scholarly journals THORACOLUMBAR BURST FRACTURE: STRUCTURAL CHANGES AND CLINICAL OUTCOME OF TREATMENT

2016 ◽  
Vol 15 (1) ◽  
pp. 68-72
Author(s):  
Rodrigo Arnold Tisot ◽  
Juliano Silveira Luiz Vieira ◽  
Orley Fauth Tisot ◽  
Renato Tadeu dos Santos ◽  
Augusto Alves Badotti ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Clinical Outcome ◽  
Neurological Deficit ◽  
Spinal Canal ◽  
Structural Changes ◽  
Life Questionnaire ◽  
Burst Fractures ◽  
Sf 36 ◽  
Thoracic And Lumbar Spine

ABSTRACT Objective: To evaluate the correlation between structural changes in burst fractures of thoracic and lumbar spine with clinical outcome of the treatment. Methods: A retrospective study in 25 patients with fractures of thoracic and lumbar spine burst fractures without neurological deficit. Eleven patients underwent conservative treatment and for the remaining the treatment was surgical. All patients were followed up for at least 24 months. The cases were evaluated by a protocol that included: posttraumatic measurement of kyphosis, vertebral body collapse and narrowing of the spinal canal, the visual analog scale of pain, and the quality of life questionnaire SF-36 at the follow-up. For statistical analysis, the significance level was 5% and the software SPSS 18.0 was used. Results: No statistically significant difference was observed when comparing the clinical outcomes of one treatment over another. Similarly, there was no statistically significant correlation between kyphosis and post-traumatic narrowing of the spinal canal with clinical worsening in the follow-up, regardless of the treatment used. We found a positive correlation (p<0.05) between initial collapse and SF-36 domains in both groups (operated and non-operated). Conclusion: There was no significant superiority of one treatment over the other, and no correlation was found between kyphosis and spinal canal narrowing in burst fractures of the thoracic and lumbar spine without neurological deficit. However, there was correlation between initial collapse and clinical outcome in some domains of the SF-36 questionnaire.

Outcome analysis of surgically managed unstable burst fracture

2015 ◽  
Vol 1 (1) ◽  
pp. 3
Author(s):  
Ganesan G. Ram ◽  
P. V. Vijayaraghavan ◽  
Kannan Karthik Kailash
Keyword(s):  
Lumbar Spine ◽  
Bone Graft ◽  
Neurological Deficit ◽  
Unstable Fracture ◽  
Anterior Decompression ◽  
Loss Of Correction ◽  
Burst Fractures ◽  
Cord Injury ◽  
Thoracic And Lumbar Spine

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong>Burst fractures are common injuries of dorsolumbar spine. In indicated cases, surgery is the treatment of choice. Significant controversy exists regarding surgical intervention for these fractures. Posterior decompression, anterior decompression and instrumentation, and combined anterior decompression and posterior instrumentation have been recommended in various studies. Here we are going to evaluate unstable burst fractures of thoracic and lumbar spine treated by isolated anterior decompression and instrumented fusion with TSM-Bone graft composite.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> Prospective study of thirty-six cases of unstable fracture of thoracic and lumbar spine treated in Sri Ramachandra Medical centre from January 2011 to January 2014. The inclusion criteria were burst fractures of thoracic or lumbar spine complete or incomplete neurological deficit and burst fractures of thoracic or lumbar spine without neurological deficit but with mechanical instability. The exclusion criteria were pathological fractures, chance fracture, stable burst, wedge compression and osteoporotic compression fractures. The results were analyzed during the follow-up using the Pain – Visual analogue scale, Fusion status and radiographic parameter – K-angle .For pain score were given as 3,2,1 for absent, moderate and severe pain respectively. Regarding fusion status score of 3,2,1 were given when fusion was good, fair and no sign of fusion respectively.<strong></strong></span></p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong>Mean pre-operative K-angle was 28o. Average loss of correction at final follow up was 3o.Mean correction of K-angle was 140.Moderate to severe loss of correction of K- angle was observed in 4 patients. Mild to moderate pain in 5 patients treated with analgesics. Average TSM subsidence was 3mm.</p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong>Bone graft composite provides stable biomechanical support to deficient anterior column in burst fractures and allows early rehabilitation and mobilization. Neural recovery may occur after anterior decompression, stabilization and fusion with TSM-Bone graft composite in dorsolumbar burst fractures with incomplete cord injury.</p>

scholarly journals Surgical Treatment of Burst Fractures of the Thoracic and Lumbar Spine Accompanied with Spinal Canal Narrowing

2007 ◽  
pp. 8-15 ◽  
Author(s):  
Viktor Rerikh ◽  
◽  
Konstantin Borzykh ◽  
Shukhrat Rakhmatillaev ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Spinal Canal ◽  
Burst Fractures ◽  
Thoracic And Lumbar Spine

Nonoperatively treated burst fractures of the thoracic and lumbar spine in adults: a 23- to 41-year follow-up

