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Original Article
Comparison of Percutaneous versus Open Pedicle Screw Fixation for Treating Unstable Thoracolumbar Fractures
Jin Young Han, Ki Youn Kwon
J Korean Fract Soc 2020;33(1):1-8.   Published online January 31, 2020
DOI: https://doi.org/10.12671/jkfs.2020.33.1.1
AbstractAbstract PDF
PURPOSE
This study compared the clinical and radiological results between two groups of patients with percutaneous fixation or conventional fixation after hardware removal.
MATERIALS AND METHODS
The study analyzed 68 patients (43 open fixation and 43 percutaneous screw fixation [PSF] 25) who had undergone fixation for unstable thoracolumbar fractures. The radiologic results were obtained using the lateral radiographs taken before and after the fixation and at the time of hardware removal. The clinical results included the time of operation, blood loss, time to ambulation, duration of the hospital stay and the visual analogue scale.
RESULTS
The percutaneous pedicle screw fixation (PPSF) group showed better results than did the conventional posterior fixation (CPF) group (p<0.05) in regard to the perioperative data such as operation time, blood loss, and duration of the hospital stay. There were no significant differences in wedge angle, local kyphotic angle, and the ΔKyphotic angle on the postoperative plane radiographs between the two groups (p>0.05). There were no significant differences in the wedge angle and local kyphotic angle after implant removal (p>0.05) between the two groups as well. However, there were significant differences in the segmental montion angle (p<0.001), and the PPSF group showed a larger segmental motion angle than did the CPF group (CPF 1.7°±1.2° vs PPSF 5.9°±3.2°, respectively).
CONCLUSION
For the treatment of unstable thoracolumbar fractures, the PPSF technique could achieve better clinical results and an improved segmental motion angle after implant removal within a year than that of the conventional fixation method.

Citations

Citations to this article as recorded by  
  • A Comparison of 2 Surgical Treatments for Thoracolumbar Burst Fractures: Temporary Osteosynthesis and Arthrodesis
    Halil Ibrahim Süner, Rafael Luque Pérez, Daniel Garríguez-Pérez, Marta Echevarría Marín, Jose Luis Pérez, Ignacio Domínguez
    World Neurosurgery.2022; 166: e419.     CrossRef
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Case Reports
Extensive Multiple Morel-Lavallée Lesions: A Case Report
Kyu Dong Shim, Won Rak Choi, Ye Soo Park
J Korean Fract Soc 2017;30(3):142-145.   Published online July 31, 2017
DOI: https://doi.org/10.12671/jkfs.2017.30.3.142
AbstractAbstract PDF
Morel-Lavallée is a rare lesion caused by post-traumatic soft tissue injury. It usually occurs around the greater trochanter, and it occurs very rarely in the lumbar region. It is often difficult to be diagnosed in the emergency room. Delayed diagnosis may result in the need for open surgery. The authors report a patient with extensive multiple Morel-Lavallée lesions in the thoracolumbar, buttock, and thigh after trauma and provide a literature review.
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Percutaneous Drainage and Sclerotherapy for Delayed Lumbar Morel-Lavalee Lesion: Two Case Reports
Hongsil Joo, Sang Gyo Seo, Sang Yeul Lee, Kun Yong Sung
J Korean Fract Soc 2016;29(4):265-269.   Published online October 31, 2016
DOI: https://doi.org/10.12671/jkfs.2016.29.4.265
AbstractAbstract PDF
Closed internal degloving is a significant soft-tissue injury associated with a trauma that results in a tear of the subcutaneous tissue away from the underlying fascia. Although the diagnosis of Morel-Lavallee lesion (MLL) is routinely based on clinical and radiological examinations, in one-third of the cases, there is a possibility that clinicians may fail to diagnose MLL due to its inconsistent clinical manifestations. Additionally, it often involves initial skin bruising due to underlying soft-tissue injury. We present two cases of delayed MLL without a fracture treated using percutaneous drainage and sclerotherapy. Our cases demonstrated successful treatment with a minimally invasive percutaneous approach. The potential advantage of using a percutaneous technique is to preserve the subdermal arterial plexus, which is the only remaining blood supply to the skin in the area of the lesion. Maintaining this blood supply may result in healthier skin at the time of any open procedure.

Citations

Citations to this article as recorded by  
  • Surgical Treatment of a Delayed Diagnosed Morel-Lavallee lesion: A Case Report
    Choong Hyeon Kim, Woo Young Choi, Kyung Min Son, Ji Seon Cheon
    Journal of Wound Management and Research.2017; 13(2): 62.     CrossRef
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Original Articles
Progression of Compression and Related Factors in Conservative Management of Osteoporotic Vertebral Compression Fractures
Young Do Koh, Jeong Soo Park
J Korean Fract Soc 2015;28(2):132-138.   Published online April 30, 2015
DOI: https://doi.org/10.12671/jkfs.2015.28.2.132
AbstractAbstract PDF
PURPOSE
The purpose of this study is to determine the ideal period of brace application for thoracolumbar (T10-L2) osteoporotic vertebral compression fracture (OVCF) based on the progression of the vertebral compression with passage of time and to evaluate the factors associated with progression of thoracolumbar OVCF, when treated conservatively.
MATERIALS AND METHODS
This retrospective study included a total of 46 patients who were diagnosed with thoracolumbar OVCF and could be followed-up for at least 6 months. In this study, the increase of compression rate and the mean slope of compression rate per weeks were compared between two periods (from diagnosed date to 8 weeks and from 8 weeks to 6 months), as the standard point. Age, bone mineral density (BMD), osteoporosis treatment after injury, diabetes mellitus (DM) as underlying disease were also compared between two groups (setting up 15% as standard point of increase of compression rate, <15% and > or =15%). Statistical analyses were performed using the paired t-test to assess the increase of compression rate and using the linear mixed model to assess the mean slope change. The relationships between the factors and progression of compression were analyzed using t-test, chi-square test, and logistic regression analysis.
RESULTS
The increase of compression rate was 13.03% and 1.97% in each period and the difference between those two periods was 11.06% (p=0.00). At 8 weeks of follow-up, the mean slope was reduced by 1.12 (p=0.00). No statistically significant difference in related factors was observed between two groups.
CONCLUSION
Considering the increase of compression rate with passage of time, brace should be applied strictly for an initial 8 weeks. And age, BMD, osteoporosis treatment after injury, and DM as underlying disease are not predictors of progression of compression in vertebral fractures.

