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Percutaneous vertebral augmentation with polyethylene mesh and allograft bone for traumatic thoracolumbar fractures.

Schulz C, Kunz U, Mauer UM, Mathieu R - Adv Orthop (2015)

Bottom Line: From before to immediately after surgery, all patients showed a significant improvement in mean mono- and bisegmental kyphoses.During the one-year period, there was a significant loss of correction.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, German Armed Forces Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany.

ABSTRACT
Purpose. In cases of traumatic thoracolumbar fractures, percutaneous vertebral augmentation can be used in addition to posterior stabilisation. The use of an augmentation technique with a bone-filled polyethylene mesh as a stand-alone treatment for traumatic vertebral fractures has not yet been investigated. Methods. In this retrospective study, 17 patients with acute type A3.1 fractures of the thoracic or lumbar spine underwent stand-alone augmentation with mesh and allograft bone and were followed up for one year using pain scales and sagittal endplate angles. Results. From before surgery to 12 months after surgery, pain and physical function improved significantly, as indicated by an improvement in the median VAS score and in the median pain and work scale scores. From before to immediately after surgery, all patients showed a significant improvement in mean mono- and bisegmental kyphoses. During the one-year period, there was a significant loss of correction. Conclusions. Based on this data a stand-alone approach with vertebral augmentation with polyethylene mesh and allograft bone is not a suitable therapy option for incomplete burst fractures for a young patient collective.

No MeSH data available.


Related in: MedlinePlus

Mean monosegmental sagittal endplate angles from before surgery to 12 months after the procedure.
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fig1: Mean monosegmental sagittal endplate angles from before surgery to 12 months after the procedure.

Mentions: Figures 1 and 2 show how the mean monosegmental and bisegmental sagittal endplate angles changed during the twelve-month period. From immediately after trauma to the day after PVA patients showed a significant improvement in mean monosegmental kyphosis (from 12.4° to 5.8°, P < 0.001, Wilcoxon's test) and bisegmental kyphosis (from 10.6° to 4.5°, P < 0.001, Wilcoxon's test). During the following 12 months, there was a significant loss of correction (monosegmental: from 5.8° to 11.3°, P < 0.001, Wilcoxon's test; bisegmental: from 4.5° to 10.4°, P < 0.001, Wilcoxon's test). The difference between the degrees of kyphosis that were measured immediately after trauma and 12 months after surgery was no longer significant (monosegmental: 12.4° versus 11.3°, P = 0.166, Wilcoxon's test; bisegmental: 10.6° versus 10.2°, P = 0.45, Wilcoxon's test). Figure 3 shows the best case and Figure 4 the worst case observed in this study. One patient was lost to follow-up. He required revision surgery probably because of inadequate closure of the polyethylene mesh with subsequent extravertebral leakage of granular bone graft material and resulting loss of correction (Figure 5).


Percutaneous vertebral augmentation with polyethylene mesh and allograft bone for traumatic thoracolumbar fractures.

Schulz C, Kunz U, Mauer UM, Mathieu R - Adv Orthop (2015)

Mean monosegmental sagittal endplate angles from before surgery to 12 months after the procedure.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4321100&req=5

fig1: Mean monosegmental sagittal endplate angles from before surgery to 12 months after the procedure.
Mentions: Figures 1 and 2 show how the mean monosegmental and bisegmental sagittal endplate angles changed during the twelve-month period. From immediately after trauma to the day after PVA patients showed a significant improvement in mean monosegmental kyphosis (from 12.4° to 5.8°, P < 0.001, Wilcoxon's test) and bisegmental kyphosis (from 10.6° to 4.5°, P < 0.001, Wilcoxon's test). During the following 12 months, there was a significant loss of correction (monosegmental: from 5.8° to 11.3°, P < 0.001, Wilcoxon's test; bisegmental: from 4.5° to 10.4°, P < 0.001, Wilcoxon's test). The difference between the degrees of kyphosis that were measured immediately after trauma and 12 months after surgery was no longer significant (monosegmental: 12.4° versus 11.3°, P = 0.166, Wilcoxon's test; bisegmental: 10.6° versus 10.2°, P = 0.45, Wilcoxon's test). Figure 3 shows the best case and Figure 4 the worst case observed in this study. One patient was lost to follow-up. He required revision surgery probably because of inadequate closure of the polyethylene mesh with subsequent extravertebral leakage of granular bone graft material and resulting loss of correction (Figure 5).

Bottom Line: From before to immediately after surgery, all patients showed a significant improvement in mean mono- and bisegmental kyphoses.During the one-year period, there was a significant loss of correction.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, German Armed Forces Hospital Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany.

ABSTRACT
Purpose. In cases of traumatic thoracolumbar fractures, percutaneous vertebral augmentation can be used in addition to posterior stabilisation. The use of an augmentation technique with a bone-filled polyethylene mesh as a stand-alone treatment for traumatic vertebral fractures has not yet been investigated. Methods. In this retrospective study, 17 patients with acute type A3.1 fractures of the thoracic or lumbar spine underwent stand-alone augmentation with mesh and allograft bone and were followed up for one year using pain scales and sagittal endplate angles. Results. From before surgery to 12 months after surgery, pain and physical function improved significantly, as indicated by an improvement in the median VAS score and in the median pain and work scale scores. From before to immediately after surgery, all patients showed a significant improvement in mean mono- and bisegmental kyphoses. During the one-year period, there was a significant loss of correction. Conclusions. Based on this data a stand-alone approach with vertebral augmentation with polyethylene mesh and allograft bone is not a suitable therapy option for incomplete burst fractures for a young patient collective.

No MeSH data available.


Related in: MedlinePlus