Burst fractures lead to a fracture-associated intervertebral vacuum phenomenon: a case series of 305 traumatic fractures of the thoracolumbar spine.
AOSpine classification
Computed tomography
Disc degeneration
Spine
Journal
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
ISSN: 1432-0932
Titre abrégé: Eur Spine J
Pays: Germany
ID NLM: 9301980
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
16
03
2020
accepted:
31
08
2020
revised:
23
06
2020
pubmed:
11
9
2020
medline:
25
2
2023
entrez:
10
9
2020
Statut:
ppublish
Résumé
Intervertebral vacuum phenomenon (IVP) is mainly seen as a sign of degenerative disc diseases. Although studies have shown that IVP also occurs after traumatic injuries to the spine, its clinical relevance in spinal fractures remains unknown. Therefore, the aim of this study was to analyse the prevalence, demographic parameters and fracture morphology in patients with fracture-associated IVP (FAVP) of the thoracolumbar spine. In this retrospective cohort study, patients with traumatic fractures of the thoracolumbar spine who were admitted between January 2014 and December 2015 were included. CT scans were assessed for the presence of intervertebral areas of gaseous radiolucency, which were defined as IVP. Fractures were classified according to the AOSpine Thoracolumbar Spine Injury Classification System. Demographic and anamnestic data, including age, sex and trauma mechanism, were documented. A total of 201 patients with 305 fractures were included. Seventy-three patients with 98 fractures had follow-up CTs. Sixty-eight patients had IVP, of whom 46 patients had FAVP. On the follow-up CT, a significant correlation was found between A3 fractures and FAVP, while initial FAVP was significantly correlated with age and low-velocity trauma mechanisms. Initial degenerative IVP also showed a significant correlation with age. FAVP occurred significantly more often in burst fractures and therefore may lead to disc degeneration due to nutritional supply disturbances via the vertebral endplate. As surgical management strategies for burst fractures are intensively discussed, the appearance of FAVP should be taken in consideration.
Identifiants
pubmed: 32910246
doi: 10.1007/s00586-020-06590-6
pii: 10.1007/s00586-020-06590-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3068-3073Informations de copyright
© 2020. Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Knuttson F (1942) The vacuum phenomenon in the intervertebral discs. Acta Radiol 23:173–179
doi: 10.3109/00016924209134912
Marr JT (1953) Gas in intervertebral discs. Am J Roentenol Radium Ther Nucl Med 70:804–809
Lafforgue PF, Chagnaud CJ, Daver LM, Daumen-Legré VM, Peragut JC, Kasbarian MJ, Volot F, Acquaviva PC (1994) Intervertebral disk vacuum phenomenon secondary to vertebral collapse: prevalence and significance. Radiology 193:853–858. https://doi.org/10.1148/radiology.193.3.7972837
doi: 10.1148/radiology.193.3.7972837
pubmed: 7972837
Tash RR, Weitzner I Jr (1986) Acute intervertebral gas following vertebral fracture: CT demonstration. J Comput Assist Tomogr 10(4):707–708. https://doi.org/10.1097/00004728-198607000-00038
doi: 10.1097/00004728-198607000-00038
pubmed: 3734219
Vaccaro AR, Schroeder GD, Kepler CK, Cumhur Oner F, Vialle LR, Kandziora F, Koerner JD, Kurd MF, Reinhold M, Schnake KJ, Chapman J, Arabi B, Fehlings MG, Dvorak MF (2016) The surgical algorithm for the AOSpine thoracolumbar spine injury classification system. Eur Spine J 25(4):1087–1094. https://doi.org/10.1007/s00586-015-3982-2
doi: 10.1007/s00586-015-3982-2
pubmed: 25953527
Wood K, Buttermann G, Mehbod A, Garvey T, Jhanjee R, Sechriest V (2003) Operative compared with nonoperative treatment of a thoracolumbar burst fracture without neurological deficit. A prospective, randomized study. J Bone Joint Surg Am 85(5):773–781. https://doi.org/10.2106/00004623-200305000-00001
doi: 10.2106/00004623-200305000-00001
pubmed: 12728024
Siebenga J, Leferink VJ, Segers MJ, Elzinga MJ, Bakker FC, Haarman HJ, Rommens PM, ten Duis HJ, Patka P (2006) Treatment of traumatic thoracolumbar spine fractures: a multicenter prospective randomized study of operative versus nonsurgical treatment. Spine (Phila Pa 1976) 31(25):2881–2890. https://doi.org/10.1097/01.brs.0000247804.91869.1e
doi: 10.1097/01.brs.0000247804.91869.1e
Vaccaro AR, Oner C, Kepler CK, Dvorak M, Schnake K, Bellabarba C, Reinhold M, Aarabi, Kandziora F, Chapman J, Shanmuganathan R, Fehlings M, Vialle L, AOSpine Spinal Cord Injury & Trauma Knowledge Forum (2013). AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers. Spine (Phila Pa 1976) 38(23):2028–37. https://doi.org/10.1097/BRS.0b013e3182a8a381
