scholarly journals A comparative study between the Universal Spinal System® (USS) and the CD Horizon® Legacy™ (CDH) in the management of thoracolumbar fractures

SICOT-J ◽  
2019 ◽  
Vol 5 ◽  
pp. 42
Author(s):  
Ahmed Samir Barakat ◽  
Ahmed Elattar ◽  
Khaled Fawaz ◽  
Ahmed Maher Sultan ◽  
Wael Koptan ◽  
...  
Keyword(s):  
Body Height ◽  
Pain Reduction ◽  
X Rays ◽  
Thoracolumbar Fractures ◽  
Short Segment ◽  
Legacy System ◽  
Neurological Improvement ◽  
Clinical And Radiological Outcome ◽  
One Year ◽  
Short Segment Fixation

Introduction: For the treatment of unstable non-osteoporotic thoracolumbar fractures, the clinical and radiological outcome of short-segment fixation with the USS™ – Universal Spine System (DePuy Orthopedics, Inc., Warsaw, IN, USA) and the CD HORIZON® LEGACY™ 5.5 Spinal System, (Medtronic Sofamor Danek USA, Inc., Memphis, TN, USA) were compared. Methods: From March 2015 to January 2016, 40 consecutive patients with unstable traumatic thoracolumbar fractures who met our inclusion criteria were treated with either the USS system or CDH Legacy system. Segmental kyphosis angle (SKA) and anterior body height (ABH) of fractured vertebrae, and ASIA Impairment Scale (AIS) were evaluated. Radiological fusion was confirmed with plain X-rays and when indicated with computerized tomography (CT). Results: The mean immediate kyphotic angle correction was 16.6° for the Schanz and 6.4 for the Legacy system, and the immediate mean anterior vertebral body height correction was 0.92 cm for the Schanz and 0.51 cm for the Legacy system. Our study shows a significant statistical difference between Schanz and Legacy systems regarding post-operative segmental kyphosis and height correction immediately postoperatively, at 6 months and at one-year follow-up (p-value < 0.005). The degree of pain reduction and neurological improvement was not influenced by the screw system. Conclusion: Usage of USS in thoracolumbar fracture as a short-segment fixation led to a near anatomical reduction when compared to the Legacy system. However, there was no advantage regarding pain reduction and neurological outcome.

scholarly journals Inclusion of the fractured level into the construct of short segment fixation in patients with thoracolumbar fractures: clinical and radiological outcome

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Ali R. Hamdan ◽  
Radwan Nouby Mahmoud ◽  
Ahmed G. Tammam ◽  
Eslam El-Sayed El-Khateeb
Keyword(s):  
Cobb Angle ◽  
Vertebral Body ◽  
Compression Ratio ◽  
Body Height ◽  
Surgical Approaches ◽  
Thoracolumbar Fractures ◽  
Vertebral Body Height ◽  
Short Segment ◽  
The Mean ◽  
Short Segment Fixation

Abstract Background Thoracolumbar fractures represent a widespread injuries that can cause significant disability and strain the healthcare system. Different surgical approaches are described in the literature. This study was conducted to evaluate the fractured level inclusion in short-segment fixation of thoracolumbar junction spine fractures. Results Preoperative neurological deficit was reported in seven patients ranging from ASIA grade C to D. All of these patients improved to grade E by the end of the follow-up period, except for one patient who improved from grade C to D. The mean Oswestry Disability Index was 19.87%. The mean postoperative Cobb angle was 11.77° which significantly improved compared to a preoperative value of 19.37°. There was a significant improvement in the postoperative anterior and posterior vertebral body height compared to the preoperative values. The vertebral body compression ratio significantly improved during the postoperative period to a mean of 84% compared to 76% preoperative. Conclusions There was significant improvement of the postoperative values of the mean Cobb angle, the anterior and the posterior vertebral body height as well as the vertebral body compression ratio compared to the preoperative values.

scholarly journals Comparative study of long segment versus short segment posterior fixation of thoracolumbar fractures with pedicle screws

