摘要

Aim. There is no consensus regarding the ideal treatment of type A thoraco-lumbar fractures. Many surgical techniques have been described but none has demonstrated its superiority over others. Recently, minimally invasive techniques have been widely used as they reduce the immediate morbidity related to the procedure. Percutaneous pedicle screw stabilization plus balloon kyphoplasty is a valuable technique, but there are only few data regarding clinical and radiological results in the long term. The purpose of this study was to report the long-term clinical and radiological outcome of patients undergoing minimally invasive management of thoracolumbar fracture in our institution.
Methods. This was a retrospective review of prospectively collected data. Between January 2006 and June 2008, 22 patients underwent short-segment percutaneous stabilization and balloon kyphoplasty for treatment of a type A fracture of the thoraco-lumbar spine. The study included 12 males and 10 females and the mean age was 50.5 years (25-75 years). The affected levels were T10 (N.=1), T11 (N.=1), T12 (N.=3), L1 (N.=9), L2 (N.=4), L3 (N.=3) and L4 (N.=1).
Results. The mean follow-up period was 60.9 months (50-75 months). The mean operative time was 77 min (range 55-135 min) and the bleeding was very low (<100 mL). VAS was significantly improved from 6.1 to 1.1 at last follow-up. Vertebral kyphosis decreased by 19 degrees to 7.7 degrees (ap<0.001) and local kyphosis was also significantly improved from 12.3 degrees to 4.4 degrees at last follow-up. We reported one screw mis-placement that required early repositioning and 4 cement leakage, none of which was symptomatic. No patient worsened his neurological condition postoperatively.
Conclusion. This treatment strategy is safe and effective. Clinical and radiological results seem to be stable over the time.

  • 出版日期2014-9