Vertebroplasty plus short segment pedicle screw fixation in a burst fracture model in cadaveric spines

2015 ◽  
Vol 22 (5) ◽  
pp. 883-888 ◽  
Author(s):  
Andrew J. Grossbach ◽  
Stephanus V. Viljoen ◽  
Patrick W. Hitchon ◽  
Nicole A. DeVries Watson ◽  
Nicole M. Grosland ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Burst Fracture ◽  
Pedicle Screw Fixation ◽  
Fracture Model ◽  
Short Segment

scholarly journals The Hardware Failure and Correction Loss of Short-segment Pedicle Screw Fixation Combined With Transforaminal Interbody Fusion in Treatment of Unstable Thoracolumbar Burst Fracture: Retrospective Study in Vietnam

2021 ◽  
Author(s):  
Ngoc Quyen Nguyen ◽  
Trong Hau Phan ◽  
Van Hong Vu
Keyword(s):  
Pedicle Screw ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Burst Fracture ◽  
Pedicle Screw Fixation ◽  
Correction Loss ◽  
Short Segment ◽  
Hardware Failure ◽  
Transforaminal Interbody Fusion

Abstract Background: Correction loss and hardware failure of short segment posterior pedicle screw fixation in treatment of thoracolumbar unstable burst fracture have been remaining a main concern. Several authors have introduced the procedures to solve these limitations including transforaminal interbody fusion (TIF). The purposes of this study were to evaluate the progressive kyphosis and implant failure of short-segment pedicle screw fixation combined with transforaminal interbody fusion in treatment of unstable thoracolumbar burst fracture.Methods: The retrospective study were enrolled in the patients with isolated unstable thoracolumbar burst fractures, Denis type IIB who were treated by posterior short fixation with TIF between January 2013 to January 2017. Patients were followed up for a minimum of one and half year. For evaluation of correction loss, % loss of anterior vertebral body heights (%AVB), vertebral kyphotic angle (VA) and regional kyphotic angle (RA) were collected preoperatively, postoperatively and at final follow-up. The hardware failure was assessed on radiological images at last follow-up. Results: There were 36 patients who met the inclusion criteria with a mean follow-up duration of 53 months. The mean correction loss of %AVB, VA and, RA were 10.2%, 2.9o and 5.6o, respectively. There were 6 patients (16.7%) with hardware failure at final follow-up. Conclusions: Short-segment posterior pedicle screw fixation with TIF using bone chip graft hasn’t prevented completely the hardware failure and progressive kyphosis in treatment of unstable thoracolumbar burst fracture.

scholarly journals Posterior fixation including the fractured vertebra in short segment fixation of unstable thoracolumbar junction burst fractures

2016 ◽  
Vol 9 (2) ◽  
pp. 81
Author(s):  
Md. Kamrul Ahsan ◽  
Zabed Zahangiri ◽  
M. A. Awwal ◽  
Naznin Zaman ◽  
Md. Hamidul Haque ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Burst Fracture ◽  
Pedicle Screw Fixation ◽  
Thoracolumbar Junction ◽  
Vertebral Height ◽  
Short Segment ◽  
The Mean ◽  
Short Segment Fixation

<p>The aim of this study was to evaluate the efficacy of inclusion of the fractured vertebra in short segment fixation in terms of clinical and the radiological outcomes in unstable thoracolumbar junction burst fractures at a minimum of 1 year follow-up. Records of 52 patients (age: 21-50 years) with thoracolumbar burst fracture (T10–L2) in Magerl Type A fractures underwent posterior pedicle screw fixation including the fractured vertebra. Clinical parameters were back pain using Visual Analogue Score (VAS) and disability using Oswestry disability index (ODI), neurological deficit (using ASIA grade) and radiologic parameters (Cobb angle, the kyphotic deformation and vertebral height) were measured before surgery and at 3, 6 and 12 months  post-operatively. The presence of screw breakage, screw pullout, peri-implant loosening, and rod breakage were considered as criteria for implant failure. The majority of fractures resulted due to falls (31 cases), and the remaining cases resulted from car accidents (21 cases). The fractured vertebral body level was L1, T12, L2, T11, and T10 in 23, 17, 6, 4 and 2 cases and achieved satisfactory clinical outcomes according to the modified Mcnab criteria 18, 25, 6 and 3 cases were considered to have excellent, good, fair, and poor outcome. The mean kyphotic angle at pre-, post-operative and final follow-up was 13.5 ± 6.3, 13.4 ± 4.3, 8.5 ± 6.  The average loss of kyphosis correction was 6.4 ± 5.2° at the final follow-up. The mean pre- and post-operative kyphotic deformation of vertebral body was 5.1 ± 3.2, 4.8 ± 2.3 and at final follow-up was 4.5 ± 4.0 (p&gt;0.05). The mean anterior and posterior vertebral height also showed significant improvements post-operatively, which were maintained at the final follow-up. The mean ODI and VAS scores at the end of 1 year were 17.4%, 1.7 respectively. There was no case of major complication after surgery and during the follow-up period. In conclusion, reduction of unstable thoracolumbar junction burst fracture can be achieved and maintained with the use of short-segment pedicle screw fixation including the fractured vertebra, avoiding the need for anterior reconstruction.</p><p> </p>

