Non-operative vs. percutaneous stabilization in Magerl’s A1 or A2 thoracolumbar spine fracture in adults: is it really advantageous for a good alignment of the spine? Preliminary data from a prospective study

Medici, Antonio; Meccariello, Luigi; Falzarano, Gabriele

doi:10.1007/s00586-014-3557-7

Cited by 19 publications

(9 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Patients' safety and experience, functional outcomes, and healthcare costs should always be considered. These key aspects further confirm that an appropriate pain control is warranted for our cohort of patients which could highlight the importance and relevance of our good results in terms of pain management, healthcare costs, and related safety of the intervention [18][19][20][21][22][23].…”

Section: Discussionsupporting

confidence: 58%

Wound Infiltration with Levobupivacaine, Ketorolac, and Adrenaline for Postoperative Pain Control after Spinal Fusion Surgery

et al. 2021

View full text Add to dashboard Cite

This study enrolled patients in from a single center who underwent primary spinal fusion procedure and divided them into two groups (group-control study). Purpose: Good local infiltration can reduce postoperative analgesic requirements and enable expedited discharge. Administration of a combination of levobupivacaine (200 mg/100 mL, 0.9% N-Saline), ketorolac (30 mg), and adrenaline (0.5 mg) as a wound infiltrate is recommended at an optimum combination. Overview of Literature: There is currently no consensus on the optimum intraoperative local infiltration of spinal surgery patients undergoing operative fusion. Methods: Patients who were enrolled in two spinal centers (over 24 months) undergoing primary spinal fusion procedures were allocated into two groups, comparing the type of local infiltration used at the time of the procedure. Group 1 received the combination of levobupivacaine (200 mg), ketorolac (30 mg), and adrenaline (0.5 mg), while group 2 received other types of local anesthetics. Primary outcome measures include patient-controlled analgesia (PCA) use, morphine consumption, and length of hospital stay. Secondary outcome measure are as follows: days of physiotherapy, pain score, side effects, and complications. Results: There are a total of 140 patients enrolled. Seventy-five patients enrolled were allocated to group 1, receiving the study combination, and 65 patients were assigned in group 2, receiving other local infiltrations. All primary outcome measures (consumption of morphine, use of PCA, and length of stay) were significantly higher in group 2 than the study combination (p<0.05). The secondary outcomes of pain scores and days of physiotherapy values were also significantly higher in group 2 (p<0.05). Patient satisfaction questionnaires gave significantly better results in group 1 (p<0.05). There were no significant statistical differences with regard to any postoperative complications between the two groups. Conclusions: Our data suggest that the studied wound infiltration is a safe and feasible option that could provide good postoperative pain control without significant side effects. It also allowed to reduce dependence of opioids and PCA, earlier postoperative mobilization, lower pain scores postoperatively, and reduced hospital stay.

show abstract

Section: Discussionsupporting

confidence: 58%

Wound Infiltration with Levobupivacaine, Ketorolac, and Adrenaline for Postoperative Pain Control after Spinal Fusion Surgery

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Thus, the LLIF procedure is considered to be a good option for safe, corrective surgery for elderly ASD patients because patients with ASD are commonly older in age. Percutaneous posterior fixation, which is applicable for flexible patients, would further reduce surgical invasiveness [ 30 , 31 , 32 , 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Lateral Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion as Corrective Surgery for Patients with Adult Spinal Deformity—A Propensity Score Matching Analysis

