scholarly journals Comparison of Percutaneous Kyphoplasty and Percutaneous Pedicle Screw Fixation for the Treatment of Osteopenic Thoracolumbar Vertebral Compression Fractures

2020 ◽  
Author(s):  
Ye Zhang ◽  
Weiwei Yi ◽  
Huiqiang Xia ◽  
Haiyang Lan ◽  
Zhijie Yang ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Long Term Results ◽  
Vertebral Compression Fractures ◽  
Compression Fractures ◽  
Percutaneous Kyphoplasty ◽  
Percutaneous Pedicle Screw ◽  
Percutaneous Pedicle Screw Fixation

Abstract BACKGROUND: Osteoporotic vertebral compression fractures (OVCFs) have a high incidence, which have attracted wide attention from society. However, few scholars have conducted researches on osteopenic vertebral compression fractures (osteopenic VCFs). Our research has compared the clinical and imaging effects of percutaneous kyphoplasty (PKP) and percutaneous pedicle screw fixation (PPSF) in the treatment of Osteopenic thoracolumbar vertebral compression fractures (Osteopenic VCFs).METHODS: From December 2018 to September 2020, 70 patients with osteopenic VCFs who had undergone PKP and PPSF surgeries at our medical center were reviewed retrospectively. All patients were divided into PKP group (n=38) and PPSF group (n=32). Clinical data including clinical and radiological evaluation results were performed pre- and postoperatively.RESULTS: The operation time, bleeding volume, postoperative bedtime, and hospitalization period in PKP group were lower than those in PPSF group (P<0.05). The visual analogue scale (VAS) and Oswestry Disability Index (ODI) of two groups in the last follow-up were lower than those before the operation (P<0.05). On the 3rd day after the operation, VAS and ODI in PPSF group were higher than those in PKP group (P<0.05). The anterior height of injured vertebrae (AH) of two groups was recovered compared with that before the operation. Compared with two groups in each period, there was no obvious difference in AH or the height restoration of injured vertebrae (HR) (P>0.05). The anterior height ratio of injured vertebrae (AHR) of PPSF group was higher than that of PKP group after the operation (P<0.05). The kyphosis angle (KA) in PPSF group was smaller than PKP group after the operation (P<0.05). All patients in PPSF group have achieved bony healing at the last follow-up.CONCLUTIONS: Both PPSF and PKP can achieve satisfactory clinical results in the treatment of Osteopenic VCFs. The short-term clinical effect of PKP is better than that of PPSF, but the latter has better long-term results, including the correction and maintenance of vertebral height and the acquisition of osseous fusion.

scholarly journals Minimally Invasive Spine Surgery for Unstable Thoracolumbar Burst Fractures: A Case Series

2016 ◽  
Vol 02 (04) ◽  
pp. e131-e138 ◽  
Author(s):  
Nitin Agarwal ◽  
Phillip Choi ◽  
Raymond Sekula
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Burst Fracture ◽  
Pedicle Screw Fixation ◽  
Thoracolumbar Burst Fracture ◽  
Thoracolumbar Burst Fractures ◽  
Percutaneous Pedicle Screw ◽  
Percutaneous Pedicle Screw Fixation

Introduction Traumatic thoracolumbar burst fracture is a common pathology without a clear consensus on best treatment approach. Minimally invasive approaches are being investigated due to potential benefits in recovery time and morbidity. We examine long-term resolution of symptoms of traumatic thoracolumbar burst fractures treated with percutaneous posterior pedicle screw fixation. Methods Retrospective clinical review of seven patients with spinal trauma who presented with thoracolumbar burst fracture from July 2012 to April 2013 and were treated with percutaneous pedicle screw fixation. Electronic patient charts and radiographic imaging were reviewed for initial presentation, fracture characteristics, operative treatment, and postoperative course. Results The patients had a median age of 29 years (range 18 to 57), and 57% were men. The median Thoracolumbar Injury Classification and Severity Scale score was 4 (range 2 to 9). All patients had proper screw placement and uneventful postoperative courses given the severity of their individual traumas. Five of seven patients were reached for long-term follow-up of greater than 28 months. Six of seven patients had excellent pain control and stability at their last follow-up. One patient required revision surgery for noncatastrophic hardware failure. Conclusion Percutaneous pedicle screw fixation for the treatment of unstable thoracolumbar burst fracture may provide patients with durable benefits and warrants further investigation.

scholarly journals Combined posterior percutaneous pedicle screw fixation with delayed anterior monosegmental column reconstruction for unstable thoracolumbar burst fractures

2020 ◽  
Author(s):  
Chao Lou ◽  
Weiyang Yu ◽  
Zhenzhong Chen ◽  
Kangtao Jin ◽  
Jiawei Gao ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Titanium Mesh ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures ◽  
Percutaneous Pedicle Screw ◽  
The Mean ◽  
Percutaneous Pedicle Screw Fixation

