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      Long versus Short Segment Instrumentation in Osteoporotic Thoracolumbar Vertebral Fracture

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      https://www.riss.kr/link?id=A107811977

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      다국어 초록 (Multilingual Abstract)

      Study DesignRetrospective comparative study.PurposeThis study aimed to compare clinical and radiological data and rate of mechanical complications in elderly patients treated with short segment (SSS) or long segment stabilization (LSS) for thoracolumb...

      Study DesignRetrospective comparative study.PurposeThis study aimed to compare clinical and radiological data and rate of mechanical complications in elderly patients treated with short segment (SSS) or long segment stabilization (LSS) for thoracolumbar junction osteoporotic vertebral fractures (OVFs).Overview of LiteratureA fervent debate is now focused on the treatment of OVF using SSS or LSS. High rate of complications is associated with pedicle screw fixation because of poor bone quality.MethodsPatients over 65 years old with a T-score of <−2.5, affected by (T10–L2) vertebral fracture treated with LSS or SSS pedicle screw fixation, with at least 24 months of follow-up were evaluated. All patients were analyzed with conventional X-ray to evaluate bisegmental kyphotic angle (BKA) and clinically with Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and rate of mechanical complications at 2, 6, 12, and 24 months. Data were expressed as mean±standard deviation. Student t-test was used to compare clinical scores between populations. Mann-Whitney U-test was used to analyze clinical and radiological variable, whereas Fisher’s exact test was used to identify differences in the rate of complications between groups.ResultsA total of 37 patients met the inclusion criteria. Mean follow-up was 33.97±9.26 months. For both groups, ODI and VAS significantly decreased over time with good results (p<0.00001). At the final follow-up, no significant differences were found in terms of ODI and VAS. There was no difference in correction of BKA between groups; however, a significant difference was found in LSS group between pre- and postoperative BKA (p=0.046), whereas no difference was found in SSS group. A significant difference in the rate of mechanical complications was found between groups (p=0.011).ConclusionsBoth treatments showed good clinical and radiological results; however, LSS group showed better BKA correction and lower mechanical complications than SSS group.

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      참고문헌 (Reference)

      1 Langella F, "Xiphopubic angle(XPA)correlates with patient’s reported outcomes in a population of adult spinal deformity : results from a multi-center cohort study" 27 : 670-677, 2018

      2 Dobran M, "Treatment of unstable thoracolumbar junction fractures : shortsegment pedicle fixation with inclusion of the fracture level versus long-segment instrumentation" 158 : 1883-1889, 2016

      3 Assuncao Filho CA, "Thoracolumbar burst fractures, short X long fixation : a metaanalysis" 15 : 78-84, 2016

      4 Girardo M, "The use of percutaneous vertebral augmentation systems in osteoporotic fractures of thoracolumbar spine" 70 : 86-90, 2019

      5 Chotigavanich C, "The surgical treatment of the osteoporotic vertebral compression fracture in the elderly patients with the spinal instrumentation" 92 (92): S109-S115, 2009

      6 Wu Y, "The stability of long-segment and short-segment fixation for treating severe burst fractures at the thoracolumbar junction in osteoporotic bone : a finite element analysis" 14 : e0211676-, 2019

      7 Girardo M, "Surgical treatment of osteoporotic thoraco-lumbar compressive fractures: the use of pedicle screw with augmentation PMMA" 26 (26): 546-551, 2017

      8 Kohno M, "Surgical intervention for osteoporotic vertebral burst fractures in middle-low lumbar spine with special reference to postoperative complications affecting surgical outcomes" 59 : 98-105, 2019

      9 Berjano P, "Successful correction of sagittal imbalance can be calculated on the basis of pelvic incidence and age" 23 (23): 587-596, 2014

      10 Ahsan MK, "Shortsegment versus long-segment stabilization for unstable thoracolumbar junction burst fractures" 26 : 762-774, 2017

      1 Langella F, "Xiphopubic angle(XPA)correlates with patient’s reported outcomes in a population of adult spinal deformity : results from a multi-center cohort study" 27 : 670-677, 2018

      2 Dobran M, "Treatment of unstable thoracolumbar junction fractures : shortsegment pedicle fixation with inclusion of the fracture level versus long-segment instrumentation" 158 : 1883-1889, 2016

      3 Assuncao Filho CA, "Thoracolumbar burst fractures, short X long fixation : a metaanalysis" 15 : 78-84, 2016

      4 Girardo M, "The use of percutaneous vertebral augmentation systems in osteoporotic fractures of thoracolumbar spine" 70 : 86-90, 2019

      5 Chotigavanich C, "The surgical treatment of the osteoporotic vertebral compression fracture in the elderly patients with the spinal instrumentation" 92 (92): S109-S115, 2009

      6 Wu Y, "The stability of long-segment and short-segment fixation for treating severe burst fractures at the thoracolumbar junction in osteoporotic bone : a finite element analysis" 14 : e0211676-, 2019

