Treatment of thoracolumbar fractures with severe collapse of the anterior and middle columns via balloon-assisted endplate reduction, transpedicular bone grafting and pedicle screw fixation
Abstract Purpose Thoracolumbar fractures involving severe collapse of the anterior and middle columns are difficult to reduce via posterior surgery. Therefore, we evaluated the effectiveness of balloon-assisted endplate reduction (BAER), transpedicular bone grafting, and pedicle screw fixation for t...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-06-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-025-05916-8 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849334577635524608 |
|---|---|
| author | Hai-qiang Shen Yun-qin Xu You-rong Yao Qi Liu Lin-ying Zhou Xiao-jie Chen Xiao-hong Lu Xing Zhao Yong Tang |
| author_facet | Hai-qiang Shen Yun-qin Xu You-rong Yao Qi Liu Lin-ying Zhou Xiao-jie Chen Xiao-hong Lu Xing Zhao Yong Tang |
| author_sort | Hai-qiang Shen |
| collection | DOAJ |
| description | Abstract Purpose Thoracolumbar fractures involving severe collapse of the anterior and middle columns are difficult to reduce via posterior surgery. Therefore, we evaluated the effectiveness of balloon-assisted endplate reduction (BAER), transpedicular bone grafting, and pedicle screw fixation for this type of thoracolumbar fracture. Methods This retrospective study included 87 patients with thoracolumbar fractures involving severe collapse of the anterior and middle columns treated from January 2020 to January 2022. Among them, 37 patients were treated via BAER, transpedicular bone grafting and pedicle screw fixation (Group A). Another 50 patients were treated via preoperative postural reduction combined with posterior pedicle screw fixation (Group B). Routine patient follow-ups were conducted to record the degree of vertebral height maintenance via X-ray and computed tomography (CT) images. The visual analog scale (VAS) score for low back pain and the Oswestry Disability Index (ODI) score were recorded. Results The operative time, blood loss and hospitalization cost were greater in Group A. Significant clinical improvements in the ODI, VAS score, AVBH, MVBH and VWA were achieved in the two groups after surgery. However, the improvements in the AVBH, MVBH and VWA were significantly greater in Group A. During the final follow-up, the VAS and ODI scores in Group A were lower. The spinopelvic parameters at the sagittal position did not significantly differ between the two groups at any time. Conclusions The technique comprising BAER, transpedicular bone grafting, and pedicle screw fixation to treat thoracolumbar fractures with severe collapse of the anterior and middle columns is feasible and provides advantages. |
| format | Article |
| id | doaj-art-bfd0f32e03b44fb2bb53b7f4e5b4fcbf |
| institution | Kabale University |
| issn | 1749-799X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj-art-bfd0f32e03b44fb2bb53b7f4e5b4fcbf2025-08-20T03:45:32ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2025-06-012011810.1186/s13018-025-05916-8Treatment of thoracolumbar fractures with severe collapse of the anterior and middle columns via balloon-assisted endplate reduction, transpedicular bone grafting and pedicle screw fixationHai-qiang Shen0Yun-qin Xu1You-rong Yao2Qi Liu3Lin-ying Zhou4Xiao-jie Chen5Xiao-hong Lu6Xing Zhao7Yong Tang8Department of Orthopaedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang UniversityDepartment of Orthopaedics, 72nd Group Army Hospital, Huzhou UniversityDepartment of Orthopaedics, 72nd Group Army Hospital, Huzhou UniversityDepartment of Orthopaedics, 72nd Group Army Hospital, Huzhou UniversityDepartment of Orthopaedics, 72nd Group Army Hospital, Huzhou UniversityDepartment of Orthopaedics, 72nd Group Army Hospital, Huzhou UniversityDepartment of Orthopaedics, 72nd Group Army Hospital, Huzhou UniversityDepartment of Orthopaedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang UniversityDepartment of Orthopaedics, 72nd Group Army Hospital, Huzhou UniversityAbstract Purpose Thoracolumbar fractures involving severe collapse of the anterior and middle columns are difficult to reduce via posterior surgery. Therefore, we evaluated the effectiveness of balloon-assisted endplate reduction (BAER), transpedicular bone grafting, and pedicle screw fixation for this type of thoracolumbar fracture. Methods This retrospective study included 87 patients with thoracolumbar fractures involving severe collapse of the anterior and middle columns treated from January 2020 to January 2022. Among them, 37 patients were treated via BAER, transpedicular bone grafting and pedicle screw fixation (Group A). Another 50 patients were treated via preoperative postural reduction combined with posterior pedicle screw fixation (Group