Percutaneous pedicle screw fixation plus kyphoplasty for thoracolumbar fractures A2, A3 and B2

Korovessis, Panagiotis; Mpountogianni, Eva; Syrimpeis, Vasilleios

doi:10.1007/s00586-016-4743-6

Cited by 26 publications

(23 citation statements)

References 25 publications

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“…This allows early mobilization, consequently improving the rehabilitation process of the patient and reducing postoperative complications, such as pulmonary infections and decubitus [3][4][5]. During the last decades the instrumentation and approaches of surgical treatment underwent numerous developments [4,[6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Posterior implant removal in patients with thoracolumbar spine fractures: long-term results

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Posterior implant removal in patients with thoracolumbar spine fractures: long-term results

et al. 2016

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“…Generally, hybrid stabilization for the treatment of unstable thoracolumbal verterbral body fractures have been reported in several studies [13][14][15][16]. The loss of reduction in geriatric patients is reported to be quite high ranging between 4.6 to 23° [17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Which anatomic structures are responsible for the reduction loss after hybrid stabilization of osteoporotic fractures of the thoracolumbar spine?

Spiegl

Ahrberg²,

Anemüller³

et al. 2020

BMC Musculoskelet Disord

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Introduction: Hybrid stabilization is an accepted therapy strategy for unstable osteoporotic thoracolumbar fractures. However, a moderate reduction loss has been reported and it remains unclear which anatomic structure is responsible for the reduction loss. Methods: This retrospective study was performed at a level I trauma center. Patients aged 61 and older were stabilized using hybrid stabilization after suffering acute and unstable osteoporotic vertebral body fractures at the thoracolumbar spine. Posterior stabilization was done short-segmental and minimal invasive with cement-augmentation of all pedicle screws. The minimum follow-up has been 2 years. The outcome parameters were the reduction loss and the relative loss of height of both intervertebral discs adjacent to the fractured vertebral body, the fractured vertebral body and a reference disc (intervertebral disc superior of the stabilization) between the postoperative and latest lateral radiographs. Additionally, implant positioning and loosening was analyzed. Results: 29 mainly female (72%) patients (73.3 ± 6.0 years) were included. Fractures consisted of 26 incomplete burst fractures and 3 complete burst fractures of the thoracolumbar junction (Th11-L2: 86%) and the midlumbar spine. The mean follow-up time was 36 months (range: 24-58 months). The mean reduction loss was 7.7°(range: 1-25). The relative loss of heights of both intervertebral discs adjacent to the fractured vertebral body, the reference disc, and the central vertebral body were significant. Thereby, the relative loss of the superior disc height was significant higher compared to the reference disc. Additionally, only the relative loss of central vertebral body height and reduction loss correlated significantly. There were no signs of implant loosening in any patient. Conclusions: The mean reduction loss was moderate 3 years after hybrid stabilization of unstable osteoporotic vertebral fractures of the thoracolumbar spine. A significant loss of both adjacent disc heights and the central vertebral body was seen, with the highest loss in the superior adjacent disc significantly outranging the reference disc. The superior adjacent intervertebral disc and the central part of the fractured vertebral body seem to be responsible for the majority of reduction loss.

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“…Operation time is reduced to an average of 78 minutes. [1][2][3][4][5][6][7][8][9] Especially in polytrauma patients with spinal fractures, the spinal column can be stabilized in an emergency setting, while limiting the risks of the patients' condition. In chest trauma, patients can be mobilized early, preventing respiratory complications.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have described the multiple advantages of posterior pedicle screw fixation techniques in thoracolumbar fractures. [1][2][3][4][5][6][7][8][9] Open surgical techniques are associated with significant morbidity due to high blood loss and infection rates. Blood loss rates of 1000 mL for open posterior, anterior, or anterior-posterior procedures can be reduced to 50 mL in less invasive spine surgery.…”

Section: Introductionmentioning

confidence: 99%

Less Invasive Surgery is Feasible in the Management of Traumatic Thoracolumbar Fractures in Isolated and Polytrauma Injury

et al. 2019

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Background: Less invasive stabilization systems (LISSs) have gained popularity. However, limited quality of life (QOL) and clinical outcome data exist for trauma patients treated with LISSs. The objective of this study is to describe QOL and outcome for posterior percutaneous pedicle screw fixation in the management of traumatic thoracolumbar fractures. Methods: Between January 2006 and December 2011, data from all patients treated with a posterior percutaneous pedicle screw fixation technique for thoracolumbar fractures were collected and analyzed. Sixty-nine patients met the inclusion criteria. Additional vertebral reduction and cement augmentation was used in 25 patients, when there was more than 50% of vertebral body comminution. Results: Mean follow up of 19 months (range ¼ 6-49 months). Fifty-one percent of the study population consisted of polytrauma patients, with 22% having injury severity score ! 15. In 6 cases (8.7%) there were perioperative complications. Response rate for the follow-up health survey was 78%, with a satisfactory overall median EuroQuol score of 0.811 (Q1-Q3 95% confidence interval ¼ 0.709-0.897). Conclusions: Posterior percutaneous pedicle screw fixation proves to be effective in the management of traumatic thoracolumbar fractures, with a good overall functional outcome. Percutaneous techniques that reduce perioperative morbidity are an alternative approach well suited for damage control orthopaedics, as long as there are no neurological deficits. Especially in polytrauma patients with spine fractures, the spinal column can be stabilized in an emergency setting, while limiting the risks of ''a second hit'' at the patients' already frail condition. Level of Evidence: 3.

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Percutaneous pedicle screw fixation plus kyphoplasty for thoracolumbar fractures A2, A3 and B2

Abstract: PSFx plus BP for thoracolumbar fractures reduces significantly spinal deformity and pain with few complications.

Cited by 26 publications

References 25 publications

Posterior implant removal in patients with thoracolumbar spine fractures: long-term results

Posterior implant removal in patients with thoracolumbar spine fractures: long-term results

Which anatomic structures are responsible for the reduction loss after hybrid stabilization of osteoporotic fractures of the thoracolumbar spine?

Less Invasive Surgery is Feasible in the Management of Traumatic Thoracolumbar Fractures in Isolated and Polytrauma Injury

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