Jodoin A, Gillet P, Dupuis P R, Maurais G
Department of Surgery, Université de Montréal, PQ.
Can J Surg. 1989 Jan;32(1):36-42.
Thoracic and lumbar spine fractures may lead to symptomatic progressive kyphosis for which surgery remains a controversial treatment. Sixteen patients with kyphosis were treated surgically at the Sacré-Coeur Hospital in Montreal between 1979 and 1985. The mean follow-up was 38 months. Initially, treatment of the fractures varied. On average the post-traumatic kyphosis was surgically corrected 34 months later. The corrective procedure consisted of staged anterior and posterior fusion with instrumentation (six patients), posterior fusion with instrumentation (five), staged anterior fusion, posterior osteotomy and fusion with instrumentation (four), posterior osteotomy and fusion with Harrington instrumentation (one). Anterior decompression was also performed in 5 of the 10 patients who had anterior fusion. There was no major perioperative complication. Pain was relieved in 13 patients and 9 of 11 had substantial neurologic improvement. Two patients had nonunion of posterior grafts, but these united after revision. The mean loss of correction in the early postoperative period was 3.5 degrees. The authors conclude that surgical treatment of post-traumatic symptomatic progressive kyphosis is effective and safe.
胸腰椎骨折可能导致有症状的进行性脊柱后凸，对此手术仍是一种有争议的治疗方法。1979年至1985年间，蒙特利尔圣心医院对16例脊柱后凸患者进行了手术治疗。平均随访时间为38个月。最初，骨折的治疗方法各不相同。平均而言，创伤后脊柱后凸在34个月后通过手术进行矫正。矫正手术包括分期前路和后路融合并使用内固定器械（6例患者）、后路融合并使用内固定器械（5例）、分期前路融合、后路截骨并融合并使用内固定器械（4例）、后路截骨并融合并使用哈灵顿内固定器械（1例）。在接受前路融合的10例患者中，有5例还进行了前路减压。围手术期无重大并发症。13例患者疼痛缓解，11例中有9例神经功能有显著改善。2例患者后路植骨不愈合，但翻修后愈合。术后早期平均矫正丢失为3.5度。作者得出结论，创伤后有症状的进行性脊柱后凸的手术治疗是有效且安全的。
