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Burst fracture

Andrew S Moon, Carly A Cignetti, Jonathan A Isbell, Chong Weng, Sakthivel Rajan Rajaram Manoharan
PURPOSE: Hyperextension-distraction type injury of the thoracolumbar spine is an unstable fracture pattern that generally necessitates surgical stabilization by posterior instrumentation. Care must be taken when positioning these patients from supine to prone due to the unstable nature of their injury. The study objectives were (1) to describe a novel modification of the Jackson table turn technique, which may be safer and more effective than the conventional log-roll method and traditional Jackson table technique for positioning patients with hyperextension-distraction injuries of the thoracolumbar spine from supine to prone in the operating room and (2) to present two cases in which this technique was successfully performed...
February 15, 2019: European Spine Journal
Motonori Kohno, Yuichi Iwamura, Riki Inasaka, Kanichiro Kaneko, Masamitsu Tomioka, Takuya Kawai, Yoichi Aota, Tomoyuki Saito, Yutaka Inaba
The purpose of this study was to investigate the clinical and radiological features of osteoporotic burst fractures affecting levels below the second lumbar (middle-low lumbar) vertebrae, and to clarify the appropriate surgical procedure to avoid postoperative complications. Thirty-eight consecutive patients (nine male, 29 female; mean age: 74.8 years; range: 60-86 years) with burst fractures affecting the middle-low lumbar vertebrae who underwent posterior-instrumented fusion were included. Using the Magerl classification system, these fractures were classified into three types: 16 patients with superior incomplete burst fracture (superior-type), 11 patients with inferior incomplete burst fracture (inferior-type) and 11 patients with complete burst fracture (complete-type)...
February 13, 2019: Neurologia Medico-chirurgica
Suresh Pillai
Introduction: Pathological fractures resulting from trivial trauma may be overlooked, especially, when it is after a road traffic accident. Case Report: A 56-year-old male was operated elsewhere for burst fracture L3 vertebra following a trivial road traffic accident. Due to the persistence of symptoms, he was reevaluated. Magnetic resonance imaging revealed infection at the operated site. The implants were removed, pus drained, and a transpedicular biopsy was taken from L3 vertebral body along with bone marrow aspirate from the iliac crest, suspecting a pathological fracture...
September 2018: Journal of Orthopaedic Case Reports
Alison M Thomas, Daniel K Fahim
BACKGROUND: Kyphoplasty is commonly employed in the treatment of compression fractures in the elderly and is increasingly utilized in the treatment of adult trauma along with concomitant instrumentation. Although kyphoplasty with instrumentation has been reported in pediatric patients, concerns regarding retardation of spinal growth and iatrogenic spinal deformity have been raised. The utilization of kyphoplasty without instrumentation has yet to be reported in the case of pediatric patients...
February 7, 2019: World Neurosurgery
Yueh Wu, Chia-Hsien Chen, Fon-Yih Tsuang, Yi-Cheng Lin, Chang-Jung Chiang, Yi-Jie Kuo
The majority of compressive vertebral fractures in osteoporotic bone occur at the level of the thoracolumbar junction. Immediate decompression is often required in order to reduce the extent of neurological damage. This study evaluated four fixation methods for decompression in patients with thoracolumbar burst fractures, and presented the most suitable method for osteoporotic patients. A finite element model of a T7-L5 spinal segment was created and subjected to an L1 corpectomy to simulate a serious burst fracture...
2019: PloS One
Zhi-Chao Hu, Xiao-Bin Li, Zhen-Hua Feng, Ji-Qi Wang, Lan-Fang Gong, Jiang-Wei Xuan, Xin Fu, Bing-Jie Jiang, Long Wu, Wen-Fei Ni
INTRODUCTION: The optimal treatment for burst fractures of the thoracolumbar spine is controversial. The addition of screws in the fractured segment has been shown to improve construct stiffness, but can aggravate the trauma to the fractured vertebra. Therefore, optimised placement of two pedicle screws at the fracture level is required for the treatment of thoracolumbar burst fractures. This randomised controlled study is the first to examine the efficacy of diverse orders of pedicle screw placement and will provide recommendations for the treatment of patients with thoracolumbar burst fractures...
January 28, 2019: BMJ Open
Felipe Ituarte, Nicholas W Wiegers, Todd Ruppar, Christina Goldstein, Ali Nourbakhsh
STUDY DESIGN: This was a meta-analysis study. OBJECTIVE: To compare different posterior spine fixation methods for burst fracture fixation. SUMMARY OF BACKGROUND DATA: This study was performed to elucidate if the current body of literature supports one posterior spinal fusion fixation method for burst fracture to minimize the rate of implant failure and progression of posttraumatic kyphosis. MATERIALS AND METHODS: An extensive electronic search was conducted using PubMed for pertinent articles...
