Early Clinical Results of Short Same-Segment Posterior Fixation in Thoracolumbar Burst Fractures

Mehraj, Misbah; Malik, Farid H

doi:10.5604/01.3001.0012.2129

Cited by 3 publications

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“…Because PPSF is effective for TLBF treatment in terms of fixation and reduction, it can reset the bone mass protruding into the spinal canal, to a certain extent, and in some cases, good spinal canal recovery can be achieved without spinal canal decompression [10]. Therefore, some surgeons believe that TLBF can be treated by posterior pedicle screw fixation alone without spinal canal incision and decompression [11,12]. Although the overall neurological functions improve significantly after surgery, there are still many cases where the neurological function is not recovered or is poorly recovered.…”

Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: Percutaneous pedicle screw fixation combined with selective transforaminal endoscopic decompression for the treatment of thoracolumbar burst fracture

et al. 2020

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Background The objective of this study was to evaluate the feasibility, safety, efficacy, and indications of percutaneous pedicle screw fixation (PPSF) combined with selective transforaminal endoscopic decompression (TED) in the treatment of thoracolumbar burst fracture (TBLF). Methods From August 2015 to October 2018, a total of 41 patients with single-segment TLBF (28 men and 13 women) were enrolled in this study. X-ray and computed tomography were obtained before surgery, 1 week after surgery, and 1 year after surgery to evaluate spinal recovery. In addition, we used the visual analog scale (VAS), the Oswestry Disability Index (ODI), the Japanese Orthopedic Association score (JOA), and the Frankel classification of neurological deficits to evaluate the effectiveness of the treatments. Results The average follow-up time was 22.02 ± 8.28 months. The postoperative Cobb angle, vertebral body compression ratio, vertebral wedge angle, mid-sagittal canal diameter compression ratio, and Frankel grade were significantly improved. There were also significant improvements in the VAS (7.61 ± 1.41 vs. 1.17 ± 0.80, P < 0.001), ODI (89.82 ± 7.44 vs. 15.71 ± 13.50, P < 0.001), and JOA (6.90 ± 2.91 vs. 24.90 ± 3.03, P < 0.001). Conclusions Our results showed that PPSF combined with selective TED in the treatment of TLBF had excellent efficacy, high safety, less secondary injury than other treatments, and a wide range of indications and that it could accurately distinguish patients who did not need spinal canal decompression after posterior fixation. PPSF combined with selective TED is therefore a good choice for the treatment of TLBF.

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Section: Introductionmentioning

confidence: 99%

RETRACTED ARTICLE: Percutaneous pedicle screw fixation combined with selective transforaminal endoscopic decompression for the treatment of thoracolumbar burst fracture

et al. 2020

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“…Furthermore, this technique allows for the maximum preservation of lumbar mobility, alleviating postoperative stiffness and reducing the occurrence of postoperative pain [24]. However, it is only suitable for fractures with intact pedicles and only one-sided burst endplates on the injured vertebra, and its reduction effect is inferior to the six-screw xation technique, limiting its applicability [25].…”

Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of Three Posterior Open Surgical Approaches for the Intraoperative and Long-term Outcomes in the Treatment of Thoracolumbar Burst Fractures

Wang,

Zhang,

Wang

et al. 2023

Preprint

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Objective Evaluating the Intraoperative and Long-term Clinical Outcomes of Three Posterior Open Surgical Approaches for the Treatment of Thoracolumbar Burst Fractures. Methods Follow-up observation of 145 patients with thoracolumbar burst fractures treated with three surgical approaches, including “traditional transpedicular four-screw fixation spanning the injured vertebral body (TFSV) (n=38), short-segment transpedicular four-screw fixation through the injured vertebral body (SFTV) (n=53), and six-screw fixation (STV) (n=54)”, at our institution from June 2014 to June 2022. Comparative analysis of perioperative parameters (operative time, intraoperative blood loss, postoperative 24-hour drainage), preoperative and postoperative radiological indices (sagittal plane Cobb angle, Vertebral wedge deformity index), postoperative functional recovery (VAS score, ODI score), and incidence of complications. Results There was no significant difference in general data among the three groups. The SFTV group is superior to the other two groups in perioperative parameters (P＜0.001, P=0.023, P＜0.001). There was significant difference in sagittal plane Cobb angle at each time point among the three groups (P=0.025), but no significant difference in Vertebral wedge deformity index (P=0.299). The improvement of sagittal plane Cobb angle was slightly worse in the group of SFTV. The VAS and ODI scores before and after surgery in each group showed significant improvement (P＜0.001, P＜0.001); however, there were no statistically significant differences between the groups at the same time points (P=0.312, P=0.924). The incisions of all the patients healed at the first stage without any complications. At the end of follow-up, the Cobb angle increased more than 10 degrees in 3 cases (16.67%) in the TFSV group and in 1 case (5.56%) in the SFTV group. Conclusion The treatment of thoracolumbar burst fracture with STV or SFTV is superior to the TFSV, SFTV is better than STV, but the indication of SFTV is limited.

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Bisegmental posterior stabilisation of thoracolumbar fractures with polyaxial pedicle screws: Does additional balloon kyphoplasty retain vertebral height?

et al. 2020

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We retrospectively evaluated single-level compression fractures (T12-L3) scheduled for a short-segment POS (posterior-only stabilization) using polyaxial screws. Patients averaged 55.7 years (range, 19-65). Patients received either POS or, concomitantly, BK (balloon kyphoplasty) of the fractured vertebrae as well. Primary endpoint was the radiological outcome at the last radiographic follow-up prior to implant removal. POS together with BK of the fractured vertebrae resulted in a significant improvement of the local kyphosis angle and vertebral body compression rates immediately post-OP. During the further course of FU, a considerable loss of correction was observed post-OP in both groups. (Local KA: pre-OP/ post-OP/ FU: 12.6±4.8/ 3.35±4.8/ 11.6±6.0; anterior vertebral body compression%: pre-OP/ post-OP/ FU: 71.94±12.3/ 94.78±19.95/ 78.17±14.74). VAS was significantly improved from 7.2±1.3 pre-OP to 2.7±1.3 (P<0.001) at FU. We found a significant restoration of the vertebral body height by BK. Nevertheless, follow-up revealed a noticeable loss of reduction. Given the fact that BK used together with polyaxial screws did not maintain intra-operative reduction, our data do not support this additional maneuver when used together with bi-segmental polyaxial pedicle screw fixation.

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Early Clinical Results of Short Same-Segment Posterior Fixation in Thoracolumbar Burst Fractures

Cited by 3 publications

References 0 publications

RETRACTED ARTICLE: Percutaneous pedicle screw fixation combined with selective transforaminal endoscopic decompression for the treatment of thoracolumbar burst fracture

RETRACTED ARTICLE: Percutaneous pedicle screw fixation combined with selective transforaminal endoscopic decompression for the treatment of thoracolumbar burst fracture

Retrospective Analysis of Three Posterior Open Surgical Approaches for the Intraoperative and Long-term Outcomes in the Treatment of Thoracolumbar Burst Fractures

Bisegmental posterior stabilisation of thoracolumbar fractures with polyaxial pedicle screws: Does additional balloon kyphoplasty retain vertebral height?

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