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Proietti L.,Catholic University Rome | Scaramuzzo L.,Istituto Ortopedico Galeazzi Spa | Schiro G.R.,Catholic University Rome | Sessa S.,Catholic University Rome | And 2 more authors.
Revue de Chirurgie Orthopedique et Traumatologique | Year: 2014

Background: Treatment of A3 thoracolumbar and lumbar spinal fractures nowadays remains a controversial issue. Percutaneous techniques are becoming very popular in the last few years to reduce the approach-related morbidity associated with conventional techniques. Hypothesis: Purpose of the study was to analyze the clinical and radiological outcome of patients who underwent percutaneous posterior fixation without fusion for the treatment of thoracolumbar and lumbar A3 fractures. Materials and methods: Sixty-three patients, having sustained a single-level thoracolumbar fracture, underwent short segment percutaneous instrumentation and were retrospectively analyzed way. Sagittal Index (SI) was calculated in all patients. Clinical and functional outcome were evaluated by Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and Short Form General Health Status (SF-36). Results: Average operative blood loss was 82. mL (50-320). Mean pre-operative SI in the thoraco-lumbar segment was 13.3° decreased to 5.8° in the immediate post-operative with a mean deformity correction of 7.5. Mean pre-operative SI in the lumbar segment was 16.5° decreased to 11.3° in the immediate post-operative with a mean deformity correction of 5.2. Not statistically significant correction loss was registered at 1. year minimum follow-up. Constant clinical conditions improvement in the examined patients was observed. Conclusion: Percutaneous pedicle screw fixation for A3 thoracolumbar and lumbar spinal fractures is a reliable and safe procedure. Level of evidence: Level IV. Retrospective study. © 2014 Elsevier Masson SAS. Source


Proietti L.,Catholic University Rome | Scaramuzzo L.,Istituto Ortopedico Galeazzi Spa | Schiro G.R.,Catholic University Rome | Sessa S.,Catholic University Rome | And 2 more authors.
Orthopaedics and Traumatology: Surgery and Research | Year: 2014

Background: Treatment of A3 thoraco-lumbar and lumbar spinal fractures nowadays remains a controversial issue. Percutaneous techniques are becoming very popular in the last few years to reduce the approach-related morbidity associated with conventional techniques. Hypothesis: Purpose of the study was to analyze the clinical and radiological outcome of patients who underwent percutaneous posterior fixation without fusion for the treatment of thoraco-lumbar and lumbar A3 fractures. Materials and methods: Sixty-three patients, having sustained a single-level thoraco-lumbar fracture, underwent short segment percutaneous instrumentation and were retrospectively analyzed. sagittal index (SI) was calculated in all patients. Clinical and functional outcome were evaluated by Visual Analog Scale (VAS), Oswestry Disability Index (ODI) and Short Form General Health Status (SF-36). Results: Average operative blood loss was 82. mL (50-320). Mean pre-operative SI in the thoraco-lumbar segment was 13.3° decreased to 5.8° in the immediate postoperative with a mean deformity correction of 7.5. Mean pre-operative SI in the lumbar segment was 16.5° decreased to 11.3° in the immediate postoperative with a mean deformity correction of 5.2. Not statistically significant correction loss was registered at 1-year minimum follow-up. Constant clinical conditions improvement in the examined patients was observed. Conclusion: Percutaneous pedicle screw fixation for A3 thoraco-lumbar and lumbar spinal fractures is a reliable and safe procedure. Level of evidence: Level IV. Retrospective study. © 2014. Source

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