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| 篇名 |
Intra Pedicular Screw Fixation for Thoracolumbar Burst Fracture: Six-Year Experience |
| 作者 |
Jiao-Chiao Yang, Chien-Pang Lin, Jun-Yeen Chan, Yuan-Kai Liu, Shao-Hwa Ko,Chih-Ju Chang, Kun-Chuan Chang, Kan-Nan Liu, Jing-Shan Huang |
| 卷期/出版年月 |
37卷4期 (2004/8) |
| 頁次 |
149-154 |
| 摘要 |
Objective: Pedicle screw fixation from posterior approach is one of the treatment options for thoracolumbar burst fracture. Traditionally, the pedicle screws are fixed above and below the fracture level, sparing the fracture level. The authors introduce a new technique of pedicle screw fixation involving the fracture level. This report presents our preliminary experience of pedicle screw fixation involving the fracture level in the treatment of thoracolumbar fracture and discusses the advantages.
Materials and Methods: We reviewed records of patients treated from 1995 to
2003 and found a total of 16 patients with a diagnosis of thoracolumbar burst
fracture. We measured the preoperative and postoperative Cobb angle and its difference. Fracture sites ranged from T12 to L5. In the patient with spinal instability, surgery was undertaken in order to achieve stabilization and laminectomy was performed for decompression of nerve root. Instrumentation included the transpedicle screw to secure the rod and crosslink bar to prevent rotation injury. Transpedicle screw fixation was used for stabilization. All our patients received laminectomy for decompression at the fracture level.
Results: The mean age in patients with fixation involving the fracture level was
54.4±16.2. The mean follow-up period was 26.19±10.96 months (ranged from 13
to 50 months). Progression of kyphosis was considered if the difference between
preoperative and postoperative kyphotic angle became positive. In patients
fusion with the fracture level, the preoperative kyphotic angle was 21.25±9.92
degrees (ranged from 9 to 43 degrees); and the postoperative kyphotic angle was
11.81 10.51 degrees (ranged from 0 to 33 degrees). The corrected kyphotic angle
was -9.44±4.44 degrees (ranged from 4 to 18 degrees). No kyphosis progression
was noted in these 16 patients. There was no instrument failure found in our
patients.
Conclusions: Our clinical experience reveals that pedicle screw instrumentation
is a very effective procedure in the treatment of fractures of the thoracic and
lumbar spine, with a high percentage of fusions and a low percentage of hardware
failures. We also find that pedicle screw fixation involving the fracture level can result in nearly complete reduction of the kyphotic deformity and less progression of kyphosis. |
| 關鍵詞 |
thoracic spine, lumbar spine, burst fracture |
| 分類 |
Original Articles |
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