Effects of endplate healing morphology on intervertebral disc degeneration after pedicle screw fixation for thoracolumbar fractures

Abstract Background: The cartilage endplate plays an important role in the stress distribution and nutrition metabolism of intervertebral disc. The healing morphology of the endplate after spinal fracture and its effect on the intervertebral disc degeneration are still unclear. Methods: 51 patients with single-level thoracolumbar fractures underwent posterior open reduction and pedicle screw fixation. Combined with the initial CT and MRI images, the endplate injury was defined as three types, which are unilateral endplate injury, bilateral endplate injury and no endplate injury. According to the location of the injury in the endplate, it was further divided into endplate central injury and endplate peripheral injury. The degree of post-traumatic disc lesions and disc degeneration during follow-up were classified based on the Sander classification and the Pfirrmann classification, respectively. According to the T1 image of MRI in the final follow-up, the healing morphology of endplates was classified into three types including the increased endplate curvature, the irregular healing and the traumatic Schmorl nodes. Results: Cartilage endplate fractures are closely related to the degree of degeneration of the intervertebral disc (P=0.003). Injuries in different parts of the endplate have no significant effect on the intervertebral disc degeneration (P=0.204). The healing morphology after endplate fracture significantly affected the degree of intervertebral disc degeneration (P=0.001). The comparison of groups showed that the effects of irregular healing and traumatic Schmorl nodes on disc degeneration were not statistically different, but were significantly different from those with increased curvature. Conclusions: Increased endplate curvature, irregular healing and traumatic Schmorl nodes are three common forms of healing. The irregular healing and the traumatic Schmorl nodes are closely related to intervertebral disc degeneration. The existence and severity of the endplate injury can provide valuable information for individualized clinical decision-making processes.

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Comparison of Short Segment Mono-axial and Poly-axial Pedicle Screw Fixation for Thoracolumbar Fractures

Case Medical Research ◽

10.31525/ct1-nct04032054 ◽

2019 ◽

Author(s):

Keyword(s):

Pedicle Screw ◽

Screw Fixation ◽

Pedicle Screw Fixation ◽

Thoracolumbar Fractures ◽

Short Segment

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Comparison of Short Segment Pedicle Screw Fixation Including the Fractured Vertebra Versus Long Segment Fixation in Thoracolumbar Fractures

Journal of Academic Research in Medicine ◽

10.4274/jarem.galenos.2019.2650 ◽

2020 ◽

Vol 10 (1) ◽

pp. 32-35

Author(s):

Engin Çetin ◽

Ali Öner

Keyword(s):

Pedicle Screw ◽

Screw Fixation ◽

Pedicle Screw Fixation ◽

Thoracolumbar Fractures ◽

Short Segment

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Does Tranexamic Acid Reduce Perioperative Bleeding in Short Segment Pedicle Screw Fixation in Thoracolumbar Spine Fractures?

Journal of Nepal Medical Association ◽

10.31729/jnma.2785 ◽

2015 ◽

Vol 53 (199) ◽

pp. 169-173 ◽

Cited By ~ 3

Author(s):

Rabindra Lal Pradhan ◽

Bimal Kumar Pandey

Keyword(s):

Tranexamic Acid ◽

Pedicle Screw ◽

Screw Fixation ◽

Thoracolumbar Spine ◽

Pedicle Screw Fixation ◽

Control Group ◽

Thoracolumbar Fractures ◽

Short Segment ◽

Perioperative Bleeding ◽

Thoracolumbar Spine Fractures

Introduction: Blood loss with spinal surgery is common potential cause of morbidity and often requires blood transfusion. Tranexamic acid (TXA), is effective in reducing bleeding in patients undergoing knee arthroplasty. TXA used in spine surgery studies have included different cases leading to inconsistence of surgical procedures. Purpose of this prospective observational study was to examine effect of TXA decreasing bleeding in short segment pedicle screw fixation for thoracolumbar fractures. Methods: 38 patients' undergoing short segment pedicle screw for thoracolumbar fractures were enrolled in study from July to August 2013. There were 28 male and 10 female patients, with an average age of 36.5 years. Patients received 10 mg/kg of TXA or a control 30 minutes intravenously before skin incision and 3 hours post-operative and oral medication for three days. Intraoperative bleeding was estimated by weighing surgical sponges, blood collected by suction container and by subtracting all irrigation fluid. Postoperative bleeding was measured from volume in vacuum drainage bag. Results: Twenty (20) patients were in control group and eighteen(18) to TXA group. There were no statistical differences between groups in terms of age, gender, co-morbidities, and operating time, preoperative Hemoglobin, PT and INR. Intra-operative bleeding in TXA group was significant than in control group. Post-operative drainage and Hemoglobin in first 48 h was reduced compared with placebo in TXA group. Need for post-operative transfusion was nil in TXA group. Conclusions: Administration of TXA before surgery significantly reduces perioperative bleeding in patients undergoing short segment pedicle screw fixation for thoracolumbar spine fractures. Keywords: bleeding; spinal surgery; tranexamic acid.

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