Burst fracture of the thoracolumbar spine: correlation between kyphosis and clinical result of the treatment

Tisot, Rodrigo Arnold; Vieira, Juliano Da Silveira; Santos, Renato; Badotti, Augusto Alves; Collares, Diego da Silva; Stumm, Leonardo Domingues; Barreto, Bruno Brum; Camargo, Paulo Bruno

doi:10.1590/s1808-185120151402146349

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…22 Tezeren and Kuru 23 reported that the failure rate is considerably lower when a long, rather than a short, fixation is performed, but concerning its association with fusion, no difference was apparent between the groups. 24 In our review, implant removals that resulted from system failure were evaluated. 4,21 The odds ratio for removal of a fixation system was 4.09 higher in the no-fusion group than in the fusion group; however, a sensitivity analysis in a study by Chou et al 5 found a high relative weight.…”

Section: Discussionmentioning

confidence: 99%

Is fusion necessary for thoracolumbar burst fracture treated with spinal fixation? A systematic review and meta-analysis

Diniz

Botelho

2017

Journal of Neurosurgery: Spine

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OBJECTIVEThoracolumbar fractures account for 90% of spinal fractures, with the burst subtype corresponding to 20% of this total. Controversy regarding the best treatment for this condition remains. The traditional surgical approach, when indicated, involves spinal fixation and arthrodesis. Newer studies have brought the need for fusion associated with internal fixation into question. Not performing arthrodesis could reduce surgical time and intraoperative bleeding without affecting clinical and radiological outcomes. With this study, the authors aimed to assess the effect of fusion, adjuvant to internal fixation, on surgically treated thoracolumbar burst fractures.METHODSA search of the Medline and Cochrane Central Register of Controlled Trials databases was performed to identify randomized trials that compared the use and nonuse of arthrodesis in association with internal fixation for the treatment of thoracolumbar burst fractures. The search encompassed all data in these databases up to February 28, 2016.RESULTSFive randomized/quasi-randomized trials, which involved a total of 220 patients and an average follow-up time of 69.1 months, were included in this review. No significant difference between groups in the final scores of the visual analog pain scale or Low Back Outcome Scale was detected. Surgical time and blood loss were significantly lower in the group of patients who did not undergo fusion (p < 0.05). Among the evaluated radiological outcomes, greater mobility in the affected segment was found in the group of those who did not undergo fusion. No significant difference between groups in the degree of kyphosis correction, loss of kyphosis correction, or final angle of kyphosis was observed.CONCLUSIONSThe data reviewed in this study suggest that the use of arthrodesis did not improve clinical outcomes, but it was associated with increased surgical time and higher intraoperative bleeding and did not promote significant improvement in radiological parameters.

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Section: Discussionmentioning

confidence: 99%

Is fusion necessary for thoracolumbar burst fracture treated with spinal fixation? A systematic review and meta-analysis

Diniz

Botelho

2017

Journal of Neurosurgery: Spine

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Biomechanical Analysis of the Impact of Transverse Connectors of Pedicle-Screw-Based Fixation on Thoracolumbar Compression Fracture

Szkoda-Poliszuk,

Żak,

Załuski

et al. 2023

Applied Sciences

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Contemporary clinical practice is progressively shifting towards percutaneous minimally invasive surgery. Conversely, the incorporation of transverse connectors in the design of spinal fixation systems is associated with more invasive open surgical procedures. The primary objective of this investigation was to evaluate the influence of transverse connectors in posterior spinal fixation system designs in cases involving vertebral compression fractures, specifically on selected mechanical parameters of the thoracolumbar spine in situations of instability. This research objective was achieved through a combination of experimental tests and numerical simulations. From the experimental tests conducted, critical mechanical parameters were ascertained, including the bending stiffness coefficient and energy dissipation. Numerical simulations were employed to determine additional parameters, such as the angular range of motion for individual spinal segments, intradiscal pressure within individual intervertebral discs, and stress distribution on the articular facets. Analyzing the impact of transverse connectors on the obtained results revealed that their inclusion in a fixation system results in a minor increase in stiffness and a decrease in mobility in comparison to fixation systems devoid of connectors. These findings create the potential for utilizing minimally invasive surgery as a viable alternative to open surgical procedures.

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Burst fracture of the thoracolumbar spine: correlation between kyphosis and clinical result of the treatment

Cited by 2 publications

References 29 publications

Is fusion necessary for thoracolumbar burst fracture treated with spinal fixation? A systematic review and meta-analysis

Is fusion necessary for thoracolumbar burst fracture treated with spinal fixation? A systematic review and meta-analysis

Biomechanical Analysis of the Impact of Transverse Connectors of Pedicle-Screw-Based Fixation on Thoracolumbar Compression Fracture

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