Journal articles: 'Thoracolumbar fracture'

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Katoh, Hiroyuki, Eijiro Okada, Toshitaka Yoshii, Tsuyoshi Yamada, Kei Watanabe, Keiichi Katsumi, Akihiko Hiyama, et al. "A Comparison of Cervical and Thoracolumbar Fractures Associated with Diffuse Idiopathic Skeletal Hyperostosis—A Nationwide Multicenter Study." Journal of Clinical Medicine 9, no. 1 (January 12, 2020): 208. http://dx.doi.org/10.3390/jcm9010208.

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In diffuse idiopathic hyperostosis (DISH), the ankylosed spine becomes susceptible to spinal fractures and spinal cord injuries due to the long lever arms of the fractured segments that make the fracture extremely unstable. The aim of this retrospective multicenter study was to examine the differences in DISH-affected spine fractures according to fracture level. The data of 285 cases with fractures of DISH-ankylosed segments diagnosed through computed tomography (CT) imaging were studied and the characteristics of 84 cases with cervical fractures were compared to 201 cases with thoracolumbar fractures. Examination of the CT images revealed that cervical fracture cases were associated with ossification of the posterior longitudinal ligament and had fractures at the intervertebral disc level, while thoracolumbar fracture cases were associated with ankylosing of the posterior elements and had fractures at the vertebral body. Neurologically, cervical fracture cases had a higher ratio of spinal cord injury leading to higher mortality, while thoracolumbar fracture cases had lower rates of initial spinal cord injury. However, a subset of thoracolumbar fracture cases suffered from a delay in diagnosis that led to higher rates of delayed neurological deterioration. Some of these thoracolumbar fracture cases had no apparent injury episode but experienced severe neurological deterioration. The information provided by this study will hopefully aid in the education of patients with DISH and raise the awareness of clinicians to potential pitfalls in the assessment of DISH trauma patients.

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HUBNER, ANDRÉ RAFAEL, MATEUS MEIRA GARCIA, RODRIGO ALVES VIEIRA MAIA, DANIEL GASPARIN, CHARLES LEONARDO ISRAEL, and LEANDRO DE FREITAS SPINELLI. "MECHANICAL BEHAVIOR OF THORACOLUMBAR CORONAL SPLIT FRACTURES: FINITE ELEMENT ANALYSIS." Coluna/Columna 19, no. 3 (July 2020): 205–8. http://dx.doi.org/10.1590/s1808-185120201903223027.

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ABSTRACT Objective To analyze the behavior of thoracolumbar fractures of the coronal split type using the finite element method. Methods Two comparative studies were conducted through simulation of coronal split fractures in a finite model in which the first lumbar vertebra (L1) was considered to be fractured. In the first case, the fracture line was considered to have occurred in the middle of the vertebral body (50%), while in the second model, the fracture line occurred in the anterior quarter of the vertebral body (25%). The maximum von Mises stress values were compared, as well as the axial displacement between fragments of the fractured vertebra. Results The stress levels found for the fracture located at half of the vertebral body were 43% higher (264.88 MPa x 151.16 MPa) than those for the fracture located at the anterior 25% of the vertebra, and the axial displacement of the 50% fractured body was also greater (1.19 mm x 1.10 mm). Conclusions Coronal split fractures located in the anterior quarter of the vertebral body incurred less stress and displacements and are more amenable to conservative treatment than 50% fractures occurring in the middle of the vertebral body. Level of Evidence III; Experimental study.

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Papadopoulos, Stephen M. "Thoracolumbar Spine Fracture." Neurosurgery 36, no. 1 (January 1995): 209–10. http://dx.doi.org/10.1227/00006123-199501000-00035.

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Panjabi, Manohar M., Tec h, Thomas R. Oxland, Ruey-Mo Lin, and Timothy W. McGowen. "Thoracolumbar Burst Fracture." Spine 19, no. 5 (March 1994): 578–85. http://dx.doi.org/10.1097/00007632-199403000-00014.

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Astolfi, Matthew M., Paul Millhouse, Hamadi Murphy, Greg Schroeder, and Alexander R. Vaccaro. "Thoracolumbar Fracture Classifications." Contemporary Spine Surgery 19, no. 1 (January 2018): 1–7. http://dx.doi.org/10.1097/01.css.0000527970.36945.2c.

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Papadopoulos, Stephen M. "Thoracolumbar Spine Fracture." Neurosurgery 36, no. 1 (January 1995): 209???210. http://dx.doi.org/10.1097/00006123-199501000-00035.

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Blumenkopf, Bennett. "Thoracolumbar Burst Fracture." Journal of SPINAL DISORDERS 4, no. 2 (June 1991): 242–43. http://dx.doi.org/10.1097/00002517-199106000-00017.

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Alam, Waqar, Faaiz Ali Shah, Ashfaq Ahmed, Qazi Muhammad Amin, Ijaz Ahmed, and Amer Aziz. "UNSTABLE FRACTURE OF THORACOLUMBAR SPINE;." Professional Medical Journal 24, no. 01 (January 18, 2017): 200–204. http://dx.doi.org/10.29309/tpmj/2017.24.01.476.

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Objectives: To evaluate the functional outcome of unstable thoracolumbarfractures fixed with pedicular screws and rods. Study Design: Descriptive case series. Setting:Department of Orthopedics and Spine surgery Ghurki Trust Teaching Hospital Lahore. Period:February 2013 to October 2015. Material & Methods: Patients of either gender or all ageswith thoracolumbar fractures fulfilling the inclusion criteria were fixed with pedicular screwsand rods under general anesthesia. Post operatively patients were reviewed monthly for oneyear and results were analyzed according to modified McNab criteria as excellent, good, fairand poor at final follow up. Results: A total of 281 patients including 193(68.68%) males and88(31.32%) females with mean age 28.32 years (range 18 to 60 years) were included in ourstudy. Majority (91 patients) had fractures of L1 followed by L2 (73 patients) fracture and D12(67 patients) fracture. Pre operatively 95(33.81%) were neurologically graded as Frankle gradeD,73 (25.98%) grade C while 49(17.44%) were graded as Frankle grade E.Post operatively finalfollow up at one year yielded excellent clinical outcome in majority (91.46%,n=257) while goodand fair outcomes were reported in 6.41%(18 patients), and 2.14%(6 patients) respectivelyaccording to modified McNab criteria. No post op neurological detoriation, mortality or othermajor complication was reported in the study. Conclusion: Pedicular screw and rod fixationfor unstable thoracolumbar fractures gave excellent functional results in majority of patient as itreduces complications of recumbency and helps in early mobilization. We recommend it as afirst line treatment for such fractures.

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Likhachev, S. V., V. V. Zaretskov, V. B. Arsenievich, V. V. Ostrovskij, A. E. Shulga, and A. V. Zaretskov. "Outcomes with fracture-level transpedicular screws used for thoracolumbar junction fractures." Genij Ortopedii 26, no. 4 (December 2020): 548–54. http://dx.doi.org/10.18019/1028-4427-2020-26-4-548-554.

