Résumé
OBJECTIVE: It has been known that the posterior pedicle screw fixation provides good mechanical stability in unstable burst fracture. But, posterior fixation without anterior column support may not be adequate to withstand the axial load and to keep the corrected kyphotic angle. We present results of one stage fixation by posterior approach in unstable burst fracture. METHODS: Nine patients with unstable burst fracture were treated with posterior fixation and intervertebral fusion using titanium mesh cages and pedicle screws. The canal decompression was achieved by laminectomy and partial pediculectomy through the posterior approach. In all cases, the short segment fixation and anterior column support with cage were performed on the one stage operation. RESULTS: Of nine patients, seven was satisfied with excellent clinical results except two cases of the Frankel's grade A. All patients had good stabilization of spinal column and enough decompression without any neurological complications. It was possible to maintain the corrected kyphotic angle with the circumferential stabilization(three column fixation). CONCLUSION: The anterior and posterior column fixation through the posterior approach provides good stability and decompression in the patients with unstable burst fracture.
Sujets)
Humains , Décompression , Laminectomie , Rachis , TitaneRésumé
The authors report two cases of giant cell tumor in the lumbar spine. Giant cell tumor in the spine is histologically malignant tumor and recurrence is often even after the surgical excision. Two case of spinal giant cell tumor received total excision of the tumor with wide fixation. We have been following up and observing the two cases of patients with surgically treated giant cell tumor. From the two cases of experience, we could not find any recurrence of the tumor after operation and got the good clinical result with anterior and posterior fixation.