Percutaneous internal fixation combined with kyphoplasty for neurologically intact thoracolumbar fractures: A prospective cohort study of 24 patients with one year of follow-up
Summary Introduction and hypothesis Neurologically intact lumbar and thoracolumbar fractures are frequent but their treatment is not codified. The purpose of this study was to evaluate the effectiveness of minimally invasive treatment of such fractures by percutaneous fixation associated with balloo...
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Veröffentlicht in: | Orthopaedics & traumatology, surgery & research surgery & research, 2011-06, Vol.97 (4), p.389-395 |
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description | Summary Introduction and hypothesis Neurologically intact lumbar and thoracolumbar fractures are frequent but their treatment is not codified. The purpose of this study was to evaluate the effectiveness of minimally invasive treatment of such fractures by percutaneous fixation associated with balloon kyphoplasty. Patients and methods Between November 2008 and July 2010, 24 patients were treated. There were 12 men and 12 women, with a mean age of 53 years (range 20–88 years). Fractures were classified as one Magerl lesion type A1, one type A2, 19 A3 (five A31, 10 A32, four A33), and three type B2. The treatment was kyphoplasty of the fractured vertebra followed by percutaneous fixation of the vertebra above and below the fracture. Patient follow-up included an analysis of pain using the visual analogic score, the Oswestry score, and functional X-ray and CT analysis. Results Surgery lasted a mean 99 minutes. At the last follow-up, the mean pain was scored at 0.9 and the Oswestry score was 13.2. Reduction of vertebral kyphosis was 8.6° and reduction of the corrected regional angle was 7.1°. The gain in vertebral height was 17%. All pedicle screws were positioned correctly and no neurological, septic, or thromboembolic complications were observed. Discussion and conclusion Percutaneous osteosynthesis combined with balloon kyphoplasty is a valuable surgical technique in the treatment of thoracolumbar and lumbar fractures with no neurologic deficit. The clinical results are good and the technique allows the patient to return home earlier without having to wear a corset. The X-ray result scores are very encouraging, with corrections similar to conventional surgery in terms of vertebral height and kyphosis. This technique can be an alternative to conventional open surgery. Level of evidence IV: prospective observational study. |
doi_str_mv | 10.1016/j.otsr.2011.02.009 |
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The purpose of this study was to evaluate the effectiveness of minimally invasive treatment of such fractures by percutaneous fixation associated with balloon kyphoplasty. Patients and methods Between November 2008 and July 2010, 24 patients were treated. There were 12 men and 12 women, with a mean age of 53 years (range 20–88 years). Fractures were classified as one Magerl lesion type A1, one type A2, 19 A3 (five A31, 10 A32, four A33), and three type B2. The treatment was kyphoplasty of the fractured vertebra followed by percutaneous fixation of the vertebra above and below the fracture. Patient follow-up included an analysis of pain using the visual analogic score, the Oswestry score, and functional X-ray and CT analysis. Results Surgery lasted a mean 99 minutes. At the last follow-up, the mean pain was scored at 0.9 and the Oswestry score was 13.2. Reduction of vertebral kyphosis was 8.6° and reduction of the corrected regional angle was 7.1°. The gain in vertebral height was 17%. All pedicle screws were positioned correctly and no neurological, septic, or thromboembolic complications were observed. Discussion and conclusion Percutaneous osteosynthesis combined with balloon kyphoplasty is a valuable surgical technique in the treatment of thoracolumbar and lumbar fractures with no neurologic deficit. The clinical results are good and the technique allows the patient to return home earlier without having to wear a corset. The X-ray result scores are very encouraging, with corrections similar to conventional surgery in terms of vertebral height and kyphosis. This technique can be an alternative to conventional open surgery. Level of evidence IV: prospective observational study.</description><identifier>ISSN: 1877-0568</identifier><identifier>EISSN: 1877-0568</identifier><identifier>DOI: 10.1016/j.otsr.2011.02.009</identifier><identifier>PMID: 21546332</identifier><language>eng</language><publisher>France: Elsevier Masson SAS</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Fracture ; Fracture Fixation, Internal - methods ; Humans ; Injury Severity Score ; Kyphoplasty ; Kyphoplasty - methods ; Lumbar Vertebrae - injuries ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures - methods ; Neurologic Examination ; Orthopedics ; Osteosynthesis ; Pain Measurement ; Percutaneous ; Prospective Studies ; Radiography ; Recovery of Function ; Risk Assessment ; Spinal Fractures - diagnostic imaging ; Spinal Fractures - surgery ; Spine ; Surgery ; Thoracic Vertebrae - injuries ; Thoracolumbar ; Time Factors ; Treatment Outcome ; Vertebroplasty - methods ; Young Adult</subject><ispartof>Orthopaedics & traumatology, surgery & research, 2011-06, Vol.97 (4), p.389-395</ispartof><rights>Elsevier Masson SAS</rights><rights>2011 Elsevier Masson SAS</rights><rights>Copyright © 2011 Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c454t-3fc571547de93fce07549d24872e08db52de416f3c808bdb1eac7974fa7550343</citedby><cites>FETCH-LOGICAL-c454t-3fc571547de93fce07549d24872e08db52de416f3c808bdb1eac7974fa7550343</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.otsr.2011.02.009$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21546332$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bironneau, A</creatorcontrib><creatorcontrib>Bouquet, C</creatorcontrib><creatorcontrib>Millet-Barbe, B</creatorcontrib><creatorcontrib>Leclercq, N</creatorcontrib><creatorcontrib>Pries, P</creatorcontrib><creatorcontrib>Gayet, L.-E</creatorcontrib><title>Percutaneous internal fixation combined with kyphoplasty for neurologically intact thoracolumbar fractures: A prospective cohort study of 24 patients with one year of follow-up</title><title>Orthopaedics & traumatology, surgery & research</title><addtitle>Orthop Traumatol Surg Res</addtitle><description>Summary Introduction and hypothesis Neurologically intact lumbar and thoracolumbar fractures are frequent but their treatment is not codified. The purpose of this study was to evaluate the effectiveness of minimally invasive treatment of such fractures by percutaneous fixation associated with balloon kyphoplasty. Patients and methods Between November 2008 and July 2010, 24 patients were treated. There were 12 men and 12 women, with a mean age of 53 years (range 20–88 years). Fractures were classified as one Magerl lesion type A1, one type A2, 19 A3 (five A31, 10 A32, four A33), and three type B2. The treatment was kyphoplasty of the fractured vertebra followed by percutaneous fixation of the vertebra above and below the fracture. Patient follow-up included an analysis of pain using the visual analogic score, the Oswestry score, and functional X-ray and CT analysis. Results Surgery lasted a mean 99 minutes. At the last follow-up, the mean pain was scored at 0.9 and the Oswestry score was 13.2. Reduction of vertebral kyphosis was 8.6° and reduction of the corrected regional angle was 7.1°. The gain in vertebral height was 17%. All pedicle screws were positioned correctly and no neurological, septic, or thromboembolic complications were observed. Discussion and conclusion Percutaneous osteosynthesis combined with balloon kyphoplasty is a valuable surgical technique in the treatment of thoracolumbar and lumbar fractures with no neurologic deficit. The clinical results are good and the technique allows the patient to return home earlier without having to wear a corset. The X-ray result scores are very encouraging, with corrections similar to conventional surgery in terms of vertebral height and kyphosis. This technique can be an alternative to conventional open surgery. Level of evidence IV: prospective observational study.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cohort Studies</subject><subject>Combined Modality Therapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fracture</subject><subject>Fracture Fixation, Internal - methods</subject><subject>Humans</subject><subject>Injury Severity Score</subject><subject>Kyphoplasty</subject><subject>Kyphoplasty - methods</subject><subject>Lumbar Vertebrae - injuries</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Minimally Invasive Surgical Procedures - methods</subject><subject>Neurologic Examination</subject><subject>Orthopedics</subject><subject>Osteosynthesis</subject><subject>Pain Measurement</subject><subject>Percutaneous</subject><subject>Prospective Studies</subject><subject>Radiography</subject><subject>Recovery of Function</subject><subject>Risk Assessment</subject><subject>Spinal Fractures - diagnostic imaging</subject><subject>Spinal Fractures - surgery</subject><subject>Spine</subject><subject>Surgery</subject><subject>Thoracic Vertebrae - injuries</subject><subject>Thoracolumbar</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Vertebroplasty - methods</subject><subject>Young Adult</subject><issn>1877-0568</issn><issn>1877-0568</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kstu1jAQhSMEoqXwAiyQd6yS2s7FCUJIVcWlUiWQgLXl2GN-_3Xi4EtL3opHxFEKQixYeSSfc-yZb4riOcEVwaQ7P1YuBl9RTEiFaYXx8KA4JT1jJW67_uFf9UnxJIQjxl1Havq4OKGkbbq6pqfFz0_gZYpiBpcCMnMEPwuLtPkhonEzkm4azQwK3Zl4QDfrcnCLFSGuSDuPZkjeWffNSGHtutmFjCgenBfS2TSNwiOd65g8hFfoAi3ehQVkNLeQo7MuohCTWpHTiDZoyY_CHMP-mpsBrZAj8qV21rq7Mi1Pi0da2ADP7s-z4uu7t18uP5TXH99fXV5cl7Jpm1jWWrYsd8kUDLkGzNpmULTpGQXcq7GlChrS6Vr2uB_VSEBINrBGC9a2uG7qs-Llnpu__D1BiHwyQYK1-6h4z0jdD223KemulLm54EHzxZtJ-JUTzDdQ_Mg3UHwDxTHlGVQ2vbiPT-ME6o_lN5kseL0LIDd5a8DzIPNsJCjj8wC5cub_-W_-sUtr5o3TDawQji5tnAMnPGQD_7ytyrYphGCMe9zVvwANob7G</recordid><startdate>20110601</startdate><enddate>20110601</enddate><creator>Bironneau, A</creator><creator>Bouquet, C</creator><creator>Millet-Barbe, B</creator><creator>Leclercq, N</creator><creator>Pries, P</creator><creator>Gayet, L.-E</creator><general>Elsevier Masson SAS</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110601</creationdate><title>Percutaneous internal fixation combined with kyphoplasty for neurologically intact thoracolumbar fractures: A prospective cohort study of 24 patients with one year of follow-up</title><author>Bironneau, A ; Bouquet, C ; Millet-Barbe, B ; Leclercq, N ; Pries, P ; Gayet, L.