Restoration of Anterior Vertebral Height by Short-Segment Pedicle Screw Fixation with Screwing of Fractured Vertebra for the Treatment of Unstable Thoracolumbar Fractures

Özdemi̇r, Bülent; Kanat, Ayhan; Erturk, Cihangir; Batcik, Osman Ersagun; Balık, Mehmet Sabri; Yazar, Uğur; Çeliker, Fatma Beyazal; Metin, Yavuz; İnecikli, Mehmet Fatih; Güvercin, Ali Rıza

doi:10.1016/j.wneu.2016.11.133

Cited by 36 publications

(27 citation statements)

References 51 publications

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“…SSPF with the screwing of fractured vertebra at unstable thoracolumbar fracture levels is as effective as LSPF to restore the anterior vertebral height for the treatment of unstable thoracolumbar fractures. [ 18 ] Two-levels-above and one-level-below pedicle screw fixation in unstable thoracolumbar burst fractures was useful to prevent progressive kyphosis and preserve one motion segment distally and was as effective as LSPF in terms of correction loss, kyphosis recurrence, and patient satisfaction. [ 20 , 21 ]…”

Section: Discussionmentioning

confidence: 99%

Extent and location of fixation affects the biomechanical stability of short- or long-segment pedicle screw technique with screwing of fractured vertebra for the treatment of thoracolumbar burst fractures

Wang

Han

et al. 2018

Medicine

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Intermediate screw fixation at the fracture level has been widely accepted to treat thoracolumbar burst fractures, but no study has shown the effect of the extent and location of fixation. The effect of the extent and location of fixation on short- or long-segment pedicle screw fixation through intermediate screw fixation at the fracture level in the treatment of thoracolumbar burst fractures is discussed.Posterior intermediate screw fixation techniques in treating T12 vertebral fracture models were simulated and compared using finite element methods; the fixation techniques included M3-L1 (bilateral 3 monoaxial pedicle screw fixation from L1 to T11), M3-L2, M4-L1 (bilateral 4 monoaxial pedicle screw fixation from L1 to T10), M4-L2, M4-L3, and M5-L2 (bilateral 5 monoaxial pedicle screw fixation from L2 to T10). Range of motion (ROM) and largest von Mises stress (LVMS) of the instrumentations were recorded and analyzed.No significant differences were observed in the mean ROM of all states of motion between the M3-L1 model and the other fixation models except for M5-L2. The LVMS of the pedicle screws and rods all occurred during flexion. The LVMS values of the pedicle screws were larger in the M3-L2 fixation model and M4-L3 fixation model than in the other fixation models. The M3-L1 model presented a significantly smaller mean LVMS of the pedicle screws in all states of motion than the M3-L2 model (P = .026). The LVMS values of the rods were larger in the M3-L2 fixation model, M4-L3 fixation model, and M4-L2 fixation model than in the other fixation models. No significant differences were observed in the mean LVMS of the rods in all states of motion among all the fixation models.When choosing short-segment pedicle screw fixation with the screwing of fractured vertebrae to treat thoracolumbar fractures, we suggest M3-L1 over M3-L2. More severe injuries can be considered to identify an alternative treatment to long-segment monoaxial pedicle fixation constructs such as the M4-L1 and M5-L2 techniques.

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Section: Discussionmentioning

confidence: 99%

Extent and location of fixation affects the biomechanical stability of short- or long-segment pedicle screw technique with screwing of fractured vertebra for the treatment of thoracolumbar burst fractures

Wang

Han

et al. 2018

Medicine

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“…Surgical managements such as PV or PK are widely preferred for the vertebral height restoration, the kyphosis correction and pain relief. However, the OVCFs patients often suffer many comorbidities and the general anesthesia is a great risk for them [6,[9][10]. The PV is usually performed under local anesthesia, which facilitates the communication and cooperation between the surgeons and patients during the surgery so that the surgeons can obtain timely and accurate feedback from the patients and ensure the surgery safety of the operation [11][12][13][14].…”

Section: Discussionmentioning

confidence: 99%

The clinical efficacy of three application methods of local anesthesia in percutaneous vertebroplasty: A retrospective single-center cohort study

