The effectiveness of short hybrid stabilization with sublaminar bands and transpedicular screws in the treatment of thoracolumbar spine fractures.

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY
Journal of neurosurgical sciences Pub Date : 2024-08-01 Epub Date: 2022-06-28 DOI:10.23736/S0390-5616.22.05661-2
Carlo Brembilla, Andrea Fanti, Angela D Rampini, Gianluigi Dorelli, Angelo M Sicignano, Giorgio Cracchiolo, Claudio Bernucci
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引用次数: 0

Abstract

Background: Long constructs have always been widely recommended for the treatment of thoracolumbar fractures, due to their biomechanical stability and minimal postoperative loss of correction. However, short constructs have significant advantages, since they enable for better postoperative lumbar mobility and reduce the risk of adjacent segment degeneration. The purpose of this study is to evaluate the safety and efficacy of hybrid screw/sublaminar bands short constructs, used for the treatment of thoracolumbar fractures.

Methods: From June 2015 until November 2017, 20 consecutive patients (14 male, 6 female) with an average age of 52.9 years, exhibiting at least one traumatic fracture in the thoracolumbar region, were treated with hybrid screw/sublaminar bands short constructs. The data for analysis included: duration of the intervention, intraoperative blood loss, complications, and clinical and radiographic postoperative results, compared with the standard for thoracolumbar fixation.

Results: The use of this type of construct allowed for simple reduction, stabilization of the fractures, and restoration of the physiological spine curvatures. During the postoperative period none of the patients had neurological worsening. 18 out of 20 patients were followed up for two years. One patient sustained implant failure six months after surgery and underwent a surgical implant revision with traditional long fixation. After two years, stability and fusion were obtained in all patients, along with correct spine alignment.

Conclusions: Hybrid screw/sublaminar bands short constructs seem to be effective in the treatment of thoracolumbar fractures, providing the same clinical results of the state-of-the-art pedicular screw/rod long constructs, but in addition they allow for better postoperative lumbar mobility and subsequently reduce the risk of adjacent segments degeneration. The results of this clinical case series might support the initiation of prospective randomized trials with more patients, a longer follow-up period, and control groups.

用椎板下带和跨椎螺钉进行短混合稳定术治疗胸腰椎骨折的效果。
背景:长结构因其生物力学稳定性和最小的术后矫正损失,一直被广泛推荐用于治疗胸腰椎骨折。然而,短结构具有显著的优势,因为它能使腰椎在术后有更好的活动度,并降低邻近节段退化的风险。本研究旨在评估用于治疗胸腰椎骨折的混合螺钉/椎板下带短结构的安全性和有效性:自2015年6月至2017年11月,连续20名患者(14名男性,6名女性)(平均年龄52.9岁)接受了混合螺钉/椎板下带短结构治疗,这些患者至少有一处胸腰部创伤性骨折。分析数据包括:干预持续时间、术中失血量、并发症、术后临床和影像学结果以及与胸腰椎固定标准的比较:结果:使用这种结构可以简单地缩小、稳定骨折并恢复脊柱的生理弯曲。术后期间,没有一名患者出现神经功能恶化。20 名患者中有 18 名接受了为期两年的随访。一名患者在术后六个月植入失败,接受了传统的长固定手术。两年后,所有患者都获得了稳定和融合,脊柱排列正确:结论:混合螺钉/椎板下带短型结构似乎能有效治疗胸腰椎骨折,其临床效果与最先进的椎弓根螺钉/长型结构相同,而且术后腰椎活动度更好,从而降低了邻近节段退变的风险。本系列临床病例的结果可能会支持开展前瞻性随机试验,并增加患者人数、延长随访时间和设立对照组。
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来源期刊
Journal of neurosurgical sciences
Journal of neurosurgical sciences CLINICAL NEUROLOGY-SURGERY
CiteScore
3.00
自引率
5.30%
发文量
202
审稿时长
>12 weeks
期刊介绍: The Journal of Neurosurgical Sciences publishes scientific papers on neurosurgery and related subjects (electroencephalography, neurophysiology, neurochemistry, neuropathology, stereotaxy, neuroanatomy, neuroradiology, etc.). Manuscripts may be submitted in the form of ditorials, original articles, review articles, special articles, letters to the Editor and guidelines. The journal aims to provide its readers with papers of the highest quality and impact through a process of careful peer review and editorial work.
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