Torakolomber patlama kırıklarının uzun segment enstrümantasyon tekniği ile tedavisi

AMAÇ: Bu çalışmanın amacı uzun segment enstrümantasyon tekniği ile tedavi ettiğimiz unstabil torakolomber patlama kırıklarının klinik ve radyolojik sonuçlarını değerlendirmektir. YÖNTEMLER: Torakolomber patlama kırığı nedeniyle tedavi edilmiş olan 23 erişkin hasta (17 erkek, 6 bayan; ort. yaş 28.7; dağılım 18-51 yıl) geriye dönük olarak değerlendirildi. T12−L2 arasındaki nörolojik durumları Frankel sınıfl amasına göre C, D ve E grubu hastalar dahil edildi. Kırık yerleşimi 7 hastada T12, 11 hastada L1 kırığı ve 5 hastada L2 vertebrada idi. Tüm hastalarda kırık seviyesinin iki alt ve iki üst seviyesine bilateral pedikül vidaları ve rot sistemi ile tespit yapıldı. Ameliyat öncesi ve sonrası dönemde kanal işgali oranı, sagittal index (SI) ve korpus yüksekliğinde çökme oranlarının yanı sıra ağrı ve iş değerlendirmeleri yapıldı. BULGULAR: Ortalama takip süresi 25.7 ay (dağılım 14-48 ay) idi. Kanal işgali oranı, SI ve korpus yüksekliğinde ameliyat sonrası dönemde, öncesine göre anlamlı bir düzelme olduğu tespit edildi. On dokuz hastada ağrı yok ya da nadir olarak bulundu. Dört hastada günlük aktiviteleri engellemeyen ağrı vardı. On iki hasta eski işine geri döndü. Sekiz hasta hafi f işlere geçmek zorunda kalırken üç hasta tam günlü işlerde çalışamıyordu. SONUÇ: Uzun segment enstrümantasyon tekniği torakolomber bölge patlama kırıklarında etkili ve güvenli bir yöntem olarak kullanılabilir.

Treatment of thoracolumbar burst fractures with long segment instrumentation

OBJECTIVE: The aim of this study was to evaluate the clinical and radiological results of the unstable thoracolumbar burst fractures which were treated with long-segment instrumentation. METHODS: Twenty-three patient (17 men, 6 women; mean age 28.7 (range18-51)) who were treated with thoracolumbar burst fractures were evaluated retrospectively. Between T12 and L2 according to Frankel classifi cation C, D and E type fractures were included in this study. Of all the patients, seven of them had T12, eleven patients had L1 and fi ve patients had L2 fractures. Two segments above and below bilateral pedicular screw and rod system were used for all patients. In the preoperative and postoperative period, work and pain scale as well as canal compromise rate, sagittal index (SI) and anterior body compression were evaluated. RESULTS: Mean follow-up period was 25.7 months (range 14-48 months). There was a signifi cant increase in postoperative period for canal compromise rate, sagittal index (SI) and anterior body compression. Nineteen patients had no or occasional minimal pain. Four patients had minimal pain but no interruption of work. Twelve patients returned to previous employment. Eight patients were unable to return to their previous employment but working full time at a new job and three patients were unable to return to their previous employment, not working full-time. CONCLUSION: Long-segment instrumentation can be used effectively and safely in the treatment of thoracolumbar burst fracture.

Kaynakça

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Kaynak Göster

  • ISSN: 1309-9833
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2008

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