Combined open decompressive laminectomy and vertebroplasty for treatment of thoracolumbar fractures retrospective review of 41 cases

Scott Boswell, Michael Sather, Meysam Kebriaei, Katie Lydiatt, Brad Bowdino, Daniel Tomes, John Treves, Les Hellbusch

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: Vertebral compression fractures are common, and can occur concomitantly in patients with symptomatic degenerative stenosis. Less commonly, complicated vertebral body fractures may involve retropulsion of bone into the spinal canal, resulting in stenosis with myelopathy and/or radiculopathy. Decompression of the neural elements can lead to destabilization and progressive kyphotic deformity. Laminectomy combined with open vertebroplasty provides a way to decompress the neural elements and stabilize the anterior columns in patients who cannot tolerate extended surgical time or complications associated with instrumentation and fusion. The authors describe the combination of decompressive laminectomy and open transpedicular vertebroplasty as a means to decompress neural elements and simultaneously stabilize the anterior vertebral column. Methods: Forty-one patients with a total of 51 thoracolumbar fractures were included in this retrospective case review. A decompressive laminectomy was performed first, followed by vertebroplasty using an open transpedicular approach. For subjective assessment of outcome, the patients were assessed using the Oswestry Low Back Disability Questionnaire and additional questions pertaining to the patient's condition. Results: Out of 51 fractures, there were 15 burst fractures and 36 compression fractures. Fracture levels ranged from T12 to S1. The average follow-up period was 27 months (range, 0.5-60 months). The mean post-operative Oswestry score was 16 (range, 0-39), and all patients except for one were subjectively pleased with the results of the procedure and said they would recommend it to others. All patients were able to return to all routine activities of daily living. Conclusions: The authors' cases indicate combining open decompressive laminectomies with vertebroplasty can be an effective treatment for patients with complicated thoracic and lumbar fractures without involving bone fusion or spinal instrumentation and with good long-term outcomes.

Original languageEnglish (US)
Pages (from-to)902-906
Number of pages5
JournalClinical Neurology and Neurosurgery
Volume114
Issue number7
DOIs
StatePublished - Sep 2012

Fingerprint

Vertebroplasty
Laminectomy
Compression Fractures
Therapeutics
Pathologic Constriction
Patient Outcome Assessment
Bone and Bones
Spinal Fusion
Radiculopathy
Spinal Canal
Spinal Cord Diseases
Operative Time
Activities of Daily Living
Decompression
Spine
Thorax

Keywords

  • Burst fracture
  • Compression fracture
  • Laminectomy
  • Vertebroplasty

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Combined open decompressive laminectomy and vertebroplasty for treatment of thoracolumbar fractures retrospective review of 41 cases. / Boswell, Scott; Sather, Michael; Kebriaei, Meysam; Lydiatt, Katie; Bowdino, Brad; Tomes, Daniel; Treves, John; Hellbusch, Les.

In: Clinical Neurology and Neurosurgery, Vol. 114, No. 7, 09.2012, p. 902-906.

Research output: Contribution to journalArticle

Boswell, Scott ; Sather, Michael ; Kebriaei, Meysam ; Lydiatt, Katie ; Bowdino, Brad ; Tomes, Daniel ; Treves, John ; Hellbusch, Les. / Combined open decompressive laminectomy and vertebroplasty for treatment of thoracolumbar fractures retrospective review of 41 cases. In: Clinical Neurology and Neurosurgery. 2012 ; Vol. 114, No. 7. pp. 902-906.
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AU - Tomes, Daniel

AU - Treves, John

AU - Hellbusch, Les

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AB - Background: Vertebral compression fractures are common, and can occur concomitantly in patients with symptomatic degenerative stenosis. Less commonly, complicated vertebral body fractures may involve retropulsion of bone into the spinal canal, resulting in stenosis with myelopathy and/or radiculopathy. Decompression of the neural elements can lead to destabilization and progressive kyphotic deformity. Laminectomy combined with open vertebroplasty provides a way to decompress the neural elements and stabilize the anterior columns in patients who cannot tolerate extended surgical time or complications associated with instrumentation and fusion. The authors describe the combination of decompressive laminectomy and open transpedicular vertebroplasty as a means to decompress neural elements and simultaneously stabilize the anterior vertebral column. Methods: Forty-one patients with a total of 51 thoracolumbar fractures were included in this retrospective case review. A decompressive laminectomy was performed first, followed by vertebroplasty using an open transpedicular approach. For subjective assessment of outcome, the patients were assessed using the Oswestry Low Back Disability Questionnaire and additional questions pertaining to the patient's condition. Results: Out of 51 fractures, there were 15 burst fractures and 36 compression fractures. Fracture levels ranged from T12 to S1. The average follow-up period was 27 months (range, 0.5-60 months). The mean post-operative Oswestry score was 16 (range, 0-39), and all patients except for one were subjectively pleased with the results of the procedure and said they would recommend it to others. All patients were able to return to all routine activities of daily living. Conclusions: The authors' cases indicate combining open decompressive laminectomies with vertebroplasty can be an effective treatment for patients with complicated thoracic and lumbar fractures without involving bone fusion or spinal instrumentation and with good long-term outcomes.

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