scholarly journals Hybrid Stabilization of Thoracic Spine Fractures with Sublaminar Bands and Transpedicular Screws: Description of a Surgical Alternative and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Marie-Therese Unterweger ◽  
Frank Kandziora ◽  
Klaus J. Schnake
Keyword(s):  
Thoracic Spine ◽  
Pedicle Screws ◽  
Spine Fractures ◽  
Review Of The Literature ◽  
Hybrid Stabilization ◽  
Loss Of Reduction ◽  
Thoracic Spine Fractures ◽  
Vertebral Bodies ◽  
Sublaminar Bands

Stabilization of unstable thoracic fractures with transpedicular screws is widely accepted. However, placement of transpedicular screws can cause complications, particularly in the thoracic spine with physiologically small pedicles. Hybrid stabilization, a combination of sublaminar bands and pedicle screws, might reduce the rate of misplaced screws and can be helpful in special anatomic circumstances, such as preexisting scoliosis and osteoporosis. We report about two patients suffering from unstable thoracic fractures, of T5 in one case and T3, T4, and T5 in the other case, with preexisting scoliosis and extremely small pedicles. Additionally, one patient had osteoporosis. Patients received hybrid stabilization with pedicle screws adjacent to the fractured vertebral bodies and sublaminar bands at the level above and below the pedicle screws. No complications occurred. Follow-up was 12 months with clinically uneventful postoperative courses. No signs of implant failure or loss of reduction could be detected. In patients with very small thoracic pedicles, scoliosis, and/or osteoporosis, hybrid stabilization with sublaminar bands and pedicle screws can be a viable alternative to long pedicle screw constructs.

Accuracy and safety of pedicle screw fixation in thoracic spine trauma

2006 ◽  
Vol 5 (6) ◽  
pp. 520-526 ◽  
Author(s):  
Charles G. Fisher ◽  
Vic Sahajpal ◽  
Ory Keynan ◽  
Michael Boyd ◽  
Douglas Graeb ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Thoracic Spine ◽  
Pedicle Screws ◽  
Pedicle Screw Fixation ◽  
Spine Fractures ◽  
Chi Square ◽  
Clinical Safety ◽  
Thoracic Spine Fractures ◽  
Screw Position ◽  
Pedicle Wall

Object The authors evaluated the accuracy of placement and safety of pedicle screws in the treatment of unstable thoracic spine fractures. Methods Patients with unstable fractures between T-1 and T-10, which had been treated with pedicle screw (PS) placement by one of five spine surgeons at a referral center were included in a prospective cohort study. Postoperative computed tomography scans were obtained using 3-mm axial cuts with sagittal reconstructions. Three independent reviewers (C.B., V.S., and D.G.) assessed PS position using a validated grading scale. Comparison of failure rates among cases grouped by selected baseline variables were performed using Pearson chi-square tests. Independent peri- and postoperative surveillance for local and general complications was performed to assess safety. Twenty-three patients with unstable thoracic fractures treated with 201 thoracic PSs were analyzed. Only PSs located between T-1 and T-12 were studied, with the majority of screws placed between T-5 and T-10. Of the 201 thoracic PSs, 133 (66.2%) were fully contained within the pedicle wall. The remaining 68 screws (33.8%) violated the pedicle wall. Of these, 36 (52.9%) were lateral, 27 (39.7%) were medial, and five (7.4%) were anterior perforations. No superior, inferior, anteromedial, or anterolateral perforations were found. When local anatomy and the clinical safety of screws were considered, 98.5% (198 of 201) of the screws were probably in an acceptable position. No baseline variables influenced the incidence of perforations. There were no adverse neurological, vascular, or visceral injuries detected intraoperatively or postoperatively. Conclusions In the vast majority of cases, PSs can be placed in an acceptable and safe position by fellowship-trained spine surgeons when treating unstable thoracic spine fractures. However, an unacceptable screw position can occur.

scholarly journals Surgical treatment of thoracic spine fractures. Outcomes on 50 patients at 23months follow-up

2014 ◽  
Vol 100 (5) ◽  
pp. 475-480 ◽  
Author(s):  
M. Vassal ◽  
G. Lonjon ◽  
S. Knafo ◽  
Y. Thouvenin ◽  
F. Segnarbieux ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Thoracic Spine ◽  
Spine Fractures ◽  
Thoracic Spine Fractures

Clinical and radiographic outcomes of pedicle screw fixation for upper thoracic spine (T1–5) fractures: a retrospective cohort study of 27 cases

2009 ◽  
Vol 10 (3) ◽  
pp. 207-213 ◽  
Author(s):  
Charles Fisher ◽  
Sandeep Singh ◽  
Michael Boyd ◽  
Stephen Kingwell ◽  
Brian Kwon ◽  
...  
Keyword(s):  
Thoracic Spine ◽  
Summary Score ◽  
Spine Fractures ◽  
Upper Thoracic Spine ◽  
Sf 36 ◽  
Health Related ◽  
Thoracic Spine Fractures ◽  
The Mean ◽  
Upper Thoracic

