Fratura toracolombar do tipo explosão: correlação entre a cifose residual e função após o tratamento cirúrgico

Sadatsune, Daniel Akira; Costa, Pedro Pereira da; Caffaro, Maria Fernanda Silber; Umeta, Ricardo Shigueaki Galhego; Meves, Robert; Avanzi, Osmar

doi:10.1590/s0102-36162012000400012

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…In recent decades, several studies have provided evidence that short-segment posterior fixation with screw fixation at the level of the fracture is sufficient to achieve stability in some injury patterns, such as burst fractures, avoiding the need for circumferential reconstruction and long segment instrumented thoracolumbar fusion. 2,[4][5][6][7] Over this period, biomechanical analyses have yielded basic knowledge, which led to the development of synthetic materials with greater rigidity and better preparation for load sharing across the three columns described by Denis. 4.8 The dissemination of minimally invasive surgery concepts has drawn the attention of surgeons to the proven minimization of soft tissue injury, reduction of intraoperative blood loss and better postoperative pain scores than those of other approaches.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Instrumentation Without Arthrodesis for Thoracolumbar Burst Fractures (A3/A4, B): A Retrospective Study

et al. 2021

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Objective: There is still no consensus as to the treatment options for thoracolumbar burst fractures, although these fractures are widely described in the literature. The aim of this study was to evaluate the clinical and radiological outcomes of percutaneous instrumentation without arthrodesis as a method of fixation of these lesions. Methods: This retrospective, cross-sectional study evaluated 16 patients by measuring regional kyphosis using the Cobb method and the scores for quality of life and return to work (Oswestry Disability Index, VAS, SF-36 and Denis). Results: Six months after surgical treatment, 62.5% of all patients showed minimal disability according to the Oswestry Disability Index, maintenance of regional kyphosis correction and no synthesis failure. Conclusions: The clinical and radiological outcomes of the study suggest that minimally invasive fixation is indicated for the treatment of thoracolumbar burst fractures. Level of evidence IV; Observational study: retrospective cohort.

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Section: Introductionmentioning

confidence: 99%

Percutaneous Instrumentation Without Arthrodesis for Thoracolumbar Burst Fractures (A3/A4, B): A Retrospective Study

et al. 2021

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Anterior versus posterior approach in traumatic thoracolumbar burst fractures deemed for surgical management: Systematic review and meta-analysis

Tan

Rutges

Marion

et al. 2019

Journal of Clinical Neuroscience

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Background. Uncertainties remain regarding the optimal surgical approach (anterior or posterior) in the treatment of traumatic thoracolumbar burst fractures. We aim to compare the surgical, radiological and functional outcomes in anterior versus posterior approaches in adult patients with traumatic thoracolumbar burst fractures deemed appropriate for surgical management. Methods. A systematic review using five electronic databases (PubMed, Web of Science, EMBASE, Google scholar, Cochrane Database) and adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. The authors reviewed comparative studies evaluating anterior versus posterior approaches in terms of clinical, surgical, radiographic and functional patient outcomes. Qualitative analysis was performed. Where suitable, meta-analysis was performed to compute pooled estimates of the differences between anterior and posterior approaches. Results. A total of six studies (three observational, one prospective non-randomized trial, two randomized controlled trials) were included. There were no cases of neurological decline postoperatively regardless of approach. Meta-analysis demonstrates a longer duration (Mean Difference (MD) +81.68, 95% CI 39.20 to 123.16, p <0.001) and increased estimated blood loss (MD+ 426.27, 95% CI 119.84 to 732.70, p = 0.006) for the anterior as compared to the posterior approach. No difference between approaches was found with regards to length of hospital stay, late postoperative kyphotic angle, construct failure rate, instrumentation revision rate, rate of return to work, and total hospital charges. Limitations include heterogeneity across studies and inclusion of both neurologically-intact and non-intact patients. Conclusion. Considering the similarities in neurological, radiological and functional outcomes between the anterior and posterior approaches, the longer duration and estimated blood loss in the anterior approach should be a point of consideration when selecting the surgical approach undertaken. To advance current evidence, future studies should compare the anterior and posterior approaches in non-intact patients with traumatic thoracolumbar burst fractures. Level of Evidence: Level III systematic review and meta-analyses

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The Diagnostic Process of Spinal Post-traumatic Deformity

Gendt

Benneker

Joaquim

et al. 2023

Clinical Spine Surgery: A Spine Publication

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Objective: To evaluate the opinion of experts in the diagnostic process of clinically relevant Spinal Post-traumatic Deformity (SPTD).Summary of Background Data: SPTD is a potential complication of spine trauma that can cause decreased function and quality of life impairment. The question of when SPTD becomes clinically relevant is yet to be resolved. Methods:The survey of 7 cases was sent to 31 experts. The case presentation was medical history, diagnostic assessment, evaluation of diagnostic assessment, diagnosis, and treatment options. Means, ranges, percentages of participants, and descriptive statistics were calculated.Results: Seventeen spinal surgeons reviewed the presented cases. The items' fracture type and complaints were rated by the participants as more important, but no agreement existed on the items of medical history. In patients with possible SPTD in the cervical spine (C) area, participants requested a conventional radiograph (CR) (76%-83%), a flexion/extension CR (61%-71%), a computed tomography (CT)-scan (76%-89%), and a magnetic resonance (MR)-scan (89%-94%). In thoracolumbar spine (ThL) cases, full spine CR (89%-100%), CT scan (72%-94%), and MR scan (65%-94%) were requested most often. There was a consensus on 5 out of 7 cases with clinically relevant SPTD (82%-100%). When consensus existed on the diagnosis of SPTD, there was a consensus on the case being compensated or decompensated and being symptomatic or asymptomatic.Conclusions: There was strong agreement in 5 out of 7 cases on the presence of the diagnosis of clinically relevant SPTD. Among spine experts, there is a strong consensus to use CT scan and MR scan, a cervical CR for C-cases, and a full spine CR for ThLcases. The lack of agreement on items of the medical history

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Fratura toracolombar do tipo explosão: correlação entre a cifose residual e função após o tratamento cirúrgico

Cited by 5 publications

References 13 publications

Percutaneous Instrumentation Without Arthrodesis for Thoracolumbar Burst Fractures (A3/A4, B): A Retrospective Study

Percutaneous Instrumentation Without Arthrodesis for Thoracolumbar Burst Fractures (A3/A4, B): A Retrospective Study

Anterior versus posterior approach in traumatic thoracolumbar burst fractures deemed for surgical management: Systematic review and meta-analysis

The Diagnostic Process of Spinal Post-traumatic Deformity

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