Objective: To investigate the effectiveness of injured vertebra fixation with inclined-long pedicle screws combined with interbody fusion for thoracolumbar fracture dislocation with disc injury.
Methods: Between January 2017 and June 2022, 28 patients with thoracolumbar fracture dislocation with disc injury were underwent posterior depression, the injured vertebra fixation with inclined-long pedicle screws, and interbody fusion. There were 22 males and 6 females, with a mean age of 41.4 years (range, 22-58 years). The causes of injury included falling from height in 18 cases, traffic accident in 5 cases, and bruise in 5 cases. Fracture segment included 1 case of T , 7 cases of T , 9 cases of L , and 11 cases of L . According to the American Spinal Injury Association (ASIA) scale, the spinal injuries were graded as grade A in 4 cases, grade B in 2 cases, grade C in 11 cases, and grade D in 11 cases. Preoperative spinal canal encroachment ratio was 17.7%-75.3% (mean, 44.0%); the thoracolumbar injury classification and severity score (TLICS) ranged from 9 to 10 (mean, 9.9). Seventeen patients were associated with other injuries. The time from injury to operation ranged from 1 to 4 days (mean, 2.3 days). The perioperative indicators (operation time, intraoperative blood loss, and the occurrence of complications), clinical evaluation indicators [visual analogue scale (VAS) score and Oswestry Disability Index (ODI)], radiologic evaluation indicators [anterior vertebral height ratio (AVHR), kyphosis Cobb angle (KCA), intervertebral space height (ISH), vertebral wedge angle (VWA), displacement angle (DA), and percent fracture dislocation displacement (PFDD)], neurological function, and interbody fusion were recorded.
Results: The operation time was 110-159 minutes (mean, 130.2 minutes). The intraoperative blood loss was 200-510 mL (mean, 354.3 mL). All incisions healed by first intention, and no surgical complications such as wound infection or hematoma occurred. All patients were followed up 12-15 months (mean, 12.7 months). The chest and lumbar pain significantly relieved, VAS scores and ODI after operation were significantly lower than those before operation, and further decreased with the extension of postoperative time, with significant differences ( <0.05). At last follow-up, the ASIA classification of neurological function of the patients was grade A in 3 cases, grade B in 1 case, grade C in 1 case, grade D in 10 cases, and grade E in 13 cases, which was significantly different from preoperative one ( =-4.772, <0.001). Imaging review showed that AVHR, KCA, ISH, VWA, DA, and PFDD significantly improved at 1 week, 3 months and last follow-up ( <0.05). There was no significant difference between different time points after operation ( >0.05). At last follow-up, according to the modified Brantigan score, all patients achieved good intervertebral bone fusion, including 22 complete fusion and 6 good intervertebral fusion with a few clear lines. No complications such as internal fixation failure or kyphosis occurred during follow-up.
Conclusion: The injured vertebra fixation with inclined-long pedicle screws combined with interbody fusion is an effective treatment for thoracolumbar fracture dislocation with disc injury, which can correct the fracture dislocation, release the nerve compression, restore the injured vertebral height, and reconstruct spinal stabilization.
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http://dx.doi.org/10.7507/1002-1892.202310042 | DOI Listing |
Spine J
December 2024
Department of Orthopaedic Surgery, University of Kansas Medical Center, Kansas City, Kansas; Rocky Mountain Scoliosis and Spine, Denver, CO, USA.
J Neurosurg Spine
December 2024
Departments of1Neurosurgery and.
Objective: Patients undergoing anterior/posterior lumbar fusion surgery can undergo either a single-stage or multistage operation, depending on surgeon preference. The goal of this study was to assess different patient outcomes between single-stage and multistage lumbar fusion procedures in a multicenter setting.
Methods: The Michigan Spine Surgery Improvement Collaborative database was queried for anterior/posterior lumbar fusion surgeries between July 2018 and January 2022.
BMC Musculoskelet Disord
December 2024
Department of Orthopedic Surgery, Hangzhou First People's Hospital, Hangzhou, 310006, China.
Background: This meta-analysis was performed to comprehensively evaluate the efficacy and safety of unilateral biportal endoscopic transforaminal lumbar interbody fusion (UBE-TLIF) versus uniportal endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) for the treatment of lumbar degenerative diseases.
Methods: We electronically searched PubMed, Embase, Scopus, Web of Science, the Cochrane Library, the Wanfang Database, and China National Knowledge Infrastructure to identify controlled clinical studies on the efficacy and safety of UBE-TLIF and Endo-TLIF for lumbar degenerative diseases from database establishment to December 2023. Two researchers screened the literature, extracted data, and evaluated the risk of bias of the included studies.
J Orthop Surg Res
December 2024
The First College of Clinical Medical Science, China Three Gorges University, Yichang, China.
Background Context: As lumbar degenerative diseases become more prevalent in an aging population, there is an increasing demand for surgical interventions, such as posterior lumbar interbody fusion (PLIF). However, cage subsidence (CS), observed in 23.9-54% of cases postoperatively, remains a significant complication.
View Article and Find Full Text PDFJ Orthop Surg Res
December 2024
Department of Orthopedic Spine Surgery, Yan'an Hospital Affiliated to Kunming Medical University, 245, East of Renmin Road, 650051, Kunming, Yunnan, P.R. China.
Background: Degenerative lumbar spondylolisthesis (DLS) with lumbar spinal stenosis (LSS) is a common condition resulting in substantial lower back pain and disability. Surgical intervention is recommended only when conservative treatment fails. This study compared UBE-TLIF and MIS-TLIF regarding clinical outcomes and fusion rates in patients with single-segment DLS with LSS.
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