Surgical treatment of traumatic fractures of the thoracic and lumbar spine: A systematic review

Introduction: The treatment of traumatic thoracic and lumbar spine fractures remains controversial. To date no consensus exists on the correct choice of surgical approach and technique. Research question: to provide a comprehensive up-to-date overview of the available different surgical methods and...

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Main Authors: Timon F.G. Vercoulen, Menco J.S. Niemeyer, Felix Peuker, Jorrit-Jan Verlaan, F. Cumhur Oner, Said Sadiqi
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Brain and Spine
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772529424000018
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author Timon F.G. Vercoulen
Menco J.S. Niemeyer
Felix Peuker
Jorrit-Jan Verlaan
F. Cumhur Oner
Said Sadiqi
author_facet Timon F.G. Vercoulen
Menco J.S. Niemeyer
Felix Peuker
Jorrit-Jan Verlaan
F. Cumhur Oner
Said Sadiqi
author_sort Timon F.G. Vercoulen
collection DOAJ
description Introduction: The treatment of traumatic thoracic and lumbar spine fractures remains controversial. To date no consensus exists on the correct choice of surgical approach and technique. Research question: to provide a comprehensive up-to-date overview of the available different surgical methods and their quantified outcomes. Methods: PubMed and EMBASE were searched between 2001 and 2020 using the term ‘spinal fractures’. Inclusion criteria were: adults, ≥10 cases, ≥12 months follow-up, thoracic or lumbar fractures, and surgery <3 weeks of trauma. Studies were categorized per surgical technique: Posterior open (PO), posterior percutaneous (PP), stand-alone vertebral body augmentation (SA), anterior scopic (AS), anterior open (AO), posterior percutaneous and anterior open (PPAO), posterior percutaneous and anterior scopic (PPAS), posterior open and anterior open (POAO) and posterior open and anterior scopic (POAS). The PO group was used as a reference group. Results: After duplicate removal 6042 articles were identified. A total of 102 articles were Included, in which 137 separate surgical technique cohorts were described: PO (n = 75), PP, (n = 39), SA (n = 12), AO (n = 5), PPAO (n = 1), PPAS (n = 1), POAO (n = 2) and POAS (n = 2). Discussion and conclusion: For type A3/A4 burst fractures, without severe neurological deficit, posterior percutaneous (PP) technique seems the safest and most feasible option in the past two decades. If needed, PP can be combined with anterior augmentation to prevent secondary kyphosis. Furthermore, posterior open (PO) technique is feasible in almost all types of fractures. Also, this technique can provide for an additional posterior decompression or fusion. Overall, no neurologic deterioration was reported following surgical intervention.
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spelling doaj-art-c25e5cd5cff24aa3a6a48fa44b0204382025-08-20T02:38:03ZengElsevierBrain and Spine2772-52942024-01-01410274510.1016/j.bas.2024.102745Surgical treatment of traumatic fractures of the thoracic and lumbar spine: A systematic reviewTimon F.G. Vercoulen0Menco J.S. Niemeyer1Felix Peuker2Jorrit-Jan Verlaan3F. Cumhur Oner4Said Sadiqi5Diakonessenhuis, Department of Orthopedic Surgery, Bosboomstraat 1, 3582, KE, Utrecht, the Netherlands; University Medical Center Utrecht, Department of Orthopedic Surgery, Heidelberglaan 100, 3584, CX, Utrecht, the Netherlands; Corresponding author. Diakonessenhuis, Department of Orthopedic Surgery, Bosboomstraat 1, 3582, KE, Utrecht, the Netherlands.University Medical Center Utrecht, Department of Orthopedic Surgery, Heidelberglaan 100, 3584, CX, Utrecht, the NetherlandsUniversity Medical Center Utrecht, Department of Orthopedic Surgery, Heidelberglaan 100, 3584, CX, Utrecht, the NetherlandsUniversity Medical Center Utrecht, Department of Orthopedic Surgery, Heidelberglaan 100, 3584, CX, Utrecht, the NetherlandsUniversity Medical Center Utrecht, Department of Orthopedic Surgery, Heidelberglaan 100, 3584, CX, Utrecht, the NetherlandsUniversity Medical Center Utrecht, Department of Orthopedic Surgery, Heidelberglaan 100, 3584, CX, Utrecht, the NetherlandsIntroduction: The treatment of traumatic thoracic and lumbar spine fractures remains controversial. To date no consensus exists on the correct choice of surgical approach and technique. Research question: to provide a comprehensive up-to-date overview of the available different surgical methods and their quantified outcomes. Methods: PubMed and EMBASE were searched between 2001 and 2020 using the term ‘spinal fractures’. Inclusion criteria were: adults, ≥10 cases, ≥12 months follow-up, thoracic or lumbar fractures, and surgery <3 weeks of trauma. Studies were categorized per surgical technique: Posterior open (PO), posterior percutaneous (PP), stand-alone vertebral body augmentation (SA), anterior scopic (AS), anterior open (AO), posterior percutaneous and anterior open (PPAO), posterior percutaneous and anterior scopic (PPAS), posterior open and anterior open (POAO) and posterior open and anterior scopic (POAS). The PO group was used as a reference group. Results: After duplicate removal 6042 articles were identified. A total of 102 articles were Included, in which 137 separate surgical technique cohorts were described: PO (n = 75), PP, (n = 39), SA (n = 12), AO (n = 5), PPAO (n = 1), PPAS (n = 1), POAO (n = 2) and POAS (n = 2). Discussion and conclusion: For type A3/A4 burst fractures, without severe neurological deficit, posterior percutaneous (PP) technique seems the safest and most feasible option in the past two decades. If needed, PP can be combined with anterior augmentation to prevent secondary kyphosis. Furthermore, posterior open (PO) technique is feasible in almost all types of fractures. Also, this technique can provide for an additional posterior decompression or fusion. Overall, no neurologic deterioration was reported following surgical intervention.http://www.sciencedirect.com/science/article/pii/S2772529424000018SpineTraumaThoracalLumbarFractureSurgery
spellingShingle Timon F.G. Vercoulen
Menco J.S. Niemeyer
Felix Peuker
Jorrit-Jan Verlaan
F. Cumhur Oner
Said Sadiqi
Surgical treatment of traumatic fractures of the thoracic and lumbar spine: A systematic review
Brain and Spine
Spine
Trauma
Thoracal
Lumbar
Fracture
Surgery
title Surgical treatment of traumatic fractures of the thoracic and lumbar spine: A systematic review
title_full Surgical treatment of traumatic fractures of the thoracic and lumbar spine: A systematic review
title_fullStr Surgical treatment of traumatic fractures of the thoracic and lumbar spine: A systematic review
title_full_unstemmed Surgical treatment of traumatic fractures of the thoracic and lumbar spine: A systematic review
title_short Surgical treatment of traumatic fractures of the thoracic and lumbar spine: A systematic review
title_sort surgical treatment of traumatic fractures of the thoracic and lumbar spine a systematic review
topic Spine
Trauma
Thoracal
Lumbar
Fracture
Surgery
url http://www.sciencedirect.com/science/article/pii/S2772529424000018
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AT jorritjanverlaan surgicaltreatmentoftraumaticfracturesofthethoracicandlumbarspineasystematicreview
AT fcumhuroner surgicaltreatmentoftraumaticfracturesofthethoracicandlumbarspineasystematicreview
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