2007 ◽  
Vol 7 (6) ◽  
pp. 701-707 ◽  
Author(s):  
Anders Moller ◽  
Ralph Hasserius ◽  
Inga Redlund-Johnell ◽  
Acke Ohlin ◽  
Magnus K. Karlsson
Keyword(s):  
Lumbar Spine ◽  
Burst Fractures ◽  
Thoracic And Lumbar Spine

Treatment of painful osteoporotic compression and burst fractures using kyphoplasty: a prospective observational design

2007 ◽  
Vol 6 (4) ◽  
pp. 313-319 ◽  
Author(s):  
Michael Stoffel ◽  
Iris Wolf ◽  
Florian Ringel ◽  
Carsten Stüer ◽  
Horst Urbach ◽  
...  
Keyword(s):  
Spinal Canal ◽  
Posterior Wall ◽  
Motor Deficit ◽  
X Ray ◽  
Burst Fractures ◽  
Osteoporotic Vertebral Fractures ◽  
Sf 36 ◽  
Computed Tomography Scanning ◽  
Observational Design

Object The aim of this study was to test the hypothesis that kyphoplasty is an effective treatment in painful osteoporotic vertebral fractures, even with involvement of the posterior cortical wall. Methods Between December 2001 and May 2004, 74 consecutive patients were treated with kyphoplasty for 118 painful osteoporotic compression (38%) or burst (62%) fractures. Additional decompression of the spinal canal was performed in six patients, internal fixation in three. Data were collected in a prospective observational design until May 2005. The preoperative workup included neuroimaging (plain x-ray films, densitometry, short tau inversion recovery magnetic resonance imaging, and computed tomography scanning) and clinical parameters (general and neurological examinations, visual analog scale [VAS], Karnofsky Performance Scale [KPS], and 36-Item Short Form Health Survey [SF]–36). At predefined time intervals (at discharge and 6 weeks and 3, 6, 12, and 24 months post-therapy) the patients were evaluated (x-ray films, neurological status, VAS, KPS, and SF-36). Kyphoplasty led to a significant reduction in kyphotic deformity (mean ± standard error of the mean, sagittal index: preoperative 10 ± 1°, postoperative 5 ± 1°), and an improvement in pain (VAS: preoperative 70 ± 3, postoperative 23 ± 2), activity (KPS score: preoperative 51 ± 3, postoperative 71 ± 2), and mental and physical health (SF-36, mental status: preoperative 43, postoperative 58; SF-36, physical status: preoperative 24, postoperative 35). No secondary narrowing of the spinal canal by the retropulsed posterior wall was observed after the procedure. Clinical improvement was durable (mean follow up 15 ± 1.1 months), although the VAS score secondarily increased slightly. All patients, who suffered from a compression-induced motor deficit, recovered completely during the follow-up interval. The main procedural complications consisted of one symptomatic extravertebral cement leakage (permanent monoparesis) requiring open revision, two nerve root contusions (transient radiculopathy), and one wound infection. Conclusions Kyphoplasty is effective in the treatment of painful osteoporotic vertebral compression and burst fractures, at least under medium-term conditions. The potential complication of procedure-related secondary narrowing of the spinal canal by the retropulsed posterior wall in burst fractures appears to be more of a theoretical than an actual risk.

Outcomes of 2-level posterior lumbar interbody fusion for 2-level degenerative lumbar spondylolisthesis

2013 ◽  
Vol 19 (1) ◽  
pp. 90-94 ◽  
Author(s):  
Hironobu Sakaura ◽  
Tomoya Yamashita ◽  
Toshitada Miwa ◽  
Kenji Ohzono ◽  
Tetsuo Ohwada
Keyword(s):  
Lumbar Spine ◽  
Clinical Outcome ◽  
Interbody Fusion ◽  
Sagittal Alignment ◽  
Posterior Lumbar Interbody Fusion ◽  
Adjacent Segment ◽  
Lumbar Interbody Fusion ◽  
Single Level ◽  
The Mean

