scholarly journals Long-segment Fixation VS Short-segment Fixation Combined With Kyphoplasty for Osteoporotic Thoracolumbar Burst Fracture

2021 ◽  
Author(s):  
Oujie Lai ◽  
Xinliang Zhang ◽  
Yong Hu ◽  
Xiaoyang Sun ◽  
Binke Zhu ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Burst Fracture ◽  
Body Height ◽  
Thoracolumbar Burst Fracture ◽  
Short Segment ◽  
Radiological Results ◽  
The Mean ◽  
Short Segment Fixation ◽  
Clinical And Radiological Results

Abstract BackgroundTo compare clinical and radiological results of long-segment fixation (LF) and six-screw short-segment fixation combined with kyphoplasty (SSFK) for osteoporotic thoracolumbar burst fracture (OTBF). Methods Forty patients affected by OTBF with mean age of 61.85 were included in this study. The mean follow-up period was 13.63 months. Twenty-four patients were treated by SSFK, and 16 patients were treated by LF. Clinical outcomes, radiological parameters and complications were assessed and compared. ResultsThe mean operative time and blood loss were 89.71±7.62min and 143.75±42.51ml for SFK group, respectively; 111.69±12.25min (P<0.01) and 259.38±49.05 ml (P<0.01) for LF group, respectively. The two groups were similar in terms of preoperative radiological and clinical results. Compared with preoperative values, both groups achieved significant improvement in terms of VAS, ODI, Cobb angle and anterior vertebral body height (AVH) ratio at final follow-up. However, during the follow-up period, the loss of Cobb angle and AVH ratio were significant different between immediately postoperative and final follow-up evaluations for both groups. Five cases (20.83%) of asymptomatic cement leakage were observed in SSFK group. One case of implant failure and two cases of adjacent or non-adjacent vertebral fractures were observed in LF group. ConclusionsFor the treatment of OTBF, SSFK shows similar clinical and radiological results as LF. Comparatively, SSFK is less invasive and can preserve more motion segments, which is a more valuable surgical option in selected elderly patients.

scholarly journals Inclusion of the fractured level into the construct of short segment fixation in patients with thoracolumbar fractures: clinical and radiological outcome

2021 ◽  
Vol 36 (1) ◽  
Author(s):  
Ali R. Hamdan ◽  
Radwan Nouby Mahmoud ◽  
Ahmed G. Tammam ◽  
Eslam El-Sayed El-Khateeb
Keyword(s):  
Cobb Angle ◽  
Vertebral Body ◽  
Compression Ratio ◽  
Body Height ◽  
Surgical Approaches ◽  
Thoracolumbar Fractures ◽  
Vertebral Body Height ◽  
Short Segment ◽  
The Mean ◽  
Short Segment Fixation

Abstract Background Thoracolumbar fractures represent a widespread injuries that can cause significant disability and strain the healthcare system. Different surgical approaches are described in the literature. This study was conducted to evaluate the fractured level inclusion in short-segment fixation of thoracolumbar junction spine fractures. Results Preoperative neurological deficit was reported in seven patients ranging from ASIA grade C to D. All of these patients improved to grade E by the end of the follow-up period, except for one patient who improved from grade C to D. The mean Oswestry Disability Index was 19.87%. The mean postoperative Cobb angle was 11.77° which significantly improved compared to a preoperative value of 19.37°. There was a significant improvement in the postoperative anterior and posterior vertebral body height compared to the preoperative values. The vertebral body compression ratio significantly improved during the postoperative period to a mean of 84% compared to 76% preoperative. Conclusions There was significant improvement of the postoperative values of the mean Cobb angle, the anterior and the posterior vertebral body height as well as the vertebral body compression ratio compared to the preoperative values.

scholarly journals Posterior fixation including the fractured vertebra in short segment fixation of unstable thoracolumbar junction burst fractures

2016 ◽  
Vol 9 (2) ◽  
pp. 81
Author(s):  
Md. Kamrul Ahsan ◽  
Zabed Zahangiri ◽  
M. A. Awwal ◽  
Naznin Zaman ◽  
Md. Hamidul Haque ◽  
...  
Keyword(s):  
Pedicle Screw ◽  
Screw Fixation ◽  
Burst Fracture ◽  
Pedicle Screw Fixation ◽  
Thoracolumbar Junction ◽  
Vertebral Height ◽  
Short Segment ◽  
The Mean ◽  
Short Segment Fixation