Object The use of pedicle screws (PSs) for stabilization of unstable thoracolumbar fractures has become the standard of care, but PS efficacy has not been reported in the upper thoracic spine. The primary outcome of this study was to determine the efficacy of PS fixation to achieve and maintain reduction of unstable upper thoracic spine fractures (T1–5). Secondary outcomes included scores on a 1-year postoperative generic health-related quality of life (QOL) questionnaire and postoperative complications. Methods This study was a retrospective analysis and cross-sectional outcome assessment of cases prospectively entered into a spine database from 1997 to 2004. All patients with a traumatic, unstable upper thoracic spine (T1–5) fracture who underwent PS fixation were included. Preoperative CT scans with sagittal plane reformatted images were used to determine kyphotic deformity and compared with immediate postoperative and latest follow-up radiographs or CT scans. Patient charts, operative notes, and the results of postoperative follow-up examinations were reviewed. Patients were mailed the Short Form-36v2 (SF-36 version 2) by an independent study coordinator. Results Cases involving 27 patients (23 male, 4 female) were evaluated. The patients' mean age was 39.9 years (range 16–73 years). In all, 251 PSs were passed between T-1 and T-8. The mean true kyphotic deformity was 18.2° preoperatively, 8.7° (p < 0.0005) initially postoperatively, and 10.1° at final follow-up (mean 2.3 years postoperatively). The mean SF-36 physical component summary score was 35.89 while the mental component summary score was 56.43 at a minimum of 1-year postoperatively (mean 3.2 years). There were no intraoperative vascular or neural complications. Conclusions In the hands of fellowship-trained spinal surgeons, PS fixation for reduction and stabilization of upper thoracic spine fractures is a safe and efficacious technique. Health-related QOL outcome data are deficient for spine trauma patients and should be an essential component of quantifying treatment outcomes.

scholarly journals Sublaminar polyester band fixation construct in the treatment of neuromuscular scoliosis

2019 ◽  
Vol 13 (4) ◽  
pp. 393-398
Author(s):  
S. Rosenfeld ◽  
S. Kenney ◽  
E. Rebich
Keyword(s):  
Blood Loss ◽  
Pedicle Screws ◽  
Posterior Spinal Fusion ◽  
Pelvic Obliquity ◽  
Neuromuscular Scoliosis ◽  
Level Of Evidence ◽  
Fixation Techniques ◽  
Clinical Records ◽  
Sublaminar Bands

Purpose Multiple fixation techniques exist for treating progressive neuromuscular scoliosis including pedicle screws, sublaminar bands/wires, hooks or a combination of instruments. Most sublaminar band constructs are supplemented with pedicle screws, hooks and/or sublaminar wires particularly at the top of the construct. There are no studies to date that describe an all/predominant sublaminar band construct. The purpose of this study was to investigate the outcomes of a sublaminar polyester band construct to treat neuromuscular scoliosis. Methods A retrospective review was conducted of 32 cases of neuromuscular scoliosis treated with posterior spinal fusion using a sublaminar band construct between 2013 and 2016 by a single surgeon at a single centre. Preoperative, immediate postoperative and two-year follow-up radiographs and clinical records were reviewed. Sagittal, coronal and pelvic obliquity correction was measured. Blood loss, length of surgery and complications were recorded. Results In all, 29 patients were included. Mean postoperative coronal plane correction was 57% (0% to 92%) and maintained at two-year follow-up. Mean sagittal balance was 2.3 cm (-2.5 to 6.4). Mean lumbar lordosis angle decreased by 7° (44° to 37°). Mean thoracic kyphosis angle increased by 9° (23° to 32°). Mean pelvic obliquity decreased by 50% (from 15° to 7°). There were four major complications (14%) and eight minor complications (21%). Mean blood loss was 1304 cc (250 cc to 2450 cc). Conclusion Sublaminar polyester band fixation constructs provide a viable option in correction of deformity in patients with neuromuscular scoliosis with comparable outcomes with what is reported with other constructs. Level of Evidence: V

Injuries significantly associated with thoracic spine fractures: A case-control study

2009 ◽  
Vol 21 (5) ◽  
pp. 419-423 ◽  
Author(s):  
Ranjit Singh ◽  
David McD Taylor ◽  
Donna D'Souza ◽  
Alexandra Gorelik ◽  
Patrick Page ◽  
...  
Keyword(s):  
Thoracic Spine ◽  
Case Control Study ◽  
Case Control ◽  
Spine Fractures ◽  
Thoracic Spine Fractures ◽  
Control Study

Thoracic Spine Fractures in Patients Older Than 50 Years

1996 ◽  
Vol 328 ◽  
pp. 190-193 ◽  
Author(s):  
Ashok Biyani ◽  
Nabil A. Ebraheim ◽  
Jike Lu
Keyword(s):  
Thoracic Spine ◽  
Spine Fractures ◽  
Thoracic Spine Fractures

Thoracic Spine Fractures

2011 ◽  
Vol 24 (2) ◽  
pp. 195 ◽  
Author(s):  
Young-Woo Kim ◽  
Young-Seok Kim ◽  
Jae-Chel Byun ◽  
Yong-Bok Park
Keyword(s):  
Thoracic Spine ◽  
Spine Fractures ◽  
Thoracic Spine Fractures
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