scholarly journals Short-segment fixation with a cement-augmented pedicle screw for Kummell disease

Medicine ◽  
2017 ◽  
Vol 96 (50) ◽  
pp. e8617 ◽  
Author(s):  
He-Xuan Di ◽  
Feng-Yu Liu ◽  
Si-Dong Yang ◽  
Hui Wang ◽  
Da-Long Yang ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Short Segment ◽  
Short Segment Fixation

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.

Pedicle screw loosening – reassessing short segment fixation in dorsolumbar junctional fractures

2017 ◽  
Vol 65 (2) ◽  
pp. 382 ◽  
Author(s):  
Prasad Krishnan ◽  
Rajaraman Kartikueyan ◽  
SachinkumarM Patel ◽  
Subhasis Deb
Keyword(s):  
Pedicle Screw ◽  
Screw Loosening ◽  
Short Segment ◽  
Short Segment Fixation ◽  
Pedicle Screw Loosening

Biomechanical Comparison of Different Pedicle Screw Fixations for Thoracolumbar Burst Fractures Using Finite Element Method

2011 ◽  
Vol 117-119 ◽  
pp. 699-702 ◽  
Author(s):  
Dong Mei Wang ◽  
Du Fang Shi ◽  
Xi Lei Li ◽  
Jian Dong ◽  
Chun Hui Wang ◽  
...  
Keyword(s):  
Finite Element Method ◽  
Finite Element ◽  
Pedicle Screw ◽  
Pedicle Screws ◽  
Loading Conditions ◽  
Lateral Bending ◽  
Short Segment ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures ◽  
Short Segment Fixation

This study was designed to compare the biomechanical effects of three posterior fixations for thoracolumbar burst fractures using the finite element (FE) method. Five T11-L1 FE models, including the intact, the fractured at T12, the monosegment fixated at the level of the fracture, the short-segment fixated with four pedicle screws and the short-segment fixated with five pedicle screws, were created. And four loading conditions (flexion, extension, lateral bending and torsion) were imposed on these models and deformations in these models under different loading conditions were calculated by finite element method. The biomechanical effects of the three different pedicle screw fixations for thoracolumbar burst fractures were compared and analyzed. The results showed that the displacement level in monosegment fixation model was close to that in the intact one. The extension motion was more limited in short-segment fixation models than that in monosegment fixation model. Under the lateral bending condition, the level of the displacements in these models were similar and the peak rotation angles in the three fixation models were close to that in the intact one. The displacements in fractured T12 were increased in monosegment fixation model under all loading conditions. These indicated that the monosegment fixation couldn’t provide desirable stability for the fractured T11-L1 and the short-segment fixation with five pedicle screws was the best selection because of ideal stability and movability.

scholarly journals Intermediate Screw pada Unstable Thoracolumbar Fracture: Case Series dan Review Article

2018 ◽  
Vol 7 (3) ◽  
pp. 387
Author(s):  
Komang Agung Irianto ◽  
Dionisius Bramta Putra
Keyword(s):  
Pedicle Screw ◽  
Burst Fracture ◽  
Case Series ◽  
Cochrane Library ◽  
Correction Loss ◽  
Short Segment ◽  
Level 3 ◽  
Level 1 ◽  
Short Segment Fixation ◽  
Level 2

Area thorakolumbar merupakan hampir 90% dari semua spinal injuries dan 10% dari cedera tersebut merupakan burst fracture yang membutuhkan intervensi operatif. Terapi burst fracture thorakolumbar meliputi restorasi dari alignment, stabilisasi spinal, koreksi kifotik, dan dekompresi spinal kanal. Pertimbangan penggunaan intermediate screw masih menjadi topik perdebatan. Penambahan intermediate pedicle screw dipercaya dapat menambah stabilitas dan membantu koreksi kifosis pada long segment, short segment fixation. Penelitian ini merupakan systematic literature review. Pencarian literatur menggunakan mesin pencari elektronik PubMed, MEDLINE, PMC, Cochrane Library, Nature, Taylor and Francis Online dan Springerlink, dari tanggal 28 Desember 2017 sampai 20 Februari 2018. Kriteria inklusi: burst fracture dari mekanisme traumatik, fraktur tulang belakang bagian thorax atau lumbal, intermediate pedicle screw dan penelitian dari tahun 2010 sampai 2017. Ditemukan 10 artikel (15,15%) artikel yang masuk kedalam kriteria inklusi. Terdapat tiga penelitian level 1, satu penelitian level 2, empat penelitian level 3 yang mendukung teknik SSPF+IS dengan hasil reduksi fraktur dan evaluasi radiologis yang baik, correction loss dan implant failure yang lebih rendah, mengurangi nyeri pascaoperasi. Teknik SSPF+IS merupakan teknik yang aman dan efektif memberikan hasil fiksasi yang stabil, hasil evaluasi akhir radiologis serta hasil evaluasi akhir klinis yang baik.

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 Intermediate Screw pada Unstable Thoracolumbar Fracture: Case Series dan Review Article

2018 ◽  
Vol 7 (3) ◽  
pp. 387
Author(s):  
Komang Agung Irianto ◽  
Dionisius Bramta Putra
Keyword(s):  
Pedicle Screw ◽  
Burst Fracture ◽  
Case Series ◽  
Cochrane Library ◽  
Correction Loss ◽  
Short Segment ◽  
Level 3 ◽  
Level 1 ◽  
Short Segment Fixation ◽  
Level 2

Area thorakolumbar merupakan hampir 90% dari semua spinal injuries dan 10% dari cedera tersebut merupakan burst fracture yang membutuhkan intervensi operatif. Terapi burst fracture thorakolumbar meliputi restorasi dari alignment, stabilisasi spinal, koreksi kifotik, dan dekompresi spinal kanal. Pertimbangan penggunaan intermediate screw masih menjadi topik perdebatan. Penambahan intermediate pedicle screw dipercaya dapat menambah stabilitas dan membantu koreksi kifosis pada long segment, short segment fixation. Penelitian ini merupakan systematic literature review. Pencarian literatur menggunakan mesin pencari elektronik PubMed, MEDLINE, PMC, Cochrane Library, Nature, Taylor and Francis Online dan Springerlink, dari tanggal 28 Desember 2017 sampai 20 Februari 2018. Kriteria inklusi: burst fracture dari mekanisme traumatik, fraktur tulang belakang bagian thorax atau lumbal, intermediate pedicle screw dan penelitian dari tahun 2010 sampai 2017. Ditemukan 10 artikel (15,15%) artikel yang masuk kedalam kriteria inklusi. Terdapat tiga penelitian level 1, satu penelitian level 2, empat penelitian level 3 yang mendukung teknik SSPF+IS dengan hasil reduksi fraktur dan evaluasi radiologis yang baik, correction loss dan implant failure yang lebih rendah, mengurangi nyeri pascaoperasi. Teknik SSPF+IS merupakan teknik yang aman dan efektif memberikan hasil fiksasi yang stabil, hasil evaluasi akhir radiologis serta hasil evaluasi akhir klinis yang baik.

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>

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