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Thoracolumbar fractures

Hai-Bo Sun, Xiao-Shan Jing, Yu-Zeng Liu, Ming Qi, Xin-Kuan Wang, Yong Hai
OBJECTIVE: Our aim was to probe the relationship among cement volume/fraction, imaging features of cement distribution, and pain relief, and then to evaluate the optimal volume during percutaneous vertebroplasty. METHODS: From January 2014 to January 2017, a total of 130 patients eligible for inclusion criteria were enrolled in this prospective cohort study. According to the different degrees of pain relief, cement leakage, and cement distribution, all patients were allocated to 2 groups...
March 16, 2018: World Neurosurgery
Michelle H Chua, Raksmey Hong, Tytim Rydeth, Iv Vycheth, Sam Nang, Din Vuthy, Kee B Park
INTRODUCTION: In recent years, delivery of cost-effective "essential neurosurgery" in resource-limited communities has been recognized as an indispensable part of health care and a global health priority. The purpose of this study was to review outcomes from operative management of spine trauma at a resource limited government hospital in Phnom Penh, Cambodia, and to provide an epidemiologic report to guide prevention programs. METHODS: A retrospective review of a prospective neurosurgical database was performed to identify risk factors for spine trauma and severe spinal cord injury (ASIA A or ASIA B) and to evaluate the cost-effectiveness of surgery for patients treated at Preah Kossamak Hospital for subaxial and thoracolumbar spine trauma from 2013 to 2016...
March 14, 2018: World Neurosurgery
Daisuke Nakashima, Tsukasa Kanchiku, Norihiro Nishida, Saki Ito, Junji Ohgi, Hidenori Suzuki, Yasuaki Imajo, Masahiro Funaba, Xian Chen, Toshihiko Taguchi
Vertebral fractures commonly occur at the thoracolumbar junction. These fractures can be treated with mild residual deformity in many cases, but are reportedly associated with increased risk of secondary vertebral fractures. In the present study, a three-dimensional (3D) whole spine model was constructed using the finite element method to explore the mechanism of development of compression fractures. The 3D model of the whole spine, from the cervical spine to the pelvis, was constructed from computed tomography (CT) images of an adult male...
April 2018: Experimental and Therapeutic Medicine
Ian Kaye, Peter Passias
Minimally invasive surgical (MIS) techniques offer promising improvements in the management of thoracolumbar trauma. Recent advances in MIS techniques and instrumentation for degenerative conditions have heralded a growing interest in employing these techniques for thoracolumbar trauma. Specifically, surgeons have applied these techniques to help manage flexion- and extension-distraction injuries, neurologically intact burst fractures, and cases of damage control. Minimally invasive surgical techniques offer a means to decrease blood loss, shorten operative time, reduce infection risk, and shorten hospital stays...
March 2018: Bulletin of the Hospital for Joint Diseases
Kivanc Atesok, Nobuhiro Tanaka, Andrew O'Brien, Yohan Robinson, Dachling Pang, Donald Deinlein, Sakthivel Rajaram Manoharan, Jason Pittman, Steven Theiss
"Spinal Cord Injury without Radiographic Abnormality" (SCIWORA) is a term that denotes objective clinical signs of posttraumatic spinal cord injury without evidence of fracture or malalignment on plain radiographs and computed tomography (CT) of the spine. SCIWORA is most commonly seen in children with a predilection for the cervical spinal cord due to the increased mobility of the cervical spine, the inherent ligamentous laxity, and the large head-to-body ratio during childhood. However, SCIWORA can also be seen in adults and, in rare cases, the thoracolumbar spinal cord can be affected too...
2018: Advances in Orthopedics
Conghui Zhang, Yang Liu
BACKGROUND: Thoracolumbar fractures is a frequent injury occurring in spinal trauma. Outcomes and complications between combined pedicle screw fixation at the fracture vertebrae (AFV) and conventional method cross the fracture vertebrae (CFV) are still controversial. Thus, this study aimed to evaluate differences in outcome variables between these two operative methods. MATERIALS AND METHODS: PubMed, Web of Science, Cochrane Library, EMBASE and CNKI were searched with the terms "thoracolumbar fractures", "posterior", "pedicle screw fixation", and "clinical trial" from Jan 1980 to July 2017...
March 10, 2018: International Journal of Surgery
Xu-Dong Hu, Wei-Hu Ma, Wei-Yu Jiang, Yun-Lin Chen, Chao-Yue Ruan
OBJECTIVE: To evaluate the clinical effects of percutaneous pedicle screw fixation combined with limited open decompression technique for the treatment of thoracolumbar fractures with neurologic deficit. METHODS: The clinical data of 76 patients with thoracolumbar fractures with neurologic deficit underwent percutaneous pedicle screw fixation combined with limited open decompression technique from June 2010 to June 2014 were retrospectively analyzed. There were 45 males and 31 femals, aged from 17 to 56 years with an average of 32...
