Preview

Grekov's Bulletin of Surgery

Advanced search

Analysis of results of reduction of kiphotic deformation by minimally invasive transpedicular stabilization in patients with traumatic compression fractures of thoracolumbar localization

https://doi.org/10.24884/0042-4625-2017-176-5-64-71

Abstract

OBJECTIVE. Minimally invasive correction of posttraumatic deformation and stabilization of damaged segment are important in treatment and prevention of complications after traumatic compression fractures of the vertebral bodies. MATERIAL AND METHODS. Retrospective study was made in 25 patients with A2-A3 fractures of the vertebral bodies at the period from 2014 to 2015. The patients underwent transcutaneous transpedicular fixation. The research was based on prospectively collected data. The authors evaluated the dynamics of kyphotic deformation of the spine (Cobb angle, sagittal index) before and after operation. RESULTS. The elimination of thoracic and lumbar spine traumatic deformation resulted in decrease of Cobb angle from 42º (39…44º) and 17º (8…24º) to 21º (20..23º) and 9º (5…14º), respectively (p < 0,01 and p < 0,03). There wasn’t noted any significant decrease of reduction angle (p =0,38 and p = 0,46). CONCLUSIONS. Percutaneous transpedicular fixation is the effective minimally invasive method of treatment for patients with A2-A3 traumatic compression fractures of the vertebral bodies.

About the Authors

V. A. Byval’Tsev
Irkutsk State Medical University; Railway Clinical Hospital on station Irkutsk-passenger
Russian Federation


A. A. Kalinin
Irkutsk State Medical University; Railway Clinical Hospital on station Irkutsk-passenger
Russian Federation


References

1. Бывальцев В. А., Калинин А. А., Белых Е. Г. Эффективность пункционных методик при лечении пациентов с переломами и гемангиомами тел позвонков // Клин. мед. 2015. № 4. С. 61-66.

2. Бывальцев В. А., Калинин А. А., Будаев А. Э. Оценка клинической эффективности малотравматичного способа транспедикулярной стабилизации в хирургическом лечении пациентов с переломами позвонков грудного и поясничного отделов позвоночника // Вестн. травмат. и ортопед. 2016. № 1. С. 15-20.

3. Бывальцев В. А., Калинин А. А., Сороковиков В. А., Белых Е. Г., Панасенков С. Ю., Григорьев Е. Г. Анализ результатов редукции кифотической деформации с помощью пункционной вертебропластики и стентопластики у пациентов с травматическими компрессионными переломами грудопоясничной локализации // Вестн. травмат. и ортопед. 2014. № 2. С. 12-18.

4. Рамих Э. А. Повреждения грудного и поясничного отделов позвоночника : (окончание) // Хирургия позвоночника. 2008. № 2. С. 94-114.

5. Рерих В. В., Борзых К. О., Лукьянов Д. С., Жеребцов С. В. Торакоскопический вентральный спондилодез в системе хирургического лечения нестабильных повреждений грудного отдела позвоночника // Хирургия позвоночника. 2009. № 2. С. 8-16.

6. Blondel B., Fuentes S., Pech-Gourg G., Adetchessi T., Tropiano P,, Dufour H. Percutaneous management of thoracolumbar burst fractures : evolution of techniques and strategy // Orthop. Traumatol. Surg. Res. 2011. Vol. 97. P. 527-532.

7. Charles Y. P., Walter A., Schuller S., Aldakheel D., Steib J. Thoracolumbar fracture reduction by percutaneous in situ contouring // Eur. Spine J. 2012. Vol. 21. P. 2214-2221.

8. Dhall S. S., Wadhwa R., Wang M. Y., Tien-Smith A., Mummaneni P. V. Traumatic thoracolumbar spinal injury : an algorithm for minimally invasive surgical management // Neurosurg. Focus. 2014. Vol. 37, N 1. P. E9.

9. Dick J. C. Spinal Fractures. New device offers improved treatment // Minnesota Physician. 2001. Vol. 14. Р. 10.

10. Dong S. H., Chen H. N., Tian J. W., Xia T., Wang L., Zhao Q. H., Liu C. Y. Effects of minimally invasive percutaneous and trans-spatiumintermuscular short-segment pedicle instrumentation on thoracolumbar mono-segmental vertebral fractures without neurological compromise // Orthopaedics & Traumatology : Surgery & Research. 2013. Vol. 99. P. 405-411.