2021 ◽  
Vol 9 (2) ◽  
pp. 77-84
Author(s):  
Vihar SJ ◽  
Naveen DS ◽  
Agrawal NK
Keyword(s):  
Pedicle Screws ◽  
Posterior Fixation ◽  
Rigid Fixation ◽  
Thoracolumbar Fractures ◽  
Kyphotic Angle ◽  
Short Segment ◽  
Duration Of Surgery ◽  
One Year ◽  
Short Segment Fixation

Choice of long or short segment fixation for thoracolumbar fractures, benefits of either of these techniques has been a topic for analysis and assessment. Kyphotic angles in twenty patients diagnosed to have thoracolumbar vertebral fractures between December 2019 to December 2020 in Bapuji hospital and Chigateri general hospital, Davanagere, Karnataka, India were measured pre operatively, post operatively and at one year follow up and assessed. No statistical difference between the degrees of correction of initial kyphotic angle between long segment fixation and short segment posterior fixation in our study was found (p<0.6). Method of fixation of the thoracolumbar vertebral fracture did not correlate with initial degree of kyphosis (p=0.4). Amount of correction loss at one year follow up was found to be statistically significant in short segment fixation (p<0.05). Loss of kyphotic angle at one year follow up was higher in case of short segment fixation than long segment fixation and found to be statistically significant (p<0.005). Our study showed that long segment fixation helps in better correction of the kyphosis angle with lesser chance of loss of correction and can be opted when pedicles aren’t intact at the fracture level, as in cases of burst fractures. Short segment fixation provides better rigid fixation at the site of fracture with increased range of motion at the thoracolumbar segment and can be treatment of choice when the pedicles at the fractured level are intact, as in cases of compression fractures, having benefits of shorter duration of surgery and reduced risks.

Role of Including the Index level in Short Segment Pedicular Fixation in Traumatic Thoraco-Lumbar Fractures

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ayman Abd-El-Ra’ouf EL-Shazly ◽  
Salah Mostafa Hamada ◽  
Ahmed Maged Nagaty ◽  
Ahmed Adel Nabih
Keyword(s):  
Pedicle Screw ◽  
Thoracolumbar Fractures ◽  
Spine Trauma ◽  
Kyphosis Angle ◽  
Short Segment ◽  
Loss Of Correction ◽  
Significant Difference ◽  
Index Level ◽  
Short Segment Fixation ◽  
Fracture Level

Abstract Background It is generally acknowledged that short-segment pedicle screw instrumentation is the preferred surgical method for thoracolumbar fractures. However, the use of short-segment instrumentation with or without intermediate screws at the fracture level remains controversial. This review will evaluate the evidence available to date regarding the efficacy of including the fracture level in trans-pedicular screw short segment fixation, to assess clinical and radiological outcome. Objectives Our primary objective is evaluating the efficacy and outcome of including the fractured level vertebra in short segment fixation. And concerns regarding the use of pedicle screws into the fractured vertebra as to whether it is safe to insert a screw through a broken bone. Our secondary objective analyzing the importance of posterior pedicle screw fixation in unstable thoracolumbar fractures. Methods The following electronic databases will be searched from 1992 to 2018: PubMed, Google scholar search engine. Cochrane database of systematic reviews, EMBASE and science Direct, using the keywords “TLICS”, "index screw", “short segment fixation”, "Thoracolumbar spine trauma", "traumatic spine injury", "spinal cord injury", "spine trauma", "role", “reliability”.Studies will be eligible if they contain the target keywords in title or abstract, addressing our age group. Afterwards the full text of the articles will be reviewed to exclude full texts not fulfilling the criteria or deviating from the initial impression taken from the title/abstract reviewing. References/bibliography of the selected articles will be examined to evaluate potential for further research and possible inclusion in the analysis. Any differences will be sorted by discussion between study team (student, director, and co-directors). Results A total of 3010 studies were screened for eligibility , 8 studies were included in our systematic review for comparing the short segment fixation “including” the fracture level with “conventional” methods whether short or long segment fixation. Overall study population reached 512 patients. Analysis showed comparable results regarding clinical picture and radiography, showing highly statistically significant difference in favor of “including” index level in fixation in post operative kyphosis angle correction, loss of correction of kyphosis angle through follow up until 2 years and loss of correction of AVH, also statistically significant difference in rate of implant failure in favor for “including” group, and with no significant difference in operative time , blood loss and VAS for post-operative pain. Conclusion We conclude that Short segment fixation including the fracture level is a promising surgical option when it comes to thoraco-lumbar unstable fractures. In conclusion, inclusion of the fracture level into the construct offers a better kyphosis correction, in addition to fewer instrument failures, without additional complications, and with a comparable-if not better-clinical outcome, the radiologic correction achieved is maintained even at the end of 2 years and reflected in good functional outcomes. We recommend insertion of screws into pedicles of the fractured thoracolumbar vertebra when considering a short segment posterior fixation, especially in Magerl type C fractures. Large population prospective randomized controlled studies and clinical trials are recommended for more high level evidence data.

