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Thoracolumbar fractures

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https://www.readbyqxmd.com/read/28807432/non-neurologic-burst-thoracolumbar-fractures-fixation-case-control-study
#1
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...
August 4, 2017: Injury
https://www.readbyqxmd.com/read/28803178/treatment-of-unstable-thoracolumbar-fractures-does-fracture-level-fixation-accelerate-the-bone-healing
#2
Zühtü Özbek, Emre Özkara, Hasan Önner, Gültekin Baş, İpek Canan Erman, Hülya Özen, Emre Entok, Ali Arslantaş
OBJECTIVE: This study aimed to investigate the effect of fusion on short segment including fractured level (SSIFL) and long segment (LS) transpedicular fixation after acute thoracolumbar junction (TLJ) burst fractures. The two-year clinical and radiological follow-up results of the two groups were also compared. METHODS: Seventy-four patients were randomized into one of two groups: SSIFL (n: 39) or LS (n: 35). The SSIFL group included one level above and one level below, including the fracture level, while the LS group included two levels above and two levels below, excluding the fracture level, for the transpedicular fixation...
August 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28801863/pedicle-screw-fixation-in-thoracolumbar-and-lumbar-spine-assisted-by-lateral-fluoroscopic-imaging-a-study-to-evaluate-the-accuracy-of-screw-placement
#3
S P Mohanty, S N Bhat, M Pai Kanhangad, G S Gosal
BACKGROUND: The purpose of this study was to evaluate the accuracy of pedicle screw placement, its advantages, and limitations in posterior instrumentation of thoracolumbar and lumbar burst fractures assisted only by lateral fluoroscopic imaging. MATERIALS AND METHODS: Pre- and postoperative computerized tomographic (CT) scans of 117 patients with thoracolumbar and lumbar burst fractures, who underwent posterior instrumentation with pedicle screw fixation, were prospectively analyzed...
August 11, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28800928/post-operative-bracing-after-pedicle-screw-fixation-for-thoracolumbar-burst-fractures-a-cost-effectiveness-study
#4
REVIEW
Matthew Piazza, Saurabh Sinha, Prateek Agarwal, Arka Mallela, Nikhil Nayak, James Schuster, Sherman Stein
PURPOSE: While frequently prescribed to patients following fixation for spine trauma, the utility of spinal orthoses during the post-operative period is poorly described in the literature. In this study, we calculated rates of reoperation and performed a decision analysis to determine the utility of bracing following pedicle screw fixation for thoracic and lumbar burst fractures. METHODS: Pubmed was searched for articles published between 2005 and 2015 for terms related to pedicle screw fixation of thoracolumbar fractures...
August 8, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28796721/mechanisms-predisposing-factors-and-prognosis-of-intraoperative-vertebral-subluxation-during-pedicle-subtraction-osteotomy-in-surgical-correction-of-thoracolumbar-kyphosis-secondary-to-ankylosing-spondylitis
#5
Bang-Ping Qian, Sai-Hu Mao, Jun Jiang, Bin Wang, Yong Qiu
STUDY DESIGN: A retrospective study. OBJECTIVE: To analyze the mechanisms, predisposing factors, and prognosis of the intraoperative vertebral subluxation (VS) during pedicle subtraction osteotomy (PSO) for thoracolumbar kyphosis secondary to ankylosing spondylitis (AS). SUMMARY OF BACKGROUND DATA: VS is one of the most daunting challenges that surgeons encounter during PSO closure, especially in patients with AS with ankylosed and mostly osteoporotic spine...
August 15, 2017: Spine
https://www.readbyqxmd.com/read/28777064/is-fusion-necessary-for-thoracolumbar-burst-fracture-treated-with-spinal-fixation-a-systematic-review-and-meta-analysis
#6
Juliete M Diniz, Ricardo V Botelho
OBJECTIVE Thoracolumbar fractures account for 90% of spinal fractures, with the burst subtype corresponding to 20% of this total. Controversy regarding the best treatment for this condition remains. The traditional surgical approach, when indicated, involves spinal fixation and arthrodesis. Newer studies have brought the need for fusion associated with internal fixation into question. Not performing arthrodesis could reduce surgical time and intraoperative bleeding without affecting clinical and radiological outcomes...
August 4, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28736621/percutaneous-cement-augmentation-for-osteoporotic-vertebral-fractures
#7
REVIEW
Amer Sebaaly, Maroun Rizkallah, Falah Bachour, Firas Atallah, Pierre Emmanuel Moreau, Ghassan Maalouf
Thoracolumbar vertebral fracture incidents usually occur secondary to a high velocity trauma in young patients and to minor trauma or spontaneously in older people.Osteoporotic vertebral fractures are the most common osteoporotic fractures and affect one-fifth of the osteoporotic population.Percutaneous fixation by 'vertebroplasty' is a tempting alternative for open surgical management of these fractures.Despite discouraging initial results of early trials for vertebroplasty, cement augmentation proved its superiority for the treatment of symptomatic osteoporotic vertebral fracture when compared with optimal medical treatment...
