We analyzed 41 cases burst fractures on the thoracolumbar junction which were operated with Kaneda and Cotrel-Dubousset implant at Chosun University Hospital between 1989 and 1993.
The purpose of this study was to evaluate the radiologic sign, the amount of reduction, complications, and functional results.
@ES The results were as follows :
@EN 1. According to McGrorys Criteria to evaluate the posterior superior vertebral body angle of burst fractures, 33 out of 41 cases(80.5%) were positive and the average angle degree was 107.6°.
2. The average postoperative kyphotic correction was 15.4° in the Kaneda group and 13.8°in the C-D group. The average loss of correction at follow-up examination was 5° in the Kaneda group and 4.8°in the C-D group.
3. Indirect reduction was achieved in 10 cases(50%) and we obtained a good indirect reductio even though canal compromise was over 50%.
4. The pain at operative site was much more severe in the Kaneda group(6 cases) than in the C-D group(2 cases) and both groups experienced 2 cases each of implant failure.
5. According to Denis' pain and work scale, 28 cases(63.8%) had good and excellent, 8 cases had fair and 5 cases had poor results.
In summary we recommend doing 1) a posterior instrumentation first for stability and indirect reduction, if it is not a severe neurologic symptom and 2) anterior decompression if it is a severe or progressive neurologic symptom.
|