MODIFIED FIXATOR FOR ANTERIOR SPINAL FUSION FOR COMMINUTED FRACTURES IN THE THORACIC AND LUMBAR SPINE

Objective.To analyse results of surgical teratment of lower thoracic and lumbar spine injuries with transpedicular fixation alone and in combination with other types of stabilization. Material and Methods. A total of 90 patients with fractures of the spine were operated on with the help of transpedicular fixation (TPF). Out of them 35 % had stable injury, 65 % – unstable; fracture was complicated in 59 cases, uncomplicated in 31 cases. The surgical approach depended on injury type, complication absence or presence, and kyphotic deformity magnitude. Complete and incomplete comminuted uncomplicated fractures were treated with transpedicular fixation alone or in combination with posterior fusion or tunnel corporoplasty with porous NiTi granules. Complicated comminuted fractures with adjacent disc injury were treated in two stages: first stage – extended laminectomy, spinal cord anterior decompression, and transpedicular fixation, and second stage – anterior fusion simulteneously or after patient stabilization. Results. Long-term outcomes of transpedicular fixation were analysed in 50 patients in follow-up period of 1 to 5 years. The smallest loss of obtained deformity correction was observed in cases of incomplete stable comminuted fractures (4.5° ± 0.9°), the largest – in those of complete and incomplete unstable fractures (9.9° ± 0.2°), and intermediate loss – in cases of complete stable fractures (7.9° ± 1.1°). The treatment result was good in 40 patients, satisfactory in 7, and unsatisfactory – in 3. Conclusion. Primary and permanent stabilization of injured spinal motion segments in unstable complicated and uncomplicated comminuted fractures in lower thoracic and lumbar spine should be performed by means of anterio-posterior fusion.

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Transpedicular fixation for non-union or delayed union following anterior spinal fusion of the thoracolumbar and lumbar spine.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.38.725 ◽

1989 ◽

Vol 38 (2) ◽

pp. 725-728

Author(s):

Yuichi Ishibashi ◽

Keiichiro Shiba ◽

Masaaki Katsuki ◽

Takayoshi Ueta ◽

Kenzo Shirasawa ◽

...

Keyword(s):

Lumbar Spine ◽

Spinal Fusion ◽

Delayed Union ◽

Anterior Spinal Fusion ◽

Non Union ◽

Transpedicular Fixation

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A case report of anterior spinal fusion with ceramic spacer for solitary myeloma of the lumbar spine.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.32.961 ◽

1984 ◽

Vol 32 (4) ◽

pp. 961-964

Author(s):

K. Kusaba ◽

S. Tanimura ◽

N. Uezaki ◽

Y. Murakami ◽

S. Shidahara ◽

...

Keyword(s):

Case Report ◽

Lumbar Spine ◽

Spinal Fusion ◽

Anterior Spinal Fusion

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Dynamics of biochemical and immunological parameters in patients with malignant and benign tumors of the thoracic and lumbar spine

ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS ◽

10.15674/0030-59872017230-34 ◽

2017 ◽

Vol 0 (2) ◽

pp. 30-34

Author(s):

Mykola Korzh ◽

Volodymyr Radchenko ◽

Frieda Leontyeva ◽

Volodymyr Kutsenko ◽

Bogdan Shevtsov ◽

...

Keyword(s):

Lumbar Spine ◽

Benign Tumors ◽

Immunological Parameters ◽

Thoracic And Lumbar Spine ◽

Malignant And Benign Tumors

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Thoracic and Lumbar Spine Trauma: Clinical Presentation and Diagnosis

10.28962/01.3.117 ◽

2017 ◽

Author(s):

F.C. Oner

Keyword(s):

Lumbar Spine ◽

Clinical Presentation ◽

Spine Trauma ◽

Thoracic And Lumbar Spine

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Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 2: Assessment of functional outcome following lumbar fusion

Journal of Neurosurgery Spine ◽

10.3171/2014.4.spine14258 ◽

2014 ◽

Vol 21 (1) ◽

pp. 7-13 ◽

Cited By ~ 15

Author(s):

Zoher Ghogawala ◽

Daniel K. Resnick ◽

William C. Watters ◽

Praveen V. Mummaneni ◽

Andrew T. Dailey ◽

...

