Treatment of thoracolumbar burst fractures without neurologic deficit by indirect reduction and posterior instrumentation: bisegmental stabilization with monosegmental fusion

Müller, Urs; Berlemann, U.; Sledge, John B.; Schwarzenbach, Othmar

doi:10.1007/s005860050175

Cited by 163 publications

(117 citation statements)

References 31 publications

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“…84.6% corresponded to Frankel E (16 cases), 2 cases to Frankel D (10.26%) and one patient to Frankel C (5.13%) [37,38]. Injured levels were: T12 (n=5, 20.8%), L1 (n=10, 41.7%), L2 (n=6.…”

Section: Methodsmentioning

confidence: 99%

“…Surgical management presents potential benefits including neural decompression, spinal anatomy restoration and inmediate stability, which improves the integral rehabilitation of patients and allows them a rapid return to work [1,19,27,32,34,37,38,43,47,49,52,53]. Historically, most surgical techniques solved the problem of instability by fusion of mobile segments.…”

Section: Introductionmentioning

confidence: 99%

“…Negative effects in spine fusion have been reported, including pseudoarthosis, spinal stenosis, spondylolysis and accelerated degeneration of non-fused segments [5,28,39,44,48]. The main argument to fuse in thoracolumbar spine fractures is the lack of correction noticed in surgeries without arthrodesis, which is mainly caused by the degeneration of intervertebral discs involved in the fracture [3,9,27,30,31,37,38,43], or by the presence of capsuloligamentous disruptive injuries of the posterior column [34,40,55].…”

Section: Introductionmentioning

confidence: 99%

“…They reported a high percentage of segments with mobility and without facetary degenerative changes once the instrumentation was removed. Later, the introduction of pedicular instrumentation allowed to reduce fixation levels (short fixations) and preserve mobility of unaffected segments [5,11,30,31,32,34,37,38,52,53]. In 1993, Lindsey and Dick [31] reported the presence of residual mobility after removal of pedicular instrumentation, observing that the segments with end plate or intervertebral disc (IVD) disruption go to ankylosis.…”

Section: Introductionmentioning

confidence: 99%

“…There is still controversy and few studies available on clinical and imaging evolution, and on residual mobility of non-fused vertebral segments, which are temporarily included in instrumentations of TLF [5,30,34,38,46]. Recent reports observed the presence of healthy IVDs in non-fused segments once the instrumentation was removed [18,41,42,45].…”

Section: Introductionmentioning

confidence: 99%

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Residual mobility of instrumented and non-fused segments in thoracolumbar spine fractures

et al. 2006

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The surgical management of thoracolumbar fractures presents potential benefits. However, the surgery solve the instability by fusion of mobile segments. We incorporate in our treatment algorithms, the use of restricted arthrodesis at injured levels, regardless of longer instrumentations, as well as the use of non-fused transitory stabilizations, based on the conviction that in non-fused segments without traumatic disc injury, mobility persists once the instrumentation is removed. The goals of this study were to compare the mobility of non-fused segments after hardware removal to a normal range of motion and to find prognostic pre-op imaging patterns. We reviewed 21 consecutive patients who underwent surgery with preservation of mobile segments (nonfused segments included in the construction) in order to recover mobility after removal of instrumentation, performed between 1995 and 2001. All patients were treated by indirect reduction with posterior transpedicular instrumentation. Clinical and radiological outcome was analyzed after an average follow-up of 46.6 months. Satisfactory subjective outcome results were obtained in 94.7%. The dynamic radiological follow-up study showed 75% (21 segments) with normal or decreased range of motion (ROM) and 25% (7 segments) without mobility. The non-fused segments with hardware removal before 10 months of evolution presented a normal or decreased mobility in 83.2% while the segments with hardware removal after 10 months showed 68.8% of mobility. The intervertebral disc (IVD)'s with normal initial MRI morphology preserved their mobility in 81.9%. Complications occurred in four patients: two superficial wound infections and two patients presented a late fracture of one USS Schanz. The results of this study prove that in thoracolumbar fractures, non-fused spinal segments included in pedicular instrumentation maintained mobility in a high percentage once the hardware is removed. 75% of the segments presented a normal or decreased ROM.

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“…84.6% corresponded to Frankel E (16 cases), 2 cases to Frankel D (10.26%) and one patient to Frankel C (5.13%) [37,38]. Injured levels were: T12 (n=5, 20.8%), L1 (n=10, 41.7%), L2 (n=6.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Residual mobility of instrumented and non-fused segments in thoracolumbar spine fractures

et al. 2006

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Percutaneous Kyphoplasty in Traumatic Fractures

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Balloon Kyphoplasty

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This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically those of translation, reprinting, re-use of illustrations, broadcasting, reproduction by photocopying machines or similar means, and storage in data banks. Product Liability: The publisher can give no guarantee for all the information contained in this book. This does also refer to information about drug dosage and application thereof. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.

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Treatment of thoracolumbar burst fractures without neurologic deficit by indirect reduction and posterior instrumentation: bisegmental stabilization with monosegmental fusion

Cited by 163 publications

References 31 publications

Residual mobility of instrumented and non-fused segments in thoracolumbar spine fractures

Residual mobility of instrumented and non-fused segments in thoracolumbar spine fractures

Percutaneous Kyphoplasty in Traumatic Fractures

Balloon Kyphoplasty

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