Review of 31 cases of anterior thoracolumbar fixation with the anterior thoracolumbar locking plate system

1999 ◽  
Vol 7 (1) ◽  
pp. E3 ◽  
Author(s):  
John A. Wilson ◽  
Sam Bowen ◽  
Charles L. Branch ◽  
J. Wayne Meredith
Keyword(s):  
Locking Plate ◽  
Average Length ◽  
Thoracolumbar Spine ◽  
Posterior Fixation ◽  
Fixation Device ◽  
Structural Bone Graft ◽  
Stabilization Procedure ◽  
Long Term Follow Up ◽  
Flexion Injury

Anterior fixation devices for the thoracolumbar spine have gained wide acceptance as viable alternatives to long-segment posterior fixation in cases of thoracolumbar spine trauma. This review was undertaken to evaluate the safety and efficacy of the Synthes anterior thoracolumbar locking plate (ATLP) system. Over a 3-year period, 31 patients with unstable traumatic fractures of the thoracolumbar spine underwent corpectomy, placement of a structural bone graft, and anterior fixation in which the Synthes ATLP system was used. Long-term follow-up data were obtained in 29 patients. Two patients were lost to follow up, one at 4 months and the other at 1 year. In the remaining patients, the average length of follow up was 20 months. In all patients radiographic evidence of solid bone fusion was demonstrated on follow-up plain x-ray films, and there were no signs or symptoms of pseudarthrosis. No patient suffered neurological deterioration as a result of surgery, and there was relatively little morbidity associated with this plating system. To date, none of the patients in this study has developed any delayed complications related to the fixation device. In one patient, who had sustained a severe flexion injury, loosening of the anterior fixation device occurred, and the patient developed progressive kyphosis, which required a posterior stabilization procedure. These results appear slightly better than those obtained in published studies in which other anterior plating systems were used, indicating that this system is safe and effective in the treatment of unstable fractures of the thoracolumbar spine.

scholarly journals Short vs long posterior fixation of thoracolumbar spine injuries

2016 ◽  
Vol 69 (suppl. 1) ◽  
pp. 15-21
Author(s):  
Milan Stankovic ◽  
Natasa Janjic ◽  
Ivica Lalic ◽  
Nemanja Gvozdenovic ◽  
Igor Elez ◽  
...  
Keyword(s):  
Orthopedic Surgery ◽  
Neurological Deficit ◽  
Anterior Part ◽  
Thoracolumbar Spine ◽  
Posterior Fixation ◽  
Low Back ◽  
Fixation Group ◽  
Clinical Center ◽  
Spine Injuries

Introduction. More than a quarter of total number of posterior fixations of thoracolumbar spine is unsuccessful. Material and methods. The aim is to compare short and long fixation of thoracolumbar spine injuries. During the period of 2006 to 2015 we examined 99 patients at the Department of Orthopedic Surgery and Traumatology of Clinical Center of Vojvodina. Short fixation was performed in 63 cases and long fixation in 36 cases. All patients underwent clinical, radiographic and neurological evaluation. Mean age in the short fixation group was 47 (18-66) and in the long fixation group it was 43 (17-70). Mean follow-up time was 4,5 years. Results. Implants were extracted in 14 cases of short and in 4 cases of long fixation. Collapse of anterior part of vertebral body developed in 28,45% in the short fixation group and in 22,43% in the long fixation group whereas angulation value was 10,2o and 12,3o respectively. Mean low back outcome scale value was 61 points in the short fixation group and 50 in the long fixation group. There were 22 patients with neurological deficit. Full recovery was recorded in 8 patients (36,4%) of the short fixation group and in 17 patients (22,7%) of the long fixation group. Complications developed in 15 patients (23,8%) of the short fixation group and 11 (30,6%) of the long fixation group. Conclusion. Short fixation is biomechanically weaker but provides a better functional recovery than long fixation.

