J Korean Soc Spine Surg.  2002 Mar;9(1):19-26. 10.4184/jkss.2002.9.1.19.

The Comparison of Loss of Reduction at the Thoracolumbar Fracture According to Insertion of Screw Including Fractured Vertebra or not in Short Segment Posterolat Fusion

Affiliations
  • 1Department of Orthopaedic Surgery, Kang Nam General Hospital, Seoul, Korea. spinemin@hanmail.net

Abstract

STUDY DESIGNS: Retrospective analysis of the surgical treatment in patients of thoracolumbar spine fractures.
OBJECTIVES
To measure by modified Cobb method the correction angle of thoracolumbar vertebral fractures and to comparison the difference between short segment pedicular fixation with fractured vertebra(group A) and without fractured vertebra (group B). SUMMARY OF LITERATURE REVIEW: The major treatment of thoracolumbar spine fractures is surgical correction of kyphotic angle by posterior decompression and posterolat. fusion at one level or more.
MATERIALS AND METHODS
The materials are the patients who visited due to trauma beween 1991.1 and 2000.12. and treated by post. decompression and short segment posterolat. fusion with iliac bone graft. The number were A group, 28 persons and B group, 15 persons. The method of radiologic measurement is done by the modified Cobb method. The follow up time is till 2001.7. and the duration are minimal 6 months and maximal 77 months. The age was between 17 old and 60 old. The neurologic abnormalities in patients are 12 persons. The fractures were classified by the Denis classification. There are compressive fracture are 3 persons and bursting fracture type A are 18 persons, type B are 22 persons. The materials were confirmed by radiologic union and excluded if more than one vertebra fusion is needed.
RESULTS
The most fractures were due to falldown injury. The most fracture site was T-L level (T12-L3). The one case was complicated by deep infection and treated and the other case was reduction loss due to metallic failure. The results of the loss of correction were A group, 5.3 degree and B group, 6.2 degree. (P>0.05). The relative correction loss were A group, 42%, and B group, 54%. (P<0.05).
CONCLUSION
The mean correction angle and loss of correction are more good results in the group of short segment pedicular fixation with fracture vertebra. But to get more good results, our study do more long term follow-up and rule out other statistical errors and consecutive radiologic follow-up.

Keyword

Cobb angle; Sup. and inf. endplate; Thoracolumbar vertebral fracture, posterolat. fusion

MeSH Terms

Classification
Decompression
Follow-Up Studies
Humans
Retrospective Studies
Spine*
Transplants

Figure

  • Fig. 1. Preoperative sagittal radiography of 51years old male and immediate postoperative sagittal radiography after short segment posterolat. fusion without fracture segment pedicular fixation, last follow up filim after 18months later. Fig. 1. The cobb angle was initial 37degree(A) and immediate post. op 15degree(B), last follow up was 22degree(C).

  • Fig. 2. Preoperative sagittal radiography of 25years old female and immediate postoperative sagittal radiography after short segment posterolat. fusion with fracture segment pedicular fixation, last follow up film after 52months later. Fig. 1. The cobb angle was initial 20degree(A) and immediate post. op 4degree(B), last follow up was 15degree(C).


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