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Safe surgical technique: cement-augmented pedicle screw instrumentation and balloon-guided kyphoplasty for a lumbar burst fracture in a 97-year-old patient

BACKGROUND: During the last few years, an increasing number of unstable thoracolumbar fractures, especially in elderly patients, has been treated by dorsal instrumentation combined with a balloon kyphoplasty. This combination provides additional stabilization to the anterior spinal column without an...

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Detalles Bibliográficos
Autores principales: Freude, Thomas, König, Benjamin, Martetschläger, Frank, Siebenlist, Sebastian, Neumaier, Markus, Stöckle, Ulrich, Döbele, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3614881/
https://www.ncbi.nlm.nih.gov/pubmed/23298619
http://dx.doi.org/10.1186/1754-9493-7-3
Descripción
Sumario:BACKGROUND: During the last few years, an increasing number of unstable thoracolumbar fractures, especially in elderly patients, has been treated by dorsal instrumentation combined with a balloon kyphoplasty. This combination provides additional stabilization to the anterior spinal column without any need for a second ventral approach. CASE PRESENTATION: We report the case of a 97-year-old male patient with a lumbar burst fracture (type A3-1.1 according to the AO Classification) who presented prolonged neurological deficits of the lower limbs - grade C according to the modified Frankel/ASIA score. After a posterior realignment of the fractured vertebra with an internal screw fixation and after an augmentation with non-absorbable cement in combination with a balloon kyphoplasty, the patient regained his mobility without any neurological restrictions. CONCLUSION: Especially in older patients, the presented technique of PMMA-augmented pedicle screw instrumentation combined with balloon-assisted kyphoplasty could be an option to address unstable vertebral fractures in “a minor-invasive way”. The standard procedure of a two-step dorsoventral approach could be reduced to a one-step procedure.