Search Results

S pine fractures comprise an estimated 6% of all fractures worldwide. 12 The thoracic and lumbar spinal segments are most commonly involved, with an estimated incidence of 700,000 fractures each year. 46 Thethoracolumbarsegment composed of T10–L2 accounts for more than half of these fractures, with the lower lumbar spine and upper thoracic spine accounting for 32% and 16%, respectively. 22 The role of early surgical stabilization and resultant early mobilization as a method to reduce morbidity and mortality associated with these fractures has sparked

I ntervertebral disc herniations at thethoracolumbar结(T12-L1 L1-2和L2–3) make up only approximately 1%–2% of lumbar disc herniations, 4 , 10 which may be due to the decreased motion occurring at this area of the spinal column. The reported outcomes for discectomy surgery at thethoracolumbarjunction are inferior to those reported in the lower lumbar spine. The worse outcomes forthoracolumbardisc surgery may be related to the anatomical features peculiar to thethoracolumbarregion. The narrow space between the two partes interarticulares

I njuries to thethoracolumbarand lumbar spine account for the majority of traumatic spine injuries. 9 , 51 These injuries can involve compression fractures, burst fractures, flexion-extension injuries (that is, Chance fractures), dislocations, and any combination thereof. In the presence of neurological injury, few would argue that surgical treatment is indicated. However, controversy arises in those cases in which patients are neurologically intact. Wood et al. have demonstrated that in neurologically intact patients operative management of

I nstrumentedthoracolumbarprocedures have experienced a dramatic increase in the US over the last 2 decades. Rajaee et al. 18 reported a 1.8- and 2.7-fold spike in thoracic and lumbar fusions, respectively, between 1998 and 2008. While pedicle screw (PS) fixation is widely believed to improve fusion rates, 2 , 3 it remains a challenging endeavor with inadequate screw placement potentially resulting in postoperative pain, neurological injury, vascular complications, and return to the operating suite. Multiple reports suggest that intraoperative spinal

T he spinal segmental arteries are often divided during anterior approaches to the spine. These arteries variably provide supply to the spinal cord; therefore, ligation carries the potential risk of spinal cord ischemia. Given the paucity of data on this topic, we sought to summarize the literature on spinal cord ischemic complications related to anteriorthoracolumbar通过two-ti脊柱外科ered systematic review of this topic, identifying studies that 1) report the incidence of vasculogenic spinal cord injury with anteriorthoracolumbarspine procedures

S urgical correction for kyphoscoliosis is increasingly being performed in patients with mucopolysaccharidosis (MPS), whose life expectancy has improved since the advent of enzyme replacement therapy and hematopoietic stem cell transplantation. 10 The musculoskeletal manifestations of MPS, including Hunter syndrome, are largely unresponsive to these treatments. 3 , 8 , 11 Reported case series of MPS patients have predominantly included individuals with Type I (Hurler) and Type IV (Morquio) MPS and have described high incidences ofthoracolumbarkyphosis

P ediatric spine injuries account for 1%–10% of all spine traumas and represent 5% of all pediatric bone fractures. 2 , 3 , 5 , 32 The reported incidence ofthoracolumbarfractures in children with spine injuries ranges from 5% to 34%. 5 , 20 Current management strategies for pediatricthoracolumbarfractures rely mostly on the discretion of the treating physician. There is no universally accepted classification system to aid in the decision for fracture management. In 2005, theThoracolumbarInjury Classification and Severity Score (TLICS) was developed with

B urst fractures mostly occur in thethoracolumbarregion and are one of the most common fracture types, especially in younger patients. 2–4 , 13 , 15 Acutethoracolumbarburst fractures are classified according to the AO/OTA Classification 12 as a subgroup of Type A fractures (A3). 7 Burst fractures are defined by involvement of the posterior vertebral body wall. The height of the posterior vertebral wall is often reduced, and spinal canal compromise 11 often accompanies this compression fracture. Burst fractures can be subdivided into incomplete

with or without a TLSO. 3 , 4 The trial showed that treatment with a TLSO is equivalent to treatment without an orthosis out to 24 months postinjury according to our primary outcome measure, the Roland Morris Disability Questionnaire (RMDQ), as well as all other secondary outcome measures. Thus, in select patients with athoracolumbarburst fracture, progressing to early ambulation with education and directed rehabilitation is both safe and equally effective with or without a brace. Concerns about treatment without an orthosis include loss of spinal alignment

I n the trauma population,thoracolumbarspine injuries are frequently encountered, accounting for almost 90% of all spinal fractures. 18 , 21 , 27 , 32 Of these fractures,thoracolumbarburst fractures comprise a significantly high percentage (45%). Fortunately, approximately half of the patients with this injury pattern are neurologically intact. 29 Recent multicenter, prospective cohort data suggest that early (defined as less than 24 hours) surgery of spinal fractures optimizes functional outcomes in those presenting with neurological impairment. 22