Long-Segment Versus Short-Segment Pedicle Screw Fixation Including Fractured Vertebrae for the Management of Unstable Thoracolumbar Burst Fractures

Choudhury, Abdullah Al Mamun; Alam, Md. Shah; Jonayed, Sharif; Dastagir, OZM; Jahan, M. Sarwar

doi:10.7759/cureus.35235

Cited by 4 publications

(3 citation statements)

References 36 publications

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“…As a result, 22 trials were included in the network meta-analysis. [8,9,11,12,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] The literature screening process is illustrated in Figure 1. Table 1 shows detailed information about the included studies.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

The efficacy of different segments fixation for treatment thoracolumbar fractures: A Bayesian network meta-analysis

He,

Zhong,

Zhou

et al. 2023

Medicine

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Background: We did this network meta-analysis to comprehensively compare the efficacy of different segments [intermediate segment (IS), short segment (SS) and long segment (LS)] in the fixation of thoracolumbar fractures. Methods: We searched studies from inception until January 20, 2023 through PubMed, Embase, Web of Science, and the Cochrane Library. All studies comparing different segments in the fixation of thoracolumbar fractures were included in this meta-analysis. Outcomes were anterior vertebral height ratio (AVHR), sagittal Cobb angle (SCA), visual analogue scale score, and implant failure rate. This network meta-analysis was performed by R software with gemtc package. Results: Finally, a total of 22 studies were finally included in this network meta-analysis. IS (WMD 2.43, 95% CrI 2.04–2.91) was more effective than SS in terms of the AVHR, and the difference was statistically significant. IS was more effective than LS in reducing SCA (WMD −2.87, 95% CrI −3.79 to −1.96) with statistically significant. Compared with SS, IS significantly reduced the SCA with statistically significant (WMD −2.52, 95% CrI −3.31 to −1.72). IS (WMD −2.87, 95% CrI −3.78 to −1.96) was more effective than LS, and the difference was statistically significant. Moreover, IS (WMD −2.52, 95% CrI −3.31 to −1.72) was more effective than SS, and the difference was statistically significant. Conclusion: IS was associated with a significant reduction in SCA, implant failure rate, and visual analogue scale compared to SS and LS, while having the most favorable impact on AVHR among all the treatments assessed.

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Section: Search Results and Study Characteristicsmentioning

confidence: 99%

The efficacy of different segments fixation for treatment thoracolumbar fractures: A Bayesian network meta-analysis

He,

Zhong,

Zhou

et al. 2023

Medicine

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“…Mahar et al, in their cadaverbased biomechanical study, proposed instrumenting pedicle screws in the fractured vertebra in short-segment fixation, which permits a three-point reduction of the fractured vertebra and enhances the biomechanical stability of the construct [16]. Multiple clinical studies on short-segment fixation of thoracolumbar burst fractures with pedicle screws in the fractured vertebra have reported clinical outcomes comparable to those of long-segment fixation [10,11,17].…”

Section: Discussionmentioning

confidence: 99%

Short segment posterior fixation of unstable thoracolumbar vertebral fractures with fractured vertebra augmentation with intermediate pedicle screw - a clinicoradiological analysis

Yadav

2024

Am J Neurodegener Dis

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Introduction: Unstable thoracolumbar burst fractures are routinely encountered in orthopedic practice. Recently, short-segment fixation with pedicle screw augmentation of the fractured vertebra for unstable thoracolumbar burst fractures has gained popularity. Nonetheless, the maintenance of the kyphotic correction during the follow-up period remains controversial. This study aimed to examine the clinical-radiological outcomes, complications, and functional outcomes of fractured vertebrae augmentation with intermediate pedicle screws in shortsegment instrumentation in acute thoracolumbar spine fractures. Methods: This retrospective study was conducted in the

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“…All patients were subjected to preoperative assessment with magnetic resonance imaging (MRI) and plain radiographs for surgical planning (Figure 2 ). A standard open posterolateral short-segment fusion with transpedicular screw fixation one level below and one level above the fracture site was conducted in all individuals, as previously described [ 13 ]. The whole procedure was performed under constant fluoroscopic navigation with C-ARM in anteroposterior (AP) and lateral views.…”

Section: Methodsmentioning

confidence: 99%

Posterolateral Instrumented Fusion in Elderly Patients With a Single Osteoporotic Vertebral Fracture: Evaluation of Health-Related Quality of Life

Kapetanakis,

Gkantsinikoudis,

Apostolakis

et al. 2024

Cureus

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Introduction Treatment of osteoporotic vertebral fractures (OVFs) is a factor that affects the quality of life and should be considered during management. In patients with a single OVF and neurologic deficit, surgical procedures aiming at neural decompression with instrumented fusion should be considered in elderly individuals. Posterolateral instrumented fusion (PLF) constitutes a largely performed fusion surgery for patients featuring indications for fusion surgery. The aim of this study was to determine the safety, effectiveness, and impact on health-related quality of life (HRQoL) of PLF surgery in elderly patients diagnosed with a single OVF. Methods This study was conducted at Interbalkan European Medical Center, Thessaloniki, Greece. Eighty (80) consecutive individuals with OVFs were subjected to PLF and recruited in this prospectively designed non-randomized study. Clinical evaluation was performed preoperatively and postoperatively at particular chronic intervals at one, three, six, and 12 months and two years. The assessment was conducted via the standardized Visual Analogue Scale (VAS) and Short-Form 36 (SF-36) Medical Health Survey Questionnaire for pain and HRQoL, respectively. Results No major perioperative complications were observed. All parameters of SF-36 presented significant improvement over the entire follow-up period with VAS scores reaching a plateau at six months. Depicted improvement of these parameters proves the beneficial role of PLF in elderly patients who suffered from a single OVF with or without referable neurological deficit. Conclusion OVFs have a significant impact on the quality of life of elderly patients, and surgical treatment with PLF with or without decompression can lead to functional recovery, pain relief, and HRQoL amelioration. Our results demonstrated that the outcomes of PLF in the surgical treatment of these patients are remarkably favorable, demonstrating the safety and efficacy of the technique.

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Long-Segment Versus Short-Segment Pedicle Screw Fixation Including Fractured Vertebrae for the Management of Unstable Thoracolumbar Burst Fractures

Cited by 4 publications

References 36 publications

The efficacy of different segments fixation for treatment thoracolumbar fractures: A Bayesian network meta-analysis

The efficacy of different segments fixation for treatment thoracolumbar fractures: A Bayesian network meta-analysis

Short segment posterior fixation of unstable thoracolumbar vertebral fractures with fractured vertebra augmentation with intermediate pedicle screw - a clinicoradiological analysis

Posterolateral Instrumented Fusion in Elderly Patients With a Single Osteoporotic Vertebral Fracture: Evaluation of Health-Related Quality of Life

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