Citations

Citations to this article as recorded by  
  • The Factors between the Progression of the Compression Rate and Magnetic Resonance Imaging Findings in Osteoporotic Vertebral Fracture Patients Treated with Teriparatide
    Taebyeong Kang, Seung-Pyo Suh, Jeongwoon Han, Byungjun Kang, Changhyun Park
    Journal of the Korean Orthopaedic Association.2023; 58(5): 392.     CrossRef
  • Effect of Weekly Teriparatide Administration Followed by Percutaneous Balloon Kyphoplasty on Post-Menopausal Osteoporotic Compression Fracture Treatment
    Sung-Ha Hong, Seung-Pyo Suh, Woo Jin Shin, Seung Gi Lee, Byung Jun Kang
    Journal of the Korean Orthopaedic Association.2022; 57(1): 35.     CrossRef
  • Treatment Effect with Weekly Teriparatide in the Vertebral Compression Fractures in Patients with Severe Osteoporosis
    Seok-Ha Hwang, Young-Kyun Woo, Ho-Seung Jeon, Seung-Pyo Suh, Joo-Young Kim, Jae-Nam Kim
    Journal of the Korean Orthopaedic Association.2019; 54(6): 528.     CrossRef
  • The Influence of Initial Magnetic Resonance Imaging Findings on the Compression Rate of Thoracolumbar Osteoporotic Vertebral Compression Fracture
    Seok-Ha Hwang, Seung-Pyo Suh, Young-Kyun Woo, Ho-Seung Jeon, Ho-Won Jeong
    Journal of the Korean Orthopaedic Association.2018; 53(4): 341.     CrossRef
  • A Retrospective Clinical Survey of Vertebral Compression Fractures
    Ji Hye Oh, Yun Kyu Lee, Jae Soo Kim, Hyun Jong Lee, Sung Chul Lim
    Journal of Acupuncture Research.2018; 35(4): 219.     CrossRef
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Comparison of Surgical Outcomes in Thoracolumbar Fractures Having 6 or Less Scored by Load-Sharing Classification Based on Posterior Fusion Level
Jung Hoon Kim, Sung Soo Kim, Jin Ho Cho, Bo Hoon Jang, Jin Hwan Kim
J Korean Fract Soc 2013;26(1):21-26.   Published online January 31, 2013
DOI: https://doi.org/10.12671/jkfs.2013.26.1.21
AbstractAbstract PDF
PURPOSE
The aim of this study is to decide the optimal level of fusion with comparing the results between the short segment fusion and long segment fusion treated with pedicle screw instrumentation, including fractured vertebra in thoracolumbar junctional fractures.
MATERIALS AND METHODS
From February 2000 to November 2009, fifty three patients with junctional fracture of thoracolumbar spine were treated with pedicle screws and posterior fusion at our hospital. They were divided into two groups, the short segment group and long segment group. Preoperatively, immediate postoperative and last follow-up lateral radiological evaluation was done by measuring the correction and loss of segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle. In addition, operation time and amount of intraoperative bleeding were measured.
RESULTS
There were no significant differences of statistical analysis regarding the radiological variables between the two groups, especially the loss of corrected segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle (p>0.05). However, operative time in the short segment group (234 minutes) was shorter than the long segment group (284 minutes), and there was statistical significance (p=0.002).
CONCLUSION
We recommend the short segment transpediculr instrumentation one level above and one level below, including the fractured vertebra for thoracolumbar junctional fracture with 6 points or less of the load-sharing score.
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Case Report
Minimally Invasive Plate Osteosynthesis for the Upper Extremity Fracture Using a Lumbar Spreader: Surgical Technique
Gu Hee Jung, Chyul Hyun Cho, Jae Do Kim
J Korean Fract Soc 2011;24(1):83-86.   Published online January 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.1.83
AbstractAbstract PDF
The minimally invasive plate osteosynthesis (MIPO) which is extensively performed, is very dependent on the indirect reduction technique to prevent the exposure of fracture sites. Indirect reduction with the use of the femoral distractor is a much more efficient technique to restore the length in the fracture of lower limbs. However, the femoral distractor cannot be used for fracture of upper limbs, and other instruments for indirect reduction have not yet been reported. Therefore, we introduce the novel indirect reduction technique with the use of the lumbar spreader for the MIPO of upper limbs.
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Original Articles
Related Factors of Ligamentotaxis with Posterior Instrumentation for the Surgical Treatment of Thoracolumbar Bursting Fracture
Sang Bum Kim, Taek Soo Jeon, Seung Hwan Kim, Han Chang, Cheol Mog Hwang
J Korean Fract Soc 2010;23(2):213-219.   Published online April 30, 2010
DOI: https://doi.org/10.12671/jkfs.2010.23.2.213
AbstractAbstract PDF
PURPOSE
To investigate factors influencing the amount of indirect reduction by ligamentotaxis according to timing of surgery, extent of surgery, and characteristics of fractures.
MATERIALS AND METHODS
We reviewed 22 cases of thoracolumbar fracture which had been performed posterior instrumentation and fusion using pedicle screw system. We divided patients into each group according to timing of surgery, number of fusion segment, insertion of screw on fractured vertebra, and rupture of posterior ligament complex, and Denis type. We measured changes of kyphotic angle, anterior vertebral height and wedge angle on plain radiographs, and we compared spinal canal area before and after operation using computed tomographic scans.
RESULTS
Kyphotic angle, anterior vertebral height, wedge angle, and area of spinal canal showed significant improvement postoperatively. The wedge angle improved significantly operated within 3 days after injury, however, kyphotic angle and anterior vertebral height had no correlation with variable factors except the rupture of posterior ligament complex. The amount of restoration of spinal canal also affected only by rupture of posterior ligament complex.
CONCLUSION
There is little relationship between timing of surgery and canal restoration, so we cannot conclude that prompt operation helps reduction of narrowed spinal canal. Otherwise narrowed spinal canal had much less restored by ligamentotaxis when there were rupture of posterior ligament complexes.
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The Effect of Adjacent Vertebral Body on Vertebroplasty for Compression Fracture
Yong Chan Kim, Ho Geun Chang, Kee Byung Lee
J Korean Fract Soc 2010;23(1):97-103.   Published online January 31, 2010
DOI: https://doi.org/10.12671/jkfs.2010.23.1.97
AbstractAbstract PDF
PURPOSE
To analyze the effect of adjacent vertebral body on local sagittal segment in performing vertebroplasty for thoracolumabr vertebral compression fracture on the terms of radiological results.
MATERIALS AND METHODS
We experienced 61 cases of T12 and L1 Compression fracture between June 2003 and November 2005. We classified with 3 groups; no collapse of adjacent body, collapse of adjacent upper body, and collapse of adjacent lower body. The measuring factors were anterior, middle, posterior vertebral height, wedge angle and local kyphotic angle.
RESULTS
In group I, Increase rate of anterior, middle, posterior vertebral height and restoration rate of wedge angle, and local kyphotic angle were average of 0.41%, 0.31%, 0.16%, 1.47%, ?3.48% respectively. Group II was -3.19%, 0.11%, -3.02%, -1.23%, -4.63%. Group III was -2.28%, 4.72%, -1.01%, -2.41%, -13.12%. There are no significant differences among the groups except local kyphotic angle in Group III statistically.
CONCLUSION
The previous wedged collapse of adjacent vertebral body do not affect local sagittal segment performed vertebroplasty in the thoracolumbar compression fracture. However the previous wedged collapse of adjacent lower body affect significantly local kyphotic angle.

Citations

Citations to this article as recorded by  
  • Survival Rate and Risk Factor Analysis in Patients Who Experience a New Fracture after Kyphoplasty
    Jung-Hoon Kim, Dong-Hyok Kim
    Journal of Korean Society of Spine Surgery.2018; 25(3): 99.     CrossRef
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The Relationship between Progression of Body Collapse and MRI Findings in Osteoporotic Stable Thoracolumbar Fractures
Young Do Koh, Jong Seok Yoon, Ji Young Hwang, Hyun Sik Park
J Korean Fract Soc 2008;21(4):304-311.   Published online October 31, 2008
DOI: https://doi.org/10.12671/jkfs.2008.21.4.304
AbstractAbstract PDF
PURPOSE
To find out the relationship between the initial Magnetic Resonance Image (MRI) findings and the progression of vertebra collapse when treated with Jewett brace in osteoporotic stable thoracolumbar fractures.
MATERIALS AND METHODS
We divided 38 cases of 37 patients of thoracolumbar osteoporotic stable thoracolumbar fractures who were treated with Jewett brace into two groups. One group was composed of those body collapse progressed more than 10% compared with the initial state, and the other group less than 10%. We analyzed the relationships between the progression of collapse and the superior endplate fractures, the fracture line extending to posterior cortex, the size of bone marrow edema, the signal intensity on T1 and T2 weighted MR images, the presence of paravertebral hematoma, and the degree of posterior extensor muscle atrophy using MR images.
RESULTS
The body collapse was more likely to progress when there was superior endplate fracture, when it showed larger size of bone marrow edema on T1 weighted image, and transverse low signal on T2 weighted image. But extending of fracture line to posterior cortex, presence of paravertebral hematoma, and degree of posterior extensor muscle atrophy did not show any statistical correlations to progression of collapse.
CONCLUSION
The body collapse is more likely to progress when there was superior endplate fracture, larger low signal on T1 weighted image and low signal on T2 weighted image at initial MRI treated with Jewett brace.

