Spontaneous Spinal Canal Remodeling after Postural Pillow Reduction and Lordotic Posterior Column Compressive Percutaneous Transpedicular Screw Fixation in Neurologically Intact Thoracolumbar Burst Fractures
Objective The optimal treatment methods for thoracolumbar burst fracture with intact neurology are not established yet. Spinal canal integrity, sagittal balance and anterior column intactness are very important for successful outcome in this type of injury. There is no study analyzing restoration of...
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| Format: | Article |
| Language: | English |
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Korean Minimally Invasive Spine Surgery Society
2017-06-01
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| Series: | Journal of Minimally Invasive Spine Surgery and Technique |
| Subjects: | |
| Online Access: | http://www.jmisst.org/upload/pdf/jmisst-2017-00213.pdf |
| _version_ | 1797951540967768064 |
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| author | Hyeun Sung Kim Byapak Paudel Ki Joon Kim Jee Soo Jang Jeong-Hoon Choi Sung Kyun Chung Jeong Hoon Kim Il Tae Jang Seong Hoon Oh Jae Eun Park Sol Lee |
| author_facet | Hyeun Sung Kim Byapak Paudel Ki Joon Kim Jee Soo Jang Jeong-Hoon Choi Sung Kyun Chung Jeong Hoon Kim Il Tae Jang Seong Hoon Oh Jae Eun Park Sol Lee |
| author_sort | Hyeun Sung Kim |
| collection | DOAJ |
| description | Objective The optimal treatment methods for thoracolumbar burst fracture with intact neurology are not established yet. Spinal canal integrity, sagittal balance and anterior column intactness are very important for successful outcome in this type of injury. There is no study analyzing restoration of these parameters by low pressure restoration using postural pillow reduction and lordotic posterior column compressive percutaneous transpedicular screw fixation and this study analyzes canal remodeling, spinal balance and anterior column intactness after this procedure. Methods The surgical procedure included three different elements: (1) preoperative postural pillow reduction for 1-2 days, (2) augmentation of fractured vertebra by polymethylmethacrylate (PMMA) in osteoporotic bone or by non-PMMA materials in non-osteoporotic bone, and (3) lordotic, posterior column compressive, percutaneous transpedicular screw fixation. We measured anterior vertebral height, canal size and lordotic angle preoperatively, immediate postoperatively and after 6 months in 34 patients treated with this technique and were analyzed. Results Of 34 patients 17 were male. The mean age was 52.03±12.51 years. They were followed for 30.68±11.67 months on average. At 6 months, preoperative canal stenosis of 44% remodeled to 12%, preoperative anterior vertebral height of 44% increased to 77% and preoperative average kyphosis of 14 degrees corrected to 3.4 degrees No neurological deterioration noted. Functionally all patients returned to their previous status. Conclusion The postural pillow reduction and lordotic posterior column compressive percutaneous screw fixation in patients with neurologically intact thoracolumbar burst fracture is effective and safe. |
| first_indexed | 2024-04-10T22:32:12Z |
| format | Article |
| id | doaj.art-b2d4bbf54f48421cb45344249e5b9adc |
| institution | Directory Open Access Journal |
| issn | 2508-2043 |
| language | English |
| last_indexed | 2024-04-10T22:32:12Z |
| publishDate | 2017-06-01 |
| publisher | Korean Minimally Invasive Spine Surgery Society |
| record_format | Article |
| series | Journal of Minimally Invasive Spine Surgery and Technique |
| spelling | doaj.art-b2d4bbf54f48421cb45344249e5b9adc2023-01-17T04:09:23ZengKorean Minimally Invasive Spine Surgery SocietyJournal of Minimally Invasive Spine Surgery and Technique2508-20432017-06-0121202610.21182/jmisst.2017.0021327Spontaneous Spinal Canal Remodeling after Postural Pillow Reduction and Lordotic Posterior Column Compressive Percutaneous Transpedicular Screw Fixation in Neurologically Intact Thoracolumbar Burst FracturesHyeun Sung Kim0Byapak Paudel1Ki Joon Kim2Jee Soo Jang3Jeong-Hoon Choi4Sung Kyun Chung5Jeong Hoon Kim6Il Tae Jang7Seong Hoon Oh8Jae Eun Park9Sol Lee10 Department of Neurosurgery, Nanoori Suwon Hospital, Suwon, Korea Department of Neurosurgery, Nanoori Suwon Hospital, Suwon, Korea Department of Neurosurgery, Nanoori Suwon Hospital, Suwon, Korea Department of Neurosurgery, Nanoori