scholarly journals Early corset reclination of uncomplicated type А3 comminuted vertebral fractures in the thoracolumbar spine

2020 ◽  
Vol 17 (2) ◽  
pp. 58-63
Author(s):  
M. S. Narkulov ◽  
S. N. Pardaev ◽  
A. Zh. Karshiboev ◽  
S. T. Meliboev
Keyword(s):  
Vertebral Body ◽  
Vertebral Fractures ◽  
Body Height ◽  
Thoracolumbar Spine ◽  
Kyphotic Deformity ◽  
Average Decrease ◽  
Pneumatic Chamber ◽  
Comminuted Fractures ◽  
Local Kyphosis ◽  
Ct Data

Objective. To analyze the results of staged preoperative correction of uncomplicated comminuted fractures in the thoracolumbar spine.Material and Methods. Retrospective study included data from 51 patients (33 men and 18 women) 17–35 years old with type A3 spinal injuries without urgent indications for surgery. In preparation for a possible operation, patients received a corset treatment with reclination pneumopelot for 2–3 days.Results. The results were evaluated based on clinical, radiological and CT data. The result after reclination corset treatment was considered good if a restoration of the vertebral height was achieved with its residual deficit of less than 10 % or local wedge shape not more  than 10°; satisfactory – with a residual decrease in vertebral body height from 10 to 30 % or in kyphotic deformity from 10 to 20°; and unsatisfactory – with a decrease in body height of more than 30 %, and in kyphotic deformity of more than 20°. With an average decrease in the height of the fractured vertebral body before surgery by 45 % and the local kyphosis magnitude of 27.0° ± 5.5°, the staged reclination provided complete correction of kyphosis in all cases and restoration of the height of the compressed vertebra to a residual deficit of less than 10 % in 78 % of cases. Neurological disorders were not noted.Conclusion. In case of incomplete burst vertebral fractures not complicated by compression of the spinal cord, the method of early (in the first 7 days after the injury) corset treatment with staged fracture reclination by a pneumatic chamber can be effectively used to eliminate local kyphotic deformity and restore the height of fractured vertebra.

scholarly journals Robot-assisted intravertebral augmentation corrects local kyphosis more effectively than a conventional fluoroscopy-guided technique

2019 ◽  
Vol 30 (2) ◽  
pp. 289-295 ◽  
Author(s):  
Sultan Alsalmi ◽  
Cyrille Capel ◽  
Louis Chenin ◽  
Johann Peltier ◽  
Michel Lefranc
Keyword(s):  
Hospital Stay ◽  
Vertebral Body ◽  
Body Height ◽  
Length Of Hospital Stay ◽  
Cement Leakage ◽  
Vertebral Body Height ◽  
Robot Assisted ◽  
Vertebral Body Fractures ◽  
Local Kyphosis ◽  
The Mean

OBJECTIVEIntravertebral augmentation (IVA) is a reliable minimally invasive technique for treating Magerl type A vertebral body fractures. However, poor correction of kyphotic angulation, the risk of cement leakage, and significant exposure to radiation (for the surgeon, the operating room staff, and the patient) remain significant issues. The authors conducted a study to assess the value of robot-assisted IVA (RA-IVA) for thoracolumbar vertebral body fractures.METHODSThe authors performed a retrospective, single-center study of patients who had undergone RA-IVA or conventional fluoroscopy-guided IVA (F-IVA) for thoracolumbar vertebral body fractures. Installation and operating times, guidance accuracy, residual local kyphosis, degree of restoration of vertebral body height, incidence of cement leakage, rate of morbidity, length of hospital stay, and radiation-related data were recorded.RESULTSData obtained in 30 patients who underwent RA-IVA were compared with those obtained in 30 patients who underwent F-IVA during the same period (the surgical indications were identical, but the surgeons were different). The mean ± SD installation time in the RA-IVA group (24 ± 7.5 minutes) was significantly shorter (p = 0.005) than that in the F-IVA group (26 ± 8 minutes). The mean operating time for the RA-IVA group (52 ± 11 minutes) was significantly longer (p = 0.026) than that for the F-IVA group (30 ± 11 minutes). All RA-IVAs and F-IVAs were Ravi’s scale grade A (no pedicle breach). The mean degree of residual local kyphosis (4.7° ± 3.15°) and the percentage of vertebral body height restoration (63.6% ± 21.4%) were significantly better after RA-IVA than after F-IVA (8.4° ± 5.4° and 30% ± 34%, respectively). The incidence of cement leakage was significantly lower in the RA-IVA group (p < 0.05). The mean length of hospital stay after surgery was 3.2 days for both groups. No surgery-related complications occurred in either group. With RA-IVA, the mean radiation exposure was 438 ± 147 mGy × cm for the patient and 30 ± 17 mGy for the surgeon.CONCLUSIONSRA-IVA provided better vertebral body fracture correction than the conventional F-IVA. However, RA-IVA requires more time than F-IVA.

