Ten-year follow-up results of posterior instrumentation without fusion for traumatic thoracic and lumbar spine fractures

✓ The short-rod/two-claw (SRTC) technique of spine instrumentation was recently introduced for the treatment of thoracic and lumbar spine fractures. The use of this technique in 10 patients harboring wedge compression or burst fractures of the thoracic or lumbar spine is described. Of three patients treated with the construct placed in a distraction mode, the average follow-up loss of angle (the difference between the immediate postoperative and follow-up midsagittal angle as measured on x-ray films) was 18.3°. Of the seven patients in whom the instrumentation was placed in a compression mode, the average observed loss of angle at follow-up examination was 1.6°. Two patients had a preoperative scoliotic deformity at the fracture site. and both deformities were exaggerated by the placement of the SRTC technique in compression. Although no patient experienced an adverse outcome and all achieved a solid fusion, the application of the SRTC technique of universal spine instrumentation in distraction was associated with an exaggerated loss of angle. Loss of angle and deformity exaggeration are not desirable and are preventable by strict patient selection and by applying the construct in a compression mode. It is emphasized that few patients are candidates for this form of instrumentation. When applicable. however, the advantages of decreased pain and stiffness and the elimination of the need for instrumentation removal make the SRTC and related short-segment techniques desirable alternatives to traditional methods of spinal fixation.

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Early Clinical Results of Short Same-Segment Posterior Fixation in Thoracolumbar Burst Fractures

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0012.2129 ◽

2018 ◽

Vol 20 (3) ◽

pp. 211-217 ◽

Cited By ~ 1

Author(s):

Misbah Mehraj ◽

Farid H. Malik

Keyword(s):

Lumbar Spine ◽

Sagittal Plane ◽

Posterior Instrumentation ◽

Body Height ◽

Posterior Fixation ◽

Spine Fractures ◽

Short Segment ◽

Thoracolumbar Burst Fractures ◽

Burst Fractures ◽

Thoracic And Lumbar Spine

Background. We did a prospective study to study the efficiency of Short Segment Posterior Instrumentation using a Universal Spine System with incorporation of the fractured vertebra in post-traumatic thoracic and lumbar spine fractures. Material and methods. 25 cases in the age group of I5-50 years with thoracic and lumbar spine fractures were included in the study. The operative decision was made on the basis of instability of spine fractures with or without neurological deficit. Patients were followed up for an average period of twelve months, reporting for assessment at 3-monthly intervals. The final result was analyzed on the basis of neurological recovery as per Frankel’s Grading, spine stability as per kyphotic angle by Cobb’s method, vertebral body height and complications. Results. Post-operatively at the final follow-up visit, 36% patients had Frankel’s grade E neurological status. The mean sagittal plane kyphosis pre-operatively was 31.16°, which reduced to 21.52° post-operatively, which represents 30.93% reduction. Mean anterior body compression was 38.6°, which decreased to 23.4° post-operatively, corresponding to 15% increase. Conclusions. 1. Although conventional short segment posterior fixation (SSPF) has become an increasingly popular method of treatment of thoracolumbar burst fractures, providing the advantage of incorporating fewer motion segments in the fixation, a review of literature demonstrated that SSPF led to 9-55% incidence of implant failure and long term loss of kyphosis correction. 2. Short segment posterior fixation with pedicle fixation at the level of the fractured vertebra (short same-segment fixation) provides more biomechanical stability than traditional SSPF.

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Stuburo krūtininės ir juosmeninės dalies lūžių operacinio gydymo rezultatai

Lietuvos chirurgija ◽

10.15388/lietchirur.2005.3.2310 ◽

2005 ◽

Vol 3 (3) ◽

pp. 0-0

Author(s):

Igoris Šatkauskas ◽

Valentinas Uvarovas ◽

Manvilius Kocius

Keyword(s):