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Background Short-segment transpedicular screw fixation (SSTSF) is the preferred treatment option for thoracolumbar burst fractures. Adding screws in the fractured body may be helpful in achieving and maintaining fracture reduction. However, the operative approach is disputed. Objective To compare clinical outcomes of transpedicular fixation with and without screws in the fractured vertebral body after isolated uncomplicated fractures at the thoracolumbar junction. Material and methods A retrospective cohort study enrolled 62 patients with Th11–L2 thoracolumbar burst fractures (AOSpine A3, A4) who underwent SSTSF with (n = 32) and without (n = 30) pedicle screws at the fracture level. Demographic data of the patients, operating time and blood loss were registered. Clinical evaluation using Visual analogue scale (VAS ) for pain, Oswestry Disability Index (ODI) to quantify disability and imaging parameters of segmental kyphosis, loss of correction, anterior vertebral body height (AVBH) at the fracture level, spinal canal stenosis (SCS) were measured preoperatively, at one week, 1 month, 6 and 12 months postoperatively. Results The patients of the two groups showed no statistically significant differences in the demographic data, VAS and ODI scores, measurements of kyphotic angle, AVBH, SCS preoperatively (p > 0.05). Screws at the fracture level did not affect the operating time and intraoperative blood loss relative to conventional no-screw group. Benefits with fracture screws were evident at 7 days (p < 0.01) measuring SCS, at 6 months (p < 0.01) and 12 (p < 0.01) months measuring kyphotic angle. There was better kyphosis correction (p < 0.01) and AVBH (p = 0.034) seen at 12 months after surgery. Conclusion Reinforcement of a broken vertebra with fracture-level screws has been shown to provide better stability of clinical and radiographic results as compared to those with conventional SSTSF.

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SJ, Vihar, Naveen DS, and Agrawal NK. "Comparative study of long segment versus short segment posterior fixation of thoracolumbar fractures with pedicle screws." Journal of Medical and Scientific Research 9, no. 2 (April 19, 2021): 77–84. http://dx.doi.org/10.17727/jmsr.2021/9-12.

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Choice of long or short segment fixation for thoracolumbar fractures, benefits of either of these techniques has been a topic for analysis and assessment. Kyphotic angles in twenty patients diagnosed to have thoracolumbar vertebral fractures between December 2019 to December 2020 in Bapuji hospital and Chigateri general hospital, Davanagere, Karnataka, India were measured pre operatively, post operatively and at one year follow up and assessed. No statistical difference between the degrees of correction of initial kyphotic angle between long segment fixation and short segment posterior fixation in our study was found (p<0.6). Method of fixation of the thoracolumbar vertebral fracture did not correlate with initial degree of kyphosis (p=0.4). Amount of correction loss at one year follow up was found to be statistically significant in short segment fixation (p<0.05). Loss of kyphotic angle at one year follow up was higher in case of short segment fixation than long segment fixation and found to be statistically significant (p<0.005). Our study showed that long segment fixation helps in better correction of the kyphosis angle with lesser chance of loss of correction and can be opted when pedicles aren’t intact at the fracture level, as in cases of burst fractures. Short segment fixation provides better rigid fixation at the site of fracture with increased range of motion at the thoracolumbar segment and can be treatment of choice when the pedicles at the fractured level are intact, as in cases of compression fractures, having benefits of shorter duration of surgery and reduced risks.

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Sebaaly, Amer, Maroun Rizkallah, Guillaume Riouallon, Zhi Wang, Pierre Emmanuel Moreau, Falah Bachour, and Ghassan Maalouf. "Percutaneous fixation of thoracolumbar vertebral fractures." EFORT Open Reviews 3, no. 11 (November 2018): 604–13. http://dx.doi.org/10.1302/2058-5241.3.170026.

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Surgical treatment of patients with thoracolumbar vertebral fracture without neurological deficit is still controversial. Management of vertebral fracture with percutaneous fixation was first reported in 2004. Advantages of percutaneous fixation are: less tissue dissection; decreased post-operative pain; decreased bleeding and operative time (depending on the steep learning curve); better screw positioning with fluoroscopy compared with an open freehand technique; and a decreased infection rate. The limitations of percutaneous fixation of vertebral fractures include increased radiation exposure to the patient and the surgeon, together with the steep learning curve for this technique. Adding a screw at the level of the fractured vertebra has the advantages of incorporating fewer motion segments with less operative time and bleeding. This also increases the axial, sagittal and torsional stiffness of the construct. Percutaneous fixation alone without grafting is sufficient for treating type A and B1 (AO classification) thoracolumbar fractures with satisfactory results concerning kyphosis reduction when compared with open instrumentation and fusion and with open fixation. Type C and B2 fractures (ligamentous injuries) should undergo fusion since the ligamentous healing is mechanically weak, increasing the risk of instability. This review offers a detailed description of percutaneous screw insertion and discusses the advantages and disadvantages. Cite this article: EFORT Open Rev 2018;3:604-613. DOI: 10.1302/2058-5241.3.170026.

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Sosa, Roberto Chapa, and Edgar Rubén Urrutia Vega. "TREATMENT OF UNSTABLE THORACOLUMBAR FRACTURES IN PEDIATRIC PATIENTS." Coluna/Columna 14, no. 3 (September 2015): 227–29. http://dx.doi.org/10.1590/s1808-185120151403152473.

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Objective:To analyze the characteristics of unstable thoracolumbar fractures in the pediatric population.Methods:A retrospective cross-sectional study was conducted with pediatric patients (0 to 15 years) who presented with unstable thoracolumbar fracture with or without neurological damage. Twenty-four operated patients were analyzed: 13 male and 11 female.Results:Falls from height are the most common cause, being the thoracolumbar junction the anatomical site most frequently injured.Conclusion:The thoracolumbar fractures are rare in the pediatric population, as well as post-surgical instrumentation structural deformities.

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Danang, Ferdiansyah, and Primadenny Ariesa Airlangga. "UNSTABLE LUMBAR FRACTURE-DISLOCATION TREATED BY LONG SEGMENT POSTERIOR PEDICLE SCREW INSTRUMENTATION." (JOINTS) Journal Orthopaedi and Traumatology Surabaya 9, no. 2 (October 31, 2020): 71. http://dx.doi.org/10.20473/joints.v9i2.2020.71-76.

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Background: Among all the thoracolumbar fractures, 50-60% affects the thoracolumbar transitional zone, and 51% AO Type C Fractures has a neurological deficit. We experienced treating a case of unstable lumbar fracture-dislocation treated with long segment pedicle screw instrumentation.Case: A 26-year-old man came to the ER after his back hit by a canopy while working 2 hours before admission. The motoric function was diminished from the L2-S1 level and hypoesthesia at the T12 level. Plain X-Ray showed Fracture-Dislocation Lumbar Vertebral 1-2 Denis Classification Flexion Rotation (AO Type C) ASIA A. The patient underwent reduction, decompression, and long-segment posterior pedicle screw instrumentation.Discussion: The surgery’s primary purpose is to restore alignment and stability to improve the patient’s quality of life by enabling daily activity in a wheelchair without significant pain. Short segment or long segment pedicle screw instrumentation remains a debate. In this case report, we apply long segment pedicle screw instrumentation for lumbar vertebral fracture-dislocation.Conclusion: Thoracolumbar fracture and dislocation fixation aim to restore alignment and stability, to reduce kyphotic deformity, and to decompress the spinal canal. The long segment pedicle screw instrumentation can resist the deforming force of thoracolumbar fractures and dislocations that will inevitably collapse into further kyphosis, resulting in a better outcome.

