Journal of Musculoskeletal Trauma

Comparison of Surgical Outcomes in Thoracolumbar Fractures Having 6 or Less Scored by Load-Sharing Classification Based on Posterior Fusion Level: Jung Hoon Kim, Sung Soo Kim, Jin Ho Cho, Bo Hoon Jang, Jin Hwan Kim; J Korean Fract Soc 2013;26(1):21-26. Published online January 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.1.21

Abstract PDF: PURPOSE
The aim of this study is to decide the optimal level of fusion with comparing the results between the short segment fusion and long segment fusion treated with pedicle screw instrumentation, including fractured vertebra in thoracolumbar junctional fractures.
MATERIALS AND METHODS
From February 2000 to November 2009, fifty three patients with junctional fracture of thoracolumbar spine were treated with pedicle screws and posterior fusion at our hospital. They were divided into two groups, the short segment group and long segment group. Preoperatively, immediate postoperative and last follow-up lateral radiological evaluation was done by measuring the correction and loss of segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle. In addition, operation time and amount of intraoperative bleeding were measured.
RESULTS
There were no significant differences of statistical analysis regarding the radiological variables between the two groups, especially the loss of corrected segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle (p>0.05). However, operative time in the short segment group (234 minutes) was shorter than the long segment group (284 minutes), and there was statistical significance (p=0.002).
CONCLUSION
We recommend the short segment transpediculr instrumentation one level above and one level below, including the fractured vertebra for thoracolumbar junctional fracture with 6 points or less of the load-sharing score.

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Multiple Non-contiguous Spine Fractures with Concomitant Injuries: A Case Report: Soo Uk Chae, Yeung Jin Kim, Jung Hwan Yang, Ji Wan Lee, Jae In Park; J Korean Fract Soc 2011;24(3):267-270. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.267

Abstract PDF: Multiple non-contiguous spinal fracture is a special type of multi-level spinal injury, which is rare but most frequently occur in motor vehicle accident or a falling from a height. We report five patients of multiple non-contiguous spinal fractures. All patients underwent segmental pedicle screws fixation without fusion for preserving facet joints and minimizing blood loss and operation time. We performed necessary operation for any concomitant injuries at the same day.

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The Relationship between Progression of Body Collapse and MRI Findings in Osteoporotic Stable Thoracolumbar Fractures: Young Do Koh, Jong Seok Yoon, Ji Young Hwang, Hyun Sik Park; J Korean Fract Soc 2008;21(4):304-311. Published online October 31, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.4.304

PURPOSE
To find out the relationship between the initial Magnetic Resonance Image (MRI) findings and the progression of vertebra collapse when treated with Jewett brace in osteoporotic stable thoracolumbar fractures.
MATERIALS AND METHODS
We divided 38 cases of 37 patients of thoracolumbar osteoporotic stable thoracolumbar fractures who were treated with Jewett brace into two groups. One group was composed of those body collapse progressed more than 10% compared with the initial state, and the other group less than 10%. We analyzed the relationships between the progression of collapse and the superior endplate fractures, the fracture line extending to posterior cortex, the size of bone marrow edema, the signal intensity on T1 and T2 weighted MR images, the presence of paravertebral hematoma, and the degree of posterior extensor muscle atrophy using MR images.
RESULTS
The body collapse was more likely to progress when there was superior endplate fracture, when it showed larger size of bone marrow edema on T1 weighted image, and transverse low signal on T2 weighted image. But extending of fracture line to posterior cortex, presence of paravertebral hematoma, and degree of posterior extensor muscle atrophy did not show any statistical correlations to progression of collapse.
CONCLUSION
The body collapse is more likely to progress when there was superior endplate fracture, larger low signal on T1 weighted image and low signal on T2 weighted image at initial MRI treated with Jewett brace.

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The Factors between the Progression of the Compression Rate and Magnetic Resonance Imaging Findings in Osteoporotic Vertebral Fracture Patients Treated with Teriparatide
Taebyeong Kang, Seung-Pyo Suh, Jeongwoon Han, Byungjun Kang, Changhyun Park
Journal of the Korean Orthopaedic Association.2023; 58(5): 392. CrossRef
Statistical Analysis on Hospitalized Patients with Thoracolumbar Compression Fracture at Single Korean Medicine Hospital: Retrospective Review
Hyun jin Jang, So jeong Kim, Min Ju Kim, Hyeon Kyu Choi, Pil Je Park, Kang Yeon soo, Jeong Kyo Jeong, Ju Hyun Jeon, Young Il Kim
Journal of Korean Medicine.2023; 44(2): 149. CrossRef
The Influence of Initial Magnetic Resonance Imaging Findings on the Compression Rate of Thoracolumbar Osteoporotic Vertebral Compression Fracture
Seok-Ha Hwang, Seung-Pyo Suh, Young-Kyun Woo, Ho-Seung Jeon, Ho-Won Jeong
Journal of the Korean Orthopaedic Association.2018; 53(4): 341. CrossRef
The Relationship between the Progression of Kyphosis in Stable Thoracolumbar Fractures and Magnetic Resonance Imaging Findings
Deuk Soo Jun, Won Ju Shin, Byoung Keun An, Je Won Paik, Min Ho Park
Asian Spine Journal.2015; 9(2): 170. CrossRef

