Ortin-Barcelo Antonio, Ortolà Morales David J, Rosa Michele Attilio, Fenga Domenico, Bañuls-Pattarelli Miguel A, Lopez-Prats Fernando A
Department of Orthopaedic Surgery, University Hospital of Elche, Alicante, Spain.
Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Section of Orthopaedics and Traumatology, Universita degli Studi di Messina, Messina, Italy.
Folia Med (Plovdiv). 2018 Sep 1;60(3):474-478. doi: 10.2478/folmed-2018-0011.
We present a series of cases of type A3.1.2 unstable fractures of the thoracolumbar hinge treated percutaneously with third-generation kyphoplasty and only one next level percutaneous screws. Four women aged 75 to 85 years with thoracolumbar vertebral fractures, classified as type A.3.1.2, were treated with Precept® monosegmental percutaneous fixation and the third-generation SpineJack® augmentation system. The traditional treatment of type A3 unstable vertebral wedging fractures is performed with transpedicular fixation of two or more levels adjacent to the fracture causing great rigidity. Recently, the concept of bridge fixation combining one segment intrapedicular fixation with kyphoplasty has emerged as a more stable and less invasive system that allows greater mobility in this type of fractures. The combination of third-generation kyphoplasty and monosegmental bridge fixation may improve results to other fixation systems in type A3 vertebral fractures.
我们展示了一系列采用第三代椎体后凸成形术和仅一枚相邻节段经皮螺钉经皮治疗的A3.1.2型胸腰段铰链不稳定骨折病例。4名年龄在75至85岁的患有胸腰椎椎体骨折（分类为A.3.1.2型）的女性接受了Precept®单节段经皮固定和第三代SpineJack®强化系统治疗。A3型不稳定椎体楔形骨折的传统治疗是对骨折相邻的两个或更多节段进行椎弓根固定，这会导致很大的僵硬程度。最近，将单节段椎弓根内固定与椎体后凸成形术相结合的桥接固定概念已成为一种更稳定且侵入性更小的系统，该系统能使此类骨折具有更大的活动度。第三代椎体后凸成形术与单节段桥接固定相结合可能会改善A3型椎体骨折相对于其他固定系统的治疗效果。
