Application of Posterior Plating and Modifications in Thoracolumbar Spine Injuries

Daniaux, H.; Seykora, P.; Genelin, A.; Lang, Thomas; Kathrein, A.

doi:10.1097/00007632-199103001-00018

Cited by 112 publications

(81 citation statements)

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“…Experimental and clinical studies [40,121] have indicated the requirement for an anterior buttress despite pedicle screw fixation to avoid implant failure and loss of correction. Grafting of the vertebral body by a transpedicular route in conjunction with pedicular screw fixation may provide a valid alternative to anterior surgery [29,98]. The possibility of rigid, short segmental stabilization overcomes the disadvantage of the distraction-type implants (e.g., Harrington instrumentation), which necessitate the inclusion of two or three levels above and below the injured vertebra [4,38,45,145].…”

Section: Spinal Fracturesmentioning

confidence: 99%

Pedicle screw fixation in spinal disorders: A European view

1997

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Continuing controversy over the use of pedicular fixation in the United States is promoted by the lack of governmental approval for the marketing of these devices due to safety and efficacy concerns. These implants have meanwhile become an invaluable part of spinal instrumentation in Europe. With regard to the North American view, there is a lack of comprehensive reviews that consider the historical evolution of pedicle screw systems, the rationales for their application, and the clinical outcome from a European perspective. This literature review suggests that pedicular fixation is a relatively safe procedure and is not associated with a significantly higher complication risk than non-pedicular instrumentation. Pedicle screw fixation provides short, rigid segmental stabilization that allows preservation of motion segments and stabilization of the spine in the absence of intact posterior elements, which is not possible with non-pedicular instrumentation. Fusion rates and clinical outcome in the treatment of thoracolumbar fractures appear to be superior to that achieved using other forms of treatment. For the correction of spinal deformity (i.e., scoliosis, kyphosis, spondylolisthesis, tumor), pedicular fixation provides the theoretical benefit of rigid segmental fixation and of facilitated deformity correction by a posterior approach, but the clinical relevance so far remains unknown. In low-back pain disorders, a literature analysis of 5,600 cases of lumbar fusion with different techniques reveals a trend that pedicle screw fixation enhances the fusion rate but not clinical outcome. The most striking finding in the literature is the large range in the radiological and clinical results. For every single fusion technique poor and excellent results have been described. This review argues that European spine surgeons should begin to back up the evident benefits of pedicle screw systems for specific spinal disorders by controlled prospective clinical trials. This may prevent forthcoming medical licensing authorities from restricting the use of pedicle screw devices and dictating the practice of spinal surgery in Europe in the near future.

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Section: Spinal Fracturesmentioning

confidence: 99%

Pedicle screw fixation in spinal disorders: A European view

1997

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“…[4][5][6] for an immediate and permanent stability and posture. The technique of transpedicular cancellous bone grafting [7,8] has not always been successful. Several authors have reported that anterior bony fusion of the inserted spongiosa was only achieved in some of the patients; in some cases with considerable postoperative loss of correction [9][10][11][12].…”

mentioning

confidence: 99%

Anterior vertebral body replacement with a titanium implant of adjustable height: a prospective clinical study

et al. 2006

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“…Considering the large bone defect created inside the fractured vertebral body after geometric restoration, Daniaux et al [3] introduced the method of transpedicular bone grafting to place spongiosa intra-and intercorporally, thus eliminating anatomic dead spaces and cavities after surgical correction, restoring the sagittal balance and mechanical competence of the anterior column, and avoiding anterior reconstruction and loss of correction [4]. They suggested that bone grafting may be more effective because a substantial amount of correction loss occurs at the injured disc space [4].…”

Section: Discussionmentioning

confidence: 99%

“…They suggested that bone grafting may be more effective because a substantial amount of correction loss occurs at the injured disc space [4].…”

Section: Discussionmentioning

confidence: 99%

Is posterior fixation alone effective to prevent the late kyphosis after T-L fracture?

et al. 2013

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Introduction The posterior transpedicular fixation technique is a standard procedure for stabilizing the injured thoracolumbar spine but the long-term results of this approach are controversial. Clear guidelines are missing and the literature shows complete disagreement regarding indications, approaches, surgical techniques, and type of fixation. Material and method The objective of this study is to investigate if the surgical treatment by posterior approach alone is always enough to prevent the late kyphotic deformity through the retrospective analysis of 219 patients affected with a thoracolumbar injury. Follow-up examinations included radiographic measurements of the sagittal index (SI) and the sagittal plane kyphosis (SPK). Result Results show that, at the follow-up, the SI remains almost stable after the surgical correction, while the SPK (which describes the eventual injury of the affected intervertebral disc) decreases indicating a progressive regional kyphotic deformity. Thus, in some cases posterior fixation alone is not sufficient for long-term spinal stabilization and often can be not effective to prevent the late kyphotic deformity.

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Application of Posterior Plating and Modifications in Thoracolumbar Spine Injuries

Cited by 112 publications

References 0 publications

Pedicle screw fixation in spinal disorders: A European view

Pedicle screw fixation in spinal disorders: A European view

Anterior vertebral body replacement with a titanium implant of adjustable height: a prospective clinical study

Is posterior fixation alone effective to prevent the late kyphosis after T-L fracture?

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