Citations

Citations to this article as recorded by  
  • The Factors between the Progression of the Compression Rate and Magnetic Resonance Imaging Findings in Osteoporotic Vertebral Fracture Patients Treated with Teriparatide
    Taebyeong Kang, Seung-Pyo Suh, Jeongwoon Han, Byungjun Kang, Changhyun Park
    Journal of the Korean Orthopaedic Association.2023; 58(5): 392.     CrossRef
  • Statistical Analysis on Hospitalized Patients with Thoracolumbar Compression Fracture at Single Korean Medicine Hospital: Retrospective Review
    Hyun jin Jang, So jeong Kim, Min Ju Kim, Hyeon Kyu Choi, Pil Je Park, Kang Yeon soo, Jeong Kyo Jeong, Ju Hyun Jeon, Young Il Kim
    Journal of Korean Medicine.2023; 44(2): 149.     CrossRef
  • The Influence of Initial Magnetic Resonance Imaging Findings on the Compression Rate of Thoracolumbar Osteoporotic Vertebral Compression Fracture
    Seok-Ha Hwang, Seung-Pyo Suh, Young-Kyun Woo, Ho-Seung Jeon, Ho-Won Jeong
    Journal of the Korean Orthopaedic Association.2018; 53(4): 341.     CrossRef
  • The Relationship between the Progression of Kyphosis in Stable Thoracolumbar Fractures and Magnetic Resonance Imaging Findings
    Deuk Soo Jun, Won Ju Shin, Byoung Keun An, Je Won Paik, Min Ho Park
    Asian Spine Journal.2015; 9(2): 170.     CrossRef
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Comparison of Bone Mineral Density in Elderly Patients according to Presence of Intertrochanteric Fracture
Sang Ho Moon, Byoung Ho Suh, Dong Joon Kim, Gyu Min Kong, Hyeon Guk Cho
J Korean Fract Soc 2007;20(3):222-226.   Published online July 31, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.3.222
AbstractAbstract PDF
PURPOSE
To analyze difference in bone mineral density (BMD) between intertrochanteric fracture and control group and to explore the predictive value of BMD for intertrochanteric fracture.
MATERIALS AND METHODS
57 patients who were over 60-year-old with intertrochanteric fracture were examined. For control group, 110 patients who did not have any fracture were selected. Dual energy X-ray absorptiometry was studied at 1, 2, 3, 4 lumbar vertebrae, femoral neck, trochanter and Ward's triangle. BMD was compared at each site between two groups statistically.
RESULTS
Fracture group consisted of 16 male, 41 female and was average 70.8 year old. Control group consisted of 21 male, 89 female and was average 68.1 year old. There was no differences in sex and age between two groups (p>0.05). BMD of L1, L2 and mean lumbar area were significantly less in fracture group than control group (p<0.05). There was no difference between two groups in BMD of another sites (p>0.05).
CONCLUSION
BMD of L1, L2 and mean lumbar area in fracture group had lower value significantly, but had no differences between two groups at another sites. BMD of L1, L2 and mean lumbar area might be used as the most sensitive predictive indicator for risk of osteoporotic fractures including intertrochanteric fracture in elderly patient.

Citations

Citations to this article as recorded by  
  • An Analysis of the Changes in Bone Mineral Density in Long-Stay Patients of a Geriatric Hospital in Relation to Physical Therapy
    Sang-Min Lee, Soon-Hee Kim, Ji-Sung Kim, Joong-San Wang, Sung-Won Kim, Nyeon-Jun Kim, Sook-Hee Lee, Kyoung-Ok Min
    Journal of International Academy of Physical Therapy Research.2011; 2(2): 267.     CrossRef
  • Comparison of Bone Mineral Density in Elderly Patients over 65 Years according to Presence and Types of Hip Fracture
    Myung-Ho Kim, Moon-Jib Yoo, Joong-Bae Seo, Hyun-Yul Yoo, Sang-Young Moon
    Journal of the Korean Fracture Society.2010; 23(3): 263.     CrossRef
  • The Relationship between Hip Fracture and Bone Mineral Density in Elderly Patients
    Hwa Jae Jeong, Jae-Yeol Choi, Jinmyung Lee, Kyubo Choi, Byeongsam Jeon
    Journal of the Korean Orthopaedic Association.2010; 45(3): 228.     CrossRef
  • The Usefulness of Hip to Thigh Ratio as an Anthropometric Indicator for the Incidence of Hip Fracture
    Jin Park, Kyu Hyun Yang, Seong Hwan Moon
    Journal of the Korean Fracture Society.2009; 22(1): 1.     CrossRef
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Factors Confluencing the Result of Percutaneous Balloon Kyphoplasty in Osteoporotic Thoracolumbar Compression Fracture
Jung Hee Lee, Dae Woo Hwang, Jae Heung Shin, Woo Sung Hong, Ju Wan Kim
J Korean Fract Soc 2007;20(1):76-82.   Published online January 31, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.1.76
AbstractAbstract PDF
PURPOSE
We are to find the method to objectify postoperative prognosis, analyzing the factors confluencing the result of kyphoplasty in osteoporotic vertebral compression fracture (OVCF).
MATERIALS AND METHODS
Our study included 50 patients (55 vertebral bodies) who have undergone kyphoplasty from Sep. 2004 until Oct. 2005. We divided in the group according to bone mineral density (BMD), compression rate, recovery rate and cement leakage. We verified the significance of each group, using independent t-test, and ANOVA test among observers.
RESULTS
We performed kyphoplasty on 55 vertebral bodies, 12 cases with more than 0.4 g/cm2 in BMD (mean: 0.53 g/cm2) and their mean preoperative compression rate (CR), immediate postoperative recovery rate (RR-IPO), and recovery rate after 6 months (RR-6M) was each 30.58%, 12.35%P, 9.93%P. 15 cases under 0.4 g/cm2 (mean 0.31 g/cm2), and their CR, RR-IPO and RR-6M was 26.73%, 11.77%P, 5.26%P respectively. The p-value was 0.004. Another studies according to CR, RR-IPO and leakage of cement revealed the better results in the cases of the lower CR, the smaller reduction and abscecnce of cement leakage, but statistically insignificant (p=0.309, 0.069, 0.356).
CONCLUSION
Preoperative BMD was most important factor that confluencing postoperative radiological result in OVCF. Other factors were also thought to be confluencing factors, but statistically insignificant..

Citations

Citations to this article as recorded by  
  • Cement Leakage into Disc after Kyphoplasty: Does It Increases the Risk of New Adjacent Vertebral Fractures?
    Hoon-Sang Sohn, Seong-Kee Shin, Eun-Seok Seo, Kang-Seob Chang
    Journal of the Korean Fracture Society.2011; 24(4): 361.     CrossRef
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Biomechanical Efficacy of Various Anterior Spinal Fixation in Treatment of Thoraco-lumbar Spine Fracture
Ye Soo Park, Hyoung Jin Kim, Choong Hyeok Choi, Won Man Park, Yoon Hyuk Kim
J Korean Fract Soc 2007;20(1):70-75.   Published online January 31, 2007
DOI: https://doi.org/10.12671/jkfs.2007.20.1.70
AbstractAbstract PDF
PURPOSE
To evaluate the biomechanical results according to various anterior spinal fixation methodology in the treatment of thoracolumbar spine fracture.
MATERIALS AND METHODS
The comparative analysis of fixation method was evaluated by three dimensional finite element model using the 1 mm reconstruction image of CT. Authors evaluated the flexion, extension, lateral bending, torsional stresses with 12 fixation methods for the compression and burst fracture.
RESULTS
In biomechanical analysis, stiffness of body-fixation device was more stable in two-rod system in compression fracture and was stable in one-rod, two-rod system in burst fracture, but two-rod system was showed over-increase of stiffness.
CONCLUSION
Authors recommend the usage of two-rod system in anterior fixation only and anterior one-rod system in anterior-posterior fixation.

