Ahmet Gürhan GÜRÇAY, Özgür ÖCAL, Yasar OZTURK

Torakal ve Lomber Patlama Kırıklı Hastalarda Uzun Segment Posterior Enstrümantasyon ve Füzyon Tekniğinin Erken ve Geç Dönem Sonuçları

Amaç:Bu çalışmada; torakal ve lomber patlama kırığı nedeniyle sadece posterior yaklaşım ile enstrümantasyon ve füzyon uyguladığımız hastalarda erken ve geç dönemde klinik ve radyolojik sonuçları araştırdık. Gereç ve Yöntem: 2008-2014 tarihleri arasında torakal ve lomber patlama kırıklı hastalardan sadece posterior enstrümantasyon ve füzyon işlemi uygulanan hastalar retrospektif olarak tarandı. Hastaların yaş, cinsiyet, fraktüre sebep olan etiyolojik faktörler, kırığın Denis sınıflandırması ve lokalizasyonu incelendi. En az 1. yıl kontrol muayenesi ve radyolojik görüntülemeleri olan hastalar çalışm aya dâhil edildi. Radyolojik olarak operasyondan hemen önce, operasyon sonrası 1. gün ve en az 1. yılda tüm hastaların anterior ko rpus yükseklik kaybı (AKYK), lokal kifoz açısı (LKA) ve sagital indeks (SI) değerleri hesaplandı. Elde edilen sonuçlar geç dönem veriler ile kıyaslandı. Bulgular: Çalışmaya toplam 35 hasta dâhil edilmiştir. Ortalama yaş 40,9 yıl olarak görüldü. Hastaların ortalama takip süreleri 25 ay (min:15, maks:56) idi. Ameliyat öncesi, ameliyat sonrası erken dönem ve geç dönemde AKYK değerleri 0.44, 0.30 ve 0.31 cm saptandı (p

The Short and Long-Te rm Results of the Long Segment Posterior Instrumentation and Fusion in Patients with Thoracic and Lumbar Burst Fractures

Fractures O bje ctive: We have investigated the clinical and radiological early and late stage results of long segment posterior instrumentation and fusion in thoracic and lumbar burst fracture patients. Mate rial and Method: Patients treated only by posterior instrumentation and fusion due to thoracic and lumbar burst fracture between the years of 2008-2014 were studied retrospectively. Patients' age, gender and etiology of fracture, Denis classification and the localization of th e fractures were recorded. Patients with radiological images taken one year after surgery were included in this study. The radiological parameters were evaluated and calculated before surgery, one day following surgery and at least one year following surgery regarding loss of height in anterior corpus (LHAC), sagittal index (SI) and local angle of kyphosis (LAK). T he obtained data was compared with late stage results. Re sults: Thirty five patients included for the study. Mean age was 40.9 year. Mean follow-up period was 25 months. T he mean values of LHAC before surgery, following surgery and 1-year later surgery were 0.44, 0.30 and 0.31 cm, respectively. Mean LAK was observed as 7.94° before the surgery, 2,86° following surgery and 4.49° at least one year later surgery. T he mean SI value of the patients before surgery, following surgery and one year later surgery were 15.4, 9.71 and 11.14, respectively (p <0,001). C onclusion: In the management of thoracic and lumbar burst fractures, long-segment posterior instrumentation and fusion is a safe and effective treatment modality because of radiological correction of the alignment in the sagittal plane with long follow-up period and satisfactory clinical results.

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