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Thoracolumbar fractures

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https://www.readbyqxmd.com/read/28412987/back-pain-in-the-emergency-department-pathological-fracture-following-spinal-manipulation
#1
Christopher Skappak, Erik J Saude
Back pain is one of the most common presentations to the emergency department. Though case reports of patients presenting with increased back pain following chiropractic spinal manipulations are rare, we have identified a case rarely reported in the literature where a potential injury from chiropractic manipulation resulted in a diagnosis of multiple myeloma. We have reported a previously healthy 66-year-old male who presented with persistent lower back pain over 4 weeks. An initial evaluation with thoracolumbar radiographs revealed no significant findings...
April 17, 2017: CJEM
https://www.readbyqxmd.com/read/28409669/treatment-of-thoracolumbar-burst-fractures-extended-follow-up-of-a-randomized-clinical-trial-comparing-orthosis-versus-no-orthosis
#2
Jennifer C Urquhart, Osama A Alrehaili, Charles G Fisher, Alyssa Fleming, Parham Rasoulinejad, Kevin Gurr, Stewart I Bailey, Fawaz Siddiqi, Christopher S Bailey
OBJECTIVE A multicenter, prospective, randomized equivalence trial comparing a thoracolumbosacral orthosis (TLSO) to no orthosis (NO) in the treatment of acute AO Type A3 thoracolumbar burst fractures was recently conducted and demonstrated that the two treatments following an otherwise similar management protocol are equivalent at 3 months postinjury. The purpose of the present study was to determine whether there was a difference in long-term clinical and radiographic outcomes between the patients treated with and those treated without a TLSO...
April 14, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28389230/thick-cement-usage-in-percutaneous-vertebroplasty-for-malignant-vertebral-fractures-at-high-risk-for-cement-leakage
#3
R M Reyad, H Z Ghobrial, S M Hakim, R H Hashem, A Elsaman, M H Shaaban
PURPOSE: To assess the feasibility and safety of transpedicular percutaneous vertebroplasty (PVP) using thick bone cement in patients with intractable metastatic vertebral pain and at high risk for cement leakage. METHODS: Unilateral transpedicular PVP using firm bone cement was performed in 77 patients with intractable pain due to vertebral metastases in the thoracolumbar spine, who had one or more relative contraindication to PVP. Primary outcome measures were the severity of pain as assessed on a 100-mm visual analogue scale and daily morphine consumption...
April 4, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28383409/clinical-case-series-report-of-traumatic-cauda-equina-herniation-a-pathological-phenomena-occurring-with-thoracolumbar-and-lumbar-burst-fractures
#4
Liang Yan, Yang Liu, Baorong He, Jijun Liu, Zhenguo Luo, Dingjun Hao
RATIONALE: Burst fractures in thoracolumbar and lumbar spine typically occur from severe trauma, which may result in cauda equina herniation (CEH). In this study, we attempted to document the incidence and evaluate the sequelae of CEH that were found during decompression and fusion surgery for patients with burst fractures. PATIENT CONCERNS: A total of 416 patients were enrolled in this study. DIAGNOSES: The patients had been operated on through an anterior or posterior approach for treatments of thoracolumbar and lumbar burst fractures at our department between June 1, 2008 and June 1, 2011...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28373079/temporary-short-segment-pedicle-screw-fixation-for-thoracolumbar-burst-fractures-comparative-study-with-or-without-vertebroplasty
#5
Hiroyuki Aono, Keisuke Ishii, Hidekazu Tobimatsu, Yukitaka Nagamoto, Shota Takenaka, Masayuki Furuya, Horii Chialki, Motoki Iwasaki
BACKGROUND CONTEXT: Short-segment posterior spinal instrumentation for thoracolumbar burst fracture provides superior correction of kyphosis by an indirect reduction technique, but it has a high failure rate. PURPOSE: The purpose of the study we report here was to compare outcomes for temporary short-segment pedicle screw fixation with vertebroplasty and for such fixation without vertebroplasty STUDY DESIGN: Prospective multicenter comparative study. PATIENT SAMPLE: We studied 62 consecutive patients with thoracolumbar burst fracture who underwent short-segment posterior instrumentation using ligamentotaxis with Schanz screws with or without vertebroplasty...