Citations

Citations to this article as recorded by  
  • Lumbar Spine Fracture
    Seung-Wook Back, Hyun-Joong Cho, Ye-Soo Park
    Journal of the Korean Fracture Society.2011; 24(3): 277.     CrossRef
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Thoracolumbar Fracture with Posterior Ligament Complex Injury
Won Ju Shin, Deuk Soo Jun, Young Do Koh, Jea Yoon Cho
J Korean Fract Soc 2006;19(2):265-270.   Published online April 30, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.2.265
AbstractAbstract
PURPOSE
To evaluate the clinical features and radiographical landmarks of patients who has a thoracolumbar fracture combined with posterior ligament complex injury retrospectively.
MATERIALS AND METHODS
The preoperative plain radiographys, axial CT, MRI and medical records of 27 patients were reviewed who were confirmed the posterior ligament complex injury in operation from January, 2002. to December, 2004.
RESULTS
The patients were from 15 years to 75 years of age (mean 39.1 years), 20 males and 7 females. The mechanisms of injury were 17 falls from a height, 7 traffic accidents and 3 direct blow injuries. There were 17 cases (63%) in thoracolumbar transitional zone, such as 11 cases in T11-T12, 6 cases T12-L1. There were 9 cases of compression fracture and 18 cases of burst fracture according to the shape of fractured vertebra. In the plain radiograph, the degree of kyphotic angle was between 6~49 degrees (mean 22 degrees), anterior vertebral height loss was 7~70% (mean 39%), and posterior vertebral height loss was 0~8% (mean 3%). 21 cases (78%) were the anterior vertebral height loss below 50%, 23 cases (85%) were the degree of kyphotic angle below 30 degrees. Neurological deficits were not registered. 23 cases (85%) were positive in MRI and 24 cases (89%) were positive in direct focal tenderness in the view of posterior ligament complex injury. Conclusions: The posterior ligament complex injury is common finding of the thoracolumbar fracture. The high resolution MRI findings and direct focal tenderness are very importance in identifying the posterior ligament complex injury that is important prognostic factor particularly in mild anterior vertebral height loss and mild kyphotic angle in the plain radiograph.
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Correlation between Progression of Compression and Bone Densiometry Index in Osteoporotic Compression Fracture of Thoracolumbar Spine
Jung Hoon Kim, Jeong Gook Seo, Jong Ho Ahn
J Korean Fract Soc 2006;19(2):254-258.   Published online April 30, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.2.254
AbstractAbstract
PURPOSE
To evaluate whether progression of compression correlates with bone densiometry index in patients who were treated conservatively for osteoporotic compression fracture of thoracolumbar spine.
MATERIALS AND METHODS
Using the results of bone densiometry, 30 patients who were treated conservatively for osteoporotic compression fracture of thoracolumbar spine between March 2002 to March 2005 were categorized into 4 groups; above 80%, 70 to 80%, 60 to 70%, and below 60%. We compared the measurements of sagittal index and anterior vertebral height from the plain radiographs taken at the time of injury and following three consecutive months after the injury.
RESULTS
Patients with lower bone densiometry index had greater amount of compression at the time of injury and more rapid progression of compression. We also found that progression of compression was lowest during the first month after injury in all groups.
CONCLUSION
Patients with low bone densiometry index in osteoporotic thoracolumbar compression fracture are susceptible to more rapid progression of compression and should have early brace application and longer duration of treatment for osteoporosis.

Citations

Citations to this article as recorded by  
  • Comparison of Outcomes of Conservative Treatment, Early Vertebroplasty, and Delayed Vertebroplasty in Patients with Osteoporotic Vertebral Compression Fractures
    Se-Hyuk Im, Young-Joon Ahn, Bo-Kyu Yang, Seung-Rim Yi, Ye-Hyun Lee, Ji-Eun Kwon, Jong-Min Kim
    Journal of Korean Society of Spine Surgery.2016; 23(3): 139.     CrossRef
  • Progression of Compression and Related Factors in Conservative Management of Osteoporotic Vertebral Compression Fractures
    Young Do Koh, Jeong Soo Park
    Journal of the Korean Fracture Society.2015; 28(2): 132.     CrossRef
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The Efficacy of the Treatment of Thoracolumbar Spine Fractures with Short-segment Posterior Instrumentation and Fusion
Hwa Yeop Na, Joon Cheol Choi, Jun Won Choi, Sang Ho Lee, Young Sang Lee, Woo Sung Kim, Sang Yoon Lee, Jong Won Won, Sang Ho Han
J Korean Fract Soc 2006;19(2):241-246.   Published online April 30, 2006
DOI: https://doi.org/10.12671/jkfs.2006.19.2.241
AbstractAbstract
PURPOSE
To evaluate the safety and usefulness of the short-segment posterior instrumentation and fusion in the treatment of thoracolumbar spine fractures.
MATERIALS AND METHODS
Forty-two patients were treated by short-segment pedicle screw instrumentation and fusion between Oct. 1998. and Jan. 2004 by single surgeon. All patients were treated posteriorly and all the pedicle screws are monoaxial. Intraoperative rod bending and fixation technique was used to reduce the collapsed vertebral body and correct the kyphotic angle. The follow up duration is mean 2.1 year (1~6 year). The mean age is 40.2 year (18~60 year) old. The fractures were classified by Denis' classification and Load-Sharing Classification. Preoperative and postoperative changes of kyphotic angle and vertebral body height were measured. Denis' Pain Score and Work scales, Frankel neurologic grade were obtained during follow-up evaluation for patients.
RESULTS
All the cases got solid bony union. Mean Load-Sharing Score was 7.3. Clinical results were good. The mean kyphotic angle was preoperatively 14.5 degree, immediate postoperatively 7.5 degree, and last follow up 9.2 degree. The mean anterior vertebral heights s were 60.8% preoperatively, 83.4% immediate postoperatively, and 79.5% last follow up. There was only one case of screw breakage but no revision operation due to loss of reduction. All the cases showed satisfactory clinical results.
CONCLUSION
This study suggest that short-segment instrumentation and fusion using pedicle screw system for thoracolumbar spine fractures could lead to good results, if comminution of vertebral body is considered in the selection of approach.

Citations

Citations to this article as recorded by  
  • Comparison of Percutaneous versus Open Pedicle Screw Fixation for Treating Unstable Thoracolumbar Fractures
    Jin Young Han, Ki Youn Kwon
    Journal of the Korean Fracture Society.2020; 33(1): 1.     CrossRef
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Differences of Bone Mineral Density between Spine and Hip in Osteoporotic Patients
Gyu Min Kong, Sang Eon Lee, Dong Jun Kim, Tae Hyun Yoon
J Korean Fract Soc 2005;18(2):181-184.   Published online April 30, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.2.181
AbstractAbstract PDF
PURPOSE
To evaluate differences and correlations of spine and hip region BMD in osteoporotic patients with or without spine fracture.
MATERIALS AND METHODS
From January 1999 to December 2002, We measured and evaluated BMD of L3 and hip by DXA in 52 patients with spine fracture (fracture group) and 96 osteoporotic patients without spine fracture (non-fracture group) above 60 years.
RESULTS
The average age of patients with spine fracture is 72.1 years and without spine fracture is 66.9 years. There were no statistical significant differences of BMD of spine, neck of femur and trochanteric area between 2 groups. But the BMD of Ward triangle of fracture group decreased significantly in statistics. The correlation coefficient between the lumbar spine and trochanteric area were 0.674 in fracture group and 0.794 in non-fracture group. They had statistical significance (<0.01).
CONCLUSION
The BMD of Ward triangle of fracture group had lower value, but the BMD of lumbar spine had no differences between 2 groups. Therefore in these persons who have decreased BMD in Ward triangle should be concerned about high vertebral compression fracture risk vertebral compression fracture.

