No abstract available.
Spinal Fractures*

No abstract available.
Cerebrospinal Fluid* ; Spinal Fractures*

STUDY DESIGN: Finite element models of the thoracolumbar spine with various techniques used in spinal fractures were developed to investigate the effects of fixation techniques on spinal stiffness. OBJECTIVES: To develop finite element models of the thoracolumbar spine with various fixation techniques to compare their spinal stiffness characteristics. SUMMARY OF LITERATURE REVIEW: Various anterior and posterior instrumentation options have been applied to stabilize unstable burst fractures of the thoracolumbar spines. The biomechanical effects of different instrumentation options on spinal stability are still unknown. MATERIALS AND METHODS: The 3-D finite element model of the human thoracolumbar spine (T12-L2) was reconstructed from CT images. Various anterior and posterior instrumentation techniques, 1-rod and 2-rod anterior fixations, anterior fixations with posterior fixation, and posterior fixation only, were virtually performed in the developed model with a long cage after corpectomy. Five loading cases, axial compression, flexion, extension, lateral bending, and torsion, were applied up to 1000 N and 10 Nm, respectively. The axial displacement and the rotations of T12 with respect to L2 were measured to analyze the stiffness of the spinal segments. RESULTS: The posterior fixation technique increased the stiffness of the spine the most. The addition of an anterior rod from 1 to 2 increased the stiffness significantly without posterior fixation, but little effect was found with posterior fixation. Among all fixation techniques, the inter-segmental stiffnesses were similar to those of the intact model in torsion cases. In the other loading cases, the inter-segmental stiffnesses were much greater than those of the intact models. CONCLUSIONS: Finite element models of the thoracolumbar spine were developed with various fixation methods. The intact models were validated with in-vitro experimental tests. The posterior fixation technique had a more significant effect on spine stability than did anterior fixation. And anteroposterior fixation techniques provided increased spinal stiffness
Humans ; Spinal Fractures ; Spine

No abstract available.
Disability Evaluation* ; Spinal Fractures*

PURPOSE: To reassess the diagnostic value of plain radiographs, compared with computed tomography, in thediagnosis of acute traumatic spinal fracture. MATERIALS AND METHODS: Forty-six patients (total 64 cases) withacute traumatic spinal fracture were studied using plain radiographs and computed tomography. Fracture site andtype (according to the three-column theory), classification as major or minor injury, stability of fracture, andthe presence of associated soft tissue change were evaluated on plain radiographs and CT. The results of the twoimaging techniques were compared. RESULTS: Excluding eight cases of C1 and C2 fractures, 41 cases involvedfractures of the vertebral body, and 15 involved only the posterior column. Plain radiographs and CT showed,respectively, 27 and 25 cases of simple compression fracture, 13 and 16 of bursting fracture. One case ofcompression fracture was not detected on plain radiographs. The results of classification as major (43/56) orminor (13/56) injury were equivalent on plain and CT films. For the evalvation of unstable fracture, plainradiographs were superior to CT(stable fracture, 46/64; unstable fracture, 18/64), while for the evaluation ofsoft tissue change, CT was better than plain radiographs. CONCLUSION: If correct procedures are meticulouslyadhered to, plain radiographs of acute traumatic spinal injury provide good information for the diagnosis oftraumatic fracture.
Classification ; Diagnosis ; Fractures, Compression ; Humans ; Spinal Fractures* ; Spinal Injuries

STUDY DESIGN: A retrograde study of metal failures at thoracolumbar spinal fractures fixed using pedicle screws. OBJECTIVES: The predictability and usefulness of the McCormack's classifications for metal failures was compared with Magerl's classifications. SUMMARY OF LITERATURE REVIEW: The load sharing classification was introduced to predict metal failure after short-segmental pedicle screw fixation by McCormack. However, its reliability is uncertain. MATERIALS AND METHODS: From July 2000 to July 2003, this study examined the plain radiographs and CT images of 31 out of 46 patients who underwent posterior stabilization using pedicle screws for thoracolumbar fractures and could be followed up at least 1 year. Fractures were classified utilizing Denis's, Magerl's, and McCormack's systems. RESULTS: As a result of analysis of relation between metal failure and classification system by Magerl or McCormack, there was no significant difference in its distribution. There was no correlation between the fixation range and metal failures in type C3 fractures, but there was a correlation between short fixation and metal failures in rotational burst fractures in short fixation. CONCLUSIONS: In order to prevent metal failures after fixing thoracolumbar spinal fractures by pedicle screws, the stability should be evaluated using Magerl's classification and McCormack's total score. In addition, in cases of type C3 fractures according to the Magerl's classification, reconstructions should be carried out with a long segment fixation or anterior supporting bone grafts, particularly when McCormack's total score is greater than 7.
Humans ; Spinal Fractures ; Spine ; Transplants

