One-stage ventral correction of the secondary thoracolumbar kyphosis in a patient with failed transpedicular fixation of Th12 fracture

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Abstract

The main surgical treatment technique of thoracic and lumbar spine acute injuries is transpedicular fixation, the failure of which, according to the literature data, occurs in 10–15% of cases. There are no common views on tactics and the surgical technique used to deal with the consequences of unstable transpedicular spondylosynthesis. And the publications devoted to the use of isolated anterior interventions are the least common.

We present a case study of the surgical management of the 71 years old patient with secondary thoracolumbar kyphosis that progressed after failed transpedicular fixation of Th12 fracture. The deformity was corrected with one-stage anterior approach and ventral crew system.

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About the authors

Vladimir V. Ostrovskij

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, V.I. Razumovsky Saratov State Medical University

Email: sarniito@yandex.ru
ORCID iD: 0000-0002-8602-2715
SPIN-code: 7078-8019

MD, Dr. Sci. (Med.), professor, neurosurgeon

Russian Federation, Saratov

Alexey E. Shulga

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, V.I. Razumovsky Saratov State Medical University

Author for correspondence.
Email: doc.shulga@yandex.ru
ORCID iD: 0000-0001-8476-0231
SPIN-code: 4018-3890

MD, Cand. Sci. (Med.), neurosurgeon

Russian Federation, Saratov

Vladimir V. Zaretskov

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, V.I. Razumovsky Saratov State Medical University

Email: vvzaretskov@mail.ru
ORCID iD: 0000-0003-3643-9560
SPIN-code: 6997-0909

MD, Dr. Sci. (Med.), professor, traumatologist-orthopedist

Russian Federation, Saratov

Sergey P. Bazhanov

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, V.I. Razumovsky Saratov State Medical University

Email: baj.s@mail.ru
ORCID iD: 0000-0001-9474-9095
SPIN-code: 2621-4519

MD, Dr. Sci. (Med.), neurosurgeon

Russian Federation, Saratov

Sergey V. Likhachov

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, V.I. Razumovsky Saratov State Medical University

Email: likha4@mail.ru
ORCID iD: 0000-0003-1874-2507
SPIN-code: 3550-1343

MD, Cand. Sci. (Med.), neurosurgeon

Russian Federation, Saratov

Alexey A. Smolkin

Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, V.I. Razumovsky Saratov State Medical University

Email: 4-4-2@mail.ru
ORCID iD: 0000-0001-8453-9465

MD, neurosurgeon

Russian Federation, Saratov

References

  1. Likhachev SV, Zaretskov VV, Shulga AE, et al. Injuries to the thoracolumbar junction: bibliometric analysis of English-language literature. Hirurgiâ pozvonočnika (Spine Surgery). 2018;15(4):52–69. (In Russ). doi: 10.14531/2018.4.52-69
  2. Prudnikova OG, Khomchenkov MV. Post-traumatic deformities of the spine: relevance, problems, and revision surgery. Hirurgiâ pozvonočnika (Spine Surgery). 2019;16(4):36–44. (In Russ). doi: 10.14531/ss2019.4.36-44
  3. Mazel C, Ajavon L. Malunion of post-traumatic thoracolumbar fractures. Orthop Traumatol Surg Res. 2018;104(1S):55–62. doi: 10.1016/j.otsr.2017.04.018
  4. Yamazaki A, Orita S, Sainoh T, et al. Anterolateral corrective lumbar corpectomy and interbody fusion by using extended screw fixation without posterior instrumentation for posttraumatic kyphosis. Case Rep Orthop. 2013;2013:614757. doi: 10.1155/2013/614757
  5. Hu W, Wang B, Run H, et al. Pedicle subtraction osteotomy and disc resection with cage placement in post-traumatic thoracolumbar kyphosis, a retrospective study. J Orthop Surg Res. 2016;11(1):112. doi: 10.1186/s13018-016-0447-1
  6. Seo DK, Kim CH, Jung SK, et al. Analysis of the risk factors for unfavorable radiologic outcomes after fusion surgery in thoracolumbar burst fracture: what amount of postoperative thoracolumbar kyphosis correction is reasonable? J Korean Neurosurg Soc. 2019;62(1):96–105. doi: 10.3340/jkns.2017.0214
  7. Yaman O, Zileli M, Şentürk S, et al. Kyphosis after thoracolumbar spine fractures: WFNS spine committee recommendations. Neurospine. 2021;18(4):681–692. doi: 10.14245/ns.2142340.170
  8. Li S, Li Z, Hua W, et al. Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation: case report and literature review. Medicine (Baltimore). 2017;96(49):e8770. doi: 10.1097/MD.0000000000008770
  9. Zhao Q, Zhang H, Hao D, et al. Complications of percutaneous pedicle screw fixation in treating thoracolumbar and lumbar fracture. Medicine (Baltimore). 2018;97(29):e11560. doi: 10.1097/MD.0000000000011560
  10. Rerikh VV, Borzykh KO. Staged surgical treatment of posttraumatic deformities in the thoracic and lumbar spine. Hirurgiâ pozvonočnika (Spine Surgery). 2016;13(4):21–27. (In Russ). doi: 10.14531/ss2016.4.21-27
  11. Smits AJ, Deunk J, Bakker FC, Bloemers FW. Thoracoscopic correction of post-traumatic kyphosis with an expandable cage: radiologic and patient-reported outcomes. Asian Spine J. 2020;14(2):157–168. doi: 10.31616/asj.2019.0062

Supplementary files

Supplementary Files
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1. Fig. 1. X-ray images of 71 years old patient E.’s spine, anterior (a) and lateral (b) view.

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2. Fig. 2. CT image of 71 years old patient E.’s spine before the surgery. Explanations in the text.

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3. Fig. 3. X-ray image of 71 years old patient E.’s spine after the surgery, (anterior (a) and lateral (b) view.

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4. Fig. 4. CT image of 71 years old patient E.’s spine after the surgery, lateral (a) and anterior (b) view.

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5. Fig. 5. X-ray image of 72 years old patient E.’s spine 12 months after the surgery, anterior (a) and lateral (b) view.

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