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  • Comparison of vertebral and femoral bone mineral density in adult females
    Han Seong Choe, Jae Hong Lee, Dong Ki Min, So Hong Shin
    Journal of Physical Therapy Science.2016; 28(6): 1928.     CrossRef
  • Functional Outcomes of Percutaneous K-Wire Fixation for Distal Radius Fractures with or without Osteoporosis
    Ki-Chan An, Gyu-Min Kong, Jang-Seok Choi, Hi-Chul Gwak, Joo-Yong Kim, Sung-Yub Jin
    Journal of the Korean Fracture Society.2013; 26(4): 248.     CrossRef
  • Comparison of Bone Mineral Density in Elderly Patients over 65 Years according to Presence and Types of Hip Fracture
    Myung-Ho Kim, Moon-Jib Yoo, Joong-Bae Seo, Hyun-Yul Yoo, Sang-Young Moon
    Journal of the Korean Fracture Society.2010; 23(3): 263.     CrossRef
  • Comparison of Bone Mineral Density in Elderly Patients according to Presence of Intertrochanteric Fracture
    Sang Ho Moon, Byoung Ho Suh, Dong Joon Kim, Gyu Min Kong, Hyeon Guk Cho
    Journal of the Korean Fracture Society.2007; 20(3): 222.     CrossRef
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Differences of Fracture Types and Associated Injuries in Thoracolumbar Fractures Caused by Fall from Height and by In-Car Accident
Eui Sung Choi, Yong Min Kim, Dong Soo Kim, Kyung Jin Park, Kyeong Il Jeong, Yoon Moo Hur, Young Chan Cha, Jun Mo Jeon, Jong Won VKang
J Korean Fract Soc 2005;18(2):176-180.   Published online April 30, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.2.176
AbstractAbstract PDF
PURPOSE
To evaluate the differences of associated factors in thoracolumbar fractures according to the mechanism of injury, level and type of the fracture, associated injuries were investigated for comparison between injuries by fall from height and by in-car accident injury.
MATERIALS AND METHODS
Medical records and X-ray findings of 249 patients with fractures of thoracolumbar spine were reviewed retrospectively. Among them, 169 patients were injured by the two main causes. McAfee classification was adopted to determine the type of fracture. Associated injuries were classified as head and neck, chest and abdomen, pelvis, proximal and distal extremity, and neurologic deficit. Statistical analysis using Chi-square method was used for comparison between the two groups.
RESULTS
In overall patients, the most common cause of thoracolumbar fracture was fall from height (44.6%) followed by in-car accident (23.3%) and fall down (16.9%). In fall-from height gruoup, burst fracture was the most common (44.1%) while flexion-distraction injury was the most popular (39.7%) in in-car accident group (p=0.05). Comparison according to height of fall showed significant increase of multiple fractures (p=0.0326). Associated injuries of distal lower and upper extremities and pelvis were common in fall-from-height group, while injuries of head and neck, proximal part of upper extremity, chest and abdomen were common in in-car accident patients.
CONCLUSION
Type of fracture and distribution of associated injuries were significantly different between the two main causes of thoracolumbar injury, which seemed to be useful for understanding the mechanical events of injury and detecting associated injuries in each victim.

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  • Injury Severity and Patterns of Accompanying Injury in Spinal Fracture
    Hun Park, Kyung-Jin Song, Kwang-Bok Lee, Joo-Hyun Sim
    Journal of the Korean Fracture Society.2012; 25(3): 203.     CrossRef
  • Differences in Thoracolumbar Burst Fractures by Falls from Height with Associated Foot and Ankle Fractures
    Chung-Shik Shin, Eea-Sub Chung, Chang-Eon Yu, Byeong-Yeol Choi
    Journal of Korean Society of Spine Surgery.2012; 19(2): 47.     CrossRef
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Treatment of Thoraco-Lumbar Bursting Fractures According to Load-Sharing Classification
Chung Hwan Kim, Jae Kwang Hwang, Young Joon Choi, Kyoung Hwan Kim, Jeong Suk Song, Jeong Ho Kang
J Korean Fract Soc 2005;18(1):69-75.   Published online January 31, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.1.69
AbstractAbstract PDF
PURPOSE
To determine optimal levels of posterior fixation in thoraco-lumbar bursting fractures according to the Load-sharing classification.
MATERIALS AND METHODS
From Aug. 1999 to Aug. 2003, 50 patients who had been operated with the posterior fixation in one-body thoraco-lumbar bursting fracture were selected. They were divided into two groups, group I, 6 points and below in the Load-sharing score and group II, 7 points and above. And also, each groups subdivided into two subgroups, A (short segment fixation including below and above one body) and B (long segment fixation including below and upper two body). So patients subdivided into I-A, I-B, II-A, II-B. Change of the corrected kyphotic angle was measured and compared with each subgroups.
RESULTS
The loss of the corrected kyphotic angle was measured average 1.7degrees in group I and 4.1degrees in group II, and there was significant difference between two groups (p>0.05). The loss of the corrected kyphotic angle in the subgroups was average 1.8degrees in I-A, 1.6degrees in I-B, 3.5degrees in II-A and 4.9degrees in II-B. And there was significant difference statistically in I-A and II-A (p>0.05).
CONCLUSION
In the thoraco-lumbar bursting fracture with 6 points and below of the Load-sharing score, the fixation of the short segment is a useful method. But in the fracture with 7 points and above, the fixation of the short segment is not enough, and these findings be required the further evaluation for some cause of the loss of corrected angle and treatment modalities including the fixation of the long segment.

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  • Surgical Techniques for Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations
    Salman Sharif, Yousuf Shaikh, Onur Yaman, Mehmet Zileli
    Neurospine.2021; 18(4): 667.     CrossRef
  • Analysis of Factors Affecting Postoperative Loss of Reduction in Unstable Thoracolumbar Fractures
    Jaewan Soh, Chang-Hwa Hong, Chung-Won Bang, Jae Chul Lee, Byung-Joon Shin
    Journal of Korean Society of Spine Surgery.2017; 24(3): 190.     CrossRef
  • More than 5-Year Follow-up Results of Two-Level and Three-Level Posterior Fixations of Thoracolumbar Burst Fractures with Load-Sharing Scores of Seven and Eight Points
    Sub-Ri Park, Hwa-Yeop Na, Jung-Mook Kim, Dong-Chan Eun, Eui-Young Son
    Clinics in Orthopedic Surgery.2016; 8(1): 71.     CrossRef
  • The Outcomes of Short and Long Segment Posterior Instrumentation of Thoracolumbar Burst Fractures with a Load Sharing Score of 7 or More
    Jeong Ho Seo, Kyu Yeol Lee
    Journal of Korean Society of Spine Surgery.2015; 22(3): 92.     CrossRef
  • Comparison of Short Segment and Long Segment Posterior Instrumentation of Thoracolumbar and Lumbar Bursting Fractures at Load Sharing Score 7 or Above
    Hwa-Yeop Na, Young-Sang Lee, Joon-Cheol Choi, Woo-Seong Kim, Woo-Suk Song, Yu-Hun Jung, Tae-Hoon Park, Tae-Hwan Kim, Kang-Won Seo
    Journal of Korean Society of Spine Surgery.2013; 20(2): 44.     CrossRef
  • The Impact on Clinical Results by Sagittal Imbalance in Posterior Fixation for Thoraco-lumbar Burst Fractures
    Seung-Wook Baek, Kyu-Dong Shim, Ye-Soo Park
    Journal of the Korean Fracture Society.2011; 24(4): 354.     CrossRef
  • Change of Kyphotic Angle in Posterior Pedicle Screw Fixation for Thoracic and Lumbar Burst Fractures: Comparison Study by the Screw Fixation Level
    Jeong-Gook Seo, Jong-Ho Park, Jeong-Seok Moon, Woo-Chun Lee
    Journal of the Korean Fracture Society.2009; 22(1): 39.     CrossRef
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A Comparison of Vertebroplasty Versus Conservative Treatment in Osteoporotic Compression Fractures
Sang Ho Moon, Dong Joon Kim, Chung Soo Hwang, Sang Eon Lee, Se Won Park
J Korean Fract Soc 2004;17(4):374-379.   Published online October 31, 2004
DOI: https://doi.org/10.12671/jkfs.2004.17.4.374
AbstractAbstract PDF
PURPOSE
To compare clinical and radiological results between vertebroplasty and conservative treatment in osteoporotic compression fractures of thoracolumbar spine.
MATERIALS AND METHODS
34 patients were reviewed with at least 1 year follow up. Vertebroplasty was used in 14 and conservative treatment was done in 20 fractures. These groups were compared by clinical results which were evaluated by the scoring system according to pain, mobility and analgesic usage at preoperative, postoperative 1 month and postoperative 1 year. And also compared by the increment of kyphosis and loss of vertebral body height in lateral films at the same time. We compared duration of hospitalization between two groups.
RESULTS
Vertebroplasty group showed statistically significant less pain and mobility than conservative treatment (p<0.05), but there was no differences in analgesic usage at postoperative 1 year while significant difference at 1 month. In radiological comparison, vertebroplasty showed less increment of kyphosis and loss of body height significantly (p<0.05). Also vertebroplasty group had shorter hospitalization stay significantly (p<0.05).
CONCLUSION
Our retrospective analysis demonstrated that vertebroplasty provided significant pain relief, improvement of motion and reduction of analgesic usage and also provided considerable spinal stabilization that prevented further kyphosis and collapse.

