Clinical Outcomes of Thoracolumbar Burst Fracture Treated by Trans-Kambin triangle versus Transpedicular Bone Grafting Combined with Posterior Internal Fixation

Dong, Hui; Le, Huynh-Nhu; Ruan, Binjia; Yu, Hang; Xu, Xiaohang; Sun, H Y; Feng, Xiaoshan; Yang, Jiandong; Wang, Yongxiang; Tao, Yuping

doi:10.1016/j.wneu.2021.09.008

Cited by 4 publications

(8 citation statements)

References 21 publications

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“…To minimize the drawbacks of surgery by the posterior approach, use of several procedures such as transpedicular bone grafting 6,7 , and balloon‐assisted vertebroplasty 8 is well‐documented. However, since the traumatic intervertebral disc lesion (TIDL) adjacent to the fractured body is not reinforced, efficacy of these methods remains debatable.…”

Section: Introductionmentioning

confidence: 99%

Wiltse Approach Versus Conventional Transforaminal Interbody Fusion for Unstable Thoracolumbar Fracture with Intervertebral Disc Lesions

Wang

Duan

Yang

et al. 2022

Orthopaedic Surgery

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Objective To compare the clinical results of two surgical techniques, Wiltse approach and conventional transforaminal interbody fusion, for the treatment of unstable thoracolumbar fracture associated with traumatic intervertebral disc lesion (TIDL). Methods A total of 76 patients with unstable thoracolumbar fracture associated with TIDL treated by posterior pedicle screw fixation and transforaminal thoracolumbar interbody fusion from June 2010 and July 2016 were reviewed retrospectively. These patients including 48 male and 28 female patients were divided into Wiltse approach transforaminal thoracolumbar interbody fusion (W‐TLIF) group (n = 38) and conventional transforaminal thoracolumbar interbody fusion (C‐TLIF) group (n = 38). Patients were followed up for about 33 months. Clinical and radiological records, kyphotic angle, fractured vertebral body height, visual analogue score (VAS), Oswestry Disability Index (ODI), complications, neurological improvement and fusion rate were compared between two groups. Results All patients underwent posterior surgery successfully. Blood loss, operation time and hospital stay in the W‐TLIF group was 437.84 ± 143.98 ml, 118.64 ± 20.55 min and 12.32 ± 2.87 days, respectively. While those parameters in the C‐TLIF group was 862.70 ± 300.24 ml, 141.35 ± 31.72 min and 15.51 ± 2.08 days, respectively. Average operation time and hospital stay time were significantly shorter, and blood loss was significantly less in the W‐TLIF group than in the C‐TLIF group (P < 0.05). VAS and ODI in the W‐TLIF group were significantly less than those in the C‐TLIF group at 1 week after operation and final follow‐up. The kyphotic angle and vertebral body height were improved. There was 1–2 grade improvement in patients with neurological deficit. Thirty‐three patients in the W‐TLIF group and 32 patients in the C‐TLIF group had achieved fusion during follow‐up. No internal fixation failure was observed in two groups. Conclusions The both techniques of W‐TLIF and C‐TLIF were feasible and effective for unstable thoracolumbar fracture with TIDL. Compare to C‐TLIF, The technique of W‐TLIF was a relatively less invasive way to decompress the neural elements and an easy method to reconstruct the anterior column using the same posterior approach.

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Section: Introductionmentioning

confidence: 99%

Wiltse Approach Versus Conventional Transforaminal Interbody Fusion for Unstable Thoracolumbar Fracture with Intervertebral Disc Lesions

Wang

Duan

Yang

et al. 2022

Orthopaedic Surgery

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“…In contrast, rhBMP-2 mainly promotes the differentiation of stem cells, stimulates the proliferation of cartilage and osteoblasts, accelerates the rate of new bone tissue generation, improves bone matrix protein synthesis, promotes angiogenesis, and provides the nutrients and oxygen needed in the fracture healing process, thus facilitating the process of fracture healing (Fig. 2) [26][27][28][29] .…”

