Preliminary Report of Temporary Posterior Instrumentation in Stable Thoracolumbar Burst Fractures

2002 ◽  
Vol 9 (4) ◽  
pp. 364 ◽  
Author(s):  
Ho-Guen Chang ◽  
Young-Woo Kim ◽  
Jong-Churel Jung ◽  
Hyeong-Su Kim ◽  
Kee-Byoung Lee
2018 ◽  
Vol 20 (3) ◽  
pp. 211-217 ◽  
Author(s):  
Misbah Mehraj ◽  
Farid H. Malik

Background. We did a prospective study to study the efficiency of Short Segment Posterior Instrumentation using a Universal Spine System with incorporation of the fractured vertebra in post-traumatic thoracic and lumbar spine fractures. Material and methods. 25 cases in the age group of I5-50 years with thoracic and lumbar spine fractures were included in the study. The operative decision was made on the basis of instability of spine fractures with or without neurological deficit. Patients were followed up for an average period of twelve months, reporting for assessment at 3-monthly intervals. The final result was analyzed on the basis of neurological recovery as per Frankel’s Grading, spine stability as per kyphotic angle by Cobb’s method, vertebral body height and complications. Results. Post-operatively at the final follow-up visit, 36% patients had Frankel’s grade E neurological status. The mean sagittal plane kyphosis pre-operatively was 31.16°, which reduced to 21.52° post-operatively, which represents 30.93% reduction. Mean anterior body compression was 38.6°, which decreased to 23.4° post-operatively, corresponding to 15% increase. Conclusions. 1. Although conventional short segment posterior fixation (SSPF) has become an increasingly popular method of treatment of thoracolumbar burst fractures, providing the advantage of incorporating fewer motion segments in the fixation, a review of literature demonstrated that SSPF led to 9-55% incidence of implant failure and long term loss of kyphosis correction. 2. Short segment posterior fixation with pedicle fixation at the level of the fractured vertebra (short same-segment fixation) provides more biomechanical stability than traditional SSPF.


Author(s):  
George M. Wahba ◽  
Nitin N. Bhatia ◽  
Thay Q. Lee

Unstable thoracolumbar burst fractures are serious injuries and their management remains controversial. Some authors advocate the use of short-segment posterior instrumentation (SSPI) for certain burst fractures which offers several benefits including preservation of motion segments; however, clinical studies have shown mixed results. Whether crosslinks contribute sufficient stability to this construct has not been determined, therefore the objective of this study was to evaluate the biomechanical characteristics of short-segment posterior instrumentation, with and without crosslinks, in an unstable human burst fracture model.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Martin C. Jordan ◽  
Hendrik Jansen ◽  
Rainer H. Meffert ◽  
Timo M. Heintel

AbstractThe aim of this study was to compare two different techniques of performing one-level spondylodesis for thoracolumbar burst fractures using either an autologous iliac crest bone graft (ICBG) or a porous tantalum fusion implant (PTFI). In a prospective nonrandomized study, 44 patients (20 women, 24 men; average age 43.1 ± 13.2 years) suffering from severe thoracolumbar burst fractures were treated with combined anterior–posterior stabilization. An ICBG was used in 21 cases, and a PTFI was used in the other 23 cases. A two-year clinical and radiographic follow-up was carried out. There were no statistically significant differences in age, sex, localization/classification of the fracture, or visual analog scale (VAS) before injury between the two groups. All 44 patients were followed up for an average period of 533 days (range 173–1567). The sagittal spinal profile was restored by an average of 11.1° (ICBG) vs. 14.3° (PTFI) (monosegmental Cobb angle). Loss of correction until the last follow-up tended to be higher in the patients treated with ICBG than in those treated with PTFI (mean: 2.8° vs. 1.6°). Furthermore, significantly better restoration of the sagittal profile was obtained with the PTFI than with the iliac bone graft at the long-term follow-up (mean: ICBG 7.8°, PTFI 12.3°; p < 0.005). Short-segment posterior instrumentation combined with anterior one-level spondylodesis using either an ICBG or a PTFI resulted in sufficient correction of posttraumatic segmental kyphosis. PTFI might be a good alternative for autologous bone grafting and prevent donor site morbidities.


2021 ◽  
Author(s):  
Martin Jordan ◽  
Hendrik Jansen ◽  
Rainer Meffert ◽  
Timo Heintel

Abstract Purpose: The aim of this study was to compare two different techniques of performing one-level spondylodesis for thoracolumbar burst fractures using either an autologous iliac crest bone graft (ICBG) or a porous tantalum fusion implant (PTFI).Methods: In a prospective nonrandomized study, 44 patients (20 women, 24 men; average age 43.1 ± 13.2 years) suffering from severe thoracolumbar burst fractures were treated with combined anterior-posterior stabilization. An ICBG was used in 21 cases, and a PTFI was used in the other 23 cases. A two-year clinical and radiographic follow-up was carried out.Results: There were no statistically significant differences in age, sex, localization/classification of the fracture, or visual analog scale (VAS) before injury between the two groups. All 44 patients were followed up for an average period of 533 days (range 173 - 1567). The sagittal spinal profile was restored by an average of 11.1° (ICBG) vs. 14.3° (PTFI) (monosegmental Cobb angle). Loss of correction until the last follow-up tended to be higher in the patients treated with ICBG than in those treated with PTFI (mean: 2.8° vs. 1.6°). Furthermore, significantly better restoration of the sagittal profile was obtained with the PTFI than with the iliac bone graft at the long-term follow-up (mean: ICBG 7.8°, PTFI 12.3°; p < 0,005).Conclusion: Short-segment posterior instrumentation combined with anterior one-level spondylodesis using either an ICBG or a PTFI resulted in sufficient correction of posttraumatic segmental kyphosis. PTFI might be a good alternative for autologous bone grafting and prevent donor site morbidities.


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