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  • Outcome Comparison between Percutaneous Vertebroplasty and Conservative Treatment in Acute Painful Osteoporotic Vertebral Compression Fracture
    Hwa-Yeop Na, Young-Sang Lee, Tae-Hoon Park, Tae-Hwan Kim, Kang-Won Seo
    Journal of Korean Society of Spine Surgery.2014; 21(2): 70.     CrossRef
  • Large Pulmonary Embolus after Percutaneous Vertebroplasty - A Case Report -
    Sang Ho Moon, Soo Won Lee, Byoung Ho Suh, Sung Hwan Kim
    Journal of Korean Society of Spine Surgery.2009; 16(1): 46.     CrossRef
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Bone & Soft Tissue Injuries Diagnosed by Magnetic Resonance Imaging in Thoracolumbar Fractures
Yong Min Kim, Dong Soo Kim, Eui Seong Choi, Hyun Chul Shon, Kyoung Jin Park, Gi Seok Han, Jae Jung Jeong, Kyoung Il Jeong, Yung Sung Kim
J Korean Fract Soc 2004;17(2):184-190.   Published online April 30, 2004
DOI: https://doi.org/10.12671/jkfs.2004.17.2.184
AbstractAbstract PDF
PURPOSE
To assess diagnostic efficacy of the MRI in thoracolumbar fractures, especially in changes of bone and soft tissue which cannot be documented by other diagnostic tools.
MATERIALS AND METHODS
Among 85 patients managed for thoracolumbar fractures between January 1997 and June 2003, MRI was performed in 30 patients to get more informations. Plain X-ray, CT and MRI of these cases were reviewed retrospectively by two orthopaedic spine surgeons and one radiologist to investigate the informations which only MRI could afford.
RESULTS
14 (46.7%) among 30 patients had occult fractures of vertebrae other than main fracture which had not been diagnosed as fractured. Besides 6 patients who showed distraction of posterior structure on plain X-ray, injury of posterior ligament complex was confirmed by MRI in 12(40%) patients. Additionally, MRI visualized other soft tissue injuries such as intramuscular and subcutaneous hematoma, changes of the spinal cord and intervertebral disc. In 16 among 30 patients, informations achieved from MRI were the most important factors in deciding treatment modality.
CONCLUSION
MRI seems to be efficient in visualizing not only soft tissue injury such as ligament but also occult fractures of additional vertebra in thoracolumbar fractures, therefore MRI seems to be an important diagnostic tool in decision of treatment modalities, especially in cases of uncertain stability.

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  • Measurement Discrepancy of Sagittal Parameters between Plain Radiography and 3D Computed Tomography in Thoracolumbar and Lumbar Fractures
    Dong-Soo Kim, Yong-Min Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho, Ji-Kang Park, Hyun-Cheol Lee
    Journal of the Korean Orthopaedic Association.2012; 47(3): 198.     CrossRef
  • Relationship between Lamina Fractures and Dural Tear in Low Lumbar Burst Fractures
    Ki-Chan An, Dae Hyun Park, Yong-Wook Kwon
    Journal of the Korean Fracture Society.2011; 24(3): 256.     CrossRef
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Correlation Analysis of BMD in Proximal Femur and Spine
Jun Young Yang, Young Mo Kim
J Korean Soc Fract 2003;16(4):570-576.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.570
AbstractAbstract PDF
PURPOSE
To analogize the result of the test through explaining the correlation of bone mineral density (BMD) test value between proximal femur and lumbar spine.
MATERIALS AND METHODS
It is based on 59 cases who visited the out-patient department. They were classified into two groups by age, group I (55~59 yr) and II (60~64 yr). Then we evaluated the average and the degree of correlation between the two groups and analyzed the correlation of the two sites according to the T & Z-score through the regression analysis.
RESULTS
In T-score, the correlation between L (independent variable, lumbar) and H (dependent variable, femur) indicated that L = 0.751 xH -0.195 for group I and L = 0.912 xH+0.31 for group II. In Z-score, the correlation was L = 0.647 xH -0.656 for group I and L = 0.897 xH -0.481 for group II.
CONCLUSION
It is regarded that there will be a clinical availability which can analogize the result of a part by using the result of the other part.

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  • A Novel Method for Estimation of Femoral Neck Bone Mineral Density Using Forearm Images from Peripheral Cone Beam Computed Tomography
    Kwanmoon Jeong, Hoon Ko, Chang-Hoon Lee, Myeung Lee, Kwon-Ha Yoon, Jinseok Lee
    Applied Sciences.2016; 6(4): 113.     CrossRef
  • The Correlation Analysis and Correction factor of BMD in Forearm and Lumbar with DXA
    Man-Seok Han
    The Journal of Digital Policy and Management.2013; 11(12): 551.     CrossRef
  • The Correlation Analysis of BMD in Proximal Femur and Spine with Dual Energy X-ray Absorptiometry
    Man-Seok Han, Dong-Heon Cho
    Journal of the Korea Society of Computer and Information.2012; 17(9): 165.     CrossRef
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MRI Findings of Posterior Ligament Complex Injury in Thorcolumbar Bursting Fractures
Young Do Koh, Yeo Heon Yun, Hoon Jeong
J Korean Soc Fract 2003;16(4):541-547.   Published online October 31, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.4.541
AbstractAbstract PDF
PURPOSE
To investigate the MR findings of structures injured in the burst fractures of thoracolumbar spine.
MATERIALS AND METHODS
Twenty-one patients who had thoracolumbar burst fractures with posterior ligament complex injury on MRI were studied. For the evaluation of stability of fractures, we used the scheme described by Oner et al. We identified the state of posterior ligament complex on surgery.
RESULTS
The MRI findings of ALL were state 1 in four, state 2 in fourteen, and state 3 in three. Those of PLL were state 1 in twelve, state 2 in six, and state 3 in three. The findings of posterior ligament complex were state 2 in one, state 3 in three, and state 4 in seventeen. The endplate state 1 was in four, state 2 in six, state 3 in seven, and state 4 in four. The disc state 1 was in twelve, state 2 in six, state 3 in two, state 4 in one. The vertebral body involvement state was 1 in four, state 2 in nine, and state 3 in eight. The injuries of posterior ligament complex were confirmed intraoperatively in all twenty-one patients.
CONCLUSION
We recommend the use of MRI to evaluate stability of fractures and state of posterior ligament complex in thoracolumbar burst fractures.
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Fracture of Vertebral Body in Flexion-Distraction Injury of Thoracolumbar Spine
Young Do Koh, Jong Oh Kim, Yeo Hon Yun, Jae Doo Yoo, Jun Mo Jung
J Korean Soc Fract 2003;16(2):262-269.   Published online April 30, 2003
DOI: https://doi.org/10.12671/jksf.2003.16.2.262
AbstractAbstract PDF
PURPOSE
To evaluate the configuration of vertebral body fractures in flexion-distraction injuries of thoracolumbar spine.
MATERIALS AND METHODS
We investigated the location of fractures, anterior or posterior vertebral body height, kyphotic angle of injured segments, canal encroachment and severity of comminution on radiologic examinations of 21 cases.
RESULTS
There were 11 compression fractures and 9 burst fractures. 85% of fractures were located in the inferior vertebrae of injured segments. Anterior vertebral height decreased by 27% on average with decrease of 18% in compression fractures and 40% in burst fractures. Posterior height decreased by 1% on average with increase of 1% in compression fractures and decrease of 4% in burst fractures. The average kyphotic angle of injured segments was 19.5 degrees with 15.4degrees in compression fractures and 26.8 degrees in burst fractures. The canal encroachment in 9 burst fractures was 27% on average, and the comminution of vertebral body was mild in 74%.
CONCLUSION
The fracture of vertebral body in flexion-distraction injuries of thoracolumbar spine was very common, and located on the inferior vertebrae of injured segment. The decrease of vertebral height, canal encroachment and severity of comminution was relatively less than the estimated from mechanism of injury, with offset effect of distraction force.