January 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
F Gilbert, T M Heintel, M G Jakubietz, H Köstler, C Sebald, R H Meffert, A M Weng
BACKGROUND: Minimally invasive pedicle screw fixation has less approach-related morbidity than open screw placement and is allegedly less traumatizing on paravertebral muscles, as there is no requirement to mobilize and retract the adjacent muscle portion. The approach-related long-term effects to the morphology of the paravertebral muscles are unknown. The purpose of this study was to compare the long-term amount of fatty degeneration of the multifidus muscle in patients treated with a classical open or a minimally invasive approach...
March 7, 2018: BMC Musculoskeletal Disorders
Wang Decheng, Shi Hao, Wang Zhongwei, Li Jiaming, Yang Bin, Hai Yong
OBJECTIVE: To investigate and compare the efficacy of three-step reduction (TSR) therapy of integrated Chinese and Western Medicine and posterior open (PO) surgery for thoracolumbar burst fracture. METHODS: We selected 60 patients diagnosed with thoracolumbar burst fracture and received treatment in our hospital from December 2014 to March 2017. According to randomized digital table, they were randomly divided into TSR and PO groups. VAS pain grade, Oswestry disability index, height of centrum front, Cobb's angle of spine, bleeding, and complication of internal fixation of the two groups were compared...
March 5, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Miguel Pishnamaz, Ulrike Schemmann, Christian Herren, Klemens Horst, Philipp Lichte, Frank Hildebrand, Hans-Christoph Pape, Philipp Kobbe
PURPOSE: This review addressed the question of whether minimally invasive surgery after traumatic thoracolumbar spine fractures can reduce paraspinal muscle injury, limit changes in muscular structure and function, and lead to better functional outcome. Special emphasis was given to studies using imaging techniques or electromyography to evaluate the lumbar multifidus muscle structure and function. METHODS: The authors searched the literature in the PubMed/Medline, EMBASE, by cross-referencing and additional hand search...
March 1, 2018: Journal of Musculoskeletal & Neuronal Interactions
Thamrong Lertudomphonwanit, Michael P Kelly, Keith H Bridwell, Lawrence G Lenke, Steven J McAnany, Prachya Punyarat, Timothy P Bryan, Jacob M Buchowski, Lukas P Zebala, Brenda A Sides, Karen Steger-May, Munish C Gupta
BACKGROUND CONTEXT: Risk factors associated with rod fracture (RF) following adult spinal deformity (ASD) surgery fused to the sacrum remain debatable and the impact of RF on patient-reported outcomes (PROs) after ASD surgery has not been investigated. PURPOSE: To evaluate the prevalence of and risk factors for RF and determine PROs change associated with RF after ASD surgery fused to the sacrum. STUDY DESIGN/SETTING: Retrospective single-center cohort...
February 28, 2018: Spine Journal: Official Journal of the North American Spine Society
Zhi-da Chen, Jin Wu, Xiao-Tao Yao, Tao-Yi Cai, Wen-Rong Zeng, Bin Lin
BACKGROUND: Posterior short-segment pedicle screw fixation is used to treat thoracolumbar burst fractures. However, no randomized controlled studies have compared the efficacy of the two approaches--the Wiltse's paraspinal approach and open book laminectomy in the treatment of thoracolumbar burst fractures with greenstick lamina fractures. MATERIALS AND METHODS: Patients with burst fractures of the thoracolumbar spine without neurological deficit were randomized to receive either the Wiltse's paraspinal approach (group A, 24 patients) or open book laminectomy (group B, 23 patients)...
March 2, 2018: Journal of Orthopaedic Surgery and Research
Junfeng Zeng, Quan Gong, Hao Liu, Xin Rong, Chen Ding
RATIONALE: Traumatic fracture of the thoracolumbar junction (T10-L2) is the most common fracture of the spinal column. Due to the disruption of the entire vertebrae column, the fracture-dislocation of the thoracolumbar spine is almost invariably associated with neurological injury. A complete fracture-dislocation of the thoracolumbar spine without neurological deficit is a rare entity. PATIENT CONCERNS: A 38-year-old man presented with severe low back pain after an accident when he was building a house...
