Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Jul 2014
Comparative StudyTranspedicular vertebral body augmentation reinforced with pedicle screw fixation in fresh traumatic A2 and A3 lumbar fractures: comparison between two devices and two bone cements.
This retrospective study compares efficacy and safety of balloon kyphoplasty (BK) with calcium phosphate (Group A) versus KIVA implant with PMMA (Group B) reinforced with three vertebrae pedicle screw constructs for A2 and A3 single fresh non-osteoporotic lumbar (L1-L4) fractures in 38 consecutive age- and diagnosis-matched patient populations. Extracanal leakage of both low-viscosity PMMA and calcium phosphate (CP) as well as the following roentgenographic parameters: segmental kyphosis (SKA), anterior (AVBHr) and posterior (PVBHr) vertebral body height ratio, spinal canal encroachment (SCE) clearance, and functional outcome measures: VAS and SF-36, were recorded and compared between the two groups. All patients in both groups were followed for a minimum 26 (Group A) and 25 (Group B) months. ⋯ VAS and SF-36 improved postoperatively in the patients of both groups. Short-segment construct with the novel KIVA implant restored better than BK-fractured lumbar vertebral body, but this had no impact in functional outcome. Since there was no leakage difference between PMMA and calcium phosphate and no short-term adverse related to PMMA use were observed, we advice the use of PMMA in fresh traumatic lumbar fractures.
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Eur J Orthop Surg Tr · Jul 2014
Pedicle subtraction osteotomy in the lumbar spine: indications, technical aspects, results and complications.
Pedicle subtraction osteotomy (PSO) consists of creating posteriorly trapezoidal shape of a vertebra, usually L3 or L4, in order to recreate lordosis in the lumbar spine. It is usually indicated to treat rigid kyphotic lumbar spine associated with sagittal imbalance and due to degenerative changes or to iatrogenic flat back. PSO is technically demanding with high rates of complications and should be performed by experienced teams. ⋯ It was associated with a non-negligible, but acceptable rate of complications. To limit the risk of mechanical complications, we recommend fusing the adjacent disks whatever the approach (PLIF/TLIF/XLIF). Most complications can be reduced with adequate environment, informed anesthesiologists and experienced surgical team.
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Eur J Orthop Surg Tr · Jul 2014
A retrospective study of treating thoracolumbar spine fractures in ankylosing spondylitis.
Spinal fractures are commonly encountered in ankylosing spondylitis (AS) patients. This study compares the outcome of early surgical treatment with initial conservative treatment for thoracolumbar fractures in patients with AS. From 1996 to 2008, 28 patients with AS were treated either operatively or conservatively for thoracolumbar fractures; however, only 25 patients met the inclusion criteria with a minimum follow-up of 2 years. ⋯ Fracture union was achieved in three cases, and pseudoarthrosis occurred in eight cases. Operative treatment can achieve solid fusion and improve the neurological status, while conservative treatment may result in pseudoarthrosis and progressive neurologic deficit. The results suggest that AS patients with unstable spinal fractures should receive early surgical management to prevent further sequelae.
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Eur J Orthop Surg Tr · Jul 2014
Review Meta Analysis Comparative StudyAdjacent segment degeneration and disease after lumbar fusion compared with motion-preserving procedures: a meta-analysis.
The purpose of our study was to compare lumbar fusion and motion-preserving procedures to determine whether lumbar fusion may be associated with a higher prevalence of adjacent segment degeneration (ASDeg) or adjacent segment disease (ASDis). ⋯ The current evidence suggests that lumbar fusion may result in a higher prevalence of adjacent segment degeneration or disease than motion-preserving procedures.
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Eur J Orthop Surg Tr · Jul 2014
Randomized Controlled Trial Comparative Study Observational StudyPosition of polyaxial versus monoaxial screws in locked plating for proximal humeral fractures: analysis of a prospective randomized study.
Aim of the study was to compare the chosen position of polyaxial locking screws with the position of monoaxial screws in the humeral head of proximal humeral fractures treated by locked plating. ⋯ Treatment Study, Level II.