January 5, 2019: Clinical Spine Surgery
I-Chi Lee, Hui-Ju Wu, Hao-Li Liu
Neural stem/progenitor cells (NSPCs) have the potential to serve as the basic materials for treating severe neural diseases and injuries. Ultrasound exposure is an effective therapy for nonunion fractures and healing fresh wounds through an easy and noninvasive application. According to the results of our preliminary study, low-intensity ultrasound (LIUS) promotes the attachment and differentiation of NSPCs. However, the parameters of and mechanisms by which LIUS induces NSPC differentiation remain unclear...
January 4, 2019: ACS Chemical Neuroscience
Fei Chen, Tao Shi, Yang Li, Han Wang, Fei Luo, Tianyong Hou
BACKGROUND: The posterior longitudinal ligament plays a key role in spinal stability. The purpose of this study was to determine the injuries of the posterior longitudinal ligament (PLL) in thoracolumbar burst fractures. PATIENTS AND METHODS: Patients suffering a thoracolumbar burst fracture from January 2011 to December 2015 were divided into an intact group and a disrupted group according to the status of the PLL. Mid-sagittal canal diameter, width and height of bone fragments, inversion angle and horizontal rotation angle of bone fragments and local kyphosis angle were measured...
December 21, 2018: Der Orthopäde
Kang-Un Kim, Joon Hyuk Choi, Gun Woo Lee
RATIONALE: We report on a patient with a positron emission tomography/computed tomography scans (PET/CT)-negative malignant spine tumor, which had even caused a pathologic fracture, and was eventually confirmed on surgical biopsy. PATIENT CONCERNS: A 67-year-old man visited our emergency department with sudden onset of lower extremities paraplegia after slip down. On examination, gradually increasing paralysis was observed in both lower limbs. DIAGNOSES: Plain radiograph and CT showed an acute burst fracture at T12 with an osteolytic mass lesion within the vertebral body and pedicle, causing severe encroachment of the spinal canal...
December 2018: Medicine (Baltimore)
Juan C Vicenty, Fanor M Saavedra, Juan A Vigo, Emil A Pastrana
OBJECTIVE: The management of thoracolumbar burst fractures often includes combined anterior/posterior approaches with prolonged operative time and complications. The transpedicular approach offers a posterior only approach with circumferential reconstruction and decompression. We aim to present the experience of a single center in the management of thoracolumbar burst fractures using a posterior-only approach for circumferential stabilization and report on this technique's effectiveness in restoring the alignment of the thoracolumbar junction...
December 2018: Puerto Rico Health Sciences Journal
Yazan Al Thaher, Lirong Yang, Steve A Jones, Stefano Perni, Polina Prokopovich
INTRODUCTION: Antibiotic-loaded poly(methyl methacrylate) bone cements (ALBCs) are widely used in total joint replacement (TJR), for local delivery of antibiotics to provide prophylaxis against prosthetic joint infections (PJI). One of the shortcomings of the current generation of ALBCs is that the antibiotic release profile is characterized by a burst over the first few hours followed by a sharp decrease in rate for the following several days (often below minimum inhibitory concentration (MIC)), and, finally, exhaustion (after, typically, ~ 20 d)...
2018: PloS One
Ian A Harris, Adrian Traeger, Ralph Stanford, Christopher G Maher, Rachelle Buchbinder
Lumbar spine fusion is a common procedure associated with a high cost burden and risk of serious complications. We aimed to summarise systematic reviews on the effectiveness of lumbar spine fusion for most diagnoses. We found no high-quality systematic reviews and the risk of bias of the randomised controlled trials in the reviews was generally high. The available evidence does not support a benefit from spine fusion compared to non-operative alternatives for back pain associated with degeneration. The available evidence does not support a clinical benefit from spine fusion compared to non-operative treatment or stabilisation without fusion for thoracolumbar burst fractures...
December 2018: Internal Medicine Journal
Mingzhi Li, Zhenyi Liu, Yao Zhao, Yi Zhou, Ping Huang, Xuan Li, Pengliang Li, Xue Wang, Deping Zhang
Highly pressurized injection pipelines in CO2 flooding often suffer from different types of corrosion defects and mechanical stresses and can easily cause serious damage to the environment. Currently, the descending rule of pipe burst pressures under different defect parameters and tensile loads has not been studied systematically. In this study, a section of injection pipe was used to simulate the burst process of pipe with groove and general corrosion defects. The crack appearance showed that the fracture began at the centre of the longitudinal defect line as an instantaneous ductile rupture and then extended along both sides as a rapid brittle rupture under high stress...