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Biomechanical Efficacy of Various Anterior Spinal Fixation in Treatment of Thoraco-lumbar Spine Fracture: Ye Soo Park, Hyoung Jin Kim, Choong Hyeok Choi, Won Man Park, Yoon Hyuk Kim; J Korean Fract Soc 2007;20(1):70-75. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.70

Abstract PDF

PURPOSE
To evaluate the biomechanical results according to various anterior spinal fixation methodology in the treatment of thoracolumbar spine fracture.
MATERIALS AND METHODS
The comparative analysis of fixation method was evaluated by three dimensional finite element model using the 1 mm reconstruction image of CT. Authors evaluated the flexion, extension, lateral bending, torsional stresses with 12 fixation methods for the compression and burst fracture.
RESULTS
In biomechanical analysis, stiffness of body-fixation device was more stable in two-rod system in compression fracture and was stable in one-rod, two-rod system in burst fracture, but two-rod system was showed over-increase of stiffness.
CONCLUSION
Authors recommend the usage of two-rod system in anterior fixation only and anterior one-rod system in anterior-posterior fixation.

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Lumbar Spine Fracture
Seung-Wook Back, Hyun-Joong Cho, Ye-Soo Park
Journal of the Korean Fracture Society.2011; 24(3): 277. CrossRef

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The Efficacy of the Treatment of Thoracolumbar Spine Fractures with Short-segment Posterior Instrumentation and Fusion: Hwa Yeop Na, Joon Cheol Choi, Jun Won Choi, Sang Ho Lee, Young Sang Lee, Woo Sung Kim, Sang Yoon Lee, Jong Won Won, Sang Ho Han; J Korean Fract Soc 2006;19(2):241-246. Published online April 30, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.2.241

Abstract

PURPOSE
To evaluate the safety and usefulness of the short-segment posterior instrumentation and fusion in the treatment of thoracolumbar spine fractures.
MATERIALS AND METHODS
Forty-two patients were treated by short-segment pedicle screw instrumentation and fusion between Oct. 1998. and Jan. 2004 by single surgeon. All patients were treated posteriorly and all the pedicle screws are monoaxial. Intraoperative rod bending and fixation technique was used to reduce the collapsed vertebral body and correct the kyphotic angle. The follow up duration is mean 2.1 year (1~6 year). The mean age is 40.2 year (18~60 year) old. The fractures were classified by Denis' classification and Load-Sharing Classification. Preoperative and postoperative changes of kyphotic angle and vertebral body height were measured. Denis' Pain Score and Work scales, Frankel neurologic grade were obtained during follow-up evaluation for patients.
RESULTS
All the cases got solid bony union. Mean Load-Sharing Score was 7.3. Clinical results were good. The mean kyphotic angle was preoperatively 14.5 degree, immediate postoperatively 7.5 degree, and last follow up 9.2 degree. The mean anterior vertebral heights s were 60.8% preoperatively, 83.4% immediate postoperatively, and 79.5% last follow up. There was only one case of screw breakage but no revision operation due to loss of reduction. All the cases showed satisfactory clinical results.
CONCLUSION
This study suggest that short-segment instrumentation and fusion using pedicle screw system for thoracolumbar spine fractures could lead to good results, if comminution of vertebral body is considered in the selection of approach.

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Comparison of Percutaneous versus Open Pedicle Screw Fixation for Treating Unstable Thoracolumbar Fractures
Jin Young Han, Ki Youn Kwon
Journal of the Korean Fracture Society.2020; 33(1): 1. CrossRef

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Atlanto-occipital Assimilation Can be Misdiagnosed as Atlantoaxial Dislocation: A Case Report: Kwang Bok Lee, Sang Rim Kim, Kwang Hoon Jung; J Korean Fract Soc 2005;18(4):470-473. Published online October 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.4.470

Abstract PDF: We present a rare case that atlanto-occipital assimilation can be misdiagnosed as C1-2 anterior subluxation. This is a lack of familiarity in orthopedic surgeon that was not used to manage the upper cervical spine injury. So the treatment of this entity need to get careful diagnosis and attention.

