A reduction method for anterior opening displacement in thoracolumbarvertebral fractures with diffuse idiopathic skeletal hyperostosis using the skull clamp-assisted position

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  • Kobayashi Hiroshi
    Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
  • Watanabe Kazuyuki
    Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
  • Kobayashi Yoshihiro
    Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
  • Kato Kinshi
    Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
  • Nikaido Takuya
    Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
  • Otani Koji
    Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
  • Yabuki Shoji
    Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
  • Konno Shin-ichi
    Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
  • Matsumoto Yoshihiro
    Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine

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<p>Diffuse idiopathic skeletal hyperostosis (DISH) frequently occurs in the spine, resulting in unstable fractures. Treating thoracolumbar fractures in patients with DISH is often difficult because the anterior opening of the vertebral body is exacerbated by dislocation in the prone position, making reduction difficult. In this study, we introduced a novel skull clamp-assisted positioning (SAP) technique. The patient is placed in a supine position with a skull clamp used in cervical spine surgery before surgery to prevent the progression of dislocation and to restore the patient’s position. Using this method, the mean difference in local kyphosis angle improved from −2.9 (±8.4)° preoperatively to 10.9 (±7.7)° postoperatively. Furthermore, posterior displacement decreased from a preoperative mean of 5.5 (±4.3) mm to 0.3 (±0.7) mm postoperatively. Complications such as neurological sequelae, implant fracture, and surgical site infection were not observed through one year of postoperative follow-up. SAP may decrease invasiveness and complications. Longer-term studies and larger sample sizes are needed to establish long-term efficacy and benefits.</p>

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