ANAPHYLACTOID PURPURA (SCHÖNLEIN-HENOCH SYNDROME)

PEDIATRICS ◽  
1955 ◽  
Vol 16 (2) ◽  
pp. 196-206
Author(s):  
Ralph J. P. Wedgwood ◽  
Marshall H. Klaus
Keyword(s):  
Renal Disease ◽  
Acute Phase ◽  
Chronic Renal Disease ◽  
Average Length ◽  
Adult Patients ◽  
Follow Up Study ◽  
Long Term Follow Up

A long-term follow-up study of 26 children with anaphylactoid purpura (Schönlein-Henoch Syndrome) is presented. The average length of follow-up was 4½ years. Of these 26 children, 10 were found to have an apparent latent nephritis characterized by hematuria and cylinduria, but without marked proteinuria. Nine of the ten children were over the age of 6 years at the time of onset of purpura; 6 had proteinuria or hematuria during the acute phase of the disease. It is suggested that this renal sequela of anaphylactoid purpura may constitute one of the origins of chronic renal disease "of unknown etoiology" which occurs in adult patients.

scholarly journals Outcome of Unstable Thoracolumbar Fracture Following Long Segment Posterior Fixation

2021 ◽  
Vol 39 (2) ◽  
pp. 114-122
Author(s):  
Abdullah Al Mamun Choudhury ◽  
Md Shah Alam ◽  
Abul Kalam Azad ◽  
Kohinoor Akhter
Keyword(s):  
Functional Outcome ◽  
Neurological Deficit ◽  
Thoracolumbar Spine ◽  
Case Series ◽  
Fusion Rate ◽  
Spine Injury ◽  
P Value ◽  
Posterior Fixation ◽  
Thoracolumbar Region

Introduction: Fractures of the thoracolumbar region are the most common injuries of the vertebral column and burst fractures are the most frequent. The purpose of this study was to see the radiological and functional outcome after long segment posterior fixation in unstable thoracolumbar spine injury with incomplete neurological deficit. Methods: A total of 146 cases were included in this prospective case series from January 2014 to December 2018 through non randomized purposive sampling. All the patients were operated with long segment posterior fixation and postero-lateral fusion by Autogenous cancellous bone graft. Postoperative functional outcome was assessed both clinically by ODI, VAS, ASIA and radiologically by Bridwell criteria. Postoperative follow up was conducted at 2nd, 6th,12th and finally 6 monthly. Results: The mean Cobb angle at pre-operative was 21.5 ±8.9 and at final follow-up was 11±4.57 in this study (p-value<0.05). At final follow up 1 grade improvement occurred in 116(79.5%) patients and 2 grade improvement in 36 (20.5%). Regarding ODI and VAS, moderate disability (25%) with mild pain (16%) was found at final follow up with a Bridwell fusion grade II (48%). Conclusion: Long segment transpedicular screw fixation in unstable thoracolumbar spine injury with incomplete neurological deficit is an effective method of treatment. This method enhances neurological and functional recovery with an acceptable fusion rate J Bangladesh Coll Phys Surg 2021; 39(2): 114-122

Novel Bilateral Extracavitary Approach for Thoracolumbar Decompression

2017 ◽  
Vol 14 (2) ◽  
pp. 145-150
Author(s):  
Jeffrey P Mullin ◽  
Alvin Y Chan ◽  
Emily Bennett ◽  
Michael P Steinmetz
Keyword(s):  
Spinal Injury ◽  
Average Length ◽  
Thoracolumbar Spine ◽  
Retrospective Chart Review ◽  
Complication Rates ◽  
Average Length Of Stay ◽  
Estimated Blood Loss ◽  
Average Patient ◽  
Baseline Characteristics

Abstract BACKGROUND Bilateral extracavitary approach (BECA) is an option for decompression cases that require a more extended ventral approach. The clear advantage is increased accessibility to the most ventral aspects of the spine from a bilateral perspective. OBJECTIVE To assess the safety and efficacy of thoracic and thoracolumbar decompression and/or reconstruction from BECA. METHODS A retrospective chart review was performed reviewing all patients who underwent BECA for thoracolumbar decompression from 2003 to 2012 at our institution. We recorded patient baseline characteristics, physical exam, surgical indications, perioperative interventions, and outcomes. RESULTS We performed 82 lateral extracavitary approaches and 10 BECAs. BECA indications included neoplasm, infection, and kyphotic deformity. Average patient age was 58 yr; 80% of BECA patients were male. Estimated blood loss was typically 1 to 3 L. Average length of stay postoperative was 12 d. Two patients required revisions; one for infection and one for revision of misplaced hardware. Eight patients improved at least one grade on the American Spinal Injury Association Impairment Scale (ASIA) or was originally ASIA E. Two patients declined 1 to 2 ASIA grades. Average length of follow-up was 16.8 mo. CONCLUSION BECA is an efficient technique with acceptable complication rates and similar risks to unilateral approaches. It should be considered when extensive bilateral decompression and/or reconstruction of the anterior thoracic or thoracolumbar spine is required.

