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Percutaneous kyphoplasty and pedicle screw fixation for the management of thoraco-lumbar burst fractures

机译:经皮椎体后凸成形术和椎弓根螺钉内固定治疗胸腰椎爆裂性骨折

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摘要

The study design includes prospective evaluation of percutaneous osteosynthesis associated with cement kyphoplasty on 18 patients. The objective of the study is to assess the efficacy of a percutaneous method of treating burst vertebral fractures in patients without neurological deficits. Even if burst fractures are frequent, no therapeutic agreement is available at the moment. We report in this study the results at 2 years with a percutaneous approach for the treatment of burst fractures. 18 patients were included in this study. All the patients had burst vertebral fractures classified type A3 on the Magerl scale, between levels T9 and L2. The patients’ mean age was 53 years (range 22–78 years) and the neurological examination was normal. A percutaneous approach was systematically used and a kyphoplasty was performed via the transpedicular pathway associated with percutaneous short-segment pedicle screw osteosynthesis. The patients’ follow-up included CT scan analysis, measurement of vertebral height recovery and local kyphosis, and clinical pain assessments. With this surgical approach, the mean vertebral height was improved by 25% and a mean improvement of 11.28° in the local kyphotic angle was obtained. 3 months after the operation, none of the patients were taking class II analgesics. The mean duration of their hospital stay was 4.5 days (range 3–7 days) and the mean follow-up period was 26 months (range 17–30 months). No significant changes in the results obtained were observed at the end of the follow-up period. Minimally invasive methods of treating burst vertebral fractures can be performed via the percutaneous pathway. This approach gives similar vertebral height recovery and kyphosis correction rates to those obtained with open surgery. It provides a short hospital stay, however, and might therefore constitute a useful alternative to open surgical methods.
机译:该研究设计包括对18例患者进行的与水泥后凸成形术相关的经皮骨合成的前瞻性评估。这项研究的目的是评估经皮方法治疗无神经功能缺损的椎体爆裂性骨折的疗效。即使经常发生爆裂性骨折,目前尚无治疗协议。我们在这项研究中报告了2年经皮方法治疗爆裂性骨折的结果。本研究包括18例患者。所有患者均在Magerl等级上处于T9和L2级之间,属于A3型爆裂性脊椎骨折。患者的平均年龄为53岁(22-78岁),神经系统检查正常。系统地采用经皮方法,并通过与经皮短节段椎弓根螺钉骨合成相关的经椎弓根途径进行后凸成形术。患者的随访包括CT扫描分析,椎体高度恢复和局部后凸畸形的测量以及临床疼痛评估。通过这种手术方法,平均椎骨高度提高了25%,局部后凸角平均提高了11.28°。术后3个月,所有患者均未服用II类镇痛药。他们的平均住院时间为4.5天(3-7天),平均随访时间为26个月(17-30月)。在随访期末未观察到获得的结果有明显变化。可以通过经皮途径进行微创治疗椎骨爆裂性骨折的方法。这种方法可提供与开放手术相似的椎体高度恢复和后凸矫正率。但是,它提供了短暂的住院时间,因此可能是开放式手术方法的一种有用替代方法。

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