The Necessity of Implant Removal after Fixation of Thoracolumbar Burst Fractures—A Systematic Review

Wang, Xing; Wu, Xiangdong; Zhang, Yanbin; Zhu, Zhenglin; Jiang, Jile; Li, Guanqing; Liu, Jiacheng; Shao, Jiashen; Sun, Yin

doi:10.3390/jcm12062213

Cited by 4 publications

(1 citation statement)

References 68 publications

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“…Both operators and their patients must be informed of the indications necessitating implant removal and have realistic expectations on the advantages and hazards. There was insu cient evidence to support routine removal of pedicle screw tools following complete fusion of thoracolumbar fractures, which could expose patients to avoidable risks like infection and costs [30]. Although there are discussions, it is not recommended to remove the implant in the literature, especially in cases with short segment posterior instrumentation + fusion since the fusion occurs throughout the construct segments.…”

Section: Short-segment Instrumentation Offers the Advantage Of Involv...mentioning

confidence: 99%

Should the Level of the Posterior Instrumentation Combined With the Intermediate Screw Be a Short Segment or a Long Segment in Thoracolumbar Fractures With Fusion to the Fractured Segment?

Suer,

Aydemir,

Kilicli

et al. 2024

Preprint

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Purpose It was aimed to compare the results of long segment posterior instrumentation with intermadiate pedicular screw + fusion at the level of the fractured segment including one vertebra above and one below the fractured vertebra (LSPI) and short segment posterior instrumentation with intermadiate pedicular screw + fusion at the level of the fractured segment including one vertebra above and one below the fractured vertebra (SSPI) in the surgical treatment of thoracolumbar vertebral fractures.Methods 90 patients with thoracolumbar vertebral (T11-L2) fractures operated between March 2015 and February 2022 were included in the study. The patients were divided into two groups as those who underwent LSPI (group A: n: 54, age: 40.3) and those who underwent SSPI (group B: n: 36, age: 39.7). Radiological evaluations like vertebral compression angle (VCA), vertebral corpus heights (VCH), intraoperative parameters and complications were compared between the groups.Results Correction in early postoperative VCA was statistically significantly better in Group A (p = 0.003). At 1-year follow-up, postoperative VCA correction was significantly more successful in group A (p = 0.001). There was no difference between the two groups in terms of correction loss in VCA measured at 1-year follow-up. There was no statistically significant difference between the two groups in terms of postoperative VCH, VCH at 1-year follow-up, and correction loss in VCH.Conclusion LSPI provides better postoperative kyphosis correction of the fractured vertebra than SSPI. Regarding of the segment level of posterior instrumentation, there was no difference between the two groups in terms of the loss of achieved correction of VCA, ABH, and PBH at 1-year follow-up. Operating a thoracolumbar fracture with LSPI will lengthen the operation and increase the number of intraoperative fluoroscopies compared to SSPI.

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Section: Short-segment Instrumentation Offers the Advantage Of Involv...mentioning

confidence: 99%

Should the Level of the Posterior Instrumentation Combined With the Intermediate Screw Be a Short Segment or a Long Segment in Thoracolumbar Fractures With Fusion to the Fractured Segment?

Suer,

Aydemir,

Kilicli

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Should the level of the posterior instrumentation combined with the intermediate screw be a short segment or a long segment in thoracolumbar fractures with fusion to the fractured segment?

Suer,

Aydemir,

Kilicli

et al. 2024

Eur J Trauma Emerg Surg

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C1-ring оsteosynthesis as a functionally preserving operation for unstable atlas fractures

Basankin,

Giulzatyan,

Magomedov

et al. 2024

Hir. pozvonoč.

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Objective. To analyze the dynamics of pain syndrome, quality of life and functional status of patients with unstable atlas fractures after C1-ring osteosynthesis.Material and Methods. Study design: observational retrospective case series study (n = 15). The intensity of pain syndrome was assessed using the VAS scale before surgery, 3 days, and 3 and 6 months after surgery. The quality of life was assessed using the Neck Disability Index (NDI) before surgery, and 3 and 6 months after surgery. Functional status, as well as cervical spine range of motion (head turn left/right, flexion/extension) was assessed 3 and 6 months after surgery. The integrity of the atlas bone ring and the degree of fusion after fixation were assessed using axial CT scans; and the lateral mass separation was assessed using frontal CT scans. The criterion for transverse ligament injury was a separation of lateral masses of more than 8.1 mm. Results. All patients had C1 fractures type 3B according to Gehweiler, out of them 7 patients (46.7 %) had traumatic injury to the atlas transverse ligament according to Dickman type 1, and 8 patients (53.3 according to Dickman type 2. The average age of patients was 40 years (12; 71), the male/female ratio was 2/1. In 7 patients (46.7 %), the cause of injury was diving, in 6 (40.0 %) it was a traffic accident, and in 2 (13.3 %) – a fall from a standing height. Observation of patients revealed a positive dynamics in the form of statistically significant regression of pain according to VAS before and 6 months after surgery from 6.8 (6.0; 8.0) to 1.0 (1.0; 0.0) points (Z = -3.434; p = 0.001). A positive trend was also noted in the form of a decrease in NDI scores and an improvement in the quality of life after 3 (Z = -3.411; p = 0.001) and 6 months after surgery (Z = -3.410; p = 0.001). The range of motion (turn left/right, flexion/extension) increased statistically significantly by the 6th month after C1-ring osteosynthesis, and its indicators were close to physiological ones. Postoperative CT scans showed positive dynamics in the form of statistically significant regression of the lateral mass separation from 10.4 mm (8.9; 11.4) to 2.2 mm (1.8; 2.6); Z = -3.408; p = 0.001. Complete fusion of the atlas fracture was observed after 12.5 months (8.5; 16.5).Conclusion. Isolated posterior osteosynthesis of the atlas ring for Gehweiler type 3B injury using a repositioning compression maneuver under distraction conditions is physiologically justified. It is a reliable method of stabilization, ensures the restoration of congruence and the entire range of motion in the atlanto-occipital and atlantoaxial joints and stability of the occipital-atlantoaxial complex. This operation contributes to a considerable and long-term reduction in the intensity of pain syndrome and a significant improvement in the quality of life.

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The Necessity of Implant Removal after Fixation of Thoracolumbar Burst Fractures—A Systematic Review

Cited by 4 publications

References 68 publications

Should the Level of the Posterior Instrumentation Combined With the Intermediate Screw Be a Short Segment or a Long Segment in Thoracolumbar Fractures With Fusion to the Fractured Segment?

Should the Level of the Posterior Instrumentation Combined With the Intermediate Screw Be a Short Segment or a Long Segment in Thoracolumbar Fractures With Fusion to the Fractured Segment?

Should the level of the posterior instrumentation combined with the intermediate screw be a short segment or a long segment in thoracolumbar fractures with fusion to the fractured segment?

C1-ring оsteosynthesis as a functionally preserving operation for unstable atlas fractures

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