Biomechanics and clinical outcome after posterior stabilization of mid-thoracic vertebral body fractures: a systematic literature review
| Autor: | Max J. Scheyerer, Klaus J. Schnake, Philipp Bula, Bernhard Ullrich, Ulrich J. Spiegl, Frank Hartmann, Georg Osterhoff |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Vertebral Body Sports medicine Thoracic Injuries Posterior stabilization Review Article Pedicle screw placement Critical Care and Intensive Care Medicine Thoracic Vertebrae 03 medical and health sciences 0302 clinical medicine Thoracic vertebral body Thoracic spine fractures Pedicle Screws Medicine Humans Orthopedics and Sports Medicine 030222 orthopedics Lumbar Vertebrae business.industry Clinical outcome Biomechanics Evidence-based medicine Additional thoracic injuries Surgery Biomechanical Phenomena Normal bone Systematic review Spinal Fusion Treatment Outcome Concomitant Emergency Medicine Spinal Fractures business 030217 neurology & neurosurgery |
| Zdroj: | European Journal of Trauma and Emergency Surgery |
| ISSN: | 1863-9941 |
| Popis: | Purpose The aim of this review is to systematically screen the literature for clinical and biomechanical studies dealing with posterior stabilization of acute traumatic mid-thoracic vertebral fractures in patients with normal bone quality. Methods This review is based on articles retrieved by a systematic search in the PubMed and Web of Science database for publications up to December 2018 dealing with the posterior stabilization of fractures of the mid-thoracic spine. Results Altogether, 1012 articles were retrieved from the literature search. A total of 960 articles were excluded. A total of 16 articles were dealing with the timing of surgery in polytraumatized patients, patients suffering of neurologic deficits after midthoracic fractures, and the impact of concomitant thoracic injuries and were excluded. Thus, 36 remaining original articles were included in this systematic review depicting the topics biomechanics, screw insertion, and outcome after posterior stabilization. The overall level of evidence of the vast majority of studies is low. Conclusion High quality studies are lacking. Long-segmental stabilization is indicated in unstable midthoracic fractures with concomitant sternal fractures. Generally, long-segmental constructs seem to be the safer treatment strategy considering the relative high penetration rate of pedicle screws in this region. Thereby, navigated insertion techniques and intraoperative 3D-imaging help to improve pedicle screw placement accuracy. |
| Databáze: | OpenAIRE |
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