Radiographic Measurement Parameters in Thoracolumbar Fractures: A Systematic Review and Consensus Statement of the Spine Trauma Study Group

Keynan, Ory; Fisher, Charles G.; Vaccaro, Alexander R.; Fehlings, Michael G.; Oner, F. Cumhur; Dietz, John; Kwon, Brian K.; Rampersaud, Raj; Bono, Christopher M.; France, John C.; Dvorak, Marcel F.

doi:10.1097/01.brs.0000201261.94907.0d

Cited by 181 publications

(127 citation statements)

References 32 publications

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“…It is worth mentioning that many studies investigating kyphosis measurement techniques only focus on the thoracic and lumbar spine [23][24][25][26]. Moreover, those studies were performed in a single center or small group setting, which makes them subjective to bias and less representative for a worldwide perspective.…”

Section: Discussionmentioning

confidence: 99%

“…This is a useful method to assess the structural integrity of the fractured vertebral body, specifically, that of the anterior and middle columns of the injured vertebra. Interestingly, based on the results of a systematic literature review, the Spine Trauma Study Group recommended to routinely use the AVBC % method to assess VBHL [26]. We think that additional reliability studies are needed to substantiate such recommendations.…”

Section: Discussionmentioning

confidence: 99%

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Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

et al. 2016

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Purpose To investigate whether wide variations are seen in the measurement techniques preferred by spine surgeons around the world to assess traumatic fracture kyphosis and vertebral body height loss (VBHL). Methods An online survey was conducted at two time points among an international community of spine trauma experts from all world regions. The first survey (TL-survey) focused on the thoracic, thoracolumbar and lumbar spine, the second survey (C-survey) on the subaxial cervical spine. Participants were asked to indicate which measurement technique(s) they used for measuring kyphosis and VBHL. Descriptive statistics, frequency analysis and the Fisher exact test were used to analyze the responses.Results Of the 279 invited experts, 107 (38.4 %) participated in the TL-survey, and 108 (38.7 %) in the C-survey. The Cobb angle was the most frequently used for all spine regions to assess kyphosis (55.6-75.7 %), followed by the wedge angle and adjacent endplates method. Concerning VBHL, the majority of the experts used the vertebral body compression ratio in all spine regions (51.4-54.6 %). The most frequently used combination for kyphosis was the Cobb and wedge angles. Considerable differences were observed between the world regions, while fewer differences were seen between surgeons with different degrees of experience. Conclusions This study identified worldwide variations in measurement techniques preferred by treating spine surgeons to assess fracture kyphosis and VBHL in spine trauma patients. These results establish the importance of standardizing assessment parameters in spine trauma care, and can be taken into account to further investigate these radiographic parameters.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

et al. 2016

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“…This process transformed the measured angle from an absolute value, into a relative one. The result was a more useful parameter, which could be used to guide surgical indications, as well as the amount of desirable correction [24].…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopically assisted corpectomy and percutaneous transpedicular instrumentation in management of burst thoracic and thoracolumbar fractures

et al. 2013

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Study design This is a prospective observational study. Purpose The aim of this study was to determine whether the combination of thoracoscopically assisted corpectomy with posterior percutaneous transpedicular instrumentation in prone position achieves treatment goals in burst thoracic or thoracolumbar fractures and minimizes the associated morbidities. Methods Between December 2007 and December 2008, 26 patients with acute burst spinal fractures were operated upon in our hospital. Those patients underwent posterior percutaneous stabilization plus anterior thoracoscopically assisted corpectomy and fusion in prone position. Clinical and radiological outcomes of these patients were evaluated after a minimum follow-up period of 2 years. The Oswestry Disability Index (ODI) combined with clinical examination was used for clinical evaluation. Plain X-ray in two views was used for the radiological evaluation. Results The mean operative time was 248 min. The average blood loss was 765 ml. Ten patients had preoperative neurological deficits ranging from Frankel A to D. One patient did not show any neurological improvement at the final follow-up. The mean ODI at final follow-up was about 7. The mean preoperative kyphosis angle was 25.58°, improved to 9.2°postoperatively and to 13.8°at the final follow-up. No cases of implant failure were reported at the final follow-up.Conclusions Minimal invasive spinal techniques including thoracoscopic decompression and fusion and short segment posterior percutaneous instrumentation showed good clinical outcomes and can be considered as alternative to open procedures with decreased rates of morbidities in managing burst thoracic and thoracolumbar fractures.

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“…Regional kyphotic angle (RKA) was measured as the angle between superior endplate of vertebral body above the affected level and inferior endplate of vertebral body below the affected level. 8 ( Figure 1) Measurements were done and repeated twice by 2 blinded radiologists and the averages were taken. Assessment of radiological fusion at follow-up was based on the presence of trabecular bone bridging at the osteotomy site according to Brantigan et al, 1 CT scanning was used for preoperative deformity assessment and also to evaluate bone fusion at the latest follow-up ( Figure 2).…”

Section: Methodsmentioning

confidence: 99%

Modified Pedicle Subtraction Osteotomy for Posttraumatic Kyphosis: Long Term Follow-Up

Sleem

2017

Egyptian Spine Journal

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Background Data: Post traumatic kyphosis (PTK) of the thoracolumbar spine is a severe complication of spine fractures and its management can be quite challenging. Pedicle subtraction osteotomy includes posteriorly based wedge resection of the posterior column and both pedicles, with the hinge located at the anterior cortex of the vertebral body. It has been developed to achieve significant deformity correction. It does not involve the adjacent disc which is usually affected and represents a cause of pain, neurological compression and progression of deformity. Modified pedicle subtraction osteotomy (MPSO) including resection of posteriorly based wedge of posterior column and both pedicles together with the damaged disc to achieve correction and solid fusion between the affected vertebra and the adjacent one. It seems to be more suitable for the management of PTK. Purpose: The purpose of this prospective study is to review our experience with modified Pedicle subtraction osteotomy (MPSO) technique for the management of thoracolumbar posttraumatic kyphosis (PTK). Study Design: Prospective cohort clinical case study. Patients and Methods: From February 2010 to July 2014, 14 consecutive patients with PTK were managed by MPSO. The patients were followed clinically and radiologically. Back pain VAS, Denis work scale and regional kyphotic angle (RKA) were recorded and analyzed preoperatively, postoperative and at the latest follow up. Results: The study included 14 patients with an average age of 38. 43±6.63 (26 -48) years. The follow up period was 46.29±15.45 months. The average operative time was 286.43±12.74 minutes and per-operative blood loss

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Radiographic Measurement Parameters in Thoracolumbar Fractures: A Systematic Review and Consensus Statement of the Spine Trauma Study Group

Cited by 181 publications

References 32 publications

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

Measurement of kyphosis and vertebral body height loss in traumatic spine fractures: an international study

Thoracoscopically assisted corpectomy and percutaneous transpedicular instrumentation in management of burst thoracic and thoracolumbar fractures

Modified Pedicle Subtraction Osteotomy for Posttraumatic Kyphosis: Long Term Follow-Up

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