Lorente Rafael, Lorente Alejandro, Rosa Bárbara, Palacios Pablo, Barrios Carlos
Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Infanta Cristina, Badajoz, España.
Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Ramón y Cajal, Madrid, España.
Neurocirugia (Engl Ed). 2018 Mar-Apr;29(2):57-63. doi: 10.1016/j.neucir.2017.09.009. Epub 2017 Nov 7.
To analyse the radiological outcomes in the long term of unstable thoracic and lumbar fractures treated through percutaneous surgery.
Retrospective review of a series of patients with unstable thoracic and lumbar fractures treated with percutaneous minimally invasive surgery between 2010 and 2015 in three different hospital centres. Six radiological parameters were measured annually during a 2-year period: Fracture angle, kyphotic deformity, sagittal index, percentage of compression, degree of displacement and deformation angle.
A total of 37 patients were included with a median age of 41.3 years and a median follow-up period of 2.2 years. Fracture angle rose from 14.8° to 17.1° (increase of 15.54%), kyphotic deformity from 15.9° to 17.7° (increase of 11.32%), sagittal index from 10.1 to 12.3 (increase of 21.78%), percentage of compression from 32.7% to 36.8% (increase of 12.53%), degree of displacement from 3.0mm to 4.4mm (increase of 50%) and deformation angle from 20.7° to 22.9° (increase of 10.62%).
All the radiological parameters studied lost correction throughout the 24 months of follow-up; the degree of displacement and the sagittal index were the most marked. Nevertheless, the greatest loss of correction occurred in the first postoperative year, the parameters then stabilised over the 24 months of follow up. We routinely recommend the measurement of all previous parameters for the follow up of unstable thoracic and lumbar fractures treated through percutaneous surgery.
分析经皮手术治疗不稳定型胸腰椎骨折的长期影像学结果。
回顾性分析2010年至2015年在三个不同医院中心接受经皮微创手术治疗的一系列不稳定型胸腰椎骨折患者。在2年期间每年测量六个影像学参数:骨折角度、后凸畸形、矢状指数、压缩百分比、移位程度和变形角度。
共纳入37例患者,中位年龄41.3岁,中位随访期2.2年。骨折角度从14.8°升至17.1°(增加15.54%),后凸畸形从15.9°升至17.7°(增加11.32%),矢状指数从10.1升至12.3(增加21.78%),压缩百分比从32.7%升至36.8%(增加12.53%),移位程度从3.0mm升至4.4mm(增加50%),变形角度从20.7°升至22.9°(增加10.62%)。
在24个月的随访期间,所有研究的影像学参数均失去了矫正;移位程度和矢状指数最为明显。然而,最大的矫正丢失发生在术后第一年,这些参数随后在24个月的随访中稳定下来。我们常规建议在随访经皮手术治疗的不稳定型胸腰椎骨折时测量所有上述参数。