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Kim, Byung-Guk, Jin-Myoung Dan, and Dong-Eun Shin. "Treatment of Thoracolumbar Fracture." Asian Spine Journal 9, no. 1 (2015): 133. http://dx.doi.org/10.4184/asj.2015.9.1.133.

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Scardino, Fabrizio Borges, Alécio Cristino Evangelista Santos Barcelos, Vanessa Bizarri Da Silva, Paulo Augusto Silva Dumont, José Marcus Rotta, and Ricardo Vieira Botelho. "What is the importance of the spinal canal encroachment in the management of thoracolumbar burst fracture without neurological deficit?" JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA 21, no. 4 (March 20, 2018): 234–38. http://dx.doi.org/10.22290/jbnc.v21i4.939.

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Introduction: The relevant features in the treatment of thoracolumbar fractures vary in the literature. The classical surgical indications of burst fractures are loss of vertebral body height, kyphosis, neurological deficit and canal encroachment. Recent papers have attributed less importance to canal impingement as a surgical indicator in intact patients, irrespectively of the degree of encroachment. The several thoracolumbar fracture classifications have prompted efforts to guide the surgical indications. We analyzed the relevance attributed to the canal encroachment by thoracolumbar fracture classifications in the management of burst fractures without neurological deficit. Objective: To evaluate the relevance attributed by the thoracolumbar fractures classifications to the canal encroachment in the management of burst fractures without posterior ligamentous complex disruptions or neurological deficits. Methods: A literature search was performed by tracking the related articles of thoracolumbar fractures classifications from Vaccaro’s to Holdsworth’s study. We analyzed the role of canal impingement in the management of burst fractures without posterior ligament complex injury or neurological deficits in each classification. Results: Seven classifications were included. Holdsworth considered the burst fractures as stable, irrespectively of the amount of canal impingement or neurological deficit. Denis considered that the burst fracture carried a neurological instability criterion, therefore, in these cases he suggested surgical treatment because of the riskof new neurological damage. McAffee postulated that there is no reliable predictor to correlate the severity of canal encroachment with the risk of neurological damage. Ferguson and Allen discussed the possibility of anterior decompression, stabilization and anterior fusion of the spine in certain cases of burst fractures. The classifications of McCormack, Karaikovic and Gaines, Magerl and Vaccaro did not include canal encroachment in their considerations. Conclusion: The thoracolumbar fractures classifications did not directly consider the severity of canal encroachment in the treatment decision making of burst fractures without neurological damage. It is not possible to predict which patients will deteriorate if not operated. It remains unclear what is the risk of neurological deterioration in a SCE greater than 50%.

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Agarwal, Nitin, Phillip Choi, and Raymond Sekula. "Minimally Invasive Spine Surgery for Unstable Thoracolumbar Burst Fractures: A Case Series." Surgery Journal 02, no. 04 (October 2016): e131-e138. http://dx.doi.org/10.1055/s-0036-1594248.

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Introduction Traumatic thoracolumbar burst fracture is a common pathology without a clear consensus on best treatment approach. Minimally invasive approaches are being investigated due to potential benefits in recovery time and morbidity. We examine long-term resolution of symptoms of traumatic thoracolumbar burst fractures treated with percutaneous posterior pedicle screw fixation. Methods Retrospective clinical review of seven patients with spinal trauma who presented with thoracolumbar burst fracture from July 2012 to April 2013 and were treated with percutaneous pedicle screw fixation. Electronic patient charts and radiographic imaging were reviewed for initial presentation, fracture characteristics, operative treatment, and postoperative course. Results The patients had a median age of 29 years (range 18 to 57), and 57% were men. The median Thoracolumbar Injury Classification and Severity Scale score was 4 (range 2 to 9). All patients had proper screw placement and uneventful postoperative courses given the severity of their individual traumas. Five of seven patients were reached for long-term follow-up of greater than 28 months. Six of seven patients had excellent pain control and stability at their last follow-up. One patient required revision surgery for noncatastrophic hardware failure. Conclusion Percutaneous pedicle screw fixation for the treatment of unstable thoracolumbar burst fracture may provide patients with durable benefits and warrants further investigation.

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Weerink, L. B. M., E. C. Folbert, M. Kraai, R. S. Smit, J. H. Hegeman, and D. van der Velde. "Thoracolumbar Spine Fractures in the Geriatric Fracture Center." Geriatric Orthopaedic Surgery & Rehabilitation 5, no. 2 (March 13, 2014): 43–49. http://dx.doi.org/10.1177/2151458514524053.

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Diamante, G. A. C., P. V. T. Marinho, C. C. Zani, and M. V. Bahr Arias. "Ex-vivo evaluation of the three-column concept in canine thoracolumbar fractures." Arquivo Brasileiro de Medicina Veterinária e Zootecnia 72, no. 4 (August 2020): 1221–30. http://dx.doi.org/10.1590/1678-4162-11533.

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ABSTRACT Traumatic events such as a motor vehicle accident or falling from heights are very common in veterinary medicine and often lead to vertebral fracture-luxation with concomitant spinal cord injuries, mostly in the thoracolumbar spine. The purpose of this cadaveric biomechanical study was to determine the feasibility of the three-column concept in canine thoracolumbar segments with induced fractures. Eighteen Functional Spinal Units (FSU) of the thoracolumbar segments (T12-L2) were collected from 18 medium-sized adult dog cadavers and were subjected to flexion-extension and lateral bending tests so that range of motion (ROM) was recorded with a goniometer. Fractures were induced by compressive loads applied by a universal testing machine (EMIC®). After this, specimens were screened using computed tomography (CT) and the fractures were graded as affecting one, two or three columns, and divided into groups A, B, and C, respectively. Post-fracture range of motion (ROM) was compared with the previous results. Groups B and C (with fractures in two or three columns) had instability in the two axes evaluated (P<0.05). The outcomes of this study support the applicability of the three-column theory to thoracolumbar spines of dogs, as the FSUs that suffered fractures in two or more columns showed axial instability.

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Hu, Zhi-Chao, Xiao-Bin Li, Zhen-Hua Feng, Ji-Qi Wang, Lan-Fang Gong, Jiang-Wei Xuan, Xin Fu, Bing-Jie Jiang, Long Wu, and Wen-Fei Ni. "Modified pedicle screw placement at the fracture level for treatment of thoracolumbar burst fractures: a study protocol of a randomised controlled trial." BMJ Open 9, no. 1 (January 2019): e024110. http://dx.doi.org/10.1136/bmjopen-2018-024110.

