Results of treatment of unstable thoracolumbar burst fractures using pedicle instrumentation with and without fracture-level screws

Ökten, Ali İhsan; Gezercan, Yurdal; Özsoy, Kerem Mazhar; Ateş, Tuncay; Menekşe, Güner; Aslan, Ali; Çetinalp, Erdal; Güzel, Aslan

doi:10.1007/s00701-015-2383-y

Cited by 42 publications

(48 citation statements)

References 33 publications

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“…They found that a screw at the fracture level resulted in a greater fracture reduction but they did not report long term results. 15 These results are different than the data of this study. Both Waqar and Sapkas report higher incidence of metal work failure compared to this series.…”

Section: Review Of the Literaturecontrasting

confidence: 92%

“…Posterior spinal instrumentation is the most frequent method of fixation due to the low morbidity and comorbidity. 15 Our results show that overall posterior fixation results in loss of correction over time. When there is no anterior support the injured intervertebral disc and the fractured vertebrae may collapse further and result in loss of the reduction by 7° to 9°.…”

Section: Review Of the Literaturementioning

confidence: 59%

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A Comparison of Three Different Methods of Fixation in the Management of Thoracolumbar Fractures

et al. 2017

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Section: Review Of the Literaturecontrasting

confidence: 92%

Section: Review Of the Literaturementioning

confidence: 59%

A Comparison of Three Different Methods of Fixation in the Management of Thoracolumbar Fractures

et al. 2017

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“…Recent literature has shown that the six-screw short-segment construct can effectively prevent early implantation, especially in those with LCS ≤7, and can provide satisfactory clinical results for thoracolumbar burst fractures [23,24]. Compared to traditional four-screw short-segment fixation, short-segment fixation with screws placed at the fractured level can achieve better correction with a lower rate of implant failure [7,8]. Lin et al and Liao et al also demonstrated that a six-screw shortsegment construct had a lower implant failure rate with better alignment maintenance compared to transpedicular grafting with short-segment instrumentation [18,25].…”

Section: Discussionmentioning

confidence: 99%

“…However, the disadvantages of long-segment posterior fixation are a long surgical time, high amounts of blood loss, and the sacrifice of two or more motion segments. More recently, six-screw short-segment posterior fixation, which involves the placement of two pedicle screws at the fractured vertebrae, has gained increasing attention because this method can reduce the surgical time and hospital costs, preserve motion segments compared to long-segment posterior fixation, and provide greater mechanical strength to prevent early implant failure compared with traditional four-screw short-segment posterior fixation [6][7][8][9]. In addition, some authors have advised that four-screw shortsegment instrumentation should be augmented by bone cement or bone substitute at the fractured vertebrae for maintaining alignment and preventing implant failure [10,11].…”

Section: Introductionmentioning

confidence: 99%

Short-Segment Instrumentation with Fractured Vertebrae Augmentation by Screws and Bone Substitute for Thoracolumbar Unstable Burst Fractures

Liao

Chen

2019

BioMed Research International

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Background. For thoracolumbar burst fractures, traditional four-screw (one above and one below) short-segment instrumentation is popular and has a high failure rate. Additional augmentation at the fractured vertebrae is believed to reduce surgical failure. The purpose of this study was to examine the clinical and radiographic results of patients who underwent short-segment posterior instrumentation with augmentation by screws and bone substitutes at the fractured vertebrae and to compare these data to those of patients who underwent long-segment instrumentation for thoracolumbar burst fractures. Methods. The study group had twenty patients who underwent short-segment instrumentation with additional augmentation by two screws and bone substitutes at the fractured vertebrae. The control group contained twenty-two patients who underwent eight-screw long instrumentation without vertebra augmentation. Local kyphosis and the anterior body height of the fractured vertebrae were measured. The severity of the fractured vertebrae was evaluated with the load sharing classification (LSC). Any implant failure or loss of correction >10° at the final follow-up was defined as surgical failure. Results. Both groups had similar distributions in terms of age, sex, the injured level, and the mechanism of injury before operation. During the operation, the study group had significantly less blood loss (136.0 vs. 363.6 ml, p=0.001) and required shorter operating times (146.8 vs. 157.5 minutes, p=0.112) than the control group. Immediately after surgery, the study group had better correction of the local kyphosis angle (13.4° vs. 11.9°, p=0.212) and restoration of the anterior height (34.7% vs. 31.0%, p=0.326) than the control group. At the final follow-up, no patients in the study group and only one patient in the control group experienced surgical failure. Conclusions. Patients with thoracolumbar burst fractures who received six-screw short-segment posterior fixators with augmentation at the level of the fractured vertebrae via injectable artificial bone substitute achieved satisfactory clinical and radiographic results, and this method could replace long-segment instrumentation methods used in unstable thoracolumbar burst fractures.

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“…Firstly, more postoperative morbidities are accompanied with the anterior approach as compared with the posterior approach [7][8][9]. In addition, spine surgeons are more familiar with posterior approach due to its easier application [10].…”

Section: Introductionmentioning

confidence: 99%

Effect of the Short-Segment Internal Fixation with Intermediate Inclined-Angle Screw at the Fractured Vertebrae on the Treatment of Denis type B thoracolumbar fracture

Xiong¹,

Huang

Wei³

et al. 2020

Preprint

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Background Short-segment internal fixation with straight-forward screw (SSIF-SF) and long-segment internal fixation (LSIF) are two major surgical options for thoracolumbar (TL) fracture, however, limitations of two surgical options are obvious. SSIF with inclined-angle screw (SSIF-IA) have been lately developed to take advantage of their benefits and minimize their adverse effects. METHODS Three different treatments were randomly performed in 69 consecutive TL fracture. 26 were allocated to treatment with SSIF–IA, 24 were assigned to treatment with SSIF–SF, 19 patients were randomized to treatment with LSIF. Sagittal Cobb’s angle (SCA), anterior vertebral body height (AVBH), vertebral body index (VBI) and spinal canal encroachment (SCE) were measured and assessed. Functional recovery Visual Analogue Scale (VAS) and Oswestry disability index (ODI) were also evaluated. RESULTS The value of incision length, mean blood loss, duration of operation and hospital stay in the SSIF–IA group and SSIF-SF group were significantly lower than those in the LSIF group. During 6 months and the latest follow-ups, the AVBH and VBI in the SSIF-IA group and LSIF group were significantly more improved than those in the SSIF–SF group (p < 0.05). The correction losses of AVBH and VBI of the fractured vertebrae in the SSIF-IA group and LSIF group were significantly lower than those in the SSIF–SF group (P<0.05). There was no significant difference of SCA among three groups. The average ODI scores in SSIF-IA and SSIF-SF group were significantly lower than those in the LSIF group. CONCLUSIONS The bio-mechanical stability of SSIF-IA was comparable to LSIF, but less invasive as compared with LSIF. SSIF–IA was effective and reliable operative technique for patients with Denis type B TL fracture.

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Results of treatment of unstable thoracolumbar burst fractures using pedicle instrumentation with and without fracture-level screws

Cited by 42 publications

References 33 publications

A Comparison of Three Different Methods of Fixation in the Management of Thoracolumbar Fractures

A Comparison of Three Different Methods of Fixation in the Management of Thoracolumbar Fractures

Short-Segment Instrumentation with Fractured Vertebrae Augmentation by Screws and Bone Substitute for Thoracolumbar Unstable Burst Fractures

Effect of the Short-Segment Internal Fixation with Intermediate Inclined-Angle Screw at the Fractured Vertebrae on the Treatment of Denis type B thoracolumbar fracture

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