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Minimal Invasive Circumferential Management of Thoracolumbar Spine Fractures.

Pesenti S, Graillon T, Mansouri N, Rakotozanani P, Blondel B, Fuentes S - Biomed Res Int (2015)

Bottom Line: Both vertebral and regional kyphoses were significantly improved on postoperative evaluation (13° and 7° versus -1° and -9°  P < 0.05, resp.) as well as vertebral body height (0.92 versus 1.16, P < 0.05).At 1-year follow-up, mean loss of correction was 1°.Results of this strategy offer satisfactory and stable results in time.

View Article: PubMed Central - PubMed

Affiliation: Spine Unit, Aix-Marseille Université, CHU Timone, 264 rue Saint-Pierre, 13005 Marseille, France.

ABSTRACT

Introduction: While thoracolumbar fractures are common lesions, no strong consensus is available at the moment.

Objectives: The aim of this study was to evaluate the results of a minimal invasive strategy using percutaneous instrumentation and anterior approach in the management of thoracolumbar unstable fractures.

Methods: 39 patients were included in this retrospective study. Radiologic evaluation was based on vertebral and regional kyphosis, vertebral body height restoration, and fusion rate. Clinical evaluation was based on Visual Analogic Score (VAS). All evaluations were done preoperatively and at 1-year follow-up.

Results: Both vertebral and regional kyphoses were significantly improved on postoperative evaluation (13° and 7° versus -1° and -9°  P < 0.05, resp.) as well as vertebral body height (0.92 versus 1.16, P < 0.05). At 1-year follow-up, mean loss of correction was 1°. A solid fusion was visible in all the cases, and mean VAS was significantly reduced form 8/10 preoperatively to 1/10 at the last follow-up.

Conclusion: Management of thoracolumbar fractures using percutaneous osteosynthesis and minimal invasive anterior approach (telescopic vertebral body prosthesis) is a valuable strategy. Results of this strategy offer satisfactory and stable results in time.

No MeSH data available.


Related in: MedlinePlus

Sagittal pre- (a) and postoperative (b) CT-scan showing a vertebral fracture with a lesion of the superior disc and results after posterior percutaneous osteosynthesis and partial corpectomy.
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fig2: Sagittal pre- (a) and postoperative (b) CT-scan showing a vertebral fracture with a lesion of the superior disc and results after posterior percutaneous osteosynthesis and partial corpectomy.

Mentions: The second step was a partial corpectomy (Figure 2) of the collapsed endplate followed by anterior reconstruction using a telescopic prosthetic body (V-lift, Stryker, Kalamazoo, MI), under lateral fluoroscopic control. According to the fracture level, the approach was either a right minithoracotomy (T4–T8), a left minithoracophrenolombotomy (T10-L2), a left minilombotomy (L3-L4), or a retroperitoneal approach (L5) [11]. The prosthetic body was fulfilled with cancellous bone (from the corpectomy) associated with rhBMP-2 (Inductos, Medtronic Inc., Memphis, Tennessee).


Minimal Invasive Circumferential Management of Thoracolumbar Spine Fractures.

Pesenti S, Graillon T, Mansouri N, Rakotozanani P, Blondel B, Fuentes S - Biomed Res Int (2015)

Sagittal pre- (a) and postoperative (b) CT-scan showing a vertebral fracture with a lesion of the superior disc and results after posterior percutaneous osteosynthesis and partial corpectomy.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663322&req=5

fig2: Sagittal pre- (a) and postoperative (b) CT-scan showing a vertebral fracture with a lesion of the superior disc and results after posterior percutaneous osteosynthesis and partial corpectomy.
Mentions: The second step was a partial corpectomy (Figure 2) of the collapsed endplate followed by anterior reconstruction using a telescopic prosthetic body (V-lift, Stryker, Kalamazoo, MI), under lateral fluoroscopic control. According to the fracture level, the approach was either a right minithoracotomy (T4–T8), a left minithoracophrenolombotomy (T10-L2), a left minilombotomy (L3-L4), or a retroperitoneal approach (L5) [11]. The prosthetic body was fulfilled with cancellous bone (from the corpectomy) associated with rhBMP-2 (Inductos, Medtronic Inc., Memphis, Tennessee).

Bottom Line: Both vertebral and regional kyphoses were significantly improved on postoperative evaluation (13° and 7° versus -1° and -9°  P < 0.05, resp.) as well as vertebral body height (0.92 versus 1.16, P < 0.05).At 1-year follow-up, mean loss of correction was 1°.Results of this strategy offer satisfactory and stable results in time.

View Article: PubMed Central - PubMed

Affiliation: Spine Unit, Aix-Marseille Université, CHU Timone, 264 rue Saint-Pierre, 13005 Marseille, France.

ABSTRACT

Introduction: While thoracolumbar fractures are common lesions, no strong consensus is available at the moment.

Objectives: The aim of this study was to evaluate the results of a minimal invasive strategy using percutaneous instrumentation and anterior approach in the management of thoracolumbar unstable fractures.

Methods: 39 patients were included in this retrospective study. Radiologic evaluation was based on vertebral and regional kyphosis, vertebral body height restoration, and fusion rate. Clinical evaluation was based on Visual Analogic Score (VAS). All evaluations were done preoperatively and at 1-year follow-up.

Results: Both vertebral and regional kyphoses were significantly improved on postoperative evaluation (13° and 7° versus -1° and -9°  P < 0.05, resp.) as well as vertebral body height (0.92 versus 1.16, P < 0.05). At 1-year follow-up, mean loss of correction was 1°. A solid fusion was visible in all the cases, and mean VAS was significantly reduced form 8/10 preoperatively to 1/10 at the last follow-up.

Conclusion: Management of thoracolumbar fractures using percutaneous osteosynthesis and minimal invasive anterior approach (telescopic vertebral body prosthesis) is a valuable strategy. Results of this strategy offer satisfactory and stable results in time.

No MeSH data available.


Related in: MedlinePlus