Objective: Percutaneous pedicle screw fixation is commonly used for upper lumber burst fractures. The direct decompression remains challenging with this minimally invasive surgery. The objective was to evaluate a novel paraspinal erector approach for effective and direct decompression in patients with canal compromise and neurologic deficit.
Method: Patients (n = 21) with neurological deficiency and Denis B type upper lumbar burst fracture were enrolled in the study, including 14 cases in the L1 and 7 cases in the L2. The patients underwent removal of bone fragments from the spinal canal through intervertebral foramen followed by short-segment fixation. Evaluations included surgery-related, such as duration of surgery and blood loss, and 12-month follow-up, such as the kyphotic angle, the height ratio of the anterior edge of the vertebra, the ratio of sagittal canal compromise, visual analog scale (VAS), Oswestry Disability Index (ODI), and Frankel scores.
Results: All patients achieved direct spinal canal decompression using the paraspinal erector approach followed by percutaneous pedicle screw fixation. The mean operation time (SD) was 173 (23) min, and the mean (SD) blood loss was 301 (104) ml. Significant improvement was noted in the kyphotic angle, 26.2 ± 8.7 prior to operation versus 9.1 ± 4.7 at 12 months after operation (p < 0.05); the height ratio of the anterior edge of the injured vertebra, 60 ± 16% versus 84 ± 9% (p < 0.05); and the ratio of sagittal canal compromise, 46.5 ± 11.4% versus 4.3 ± 3.6% (p < 0.05). Significant improvements in VAS (7.3 ± 1.2 vs. 1.9 ± 0.7, p < 0.05), ODI (86.7 ± 5.8 vs. 16.7 ± 5.1, p < 0.05), and Frankel scores were also noted.
Conclusions: The paraspinal erector approach was effective for direct spinal canal decompression with minimal injury in the paraspinal muscles or spine. Significant improvements in spinal function and prognostics were achieved after the percutaneous pedicle screw fixation.
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http://dx.doi.org/10.1186/s13018-014-0105-4 | DOI Listing |
BMC Anesthesiol
January 2025
Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Background: Postoperative pain remains a significant problem in patients undergoing donor nephrectomy despite reduced tissue trauma following laparoscopic living donor nephrectomy (LLDN). Inadequately treated pain leads to physiological and psychological consequences, including chronic neuropathic pain.
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Clin Orthop Relat Res
January 2025
School of Biomedical Sciences, The University of Queensland, St. Lucia, Australia.
Background: Adolescent idiopathic scoliosis (AIS) is characterized by an asymmetrical formation of the spine and ribcage. Recent work provides evidence of asymmetrical (right versus left side) paraspinal muscle size, composition, and activation amplitude in adolescents with AIS. Each of these factors influences muscle force generation.
View Article and Find Full Text PDFWorld Neurosurg
January 2025
School of Medicine, Zhejiang University, 866 Yuhangtang Rd, Hangzhou 310058, P.R. China; Orthopaedics Center, the Second Affiliated Hospital Zhejiang University School of Medicine, 1511 Jianghong Rd, Hangzho 310014, P.R. China. Electronic address:
Purpose: This study aimed to investigate the impact of paraspinal muscle (PSM) degeneration on coronal balance in patients with degenerative lumbar scoliosis (DLS) METHODS: In this retrospective cross-sectional study, 127 DLS patients who underwent spinal fusion surgery were reviewed. Preoperative X-rays and MRIs were used to assess PSM degeneration, measured by the cross-sectional area (CSA) and fat infiltration rate (FIR) of the multifidus (MF) and erector spinae (ES) muscles. The ratios of the convex to concave sides, namely RCSA and RFIR, were calculated.
View Article and Find Full Text PDFQuant Imaging Med Surg
December 2024
Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
N Am Spine Soc J
December 2024
Northwell Health Long Island Jewish Medical Center, Department of Orthopedic Surgery, 270-05 76th Avenue, Queens, NY 11040, United States.
Background: Prior studies have linked sarcopenia and fat infiltration in paraspinal muscles with lumbar pain, spinal pathology, and adverse postoperative outcomes in lumbar spine surgery. A recent magnetic resonance imaging (MRI)-based method for assessing muscle health, incorporating parameters such as Goutallier Classification (GC) and the Paralumbar Muscle Cross-Sectional Area to Body Mass Index ratio (PL-CSA/BMI), has shown that higher muscle grades correlate with significant improvements in patient-reported outcomes. Despite these advancements, there is limited research on the associations between paralumbar muscle health and factors such as age, BMI, walking tolerability, and spondylolisthesis.
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