Thoracic and Lumbar Spine Injury: Evidence-Based Diagnosis, Management, and Outcomes

Gomez, Giselle I.; Li, Guan Q.; Valido, Austin A.; Stoner, Austin J.; Bromley-Dulfano, Rebecca A.; Sheira, Dina; Gonzalez, Cayo A.; Khan, Suleman I.; Choi, Jeff; Zygourakis, Corinna C.; Weiser, Thomas G.

doi:10.1177/00031348231216479

Cited by 2 publications

(1 citation statement)

References 61 publications

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“…This modification to the classification system still uses a score of greater than 4 as the threshold for operative management in the surgical treatment algorithm 45 . TL AOSIS removes points for the integrity of the PLC and instead adds clinical modifiers for neurologic status 46 . Most pediatric TL trauma can be classified as type A, compression-type injuries 47 .…”

Section: Classificationmentioning

confidence: 99%

Evaluation and Management of Thoracolumbar Spine Trauma in Pediatric Patients

Bonsignore-Opp,

O'Donnell,

Agha

et al. 2024

JBJS Reviews

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» Pediatric thoracolumbar trauma, though rare, is an important cause of morbidity and mortality and necessitates early, accurate diagnosis and management.» Obtaining a detailed history and physical examination in the pediatric population can be difficult. Therefore, the threshold for advanced imaging, such as magnetic resonance imaging, is low and should be performed in patients with head injuries, altered mental status, inability to cooperate with examination, and fractures involving more than 1 column of the spine.» The classification of pediatric thoracolumbar trauma is based primarily on adult studies and there is little high-level evidence examining validity and accuracy in pediatric populations.» Injury pattern and neurologic status of the patient are the most important factors when determining whether to proceed with operative management.

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Section: Classificationmentioning

confidence: 99%

Evaluation and Management of Thoracolumbar Spine Trauma in Pediatric Patients

Bonsignore-Opp,

O'Donnell,

Agha

et al. 2024

JBJS Reviews

View full text Add to dashboard Cite

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UBE decompression combined with percutaneous pedicle screw internal fixation for thoracolumbar burst fracture with secondary spinal stenosis: a technical note

Bai,

Qiu,

Wei

et al. 2024

Preprint

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Objective:The purpose of this study was to present the surgical technique of UBE decompression combined with percutaneous pedicle screws for the treatment of thoracolumbar burst fractures with secondary spinal stenosis. Background: Thoracolumbar burst fracture is a common traumatic disease in spinal surgery, the incidence of Atype fracture is the highest in the AO classification of thoracolumbar burst fracture, accounting for about 70% of the fracture, which is most common in the A1 and A3 fractures [1], and the fracture of the A3 fracture often occurs in the fracture block to the intra-vertebral canal displacement, resulting in secondary stenosis. The traditional approach is posterior open surgery pedicle screws combined with direct visualization for decompression, which requires extensive stripping of paravertebral muscles and resection of more bone, and is more traumatic [2], which is not in line with the current development concept of minimally invasive spine. The UBE technique in spinal endoscopy is currently a hot spot in the development of minimally invasive spine [3], and we attempted to utilize UBE decompression combined with percutaneous pedicle screws to treat thoracolumbar burst fracture with spinal stenosis, which provides a new option for the surgical treatment of thoracolumbar burst fracture with spinal stenosis. Methods: We included five patients with thoracolumbar burst fractures with secondary spinal stenosis admitted to our hospital between January 2023 and January 2024, who were treated with sub-UBE decompression combined with percutaneous pedicle screw internal fixation by our team. The degree of correction of spinal deformity was assessed using the sagittal Cobb angle and the percentage of height of the anterior margin of the vertebral body, the rate of canal encroachment was used to assess the decompression of the spinal canal, and the recovery of the patients' ability to live was assessed using the VAS and JOA scales. Results：the results showed that the average operative length of the patients was 154.2mins, and the average intraoperative bleeding was 90ml; the sagittal Cobb angle averaged 22.23° preoperatively, and 6.10° at 3 days postoperatively; the anterior vertebral body height ratio averaged 36.77% preoperatively, and 91.16% at 3 days postoperatively; and the residual spinal canal volume averaged 52.01% preoperatively, and 91.58% at 3 days postoperatively; VAS score averaged 7 preoperatively and 2 at 3 days postoperatively; JOA score averaged 8.4 preoperatively and 22.4 at 3 days postoperatively. Conclusions：UBE decompression combined with percutaneous pedicle screws is effective in the treatment of thoracolumbar burst fractures with secondary spinal stenosis and is a safe, minimally invasive surgical option for this patient population.

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Thoracic and Lumbar Spine Injury: Evidence-Based Diagnosis, Management, and Outcomes

Cited by 2 publications

References 61 publications

Evaluation and Management of Thoracolumbar Spine Trauma in Pediatric Patients

Evaluation and Management of Thoracolumbar Spine Trauma in Pediatric Patients

UBE decompression combined with percutaneous pedicle screw internal fixation for thoracolumbar burst fracture with secondary spinal stenosis: a technical note

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