Universität zu Köln

Herren, Christian, Reijnen, Marly, Pishnamaz, Miguel, Lichte, Philipp, Andruszkow, Hagen, Nebelung, Sven, Siewe, Jan, Hildebrand, Frank and Kobbe, Philipp (2018). Incidence and Risk Factors for Facet Joint Violation in Open Versus Minimally Invasive Procedures During Pedicle Screw Placement in Patients with Trauma. World Neurosurg., 112. S. E711 - 8. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1878-8769

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Abstract

OBJECTIVE: A possible risk factor for premature facet joint degeneration or adjacent segment degeneration after surgical treatment of spine fractures is facet joint violation (FV) during insertion of pedicle screws. The aim of this study was to determine risk factors for FV in the thoracic and lumbar spine after minimally invasive screw insertion or open instrumentation (OI). METHODS: A retrospective analysis of all patients with spine fractures requiring posterior stabilization was performed. After patients were allocated to the thoracic/lumbar group, FV was defined as an involvement caused by the positioning of a pedicle screw and its severity as determined by computed tomography was assessed by using a customized scoring system. Gender, age, and body mass index as well as segmental facet joint angle and the instrumentation system used (side-loading [SL] vs. top-loading) were considered as individual factors. RESULTS: In total, 1099 pedicle screws were evaluated and an FV was identified in 433 instrumentations (39.0%). OI was used in 61.1% (n- 671) and an SL system was inserted in 45.0% (n = 494). In both, the thoracic (odds ratio [OR], 1.663; 95% confidence interval [CI], 1.119-2.472; P = 0.012) and the lumbar spine (OR, 0.494; 95% CI, 0.317-0.771; P = 0.002), OI was associated with a lower risk of FV. The violation rate was significantly higher when using a SL system (thoracic spine: OR, 1.822; 95% CI, 1.163-854; P = 0.009; lumbar spine: OR, 0.311; 95% CI, 0.2030.477; p S 0.001). CONCLUSIONS: FV is a common complication after thoracic and lumbar spine surgery. Although both, the SL instrumentation and a minimally invasive procedure increases its occurrence, the patient characteristics do not affect the rate of FV.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Herren, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Reijnen, Marly UNSPECIFIED UNSPECIFIED UNSPECIFIED Pishnamaz, Miguel UNSPECIFIED UNSPECIFIED UNSPECIFIED Lichte, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Andruszkow, Hagen UNSPECIFIED UNSPECIFIED UNSPECIFIED Nebelung, Sven UNSPECIFIED UNSPECIFIED UNSPECIFIED Siewe, Jan UNSPECIFIED UNSPECIFIED UNSPECIFIED Hildebrand, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Kobbe, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-190546
DOI:	10.1016/j.wneu.2018.01.138
Journal or Publication Title:	World Neurosurg.
Volume:	112
Page Range:	S. E711 - 8
Date:	2018
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1878-8769
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LUMBAR INTERBODY FUSION; BODY-MASS INDEX; TRANSPEDICULAR INSTRUMENTATION; CLINICAL ARTICLE; FOLLOW-UP; SPINE; SEGMENT; STABILIZATION; LIMITATIONS; ORIENTATION Multiple languages Clinical Neurology; Surgery Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19054