Artikel
Alignment after thoracolumbar fractures: Long-term results after surgery
Korrekturstellung nach thorakolumbaler Wirbelkörperfraktur: Langzeitergebnisse nach Operation
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
In a retrospective study the kyphotic angle was assessed one year after implantation of a dorsal fixator. Results were related with the classification of fractures.
Methods
147 patients (99 were male and 48 were female) with one unstable vertebral body fracture of the lower thoracic and lumbar spine were operated on between January 1995 and October 2001 using open reduction, internal posterior fixation, neural decompression including reduction of the posterior wall fragments, removing destructed intervertebral discs and intervertebral autologous bone grafting. The implant was removed about one year after surgery. Radiographs were evaluated to determine the angle of kyphosis, wedge index and wedge angle of the injured vertebra. Radiographs were obtained before surgery, immediately after surgery and before and after implant removal. The spine fractures were classified by the universal spine fracture classification (MEYER).
Results
46 patients (31%) had a type b fracture, 101 patients (69%) had a type c fracture. The mean angle of kyphosis there was a 13,3 degree loss one year after dorsal stabilisation of a vertebra body fracture type c and only 6,2 degree by vertebra body fracture type b. The mean wedge angle was a 5 degree loss by fracture type b and 8 degree by type c one year after dorsal stabilisation.
Conclusions
Long-term results in terms of alignment after thoracolumbar fractures and subsequent dorsal surgical fixation are clearly related to the type of fracture. In vertebra body fracture type c a lateral or ventral fusion in addition to internal posterior fixation is recommend.