Martin-Somoza Francisco José, Cantero Escribano Jose Miguel, Ramírez-Villaescusa Jose Vicente
Department of Orthopaedics Surgery and Traumatology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.
Preventive Medicine Unit, La Paz University Hospital, Madrid, Spain.
Int J Spine Surg. 2021 Feb;15(1):169-178. doi: 10.14444/8022. Epub 2021 Feb 18.
There is some controversy about which is the best approach, decompression technique and number of fixed levels in the surgical treatment for burst thoracolumbar fractures. Without a neurological injury, correcting thoracolumbar kyphosis and preventing mechanical failure should be the main concerns. The two-segment short fusion with screws at fractured vertebra by posterior approach was performed in 64 patients. Although a significant increase of postoperative kyphosis was observed, there were not clinical consequences, nor was there reintervention for mechanical failure.
Patients with unstable T11-L2 burst fractures and a two-level fusion including screws at the injured vertebra between 2000 and 2015 were included in the study. Demographic, clinical, and radiological variables were analyzed. Thoracolumbar, segmental, and vertebral kyphosis and anterior and posterior vertebral height were measured preoperatively, postoperatively, at one-year, and at the end of follow-up in the radiological study. The statistical analysis consisted of a descriptive analysis, and we used the test to compare the preoperative, postoperative, one-year, and end-of-follow-up radiographs to observe a thoracolumbar T10-L2 kyphosis increase. Significance level was established at < .05.
Fifty-four patients were included. A statistically significant increase of vertebral, segmental, and thoracolumbar kyphosis ( < .05) was observed during follow-up, without clinical consequences.
Two-segment fusion is an effective technique and allows initial deformity kyphotic correction after thoracolumbar burst fracture. The thoracolumbar kyphosis increased during the follow-up, without pain, disability, or mechanical failure.
2a.
在爆裂性胸腰椎骨折的手术治疗中，关于哪种方法是最佳方法、减压技术以及固定节段数量存在一些争议。在没有神经损伤的情况下，矫正胸腰椎后凸畸形和预防机械性失效应是主要关注点。对64例患者采用后路经骨折椎弓根螺钉两节段短节段融合术。虽然术后观察到后凸畸形有显著增加，但没有临床后果，也没有因机械性失效而再次干预。
本研究纳入2000年至2015年间患有不稳定T11-L2爆裂骨折且在损伤椎体处进行包括螺钉的两节段融合术的患者。分析人口统计学、临床和放射学变量。在放射学研究中，术前、术后、术后一年及随访结束时测量胸腰椎、节段和椎体的后凸畸形以及椎体的前后高度。统计分析包括描述性分析，我们使用检验比较术前、术后、术后一年及随访结束时的X线片，以观察胸腰椎T10-L2后凸畸形的增加情况。显著性水平设定为<.05。
纳入54例患者。随访期间观察到椎体、节段和胸腰椎后凸畸形有统计学意义的增加（<.05），但无临床后果。
两节段融合术是一种有效的技术，可在胸腰椎爆裂骨折后实现初始畸形后凸矫正。随访期间胸腰椎后凸畸形增加，但无疼痛、功能障碍或机械性失效。
2a。