Suwon Hospital, Suwon, Korea Department of Neurosurgery, Nanoori Suwon Hospital, Suwon, Korea Department of Neurosurgery, Nanoori Suwon Hospital, Suwon, Korea Department of Neurosurgery, Nanoori Suwon Hospital, Suwon, Korea Department of Neurosurgery, Nanoori Hospital, Seoul, Korea Department of Neurosurgery, Nanoori Incheon Hospital, Incheon, Korea Nanoori Medical Research Institute, Nanoori Hospital, Seoul, Korea Nanoori Medical Research Institute, Nanoori Hospital, Seoul, KoreaObjective The optimal treatment methods for thoracolumbar burst fracture with intact neurology are not established yet. Spinal canal integrity, sagittal balance and anterior column intactness are very important for successful outcome in this type of injury. There is no study analyzing restoration of these parameters by low pressure restoration using postural pillow reduction and lordotic posterior column compressive percutaneous transpedicular screw fixation and this study analyzes canal remodeling, spinal balance and anterior column intactness after this procedure. Methods The surgical procedure included three different elements: (1) preoperative postural pillow reduction for 1-2 days, (2) augmentation of fractured vertebra by polymethylmethacrylate (PMMA) in osteoporotic bone or by non-PMMA materials in non-osteoporotic bone, and (3) lordotic, posterior column compressive, percutaneous transpedicular screw fixation. We measured anterior vertebral height, canal size and lordotic angle preoperatively, immediate postoperatively and after 6 months in 34 patients treated with this technique and were analyzed. Results Of 34 patients 17 were male. The mean age was 52.03±12.51 years. They were followed for 30.68±11.67 months on average. At 6 months, preoperative canal stenosis of 44% remodeled to 12%, preoperative anterior vertebral height of 44% increased to 77% and preoperative average kyphosis of 14 degrees corrected to 3.4 degrees No neurological deterioration noted. Functionally all patients returned to their previous status. Conclusion The postural pillow reduction and lordotic posterior column compressive percutaneous screw fixation in patients with neurologically intact thoracolumbar burst fracture is effective and safe.http://www.jmisst.org/upload/pdf/jmisst-2017-00213.pdfburst fracturecanal remodelingpostural reductionpercutaneouspedicle screw |
| spellingShingle | Hyeun Sung Kim Byapak Paudel Ki Joon Kim Jee Soo Jang Jeong-Hoon Choi Sung Kyun Chung Jeong Hoon Kim Il Tae Jang Seong Hoon Oh Jae Eun Park Sol Lee Spontaneous Spinal Canal Remodeling after Postural Pillow Reduction and Lordotic Posterior Column Compressive Percutaneous Transpedicular Screw Fixation in Neurologically Intact Thoracolumbar Burst Fractures Journal of Minimally Invasive Spine Surgery and Technique burst fracture canal remodeling postural reduction percutaneous pedicle screw |
| title | Spontaneous Spinal Canal Remodeling after Postural Pillow Reduction and Lordotic Posterior Column Compressive Percutaneous Transpedicular Screw Fixation in Neurologically Intact Thoracolumbar Burst Fractures |
| title_full | Spontaneous Spinal Canal Remodeling after Postural Pillow Reduction and Lordotic Posterior Column Compressive Percutaneous Transpedicular Screw Fixation in Neurologically Intact Thoracolumbar Burst Fractures |
| title_fullStr | Spontaneous Spinal Canal Remodeling after Postural Pillow Reduction and Lordotic Posterior Column Compressive Percutaneous Transpedicular Screw Fixation in Neurologically Intact Thoracolumbar Burst Fractures |
| title_full_unstemmed | Spontaneous Spinal Canal Remodeling after Postural Pillow Reduction and Lordotic Posterior Column Compressive Percutaneous Transpedicular Screw Fixation in Neurologically Intact Thoracolumbar Burst Fractures |
| title_short | Spontaneous Spinal Canal Remodeling after Postural Pillow Reduction and Lordotic Posterior Column Compressive Percutaneous Transpedicular Screw Fixation in Neurologically Intact Thoracolumbar Burst Fractures |
| title_sort | spontaneous spinal canal remodeling after postural pillow reduction and lordotic posterior column compressive percutaneous transpedicular screw fixation in neurologically intact thoracolumbar burst fractures |
| topic | burst fracture canal remodeling postural reduction percutaneous pedicle screw |
| url | http://www.jmisst.org/upload/pdf/jmisst-2017-00213.pdf |
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