March 31, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28367388/delayed-recognition-of-thoracic-and-lumbar-vertebral-compression-fractures-in-minor-accident-cases
#6
Jesse Hatgis, Michelle Granville, Robert E Jacobson
Osteoporotic vertebral compression fractures (VCFs) in the elderly are commonly diagnosed after a minor fall or trauma; however, the majority of these patients have either been previously evaluated for osteoporosis or are already under some form of medical treatment for osteoporosis at the time of the fall. Although accidents are a known cause of VCFs, these fractures are too often undiagnosed. In reviewing a group of patients seen after minor falls or automobile accidents who were complaining of general spine pain, we found a smaller subgroup with previously undiagnosed VCFs...
February 23, 2017: Curēus
https://www.readbyqxmd.com/read/28343026/comparison-of-unilateral-versus-bilateral-pedicle-screw-fixation-at-the-level-of-fracture-using-posterior-short-segment-pedicle-instrumentation-in-the-treatment-of-severe-thoracolumbar-burst-fractures
#7
Chao Sun, Xinhui Liu, Jiwei Tian, Guoping Guan, Hailong Zhang
BACKGROUND: Thoracolumbar burst fractures (TBFs) are often followed by bilateral pedicle screw fixation (BPSF) at the level of fracture using posterior short-segment pedicle instrumentation (SSPI). There has been increasing support for unilateral pedicle screw fixation (UPSF) in an attempt to reduce complications and costs. The aim of this study was to compare the clinical and radiologic results of UPSF versus BPSF at the level of fracture using SSPI in the treatment of severe TBFs. METHODS: The records of 42 consecutive patients with severe TBFs who underwent SSPI were divided into 2 groups according to the number of screws in the fracture level, including 20 patients (five screws) in UPSF group and 22 patients (six screws) in BPSF...
March 22, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28342638/-rationale-and-complications-of-the-anterior-lateral-extrapleural-retroperitoneal-approach-for-unstable-thoracolumbar-fractures-experience-in-86-consecutive-patients
#8
Pedro David Delgado-López, Antonio Rodríguez-Salazar, Vicente Martín-Velasco, Javier Martín-Alonso, José Manuel Castilla-Díez, Ana Galacho-Harriero, Elena Araús-Galdós
OBJECTIVES: To describe the rationale, pros and cons, and complications of the anterior-lateral extrapleural retroperitoneal approach for unstable (TLICS>4) thoracolumbar fractures. PATIENTS AND METHODS: Clinical and radiological data and outcomes from a cohort treated surgically via said approach were retrospectively reviewed. All patients were operated on exclusively by 5 neurosurgeons trained in spine surgery. RESULTS: Between June 1999 and December 2015, 86 patients underwent surgery (median age 42years, most common level: L1)...
March 22, 2017: Neurocirugía
https://www.readbyqxmd.com/read/28324212/anterior-monosegmental-stabilization-and-fusion-of-an-incomplete-cranial-burst-fracture-in-the-thoracolumbar-spine-via-a-mini-open-thoracoscopically-assisted-transthoracic-approach
#9
Andreas Pingel, Jens Castein, Frank Kandziora
No abstract text is available yet for this article.