B). Routine patient follow-ups were conducted to record the degree of vertebral height maintenance via X-ray and computed tomography (CT) images. The visual analog scale (VAS) score for low back pain and the Oswestry Disability Index (ODI) score were recorded. Results The operative time, blood loss and hospitalization cost were greater in Group A. Significant clinical improvements in the ODI, VAS score, AVBH, MVBH and VWA were achieved in the two groups after surgery. However, the improvements in the AVBH, MVBH and VWA were significantly greater in Group A. During the final follow-up, the VAS and ODI scores in Group A were lower. The spinopelvic parameters at the sagittal position did not significantly differ between the two groups at any time. Conclusions The technique comprising BAER, transpedicular bone grafting, and pedicle screw fixation to treat thoracolumbar fractures with severe collapse of the anterior and middle columns is feasible and provides advantages.https://doi.org/10.1186/s13018-025-05916-8Thoracolumbar fractureSevere collapse of the anterior and middle columnsBalloon-assisted endplate reduction (BAER)Transpedicular bone graftingPedicle screw fixation |
| spellingShingle | Hai-qiang Shen Yun-qin Xu You-rong Yao Qi Liu Lin-ying Zhou Xiao-jie Chen Xiao-hong Lu Xing Zhao Yong Tang Treatment of thoracolumbar fractures with severe collapse of the anterior and middle columns via balloon-assisted endplate reduction, transpedicular bone grafting and pedicle screw fixation Journal of Orthopaedic Surgery and Research Thoracolumbar fracture Severe collapse of the anterior and middle columns Balloon-assisted endplate reduction (BAER) Transpedicular bone grafting Pedicle screw fixation |
| title | Treatment of thoracolumbar fractures with severe collapse of the anterior and middle columns via balloon-assisted endplate reduction, transpedicular bone grafting and pedicle screw fixation |
| title_full | Treatment of thoracolumbar fractures with severe collapse of the anterior and middle columns via balloon-assisted endplate reduction, transpedicular bone grafting and pedicle screw fixation |
| title_fullStr | Treatment of thoracolumbar fractures with severe collapse of the anterior and middle columns via balloon-assisted endplate reduction, transpedicular bone grafting and pedicle screw fixation |
| title_full_unstemmed | Treatment of thoracolumbar fractures with severe collapse of the anterior and middle columns via balloon-assisted endplate reduction, transpedicular bone grafting and pedicle screw fixation |
| title_short | Treatment of thoracolumbar fractures with severe collapse of the anterior and middle columns via balloon-assisted endplate reduction, transpedicular bone grafting and pedicle screw fixation |
| title_sort | treatment of thoracolumbar fractures with severe collapse of the anterior and middle columns via balloon assisted endplate reduction transpedicular bone grafting and pedicle screw fixation |
| topic | Thoracolumbar fracture Severe collapse of the anterior and middle columns Balloon-assisted endplate reduction (BAER) Transpedicular bone grafting Pedicle screw fixation |
| url | https://doi.org/10.1186/s13018-025-05916-8 |
| work_keys_str_mv | AT haiqiangshen treatmentofthoracolumbarfractureswithseverecollapseoftheanteriorandmiddlecolumnsviaballoonassistedendplatereductiontranspedicularbonegraftingandpediclescrewfixation AT yunqinxu treatmentofthoracolumbarfractureswithseverecollapseoftheanteriorandmiddlecolumnsviaballoonassistedendplatereductiontranspedicularbonegraftingandpediclescrewfixation AT yourongyao treatmentofthoracolumbarfractureswithseverecollapseoftheanteriorandmiddlecolumnsviaballoonassistedendplatereductiontranspedicularbonegraftingandpediclescrewfixation AT qiliu treatmentofthoracolumbarfractureswithseverecollapseoftheanteriorandmiddlecolumnsviaballoonassistedendplatereductiontranspedicularbonegraftingandpediclescrewfixation AT linyingzhou treatmentofthoracolumbarfractureswithseverecollapseoftheanteriorandmiddlecolumnsviaballoonassistedendplatereductiontranspedicularbonegraftingandpediclescrewfixation AT xiaojiechen treatmentofthoracolumbarfractureswithseverecollapseoftheanteriorandmiddlecolumnsviaballoonassistedendplatereductiontranspedicularbonegraftingandpediclescrewfixation AT xiaohonglu treatmentofthoracolumbarfractureswithseverecollapseoftheanteriorandmiddlecolumnsviaballoonassistedendplatereductiontranspedicularbonegraftingandpediclescrewfixation AT xingzhao treatmentofthoracolumbarfractureswithseverecollapseoftheanteriorandmiddlecolumnsviaballoonassistedendplatereductiontranspedicularbonegraftingandpediclescrewfixation AT yongtang treatmentofthoracolumbarfractureswithseverecollapseoftheanteriorandmiddlecolumnsviaballoonassistedendplatereductiontranspedicularbonegraftingandpediclescrewfixation |