Objective:To evaluate the efficacy and significance of posterolateral fusion in preventing failure of short-segment stabilization for the treatment of thoracolumbar burst fractures. Methods:Sixty patients with thoraco...Objective:To evaluate the efficacy and significance of posterolateral fusion in preventing failure of short-segment stabilization for the treatment of thoracolumbar burst fractures. Methods:Sixty patients with thoracolumbar burst fractures were included in the study. The patients were classified into two groups (n =30 in each group). In Group A, patients were treated in our hospital with short-segment instrumentation via posterolateral fusion with iliac bone. In Group B, patients were treated in other hospital with short-segment fixation without fusion. All cases came to our hospital for reexamination. There were 18 males and 12 females in Group A with a mean age of 42.3 years (range, 24 to 52 years) and 16 males and 14 females in Group B with a mean age of 41.5 years (range, 19 to 54 years). Radiographic (Cobb angle, kyphosis of the vertebral body, and sagittal index) and clinical outcomes (Low Back Outcome Score) were analyzed after an average follow-up of 16 months. Results:After operation, Cobb angle was reduced from 19.3°to 3.1°in Group A and from 19. 1°to 3. 3°in Group B (P>0.05).It was 5.9°in Group A and 11. 9°in Group B at the final follow-up (P < 0.01). Its average loss of correction was 2. 8°in Group A and 8. 6°in Group B. Average kyphosis of the vertebral body was reduced from 21.3°to 6.2°in Group A and from 21.7°to 7.4°in Group B (P > 0.05). It was decreased to 7.9°in Group A and 13.5°in Group B at the final follow-up (P < 0. 01). Its average loss of correction was 1.7°in Group A and 6.1°in Group B. Sagittal index was reduced from 21.3°to 3.6°in Group A and from 20. 5°to 3. 8°in Group B (P < 0.05). It was decreased to 5. 1°in Group A and 9. 8°in Group B at the final follow-up (P < 0. 01). Its average loss was 1.5°in Group A and 6.0°in Group B. In Group A, 73.3% of patients had an excellent result based on Low Back Outcome Score system, while that in Group B was only 43.3%. Conclusions:Posterolateral fusion is an effective measure to prevent implant failure, and decrease loss of展开更多
Objective: To evaluate the efficacy of Cotrel-Dubeusset （CD） instrumentation combined with translaminar facet joint screw （TLS） in the treatment of thoracolumbar fracture.Methods: A total of six L2-L4 spines were ...Objective: To evaluate the efficacy of Cotrel-Dubeusset （CD） instrumentation combined with translaminar facet joint screw （TLS） in the treatment of thoracolumbar fracture.Methods: A total of six L2-L4 spines were used to establish unstable fracture model with three-dimensional range of motion （ROM） of the spines measured. Fixation with CD and fixation with CD combined with translaminar facet joint screw were achieved to compare their stability. Thirty cases of thoracolumbar fracture, in whom the anterior edge of vertebral body was compressed to 59% and the posterior edge compressed to 88%, were treated by pedicle screw fixation combined with TLS. Among them, 19 received posterolateral or anterior-posterior bone graftingResults: There was significant difference in ROM between the two techniques except that in extension. In Group CD+TLS, ROM was （5.38）% lower, lateral bending （4.91）% lower and axial rotation （11.85）% lower than those in Group CD respectively. In the clinical group, the average anterior edge restored to 97% and posterior edge to 98%. The duration of follow-up was 5-24 months （mean, 10 months）. The rate of correction loss on the anterior edge was （4.5）%. Among the 19 cases of bone grafting, all of them achieved bony fusion （mean fusion time, （4.3） month） with a correction loss rate of （3.4）%.Conclusions: In the treatment of thoracolumbar fracture, pedicle screw fixation combined with TLS can strengthen the stability of pedicle screws, especially anti-rotation stability and enhance fusion rate and reduce correction loss.展开更多
文摘Objective:To evaluate the efficacy and significance of posterolateral fusion in preventing failure of short-segment stabilization for the treatment of thoracolumbar burst fractures. Methods:Sixty patients with thoracolumbar burst fractures were included in the study. The patients were classified into two groups (n =30 in each group). In Group A, patients were treated in our hospital with short-segment instrumentation via posterolateral fusion with iliac bone. In Group B, patients were treated in other hospital with short-segment fixation without fusion. All cases came to our hospital for reexamination. There were 18 males and 12 females in Group A with a mean age of 42.3 years (range, 24 to 52 years) and 16 males and 14 females in Group B with a mean age of 41.5 years (range, 19 to 54 years). Radiographic (Cobb angle, kyphosis of the vertebral body, and sagittal index) and clinical outcomes (Low Back Outcome Score) were analyzed after an average follow-up of 16 months. Results:After operation, Cobb angle was reduced from 19.3°to 3.1°in Group A and from 19. 1°to 3. 3°in Group B (P>0.05).It was 5.9°in Group A and 11. 9°in Group B at the final follow-up (P < 0.01). Its average loss of correction was 2. 8°in Group A and 8. 6°in Group B. Average kyphosis of the vertebral body was reduced from 21.3°to 6.2°in Group A and from 21.7°to 7.4°in Group B (P > 0.05). It was decreased to 7.9°in Group A and 13.5°in Group B at the final follow-up (P < 0. 01). Its average loss of correction was 1.7°in Group A and 6.1°in Group B. Sagittal index was reduced from 21.3°to 3.6°in Group A and from 20. 5°to 3. 8°in Group B (P < 0.05). It was decreased to 5. 1°in Group A and 9. 8°in Group B at the final follow-up (P < 0. 01). Its average loss was 1.5°in Group A and 6.0°in Group B. In Group A, 73.3% of patients had an excellent result based on Low Back Outcome Score system, while that in Group B was only 43.3%. Conclusions:Posterolateral fusion is an effective measure to prevent implant failure, and decrease loss of
文摘Objective: To evaluate the efficacy of Cotrel-Dubeusset （CD） instrumentation combined with translaminar facet joint screw （TLS） in the treatment of thoracolumbar fracture.Methods: A total of six L2-L4 spines were used to establish unstable fracture model with three-dimensional range of motion （ROM） of the spines measured. Fixation with CD and fixation with CD combined with translaminar facet joint screw were achieved to compare their stability. Thirty cases of thoracolumbar fracture, in whom the anterior edge of vertebral body was compressed to 59% and the posterior edge compressed to 88%, were treated by pedicle screw fixation combined with TLS. Among them, 19 received posterolateral or anterior-posterior bone graftingResults: There was significant difference in ROM between the two techniques except that in extension. In Group CD+TLS, ROM was （5.38）% lower, lateral bending （4.91）% lower and axial rotation （11.85）% lower than those in Group CD respectively. In the clinical group, the average anterior edge restored to 97% and posterior edge to 98%. The duration of follow-up was 5-24 months （mean, 10 months）. The rate of correction loss on the anterior edge was （4.5）%. Among the 19 cases of bone grafting, all of them achieved bony fusion （mean fusion time, （4.3） month） with a correction loss rate of （3.4）%.Conclusions: In the treatment of thoracolumbar fracture, pedicle screw fixation combined with TLS can strengthen the stability of pedicle screws, especially anti-rotation stability and enhance fusion rate and reduce correction loss.
