These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: [Treatment of unstable fresh thoracolumbar burst fracture by over-bending rod reduction and fixation technique via posterior approach].
    Author: Li Y, Wang H, Cui W, Zhou P, Zhao S.
    Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2021 Apr 15; 35(4):458-463. PubMed ID: 33855830.
    Abstract:
    OBJECTIVE: To investigate the efficacy and safety of over-bending rod reduction and fixation technique via posterior approach in the treatment of unstable fresh thoracolumbar burst fracture. METHODS: A clinical data of 27 patients with unstable fresh thoracolumbar burst fracture, who were met the inclusive criteria and admitted between January 2018 and October 2019, was retrospectively analyzed. There were 15 males and 12 females with an average age of 41.8 years (range, 26-64 years). The fractures were caused by falling from height in 14 cases, traffic accident in 8 cases, and crushing by a heavy objective in 5 cases. The interval between injury and operation was 1-7 days (mean, 3.2 days). The injured fracture was located at T 10 in 1 case, T 11 in 3 cases, T 12 in 6 cases, L 1 in 7 cases, L 2 in 7 cases, and L 3 in 3 cases. According to AO classification, there were 11 cases of type A3, 7 cases of type B, and 9 cases of type C. Neurological function was rated as grade A in 3 cases, grade B in 7 cases, grade C in 5 cases, and grade D in 12 cases according to the American Spinal Injury Association (ASIA) grading. All cases were treated by over-bending rod reduction and fixation technique via posterior approach, and 16 cases were combined with limited fenestration decompression. The evaluation indicators consisted of operation time, intraoperative blood loss, the compression ratio of the anterior vertebral height, the invasion rate of the injured vertebra into the spinal canal, the Cobb angle of segmental kyphosis, visual analogue scale (VAS) score, and Oswestry Disability Index (ODI). RESULTS: The operation time was 67-128 minutes (mean, 81.6 minutes), and the intraoperative blood loss was 105-295 mL (mean, 210 mL). All patients were followed up 12-23 months (mean, 17.2 months). A total of 178 pedicle screws were implanted during operation, and the accuracy of the implantation was 98.9% (176/178). The compression ratios of the anterior vertebral height at the early postoperatively and last follow-up were significantly increased when compared with preoperative one ( P<0.05), and the invasion rate of the injured vertebra into the spinal canal, Cobb angle, VAS score, and ODI were significantly lower than those preoperatively ( P<0.05). Except that the ODI at last follow-up was significantly lower than that of the early postoperative period ( P<0.05), there was no significant difference between the last follow-up and the early postoperative period for other indicators ( P>0.05). At last follow-up, the neurological function was rated as grade A in 1 case, grade B in 2 cases, grade C in 4 cases, grade D in 9 cases, and grade E in 11 cases according to the ASIA grading, showing significant difference when compared with that before operation ( Z=-3.446, P=0.001). CONCLUSION: Over-bending rod reduction and fixation technique can effectively restore vertebral height, reset the invaded vertebral block, and selectively perform limited decompression and posterolateral bone grafting to ensure the completeness of intravertebral decompression and stability, which is one of the effective methods to treat unstable fresh thoracolumbar burst vertebral fracture. 目的: 探讨后路过弯棒复位固定技术治疗不稳定新鲜胸腰椎爆裂骨折的安全性和有效性。. 方法: 回顾分析 2018 年 1 月—2019 年 10 月符合选择标准的 27 例不稳定新鲜胸腰椎爆裂骨折患者临床资料。男 15 例，女 12 例；年龄 26～64 岁，平均 41.8 岁。致伤原因：高处坠落伤 14 例，交通事故伤 8 例，重物砸伤 5 例。受伤至手术时间 1～7 d，平均 3.2 d。损伤节段：T 10 1 例、T 11 3 例、T 12 6 例、L 17 例、L 27 例、L 3 3 例。按照 AO 分型标准，A3 型 11 例、B 型 7 例、C 型 9 例。神经功能按照美国脊髓损伤协会（ASIA）分级：A 级 3 例、B 级 7 例、C 级 5 例、D 级 12 例。术中行后路过弯棒复位固定技术固定，其中 16 例联合有限开窗减压术。记录手术时间及术中出血量；比较手术前后疼痛视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）以及椎弓根螺钉植钉准确率、伤椎椎管侵占率、椎体前缘高度压缩比、节段后凸 Cobb 角。. 结果: 手术时间 67～128 min，平均 81.6 min；术中出血量 105～295 mL，平均 210 mL。患者术后均获随访，随访时间 12～23 个月，平均 17.2 个月。术中共植入 178 枚椎弓根螺钉，植钉准确率为 98.9%（176/178）。术后早期及末次随访时，伤椎椎体前缘高度压缩比较术前明显增加，椎管侵占率、后凸 Cobb 角以及 VAS 评分、ODI 较术前明显降低，差异均有统计学意义（ P<0.05）；除 ODI 末次随访时较术后早期明显降低（ P<0.05）外，其余指标末次随访与术后早期差异均无统计学意义（ P>0.05）。末次随访时，ASIA 分级为 A 级 1 例、B 级 2 例、C 级 4 例、D 级 9 例、E 级 11 例，与术前比较差异有统计学意义（ Z=−3.446， P=0.001）。. 结论: 后路过弯棒复位固定技术能有效恢复伤椎前缘高度、复位侵入椎管骨折块，同时选择性行有限开窗减压及后外侧植骨，保证了椎管内减压的彻底性和脊柱稳定性，是治疗不稳定新鲜胸腰椎爆裂骨折的有效方法之一。.
    [Abstract] [Full Text] [Related] [New Search]