Review
Clinical Neurology
Teerachat Tanasansomboon, Thanachaporn Kittipibul, Worawat Limthongkul, Wicharn Yingsakmongkol, Vit Kotheeranurak, Weerasak Singhatanadgige
Summary: Thoracolumbar burst fractures without neurological deficit are common spinal injuries. The ideal classification and management strategies for this type of injury are controversial and currently being investigated. This article reviews the current literature to provide updated evidence on these topics. The integrity of the posterior ligamentous complex is important in treatment decision-making, and minimally invasive surgery techniques can replace open approaches. Implant removal after stabilization may provide benefits, especially in younger patients.
WORLD NEUROSURGERY
(2022)
Review
Clinical Neurology
Tzu-Yi Chou, Fon-Yih Tsuang, Yu-Lun Hsu, Chung Liang Chai
Summary: This systematic review and meta-analysis compared the outcomes between surgical and non-surgical treatment for thoracolumbar burst fractures without neurological deficit. The results showed little to no difference in pain, functional outcomes, and kyphotic angulation between the two treatment groups at >= 6 months. The certainty of the evidence for all outcomes was very low.
GLOBAL SPINE JOURNAL
(2023)
Article
Clinical Neurology
Azmi Hamzaoglu, Mustafa Elsadig, Selhan Karadereler, Ayhan Mutlu, Yunus Emre Akman, Huseyin Ozturk, Okan Aslanturk, Tunay Sanli, Sinan Kahraman, Meric Enercan
Summary: This retrospective study evaluated the clinical, neurological, and radiological outcomes of posterior vertebral column resection (PVCR) technique for thoracic and thoracolumbar burst fractures. The study found that single-stage PVCR provided complete spinal canal decompression, ideal kyphosis correction, and advantages in improving neurological deficit.
GLOBAL SPINE JOURNAL
(2022)
Article
Clinical Neurology
Abhinandan Reddy Mallepally, Nandan Marathe, Gururaj Sangondimath, Kalidutta Das, Harvinder Singh Chhabra
Summary: This study analyzed the data of patients with osteoporotic vertebral compression fractures who underwent posterior instrumented fusion without neural decompression. The results suggest that instability at the fracture site, rather than neural compression, is the main factor leading to neurological deficits. Additionally, dynamic magnetic resonance imaging is a valuable tool for accurate diagnosis and surgical planning.
GLOBAL SPINE JOURNAL
(2022)
Review
Clinical Neurology
Nikolay Peev, Mehmet Zileli, Salman Sharif, Shahswar Arif, Zarina Brady
Summary: The study aims to clarify the indications for nonsurgical treatment of thoracolumbar fractures, demonstrating that while some types of fractures can be managed conservatively, surgical intervention may still be needed in specific cases. The research calls for further studies to address the relative lack of evidence concerning patients with thoracolumbar fractures.
Article
Medicine, General & Internal
Paul S. Page, Vikas K. Parmar, Evalina Bond, Darnell T. Josiah
Summary: This study reviewed 112 patients treated with thoracolumbar orthosis, showing that A3 and A4 fractures can be conservatively managed with low failure rates. However, at the one-year follow-up, A4 fractures result in significantly worse segmental kyphosis.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2022)
Article
Orthopedics
Xin Song, Donglin Ren, Feng Zhang, Shuai Han, Desheng Wu, Jian Wang
Summary: This retrospective cohort study compared the clinical and radiological outcomes of two treatment strategies for non-osteoporotic AOSpine-type A3 fractures of the thoracolumbar spine with neurological deficits. The study found that minimally invasive surgery (MIS) had shorter surgical time and postoperative hospital stay, as well as less intraoperative blood loss. Radiological outcomes showed similar Cobb angle (CA) and anterior height ratio of the fractured vertebrae (AHRV) at follow-up, but improved degree of canal encroachment (DCE) in the MIS group. Functional outcomes, such as Visual Analog Scale (VAS) scores and Oswestry Disability Index (ODI), were better in the MIS group at 6-month follow-up, but similar at 12-month follow-up. The American Spinal Injury Association (ASIA) score was similar between both groups at 12-month follow-up.
