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Flail Chest-II

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Updated: Jan 18, 2026

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device

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Mechanical Instability After Civilian Thoracolumbar Gunshot Injuries: A Systematic Review to Support Classification

Guillermo Alejandro Ricciardi^1,2,3, Ignacio Cirillo^4,5,6, Juan Pablo Cabrera^7,8

¹Orthopaedic and Traumatology, Sanatorio Güemes, Buenos Aires, Argentina.

Global Spine Journal

|September 11, 2025

Summary

This summary is machine-generated.

Mechanical instability in thoracolumbar gunshot wounds lacks standardized definitions. Vertebral body comminution is a key marker, highlighting the need for a new classification system.

Keywords:

gunshot mechanical stability spine spine fracture systematic review

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Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability

Multilevel Oblique Lumbar Interbody Fusion in Degenerative Lumbar Disc Disease with Instability

Published on: July 25, 2025

Area of Science:

Orthopedic Surgery
Trauma Surgery
Spinal Surgery

Background:

Thoracolumbar gunshot wounds present complex challenges in assessing mechanical instability.
Existing literature lacks standardized definitions and classification systems for these injuries.

Purpose of the Study:

To identify risk factors for mechanical instability in thoracolumbar gunshot wounds.
To propose a novel classification system for these injuries.

Main Methods:

Systematic review adhering to PRISMA 2020 guidelines.
Searched multiple databases from 1990 to 2024 for relevant studies.
Included 33 studies (3195 patients) with varying methodologies.

Main Results:

Mechanical instability was defined in only 12 studies, primarily using the Denis three-column theory.
Instability reported in <10% of cases, with vertebral body comminution and ligamentous injury as main markers.
Conservative management was prevalent; surgical fixation rates were low (1.5-9.7%).

Conclusions:

A significant lack of standardized definitions for mechanical instability in thoracolumbar gunshot injuries exists.
Four recurrent patterns of instability were identified, with vertebral body comminution being the most consistent indicator.
Development of a standardized classification system and prospective research are crucial.