-E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c454t-3fc571547de93fce07549d24872e08db52de416f3c808bdb1eac7974fa7550343</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cohort Studies</topic><topic>Combined Modality Therapy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fracture</topic><topic>Fracture Fixation, Internal - methods</topic><topic>Humans</topic><topic>Injury Severity Score</topic><topic>Kyphoplasty</topic><topic>Kyphoplasty - methods</topic><topic>Lumbar Vertebrae - injuries</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Minimally Invasive Surgical Procedures - methods</topic><topic>Neurologic Examination</topic><topic>Orthopedics</topic><topic>Osteosynthesis</topic><topic>Pain Measurement</topic><topic>Percutaneous</topic><topic>Prospective Studies</topic><topic>Radiography</topic><topic>Recovery of Function</topic><topic>Risk Assessment</topic><topic>Spinal Fractures - diagnostic imaging</topic><topic>Spinal Fractures - surgery</topic><topic>Spine</topic><topic>Surgery</topic><topic>Thoracic Vertebrae - injuries</topic><topic>Thoracolumbar</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Vertebroplasty - methods</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bironneau, A</creatorcontrib><creatorcontrib>Bouquet, C</creatorcontrib><creatorcontrib>Millet-Barbe, B</creatorcontrib><creatorcontrib>Leclercq, N</creatorcontrib><creatorcontrib>Pries, P</creatorcontrib><creatorcontrib>Gayet, L.-E</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Orthopaedics & traumatology, surgery & research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bironneau, A</au><au>Bouquet, C</au><au>Millet-Barbe, B</au><au>Leclercq, N</au><au>Pries, P</au><au>Gayet, L.-E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Percutaneous internal fixation combined with kyphoplasty for neurologically intact thoracolumbar fractures: A prospective cohort study of 24 patients with one year of follow-up</atitle><jtitle>Orthopaedics & traumatology, surgery & research</jtitle><addtitle>Orthop Traumatol Surg Res</addtitle><date>2011-06-01</date><risdate>2011</risdate><volume>97</volume><issue>4</issue><spage>389</spage><epage>395</epage><pages>389-395</pages><issn>1877-0568</issn><eissn>1877-0568</eissn><abstract>Summary Introduction and hypothesis Neurologically intact lumbar and thoracolumbar fractures are frequent but their treatment is not codified. The purpose of this study was to evaluate the effectiveness of minimally invasive treatment of such fractures by percutaneous fixation associated with balloon kyphoplasty. Patients and methods Between November 2008 and July 2010, 24 patients were treated. There were 12 men and 12 women, with a mean age of 53 years (range 20–88 years). Fractures were classified as one Magerl lesion type A1, one type A2, 19 A3 (five A31, 10 A32, four A33), and three type B2. The treatment was kyphoplasty of the fractured vertebra followed by percutaneous fixation of the vertebra above and below the fracture. Patient follow-up included an analysis of pain using the visual analogic score, the Oswestry score, and functional X-ray and CT analysis. Results Surgery lasted a mean 99 minutes. At the last follow-up, the mean pain was scored at 0.9 and the Oswestry score was 13.2. Reduction of vertebral kyphosis was 8.6° and reduction of the corrected regional angle was 7.1°. The gain in vertebral height was 17%. All pedicle screws were positioned correctly and no neurological, septic, or thromboembolic complications were observed. Discussion and conclusion Percutaneous osteosynthesis combined with balloon kyphoplasty is a valuable surgical technique in the treatment of thoracolumbar and lumbar fractures with no neurologic deficit. The clinical results are good and the technique allows the patient to return home earlier without having to wear a corset. The X-ray result scores are very encouraging, with corrections similar to conventional surgery in terms of vertebral height and kyphosis. This technique can be an alternative to conventional open surgery. Level of evidence IV: prospective observational study.</abstract><cop>France</cop><pub>Elsevier Masson SAS</pub><pmid>21546332</pmid><doi>10.1016/j.otsr.2011.02.009</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Aged Aged, 80 and over Cohort Studies Combined Modality Therapy Female Follow-Up Studies Fracture Fracture Fixation, Internal - methods Humans Injury Severity Score Kyphoplasty Kyphoplasty - methods Lumbar Vertebrae - injuries Male Middle Aged Minimally Invasive Surgical Procedures - methods Neurologic Examination Orthopedics Osteosynthesis Pain Measurement Percutaneous Prospective Studies Radiography Recovery of Function Risk Assessment Spinal Fractures - diagnostic imaging Spinal Fractures - surgery Spine Surgery Thoracic Vertebrae - injuries Thoracolumbar Time Factors Treatment Outcome Vertebroplasty - methods Young Adult |
title | Percutaneous internal fixation combined with kyphoplasty for neurologically intact thoracolumbar fractures: A prospective cohort study of 24 patients with one year of follow-up |
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