Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea.
Spine (Phila Pa 1976). 2011 Jan 15;36(2):170-6. doi: 10.1097/BRS.0b013e3181cd59d1.
a retrospective study of surgically managed patients.
to evaluate the results of posterior stabilization of thoracolumbar fracture using nonfusion method followed by the removal of metal implants within an appropriate period. Changes in the sagittal alignment and the restoration of segmental motion were also investigated.
posterior fusion using a transpedicular screw system remains the treatment of choice for the management of thoracolumbar and lumbar fractures. However, fusion methods result in the permanent loss of segmental motion. If both stability and motion could be achieved, functional results would improve considerably.
twenty-three patients under 40 years of age (mean, 28.0 years) with thoracolumbar or lumbar spine fractures were managed by this nonfusion method. Implants were removed at a mean 9.7 months after initial fracture fixation, and patients were observed for more than 18 months. Sagittal alignments of metal fixed segments, heights of vertebral bodies, recovered motion ranges in flexion/extension, right-left bending view were measured radiologically. Clinical aspects, such as gross deformities and functional abilities, were also investigated.
heights of fractured bodies were well maintained at final follow-up. Initial mean sagittal angle was 17.2° kyphosis, which became 2.8° lordosis after fixation of fractures. This angle was 1.7° kyphosis just before implant removal, 2.4° kyphosis just after implant removal, and showed 5.9° kyphosis at final follow-up. Mean segmental motion was 14.2° in the sagittal plane and 13.1° in the coronal plane at final follow-up. Most patients were satisfied with final gross appearance and functional outcome.
the described nonfusion method appears to be effective in achieving favorable sagittal alignment and regaining motions of fixed segments. The present study suggests that the nonfusion method is one of the most effective methods for managing thoracolumbar fractures, especially in young active people.
回顾性研究手术治疗的患者。
评估非融合方法后，在适当的时间内取出金属植入物，对胸腰椎骨折后路稳定的结果。还研究了矢状面排列的变化和节段运动的恢复。
经皮椎弓根螺钉系统融合仍然是胸腰椎和腰椎骨折治疗的首选方法。然而，融合方法导致节段运动的永久性丧失。如果既能达到稳定性又能获得运动，功能结果将大大改善。
23 例年龄在 40 岁以下（平均 28.0 岁）的胸腰椎或腰椎骨折患者采用非融合方法治疗。植入物在初次骨折固定后平均 9.7 个月取出，患者观察超过 18 个月。测量金属固定节段矢状面排列、椎体高度、屈伸、左右弯曲视图的恢复运动范围。还对临床方面，如大体畸形和功能能力进行了研究。
骨折体的高度在最终随访时得到很好的维持。初始平均矢状角为 17.2°后凸，骨折固定后变为 2.8°前凸。这一角度在植入物取出前为 1.7°后凸，取出后为 2.4°后凸，最终随访时为 5.9°后凸。矢状面平均节段运动为 14.2°，冠状面为 13.1°。大多数患者对最终的大体外观和功能结果满意。
所描述的非融合方法似乎在获得良好的矢状面排列和恢复固定节段的运动方面是有效的。本研究表明，非融合方法是治疗胸腰椎骨折最有效的方法之一，特别是在年轻活跃的人群中。
