Abstract
This article presents an evaluation of fluoroscopy for indirect, posterior reduction and fixation of thoracolumbar burst fractures. A prospective study of 25 patients with thoracolumbar burst fractures who underwent C-arm machine-guided posterior indirect reduction and short segment fixation without fusion is described. No laminotomies were performed. All patients had a mean follow-up of 30.4 months. At postoperative review, the average anterior and posterior vertebral heights were corrected from 57.9% to 99.0% and 89.0% to 99.5%, respectively. The Cobb angle was corrected from 18.4° to 0.17°. The canal compromise ratio was improved from 35.2% to 8.6%. In all 25 cases, neurological status was intact at last follow-up. Fluoroscopy guidance is an effective method to accomplish indirect reduction and fixation. Reduction was confirmed on lateral fluoroscopic views by looking for a “one-line sign,” which is the reconstitution of the posterior border of the vertebral body.
Résumé
L’objectif de cette étude est d’évaluer l’intérêt de l’amplificateur de brillance dans les réductions et les fixations de fractures dorso-lombaires. Matériel et méthode: une étude prospective de 25 patients présentant une fracture dorso-lombaire a été réalisée. Ces patients ont été opérés avec une fixation courte sans greffe et sans laminotomie. Résultats: tous les patients ont eu un suivi moyen de 30,4 mois. Après l’intervention chirurgicale, la hauteur vertébrale a été améliorée respectivement de 57,9%, 89,0% à 99,2% et 99,5%. L’angle de Cobb a été corrigé de 18,4 à 0,17. La largeur du canal vertébral est améliorée de 35,2 à 8,6%. Dans tous ces 25 cas, le statut neurologique des patients est normal au dernier suivi. En conclusion: l’utilisation d’un guidage par amplificateur de brillance est une méthode qui permet de réduire et de fixer de façon satisfaisante ce type de fracture. La réduction est confirmée par le signe « one-line » qui permet d’affirmer la bonne reconstitution du mur vertébral postérieur.
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Yang, Hl., Shi, Jh., Liu, J. et al. Fluoroscopically-guided indirect posterior reduction and fixation of thoracolumbar burst fractures without fusion. International Orthopaedics (SICOT) 33, 1329–1334 (2009). https://doi.org/10.1007/s00264-008-0626-8
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DOI: https://doi.org/10.1007/s00264-008-0626-8