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Treatment of Vertebral Pseudarthrosis after Compression Fracture: Young Do Koh, Hoon Jeong; J Korean Fract Soc 2004;17(2):191-196. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.191

Abstract PDF: PURPOSE
To clarity the features of vertebral pseudarthrosis and to evaluate the efficacy of posterior instrumentation and fusion in treatment of it.
MATERIALS AND METHODS
Twelve patients with severe back pain and intravertebral pseudarthrosis showing vacuum phenomenon were treated by in situ posterior instrumentation and fusion. The kyphotic angle of pre- and post-treatment was measured on a lateral radiograph. MRI was performed in all patients. The intravertebral instability was confirmed from the dynamic lateral view. The pain level was assessed both before and after the treatment using a visual analog scale. The kyphotic angle at last follow up was also checked.
RESULTS
In eight cases, intravertebral instability was shown at the clefts in flexion-extension radiographs. MRI showed that the cleft was low intensity on the T1- weighted image and high intensity on the T2-weighted image. The pre-and postoperative mean kyphotic angles were -18.3degrees and -8.5degrees respectively. The preoperative average pain score was nine and postoperative four. At last follow up the mean kyphotic angle was -16.6degrees CONCLUSION: The cleft with intravertebral vacuum phenomenon and magnetic resonance findings of low intensity on the T1-weighted scans and high intensity on the T2-weighted scans suggests that the cleft is a pseudarthrosis associated with avascular necrosis of the vertebral body. The posterior instrumentation and fusion provides satisfactory pain relief in patient with vertebral pseudarthsosis.

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Correlation Analysis of BMD in Proximal Femur and Spine: Jun Young Yang, Young Mo Kim; J Korean Soc Fract 2003;16(4):570-576. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.570

Abstract PDF

PURPOSE
To analogize the result of the test through explaining the correlation of bone mineral density (BMD) test value between proximal femur and lumbar spine.
MATERIALS AND METHODS
It is based on 59 cases who visited the out-patient department. They were classified into two groups by age, group I (55~59 yr) and II (60~64 yr). Then we evaluated the average and the degree of correlation between the two groups and analyzed the correlation of the two sites according to the T & Z-score through the regression analysis.
RESULTS
In T-score, the correlation between L (independent variable, lumbar) and H (dependent variable, femur) indicated that L = 0.751 xH -0.195 for group I and L = 0.912 xH+0.31 for group II. In Z-score, the correlation was L = 0.647 xH -0.656 for group I and L = 0.897 xH -0.481 for group II.
CONCLUSION
It is regarded that there will be a clinical availability which can analogize the result of a part by using the result of the other part.

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A Novel Method for Estimation of Femoral Neck Bone Mineral Density Using Forearm Images from Peripheral Cone Beam Computed Tomography
Kwanmoon Jeong, Hoon Ko, Chang-Hoon Lee, Myeung Lee, Kwon-Ha Yoon, Jinseok Lee
Applied Sciences.2016; 6(4): 113. CrossRef
The Correlation Analysis and Correction factor of BMD in Forearm and Lumbar with DXA
Man-Seok Han
The Journal of Digital Policy and Management.2013; 11(12): 551. CrossRef
The Correlation Analysis of BMD in Proximal Femur and Spine with Dual Energy X-ray Absorptiometry
Man-Seok Han, Dong-Heon Cho
Journal of the Korea Society of Computer and Information.2012; 17(9): 165. CrossRef

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MRI Findings of Posterior Ligament Complex Injury in Thorcolumbar Bursting Fractures: Young Do Koh, Yeo Heon Yun, Hoon Jeong; J Korean Soc Fract 2003;16(4):541-547. Published online October 31, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.4.541

Abstract PDF: PURPOSE
To investigate the MR findings of structures injured in the burst fractures of thoracolumbar spine.
MATERIALS AND METHODS
Twenty-one patients who had thoracolumbar burst fractures with posterior ligament complex injury on MRI were studied. For the evaluation of stability of fractures, we used the scheme described by Oner et al. We identified the state of posterior ligament complex on surgery.
RESULTS
The MRI findings of ALL were state 1 in four, state 2 in fourteen, and state 3 in three. Those of PLL were state 1 in twelve, state 2 in six, and state 3 in three. The findings of posterior ligament complex were state 2 in one, state 3 in three, and state 4 in seventeen. The endplate state 1 was in four, state 2 in six, state 3 in seven, and state 4 in four. The disc state 1 was in twelve, state 2 in six, state 3 in two, state 4 in one. The vertebral body involvement state was 1 in four, state 2 in nine, and state 3 in eight. The injuries of posterior ligament complex were confirmed intraoperatively in all twenty-one patients.
CONCLUSION
We recommend the use of MRI to evaluate stability of fractures and state of posterior ligament complex in thoracolumbar burst fractures.

