A Therapeutic Efficacy of the Transpedicular Intracorporeal Bone Graft with Short-Segmental Posterior Instrumentation in OsteoNecrosis of Vertebral Body: A Minimum Five-Year Follow-Up Study

Lee, Gun Woo; Suh, Bo Gun

doi:10.1016/j.spinee.2013.07.354

Cited by 7 publications

(10 citation statements)

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“…Compared with bone cement, bone grafting has the advantages of causing only mild tissue rejection, and it easily induces bone formation and facilitates bone healing. 14 More importantly, TIBG is safer than injecting E, F, One week after operation, radiographs demonstrated restoration of the vertebral height and the kyphosis was corrected to 88. G, H, Postoperative CT scan revealed that the bone graft in the vertebral body was sufficient and uniform, and the condition of internal fixation was good.…”

Section: Discussionmentioning

confidence: 93%

“…3,4 As vertebral ischemic osteonecrosis has been widely accepted as the pathophysiological mechanism of Ku ¨mmell disease, and intravertebral bone grafting is considered to be an intuitive therapeutic approach. 14 However, there are few studies on the treatment of Ku ¨mmell disease using this technology, and the results were inconsistent. 14,15 In this study, transpedicular impaction bone grafting (TIBG) was performed to restore the height of the vertebral body and correct kyphotic deformities, with long segmental posterior instrumentation (LSPI) to stabilize the spinal column.…”

mentioning

confidence: 99%

“…14 However, there are few studies on the treatment of Ku ¨mmell disease using this technology, and the results were inconsistent. 14,15 In this study, transpedicular impaction bone grafting (TIBG) was performed to restore the height of the vertebral body and correct kyphotic deformities, with long segmental posterior instrumentation (LSPI) to stabilize the spinal column. The purpose of this study was to investigate the efficacy of TIBG with LSPI in treating stage III Ku ¨mmell disease.…”

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confidence: 99%

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Therapeutic Efficacy of Transpedicular Impaction Bone Grafting with Long Segmental Posterior Instrumentation in Stage III Kümmell Disease

Zhu

Zhang

Jiang

et al. 2021

Spine

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Study Design. A retrospective review of clinical and radiological parameters. Objective. To evaluate the therapeutic efficacy of transpedicular impaction bone grafting (TIBG) with long segmental posterior instrumentation for the treatment of stage III Ku ¨mmell disease. Summary of Background Data. The optimal treatment for stage III Ku ¨mmell disease remains controversial and unclear. Theoretically, transpedicular bone grafting can reconstruct anterior column support and reduce the failure of internal fixation, which is an intuitive method for the treatment of Ku ¨mmell disease. However, the use of this technique has rarely been reported for the treatment of this disease. This study reported the clinical and radiological results of TIBG with long segmental posterior instrumentation for the treatment of stage III Ku ¨mmell disease. Methods. Between August 2011 and December 2017, we retrospectively analyzed 24 patients with stage III Ku ¨mmell disease who underwent TIBG with long segmental posterior instrumentation. Anterior vertebral heights, kyphotic Cobb angle, visual analog scale (VAS), Oswestry disability index (ODI), and American Spinal Injury Association (ASIA) impairment scale were used to evaluate the effects of surgery.Results. The mean time to follow-up was 38.1 AE 10.2 months. The average operative duration was 136 AE 16.5 minutes, and the average intraoperative blood loss was 293 AE 41.3 mL. The VAS, ODI, anterior vertebral heights, and kyphotic Cobb angles were improved significantly at 1 week after surgery compared the preoperative examinations, and were well maintained at the final follow-up evaluation. Fourteen patients (58%) had mild neurological impairments before surgery, with neurological function returning to normal at the final follow-up evaluation. There was no instance of instrumentation failure. Conclusion. TIBG combined with long segmental posterior instrumentation is a safe and effective surgical option for stage III Ku ¨mmell disease.

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Section: Discussionmentioning

confidence: 93%

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confidence: 99%

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confidence: 99%

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Therapeutic Efficacy of Transpedicular Impaction Bone Grafting with Long Segmental Posterior Instrumentation in Stage III Kümmell Disease

Zhu

Zhang

Jiang

et al. 2021

Spine

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“…Hence, many surgeons have advised that Kummell's disease should be treated by operative intervention [8] . For the posterior vertebral wall rupture, combined with severe kyphotic deformity and neurological symptoms at stage III of Kummell's disease, open surgery is recommended [9] . Patients with stage I and II Kummell's disease have no neurological symptoms, and the main goal of surgery is to eliminate fractured vertebral micromotion and reconstruct spinal stability, therefore, PVP or PKP is recommended [10] .…”

Section: Discussionmentioning

confidence: 99%

Comparison of Unipedicular and Bipedicular Percutaneous Kyphoplasty for Kummell's Disease