Section: Discussionmentioning

confidence: 99%

A Randomized Controlled Trial: Short-Segment Posterior Fixation and Transpedicular Bone Grafting combined with rhBMP-2 for the Treatment of Thoracolumbar Burst Fracture

Cheng,

Pan,

et al. 2024

Preprint

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Purpose The current study presents a novel treatment strategy involving short-segment posterior fixation and transpedicular bone grafting combined with recombinant human bone morphogenetic protein-2 (rhBMP-2). The aimed is to investigate the clinical efficacy in treating thoracolumbar burst fracture (TLBF). Methods Patients with acute TLBF requiring surgical treatment were conducted. Enrolled patients were randomly assigned to either the intervention or control groups. All patients underwent short-segment posterior fixation treatment, with the intervention group receiving additional transpedicular bone grafting and rhBMP-2 into the fractured vertebral body using vertebroplasty instrumentation. In contrast, the control group did not undergo any bone implantation procedures. Preoperative and postoperative imaging indices, including Sagittal Cobb Angle (SCA) and Anterior Vertebral Height Ratio (A VHR), as well as fracture healing rate, were assessed. Treatment indices, such as the visual analog scale (VAS), were also measured. Furthermore, general information was compared between the two groups. Results There were 24 patients enrolled in the intervention group, and 36 patients in the control group. Demographic data showed no significant differences between groups (P > 0.05). One year after the operation, the SCA was significantly lower in both groups compared to the preoperative period. However, the intervention group exhibited less loss in SCA compared to the control group at the 1-year follow-up (P < 0.05). There was no significant difference in the anterior A VHR between the two groups at 7 days, 3 months, and 1 year after operation (P > 0.05). Regarding the fracture healing rate, the postoperative Lane-Sandhu scores of both groups increased significantly. At 3 months after surgery, the observation group showed a significantly higher score than the control group (P < 0.05). Conclusion This RCT demonstrated that the short-segment posterior fixation and transpedicular vertebral bone graft combined with rhBMP-2 can effectively reduce the SCA and accelerate fracture healing.

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“…Spinal fixation procedures have seen an incredible advancement in techniques and technologies in the past decades. Prior to the use of Kambin's triangle for treating lumbar spine pathologies, postoperative bleeding, tissue disruption, and neurovascular complications were common in these procedures [31,32]. Following the introduction of Kambin's triangle approach, lumbar fusion saw a shift from a posterolateral approach to the current transforaminal interbody approach, which is now being used in combination with minimally invasive techniques.…”

Section: Lumbar Fusionmentioning

confidence: 99%

Current and Future Applications of the Kambin’s Triangle in Lumbar Spine Surgery

Waguia¹,

Gupta²,

Gamel³

et al. 2022

Cureus

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Kambin's triangle has become the anatomical location of choice when accessing the lumbar spine to treat degenerative spinal disorders. Currently, lumbar interbody fusion is the most common procedure utilizing this space; however, with the advent of the Kambin's prism definition, advanced imaging modalities, and robotic-assisted techniques, lumbar spine surgery has become increasingly precise and less invasive. These technological and procedural advances have drastically reduced the rate of complications, improved patient outcomes, and expanded the use of the Kambin's triangle to treat different pathologies utilizing cuttingedge techniques. In this review, the authors present the current uses of the Kambin's triangle and the future application of this anatomical corridor in lumbar spine surgery.

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Clinical Outcomes of Thoracolumbar Burst Fracture Treated by Trans-Kambin triangle versus Transpedicular Bone Grafting Combined with Posterior Internal Fixation

Cited by 4 publications

References 21 publications

Wiltse Approach Versus Conventional Transforaminal Interbody Fusion for Unstable Thoracolumbar Fracture with Intervertebral Disc Lesions

Wiltse Approach Versus Conventional Transforaminal Interbody Fusion for Unstable Thoracolumbar Fracture with Intervertebral Disc Lesions

A Randomized Controlled Trial: Short-Segment Posterior Fixation and Transpedicular Bone Grafting combined with rhBMP-2 for the Treatment of Thoracolumbar Burst Fracture

Current and Future Applications of the Kambin’s Triangle in Lumbar Spine Surgery

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