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Journal of Korean Neurosurgical Society 2006;40(4): 249-255.
Dorsal Short-Segment Fixation for Unstable Thoracolumbar Junction Fractures.
Kwan Sik Kim, Sung Han Oh, Ji Soon Huh, Jae Sub Noh, Bong Sub Chung
Department of Neurosurgery, Bundang Jesaeng General Hospital, Seongnam, Korea. shoh1@dmc.or.kr
This study is to evaluate the efficacy of dorsal short-segment fixation in unstable thoracolumbar junction fractures.
The cases of 20 patients who underwent dorsal short-segment fixation were reviewed retrospectively. Clinical outcomes were analysed using Sonntag's pain level, work status, and neurological scale according to the modified Frankel classification. Radiological outcomes were analysed using Mumford's anterior body compression(%), canal compromise ratio, and Cobb's kyphotic angle.
At the latest clinical follow-up (average=14.6 months), there were 19 (95.0%) in group I and 1 patient (5.0%) in II in pain level35). The postoperative work status were 17 (85.0%) in group I, 2 patients (10.0%) in II, and 1 patient (5.0%) in V. Surgery brought to improve the neurologic status. In success group (19 cases, 95%), the average canal compromise ratio was reduced from 0.57 (+/-0.07) to 0.05 (+/-0.08) (P<0.05), the average anterior body compression (%) was reduced from 41% (+/-17) to 18% (+/-14) (P<0.05), and the average preoperative kyphotic angle was 20.0 degrees (+/-9.0), and corrected to 5.7 degrees (+/-7.1) postoperatively, and progressed to 7.8 degrees (+/-6.2) at the latest follow-up. There was a case of implantation failure in an elderly osteoporotic patient.
Although there are limitations in the patient number and follow-up period, the present study favors dorsal short-segment fixation for selective cases in unstable thoracolumbar junction fractures.
Key Words: Unstable thoracolumbar junction fracture; Articulectomy; Dorsal reduction; Dorsal short-segment fixation
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