Application of transforaminal lumbar interbody fusion in old thoracolumbar fracture and dislocation

Fang, Xiangqian; Fan, Shunwu; Zhao, Xiaoyong

doi:10.1179/2045772311y.0000000025

Cited by 7 publications

(10 citation statements)

References 13 publications

(18 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The majority of cases are caused by implant failure from an isolated posterior spinal fusion, 35,39 and progression of listhesis from nonoperative and noninstrumented cases due to pseudarthrosis. 52,53 Questions remain regarding the disc status from these complications during time of treatment. These findings emphasize the need for a circumferential fusion as the best procedure, especially with documented disc lesions, with adequate decompression, reduction, and stabilization to ensure solid fusion and good outcomes.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Lumbar Spondylolisthesis: A Systematic Review and Case Series

Ver

Dimar

Carreon

2018

Global Spine Journal

View full text Add to dashboard Cite

Study Design: Systematic review and case series. Objectives: Any acute injury to the posterior elements of the lumbar spine resulting in listhesis is considered a traumatic spondylolisthesis. This rare injury caused by high-energy trauma is variably described in the literature as fracture-dislocation, where only case reports and series have been published. Our objectives were to propose evidence-based treatment recommendations and a new classification system for this injury. Methods: A systematic review of literature from PubMed, EMBASE, and Cochrane without time frame limitations was performed, which included 77 level IV and V articles and 9 patients as case series in the analysis. Results: A total of 125 cases were reviewed with mean age of 30.5 years. Half of the cases resulted from a vehicular accident. Back pain presented in 82%, while 50% had neurologic deficits. Operative treatment was performed in 93.6% (posterior decompression [PD] = 4%; posterior spinal fusion [PSF] = 43.2%; interbody fusion [IB] = 46.4%) with overall fusion rates of 74%. Binomial regression analysis for achieving solid fusion showed a 28.6× higher odds for IB compared to PSF ( P = .008, r2 = 0.633). Subanalysis of cases with disc injuries revealed higher fusion outcomes for IB (87%) compared to PSF (46%; P = .006), while there were no significant differences for patients without disc injury. Pain and neurological symptoms improved significantly on final follow-up ( P < .001). Overall complication rate was 22%. Conclusion: Operative management with reduction, decompression for neurologic deficits, instrumentation, and fusion is recommended for traumatic spondylolisthesis. Interbody fusion is recommended to achieve better fusion outcomes especially with preoperatively identified disc lesions.

show abstract

Section: Discussionmentioning

confidence: 99%

Traumatic Lumbar Spondylolisthesis: A Systematic Review and Case Series

Ver

Dimar

Carreon

2018

Global Spine Journal

View full text Add to dashboard Cite

show abstract

“…Vertical compressive and flexion forces are the general mechanism of injury for burst fractures of the thoracolumbar and lumbar spine. The bony end plates and cortical margins of the vertebral body can be fractured by axial loading due to high-energy forces, [ 7 – 10 ] A radial displacement of corticocancellous bone fragments will occur when the vertebral body is compressed. Retropulsion of these bone and disc fragments into the spinal canal will impact the neural structures, resulting in displacement of the dural sac in the posterior direction and narrowness of the spinal canal.…”