scholarly journals Modified Posterior Short-Segment Pedicle Screw Fixation at The Fracture Level for Treatment of Upper Lumbar Burst Fracture

2020 ◽  
Author(s):  
Xubiao Chen ◽  
Shixin Lu ◽  
Songjie Yang ◽  
Junshen Huang ◽  
Jiajun Huang ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Burst Fracture ◽  
Conventional Technique ◽  
Pedicle Screw Fixation ◽  
Conventional Group ◽  
Modified Technique ◽  
Short Segment ◽  
Burst Fractures

Abstract Introduction Upper lumbar burst fractures (L1or L2) are often followed by bilateral pedicle screw fixation at the level of fracture using posterior short-segment pedicle instrumentation. However, it can aggravate the trauma to the fractured vertebra. We have introduced a modified technique of posterior short-segment instrumentation for the treatment of upper lumbar burst fracture. The aim of this study was to compare the clinical and radiologic results of modified technique versus conventional technique using posterior short-segment pedicle instrumentation in the treatment of upper lumbar burst fractures. Methods The data from 64 patients with upper lumbar burst fracture who had undergone posterior short-segment instrumentation from April 2014 to November 2018 in our clinic were evaluated in the present retrospective study. All the patients were divided into 2 groups according to the surgical technique, including 27 patients (modified order of intraoperative pedicle screw placement) in modified group and 37 patients (conventional order of intraoperative pedicle screw placement) in conventional group. The clinical outcomes and radiological parameters were evaluated preoperatively, postoperatively, at 3-month follow-up and final follow-up.Results Technical success was achieved in all 64 patients. The operation time of modified group(130.4±32.4min) is significantly longer than conventional group (115.3±26.8min, p<0.05). Significant improvement in the anterior vertebral height(AVH) ratio (97.9%±6.7% in modified group, 94.1%±7.8% in conventional group, p<0.05) was found postoperatively, (100.1%±9.7% in modified group, 89.6%±6.7% in conventional group, p<0.01) at the 3-month follow-up and(98.8%±7.7% in modified group, 90.9%±7.6% in conventional group, p<0.01) at the final follow-up. And post-operative correction of AVH ratio was significantly better in modified group (45.0%) than in conventional group (38.8%, p<0.01). There was 1 case of wound infection in both groups respectively. No instrument loosening or failure, or breakage was observed during follow-up.Conclusions Modified technique and conventional technique of posterior short-segment pedicle screw fixation for upper lumbar burst fractures both provided immediate stability and reduction of post-traumatic segmental kyphosis. In addition, modified technique of posterior short-segment pedicle screw fixation seems to be a promising method for upper lumbar burst fractures because it led to better reduction of fractured vertebra than in patients who received conventional technique.

scholarly journals “Short Segment pedicle screw fixation for the treatment of unstable thoracolumbar fracture”- a study of 50 cases.

