A comparative study between the Universal Spinal System^® (USS) and the CD Horizon^® Legacy™ (CDH) in the management of thoracolumbar fractures

Abstract

Introduction: For the treatment of unstable non-osteoporotic thoracolumbar fractures, the clinical and radiological outcome of short-segment fixation with the USS™ – Universal Spine System (DePuy Orthopedics, Inc., Warsaw, IN, USA) and the CD HORIZON® LEGACY™ 5.5 Spinal System, (Medtronic Sofamor Danek USA, Inc., Memphis, TN, USA) were compared.Methods: From March 2015 to January 2016, 40 consecutive patients with unstable traumatic thoracolumbar fractures who met our inclusion criteria were treated with either the USS system or CDH Legacy system. Segmental kyphosis angle (SKA) and anterior body height (ABH) of fractured vertebrae, and ASIA Impairment Scale (AIS) were evaluated. Radiological fusion was confirmed with plain X-rays and when indicated with computerized tomography (CT).Results: The mean immediate kyphotic angle correction was 16.6° for the Schanz and 6.4 for the Legacy system, and the immediate mean anterior vertebral body height correction was 0.92 cm for the Schanz and 0.51 cm for the Legacy system. Our study shows a significant statistical difference between Schanz and Legacy systems regarding post-operative segmental kyphosis and height correction immediately postoperatively, at 6 months and at one-year follow-up (p-value < 0.005). The degree of pain reduction and neurological improvement was not influenced by the screw system.Conclusion: Usage of USS in thoracolumbar fracture as a short-segment fixation led to a near anatomical reduction when compared to the Legacy system. However, there was no advantage regarding pain reduction and neurological outcome.

Bending rod is unnecessary in single-level posterior internal fixation and fusion in treatment of lumbar degenerative diseases

“…Our application of unbent rod is based on the design of fixation instrument. We chose Legacy polyaxial pedicle screw produced by Medtronic, which provides a motion range of ± 15° [ 26 ]. The median of SLA is 10 preoperatively and 14 postoperatively, which is within the motion range of the screw.…”

Manual Reduction, Subpedicle Approach, and Body Cages to Treat Burst Fracture

“…Thoracolumbar (TL) burst fractures occasionally lead to severe spinal instability and even cause acute or delayed neurological dysfunction, and surgical treatments are required [1][2][3]. The purpose of surgical intervention is to bring about nerve decompression, reconstruction of the vertebral body, and correction of angular deformity and stability [4].…”

Effect of postural nursing intervention on preventing pressure injury after thoracolumbar incision and internal fixation in southern China

“…Most patients are prone to complications after surgery, which affects their recovery. At the same time, it is easy to cause psychological disorders and induce bad emotions, which will greatly affect the recovery of patients after surgery (Oh & Seo 2019;Barakat et al, 2019). Posterior thoracolumbar spine incision and internal fixation surgery is a more effective plan for the treatment of thoracolumbar vertebral fractures, but if improper posture care is performed during the operation, pressure ulcers are prone to occur and affect postoperative rehabilitation (Wang et al, 2017a).…”