PMID- 35141580
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220501
IS  - 2666-5484 (Electronic)
IS  - 2666-5484 (Linking)
VI  - 1
DP  - 2020 May
TI  - Osteoporotic burst fracture-clinical, radiological and functional outcome of 
      three-column reconstruction using single posterior approach (Instrumentation, 
      Corpectomy, Arthroscope Assisted Transpedicular Decompression and Mesh Cage).
PG  - 100009
LID - 10.1016/j.xnsj.2020.100009 [doi]
LID - 100009
AB  - PURPOSE: To evaluate a novel effective procedure utilizing three-column 
      reconstruction via a posterior approach with a technique that utilizes an 
      arthroscope to visualize the anterior surface of the dura during decompression. 
      METHODS: A Prospective Study. 80 Osteoporotic vertebral burst fracture patients 
      with similar demographic data managed by three-column reconstruction through 
      single posterior approach surgery: Pedicle screw fixation, Corpectomy, 
      Arthroscope Assisted Transpedicular Decompression (AATD) and Fusion (Mesh 
      Cage + Bone grafting). Preoperative and postoperative clinical parameters (Visual 
      Analog Score VAS, swestry Disability Index ODI, neurlogy, radiological parameters 
      and surgical variables were recorded analysed. RESULTS: No significant 
      differences in demographic data. Significant improvement was noted in VAS 
      (pre-operative, 7.90 +/-0.60; final follow-up 2.90 +/- 0.54) and ODI (preoperative, 
      77.10 +/- 6.96; final follow-up 21.30 +/- 6.70). Neurological improvement was noted 
      in 74 patients (Frankel grade E) while six patients remained non-ambulatory 
      (Frankel grade C). Significant improvement was noted in local kyphosis angle 
      (preoperative, 22.14 +/- 2.60; postoperative, 10.40 +/- 1.40) with a 10% loss of 
      correction (2.5 +/- 0.90) at final follow-up. Implant failure in two patients and 
      proximal junctional failure in two patients managed with revision surgery. No 
      iatrogenic dural or nerve injury. CONCLUSIONS: Osteoporotic Burst fracture can be 
      managed with single posterior surgery, three-column reconstruction with mesh 
      cage. It provides a significant improvement in clinical, radiological and 
      functional outcomes. The arthroscope can improve a surgeon's operative field and 
      magnification thereby ensuring complete decompression without injuring the dura 
      or spinal cord.
CI  - (c) 2020 The Authors. Published by Elsevier Ltd on behalf of North American Spine 
      Society.
FAU - Kakadiya, Ghanshyam
AU  - Kakadiya G
AD  - Department of Orthopaedics, TNMC & BYL Nair Hospital, Mumbai 400008, India.
FAU - Gandbhir, Viraj
AU  - Gandbhir V
AD  - Department of Orthopaedics, TNMC & BYL Nair Hospital, Mumbai 400008, India.
FAU - Soni, Yogesh
AU  - Soni Y
AD  - Department of Orthopaedics, TNMC & BYL Nair Hospital, Mumbai 400008, India.
FAU - Gohil, Kushal
AU  - Gohil K
AD  - Department of Orthopaedics, TNMC & BYL Nair Hospital, Mumbai 400008, India.
FAU - Shakya, Akash
AU  - Shakya A
AD  - Department of Orthopaedics, TNMC & BYL Nair Hospital, Mumbai 400008, India.
LA  - eng
PT  - Journal Article
DEP - 20200529
PL  - United States
TA  - N Am Spine Soc J
JT  - North American Spine Society journal
JID - 9918335076906676
PMC - PMC8820035
OTO - NOTNLM
OT  - Arthroscope Assisted Transpedicular decompression
OT  - Mesh CageIntroduction
OT  - Osteoporotic fracture
OT  - Posterior approach
OT  - three-column reconstruction
COIS- There are no conflicts of interest.
EDAT- 2020/05/29 00:00
MHDA- 2020/05/29 00:01
PMCR- 2020/05/29
CRDT- 2022/02/10 05:40
PHST- 2020/04/09 00:00 [received]
PHST- 2020/05/08 00:00 [revised]
PHST- 2020/05/20 00:00 [accepted]
PHST- 2022/02/10 05:40 [entrez]
PHST- 2020/05/29 00:00 [pubmed]
PHST- 2020/05/29 00:01 [medline]
PHST- 2020/05/29 00:00 [pmc-release]
AID - S2666-5484(20)30009-3 [pii]
AID - 100009 [pii]
AID - 10.1016/j.xnsj.2020.100009 [doi]
PST - epublish
SO  - N Am Spine Soc J. 2020 May 29;1:100009. doi: 10.1016/j.xnsj.2020.100009. 
      eCollection 2020 May.