March 21, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28323718/posterior-distraction-and-instrumentation-cannot-always-reduce-displaced-and-rotated-posterosuperior-fracture-fragments-in-thoracolumbar-burst-fracture
#10
Xiao-Bin Wang, Guo-Hua Lü, Jing Li, Bing Wang, Chang Lu, Kevin Phan
STUDY DESIGN: A retrospective clinical study. OBJECTIVE: To determine the imaging features that can be used to predict failure of reduction of a retropulsed fracture fragment by posterior ligamentotaxis in thoracolumbar burst fractures. SUMMARY OF BACKGROUND DATA: Posterior instrumentation and distraction with ligamentotaxis has been successfully used to shift retropulsed fragments anteriorly in thoracolumbar burst fractures. However, posterior longitudinal ligament rupture can lead to treatment failure...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323710/does-sagittal-spinopelvic-configuration-influence-vertebral-fracture-type-or-localization-in-trauma-patients-a-retrospective-radiologic-analysis
#11
Samy Bouaicha, Marc Cunier, Max J Scheyerer, Guido A Wanner, Hans-Peter Simmen, Clément M L Werner
STUDY DESIGN: Retrospective data analysis. OBJECTIVE: The aim of this study was to analyze correlations between spinopelvic configuration and fracture pattern or location in traumatic vertebral fractures. SUMMARY OF BACKGROUND DATA: The spinopelvic configuration represented by the pelvic incidence (PI) angle showed to have a strong correlation with the occurrence of degenerative diseases of the thoracolumbar spine. No data are available on whether there is an influence of the PI angle on traumatic vertebral lesions as well...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28323706/comparison-of-open-versus-percutaneous-pedicle-screw-fixation-using-the-sextant-system-in-the-treatment-of-traumatic-thoracolumbar-fractures
#12
Hongwei Wang, Yue Zhou, Changqing Li, Jun Liu, Liangbi Xiang
STUDY DESIGN: We retrospectively reviewed 100 patients who were posterior stabilized without graft fusion. Using the Sextant system, 22 patients underwent minimally invasive short-segment 4-pedicle screw fixation (MIF4) and 39 patients underwent minimally invasive short-segment combined with intermediate screws fixation, that is, 6-pedicle screw fixation (MIF6). The conventional open posterior short-segment 4-pedicle screw fixation (OPF4) technique was used in 39 patients. OBJECTIVE: To evaluate the feasibility, safety, and efficacy of percutaneous pedicle screw fixation using the Sextant system in the treatment of traumatic thoracolumbar fractures compared with the conventional open posterior short-segment pedicle screw fixation technique...
April 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28306642/damage-identification-on-vertebral-bodies-during-compressive-loading-using-digital-image-correlation
#13
Hannah M Gustafson, Angela D Melnyk, Gunter P Siegmund, Peter A Cripton
STUDY DESIGN: Ex vivo compression experiments on isolated cadaveric vertebrae OBJECTIVE.: To qualitatively compare the fracture locations identified in video analysis with the locations of high compressive strain measured with DIC on vertebral bodies and to evaluate the timing of local damage to the cortical shell relative to the global yield force SUMMARY OF BACKGROUND DATA.: In previous ex vivo experiments, cortical bone fracture has been identified using various methods including acoustic emission sensors, strain gages, video analysis, or force signals...
March 16, 2017: Spine
https://www.readbyqxmd.com/read/28291409/association-between-bicortical-screw-fixation-at-upper-instrumented-vertebra-and-risk-for-upper-instrumented-vertebra-fracture
#14
Young-Seop Park, Seung-Jae Hyun, Ho Yong Choi, Ki-Jeong Kim, Tae-Ahn Jahng
OBJECTIVE The aim of this study was to investigate the risk of upper instrumented vertebra (UIV) fractures associated with UIV screw fixation (unicortical vs bicortical) and polymethylmethacrylate (PMMA) augmentation after adult spinal deformity surgery. METHODS A single-center, single-surgeon consecutive series of adult patients who underwent lumbar fusion for ≥ 4 levels (that is, the lower instrumented vertebra at the sacrum or pelvis and the UIV of the thoracolumbar spine [T9-L2]) were retrospectively reviewed...
