Posterior Fusion for Thoracolumbar Fractures with a Neurologic Deficit: A Comparison of Fusion and Additional Decompression
Journal of Korean Society of Spine Surgery
; : 7-14, 2016.
Article
em Ko
| WPRIM
| ID: wpr-14464
Biblioteca responsável:
WPRO
ABSTRACT
STUDY DESIGN: A retrospective study. OBJECTIVES: To understand the necessity of additional posterior decompression when treating a patient with posterior fusion for thoracolumbar fractures with a neurologic deficit. SUMMARY OF LITERATURE REVIEW: Additional posterior decompression is still controversial when treating a patient with posterior fusion for thoracolumbar fractures with neurologic a deficit. MATERIALS AND METHODS: 40 patients who underwent posterior fusion surgery for thoracolumbar fractures with a neurologic deficit were evaluated. The posterior fusion group (Group 1) included 23 patients (M:F=14:9), and the posterior decompression with laminectomy and posterolateral fusion group (Group 2) included 17 patients (M:F=9:8). According to the Frankel grade, the most common neurologic deficit was grade D in both groups. Unstable burst fractures were the most commonly observed fractures in both groups according to the McAfee classification. A radiographic evaluation was carried out along with a comparison of the spinal canal encroachment and the kyphotic angle. We evaluated neurologic improvement as the clinical criterion. RESULTS: The l-kyphotic angle at last follow-up was smaller than the preoperative kyphotic angle in both groups. The preoperative canal encroachment was 53.4% (Group 1) and 59.8% (Group 2). Further, neurologic improvement was observed in 19 cases (Group 1) and 14 cases (Group 2). There was no significant difference in the proportion of cases with neurologic improvement between the two groups (improvement in 19 cases in Group 1 and in 14 cases in Group 2) (p0.05). CONCLUSION: We concluded that additional posterior decompression in the case of thoracolumbar fractures with neurologic deficit is not required for neurologic improvement.
Palavras-chave
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Canal Medular
/
Estudos Retrospectivos
/
Seguimentos
/
Classificação
/
Descompressão
/
Laminectomia
/
Manifestações Neurológicas
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
Ko
Revista:
Journal of Korean Society of Spine Surgery
Ano de publicação:
2016
Tipo de documento:
Article