Operative Treatment of Unstable Thoracolumbar Fractures with Reduction-Fixation System

Eighteen patients with unstable thoracolumbar fracture were reviewed ret-rospecitvely, 15 patients were regularly follow up. The diagnosis included 3 frac-ture-dislocation, 1 chance fracture, 11 burst fracture. Every patient was treated with R-F system and posterolateral fusion. The segmental kyphosis before surgery, after surgery, and during follow up were 11.9˚ (-17˚↔29˚), 2.6 (-20↔15˚), 7.6 (-17↔25˚) respectively. The vertebral height in burst fractures before surgery, after surgery and follow up were53.9%(43.3%-70%),74.2%(55.1%-85.2%),67%(39.3%-84.6%). The overall percentage of preoperative encroach-ment of canal improved from 58.7% to 44.2% postoperatively, but Denis type A improved from 53.3% to 26.7%. Removal of implants was underwent in 2(13.3%). Incomplete patients gained an average of 1.5 Frankel subgrades. R-F system allows limited dissection and levels of fusion and thus preserves more lumbar motion segement. Immediate sagittal angular correction was impressive. But loss of reduction was also significant at final follow up. This meant that whether reconstruction or augmentation of the anterior and middle columns be necessary for sagittal maintenance needed further evaluation. Canal clearance is not effectively satisfactory. Denis type A could be reduced well in our series, but our cases is too less to make a conclusion.

並列關鍵字

spinal fracture, posterior instrumentation, segmental kyphosis, canal clearance.

國際替代計量

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