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Long-term results of surgical treatment in patients with uncomplicated trauma to the thoracic and lumbar spine segments (systematic review)

Year: 2025, volume 21 Issue: №3 Pages: 273-279
Heading: Traumatology and Orthopedics Article type: Review
Authors: Tolkachev V.S., Shulga A.E., Bazhanov S.P., Shuvalov S.D., Ostrovskij V.V.
Organization: Saratov State Medical University
Summary:

Objective: to conduct a systematic analysis of long-term outcomes of surgical treatment in patients with uncomplicated thoracic and lumbar spine trauma. Review methodology. The studies to analyze were retrieved from PubMed, Scopus, and Web of Science using a combination of MeSH terms and keywords: "spinal fracture", "surgical treatment", "support spondylosis", "visual analog scale", "health-related quality of life", "Oswestry Disability Index". The search was limited to the full text original studies. The search retrieved 1,245 articles, leaving 6 articles published between 2018 and 2024 after checking the eligibility criteria for inclusion. We calculated the changes in visual analog scale (AVAS) and Oswestry Disability Index (AODI) scores, Cobb loss of primary correction (COBB0), and complication rates (percent). Conclusion. AVAS ranged from 1.88 to 7.8 scores, AODI ranged from 33.05 to 51.85 percent, ACOBB0 ranged from 0.9 to 4.7 degrees, and complication rates ranged from 5 to 70 percent. Thus, the anterior support spondylosis leads to clinically significant reduction of pain syndrome and restoration of functional activity in patients who suffered uncomplicated fractures of thoracic and lumbar vertebrae; however, it should be noted that the data are limited by small samples and heterogeneity of study protocols, which may require further randomized multicenter studies.

Keywords: long-term treatment outcomes, lumbar spine, thoracic spine, uncomplicated trauma