June 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28735766/risk-factor-analysis-for-predicting-vertebral-body-re-collapse-after-posterior-instrumented-fusion-in-thoracolumbar-burst-fracture
#8
Hae-Dong Jang, Jae Chul Lee, Jae-Wan Soh, Sung-Woo Choi, Hyeung-Kyu Cho, Byung-Joon Shin
BACKGROUND CONTEXT: In the posterior instrumented fusion surgery for thoracolumbar (T-L) burst fracture, early postoperative re-collapse of well-reduced vertebral body fracture could induces critical complications such as correction loss, post-traumatic kyphosis, metal failure, often lead to revision surgery. Furthermore, re-collapse is quite difficult to predict because of the variety of risk factors and no widely accepted accurate prediction systems existed. Although load sharing classification (LSC) has been known to help to decide the need for additional anterior column support, this radiographic scoring system has several critical limitations...
July 20, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28735127/the-fate-of-patients-with-adult-spinal-deformity-incurring-rod-fracture-after-thoracolumbar-fusion
#9
D Kojo Hamilton, John A Buza, Peter Passias, Cyrus Jalai, Han Jo Kim, Tamir Ailon, Munish Gupta, Daniel Sciubba, Amit Jain, Christopher P Ames, Vedat Deviren, Alan Daniels, Virginie Lafage, Shay Bess, Eric Klineberg, Christopher I Shaffrey, Justin S Smith, Robert Hart
OBJECTIVE: To report the outcome of adult spinal deformity (ASD) in patients with rod fracture (RF) after thoracolumbar fusion. METHODS: Retrospective review of prospective, multicenter database. Operative patients with ASD ≥18 years old with RF after ASD surgery and with a minimum 6-month follow-up after RF were included. Health-related quality of life scores and radiographic alignment were compared with nonparametric paired and independent testing (P < 0...
July 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28716553/regional-analysis-of-age-related-local-bone-loss-in-the-spine-of-a-healthy-population-using-3d-voxel-based-modeling
#10
Alexander Valentinitsch, Stefano Trebeschi, Eva Alarcón, Thomas Baum, Johannes Kaesmacher, Claus Zimmer, Cristian Lorenz, Jan S Kirschke
Local variations in bone loss may be of great importance to individually predict osteoporotic fractures but are neglected by current densitometry techniques. The purpose of this study was to evaluate regional variations of normal bone loss at the spine among different age groups using voxel-based morphometry. Non-contrast MDCT scans of 16 patients under the age of 40 (mean age 26years) without spinal pathology were identified as a reference cohort, where each thoracolumbar vertebra was assessed individually...
July 14, 2017: Bone
https://www.readbyqxmd.com/read/28713528/the-double-transforaminal-lumbar-interbody-fusion-an-innovative-one-stage-surgical-technique-for-posterior-kyphosis-correction
#11
Marcus Jäger, Tjark Tassemeier
Posttraumatic deformities after vertebral fractures are challenging for orthopedic surgeons in the non-operative and operative field. Especially osteoporotic fractures may cause a hyperkyphosis resulting in segmental or global sagittal imbalance and chronic back pain. Different vertebral osteotomies are potent to restore sagittal profile but show a very high perioperative risk including neurological and soft tissue complications. In addition, some of these extensive operations require a two-step procedure including posterior and anterior approaches...
June 23, 2017: Orthopedic Reviews
https://www.readbyqxmd.com/read/28662833/additional-vertebral-augmentation-with-posterior-instrumentation-for-unstable-thoracolumbar-burst-fractures
#12
Fu-Cheng Kao, Ming-Kai Hsieh, Chia-Wei Yu, Tsung-Ting Tsai, Po-Liang Lai, Chi-Chien Niu, Lih-Huei Chen, Wen-Jer Chen
BACKGROUND: To investigate the role of vertebral augmentation in kyphosis reduction, vertebral fracture union, and correction loss after surgical management of thoracolumbar burst fracture. DESIGN: Retrospective chart and radiographic review. SETTING: Level 1 trauma center. METHODS: The analysis included patients treated between April 2007 and June 2015, who received pedicle-screw-rod distraction and reduction within two days following acute traumatic thoracolumbar burst fracture with a load sharing score >6...
June 20, 2017: Injury
https://www.readbyqxmd.com/read/28648115/complete-thoracolumbar-fracture-dislocation-with-intact-neurologic-function-explanation-of-a-novel-cord-saving-mechanism
#13
Abolfazl Rahimizadeh, Naser Asgari, Ava Rahimizadeh
BACKGROUND: The thoracolumbar junction from T11 to L2 is a common site of injury in which fracture and dislocations are the most prevalent ones occurring at this location. Fracture dislocation is defined as failure of all three columns of the spine with gross displacement. Considering the significant violence necessary to produce fracture dislocations, these injuries are often associated with major neural deficit, with the majority of casualties becoming paraplegic immediately. Preservation of neurological function following complete fracture dislocation is quite rare entity...
