Surgical timing prevails as the main factor over morphologic characteristics in the reduction by ligamentotaxis of thoracolumbar burst fractures
Abstract Background thoracolumbar burst fractures are associated with spinal canal occupation. The indirect decompression of the spinal canal and reduction of the fragment can be achieved with the distraction of the middle column and ligamentotaxis. Nevertheless, the factors that influence the effec...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-023-02061-z |
| _version_ | 1827917198279049216 |
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| author | Juan Ignacio Cirillo Ignacio Farias Cristóbal Del Pino Marcos Gimbernat Alejandro Urzúa Carlos Tapia Juan José Zamorano |
| author_facet | Juan Ignacio Cirillo Ignacio Farias Cristóbal Del Pino Marcos Gimbernat Alejandro Urzúa Carlos Tapia Juan José Zamorano |
| author_sort | Juan Ignacio Cirillo |
| collection | DOAJ |
| description | Abstract Background thoracolumbar burst fractures are associated with spinal canal occupation. The indirect decompression of the spinal canal and reduction of the fragment can be achieved with the distraction of the middle column and ligamentotaxis. Nevertheless, the factors that influence the effectiveness of this procedure and its temporality are controversial. Methods The aim of this observational, cross-sectional study was to evaluate the effectiveness of indirect reduction by ligamentotaxis in thoracolumbar burst fractures according to the fracture’s radiologic characteristics and the procedure’s temporality. Patients diagnosed with a thoracolumbar burst fracture between 2010 and 2021 were submitted to indirect reduction by distraction and ligamentotaxis. A retrospective analysis of radiologic characteristics and temporality of the procedure was performed with an independent sample t-test or Pearson’s correlation coefficient, as required. Results A total of 58 patients were included in the analysis. Postoperatively, ligamentotaxis significantly improved all radiologic parameters (canal occupation, endplates distance, and vertebra height). Still, none of the radiological characteristics of the fracture (width, height, position, sagittal angle) were associated with the postoperative change in canal occupation. The endplates distance and the temporality of ligamentotaxis significantly predicted the reduction of the fracture. Conclusion Fragment reduction effectiveness is more significant when performed as early as possible and adequate distraction is achieved using the internal fixator system. The radiologic characteristics of the fractured fragment do not determine its reduction capacity. |
| first_indexed | 2024-03-13T03:24:22Z |
| format | Article |
| id | doaj.art-90cc735f7b54480bb9be5a77e6c05b66 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-13T03:24:22Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-90cc735f7b54480bb9be5a77e6c05b662023-06-25T11:07:39ZengBMCBMC Surgery1471-24822023-06-012311910.1186/s12893-023-02061-zSurgical timing prevails as the main factor over morphologic characteristics in the reduction by ligamentotaxis of thoracolumbar burst fracturesJuan Ignacio Cirillo0Ignacio Farias1Cristóbal Del Pino2Marcos Gimbernat3Alejandro Urzúa4Carlos Tapia5Juan José Zamorano6Hospital del TrabajadorHospital San JoséHospital del TrabajadorHospital del TrabajadorHospital del TrabajadorHospital del TrabajadorHospital del TrabajadorAbstract Background thoracolumbar burst fractures are associated with spinal canal occupation. The indirect decompression of the spinal canal and reduction of the fragment can be achieved with the distraction of the middle column and ligamentotaxis. Nevertheless, the factors that influence the effectiveness of this procedure and its temporality are controversial. Methods The aim of this observational, cross-sectional study was to evaluate the effectiveness of indirect reduction by ligamentotaxis in thoracolumbar burst fractures according to the fracture’s radiologic characteristics and the procedure’s temporality. Patients diagnosed with a thoracolumbar burst fracture between 2010 and 2021 were submitted to indirect reduction by distraction and ligamentotaxis. A retrospective analysis of radiologic characteristics and temporality of the procedure was performed with an independent sample t-test or Pearson’s correlation coefficient, as required. Results A total of 58 patients were included in the analysis. Postoperatively, ligamentotaxis significantly improved all radiologic parameters (canal occupation, endplates distance, and vertebra height). Still, none of the radiological characteristics of the fracture (width, height, position, sagittal angle) were associated with the postoperative change in canal occupation. The endplates distance and the temporality of ligamentotaxis significantly predicted the reduction of the fracture. Conclusion Fragment reduction effectiveness is more significant when performed as early as possible and adequate distraction is achieved using the internal fixator system. The radiologic characteristics of the fractured fragment do not determine its reduction capacity.https://doi.org/10.1186/s12893-023-02061-zThoracolumbarBurst fractureDecompressionTraumaCTSpinal cord injury |
| spellingShingle | Juan Ignacio Cirillo Ignacio Farias Cristóbal Del Pino Marcos Gimbernat Alejandro Urzúa Carlos Tapia Juan José Zamorano Surgical timing prevails as the main factor over morphologic characteristics in the reduction by ligamentotaxis of thoracolumbar burst fractures BMC Surgery Thoracolumbar Burst fracture Decompression Trauma CT Spinal cord injury |
| title | Surgical timing prevails as the main factor over morphologic characteristics in the reduction by ligamentotaxis of thoracolumbar burst fractures |
| title_full | Surgical timing prevails as the main factor over morphologic characteristics in the reduction by ligamentotaxis of thoracolumbar burst fractures |
| title_fullStr | Surgical timing prevails as the main factor over morphologic characteristics in the reduction by ligamentotaxis of thoracolumbar burst fractures |
| title_full_unstemmed | Surgical timing prevails as the main factor over morphologic characteristics in the reduction by ligamentotaxis of thoracolumbar burst fractures |
| title_short | Surgical timing prevails as the main factor over morphologic characteristics in the reduction by ligamentotaxis of thoracolumbar burst fractures |
| title_sort | surgical timing prevails as the main factor over morphologic characteristics in the reduction by ligamentotaxis of thoracolumbar burst fractures |
| topic | Thoracolumbar Burst fracture Decompression Trauma CT Spinal cord injury |
| url | https://doi.org/10.1186/s12893-023-02061-z |
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