Lee Kyu Yeol, Kim Min-Woo, Seok Sang Yun, Kim Dong Ryul, Im Chul Soon
Department of Orthopedic Surgery, Dong-A University College of Medicine, Busan, Korea.
Clin Orthop Surg. 2017 Dec;9(4):465-471. doi: 10.4055/cios.2017.9.4.465. Epub 2017 Nov 10.
To determine the relationship between superior disc-endplate complex injury and correction loss after surgery in a group of young adult patients with a stable thoracolumbar burst fracture.
The study group was comprised of young adult patients who had undergone short-segment posterior fixation and bone grafting under the diagnosis of a stable thoracolumbar burst fracture from March 2008 to February 2014. Follow-up was available for more than 1 year. Before surgery, magnetic resonance imaging was performed to determine injury to the anterior longitudinal ligament, posterior longitudinal ligament, and superior and inferior intervertebral discs and endplates. Correction loss was evaluated by the Cobb angle, intervertebral disc height, upper intervertebral disc angle, vertebral wedge angle, and vertebral body height.
No significant relation was noted between correction loss and an injury to the anterior longitudinal ligament, posterior longitudinal ligament, inferior intervertebral disc/endplate, and fracture site, whereas an injury to the superior endplate alone and superior disc-endplate complex showed a significant association. Specifically, a superior intervertebral disc-endplate complex injury showed statistically significant relation to postoperative changes in Cobb angle ( = 0.026) and vertebral wedge angle ( = 0.047).
A superior intervertebral disc-endplate complex injury may have an influence on the prognosis after short-segment fixation in young adult patients with a stable thoracolumbar burst fracture.
确定一组年轻成年稳定型胸腰椎爆裂骨折患者术后椎间盘终板复合体损伤与矫正丢失之间的关系。
研究组由2008年3月至2014年2月期间诊断为稳定型胸腰椎爆裂骨折并接受短节段后路固定及植骨的年轻成年患者组成。随访时间超过1年。术前进行磁共振成像以确定前纵韧带、后纵韧带、上下椎间盘及终板的损伤情况。通过Cobb角、椎间盘高度、上位椎间盘角、椎体楔角和椎体高度评估矫正丢失情况。
矫正丢失与前纵韧带、后纵韧带、下位椎间盘/终板及骨折部位的损伤之间未发现显著关系,而单独的上位终板损伤和上位椎间盘终板复合体损伤显示出显著相关性。具体而言,上位椎间盘终板复合体损伤与术后Cobb角(P = 0.026)和椎体楔角(P = 0.047)的变化具有统计学显著关系。
上位椎间盘终板复合体损伤可能会影响年轻成年稳定型胸腰椎爆裂骨折患者短节段固定后的预后。