Keyword(s):

Lumbar Spine ◽

Functional Outcome ◽

Spinal Fusion ◽

Lumbar Fusion ◽

Minimum Clinically Important Difference ◽

Degenerative Disease ◽

Psychological State ◽

Lumbar Spinal Fusion ◽

Patient Reported ◽

Lumbar Spinal

Assessment of functional patient-reported outcome following lumbar spinal fusion continues to be essential for comparing the effectiveness of different treatments for patients presenting with degenerative disease of the lumbar spine. When assessing functional outcome in patients being treated with lumbar spinal fusion, a reliable, valid, and responsive outcomes instrument such as the Oswestry Disability Index should be used. The SF-36 and the SF-12 have emerged as dominant measures of general health-related quality of life. Research has established the minimum clinically important difference for major functional outcomes measures, and this should be considered when assessing clinical outcome. The results of recent studies suggest that a patient's pretreatment psychological state is a major independent variable that affects the ability to detect change in functional outcome.

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Thoracic and lumbar spine pedicle morphology in Japanese patients

Surgical and Radiologic Anatomy ◽

10.1007/s00276-021-02707-8 ◽

2021 ◽

Author(s):

Kohei Morita ◽

Hiroki Ohashi ◽

Daichi Kawamura ◽

Satoshi Tani ◽

Kostadin Karagiozov ◽

...

Keyword(s):

Lumbar Spine ◽

Japanese Patients ◽

Thoracic And Lumbar Spine ◽

Pedicle Morphology

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Rating the incidence of iatrogenic vascular injuries in thoracic and lumbar spine surgery as regards the approach: A PRISMA-based literature review

European Spine Journal ◽

10.1007/s00586-021-06956-4 ◽

2021 ◽

Author(s):

Alice Giotta Lucifero ◽

Cristian Gragnaniello ◽

Matias Baldoncini ◽

Alvaro Campero ◽

Gabriele Savioli ◽

...

Keyword(s):

At Risk ◽

Lumbar Spine ◽

Spine Surgery ◽

Iliac Vein ◽

Lumbar Spine Surgery ◽

Common Iliac Vein ◽

Suture Repair ◽

Vascular Injuries ◽

Mesh Terms ◽

Thoracic And Lumbar Spine

Abstract Purpose To assess the rate, timing of diagnosis, and repairing strategies of vascular injuries in thoracic and lumbar spine surgery as their relationship to the approach. Methods PubMed, Medline, and Embase databases were utilized for a comprehensive literature search based on keywords and mesh terms to find articles reporting iatrogenic vascular injury during thoracic and lumbar spine surgery. English articles published in the last ten years were selected. The search was refined based on best match and relevance. Results Fifty-six articles were eligible, for a cumulative volume of 261 lesions. Vascular injuries occurred in 82% of instrumented procedures and in 59% during anterior approaches. The common iliac vein (CIV) was the most involved vessel, injured in 49% of anterior lumbar approaches. Common iliac artery, CIV, and aorta were affected in 40%, 28%, and 28% of posterior approaches, respectively. Segmental arteries were injured in 68% of lateral approaches. Direct vessel laceration occurred in 81% of cases and recognized intraoperatively in 39% of cases. Conclusions Incidence of iatrogenic vascular injuries during thoracic and lumbar spine surgery is low but associated with an overall mortality rate up to 65%, of which less than 1% for anterior approaches and more than 50% for posterior ones. Anterior approaches for instrumented procedures are at risk of direct avulsion of CIV. Posterior instrumented fusions are at risk for injuries of iliac vessels and aorta. Lateral routes are frequently associated with lesions of segmental vessels. Suture repair and endovascular techniques are useful in the management of these severe complications.

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