Der Unfallchirurg · 2003
[Thoracolumbar spine fractures after conservative and surgical treatment. Dependence of correction loss on fracture level].
Сравнительное исследованиеАннотация на английскомСтатьяНазвание и аннотация: Перевод в очереди
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Katscher S, Verheyden P, Gonschorek O, Glasmacher S, Josten C
Аннотация
QUESTION: This retrospective study presents results after conservative and operative treatment of thoracolumbar fractures as function of its localization.
METHODOLOGY: In 2 years 70 patients with A1/A2 fracture were conservatively treated, 38 patients with A3/B/C injury were treated by internal fixtor. For evaluation 3 vertebral sections(Th5-10,Th11-L2,L3-5)were defined. Follow-up took place 1 year after implant removal or end of conservative treatment.
RESULTS: The correction-loss was highest in thoracic, lowest in lumbar region. After conservative therapy,correction-loss was located to 3/4 in vertebra itself, after operative treatment especially in adjacent disc spaces. There was no general correlation to complaints.
CONCLUSION: In consequence of these results A1/A2-fractures in the upper thoracic spine (<Th10) with kyphosis >15 degrees will be stabilized anteriorly, in other regions functional treated. A3-fractures of thoracic spine and thoracolumbar junction will be operated from anterior, in lower lumbar spine (>L3) from dorsal. B- and C-injuries should be instrumented with a combined dorsoventral procedure.
METHODOLOGY: In 2 years 70 patients with A1/A2 fracture were conservatively treated, 38 patients with A3/B/C injury were treated by internal fixtor. For evaluation 3 vertebral sections(Th5-10,Th11-L2,L3-5)were defined. Follow-up took place 1 year after implant removal or end of conservative treatment.
RESULTS: The correction-loss was highest in thoracic, lowest in lumbar region. After conservative therapy,correction-loss was located to 3/4 in vertebra itself, after operative treatment especially in adjacent disc spaces. There was no general correlation to complaints.
CONCLUSION: In consequence of these results A1/A2-fractures in the upper thoracic spine (<Th10) with kyphosis >15 degrees will be stabilized anteriorly, in other regions functional treated. A3-fractures of thoracic spine and thoracolumbar junction will be operated from anterior, in lower lumbar spine (>L3) from dorsal. B- and C-injuries should be instrumented with a combined dorsoventral procedure.