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Treatment Tactics for Patients with Isolated Injuries of the Fifth Lumbar Vertebra

The major management technique for lumbar burst fractures is transpedicular fixation (TPF). However, in relation to fractures of the L(5) vertebra, this tactic often has no advantages over conservative treatment, and, therefore, it is expected to be supplemented with anterior decompression and recon...

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Autores principales: Likhachev, S.V., Zaretskov, V.V., Arsenievich, V.B., Ostrovskij, V.V., Shchanitsyn, I.N., Shulga, A.E., Bazhanov, S.P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Privolzhsky Research Medical University 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8858414/
https://www.ncbi.nlm.nih.gov/pubmed/35265347
http://dx.doi.org/10.17691/stm2021.13.5.04
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author Likhachev, S.V.
Zaretskov, V.V.
Arsenievich, V.B.
Ostrovskij, V.V.
Shchanitsyn, I.N.
Shulga, A.E.
Bazhanov, S.P.
author_facet Likhachev, S.V.
Zaretskov, V.V.
Arsenievich, V.B.
Ostrovskij, V.V.
Shchanitsyn, I.N.
Shulga, A.E.
Bazhanov, S.P.
author_sort Likhachev, S.V.
collection PubMed
description The major management technique for lumbar burst fractures is transpedicular fixation (TPF). However, in relation to fractures of the L(5) vertebra, this tactic often has no advantages over conservative treatment, and, therefore, it is expected to be supplemented with anterior decompression and reconstruction of the anterior column of the L(5) vertebra. The aim of the study was to determine the most optimal treatment tactics for patients with isolated burst fractures of the fifth lumbar vertebra. MATERIALS AND METHODS: We performed a retrospective study of 58 patients treated for isolated burst L(5) fractures. 12 patients refused to undergo surgery and received conservative outpatient treatment. TPF was performed in 27 patients; circular spondylosynthesis (TPF + anterior column support with a Mesh implant) — in 19 patients. The effectiveness of the treatment was assessed by clinical and introscopic research methods. RESULTS: The radiological and functional outcomes of surgery with conventional TPF for isolated L(5) burst fractures are generally comparable with the outcomes of conservative treatment. In 26% of the patients, the instability of the metal construction developed within 12 months after surgical intervention. Supplementing the transpedicular system with wedging anterior column support with a Mesh implant ensures preservation in 21%, and improves the parameters of the sagittal profile of the lumbosacral transition in 79% of cases.
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spelling pubmed-88584142022-03-08 Treatment Tactics for Patients with Isolated Injuries of the Fifth Lumbar Vertebra Likhachev, S.V. Zaretskov, V.V. Arsenievich, V.B. Ostrovskij, V.V. Shchanitsyn, I.N. Shulga, A.E. Bazhanov, S.P. Sovrem Tekhnologii Med Modern Spine Surgery The major management technique for lumbar burst fractures is transpedicular fixation (TPF). However, in relation to fractures of the L(5) vertebra, this tactic often has no advantages over conservative treatment, and, therefore, it is expected to be supplemented with anterior decompression and reconstruction of the anterior column of the L(5) vertebra. The aim of the study was to determine the most optimal treatment tactics for patients with isolated burst fractures of the fifth lumbar vertebra. MATERIALS AND METHODS: We performed a retrospective study of 58 patients treated for isolated burst L(5) fractures. 12 patients refused to undergo surgery and received conservative outpatient treatment. TPF was performed in 27 patients; circular spondylosynthesis (TPF + anterior column support with a Mesh implant) — in 19 patients. The effectiveness of the treatment was assessed by clinical and introscopic research methods. RESULTS: The radiological and functional outcomes of surgery with conventional TPF for isolated L(5) burst fractures are generally comparable with the outcomes of conservative treatment. In 26% of the patients, the instability of the metal construction developed within 12 months after surgical intervention. Supplementing the transpedicular system with wedging anterior column support with a Mesh implant ensures preservation in 21%, and improves the parameters of the sagittal profile of the lumbosacral transition in 79% of cases. Privolzhsky Research Medical University 2021 2021-10-29 /pmc/articles/PMC8858414/ /pubmed/35265347 http://dx.doi.org/10.17691/stm2021.13.5.04 Text en https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Modern Spine Surgery
Likhachev, S.V.
Zaretskov, V.V.
Arsenievich, V.B.
Ostrovskij, V.V.
Shchanitsyn, I.N.
Shulga, A.E.
Bazhanov, S.P.
Treatment Tactics for Patients with Isolated Injuries of the Fifth Lumbar Vertebra
title Treatment Tactics for Patients with Isolated Injuries of the Fifth Lumbar Vertebra
title_full Treatment Tactics for Patients with Isolated Injuries of the Fifth Lumbar Vertebra
title_fullStr Treatment Tactics for Patients with Isolated Injuries of the Fifth Lumbar Vertebra
title_full_unstemmed Treatment Tactics for Patients with Isolated Injuries of the Fifth Lumbar Vertebra
title_short Treatment Tactics for Patients with Isolated Injuries of the Fifth Lumbar Vertebra
title_sort treatment tactics for patients with isolated injuries of the fifth lumbar vertebra
topic Modern Spine Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8858414/
https://www.ncbi.nlm.nih.gov/pubmed/35265347
http://dx.doi.org/10.17691/stm2021.13.5.04
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