Abstract Objective: This study aimed to assess the feasibility as well as the clinical and radiological outcomes of posterior percutaneous pedicle screw fixation (PPSF) combined with anterior monosegmental column reconstruction in unstable thoracolumbar burst fractures. Methods: From January 2011 to August 2017, thirty-five patients with unstable thoracolumbar burst fractures were enrolled in this study. The patients underwent posterior PPSF combined surgery with delayed anterior monosegmental reconstruction utilizing titanium mesh cages. Clinical outcomes, radiological parameters, and treatment-related complications were assessed. Results: The mean age of the patients was 44.8 years. The mean operative time and blood loss were 205 min and 560 ml, respectively. The mean follow-up period was 25.2 months. The Visual analog scale (VAS) pain score was significantly improved postoperatively, and the improvement was maintained until the final follow-up. The mean sagittal kyphosis was corrected from 16.3 preoperatively to 1.5 postoperatively, which increased slightly to 2.6 at the final follow-up. In 24 patients with neurologic dysfunction, 21 (87.5 %) patients had improvement after surgery. None obvious subsidence of the titanium mesh cage and none dislodgement, loosening or breakage of the instrumentation was observed in any patient during the follow-up period. Solid bony fusion was achieved in all patients. Conclusions: Combined posterior PPSF with delayed anterior monosegmental column reconstruction for unstable thoracolumbar burst fractures can produce good clinical and radiological outcomes.

scholarly journals Flexion-distraction injuries of the thoracolumbar spine: open fusion versus percutaneous pedicle screw fixation

2013 ◽  
Vol 35 (2) ◽  
pp. E2 ◽  
Author(s):  
Andrew J. Grossbach ◽  
Nader S. Dahdaleh ◽  
Taylor J. Abel ◽  
Gregory D. Woods ◽  
Brian J. Dlouhy ◽  
...  
Keyword(s):  
Blood Loss ◽  
Minimally Invasive ◽  
Pedicle Screw ◽  
Operative Time ◽  
Spinal Injury ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Percutaneous Pedicle Screw ◽  
Percutaneous Pedicle Screw Fixation

Object Flexion-distraction injuries occur due to distractive forces causing disruption of the posterior and middle spinal columns. These fractures classically consist of a fracture line through the posterior bony elements; involvement of the posterior ligamentous complex is, however, common. Surgical treatment is often required for these unstable injuries to avoid neurological deterioration and posttraumatic kyphosis, and the surgery traditionally consists of an open posterior approach with instrumented fusion. Percutaneous pedicle screw fixation for these injuries, with the goal of minimal tissue disruption and preservation of normal anatomy while achieving adequate stabilization, has recently been reported in the literature, but to date, a direct comparative study comparing open and percutaneous fixation has not been reported. The authors report their experience treating these fractures with both techniques and review the available literature. Methods Patients with flexion-distraction injury who were treated between May 2003 and March 2013 were prospectively followed. American Spinal Injury Association scores and degree of kyphotic angulation were recorded at admission, discharge, and follow-up. Data regarding intraoperative blood loss and operative time were obtained from a chart review. Patients treated with open versus minimally invasive procedures were compared. Results The authors identified 39 patients who suffered flexion-distraction injuries and were treated at their institution during the specified period; one of these patients declined surgery. All had injury to the posterior ligamentous complex. Open surgical procedures with pedicle screw fixation and posterolateral fusion were performed in 27 patients, while 11 patients underwent minimally invasive pedicle screw placement. Overall, there was improvement in kyphotic angulation at the time of discharge as well as most recent follow-up in both the open surgery and minimally invasive surgery (MIS) groups. The authors found no significant difference in American Spinal Injury Association score or the degree of kyphotic angulation between the MIS and open surgery groups. There was a trend toward shorter operative time for the MIS group, and patients who underwent minimally invasive procedures had significantly less blood loss. Conclusions Minimally invasive percutaneous pedicle screw fixation appears to have similar efficacy in the treatment of flexion-distraction injuries and it allows for reduced blood loss and tissue damage compared with open surgical techniques. Therefore it should be considered as an option for the treatment of this type of injury.

scholarly journals Outcome of One-Stage Percutaneous Endoscopic Debridement and Lavage Combined with Percutaneous Pedicle Screw Fixation for Lumbar Pyogenic Spondylodiscitis

2021 ◽  
Author(s):  
Jianquan Chen ◽  
Zhenyu Li ◽  
Yong Li ◽  
Shangde Tang ◽  
Zhouming Lv ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Pyogenic Spondylodiscitis ◽  
One Stage ◽  
Percutaneous Pedicle Screw ◽  
Endoscopic Debridement ◽  
Percutaneous Pedicle Screw Fixation ◽  
Conventional Open Surgery

