Zelle Boris A, Dorner Jochen
Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Am J Orthop (Belle Mead NJ). 2008 Feb;37(2):76-80.
Failed treatment of thoracolumbar spine fractures may lead to late posttraumatic kyphosis (LPK), and LPK treatment is challenging. The aim of this retrospective study was to investigate whether anterior reduction and Z-plate instrumentation constitute feasible treatment for LPK (> 30 days after injury). Twenty patients who developed LPK after a thoracolumbar fracture were treated with the Z-plate anterior thoracolumbar plating system. Sixteen patients were followed for a mean of 35 months. Ten of 15 patients with a thoracotomy had persistent postthoracotomy pain. Mean back pain decreased significantly, from 9.2 before surgery to 4.1 after surgery (10 = worst pain ever experienced, 0 = no pain). Osseous union occurred in all patients. Postoperative loss of reduction of 4.9 degrees kyphotic angle was recorded at follow-up. Anterior stabilization with the Z-plate is a technically feasible procedure in patients with LPK. Long-term postthoracotomy pain seems to be a significant problem in these patients.
胸腰椎骨折治疗失败可能导致创伤后迟发性后凸畸形（LPK），而LPK的治疗具有挑战性。这项回顾性研究的目的是调查前路复位和Z形钢板内固定是否构成对LPK（伤后>30天）的可行治疗方法。20例胸腰椎骨折后发生LPK的患者接受了Z形钢板前路胸腰椎钢板固定系统治疗。16例患者平均随访35个月。15例行开胸手术的患者中有10例持续存在开胸术后疼痛。平均背痛显著减轻，从术前的9.2降至术后的4.1（10表示经历过的最严重疼痛，0表示无疼痛）。所有患者均实现骨愈合。随访时记录到术后后凸角有4.9度的复位丢失。对于LPK患者，采用Z形钢板进行前路稳定术在技术上是可行的。长期开胸术后疼痛似乎是这些患者的一个重大问题。