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Fracture of Vertebral Body in Flexion-Distraction Injury of Thoracolumbar Spine: Young Do Koh, Jong Oh Kim, Yeo Hon Yun, Jae Doo Yoo, Jun Mo Jung; J Korean Soc Fract 2003;16(2):262-269. Published online April 30, 2003; DOI: https://doi.org/10.12671/jksf.2003.16.2.262

Abstract PDF

PURPOSE
To evaluate the configuration of vertebral body fractures in flexion-distraction injuries of thoracolumbar spine.
MATERIALS AND METHODS
We investigated the location of fractures, anterior or posterior vertebral body height, kyphotic angle of injured segments, canal encroachment and severity of comminution on radiologic examinations of 21 cases.
RESULTS
There were 11 compression fractures and 9 burst fractures. 85% of fractures were located in the inferior vertebrae of injured segments. Anterior vertebral height decreased by 27% on average with decrease of 18% in compression fractures and 40% in burst fractures. Posterior height decreased by 1% on average with increase of 1% in compression fractures and decrease of 4% in burst fractures. The average kyphotic angle of injured segments was 19.5 degrees with 15.4degrees in compression fractures and 26.8 degrees in burst fractures. The canal encroachment in 9 burst fractures was 27% on average, and the comminution of vertebral body was mild in 74%.
CONCLUSION
The fracture of vertebral body in flexion-distraction injuries of thoracolumbar spine was very common, and located on the inferior vertebrae of injured segment. The decrease of vertebral height, canal encroachment and severity of comminution was relatively less than the estimated from mechanism of injury, with offset effect of distraction force.

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Differences in Thoracolumbar Burst Fractures by Falls from Height with Associated Foot and Ankle Fractures
Chung-Shik Shin, Eea-Sub Chung, Chang-Eon Yu, Byeong-Yeol Choi
Journal of Korean Society of Spine Surgery.2012; 19(2): 47. CrossRef

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Differences of Bone Mineral Density and Fracture Threshold Between Lumbar Spine Fracture and Control group: Ig Gon Kim, Jae Hyek Kim, Jung Ill Kim, Young Ill Hong; J Korean Soc Fract 2001;14(2):257-264. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.257

Abstract PDF: PURPOSE
The purpose of this study was to show how bone mineral densities of the lumbar spine decrease with aging, to investigate the relationship between the bone mineral densities of the control and fracture group, and to obtain fracture threshold values.
MATERIALS AND METHOD
From January 1995 to December 1999, we measured and evaluated BMD of L3 by DXA in 239 normal volunteers(96 men and 143 women), and in 218 patients with lumbar spine fracture(91 men and 127 women) above 50 years. The Chi-Square test was used for statistical analysis.
RESULTS
1. The average BMD of L3 in control group and lumbar spine fracture group were 0.772+/-0.030 g/cm2 in male and 0.732+/-0 . 0 8 9 g / c m2 i n female and 0.720+/-0 . 0 3 1 g / c m2 in male and 0.692+/-0 . 0 0 2 g / c m2 i n female, respectively.
RESULTS
2. The BMD of the control group and fracture group decreased with aging(p<0.05) and were higher in men than in women. There were statistically significant difference(p<0.001).
RESULTS
3. There were statistically significant difference between BMD of the control group and BMD of the lumbar spine fracture group(p<0.05). The BMD were higher in the control group than fracture group.
RESULTS
4. Fracture threshold of the lumbar spine fracture group were 0.867g/cm2( male: 0.898g /cm2, female:0.836g/cm2) according to 90 percentile.

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Posterior Short Segment Instreumntation and Fusion for the Unstable Thoracolumbar Spine Fracture: A Comparative Study: Ki Tack Kim, Gyu Pyo Hong, Dae Woo Hwang, Sang Un Lee, Sang Wook Bae; J Korean Soc Fract 2000;13(2):352-360. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.352

Abstract PDF: INTRODUCTION : In treating of acute unstable thoracolumbar spine fractures, current trend is a toward short segment instrumentation to spare the motion segments. Many authors reported the result of short instrumentation and fusion, but there have been few reports about the effect of additional screw fixation at fractured vertebra in posterior short segment instrumentation and fusion. Therefore, the objective of this study is to compare the results of treatment between with/without screw fixation at the fractured vertebra in posterior short segment pedicle screw fixation. MATERIAL AND METHODS : Twenty-three patients with unstable thoracolumbar spine fractures were treated with posterior short segment instrumentation and fusion. Eleven cases classified into group A were not fixed at the fractured vertebre. They were followed up to average 45 months(24-79). Twelve cases classified into group B were treated with screw fixation at the injured vertebra and followed up to average 38 months(14-78). Authors evaluated the radiologic assessment, such as wedge angle of fractured body, local kyphotic angle and wedge index(the ratio of anterior body height to posterior body height), the neurologic assessment by Frankel grade system and functional assessment by Denis system.
RESULTS
: There was no complication resulted from additional pedicle screw fixation at fractured level. In rediologic assessment, wedge angle were measured at preoperative, postoperative and last follow-up time as follows; in group A, 22.2degrees -11.3degrees -14.1degrees and in group B, 19.5degrees -8.8degrees -9.8degrees . The local kyphotic angle measured were 17.9degrees -7.0degrees -14degrees in group A and 17.1degrees -6.3degrees -7.9degrees in group B. The wedge index were 42.9%-22.6%-28.5% in group A and 40%-19.5%-22.4% in group B. At last follow-up time, eight eases showed Frankel grade E and three cases showed grade D in group A, and all cases of group B were Frankel E. Denis pain score were satisfctory in all of both group and Denis work score were also satisfactory in two group except one case of group A.
CONCLUSIONS
: Additional screw fixation at fractured verteba did not cause any complication. There was no significant difference in reduction rate between two groups(P>0.05), but group B showed better maintenance of correction of kyphotic deformity than that of group A(P<0.05). In conclusion, it seems that additional screw fixation at fractured level may be better method in maintaining asgittal alignment and decreasing the risk collapsing of body.