Abstract Background This study assessed the therapeutic effect of one-stage percutaneous endoscopic debridement and lavage (PEDL) combined with percutaneous pedicle screw fixation (PPSF) in the treatment of lumbar pyogenic spondylodiscitis. Methods From March 2017 to October 2019, 25 patients diagnosed with pyogenic spondylodiscitis underwent PPSF followed by PEDL in our department. Biopsy specimens were examined for microorganisms and evaluated histopathologically. Clinical outcomes were assessed by physical examination, routine serological testing, visual analogue scale (VAS), Oswestry Disability Index (ODI), and imaging studies. Results All operations were successful, with no severe surgical complications in any patient and excellent incision healing. Causative bacteria were identified in most cases; Staphylococcus aureus was the most prevalent. The mean follow-up was 25.0 ± 3.8 (range: 20–32) months. Inflammatory markers showed that infection was controlled. The VAS and ODI improved significantly. At the last follow-up, magnetic resonance imaging showed that the infected lesions had disappeared. Conclusion PEDL supplementing PPSF may be useful for patients with single-level lumbar pyogenic spondylodiscitis, as it is minimally invasive, especially for patients who cannot undergo conventional open surgery due to poor health or advanced age.

scholarly journals Outcome of one-stage percutaneous endoscopic debridement and lavage combined with percutaneous pedicle screw fixation for lumbar pyogenic spondylodiscitis

2021 ◽  
Vol 29 (3) ◽  
pp. 230949902110655
Author(s):  
Jianquan Chen ◽  
Tianhang Xuan ◽  
Yao Lu ◽  
Xinyuan Lin ◽  
Zhouming Lv ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Pyogenic Spondylodiscitis ◽  
One Stage ◽  
Biopsy Specimens ◽  
Percutaneous Pedicle Screw ◽  
Endoscopic Debridement ◽  
Percutaneous Pedicle Screw Fixation

Background This study assessed the therapeutic effect of one-stage percutaneous endoscopic debridement and lavage (PEDL) combined with percutaneous pedicle screw fixation (PPSF) in the treatment of lumbar pyogenic spondylodiscitis. Methods From March 2017 to October 2019, 51 patients diagnosed with pyogenic spondylodiscitis underwent PPSF followed by PEDL in our department. Biopsy specimens were examined for microorganisms and evaluated histopathologically. Clinical outcomes were assessed by physical examination, routine serological testing, visual analogue scale (VAS), Oswestry Disability Index (ODI) and imaging studies. Results Of the enrolled patients, the operation time ranged from 90 min to 114 min every level with an average of 102 min, and the average drainage time ranged from 6 days to 10 days with an average of 7.4 days. All patients who complained of lower back pain symptoms were more relieved than before surgery. Causative pathogens were identified in 20 of 51 biopsy specimens; Staphylococcus aureus was the most prevalent. However, there were eight patients with postoperative complications. The mean follow-up was 25.0 ± 3.8 (range: 20–32) months. Inflammatory markers showed that infection was controlled. The VAS and ODI improved significantly. At the last follow-up, magnetic resonance imaging showed that the infected lesions had disappeared. Conclusion PEDL supplementing PPSF may be useful for patients with single-level lumbar pyogenic spondylodiscitis, as it is minimally invasive, especially for patients who cannot undergo conventional open surgery due to poor health or advanced age.

scholarly journals Percutaneous Pedicle Screw Fixation with Polymethylmethacrylate Augmentation for the Treatment of Thoracolumbar Intravertebral Pseudoarthrosis Associated with Kummell’s Osteonecrosis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Hyeun-Sung Kim ◽  
Dong-Hwa Heo
Keyword(s):  
Pedicle Screw ◽  
Compression Ratio ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Vertebral Height ◽  
Kyphotic Angle ◽  
Short Segment ◽  
Compression Fractures ◽  
Percutaneous Pedicle Screw ◽  
Percutaneous Pedicle Screw Fixation

Purpose. The purpose of our study is to evaluate the therapeutic efficacy of short-segment percutaneous pedicle screw fixation with polymethylmethacrylate (PMMA) augmentation for the treatment of osteoporotic thoracolumbar compression fracture with osteonecrosis.Methods. Osteoporotic thoracolumbar compression fractures with avascular necrosis were treated by short-segment PPF with PMMA augmentation. Eighteen were followed up for more than 2 years. The kyphotic angle, compression ratio, visual analog scale (VAS) score for back pain, and the Oswestry Disability Index (ODI) were analyzed. In addition, radiologic and clinical parameters of PPF group were compared with percutaneous vertebroplasty (PVP) group.Results. Vertebral height and kyphotic angle of the compressed vertebral bodies were significantly corrected after the operation (P<0.05). Further, restored vertebral height was maintained during the 2 or more years of postoperative follow-up. Compared to the PVP group the postoperative compression ratio and kyphotic angle were significantly lower in the PPF group (P<0.05). The postoperative ODI and VAS of the PVP group were significantly higher than the PPF (P<0.05).Conclusions. According to our results, short-segment PPF with PMMA augmentation may be an effective minimally invasive treatment for osteoporosis in cases of osteoporotic vertebral compression fractures with Kummell’s osteonecrosis.

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