Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures

Background Data: Burst fractures are commonly provoked by axial compression which disrupts the anterior column. In this setting, posterior stabilization using pedicle screws alone may lead to delayed kyphosis and instrumentation failure due to inadequate support of the anterior column. Purpose: To...

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Autor principal:	Mohamed Hassanein, MD.
Formato:	article
Lenguaje:	EN
Publicado:	Egyptian Spine Association 2018
Materias:	burst fractures thoracolumbar kyphosis titanium mesh cage Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/bf273104775444249f062fce2939d5fa
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spelling	oai:doaj.org-article:bf273104775444249f062fce2939d5fa2021-12-02T09:01:12ZEvaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures10.21608/esj.2018.4651.10542314-89502314-8969https://doaj.org/article/bf273104775444249f062fce2939d5fa2018-10-01T00:00:00Zhttp://www.esj.journals.ekb.eg/article_26430.htmlhttps://doaj.org/toc/2314-8950https://doaj.org/toc/2314-8969Background Data: Burst fractures are commonly provoked by axial compression which disrupts the anterior column. In this setting, posterior stabilization using pedicle screws alone may lead to delayed kyphosis and instrumentation failure due to inadequate support of the anterior column. Purpose: To evaluate the efficacy of pedicle screw instrumentation combined with transpedicular titanium mesh cage augmentation for treatment of burst fractures. Study Design: Prospective descriptive cohort clinical case study. Patients and Methods: Fourteen neurologically intact patients with acute incomplete thoracolumbar burst fracture (AO type A 3.1), and operated upon through period from January 2016 to June 2017 were included. Patients were treated using a three vertebrae pedicle screw fixation construct combined with bilateral transpedicular titanium mesh cage augmentation of the fracture. Patients were followed for at least one year. Data about pain (VAS), function (ODI) and vertebral body deformity (Beck index and local kyphotic angle) were recorded prospectively. Results: Patients were operated within 5 days after trauma. The mean VAS score improved after surgeryfrom 8.2±1.3 to 3.7±1.1 postoperatively and to 1.8±0.7 at final follow up(P˂0.05). The mean ODI score improved from 69.4±5.2 preoperatively to 17.2±2.4 at final follow up. The mean Beck index improved from 0.63 preoperatively to 0.81 postoperatively and to 0.79 at final follow up. The mean local kyphotic angle improved from 20.4opreoperatively to 11.5opostoperatively and declined to 13.7o at final visit. No patient had neurological deterioration or hardware failure during the follow up.The mean follow up was 13.4±1.8 months. Conclusion: Posterior stabilization using pedicle screw fixation in combination with titanium mesh cage augmentation can maintain vertebral restoration, prevent hardware failure and lead to better clinical outcome. (2018ESJ162) Mohamed Hassanein, MD.Egyptian Spine Associationarticleburst fracturesthoracolumbarkyphosistitanium mesh cageNeurology. Diseases of the nervous systemRC346-429ENEgyptian Spine Journal, Vol 28, Iss 1, Pp 2-12 (2018)
institution	DOAJ
collection	DOAJ
language	EN
topic	burst fractures thoracolumbar kyphosis titanium mesh cage Neurology. Diseases of the nervous system RC346-429
spellingShingle	burst fractures thoracolumbar kyphosis titanium mesh cage Neurology. Diseases of the nervous system RC346-429 Mohamed Hassanein, MD. Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures
description	Background Data: Burst fractures are commonly provoked by axial compression which disrupts the anterior column. In this setting, posterior stabilization using pedicle screws alone may lead to delayed kyphosis and instrumentation failure due to inadequate support of the anterior column. Purpose: To evaluate the efficacy of pedicle screw instrumentation combined with transpedicular titanium mesh cage augmentation for treatment of burst fractures. Study Design: Prospective descriptive cohort clinical case study. Patients and Methods: Fourteen neurologically intact patients with acute incomplete thoracolumbar burst fracture (AO type A 3.1), and operated upon through period from January 2016 to June 2017 were included. Patients were treated using a three vertebrae pedicle screw fixation construct combined with bilateral transpedicular titanium mesh cage augmentation of the fracture. Patients were followed for at least one year. Data about pain (VAS), function (ODI) and vertebral body deformity (Beck index and local kyphotic angle) were recorded prospectively. Results: Patients were operated within 5 days after trauma. The mean VAS score improved after surgeryfrom 8.2±1.3 to 3.7±1.1 postoperatively and to 1.8±0.7 at final follow up(P˂0.05). The mean ODI score improved from 69.4±5.2 preoperatively to 17.2±2.4 at final follow up. The mean Beck index improved from 0.63 preoperatively to 0.81 postoperatively and to 0.79 at final follow up. The mean local kyphotic angle improved from 20.4opreoperatively to 11.5opostoperatively and declined to 13.7o at final visit. No patient had neurological deterioration or hardware failure during the follow up.The mean follow up was 13.4±1.8 months. Conclusion: Posterior stabilization using pedicle screw fixation in combination with titanium mesh cage augmentation can maintain vertebral restoration, prevent hardware failure and lead to better clinical outcome. (2018ESJ162)
format	article
author	Mohamed Hassanein, MD.
author_facet	Mohamed Hassanein, MD.
author_sort	Mohamed Hassanein, MD.
title	Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures
title_short	Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures
title_full	Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures
title_fullStr	Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures
title_full_unstemmed	Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures
title_sort	evaluation of posterior stabilization reinforced with intravertebral titanium mesh cages in treating acute thoracolumbar burst fractures
publisher	Egyptian Spine Association
publishDate	2018
url	https://doaj.org/article/bf273104775444249f062fce2939d5fa
work_keys_str_mv	AT mohamedhassaneinmd evaluationofposteriorstabilizationreinforcedwithintravertebraltitaniummeshcagesintreatingacutethoracolumbarburstfractures
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Evaluation of Posterior Stabilization Reinforced with Intravertebral Titanium Mesh Cages in Treating Acute Thoracolumbar Burst Fractures

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