Single-stage posterior vertebral column resection and internal fixation for old fracture–dislocations of thoracolumbar spine: a case series and systematic review

Tang, Huan-zhang; Xu, Hao; Yao, Xiaodong; Shen, Lin

doi:10.1007/s00586-015-3955-5

Cited by 10 publications

(11 citation statements)

References 41 publications

(18 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…PUVCR, a modi ed modi cation of VCR, exposes the vertebral body through a unilateral approach, removes half of the vertebral body and the upper and lower intervertebral discs, shortens the operation time, and reduces the blood loss while restoring the sagittal sequence of the spine [13]. Some studies suggest that PUVCR can completely decompress and effectively restore deformity in the treatment of old thoracolumbar fractures [1,13,14]. Nevertheless, there is a lack of effective biomechanical veri cation as to whether only half of the vertebral body and the upper and lower intervertebral discs has any effect on spinal biomechanics; there also remains debate as to the appropriate length of xation.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical symptoms of old vertebral fractures with kyphotic deformities are often persistent low back pain, sometimes accompanied by spinal cord compression symptoms. Conservative treatment of old vertebral compression fractures with kyphotic deformities is often not effective; therefore, clinical treatment is primarily surgical [1]. For severe old vertebral compression fractures with kyphotic deformities, vertebral column resection (VCR) surgery can relieve spinal cord compression and restore vector sequence balance, and this has been the classical clinical goal.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment of Old Vertebral Compression Fracture With Kyphosis by Different Reconstruction Methods: a Finite Element Analysis

Han¹,

Wang²,

Wu³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: In repair of vertebral compression fractures, there is a lack of effective biomechanical verification as to whether only half of the vertebral body and the upper and lower intervertebral discs has any effect on spinal biomechanics; there also remains debate as to the appropriate length of fixation.Methods: A model of old vertebral compression fractures with kyphosis was established based on CT data. Vertebral column resection (VCR) and posterior unilateral vertebral resection and reconstruction (PUVCR) were performed at T12; long- and short-segment fixation methods were applied, and we analyzed biomechanical changes after surgery.Results: Range of motion (ROM) decreased in all fixed models, with lumbar VCR decreasing the most and short posterior unilateral vertebral resection and reconstruction (SPUVCR) decreasing the least; in the long posterior unilateral vertebral resection and reconstruction (LPUVCR) model, the internal fixation system produced the maximum VMS stress of 213.25 MPa in a lateral bending motion, and a minimum stress of 40.22 MPa in a lateral bending motion in the SVCR.Conclusion: There was little difference in thoracolumbar ROM between PUVCR and VCR models, while thoracolumbar ROM was smaller in long-segment fixation than in short-segment fixation. In all models, the VMS was greatest at the screw-rod junction and greatest at the ribcage–vertebral body interface, which partly explains the high probability of internal fixation failure and prosthesis migration in these two positions.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Treatment of Old Vertebral Compression Fracture With Kyphosis by Different Reconstruction Methods: a Finite Element Analysis

Han¹,

Wang²,

Wu³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Based on previous related research [18][19][20], this study established a nite element model of an L1 burst fracture. Because the nite element model requires the internal structure to be as regular as possible during the meshing process, the model was repaired and slightly modi ed during the introduction process; however, the basic shape of the structure was basically retained.…”

Section: Discussionmentioning

confidence: 99%

Finite Element Analysis of the Indirect Reduction of Posterior Pedicle Screw Fixation for a Thoracolumbar Burst Fracture

