Multimodal intraoperative monitoring during reduction of spine burst fracture and dislocation prevents neurologic injury

Abstract

This study aims to evaluate the application of multimodal intraoperative monitoring (MIOM) in surgical treatment for spine burst fracture and dislocation (SBFD) patients.Eleven patients who underwent posterior reduction and instrumentation (PRI) for SBFD from June 2014 to July 2016 were included into the study. The function of the spinal cord was monitored by MIOM. The muscle strength of the lower extremities and American Spinal Injury Association (ASIA) scores were, respectively, evaluated (before surgery, and at 1, 3, 6, and 12 months after surgery). Furthermore, the extent of reduction was also assessed.Muscle strength recovery, ASIA score changes, and the extent of reduction were correlated with MIOM results. Among the 11 patients who received surgery under MIOM, 8 patients with negative MIOM results during the operation did not demonstrate neurological deterioration postoperatively and exhibited improvements in ASIA scores during follow-ups. However, among the 3 patients who encountered MIOM events (case 4, 7, and 8), 2 patients avoided nerve lesion and 1 patient suffered from neurologic deterioration postoperatively.The application of MIOM technology during PRI surgery may detect spinal cord impairment at the early stage, and operative schemes can be modified before permanent nerve compromise is triggered by surgical manipulation.

Treatment of Thoracolumbar Fractures Through Different Short Segment Pedicle Screw Fixation Techniques: A Finite Element Analysis

“…Twenty percent of thoracolumbar fractures are burst fractures, which are usually caused by high‐energy damage, and are due to axial pressure. The buckling rotation force causes the front column and the center column to be unable to support. In 15% to 30% of cases, spinal cord injuries are associated with neurological complications.…”

Comparative Evaluation of Posterior Percutaneous Endoscopic Cervical Discectomy Using 3.7mm Endoscopic and 6.9mm Endoscopic for Cervical Disc Herniation: a retrospective comparative cohort study. 

“…In 1944, Spurling et al rst described the effectiveness of p-PECD for the treatment of cervical foraminal stenosis which induced by a lateral CDH or osteophytes (32). Studies proved that p-PECD is an effective treatment for cervical diseases and its inner diameter of working cannula ranges from 3.7 mm to 6.9 mm (17,22,28). In our opinion, different diameters of the working cannula may lead to different surgical e ciency.…”

“…Recently, PECD for the treatment of spinal diseases has become favorable. It offers the advantage of reducing trauma, promoting faster rehabilitation (9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) and has a similar short-term clinical bene t to ACDF (22). PECD can be performed through the anterior approach and posterior approach (21) which depends on the site of pathology.…”

“…To date, numerous studies reported p-PECD for management of cervical disorders (19) (13,(15)(16)(17)(18)(19)(20)(21)(23)(24)(25)(26)(27) and the inner diameter range of p-PECD working channel was from 3.7mm to 6.9mm (17,22,28).…”

A novel computer navigation model guided unilateral percutaneous vertebroplasty for vertebral compression fracture

“…Vertebral compression fracture (VCF) is one of the most common diseases in spinal surgery, which caused by osteoporosis, [ 1 ] high-energy injury [ 2 ] and primary or metastatic tumor. [ 3 , 4 ] Traditional percutaneous vertebroplasty (PVP) under fluoroscopy is an effective method to treat vertebral compression fracture.…”