Anterior vertebroplasty of adjacent levels after vertebral body replacement

Geiger, Florian; Kafchitsas, Konstantinos; Rauschmann, Michael

doi:10.1007/s00586-011-1766-x

Cited by 18 publications

(6 citation statements)

References 24 publications

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“…3). 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63…”

Section: Resultsunclassified

Outcome Instruments in Spinal Trauma Surgery: A Bibliometric Analysis

Cutler

Guzman

Connolly

et al. 2016

Global Spine Journal

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Study Design Literature review. Objective To identify outcomes instruments used in spinal trauma surgery over the past decade, their frequency of use, and usage trends. Methods Five top orthopedic journals were reviewed from 2004 to 2013 for clinical studies of surgical intervention in spinal trauma that reported patient-reported outcome instruments use or neurologic function scale use. Publication year, level of evidence (LOE), and outcome instruments were collected for each article and analyzed. Results A total of 58 studies were identified. Among them, 26 named outcome instruments and 7 improvised questionnaires were utilized. The visual analog scale (VAS) for pain was used most frequently (43.1%), followed by the Short Form 36 (34.5%), Frankel grade scale (25.9%), Oswestry Disability Index (20.7%) and American Spinal Injury Association Impairment Scale (15.5%). LOE 4 was most common (37.9%), and eight LOE 1 studies were identified (10.3%). Conclusions The VAS pain scale is the most common outcome instrument used in spinal trauma. The scope of this outcome instrument is limited, and it may not be sufficient for discriminating between more and less effective treatments. A wide variety of functional measures are used, reflecting the need for a disease-specific instrument that accurately measures functional limitation in spinal trauma.

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Section: Resultsunclassified

Outcome Instruments in Spinal Trauma Surgery: A Bibliometric Analysis

Cutler

Guzman

Connolly

et al. 2016

Global Spine Journal

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“…Currently there are limited literature regarding anterior approach for complete vertebrectomy. However, with proper exposure, this technique is safe, direct and quick with complete visual control (6).…”

Section: Discussionmentioning

confidence: 99%

Anterior lumbar vertebrectomy via direct anterior approach: technical note

et al. 2017

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Clinical vignetteThe authors report the case of a 67-year-old female who presented with progressive worsening of low back pain for a period of 3 to 4 weeks, with acute severe deterioration over one week associated with left quadriceps weakness and absence of knee reflex. Imaging reveals a lytic lesion on the L4 vertebral body, with a pathological fracture. Positron emission tomography (PET) revealed significant uptake in the L4 vertebral body and minimal uptake in the lungs. Surgical removal of the lesion was recommended as the choice of treatment. An anterior approach for a complete vertebrectomy and a conventional minimally invasive posterior approach for lumbar interbody fusion 3 days postanterior vertebrectomy was planned. The anterior approach for complete L4 vertebrectomy was documented in the presented video.Technical note (Figure 1) The patient was placed in a supine position and a midline incision from the symphysis to the umbilicus was performed. Retroperitoneal dissection with blunt dissection was performed via a left sided approach, with fixed-bedbased round retractor and multiple retraction blades to reveal the retroperitoneum. Mobilization of the aorta and inferior vena cava was performed with ligation of segmental vessels. A key point here is ligation of the iliolumbar vein, which allows safe mobilization and retraction of the left common iliac vein and the inferior vena cava, which was performed using ligaclip and suture tie. These steps allow exposure of the appropriate surgical anatomy (Figure 2).The L4 vertebrae, L3/4 and L4/5 intervertebral discs were then removed. Complete vertebrectomy was performed using piecemeal technique using drill and bone nibblers of the L4 vertebral body along with the tumour.

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“…36,62 As cage subsidence is mainly caused by axial compression forces, cement augmentation of the adjacent endplates leads to higher construct stability and less reduction loss following vertebral body replacements and therefore should be considered in patients with HU values of 180 or less. 63,64 Furthermore, in anterior-posterior approaches short-segmental posterior instrumentation provides better fixation of the corporectomy level compared to long-segmental instrumentation. 65…”

Section: Multidisciplinary Strategies In Osteoporotic Patientsmentioning

confidence: 99%

Avoiding Spinal Implant Failures in Osteoporotic Patients: A Narrative Review

Schömig

Becker

Schönnagel

et al. 2023

Global Spine Journal

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Study design Narrative review. Objectives With an aging population, the prevalence of osteoporosis is continuously rising. As osseous integrity is crucial for bony fusion and implant stability, previous studies have shown osteoporosis to be associated with an increased risk for implant failure and higher reoperation rates after spine surgery. Thus, our review’s purpose was to provide an update of evidence-based solutions in the surgical treatment of osteoporosis patients. Methods We summarize the existing literature regarding changes associated with decreased bone mineral density (BMD) and resulting biomechanical implications for the spine as well as multidisciplinary treatment strategies to avoid implant failures in osteoporotic patients. Results Osteoporosis is caused by an uncoupling of the bone remodeling cycle based on an unbalancing of bone resorption and formation and resulting reduced BMD. The reduction in trabecular structure, increased porosity of cancellous bone and decreased cross-linking between trabeculae cause a higher risk of complications after spinal implant-based surgeries. Thus, patients with osteoporosis require special planning considerations, including adequate preoperative evaluation and optimization. Surgical strategies aim towards maximizing screw pull-out strength, toggle resistance, as well as primary and secondary construct stability. Conclusions As osteoporosis plays a crucial role in the fate of patients undergoing spine surgery, surgeons need to be aware of the specific implications of low BMD. While there still is no consensus on the best course of treatment, multidisciplinary preoperative assessment and adherence to specific surgical principles help reduce the rate of implant-related complications.

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Anterior vertebroplasty of adjacent levels after vertebral body replacement

Cited by 18 publications

References 24 publications

Outcome Instruments in Spinal Trauma Surgery: A Bibliometric Analysis

Outcome Instruments in Spinal Trauma Surgery: A Bibliometric Analysis

Anterior lumbar vertebrectomy via direct anterior approach: technical note

Avoiding Spinal Implant Failures in Osteoporotic Patients: A Narrative Review

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