Long-term results after posterior fixation of thoraco-lumbar burst fractures

Andress, Hans-Joachin; Braun, H; Helmberger, Thomas; Schürmann, Martin; Hertlein, H.; Hartl, Wolfgang H.

doi:10.1016/s0020-1383(02)00030-x

Cited by 71 publications

(70 citation statements)

References 27 publications

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“…Fractures of the thoracolumbar spine are major injuries that often require surgical intervention and are known to have an important impact on the long-term outcome after trauma [1]. Most of the studies on the outcome after fractures of the thoracolumbar spine focused on radiological parameters, return to work, activity, and pain [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] without consideration of specific HRQoL outcome measures. Assessment of HRQoL after thoracolumbar fractures with generic instruments such as Short Form-36 health survey (SF-36) has only been reported in a few works [1,[17][18][19][20], which are all limited by the low number of the used HRQoL instruments.…”

Section: Introductionmentioning

confidence: 99%

Association of clinical parameters of operatively treated thoracolumbar fractures with quality of life parameters

Thormann

Erli

Brügmann³

et al. 2013

Eur Spine J

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Purpose The intention of the current work was to assess the association between clinical parameters and seven different quality of life (QoL) instruments after surgical treatment of thoracolumbar spinal fractures after an average follow-up of 4.2 years. Methods The following human-related quality of life and PRO measures of 66 patients were correlated to clinical parameters such as fingertip-to-floor distance (FFD), Schober measurement, pressure and percussion pain in the lumbopelvine area (PPP), and paravertebral muscle tension: reALOS, SF-36, VAS, VAS spine score, BDI, the GBB-24, and the IES-R. Results Overall, there was a significant association between the clinical parameters of the thoracolumbar spine such as PPP, paravertebral muscle tension, FFD and Schober's sign on one side, and the seven tested instruments on the other side.Conclusions PPP and FFD as well as a small Schober measurement are clinical parameters which significantly influence QoL after surgical treatment of thoracolumbar fractures.

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Section: Introductionmentioning

confidence: 99%

Association of clinical parameters of operatively treated thoracolumbar fractures with quality of life parameters

Thormann

Erli

Brügmann³

et al. 2013

Eur Spine J

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show abstract

“…Indications for operative treatment may include neurologic deficit, unstable fracture, severe kyphosis greater than 35°, canal compromise greater than 50%, or posterior ligamentous complex injury [18,38]. Other arguments for surgery include decreased rates of neurologic deterioration, improved kyphosis correction, and facilitation of early mobilization that may decrease complications from prolonged bed rest [1,5,45].…”

mentioning

confidence: 99%

“…This is associated with kyphosis progression of 1°to 8.3°, spontaneous spinal canal remodeling (from an average of 26% to 36% compression at the time of injury to 12% to 18% at last followup) [3, 4, 10-14, 27, 41, 44], and rare cases of neurologic deterioration [21,34]. Observational studies of operative treatment suggest the majority of patients experience satisfactory pain and functional outcomes, kyphosis correction of 0.5°to 10.2°, reduction in canal stenosis, and no neurologic deterioration at last followup [1,2,5,10,11,21,27,41,42,52].…”

mentioning

confidence: 99%

Nonoperative versus Operative Treatment for Thoracolumbar Burst Fractures Without Neurologic Deficit: A Meta-analysis

Gnanenthiran¹,

Adie²,

Harris³

2012

Clinical Orthopaedics &Amp; Related Research

149

121

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“…The modern surgical treatment of thoracolumbar fractures is based on posterior transpedicular fixation techniques, which are angular stable and can provide an excellent stability in the three planes of the space [2]. After its introduction, the exclusive dorsal pedicle screw instrumentation with or without transpedicular bone grafting became widely popular and a standard procedure for stabilizing the injured thoracolumbar spine [13].…”

Section: Introductionmentioning

confidence: 99%

“…After its introduction, the exclusive dorsal pedicle screw instrumentation with or without transpedicular bone grafting became widely popular and a standard procedure for stabilizing the injured thoracolumbar spine [13]. But the long-term results of this approach today are controversial due to inconsistent reports and to a paucity of data on late outcome [2] and several authors reported increasing instability or a loss in kyphotic correction of the repaired spinal segment [12,20].…”

Section: Introductionmentioning

confidence: 99%

Is posterior fixation alone effective to prevent the late kyphosis after T-L fracture?

et al. 2013

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Introduction The posterior transpedicular fixation technique is a standard procedure for stabilizing the injured thoracolumbar spine but the long-term results of this approach are controversial. Clear guidelines are missing and the literature shows complete disagreement regarding indications, approaches, surgical techniques, and type of fixation. Material and method The objective of this study is to investigate if the surgical treatment by posterior approach alone is always enough to prevent the late kyphotic deformity through the retrospective analysis of 219 patients affected with a thoracolumbar injury. Follow-up examinations included radiographic measurements of the sagittal index (SI) and the sagittal plane kyphosis (SPK). Result Results show that, at the follow-up, the SI remains almost stable after the surgical correction, while the SPK (which describes the eventual injury of the affected intervertebral disc) decreases indicating a progressive regional kyphotic deformity. Thus, in some cases posterior fixation alone is not sufficient for long-term spinal stabilization and often can be not effective to prevent the late kyphotic deformity.

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Long-term results after posterior fixation of thoraco-lumbar burst fractures

Cited by 71 publications

References 27 publications

Association of clinical parameters of operatively treated thoracolumbar fractures with quality of life parameters

Association of clinical parameters of operatively treated thoracolumbar fractures with quality of life parameters

Nonoperative versus Operative Treatment for Thoracolumbar Burst Fractures Without Neurologic Deficit: A Meta-analysis

Is posterior fixation alone effective to prevent the late kyphosis after T-L fracture?

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