The treatment of traumatic thoracolumbar dislocation with interbody compression fusion using pedicle screw system
- VernacularTitle:椎间加压融合治疗胸腰椎骨折脱位
- Author:
Huan WANG
;
Xueyong LIU
;
Lei LI
- Publication Type:Journal Article
- Keywords:
Bone screws;
Lumbar vertebrae;
Thoracic vertebrae;
Fractures;
Dislocations
- From:
Chinese Journal of Orthopaedics
1998;0(12):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy of one-stage posterior procedure including reduction, segmental instrumentation, foraminal enlargement and interbody compressive fusion in treating traumatic thoracolumbar fracture and dislocation. Methods 17 patients, which were 11 males and 6 females with a mean age of 37.1 years (range, 23-56 years) were recruited. The injury mechanism consisted of motor vehicle accident, falling from the height and horizontal compression crash. The preoperation neurological function were complete paraplegia in 4 cases, and incomplete paraplegia in 13 cases. Laminectomy and bilateral partial facetectomies were performed in injuried levels to free the nerve roots, followed by intervertebral foraminal enlargement and distraction through inserted pedicle screws. Intervertebral disc including upper and lower endplate were removed with rongeur, and morselized cancellous bone were fulfilled into cavity. Reduction and interbody compressive fusion were achieved through compression on the segmental pedicle screw system to make contact the posterior wall of adjacent vertebrae. Results No intraoperative and postoperative complications were observed. All patients except one underwent successful follow-up for an average of 25.6 months, ranging from 19 to 37 months. The neurological function of the patients were restored partially or complete during follow-up. The thoracolumbar spine were stable during physical examination, and all patients were satisfied with surgery. Radiographic evaluation showed close conjunction of adjacent posterior edges of vertebral body in 12 cases, and all cases demonstrated solid bony fusion without loss of reduction. No implant failure or neurological complication were found during follow-up. Conclusion Interbody compressive fusion by pedicle screws with foraminal enlargement procedure is a reliable and effective method in the management of thoracolumbar fracture and dislocation, which can achieve early stabilization and interbody bony fusion.
