{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:05:07Z","timestamp":1780131907891,"version":"3.54.0"},"reference-count":82,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:sec>\n                    <jats:title>Object<\/jats:title>\n                    <jats:p>The optimal management of unstable thoracolumbar fractures remains unclear. The objective of the present study was to evaluate the results of using an expandable prosthetic vertebral body cage (EPVBC) in the management of unstable thoracolumbar fractures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eighty-five patients with unstable T7\u2013L4 thoracolumbar fractures underwent implantation of an EPVBC via an anterior approach combined with posterior fixation. Long-term functional outcomes, including visual analog scale and Oswestry disability index scores, were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In a mean follow-up period of 16 months, anterior fixation led to a significant increase in vertebral body height, with an average gain of 19%. However, the vertebral regional kyphosis angle was not significantly increased by anterior fixation alone. No significant difference was found between early postoperative, 3-month, and 1-year postoperative regional kyphosis angle and vertebral body height. Postoperative impaction of the prosthetic cage in adjacent endplates was observed in 35% of the cases, without worsening at last follow-up. Complete fusion was observed at 1 year postoperatively and no cases of infections or revisions were observed in relation to the anterior approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The use of EPVBCs for unstable thoracolumbar fractures is safe and effective in providing long-term vertebral body height restoration and kyphosis correction, with a moderate surgical and sepsis risk. Anterior cage implantation is an alternative to iliac bone graft fusion and is a viable option in association with a posterior approach, in a single operation without additional risks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2014.5.focus1452","type":"journal-article","created":{"date-parts":[[2014,7,1]],"date-time":"2014-07-01T11:06:02Z","timestamp":1404212762000},"page":"E10","source":"Crossref","is-referenced-by-count":11,"title":["Circumferential management of unstable thoracolumbar fractures using an anterior expandable cage, as an alternative to an iliac crest graft, combined with a posterior screw fixation: results of a series of 85 patients"],"prefix":"10.3171","volume":"37","author":[{"given":"Thomas","family":"Graillon","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, Aix-Marseille University;"},{"name":"APHM, Service Neurochirurgie, H\u00f4pital de la Timone; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Rakotozanany","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Aix-Marseille University;"},{"name":"APHM, Service Neurochirurgie, H\u00f4pital de la Timone; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Blondel","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Aix-Marseille University;"},{"name":"APHM, Service Orthop\u00e9die, H\u00f4pital Nord, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Adetchessi","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Aix-Marseille University;"},{"name":"APHM, Service Neurochirurgie, H\u00f4pital de la Timone; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Dufour","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Aix-Marseille University;"},{"name":"APHM, Service Neurochirurgie, H\u00f4pital de la Timone; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Fuentes","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery, Aix-Marseille University;"},{"name":"APHM, Service Neurochirurgie, H\u00f4pital de la Timone; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus1452","series-title":"Eur Spine J","first-page":"512","article-title":"The effect of transpedicular intracorporeal grafting in the treatment of thoracolumbar burst fractures on canal remodeling","volume":"10","author":"Alanay","year":"2001"},{"key":"b2-focus1452","series-title":"Acta Neurochir (Wien)","first-page":"349","article-title":"Comparison of two types of surgery for thoraco-lumbar burst fractures: combined anterior and posterior stabilisation vs. posterior instrumentation only","volume":"141","author":"Been","year":"1999"},{"issue":"4","key":"b3-focus1452","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Surgical Interbody Research Group\u2014radiographic assessment of interbody fusion devices: fusion criteria for anterior lumbar interbody surgery","volume":"10","author":"Burkus","year":"2001"},{"issue":"6 Suppl Operative","key":"b4-focus1452","series-title":"Neurosurgery","first-page":"314","article-title":"Comparison of allograft bone and titanium cages for vertebral body replacement in the thoracolumbar spine: a biomechanical study","volume":"66","author":"Cardenas","year":"2010"},{"key":"b5-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"686","article-title":"Anterolateral dynamized instrumentation and fusion for unstable thoracolumbar and lumbar burst fractures","volume":"22","author":"Carl","year":"1997"},{"key":"b6-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"1429","article-title":"Anterior-only stabilization