSEP), Transcranial electric Muscle Evoked Potentials (tceMEPs), and free run EMG are parameters used to asses functional integrity of the nervous system during surgical procedures. Once warning signal was recognized, surgeon have to make a precise decision to overcome that problem. PRESENTATION OF CASE: We present a 47-year old male with back pain due to compression fracture of thoracic vertebra T12 and lumbar vertebrae L1...
September 23, 2016: International Journal of Surgery Case Reports
Yong-Hyun Hwang, Hee-Chun Lee, Jae-Hoon Lee
OBJECTIVE: To examine the technical feasibility of percutaneous endoscopic pediculectomy using a lateral approach and to evaluate its use for decompression and examination of the thoracic and lumbar spinal canals in small dogs. STUDY DESIGN: Experimental study. ANIMALS: Clinically normal adult dogs (n=10). METHODS: After optimizing the technique in cadavers, percutaneous endoscopic pediculectomy was performed using a lateral approach to the thoracic (T12) or lumbar (L2) vertebrae in 5 dogs each...
October 6, 2016: Veterinary Surgery: VS
Charline Estublier, Roland Chapurlat, Pawel Szulc
OBJECTIVE: Data on the relationship between disc degeneration (DD) and fragility fractures in men are limited. The aim of this study was to prospectively analyse the risk of vertebral and non-vertebral fractures in men with thoracolumbar DD according to the severity of its radiological signs: disc space narrowing (DSN), osteophytes and endplate sclerosis. METHODS: Men >50 years of age (n = 765) had lateral spine radiographs and DXA and were monitored prospectively...
October 3, 2016: Rheumatology
M S Reich, A J Dolenc, T A Moore, H A Vallier
BACKGROUND: Previous work established resuscitation parameters that minimize complications with early fracture management. This Early Appropriate Care (EAC) protocol was applied to patients with advanced age to determine if they require unique parameters to mitigate complications. METHODS: Between October 2010 and March 2013, 376 consecutive skeletally mature patients with unstable fractures of the pelvis, acetabulum, thoracolumbar spine, and/or proximal or diaphyseal femur fractures were treated at a level I trauma center and were prospectively studied...
September 26, 2016: Journal of Orthopaedic Surgery and Research
Jacqui Agostinello, Camila R Battistuzzo, Peta Skeers, Stephen Bernard, Peter E Batchelor
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: The aims of this study were to (1) determine the timing of surgery for traumatic TLSCI between 2010 and 2014 and (2) identify major delays in the process of care from accident scene to surgery. SUMMARY OF BACKGROUND DATA: Early spinal surgery may promote neurological recovery and reduce acute complications after thoracolumbar spinal cord injury (TLSCI), however it is difficult to achieve due to logistical issues and the frequent presence of other non-life threatening injuries...
September 23, 2016: Spine
Aleksandr Rozenberg, Jonathan C Weinstein, Adam E Flanders, Pranshu Sharma
Reformatted CTs of the thoracic and lumbar spine (CT T/L) from CTs of the chest, abdomen, and pelvis (CT body) may be performed for screening the thoracolumbar spine in patients sustaining blunt trauma. The purpose of this study was to determine whether there was a difference in the rate of detection of spinal fractures on CTs of the body compared to the reformatted T/L spine. A secondary endpoint was to evaluate whether cases dictated by trainees improved fracture detection rate. We reviewed the records of 250 consecutive blunt trauma patients that received CTs of the chest, abdomen, and pelvis (CT body) with concurrent CT T/L reformats...
September 23, 2016: Emergency Radiology
Julio J Jauregui, Dean C Perfetti, Frank S Cautela, David B Frumberg, Qais Naziri, Carl B Paulino
BACKGROUND: Although rare, spinal injuries associated with abuse can have potentially devastating implications in the pediatric population. We analyzed the association of pediatric spine injury in abused children and determined the anatomic level of the spine affected, while also focusing on patient demographics, length of stay, and total hospital charges compared with spine patients without a diagnosis of abuse. METHODS: A retrospective review of the Kids' Inpatient Database was conducted from 2000 to 2012 to identify pediatric patients (below 18 y) who sustained vertebral column fractures or spinal cord injuries...
September 22, 2016: Journal of Pediatric Orthopedics
Yin-Fan Chang, Chin-Sung Chang, Mei-Wen Wang, Chun-Feng Wu, Chuan-Yu Chen, Hsuan-Jui Chang, Po-Hsiu Kuo, Chih-Hsing Wu
PURPOSE: The aim of this study was to determine the effects of diagnostic discordance with or without a thoracolumbar spine lateral view X-ray in patients with osteoporosis. METHODS: We randomly enrolled 368 women over 65 years old (74.3 ± 6.0 years) from Tianliao Township in 2009 (response rate: 75.7%). A diagnosis of osteoporosis was confirmed using one of these criteria: (1) a history of non-traumatic fracture, (2) vertebral fractures based on a thoracolumbar spine lateral view X-ray, or (3) a bone mineral density T-score ≤ -2...