      7 Girardo M, "Surgical treatment of osteoporotic thoraco-lumbar compressive fractures: the use of pedicle screw with augmentation PMMA" 26 (26): 546-551, 2017

      8 Kohno M, "Surgical intervention for osteoporotic vertebral burst fractures in middle-low lumbar spine with special reference to postoperative complications affecting surgical outcomes" 59 : 98-105, 2019

      9 Berjano P, "Successful correction of sagittal imbalance can be calculated on the basis of pelvic incidence and age" 23 (23): 587-596, 2014

      10 Ahsan MK, "Shortsegment versus long-segment stabilization for unstable thoracolumbar junction burst fractures" 26 : 762-774, 2017

      11 Sallam AM, "Short-segment posterior fixation with index level screws versus long-segment posterior fixation for thoracolumbar spine fracture : angle of correction and pain" 33 : 11-, 2018

      12 Waqar M, "Short versus long-segment posterior fixation in the treatment of thoracolumbar junction fractures : a comparison of outcomes" 31 : 54-57, 2017

      13 Tarek Ahmed Aly, "Short Segment versus Long Segment Pedicle Screws Fixation in Management of Thoracolumbar Burst Fractures: Meta-Analysis" 대한척추외과학회 11 (11): 150-160, 2017

      14 Canbek U, "Posterior fixation of thoracolumbar burst fractures: is it possible to protect one segment in the lumbar region?" 24 : 459-465, 2014

      15 Blattert TR, "Nonsurgical and surgical management of osteoporotic vertebral body fractures : recommendations of the spine section of the German Society for Orthopaedics and Trauma(DGOU)" 8 (8): 50S-55S, 2018

      16 Wood KB, "Management of thoracolumbar spine fractures" 14 : 145-164, 2014

      17 Lehman RA Jr, "Management of osteoporosis in spine surgery" 23 : 253-263, 2015

      18 Rollinghoff M, "Indications and contraindications for vertebroplasty and kyphoplasty" 130 : 765-774, 2010

      19 Girardo M, "Importance of polymethylmethacrylate augmentation in the treatment of thoracolumbar osteoporotic vertebral fractures" 70 : 65-69, 2019

      20 Basaran R, "Finite element analysis of short-versus longsegment posterior fixation for thoracolumbar burst fracture" 128 : e1109-17, 2019

      21 Johnell O, "Epidemiology of osteoporotic fractures" 16 (16): S3-S7, 2005

      22 Girardo M, "Different pedicle osteosynthesis for thoracolumbar vertebral fractures in elderly patients" 27 (27): 198-205, 2018

      23 Schnake KJ, "Development of a classification system (OF-classification) and a score for therapeutic decision-making (OF-score) for osteoporotic thoracolumbar fractures" 5 (5): s-0035-, 2015

      24 Li J, "Comparison of short-segment versus long-segment fixation for the treatment of thoracolumbar burst fracture : a meta-analysis" 10 : 1750-1762, 2017

      25 Gargiulo G, "Clinical comparison between simple laminectomy and laminectomy plus posterior instrumentation in surgical treatment of cervical myelopathy" 29 : 975-982, 2019

      26 Girardo M, "Clinical and radiological union rate evaluation of type 2 odontoid fractures : a comparison between anterior screw fixation and halo vest in elderly patients" 9 : 254-259, 2018

      27 Schnake KJ, "Classification of osteoporotic thoracolumbar spine fractures : recommendations of the spine section of the German Society for Orthopaedics and Trauma(DGOU)" 8 (8): 46S-49S, 2018

      28 Weiser L, "Cement augmentation versus extended dorsal instrumentation in the treatment of osteoporotic vertebral fractures : a biomechanical comparison" 98 (98): 1099-1105, 2016

      29 Ferguson SJ, "Biomechanics of the aging spine" 12 (12): S97-S103, 2003

      30 Schulze M, "Biomechanical characteristics of pedicle screws in osteoporotic vertebrae-comparing a new cadaver corpectomy model and pure pull-out testing" 35 : 167-174, 2017

      31 Baaj AA, "Biomechanical advantage of the index-level pedicle screw in unstable thoracolumbar junction fractures" 14 : 192-197, 2011

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      학술지 이력

      학술지 이력
      연월일 이력구분 이력상세 등재구분
      2024 평가예정 해외DB학술지평가 신청대상 (해외등재 학술지 평가)
      2021-01-01 평가 등재학술지 선정 (해외등재 학술지 평가) KCI등재
      2020-12-01 평가 등재 탈락 (해외등재 학술지 평가)
      2013-10-01 평가 등재학술지 선정 (기타) KCI등재
      2011-01-01 평가 SCOPUS 등재 (신규평가) KCI등재후보
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      기준연도 WOS-KCI 통합IF(2년) KCIF(2년) KCIF(3년)
      2016 0 0 0
      KCIF(4년) KCIF(5년) 중심성지수(3년) 즉시성지수
      0 0 0 0
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