Journal of Musculoskeletal Trauma

Original Articles

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

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 Î”Kyphotic 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 1.7Â°Â±1.2Â° vs PPSF 5.9Â°Â±3.2Â°, 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.

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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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The Diagnosis of Osteoporotic Occult Vertebral Fracture and Vertebroplasty: Seong Jun Ahn, Bu Hwan Kim, Moo Ho Song, Seong Ho Yoo, Yeong Joon Kim; J Korean Fract Soc 2012;25(3):208-214. Published online July 31, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.3.208

Abstract PDF: PURPOSE
To evaluate the effectiveness of magnetic resonance imaging (MRI) for the diagnosis and usefulness of vertebroplasty in osteoporotic occult vertebral fractures.
MATERIALS AND METHODS
Of 472 osteoporotic vertebral fractures treated from May 2003 to July 2009, 45 patients were diagnosed with occult osteoporotic vertebral fracture. Their medical charts and radiographs were reviewed. The degree of vertebral body collapse was graded by a semiquantitative method. In order to increase the reliability, interpretation was based on radiographic diagnoses from 3 orthopedic surgeons. Vertebroplasty was performed at 31 of the 45 patients, for whom conservative treatment failed. Pre-operatively and post-operatively, pain was evaluated using a visual analog scale (VAS).
RESULTS
We observed 55 occult fractures in 45 patients. Forty vertebrae (72.7%) among the 55 vertebrae were just adjacent to an old vertebral fracture with deformation of the vertebral body. The rediagnosis rate of occult fracture attempted without MRI was only 21.8%. The average pre-operative VAS score of 8.07 (6~9) was improved to 2.43 after surgery and showed no delayed vertebral body collapse.
CONCLUSION
Gadolinium enhancement of MRI is critical to the diagnosis of occult vertebral fractures, which are 9% of whole osteoporotic vertebral fractures. Seventy-two point seven percent of occult vertebral fractures were just adjacent to an old vertebral fracture with collapse of the vertebral body. This means that if vertebroplasty is performed without thorough MRI examination, it may fail.

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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

Abstract 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.

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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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Risk Factors of New Compression Fractures in Adjacent Vertebrae after Percutaneous Vertebroplasty: Myung Ho Kim, Sang Hyuk Min, Suk Ha Jeon; J Korean Fract Soc 2007;20(3):260-265. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.260

Abstract PDF

PURPOSE
To evaluate the risk factors related to the development of new fractures in adjacent vertebrae after vertebroplasty.
MATERIALS AND METHODS
The study was conducted on 46 patients in whom 296 patients were performed during last 9 years. We were especially concerned with the restoration rate of vertebral height and kyphotic angle and estimated them on simple X-ray films.
RESULTS
In patients experienced subsequent vertebral fractures and no subsequent vertebral fractures after vertebroplasty, the mean height restoration rate of treated vertebra were 16.7% and 7.07%, and the kyphotic angle difference were 2.53 degree and 4.2 degree. The greater degree of height restoration of the vertebral body, especially in middle vertebral height and the lesser degree of kyphotic angle difference increased the risk of adjacent vertebral fracture risk. This results were available statistically (all p<0.05, Logistic regression test, SPSS 13.0).
CONCLUSION
It may be thought that the vertebral body height restoration rate will become risk factor of adjacent vertebral fractures.

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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
Adjacent Vertebral Compression Fracture after Percutaneous Vertebroplasty
Chung-Hwan Kim, Jae-Kwang Hwang, Jun-Seok Park
Journal of Korean Society of Spine Surgery.2013; 20(4): 163. CrossRef
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
Risk Factors of New Compression Fractures in Adjacent Vertebrae after Percutaneous Vertebroplasty
Myung-Ho Kim, Andrew S. Lee, Sang-Hyuk Min, Sung-Hyun Yoon
Asian Spine Journal.2011; 5(3): 180. CrossRef
The Effect of Adjacent Vertebral Body on Vertebroplasty for Compression Fracture
Yong-Chan Kim, Ho-Geun Chang, Kee-Byung Lee
Journal of the Korean Fracture Society.2010; 23(1): 97. CrossRef
The Factors that Affect the Deformity Correction of Vertebral Body during Kyphoplasty of Osteoporotic Vertebral Compression Fracture
Young-Do Koh, Jong-Seok Yoon, Sung-Il Kim
Journal of the Korean Fracture Society.2008; 21(1): 57. CrossRef

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The Surgical Reconstruction of Osteoporotic Vertebral Fractures: Suck Woo Kim, Yung Khee Chung; J Korean Soc Fract 2001;14(1):30-36. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.30

Abstract PDF

PURPOSE
The purpose of this study is to analyze the surgical results of 11 patients who underwent posterior instrumentation and anterior interbody fusion using titanium mesh vertebral ring(MOSS) in osteoporotic vertebral fracture. MATERIAL AND METHODS: From May 1997 to July 1999, we checked plain radiographs every 3 months and evaluated the change of kyphotic angle, fusion rate, change of clinical, neurologic symptoms and complications of these patients.
RESULTS
There were only average 0.2 degree correction of preoperative kyphotic angle at last follow-up X-ray. However, we confirmed successful bony fusion at nine of eleven patients(82%) and ten of eleven patients(90.9%) got satisfactory clinical results. Four patients with neurologic symptoms have recovered from their original neurologic status. Only one patient reoperated her back because of displacement of surgical device used in previous operation.
CONCLUSION
Among the surgical treatment methods in osteoporotic vertebral fractures, posterior instrumentation and anterior interbody fusion using titanium mesh vertebral ring(MOSS) is recommended as one of the effective surgical methods in severe osteoporotic patients.

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Kümmell's Disease Treated with Percutaneous Vertebroplasty: Minimum 1 Year Follow-Up
Jae Won Park, Jong-Hwa Park, Hong Jun Jeon, Jong Young Lee, Byung Moon Cho, Se-Hyuck Park
Korean Journal of Neurotrauma.2017; 13(2): 119. CrossRef
Peculiarities of Treatment of Patients with Complicated Compression Fractures of Thoracic and Lumbar Spine Vertebral Bodies on the Background of Osteoporosis
S T Vetrile, Aleksandr Alekseevich Kuleshov, L Yu Darchiya, S T Vetrile, A A Kuleshov, L Yu Darchiya
N.N. Priorov Journal of Traumatology and Orthopedics.2009; 16(2): 34. CrossRef
Delayed vertebral collapse with neurological deficits secondary to osteoporosis
K-T Kim, K-S Suk, J-M Kim, S-H Lee
International Orthopaedics.2003; 27(2): 65. CrossRef
Surgical Treatment of Kümmell Disease with Neurologic Deficits - Posterolateral Decompression and Posterior Reconstruction -
Ki-Tack Kim, Kyung-Soo Suk, Jin-Moon Kim
Journal of Korean Society of Spine Surgery.2001; 8(2): 136. CrossRef

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