SURGICAL TREATMENT OF BURST FRACTURES OF THE THORACIC AND LUMBAR SPINE ACCOMPANIED WITH SPINAL CANAL NARROWING
https://doi.org/10.14531/ss2007.2.8-15
Abstract
Objective. To substantiate the possibility of combination of indirect reposition of vertebral body fragments displaced into the spinal canal and posterior spinal fusion, and to identify factors resulting in successful reduction.
Material and Methods. Total of 78 patients with acute fractures of thoracic and lumbar vertebrae accompanied with critical or close to it intracanal retropulsion of fragments were operated on. Two groups of patients were formed. Group I included 38 patients with A3 type burst fractures who underwent anterior spinal fusion and reposition of fragments using suggested technique of spinal canal closed remodelling. Group II included 40 patients with burst fractures accompanied with critical displacement of fragments who underwent transpedicular fixation and ligamentotaxis by means of extension and distraction along the rods.
Results. A higher rate of intraoperation correction of kyphosis was achieved in Group I. However after two-stage intervention in Group II the long-term loss of correction (16.4 ± 3.2 %) was less as compared to that (28.5 ± 6.2 %) in Group I but here the correction was compensated due to initial hypercorrection. The mean reduction of displacement in Group I was 63.3 ± 27.9 % and in Group II – 35. 6 ± 29.1%.
Conclusion. Spinal canal remodelling combined with anterior spinal fusion is an effective and safe technique for burst fractures of thoracic and lumbar vertebrae allowing restoration of spinal canal size without anterior decompression.
About the Authors
Viktor Viktorovich Rerikh
Novоsibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
Konstantin Olegovich Borzykh
Novоsibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
Shukhrat Numonzhonovich Rakhmatillaev
Novоsibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
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Review
For citations:
Rerikh V.V., Borzykh K.O., Rakhmatillaev Sh.N. SURGICAL TREATMENT OF BURST FRACTURES OF THE THORACIC AND LUMBAR SPINE ACCOMPANIED WITH SPINAL CANAL NARROWING. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2007;(2):008-015. (In Russ.) https://doi.org/10.14531/ss2007.2.8-15
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