The results of conservative treatment and short transpedicular fixation at burst fractures of thoracic and lumbar spine

Authors

  • Volodymyr Radchenko Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0001-5949-0882
  • Konstantin Popsuishapka Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine https://orcid.org/0000-0002-8552-7287
  • Dmytro Chekryzhev LTD «Medical center «Orthospine», Kharkiv. Ukraine, Ukraine
  • Sergii Teslenko Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv, Ukraine

DOI:

https://doi.org/10.15674/0030-59872018119-28

Keywords:

burst fracture, posterior transpedicular fixation, fusion, orthesis

Abstract

Multifragmentary (burst) fracture can happen in case of spine trauma under the influence of high-energy axial compression with penetration of bone fragments into spine canal and paravertebral tissues.

Objective: to analyze the results of treatment of patients with burst thoracic and lumbar spine fractures who were treated by conservative therapy and surgery with short transpedicular fixation.

Methods: we made retrospective analysis of 23 patients with incomplete burst fractures type A3.1 and burst split fractures type 3.2 of thoracic and lumbar spine without neurological deficiency. Patients were divided into two groups: group A (conservative treatment) and group B (surgical treatment with short transpedicular fixation). We made assessment of pain, value of kyphotic deformity, compression degree, spine canal stenosis and index of sagital balance.

Results: conservative treatment is indicated for patients with burst fractures type A3.1 without neurological symptoms, spine canal stenosis (up to 10 %) and posterior ligaments damage. Method of posterior fusion with short transpedicular fixation can be recommended for the treatment of incomplete burst fractures type A3.1 and A3.2 without neurological symptoms, with reserved pedicles and fragmentation of vertebrae up to 50 % of its square. Short six screws fixation can provide incomplete deformity correction (to 5 %), stable fixation with minimal loss of correction.

Conclusions: conservative and surgical methods of treatment can provide satisfactory clinical results. But X-rays analysis showed advantages of surgical treatment.

Author Biographies

Volodymyr Radchenko, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

MD, Prof. in Orthopaedics and Traumatology

 

Konstantin Popsuishapka, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

PhD in Orthopaedics and Traumatology 

 

Dmytro Chekryzhev, LTD «Medical center «Orthospine», Kharkiv. Ukraine

 

 

Sergii Teslenko, Sytenko Institute of Spine and Joint Pathology National Academy of Medical Sciences of Ukraine, Kharkiv

 

 

 

References

  1. Ramich, E. A. (1975). Reparative regeneration of fractures of vertebral bodies. (clinical and experimental substantiation (Doctoral dissertation). Moscow. (in Russian)
  2. Aebi, M., Arlet, V., & Webb, J. (2007). AO Spine manual principles and techniques. Thieme, 1, 663.
  3. Aebi, M., Arlet, V., & Webb, J. (2007). AO Spine manual principles and techniques. Thieme, 2, 837.
  4. Dai, L., Jiang, L., & Jiang, S. (2008). Conservative treatment of thoracolumbar burst fractures. Spine, 33(23), 2536-2544. doi: https://doi.org/10.1002/jbm.a.34741
  5. Joaquim, A. F., Fernandes, Y. B., Cavalcante, R. A., Fragoso, R. M., Honorato, D. C., & Patel, A. A. (2011). Evaluation of the thoracolumbar injury classification system in thoracic and lumbar spinal trauma. Spine, 36(1), 33-36. doi: https://doi.org/10.1097/brs.0b013e3181c95047
  6. Vaccaro, A. R., Rihn, J. A., Saravanja, D., Anderson, D. G., Hilibrand, A. S., Albert, T. J., … Fisher, C. (2009). Injury of the posterior ligamentous complex of the thoracolumbar spine. Spine, 34(23), E841-E847. doi: https://doi.org/10.1097/brs.0b013e3181bd11be
  7. Jackson, R. P., & McManus, A. C. (1994). Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. Spine, 19(Supplement), 1611-1618. doi: https://doi.org/10.1097/00007632-199407001-00010
  8. Keynan, O., Fisher, C. G., Vaccaro, A., Fehlings, M. G., Oner, F. C., Dietz, J., … Dvorak, M. (2006). Radiographic measurement parameters in thoracolumbar fractures: a systematic review and consensus statement of the spine trauma study group. Spine, 31(5), E156-E165. doi: https://doi.org/10.1097/01.brs.0000201261.94907.0d
  9. Schwab, F., Ungar, B., Blondel, B., Buchowski, J., Coe, J., Deinlein, D., … Lafage, V. (2012). Scoliosis research society—schwab adult spinal deformity classification. Spine, 37(12), 1077-1082. doi: https://doi.org/10.1097/brs.0b013e31823e15e2
  10. Altay, M., Ozkurt, B., Aktekin, C. N., Ozturk, A. M., Dogan, Ö., & Tabak, A. Y. (2007). Treatment of unstable thoracolumbar junction burst fractures with short- or long-segment posterior fixation in magerl type a fractures. European Spine Journal, 16(8), 1145-1155. doi: https://doi.org/10.1007/s00586-007-0310-5

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How to Cite

Radchenko, V., Popsuishapka, K., Chekryzhev, D., & Teslenko, S. (2023). The results of conservative treatment and short transpedicular fixation at burst fractures of thoracic and lumbar spine. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (1), 19–28. https://doi.org/10.15674/0030-59872018119-28

Issue

No. 1 (2018)

Section

ORIGINAL ARTICLES

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Copyright (c) 2018 Volodymyr Radchenko, Konstantin Popsuishapka, Dmytro Chekryzhev, Sergii Teslenko

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