ABSTRACT
OBJECTIVE@#To analyze the correction loss after posterior segmental fixation for lumbar spine fractures and explore the related image factors.@*METHODS@#Posterior short-segment fixation was received in 48 patients with L@*RESULTS@#The average follow-up was 12 to 18 (16.13±5.39) months. LKA, AVH and VWA at 1 week postoperative and those at the final follow up, were significantly improved compared with those preoperative (@*CONCLUSION@#The angle of adjacent intervertebral discs and anterior height of injured vertebrae were lost statistically after posterior short-segment pedicle screw treatment for lumbar fractures, and multivariate analysis showed that all of them were correlated with load-sharing score.
Subject(s)
Female , Humans , Male , Fracture Fixation, Internal , Lumbar Vertebrae/surgery , Pedicle Screws , Spinal Fractures/surgery , Thoracic Vertebrae/surgery , Treatment OutcomeABSTRACT
Objective To discuss indications,operation method and clinical outcome of posterior short-segment pedicle fixation at the injured level for treatment of thoracolumbar spine fractures.Methods A total of 38 patients with thoracolumbar spine fractures were equally randomized to Group A(treated with classic short-segment pedicle screw fixation)and Group B(treated with short-segment pedicle screw fixation at the injured level)based on fixation methods(19 patients per group).Preoperative and postoperative JOA score,segmental lordosis(Cobb' s angle),R value(anterior fractured vertebral body height/mean normal vertebral body height×100%),VSA score and internal fixation condition were assessed and compared clinically.Results All patients were followed up for 6-37 months(mean 20.5 months),which showed no statistical difference upon Frankel scores of two operation modes,while the segmental lordosis,VAS score and R value in Group B were than those in Group A.There occurred nuts loosening in one patient and screw bending in one in Group A.There was no implant breakage,loosening or emersion in Group B.Conclusion Posterior short-segmental fixation at the injured level is an adequate and effective procedure for compression fractures and mild to moderate burst fractures of the thoracolumbar spine.
ABSTRACT
STUDY DESIGN: This is a retrospective study. OBJECTIVES: We wanted to evaluate the outcomes of selective thoracic fusion with segmental pedicle screw fixation for treating thoracic idiopathic scoliosis with a minimum 5-year follow-up. SUMMARY OF THE LITERATURE REVIEW: Segmental pedicle screw fixation has been proven to achieve true segmental control and greater correction of scoliosis in both the coronal and sagittal planes. However, there is no long-term study of selective thoracic fusion with segmental pedicle screw fixation for treating thoracic idiopathic scoliosis. MATERIALS AND METHODS: We analyzed 203 thoracic idiopathic scoliosis patients (236 thoracic curves) who underwent selective thoracic fusion with segmental pedicle screw fixation. The mean patient age at the time of operation was 13.8 years (range: 8.9~18 years). RESULTS: The preoperative thoracic curve of 51+/-12 degrees was corrected to 16+/-7 degrees(69% correction with 3% loss of correction) at the most recent follow-up. The non-instrumented lumbar curve of 30+/-10 degrees was corrected to 10+/-8 degrees(66% correction with 5% loss of correction) at the most recent follow-up. The preoperative thoracic kyphosis of 18+/-11 degrees and the lumbar lordosis of 43+/-10 degrees were improved to 23+/-8 degrees and 46+/-9 degrees, respectively, at the most recent follow-up. There was no junctional kyphosis at the most recent follow-up. Coronal decompensation at the most recent follow-up occurred in 10 patients. Postoperative adding-on occurred in 17 patients who were fused two levels short of the neutral vertebra. Of the 2867 thoracic pedicle screws inserted at the thoracic level, 43 screws were found to be malpositioned (1.5%), but they did not cause neurologic complications or adversely affect the long-term results. CONCLUSIONS: Selective thoracic fusion with segmental pedicle screw fixation for treating thoracic idiopathic scoliosis had satisfactory radiographic and clinical outcomes after surgery, and the outcomes were well-maintained for a minimum of 5 years follow-up. It is a safe and effective method for preserving segments of lumbar motion as well as for the restoration and maintenance of both the coronal and sagittal alignments.