Senior Researcher, Department of Innovative Projects for Neurosurgery and Vertebrology, Research Institute of Traumatology, Orthopedics and Neurosurgery Saratov State Medical University named after V.I. Razumovsky, 112 Bolshaya Kazachia St., Saratov, 410012, Russia.
Leading Researcher, Department of Innovative Projects for Neurosurgery and Vertebrology, Research Institute of Traumatology, Orthopedics and Neurosurgery; Professor, Traumatology and Orthopedics Department Saratov State Medical University named after V.I. Razumovsky, 112 Bolshaya Kazachia St., Saratov, 410012, Russia.
Sovrem Tekhnologii Med. 2021;13(5):31-39. doi: 10.17691/stm2021.13.5.04. Epub 2021 Oct 29.
The major management technique for lumbar burst fractures is transpedicular fixation (TPF). However, in relation to fractures of the L vertebra, this tactic often has no advantages over conservative treatment, and, therefore, it is expected to be supplemented with anterior decompression and reconstruction of the anterior column of the L vertebra. was to determine the most optimal treatment tactics for patients with isolated burst fractures of the fifth lumbar vertebra.
We performed a retrospective study of 58 patients treated for isolated burst L fractures. 12 patients refused to undergo surgery and received conservative outpatient treatment. TPF was performed in 27 patients; circular spondylosynthesis (TPF + anterior column support with a Mesh implant) - in 19 patients. The effectiveness of the treatment was assessed by clinical and introscopic research methods.
The radiological and functional outcomes of surgery with conventional TPF for isolated L burst fractures are generally comparable with the outcomes of conservative treatment. In 26% of the patients, the instability of the metal construction developed within 12 months after surgical intervention. Supplementing the transpedicular system with wedging anterior column support with a Mesh implant ensures preservation in 21%, and improves the parameters of the sagittal profile of the lumbosacral transition in 79% of cases.
确定治疗单纯第五腰椎爆裂骨折患者的最佳治疗策略。
我们对 58 例接受单纯 L 爆裂骨折治疗的患者进行了回顾性研究。12 例患者拒绝手术，接受保守门诊治疗。27 例行经皮椎弓根固定术（TPF）；19 例行环形脊柱融合术（TPF+Mesh 植入物前柱支撑）。通过临床和内窥镜研究方法评估治疗效果。
对于单纯 L 爆裂骨折，常规 TPF 手术的影像学和功能结果通常与保守治疗相当。在 26%的患者中，手术干预后 12 个月内金属结构的不稳定性发展。用 Mesh 植入物楔形前柱支撑补充经皮椎弓根系统可确保 21%的稳定性，并改善腰骶过渡矢状轮廓参数的 79%。
