Hybrid Stabilization of Thoracic Spine Fractures with Sublaminar Bands and Transpedicular Screws: Description of a Surgical Alternative and Review of the Literature

Stabilization of unstable thoracic fractures with transpedicular screws is widely accepted. However, placement of transpedicular screws can cause complications, particularly in the thoracic spine with physiologically small pedicles. Hybrid stabilization, a combination of sublaminar bands and pedicle...

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Main Authors: Marie-Therese Unterweger, Frank Kandziora, Klaus J. Schnake
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2015/857607
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author Marie-Therese Unterweger
Frank Kandziora
Klaus J. Schnake
author_facet Marie-Therese Unterweger
Frank Kandziora
Klaus J. Schnake
author_sort Marie-Therese Unterweger
collection DOAJ
description Stabilization of unstable thoracic fractures with transpedicular screws is widely accepted. However, placement of transpedicular screws can cause complications, particularly in the thoracic spine with physiologically small pedicles. Hybrid stabilization, a combination of sublaminar bands and pedicle screws, might reduce the rate of misplaced screws and can be helpful in special anatomic circumstances, such as preexisting scoliosis and osteoporosis. We report about two patients suffering from unstable thoracic fractures, of T5 in one case and T3, T4, and T5 in the other case, with preexisting scoliosis and extremely small pedicles. Additionally, one patient had osteoporosis. Patients received hybrid stabilization with pedicle screws adjacent to the fractured vertebral bodies and sublaminar bands at the level above and below the pedicle screws. No complications occurred. Follow-up was 12 months with clinically uneventful postoperative courses. No signs of implant failure or loss of reduction could be detected. In patients with very small thoracic pedicles, scoliosis, and/or osteoporosis, hybrid stabilization with sublaminar bands and pedicle screws can be a viable alternative to long pedicle screw constructs.
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spelling doaj-art-68b54acd665d4cf39d41d381e26688c72025-08-20T03:33:31ZengWileyCase Reports in Orthopedics2090-67492090-67572015-01-01201510.1155/2015/857607857607Hybrid Stabilization of Thoracic Spine Fractures with Sublaminar Bands and Transpedicular Screws: Description of a Surgical Alternative and Review of the LiteratureMarie-Therese Unterweger0Frank Kandziora1Klaus J. Schnake2Center of Spinal Therapy, Schön Klinik Nürnberg Fürth, 90763 Fürth, GermanyCenter of Spinal Therapy, Schön Klinik Nürnberg Fürth, 90763 Fürth, GermanyCenter of Spinal Therapy, Schön Klinik Nürnberg Fürth, 90763 Fürth, GermanyStabilization of unstable thoracic fractures with transpedicular screws is widely accepted. However, placement of transpedicular screws can cause complications, particularly in the thoracic spine with physiologically small pedicles. Hybrid stabilization, a combination of sublaminar bands and pedicle screws, might reduce the rate of misplaced screws and can be helpful in special anatomic circumstances, such as preexisting scoliosis and osteoporosis. We report about two patients suffering from unstable thoracic fractures, of T5 in one case and T3, T4, and T5 in the other case, with preexisting scoliosis and extremely small pedicles. Additionally, one patient had osteoporosis. Patients received hybrid stabilization with pedicle screws adjacent to the fractured vertebral bodies and sublaminar bands at the level above and below the pedicle screws. No complications occurred. Follow-up was 12 months with clinically uneventful postoperative courses. No signs of implant failure or loss of reduction could be detected. In patients with very small thoracic pedicles, scoliosis, and/or osteoporosis, hybrid stabilization with sublaminar bands and pedicle screws can be a viable alternative to long pedicle screw constructs.http://dx.doi.org/10.1155/2015/857607
spellingShingle Marie-Therese Unterweger
Frank Kandziora
Klaus J. Schnake
Hybrid Stabilization of Thoracic Spine Fractures with Sublaminar Bands and Transpedicular Screws: Description of a Surgical Alternative and Review of the Literature
Case Reports in Orthopedics
title Hybrid Stabilization of Thoracic Spine Fractures with Sublaminar Bands and Transpedicular Screws: Description of a Surgical Alternative and Review of the Literature
title_full Hybrid Stabilization of Thoracic Spine Fractures with Sublaminar Bands and Transpedicular Screws: Description of a Surgical Alternative and Review of the Literature
title_fullStr Hybrid Stabilization of Thoracic Spine Fractures with Sublaminar Bands and Transpedicular Screws: Description of a Surgical Alternative and Review of the Literature
title_full_unstemmed Hybrid Stabilization of Thoracic Spine Fractures with Sublaminar Bands and Transpedicular Screws: Description of a Surgical Alternative and Review of the Literature
title_short Hybrid Stabilization of Thoracic Spine Fractures with Sublaminar Bands and Transpedicular Screws: Description of a Surgical Alternative and Review of the Literature
title_sort hybrid stabilization of thoracic spine fractures with sublaminar bands and transpedicular screws description of a surgical alternative and review of the literature
url http://dx.doi.org/10.1155/2015/857607
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