scholarly journals Short same segment fixation versus short segment fixation in postoperative correction of kyphosis and pain reduction in thoracolumbar spine fractures

2017 ◽  
Vol 31 (1) ◽  
pp. 3-7
Author(s):  
Mohamed State ◽  
Ahmed Zaher ◽  
Nabil Ali
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Thoracolumbar Spine ◽  
Pain Reduction ◽  
Pedicle Screw Fixation ◽  
Spine Fracture ◽  
Kyphotic Angle ◽  
Short Segment ◽  
Short Segment Fixation

Abstract Introduction: Posterior short segment pedicle screw fixation is considered the most common way for management of unstable thoracolumbar spine fracture. This study is aiming to evaluate the efficacy of both posterior short same segment and posterior short segment pedicle screw fixation on postoperative kyphotic angle and pain dense score in thoracolumbar fractures. Methods: This is a Prospective study of 32 patients with single level thoracolumbar spine fracture between June 2011 and May 2014. Patients were divided randomly into 2 groups, one of them was submitted to short same segment posterior pedicle screw fixation with mean age 31.25+9.25ys, while the other group submitted to short segment posterior pedicle screw fixation with mean age 29.18+9.65ys. Cobb method and Denis work scale were used to assess kyphotic angle and pain score respectively on admission, during follow up period and after one year postoperatively. Results: The short same segment type of operation showed improvement in correction in kyphotic angle deformity at the end of follow up period although this improvement was not statistically significant compared to short segment type. The short same segment patients showed statistically significant improvement as regard pain Denis score among those patients treated by short segment fixation. Conclusion: In this study short same segment posterior pedicle screw fixation is more efficient in postoperative pain reduction than short segment posterior pedicle screw fixation.

scholarly journals Short‐Segment Fixation of Thoracolumbar Fractures with Incorporated Screws at the Level of Fracture

2020 ◽  
Vol 12 (1) ◽  
pp. 170-176
Author(s):  
Hassan Fathy El Behairy ◽  
Ashraf M Abdelaziz ◽  
Ayman K Saleh ◽  
Faisal Ahmed Hashem Elsherief ◽  
Ibrahim Elsayed Abdellatif Abuomira ◽  
...  
Keyword(s):  
Thoracolumbar Fractures ◽  
Short Segment ◽  
Short Segment Fixation

scholarly journals Short term radiological outcome of inserting screw at fracture level in posterior short segment fixation in thoracolumbar burst fractures

2017 ◽  
Vol 4 (3) ◽  
pp. 71-76
Author(s):  
Rabindra Lal Pradhan ◽  
Bimal Kumar Pandey ◽  
Krishna Raj Khanal
Keyword(s):  
Vertebral Body ◽  
Body Height ◽  
Fracture Site ◽  
Implant Failure ◽  
Vertebral Body Height ◽  
Short Segment ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures ◽  
Short Segment Fixation