Song¹,

Li²,

Zhu³

2020

Preprint

View full text Add to dashboard Cite

Background: Because burst fractures often involve damage to the column and posterior structures of the spine, the fracture block may invade the spinal canal and compress the spinal cord or the cauda equina, causing corresponding neurological dysfunction. When a thoracolumbar burst fracture is accompanied by the presence of bone in the spinal canal, whether posterior surgery requires spinal canal incision decompression remains controversial.Methods: Computed tomography (CT) images of the thoracolumbar spine of a 31-year-old male with an L1 burst fracture and Mimics 10.0 were used to establish a three-dimensional fracture model for simulating the indirect reduction process. The model was imported into Ansys 10.0, and a 1-10 mm displacement was loaded 10° behind the Z-axis on the upper endplate of the L1 vertebral body to simulate position reduction and open reduction. The displacement and stress changes in the intervertebral disc, fractured vertebral body and posterior longitudinal ligament were observed during reduction.Results: Under a displacement loaded 10° behind the Z-axis, the maximum stress in the vertebral body was concentrated on the upper disc of the injured vertebrae. The maximum displacement corresponded to the anterior edge of the vertebral body of the injured vertebrae, and the vertebral body height and the anterior lobes were essentially restored. When the displacement load was applied in the positive Z-axis direction, the maximum displacement corresponded to the posterior longitudinal ligament behind the injured vertebrae. Under a 6 mm load, the posterior longitudinal ligament displacement was 11.3 mm. Under an 8 mm load, this displacement significantly increased to 15.0 mm, and the vertebral stress was not concentrated on the intervertebral disc.Conclusions: The reduction of thoracolumbar burst fractures by positioning and distraction allowed the injured vertebrae to be restored to the normal height and kyphotic angle. The reduction of the posterior longitudinal ligament can move the bone block in the spinal canal into the reset space and yield good reset results.

show abstract

“…The symptoms of old vertebral fractures with kyphotic deformities include persistent low back pain, sometimes accompanied by spinal cord compression symptoms. Conservative treatment of old vertebral compression fractures with kyphotic deformities is often not effective; therefore, treatment is often surgical [1]. For severe old vertebral compression fractures with kyphotic deformities, vertebral column resection (VCR) surgery can relieve spinal cord compression and restore vector sequence balance.…”

Section: Introductionmentioning

confidence: 99%

Biomechanical finite element analysis of vertebral column resection and posterior unilateral vertebral resection and reconstruction osteotomy

Han

Wang

et al. 2021

J Orthop Surg Res

View full text Add to dashboard Cite

Background Regarding the repair of vertebral compression fractures, there is a lack of adequate biomechanical verification as to whether only half of the vertebral body and the upper and lower intervertebral discs affect spinal biomechanics; there also remains debate as to the appropriate length of fixation. Methods A model of old vertebral compression fractures with kyphosis was established based on CT data. Vertebral column resection (VCR) and posterior unilateral vertebral resection and reconstruction (PUVCR) were performed at T12; long- and short-segment fixation methods were applied, and we analyzed biomechanical changes after surgery. Results Range of motion (ROM) decreased in all fixed models, with lumbar VCR decreasing the most and short posterior unilateral vertebral resection and reconstruction (SPUVCR) decreasing the least; in the long posterior unilateral vertebral resection and reconstruction (LPUVCR) model, the internal fixation system produced the maximum VMS stress of 213.25 mPa in a lateral bending motion and minimum stress of 40.22 mPa in a lateral bending motion in the SVCR. Conclusion There was little difference in thoracolumbar ROM between PUVCR and VCR models, while thoracolumbar ROM was smaller in long-segment fixation than in short-segment fixation. In all models, the VMS was most significant at the screw-rod junction and greatest at the ribcage–vertebral body interface, partly explaining the high probability of internal fixation failure and prosthesis migration in these two positions.

show abstract

Single-stage posterior vertebral column resection and internal fixation for old fracture–dislocations of thoracolumbar spine: a case series and systematic review

Abstract: IV.

Cited by 10 publications

References 41 publications

Treatment of Old Vertebral Compression Fracture With Kyphosis by Different Reconstruction Methods: a Finite Element Analysis

Treatment of Old Vertebral Compression Fracture With Kyphosis by Different Reconstruction Methods: a Finite Element Analysis

Finite Element Analysis of the Indirect Reduction of Posterior Pedicle Screw Fixation for a Thoracolumbar Burst Fracture

Biomechanical finite element analysis of vertebral column resection and posterior unilateral vertebral resection and reconstruction osteotomy

Contact Info

Product

Resources

About