Citations

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  • Differences in Thoracolumbar Burst Fractures by Falls from Height with Associated Foot and Ankle Fractures
    Chung-Shik Shin, Eea-Sub Chung, Chang-Eon Yu, Byeong-Yeol Choi
    Journal of Korean Society of Spine Surgery.2012; 19(2): 47.     CrossRef
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The effect of percutaneous vertebroplasty with bone cement in the treatment of osteoporotic thoracolumbar compression fracture
Jae Do Kang, Kwang Yul Kim, Sang In Park
J Korean Soc Fract 2001;14(2):265-271.   Published online April 30, 2001
DOI: https://doi.org/10.12671/jksf.2001.14.2.265
AbstractAbstract PDF
PURPOSE
To analyzed the degree of pain relief of 40 patients with osteoporotic thoracolumbar compression fracture treated by percutaneous vertebroplasty with bone cement.
MATERIALS AND METHODS
We studied 40 cases of the osteoporotic thoracolumbar compression fracture from January 2000 to June 2000. It was evaluated with simple Xray, bone scan, bone mineral density and CT for the patients 1)who had the compressed wedge fracture of vertebral body on simple X-ray, 2)who had increased bony uptakes of fracture site on bone scan, 3)who were under -2.5 in T-score on bone mineral density, 4)who were not relieved the pain to analgesic drug medication for more than 3 month with no radiating pain, 5)who had no fracture of posterior wall of vertebral body on CT in the case of acute fracture. We performed percutaneous vertebroplasty with bone cement and observed the degree of pain relief using pain scale pre-/ postoperation.
RESULTS
The average pain point decreased from 6.17 points to 1.06 points at postoperative 1 day, total decreased points were 5.11 points. The average pain point was 1.05 at postoperative 6 months in the patients followed up for more than 6 months.
CONCLUSION
Percutaneous vertebroplasty with bone cement is valuable method in the treatment of osteoporotic thoracolumbar compression fracture, providing pain relief, prevention of complication originated from long term traction and bed rest, unwearing brace and early ambulation

Citations

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  • Treatment of Combined Degenerative Lumbar Disease and Adjacent Vertebral Fracture
    Jae-Lim Cho, IL-Hoon Sung, Seung-Wook Baek, Ye-Soo Park
    Journal of Korean Society of Spine Surgery.2008; 15(4): 236.     CrossRef
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Differences of Bone Mineral Density and Fracture Threshold Between Lumbar Spine Fracture and Control group
Ig Gon Kim, Jae Hyek Kim, Jung Ill Kim, Young Ill Hong
J Korean Soc Fract 2001;14(2):257-264.   Published online April 30, 2001
DOI: https://doi.org/10.12671/jksf.2001.14.2.257
AbstractAbstract PDF
PURPOSE
The purpose of this study was to show how bone mineral densities of the lumbar spine decrease with aging, to investigate the relationship between the bone mineral densities of the control and fracture group, and to obtain fracture threshold values.
MATERIALS AND METHOD
From January 1995 to December 1999, we measured and evaluated BMD of L3 by DXA in 239 normal volunteers(96 men and 143 women), and in 218 patients with lumbar spine fracture(91 men and 127 women) above 50 years. The Chi-Square test was used for statistical analysis.
RESULTS
1. The average BMD of L3 in control group and lumbar spine fracture group were 0.772+/-0.030 g/cm2 in male and 0.732+/-0 . 0 8 9 g / c m2 i n female and 0.720+/-0 . 0 3 1 g / c m2 in male and 0.692+/-0 . 0 0 2 g / c m2 i n female, respectively.
RESULTS
2. The BMD of the control group and fracture group decreased with aging(p<0.05) and were higher in men than in women. There were statistically significant difference(p<0.001).
RESULTS
3. There were statistically significant difference between BMD of the control group and BMD of the lumbar spine fracture group(p<0.05). The BMD were higher in the control group than fracture group.
RESULTS
4. Fracture threshold of the lumbar spine fracture group were 0.867g/cm2( male: 0.898g /cm2, female:0.836g/cm2) according to 90 percentile.
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Posterior Short Segment Instreumntation and Fusion for the Unstable Thoracolumbar Spine Fracture: A Comparative Study
Ki Tack Kim, Gyu Pyo Hong, Dae Woo Hwang, Sang Un Lee, Sang Wook Bae
J Korean Soc Fract 2000;13(2):352-360.   Published online April 30, 2000
DOI: https://doi.org/10.12671/jksf.2000.13.2.352
AbstractAbstract PDF
INTRODUCTION : In treating of acute unstable thoracolumbar spine fractures, current trend is a toward short segment instrumentation to spare the motion segments. Many authors reported the result of short instrumentation and fusion, but there have been few reports about the effect of additional screw fixation at fractured vertebra in posterior short segment instrumentation and fusion. Therefore, the objective of this study is to compare the results of treatment between with/without screw fixation at the fractured vertebra in posterior short segment pedicle screw fixation. MATERIAL AND METHODS : Twenty-three patients with unstable thoracolumbar spine fractures were treated with posterior short segment instrumentation and fusion. Eleven cases classified into group A were not fixed at the fractured vertebre. They were followed up to average 45 months(24-79). Twelve cases classified into group B were treated with screw fixation at the injured vertebra and followed up to average 38 months(14-78). Authors evaluated the radiologic assessment, such as wedge angle of fractured body, local kyphotic angle and wedge index(the ratio of anterior body height to posterior body height), the neurologic assessment by Frankel grade system and functional assessment by Denis system.
RESULTS
: There was no complication resulted from additional pedicle screw fixation at fractured level. In rediologic assessment, wedge angle were measured at preoperative, postoperative and last follow-up time as follows; in group A, 22.2degrees -11.3degrees -14.1degrees and in group B, 19.5degrees -8.8degrees -9.8degrees . The local kyphotic angle measured were 17.9degrees -7.0degrees -14degrees in group A and 17.1degrees -6.3degrees -7.9degrees in group B. The wedge index were 42.9%-22.6%-28.5% in group A and 40%-19.5%-22.4% in group B. At last follow-up time, eight eases showed Frankel grade E and three cases showed grade D in group A, and all cases of group B were Frankel E. Denis pain score were satisfctory in all of both group and Denis work score were also satisfactory in two group except one case of group A.
CONCLUSIONS
: Additional screw fixation at fractured verteba did not cause any complication. There was no significant difference in reduction rate between two groups(P>0.05), but group B showed better maintenance of correction of kyphotic deformity than that of group A(P<0.05). In conclusion, it seems that additional screw fixation at fractured level may be better method in maintaining asgittal alignment and decreasing the risk collapsing of body.
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Relationship between Simple X-ray and CT Findings on the Degree of Canal Encroachment in Burst Fracture of Thoracolumbar Junction
Young Do Koh, Jong Oh Kim
J Korean Soc Fract 1999;12(2):388-394.   Published online April 30, 1999
DOI: https://doi.org/10.12671/jksf.1999.12.2.388
AbstractAbstract PDF
In burst fracture of thoracolumbar junction, compressive injury of middle column is characteristic and neurologic symptom develops by retropulsion of bony fragment into spinal canal. Authors had treated 44 cases with burst fracture of thoracolumbar junction at Ewha Woman' University Mokdong Hospital from September, 1993 to December, 1997 and analyzed the relationships between simple radiologic findings and canal encroachment and between neurology and canal encroachment. The results were as follows; Canal encroachment by bony fragment was larger in lower vertebra than in upper one. Canal encroachment was larger in Denis type A than in type B. Both anterior vertebral height(AVH) and presence of neurology were not related with the amount of canal encroachment. The lesser loss of posterior vertebral height(PVH) and kyphotic angle were, the more canal encroachment was. In summary, factors that influenced the amount of canal encroachment were fracture level and type. There was no significant relationship between neurology and the amount of canal encroachment. AVH, PVH and kyphotic angle were not related with the amount of canal encroachment.
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The Change of Kyphotic Angle and Anterior Vertebral Height after Posterior or Posterolateral Fusion with Transpedicular Screws for Thoracolumbar Bursting Fractures
Jae Sung Ahn, June Kyu Lee, Deuk Soo Hwang, Young Mo Kim, Won Jung Kim, Kyu Hwan Byun
J Korean Soc Fract 1999;12(2):379-387.   Published online April 30, 1999
DOI: https://doi.org/10.12671/jksf.1999.12.2.379
AbstractAbstract PDF
The purposes of this study are to make an operative treatment option of thoracolumbar burst fractures by the degree of initial kyphotic deformity or by the degree of initial loss of anterior vertebral height. We analyzed sixty-three cases of one segmental thoracolumbar bursting fractures treated surgically by posterior or posterolateral fusion with short segmental transpedicular screws fixation method using Diapason or CD from January, 1992 to October, 1996. Indications of operative treatment were that the degree of initial kyphotic deformity was above 15degreesor initial loss of anterior vertebral height was above 30%. Minimum follow-up period was 12 months and the results were as follows : 1. Entirely, mean kyphotic angle was 21.6degreesinitially, 11.3degreespostoperatively and 14.2degrees at the end of follow-up. Mean anterior vertebral height was 59.6% initially, 83.8% postoperatively and 80.8% at the end of follow-up. So 10.3degrees , 24.2% was corrected postoperatively and loss of correction was 2.9degrees , 3% at the end of follow-up. 2. In the respect of the degree of initial kyphotic deformity, when compared above 30degrees with below 30degrees , loss of correction was 7.3degrees , 1.4degrees at the end of follow-up respectively and this result had significant difference between these two groups statistically. 3. In the respect of initial loss of anterior vertebral height, when compared above 55% with below 55%, loss of correction was 7.7%, 2.2% at the end of follow-up respectively and this result had significant difference between these two groups statistically. 4. In the respect of time interval from injury to operation, when compared within 2 weeks with after 2 weeks, respectively loss of correction was 1.7-2.2degrees , 3-3.9% and 4.1degrees , 6.7% at the end of follow-up and this results had significant difference between these two groups statistically. These data suggested if initial kyphotic angle is below 30degrees or initial loss of anterior vertebral height less than 55%, short segmental transpedicular screw fixation provide sufficient stability but if initial kyphotic angle is above 30degrees or initial loss of anterior vertebral height is above 55%,additional anterior interbody fusion may be considered.

