Asian Spine J.  2013 Jun;7(2):81-90. 10.4184/asj.2013.7.2.81.

The Efficacy of Percutaneous Long-Segmental Posterior Fixation of Unstable Thoracolumbar Fracture with Partial Neurologic Deficit

• Lee GW
• Jang SJ
• Kim JD
• Son JH
• Jang JH

• KMID: 2048095
• DOI: http://doi.org/10.4184/asj.2013.7.2.81

Abstract

STUDY DESIGN: Retrospective analysis. PURPOSE: The aim of this study was to evaluate the clinical and radiological outcomes of patients with unstable thoracolumbar fracture (UTLF) who were treated by percutaneous long-segmental posterior fixation (PLSPF) by two vertebrae cranial to the fracture with two vertebrae caudal. OVERVIEW OF LITERATURE: To the best of our knowledge, PLSPF for stabilization of UTLF has not been reported.
METHODS
The study involved retrospective analysis and investigation from the results of 27 patients who had undergone PLSPF for stabilization of a UTLF with partial neurologic deficit, over a follow-up period of two years. Kyphotic angle (KA), anterior vertebral height percentage (AVHP) and cross-sectional ratio of the displaced fragment within the spinal canal were evaluated with simple radiographs and axial computed tomography scans preoperatively and two years postoperatively. The clinical outcome for pain was assessed by a visual analogue scale (VAS) and Denis' scale, and the degree of neurologic deficit was measured by modified Frankel classification.
RESULTS
Five patients had minor complications. The KA, AVHP, and cross-sectional ratio of the displaced fragment improved significantly after surgery (p<0.001, p<0.001, p<0.003, respectively). Neurologic recovery of one or more for the Frankel grade was seen in 19 patients with an average improvement of 1.7. The VAS and Denis' score improved significantly at a two year follow-up (p=0.02, p=0.012, respectively).
CONCLUSIONS
The technique of PLSPF is useful for the treatment of UTLF with partial neurologic deficit, and produces decreased morbidity and fewer complications.

Keyword

Spinal fracture; Fracture fixation, Internal

MeSH Terms

Follow-Up Studies
Fracture Fixation, Internal
Humans
Neurologic Manifestations
Retrospective Studies
Spinal Canal
Spinal Fractures
Spine