using plating with bone structural autograft versus titanium mesh cages for two- or three-column thoracolumbar burst fractures: a prospective randomized study","volume":"34","author":"Dai","year":"2009"},{"key":"b7-focus1452","series-title":"World Neurosurg","first-page":"149","article-title":"Expandable versus nonexpandable cages for thoracolumbar burst fracture","volume":"75","author":"Eleraky","year":"2011"},{"issue":"335","key":"b8-focus1452","series-title":"Clin Orthop Relat Res","first-page":"89","article-title":"Anterior instrumentation in the management of thoracolumbar burst fractures","author":"Ghanayem","year":"1997"},{"key":"b9-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"E295","article-title":"Three-column reconstruction through single posterior approach for the treatment of unstable thoracolumbar fracture","volume":"35","author":"Haiyun","year":"2010"},{"key":"b10-focus1452","series-title":"Neurosurgery","first-page":"810","article-title":"Stackable carbon fiber cages for thoracolumbar interbody fusion after corpectomy: long-term outcome analysis","volume":"68","author":"Heary","year":"2011"},{"key":"b11-focus1452","series-title":"J Neurosurg Spine","first-page":"117","article-title":"Comparison of anterolateral and posterior approaches in the management of thoracolumbar burst fractures","volume":"5","author":"Hitchon","year":"2006"},{"key":"b12-focus1452","series-title":"Surg Neurol","first-page":"619","article-title":"Management options in thoracolumbar burst fractures","volume":"49","author":"Hitchon","year":"1998"},{"key":"b13-focus1452","series-title":"J Neurosurg Spine","first-page":"388","article-title":"Posterior approach for thoracolumbar corpectomies with expandable cage placement and circumferential arthrodesis: a multicenter case series of 67 patients. Clinical article","volume":"14","author":"Hofstetter","year":"2011"},{"key":"b14-focus1452","series-title":"J Bone Joint Surg Am","first-page":"69","article-title":"Anterior decompression and stabilization with the Kaneda device for thoracolumbar burst fractures associated with neurological deficits","volume":"79","author":"Kaneda","year":"1997"},{"key":"b15-focus1452","series-title":"Unfallchirurg","first-page":"20","article-title":"[Thoracolumbar spine fractures after conservative and surgical treatment. Dependence of correction loss on fracture level.]","volume":"106","author":"Katscher","year":"2003"},{"key":"b16-focus1452","series-title":"Eur Spine J","first-page":"251","article-title":"Fate of the transpedicular intervertebral bone graft after posterior stabilisation of thoracolumbar fractures","volume":"11","author":"Knop","year":"2002"},{"key":"b17-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"2139","article-title":"The use of the percentage change in Oswestry Disability Index score as an outcome measure in lumbar spinal surgery","volume":"19","author":"Little","year":"1994"},{"key":"b18-focus1452","series-title":"J Bone Joint Surg Am","first-page":"1519","article-title":"Complications associated with pedicle screws","volume":"81","author":"Lonstein","year":"1999"},{"key":"b19-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"2030","article-title":"Posterior approach with Louis plates for fractures of the thoracolumbar and lumbar spine with and without neurologic deficits","volume":"23","author":"Louis","year":"1998"},{"key":"b20-focus1452","series-title":"Eur Spine J","first-page":"184","article-title":"A comprehensive classification of thoracic and lumbar injuries","volume":"3","author":"Magerl","year":"1994"},{"key":"b21-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"1741","article-title":"The load sharing classification of spine fractures","volume":"19","author":"McCormack","year":"1994"},{"key":"b22-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"1901","article-title":"The management of acute thoracolumbar burst fractures with anterior corpectomy and Z-plate fixation","volume":"29","author":"McDonough","year":"2004"},{"key":"b23-focus1452","series-title":"Eur Spine J","first-page":"284","article-title":"Treatment of thoracolumbar burst fractures without neurologic deficit by indirect reduction and posterior instrumentation: bisegmental stabilization with monosegmental fusion","volume":"8","author":"M\u00fcller","year":"1999"},{"key":"b24-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"955","article-title":"Thoracolumbar burst fractures. The clinical efficacy and outcome of nonoperative management","volume":"18","author":"Mumford","year":"1993"},{"key":"b25-focus1452","series-title":"Acta Neurochir (Wien)","first-page":"771","article-title":"Limitations of dorsal transpedicular stabilization in unstable fractures of the lower thoracic and lumbar spine: an analysis of 133 patients","volume":"146","author":"Oertel","year":"2004"},{"key":"b26-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"620","article-title":"Outcome of anterior decompression and stabilization for thoracolumbar unstable burst fractures in the absence of neurologic deficits","volume":"21","author":"Okuyama","year":"1996"},{"key":"b27-focus1452","series-title":"Acta Neurochir (Wien)","first-page":"299","article-title":"Unstable burst fractures of the thoraco-lumbar junction: treatment by posterior bisegmental