Short Segment Fixation for Thoracolumbar Burst Fracture Accompanying Osteopenia : A Comparative Study

Kim, Hyeun Sung; Kim, Seok Won; Ju, Chang Il; Lee, Sung Myung; Shin, Ho Seong

doi:10.3340/jkns.2013.53.1.26

Cited by 9 publications

(8 citation statements)

References 7 publications

(11 reference statements)

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“…Kim et al had addressed outcomes including pain in different three groups underwent short-segment stabilization with screws in index vertebra; the first group (n = 26) was similar to our short segment group. The mean VAS scores were 7.6 before surgery and 3.0 at the last followup, while in our group, VAS scores were 5.59 and 1.39 respectively [11].…”

Section: Paincontrasting

confidence: 51%

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Short-segment posterior fixation with index level screws versus long-segment posterior fixation for thoracolumbar spine fracture: angle of correction and pain

Sallam¹,

Ghany

Ali

et al. 2018

Egypt J Neurosurg

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Background: Thoracic and lumbar fractures represent nearly 90% of traumatic spine injuries. Thoracolumbar region is susceptible to injury because of its location between the stiff kyphotic thoracic spine and the mobile lordotic lumbar region. To compare between short-segment fixation with screws into index level and long-segment fixation in maintaining angle of correction and pain. Methods: A prospective study included 91 patients, who had single-level thoracolumbar fracture with Cobb's angle ≤ 25°and underwent posterior fixation. Forty-four patients underwent short-segment fixation with screws into the index level, and 47 patients underwent long-segment fixation with skipped index level. The angle of correction, pain, and neurological state were regularly assessed. Results: Forty-four patients (48.35%) had short segment and 47 (51.65%) had long-segment fixation. In the short segment group, the pre-operative mean Cobb's angle was 19.34°± 3.63°and the angle of correction was 8.14°± 1.9°a fter 1 year, while in the long segment group, the pre-operative mean Cobb's angle was 19.08°± 4.0°and the angle of correction was 8.62°± 2.59°. Regarding pain, in the short segment group, the pre-operative visual analogue scale (VAS) was 5.59 ± 2.09 that was reduced to 1.39 ± 0.58 at the 1 year follow-up, while the long segment group VAS was 5.4 ± 2.01 pre-operatively that was reduced to 1.47 ± 0.58. Conclusions: Short-segment fixation can maintain the angle of correction as long-segment fixation for single level thoracolumbar traumatic fracture with lower complication and faster pain relief. Trial registration: Clinicaltrials.gov/NCT03272243.

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Section: Paincontrasting

confidence: 51%

“…Adding bilateral index level screws to short-segment fixation increased the stability of the construct by 25%. The increase in stability was significant during flexion and lateral bending [11].…”

Section: Discussionmentioning

confidence: 84%

Short-segment posterior fixation with index level screws versus long-segment posterior fixation for thoracolumbar spine fracture: angle of correction and pain

Sallam¹,

Ghany

Ali

et al. 2018

Egypt J Neurosurg

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“…As a result, following VP or KP, accelerated osteolysis may occur and displace the bone cement, and bone cement augmentation procedures such as VP and KP alone for Kummell's disease, even without neurologic deficits, often result in bone cement displacement 8 13 14) . Nowadays some good clinical outcomes are reported with bone cement augmented short segment fixation with thoracolumbar burst fractures regardless of osteoporosis 5) .…”

Section: Introductionmentioning

confidence: 99%

Bone Cement-Augmented Percutaneous Short Segment Fixation: An Effective Treatment for Kummell's Disease?