Liang

Zhong

Huang

et al. 2020

Preprint

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Background: Although various studies have described the methods of anaesthesia in percutaneous vertebroplasty(PV) in treating osteoporotic vertebral compression fractures (OVCFs), there is still no consensus on the optimal treatment regimen.The study aims to investigate the efficacy of three application methods of local anesthesia in PV treating OVCFs.Methods：A total of 96 patients of OVCFs were reviewed and divided into three groups(A: lidocaine, B: ropivacaine, C: lidocaine+ropivacaine). The visual analog scale(VAS), blood pressure(BP), heart rate(HR), blood oxygen saturation(BOS), surgery time were recorded at the points of before puncture, puncture, cement injection, and after surgery.Results: The mean age of the patients was 74.13±7.02 years in group A, 70.47±5.50 years in group B, and 73.07±7.51 years respectively without significant difference. No significant differences were found in the sex, age, hospital stay, surgery time, blood loss, and cement volume. During the period of before surgery and 4-hour after surgery, the VAS in group C decreased significantly at the period of puncture, cement injection, immediately after surgery. Overall, the systolic BP, diastolic BP, HR, BOS during the different period among the groups, there were no significant differences except the HR in the period of the puncture in group C was slower than that in other groups and HR in the period of cement injection in the group A was faster than other two groups. A correlation was observed between the VAS and the period of cement injection(r=0.5358), after surgery(r=0.5775) in group C.Conclusion: In conclusion, the use of the lidocaine in combination with ropivacaine could relieve the effective intraoperative pain in PV treating OVCFs patients which is reliable and safe.

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“…Posterior intermediate screw fixation at the fracture level can help improve and maintain the kyphosis correction, and the biomechanical stability also can be increased [4–18]. However, no studies have compared the hybrid Mps and Pps fixation techniques with regard to the ROM, VMS of the instrumentations, and IDPs of the adjacent segments.…”

Section: Discussionmentioning

confidence: 99%

“…Posterior short-segment pedicle screw fixation is widely used for the management of traumatic thoracolumbar burst fractures [1–3], posterior intermediate screw fixation technique (ISFT) at the fracture level can help improve and maintain the kyphosis correction, and the biomechanical stability also can be increased [4–18]. As a result, improved design and implantation techniques of pedicle screws such as polyaxial pedicle screws have reduced the rate of a pedicle screw and rod breakage and facilitated efficient application of the connecting rod without undue stress on the construct [5, 11, 12, 19–21].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical comparison of posterior intermediate screw fixation techniques with hybrid monoaxial and polyaxial pedicle screws in the treatment of thoracolumbar burst fracture: a finite element study

et al. 2019

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Background To compare the biomechanical characteristics of different posterior intermediate screw fixation techniques (ISFTs) with hybrid monoaxial pedicle screws (Mps) and polyaxial pedicle screws (Pps) used in thoracolumbar burst fractures. Methods Fixation techniques are compared with regard to the von Mises stress (VMS) of the instrumentations and intradiscal pressures (IDPs) of the adjacent segments by finite element method (FEM). Results The redistributed ROM of the fixation models with Pps fixed at the lowest segment was twice of the other fixation models in flexion and extension. The largest value of maximal VMS of a pedicle screw was located at the lowest pedicle screws when Mps are fixed at the lowest segment. The largest value of maximal VMS of the rods was decreased when more Pps are fixed at the models. Maximal IDPs of the upper adjacent segments were all larger than those of the lower adjacent segments. The maximal IDPs of the fixation model with MPs fixed at the lowest segment were larger than the other fixation models in flexion and extension. Conclusions Polyaxial pedicle screws could be placed at the upper or the median segment for the facilitated efficient application of the connecting rod. We should focus on the adjacent segmental degeneration especially the upper adjacent segment in the fixation model with Mps fixed at the lowest segment.

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Restoration of Anterior Vertebral Height by Short-Segment Pedicle Screw Fixation with Screwing of Fractured Vertebra for the Treatment of Unstable Thoracolumbar Fractures

Cited by 36 publications

References 51 publications

Extent and location of fixation affects the biomechanical stability of short- or long-segment pedicle screw technique with screwing of fractured vertebra for the treatment of thoracolumbar burst fractures

Extent and location of fixation affects the biomechanical stability of short- or long-segment pedicle screw technique with screwing of fractured vertebra for the treatment of thoracolumbar burst fractures

The clinical efficacy of three application methods of local anesthesia in percutaneous vertebroplasty: A retrospective single-center cohort study

Biomechanical comparison of posterior intermediate screw fixation techniques with hybrid monoaxial and polyaxial pedicle screws in the treatment of thoracolumbar burst fracture: a finite element study

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