Combined Anterior Plus Posterior Stabilization Versus Posterior Short-Segment Instrumentation and Fusion for Mid-Lumbar (L2–L4) Burst Fractures

Korovessis, Panagiotis; Baikousis, Andreas; Zacharatos, Spyridon; Petsinis, Georgios; Κουρέας, Γεώργιος; Iliopoulos, Panagiotis

doi:10.1097/01.brs.0000209251.65417.16

Cited by 138 publications

(130 citation statements)

References 80 publications

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“…Hence, with relative frequencies being analyzed relative to the total number of participants, the sum of relative frequencies could exceed 100 %. Descriptive statistics and the Fisher exact test (significance level a = 0.05) were used to analyze any differences between the five world regions, and the influence of clinical experience (B10, [11][12][13][14][15][16][17][18][19][20] or [20 years). …”

Section: Discussionmentioning

confidence: 99%

“…We hypothesize that different measurement techniques are used to assess fracture kyphosis and vertebral body height loss. The use of different techniques could result in different measurements and thereby lead to treatment variability for certain types of spine fractures [17][18][19]. Moreover, the use of a standardized technique would facilitate a universal language, both in research and clinical settings.…”

Section: Introductionmentioning

confidence: 99%

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Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

et al. 2016

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Purpose To investigate whether wide variations are seen in the measurement techniques preferred by spine surgeons around the world to assess traumatic fracture kyphosis and vertebral body height loss (VBHL). Methods An online survey was conducted at two time points among an international community of spine trauma experts from all world regions. The first survey (TL-survey) focused on the thoracic, thoracolumbar and lumbar spine, the second survey (C-survey) on the subaxial cervical spine. Participants were asked to indicate which measurement technique(s) they used for measuring kyphosis and VBHL. Descriptive statistics, frequency analysis and the Fisher exact test were used to analyze the responses.Results Of the 279 invited experts, 107 (38.4 %) participated in the TL-survey, and 108 (38.7 %) in the C-survey. The Cobb angle was the most frequently used for all spine regions to assess kyphosis (55.6-75.7 %), followed by the wedge angle and adjacent endplates method. Concerning VBHL, the majority of the experts used the vertebral body compression ratio in all spine regions (51.4-54.6 %). The most frequently used combination for kyphosis was the Cobb and wedge angles. Considerable differences were observed between the world regions, while fewer differences were seen between surgeons with different degrees of experience. Conclusions This study identified worldwide variations in measurement techniques preferred by treating spine surgeons to assess fracture kyphosis and VBHL in spine trauma patients. These results establish the importance of standardizing assessment parameters in spine trauma care, and can be taken into account to further investigate these radiographic parameters.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

et al. 2016

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“…O uso de instrumentação segmentar com parafusos de pedículo através de uma abordagem posterior tradicional tem apresentado alta taxa de falha em ossos osteoporóticos [8][9][10][11] ; consequentemente, técnicas de instrumentação anterior mais enxerto ósseo estruturado, cages e placas foram introduzidos para aumentar a estabilidade da coluna anterior e mostraram-se efetivas [12][13][14][15][16] . Entretanto, estabilização anterior requer uma abordagem mais invasiva que é associada um tempo cirúrgico e de internação hospitalar prolongados, perda sanguínea, complicações do sítio doador de enxerto e, aumento da morbidade e mortalidade em pessoas idosas [12][13][14][15] .…”

Section: Objetivo: Evaluar El Resultado Funcional Y El Grado De Satisunclassified

“…Entretanto, estabilização anterior requer uma abordagem mais invasiva que é associada um tempo cirúrgico e de internação hospitalar prolongados, perda sanguínea, complicações do sítio doador de enxerto e, aumento da morbidade e mortalidade em pessoas idosas [12][13][14][15] . O presente estudo procurou avaliar prospectivamente a eficácia da cifoplastia em melhorar a função e liberar a dor em pacientes com fratura vertebral por insuficiência localizadas na coluna tóraco-lombar.…”

Section: Objetivo: Evaluar El Resultado Funcional Y El Grado De Satisunclassified

