Posterior Short Segment Instrumentation in Thoracolumbar Burst Fractures

作者：Ocguder D Ali^*; Guler Ferhat; Firat Ahmet; Demirkale Ismail; Tecimel Osman; Solak Sukru

来源：Turkiye Klinikleri Tip Bilimleri Dergisi, 2011, 31(2): 363-370.

DOI：10.5336/medsci.2009-14436

• Spinal fractures
• spine
• injuries
• bone screws
• lumbar vertebrae

Objective: This study evaluates the results of the posterior short segment instrumentation performed in patients with thoracolumber burst fractures. Material and Methods: Posterior short segment fixation and fusion has been performed in 26 patients (18 males, 8 females, mean age 39.9 +/- 11.2; range 17-57 years) with thoracolumber burst fractures. The most common involvement site was L1 vertabra seen in eight patients (30.7%). The most common fracture type was Denis Type B, seen in 24 patients (50.3%). Denis pain scale was used for clinical assessment and neurological evaluation was performed with Frankel classification. The anterior collapse angles, sagittal indices and kyphosis angles were obtained preoperatively, postoperatively and on the last follow up of the patient using radiological studies. Oswestry disability questionnare and Denis work scale were used for functional assessment. All patients were rated according to load sharing classification. Results: Last follow up of patients showed lower rates of residual pain and higher patient satisfaction. Mean follow up period was 28 +/- 8.3 months (range 12-58 months). Functional assessment showed that 22 patients (%84) were able to return their work, two patients (%8) needed to change their occupation and two patients (8%) with neurological compromise were not able to work. Mean load sharing score were 6.2 +/- 0.7. A loss of 3.3 +/- 2.7 degrees in anterior collapse angle, 5.6 +/- 4.2 degrees in sagittal index, and 10.2 +/- 7.degrees 8 in kyphosis angle were observed radiologically in the last follow up. The correlation of loss in kyphosis angle and results of Denis work scale was not statistically significant. Non-union or broken implant has not occured in any of the patients. Condusion: Since functional results are favorable and complication rates are low, the posterior short segment fixation is an efficient method of treatment in carefully selected patients with thoracolumber burst fractures (Gaines score is less than 7 or corset-compliant patients) in spite of insatisfactory radiological results.

• 出版日期2011-4