Burst fractures of the thoracolumbar spine: changes of the spinal canal during operative treatment and follow-up

Leferink, V. J. M.; Nijboer, J M M; Zimmerman, K. W.; Veldhuis, E. F. M.; Vergert, E.M. Ten; Duis, H. J. ten

doi:10.1007/s00586-002-0499-2

Cited by 37 publications

(22 citation statements)

References 30 publications

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“…Anterior column lengthening further leads to a ligamentotaxis effect, which pulls the fragments anteriorly out of the canal. The internal AO fixator provides a fragment reduction by ligamentotaxis using a parallel distraction and a pivot movement of the screws [23]. The reduction mechanism is slightly different from in situ contouring, which works by initial lordosis increase, but both techniques stretch the anterior spine.…”

Section: Discussionmentioning

confidence: 99%

Thoracolumbar fracture reduction by percutaneous in situ contouring

et al. 2012

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Percutaneous instrumentation and anterior fusion provides good clinical results. In situ contouring increases lordosis obtained by prone positioning. Anterior column lengthening and ligamentotaxis reduce posterior wall fragments, which decompress the canal without laminectomy. The fusion of anterior defects prevents the loss of correction and provides a stable sagittal profile. The instrumentation may be removed without damaging the paravertebral muscles and loss of correction.

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Section: Discussionmentioning

confidence: 99%

Thoracolumbar fracture reduction by percutaneous in situ contouring

et al. 2012

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“…

○ Distance from the posterior margin of fractured segment to that of the vertebral body from top to bottom. The distance between the posterior margin of the fractured segment and that of the adjacent segment reflected the length of the posterior longitudinal ligament, which further reflected the injury of the spinal sequence [19].

○ Cobb angle.

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Section: Methodsmentioning

confidence: 99%

“…The distance between the posterior margin of the fractured segment and that of the adjacent segment reflected the length of the posterior longitudinal ligament, which further reflected the injury of the spinal sequence [19]. …”

Section: Methodsmentioning

confidence: 99%

Analysis of the independent risk factors of neurologic deficit after thoracolumbar burst fracture

et al. 2016

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BackgroundThe objective of this study is to identify the independent risk factors of neurologic deficit after thoracolumbar burst fracture. Traumatic fractures of the thoracolumbar spine are the most common type of spinal column fractures. Many studies have attempted to determine whether neurologic deficit in such fractures is related to spinal canal stenosis or other parameters observed on axial computed tomography. However, this relationship remains controversial.MethodsA review of the clinical data and axial computed tomography (CT) for 105 patients was performed. Neurologic deficit was classified according to the American Spinal Injury Association (ASIA) classification. Various preoperative CT parameters, including vertebral body compression, canal stenosis, sagittal alignment, and fragment reverse, were analyzed using ordinal logistic regression analysis.Results Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification, canal volume, transverse canal diameter, median sagittal diameter, Cobb angle, compression ratio of the sagittal diameter, compression ratio of the cross-sectional area, and compression ratios of the anterior vertebral height (AVH), middle vertebral height (MVH), and posterior vertebral height (PVH) were significantly associated with severity of nerve injury (P < 0.05). However, flip angle and rotation angle of bony fragments were unrelated to severity of nerve damage. Multivariate logistic regression identified AO classification, compression ratio of median sagittal diameter, anterior vertebral compression ratio, and distance from the posterior margin to the vertebral body above to be independent variables associated with neurologic deficit.ConclusionsThe four CT parameters most strongly associated with neurologic deficit in thoracolumbar burst fractures are AO classification, compression ratio of median sagittal diameter, anterior vertebral compression ratio, and distance from the posterior margin to the vertebral body above.

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“…TLBFs are generally unstable fractures and [28] surgery is typically required to restore the spinal canal and vertebral alignment [3,[28][29][30]. Surgery decompresses the spinal cord and corrects the vertebral column alignment by using laminectomy and applying transpedicular screws [30]. Surgical procedures have been further developed based on technological advancements.…”

Section: Introductionmentioning

confidence: 99%

“…Spontaneous resorption of bone fragments in the spinal canal with or without instrumentation has been reported in some cases [3,30] and also surgical and conservative treatment strategies for patients without neurologic deficits have been discussed extensively in the literature [3,[31][32][33].…”

Section: Introductionmentioning

confidence: 99%