Early corset reclination of uncomplicated type А3 comminuted vertebral fractures in the thoracolumbar spine
https://doi.org/10.14531/ss2020.2.58-63
Abstract
Objective. To analyze the results of staged preoperative correction of uncomplicated comminuted fractures in the thoracolumbar spine.
Material and Methods. Retrospective study included data from 51 patients (33 men and 18 women) 17–35 years old with type A3 spinal injuries without urgent indications for surgery. In preparation for a possible operation, patients received a corset treatment with reclination pneumopelot for 2–3 days.
Results. The results were evaluated based on clinical, radiological and CT data. The result after reclination corset treatment was considered good if a restoration of the vertebral height was achieved with its residual deficit of less than 10 % or local wedge shape not more than 10°; satisfactory – with a residual decrease in vertebral body height from 10 to 30 % or in kyphotic deformity from 10 to 20°; and unsatisfactory – with a decrease in body height of more than 30 %, and in kyphotic deformity of more than 20°. With an average decrease in the height of the fractured vertebral body before surgery by 45 % and the local kyphosis magnitude of 27.0° ± 5.5°, the staged reclination provided complete correction of kyphosis in all cases and restoration of the height of the compressed vertebra to a residual deficit of less than 10 % in 78 % of cases. Neurological disorders were not noted.
Conclusion. In case of incomplete burst vertebral fractures not complicated by compression of the spinal cord, the method of early (in the first 7 days after the injury) corset treatment with staged fracture reclination by a pneumatic chamber can be effectively used to eliminate local kyphotic deformity and restore the height of fractured vertebra.
About the Authors
M. S. Narkulov
Samarkand Branch of the Republican Specialized Scientific and Practical Medical Center for Traumatology and Orthopedics
Uzbekistan
Uzbekistan
Maksudzhon Saidkasimovich Narkulov, physician of the spine department
28 Fotima Kasimovna str., Samarkand, 140100
S. N. Pardaev
Samarkand Branch of the Republican Specialized Scientific and Practical Medical Center for Traumatology and Orthopedics
Uzbekistan
Uzbekistan
Saidkasim Narkulovich Pardaev, Head of the Department
28 Fotima Kasimovna str., Samarkand, 140100
A. Zh. Karshiboev
Samarkand Branch of the Republican Specialized Scientific and Practical Medical Center for Traumatology and Orthopedics
Uzbekistan
Uzbekistan
Abduvakhob Zhambaevich Karshiboev, physician of the spine department
28 Fotima Kasimovna str., Samarkand, 140100
S. T. Meliboev
Samarkand Branch of the Republican Specialized Scientific and Practical Medical Center for Traumatology and Orthopedics
Uzbekistan
Uzbekistan
Salim Tashtanovich Meliboev, physician of the spine department
28 Fotima Kasimovna str., Samarkand, 140100
References
1. Sergeev KS, Durov MF, Kucheryuk VI, Gunter VE, Prokhorov NA, Paskov RV, Faryon AO, Oleneva TYu. Surgical Stabilization of Lower Thoracic and Lumbar Spine Fractures. Tyumen, 2005. In Russian.
2. Afaunov AA, Kuzmenko AV. Transpedicular fixation for thoracic and lumbar spine injury with posttraumatic spinal stenosis. Hir. Pozvonoc. 2011;(4):8–17. In Russian.
3. Ramikh EA. Injuries of the thoracic and lumbar spine.Hir. Pozvonoc. 2008;(2):94–114. In Russian. DOI: 10.14531/ss2008.2.94-114.
4. Mushkin AY, Ulrikh EV, Zuev IV. Normal and pathological biomechanics of the spine: major aspects of investigation. Hir. Pozvonoc. 2009;(4):53–61. In Russian. DOI: 10.14531/ss2009.4.53-61.
5. Rerikh VV, Borzykh KO. Post-traumatic spinal canal narrowing and its surgical remodeling for thoracic and lumbar burst fractures. Hir. Pozvonoc. 2011;(3):15–20. In Russian. DOI: 10.14531/ss2011.3.15-20.
