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Surgical outcomes of anterior column reconstruction for spinal fractures caused by minor trauma-preoperative examination of the number of intervertebral bone bridges is key to obtaining good bone fusion – Lumbar Fusion

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The article discusses the importance of evaluating lever arms due to bone bridging between vertebral bodies in achieving good bone fusion in anterior column reconstruction for vertebral fractures. The study introduces the concept of using the maximum number of vertebral bodies that are bony and cross-linked with contiguous adjacent vertebrae (maxVB) as a measure for lever arms. The research conducted on 81 patients who underwent anterior column reconstruction for spinal fractures revealed that patients with a higher maxVB had significantly higher bone fusion rates and postoperative back pain scores. The study concludes that examining maxVB as an indicator for lever arm usage is beneficial in determining the need for measures to promote bone fusion in patients undergoing anterior column reconstruction for vertebral fractures

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : innovative spinal hospital in London

Published article

S: Examination of the maxVB as an indicator of the use of a lever arm is beneficial for anterior column reconstruction for vertebral fractures. Patients with no intervertebral bone bridging or a high number of bone bridges are in more need of measures to promote bone fusion than patients with a moderate number of bone bridges are.

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BMC Musculoskelet Disord. 2024 Mar 14;25(1):216. doi: 10.1186/s12891-024-07326-z.ABSTRACTBACKGROUND: To achieve good bone fusion in anterior column reconstruction for vertebral fractures, not only bone mineral density (BMD) and bone metabolism markers but also lever arms due to bone bridging between vertebral bodies should be evaluated. However, until now, no lever arm index has been devised. Therefore,

BMC Musculoskeletal Disord. 2024 Mar 14;25(1):216. doi: 10.1186/s12891-024-07326-z.

ABSTRACT

BACKGROUND: To achieve good bone fusion in anterior column reconstruction for vertebral fractures, not only bone mineral density (BMD) and bone metabolism markers but also lever arms due to bone bridging between vertebral bodies should be evaluated. However, until now, no lever arm index has been devised. Therefore, we believe that the maximum number of vertebral bodies that are bony and cross-linked with the contiguous adjacent vertebrae (maxVB) can be used as a measure for lever arms. The purpose of this study is to investigate the surgical outcomes of anterior column reconstruction for spinal fractures and to determine the effect of bone bridging between vertebral bodies on the rate of bone fusion using the maxVB as an indicator of the length of the lever arm.

METHODS: The clinical data of 81 patients who underwent anterior column reconstruction for spinal fracture between 2014 and 2022 were evaluated. The bone fusion rate, back pain score, between the maxVB = 0 and the maxVB ≥ 2 patients were adjusted for confounding factors (age, smoking history, diabetes mellitus history, BMD, osteoporosis drugs, surgical technique, number of fixed vertebrae, materials used for the anterior props, etc.) and analysed with multivariate or multiple regression analyses. The bone healing rate and incidence of postoperative back pain were compared among the three groups (maxVB = 0, 2≦maxVB≦8, maxVB ≧ 9) and divided by the maxVB after adjusting for confounding factors.

RESULTS: Patients with a maxVB ≥ 2 had a significantly higher bone fusion rate (p < 0.01) and postoperative back pain score (p < 0.01) than those with a maxVB = 0. Among the three groups, the bone fusion rate and back pain score were significantly higher in the 2≦maxVB≦8 group (p = 0.01, p < 0.01).

S: Examination of the maxVB as an indicator of the use of a lever arm is beneficial for anterior column reconstruction for vertebral fractures. Patients with no intervertebral bone bridging or a high number of bone bridges are in more need of measures to promote bone fusion than patients with a moderate number of bone bridges are.

PMID:38481188 | PMC:PMC10938728 | DOI:10.1186/s12891-024-07326-z

The London Spine Unit : innovative spinal hospital in London

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Surgical outcomes of anterior column reconstruction for spinal fractures caused by minor trauma-preoperative examination of the number of intervertebral bone bridges is key to obtaining good bone fusion

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BMC Musculoskelet Disord. 2024 Mar 14;25(1):216. doi: 10.1186/s12891-024-07326-z.ABSTRACTBACKGROUND: To achieve good bone fusion in anterior column reconstruction for vertebral fractures, not only bone mineral density (BMD) and bone metabolism markers but also lever arms due to bone bridging between vertebral bodies should be evaluated. However, until now, no lever arm index has been devised. Therefore

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