correction\/fixation and staged anterior corpectomy and titanium cage implantation","volume":"148","author":"Payer","year":"2006"},{"key":"b28-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"1413","article-title":"Biomechanical comparison of expandable cages for vertebral body replacement in the thoracolumbar spine","volume":"29","author":"Pflugmacher","year":"2004"},{"key":"b29-focus1452","series-title":"Acta Neurochir (Wien)","first-page":"597","article-title":"Blood transfusions after thoracoscopic anterior thoracolumbar vertebrectomy","volume":"152","author":"Ragel","year":"2010"},{"key":"b30-focus1452","series-title":"Unfallchirurg","first-page":"566","article-title":"[Nonoperative treatment of thoracolumbar spinal fractures. Longterm clinical results over 16 years.]","volume":"106","author":"Reinhold","year":"2003"},{"key":"b31-focus1452","series-title":"Eur Spine J","first-page":"495","article-title":"Short segment fixation of thoracolumbar burst fractures without fusion","volume":"8","author":"Sanderson","year":"1999"},{"key":"b32-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"997","article-title":"Radiologic assessment of interbody fusion using carbon fiber cages","volume":"28","author":"Santos","year":"2003"},{"key":"b33-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"E33","article-title":"Single-stage posterior corpectomy and expandable cage placement for treatment of thoracic or lumbar burst fractures","volume":"34","author":"Sasani","year":"2009"},{"key":"b34-focus1452","series-title":"Eur Spine J","first-page":"197","article-title":"Is a single anterolateral screw-plate fixation sufficient for the treatment of spinal fractures in the thoracolumbar junction? A biomechanical in vitro investigation","volume":"14","author":"Schreiber","year":"2005"},{"key":"b35-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"412","article-title":"Nonsurgical treatment of three-column thoracolumbar junction burst fractures without neurologic deficit","volume":"24","author":"Shen","year":"1999"},{"key":"b36-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"1704","article-title":"Long-term follow-up results of thoracolumbar fractures after posterior instrumentation","volume":"20","author":"Tasdemiroglu","year":"1995"},{"key":"b37-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"803","article-title":"Surgical treatment of traumatic fractures of the thoracic and lumbar spine: a systematic review of the literature on techniques, complications, and outcome","volume":"29","author":"Verlaan","year":"2004"},{"issue":"1","key":"b38-focus1452","series-title":"Neurosurg Focus","first-page":"e3","article-title":"A new technique for the surgical management of unstable thoracolumbar burst fractures: a modification of the anterior approach and an outcome comparison to traditional methods","volume":"7","author":"Wiggins","year":"1999"},{"key":"b39-focus1452","series-title":"J Bone Joint Surg Am","first-page":"773","article-title":"Operative compared with nonoperative treatment of a thoracolumbar burst fracture without neurological deficit. A prospective, randomized study","volume":"85-A","author":"Wood","year":"2003"},{"key":"b40-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"1357","article-title":"Pelvic fractures after long lumbosacral spine fusions","volume":"21","author":"Wood","year":"1996"},{"key":"b41-focus1452","series-title":"J Spinal Disord Tech","first-page":"30","article-title":"Treatment of thoracolumbar burst fractures by means of anterior fusion and cage","volume":"25","author":"Zahra","year":"2012"},{"key":"b1-focus1452","series-title":"Eur Spine J","first-page":"512","article-title":"The effect of transpedicular intracorporeal grafting in the treatment of thoracolumbar burst fractures on canal remodeling","volume":"10","author":"Alanay","year":"2001"},{"key":"b2-focus1452","series-title":"Acta Neurochir (Wien)","first-page":"349","article-title":"Comparison of two types of surgery for thoraco-lumbar burst fractures: combined anterior and posterior stabilisation vs. posterior instrumentation only","volume":"141","author":"Been","year":"1999"},{"issue":"4","key":"b3-focus1452","series-title":"Neurosurg Focus","first-page":"E11","article-title":"Surgical Interbody Research Group\u2014radiographic assessment of interbody fusion devices: fusion criteria for anterior lumbar interbody surgery","volume":"10","author":"Burkus","year":"2001"},{"issue":"6 Suppl Operative","key":"b4-focus1452","series-title":"Neurosurgery","first-page":"314","article-title":"Comparison of allograft bone and titanium cages for vertebral body replacement in the thoracolumbar spine: a biomechanical study","volume":"66","author":"Cardenas","year":"2010"},{"key":"b5-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"686","article-title":"Anterolateral dynamized instrumentation and fusion for unstable thoracolumbar and lumbar burst fractures","volume":"22","author":"Carl","year":"1997"},{"key":"b6-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"1429","article-title":"Anterior-only stabilization using plating with bone structural autograft versus titanium mesh cages for two- or three-column thoracolumbar burst fractures: a prospective randomized study","volume":"34","author":"Dai","year":"2009"},{"key":"b7-focus1452","series-title":"World