Early failure of short-segment pedicle instrumentation for thoracolumbar fractures. A preliminary report.

McLain, Robert F.; Sparling, Edward; Benson, Daniel R.

doi:10.2106/00004623-199302000-00002

Cited by 562 publications

(358 citation statements)

References 7 publications

Supporting

Mentioning

310

Contrasting

Unclassified

Order By: Relevance

“…Our long-term follow-up concerning pain and social reintegration shows good results in 90% of cases by the Coventry and Stauffer scale; this is as good or better than results reported for both operative and nonoperative treatments [1,6,24,28,31,32] (Table 4). We found no association between the degree of kyphosis and pain score, which is also supported by others [6,32,33].…”

Section: Clinical Outcomesupporting

confidence: 53%

“…Most other studies do not present follow-ups beyond implant removal or long enough to observe this pro-287 gressive kyphosis (Table 4). However, within the first 6 months of follow-up implant failure of short-segment pedicle fixations has been reported in up to 50% of cases [31]. In our study, no broken screw was noted before 12 months follow-up, which seems to indicate fatigue failure due to long-term cyclic loading.…”

Section: Vertebral Height Reconstitution and Correction Of Kyphosissupporting

confidence: 39%

See 1 more Smart Citation

Treatment of thoracolumbar burst fractures without neurologic deficit by indirect reduction and posterior instrumentation: bisegmental stabilization with monosegmental fusion

Müller

Berlemann

Sledge

et al. 1999

European Spine Journal

163

102

View full text Add to dashboard Cite

Section: Clinical Outcomesupporting

confidence: 53%

Section: Vertebral Height Reconstitution and Correction Of Kyphosissupporting

confidence: 39%

Treatment of thoracolumbar burst fractures without neurologic deficit by indirect reduction and posterior instrumentation: bisegmental stabilization with monosegmental fusion

Müller

Berlemann

Sledge

et al. 1999

European Spine Journal

163

102

View full text Add to dashboard Cite

“…exposure of the spine, with prolonged operative times and profuse intraoperative blood loss [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous augmented instrumentation of unstable thoracolumbar burst fractures

et al. 2011

View full text Add to dashboard Cite

Background Internal fixation of unstable thoracolumbar spine fractures requires correction of the lacking anterior column support. This usually entails insertion of a vertebral body replacement strut through an anterior approach, or a long posterior construct spanning at least two vertebrae above and two vertebrae below the fracture. Posterior short-segment pedicle instrumentation (SSPI)-one vertebra above and below-is suitable for approximately 40% of fractures, but not for all. Methods A total of 52 patients with unstable thoracolumbar burst fractures meeting our inclusion criteria were instrumented using a novel approach, combining percutaneous SSPI, pedicle screw augmentation with polymethyl methacrylate (PMMA) and fractured vertebra kyphoplasty. We retrospectively reviewed patient and fracture data, operative results and 1 year radiographic follow-up postoperatively in 40 of the patients. We reviewed operative complications of all 52 patients. Results Most fractures were AO/Magerl type A3.1, A3.2 and A3.3. They were instrumented within 72 h and ambulated without additional external bracing. Operative time averaged 2 h and blood loss was less than 50 cc in most cases. Complications were mostly related to PMMA leakage. On average, 3.3°(0-13) of correction was lost after 3 months, but remained constant afterward. Conclusions Percutaneous augmented short-segment pedicle instrumentation of unstable thoracolumbar fractures can be done with short operative times, minimal blood loss and a low complication rate. The radiographical results at 1 year are equal to anterior stabilization and are better than other posterior-only techniques.

show abstract

“…Indirect reduction does not allow restoration of the mechanical properties of the end plate-disc interface. Moreover, pedicle screw instrumentation does not prevent recurrent kyphosis, particularly with short arthrodesis (one level above, one level below) [3].In our point of view, disc height loss is not a disc degenerative process but an adaptation to new mechanical conditions. Vertebroplasty [4] allows to improve the vertebral body mechanical quality, particularly at the disc-end plate interface.…”

mentioning

confidence: 75%

mentioning

confidence: 99%

Letter to the Chief Editor: Outcome of thoracolumbar burst fractures treated with indirect reduction and fixation without fusion. Huilin Yang, Jin-hui Shi, Molly Ebraheim, Xiaochen Liu, Joseph Konrad, Ibrahim Husain, Tian-si Tang, Jiayong Liu Eur Spine J. Published online 8 August 2010

Lucas

Emery

2011

Eur Spine J

View full text Add to dashboard Cite

We read with great interest the article written by Liu et al. This retrospective study included patients with type A or C according AO classification non-osteoporosis thoracolumbar fractures. They were treated with posterior fixation without fusion after indirect reduction. Almost all patients had instrumentation removal at 9-12 months post-operative. The authors report good long-term outcome for the great majority of included patients.However, the authors report adjacent disc injury and disc degeneration after implants removal without clinical deterioration.According to Roaf [5], the intervertebral disc is always stronger than the vertebral end plate and excessive compression force creates an end-plate fracture. Several animal experimental studies have shown that end-plate fracture can occur when there is pressurization of the nucleus [1]. These studies allow us to hypothesize that human vertebral end-plate fractures are due to excessive nucleus pressurization when brutal compressive loading is transmitted. In this context, disc-end plate interface restoration seems to be one of the main objectives in compressive fractures (type A of Magerl classification) treatment.Disc height loss leading to kyphosis is the main complication of vertebral fractures. MRI analysis of the disc signal have showed no significant signal intensity modification, and more particularly, no degeneration process. According to Oner [2], the disc changes are the consequences of adaptation to the morphological changes of the end plate with settling of the end-plate defect. Indirect reduction does not allow restoration of the mechanical properties of the end plate-disc interface. Moreover, pedicle screw instrumentation does not prevent recurrent kyphosis, particularly with short arthrodesis (one level above, one level below) [3].In our point of view, disc height loss is not a disc degenerative process but an adaptation to new mechanical conditions. Vertebroplasty [4] allows to improve the vertebral body mechanical quality, particularly at the disc-end plate interface. Therefore, this technique seems to prevent disc height loss and recurrent kyphosis.

show abstract

Early failure of short-segment pedicle instrumentation for thoracolumbar fractures. A preliminary report.

Cited by 562 publications

References 7 publications

Treatment of thoracolumbar burst fractures without neurologic deficit by indirect reduction and posterior instrumentation: bisegmental stabilization with monosegmental fusion

Treatment of thoracolumbar burst fractures without neurologic deficit by indirect reduction and posterior instrumentation: bisegmental stabilization with monosegmental fusion

Percutaneous augmented instrumentation of unstable thoracolumbar burst fractures

Letter to the Chief Editor: Outcome of thoracolumbar burst fractures treated with indirect reduction and fixation without fusion. Huilin Yang, Jin-hui Shi, Molly Ebraheim, Xiaochen Liu, Joseph Konrad, Ibrahim Husain, Tian-si Tang, Jiayong Liu Eur Spine J. Published online 8 August 2010

Contact Info

Product

Resources

About