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Immediate Quadriparesis after Posterior Sublaminar Wiring for Cervical Fracture Dislocation: A Case Report: Byeong Yeon Seong, Chan Ji Park, Dong Seong Park; J Korean Soc Fract 1999;12(3):679-685. Published online July 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.3.679

Abstract PDF: Open reduction and internal fixation of the cervical spine is a commonly performed method of treatment for acute cervical fracture dislocation. A sudden or gradual worsening of the neurological status of a patient during reduction should alert the physician to the presence of high grade compression of the spinal canal. Loss of neurological function during or after manipulation or open reduction and internal fixation should raise the suspicion of compression of the spinal cord from a lesion occupying the canal, such as a herniated disc, buckling of the ligamentum flavum, an epidural hematoma or bone fragments. Magnetic resonance imaging or myelogram are the most helpful diagnostic means and should be used initially if suspected. Treatment is anterior decompression and autogenous strut bone graft. Causes of our case include ruptured disc, vertebral end plate and posterior longitudinal ligament. We experienced a case of immediate quadriparesis after posterior decompression and sublaminar wiring for cervical fracture dislocation which was resulted from ruptured disc, vertebral end plate and posterior longitudinal ligament.

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The Change of Kyphotic Angle and Anterior Vertebral Height after Posterior or Posterolateral Fusion with Transpedicular Screws for Thoracolumbar Bursting Fractures: Jae Sung Ahn, June Kyu Lee, Deuk Soo Hwang, Young Mo Kim, Won Jung Kim, Kyu Hwan Byun; J Korean Soc Fract 1999;12(2):379-387. Published online April 30, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.2.379

Abstract PDF

The purposes of this study are to make an operative treatment option of thoracolumbar burst fractures by the degree of initial kyphotic deformity or by the degree of initial loss of anterior vertebral height. We analyzed sixty-three cases of one segmental thoracolumbar bursting fractures treated surgically by posterior or posterolateral fusion with short segmental transpedicular screws fixation method using Diapason or CD from January, 1992 to October, 1996. Indications of operative treatment were that the degree of initial kyphotic deformity was above 15degreesor initial loss of anterior vertebral height was above 30%. Minimum follow-up period was 12 months and the results were as follows : 1. Entirely, mean kyphotic angle was 21.6degreesinitially, 11.3degreespostoperatively and 14.2degrees at the end of follow-up. Mean anterior vertebral height was 59.6% initially, 83.8% postoperatively and 80.8% at the end of follow-up. So 10.3degrees , 24.2% was corrected postoperatively and loss of correction was 2.9degrees , 3% at the end of follow-up. 2. In the respect of the degree of initial kyphotic deformity, when compared above 30degrees with below 30degrees , loss of correction was 7.3degrees , 1.4degrees at the end of follow-up respectively and this result had significant difference between these two groups statistically. 3. In the respect of initial loss of anterior vertebral height, when compared above 55% with below 55%, loss of correction was 7.7%, 2.2% at the end of follow-up respectively and this result had significant difference between these two groups statistically. 4. In the respect of time interval from injury to operation, when compared within 2 weeks with after 2 weeks, respectively loss of correction was 1.7-2.2degrees , 3-3.9% and 4.1degrees , 6.7% at the end of follow-up and this results had significant difference between these two groups statistically. These data suggested if initial kyphotic angle is below 30degrees or initial loss of anterior vertebral height less than 55%, short segmental transpedicular screw fixation provide sufficient stability but if initial kyphotic angle is above 30degrees or initial loss of anterior vertebral height is above 55%,additional anterior interbody fusion may be considered.