BMC MUSCULOSKELETAL DISORDERS
(2023)
Review
Clinical Neurology
Terence Tan, Milly S. Huang, Joost Rutges, Travis E. Marion, Mark Fitzgerald, Martin K. Hunn, Jin Tee
Summary: This systematic review examined the rate of conservative management failure and predictive factors for neurologically-intact patients with stable traumatic thoracolumbar burst fractures. The study found that 9.2% of patients failed conservative management, with factors such as age, kyphotic angle, residual canal area, and interpedicular distance being predictive of failure. Prospective studies should investigate these factors further to identify patients at risk for conservative management failure.
GLOBAL SPINE JOURNAL
(2022)
Article
Orthopedics
Christopher Lucasti, Maxwell M. Scott, Joshua Slowinski, Mark Maraschiello, Lindsey D. Clark, Joseph M. Kowalski
Summary: Thoracolumbar fractures (TLFs) are common in trauma patients, and the TLICS classification system helps guide surgical decisions. Some patients with TLICS scores <4 who initially receive conservative treatment may later require surgery. Surgical patients have longer hospital stays, but when considering the time between consultation and surgery, the length of stay is similar to that of conservatively treated patients.
JOURNAL OF THE AMERICAN ACADEMY OF ORTHOPAEDIC SURGEONS
(2023)
Review
Clinical Neurology
Salman Sharif, Yousuf Shaikh, Onur Yaman, Mehmet Zileli
Summary: This study formulated specific guidelines for thoracolumbar fracture recommendations regarding surgical techniques and nonfusion surgery through two consensus meetings, concluding that surgical treatment may be a better option in certain situations.
Review
Medicine, General & Internal
Xing Wang, Xiang-Dong Wu, Yanbin Zhang, Zhenglin Zhu, Jile Jiang, Guanqing Li, Jiacheng Liu, Jiashen Shao, Yuqing Sun
Summary: This review examines the benefits and risks of removing pedicle screw implants after fixation of thoracolumbar burst fractures. The possible risks include deformity progression and surgical complications, while the potential benefits include improved range of motion and pain relief. The decision to remove the implants should be made carefully based on individual patient circumstances.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Clinical Neurology
Huiming Yang, Dan Han, Xuan Li
Summary: This study aims to introduce the surgical technique of endoscopic decompression combined with posterior pedicle screw fixation and evaluate its efficacy. A total of 32 patients with TLBFs and neurological deficits were included and underwent various assessments. The results showed that this minimally invasive method was safe and effective in treating TLBFs.
WORLD NEUROSURGERY
(2023)
Article
Health Care Sciences & Services
Elizabeth Cook, Arabella Scantlebury, Alison Booth, Emma Turner, Arun Ranganathan, Almas Khan, Sashin Ahuja, Peter May, Amar Rangan, Jenny Roche, Elizabeth Coleman, Catherine Hilton, Belen Corbacho, Catherine Hewitt, Joy Adamson, David Torgerson, Catriona McDaid
Summary: The feasibility study comparing surgical fixation with conservative treatment for stable thoracolumbar fractures without spinal cord injury showed a slightly lower recruitment rate than anticipated, with patients expressing a strong preference for surgical treatment. Key themes included the lack of clinical consensus on eligibility criteria implementation and lack of equipoise regarding treatment options.
HEALTH TECHNOLOGY ASSESSMENT
(2021)
Article
Clinical Neurology
Sokol Trungu, Luca Ricciardi, Stefano Forcato, Amadeo Piazza, Giancarlo D'Andrea, Filippo Maria Polli, Marco Cimatti, Alessandro Frati, Massimo Miscusi, Antonino Raco
Summary: This retrospective cohort study evaluated the long-term clinical-radiological outcomes of percutaneous pedicle screw fixation (PPSF) in traumatic thoracolumbar (TL) fractures. The results showed significant improvements in clinical and radiological parameters from preoperative to last follow-up measurements. PPSF could be considered as a valuable treatment option for neurologically intact patients with TL fractures.
EUROPEAN SPINE JOURNAL
(2023)
Article
Biotechnology & Applied Microbiology
Guodong Zhang, Yukun Du, Guangzong Jiang, Weiqing Kong, Jianyi Li, Zhongjiao Zhu, Yongming Xi
Summary: This study investigated the biomechanical characteristics of different posterior fixation techniques for osteoporotic thoracolumbar burst fractures. The results showed that long-segment posterior fixation provided the greatest stability, while cortical bone screw fixation provided the smallest stability. Cement-augmented pedicle screw-rod fixation and combined cortical bone screw and pedicle screw fixation exhibited moderate stability.
FRONTIERS IN BIOENGINEERING AND BIOTECHNOLOGY
(2023)