11. Faciszewski T., Winter R. B., Lonstein J. E., Denis F., Johnson L. The surgical and medical perioperative complications of anterior spinal fusion surgery in the thoracic and lumbar spine in adults : a review of 1223 procedures // Spine. 1995. Vol. 20. P. 1592-1599.

12. Fang L. M., Zhang Y. J., Zhang J., Huang N., Zuo Z. H., Li B., Wang B., Lin H. G. Minimally invasive percutaneous pedicle screw fixation for the treatment of thoracolumbar fractures and posterior ligamentous complex injuries // J. Peking University (Health Sciences). 2012. Vol. 44. N 6. P. 851-854.

13. Farcry J., Weidenbaum C. M., Glassman S. D. Sagittal index in management of thoracolumbar burst fractures // Spine. 1992. Vol. 15. N 9. P. 958-965.

14. Fuentes S., Blondel B., Metellus P., Gaudart J., Adetchessi T., Dufour H. Percutaneous kyphoplasty and pedicle screw fixation for the management of thoraco-lumbar burst fractures // Eur. Spine. J. 2010. Vol. 19. P. 1281-1287.

15. Gu Y., Zhang F., Jiang X., Jia L., McGuire R. Minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty in the surgical treatment of thoracolumbar osteoporosis fracture // J. Neurosurg. Spine. 2013. Vol. 18, N 6. P. 634-640.

16. Koreckij T., Park D. K., Fischgrund J. Minimally invasive spine surgery in the treatment of thoracolumbar and lumbar spine trauma // Neurosurg. Focus. 2014. Vol. 37, N 1. P. E11.

17. Magerl F., Aebi M., Gertzbein S. D., Harms J., Nazarian S. A comp rehensive classification of thoracic and lumbar injuries // Eur. Spine J. 1994. Vol. 3. P. 184-201.

18. Palmisani M., Gasbarrini A., Brodano G. B., De Iure F., Cappuccio M., Boriani L., Amendola L., Boriani S. Minimally invasive percutaneous fixation in the treatment of thoracic and lumbar spine fractures // Eur. Spine J. 2009. Vol. 18, N 1. P. S71-S74.

19. Park P. K. Foley percutaneous lumbar pedicle screw fixation // Eur. Musculoskelet. Rev. 2007. Vol. 1. P. 59-61.

20. Rahamimov N., Mulla H., Shani A., Freiman S. Percutaneous augmented instrumentation of unstable thoracolumbar burst fractures // Eur. Spine J. 2012. Vol. 21. P. 850-854.

21. Voggenreiter G. Ballonkyphoplasty is effective in deformity correction of osteoporotic vertebral compression fractures // Spine. 2005. Vol. 30. P. 2806-2812.

22. Wilcox R. K., Allen D. J., Hall R. M., Limb D., Barton D. C., Dickson R. A. A dynamic investigation of the burst fracture process using a combined experimental and finite element approach // Eur. Spine J. 2004. Vol. 13. P. 481-488.

23. Wild M. H., Glees M., Plieschnegger C., Wenda K. Five-year follow-up examination after purely minimally invasive percutaneously and conventionally treated patients // Arch. Orthop. Trauma Surg. 2007. Vol. 127. P. 335-343.

24. Yang W. E., Ng Z. X., Koh K. M. R., Low S. W., Lwin S., Choy K. S. D., Seet E., Yeo T. T. Percutaneous pedicle screw fixation for thora columbar burst fracture : a Singapore experience // Sin ga pore Med. J. 2012. Vol. 53. P. 577-581.


Review

For citations:


Byval’Tsev V.A., Kalinin A.A. Analysis of results of reduction of kiphotic deformation by minimally invasive transpedicular stabilization in patients with traumatic compression fractures of thoracolumbar localization. Grekov's Bulletin of Surgery. 2017;176(5):64-71. (In Russ.) https://doi.org/10.24884/0042-4625-2017-176-5-64-71

Views: 475


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 0042-4625 (Print)
ISSN 2686-7370 (Online)