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  • Comparison of Percutaneous versus Open Pedicle Screw Fixation for Treating Unstable Thoracolumbar Fractures
    Jin Young Han, Ki Youn Kwon
    Journal of the Korean Fracture Society.2020; 33(1): 1.     CrossRef
  • Nonfusion Method in Thoracolumbar and Lumbar Spinal Fractures
    Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho, Jae-Jung Jeong, Young-Chan Cha, Ji-Kang Park
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Risk Factors in Progression of Deformity in Compression Fracture of Thoracolumbar Junction
Young Do Koh, Jong Oh Kim
J Korean Soc Fract 1999;12(2):372-378.   Published online April 30, 1999
DOI: https://doi.org/10.12671/jksf.1999.12.2.372
AbstractAbstract PDF
Compression fracture of thoracolumbar junction is considered to be stable, and usually treated by conservative methods, such as bed rest followed by bracing. However, we can often see the progression of deformity during follow-up. Authors had treated 62 cases with compression fractures of thoracolumbar junction conservatively at Ewha Woman' University Mokdong Hospital from September, 1993 to December, 1997, and analyzed risk factors of progression in anterior vertebral height (AVH) collapse and kyphotic angle after the minimum 1 year follow-up. The results were as follows; The anterior vertebral height significantly more decreased in the group with age over 60, but increase of kyphotic angle was not related with age factor. In female, decrease of AVH and increase of kyphotic angle were more than in male. AVH significantly more decreased in L1 than in T12 or L2, but increase of kyphotic angle was not related with fracture level. Decrease of AVH and increase of kyphotic angle were not related with fracture type. Osteoporosis seems to be the most important single risk factor in progression of compression and more strict wearing of well-fitting brace is necessary to protect the progression in case of severe osteoporosis.

Citations

Citations to this article as recorded by  
  • The Influence of Initial Magnetic Resonance Imaging Findings on the Compression Rate of Thoracolumbar Osteoporotic Vertebral Compression Fracture
    Seok-Ha Hwang, Seung-Pyo Suh, Young-Kyun Woo, Ho-Seung Jeon, Ho-Won Jeong
    Journal of the Korean Orthopaedic Association.2018; 53(4): 341.     CrossRef
  • Nonfusion Method in Thoracolumbar and Lumbar Spinal Fractures
    Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho, Jae-Jung Jeong, Young-Chan Cha, Ji-Kang Park
    Spine.2011; 36(2): 170.     CrossRef
  • The Efficacy of Kyphoplasty on Osteoporotic Vertebral Compression Fracture - A 1-Year Follow-up Study -
    Dong-Ki Ahn, Song Lee, Dea-Jung Choi, Hoon-Seok Park, Kwan-Soo Kim, Tae-Woo Kim
    Journal of Korean Society of Spine Surgery.2009; 16(2): 79.     CrossRef
  • Clinical Outcome of Conservative Treatment for Osteoporotic Compression Fractures in Thoracolumbar Junction
    Whoan Jeang Kim, Jong Won Kang, Kun Young Park, Jae Guk Park, Se Hyun Jung, Won Sik Choy
    Journal of Korean Society of Spine Surgery.2006; 13(4): 240.     CrossRef
  • Results of Non-fusion Method in Thoracolumbar and Lumbar Spinal Fractures
    Yong-Min Kim, Dong-Soo Kim, Eui-Seong Choi, Hyun-Chul Shon, Kyoung-Jin Park, Kyeong-Il Jeong, Young-Chan Cha, Hu-Shan Cui
    Journal of Korean Society of Spine Surgery.2005; 12(2): 132.     CrossRef
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  • 5 Crossref
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Change of Canal Compromise After Ligamentotaxis in Thoracolumbar Burst Fracture
Kyu Jung Cho, Min Suk Yang
J Korean Soc Fract 1996;9(3):759-766.   Published online July 31, 1996
DOI: https://doi.org/10.12671/jksf.1996.9.3.759
AbstractAbstract PDF
Twenty-one patients with burst fracture of the thoracolumbar spine were treated by posterior pedicle screw instrumentation and fusion. We assessed canal compromise using CT fcan preoperatively and its restoration shortly after instrunientation lot confirmation of effect of lisamentotafis. The amount of neurologic recovery in each patient was compared to the final area of the spinal canal. The mean initial canal compromise was 42.6% and this was reduced to 16.2% postoperatively. The mean sagittal diameter was 10.2mm preoperatively & 12.9mm postoperatively. We achieved a mean reduction of canal compromise of 62%. A significant correlation between preoperative canal compromise and amount of restoration, or severity of neurologic deficit could not be established. Ligamentotaxis by pedicle screw instrumentation could effectively decompress the canal in thoracolumbar burst fracture.
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J Musculoskelet Trauma : Journal of Musculoskeletal Trauma
© The Korean Fracture Society.
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