2016: PloS One
Shari Cui, Gennadiy A Busel, Aki S Puryear
BACKGROUND: Pediatric spine trauma often results from high-energy mechanisms. Despite differences in healing potential, comorbidities, and length of remaining life, treatment is frequently based on adult criteria; ligamentous injuries are fused and bony injuries are treated accordingly. In this study, we present short-term results of a select group of adolescent patients treated using percutaneous pedicle screw instrumentation without fusion. METHODS: An IRB-approved retrospective review was performed at a level 1 pediatric trauma center for thoracolumbar spine fractures treated by percutaneous pedicle screw instrumentation...
October 2016: Journal of Pediatric Orthopedics
Zhiguo Fu, Xi Zhang, Yaohua Shi, Qirong Dong
BACKGROUND This study aimed to compare the surgical outcomes between open pedicle screw fixation (OPSF) and percutaneous pedicle screw fixation (PPSF) for the treatment of thoracolumbar fractures, which has received scant research attention to date. MATERIAL AND METHODS Eight-four patients with acute and subacute thoracolumbar fractures who were treated with SSPSF from January 2013 to June 2014 at the Changzhou Hospital of Traditional Chinese Medicine (Changzhou, China) were retrospectively reviewed. The patients were divided into 4 groups: the OPSF with 4 basic screws (OPSF-4) group, the OPSF with 4 basic and 2 additional screws (OPSF-6) group, the PPSF with 4 basic screws (PPSF-4) group, and the PPSF with 4 basic and 2 additional screws (PPSF-6) group...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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
Hyeun-Sung Kim, Dong-Hwa Heo
Purpose. The purpose of our study is to evaluate the therapeutic efficacy of short-segment percutaneous pedicle screw fixation with polymethylmethacrylate (PMMA) augmentation for the treatment of osteoporotic thoracolumbar compression fracture with osteonecrosis. Methods. Osteoporotic thoracolumbar compression fractures with avascular necrosis were treated by short-segment PPF with PMMA augmentation. Eighteen were followed up for more than 2 years. The kyphotic angle, compression ratio, visual analog scale (VAS) score for back pain, and the Oswestry Disability Index (ODI) were analyzed...
2016: BioMed Research International
H M Yu, K Malhotra, J S Butler, A Patel, M D Sewell, Y Z Li, S Molloy
AIMS: Patients with multiple myeloma (MM) develop deposits in the spine which may lead to vertebral compression fractures (VCFs). Our aim was to establish which spinopelvic parameters are associated with the greatest disability in patients with spinal myeloma and VCFs. PATIENTS AND METHODS: We performed a retrospective cross-sectional review of 148 consecutive patients (87 male, 61 female) with spinal myeloma and analysed correlations between spinopelvic parameters and patient-reported outcome scores...
September 2016: Bone & Joint Journal
Mona Saffarzadeh, R Caresse Hightower, Jennifer W Talton, Anna N Miller, Joel D Stitzel, Ashley A Weaver
OBJECTIVE: This study aimed to quantify lumbar volumetric bone mineral density (vBMD) for 873 seriously injured Crash Injury Research and Engineering Network (CIREN) motor vehicle crash occupants (372 male, 501 female) from 8 centers using phantomless computed tomography scans and to associate vBMD with age, fracture incidence, and osteopenia/osteoporosis diagnoses. The novelty of this work is that it associates vBMD with region of injury by applying an established method for vBMD measurement using phantomless computed tomography (CT)...
September 2016: Traffic Injury Prevention
Hesham M Soliman, Ha Son Nguyen, Anjishnu Banerjee, Frank Pintar, Narayan Yoganandan, Shekar Kurpad, Dennis Maiman
BACKGROUND: The Abbreviated Injury Scale (AIS) is an anatomical-based coding system created by the Association for the Advancement of Automotive Medicine, utilized to classify and code injuries resulting from trauma, in order of severity. According to the latest version, all Thoraco-Lumbar Compression Fractures (TLCF), even without injury to other spine components and with >20% loss of height, were branded AIS 3 injuries, reflecting a serious threat to life or permanent disability...
September 2016: Traffic Injury Prevention
Yann Philippe Charles, Axel Walter, Sébastien Schuller, Jean-Paul Steib
STUDY DESIGN: Prospective clinical trial in thoracolumbar trauma with 5-year follow-up. OBJECTIVE: To analyze clinical and radiographic outcomes of minimal invasive surgery, and the rational of circumferential fracture treatment with regard to age, degenerative changes, bone mineral density and global sagittal balance. SUMMARY OF BACKGROUND DATA: Non-neurologic fractures with anterior column defect can be treated by posterior percutaneous instrumentation and selective anterior fusion...
August 31, 2016: Spine
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