Posterior reduction and interbody fusion for the treatment of thoracolumbar fractures and dislocations / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To explore efficacy of posterior reduction and interbody fusion in treating thoracolumbar fractures and dislocations.</p><p><b>METHODS</b>From August 2004 to May 2009, 24 patients (18 males and 6 females with an average of 38.2 years, ranged 24 to 56 years old) were treated. Among them, 14 cases were by traffic accident,6 cases were falling down, 2 cases were heavy hit, 2 cases were transverse crush. According to AO classification, 12 cases were type B1, 5 cases B2, 2 cases B3,3 cases C1, 2 cases C2. One cases in T(10,11), 2 cases in T(11,12), 5 cases in T12L1, 8 cases in L(1,2), 2 cases in L(2,3), 4 cases in L(3,4), 2 cases in L4/5. Acoording to Frankle classification,5 cases in grade A, 9 cases in grade B, 8 cases in grade C and 2 cases in grade D. The reduction, graft healing and recovery of nervous function were followed up.</p><p><b>RESULTS</b>All patients were followed up from 8 to 33 months with an average of 16 months. The operation time was for 3.0 to 5.8 hours, meaned 3.7 h, and mean blood loss was 860 ml (ranged, 500 to 1800 ml). Cobb angle improved from preoperative (32.6 +/- 3.7) degrees to postoperative (13.7 +/- 2.4) degrees. The anterior high of fractured vertebrae increased from preoperative (41.0 +/- 11.6)% to postoperative (87.6 +/- 2.3)% .Three cases of 5 cases with Frankle A were not recovery, 1 case changed to grade B, 1 case changed to grade C; Five cases of 9 cases with Frankle B were changed to grade C, 3 cases to grade D, 1 case changed to grade E; Five cases of 8 cases with Frankle C were changed to Grade D, 3 cases to Grade E; Two cases with Frankle D were recoved to normal. Planting bone surface got bone fusion, and no internal fixation lossen, dislocation occurred.</p><p><b>CONCLUSION</b>Posterior reduction and rigid interbody fusion for the treatment of thoracolumbar fractures and dislocations can receive satisfactory fusion based on recovering normal spinal sequence</p>