Abstract
Fifty patients with thoracolumbar fractures were treated operatively between July 2000 and December 2001. The average age of the patients was 33.6 years (range: 20–50 years), 36 were males and 14 were females and the follow-up averaged 59 months (range: 49–68 months). A fall from a height, usually a tree, was the most common cause of injury. Twenty six patients had unstable burst fractures and 13 had translational injury. There were 15 patients with complete neurological deficit, 17 had partial neurological lesions, while 18 had no neurological deficit. All patients were treated by posterior short segment fixation (Steffee VSP). The average pre-operative kyphotic angle was 21.48°, which improved to 12.86° in the immediate post-operative period. The loss of kyphosis averaged 3.46° (0–26°) at the final follow-up. The average pre-operative anterior vertebral body height was 44.7% (range: 36–90%), which improved to 72.0% (range: 55–97%) in the immediate post-operative period. The loss of body height averaged 3.0% (range: 1–15%) at the final follow-up. No neurological deterioration was seen, and in 24 cases a one grade or better improvement was observed. The mean pain score was 1.6, and the mean functional score was 2.8. We found that the application of posterior instrumentation resulted in a reasonable correction of the deformity with a significant reduction in recumbency-associated complications; there were, however, significant other complications.
Résumé
Cinquante patients présentant une fracture thoracolombaire ont été traités entre juillet 2000 et décembre 2001. L’âge moyen était de 33.6 ans (20 à 50). Il s’agissait de 36 hommes et 14 femmes. Le suivi moyen était de 59 mois (49 à 68). La chute d’une hauteur habituellement d’un arbre était la cause la plus connue. Vingt-six patients avaient une fracture instable et 13 un traumatisme avec translation. Quinze patients avaient un déficit neurologique complet, 17 un déficit neurologique partiel et 18 aucun déficit neurologique. Tous les patients ont été traités par une fixation postérieure (Steffee VSP). L’angulation sans cyphose préopératoire a été de 21.48° en moyenne, celle-ci s’est améliorée de 12.86° en postopératoire immédiat. La perte de cyphose a été de 3.46° (0–26) au suivi final. La hauteur vertébrale de 44.7% (36–90) s’est améliorée à 72% (55 à 97) en postopératoire immédiat. La perte de hauteur du corps vertébral a été de 3% (1–15) au suivi final. Aucune dégradation neurologique n’a été constatée. Une amélioration a été retrouvée dans 24 cas le score douleur moyen a été de 1.6 le score fonction de 2.8. Une instrumentation postérieure permet une correction raisonnable de la déformation avec une réduction significative des complications.
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Butt, M.F., Farooq, M., Mir, B. et al. Management of unstable thoracolumbar spinal injuries by posterior short segment spinal fixation. International Orthopaedics (SICOT) 31, 259–264 (2007). https://doi.org/10.1007/s00264-006-0161-4
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DOI: https://doi.org/10.1007/s00264-006-0161-4