Abstract
The current project investigates the role of vertebroplasty in supplementing short
segment (SS) posterior instrumentation, only one level above and below a fracture.
In the treatment of thoracolumbar burst fractures, long segment (LS) posterior instrumentation
two levels above and below the fracture level has been used. In our study, burst fractures
were produced at L1 in eight fresh frozen human cadaveric spines. The spines were
then tested in three conditions: 1) intact, 2) after LS (T11–L3), 3) SS (T12–L2) instrumentation
with pedicle screws and rods, and 4) short segment instrumentation plus cement augmentation
of the fracture level (SSC). LS instrumentation was found to significantly reduce
the motion at the instrumented level (T12–L2) as well as the levels immediately adjacent
in flexion, extension and lateral bending. Similarly, SSC augmentation was found to
significantly reduce the motion compared to intact at T12–L2 but still maintained
the adjacent level motion. However, SS instrumentation alone did not significantly
reduce the motion at T12–L2 except for left lateral bending. While LS instrumentation
remains the most stable construct, SS instrumentation augmented with vertebroplasty
at the fracture level increases rigidity in flexion, extension and right lateral bending
beyond SS instrumentation alone.
Keywords
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Article info
Publication history
Published online: January 29, 2015
Accepted:
November 25,
2014
Received:
September 18,
2014
Identification
Copyright
© 2015 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