June 26, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28641907/is-fusion-superior-to-non-fusion-for-the-treatment-of-thoracolumbar-burst-fracture-a-systematic-review-and-meta-analysis
#14
Tao Lan, Yang Chen, Shi-Yu Hu, Ao-Lin Li, Xin-Jian Yang
OBJECTIVE: The purpose of this meta-analysis was to compare the efficacy and safety between patients with thoracolumbar burst fracture who underwent posterior fixation alone (non-fusion) and supplemented with fusion. METHODS: A comprehensive search of related literature was performed in PubMed, Embase and the Cochrane library. Clinical outcomes (LBOS and VAS), surgical outcomes (operation time, blood loss, hospital stay and perioperative complications), and radiographic outcomes (kyphotic angle, decreased vertebral body height and segmental motion) were assessed in the meta-analysis...
June 19, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28640112/cement-leakage-in-osteoporotic-vertebral-compression-fractures-with-cortical-defect-using-high-viscosity-bone-cement-during-unilateral-percutaneous-kyphoplasty-surgery
#15
Tie Liu, Zhe Li, Qingjun Su, Yong Hai
The purpose of this study was to investigate cement leakage (CL) in osteoporotic vertebral compression fractures (OVCFs) with cortical defect using high-viscosity bone cement during unilateral percutaneous kyphoplasty (PKP) surgery.This study included a series of 77 patients (23 males, 54 females) with single level osteoporotic vertebral body fracture (OVCF) who underwent unilateral PKP in our hospital. Preoperative x-ray, computed tomography (CT) scan, and 3-dimensional reconstructions were studied. During the PKP procedure, needle was carefully put to avoid too near to the cortical defect according to CT image...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639828/prevalence-of-vertebral-compression-fractures-on-routine-ct-scans-according-to-l1-trabecular-attenuation-determining-relevant-thresholds-for-opportunistic-osteoporosis-screening
#16
Peter M Graffy, Scott J Lee, Timothy J Ziemlewicz, Perry J Pickhardt
OBJECTIVE: Radiologists interpreting body CT scans may be the first to identify osteoporosis and associated vertebral fractures. This study correlates L1 trabecular attenuation measurements with prevalent vertebral body fractures in older adults undergoing routine CT. MATERIALS AND METHODS: Mean L1 trabecular attenuation was measured at thoracoabdominal CT in 1966 consecutive adults (983 men and 983 women) 65 years and older (mean age, 74.1 ± 6.6 [SD] years). Sagittal reconstructions and lateral scouts were analyzed for moderate or severe thoracolumbar vertebral compression fractures according to the Genant semiquantitative assessment method...
June 22, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28632547/a-less-invasive-retroperitoneal-lumbar-approach-animal-feasibility-study-and-primary-clinical-study
#17
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...
July 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28619021/treatment-of-thoracolumbar-burst-fractures-by-short-segment-pedicle-screw-fixation-using-a-combination-of-two-additional-pedicle-screws-and-vertebroplasty-at-the-level-of-the-fracture-a-finite-element-analysis
#18
Jen-Chung Liao, Weng-Pin Chen, Hao Wang
BACKGROUND: Traditional one-above and one-below four-screw posterior short-segment instrumentation is used for unstable thoracolumbar burst fractures. However, this method has a high rate of implant failure and early loss of reduction. The purpose of this study was to use finite element (FE) analysis to determine the effect of treating thoracolumbar burst fractures by short-segment pedicle screw fixation using a combination of two additional pedicle screws and vertebroplasty at the level of the fracture...
June 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28598294/open-versus-percutaneous-instrumentation-in-thoracolumbar-fractures-magnetic-resonance-imaging-comparison-of-paravertebral-muscles-after-implant-removal
#19
COMPARATIVE STUDY
Yves Ntilikina, David Bahlau, Julien Garnon, Sébastien Schuller, Axel Walter, Mickaël Schaeffer, Jean-Paul Steib, Yann Philippe Charles
OBJECTIVE Percutaneous instrumentation in thoracolumbar fractures is intended to decrease paravertebral muscle damage by avoiding dissection. The aim of this study was to compare muscles at instrumented levels in patients who were treated by open or percutaneous surgery. METHODS Twenty-seven patients underwent open instrumentation, and 65 were treated percutaneously. A standardized MRI protocol using axial T1-weighted sequences was performed at a minimum 1-year follow-up after implant removal. Two independent observers measured cross-sectional areas (CSAs, in cm(2)) and region of interest (ROI) signal intensity (in pixels) of paravertebral muscles by using OsiriX at the fracture level, and at cranial and caudal instrumented pedicle levels...
August 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28597301/osteoarthritis-and-spontaneous-fusion-of-facet-joints-after-percutaneous-instrumentation-in-thoracolumbar-fractures
#20
Alix Tromme, Yann Philippe Charles, Sébastien Schuller, Axel Walter, Mickaël Schaeffer, Jean-Paul Steib
PURPOSE: This retrospective study determined the rate of osteoarthritis and spontaneous facet joint fusion and analyzed risk factors related to patient characteristics, fracture type or surgical technique on pre- and postoperative CT after percutaneous instrumentation in thoracolumbar fractures. METHODS: 1050 facet joints adjacent to screws in 148 patients (15-85 years) with thoracolumbar fractures were analyzed with an average time between CTs of 12.3 months...
June 9, 2017: European Spine Journal
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