Occipitocervical instrumentation in the pediatric population using a custom loop construct: initial results and long-term follow-up experience

2010 ◽  
Vol 5 (3) ◽  
pp. 285-291 ◽  
Author(s):  
Daniel Couture ◽  
Nathan Avery ◽  
Douglas L. Brockmeyer
Keyword(s):  
Pediatric Population ◽  
Loop System ◽  
Fixation Device ◽  
Occipitocervical Fixation ◽  
Institutional Review ◽  
Posttraumatic Instability ◽  
Long Term Follow Up ◽  
Halo Orthosis

Object Rigid occipitocervical instrumentation for craniovertebral instability is gaining widespread acceptance for use in pediatric patients; however, most of the instrumentation has been modified from adult-sized hardware. The Wasatch loop system (formerly the Avery-Brockmeyer-Thiokol loop system) is a rigid occipitocervical fixation device designed specifically for use in children. It affixes to the occiput and incorporates either C1–2 transarticular screws or C-2 pars screws. It is preformed and is available in a variety of sizes. The authors describe their clinical experience and long-term follow-up experience with the first 22 patients. Methods An institutional review board–approved retrospective review of medical records and radiographs was performed for patients who underwent occipitocervical fusion with the Wasatch loop. The mean patient age was 4.9 years (1.2–13 years), and the overall mean follow-up was 4 years (1.5–6.5 years). Six patients had posttraumatic instability, and 16 patients had congenital instability. Results Twelve patients underwent placement of bilateral C1–2 transarticular screws, 6 patients had placement of a combination of C1–2 transarticular and C-2 pars screws, and 4 patients had placement of bilateral C-2 pars screws. One patient required a halo orthosis; the others were treated postoperatively with a hard cervical collar. All patients had radiographic evidence of solid occipitocervical arthrodesis on last follow-up examination. Conclusions The Wasatch loop system is a novel internal fixation device for children who have posttraumatic or congenital occipitocervical instability. Successful arthrodesis was achieved in all patients with minimal use of halo orthoses.

scholarly journals An Unusual Instrumentation-Related S1 Radiculopathy in a Patient Treated for a Primary Vertebral (L3) Lymphoma

2012 ◽  
Vol 6 ◽  
pp. CMO.S10773 ◽  
Author(s):  
Maurizio Iacoangeli ◽  
Alessandro Di Rienzo ◽  
Niccolò Nocchi ◽  
Lorenzo Alvaro ◽  
Maurizio Gladi ◽  
...  
Keyword(s):  
Unusual Complication ◽  
Non Hodgkin Lymphoma ◽  
Clinical Onset ◽  
Pathological Conditions ◽  
Stabilization Procedure ◽  
Long Term Follow Up ◽  
Rod Migration ◽  
Vertebral Stabilization

Paravertebral titanium rod migration represents an unusual and potentially fatal complication of vertebral stabilization surgical procedures. This condition, which requires a prompt and rapid diagnosis, is often mistaken for other more common diseases, or scotomized. We present a case of a 69 years old female affected by a non-Hodgkin lymphoma with evidence of migration of both rods five years after the posterior stabilization procedure for a pathological L3 fracture. Unusual clinical onset was represented by a left S1 radiculopathy without other symptoms. For several months, the symptoms were attributed to a possible radicular infiltration by the lymphoma. We conclude that paravertebral rod migration could happen not only within the spinal canal, but could also rarely damage blood vessels or parenchymal organs. This is generally a long-term complication, probably due to an insufficient fixation. Strict long-term follow-up monitoring is mandatory since this unusual complication can mimic other more common pathological conditions.

scholarly journals Nonresection management of the pancreas for grade III and IV blunt pancreatic injuries in children: a single center’s experience

