Safety and efficacy studies of kyphoplasty, mesh-container-plasty, and pedicle screw fixation plus vertebroplasty for thoracolumbar osteoporotic vertebral burst fractures

Li, Yimin; Qian, Yunfan; Shen, Guangjie; Tang, Chengxuan; Zhong, Xiqiang; Su, He

doi:10.1186/s13018-021-02591-3

Cited by 11 publications

(14 citation statements)

References 26 publications

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“… 27 ) If posterior-only fixation is used for patients aged 40 years or older with PLC injuries, more invasive treatments may need to be taken into consideration, including vertebroplasty, cement-augmented screws, or lengthy fusion techniques like three-above, three-below level fixations. 28 ) The consequences of ignoring PLC injuries can be particularly important for elderly patients with poor bone quality.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Posterior Ligamentous Complex Injury in Thoracolumbar Burst Fractures: Correlation Analysis of CT and MRI Findings

Yoshikawa¹,

Nishimura

Nagashima

et al. 2023

Neurol. Med. Chir.(Tokyo)

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The goal of this study is to perform correlation analysis of Computed tomography (CT) and magnetic resonance imaging (MRI) results in posterior ligament complex (PLC) injury and define the morphological traits of thoracolumbar (TL) burst fractures connected to PLC injury. Forty patients with surgically repaired TL burst fractures between January 2013 and December 2020 were retrospectively analyzed. The patients were split into two groups for comparison based on MRI (Group P: patients with a confirmed or suspected PLC injury; Group N: patients with PLC injury denied). The radiographic morphological examination based on CT scans and clinical evaluation was performed and compared between two groups. The thoracolumbar injury classification and severity score (TLICS), the load sharing classification (LSC) scores, and the number of patients with neurological impairments were considerably greater in Group P. Loss of height of the fracture (loss height), local kyphosis of the fracture (local kyphosis), and supraspinous distance were significantly higher in Group P and significantly associated with PLC injuries indicating severe vertebral body destruction and traumatic kyphosis in multivariate logistic analysis [odds ratio: 1.90, 1.06, and 1.13, respectively]. Cutoff value for local kyphosis obtained from the receiver operating characteristic curve was 18.8. If local kyphosis is greater than 18.8 degrees on CT scans, we should take into account the probability of the highly damaged burst fracture associated with PLC injury. In this situation, we should carefully assess MRI to identify the spinal cord injury or spinal cord compression in addition to PLC injury because these instances likely present with neurological abnormalities.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Posterior Ligamentous Complex Injury in Thoracolumbar Burst Fractures: Correlation Analysis of CT and MRI Findings

Yoshikawa¹,

Nishimura

Nagashima

et al. 2023

Neurol. Med. Chir.(Tokyo)

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“…By drawing the ROC curve and analyzing AUC, it was found that the preoperative vertebral compression degree was positively correlated with the risk of postoperative VHL. Therefore, when patients are found to have preoperative vertebral compression of ≥38.5%, it is recommended to prevent postoperative VHL by combining pedicle screw internal fixation with transforaminal injury implants or percutaneous kyphoplasty/percutaneous vertebroplasty 18–20 …”

Section: Discussionmentioning

confidence: 99%

“…Therefore, when patients are found to have preoperative vertebral compression of ≥ 38.5%, it is recommended to prevent postoperative VHL by combining pedicle screw internal fixation with transforaminal injury implants or percutaneous kyphoplasty/percutaneous vertebroplasty. [18][19][20] Effect of Other Relevant Factors on Vertebral Height Loss After Internal Fixation…”

Section: Effect Of Preoperative Degree Of Vertebral Compression and P...mentioning

confidence: 99%

Analysis of Influencing Factors of Vertebral Height Loss After Pedicle Screw Fixation of Thoracolumbar Fracture

