Study Design: This was a retrospective study of the clinical and radiologic outcomes of traumatic thoracolumbar (TL) burst fractures. Objectives: We aimed to evaluate the clinical and radiologic outcomes after 6 years of follow-up of 144 patients with monosegmental TL burst fractures treated with percutaneous short-segment pedicle screw fixation, comparing two groups with versus without placement of an intermediate screw at the fractured vertebra. Summary of Background Data: Traumatic TL fractures are the most common vertebral fractures, especially at the TL junction (T10-L2). Minimally invasive surgery (MIS) is a valuable treatment option for traumatic TL burst fractures. Materials and Methods: The clinical outcomes and radiologic parameters (Cobb angle, midsagittal index, and sagittal index) of 144 patients with traumatic monosegmental TL fractures treated with MIS were evaluated preoperatively, postoperatively, and after 3 and 6 years of follow-up. Patients were categorized into a nonintermediate screw group (nISG) and an intermediate screw group (ISG), and the groups were compared. Results: There were 71 patients (49.3%) in the nISG and 73 patients (50.7%) in the ISG. The radiologic parameters improved significantly more from the preoperative evaluation to the 6-year follow-up in the ISG than in the nISG (P<0.025). There were no significant differences in the mean Oswestry Disability Index (ODI) and Visual Analog Scale scores at the 6-year follow-up between the ISG and the nISG: 15.6% (ISG) versus 16.8% (nISG) for ODI (P<0.1) and 2.2 (ISG) versus 2.4 (nISG) for Visual Analog Scale score (P<0.85) (P<0.73). Conclusions: MIS showed good clinical outcomes 6 years after surgery in both the ISG and the nISG. The additional intermediate screw significantly improved radiologic parameters but not clinical outcomes.

Minimally invasive surgery for the treatment of traumatic monosegmental thoracolumbar burst fractures. clinical and radiologic outcomes of 144 patients with a 6-year follow-up comparing two groups with or without intermediate screw / Trungu, Sokol; Forcato, Stefano; Bruzzaniti, Placido; Fraschetti, Flavia; Miscusi, Massimo; Cimatti, Marco; Raco, Antonino. - In: CLINICAL SPINE SURGERY. - ISSN 2380-0186. - 32:4(2019), pp. 171-176. [10.1097/BSD.0000000000000791]

Minimally invasive surgery for the treatment of traumatic monosegmental thoracolumbar burst fractures. clinical and radiologic outcomes of 144 patients with a 6-year follow-up comparing two groups with or without intermediate screw

Trungu, Sokol
Primo
Writing – Original Draft Preparation
;
Forcato, Stefano
Secondo
Writing – Original Draft Preparation
;
Bruzzaniti, Placido
Methodology
;
Miscusi, Massimo
Writing – Review & Editing
;
Cimatti, Marco
Penultimo
Writing – Review & Editing
;
Raco, Antonino
Ultimo
Supervision
2019

Abstract

Study Design: This was a retrospective study of the clinical and radiologic outcomes of traumatic thoracolumbar (TL) burst fractures. Objectives: We aimed to evaluate the clinical and radiologic outcomes after 6 years of follow-up of 144 patients with monosegmental TL burst fractures treated with percutaneous short-segment pedicle screw fixation, comparing two groups with versus without placement of an intermediate screw at the fractured vertebra. Summary of Background Data: Traumatic TL fractures are the most common vertebral fractures, especially at the TL junction (T10-L2). Minimally invasive surgery (MIS) is a valuable treatment option for traumatic TL burst fractures. Materials and Methods: The clinical outcomes and radiologic parameters (Cobb angle, midsagittal index, and sagittal index) of 144 patients with traumatic monosegmental TL fractures treated with MIS were evaluated preoperatively, postoperatively, and after 3 and 6 years of follow-up. Patients were categorized into a nonintermediate screw group (nISG) and an intermediate screw group (ISG), and the groups were compared. Results: There were 71 patients (49.3%) in the nISG and 73 patients (50.7%) in the ISG. The radiologic parameters improved significantly more from the preoperative evaluation to the 6-year follow-up in the ISG than in the nISG (P<0.025). There were no significant differences in the mean Oswestry Disability Index (ODI) and Visual Analog Scale scores at the 6-year follow-up between the ISG and the nISG: 15.6% (ISG) versus 16.8% (nISG) for ODI (P<0.1) and 2.2 (ISG) versus 2.4 (nISG) for Visual Analog Scale score (P<0.85) (P<0.73). Conclusions: MIS showed good clinical outcomes 6 years after surgery in both the ISG and the nISG. The additional intermediate screw significantly improved radiologic parameters but not clinical outcomes.
2019
burst fracture; fractured vertebra screw; intermediate screw; percutaneous pedicle screw fixation; thoracolumbar fracture; Surgery; Orthopedics and Sports Medicine; Neurology (clinical)
01 Pubblicazione su rivista::01a Articolo in rivista
Minimally invasive surgery for the treatment of traumatic monosegmental thoracolumbar burst fractures. clinical and radiologic outcomes of 144 patients with a 6-year follow-up comparing two groups with or without intermediate screw / Trungu, Sokol; Forcato, Stefano; Bruzzaniti, Placido; Fraschetti, Flavia; Miscusi, Massimo; Cimatti, Marco; Raco, Antonino. - In: CLINICAL SPINE SURGERY. - ISSN 2380-0186. - 32:4(2019), pp. 171-176. [10.1097/BSD.0000000000000791]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1268865
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