POST-TRAUMATIC SPINAL CANAL NARROWING AND ITS SURGICAL REMODELINGFOR THORACIC AND LUMBAR BURST FRACTURES

Objective. To analyze variants of post-traumatic spinal canal narrowing in burst fractures accompanied by fragment displacement of critical values, and to determine the effectiveness of surgical remodeling of the spinal canal.

Material and Methods. Medical records of 136 patients with burst fractures of thoracic and lumbar vertebrae involving displacement of fragments into spinal canal on critical values were analyzed. Fragments were classified by their quantity, width, displacement type, and connection with the rest of vertebral body.

Results. Three types of fragments displaced into spinal canal were identified: Type I – a large free fragment occupying all interpedicular space in the cranial part of the spinal canal with linear and angular displacement; Type II – a large fragment impacted into the central and posterior parts of the vertebral body and occupying the whole interpedicular space with linear displacement; and Type III – several fragments connected with the central part of the vertebral body and occupying the space less than interpedicular one with linear displacement.

Conclusion. Type I fragments are most favorable for application of indirect reduction, while Types II and III fragments are less likely reduced by transpedicular fusion and ligamentotaxis than by anterior spinal canal remodeling. Accounting for a type of fragment displacement into the spinal canal is important in preoperative planning for burst fracture surgery.

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