OBJECTIVE: Percutaneous vertebroplasty is a minimally invasive procedure to relieve or decrease pain in patients with osteoporotic compression fractures. However, vertebroplasty in the osteoporotic burst fracture patients with preoperative canal encroachment are still being debated, because it can aggravate spinal canal encroachment. The objects of this study is evaluation of the changes in spinal canal narrowing after percutaneous vertebroplasty. METHODS: Inclusion criteria was osteoporotic bursting fracture patients with 5 to 20% canal encroachment (less than 5 mm). Exclusion criteria included pathological fractures, unstable vertebral fractures involving the posterior column, and severe neurological deficit. We measured the changes in spinal canal narrowing by pre- and postoperative computed tomography. Degree of canal encroachment was measured as the distance between the imaginary line along the posterior margin of the bony fragment and the maximal anterior imaginary line of the spinal canal in the axial CT scan. RESULTS: This study was based on 10 patients (1 male and 9 female; age range, 52-89 years; mean age, 75 years). The mean decrease in the compression rate of the vertebral body height was 14.4% (43.4% to 29%). The mean decrease in the kyphotic angle was 4.3degrees (11.7degrees to 7.4degrees). The mean preoperative canal encroachment were 3.5 mm and postoperative canal encroachment was 3.7 mm, respectively. The mean preoperative VAS score was 4.3 and postoperative VAS score was 1.4. CONCLUSION: Vertebroplasty can be a safe treatment option for osteoporotic burst fractures with preoperative minimal canal encroachment.
Body Height ; Fractures, Compression ; Fractures, Spontaneous ; Humans ; Kyphosis ; Male ; Osteoporotic Fractures ; Spinal Canal ; Spinal Injuries ; Vertebroplasty

OBJECTIVE: The treatment of multiple thoracolumbar spine fractures according to fracture continuity has rarely been reported. Herein we evaluate the clinical features and outcomes of multiple thoracolumbar fractures depending on continuous or noncontinuous status.METHODS: From January 2010 to January 2016, 48 patients with acute thoracic and lumbar multiple fractures who underwent posterior fusion surgery were evaluated. Patients were divided into two groups (group A : continuous; group B : noncontinuous). We investigated the causes of the injuries, the locations of the injuries, the range of fusion levels, and the functional outcomes based on the patients’ general characteristics.RESULTS: A total of 48 patients were enrolled (group A : 25 patients; group B : 23 patients). Both groups had similar pre-surgical clinical and radiologic features. The fusion level included three segments (group A : 4; group B : 5) or four segments (group A : 19; group B : 5). Group B required more instrumented segments than did group A. Group A scored 23.5 and group B scored 33.4 on the Korean Oswestry Disability Index (KODI) at the time of last follow-up. In both groups, longer fusion was associated with worse KODI score.CONCLUSION: In this study, due to the assumption of similar initial clinical and radiologic features in both group, the mechanism of multiple fractures is presumed to be the same between continuous and noncontinuous fractures. The noncontinuous fracture group had worse KODI scores in long-term follow-up, thought to be due to long fusion level. Therefore, we recommend minimizing the number of segments that are fused in multiple thoracolumbar and lumbar fractures when decompression is not necessary.
Decompression ; Follow-Up Studies ; Fractures, Multiple ; Humans ; Spinal Fractures ; Spine

With the advantages of inflatable bone expander in the treatment of osteoporotic vertebral compression fractures, the number of applications for registration of such products is increasing. Based on the characteristics of the medical device, this article analyzed and summarized the relevant requirements for the basic information, product performance research, product manufacturing, clinical evaluation, and product instructions that should be focused on the registration application dossiers, as well as comply with the requirements of CMDE. The focus of the registration application for Inflatable Bone Expander should be the standardization of the application dossiers, while the difficulty was the scientific rationality of the research data. Comments and suggestions are provided to relevant practitioners on standardization of registration application dossiers. It may help them to optimize the quality of registration application dossiers while improve the efficiency of registration applications.
Bone Cements ; Fractures, Compression ; Humans ; Spinal Fractures ; Treatment Outcome

Humans ; Hip Fractures ; Spinal Fractures ; Acetabulum ; Fracture Fixation ; Osteoporosis