Barakat Ahmed Samir, Elattar Ahmed, Fawaz Khaled, Sultan Ahmed Maher, Koptan Wael, ElMiligui Yasser, Alobaid Abdelrazzaq
Orthopedics and Traumatology Department, Faculty of Medicine, Cairo University, Kasr Al Ainy Street, Cairo 11562, Egypt.
Orthopedic Department, Spine Surgery Unit, Al-Razi Hospital, Block 1, Jamal Abdul Nasser Street, Kuwait City, State of Kuwait.
SICOT J. 2019;5:42. doi: 10.1051/sicotj/2019039. Epub 2019 Nov 29.
For the treatment of unstable non-osteoporotic thoracolumbar fractures, the clinical and radiological outcome of short-segment fixation with the USS™ - Universal Spine System (DePuy Orthopedics, Inc., Warsaw, IN, USA) and the CD HORIZON LEGACY™ 5.5 Spinal System, (Medtronic Sofamor Danek USA, Inc., Memphis, TN, USA) were compared.
From March 2015 to January 2016, 40 consecutive patients with unstable traumatic thoracolumbar fractures who met our inclusion criteria were treated with either the USS system or CDH Legacy system. Segmental kyphosis angle (SKA) and anterior body height (ABH) of fractured vertebrae, and ASIA Impairment Scale (AIS) were evaluated. Radiological fusion was confirmed with plain X-rays and when indicated with computerized tomography (CT).
The mean immediate kyphotic angle correction was 16.6° for the Schanz and 6.4 for the Legacy system, and the immediate mean anterior vertebral body height correction was 0.92 cm for the Schanz and 0.51 cm for the Legacy system. Our study shows a significant statistical difference between Schanz and Legacy systems regarding post-operative segmental kyphosis and height correction immediately postoperatively, at 6 months and at one-year follow-up (p-value < 0.005). The degree of pain reduction and neurological improvement was not influenced by the screw system.
Usage of USS in thoracolumbar fracture as a short-segment fixation led to a near anatomical reduction when compared to the Legacy system. However, there was no advantage regarding pain reduction and neurological outcome.
为了治疗不稳定的非骨质疏松性胸腰椎骨折,对使用USS™通用脊柱系统(美国印第安纳州华沙市迪普伊骨科公司)和CD HORIZON LEGACY™ 5.5脊柱系统(美国田纳西州孟菲斯市美敦力索法玛丹尼克公司)进行短节段固定的临床和放射学结果进行了比较。
从2015年3月至2016年1月,40例符合纳入标准的不稳定创伤性胸腰椎骨折患者接受了USS系统或CDH Legacy系统治疗。评估了骨折椎体的节段后凸角(SKA)、椎体前缘高度(ABH)以及美国脊髓损伤协会损伤分级(AIS)。通过X线平片确认放射学融合情况,必要时结合计算机断层扫描(CT)。
Schanz系统的平均即刻后凸角矫正为16.6°,Legacy系统为6.4°;Schanz系统的平均即刻椎体前缘高度矫正为0.92 cm,Legacy系统为0.51 cm。我们的研究表明,Schanz系统和Legacy系统在术后即刻、6个月和1年随访时的节段后凸和高度矫正方面存在显著统计学差异(p值<0.005)。疼痛减轻程度和神经功能改善不受螺钉系统的影响。
与Legacy系统相比,在胸腰椎骨折中使用USS进行短节段固定可实现近乎解剖复位。然而,在减轻疼痛和神经功能结果方面并无优势。