Su Y, Ren D, Zou Y, Lu J, Wang P (2016) A retrospective study evaluating the correlation between the severity of intervertebral disc injury and the anteroposterior type of thoracolumbar vertebral fractures. Clin (Sao Paulo) 71(6):297–301. https://doi.org/10.6061/clinics/2016(06)02
doi: 10.6061/clinics/2016(06)02
Pumberger M, Fuchs M, Engelhard N, Hermann KG, Putzier M, Makowski MR, Hamm B, Diekhoff T (2019) Disk injury in patients with vertebral fractures—a prospective diagnostic accuracy study using dual-energy computed tomography. Eur Radiol 29(8):4495–4502. https://doi.org/10.1007/s00330-018-5963-4
doi: 10.1007/s00330-018-5963-4
pubmed: 30649597
pmcid: 6610270
Fujiwara T, Akeda K, Yamada J, Kondo T, Sudo A (2019) Endplate and intervertebral disc injuries in acute and single level osteoporotic vertebral fractures: is there any association with the process of bone healing? BMC Musculoskelet Dosrd 20(1):336. https://doi.org/10.1186/s12891-019-2719-5
doi: 10.1186/s12891-019-2719-5
Ortiz AO, Bordia R (2011). Injury to the vertebral endplate-disk complex associated with osteoporotic vertebral compression fractures. AJNR Am J Neuroradiol 32(1):115–20. https://doi.org/10.3174/ajnr.A2223
Kerttula LI, Serlo WS, Tervonen OA, Pääkkö EL, Vanharanta HV (2000) Post-traumatic findings of the spine after earlier vertebral fracture in young patients: clinical and MRI study. Spine (Phila Pa 1976) 25(9):1104–1108. https://doi.org/10.1097/00007632-200005010-00011
doi: 10.1097/00007632-200005010-00011
Yurac R, Marré B, Urzua A, Munjin M, Lecaros MA (2006) Residual mobility of instrumented and non-fused segments in thoracolumbar spine fractures. Eur Spine J 15(6):864–875. https://doi.org/10.1007/s00586-005-0939-x
doi: 10.1007/s00586-005-0939-x
pubmed: 16601974
pmcid: 3489432
Oner FC, van der Rijt RH, Ramos LM, Groen GJ, Dhert WJ, Verbout AJ (1998) Changes in the disc space after fractures of the thoracolumbar spine. J Bone Joint Surg Br 80(5):833–839. https://doi.org/10.1302/0301-620x.80b5.8830
doi: 10.1302/0301-620x.80b5.8830
pubmed: 9768894
Oner FC, van der Rijt RH, Ramos LM, Groen GJ, Dhert WJ, Verbout AJ (1999). Correlation of MR images of disc injuries with anatomic sections in experimental thoracolumbar spine fractures. Eur Spine J, 1999 8(3):194–8. https://doi.org/10.1007/s005860050156
Holland CM, Mazur MD, Bisson EF, Schmidt MH, Dailey AT (2017) Trends in patient care for traumatic spinal injuries in the United States: a national inpatient sample study of the correlations with patient outcomes from 2001 to 2012. Spine (Phila Pa 1976) 42(24):1923–1929. https://doi.org/10.1097/BRS.0000000000002246
doi: 10.1097/BRS.0000000000002246
Vaccaro AR, Oner C, Kepler CK, Dvorak M, Schnake K, Bellabarba C, Reinhold M, Aarabi B, Kandziora F, Chapman J, Shanmuganathan R, Fehlings M, Vialle L (2013) AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers. Spine 38(23):2028–2037. https://doi.org/10.1097/BRS.0b013e3182a8a381
doi: 10.1097/BRS.0b013e3182a8a381
pubmed: 23970107
Deutsche Gesellschaft für Unfallchirurgie (2016). S3-Leitlinie Polytrauma / Schwerverletzten-Behandlung. AWMF. https://www.awmf.org/uploads/tx_szleitlinien/012019l_S3_Polytrauma_Schwerverletzten-Behandlung_2017-08.pdf
Grenier N, Grossman RI, Schiebler M, Yeager BA, Goldber HI, Kressel HY (1987) Degenerative lumbar disk disease: pitfalls and usefulness of MR imaging in detection of vacuum phenomenon. Radiology 164(3):861–865
doi: 10.1148/radiology.164.3.3615888
Kanezaki S, Miyazaki M, Ishihara T, Notani N, Tsumura H (2018) Magnetic resonance imaging evaluation of intervertebral disc injuries can predict kyphotic deformity after posterior fixation of unstable thoracolumbar spine injuries. Medicine (Baltimore) 97(28):e11442. https://doi.org/10.1097/MD.0000000000011442
doi: 10.1097/MD.0000000000011442
Sander AL, Lehnert T, El SamanEichler AK, Marzi I, Laurer H (2014) Outcome of traumatic intervertebral disk lesions after stabilization by internal fixator. AJR Am J Roentgenol 203(1):140–145. https://doi.org/10.2214/AJR.13.11590
doi: 10.2214/AJR.13.11590
pubmed: 24951207
Wang J, Zhour Y, Zhang ZF, Li CQ, Zhen WJ, Liu J (2013) Radiological study on disc degeneration of thoracolumbar burst fractures treated by percutaneous pedicle screw fixation. Eur Spine J 22(3):489–494. https://doi.org/10.1007/s00586-012-2462-1
doi: 10.1007/s00586-012-2462-1
pubmed: 22890568
Morishita K, Kasai Y, Uchida A (2008) Clinical symptoms of patients with intervertebral vacuum phenomenon. Neurologist 14(1):37–39
doi: 10.1097/NRL.0b013e3180dc9992
Resnick D, Niwayama G, Guerra J, Vint V, Usselman J (1981) Spinal vacuum phenomena: anatomical study and review. Radiology 139:341–348
doi: 10.1148/radiology.139.2.7220878
Gershon-Cohen J, Schraer H, Sklaroff DM, Blumberg N (1954) Dissolution of the intervertebral disc in the aged normal: the phantom nucleus pulposus. Radiology 62:383–387
doi: 10.1148/62.3.383