Cifoplastia no tratamento da fratura vertebral por insuficiência: avaliação funcional prospectiva

et al. 2011

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RESUMOObjetivo: Avaliar o resultado funcional e o grau de satisfação do tratamento cirúrgico utilizando cifoplastia em pacientes com fratura vertebral por insuficiência localizada na coluna tóraco-lombar. Métodos: Foi realizado um estudo prospectivo em pacientes adultos, com diagnóstico de fratura vertebral por insuficiência com evolução superior a oito semanas, apresentando dor no local da fratura e edema ósseo evidente ao exame de RM. A avaliação funcional foi realizada através do Oswestry Disability Index 2.0 e da Escala Visual Analógica de Dor no pré-e pós-operatório. A satisfação pessoal com o tratamento foi quantificada pela escala de Johnson. Resultados: Houve melhora significativa da dor com uma queda média de 6.4 pontos na Escala Visual Analógica de Dor ao final de doze meses de seguimento em comparação ao período pré-operatório (p < 00,5). A avaliação funcional mostrou 88% de resultados excelentes ou bons, sendo que sete pacientes (41%) apresentaram excelentes resultados e oito pacientes (47%) tiveram resultados bons. Dois pacientes (12%) mantiveram sua avaliação funcional inalterada. Quanto à graduação subjetiva de satisfação, 82% declararam-se satisfeitos sendo que 59% estavam completamente satisfeitos e 23% satisfeitos com mínimas restrições. Três pacientes (18%) declararam-se insatisfeitos com o resultado do procedimento. Conclusão: A cifoplastia mostrou-se efetiva em melhorar a função e liberar a dor em pacientes com fratura vertebral por insuficiência. A ocorrência de uma complicação grave (IAM) chama atenção para a necessidade de suporte hospitalar adequado durante a realização do procedimento.Descritores: Fraturas da coluna vertebral/cirurgia; Osteoporose/complicações; Fraturas por compressão/cirurgia.

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“…Pedicle screws have superior biomechanical as well as clinical data when compared to other methods of instrumentation [1,9,11,13]. Despite earlier concerns regarding the safety of thoracic pedicle screws insertion, introduction of newer techniques has lowered pedicle perforation rates [2,15].…”

Section: Introductionmentioning

confidence: 99%

Safety of thoracic pedicle screw application using the funnel technique in Asians: a cadaveric evaluation

2009

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The objective of this cadaveric study is to determine the safety and outcome of thoracic pedicle screw placement in Asians using the funnel technique. Pedicle screws have superior biomechanical as well as clinical data when compared to other methods of instrumentation. However, misplacement in the thoracic spine can result in major neurological implications. There is great variability of the thoracic pedicle morphometry between the Western and the Asian population. The feasibility of thoracic pedicle screw insertion in Asians has not been fully elucidated yet. A pre-insertion radiograph was performed and surgeons were blinded to the morphometry of the thoracic pedicles. 240 pedicle screws were inserted in ten Asian cadavers from T1 to T12 using the funnel technique. 5.0 mm screws were used from T1 to T6 while 6.0 mm screws were used from T7 to T12. Perforations were detected by direct visualization via a wide laminectomy. The narrowest pedicles are found between T3 and T6. T5 pedicle width is smallest measuring 4.1 ± 1.3 mm. There were 24 (10.0%) Grade 1 perforations and only 1 (0.4%) Grade 2 perforation. Grade 2 or worse perforation is considered significant perforation which would threaten the neural structures. There were twice as many lateral and inferior perforations compared to medial perforations. 48.0% of the perforations occurred at T1, T2 and T3 pedicles. Pedicle fracture occurred in 10.4% of pedicles. Intra-operatively, the absence of funnel was found in 24.5% of pedicles. In conclusion, thoracic pedicle screws using 5.0 mm at T1-T6 and 6.0 mm at T7-T12 can be inserted safely in Asian cadavers using the funnel technique despite having smaller thoracic pedicle morphometry.

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Combined Anterior Plus Posterior Stabilization Versus Posterior Short-Segment Instrumentation and Fusion for Mid-Lumbar (L2–L4) Burst Fractures

Cited by 138 publications

References 80 publications

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

Cifoplastia no tratamento da fratura vertebral por insuficiência: avaliação funcional prospectiva

Safety of thoracic pedicle screw application using the funnel technique in Asians: a cadaveric evaluation

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