Park

Kim²,

Lee

et al. 2015

J Korean Neurosurg Soc

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ObjectiveThe aim of this prospective study was to evaluate the efficacy of bone cement-augmented percutaneous short segment fixation for treating Kummell's disease accompanied by severe osteoporosis.MethodsFrom 2009 to 2013, ten patients with single-level Kummell's disease accompanied by severe osteoporosis were enrolled in this study. After postural reduction for 1-2 days, bone cement-augmented percutaneous short segment fixation was performed at one level above, one level below, and at the collapsed vertebra. Clinical results, radiological parameters, and related complications were assessed preoperatively and at 1 month and 12 months after surgery.ResultsPrior to surgery, the mean pain score on the visual analogue scale was 8.5±1.5. One month after the procedure, this score improved to 2.2±2.0 and the improvement was maintained at 12 months after surgery. The mean preoperative vertebral height loss was 48.2±10.5%, and the surgical procedure reduced this loss to 22.5±12.4%. In spite of some recurrent height loss, significant improvement was achieved at 12 months after surgery compared to preoperative values. The kyphotic angle improved significantly from 22.4±4.9° before the procedure to 10.1±3.8° after surgery and the improved angle was maintained at 12 months after surgery despite a slight correction loss. No patient sustained adjacent fractures after bone cement-augmented percutaneous short segment fixation during the follow-up period. Asymptomatic cement leakage into the paravertebral area was observed in one patient, but no major complications were seen.ConclusionBone cement-augmented percutaneous short segment fixation can be an effective and safe procedure for Kummell's disease.

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“…It is also a simple technique and allows for more segmental motion of the spine. Age, osteoporosis and degree of comminution of the vertebral body are risk factors for poor surgical outcomes [ 9 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…With remarkable improvements in instrument quality, the posterior approach alone can obviate the need for reconstruction of the anterior and middle columns of the fractured vertebra. The short segment posterior instrumentation and fusion is the current trend as it can reduce the blood loss, preserving segmental motion with an acceptable anatomic and functional outcome [ 5 6 7 8 9 10 11 12 13 ]. However, there are also reports of high percentages of instrumentation failure [ 14 15 ].…”

Section: Introductionmentioning

confidence: 99%

Radiological Outcome of Short Segment Posterior Instrumentation and Fusion for Thoracolumbar Burst Fractures

Morishita

Yugue

et al. 2015

Asian Spine J

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Study DesignRetrospective study.PurposeTo evaluate the radiological outcome of the surgical treatment of thoracolumbar burst fractures by using short segment posterior instrumentation (SSPI) and fusion.Overview of LiteratureThe optimal surgical treatment of thoracolumbar burst fractures remains a matter of debate. SSPI is one of a number of possible choices, yet some studies have revealed high rates of poor radiological outcome for this SSPI.MethodsPatients treated using the short segment instrumentation and fusion technique at the Spinal Injuries Center (Iizuka, Fukuoka, Japan) from January 1, 2006 to July 31, 2012 were selected for this study. Radiographic parameters such as local sagittal angle, regional sagittal angle, disc angle, anterior or posterior height of the vertebral body at admission, postoperation and final observation were collected for radiological outcome evaluation.ResultsThere were 31 patients who met the inclusion criteria with a mean follow-up duration of 22.7 months (range, 12-48 months). The mean age of this group was 47.9 years (range, 15-77 years). The mean local sagittal angles at the time of admission, post-operation and final observation were 13.1°, 7.8° and 14.8°, respectively. There were 71% good cases and 29% poor cases based on our criteria for the radiological outcome evaluation. The correction loss has a strong correlation with the load sharing classification score (Spearman rho=0.64, p<0.001).ConclusionsThe loss of kyphotic correction following the surgical treatment of thoracolumbar burst fracture by short segment instrumentation is common and has a close correlation with the degree of comminution of the vertebral body. Patients with high load sharing scores are more susceptible to correction loss and postoperative kyphotic deformity than those with low scores.

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Short Segment Fixation for Thoracolumbar Burst Fracture Accompanying Osteopenia : A Comparative Study

Cited by 9 publications

References 7 publications

Short-segment posterior fixation with index level screws versus long-segment posterior fixation for thoracolumbar spine fracture: angle of correction and pain

Short-segment posterior fixation with index level screws versus long-segment posterior fixation for thoracolumbar spine fracture: angle of correction and pain

Bone Cement-Augmented Percutaneous Short Segment Fixation: An Effective Treatment for Kummell's Disease?

Radiological Outcome of Short Segment Posterior Instrumentation and Fusion for Thoracolumbar Burst Fractures

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