Minimally Invasive Decompression and Intracorporeal Bone Grafting Combined with Temporary Percutaneous Short-Segment Pedicle Screw Fixation for Treatment of Thoracolumbar Burst Fracture with Neurological Deficits

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

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Minimally Invasive Spine Surgery for Unstable Thoracolumbar Burst Fractures: A Case Series

The Surgery Journal ◽

10.1055/s-0036-1594248 ◽

2016 ◽

Vol 02 (04) ◽

pp. e131-e138 ◽

Cited By ~ 2

Author(s):

Nitin Agarwal ◽

Phillip Choi ◽

Raymond Sekula

Keyword(s):

Pedicle Screw ◽

Screw Fixation ◽

Burst Fracture ◽

Pedicle Screw Fixation ◽

Thoracolumbar Burst Fracture ◽

Thoracolumbar Burst Fractures ◽

Percutaneous Pedicle Screw ◽

Percutaneous Pedicle Screw Fixation

Introduction Traumatic thoracolumbar burst fracture is a common pathology without a clear consensus on best treatment approach. Minimally invasive approaches are being investigated due to potential benefits in recovery time and morbidity. We examine long-term resolution of symptoms of traumatic thoracolumbar burst fractures treated with percutaneous posterior pedicle screw fixation. Methods Retrospective clinical review of seven patients with spinal trauma who presented with thoracolumbar burst fracture from July 2012 to April 2013 and were treated with percutaneous pedicle screw fixation. Electronic patient charts and radiographic imaging were reviewed for initial presentation, fracture characteristics, operative treatment, and postoperative course. Results The patients had a median age of 29 years (range 18 to 57), and 57% were men. The median Thoracolumbar Injury Classification and Severity Scale score was 4 (range 2 to 9). All patients had proper screw placement and uneventful postoperative courses given the severity of their individual traumas. Five of seven patients were reached for long-term follow-up of greater than 28 months. Six of seven patients had excellent pain control and stability at their last follow-up. One patient required revision surgery for noncatastrophic hardware failure. Conclusion Percutaneous pedicle screw fixation for the treatment of unstable thoracolumbar burst fracture may provide patients with durable benefits and warrants further investigation.

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Minimally Invasive Transpsoas L2 Corpectomy and Percutaneous Pedicle Screw Fixation for Osteoporotic Burst Fracture in the Elderly

Journal of Spinal Disorders & Techniques ◽

10.1097/bsd.0b013e318269ca7c ◽

2015 ◽

Vol 28 (2) ◽

pp. 53-60 ◽

Cited By ~ 5

Author(s):

Luke Tomycz ◽

Scott L. Parker ◽

Matthew J. McGirt

Keyword(s):

Minimally Invasive ◽

Pedicle Screw ◽

Screw Fixation ◽

Burst Fracture ◽

The Elderly ◽

Pedicle Screw Fixation ◽

Percutaneous Pedicle Screw ◽

Percutaneous Pedicle Screw Fixation

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

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2014.11.031 ◽

2015 ◽

Vol 22 (5) ◽

pp. 883-888 ◽

Cited By ~ 2

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

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Vacuum Phenomenon as a Predictor of Kyphosis After Implant Removal Following Posterior Pedicle Screw Fixation Without Fusion for Thoracolumbar Burst Fracture: a Single-center Retrospective Study

10.21203/rs.3.rs-190211/v1 ◽

2021 ◽

Author(s):

Masahiro Hirahata ◽

Tomoaki Kitagawa ◽

Youichi Yasui ◽

Hiroyuki Oka ◽

Iwao Yamamoto ◽

...