Neurosurg","first-page":"149","article-title":"Expandable versus nonexpandable cages for thoracolumbar burst fracture","volume":"75","author":"Eleraky","year":"2011"},{"issue":"335","key":"b8-focus1452","series-title":"Clin Orthop Relat Res","first-page":"89","article-title":"Anterior instrumentation in the management of thoracolumbar burst fractures","author":"Ghanayem","year":"1997"},{"key":"b9-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"E295","article-title":"Three-column reconstruction through single posterior approach for the treatment of unstable thoracolumbar fracture","volume":"35","author":"Haiyun","year":"2010"},{"key":"b10-focus1452","series-title":"Neurosurgery","first-page":"810","article-title":"Stackable carbon fiber cages for thoracolumbar interbody fusion after corpectomy: long-term outcome analysis","volume":"68","author":"Heary","year":"2011"},{"key":"b11-focus1452","series-title":"J Neurosurg Spine","first-page":"117","article-title":"Comparison of anterolateral and posterior approaches in the management of thoracolumbar burst fractures","volume":"5","author":"Hitchon","year":"2006"},{"key":"b12-focus1452","series-title":"Surg Neurol","first-page":"619","article-title":"Management options in thoracolumbar burst fractures","volume":"49","author":"Hitchon","year":"1998"},{"key":"b13-focus1452","series-title":"J Neurosurg Spine","first-page":"388","article-title":"Posterior approach for thoracolumbar corpectomies with expandable cage placement and circumferential arthrodesis: a multicenter case series of 67 patients. Clinical article","volume":"14","author":"Hofstetter","year":"2011"},{"key":"b14-focus1452","series-title":"J Bone Joint Surg Am","first-page":"69","article-title":"Anterior decompression and stabilization with the Kaneda device for thoracolumbar burst fractures associated with neurological deficits","volume":"79","author":"Kaneda","year":"1997"},{"key":"b15-focus1452","series-title":"Unfallchirurg","first-page":"20","article-title":"[Thoracolumbar spine fractures after conservative and surgical treatment. Dependence of correction loss on fracture level.]","volume":"106","author":"Katscher","year":"2003"},{"key":"b16-focus1452","series-title":"Eur Spine J","first-page":"251","article-title":"Fate of the transpedicular intervertebral bone graft after posterior stabilisation of thoracolumbar fractures","volume":"11","author":"Knop","year":"2002"},{"key":"b17-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"2139","article-title":"The use of the percentage change in Oswestry Disability Index score as an outcome measure in lumbar spinal surgery","volume":"19","author":"Little","year":"1994"},{"key":"b18-focus1452","series-title":"J Bone Joint Surg Am","first-page":"1519","article-title":"Complications associated with pedicle screws","volume":"81","author":"Lonstein","year":"1999"},{"key":"b19-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"2030","article-title":"Posterior approach with Louis plates for fractures of the thoracolumbar and lumbar spine with and without neurologic deficits","volume":"23","author":"Louis","year":"1998"},{"key":"b20-focus1452","series-title":"Eur Spine J","first-page":"184","article-title":"A comprehensive classification of thoracic and lumbar injuries","volume":"3","author":"Magerl","year":"1994"},{"key":"b21-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"1741","article-title":"The load sharing classification of spine fractures","volume":"19","author":"McCormack","year":"1994"},{"key":"b22-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"1901","article-title":"The management of acute thoracolumbar burst fractures with anterior corpectomy and Z-plate fixation","volume":"29","author":"McDonough","year":"2004"},{"key":"b23-focus1452","series-title":"Eur Spine J","first-page":"284","article-title":"Treatment of thoracolumbar burst fractures without neurologic deficit by indirect reduction and posterior instrumentation: bisegmental stabilization with monosegmental fusion","volume":"8","author":"M\u00fcller","year":"1999"},{"key":"b24-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"955","article-title":"Thoracolumbar burst fractures. 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Longterm clinical results over 16 years.]","volume":"106","author":"Reinhold","year":"2003"},{"key":"b31-focus1452","series-title":"Eur Spine J","first-page":"495","article-title":"Short segment fixation of thoracolumbar burst fractures without fusion","volume":"8","author":"Sanderson","year":"1999"},{"key":"b32-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"997","article-title":"Radiologic assessment of interbody fusion using carbon fiber cages","volume":"28","author":"Santos","year":"2003"},{"key":"b33-focus1452","series-title":"Spine (Phila Pa 1976)","first-page":"E33","article-title":"Single-stage posterior corpectomy and expandable cage placement for treatment of thoracic or lumbar burst fractures","volume":"34","author":"Sasani","year":"2009"},{"key":"b34-focus1452","series-title":"Eur Spine J","first-page":"197","article-title":"Is a single anterolateral screw-plate fixation sufficient for the treatment of spinal fractures in the thoracolumbar junction? 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