Surgical Treatment in Delayed Posttraumatic Thoracolumbar Kyphosis
10.4055/jkoa.1995.30.6.1647
- Author:
Se Il SUK
;
Choon Ki LEE
;
Kang Sup YOON
;
Ji Ho LEE
;
Won Joong KIM
;
Sang Ho MOON
- Publication Type:Original Article
- Keywords:
Delayed posttraumatic Kyphosis;
Anterior-posterior fusion
- MeSH:
Back Pain;
Congenital Abnormalities;
Decompression;
Follow-Up Studies;
Humans;
Kyphosis;
Laminectomy;
Retrospective Studies;
Risk Factors
- From:The Journal of the Korean Orthopaedic Association
1995;30(6):1647-1655
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: This is a retrospective study analyzing the clinical results of various surgical methods for the treatment of delayed posttraumatic kyphosis. OBJECTIVES: The purposes of this study are to define the risk factors of delayed postraumatic kyphosis and to establish a rational therapeutic guideline for the treatment of established kyphosis. METHODS: Sixteen cases of surgically treated delayed posttraumatic kyphosis were analyzed. Their initial injuries were burst type in 10, flexion-distraction in 5 and uncertain in l. Initial treatments were conservative in 10 and surgical in 6. Treatments for established kyphosis were posterior fusion in 2, anterior fusion in 5, combined anterior-posterior fusion in 9. Anterior decompression was carried out in 5 treated with anterior fusion and in 4 treated with combined anterior-posterior fusion. RESULTS: Mean follow-up was 2.7 years. The mean preoperative kyphosis of 28.6。 was reduced to 18.5。 (35.3% correction) with most pronounced correction in the group with combined anterior and posterior stabilization(44.8% correction). Early loss of correction averaged 2.7。 (18.5%) with least loss in the combined anterior-posterior group. Neurological improvement was related to the duration of the symptoms(P < 0.05). Back pain was improved in all patients. CONCLUSIONS: Thoracolumbar fractures with initial three column injuries or those rendered unstable by laminectomy are highly susceptible to development of delayed posttraumatic kyphosis; Combined anterior and posterior fusion offered the most satisfactory result in correction and stabilization of the deformity; Neurologic improvement was more pronounced with shorter duration of the symptoms.