Yoshii

Morishita

et al. 2021

JCM

View full text Add to dashboard Cite

Lateral lumbar interbody fusion (LLIF) is increasingly performed as corrective surgery for patients with adult spinal deformity (ASD). This paper compares the surgical results of LLIF and conventional posterior lumbar interbody fusion (PLIF)/transforaminal lumbar interbody fusion (TLIF) in ASD using a propensity score matching analysis. We retrospectively reviewed patients with ASD who received LLIF and PLIF/TLIF, and investigated patients’ backgrounds, radiographic parameters, and complications. The propensity scores were calculated from patients’ characteristics, including radiographic parameters and preoperative comorbidities, and one–to-one matching was performed. Propensity score matching produced 21 matched pairs of patients who underwent LLIF and PLIF/TLIF. All radiographic parameters significantly improved in both groups at the final follow-up compared with those of the preoperative period. The comparison between both groups demonstrated no significant difference in terms of postoperative pelvic tilt, lumbar lordosis (LL), or pelvic incidence–LL at the final follow-up. However, the sagittal vertical axis tended to be smaller in the LLIF at the final follow-up. Overall, perioperative and late complications were comparable in both procedures. However, LLIF procedures demonstrated significantly less intraoperative blood loss and a smaller incidence of postoperative epidural hematoma compared with PLIF/TLIF procedures in patients with ASD.

show abstract

“…For a single-level vertebral fracture, four-screw pedicle fixation has been used in the respective upper and lower vertebrae [ 1 , 2 , 16 , 17 ]; however, this cannot achieve satisfactory reduction in the absence of ligament and annulus fibrosus traction. Moreover, the stress concentrated at the pedicle screws leads to a high incidence of loosening and breakage of fixation and loss of vertebral height or kyphosis [ 3 , 4 , 18 , 19 ]. In order to reduce the incidence of these complications, the screws were fixed to the injured vertebra [ 8 , 9 , 20 , 21 ]; this did not increase fixation length, and it maintained motion segments of the spine as much as possible, dispersed load bearing, supported the spine, and maintained reduction until bony fusion.…”

Section: Discussionmentioning

confidence: 99%

Transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach for thoracolumbar fractures: a retrospective study

Cai

2016

J Orthop Surg Res

View full text Add to dashboard Cite

BackgroundComplications in posterior pedicle screw fixation using a conventional posterior approach for thoracolumbar fractures include vertebral height loss, kyphosis relapse and breakage, or loosening of instrumentation. The purpose of this study was to evaluate the clinical effects of transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach for thoracolumbar fractures.MethodsWe retrospectively analyzed 50 patients with thoracolumbar fractures treated with transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach. Operative time, blood loss, visual analog scale (VAS) scores for back pain, and the relative height and Cobb angle of the fractured vertebrae were measured.ResultsThe average operative time was 71.8 min, and the blood loss was 155 ml. Postoperative VAS scores were significantly lower than preoperative scores (P = 0.08), but there was no difference between 1 week and 1 year postoperatively (P = 0.18). The postoperative relative heights of the fractured vertebrae were higher than the preoperative heights (P = 0.001, 0.005, 0.001), but there were no differences between 1 week and 1 or 2 years postoperatively (P = 0.24/0.16). The postoperative Cobb angles were larger than the preoperative angles (P = 0.002, 0.007, 0.001), but there were no differences between 1 week and 1 or 2 years postoperatively (P = 0.19/0.23).ConclusionsTranspedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach for thoracolumbar fractures achieved satisfactory results and can restore vertebral height, increase the stability of the anterior and middle columns of injured vertebrae, and decrease the risk of back pain.

show abstract

Non-operative vs. percutaneous stabilization in Magerl’s A1 or A2 thoracolumbar spine fracture in adults: is it really advantageous for a good alignment of the spine? Preliminary data from a prospective study

Abstract: Although the data are preliminary and based on data available in the literature, we can say that the Percutaneous posterior stabilization of thoracolumbar fractures in Magerl's A1 and A2 in adults is the ideal method for a good and functional alignment of the spine.

Cited by 19 publications

References 25 publications

Wound Infiltration with Levobupivacaine, Ketorolac, and Adrenaline for Postoperative Pain Control after Spinal Fusion Surgery

Wound Infiltration with Levobupivacaine, Ketorolac, and Adrenaline for Postoperative Pain Control after Spinal Fusion Surgery

Comparison of Lateral Lumbar Interbody Fusion and Posterior Lumbar Interbody Fusion as Corrective Surgery for Patients with Adult Spinal Deformity—A Propensity Score Matching Analysis

Transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach for thoracolumbar fractures: a retrospective study

Contact Info

Product

Resources

About