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Comparison of Percutaneous versus Open Pedicle Screw Fixation for Treating Unstable Thoracolumbar Fractures
Jin Young Han, Ki Youn Kwon
Journal of the Korean Fracture Society.2020; 33(1): 1. CrossRef
Nonfusion Method in Thoracolumbar and Lumbar Spinal Fractures
Yong-Min Kim, Dong-Soo Kim, Eui-Sung Choi, Hyun-Chul Shon, Kyoung-Jin Park, Byung-Ki Cho, Jae-Jung Jeong, Young-Chan Cha, Ji-Kang Park
Spine.2011; 36(2): 170. CrossRef
Efficiency of Implant Removal for Treatment of the Thoraco-lumbar Unstable Fractures - Multi Segments Fixation · Single Segment Fusion -
Heui-Jeon Park, Young-Jun Shim, Wan-Ki Kim, Tae-Yeon Cho, Sung-Min Kwon
Journal of Korean Society of Spine Surgery.2011; 18(3): 103. CrossRef
Change of Kyphotic Angle in Posterior Pedicle Screw Fixation for Thoracic and Lumbar Burst Fractures: Comparison Study by the Screw Fixation Level
Jeong-Gook Seo, Jong-Ho Park, Jeong-Seok Moon, Woo-Chun Lee
Journal of the Korean Fracture Society.2009; 22(1): 39. CrossRef
Clinical Efficacy of Implant Removal after Posterior Spinal Arthrodesis with Pedicle Screw Fixation for the Thoracolumbar Burst Fractures
Kyung-Jin Song, Kyu-Hyung Kim, Su-Kyung Lee, Jung-Ryul Kim
The Journal of the Korean Orthopaedic Association.2007; 42(6): 808. CrossRef
Results of Non-fusion Method in Thoracolumbar and Lumbar Spinal Fractures
Yong-Min Kim, Dong-Soo Kim, Eui-Seong Choi, Hyun-Chul Shon, Kyoung-Jin Park, Kyeong-Il Jeong, Young-Chan Cha, Hu-Shan Cui
Journal of Korean Society of Spine Surgery.2005; 12(2): 132. CrossRef
Relationships between Posterior Ligament Complex Injury and Plain Radiograph in Thoracolumbar Spinal Fracture
Heui-Jeon Park, Phil-Eun Lee, Byung-Ho Lee, Myung-Soon Kim
Journal of Korean Society of Spine Surgery.2005; 12(2): 140. CrossRef

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Diffrences of Bone Mineral Density between Osteoporotic Group with or without Compression Fracture of the Spine: Eu Sub Jung, Young Ki Lee, Seung Ill Baek; J Korean Soc Fract 1998;11(3):629-633. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.629

Abstract PDF

Osteoporosis is the metabolic bone disease and the bone is easily fracture by minimal stress due to decreased bone mass. It gets to attract more and more interest due to surprisingly high incidence and prevalence as well as its complications, fracture. We compared the bone mineral density between 45 osteoporotic patients group with compression fractures of the spine, 105 osteoporotic patients group without fractures and 45 normal control group using dual energy X-ray absorptiometry. We obtained following results. 1. There are statistically no significant differences between bone mineral density of the osteoporotic group with compression fracture of the spine and bone mineral density of the osteoporotic group without fractures. 2. Height and weight had statistically significant correlation with bone mineral density of the lumbar spine anteroposterior view, lateral view and Ward triangle. 3. Fracture threshold of the lumbar spine anteroposterior view, lateral wiew and Ward triangle are 0.884g/cm2, 0.694g/cm2 and 0.514g/cm2 according to 90percentile, 0.979g/cm2, 0.732g/cm2, 0.545g/cm2 according to 95percentile.

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Subsequent Hip Fracture in Osteoporotic Hip Fracture Patients
Sang Ho Lee, Tong Joo Lee, Kyu Jung Cho, Sang Hyun Shin, Kyoung Ho Moon
Yonsei Medical Journal.2012; 53(5): 1005. CrossRef

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Biomechanical Evaluation on Hooks Pattern of the Posterior Constructs in an Unstable Burst Fracture Model: Jae Won You, Tae Hong Lim; J Korean Soc Fract 1998;11(2):337-344. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.337

Abstract PDF: We prefer the posterior instrumentation system for the surgical treatment of the unstable burst fractures of the thoracolumbar spine. We are usually using a hooks pattern with posterior instrumentation, when we can not use a pedicle screw instrumentation in the case of an one stage operation of anterior decompression and posterior stabilization or injury of osteoporotic spine. The purpose of this study was designed to compare biomechanical flexibilities of posterior instrumentation constructs provided by hooks pattern in an unstable calf spine model. Ten fresh frozen calf spines (T10-L4) were used for this study with an anterior and middle column defect and loaded with pure unconstrained moments in flexion, extension, axial rotation, and lateral bending directions. Testing was performed on intact specimens first and then each specimens after laminar hooks insertion and ISOLA posterior implants and any kind of graft materials or transfixation devices were not used to make the worst possible case of instability of an injured spine. Three different fixation methods were instrumented. These included: (1) 2 hooks 2 levels above and 2 levels below corpectomy site in distraction modes bilaterally, (2) 2 levels above and 2 levels below hooks with one rod in distraction and the another rod in compression modes, (3) 2 levels above and 2 levels below hooks with claw hook configuration bilaterally. The results were as follows; 1. At the level of corpectomy site, the group I significantly reduced the motion in flexion and lateral bending (p<0.001), but not in extension as compared to the intact specimen. The group I provided significantly less stabilization than other fixation methods in all motions (p<0.01). The group II and III significantly reduced the motions in flexion, extension, and lateral bending as compared to the intact specimen (p<0.001). Axial rotational motions of all fixation constructs were significantly larger than the intact specimens (p<0.001), and the group I showed greater axial rotational motion than the groups II and III (p<0.001). 2. At the level below corpectomy site, all fixation methods showed the reduced motion significantly in all loading modes and the stabilization was similar with each other. 3. At the level above corpectomy site, all tested fixation methods did not improve the axial rotational stability beyond the intact case, but reduced flexion, extension, and lateral bending motions significantly(p<0.001). In conclusion, the hooks pattern construct in distraction modes is least stable at the corpectomy and above corpectomy sites. It was showed similar stabilizing effect between the claw and compression-distraction configuration. when using hooks, the hooks should be placed in either the claw or compression-distraction configuration.

