Thoracolumbar Burst Fractures: A Systematic Review and Meta-Analysis on the Anterior and Posterior Approaches

Roblesgil‐Medrano, Andres; Tellez-Garcia, Eduardo; Bueno-Gutierrez, Luis Carlos; Villarreal-Espinosa, Juan Bernardo; Galindo-Garza, Cecilia Anabell; Rodriguez-Barreda, Jose Ramon; Flores‐Villalba, Eduardo; Hinojosa-González, David Eugenio; Figueroa-Sánchez, José A.

doi:10.22603/ssrr.2021-0122

Cited by 9 publications

(4 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Osteoporotic vertebral fractures are infrequent in young adults [ 12 ]. Specifically, burst fractures in this age group are typically the result of high-energy trauma such as a fall from height or motor vehicle accidents [ 13 ]. Thus, there is a high probability to misdiagnose a burst fracture in a young patient without a history of chronic illness as traumatic instead of osteoporotic.…”

Section: Discussionmentioning

confidence: 99%

Osteoporotic Burst Fracture in a Young Male Adult as First Presentation of a Rare PLS3 Mutation: A Case Report

Nikolaou,

Chatzikomninos,

Tournis

et al. 2023

Cureus

View full text Add to dashboard Cite

Low-impact spinal fractures in young patients are rare and should raise suspicion of an underlying condition, as these injuries are typically the result of high-energy trauma. We describe a case of a young male patient who sustained a burst fracture of the first lumbar vertebra (L1) following low-energy trauma. The patient underwent percutaneous posterior spinal instrumentation, yet the poor bone quality detected intraoperatively prompted further diagnostic evaluation. Subsequently, low bone mineral density (BMD) was detected, and a rare plastine-3 (PLS3) gene mutation was revealed in the genetic analysis. The patient was initiated on teriparatide therapy after the discovery of osteoporosis postoperatively. It is, therefore, imperative to investigate all young patients with low-energy spinal fractures preoperatively to discover the underlying pathology promptly.

show abstract

Section: Discussionmentioning

confidence: 99%

Osteoporotic Burst Fracture in a Young Male Adult as First Presentation of a Rare PLS3 Mutation: A Case Report

Nikolaou,

Chatzikomninos,

Tournis

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…A Bayesian network meta-analysis framework was created from the analyzed network, which was used to run Markov chain Monte-Carlo simulations with 5,000 burnins, 100,000 interface iterations, and a thinning factor of 10. Trace and density analysis was used for model fit assessment 22 . Both fixed and random effects models were used to analyze data from specific drug and dosage analysis.…”

Section: Statistical Analysesmentioning

confidence: 99%

A Network Meta-Analysis on the Surgical Management of Thoracolumbar Burst Fractures: Anterior, Posterior, and Combined

Hinojosa-González

Estrada‐Mendizabal

Bueno-Gutierrez

et al. 2023

Spine Surg Relat Res

Self Cite

View full text Add to dashboard Cite

Background Thoracolumbar burst fractures (BFs) are traumatic lesions instigated by compression forces. Canal compression and compromise may lead to neurological deficits. Optimal surgical management is yet to be fully defined since various approaches such as anterior, posterior, or combined exist. This study aims to determine the operative performance of these three treatment modalities. Methods In accordance with the PRISMA guidelines, a systematic review was performed, identifying studies comparing anterior, posterior, and/or combined surgical approaches in patients with thoracolumbar BFs. To analyze available evidence, a Bayesian network meta-analysis framework was utilized. Results In this study, 16 studies were included. The shortest operative times and lowest operative blood losses were found for a posterior approach. The length of stay (LoS) was shorter with the posterior approach compared with the other two modalities. Return to work, postoperative kyphotic angle (PKA), and complications all favored the posterior approach. The visual analog scale score was similar between groups. Conclusions This study suggests that the posterior approach has significant advantages in terms of operative time, blood loss, LoS, PKA, return to work, and complication rates when compared to the other approaches. Treatment should remain an individualized process, and before choosing an approach, factors such as patient characteristics, surgeon experience, and hospital settings should be considered.

show abstract

“…[1,2] This injury is frequently observed in younger patients and can significantly affect their daily physical activities. [3,4] While certain types of fractures still pose a treatment controversy, treatment of TLF often involves the use of posterior segment fixation. [5,6] In the past, posterior internal fixation (PIF) was typically performed using a 4-screw configuration in a short segment (SS), with 2 pedicle screws inserted into the upper and lower adjacent vertebrae of the fractured vertebral body.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The efficacy of different segments fixation for treatment thoracolumbar fractures: A Bayesian network meta-analysis

He,

Zhong,

Zhou

et al. 2023

Medicine

View full text Add to dashboard Cite

Background: We did this network meta-analysis to comprehensively compare the efficacy of different segments [intermediate segment (IS), short segment (SS) and long segment (LS)] in the fixation of thoracolumbar fractures. Methods: We searched studies from inception until January 20, 2023 through PubMed, Embase, Web of Science, and the Cochrane Library. All studies comparing different segments in the fixation of thoracolumbar fractures were included in this meta-analysis. Outcomes were anterior vertebral height ratio (AVHR), sagittal Cobb angle (SCA), visual analogue scale score, and implant failure rate. This network meta-analysis was performed by R software with gemtc package. Results: Finally, a total of 22 studies were finally included in this network meta-analysis. IS (WMD 2.43, 95% CrI 2.04–2.91) was more effective than SS in terms of the AVHR, and the difference was statistically significant. IS was more effective than LS in reducing SCA (WMD −2.87, 95% CrI −3.79 to −1.96) with statistically significant. Compared with SS, IS significantly reduced the SCA with statistically significant (WMD −2.52, 95% CrI −3.31 to −1.72). IS (WMD −2.87, 95% CrI −3.78 to −1.96) was more effective than LS, and the difference was statistically significant. Moreover, IS (WMD −2.52, 95% CrI −3.31 to −1.72) was more effective than SS, and the difference was statistically significant. Conclusion: IS was associated with a significant reduction in SCA, implant failure rate, and visual analogue scale compared to SS and LS, while having the most favorable impact on AVHR among all the treatments assessed.

show abstract

Thoracolumbar Burst Fractures: A Systematic Review and Meta-Analysis on the Anterior and Posterior Approaches

Cited by 9 publications

References 34 publications

Osteoporotic Burst Fracture in a Young Male Adult as First Presentation of a Rare PLS3 Mutation: A Case Report

Osteoporotic Burst Fracture in a Young Male Adult as First Presentation of a Rare PLS3 Mutation: A Case Report

A Network Meta-Analysis on the Surgical Management of Thoracolumbar Burst Fractures: Anterior, Posterior, and Combined

The efficacy of different segments fixation for treatment thoracolumbar fractures: A Bayesian network meta-analysis

Contact Info

Product

Resources

About