39-217
¿Qué aporta la artrodesis en la estabilización de las fracturas de la transición toracolumbar?
How does arthrodesis contribute to the stabilisation of thoracolumbar transition fractures?
A. J. GARBAYO MARTURET, V. POMBO MANERO, A. ARENAS PLANELLES, A. TEJERO IBÁÑEZ, Mª. L. FERNÁNDEZ HORTIGÜEL SERVICIO DE TRAUMATOLOGÍA Y CIRUGÍA ORTOPÉDICA. HOSPITAL DE NAVARRA. PAMPLONA. NAVARRA.
Recepción:
15/09/2008
Aceptación:
15/09/2008
Publicación:
15/09/2008
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Resumen (ES)
A retrospective study has been made on 26
patients with type II burst Denis fracture (23 cases) and type
IV Denis fracture-dislocation (3 cases) of the thoracolumbar
transition (T11-L2). Treatment consisted on a reduction and a
stabilisation with a single transpedicular fixation (16 cases) or
associated to a posterolateral arthrodesis (10 cases). The
84,6% of the patients carry out a normal life without pain or
with slight problems which do not limit daily activity. The segmental
traumatic average angle of kyphosis improved from
19,4 ± 7,8º to 8,7 ± 11,8º (p < 0,001). When comparing the final
segmental traumatic average angle of kyphosis of the group
of patients with arthrodesis (3,8 ± 6,9º) to the group without
arthrodesis (7,8 ± 8,7º), the differences were not significant.
The 6 patients who presented a marked loss of correction
during the post-operative time, with breakage of material in 5
of them, belonged to the group without arthrodesis, and 4 of
them had a laminectomy performed. The posterolateral arthrodesis
associated to the stabilisation in burst thoracolumbar
transition fractures did not improve the final kyphotic deformity
significantly. The failures of material which brought on a
marked loss of previous correction were related significantly
to laminectomy without arthrodesis.
patients with type II burst Denis fracture (23 cases) and type
IV Denis fracture-dislocation (3 cases) of the thoracolumbar
transition (T11-L2). Treatment consisted on a reduction and a
stabilisation with a single transpedicular fixation (16 cases) or
associated to a posterolateral arthrodesis (10 cases). The
84,6% of the patients carry out a normal life without pain or
with slight problems which do not limit daily activity. The segmental
traumatic average angle of kyphosis improved from
19,4 ± 7,8º to 8,7 ± 11,8º (p < 0,001). When comparing the final
segmental traumatic average angle of kyphosis of the group
of patients with arthrodesis (3,8 ± 6,9º) to the group without
arthrodesis (7,8 ± 8,7º), the differences were not significant.
The 6 patients who presented a marked loss of correction
during the post-operative time, with breakage of material in 5
of them, belonged to the group without arthrodesis, and 4 of
them had a laminectomy performed. The posterolateral arthrodesis
associated to the stabilisation in burst thoracolumbar
transition fractures did not improve the final kyphotic deformity
significantly. The failures of material which brought on a
marked loss of previous correction were related significantly
to laminectomy without arthrodesis.
Palabras clave (ES):
Tratamiento
Raquis
Columna
Lumbar
Torácica
Toracolumbar
Transición
Fractura
Estabilización
Artrodesis
Resumen (EN)
A retrospective study has been made on 26
patients with type II burst Denis fracture (23 cases) and type
IV Denis fracture-dislocation (3 cases) of the thoracolumbar
transition (T11-L2). Treatment consisted on a reduction and a
stabilisation with a single transpedicular fixation (16 cases) or
associated to a posterolateral arthrodesis (10 cases). The
84,6% of the patients carry out a normal life without pain or
with slight problems which do not limit daily activity. The segmental
traumatic average angle of kyphosis improved from
19,4 ± 7,8º to 8,7 ± 11,8º (p < 0,001). When comparing the final
segmental traumatic average angle of kyphosis of the group
of patients with arthrodesis (3,8 ± 6,9º) to the group without
arthrodesis (7,8 ± 8,7º), the differences were not significant.
The 6 patients who presented a marked loss of correction
during the post-operative time, with breakage of material in 5
of them, belonged to the group without arthrodesis, and 4 of
them had a laminectomy performed. The posterolateral arthrodesis
associated to the stabilisation in burst thoracolumbar
transition fractures did not improve the final kyphotic deformity
significantly. The failures of material which brought on a
marked loss of previous correction were related significantly
to laminectomy without arthrodesis.
patients with type II burst Denis fracture (23 cases) and type
IV Denis fracture-dislocation (3 cases) of the thoracolumbar
transition (T11-L2). Treatment consisted on a reduction and a
stabilisation with a single transpedicular fixation (16 cases) or
associated to a posterolateral arthrodesis (10 cases). The
84,6% of the patients carry out a normal life without pain or
with slight problems which do not limit daily activity. The segmental
traumatic average angle of kyphosis improved from
19,4 ± 7,8º to 8,7 ± 11,8º (p < 0,001). When comparing the final
segmental traumatic average angle of kyphosis of the group
of patients with arthrodesis (3,8 ± 6,9º) to the group without
arthrodesis (7,8 ± 8,7º), the differences were not significant.
The 6 patients who presented a marked loss of correction
during the post-operative time, with breakage of material in 5
of them, belonged to the group without arthrodesis, and 4 of
them had a laminectomy performed. The posterolateral arthrodesis
associated to the stabilisation in burst thoracolumbar
transition fractures did not improve the final kyphotic deformity
significantly. The failures of material which brought on a
marked loss of previous correction were related significantly
to laminectomy without arthrodesis.
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