Result of Posterior Instrumentation Without Fusion in the Management of Thoracolumbar and Lumbar Unstable Burst Fracture

Ko, Sangbong; Lee, Sangwook

doi:10.1097/bsd.0b013e31825bfc8e

Cited by 24 publications

(39 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is probably due to the fusion performed during anterior stabilization, while no fusion was performed during solely posterior stabilization. Previous studies reported conflicting outcomes after posterior implant removal, ranging from no [17,18] to significant loss of correction [6,31]. Different studies are hard to compare while different follow-up times and surgical techniques are used.…”

Section: Kyphosis and Correlationsmentioning

confidence: 99%

“…Some described only small cohorts [2,4,16] or focused largely on removal of long-segment fixation [10]. Other studies focused on the posterior stabilization itself, but advocated routine removal of implants to regain mobility of the spine and minimize potential damage [4,18]. In the current literature there is no consensus whether implants should be removed routinely after fracture consolidation, or only in selected cases with pain or other implant related symptoms.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 2016

View full text Add to dashboard Cite

show abstract

Section: Kyphosis and Correlationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Th e 10 articles -out of 33 -that met the criteria and were included in the fi nal database, discuss the most frequently employed surgical treatment methods for the thoracal and lumbar fractures: posterior short segment fi xation [10][11][12][13][14][15], on one hand, and anterior approach only, as well as posterior-anterior approach [16][17][18][19], on the other.…”

Section: Methodsmentioning

confidence: 99%

The Loss of Correction in Thoracolumbar Burst Fracture Treated by Surgery. Can We Predict It?

Anghel

Dénes

2014

Acta Medica Marisiensis

View full text Add to dashboard Cite

Objective: This paper aims to differentially depict potential patterns of the loss of correction in surgically treated thoraco-lumbar burst fractures. These may eventually serve to foreseeing and even forestalling loss of correction. Methods: The study focused on 253 patients with surgically treated thoraco-lumbar fractures. This cohort of patients was clustered in four subgroups according to the fracture spine segment (T11-L1 or L1-L2) and surgery type (short segment fi xation or anterior approach). Relevant recorded and processed data were the fracture level, post-operative (Kpo) and last follow-up (Kf) kyphosis angle values. Correlation, regression and determination testing were performed for the last follow-up kyphosis angle and post-operative kyphosis angle, and regression equations were determined for each subgroup of patients. Results:The patterns of loss of correction were described through the following equations: K f = 0.95*K po + 3.2° for the T11-L1 level fractured vertebrae treated by posterior short segment fi xation; K f = 0.98*K po + 3.4° for the L1-L2 level fractured vertebrae treated by posterior short segment fi xation; K f = 1.1*K po + 1.6° for the T11-L1 level fractured vertebrae treated by anterior approach; and K f = 0.7*K po + 2.8° for the L1-L2 level fracture vertebrae treated by anterior approach. Conclusions:The loss of correction may be predicted, to a certain extent, for thoraco-lumbar fractured vertebrae treated surgically. The bestfi t equations depicted for both type of surgery (short segment fi xation and anterior approach) and both spinal segments (T11-L1 and L2-L3) are signifi cantly different than the equations delineated for the collapse of non-surgically treated fractures.

show abstract

“…39 In this setting, the stress concentrated at the pedicle screws leads to a high incidence of instrumentation failure (loosening, breakage), nonunion of the fracture, and progressive loss of the achieved kyphosis reduction. 9,26 Therefore, additional load-sharing through anterior column reconstruction should be added. 20 Many authors have advocated anterior approach using strut grafts or cages and plates to establish anterior vertebral support.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures

Hassanein

2018

Egyptian Spine Journal

View full text Add to dashboard Cite

Background Data: Burst fractures are commonly provoked by axial compression which disrupts the anterior column. In this setting, posterior stabilization using pedicle screws alone may lead to delayed kyphosis and instrumentation failure due to inadequate support of the anterior column.Purpose: To evaluate the efficacy of pedicle screw instrumentation combined with transpedicular titanium mesh cage augmentation for treatment of burst fractures.Study Design: Prospective descriptive cohort clinical case study.Patients and Methods: Fourteen neurologically intact patients with acute incomplete thoracolumbar burst fracture (AO type A 3.1), and operated upon through period from January 2016 to June 2017 were included. Patients were treated using a three vertebrae pedicle screw fixation construct combined with bilateral transpedicular titanium mesh cage augmentation of the fracture. Patients were followed for at least one year. Data about pain (VAS), function (ODI) and vertebral body deformity (Beck index and local kyphotic angle) were recorded prospectively.Results: Patients were operated within 5 days after trauma. The mean VAS score improved after surgeryfrom 8.2±1.3 to 3.7±1.1 postoperatively and to 1.8±0.7 at final follow up (P<0.05). The mean ODI score improved from 69.4±5.2 preoperatively to 17.2±2.4 at final follow up. The mean Beck index improved from 0.63 preoperatively to 0.81 postoperatively and to 0.79 at final follow up. The mean local kyphotic angle improved from 20.4 o preoperatively to 11.5 o postoperatively and declined to 13.7 o at final visit. No patient had neurological deterioration or hardware failure during the follow up.The mean follow up was 13.4±1.8 months.Conclusion: Posterior stabilization using pedicle screw fixation in combination with titanium mesh cage augmentation can maintain vertebral restoration, prevent hardware failure and lead to better clinical outcome. (2018ESJ162)

show abstract

Result of Posterior Instrumentation Without Fusion in the Management of Thoracolumbar and Lumbar Unstable Burst Fracture

Abstract: In thoracolumbar and lumbar unstable burst fracture, performing posterior instrumentation without fusion and removing the instrument after bone union is achieved is considered a useful procedure for selected patients.

Cited by 24 publications

References 13 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

The Loss of Correction in Thoracolumbar Burst Fracture Treated by Surgery. Can We Predict It?

Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures

Contact Info

Product

Resources

About