Keyword(s):

Retrospective Study ◽

Pedicle Screw ◽

Old Age ◽

Screw Fixation ◽

Burst Fracture ◽

Pedicle Screw Fixation ◽

Implant Removal ◽

Thoracolumbar Burst Fracture ◽

Loss Of Correction ◽

Vacuum Phenomenon

Abstract Background: Posterior pedicle screw fixation without fusion has been commonly applied for thoracolumbar burst fracture. Implant removal is performed secondarily after bone union. However, the occurrence of secondary kyphosis has recently attracted attention. Secondary kyphosis results in poor clinical outcomes. The purpose of this was to determine predictors of kyphosis after implant removal following posterior pedicle screw fixation without fusion for thoracolumbar burst fracture.Methods: This retrospective study reviewed 60 consecutive patients with thoracolumbar burst fracture who underwent implant removal following posterior pedicle screw fixation without fusion. Inclusion criteria were non-osteoporotic fracture and T11-L4 burst fracture. Old age, sex, initial severe wedge deformity, initial severe kyphosis, and vacuum phenomenon were examined as factors potentially associated with final kyphotic deformity (defined as kyphotic angle greater than 25°) or loss of correction. Logistic regression analysis was performed using propensity score matching.Results: Among the 31 female and 29 male patients (mean age 39 years), final kyphotic deformity was found in 17 cases (28%). Multivariate analysis showed a significant association with the vacuum phenomenon. Loss of correction was found in 35 cases (58%) and showed a significant association with the vacuum phenomenon. There were no significant associations with other factors.Conclusions: The findings of this study suggest that the vacuum phenomenon before implant removal may be a predictor of secondary kyphosis of greater than 25° after implant removal following posterior pedicle screw fixation without fusion for thoracolumbar burst fracture, but that old age, sex, initial severe kyphosis, and initial severe wedge deformity may not be predictors.

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RETRACTED ARTICLE: Percutaneous pedicle screw fixation combined with selective transforaminal endoscopic decompression for the treatment of thoracolumbar burst fracture

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01946-6 ◽

2020 ◽

Vol 15 (1) ◽

Cited By ~ 1

Author(s):

Zhangheng Huang ◽

Yuexin Tong ◽

Zhiyi Fan ◽

Chuan Hu ◽

Chengliang Zhao

Keyword(s):

Pedicle Screw ◽

Compression Ratio ◽

Screw Fixation ◽

Burst Fracture ◽

Pedicle Screw Fixation ◽

Thoracolumbar Burst Fracture ◽

Endoscopic Decompression ◽

Percutaneous Pedicle Screw ◽

Wide Range ◽

Percutaneous Pedicle Screw Fixation

Abstract Background The objective of this study was to evaluate the feasibility, safety, efficacy, and indications of percutaneous pedicle screw fixation (PPSF) combined with selective transforaminal endoscopic decompression (TED) in the treatment of thoracolumbar burst fracture (TBLF). Methods From August 2015 to October 2018, a total of 41 patients with single-segment TLBF (28 men and 13 women) were enrolled in this study. X-ray and computed tomography were obtained before surgery, 1 week after surgery, and 1 year after surgery to evaluate spinal recovery. In addition, we used the visual analog scale (VAS), the Oswestry Disability Index (ODI), the Japanese Orthopedic Association score (JOA), and the Frankel classification of neurological deficits to evaluate the effectiveness of the treatments. Results The average follow-up time was 22.02 ± 8.28 months. The postoperative Cobb angle, vertebral body compression ratio, vertebral wedge angle, mid-sagittal canal diameter compression ratio, and Frankel grade were significantly improved. There were also significant improvements in the VAS (7.61 ± 1.41 vs. 1.17 ± 0.80, P < 0.001), ODI (89.82 ± 7.44 vs. 15.71 ± 13.50, P < 0.001), and JOA (6.90 ± 2.91 vs. 24.90 ± 3.03, P < 0.001). Conclusions Our results showed that PPSF combined with selective TED in the treatment of TLBF had excellent efficacy, high safety, less secondary injury than other treatments, and a wide range of indications and that it could accurately distinguish patients who did not need spinal canal decompression after posterior fixation. PPSF combined with selective TED is therefore a good choice for the treatment of TLBF.

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