Treatment of thoracolumbar burst fractures without neurologic deficit by indirect reduction and posterior instrumentation:: bisegmental stabilization with monosegmental fusion

被引:287
作者
Müller, U [1 ]
Berlemann, U
Sledge, J
Schwarzenbach, O
机构
[1] Kantonsspital Liestal, Clin Orthoped, CH-4410 Liestal, Switzerland
[2] Univ Bern, Inselspital, Dept Orthoped Surg, CH-3012 Bern, Switzerland
关键词
lumbar spine; burst fracture; transpedicular instrumentation; monosegmental fusion;
D O I
10.1007/s005860050175
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
This study retrospectively reviews 20 sequential patients with thoracolumbar burst fractures without neurologic deficit. All patients were treated by indirect reduction, bisegmental posterior transpedicular instrumentation and monosegmental fusion. Clinical and radiological outcome was analyzed after an average follow-up of 6.4 years. Re-kyphosis of the entire segment including the cephaled disc was significant with loss of the entire postoperative correction over time. This did not influence the generally benign clinical outcome. Compared to its normal height the fused cephalad disc was reduced by 70% and the temporarily spanned caudal disc by 40%. Motion at the temporarily spanned segment could be detected in 11 patients at follow-up, with no relation to the clinical result. Posterior instrumentation of thoracolumbar burst fractures can initially reduce the segmental kyphosis completely. The loss of correction within the fractured vertebral body is small. However, disc space collapse leads to eventual complete loss of segmental reduction. Therefore, posterolateral fusion alone does not prevent disc space collapse. Nevertheless, clinical longterm results are favorable. However, if disc space collapse has to prevented, an interbody disc clearance and fusion is recommended.
引用
收藏
页码:284 / 289
页数:6
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