Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures
Background Data: Burst fractures are commonly provoked by axial compression which disrupts the anterior column. In this setting, posterior stabilization using pedicle screws alone may lead to delayed kyphosis and instrumentation failure due to inadequate support of the anterior column. Purpose: To...
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| Format: | Article |
| Language: | English |
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Egyptian Spine Association
2018-10-01
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| Series: | Egyptian Spine Journal |
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| Online Access: | http://www.esj.journals.ekb.eg/article_26430.html |
| _version_ | 1818889082731757568 |
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| author | Mohamed Hassanein, MD. |
| author_facet | Mohamed Hassanein, MD. |
| author_sort | Mohamed Hassanein, MD. |
| collection | DOAJ |
| description | Background Data: Burst fractures are commonly provoked by axial compression which disrupts the anterior column. In this setting, posterior stabilization using pedicle screws alone may lead to delayed kyphosis and instrumentation failure due to inadequate support of the anterior column.
Purpose: To evaluate the efficacy of pedicle screw instrumentation combined with transpedicular titanium mesh cage augmentation for treatment of burst fractures.
Study Design: Prospective descriptive cohort clinical case study.
Patients and Methods: Fourteen neurologically intact patients with acute incomplete thoracolumbar burst fracture (AO type A 3.1), and operated upon through period from January 2016 to June 2017 were included. Patients were treated using a three vertebrae pedicle screw fixation construct combined with bilateral transpedicular titanium mesh cage augmentation of the fracture. Patients were followed for at least one year. Data about pain (VAS), function (ODI) and vertebral body deformity (Beck index and local kyphotic angle) were recorded prospectively.
Results: Patients were operated within 5 days after trauma. The mean VAS score improved after surgeryfrom 8.2±1.3 to 3.7±1.1 postoperatively and to 1.8±0.7 at final follow up(P˂0.05). The mean ODI score improved from 69.4±5.2 preoperatively to 17.2±2.4 at final follow up. The mean Beck index improved from 0.63 preoperatively to 0.81 postoperatively and to 0.79 at final follow up. The mean local kyphotic angle improved from 20.4opreoperatively to 11.5opostoperatively and declined to 13.7o at final visit. No patient had neurological deterioration or hardware failure during the follow up.The mean follow up was 13.4±1.8 months.
Conclusion: Posterior stabilization using pedicle screw fixation in combination with titanium mesh cage augmentation can maintain vertebral restoration, prevent hardware failure and lead to better clinical outcome. (2018ESJ162) |
| first_indexed | 2024-12-19T17:03:22Z |
| format | Article |
| id | doaj.art-bf273104775444249f062fce2939d5fa |
| institution | Directory Open Access Journal |
| issn | 2314-8950 2314-8969 |
| language | English |
| last_indexed | 2024-12-19T17:03:22Z |
| publishDate | 2018-10-01 |
| publisher | Egyptian Spine Association |
| record_format | Article |
| series | Egyptian Spine Journal |
| spelling | doaj.art-bf273104775444249f062fce2939d5fa2022-12-21T20:13:14ZengEgyptian Spine AssociationEgyptian Spine Journal2314-89502314-89692018-10-0128121210.21608/esj.2018.4651.1054Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst FracturesMohamed Hassanein, MD.0Neurosurgery Department, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.Background Data: Burst fractures are commonly provoked by axial compression which disrupts the anterior column. In this setting, posterior stabilization using pedicle screws alone may lead to delayed kyphosis and instrumentation failure due to inadequate support of the anterior column. Purpose: To evaluate the efficacy of pedicle screw instrumentation combined with transpedicular titanium mesh cage augmentation for treatment of burst fractures. Study Design: Prospective descriptive cohort clinical case study. Patients and Methods: Fourteen neurologically intact patients with acute incomplete thoracolumbar burst fracture (AO type A 3.1), and operated upon through period from January 2016 to June 2017 were included. Patients were treated using a three vertebrae pedicle screw fixation construct combined with bilateral transpedicular titanium mesh cage augmentation of the fracture. Patients were followed for at least one year. Data about pain (VAS), function (ODI) and vertebral body deformity (Beck index and local kyphotic angle) were recorded prospectively. Results: Patients were operated within 5 days after trauma. The mean VAS score improved after surgeryfrom 8.2±1.3 to 3.7±1.1 postoperatively and to 1.8±0.7 at final follow up(P˂0.05). The mean ODI score improved from 69.4±5.2 preoperatively to 17.2±2.4 at final follow up. The mean Beck index improved from 0.63 preoperatively to 0.81 postoperatively and to 0.79 at final follow up. The mean local kyphotic angle improved from 20.4opreoperatively to 11.5opostoperatively and declined to 13.7o at final visit. No patient had neurological deterioration or hardware failure during the follow up.The mean follow up was 13.4±1.8 months. Conclusion: Posterior stabilization using pedicle screw fixation in combination with titanium mesh cage augmentation can maintain vertebral restoration, prevent hardware failure and lead to better clinical outcome. (2018ESJ162)http://www.esj.journals.ekb.eg/article_26430.htmlburst fracturesthoracolumbarkyphosistitanium mesh cage |
| spellingShingle | Mohamed Hassanein, MD. Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures Egyptian Spine Journal burst fractures thoracolumbar kyphosis titanium mesh cage |
| title | Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures |
| title_full | Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures |
| title_fullStr | Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures |
| title_full_unstemmed | Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures |
| title_short | Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures |
| title_sort | evaluation of posterior stabilization reinforced with intravertebral titanium mesh cages in treating acute thoracolumbar burst fractures |
| topic | burst fractures thoracolumbar kyphosis titanium mesh cage |
| url | http://www.esj.journals.ekb.eg/article_26430.html |
| work_keys_str_mv | AT mohamedhassaneinmd evaluationofposteriorstabilizationreinforcedwithintravertebraltitaniummeshcagesintreatingacutethoracolumbarburstfractures |