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dan Zhang ◽  
Jiayu Yan ◽  
Sarah Tan Siyin ◽  
Wenbo Pang ◽  
Yajun Chen
Keyword(s):  
Conservative Treatment ◽  
Average Length ◽  
Pancreatic Pseudocysts ◽  
Abdominal Infection ◽  
Average Length Of Stay ◽  
Pancreatic Injuries ◽  
Long Term Follow Up ◽  
Grade Iii

Abstract Background The treatment of high-grade (III/IV/V) blunt pancreatic injuries remains controversial. The study aims to summarize and evaluate nonresection management of the pancreas for grade III and IV blunt pancreatic injuries in children. Methods Twenty children [6.9 (3–12) years] treated at our center between January 2010 and June 2018 were included in this study. Their medical records and the outpatient follow-up data within 12 weeks after discharge were retrospectively reviewed. Long-term follow-up was conducted by telephone in February 2020. Results Nine children developed complications, including 8 pancreatic pseudocysts and 1 abdominal infection, after treatment at external hospitals and were transferred to our center with an average length of stay of 33.8 (8–63) days. Eleven children were admitted to our hospital directly after injury, with an average length of stay of 47.5 (23–69) days. One child underwent emergency laparotomy for hemorrhagic shock and Roux-en-Y drainage of the distal pancreas. The remaining 10 children received conservative treatment: 7 developed pancreatic pseudocysts, 2 developed abdominal infections, and 1 recovered uneventfully. For children with pancreatic pseudocysts (15/20, 75.0%), 4 recovered after conservative treatment, 4 recovered after percutaneous puncture, 5 recovered after external drainage of the cyst, and 2 recovered after alimentary tract anastomosis. Three children (3/20, 15.0%) who developed abdominal infection recovered after abdominal irrigation and drainage. No child was admitted to the ICU or died. Four children (4/20, 20.0%) developed local pancreatic atrophy within 12 weeks after discharge, but no other long-term complications were observed. Conclusions Nonresection management of the pancreas could be a feasible option for children with grade III and IV blunt pancreatic injuries. Regular long-term follow-up is essential in terms of pancreatic function, especially in patients with pancreatic atrophy.

Experiences using the Fixin locking plate system for the stabilization of appendicular fractures in dogs

2013 ◽  
Vol 26 (01) ◽  
pp. 61-68 ◽  
Author(s):  
T. Nicetto ◽  
A. Urizzi ◽  
M. Isola ◽  
M. Petazzoni
Keyword(s):  
Complication Rate ◽  
Medical Records ◽  
Locking Plate ◽  
Inclusion Criteria ◽  
Limb Function ◽  
Long Term Follow Up ◽  
Locking Plate System ◽  
Plate System

SummaryObjectives: To retrospectively evaluate the stabilization of appendicular fractures in dogs using the Fixin locking plate system.Materials and methods: Medical records and radiographs of dogs with fractures stabilized with the Fixin system in the period from May 2005 to September 2010 were reviewed. For each patient, data pertaining to signalment, the nature of the fracture, implants used, and evidence of fracture healing were recorded. The outcome and complications were determined from clinical and radiographic follow-up examinations. Limb function was evaluated between 40 days and 90 days postoperatively. Owners of pets with complications were contacted by phone for long-term follow-up.Results: Eighty-two fractures in seventy-five dogs met the inclusion criteria for the study. Radiographic re-examinations were carried out between eight days to two years (median 60 days) following surgery. Seventy-three out of 82 fractures (89%) reached union without complications. Major complications were seen in six dogs (7%). Limb function was graded as ‘normal’ in 73/75 (97%) dogs and ‘mild lameness’ in 2/75 (3%) cases.Clinical significance: Despite a modest complication rate, the Fixin locking bone plating system appears to be an acceptable choice of implant for the stabilization of appendicular fractures in dogs.

Long-Term Follow-up of Nonoperatively Treated Thoracolumbar Spine Fractures

1987 ◽  
Vol 1 (2) ◽  
pp. 152-159 ◽  
Author(s):  
James N. Weinstein ◽  
Patrick Collalto ◽  
Thomas R. Lehmann
Keyword(s):  
Thoracolumbar Spine ◽  
Spine Fractures ◽  
Long Term Follow Up ◽  
Thoracolumbar Spine Fractures
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