Background: Unstable thoracolumbar burst fractures are treated surgically by short segment fixation but may be associated with high implant failure. Supplementation of anterior column by insertion of screw at fracture site makes it more biomechanically stable.Objectives: The purpose of this prospective study was to evaluate radiological parameters in thoracolumbar fractures treated with intermediate screw fixation with a minimum follow up of two years.Methods: This prospective study was conducted from 2011 till 2012 where unstable  thoracolumbar fractures treated with short segment posterior instrumentation with screw at fracture site were evaluated. All patients (average age 34.64 were followed up for at least 24 months and were classified according to Thoracolumbar Injury Classification and Severity Score and load sharing classifi cation. Out of total 32 patients, four lost to follow up. Radiological parameters like vertebral body height and segmental kyphosis were evaluated and pain was evaluated by Visual Analogue Scale score.Results: Preoperative pain showed mean Visual Analogue Scale Score score of 8.29 that improved to 0.97 at fi nal follow up. Average preoperative loss of vertebral body height was 48.19 %, which improved to 11.4 % after surgery (p<.001). Final vertebral body collapse was 12.98 % with mean percentage loss of vertebral height at 1.57%. Average segmental kyphotic angle was 22.54 before surgery, which corrected to 5.89 immediately after surgery (p<0.001). Final segmental kyphosis was 8.46. Loss of kyphosis correction was 2.57. Two patients had implant failure, but was solidly united during implant removal in both cases.Conclusion: Excellent maintenance of reduction in thoracolumbar burst fractures with short segment fixation with intermediate screws at fracture site with limited decompression resulted in improved neurologic function and satisfactory clinical outcomes, with a low incidence of implant failure and progressive deformity.

scholarly journals Inclusion of the fracture level in short segment fixation of thoracolumbar fractures

2010 ◽  
Vol 19 (10) ◽  
pp. 1651-1656 ◽  
Author(s):  
Majid-Reza Farrokhi ◽  
Ali Razmkon ◽  
Zohreh Maghami ◽  
Zahra Nikoo
Keyword(s):  
Thoracolumbar Fractures ◽  
Short Segment ◽  
Short Segment Fixation ◽  
Fracture Level

scholarly journals Long-segment Fixation VS Short-segment Fixation Combined With Kyphoplasty for Osteoporotic Thoracolumbar Burst Fracture

2021 ◽  
Author(s):  
Oujie Lai ◽  
Xinliang Zhang ◽  
Yong Hu ◽  
Xiaoyang Sun ◽  
Binke Zhu ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Burst Fracture ◽  
Body Height ◽  
Thoracolumbar Burst Fracture ◽  
Short Segment ◽  
Radiological Results ◽  
The Mean ◽  
Short Segment Fixation ◽  
Clinical And Radiological Results

Abstract BackgroundTo compare clinical and radiological results of long-segment fixation (LF) and six-screw short-segment fixation combined with kyphoplasty (SSFK) for osteoporotic thoracolumbar burst fracture (OTBF). Methods Forty patients affected by OTBF with mean age of 61.85 were included in this study. The mean follow-up period was 13.63 months. Twenty-four patients were treated by SSFK, and 16 patients were treated by LF. Clinical outcomes, radiological parameters and complications were assessed and compared. ResultsThe mean operative time and blood loss were 89.71±7.62min and 143.75±42.51ml for SFK group, respectively; 111.69±12.25min (P<0.01) and 259.38±49.05 ml (P<0.01) for LF group, respectively. The two groups were similar in terms of preoperative radiological and clinical results. Compared with preoperative values, both groups achieved significant improvement in terms of VAS, ODI, Cobb angle and anterior vertebral body height (AVH) ratio at final follow-up. However, during the follow-up period, the loss of Cobb angle and AVH ratio were significant different between immediately postoperative and final follow-up evaluations for both groups. Five cases (20.83%) of asymptomatic cement leakage were observed in SSFK group. One case of implant failure and two cases of adjacent or non-adjacent vertebral fractures were observed in LF group. ConclusionsFor the treatment of OTBF, SSFK shows similar clinical and radiological results as LF. Comparatively, SSFK is less invasive and can preserve more motion segments, which is a more valuable surgical option in selected elderly patients.

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