scholarly journals Analysis of Related Factors on The Vertebral Height Restoration of Percutaneous Vertebral Augmentation

2019 ◽  
Vol 104 (7-8) ◽  
pp. 398-405
Author(s):  
Weixing Xie
Keyword(s):  
Vertebral Body ◽  
Compression Ratio ◽  
Univariate Analysis ◽  
Body Height ◽  
Height Loss ◽  
Loss Ratio ◽  
Vertebral Body Height ◽  
Kyphosis Angle ◽  
Local Kyphosis

Background Percutaneous vertebral augmentation (PVA) is widely applied for the treatment of osteoporotic vertebral fractures. The degree of vertebral body height restoration and deformity correction after the procedure is not consistent. Methods We retrospectively reviewed 97 patients who underwent PVA, because of osteoporotic vertebral compression fractures. The following data about the patients were recorded: age, sex, bone density, number of treated vertebrae, severity of fracture of the treated vertebrae, operative approach (PVP or PKP), volume of injected bone cement, preoperative vertebral compression ratio, preoperative local kyphosis angle, cement leakage, postoperative vertebral body height restoration ratio, follow-up period, and latest follow-up height loss ratio. Bivariate regression analysis and t-test were applied for univariate analysis, while multivariate linear regression analysis was applied for multivariate analysis. Results The postoperative vertebral body height restoration ratio was (14.7% ± 15.2%), and the last follow-up height loss ratio was (13.5% ± 11.5%). The multivariate analysis showed that the number of treated vertebrae, preoperative vertebral compression ratio, and preoperative local kyphosis angle are the main factors influencing the postoperative vertebral body height restoration. The univariate analysis also showed that only the postoperative vertebral body height restoration ratio is related to the last follow-up height loss ratio. Conclusions The number of treated vertebrae, preoperative vertebral compression ratio, and preoperative local kyphosis angle are the main influencing factors of patients' vertebral body height restoration after PVA, and the postoperative vertebral body height restoration ratio is the main factor influencing the last follow-up height loss ratio.

scholarly journals Minimal Invasive Circumferential Management of Thoracolumbar Spine Fractures

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
S. Pesenti ◽  
T. Graillon ◽  
N. Mansouri ◽  
P. Rakotozanani ◽  
B. Blondel ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Anterior Approach ◽  
Body Height ◽  
Thoracolumbar Spine ◽  
Fusion Rate ◽  
Minimal Invasive ◽  
Reduced Form ◽  
Thoracolumbar Fractures ◽  
Vertebral Body Height

Introduction. While thoracolumbar fractures are common lesions, no strong consensus is available at the moment.Objectives. The aim of this study was to evaluate the results of a minimal invasive strategy using percutaneous instrumentation and anterior approach in the management of thoracolumbar unstable fractures.Methods. 39 patients were included in this retrospective study. Radiologic evaluation was based on vertebral and regional kyphosis, vertebral body height restoration, and fusion rate. Clinical evaluation was based on Visual Analogic Score (VAS). All evaluations were done preoperatively and at 1-year follow-up.Results. Both vertebral and regional kyphoses were significantly improved on postoperative evaluation (13° and 7° versus −1° and −9°  P<0.05, resp.) as well as vertebral body height (0.92 versus 1.16,P<0.05). At 1-year follow-up, mean loss of correction was 1°. A solid fusion was visible in all the cases, and mean VAS was significantly reduced form 8/10 preoperatively to 1/10 at the last follow-up.Conclusion. Management of thoracolumbar fractures using percutaneous osteosynthesis and minimal invasive anterior approach (telescopic vertebral body prosthesis) is a valuable strategy. Results of this strategy offer satisfactory and stable results in time.

scholarly journals Vertebral body changes after continuous spinal distraction in scoliotic children

2021 ◽  
Author(s):  
Sebastian Lippross ◽  
Antonia Grages ◽  
Katja A. Lueders ◽  
Lena Braunschweig ◽  
Friederike Austein ◽  
...  
Keyword(s):  
Spinal Fusion ◽  
Vertebral Body ◽  
Body Height ◽  
Treated Group ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Radiographic Measurements ◽  
Ct Data ◽  
3D Volume ◽  
Vertebral Shape