Shi

Zhang

Wang

et al. 2023

Clinical Spine Surgery: A Spine Publication

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Objective: To explore the related factors of vertebral height loss (VHL) after pedicle screw fixation of thoracolumbar fracture and to determine the optimum prediction point. Summary of Background Data:With the widespread application of thoracolumbar fracture internal fixation, VHL after the operation is increasingly presented. However, there is no unified conclusion on the specific cause of VHL and how to predict it.Methods: A total of 186 patients were selected and divided into the loss group (n = 72) and the not-loss group (n = 114) according to whether the fractured vertebral height was lost after the operation. The two groups were compared concerning sex, age, body mass index, osteoporosis self-assessment tool for Asians (OSTA), fracture types, number of fractured vertebrae, preoperative Cobb angle and compression degree, number of screws, and extent of vertebral restore. Univariate analysis and Multivariate logistic regression analysis were performed to identify the independent factors for the VHL with the receiver operating characteristic curve and the optimal prediction value was calculated according to area under the curve.Results: Multivariate logistic regression analysis showed that OSTA (P < 0.05) and preoperative vertebral compression (P < 0.05) were significantly correlated with postoperative VHL, which were independent risk factors for postoperative VHL. The OSTA of 2.32 and the preoperative vertebral compression degree of 38.5% were the best prediction points for postoperative VHL based on the Youden Index analysis. Conclusions:The OSTA and preoperative vertebral compression were independent risk factors for VHL. The risk of postoperative VHL was significantly higher when the OSTA was ≤ 2.32 or the preoperative vertebral compression was ≥ 38.5%.

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“…Reactions. 3 ml of fasting venous blood was drawn, centrifuged, and processed to see at 3500 rpm, and serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), norepinephrine (NE), and cortisol (Cor) levels were detected by applying enzymelinked immunoassay [11], and serum creatine kinase (CK) was determined by applying electrochemiluminescence method [12]. Levels and the related operations were performed strictly according to the instructions.…”

Section: Inflammatory Factors and Stressmentioning

confidence: 99%

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

Zhou

Chen

Gao

et al. 2022

Contrast Media & Molecular Imaging

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Objective. To analyze the influence of minimally invasive arch root nailing internal fixation surgery on tissue traumatic stress response in patients with vertebral fractures and explore the advantages of this treatment. Methods. One hundred and thirty-six patients with vertebral fractures admitted to our hospital from January 2020 to January 2022 were selected and divided into two groups based on the treatment method: the control group was treated with open arch root nail internal fixation surgery and the study group was treated with minimally invasive arch root nail internal fixation. The lumbar spine function, ODI, VAS, JOA score, complications, inflammation, and stress response were compared between the two groups. Results. After the operation, the ratio of intervertebral space and anterior edge height increased, and the Cobb angle decreased in both groups; the surgical incision, hospital stay, and operation time in the study group were shorter than those in the control group, and the intraoperative drainage volume and intraoperative blood loss were smaller than those in the control group ( P < 0.05 ); before surgery, there was no significant difference in ODI and VAS scores between the two groups ( P > 0.05 ). After surgery, the ODI and VAS scores in the two groups were significantly decreased, and the JOA score was significantly increased; complications occurred in the control group and the study. The incidence of complications in the study group was lower than that in the control group ( P < 0.05 ); after surgery, compared with the control group, the serum TNF-α, CRP levels, and stress response indexes of the study group decreased more significantly ( P < 0.05 ). Conclusion. Minimally invasive pedicle screw fixation has high safety and obvious advantages. The patient’s stress response index and pain level are low, and it will not cause obvious damage to the patient. The postoperative lumbar spine function is significantly improved, which is beneficial to the patient’s postoperative recovery. It is easy to operate, will not damage the thoracic and lumbar vertebrae significantly, and the fluoroscopy time is relatively short, and it has a good recovery effect. Therefore, minimally invasive internal arch nailing surgery can be used as the preferred treatment for patients with vertebral fractures.

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Safety and efficacy studies of kyphoplasty, mesh-container-plasty, and pedicle screw fixation plus vertebroplasty for thoracolumbar osteoporotic vertebral burst fractures

Cited by 11 publications

References 26 publications

Evaluation of Posterior Ligamentous Complex Injury in Thoracolumbar Burst Fractures: Correlation Analysis of CT and MRI Findings

Evaluation of Posterior Ligamentous Complex Injury in Thoracolumbar Burst Fractures: Correlation Analysis of CT and MRI Findings

Analysis of Influencing Factors of Vertebral Height Loss After Pedicle Screw Fixation of Thoracolumbar Fracture

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

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