<p>The aim of this study was to evaluate the efficacy of inclusion of the fractured vertebra in short segment fixation in terms of clinical and the radiological outcomes in unstable thoracolumbar junction burst fractures at a minimum of 1 year follow-up. Records of 52 patients (age: 21-50 years) with thoracolumbar burst fracture (T10–L2) in Magerl Type A fractures underwent posterior pedicle screw fixation including the fractured vertebra. Clinical parameters were back pain using Visual Analogue Score (VAS) and disability using Oswestry disability index (ODI), neurological deficit (using ASIA grade) and radiologic parameters (Cobb angle, the kyphotic deformation and vertebral height) were measured before surgery and at 3, 6 and 12 months  post-operatively. The presence of screw breakage, screw pullout, peri-implant loosening, and rod breakage were considered as criteria for implant failure. The majority of fractures resulted due to falls (31 cases), and the remaining cases resulted from car accidents (21 cases). The fractured vertebral body level was L1, T12, L2, T11, and T10 in 23, 17, 6, 4 and 2 cases and achieved satisfactory clinical outcomes according to the modified Mcnab criteria 18, 25, 6 and 3 cases were considered to have excellent, good, fair, and poor outcome. The mean kyphotic angle at pre-, post-operative and final follow-up was 13.5 ± 6.3, 13.4 ± 4.3, 8.5 ± 6.  The average loss of kyphosis correction was 6.4 ± 5.2° at the final follow-up. The mean pre- and post-operative kyphotic deformation of vertebral body was 5.1 ± 3.2, 4.8 ± 2.3 and at final follow-up was 4.5 ± 4.0 (p&gt;0.05). The mean anterior and posterior vertebral height also showed significant improvements post-operatively, which were maintained at the final follow-up. The mean ODI and VAS scores at the end of 1 year were 17.4%, 1.7 respectively. There was no case of major complication after surgery and during the follow-up period. In conclusion, reduction of unstable thoracolumbar junction burst fracture can be achieved and maintained with the use of short-segment pedicle screw fixation including the fractured vertebra, avoiding the need for anterior reconstruction.</p><p> </p>

scholarly journals The Retrospective Analysis of Posterior Short-Segment Pedicle Instrumentation without Fusion for Thoracolumbar Burst Fracture with Neurological Deficit

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Zhouming Deng ◽  
Hui Zou ◽  
Lin Cai ◽  
Ansong Ping ◽  
Yongzhi Wang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Vertebral Body ◽  
Burst Fracture ◽  
Body Height ◽  
Operation Time ◽  
Thoracolumbar Burst Fracture ◽  
Vertebral Body Height ◽  
Kyphotic Angle ◽  
Short Segment ◽  
The Mean

This study aims to investigate the efficacy of posterior short-segment pedicle instrumentation without fusion in curing thoracolumbar burst fracture. All of the 53 patients were treated with short-segment pedicle instrumentation and laminectomy without fusion, and the restoration of retropulsed bone fragments was conducted by a novel custom-designed repositor (RRBF). The mean operation time and blood loss during surgery were analyzed; the radiological index and neurological status were compared before and after the operation. The mean operation time was 93 min (range: 62–110 min) and the mean intraoperative blood loss was 452 mL in all cases. The average canal encroachment was 50.04% and 10.92% prior to the surgery and at last followup, respectively (P<0.01). The preoperative kyphotic angle was 17.2 degree (±6.87 degrees), whereas it decreased to 8.42 degree (±4.99 degrees) at last followup (P<0.01). Besides, the mean vertebral body height increased from 40.15% (±9.40%) before surgery to 72.34% (±12.32%) at last followup (P<0.01). 45 patients showed 1-2 grades improvement in Frankel’s scale at last followup. This technique allows for satisfactory canal clearance and restoration of vertebral body height and kyphotic angle, and it may promote the recovery of neurological function. However, further research is still necessary to confirm the efficacy of this treatment.

scholarly journals The Loss of Correction in Thoracolumbar Burst Fracture Treated by Surgery. Can We Predict It?

2014 ◽  
Vol 60 (3) ◽  
pp. 99-101
Author(s):  
S. Anghel ◽  
D. Márton
Keyword(s):  
Anterior Approach ◽  
Burst Fracture ◽  
Regression Equations ◽  
Kyphosis Angle ◽  
Short Segment ◽  
Loss Of Correction ◽  
Short Segment Fixation ◽  
Lumbar Fractures ◽  
Fracture Level

