Leriche-Like Syndrome as a Delayed Complication Following Posterior Instrumentation of a Traumatic L1 Fracture

Blocher, Martina; Mayer, Michaël; Resch, Herbert; Ortmaier, Reinhold

doi:10.1097/brs.0000000000001057

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…Currently, damage to the PGVs from pedicle screws in the thoracic vertebrae has been reported in several papers [24–28], but this damage has rarely been reported in the lumbar vertebrae [18]. In 2010, Foxx et al [29] retrospectively analyzed 182 patients with thoracolumbar and lumbosacral pedicle screw fusion.…”

Section: Discussionmentioning

confidence: 99%

“…Zhuang et al [17] confirmed that the mechanical properties and early screw loosening of bone cement screws were not better than those of the BPSs. Because the abdominal aorta, inferior vena cava, and iliac vessels are located in front of the lumbar spine, a BPS that breaks through the anterior cortex of the lumbar vertebral body can potentially 0damage the prevertebral great vessels (PGVs) [18]. To the best of our knowledge, there have been no reports on the anatomy of the PGVs and their association with BPSs.…”

Section: Introductionmentioning

confidence: 99%

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The methods for inserting lumbar bicortical pedicle screws from the anatomical perspective of the prevertebral great vessels

Liu

Wang

et al. 2019

BMC Musculoskelet Disord

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Background At present, bicortical pedicle screws (BPSs) are not used clinically because they carry the potential risk of damaging the prevertebral great vessels (PGVs). The authors observed the anatomical relationship between the PGVs and simulated BPSs at different transverse screw angles (TSAs), exploring the insertion method of the BPS. Methods Computed tomography angiography (CTA) images from 65 adults were collected. A total of 4–5 TSAs of the BPSs were simulated on the left and right sides of L1-L5 (L1-L3: 0°, 5°, 10°, 15°; L4-L5: 0°, 5°, 10°, 15°, 20°). There were three types of distances from the anterior vertebral cortex (AVC) to the PGVs (D AVC-PGV ); D AVC-PGV < 0.50 cm , D AVC-PGV ≥ 0.50 cm , and D AVC-PGV↑ ; these distances represented close, distant, and noncontact PGV, respectively. Results The ratio of every type of PGV was calculated, and the appropriate TSA of the BPS was recommended. In L1, the recommended left TSA of the BPS was 0°, and the ratio of the close PGV was 7.69%, while the recommended right TSA was 0°-10°, and the ratio of the close PGV was 1.54–4.62%. In L2, the recommended left TSA of the BPS was 0° and the ratio of the close PGV was 1.54%, while the recommended right TSA was 0°-15° and the ratio of the close PGV was 3.08–9.23%. In L3, the recommended left TSA was 0°-5°, and the ratio of the close PGV was 1.54–4.62%. In L4, the recommended left TSA was 0°, and the ratio of the close PGV was 4.62%. BPS use was not recommended on the right side of either L3 or L4 or on the either side of L5. Conclusions From the anatomical perspective of the PGVs, BPSs were not suitable for insertion into every lumbar vertebra. Furthermore, the recommended methods for inserting BPSs were different in L1-L4.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The methods for inserting lumbar bicortical pedicle screws from the anatomical perspective of the prevertebral great vessels

Liu

Wang

et al. 2019

BMC Musculoskelet Disord

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“…This was illustrated in a study done by Karami et al, where an increased fixation strength of bicortical screws was observed with screw toggle testing [12]. The drawback of a bicortical screw placement is the risk of iatrogenic damage to neurovascular structures anterior to the spine [32][33][34][35]. This leads to the question if the mechanical benefit of placing pedicle screws bicortically using a CBT justifies this associated risk.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical performance of bicortical versus pericortical bone trajectory (CBT) pedicle screws

et al. 2021

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Purpose The cortical bone trajectory (CBT) is an alternative to the traditional pedicle screw trajectory (TT) in posterior spinal instrumentation, enhancing screw contact with cortical bone and therefore increasing fixation strength. Additional to the trajectory, insertion depth (pericortical vs. bicortical placement) could be a relevant factor affecting the fixation strength. However, the potential biomechanical benefit of a bicortical placement of CBT screws is unknown. Therefore, the aim of this study was to quantify the fixation strength of pericortical-versus bicortical-CBT (pCBT versus bCBT) screws in a randomized cadaveric study. Methods Pedicle screws were either placed pericortical or bicortical with a CBT in 20 lumbar vertebrae (2 × 20 instrumented pedicles) from four human spine cadavers by using patient-specific templates. Instrumented specimens underwent physiological cyclic loading testing (1′800′000 cycles, 10 Hz), including shear and tension loads as well as bending moments. Translational and angular displacements of the screws were quantified and compared between the two techniques. Results There was a slight decrease in translational (0.2 mm ± 0.09 vs. 0.24 mm ± 0.11) and angular displacements (0.06° ± 0.05 vs. 0.13° ± 0.11) of bCBT screws when compared with pCBT screws after 1′800′000 cycles. However, the results were non-significant (p > 0.05). Conclusion The authors do not recommend placing CBT screws bicortically, as no relevant biomechanical advantage is gained while the potential risk for iatrogenic injury to structures anterior to the spine is increased.

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“…[13] In the literature review, it was found that ALIF surgery at L2-L5 levels is most likely prone to cause vascular injury, [3][4][5] just as the procedure in our case. The explained reason is that left common iliac vessels normally transverse the prevertebral space the L4-5 interspace, and thus prevents direct access to the spine.…”

Section: Discussionmentioning

confidence: 99%

Leriche’s syndrome: a rare complication following anterior approach lumbar spinal surgery

Tummala¹,

Ravakhah²,

Gupta³

2017

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Leriche-Like Syndrome as a Delayed Complication Following Posterior Instrumentation of a Traumatic L1 Fracture

Abstract: 5.

Cited by 6 publications

References 13 publications

The methods for inserting lumbar bicortical pedicle screws from the anatomical perspective of the prevertebral great vessels

The methods for inserting lumbar bicortical pedicle screws from the anatomical perspective of the prevertebral great vessels

Biomechanical performance of bicortical versus pericortical bone trajectory (CBT) pedicle screws

Leriche’s syndrome: a rare complication following anterior approach lumbar spinal surgery

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