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IntroductionThe optimal treatment for burst fractures of the thoracolumbar spine is controversial. The addition of screws in the fractured segment has been shown to improve construct stiffness, but can aggravate the trauma to the fractured vertebra. Therefore, optimised placement of two pedicle screws at the fracture level is required for the treatment of thoracolumbar burst fractures. This randomised controlled study is the first to examine the efficacy of diverse orders of pedicle screw placement and will provide recommendations for the treatment of patients with thoracolumbar burst fractures.Methods and analysisA randomised controlled trial with blinding of patients and the statistician, but not the clinicians and researchers, will be conducted. A total of 70 patients with single AO type A3 or A4 thoracolumbar fractures who are candidates for application of short-segment pedicle screws at the fractured vertebral level will be allocated randomly to the distraction-screw and screw-distraction groups at a ratio of 1:1. The primary clinical outcome measures will be the percentage loss of vertebral body height, screw depth in the injured vertebrae and kyphosis (Cobb angle). Secondary clinical outcome measures will be complications, Visual Analogue Scale scores for back and leg pain, neurological function, operation time, intraoperative blood loss, Japanese Orthopaedic Association score and Oswestry Disability Index. These parameters will be evaluated preoperatively, intraoperatively, on postoperative day 3, and at 1, 3, 6, 12 and 24 months postoperatively.Ethics and disseminationThe Institutional Review Board of the Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University have reviewed and approved this study (batch: LCKY2018-05). The results will be presented in peer-reviewed journals and at an international spine-related meeting after completion of the study.Trial registration numberNCT03384368; Pre-results.

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Rahman, Md Atikur, Sukriti Das, Md Rezaul Amin, Mohammad Hossain, and Kanak Kanti Barua. "Transpedicular screw fixation for the treatment of thoracolumbar spine fracture." Bangabandhu Sheikh Mujib Medical University Journal 10, no. 2 (June 6, 2017): 112. http://dx.doi.org/10.3329/bsmmuj.v10i2.32709.

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One of the most popular procedures for treating the unstable thoracolumbar fracture is the short segment pedicle screw fixation. Due to lack of adequate neurological improvement, progressive kyphosis and hardware failure, the efficacy of different methods remain debatable. One hundred patients of thoracolumbar burst fractures were managed from January 2010 to December 2014 by transforaminal thoracolumbar interbody fusion and short-segment pedicle screw stabilization. Each patient was followed-up for a minimum of 2 years. Bony fusion was done in each patient in between two vertebra along with transpedicular fixation. Follow-up radiological images showed good reduction and the fusion of the vertebral body was good. Excellent neurological improvement of the Frankel grade C and D was seen in 84 patients. Ten patients had grade B, improvement which was not satisfactory. 15 patients with no paraplegia/hemiplegia on admission remained neurologically intact. For the management of thoracolumbar burst fractures short segment posterior transpedicular fixation with bone graft is very economic and safe procedure with good neurological improvement.

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Pradhan, Rabindra Lal, Bimal Kumar Pandey, and Krishna Raj Khanal. "Short term radiological outcome of inserting screw at fracture level in posterior short segment fixation in thoracolumbar burst fractures." Journal of Kathmandu Medical College 4, no. 3 (September 17, 2017): 71–76. http://dx.doi.org/10.3126/jkmc.v4i3.18236.

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Background: Unstable thoracolumbar burst fractures are treated surgically by short segment fixation but may be associated with high implant failure. Supplementation of anterior column by insertion of screw at fracture site makes it more biomechanically stable.Objectives: The purpose of this prospective study was to evaluate radiological parameters in thoracolumbar fractures treated with intermediate screw fixation with a minimum follow up of two years.Methods: This prospective study was conducted from 2011 till 2012 where unstable thoracolumbar fractures treated with short segment posterior instrumentation with screw at fracture site were evaluated. All patients (average age 34.64 were followed up for at least 24 months and were classified according to Thoracolumbar Injury Classification and Severity Score and load sharing classifi cation. Out of total 32 patients, four lost to follow up. Radiological parameters like vertebral body height and segmental kyphosis were evaluated and pain was evaluated by Visual Analogue Scale score.Results: Preoperative pain showed mean Visual Analogue Scale Score score of 8.29 that improved to 0.97 at fi nal follow up. Average preoperative loss of vertebral body height was 48.19 %, which improved to 11.4 % after surgery (p<.001). Final vertebral body collapse was 12.98 % with mean percentage loss of vertebral height at 1.57%. Average segmental kyphotic angle was 22.54 before surgery, which corrected to 5.89 immediately after surgery (p<0.001). Final segmental kyphosis was 8.46. Loss of kyphosis correction was 2.57. Two patients had implant failure, but was solidly united during implant removal in both cases.Conclusion: Excellent maintenance of reduction in thoracolumbar burst fractures with short segment fixation with intermediate screws at fracture site with limited decompression resulted in improved neurologic function and satisfactory clinical outcomes, with a low incidence of implant failure and progressive deformity.

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Hubner, André Rafael, Danilo Mourão Ribeiro, Eduardo Dassoler, Daniel Gasparin, Charles Leonardo Israel, and Leandro de Freitas Spinelli. "NUMERICAL ANALYSIS OF SHORT AND LONG INSTRUMENTATION IN THE TREATMENT OF THORACOLUMBAR FRACTURES CONSIDERING THE LIGAMENTOUS PORTION." Coluna/Columna 18, no. 2 (June 2019): 144–50. http://dx.doi.org/10.1590/s1808-185120191802195561.

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ABSTRACT Objective: This study aims to numerically evaluate the surgical treatment of thoracolumbar fractures, comparing the strengths between the long and short fixations using the pedicle of the fractured vertebra, taking into account the supraspinous, intertransverse, and anterior longitudinal ligaments. Methods: A numerical analysis of the techniques of long and short fixation of a thoracolumbar spine fracture was performed using computed tomography images that were converted into three-dimensional models and analyzed through the ANSYS program. The two types of treatments were analyzed considering the tensions generated in the immediate postoperative period, when the fracture has not yet been consolidated. The anterior, posterior, supraspinal and intertransverse longitudinal ligaments were added, in addition to considering different vertebral geometries. Results: Taking into account that the maximum tensile stress of the material used in the metal implant, in the case of titanium, was 960 MPa, the highest tension found in the analysis of the short instrumentation was 346.83 MPa, reaching only 36.13% of the load the material supports, being, therefore, within a safety limit. The analysis performed in the spine with long instrumentation showed the highest tension value of 229.22 MPa. Conclusions: Considering the values found and the resistance of the synthesis material used, the short and long fixation can be considered in the treatment of thoracolumbar fractures with similarity and a good safety coefficient. Level of Evidence III; Case-Control.

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Anghel, S., and D. Márton. "The Loss of Correction in Thoracolumbar Burst Fracture Treated by Surgery. Can We Predict It?" Acta Medica Marisiensis 60, no. 3 (June 1, 2014): 99–101. http://dx.doi.org/10.2478/amma-2014-0020.

