Abstract:
BACKGROUND:Controversy continues regarding the best treatment for compression and burst fractures. The axial distraction reduction utilizing the technique employing the long straight rod or curved short rod without derotation to reduce fracture are practised together with short segment posterolateral fusion (PLF). Effects of the early postoperative mobilization without posterolateral fusion on reduction maintenance and fracture consolidation were not evaluated so far. The present prospective study is designed to assess the effectiveness of i) reduction and restoration of sagittal alignment, ii) no posterolateral fusion on the reduced, fractured vertebral body and injured disc, iii) fracture consolidation and iv) the fate of the unfused cephalad and caudal injured motion segments of the fractured vertebra. MATERIALS AND METHODS:The study includes 15 Denis burst and two Denis type D compression fractures between T(12) and L(3). The lordotic distraction technique was used for ligamentotaxis utilizing the contoured short rods and pedicle screw fixator. Three vertebrae including the fractured one were fixed. The patients after surgery were braced for ten weeks with activity restriction for 2-4 weeks. The patients were evaluated for change in vertebral body height, sagittal curve, reduction of retropulsion, improvement in neural deficit. The unfused motion segments, residual postoperative pain and bone and metal failure were also evaluated. RESULTS:The preoperative and postreduction percentile vertebral heights at, zero (immediate postoperative), at three, six and 12 months followup were 62.4, 94.8, 94.6, 94.5 and 94.5%, respectively. The percentages of the intracanal fragment retropulsion at preoperative, and postoperative at zero, 3, 6 and 12 months followup were 59.0, 36.2,, 36.0, 32.3, and 13.6% respectively. The preoperative and postreduction percentile loss of the canal dimension and at zero, three, six and 12 months were 52.1, 45.0, 44.0, 41.0 and 29% respectively suggesting that the under-reduced fragment was being resorbed gradually by a remodeling process. The mean initial kyphosis of 33° became mean 2° immediately after reduction and mean 3° at the final followup. The fractured vertebral bodies consolidated in an average period of ten weeks (range 8-14 weeks). The restored disc heights were relatively well maintained throughout the observation period. All paraparetic patients recovered neurologically. There were no postoperative complications. CONCLUSION:Instrument-aided ligamentotaxis for compression and burst fractures utilizing the short contoured rod derotation technique and the instrumented stabilization of the fractured spine are found to be effective procedures which contribute to the fractured vertebral body consolidation without recollapse and maintain the motion segment function.
journal_name
Indian J Orthopjournal_title
Indian journal of orthopaedicsauthors
Moon MS,Choi WT,Sun DH,Chae JW,Ryu JS,Chang H,Lin JFdoi
10.4103/0019-5413.36999subject
Has Abstractpub_date
2007-10-01 00:00:00pages
346-53issue
4eissn
0019-5413issn
1998-3727journal_volume
41pub_type
杂志文章abstract:INTRODUCTION:The 3 bony point relationship of the elbow is an important surface evaluation done in all cases of elbow pathology; its importance is highlighted by the fact that significant emphasis is also laid on this during the specialty board examinations. Confusion about the exact inter relationship exists even in t...
journal_title:Indian journal of orthopaedics
pub_type: 杂志文章
doi:10.4103/0019-5413.139835
更新日期:2014-09-01 00:00:00
abstract::[This corrects the article on p. 347 in vol. 45, PMID: 21772629.]. ...
journal_title:Indian journal of orthopaedics
pub_type: 杂志文章
doi:
更新日期:2011-11-01 00:00:00
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journal_title:Indian journal of orthopaedics
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更新日期:2015-07-01 00:00:00
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更新日期:2014-05-01 00:00:00
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更新日期:2016-07-01 00:00:00
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journal_title:Indian journal of orthopaedics
pub_type: 杂志文章,评审
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journal_title:Indian journal of orthopaedics
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journal_title:Indian journal of orthopaedics
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doi:10.4103/0019-5413.87131
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journal_title:Indian journal of orthopaedics
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更新日期:2007-01-01 00:00:00
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journal_title:Indian journal of orthopaedics
pub_type: 杂志文章
doi:10.4103/0019-5413.97260
更新日期:2012-07-01 00:00:00
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journal_title:Indian journal of orthopaedics
pub_type: 杂志文章
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journal_title:Indian journal of orthopaedics
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journal_title:Indian journal of orthopaedics
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doi:10.4103/0019-5413.37007
更新日期:2007-10-01 00:00:00
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journal_title:Indian journal of orthopaedics
pub_type: 杂志文章
doi:10.4103/0019-5413.65158
更新日期:2010-07-01 00:00:00
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journal_title:Indian journal of orthopaedics
pub_type: 杂志文章
doi:10.4103/0019-5413.43400
更新日期:2008-10-01 00:00:00
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journal_title:Indian journal of orthopaedics
pub_type: 杂志文章
doi:10.4103/0019-5413.96390
更新日期:2012-05-01 00:00:00
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journal_title:Indian journal of orthopaedics
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更新日期:2012-07-01 00:00:00
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pub_type: 已发布勘误
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更新日期:2009-01-01 00:00:00
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