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Journal of Korean Neurosurgical Society > Volume 30(11); 2001 > Article
Journal of Korean Neurosurgical Society 2001;30(11): 1271-1277.
Short Segment Pedicle Screw Fixation with Augmented Intra-Operative Vertebroplasty in Unstable Thoraco-Lumbar Fracture: Preliminary Report.
Young Woo Kim, Sung Han Oh, Do Heum Yoon, Dong Kyu Chin, Yong Eun Cho, Young Soo Kim
Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea.
OBJECTIVES: Since vertebroplasty has been introduced, we performed short segment pedicle screw fixation with augmented intra-operative vertebroplasty in patients with unstable thoraco-lumbar fracture. Our intentions are to demonstrate the efficacy and indication of this new technique compare to conventional methods. MATERIAL AND
The surgery comprised of pedicle screw fixations on one level above and below the fracture site, and the fractured level itself, if pedicle is intact, and intra-operative vertebroplasty under the fluoroscopic guide with in-situ postero-lateral bone graft. Also, in cases of bone apposition, we removed those with small impactor through a transfascetal route. During the last 2 years, we performed in seven(7) unstable thoraco-lumbar fracture patients who consisted of two different characteristics, those four(4) with primary or secondary osteoporosis and three(3) of young and very healthy. All patients were followed clinically by A.S.I.A. score and radiography.
Mean follow up period was 14 months. We observed well decompressed state via transfascetal route in cases of bone fragments apposition and no hardware pullout in osteoporotic cases, no poly-methyl-methacrylate (PMMA) leakage through the fracture sites into the spinal canal, and no kyphotic deformities in both cases during follow-up periods. All patients demonstrated solid bony fusion except one following osteoporotic compression fracture on other sites. CONCLUSIONS: In the management of unstable thoraco-lumbar fracture, we believe that this short segment pedicle screw fixation with augmented intra-operative vertebroplasty reduce the total length or levels of pedicle screw fixation without post-operative kyphotic deformity.
Key Words: Unstable thoraco-lumbar fracture; Short segment fixation; Vertebroplasty
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