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Abstract Objective: This paper aims to differentially depict potential patterns of the loss of correction in surgically treated thoraco-lumbar burst fractures. These may eventually serve to foreseeing and even forestalling loss of correction. Methods: The study focused on 253 patients with surgically treated thoraco-lumbar fractures. This cohort of patients was clustered in four subgroups according to the fracture spine segment (T11-L1 or L1-L2) and surgery type (short segment fi xation or anterior approach). Relevant recorded and processed data were the fracture level, post-operative (Kpo) and last follow-up (Kf) kyphosis angle values. Correlation, regression and determination testing were performed for the last follow-up kyphosis angle and post-operative kyphosis angle, and regression equations were determined for each subgroup of patients. Results: The patterns of loss of correction were described through the following equations: Kf = 0.95*Kpo + 3.2° for the T11-L1 level fractured vertebrae treated by posterior short segment fixation; Kf = 0.98*Kpo + 3.4° for the L1-L2 level fractured vertebrae treated by posterior short segment fixation; Kf = 1.1*Kpo + 1.6° for the T11-L1 level fractured vertebrae treated by anterior approach; and Kf = 0.7*Kpo + 2.8° for the L1-L2 level fracture vertebrae treated by anterior approach. Conclusions: The loss of correction may be predicted, to a certain extent, for thoraco-lumbar fractured vertebrae treated surgically. The bestfit equations depicted for both type of surgery (short segment fixation and anterior approach) and both spinal segments (T11-L1 and L2-L3) are significantly different than the equations delineated for the collapse of non-surgically treated fractures.

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Du, Jin Peng, Ji Jun Liu, Yong Fan, Jia Nan Zhang, Yan Sheng Huang, Jing Zhang, and Ding Jun Hao. "Surgery for Multisegment Thoracolumbar Mild Osteoporotic Fractures: Revised Assessment System of Thoracolumbar Osteoporotic Fracture." World Neurosurgery 114 (June 2018): e969-e975. http://dx.doi.org/10.1016/j.wneu.2018.03.122.

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Guo, Hui, Jiantao Li, Yuan Gao, Shaobo Nie, Chenliang Quan, Jia Li, and Wei Zhang. "A Finite Element Study on the Treatment of Thoracolumbar Fracture with a New Spinal Fixation System." BioMed Research International 2021 (April 10, 2021): 1–9. http://dx.doi.org/10.1155/2021/8872514.

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Objective. In this study, the mechanical properties of the new spinal fixation system (NSFS) in the treatment of thoracolumbar fractures were evaluated by the finite element analysis method, so as to provide a mechanical theoretical basis for the later biomechanical experiments and clinical experiments. Methods. T12-L2 bone model was constructed to simulate L1 vertebral fracture, and three models of internal fixation systems were established on the basis of universal spinal system (USS): Model A: posterior short-segment fixation including the fractured vertebra (PSFFV); Model B: short-segment pedicle screw fixation (SSPF); Model C: new spinal fixation system (NSFS). After assembling the internal fixation system and fracture model, the finite element analysis was carried out in the ANSYS Workbench 18.0 software, and the stress of nail rod system, fracture vertebral body stress, vertebral body mobility, and vertebral body displacement were recorded in the three models. Results. The peak values of internal fixation stress, vertebral body stress, vertebral body maximum displacement, and vertebral body maximum activity in Model C were slightly smaller than those in Model B. Conclusions. Compared with the traditional internal fixation system, the new spinal internal fixation system may have the mechanical advantage and can provide sufficient mechanical stability for thoracolumbar fractures.

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Kirkpatrick, John S. "Thoracolumbar Fracture Management: Anterior Approach." Journal of the American Academy of Orthopaedic Surgeons 11, no. 5 (September 2003): 355–63. http://dx.doi.org/10.5435/00124635-200309000-00008.

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Lee, Jin-Young, and Gab-Lae Kim. "Posterior Instrumentation of Thoracolumbar Fracture." Journal of Korean Society of Spine Surgery 8, no. 3 (2001): 423. http://dx.doi.org/10.4184/jkss.2001.8.3.423.

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Bae, Hyun W., and Rick B. Delamarter. "Neurologic recovery from thoracolumbar fracture." Current Opinion in Orthopaedics 13, no. 3 (June 2002): 184–87. http://dx.doi.org/10.1097/00001433-200206000-00005.

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Petersilge, Cheryl A., and Sanford E. Emery. "Thoracolumbar burst fracture: Evaluating stability." Seminars in Ultrasound, CT and MRI 17, no. 2 (April 1996): 105–13. http://dx.doi.org/10.1016/s0887-2171(96)90010-4.

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Zdeblick, Thomas A., and Steven R. Garfin. "Discussion on Thoracolumbar Burst Fracture." Journal of SPINAL DISORDERS 4, no. 2 (June 1991): 244–49. http://dx.doi.org/10.1097/00002517-199106000-00018.

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Zhu, Qicong, Fengchao Shi, Weihua Cai, Jianling Bai, Jin Fan, and Huilin Yang. "Comparison of Anterior Versus Posterior Approach in the Treatment of Thoracolumbar Fractures: A Systematic Review." International Surgery 100, no. 6 (June 1, 2015): 1124–33. http://dx.doi.org/10.9738/intsurg-d-14-00135.1.

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Despite extensive research on thoracolumbar fractures, controversy still exists about which approach is the most appropriate. Lack of evidence-based practice may result in patients being treated inappropriately. The objective of study was to perform a systematic review of the effectiveness of the anterior and posterior approaches in the treatment of thoracolumbar fractures. We conducted searches of PubMed and the Cochrane Library, searching for relevant trials up to August 2013 that compared anterior and posterior for the treatment of thoracolumbar fractures. The key words “anterior,” “posterior,” “thoracolumbar fracture,” “CCT,” and “RCT” were used. We assessed all included literature by using the Cochrane handbook (version 5.1). The results were expressed as the mean difference for continuous outcomes and risk difference for dichotomous outcomes, with a 95% confidence interval, using RevMan version 5.2. There were 3 randomized controlled trials and 11 clinical controlled trials included. The meta-analysis showed no significant difference between groups regarding Cobb angle, the Frankel scale, ASIA/JOA motor score, complications, and number of patients returning to work. Compared with the anterior approach, the posterior approach demonstrated superior canal decompression. In the burst fracture subgroup, operative times were significantly shorter and perioperative blood loss was less in the posterior approach group. The posterior approach is more effective for canal decompression, operative times, and perioperative blood loss. However, because of the lack of randomized controlled trials, and because of large sample size studies, heterogeneity was significant between reports. The optimal treatment for thoracolumbar fractures requires further study.

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Kapoen, Carolijn, Yang Liu, Frank W. Bloemers, and Jaap Deunk. "Pedicle screw fixation of thoracolumbar fractures: conventional short segment versus short segment with intermediate screws at the fracture level—a systematic review and meta-analysis." European Spine Journal 29, no. 10 (June 11, 2020): 2491–504. http://dx.doi.org/10.1007/s00586-020-06479-4.