2015 ◽  
Vol 31 (1) ◽  
pp. 30-33
Author(s):  
Sukriti Das ◽  
Md Atikur Rahman ◽  
Md Manirul Islam ◽  
Md Mahfuzur Rahman ◽  
Md Reaz Ahmed Howlader ◽  
...  
Keyword(s):  
Bone Graft ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Burst Fracture ◽  
Pedicle Screw Fixation ◽  
Thoracolumbar Burst Fracture ◽  
Short Segment ◽  
Hardware Failure ◽  
Neurological Improvement ◽  
Frankel Grade

Introduction: Short segment pedicle screw fixation is a popular procedure for treating unstable thoracolumbar burst fracture. But due to lack of adequate neurological improvement, progressive kyphosis and hardware failure- the efficacy of different methods remain debatable. Method : 50 patients with isolated thoracolumbar burst fractures were treated by short segment pedicle screw fixation and transforaminal thoracolumbar inter body fusion (TLIF) between January 2010 to December 2013. All patients were followed up for a minimum 2 years. Demographic data, Neurological improvement (Frankel) grade and Hardware failure related complication were evaluated. Results: All patients recovered with solid bony fusion by inter vertebral bone graft and pedicle screw without complications like misplacement of screw, nerve or vessel lesion or hardware failure. The post-operative radiographic demonstration reveals- good fracture reduction and it was well maintained until the bone graft fusion. Neurological recovery of the one to three Frankel grade was seen in 42 patients with partial neurological deficit. Among the 30 patients 3 grade improvements was seen in 4 patients, 2 grade of improvement was observed in 20 patients and 1 grade of improvement was found in 18 patients. 3 patients with Franke-D on admission showed no improvement. 5 patients with no paraplegia/hemiplegia on admission remained neurological intact. Conclusion: Posterior short segment pedicle fixation in conjunction with TLIF seems to be a feasible option in the management of selected thoracolumbar burst fracture with good neurological improvement. Bangladesh Journal of Neuroscience 2015; Vol. 31 (1): 30-33

scholarly journals Posterior thoracolumbar hemivertebra resection and short-segment fusion in congenital scoliosis: surgical outcomes and complications with more than 5-year follow-up

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Beixi Bao ◽  
Qingjun Su ◽  
Yong Hai ◽  
Peng Yin ◽  
Yaoshen Zhang ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Surgical Outcomes ◽  
Screw Fixation ◽  
Congenital Scoliosis ◽  
Pedicle Screw Fixation ◽  
Rigid Fixation ◽  
Short Segment ◽  
Hemivertebra Resection ◽  
Main Curve

Abstract Background Treatment of congenital hemivertebra is challenging and data on long-term follow-up (≥ 5 years) are lacking. This study evaluated the surgical outcomes of posterior thoracolumbar hemivertebra resection and short-segment fusion with pedicle screw fixation for treatment of congenital scoliosis with over 5-year follow-up. Methods This study evaluated 27 consecutive patients with congenital scoliosis who underwent posterior thoracolumbar hemivertebra resection and short-segment fusion from January 2007 to January 2015. Segmental scoliosis, total main scoliosis, compensatory cranial curve, compensatory caudal curve, trunk shift, shoulder balance, segmental kyphosis, and sagittal balance were measured on radiographs. Radiographic outcomes and all intraoperative and postoperative complications were recorded. Results The segmental main curve was 40.35° preoperatively, 11.94° postoperatively, and 13.24° at final follow-up, with an average correction of 65.9%. The total main curve was 43.39° preoperatively, 14.13° postoperatively, and 16.06° at final follow-up, with an average correction of 60.2%. The caudal and cranial compensatory curves were corrected from 15.78° and 13.21° to 3.57° and 6.83° postoperatively and 4.38° and 7.65° at final follow-up, with an average correction of 69.2% and 30.3%, respectively. The segmental kyphosis was corrected from 34.30° to 15.88° postoperatively and 15.12° at final follow-up, with an average correction of 61.9%. A significant correction (p < 0.001) in segmental scoliosis, total main curve, caudal compensatory curves and segmental kyphosis was observed from preoperative to the final follow-up. The correction in the compensatory cranial curve was significant between preoperative and postoperative and 2-year follow-up (p < 0.001), but a statistically significant difference was not observed between the preoperative and final follow-up (p > 0.001). There were two implant migrations, two postoperative curve progressions, five cases of proximal junctional kyphosis, and four cases of adding-on phenomena. Conclusion Posterior thoracolumbar hemivertebra resection after short-segment fusion with pedicle screw fixation in congenital scoliosis is a safe and effective method for treatment and can achieve rigid fixation and deformity correction.

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