November 23, 2018: Journal of Hazardous Materials
Ulrich J Spiegl, Klaus Fischer, Jörg Schmidt, Jörg Schnoor, Stefan Delank, Christoph Josten, Tobias Schulte, Christoph-Eckhardt Heyde
BACKGROUND: The conservative treatment of traumatic thoracolumbar vertebral fractures is often not clearly defined. METHODS: This review is based on articles retrieved by a systematic search in the PubMed and Web of Science databases for publications up to February 2018 dealing with the conservative treatment of traumatic thoracolumbar vertebral fractures. The search initially yielded 3345 hits, of which 35 were suitable for use in this review. RESULTS: It can be concluded from the available original clinical research on the subject, including three randomized controlled trials (RCTs), that the primary diagnostic evaluation should be with plain x-rays, in the standing position if possible...
October 19, 2018: Deutsches Ärzteblatt International
S Santucci, K T Tallakstad, L Angheluta, L Laurson, R Toussaint, K J Måløy
We study the avalanche and extreme statistics of the global velocity of a crack front, propagating slowly along a weak heterogeneous interface of a transparent polymethyl methacrylate block. The different loading conditions used (imposed constant velocity or creep relaxation) lead to a broad range of average crack front velocities. Our high-resolution and large dataset allows one to characterize in detail the observed intermittent crackling dynamics. We specifically measure the size S , the duration D , as well as the maximum amplitude [Formula: see text] of the global avalanches, defined as bursts in the interfacial crack global velocity time series...
November 26, 2018: Philosophical Transactions. Series A, Mathematical, Physical, and Engineering Sciences
Jian-Feng Zhang, Gang-Liang Wang, Zhi-Jie Zhou, Xiang-Qian Fang, Shuai Chen, Shun-Wu Fan
OBJECTIVE: Turnover of cartilage endplate extracellular matrix (ECM) may play an important role in disc degeneration and low back pain (LBP). However, the expression pattern of pro-inflammatory factors, matrix metalloproteinases (MMP), and tissue inhibitors of metalloproteinases (TIMP) in the cartilage endplates (CEP) of intervertebral discs (IVD) is not understood. We aimed to examine the transcriptional levels of MMP, TIMP, and interleukins (IL), and the correlations between them. METHODS: Thirty degenerated cartilage endplate samples from patients with LBP who underwent lumbar fusion surgery were included in the degenerated group...
November 2018: Orthopaedic Surgery
Junxin Zhang, Hao Liu, Hui Liu, Angela Carley Chen, Fan He, Feng Zhou, Huilin Yang, Tao Liu
PURPOSE: To compare intermediate screws (IS) with kyphoplasty (KP) in posterior short-segment fixation (PSSF) for patients with single-level thoracolumbar burst fractures. METHODS: Between 2010 and 2016, 1465 patients were retrospectively reviewed; 48 patients were enrolled with a minimal follow-up of 2 years. Perioperative and functional outcomes were compared. The regional Cobb angle (CA) was included in radiographic analysis. Implant failures or CA correction loss over 10° were regarded as surgical failures...
November 17, 2018: European Spine Journal
James Y H Yu, Jared Fridley, Ziya Gokaslan, Albert Telfeian, Adetokunbo A Oyelese
BACKGROUND: Minimally invasive (MIS) 'mini-open' lateral retropleural or retroperitoneal approach corpectomy is a well described procedure for treating unstable thoracolumbar burst fractures. Most surgeons incorporate fluoroscopy for localization and determination of hardware placement accuracy, but the utility of computer assisted image guided spinal navigation has not been well described. In this study, we report a series of mini-open lateral approach thoracolumbar corpectomy cases using either fluoroscopy or intraoperative computed tomography (iCT) with computer assisted navigation and discuss the technical nuances and advantages of using iCT with navigation versus fluoroscopy...
November 14, 2018: World Neurosurgery
Jianwei Feng, Li Li, Jianli Jin, Junsheng Dai, Peng Luo
It is generally difficult to predict fractures of low-permeability reservoirs under high confining pressures by data statistical method and simplified strain energy density method. In order to establish a series of geomechanical models for the prediction of multi-scale fractures in brittle tight sandstones, firstly, through a series of rock mechanics experiments and CT scanning, we determined 0.85 σc as the key thresholds for mass release of elastic strain energy and bursting of micro-fractures. A correlation between fracture volume density and strain energy density under uniaxial stress state was developed based on the Theory of Geomechanics...
2018: PloS One
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