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Abstract Objective Posterior short-segment fixation (4-screw construct = 4S) is the conventional surgical technique for thoracolumbar fractures. The effect of adding two intermediate pedicle screws at the fractured level (6-screw construct = 6S) is still a matter of debate. This review aims to compare the results between 4 and 6S pedicle screw fixation for thoracolumbar fractures. Methods A systematic review and meta-analysis were performed. The databases PubMed, Embase and Google Scholar were searched until January 2020. Inclusion criteria were studies comparing 4S and 6S techniques in patients with thoracolumbar fractures. Non-comparative studies and studies without full text were excluded. Cochrane risk of bias was assessed, and the GRADE approach was used to present the quality of evidence. Results Twenty-seven studies, of which 21 randomized controlled trials, with a total of 1890 patients (940 with 4S and 950 with 6S) were included. Meta-analysis showed that the 6S technique resulted in significantly lower pain scores, better short-term and long-term Cobb angles, less loss of correction and less implant failures. However, longer operation time and more blood loss were seen with the 6S technique. Length of hospital stay, Oswestry Disability Index scores and infections did not differ significantly between the 6S and 4S techniques. Quality of the evidence according to GRADE was moderate to low. Conclusion In the treatment of thoracolumbar fractures, adding intermediate screws at the fracture level (6S) results in less post-operative pain, better radiological outcomes and less implant failure at the cost of a longer operation time and higher blood loss.

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Zhang, Hongyi, Haoyu Feng, Chen Chen, Li Zhang, Qiang Li, and Haoliang Zhao. "X-ray and Computed Tomography Analysis of Spinal Joint Injuries." Journal of Medical Imaging and Health Informatics 10, no. 12 (December 1, 2020): 2959–64. http://dx.doi.org/10.1166/jmihi.2020.3242.

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Objective: The X-ray and CT features of minimally invasive percutaneous pedicle screw for open reduction and internal fixation and traditional open reduction and internal fixation for thoracolumbar fractures were compared. Methods: Sixty-two patients with thoracolumbar fractures were analyzed with single vertebral body injury without obvious osteoporosis. Patients were randomly divided into two groups. In group A, minimally invasive percutaneous pedicle screws were used for open reduction and fixation. Group B was treated with thoracolumbar vertebral fracture with traditional incision and reduction and internal fixation with posterolateral fusion. Both groups followed standard surgical methods and methods, the same postoperative treatment and functional exercise plan. Results: During a 9-month follow-up, X-ray and computed tomography were used to analyze fracture joint motion injuries. The recovery rate of vertebral height in group A was significantly better than that in group B. At 9 months after operation, the recovery rate of vertebral height in group A increased. The neural function was similar, but the improvement rate in group A was significantly better than that in group B. Conclusions: Minimally invasive percutaneous pedicle screws for open reduction and internal fixation are compared with traditional open reduction and internal fixation for thoracolumbar fractures. Vertebral body height, symptom improvement, and neurological recovery after a lumbar fracture. However, minimally invasive percutaneous pedicle screws for open reduction and internal fixation can immediately increase the compression stability of the anterior spine and reduce complications such as nail and rod rupture due to excessive fixation pressure.

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BENSON, DANIEL R. "Unstable Thoracolumbar Fractures, with Emphasis on the Burst Fracture." Clinical Orthopaedics and Related Research &NA;, no. 230 (May 1988): 14???29. http://dx.doi.org/10.1097/00003086-198805000-00003.

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Gopinath, Shankar. "Abstract For Thoracolumbar Trauma." Neurologico Spinale Medico Chirurgico 1, no. 2 (August 7, 2018): 4. http://dx.doi.org/10.15562/nsmc.v1i2.82.

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In both adult and pediatric populations, thoracolumbar trauma accounts for a large portion of traumatic injuries. There is a wide spectrum of injury types, including compression fractures, burst fractures, fracture-dislocations, and more. The traditional treatment for many of these has been instrumented stabilization by an “open” approach. However, as minimally invasive techniques have been developed for degenerative disorders, there has been considerable interest in bringing the same benefits of decreased blood loss, improved wound exposure, and potentially decreased operative time to the trauma population. Further, “minimally invasive” is a broad category, encompassing percutaneous pedicle screw fixation, endoscopic/thoracoscopic approaches, and anterior column reconstruction. A few authors have put forward some algorithms of selecting appropriate patients for MIS techniques. However, the majority of published data has been limited to small case series with very heterogeneous pathologies. Further studies are needed to assess minimally invasive surgery for thoracolumbar spine trauma, with respect to short- and long-term clinical outcome, fusion rates/radiographic outcome, and cost-effectiveness.

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Kim, Nam Hyun, Beong Mun Park, and Hong Kyu Lee. "Conservative Treatment in Thoracolumbar Fracture and Fracture-Dislocations." Journal of the Korean Orthopaedic Association 21, no. 6 (1986): 1016. http://dx.doi.org/10.4055/jkoa.1986.21.6.1016.

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Niu, Junjie, Dawei Song, Minfeng Gan, Bin Liu, Chenglong Tan, Huilin Yang, and Bin Meng. "Percutaneous kyphoplasty for the treatment of distal lumbosacral pain caused by osteoporotic thoracolumbar vertebral fracture." Acta Radiologica 59, no. 11 (February 26, 2018): 1351–57. http://dx.doi.org/10.1177/0284185118761204.

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Background Kyphoplasty has been demonstrated to be minimally invasive and effective in treating osteoporotic vertebral fracture patients with back pain over the level of the fractured vertebrae. Rare studies have reported on thoracolumbar vertebral fracture patients presenting with distal lumbosacral pain (DLP). Whether kyphoplasty had a favorable therapeutic benefit for these patients remains unclear. Purpose To evaluate the therapeutic efficacy of kyphoplasty in treating osteoporotic thoracolumbar vertebral fracture (OTVF) patients with DLP and assess the clinical significance of focal tenderness to palpation in these patients. Material and Methods Thirty-two OTVF patients who only complained of DLP were treated by kyphoplasty. The vertebral heights, local kyphotic angle, Visual Analogue Scale (VAS), and Oswestry Disability Index (ODI) scores were assessed preoperatively, one day after surgery, and at last follow-up. All patients were evaluated regarding their degree of satisfaction with kyphoplasty. In addition, we compared the therapeutic efficacy of kyphoplasty in patients with and without focal tenderness to palpation. Results All patients successfully underwent kyphoplasty without complications. The vertebral heights, local kyphotic angles, VAS, and ODI scores were all significantly improved after kyphoplasty and maintained at last follow-up in our patients ( P < 0.001). At last follow-up, all patients expressed satisfaction with kyphoplasty. No significant differences in these parameters were detected between patients with and without focal tenderness. Conclusion The possibility of thoracolumbar vertebral fractures in elderly patients complaining of DLP should not be neglected. Kyphoplasty presents a superior benefit in treating OTVF patients with DLP. The absence of focal tenderness does not influence the clinical efficacy in these patients.

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Oberkircher, Ludwig, Maya Schmuck, Martin Bergmann, Philipp Lechler, Steffen Ruchholtz, and Antonio Krüger. "Creating reproducible thoracolumbar burst fractures in human specimens: an in vitro experiment." Journal of Neurosurgery: Spine 24, no. 4 (April 2016): 580–85. http://dx.doi.org/10.3171/2015.6.spine15176.