6. Dulaev AK, Kutyanov DI, Manukovskiy VA, Parshin MS, Iskrovskiy SV, Zhelnov PV. Decision-making and technical choice in instrumental fixation for neurologically uncomplicated isolated burst fractures of the thoracic and lumbar vertebrae. Hir. Pozvonoc. 2019;16(2):7–17. In Russian. DOI: 10.14531/ss2019.2.7-17.
7. Magerl F, Aebi M, Gertzbein SD,Harms J, Nazarian S. A comprehensive classification of thoracic and lumbar injuries. Eur Spine J. 1994;3:184–201. DOI: 10.1007/BF02221591.
8. AOSpine thoracolumbar injury classification score. [Electronic resource]. URL:http:/www.aospine.org/Classification.
9. Lee JY.Thoracolumbar Injury Classification and Severity Scale (TLICS). [Electronic resource]. URL:https://www.mdcalc.comthoracolumbar-injury-classification-severityscale-tlics#creator-insights.
10. Berdugin KA, Chertkov AK, Shtadler DI, Berdugina OV. On unsatisfactory outcomesof transpedicular fixation. Hir. Pozvonoc. 2010;(4):19–24. In Russian. DOI: 10.14531/ss2010.4.19-24.
11. Davne SH, Myers DL.Complications of lumbar spinal fusion with transpedicular instrumentation. Spine. 1992;17(6 Suppl):S184–S189. DOI: 10.1097/00007632-199206001-00021.
12. Pardaev SN, Urinbaev PU. Device for the treatment of the spine: Patent RF 2033775, appl.07.09.1992, publ. 30.04.1995. In Russian.
13. Narkulov MS, Pardaev SN, Karshiboev AZh, Meliboev ST. The way to stabilize the spinal column for comminuted injury to the vertebral body in the thoracolumbar spine: Patent IAP 05898. Publ. 2019. In Russian.
14. McCormack T, Karaikovic E, Gaines RW.The load sharing classification of spine fractures. Spine. 1994;19:1741–1744. DOI: 10.1097/00007632-199408000-00014.
15. Avanzi O, Landim E, Meves R, Caffaro MF, de Albuquerque Araujo Luyten F, Faria AA.Thoracolumbar burst fracture: load sharing classification and posterior instrumentation failure. Rev Bras Ortop. 2015;45:236–240. DOI: 10.1016/S2255-4971(15)30363-3.
16. Verheyden AP, Holzl A, Ekkerlein H, Gercek E, Hauck S, Josten C, Kandziora F, Katscher S, Knop C, Lehmann W, Meffert R, Muller CW, Partenheimer A, Schinkel C, Schleicher P, Schnake KJ, Scholz M, Ulrich C.[Recommendations for the treatment of thoracolumbar and lumbar spine]. Unfallchirurg. 2011;114:9–16. In German. DOI: 10.1007/s00113-010-1934-1.
17. Zaretskov VV, Arsenievich VB, LikhachevSV, ShulgaAE, Titova JuI. Transpedicular fixation in comminuted fractures of bodies of thoracic and lumbar vertebrae. Saratov Journal of Medical Scientific Research. 2014;10 (3):441–446. In Russian.
18. Spiegl UJ, Fischer K, Schmidt J, Schnoor J, Delank S, Josten C, Schulte T, Heyde CE.The conservative treatment of traumatic thoracolumbar vertebral fractures. Dtsch Arztebl Int. 2018;115:697–704. DOI: 10.3238/arztebl.2018.0697
Review
For citations:
Narkulov M.S., Pardaev S.N., Karshiboev A.Zh., Meliboev S.T. Early corset reclination of uncomplicated type А3 comminuted vertebral fractures in the thoracolumbar spine. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2020;17(2):58-63. https://doi.org/10.14531/ss2020.2.58-63
Email this article 