Posterior percutaneous reduction and fixation of thoraco-lumbar burst fractures

Proietti, Luca; Scaramuzzo, Laura; Schirò, Giuseppe; Sessa, S.; D’Aurizio, G.; Tamburrelli, Francesco Ciro

doi:10.1016/j.otsr.2014.06.003

Cited by 25 publications

(22 citation statements)

References 25 publications

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“…After full text assessment, 11 articles were deemed eligible. 14 , 15 , 30 – 38 Additionally, 26 reviews and meta-analyses were screened for further potentially eligible references, which led to the identification of another primary study. 39 …”

Section: Resultsmentioning

confidence: 99%

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Does Operative or Nonoperative Treatment Achieve Better Results in A3 and A4 Spinal Fractures Without Neurological Deficit?

Rometsch

Spruit

Härtl

et al. 2017

Global Spine Journal

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Study Design:Systematic literature review with meta-analysis.Objective:Thoracolumbar (TL) fractures can be treated conservatively or surgically. Especially, the treatment strategy for incomplete and complete TL burst fractures (A3 and A4, AOSpine classification) in neurologically intact patients remains controversial. The aim of this work was to collate the clinical evidence on the respective treatment modalities.Methods:Searches were performed in PubMed and the Web of Science. Clinical and radiological outcome data were collected. For studies comparing operative with nonoperative treatment, the standardized mean differences (SMD) for disability and pain were calculated and methodological quality and risk of bias were assessed.Results:From 1929 initial matches, 12 were eligible. Four of these compared surgical with conservative treatment. A comparative analysis of radiological results was not possible due to a lack of uniform reporting. Differences in clinical outcomes at follow-up were small, both between studies and between treatment groups. The SMD was 0.00 (95% CI −0.072, 0.72) for disability and −0.05 (95% CI −0.91, 0.81) for pain. Methodological quality was high in most studies and no evidence of publication bias was revealed.Conclusions:We did not find differences in disability or pain outcomes between operative and nonoperative treatment of A3 and A4 TL fractures in neurologically intact patients. Notwithstanding, the available scores have been developed and validated for degenerative diseases; thus, their suitability in trauma may be questionable. Specific and uniform outcome parameters need to be defined and enforced for the evaluation of TL trauma.

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Section: Resultsmentioning

confidence: 99%

“… 15 Six additional comparative studies had a different focus, and 3 studies compared different types of surgical treatment. 34 , 37 , 38 Another 2 studies compared the outcome of patients with different degrees of injury severity, 31 , 36 and 1 study, designed as an RCT, compared 2 types of conservative treatment. 30 …”

Section: Resultsmentioning

confidence: 99%

Does Operative or Nonoperative Treatment Achieve Better Results in A3 and A4 Spinal Fractures Without Neurological Deficit?

Rometsch

Spruit

Härtl

et al. 2017

Global Spine Journal

View full text Add to dashboard Cite

show abstract

“…Secondly, the author said that multilevel fracture was one of the exclusion criteria in this study [1]. But, the Fig.…”

mentioning

confidence: 83%

“…We read with interest Proietti's study [1] and wish to congratulate the authors on work which adds to our knowledge and understanding of the difficult clinical problem of choosing minimal invasive surgery for treatment of thoracic and lumbar burst fractures. However, we have some concerns regarding the paper and wish to share them.…”

mentioning

confidence: 99%

Comments on: “Posterior percutaneous reduction and fixation of thoraco-lumbar burst fractures” by L. Proietti, L. Scaramuzzo, G.R. Schirò et al. published in Orthop Traumatol Surg Res 2014;100:455–60

Peng

Jiao

2015

Orthopaedics & Traumatology: Surgery & Research

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“…The surgical treatment via posterior approaches, known as traditional open surgery, was popular for decades. In recent years, percutaneous pedicle screw fixation technique has been widely used [2,3]. The use of additional screws in the intermediate pedicles is also disputable.…”

Section: Introductionmentioning

confidence: 99%

A comparison of three different surgical procedures in the treatment of type A thoracolumbar fractures: a randomized controlled trial

Lyu¹,

Chen

Tang

et al. 2016

International Orthopaedics (SICOT)

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Purpose The aim of the study was to evaluate the efficacy of three different surgical procedures in the treatment of type A thoracolumbar fractures. Materials and methods Between September 2012 and January 2015, a total of 90 patients with type A thoracolumbar fractures were randomly assigned into three groups of 30 each. Patients in group A, B, and C were treated with threelevel percutaneous fixation, two-level percutaneous fixation, and three-level open fixation, respectively. Blood loss, duration of surgery, VAS scores, Cobb angles, and anterior height ratios of fractured vertebrae were collected for statistical analysis.Results The average follow-up was 17.7 months. Postoperative Cobb angles were significantly corrected and anterior height ratios of fractured vertebrae were well restored in all three groups (p < 0.01). Back pain was efficiently relieved according to VAS score change (p < 0.01). There were significant differences in values of blood loss and post-operative VAS scores (at three months) between group A and group C (p < 0.01). No significant difference concerning post-operative anterior height ratios of fractured vertebrae, Cobb angles and correction losses was observed between group A and group B (p = 0.580, 0.840, 0.215, respectively). Conclusion Percutaneous fixation not only provides the same reduction effect as open fixation, but also has an advantage of causing less operation related trauma which is beneficial to post-operative rehabilitation. The efficacy of three-level percutaneous fixation and two-level percutaneous fixation in the treatment of type A thoracolumbar fractures is not significantly different.

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Posterior percutaneous reduction and fixation of thoraco-lumbar burst fractures

Abstract: Level IV. Retrospective study.

Cited by 25 publications

References 25 publications

Does Operative or Nonoperative Treatment Achieve Better Results in A3 and A4 Spinal Fractures Without Neurological Deficit?

Does Operative or Nonoperative Treatment Achieve Better Results in A3 and A4 Spinal Fractures Without Neurological Deficit?

Comments on: “Posterior percutaneous reduction and fixation of thoraco-lumbar burst fractures” by L. Proietti, L. Scaramuzzo, G.R. Schirò et al. published in Orthop Traumatol Surg Res 2014;100:455–60

A comparison of three different surgical procedures in the treatment of type A thoracolumbar fractures: a randomized controlled trial

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