Lumbar Spine ◽

Posterior Fixation ◽

Spine Fractures ◽

Fixation Failure ◽

Radiographic Findings ◽

Failure Group ◽

Thoracic And Lumbar Spine ◽

The Mean ◽

Vilnius University

Igoris Šatkauskas1, Valentinas Uvarovas2, Manvilius Kocius21 Vilniaus greitosios pagalbos universitetinės ligoninės2-asis ortopedijos ir traumatologijos skyrius,Šiltnamių g. 29, LT-04130 Vilnius2 Vilniaus universiteto Bendrosios, plastinės chirurgijos,ortopedijos ir traumatologijos klinika,Šiltnamių str. 29, LT-04130 VilniusEl paštas: [email protected]; [email protected] Tikslas Įvertinti stuburo krūtininės ir juosmeninės dalių nestabilių lūžių operacinio gydymo rezultatus. Nustatyti komplikacijų ir rentgenologinių deformacijos kriterijų įtaką ligonių skundams. Ligoniai ir metodai Ištirti 48 ligoniai, operuoti nuo nestabilių stuburo krūtininės ir juosmeninės dalių lūžių be neurologinių komplikacijų. Stuburo slankstelių ir judesio segmento kifozė, Cobbo kampas ir kūno kompresija nustatyta rentgenologiškai prieš operaciją, po operacijos ir vėlesnio ištyrimo metu. Ligonių skausminiai skundai ir negalia įvertinti Šiaurės Amerikos stuburo draugijos (NASS) ir Roland-Morriso klausimynais. Atlikta ligonių asmeninio gydymo rezultatų vertinimo ir nedarbingumo analizė. Įvertintas ryšys tarp stuburo trauminės deformacijos rentgenologinių kriterijų ir klausimynų duomenų. Rezultatai Vidutiniškai po 16,8 mėnesio nuo traumos ištirto 48 ligonio amžiaus vidurkis buvo 38,4 metų (nuo 19 iki 71 metų). Operacijos metu koreguota kifozinė deformacija statistiškai reikšmingai progresavo, tačiau išliko daug mažesnė už pradinę. Iš 38 pacientų, kuriems buvo atlikta tik traspedikulinė fiksacija ir užpakalinė spondilodezė, 10 (26,3%) įvyko metalo konstrukcijų nuovargio lūžiai, o grupėje, kurioje, be transpedikulinės fikacijos, atlikta papildoma priekinė spondilodezė, šių komplikacijų nebuvo. Su metalo konstrukcijomis susijusių komplikacijų grupėje segmento kifozė ir Cobbo kampas progresavo labiau nei grupėje be komplikacijų, bet tai neturėjo jokios įtakos klausimynų rezultatams. NASS skausmo / negalios skalės taškų vidurkis buvo 76,8 ± 20,0, o Roland-Morriso klausimyno – 5,9 ± 6,4. Koreliacijos tarp rentgeninių deformacijos kriterijų ir klausimynų duomenų nerasta. Išvados Nestabiliems sprogstamiesiems lūžiams gydyti trumpos transpedikulinės fiksacijos ir užpakalinės spondilodezės nepakanka. Jei slankstelio kūno kompresija didelio laipsnio, indikuojama papildoma priekinės stuburo kolonos rekonstrukcija ir spondilodezė. Reikšminiai žodžiai: stuburas, lūžiai, operacinis gydymas, komplikacijos Outcome of surgical treatment of thoracic and lumbar spine fractures Igoris Šatkauskas1, Valentinas Uvarovas2, Manvilius Kocius21 Vilnius University Emergency Hospital,2nd Department of Orthopaedics and Traumatology,Šiltnamių str. 29, LT-04130 Vilnius, Lithuania2 Vilnius University Clinic of General, Plastic Surgery,Orthopaedics and Traumatology,Šiltnamių str. 29, LT-04130 Vilnius, LithuaniaE-mail: [email protected]; [email protected] Objective To evaluate functional and radiological outcomes of thoracic and lumbar spine fractures stabilized surgically and to identify any radiographic findings that may adversely influence posterior fixation failure and final functional outcome. Patients and methods A retrospective review of 48 neurologically intact patients who had undergone surgical stabilization and fusion of unstable thoracic and lumbar spine fractures was performed. Vertebral and regional kyphosis angles, anterior ant posterior vertebral body compression were measured on injury, postoperative and final follow-up radiographs. Functional, pain status and disability were evaluated using the North American Spine Society (NASS) lumbar spine and Roland-Morris Disability (RMDQ) questionnaires. Relationships were sought between radiographic findings, complications and self-reported outcome measurement scores. Results The mean follow-up time for the 48 patients (mean age 38.4, range 19 to 71 years) was 16.8 months. Despite a significant loss of correction, the degree of residual deformity was significantly less than at the time of injury. Of 38 patients treated with posterior short-segment pedicle-screw instrumentation ant posterior fusion, 10 (26.3%) had a fixation failure. In the fixation failure group, the loss of correction of regional kyphosis was significantly greater than in the non-failure group, but it had no influence on the final functional outcome. The mean NASS pain/disability subscale and RMDQ scores were 76.8 ± 20.0 and 5.9 ± 6.4, respectively. No correlation was found between the radiographic findings and questionnaire scores. Conclusions The short-segment pedicle fixation and posterior fusion of unstable burst spine fractures is not sufficient and related with a high rate of the hardware failure. In the presence of a substantial anterior column compromise, a combined procedure of posterior fixation and anterior reconstruction should be considered. Keywords: thoracolumbar spine, fracture, surgical treatment, outcome

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Thoracic and Lumbar Spine Fractures

Management of Fractures in Severely Osteoporotic Bone ◽

10.1007/978-1-4471-3825-9_16 ◽

2000 ◽

pp. 214-227

Author(s):

K. Kaneda ◽

M. Ito

Keyword(s):

Lumbar Spine ◽

Spine Fractures ◽

Thoracic And Lumbar Spine

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Percutaneous Stabilization of Thoracic and Lumbar Spine Fractures. Clinical and Radiological Outcome.

Egyptian Spine Journal ◽

10.21608/esj.2012.3801 ◽

2012 ◽

Vol 4 (1) ◽

pp. 34-40

Author(s):

Hossam Taha

Keyword(s):

Lumbar Spine ◽

Spine Fractures ◽

Radiological Outcome ◽

Thoracic And Lumbar Spine ◽

Clinical And Radiological Outcome ◽

Percutaneous Stabilization

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Minimal Invasive Percutaneous Fixation of Thoracic and Lumbar Spine Fractures

Minimally Invasive Surgery ◽

10.1155/2012/141032 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 2

Author(s):

Federico De Iure ◽

Michele Cappuccio ◽

Stefania Paderni ◽

Giuseppe Bosco ◽

Luca Amendola

Keyword(s):

Lumbar Spine ◽

Minimally Invasive ◽

Minimal Invasive ◽

Minimally Invasive Technique ◽

Radiographic Evaluation ◽

Invasive Technique ◽

Spine Fractures ◽

Percutaneous Fixation ◽

Transpedicular Fixation ◽

Thoracic And Lumbar Spine

We studied 122 patients with 163 fractures of the thoracic and lumbar spine undergoing the surgical treatment by percutaneous transpedicular fixation and stabilization with minimally invasive technique. Patient followup ranged from 6 to 72 months (mean 38 months), and the patients were assessed by clinical and radiographic evaluation. The results show that percutaneous transpedicular fixation and stabilization with minimally invasive technique is an adequate and satisfactory procedure to be used in specific type of the thoracolumbar and lumbar spine fractures.

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