Comparative study of different dorsal stabilization techniques in recent thoraco-lumbar spine fractures

Abstract

The authors initially outline the development of operative techniques to stabilize traumatic thoraco-lumbar spine fractures. Thereafter their own results in 125 patients, treated operatively between 1.1.1983 and 15.9.1988, are presented. The different techniques (Harrington-instrumentation, transpedicular plate stabilization, fixateur interne) are evaluated. In the clinical neurological examination 25% of the patients experienced an improvement by at least one point in the FRANKEL classification. Four patients suffered neurological deterioration. In the radiological follow-up the "Sintering" process, the kyphotic and scoliotic deformity of the spinal segment were measured. The fixateur interne had the best overall results (loss of reposition averaged a kyphosis of 6.8 degrees, no fracture instability). Less good results were obtained with both the Harrington stabilization (loss of reposition 9.1 degrees, fracture instability in 3 cases) and with the transpedicular plate stabilization (loss of reposition 12.4 degrees, fracture instability in 2 cases). Finally the complications are described. The optimal approach is based on the clinical development. The fusion should be as short as possible with a stable angle implant and the possibility to reposition intraoperatively should be given. Postero-lateral spongiosa application, fusion of the vertebral arch joints, diskectomy with transpedicular spongiosa application and intercorporal blocking should be considered.

Video-assisted treatment of thoracolumbar junction fractures using a specific distractor for reduction: prospective study of 50 cases

“…Correction of localized kyphosis (13.54°) and in CRA (13.80°) was stable compared to the immediate postoperative assessment. This is in agreement with the findings of Kirkpatrick et al [23] and Eysel et al [12] who reported greater stability over time with the anterior approach. The endodistractor gave a much better CRA correction (3.57°) than did external maneuvres or a system involving the vertebral plates (8.09°).…”

Impact of implant removal on quality of life and loss of correction in the treatment of traumatic fractures of the thoracolumbar spine

“…Other studies showed mean ages ranging from 37 to 45 years. Gender ratio of approximately 60:40 (male: female) showed no difference to previous results ( Knop et al, 1999a ; Eysel et al, 1991 ; Eysel and Meinig, 1991 ; Gertzbein and Scoliosis Research Society, 1992 ; Kaneda et al, 1997 ; Knop et al, 1997 ; Knop et al, 2001a ; Lindsey and Dick, 1991 ).…”

“…Knop et al reported involvement of L1 in 49.3% of cases. Several studies have shown this kind of distribution similarly ( Eysel et al, 1991 ; Eysel and Meinig, 1991 ; Gertzbein and Scoliosis Research Society, 1992 ; Kaneda et al, 1997 ; Knop et al, 1997 ; Lindsey and Dick, 1991 ; Knop et al, 2001b ; Knop et al, 1999b ; Katz et al, 1988 ; Scalea et al, 1986 ).…”

Die biomechanischen Eigenschaften von künstlichen Implantaten der lumbalen Bandscheibe

“…ment und zum anderen die Degeneration der angrenzenden Bandscheiben und Wirbelbogengelenken [24]. Ein Grund für die progrediente Degeneration besteht in der abnormen segmentalen Beweglichkeit, wie sie in zerstörten Bandscheiben nach Wirbelkörperfrakturen gezeigt werden konnte [7,8]. Die klinischen Ergebnisse verschlechtern sich zusehends auch mit steigender Zahl weiterer Operationen in bis zu 38% der Fälle [5,15].…”