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OBJECT The treatment of traumatic burst fractures unaccompanied by neurological impairment remains controversial and ranges from conservative management to 360° fusion. Because of the heterogeneity of fracture types, classification systems, and treatment options, comparative biomechanical studies might help to improve our knowledge. The aim of the current study was to create a standardized fracture model to investigate burst fractures in a multisegmental setting. METHODS A total of 28 thoracolumbar fresh-frozen human cadaveric spines were used. The spines were dissected into segments (T11–L3). The T-11 and L-3 vertebral bodies were embedded in Technovit 3040 (cold-curing resin for surface testing and impressions). To simulate high energy, a metallic drop tower was designed. Stress risers were used to ensure comparable fractures. CT scans were acquired before and after fracture. All fractures were classified using the AO/OTA classification. RESULTS The preparation and embedding of the spine segments worked well. No repositioning or second embedding of the specimen, even after fracture, was required. It was possible to create single burst fractures at the L-1 level in all 28 spine segments. Among the 28 fractures there were 16 incomplete burst fractures (Type A3.1), 8 burst-split fractures (Type A3.2), and 4 complete burst fractures (Type A3.3). The differences before and after fracture for stiffness and for anterior, posterior, and central heights were all significant (p < 0.05). CONCLUSIONS The ability to create reproducible burst fractures of a single vertebral body in a thoracolumbar spine segment may serve as a basis for future biomechanical studies that will provide better understanding of mechanical properties or fixation techniques.

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Mao, Ke Zheng, Ke Ya Mao, Zi Shen Cheng, Peng Li, Zong Gang Chen, Xu Mei Wang, and Fu Zai Cui. "Performance of Composite Cements in the Repair of Porcine Thoracolumbar Burst Fracture In Vitro." Materials Science Forum 745-746 (February 2013): 13–20. http://dx.doi.org/10.4028/www.scientific.net/msf.745-746.13.

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An ideal injectable bone cement should be able to fill fully the fractures gap and provide good mechanical support. In the present work, the mineralized collagen and calcium sulphate dehydrate (CSD) was incorporated into α-calcium sulphate hemihydrates (α-CSH) to explore an injectable composite cement. The injectability, the setting time and the biomechanics properties were investigated. A porcine thoracolumbar burst fracture model was used to evaluate the biomechanical performance of composite cements. The porcine thoracolumbar burst fracture models in vitro were prepared. A half of models was made by the vertebroplasty of the composite cements, the other half of models was used as control. Imaging analysis showed the composite cements distributed uniformly and solidified well. Biomechanical test showed the ability of the composite cements to repair spinal burst fractures was significant.

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Furuta, Takanori, Ichiro Nakagawa, HunSoo Park, Kenta Nakase, Shohei Yokoyama, Masashi Kotsugoi, Yasuhiro Takeshima, and Hiroyuki Nakase. "Thoracolumbar intraosseous spinal epidural arteriovenous fistulas after vertebral compression fracture: A case report and literature review." Surgical Neurology International 12 (June 7, 2021): 270. http://dx.doi.org/10.25259/sni_349_2021.

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Background: The pathophysiology of spinal epidural arteriovenous fistulas (SEAVFs) with perimedullary venous drainage remains to be elucidated. This report describes a case of intraosseous SEAVF in a patient with a history of a thoracolumbar vertebral fracture at the same level 10 years before presenting with progressive myelopathy secondary to retrograde venous reflux into the perimedullary vein. Case Description: A 71-year-old man presenting with progressive paraparesis was diagnosed with a SEAVF involving a previous Th12 and L1 vertebral compression fracture on which feeders from multiple segmental arteries converged. The interesting feature of this case was that the fistula was located in the fractured vertebral body. The fistula was totally obliterated by transarterial embolization of the segmental arteries followed by symptom improvement. Conclusion: We presented a rare case of an intraosseous SEAVF secondary to a thoracolumbar compression fracture with perimedullary venous reflux causing progressive myelopathy. The fistula was located in the fractured vertebral body.

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Chung, Weng Hong, Wei Cheong Eu, Chee Kidd Chiu, Chris Yin Wei Chan, and Mun Keong Kwan. "Minimally invasive reduction of thoracolumbar burst fracture using monoaxial percutaneous pedicle screws: Surgical technique and report of radiological outcome." Journal of Orthopaedic Surgery 28, no. 1 (December 26, 2019): 230949901988897. http://dx.doi.org/10.1177/2309499019888977.

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Purpose: To describe the reduction technique of thoracolumbar burst fracture using percutaneous monoaxial screws and its radiological outcomes compared to polyaxial screws. Methods: All surgeries were performed by minimally invasive technique with either percutaneous monoaxial or percutaneous polyaxial screws inserted at adjacent fracture levels perpendicular to both superior end plates. Fracture reduction is achieved with adequate rod contouring and distraction maneuver. Radiological parameters were measured during preoperation, postoperation, and follow-up. Results: A total of 21 patients were included. Eleven patients were performed with monoaxial pedicle screws and 10 patients performed with polyaxial pedicle screws. Based on AO thoracolumbar classification system, 10 patients in the monoaxial group had A3 fracture type and 1 had A4. In the polyaxial group, six patients had A3 and four patients had A4. Total correction of anterior vertebral height (AVH) ratio was 0.30 ± 0.10 and 0.08 ± 0.07 in monoaxial and polyaxial groups, respectively ( p < 0.001). Total correction of posterior vertebral height (PVH) ratio was 0.11 ± 0.05 and 0.02 ± 0.02 in monoaxial and polyaxial groups, respectively ( p < 0.001). Monoaxial group achieved more correction of 13° (62.6%) in local kyphotic angle compared to 8.2° (48.0%) in polyaxial group. Similarly, in regional kyphotic angle, 16.5° (103.1%) in the monoaxial group and 8.1° (76.4%) in the polyaxial group were achieved. Conclusions: Monoaxial percutaneous pedicle screws inserted at adjacent fracture levels provided significantly better fracture reduction compared to polyaxial screws in thoracolumbar fractures.

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Moon, MS, WT Choi, YW Moon, YS Kim, and JL Moon. "Stabilisation of Fractured Thoracic and Lumbar Spine with Cotrel-Dubousset Instrument." Journal of Orthopaedic Surgery 11, no. 1 (June 2003): 59–66. http://dx.doi.org/10.1177/230949900301100113.

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Objective. To evaluate the effectiveness of 2 different types of Cotrel-Dubousset instrument systems in stabilising thoracolumbar and lumbar spine fractures. Methods. Between January 1989 and December 1993, 45 fractures in 42 patients with unstable fracture or fracture dislocation of the thoracolumbar and lumbar spines were randomly assigned to 2 surgical treatments with Cotrel-Dubousset instrumentation—using either a long segment (Group 1) or a short segment (Group 2)—and short posterolateral fusion. Results. Consolidation of the fractured vertebral body and posterolateral fusion were achieved at a mean time of 4.5 months; fusion rates were 75% in Group 1 and 83% in Group 2. The average collapses of anterior vertebral body height in Group 1, in the immediate postoperative period and at the final follow-up, were 15% and 17%, respectively; and in Group 2, the figures were 16% and 24%, respectively. The correction of vertebral height and kyphosis at the last follow-up were lost more in Group 2 (5.7°) than in Group 1 (4.4°). There were neurological recoveries in 6 of the 9 cases of incomplete paraplegics, including complete recovery in 5, and one-Frankel grade increase in one. There were 15 instrument failures in 12 patients, including screw breakage in 3 Group 1 cases and 6 Group 2 cases. The plug dislodged in 3 Group 1 cases, and the hook dislodged in 3 Group 2 cases. In other words, instrument failures were more common in Group 2. Conclusion. Cotrel-Dubousset stabilisation of the fractured spine achieves fracture consolidation, but does not maintain the restored height and sagittal curve completely until fusion. The long rod and short fusion construct was more effective for all fracture types than was the short rod and fusion construct, although it leads to wider immobilisation of normal segments.

