Short-segment fixation of thoracolumbar burst fractures using pedicle fixation at the level of the fracture and in situ bending [Montagens curtas com instrumentação do nível fracturado e moldagem in situ no tratamento das fracturas tipo "burst" da coluna toracolombar]

• Type: Article in International Scientific Journal
• Date: 2010

Authors

Rodrigues, PC (Author) Other; Da Silva, MR (Author) Other; Vidinha, V (Author) Other; Neves, N (Author) FMUP; Matos, R (Author) Other; Pinto, R (Author) Other

Journal

Title: Coluna/ Columna

Vol. 9

Pages: 309-314

ISSN: 1808-1851

Publisher: Bevilaqua Publisher

Indexing

Scopus - 0 Citations

Other information

Authenticus ID: P-007-X9E

DOI: 10.1590/s1808-18512010000300011

Abstract (EN): Objective: Evaluation of clinical and radiographic results of the surgical treatment of thoracolumbar burst fractures with short posterior fixation, including the fractured vertebra and in situ bending. Methods: From November 2007 to January 2009, the authors reviewed patients with traumatic thoracolumbar burst fractures of a single vertebral level, with neurological or mechanical instability, and surgically treated with short posterior fixation including the fractured level and in situ bending. Clinical and radiographic evaluations were performed before, immediately after surgery, and at least at one year after surgery. Results: Twelve patients were included with an average age of 39.1 years. The average follow-up was 14.5 months. One patient was lost tofollowup at two months, and two were lost to clinical evaluation. Two patients presented with neurological deficits (Frankel B). We achieved an improvement of 14.2° of vertebral angulation, 11.2° of kyphotic deformity and a restoration of 27.2% of anterior vertebral height. At final follow up 2.7°, 3.8° and 6.1% were lost, respectively. We obtained an average Oswestry Disability Index (ODI) of 6.2 and a Visual Analogic Scale (VAS) of 1.6. The two patients with neurological deficits improved to a level D of Frankel. There was no instrumentation failure. Conclusion: Segmental fixation with instrumentation of the level of the fracture increases construct stiffness and gives additional vertebral body protection from anterior loads, achieving an additional point of fixation that allows a better kyphosis correction by in situ bending. Our clinical and radiographic results are good and long-lasting.

Language: Portuguese

Type (Professor's evaluation): Scientific