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[Effectiveness of injured vertebra fixation with inclined-long pedicle screws combined with interbody fusion for thoracolumbar fracture dislocation with disc injury].

作者信息

Han Yaozheng, Ma Jun, Huang Liangliang, Su Lintao, Lei Changyu, Jiang Jianfeng, Kang Hui

机构信息

Medical College, Wuhan University of Science and Technology, Wuhan Hubei, 430065, P. R. China.

Department of Orthopaedics, General Hospital of Central Theater Command of Chinese PLA, Wuhan Hubei, 430070, P. R. China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024 Apr 15;38(4):466-473. doi: 10.7507/1002-1892.202310042.


DOI:10.7507/1002-1892.202310042
PMID:38632068
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11024526/
Abstract

OBJECTIVE: To investigate the effectiveness of injured vertebra fixation with inclined-long pedicle screws combined with interbody fusion for thoracolumbar fracture dislocation with disc injury. METHODS: Between January 2017 and June 2022, 28 patients with thoracolumbar fracture dislocation with disc injury were underwent posterior depression, the injured vertebra fixation with inclined-long pedicle screws, and interbody fusion. There were 22 males and 6 females, with a mean age of 41.4 years (range, 22-58 years). The causes of injury included falling from height in 18 cases, traffic accident in 5 cases, and bruise in 5 cases. Fracture segment included 1 case of T , 7 cases of T , 9 cases of L , and 11 cases of L . According to the American Spinal Injury Association (ASIA) scale, the spinal injuries were graded as grade A in 4 cases, grade B in 2 cases, grade C in 11 cases, and grade D in 11 cases. Preoperative spinal canal encroachment ratio was 17.7%-75.3% (mean, 44.0%); the thoracolumbar injury classification and severity score (TLICS) ranged from 9 to 10 (mean, 9.9). Seventeen patients were associated with other injuries. The time from injury to operation ranged from 1 to 4 days (mean, 2.3 days). The perioperative indicators (operation time, intraoperative blood loss, and the occurrence of complications), clinical evaluation indicators [visual analogue scale (VAS) score and Oswestry Disability Index (ODI)], radiologic evaluation indicators [anterior vertebral height ratio (AVHR), kyphosis Cobb angle (KCA), intervertebral space height (ISH), vertebral wedge angle (VWA), displacement angle (DA), and percent fracture dislocation displacement (PFDD)], neurological function, and interbody fusion were recorded. RESULTS: The operation time was 110-159 minutes (mean, 130.2 minutes). The intraoperative blood loss was 200-510 mL (mean, 354.3 mL). All incisions healed by first intention, and no surgical complications such as wound infection or hematoma occurred. All patients were followed up 12-15 months (mean, 12.7 months). The chest and lumbar pain significantly relieved, VAS scores and ODI after operation were significantly lower than those before operation, and further decreased with the extension of postoperative time, with significant differences ( <0.05). At last follow-up, the ASIA classification of neurological function of the patients was grade A in 3 cases, grade B in 1 case, grade C in 1 case, grade D in 10 cases, and grade E in 13 cases, which was significantly different from preoperative one ( =-4.772, <0.001). Imaging review showed that AVHR, KCA, ISH, VWA, DA, and PFDD significantly improved at 1 week, 3 months and last follow-up ( <0.05). There was no significant difference between different time points after operation ( >0.05). At last follow-up, according to the modified Brantigan score, all patients achieved good intervertebral bone fusion, including 22 complete fusion and 6 good intervertebral fusion with a few clear lines. No complications such as internal fixation failure or kyphosis occurred during follow-up. CONCLUSION: The injured vertebra fixation with inclined-long pedicle screws combined with interbody fusion is an effective treatment for thoracolumbar fracture dislocation with disc injury, which can correct the fracture dislocation, release the nerve compression, restore the injured vertebral height, and reconstruct spinal stabilization.

摘要

相似文献

[1]
[Effectiveness of injured vertebra fixation with inclined-long pedicle screws combined with interbody fusion for thoracolumbar fracture dislocation with disc injury].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024-4-15

[2]
[Effectiveness of one-stage posterior eggshell osteotomy and long-segment pedicle screw fixation for ankylosing spondylitis kyphosis combined with acute thoracolumbar vertebral fracture].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023-12-15

[3]
[The effect of the sequence of intermediate instrumentation and distraction-reduction of the fractured vertebrae on the surgical treatment of mild to moderate thoracolumbar burst fractures].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022-5-15

[4]
[MINIMALLY INVASIVE PASSAGE IN POSTERIOR LAMINOTOMY DECOMPRESSION AND INTERVERTEBRAL BONE GRAFTING COMBINED WITH PERCUTANEOUS PEDICLE SCREW FIXATION FOR TREATMENT OF Denis TYPE B THORACOLUMBAR BURST FRACTURES].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016-8-8

[5]
[Effectiveness of sagittal top compression reduction technique in treatment of thoracolumbar vertebral fractures].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023-10-15

[6]
[To fix the unstable region of sagittal injured unit symmetrically with pedicle screws combined with bone graft fusion for treating thoracolumbar fractures].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018-7-15

[7]
[Treatment of unstable fresh thoracolumbar burst fracture by over-bending rod reduction and fixation technique via posterior approach].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021-4-15

[8]
[Posterior short-segment fixation including the fractured vertebra for severe unstable thoracolumbar fractures].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018-1-15

[9]
[Three-dimensional printed drill guide template assisting percutaneous pedicle screw fixation for multiple-level thoracolumbar fractures].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2021-6-15

[10]
[A comparative study on treatment of thoracolumbar fracture with injured vertebra pedicle instrumentation and cross segment pedicle instrumentation].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2014-2

本文引用的文献

[1]
Correction loss following short-segment posterior fixation for traumatic thoracolumbar burst fractures related to endplate and intervertebral disc destruction.

BMC Musculoskelet Disord. 2023-3-8

[2]
A cost-utility analysis between decompression only and fusion surgery for elderly patients with lumbar spinal stenosis and sagittal imbalance.

Sci Rep. 2022-11-27

[3]
The Radiological Complications of Short-Segment Pedicle Screw Fixation Combined with Transforaminal Interbody Fusion in the Treatment of Unstable Thoracolumbar Burst Fracture: A Retrospective Case Series Study in Vietnam.

Orthop Res Rev. 2022-3-29

[4]
Morcellized local grafts as cost effective option for interbody fusion in thoracolumbar fracture dislocation: Seven years follow up of 53 patients.

J Orthop. 2022-3-18

[5]
Surgical Techniques for Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations.

Neurospine. 2021-12

[6]
Outcomes of Thoracolumbar Fracture-Dislocation Managed by Short-Segment and Long-Segment Posterior Fixation: A Single-Center Retrospective Study.

Int J Spine Surg. 2021-2

[7]
Thoracolumbar fracture dislocation (AO type C injury): A systematic review of surgical reduction techniques.

J Clin Orthop Trauma. 2020

[8]
Effect of the short-segment internal fixation with intermediate inclined-angle polyaxial screw at the fractured vertebra on the treatment of Denis type B thoracolumbar fracture.

J Orthop Surg Res. 2020-5-24

[9]
Outcomes of Including Fracture Level in Short- Segment Fixation for Th oracolumbar Fracture Dislocation.

Asian Spine J. 2019-2

[10]
Treatment of Lumbar Split Fracture-Dislocation With Short-Segment or Long-Segment Posterior Fixation and Anterior Fusion.

Clin Spine Surg. 2017-4

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