scholarly journals Efficacy of Pedicle Screw Fixation in Unstable Upper and Middle Thoracic Spine Fractures

2016 ◽  
Vol 21 (1) ◽  
Author(s):  
Amir Abbas Ghasemi ◽  
Soudabeh Ashoori
2004 ◽  
Vol 4 (5) ◽  
pp. S23-S24
Author(s):  
Fisher Charles ◽  
Vic Sahajpal ◽  
Bailey Christoper ◽  
Michael Boyd ◽  
Brian Kwon ◽  
...  

2006 ◽  
Vol 5 (6) ◽  
pp. 520-526 ◽  
Author(s):  
Charles G. Fisher ◽  
Vic Sahajpal ◽  
Ory Keynan ◽  
Michael Boyd ◽  
Douglas Graeb ◽  
...  

Object The authors evaluated the accuracy of placement and safety of pedicle screws in the treatment of unstable thoracic spine fractures. Methods Patients with unstable fractures between T-1 and T-10, which had been treated with pedicle screw (PS) placement by one of five spine surgeons at a referral center were included in a prospective cohort study. Postoperative computed tomography scans were obtained using 3-mm axial cuts with sagittal reconstructions. Three independent reviewers (C.B., V.S., and D.G.) assessed PS position using a validated grading scale. Comparison of failure rates among cases grouped by selected baseline variables were performed using Pearson chi-square tests. Independent peri- and postoperative surveillance for local and general complications was performed to assess safety. Twenty-three patients with unstable thoracic fractures treated with 201 thoracic PSs were analyzed. Only PSs located between T-1 and T-12 were studied, with the majority of screws placed between T-5 and T-10. Of the 201 thoracic PSs, 133 (66.2%) were fully contained within the pedicle wall. The remaining 68 screws (33.8%) violated the pedicle wall. Of these, 36 (52.9%) were lateral, 27 (39.7%) were medial, and five (7.4%) were anterior perforations. No superior, inferior, anteromedial, or anterolateral perforations were found. When local anatomy and the clinical safety of screws were considered, 98.5% (198 of 201) of the screws were probably in an acceptable position. No baseline variables influenced the incidence of perforations. There were no adverse neurological, vascular, or visceral injuries detected intraoperatively or postoperatively. Conclusions In the vast majority of cases, PSs can be placed in an acceptable and safe position by fellowship-trained spine surgeons when treating unstable thoracic spine fractures. However, an unacceptable screw position can occur.


Spine ◽  
2005 ◽  
Vol 30 (22) ◽  
pp. 2530-2537 ◽  
Author(s):  
Vedat Deviren ◽  
Emre Acaroglu ◽  
Joe Lee ◽  
Masaru Fujita ◽  
Serena Hu ◽  
...  

2019 ◽  
Vol 13 (3) ◽  
pp. 39-44 ◽  
Author(s):  
Tamburrelli FC ◽  
Perna A ◽  
Proietti L ◽  
Zirio G ◽  
Santagada DA ◽  
...  

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ali K Ali ◽  
Ahmed M Hamad ◽  
Ahmed R Farghaly ◽  
Mohamed S Ghaly

Abstract Background Thoracolumbar spine fractures are common injuries that can result in significant disability, deformity and neurological deficit. Controversies exist regarding the appropriate radiological investigations, the indications for surgical management and the timing, approach and type of surgery. Aim of the Work to discuss: Guidelines and controversies of short versus long posterior fixation in management of thoracolumbar spine fractures. Patients and Methods 20 articles were identified through specified electronic databases. After application of the inclusion and exclusion criteria, 9 comparative studies were finally included in this systematic review. Various other approaches were used in combination with posterior pedicle screw fixation according to the underlying pathology (e.g. Discectomy, Laminectomy, Vertebroplasty, Kyphoplasty, etc.). A total of 194 patients underwent short segment pedicle screw fixation compared to 158 patients who underwent Long segment pedicle screw fixation for various indications. The majority of the included trials were small studies with between 12 and 69 participants. The patients’ characteristics were comparable within each study group. Individual patient data were available from these articles. Results A total of 194 patients underwent short segment pedicle screw fixation compared to 158 patients who underwent Long segment pedicle screw fixation for various indications. The majority of the included trials were small studies with between 12 and 69 participants. The patients’ characteristics were comparable within each study group. Individual patients data were available from these articles; longest follow up post operative record was about 71 months; 162 male and 93 female in these studies; the mean age about 38 years; the level of thoracolumbar fracture was: 60 patients at T12,104 patients at L1 and 41 patients at L2. Conclusion This review suggest work on the guidelines with evaluating of each case according to age, angels, height, weight (BMI), comorbidities, ability to anaesthesia and types of instability in the patient before as osteoporosis and kyphosis. Degree of angels of cobb and kyphotic angel which are major factors determine if posterior long or short.


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