Surgical Management of Thoracolumbar Spine Fractures with Incomplete Neurologic Deficits

Bradford, David S.; McBride, G G

doi:10.1097/00003086-198705000-00029

Cited by 230 publications

(124 citation statements)

References 0 publications

Supporting

Mentioning

114

Contrasting

Unclassified

Order By: Relevance

“…Eight patients had a total of 16 old thoracolumbar compression fractures at other levels: 4 in adjacent vertebrae, 6 in vertebrae two levels above or below the affected level, and 6 in vertebrae three or more levels above or below the affected level. Their neurological functions were assessed with a modified Frankel grading system (Table 2) [3]. Five patients had deficits of grade C, six had grade D1 deficits, two grade D2 deficits, and one grade D3 deficits.…”

Section: Patient Populationmentioning

confidence: 99%

See 1 more Smart Citation

Posterior instrumented fusion without neural decompression for incomplete neurological deficits following vertebral collapse in the osteoporotic thoracolumbar spine

2008

View full text Add to dashboard Cite

Previous reports have emphasized the importance of neural decompression through either an anterior or posterior approach when reconstruction surgery is performed for neurological deficits following vertebral collapse in the osteoporotic thoracolumbar spine. However, the contribution of these decompression procedures to neurological recovery has not been fully established. In the present study, we investigated 14 consecutive patients who had incomplete neurological deficits following vertebral collapse in the osteoporotic thoracolumbar spine and underwent posterior instrumented fusion without neural decompression. They were radiographically and neurologically assessed during an average follow-up period of 25 months. The mean local kyphosis angle was 14.6°at flexion and 4.1°at extension preoperatively, indicating marked instability at the collapsed vertebrae. The mean spinal canal occupation by bone fragments was 21%. After surgery, solid bony fusion was obtained in all patients. The mean local kyphosis angle became 5.8°immediately after surgery and 9.9°at the final follow-up. There was no implant dislodgement, and no additional surgery was required. In all patients, back pain was relieved, and neurological improvement was obtained by at least one modified Frankel grade. The present series demonstrate that the posterior instrumented fusion without neural decompression for incomplete neurological deficits following vertebral collapse in the osteoporotic thoracolumbar spine can provide neurological improvement and relief of back pain without major complications. We suggest that neural decompression is not essential for the treatment of neurological impairment due to osteoporotic vertebral collapse with dynamic mobility.

show abstract

Section: Patient Populationmentioning

confidence: 99%

“…Clinical outcomes for back pain were assessed using this classification. In addition, neurological function was evaluated using a modified Frankel grading system (Table 2) [3].…”

Section: Clinical Assessmentmentioning

confidence: 99%

Posterior instrumented fusion without neural decompression for incomplete neurological deficits following vertebral collapse in the osteoporotic thoracolumbar spine

2008

View full text Add to dashboard Cite

show abstract

“…Finally, surgical decompression more reliably restores neurologic function and decreases rehabilitation time [3][4][5][6]. The spinal cord must be decompressed at the site of compression if there is intent of relieving the source of pressure [7].…”

Section: Introductionmentioning

confidence: 99%

Thoracoscopically assisted corpectomy and percutaneous transpedicular instrumentation in management of burst thoracic and thoracolumbar fractures

et al. 2013

View full text Add to dashboard Cite

Study design This is a prospective observational study. Purpose The aim of this study was to determine whether the combination of thoracoscopically assisted corpectomy with posterior percutaneous transpedicular instrumentation in prone position achieves treatment goals in burst thoracic or thoracolumbar fractures and minimizes the associated morbidities. Methods Between December 2007 and December 2008, 26 patients with acute burst spinal fractures were operated upon in our hospital. Those patients underwent posterior percutaneous stabilization plus anterior thoracoscopically assisted corpectomy and fusion in prone position. Clinical and radiological outcomes of these patients were evaluated after a minimum follow-up period of 2 years. The Oswestry Disability Index (ODI) combined with clinical examination was used for clinical evaluation. Plain X-ray in two views was used for the radiological evaluation. Results The mean operative time was 248 min. The average blood loss was 765 ml. Ten patients had preoperative neurological deficits ranging from Frankel A to D. One patient did not show any neurological improvement at the final follow-up. The mean ODI at final follow-up was about 7. The mean preoperative kyphosis angle was 25.58°, improved to 9.2°postoperatively and to 13.8°at the final follow-up. No cases of implant failure were reported at the final follow-up.Conclusions Minimal invasive spinal techniques including thoracoscopic decompression and fusion and short segment posterior percutaneous instrumentation showed good clinical outcomes and can be considered as alternative to open procedures with decreased rates of morbidities in managing burst thoracic and thoracolumbar fractures.

show abstract

“…Preoperative neurologic deficit was classified using the information available at the COSS center according to Bradford and McBride's modification of the Frankel grading system (Table 2) 19 : The location and extension of the spinal tumors (not sacral tumors) could be classified into seven types according to the criteria by Tomita et al 20 ( Table 3). The location and extension of sacral tumors also were classified into four types according to the criteria by Tomita et al 21 ( Table 4, Fig.…”

Section: Evaluation Methodsmentioning

confidence: 99%

Osteosarcoma of the spine

Ozaki¹,

Flege²,

Liljenqvist³

et al. 2002

Cancer

View full text Add to dashboard Cite

Surgical Management of Thoracolumbar Spine Fractures with Incomplete Neurologic Deficits

Cited by 230 publications

References 0 publications

Posterior instrumented fusion without neural decompression for incomplete neurological deficits following vertebral collapse in the osteoporotic thoracolumbar spine

Posterior instrumented fusion without neural decompression for incomplete neurological deficits following vertebral collapse in the osteoporotic thoracolumbar spine

Thoracoscopically assisted corpectomy and percutaneous transpedicular instrumentation in management of burst thoracic and thoracolumbar fractures

Osteosarcoma of the spine

Contact Info

Product

Resources

About