Section: Discussionmentioning

confidence: 99%

Clinical case-series report of traumatic cauda equina herniation

Yan¹,

Liu²,

He³

et al. 2017

Medicine

View full text Add to dashboard Cite

Rationale:Burst fractures in thoracolumbar and lumbar spine typically occur from severe trauma, which may result in cauda equina herniation (CEH). In this study, we attempted to document the incidence and evaluate the sequelae of CEH that were found during decompression and fusion surgery for patients with burst fractures.Patient concerns:A total of 416 patients were enrolled in this study.Diagnoses:The patients had been operated on through an anterior or posterior approach for treatments of thoracolumbar and lumbar burst fractures at our department between June 1, 2008 and June 1, 2011.Interventions:A retrospective analysis of hospital records and a review on radiographs were performed. Data regarding demographics, injury mechanism, radiographs, surgical procedures, outcomes and follow-ups were collected and analyzed.Outcomes:The CEH was observed in 49 patients (12%), including 40 males and 9 females with a mean age of 33.7 years old. The posterior approach group included 301 patients (215 males and 86 females), with 13% incident rate for CEH (40/301). The anterior approach group included 115 patients (80 males and 35 females), with 8% incident rate for CEH (9/115). Forty-four patients (90%) with CEH had neurological deficits; while other 5 patients (10%) were neurologically intact but entrapments of a significant proportion of their cauda equina rootlets in the dorsal lamina fracture were observed during operations. Both vertebrae burst fracture and lamina fracture were observed in 95% patients with posterior CEH (38 out of 40).Lessons:Traumatic CEH were found in 12% of the patients with thoracolumbar and lumbar burst fractures that were treated by surgery. Patients with a lumbar burst fracture showing neurological deficits in combination with a laminar fracture have an increased risk of traumatic CEH.

show abstract

“…Similarly, Fang et al . [9] applied transforaminal decompression and interbody fusion to treat a 26-year-old man with an old T12–L1 fracture and dislocation. These two cases both achieved a good clinical outcome.…”

Section: Discussionmentioning

confidence: 99%

“…In 2011, Fang et al . [9] used the TLIF technique to treat patient with an old T12/L1 fracture and dislocation. Compared to the posterior lumbar interbody fusion technique, transforaminal interbody fusion can be used to treat a fracture and dislocation above the lumbar spine [7] , [9] , [10] .…”

Section: Introductionmentioning

confidence: 99%

“… [9] used the TLIF technique to treat patient with an old T12/L1 fracture and dislocation. Compared to the posterior lumbar interbody fusion technique, transforaminal interbody fusion can be used to treat a fracture and dislocation above the lumbar spine [7] , [9] , [10] . Here, we retrospectively reviewed 24/26 consecutive patients (two patients were lost) with thoracolumbar fractures and dislocations treated by transforaminal decompression and interbody fusion.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Transforaminal Decompression and Interbody Fusion in the Treatment of Thoracolumbar Fracture and Dislocation with Spinal Cord Injury

Zheng

Lin

et al. 2014

PLoS ONE

View full text Add to dashboard Cite

Study DesignA retrospective clinical study.ObjectiveTo evaluate the efficacy and safety of transforaminal decompression and interbody fusion in the treatment of thoracolumbar fracture and dislocation with spinal cord injury.MethodsTwenty-six spinal cord injured patients with thoracolumbar fracture and dislocation were treated by transforaminal decompression and interbody fusion. The operation time, intraoperative blood loss, and complications were recorded; the Cobb angle and compressive rate (CR) of the anterior height of two adjacent vertebrae were measured; and the nerve injury was assessed according to sensory scores and motor scores of the American Spinal Injury Association (ASIA) standards for neurological classification of spinal cord injury.ResultsThe operative time was 250±57 min, and intraoperative blood loss was 440±168 ml. Cerebrospinal leakage was detected and repaired during the operation in two patients. A total of 24 of 26 patients were followed up for more than 2 years. ASIA sensory scores and motor scores were improved significantly at 3 months and 6 months after operation; the Cobb angle and CR of the anterior height of two adjacent vertebrae were corrected and showed a significant difference at post-operation; and the values were maintained at 3 months after operation and the last follow-up.ConclusionWe showed that transforaminal decompression together with interbody fusion is an alternative method to treat thoracolumbar fracture and dislocation.

show abstract

Application of transforaminal lumbar interbody fusion in old thoracolumbar fracture and dislocation

Cited by 7 publications

References 13 publications

Traumatic Lumbar Spondylolisthesis: A Systematic Review and Case Series

Traumatic Lumbar Spondylolisthesis: A Systematic Review and Case Series

Clinical case-series report of traumatic cauda equina herniation

Transforaminal Decompression and Interbody Fusion in the Treatment of Thoracolumbar Fracture and Dislocation with Spinal Cord Injury

Contact Info

Product

Resources

About