Anterolateral Approach for Unstable Lumbar Burst Fracture with Anterior Compression

Hammad, Wael; Barania, Mohamed; Alaghory, Islam M.; El-Sherif, Ahmed Mahmoud

doi:10.4236/ojmn.2018.82017

Cited by 3 publications

(1 citation statement)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Despite the fact that many studies recommend against needless anterior surgery (particularly in young and otherwise healthy patients aged <40 years), anterior column support may be required in situations of elderly individuals with extensive destruction of the vertebral body and traumatic kyphosis. 24,26) Recently, the effectiveness of minimally invasive anterior procedure described in the present study is advocated for TL burst fractures because it may lead to reduction of fusion segment and better correction of traumatic kyphosis. 27) If posterior-only fixation is used for patients aged 40 years or older with PLC injuries, more invasive treatments may need to be taken into consideration, including vertebroplasty, cement-augmented screws, or lengthy fusion techniques like three-above, three-below level fixations.…”

Section: Discussionmentioning

confidence: 93%

Evaluation of Posterior Ligamentous Complex Injury in Thoracolumbar Burst Fractures: Correlation Analysis of CT and MRI Findings

Yoshikawa¹,

Nishimura

Nagashima

et al. 2023

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

The goal of this study is to perform correlation analysis of Computed tomography (CT) and magnetic resonance imaging (MRI) results in posterior ligament complex (PLC) injury and define the morphological traits of thoracolumbar (TL) burst fractures connected to PLC injury. Forty patients with surgically repaired TL burst fractures between January 2013 and December 2020 were retrospectively analyzed. The patients were split into two groups for comparison based on MRI (Group P: patients with a confirmed or suspected PLC injury; Group N: patients with PLC injury denied). The radiographic morphological examination based on CT scans and clinical evaluation was performed and compared between two groups. The thoracolumbar injury classification and severity score (TLICS), the load sharing classification (LSC) scores, and the number of patients with neurological impairments were considerably greater in Group P. Loss of height of the fracture (loss height), local kyphosis of the fracture (local kyphosis), and supraspinous distance were significantly higher in Group P and significantly associated with PLC injuries indicating severe vertebral body destruction and traumatic kyphosis in multivariate logistic analysis [odds ratio: 1.90, 1.06, and 1.13, respectively]. Cutoff value for local kyphosis obtained from the receiver operating characteristic curve was 18.8. If local kyphosis is greater than 18.8 degrees on CT scans, we should take into account the probability of the highly damaged burst fracture associated with PLC injury. In this situation, we should carefully assess MRI to identify the spinal cord injury or spinal cord compression in addition to PLC injury because these instances likely present with neurological abnormalities.

show abstract

Section: Discussionmentioning

confidence: 93%

Evaluation of Posterior Ligamentous Complex Injury in Thoracolumbar Burst Fractures: Correlation Analysis of CT and MRI Findings

Yoshikawa¹,

Nishimura

Nagashima

et al. 2023

Neurol. Med. Chir.(Tokyo)

View full text Add to dashboard Cite

show abstract

Kyphotic deformity correction of different operative approaches in patients with thoracolumbar burst fractures: a meta-analysis

Xuan

Liao

2020

E3S Web Conf.

View full text Add to dashboard Cite

Background: As a common traumatic disease in spine surgery, thoracolumbar burst fractures (TLBF) often leads to complications such as back pain, kyphotic deformity and nerve damage, causing severe physical defects and economic burden on patients. Objective: To explore kyphotic deformity correction of different operative approaches for TLBF. Design of research: Systematic review and meta-analysis are utilized to compare the efficacy of different approaches for postoperative kyphotic deformity in TLBF patients. Methods: English documents that discussed TLBF with different operative approaches were searched from various databases. The obtained documents were screened and evaluated. Results: The comparison and analysis of preoperative Cobb angle, early-postoperative Cobb angle correction, and follow-up Cobb angle correction between the anterior and posterior approach groups showed no statistical significance [MD=0.97, 95% CI (-0.44, 2.38), P=0.18; MD=0.25, 95% CI (-0.04, 0.54), P=0.10; MD=-0.12, 95% CI (-0.44, 0.19), P=0.45]. Conclusion: While treating TLBF symptoms, both the anterior and posterior approaches were effective in correcting postoperative kyphosis deformity. Therefore, while determining a treatment method, the age and the tolerance to the surgery of each patient should be considered for the surgical treatment options. This study provides new ideas for clinical treatment of TLBF in the future.

show abstract

A Prospective Study of Posterior (Transpedicular) Approach versus Anterior (Transthoracic/Thoracoabdominal) Approach for Posttraumatic Compression Fracture of Thoracolumbar Vertebra in a Tertiary Care Center: Comparison of Clinical and Radiological Outcomes

Varshney

Datta

Deb

et al. 2020

Indian Journal of Neurotrauma

View full text Add to dashboard Cite

Objective The aim of this article was to analyze the clinical and radiological outcomes of transpedicular decompression (posterior approach) and anterolateral approach in patients with traumatic thoracolumbar spinal injuries. Methods It was a prospective study of patients with fractures of dorsolumbar spine from December 2011 to December 2013. A total of 60 patients with traumatic spinal injuries were admitted during the study period (December 2011–2013), of which 51 cases were finally selected and taken for operations while 3 were eventually lost in follow-up. Twenty patients were operated by anterolateral approach, titanium mesh cage, and fixation with bicortical screws. Twenty-eight patients were treated with posterior approach and transpedicular screw fixation. Clinical and radiographic evaluations were performed on all 48 patients before and after surgery. Results There were 48 patients of thoracolumbar burst fractures with 40 male and 8 female patients. Range of follow-up was from 1 month to 20 months, with a mean of 7.4. Preoperatively in anterior group, 65% of the patients were bed ridden, 20% patients were able to walk with support, and 15% of the patients were able to walk without support. In posterior group, 78.57% patients were bed ridden, 10.71% were able to walk with support, and 10.71% patients were able to walk without support. Kyphotic angle changes were seen in 16 patients out of 18 in anterior group and 20 patients in posterior group out of 25. Out of 18 patients in anterior group, 14 showed reduction in kyphotic angle of 10 to 100 (improvement), with mean improvement of 4.070. In posterior group, 7 patients showed improvement of 10 to 80 (reduction in kyphotic angle) whereas 13 patients showed deterioration of 1 to 120. The mean improvement was 2.140 in 7 patients and mean deterioration was 4.920. No statistical difference was found (p > 0.05) regarding improvement in urinary incontinence during the follow-up period. Conclusion There are significant differences in anterior and posterior approaches in terms of clinical improvement. Compared with posterior approach, the anterolateral approach can reduce fusion segment and well maintain the kyphosis correction. The selection of treatment should be based on clinical and radiological findings, including neurological deficit.

show abstract

Anterolateral Approach for Unstable Lumbar Burst Fracture with Anterior Compression

Cited by 3 publications

References 17 publications

Evaluation of Posterior Ligamentous Complex Injury in Thoracolumbar Burst Fractures: Correlation Analysis of CT and MRI Findings

Evaluation of Posterior Ligamentous Complex Injury in Thoracolumbar Burst Fractures: Correlation Analysis of CT and MRI Findings

Kyphotic deformity correction of different operative approaches in patients with thoracolumbar burst fractures: a meta-analysis

A Prospective Study of Posterior (Transpedicular) Approach versus Anterior (Transthoracic/Thoracoabdominal) Approach for Posttraumatic Compression Fracture of Thoracolumbar Vertebra in a Tertiary Care Center: Comparison of Clinical and Radiological Outcomes

Contact Info

Product

Resources

About