Zobrazit v EDS

Is restoration of vertebral body height after vertebral body fractures and minimally-invasive dorsal stabilization with polyaxial pedicle screws just an illusion?

Uloženo v:
Podrobná bibliografie
Název: Is restoration of vertebral body height after vertebral body fractures and minimally-invasive dorsal stabilization with polyaxial pedicle screws just an illusion?
Autoři: Simon Thelen, Lisa Oezel, Lena Hilss, Jan-Peter Grassmann, Marcel Betsch, Michael Wild
Zdroj: Arch Orthop Trauma Surg
Informace o vydavateli: Springer Science and Business Media LLC, 2023.
Rok vydání: 2023
Témata: Adult, Vertebral Body, Lumbar Vertebrae, Trauma Surgery, Middle Aged, Illusions, Thoracic Vertebrae, Fractures, Bone, Fracture Fixation, Internal, 03 medical and health sciences, Treatment Outcome, 0302 clinical medicine, Pedicle Screws, Aged [MeSH], Fractures, Bone/complications [MeSH], Kyphosis/etiology [MeSH], Illusions [MeSH], Thoracic Vertebrae/surgery [MeSH], Vertebral Body [MeSH], Kyphosis/surgery [MeSH], Pedicle Screws/adverse effects [MeSH], Polyaxial pedicle screws, Spinal Fractures/surgery [MeSH], Sagittal alignment, Thoracic Vertebrae/injuries [MeSH], Minimal invasive posterior stabilization, Adult [MeSH], Humans [MeSH], Prospective Studies [MeSH], Kyphotic deformity, Lumbar Vertebrae/injuries [MeSH], Treatment Outcome [MeSH], Retrospective Studies [MeSH], Middle Aged [MeSH], Thoracolumbar fractures, Lumbar Vertebrae/surgery [MeSH], Fracture Fixation, Internal/methods [MeSH], Spinal Fractures/complications [MeSH], Spinal Fractures/diagnostic imaging [MeSH], Humans, Spinal Fractures, Prospective Studies, Kyphosis, Aged, Retrospective Studies
Popis: Introduction Thoracolumbar spine fractures often require surgical treatment as they are associated with spinal instability. Optimal operative techniques and treatment are discussed controversially. Aim of our prospective cohort study was to investigate the sagittal alignment after reduction, the secondary loss of reduction and the subjective outcome as well as the causal correlation of these parameters after minimally invasive stabilization of thoracic and lumbar fractures with polyaxial pedicle screws. Materials and methods In a single-center study, a total of 78 patients with an average age of 61 ± 17 years who suffered a fracture of the thoracic or lumbar spine were included and subjected to a clinical and radiological follow-up examination after 8.5 ± 8 months. The kyphotic deformity was measured by determining the vertebral body angle, the mono- and bi-segmental wedge angle at three time points. The patients’ subjective outcome was evaluated by the VAS spine score. Results After surgical therapy, a significant reduction of the traumatic kyphotic deformity was shown with an improvement of all angles (vertebral body angle: 3.2° ± 4.4°, mono- and bi-segmental wedge angle: 3.1° ± 5.6°, 2.0° ± 6.3°). After follow-up, a significant loss of sagittal alignment was observed for all measured parameters with a loss of correction. However, no correlation between the loss of reduction and the subjective outcome regarding the VAS spine scale could be detected. Conclusion The minimally invasive dorsal stabilization of thoracic and lumbar spine fractures with polyaxial pedicle screws achieved a satisfactory reduction of the fracture-induced kyphotic deformity immediately postoperatively with a floss of reduction in the further course. However, maybe the main goal of this surgical procedure should be the prevention of a complete collapse of the vertebral body instead of a long-lasting restoration of anatomic sagittal alignment. Level of evidence II.
Druh dokumentu: Article
Other literature type
Popis souboru: Text
Jazyk: English
ISSN: 1434-3916
DOI: 10.1007/s00402-023-05082-8
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/37838983
https://repository.publisso.de/resource/frl:6523526
Rights: CC BY
Přístupové číslo: edsair.doi.dedup.....c9a3429cd119b5c89e59dcc83af24592
Databáze: OpenAIRE
Popis
Abstrakt:Introduction Thoracolumbar spine fractures often require surgical treatment as they are associated with spinal instability. Optimal operative techniques and treatment are discussed controversially. Aim of our prospective cohort study was to investigate the sagittal alignment after reduction, the secondary loss of reduction and the subjective outcome as well as the causal correlation of these parameters after minimally invasive stabilization of thoracic and lumbar fractures with polyaxial pedicle screws. Materials and methods In a single-center study, a total of 78 patients with an average age of 61 ± 17 years who suffered a fracture of the thoracic or lumbar spine were included and subjected to a clinical and radiological follow-up examination after 8.5 ± 8 months. The kyphotic deformity was measured by determining the vertebral body angle, the mono- and bi-segmental wedge angle at three time points. The patients’ subjective outcome was evaluated by the VAS spine score. Results After surgical therapy, a significant reduction of the traumatic kyphotic deformity was shown with an improvement of all angles (vertebral body angle: 3.2° ± 4.4°, mono- and bi-segmental wedge angle: 3.1° ± 5.6°, 2.0° ± 6.3°). After follow-up, a significant loss of sagittal alignment was observed for all measured parameters with a loss of correction. However, no correlation between the loss of reduction and the subjective outcome regarding the VAS spine scale could be detected. Conclusion The minimally invasive dorsal stabilization of thoracic and lumbar spine fractures with polyaxial pedicle screws achieved a satisfactory reduction of the fracture-induced kyphotic deformity immediately postoperatively with a floss of reduction in the further course. However, maybe the main goal of this surgical procedure should be the prevention of a complete collapse of the vertebral body instead of a long-lasting restoration of anatomic sagittal alignment. Level of evidence II.
ISSN:14343916
DOI:10.1007/s00402-023-05082-8