Abstract Purpose Growth-friendly spinal implants (GFSI) were established for scoliotic children as an interim solution until definite spinal fusion could be performed during puberty. While deformity control was clearly proven, the effects on vertebral shape and morphology are still unclear. Our prospective study assesses the effect of GFSI with continuous distraction on vertebral body shape and volume in SMA children in comparison with previously untreated age-matched SMA patients. Methods Cohort I (n = 19, age 13.2 years) were SMA patients without prior surgical scoliosis treatment. Cohort II (n = 24, age 12.4 years) were children, who had continuous spinal distraction with GFSI for 4.5 years. Radiographic measurements and computed tomography (CT) 3D volume rendering were performed before definite spinal fusion. For cohort II, additional radiographs were analyzed before the first surgical implantation of GFSI, after surgery and every year thereafter. Results Our analysis revealed decreased depth and volume in scoliotic patients with prior GFSI compared to scoliotic patients without prior implants. This difference was significant for the lower thoracic and entire lumbar spine. Vertebral body height and pedicle size were unchanged between the two cohorts. Conclusion CT data showed volume reduction in the vertebral body in scoliotic children after GFSI treatment. This effect was more severe in the lumbar and lower thoracic area. While vertebral height was identical in both groups, vertebral depth was reduced in the GFSI-treated group. Reduced vertebral depth and altered vertebral morphology should be considered before instrumenting the spine in previously treated scoliotic SMA children. Level of evidence III Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.

Percutaneous balloon kyphoplasty in the treatment of pathological vertebral body fracture and deformity in multiple myeloma: a one-year follow-up

2006 ◽  
Vol 47 (4) ◽  
pp. 369-376 ◽  
Author(s):  
R. Pflugmacher ◽  
F. Kandziora ◽  
R. -J. Schroeder ◽  
I. Melcher ◽  
N. P. Haas ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Vertebral Body ◽  
Vertebral Fractures ◽  
Body Height ◽  
Balloon Kyphoplasty ◽  
Disability Score ◽  
Pain Status ◽  
Body Fracture ◽  
Percutaneous Balloon

Purpose: To evaluate the clinical and radiographic outcomes of balloon kyphoplasty in patients with fractures of the thoracic and lumbar spine caused by multiple myeloma. Material and Methods: Vertebral fractures due to multiple myeloma were treated by balloon kyphoplasty (20 patients, 48 vertebral bodies). Symptomatic levels were identified by clinical presentation, magnetic resonance imaging (MRI), radiographs, and computed tomography (CT). During the following year, visual analog scale (VAS) and Oswestry disability score were documented. Radiographs were taken pre- and postoperatively at 3, 6, and 12 months. Vertebral height and kyphotic deformity were measured to assess restoration of the sagittal alignment. Results: The median pain scores (VAS) decreased significantly from pre- to post-treatment, as did the Oswestry disability score ( p<0.05). Clinically asymptomatic cement leakage occurred at 5 fracture levels (10.4%). During 1-year follow-up, this surgical technique demonstrated restoration and stabilization of the height of the vertebral body. Conclusion: Balloon kyphoplasty is an effective minimally invasive procedure for stabilizing pathological vertebral fractures caused by multiple myeloma and leading to a statistically significant reduction of pain status. Balloon kyphoplasty stabilizes the vertebral body height, but is only partially able to prevent further kyphotic deformities.

Relationship Between the OF Classification and Radiological Outcome of Osteoporotic Vertebral Fractures After Kyphoplasty

2020 ◽  
pp. 219256822096405
Author(s):  
Yannick Palmowski ◽  
Sophie Balmer ◽  
Zhouyang Hu ◽  
Tobias Winkler ◽  
Klaus John Schnake ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Vertebral Fractures ◽  
Body Height ◽  
Postoperative Outcome ◽  
Osteoporotic Fractures ◽  
Preoperative Assessment ◽  
Visual Analogue Scale Pain ◽  
Vertebral Body Height ◽  
Osteoporotic Vertebral Fractures ◽  
Clinical And Radiological Results

Study Design: Retrospective cohort study. Objectives: The OF classification is a new classification for osteoporotic vertebral fractures. The aim of this study was to clarify the relationship between preoperative OF subgroups and the postoperative outcome after kyphoplasty in patients with such fractures. Methods: Patients who underwent kyphoplasty of a single osteoporotic vertebral fracture were included and divided into groups according to the OF subgroups. Pre- and postoperative plain radiographs were analyzed in regard to the restoration of vertebral body height and local kyphotic angle (LKA). Additionally, clinical data including pre- and postoperative Visual Analogue Scale pain scores was documented. The clinical and radiological results were compared pre- and postoperatively within groups and between groups. Results: A total of 156 patients from OF subgroups 2 to 4 were included (OF 2: n = 58; OF 3: n = 36; OF 4: n = 62). Patients from all groups experienced significant pain relief postoperatively ( P < .001). Patients with OF 2 fractures showed a repositioning of the vertebral body height in the anterior and middle portions (both P < .001), but no significant improvement in LKA. For OF 3 and 4 fractures, there was a significant restoration of vertebral body height ( P < .001 for both) and a significant improvement of LKA ( P < .001 for both). The highest average restoration was noted in the OF 4 group. Conclusions: A higher OF subgroup is related to a higher radiological benefit from kyphoplasty. This confirms that the OF classification is an appropriate tool for the preoperative assessment of osteoporotic fractures.