March 3, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28264237/risk-factors-of-proximal-junctional-kyphosis-after-multilevel-fusion-surgery-more-than-2-years-follow-up-data
#15
Do Keun Kim, Ji Yong Kim, Do Yeon Kim, Seung Chul Rhim, Seung Hwan Yoon
OBJECTIVE: Proximal junctional kyphosis (PJK) is radiologic finding, and is defined as kyphosis of >10° at the proximal end of a construct. The aim of this study is to identify factors associated with PJK after segmental spinal instrumented fusion in adults with spinal deformity with a minimum follow-up of 2 years. METHODS: A total of 49 cases of adult spinal deformity treated by segmental spinal instrumented fusion at two university hospitals from 2004 to 2011 were enrolled in this study...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28251286/thoracolumbar-kyphosis-is-associated-with-compressive-vertebral-fracture-in-postmenopausal-women
#16
Y Wei, W Tian, G L Zhang, Y W Lv, G Y Cui
The main aim of this retrospective cross-sectional study was to examine the relationship between vertebral compression fracture and thoracolumbar Cobb angles. Fracture prevalence was found to be significantly higher for patients with moderate [odds ratio (OR) = 4.78 (2.88-7.95)] or severe kyphosis [OR = 10.7 (5.11-22.40)] than for patients with mild kyphosis. The relationship between degree of thoracolumbar kyphosis and vertebral compression fracture was analyzed. INTRODUCTION: The hypothesis that vertebral compression fracture in women is related to thoracolumbar kyphosis severity was tested, and a clinically important cutoff degree of sagittal thoracolumbar Cobb angle (TLCobb) was determined...
March 1, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28247080/comparison-of-pedicle-fixation-by-the-wiltse-approach-and-the-conventional-posterior-open-approach-for-thoracolumbar-fractures-using-mri-histological-and-electrophysiological-analyses-of-the-multifidus-muscle
#17
Liu Junhui, Pang Zhengbao, Xu Wenbin, Hao Lu, Li Shengyun, Fan Shunwu, Zhao Fengdong
PURPOSE: To use imaging, histology and electrophysiological assessment to compare the Wiltse approach to pedicle fixation with the conventional posterior open approach for thoracolumbar fractures. METHODS: We analyzed clinical and histopathological information of consecutive patients with thoracolumbar fractures who underwent short-segment pedicle fixation using either the Wiltse approach or the posterior open approach. Seventy-five patients were enrolled between June 2010 and August 2014 (Wiltse group 35 cases; posterior open group 40 cases)...
February 28, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28244135/spinal-loading-patterns-from-biomechanical-modeling-explain-the-high-incidence-of-vertebral-fractures-in-the-thoracolumbar-region
#18
Alexander G Bruno, Katelyn Burkhart, Brett Allaire, Dennis E Anderson, Mary L Bouxsein
Vertebral fractures occur most frequently in the mid-thoracic and thoracolumbar regions of the spine, yet the reasons for this site-specific occurrence are not known. Our working hypothesis is that the locations of vertebral fracture may be explained by the pattern of spine loading, such that during daily activities the mid-thoracic and thoracolumbar regions experience preferentially higher mechanical loading compared to other spine regions. To test this hypothesis, we used a female musculoskeletal model of the full thoracolumbar spine and rib cage to estimate the variation in vertebral compressive loads and associated factor-of-risk (load-to-strength ratio) throughout the spine for 119 activities of daily living, while also parametrically varying spine curvature (high, average, low, and zero thoracic kyphosis models)...
February 27, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28243383/short-segment-versus-long-segment-pedicle-screws-fixation-in-management-of-thoracolumbar-burst-fractures-meta-analysis
#19
REVIEW
Tarek Ahmed Aly
Posterior pedicle screw fixation has become a popular method for treating thoracolumbar burst fractures. However, it remains unclear whether additional fixation of more segments could improve clinical and radiological outcomes. This meta-analysis was performed to evaluate the effectiveness of fixation levels with pedicle screw fixation for thoracolumbar burst fractures. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Springer, and Google Scholar were searched for relevant randomized and quasirandomized controlled trials that compared the clinical and radiological efficacy of short versus long segment for thoracolumbar burst fractures managed by posterior pedicle screw fixation...
February 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28230624/response-letter-to-minimally-invasive-posterior-decompression-combined-with-percutaneous-pedicle-screw-fixation-for-the-treatment-of-thoracolumbar-fractures-with-neurological-deficits
#20
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