Frakturen der Lendenwirbelsäule und unteren Brustwirbelsäule-operative Technik und Ergebnisse

Dörner, A.; Mommsen, Ulrich; Müller, S.; Jungbluth, K. H.

doi:10.1007/bf02587920

Unfallchirurgie

1985

DOI: 10.1007/bf02587920

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Frakturen der Lendenwirbelsäule und unteren Brustwirbelsäule-operative Technik und Ergebnisse

A. Dörner

Ulrich Mommsen

S. Müller

et al.

Abstract: Improved healing results are achieved by surgical treatment of fractures of the lumbar spine and of the thoracic transition, if the indication is correct, i.e. in case of splintered fracture with severe instability or neurologic troubles, but also in case of luxations occurring rarely in the region of the lumbar spine. The anterior fusion of fractions with bone defects in the region of the vertebral body is more logical with regard to the biomechanical aspect.

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Cited by 3 publications

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The fixateur interne for stabilising fractures of the thoracolumbar and lumbar spine

Sim

Stergar

1992

International Orthopaedics

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Between 1986 and 1988, 27 patients with fractures of the thoracolumbar and lumbar spine were treated by fixateur interne (FI) instrumentation, and 24 were followed up for a mean of 25 months. Complications occurred in 13 cases, mostly due to loosening and corrosion. The results were compared with plate fixation. The radiological parameters and differences between the preoperative and postoperative indices were well within the normal range. The inferiority of FI instrumentation compared to plate fixation during follow up was mainly attributable to the complications. Reduction of the posterior wall fragments by the intact posterior longitudinal ligament was not consistent, so instrumented reduction is usually the method of choice.

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The fixateur interne for stabilising fractures of the thoracolumbar and lumbar spine

Sim

Stergar

1992

International Orthopaedics

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

Eysel¹,

Meinig

1991

Acta neurochir

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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.

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Vergleichende Untersuchung unterschiedlicher dorsaler Stabilisierungsverfahren bei frischen Frakturen der Rumpfwirbelsäule

1991

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After giving a brief summary describing the development of different methods for stabilisation of traumatic spine fractures the authors discuss their own results on 125 patients, who were treated between January 1st 1983 and September 15th 1988. The different surgical procedures (Harrington-instrumentation, transpedicular osteosynthetic stabilisation, fixateur interne) are compared. In the neurological physical examination 25% of the patients improved at least one degree in the Frankel-scale. In four patients there was worsening of the neurological findings. The radiological postoperative studies analyzed the angles of kyphosis and scoliosis within the traumatized spine segments. In overall-comparison of surgical procedures the fixateur interne showed best results (repositional loss of kyphosis angle 6.8 degrees, no fracture instability). Worse results were found for Harrington-stabilisation (repositional loss 9.1 degrees, fracture instability in three cases) and for transpedicular osteosynthetic stabilisation (repositional loss 12.4 degrees, fracture instability in two cases). In conclusion the authors describe the possible different complications for the three methods of judging from the clinical aspect and propose the following standard way of procedure: Fusion of the vertebral bodies with a stable implant and the possibility for intraoperative repositioning, postero-lateral spongiosa-grafting, fusion of the vertebral arc joints, transpedicular spongiosal filling of the traumatized vertebral body, resection of traumatized tissue from intervertebral discs and intercorporal blocking.

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Frakturen der Lendenwirbelsäule und unteren Brustwirbelsäule-operative Technik und Ergebnisse

Cited by 3 publications

References 7 publications

The fixateur interne for stabilising fractures of the thoracolumbar and lumbar spine

The fixateur interne for stabilising fractures of the thoracolumbar and lumbar spine

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

Vergleichende Untersuchung unterschiedlicher dorsaler Stabilisierungsverfahren bei frischen Frakturen der Rumpfwirbelsäule

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