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Cervical Spine Fractures in Ankylosing Spondylitis : A case Report: Jae Yoon Chung, Jung Pil Heo, Hyong Yeon Seo; J Korean Soc Fract 1997;10(1):175-179. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.175

Abstract PDF: The patient with ankylosing spondylitis is easily apt to be fractured in spine regions, even by minor trauma due to severe limitation of spinal motion and progressive osteoporosis. In those patients, accurate reduction and rigid internal or external immobilization and postoperative early mobilization is very important to treat or prevent the spinal cord injury. Untill now halo-vest immobilization or posterior fusion is widely accepted method of treatment and there was no report about anterior plate fixation. Authors fused the patient anterorily with tricortical iliac graft and plate with compression mechanism to get early solid bony union, to increase the immediate rigid stability, to correct the deformity and to mobilize the patient early as possible. We have experienced a 54-year-old male patient with ankylosing spondylitis complicating traumatic fracture of the cervical spine at C6-7 and follow up study of 9 years was possible. The patient was injured by minor pedestrian motor vehicle accident. Pre-injury activity was normal, and neurological status was Frankel grade D just after trauma however, it was aggrevated to Frankel grade C paraplegia during position change before operation. The patient was anesthesized with aid of the tracheostomy. Anterior plate fixation was performed with tricortical iliac suut bone graft and plate. And then early mobilization was encouraged with SOMI brace. Neurological status was improved and there was no peri- and post-operative complications. Systemic complications was not occured also. Re-displacement at fracture site with minimal screw loosening during follow up period was observed however, solid bony union was obtained at post-operative 3 months without further displacement or loosening. We report this case with review of literatures for good clinical result of anterior fusion with plate during long term follow up period of 9 years.

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Nonoperative Management of Stable Thoracolumbar Fracture with Bracing in Old Age: Jong Oh Kim; J Korean Soc Fract 1996;9(3):750-758. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.750

Abstract PDF: Fourteen neurologically intact patients with stable fractures at the thoracolumbar junction above 60yrs old age were treated with early ambulation in a total contact orthosis, Jewett Brace, Knight-Taylor Brace and had followed up greater than one year. Spinal orthosis have been traditionally used in the management of thoracolumbar junction treated with or without surgical stabilization However, the orthotic treatment modality in the management of spinal fractures remain subjective, especially old age. since few objective data are available on the effectiveness of orthosis in stabilizing injuried segments. At minimum follow up of one year, an overall outcome evaluation involved verbal numerical scale ( VNS ) and radilogical assessment. Approxiamately 80% of the patient had under 3 points in the verbal numerical scale, serial roentgenograms documented significant progressing in body collapse which averaged 9.6% compression,5.2 in Cobbs angle, not correlate with type of brace. Mainly body collapse and increasing Cobbs angle at the fracture site developed within posttraumatic 3 months. Degree of osteoporosis did not correlate with change in deformity. Initial radiographic severity of injury or residual deformity following closed management did not correlate with symptoms at follow-up. This pattern of results suggested comportable brace treatment such as Jewett and Knight-Taylor Brace, as the preferred treatment in stable thoracolumbar fracture in old age.

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The Comparision of Conservative Treatment with Operative Treatment in Bursting fracture: Chung Nam Kang, Jong Oh Kim, Oh Yong Kang, Seung Youn Ahn; J Korean Soc Fract 1995;8(4):807-814. Published online October 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.4.807

Abstract PDF

Internal fixation with dynamic compression plate is an accepted method of treating diaphyseal The treatment of stable bursting fracture of thoracolumbar spine has long been controversal and middle column theory has been known important factor to determine fracture stability, following to "Three column theroy" by Denis & McAfee in 1983. We have analyBed kyphotic angle and compression degree, each 7 cases of thoracolumbar stable bursting fracture, treated consertive or operative, from Oct. 1993 to Dec. 1994. We obtained following results; 1. The correction of kyphotic angle was more increased in the average 12 in conservative treatment and decreased in the average 8.3 in operative treatment than admission date. 2. The correction of compression degree was more increased in the average 30% in conservative treatment and decreased in the average 18% in operative treatment. 3. More severe deformity was noted in the active young adult rather than old age. 4. MRI study and bending stress view are needed in the detect of the posterior column injury. In summary, more severe deformity was noted not only in the adult, but in the conservative treatment. Thus, we must consider the operative treatment in active young adult in cases of stable bursting fracture.