Peng¹,

Ouyang²,

Huang³

et al. 2020

Preprint

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Background: Percutaneous kyphoplasty (PKP) is effective for the treatment of Kummell's disease. However, controversy remains regarding whether a unipedicular or bipedicular PKP is superior.Methods: A retrospective study was performed to review 40 patients with stage I and II Kummell's disease who underwent PKP in our hospital from January 2015 to June 2018. Based on the transpedicular approach of PKP, those patients were randomly divided into unipedicular group (n = 19) and bipedicular group (n = 21) . Operative time, bone cement injection volume and cement leakage rate were compared in the two groups. Pre- and post-operative visual analogue score (VAS), local kyphotic angle and average vertebral height were also evaluated.Results: All patients underwent surgery successfully. Compared with preoperative condition, VAS was significantly decreased at 1 day after operation and the last follow-up in both groups (P < 0.05) , and local kyphotic angle and average vertebral height were restored markedly (P < 0.05). Operative time of both groups had no significant difference (P > 0.05). Bone cement injection volume was larger in bipedicular group (P < 0.05). At 1 day after operation and the last follow-up , the local kyphotic angle and average vertebral height in bipedicular group were restored better than those in unipedicular group (P < 0.05). There were 4 cases of cement leakage in both groups, with leakage rates of 21.1% and 19.0%, respectively, and the difference was not significant (P > 0.05).Conclusion: Both unipedicular and bipedicular PKP are effective for treating patients with stage I and II Kummell's disease, while postoperative pain relief and imaging results in bipedicular group were better than those in unipedicular group.

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“…Additionally, postoperative back pain is a common symptom [3] . Some patients may also have complications such as vertebral height loss and Cobb angle correction failure in the long term [4] , which are not conducive to the recovery of muscle function and the maintenance of spinal stability.…”

Section: Introductionmentioning

confidence: 99%

Treatment of A3 thoracolumbar vertebral burst fractures with posterior minimally invasive channels and short tail pedicle screw fixation: technical report and efficacy analysis

Wu¹,

ju²,

Hou³

et al. 2020

Preprint

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Background To evaluate the clinical efficacy of common pedicle screw placement combined with pedicle screw fixation for the treatment of thoracolumbar burst fractures using a posterior minimally invasive approach. Methods Between May 2015 and December 2016, a total of 33 cases of thoracolumbar burst fracture (AO/Magerl type A3) were treated using a posterior minimally invasive procedure with ordinary pedicle screws under the channel in combination with injured vertebra transpedicular fixations. The patient cohort included 20 males and 13 females with an average age of 43.5 yr (range: 26～61 yr). 16 cases were due to traffic accidents, whereas 11 cases were due to falls, and 6 cases of other injuries. All patients showed no nerve injury. Of the injured segments, 5 cases were T 11 , 14 were T 12 , 13 were L 1 , and one was L 2 .No patients presented with spinal nerve injury. The duration of the operations and intraoperative blood loss in each patient were recorded. The pain visual analogue scale (VAS) was used to estimate the degree of back -surgical incision pain. Measurements of the percentage of injured vertebral height loss and the sagittal Cobb angle, which was evaluated for correction of the kyphosis angle and height restoration using plain radiographs, Every patient were recorded preoperatively and at postoperative day 3, 6 month, 1 year, and final follow-up visits. Plain CT scans and reconstructions were used to assess fracture healing. Results No patients experienced intraoperative complications. The average operating time was 109.2 min (range: 90～130 min), and the average intraoperative blood loss was 82.4 ml (range: 50～150 ml). The VAS scores for the lumbar back incision on the 3rd postoperative day and at the final follow-up were 2.39 ± 0.83 points and 0.70 ± 0.68 points, respectively.Additionally, all incisions healed without any postoperative complications. All patients were followed up over a period of 13 to 24 months postoperatively (average 15.9 months). Compared to preoperative values, every patient in the percentage of vertebral height loss and the sagittal Cobb angle significantly improved over the follow-up period, with significant differences between day 3, 6 month, 1 year, and final follow-up visits (P<0.05). However, the difference was not significant between the groups at all postoperative time points (P>0.05). CT scans showed that the injured vertebrae healed well, with no subsidence, loosening, or fractures of the internal fixation. Conclusion The minimally invasive posterior approach with common pedicle screw placements and combined pedicle screw fixation is similar to percutaneous minimally invasive screw fixation. The pedicle screw rests on a strong internal fixation to restore and maintain vertebral height. This procedure is safe and effective for the treatment of A3 thoracolumbar burst fractures, resulting in less trauma and bleeding as well as satisfactory deformity correction.

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A Therapeutic Efficacy of the Transpedicular Intracorporeal Bone Graft with Short-Segmental Posterior Instrumentation in OsteoNecrosis of Vertebral Body: A Minimum Five-Year Follow-Up Study

Cited by 7 publications

References 0 publications

Therapeutic Efficacy of Transpedicular Impaction Bone Grafting with Long Segmental Posterior Instrumentation in Stage III Kümmell Disease

Therapeutic Efficacy of Transpedicular Impaction Bone Grafting with Long Segmental Posterior Instrumentation in Stage III Kümmell Disease

Comparison of Unipedicular and Bipedicular Percutaneous Kyphoplasty for Kummell's Disease

Treatment of A3 thoracolumbar vertebral burst fractures with posterior minimally invasive channels and short tail pedicle screw fixation: technical report and efficacy analysis

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