Abstract Objective: This paper aims to differentially depict potential patterns of the loss of correction in surgically treated thoraco-lumbar burst fractures. These may eventually serve to foreseeing and even forestalling loss of correction. Methods: The study focused on 253 patients with surgically treated thoraco-lumbar fractures. This cohort of patients was clustered in four subgroups according to the fracture spine segment (T11-L1 or L1-L2) and surgery type (short segment fi xation or anterior approach). Relevant recorded and processed data were the fracture level, post-operative (Kpo) and last follow-up (Kf) kyphosis angle values. Correlation, regression and determination testing were performed for the last follow-up kyphosis angle and post-operative kyphosis angle, and regression equations were determined for each subgroup of patients. Results: The patterns of loss of correction were described through the following equations: Kf = 0.95*Kpo + 3.2° for the T11-L1 level fractured vertebrae treated by posterior short segment fixation; Kf = 0.98*Kpo + 3.4° for the L1-L2 level fractured vertebrae treated by posterior short segment fixation; Kf = 1.1*Kpo + 1.6° for the T11-L1 level fractured vertebrae treated by anterior approach; and Kf = 0.7*Kpo + 2.8° for the L1-L2 level fracture vertebrae treated by anterior approach. Conclusions: The loss of correction may be predicted, to a certain extent, for thoraco-lumbar fractured vertebrae treated surgically. The bestfit equations depicted for both type of surgery (short segment fixation and anterior approach) and both spinal segments (T11-L1 and L2-L3) are significantly different than the equations delineated for the collapse of non-surgically treated fractures.

scholarly journals Implant Removal after Percutaneous Short Segment Fixation for Thoracolumbar Burst Fracture : Does It Preserve Motion?

2014 ◽  
Vol 55 (2) ◽  
pp. 73 ◽  
Author(s):  
Hyeun Sung Kim ◽  
Seok Won Kim ◽  
Chang Il Ju ◽  
Hui Sun Wang ◽  
Sung Myung Lee ◽  
...  
Keyword(s):  
Burst Fracture ◽  
Implant Removal ◽  
Thoracolumbar Burst Fracture ◽  
Short Segment ◽  
Short Segment Fixation

scholarly journals Results of using Thoracolumbar Injury Classification and Severity Score (TLICS) in Treatment of Thoracolumbar Fractures

2021 ◽  
Author(s):  
Serdar Kabataş ◽  
Erdinç Civelek ◽  
Erek Öztürk ◽  
Eyüp Can Savrunlu ◽  
Murat Kahraman ◽  
...  
Keyword(s):  
Cobb Angle ◽  
Case Reports ◽  
Burst Fracture ◽  
Loss Of Correction ◽  
Thoracolumbar Injury ◽  
Intensity Changes ◽  
Vas Scores ◽  
The Mean

Aim: To compare short and long term pain intensity changes and long term loss of correction rates in patients who were treated either by kyphoplasty or posterior segmentation due to their TLICS and LSC scores, therefore evaluate the specificity of these classifications. Material and Methods: Medical records of 106 patients operated due to thoracolumbar compression or burst fracture in our clinics between years 2012 to 2015 have been evaluated retrospectively. The patients were evaluated with postoperative radiography (loss of reduction) and visual analogue scale (VAS) in their follow-ups. Results: The average stay on hospital was 6.53 ± 4.51 days in kyphoplasty group. The mean preoperative cobb angle was 10.76±11.67 degrees, which improved to 10.19±10.66 degrees at postoperative 1th month. Beside this, the mean preoperative VAS score was 7.93±0.68 then improved to 4.25±0.77 and 2.75 ± 1.43 at postoperative 6th, 12th month follow-ups respectively. There were 42 patients in instrumentation group. The mean hospitalization was 13.47±10.43 days. The mean preoperative cobb angle was 15.84±10.52 and it improved to 11.86±8.15 degrees at the postoperative 1th-month follow-up. The preoperative VAS scores of the patients improved from 7.71±0.71 to 4.09±0.79 and 4.26±1.23 at 6th and 12th month follow-ups. Conclusion: In long term follow up the kyphoplasty group showed more loss of correction however lesser VAS scores comparing to the instrumentation group. Although evaluating TLICS scores to kyphoplasty patients is still based on case reports in our series it was performed to 64 patients.

scholarly journals Smith-Peterson osteotomy and lordotic posterior column compressive screw fixation proceed by postural pillow reduction improved realignment for unstable lumbar burst fracture

2020 ◽  
Vol 3 (2) ◽  
pp. 36-39
Author(s):  
Farid Yudoyono ◽  
Hasan Baraqbah ◽  
Deasy Herminawaty
Keyword(s):  
Burst Fracture ◽  
Difficult Problem ◽  
Tissue Destruction ◽  
Short Term ◽  
Surgical Costs ◽  
Radiological Results ◽  
High Incidence ◽  
Trauma Case ◽  
Clinical And Radiological Results

Lumbar burst fractures (LBF) is a common trauma case of the spine, recently still a difficult problem to solve. Experts have published the approaches and techniques, but there is still a high incidence of morbidity and mortality, unsatisfactory clinical and radiological results especially in developing countries. The minimal tissue destruction approach with rigid screw-rod construction allowed to lowering surgical costs and earlier patient recovery with successfully clinical and radiological results in the short term follow up.

scholarly journals Short term radiological outcome of inserting screw at fracture level in posterior short segment fixation in thoracolumbar burst fractures