March 2018: Medicine (Baltimore)
Claudia Frellesen, Mehrnoush Azadegan, Simon S Martin, Katharina Otani, Tommaso DʼAngelo, Christian Booz, Katrin Eichler, Bita Panahi, Moritz Kaup, Ralf W Bauer, Thomas J Vogl, Julian L Wichmann
PURPOSE: The aim of this study was to evaluate the diagnostic performance of virtual noncalcium (VNCa) dual-energy computed tomography (DECT) reconstructions enabling visualization of bone marrow edema for characterization of incidental thoracolumbar compression fractures in routine thoracoabdominal staging computed tomography (CT). MATERIALS AND METHODS: We retrospectively analyzed 51 oncological patients without suspected fracture or indicative complaints presenting at least 1 thoracolumbar compression fracture on routine thoracoabdominal staging DECT who had been examined between October 2015 and June 2017 using third-generation dual-source CT, had a previous CT within 3 months before, and also had undergone additional magnetic resonance imaging within 14 days, which served as the standard of reference...
February 27, 2018: Investigative Radiology
Christina Mousele, Miltiadis Georgiopoulos, Constantine Constantoyannis
CONTEXT: Syringobulbia is a very rare progressive disorder of central nervous system, with several possible underlying conditions. Rarely, it is also encountered as a late complication of syringomyelia. FINDINGS: In the present manuscript, a case of a paraplegic patient, due to traumatic spinal cord injury (thoracolumbar fracture), presenting after years progressively developing symptoms of the lower cranial nerves and upper extremities, owed to syringomyelia and syringobulbia, the surgical treatment applied and its outcomes are described...
February 27, 2018: Journal of Spinal Cord Medicine
Junjie Niu, Dawei Song, Minfeng Gan, Bin Liu, Chenglong Tan, Huilin Yang, Bin Meng
Background Kyphoplasty has been demonstrated to be minimally invasive and effective in treating osteoporotic vertebral fracture patients with back pain over the level of the fractured vertebrae. Rare studies have reported on thoracolumbar vertebral fracture patients presenting with distal lumbosacral pain (DLP). Whether kyphoplasty had a favorable therapeutic benefit for these patients remains unclear. Purpose To evaluate the therapeutic efficacy of kyphoplasty in treating osteoporotic thoracolumbar vertebral fracture (OTVF) patients with DLP and assess the clinical significance of focal tenderness to palpation in these patients...
January 1, 2018: Acta Radiologica
Hiroshi Uei, Yasuaki Tokuhashi, Masafumi Maseda, Masahiro Nakahashi, Enshi Nakayama
Surgical treatment of multiple vertebral fractures in patients with glucocorticoid-induced osteoporosis is difficult because of a high rate of secondary fracture postoperatively. A case is described in which initial treatment with teriparatide to improve osteoporosis followed by treatment of kyphosis with correction fusion achieved a favorable outcome. INTRODUCTION: Secondary fracture frequently occurs after treatment of vertebral fracture with vertebroplasty and balloon kyphoplasty in patients with glucocorticoid-induced osteoporosis, but effective treatment of multiple vertebral fractures has rarely been reported...
February 23, 2018: Osteoporosis International
Bradford A Wall, Alan Moskowitz, M Camden Whitaker, Teresa L Jones, Ryan M Stuckey, Catherine L Carr-Maben, Alexander Cm Chong
Introduction: Few studies have evaluated the functional outcomes of traumatic thoracic and lumbar vertebral body fractures. This study evaluated the functional and clinical outcomes of patients, who sustained a fracture to the thoracolumbar area of the spine (T10 to L2 region), with ≥ 25° kyphosis versus those with less kyphotic curvature. Methods: The trauma registry records of two level 1 trauma centers using ICD-9 codes for fracture to the thoracolumbar juncture (T10 to L2 region) were reviewed...
May 2017: Kansas Journal of Medicine
Xin Zhao, Jie Zhao, Jie Guan, Junkai Zeng, Chen Han, Yuzhou He, Tangjun Zhou, Chen Chen, Youzhuan Xie
The purpose of this study was to evaluate the relationship between the nerve root of lower lumbar and the surrounding structures using three-dimensional computed tomography (3D CT).Twenty-three consecutive patients with thoracolumbar fractures without obvious radiological degeneration were retrospectively studied at the spinal surgery department of the hospital. The parameters of the relationship between the nerve root of the lower lumbar and the surrounding structures were measured using 3D CT in the work station of the picture archiving and communication system...
February 2018: Medicine (Baltimore)
Rafael A Buerba, Akshay Sharma, Chason Ziino, Alexander Arzeno, Remi M Ajiboye
STUDY DESIGN: Systematic review and meta-analysis. OBJECTIVE: To compare the efficacy of the use of either bisphosphonates or teriparatide on radiographic and functional outcomes of patients that had thoracolumbar spinal fusion. SUMMARY OF BACKGROUND DATA: Controversy exists as to whether bisphosphonates interfere with successful spinal arthrodesis. An alternative osteoporosis medication is teriparatide, a synthetic parathyroid hormone that has an anabolic effect on osteoblast function...
February 16, 2018: Spine
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