Treatment of Vertebral Pseudarthrosis after Compression Fracture.
10.12671/jkfs.2004.17.2.191
- Author:
Young Do KOH
1
;
Hoon JEONG
Author Information
1. Department of Orthopaedic Surgery, College of Medicine, Ewha Woman's University, Seoul, Korea. ydkoh@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
Spine;
vertebral pseudarthrosis;
Avascular necrosis of vertebral body;
Posterior fusion
- MeSH:
Back Pain;
Follow-Up Studies;
Fractures, Compression*;
Humans;
Magnetic Resonance Imaging;
Necrosis;
Pseudarthrosis*;
Spine;
Vacuum;
Visual Analog Scale
- From:Journal of the Korean Fracture Society
2004;17(2):191-196
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To clarity the features of vertebral pseudarthrosis and to evaluate the efficacy of posterior instrumentation and fusion in treatment of it. MATERIALS AND METHODS: Twelve patients with severe back pain and intravertebral pseudarthrosis showing vacuum phenomenon were treated by in situ posterior instrumentation and fusion. The kyphotic angle of pre- and post-treatment was measured on a lateral radiograph. MRI was performed in all patients. The intravertebral instability was confirmed from the dynamic lateral view. The pain level was assessed both before and after the treatment using a visual analog scale. The kyphotic angle at last follow up was also checked. RESULTS: In eight cases, intravertebral instability was shown at the clefts in flexion-extension radiographs. MRI showed that the cleft was low intensity on the T1- weighted image and high intensity on the T2-weighted image. The pre-and postoperative mean kyphotic angles were -18.3degrees and -8.5degrees respectively. The preoperative average pain score was nine and postoperative four. At last follow up the mean kyphotic angle was -16.6degrees CONCLUSION: The cleft with intravertebral vacuum phenomenon and magnetic resonance findings of low intensity on the T1-weighted scans and high intensity on the T2-weighted scans suggests that the cleft is a pseudarthrosis associated with avascular necrosis of the vertebral body. The posterior instrumentation and fusion provides satisfactory pain relief in patient with vertebral pseudarthsosis.