Bibliography:
1. Rerikh VV, Sinyavin VD. Surgical treatment of burst fractures of the vertebral bodies of the thoracic and lumbar spine (literature review). Sovremennye problemy nauki i obrazovaniya = Modern Problems of Science and Education. 2021 ;(6). DOI:10.17513/spno
2. Borzykh КО, Rerikh VV. Surgical treatment of posttraumatic kyphosis of the lumbar spine: compensatory changes and dynamics of sagittal balance. Khirurgiya Pozvonochnika = Russian Journal of Spine Surgery. 2024;21(4):34-45. DOI:10.14531/SS2024.4.34-45
3. Vaccaro AR, Schroeder GD, Kepler CK, et al. The surgical algorithm for the AOSpine thoracolumbar spine injury classification system. Eur Spine J. 2016;25(4):1087-94. DOI:10.1007/S00586-015-3982-2
4. Borzykh КО, Rerich VV, Zhukov DV Posttraumatic deformities of the thoracic and lumbar spine. Novosibirsk: FGBU "Ya.L. Tsivyan Novosibirsk Research Institute of Traumatology and Orthopedics" Ministry of Health of Russia, 2024. 56 p..
5. Aleem IS, Nassr A. Cochrane in CORR: Surgical versus non-surgical treatment for thoracolumbar burst fractures without neurological deficit. Clin Orthop Relat Res. 2016;474(3):619-24. DOI: 10.1007/sl1999-015-4305-y
6. Grin A, Karanadze V, Lvov I, et al. Is anterior fusion still necessary in patients with neurologically intact thoracolumbar burst fractures? A systematic review and meta-analysis. Neuro-cirugia (Astur: Engl Ed). 2025;36(2):112-28. DOI:10.1016/j.neu-cie.2024.11.006
7. Wu J, Zhu J, Wang Z, et al. Outcomes in thoracolumbar and lumbar traumatic fractures: Does restoration of unfused segmental mobility correlated to implant removal time? World Neuro-surg.2022;157:e254-63. DOI:10.1016/j.wneu.2021.09.138
8. Abudou M, Chen X, Kong X, Wu T. Surgical versus non-surgical treatment for thoracolumbar burst fractures without neurological deficit. Cochrane Database Syst Rev. 2013;(6):CD005079. DOI:10.1002/14651858.CD005079.pub3
9. Wang HW, Hu YC, Wu ZY, et al. One approach anterior decompression and fixation with posterior unilateral pedicle screw fixation for thoracolumbar osteoporotic vertebral compression fractures. Orthop Surg. 2021;13(3):908-19. DOI:10.1111/os.12947
10. Rethlefsen ML, Kirtley S, Waffenschmidt S, et al. PRIS-MA-S: An extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews. Syst Rev. 2021 ;10(1 ):39. DOI :10.1186/s13643-020-01542-z
11. MethleyAM, Campbell S, Chew-Graham C, et al. PICO, PICOS and SPIDER: A comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. ВМС Health Serv Res. 2014;(14):579. DOI:10.1186/s12913-014-0579-0
12. Copay AG, Subach BR, Glassman SD, et al. Understanding the minimum clinically important difference: A review of concepts and methods. Spine J. 2007;7(5):541-6. DOI:10.1016/j.spinee.2007.01.008
13. Lee JS, Hobden E, Stiell IG, Wells GA. Clinically important change in the visual analog scale after adequate pain control. Acad Emerg Med. 2003;10(10):1128-30. DOI:10.1111/j.1553-2712.2003.tb00586.x
14. Yoshida G, Hasegawa T, Yamato Y, et al. Minimum clinically important differences in oswestry disability index domains and their impact on adult spinal deformity surgery. Asian Spine J. 2019;13(1):35-44. DOI:10.31616/asj.2018.0077
15. Zhong W, Hu Y Long-term outcomes of nano-hydroxy-apatite/polyamide 66 strut in thoracolumbar burst fractures. Med Sci Monit. 2024;30:e946091. DOI:10.12659/MSM.946091
16. Sasaki M, Fukunaga T, Ninomiya K, et al. Lateral lumbar interbody fusion using bone graft substitute for lumbar vertebral fracture associated radiculopathy. Neurol Med Chir (Tokyo). 2022;62(7):342-6. DOI:10.2176/jns-nmc.2021-0395
17. Koepke LG, Weiser L, Stangenberg M, et al. outcome after posterior vertebral column resection in patients with severe osteoporotic fractures-a retrospective analysis from two centers. Medicina (Kaunas). 2022;58(2):277. DOI:10.3390/medici-na58020277
18. Guo DQ, Yu M, Zhang SC, et al. Novel surgical strategy for treating osteoporotic vertebral fractures with cord compression. OrthopSurg. 2019;11(6):1082-92. DOI:10.1111/os.12558
19. Lindtner RA, Mueller M, Schmid R, et al. Monosegmental anterior column reconstruction using an expandable vertebral body replacement device in combined posterior-anterior stabilization of thoracolumbar burst fractures. Arch Orthop Trauma Surg. 2018;138(7):939-51. DOI:10.1007/s00402-018-2926-9
20. Rerikh VV, Borzykh КО, Samokhin AG. Correlations of functional capacity and parameters of sagittal balance in patients with posttraumatic deformities of the spine. Sovremennye problemy nauki i obrazovaniya = Modern Problems of Science and Education. 2017;(6).
21. Roblesgil-Medrano A, Tellez-Garcia Е, Bueno-Gutierrez LC, et al. Thoracolumbar burst fractures: A systematic reviewand meta-analysis on the anterior and posterior approaches. Spine Surg Relat Res. 2021 ;6(2):99-108. DOI:10.22603/ssrr.2021-0122
22. Hughes H, CarthyAM, Sheridan GA, et al. Thoracolumbar burst fractures: A systematic reviewand meta-analysis comparing posterior-only instrumentationversus combined anterior - posterior instrumentation. Spine (Phila Pa 1976). 2021;46(15):e840-9. DOI:10.1097/BRS.0000000000003934
23. Xu GJ, Li ZJ, Ma JX, et al. Anterior versusposterior approach for treatment of thoracolumbar burstfractures: A meta-analysis. Eur Spine J. 2013;22(10):2176-83. DOI:10.1007/s00586-013-2987-y
24. Lang S, Neumann C, Schwaiger C, et al. Radiological and mid-to long-term patient-reported outcome after stabilization of traumatic thoraco-lumbar spinal fractures using an expandable vertebral body replacement implant. ВМС Musculoskelet Disord. 2021 ;22(1 ):744. DOI: 10.1186/s12891-021-04585-y
25. Gumussuyu G, Islam NC, Kose O, et al. Comparison of two segment combined instrumentation and fusion versus three segment posterior instrumentation in thoracolumbar burst fractures: A randomized clinical trial with 10 years of follow up. Turk Neurosurg. 2019;29(4):555-63. DOI:10.5137/1019-5149.JTN.25025-18.3

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All articles of the authors: Bazhanov S.P., Ostrovsky V.V., Shulga A.Е., Shuvalov S.D. , Tolkachev V.S.

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