thoracolumbar_burst_fracture

Thoracolumbar spine fractures account for 90% of spine fractures, with the thoracolumbar burst fracture. subtype corresponding to 20% of this total, with the majority occurring at the junctional area where mechanical load is maximal

(AOSpine thoracolumbar spine injury classification system Subtype A3 or A4).

see Thoracolumbar burst fracture treatment.

A thoracolumbar burst fracture is usually unstable and can cause neurological deficits and angular deformity.

Burst fractures entail the involvement of the middle column, and therefore, they are typically associated with bone fragment in the spinal canal, which may cause compression of the spinal cord, conus medullaris, cauda equina, or a combination of these.

Fortunately, approximately half of the patients with thoracolumbar burst fractures are neurologically intact due to the wide canal diameter.

Fifty-nine consecutive patients were treated with bisegmental short posterior instrumentation and additional vertebroplasty of the fractured vertebra. Twenty-nine patients (male/female 17/12; age: 41.7 ± 15.4 years) underwent implant removal. Changes of segmental kyphosis and disc heights between both groups (with and without implant removal) were compared on lateral X-rays preoperative, postoperative, after 1 year and after implant removal. Risk factors for loss of reduction were analyzed.

Kyphosis increased up to 12 months after implant removal. The loss of bisegmental correction was 6.0 ± 4.2 (range 0° to 16°) 12 months after implant removal. Risk factors for loss of reduction are younger patient age, fractures of the thoracolumbar junction (Th12), and degree of traumatic kyphosis. Intervertebral discs traversed by the stabilization lose height and don't recover within 1 year after implant removal. Without implant removal, disc height of the lower adjacent level is reduced after 24 months.

Short posterior stabilization in combination with vertebroplasty is a treatment alternative for thoracic and lumbar AO A3 fractures. After implant removal kyphosis increases, predominantly in the segment above the augmented vertebra. Risk factors for loss of reduction include younger age, fractures of the thoracolumbar junction (T12), and higher fracture kyphosis 1).


1)
Hoppe S, Aghayev E, Ahmad S, Keel MJB, Ecker TM, Deml M, Benneker LM. Short Posterior Stabilization in Combination With Cement Augmentation for the Treatment of Thoracolumbar Fractures and the Effects of Implant Removal. Global Spine J. 2017 Jun;7(4):317-324. doi: 10.1177/2192568217699185. Epub 2017 Apr 7. PubMed PMID: 28815159; PubMed Central PMCID: PMC5546680.
  • thoracolumbar_burst_fracture.txt
  • Last modified: 2020/12/03 09:48
  • by administrador