Evidence map›Paper›PMID 34773149›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2022

The effect of posterior compression of the facet joints for initial stability and sagittal profile in the treatment of thoracolumbar fractures: a biomechanical study.

Michael Ruf, Tobias Pitzen, Ivo Nennstiel, David Volkheimer, Jörg Drumm, Klaus Püschel, Hans-Joachim Wilke

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In one paragraph

Article in 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, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Establishing a standardized biomechanical model for osteoporotic pincer (OF4) Fracture creation in human cadaveric spines: a novel experimental technique.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 · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Michael RufCenter for Spine Surgery, Orthopedics, and Traumatology, SRH Klinikum Karlsbad-Langensteinbach, Guttmannstrasse 1, 76307, Karlsbad, Germany.
Tobias PitzenCenter for Spine Surgery, Orthopedics, and Traumatology, SRH Klinikum Karlsbad-Langensteinbach, Guttmannstrasse 1, 76307, Karlsbad, Germany.
Ivo NennstielCenter for Orthopedic Surgery and Traumatology, SRH Central Hospital Suhl, Albert-Schweitzer-Strasse 2, 98527, Suhl, Germany.
David VolkheimerInstitute of Orthopaedic Research and Biomechanics, University of Ulm, Helmholtzstrasse 14, 89901, Ulm, Germany.
Jörg DrummCenter for Spine Surgery, Orthopedics, and Traumatology, SRH Klinikum Karlsbad-Langensteinbach, Guttmannstrasse 1, 76307, Karlsbad, Germany.
Klaus PüschelDepartment of Legal Medicine, University Hospital Hamburg-Eppendorf, Butenfeld 34, 22529, Hamburg, Germany.
Hans-Joachim WilkeInstitute of Orthopaedic Research and Biomechanics, University of Ulm, Helmholtzstrasse 14, 89901, Ulm, Germany. hans-joachim.wilke@uni-ulm.de.ORCID 0000-0001-6007-8844

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSurgical treatment of thoracolumbar A3-fractures usually comprises posterior fixation-in neutral position or distraction-potentially followed by subsequent anterior support. We hypothesized that additional posterior compression in circumferential stabilization may increase stability by locking the facets, and better restore the sagittal profile.

methodsBurst fractures Type A3 were created in six fresh frozen cadaver spine segments (T12-L2). Testing was performed in a custom-made spinal loading simulator. Loads were applied as pure bending moments of ± 3.75 Nm in all six movement axes. We checked range of motion, neutral zone and Cobb's angle over the injured/treated segment within the following conditions: Intact, fractured, instrumented in neutral alignment, instrumented in distraction, with cage left in posterior distraction, with cage with posterior compression.

resultsWe found that both types of instrumentation with cage stabilized the segment compared to the fractured state in all motion planes. For flexion/extension and lateral bending, flexibility was decreased even compared to the intact state, however, not in axial rotation, being the most critical movement axis. Additional posterior compression in the presence of a cage significantly decreased flexibility in axial rotation, thus achieving stability comparable to the intact state even in this movement axis. In addition, posterior compression with cage significantly increased lordosis compared to the distracted state.

conclusionAmong different surgical modifications tested, circumferential fixation with final posterior compression as the last step resulted in superior stability and improved sagittal alignment. Thus, posterior compression as the last step is recommended in these pathologies.

Indexed as

Spinal FracturesZygapophyseal JointAnimalsBiomechanical PhenomenaCadaverHumansLumbar VertebraeRange of Motion, ArticularBiomechanical studyPosterior compressionSagittal profileStabilityThoracolumbar fractures

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.