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The Impact on Clinical Results by Sagittal Imbalance in Posterior Fixation for Thoraco-lumbar Burst Fractures
Seung-Wook Baek, Kyu-Dong Shim, Ye-Soo Park
Journal of the Korean Fracture Society.2011; 24(4): 354. CrossRef
Biomechanical Efficacy of Various Anterior Spinal Fixation in Treatment of Thoraco-lumbar Spine Fracture
Ye-Soo Park, Hyoung-Jin Kim, Choong-Hyeok Choi, Won-Man Park, Yoon-Hyuk Kim
Journal of the Korean Fracture Society.2007; 20(1): 70. CrossRef

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Comparative Study of Radiologic Changes after Conservative Treatment in Compression fracture and Stable Bursting Fracture of Thoracolumbar Spine: Ho Young Sun, Jung Woung Lee, Sang Don Jung, Jae Young Cho, Deok Young Yoon; J Korean Soc Fract 1995;8(3):667-674. Published online July 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.3.667

Abstract PDF: The diagnosis and management of thoracolumbar spine fracture have been progressrd greatly, because CT and MRI increase the apprehension to thoracolumbar fracture. Middle dolumn was known to be important factor in determining fracture stability, according to "Three column concept by Denis and McAfee." From Jan. 1990 to Jan. 1994 we have managed 63 cases of thoracolumbar compressive fracture and stable burst type thoracolumbar wpine fracture nonoperatively Clinical and radiologic results(kyphotic angle, wedging angle) were evaluated according to fracture pattern. We obtained the following results; 1. The change of kyphotic angle in stable burst fracture is more severe than compressive fracture. 2. The change of wedging angle in stable burst fracture is more severe than compressive fracture. 3. Clinical results of stable bursting fracture was worse than compressive fracture. We concBuded that stable bursting thoracolumbar fracture need more aggressive management.

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Clinical Application of Halo-Vest Apparatus in Cervical Spine Lesions: Yung Tae Kim, Yong Jung Kim, Ho Seung Lee; J Korean Soc Fract 1995;8(1):262-268. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.262

Abstract PDF: Halo-vest apparatus has the mechanical advantages that provides immediate cervical stabilization and can afford the diagnostic work-up for the acute cervical spine injuried patients, and does not interfere with MRI test. Furthermore, we can take the reduction of the dislocation by controlling it in any plane. Especially it is effective in conseuative treatment in upper cervical lesion without neurologic deficit or patient with high risk of operation. We put on the Halo-vest apparatus in seventeen patients with cervical spine lesion. There were fifteen cases of fracture-dislocation, one case of pathologic fracture, and one case of tuberculous spondylitis. The lesion site were upper ceuical in ten cases and others were lower cervical lesion. Three cases were undergone surgical intervention and were fixed with Halo-vest apparstus for further stabilization. We could get the external fixation for the unstable cervical lesion after several segment fusion. Initial immobilization were undertaken with Gardner well tong, Halter or Halo treation for 1.6 weeks in average. They were changed to Halo-vest apparatus for further immobilization and concomitant ambulation. Halo-vest apparatus were put on for 10.2 weeks to get solid bony union. After then other conventional brace were worn such as neck collar,S.0.M.I., four-poster or Philadelphia brace. The complications were one case of pin loosening, and three cases of pin tract infection.

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Treatment of Unstable Thoracic and Lumbar Spine Fracture with Harrington SSI(Segmental Spinal Instrumentation): Se IL Suk, Choon Ki Lee, Chong Suh Lee; J Korean Soc Fract 1988;1(1):54-63. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.54

Abstract PDF: This is a retrospective clinical and roentgenographic study to measure the correction of deformity and rigidity of Harrington SSI in the stabilization of unstable thoracic and lumbar spine fractures. 35 patients with unstable thoracic and lumbar spine fracture were treated with Harrington SSI from Feb. 1985 to Mar. 1987 in SNUH and 29 patients were followed up for more than 1 year, average 15.6 months. At final follow up of these 29 patients, 73.1% of patents gained neurologic improvment. Measurement of correction of anterior, middle and posterior coumn height, local kyphosis and anteroposterior offset were 29.7%, 5.2%, 31.2%, 12.8Â° and 5.3mm and loss of correction of these were 6.5%, 0.1%, 5.8%, 3.1Â° and 1.1m.

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