2017 ◽  
Vol 4 (3) ◽  
pp. 71-76
Author(s):  
Rabindra Lal Pradhan ◽  
Bimal Kumar Pandey ◽  
Krishna Raj Khanal
Keyword(s):  
Vertebral Body ◽  
Body Height ◽  
Fracture Site ◽  
Implant Failure ◽  
Vertebral Body Height ◽  
Short Segment ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures ◽  
Short Segment Fixation

Background: Unstable thoracolumbar burst fractures are treated surgically by short segment fixation but may be associated with high implant failure. Supplementation of anterior column by insertion of screw at fracture site makes it more biomechanically stable.Objectives: The purpose of this prospective study was to evaluate radiological parameters in thoracolumbar fractures treated with intermediate screw fixation with a minimum follow up of two years.Methods: This prospective study was conducted from 2011 till 2012 where unstable  thoracolumbar fractures treated with short segment posterior instrumentation with screw at fracture site were evaluated. All patients (average age 34.64 were followed up for at least 24 months and were classified according to Thoracolumbar Injury Classification and Severity Score and load sharing classifi cation. Out of total 32 patients, four lost to follow up. Radiological parameters like vertebral body height and segmental kyphosis were evaluated and pain was evaluated by Visual Analogue Scale score.Results: Preoperative pain showed mean Visual Analogue Scale Score score of 8.29 that improved to 0.97 at fi nal follow up. Average preoperative loss of vertebral body height was 48.19 %, which improved to 11.4 % after surgery (p<.001). Final vertebral body collapse was 12.98 % with mean percentage loss of vertebral height at 1.57%. Average segmental kyphotic angle was 22.54 before surgery, which corrected to 5.89 immediately after surgery (p<0.001). Final segmental kyphosis was 8.46. Loss of kyphosis correction was 2.57. Two patients had implant failure, but was solidly united during implant removal in both cases.Conclusion: Excellent maintenance of reduction in thoracolumbar burst fractures with short segment fixation with intermediate screws at fracture site with limited decompression resulted in improved neurologic function and satisfactory clinical outcomes, with a low incidence of implant failure and progressive deformity.

scholarly journals The clinical and radiological results of arthroscopic versus arthroscopy assisted mini-open repair of rotator cuff tears

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0006
Author(s):  
Muhammed Sefa Özcan ◽  
Hasan Basri Sezer ◽  
Osman Tuğrul Eren ◽  
Raffi Armağan ◽  
Muharrem Kanar
Keyword(s):  
Rotator Cuff ◽  
Open Surgery ◽  
Open Group ◽  
Rotator Cuff Tears ◽  
Radiological Results ◽  
Arthroscopically Assisted ◽  
The Mean ◽  
Clinical And Radiological Results ◽  
Mini Open

In this study we reported retrospectively the comperative clinical and radiological results of the two most common surgical procedures in rotator cuff tear repair of shoulder, the golden standart arthroscopic and alternative arthroscopically assisted mini-open surgery. We included 58 patients who admitted to our clinic for rotator cuff tear and treated surgically between january 2013 and august 2015. The two groups were composed of arthroscopically treated 29 patients and 29 patients who were treated with arthroscopically assisted mini open surgery. The arthroscopy group included 18 females and 11 males, the mini-open group included 10 females and 19 males. The mean age was 56,0 (39,0-73,0) years, in arthroscopic and 55,0 (40,0-70,0) years in mini-open surgery group. 6 patients in the arthroscopy group(20,7%) and 10 patients in the mini-open group(34,5%) were defining trauma before the beginning of their complaints. The postoperative follow up was 28,9 months in arthroscopy group and 22,6 months in the mini-open surgery group. Preoperative physical or medical treatments were documented. Any additional surgical procedures like biceps long head tenotomy, subacromial decompression and bursectomy were also noted. Patients were evaluated with ASES and Constant shoulder scales before and after the surgery. Patients were evaluated radiologically with MRI at the last follow up for healing and tendon quality. The type 2 acromion was the dominant in both groups constituting the 44,8% of the total number of patients. 24 (82,8%)patients in the arthroscopically treated patients and 18(62,1%) patients in the mini-open group were undergone at least one of the additional surgical treatments. The mean length of the surgical scar was 3,4(3-5) cm in mini open group. None of the patients complained of the surgical scar. 16 patients in the arthroscopy group and 17 patients in the mini-open group had supraspinatus tendon pathology(either tear or degeneration) in the MRI control at the last follow up. Postoperative pain was present in 1 patient in each group who were classified as bad result. There was no statistically meaningful difference between two groups in terms of clinical or radiological results. In conclusion the arthroscopy assisted mini-open surgery may be a useful tool in hands of training surgeons to prevent ineffective treatment of rotator cuff tears.

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