A study on the relationship between the rate of vertebral body height loss before balloon kyphoplasty and early adjacent vertebral fracture

2021 ◽  
pp. 1-8
Author(s):  
Hun Kyu Shin ◽  
Jai Hyung Park ◽  
In Gyu Lee ◽  
Jin Hun Park ◽  
Jun Hyoung Park ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Vertebral Fractures ◽  
Body Height ◽  
Balloon Kyphoplasty ◽  
Height Loss ◽  
Vertebral Body Height ◽  
Fracture Group ◽  
Significant Difference ◽  
Adjacent Vertebral Fracture ◽  
The Relationship

BACKGROUND: The number of patients with an osteoporotic vertebral compression fracture, which is often accompanied by lower back pain and restrained activities, is growing. Balloon kyphoplasty involves the inflation of a balloon to restore height and reduce kyphotic deformity before stabilization with polymethylmethacrylate. However, there is a great deal of debate about whether balloon kyphoplasty also increases fracture morbidity by either inducing or facilitating subsequent adjacent vertebral fractures. OBJECTIVE: To evaluate the relationship between the rate of vertebral body height loss before balloon kyphoplasty and the etiology of early adjacent vertebral fracture after augmentation. METHODS: A total of 59 patients with osteoporotic vertebral compression fractures who underwent kyphoplasty were enrolled. This study defined early adjacent segmental fractures as new fractures occurring within three months after surgery. This study included the rate of vertebral body height loss. RESULTS: Early adjacent vertebral fractures were diagnosed in nine (15%) of the 59 patients. The patients were divided into two groups, with and without adjacent vertebral fractures. There was no significant difference in terms of age, body mass index, bone mineral density, local kyphotic angle, Cobb’s angle, cement volume, cement leakage, and percent height restored between the groups with fractures and without fractures. There was a statistically significant difference between the two groups in the rate of vertebral body height loss. The rate of vertebral body height loss was significantly higher in the fracture group than in the without fracture group. CONCLUSIONS: A high rate of vertebral body height loss increased the risk of early adjacent vertebral fractures after balloon kyphoplasty.

Effect of CT-based attenuation correction on uptake ratios in skeletal SPECT

2007 ◽  
Vol 46 (01) ◽  
pp. 38-42 ◽  
Author(s):  
V. Schulz ◽  
I. Nickel ◽  
A. Nömayr ◽  
A. H. Vija ◽  
C. Hocke ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Facet Joint ◽  
One Dimension ◽  
Patient Specific ◽  
Data Sets ◽  
Facet Joints ◽  
Lumbar Vertebral Body ◽  
Ct System ◽  
Ct Data ◽  
Attenuation Corrected

SummaryThe aim of this study was to determine the clinical relevance of compensating SPECT data for patient specific attenuation by the use of CT data simultaneously acquired with SPECT/CT when analyzing the skeletal uptake of polyphosphonates (DPD). Furthermore, the influence of misregistration between SPECT and CT data on uptake ratios was investigated. Methods: Thirty-six data sets from bone SPECTs performed on a hybrid SPECT/CT system were retrospectively analyzed. Using regions of interest (ROIs), raw counts were determined in the fifth lumbar vertebral body, its facet joints, both anterior iliacal spinae, and of the whole transversal slice. ROI measurements were performed in uncorrected (NAC) and attenuation-corrected (AC) images. Furthermore, the ROI measurements were also performed in AC scans in which SPECT and CT images had been misaligned by 1 cm in one dimension beforehand (ACX, ACY, ACZ). Results: After AC, DPD uptake ratios differed significantly from the NAC values in all regions studied ranging from 32% for the left facet joint to 39% for the vertebral body. AC using misaligned pairs of patient data sets led to a significant change of whole-slice uptake ratios whose differences ranged from 3,5 to 25%. For ACX, the average left-to-right ratio of the facet joints was by 8% and for the superior iliacal spines by 31% lower than the values determined for the matched images (p <0.05). Conclusions: AC significantly affects DPD uptake ratios. Furthermore, misalignment between SPECT and CT may introduce significant errors in quantification, potentially also affecting leftto- right ratios. Therefore, at clinical evaluation of attenuation- corrected scans special attention should be given to possible misalignments between SPECT and CT.

MR-derived CT-like Images for the Assessment of Acute Vertebral Fractures and Osseous Degenerative Changes in the Thoracolumbar Spine

2020 ◽  
Author(s):  
Benedikt J. Schwaiger ◽  
Charlotte Schneider ◽  
Sophia Kronthaler ◽  
Christoph Böhm ◽  
Julian Zapf ◽  
...  
Keyword(s):  
Vertebral Fractures ◽  
Thoracolumbar Spine ◽  
Degenerative Changes
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