DOI: https://doi.org/10.15674/0030-59872017449-56

Clinical-experimental correlation of residual spinal deformation development under the condition of thoracolumbar fractures

Konstantin Popsuishapka, Mykhaylo Karpinsky, Andrey Popov, Igor Subbota, Sergii Teslenko

Abstract


Objective: determination of residual deformation and fixation of the spine in thoracolumbar burst fractures.

Methods: the re­sults of X-ray and CT examinations of 49 patients were ana­lyzed, which were divided into 4 groups depending on the mag­nitude of kyphotic deformation: I (16 people) — from 0º to 12º, II (21) —from 12º to 21º, III (7) — from 21º up to 30º, IV (5) — more than 30º. In the experiment, 6 physical models were cre­ated: 1st — normal; 2nd — up to 50 % of the vertebral body and one adjacent intervertebral disc were destroyed; 3rd — 50 % of vertebral body destroyed, one adjacent intervertebral disc, posterior parts of vertebral body and roots of arches (incom­plete with type A explosive fracture); 4th — 50 % of vertebral body, one adjacent intervertebral disc, posterior parts of verte­bral body, pedicles, interspinous ligaments (type AB, AC); 5th — the whole body (100 %) and two adjacent discs (full burst frac­ture type A); 6th — 100 % of the vertebral body, discs, pedicles and ligaments (damages of the AC type).

Results: it is established that the parameters of the experimental models can be compared with the clinical data. The possibility of subsequent develop­ment of the spinal deformation is associated with the morphology of the injury. With the help of the developed experimental model, the main regularities of development of kyphotic de­formation in thoracolumbar burst fractures were determined. It is shown that the destruction of the vertebral body to 50 % results into the development of primary deformation, which does not progress with further loading. Damage to the posterior sup­port of the spinal column leads to the progression of residual deformation to 10 %.

Conclusions: the deformation of the spine occurs during the destruction of the vertebral body, immediately at the time of injury and depends on its intensity. In case of damage to the posterior parts of the spine, in the case of subsequent loading, the deformation progression is possible. 


Keywords


burst spinal fractures; residual deformation of spine; residual fixation of fragments; thoracolumbar spine

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Copyright (c) 2018 Konstantin Popsuishapka, Mykhaylo Karpinsky, Andrey Popov, Igor Subota, Sergii Teslenko

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