Object A systematic review concerning surgical management of lumbar degenerative spondylolisthesis (DS) showed that a satisfactory clinical outcome was significantly more likely with adjunctive spinal fusion than with decompression alone. However, the role of adjunctive fusion and the optimal type of fusion remain controversial. Therefore, operative management for multilevel DS raises more complicated issues. The purpose of this retrospective study was to elucidate clinical and radiological outcomes after 2-level PLIF for 2-level DS with the least bias in determination of operative procedure. Methods Since 2005, all patients surgically treated for lumbar DS at the authors' hospital have been treated using posterior lumbar interbody fusion (PLIF) with pedicle screws, irrespective of severity of slippage, patient age, or bone quality. The authors conducted a retrospective review of 20 consecutive cases involving patients who underwent 2-level PLIF for 2-level DS and had been followed up for 2 years or longer (2-level PLIF group). They also analyzed data from 92 consecutive cases involving patients who underwent single-level PLIF for single-level DS during the same time period and had been followed for at least 2 years (1-level PLIF group). This second group served as a control. Clinical status was assessed using the Japanese Orthopaedic Association (JOA) score. Fusion status and sagittal alignment of the lumbar spine were assessed by comparing serial plain radiographs. Surgery-related complications and the need for additional surgery were evaluated. Results The mean JOA score improved significantly from 12.8 points before surgery to 20.4 points at the latest follow-up in the 2-level PLIF group (mean recovery rate 51.8%), and from 14.2 points preoperatively to 22.5 points at the latest follow-up in the single-level PLIF group (mean recovery rate 55.3%). At the final follow-up, 95.0% of patients in the 2-level PLIF group and 96.7% of those in the 1-level PLIF group had achieved solid spinal fusion, and the mean sagittal alignment of the lumbar spine was more lordotic than before surgery in both groups. Early surgery-related complications, including transient neurological complications, occurred in 6 patients in the 2-level PLIF group (30.0%) and 11 patients in the 1-level PLIF group (12.0%). Symptomatic adjacent-segment disease was found in 4 patients in the 2-level PLIF group (20.0%) and 10 patients in the 1-level PLIF group (10.9%). Conclusions The clinical outcome of 2-level PLIF for 2-level lumbar DS was satisfactory, although surgery-related complications including symptomatic adjacent-segment disease were not negligible.

scholarly journals Treatment of Injuries of the Lumbar Spine

2019 ◽  
Vol 5 (12) ◽  
pp. 156-162
Author(s):  
M. Sabyraliev
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Spinal Canal ◽  
Thoracolumbar Spine ◽  
Spinal Injuries ◽  
Long Term Results ◽  
Results Of Treatment ◽  
Post Traumatic

Surgical treatment of patients with spinal injuries, accompanied by traumatic stenosis of the spinal canal, is an urgent and discussed problem of modern vertebrology. Surgical treatment of 111 patients with various injuries of the thoracolumbar spine was performed. In 40 patients, post-traumatic stenosis was eliminated using ligamentotaxis using transpedicular osteosynthesis. The immediate results of treatment were followed up in all patients: good results were obtained in 33 (82.5%) cases; satisfactory — in 6 (15.0%), unsatisfactory — in 1 (2.5%). Long-term results with a follow-up of more than 1 year were followed up in 27 (67.5%) patients; good results were obtained in 20 (74.0%), satisfactory in 7 (25.0%).

scholarly journals Single-Stage Posterior Vertebral Column Resection With Circumferential Reconstruction for Thoracic/Thoracolumbar Burst Fractures With or Without Neurological Deficit: Clinical Neurological and Radiological Outcomes

2020 ◽  
pp. 219256822096445
Author(s):  
Azmi Hamzaoglu ◽  
Mustafa Elsadig ◽  
Selhan Karadereler ◽  
Ayhan Mutlu ◽  
Yunus Emre Akman ◽  
...  
Keyword(s):  
Neurological Deficit ◽  
Vertebral Column ◽  
Single Stage ◽  
Anterior Column ◽  
Vertebral Column Resection ◽  
Posterior Vertebral Column Resection ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures ◽  
The Mean

Study Design: Retrospective study. Objective: The aim of this study is to evaluate the clinical, neurological, and radiological outcomes of posterior vertebral column resection (PVCR) technique for treatment of thoracic and thoracolumbar burst fractures. Methods: Fifty-one patients (18 male, 33 female) with thoracic/thoracolumbar burst fractures who had been treated with PVCR technique were retrospectively reviewed. Preoperative and most recent radiographs were evaluated and local kyphosis angle (LKA), sagittal and coronal spinal parameters were measured. Neurological and functional results were assessed by the American Spinal Injury Association (ASIA) Impairment Scale, visual analogue scale score, Oswestry Disability Index, and Short Form 36 version 2. Results: The mean age was 49 years (range 22-83 years). The mean follow-up period was 69 months (range 28-216 months). Fractures were thoracic in 16 and thoracolumbar in 35 of the patients. AO spine thoracolumbar injury morphological types were as follows: 1 type A3, 15 type A4, 4 type B1, 23 type B2, 8 type C injuries. PVCR was performed in a single level in 48 of the patients and in 2 levels in 3 patients. The mean operative time was 434 minutes (range 270-530 minutes) and mean intraoperative blood loss was 520 mL (range 360-1100 mL). The mean LKA improved from 34.7° to 4.9° (85.9%). For 27 patients, the initial neurological deficit (ASIA A in 8, ASIA B in 3, ASIA C in 5, and ASIA D in 11) improved at least 1 ASIA grade (1-3 grades) in 22 patients (81.5%). Solid fusion, assessed with computed tomography at the final follow-up, was achieved in all patients. Conclusion: Single-stage PVCR provides complete spinal canal decompression, ideal kyphosis correction with gradual lengthening of anterior column together with sequential posterior column compression. Anterior column support, avoidance of the morbidity of anterior approach and improvement of neurological deficit are the other advantages of the single stage PVCR technique in patients with thoracic/thoracolumbar burst fractures.

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