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Taguchi, Toshihiko, Daishirou Yuge, Hiroshi Mimura, Youzi Maehara, Takashi Hashiguchi, and Katsuki Taguchi. "Thoracolumbar Spinal Fracture due to Osteoporosis." Orthopedics & Traumatology 42, no. 4 (1993): 1710–12. http://dx.doi.org/10.5035/nishiseisai.42.1710.

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Bode, Kenneth S., and Peter O. Newton. "Pediatric Nonaccidental Trauma Thoracolumbar Fracture-Dislocation." Spine 32, no. 14 (June 2007): E388—E393. http://dx.doi.org/10.1097/brs.0b013e318067dcad.

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Tezeren, Gunduz, and Ilhami Kuru. "Posterior Fixation of Thoracolumbar Burst Fracture." Journal of Spinal Disorders & Techniques 18, no. 6 (December 2005): 485–88. http://dx.doi.org/10.1097/01.bsd.0000149874.61397.38.

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Sangameswaran, T. K., T. Elango, G. Kesavaperumal, and E. DineshKarthik. "Retrospective analysis of conservatively treated thoracolumbar burst fracture." International Journal of Research in Orthopaedics 3, no. 3 (April 25, 2017): 431. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20170906.

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Background: Thoracolumbar burst fractures accounts for 10 to 40 percent of the spinal column fractures caries a significant morbidity and mortality. Vertebral fractures are usually followed by chronic pain, deformity, loss of height and crowding of internal organs. A combination of the above problems can adversely affect the self-esteem and ability to carry on the daily activities.The objective of the study was to find proportion of the conservatively treated thoracolumbar burst fracture and the factors associated with the final outcome of the treatment with the clinical, radiological evidences.Methods: In this study 36 patients with burst fracture of thoracolumbar spine without neurological deficit, treated conservatively from January 2015–August 2016 were included. The overall follow up period was 18 months. Various radiological parameters were taken in to consideration like Cobb angle, canal stenosis, sagittal alignment, and fragment displacement. Treatment outcome was evaluated by short form survey questionnaire (SF-36), Denis score for pain and work and the visual analogue scale (VAS).Results: The overall functional outcome in this study group 30.55% returned to the previous employment. 25% back to their previous job with restrictions.27.7% unable to return to the previous job but works fulltime in a new job. 16.7% unable to return to full time work. No one is completely disabled. The Cobb angle remains same or decreased in 53% and in 47% with minimum -8 maximum 5. The severe pain score was in 5.6% of cases. Conclusions: Proper selection of patients and their prior activities, social and educational background and future plans in addition to a thorough physical, neurological and spinal examination are mandatory to achieve satisfactory result.

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Ahsan, Md Kamrul, Zabed Zahangiri, M. A. Awwal, Naznin Zaman, Md Hamidul Haque, and Abdullah Al Mahmud. "Posterior fixation including the fractured vertebra in short segment fixation of unstable thoracolumbar junction burst fractures." Bangabandhu Sheikh Mujib Medical University Journal 9, no. 2 (August 17, 2016): 81. http://dx.doi.org/10.3329/bsmmuj.v9i2.29046.

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The aim of this study was to evaluate the efficacy of inclusion of the fractured vertebra in short segment fixation in terms of clinical and the radiological outcomes in unstable thoracolumbar junction burst fractures at a minimum of 1 year follow-up. Records of 52 patients (age: 21-50 years) with thoracolumbar burst fracture (T10–L2) in Magerl Type A fractures underwent posterior pedicle screw fixation including the fractured vertebra. Clinical parameters were back pain using Visual Analogue Score (VAS) and disability using Oswestry disability index (ODI), neurological deficit (using ASIA grade) and radiologic parameters (Cobb angle, the kyphotic deformation and vertebral height) were measured before surgery and at 3, 6 and 12 months post-operatively. The presence of screw breakage, screw pullout, peri-implant loosening, and rod breakage were considered as criteria for implant failure. The majority of fractures resulted due to falls (31 cases), and the remaining cases resulted from car accidents (21 cases). The fractured vertebral body level was L1, T12, L2, T11, and T10 in 23, 17, 6, 4 and 2 cases and achieved satisfactory clinical outcomes according to the modified Mcnab criteria 18, 25, 6 and 3 cases were considered to have excellent, good, fair, and poor outcome. The mean kyphotic angle at pre-, post-operative and final follow-up was 13.5 ± 6.3, 13.4 ± 4.3, 8.5 ± 6. The average loss of kyphosis correction was 6.4 ± 5.2° at the final follow-up. The mean pre- and post-operative kyphotic deformation of vertebral body was 5.1 ± 3.2, 4.8 ± 2.3 and at final follow-up was 4.5 ± 4.0 (p>0.05). The mean anterior and posterior vertebral height also showed significant improvements post-operatively, which were maintained at the final follow-up. The mean ODI and VAS scores at the end of 1 year were 17.4%, 1.7 respectively. There was no case of major complication after surgery and during the follow-up period. In conclusion, reduction of unstable thoracolumbar junction burst fracture can be achieved and maintained with the use of short-segment pedicle screw fixation including the fractured vertebra, avoiding the need for anterior reconstruction.

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Alves, Raphael Vicente, and Wilson T. Asfora. "Minimally invasive surgical management of a fracture-dislocation at the thoracolumbar junction." JBNC - JORNAL BRASILEIRO DE NEUROCIRURGIA 21, no. 2 (March 19, 2018): 118–21. http://dx.doi.org/10.22290/jbnc.v21i2.833.

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Introduction: The surgical approach to treat thoracolumbar fractures is controversial. Case Report: The authors report the case of an L1 fracture-dislocation treated through posterior approach to perform spinal canal decompression, interbody fusion, transpedicular stabilization, posterolateral fusion, and reduction of kyphotic deformity. Conclusion: Minimally invasive surgical procedure with circumferential arthrodesis through the posterior approach could be considered an option to manage selected L1 fracture-dislocation.

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Kim, Nam Hyun, and Jeong Hwan Oh. "Stabilization of Fractures and Fracture-Dislocations of the Thoracolumbar Spine." Journal of the Korean Orthopaedic Association 20, no. 4 (1985): 561. http://dx.doi.org/10.4055/jkoa.1985.20.4.561.

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Carl, Allen L., Scott G. Tromanhauser, and Douglas J. Roger. "Pedicle Screw Instrumentation for Thoracolumbar Burst Fractures and Fracture-Dislocations." Spine 17 (August 1992): 317–24. http://dx.doi.org/10.1097/00007632-199208001-00018.

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Journal articles on the topic 'Thoracolumbar fracture'

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