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Functional spine analysis at surgical treatment of burst fractures of thoracic and lumbar spine

Volodymyr Radchenko, Konstantin Popsuishapka, Sergii Teslenko

Abstract


Burst fracture — is traumatic injury under the influence of high-energy axial compression which results multifragmentary vertebrae fracture with penetration of bone fragments into spine canal and paravertebral tissues.

Objective: to analyze the magnitude of kyphotic deformity and indexes of sagittal spine balance after surgical treatment of burst fractures.

Methods: retrospective study was made of 99 case histories. Criteria of inclusion were: incomplete burst (type А3.1) and incomplete split burst fracture (А3.2), complete burst fracture (type А3.3), vertebrae body with destruction (АВ) and rotation (АС). All patients were divided into 4 groups: I (17 patients) — transpedicular fixation with six screws; II (55) — posterior fixation with eight screws; III (22) — anterior-posterior combined spinal 360° fusion; IV (5) — tree column reconstruction from posterior approach.

Results: fixation with six screws was used mostly in patients with type A3.1 fractures, it allowed us to correct kyphotic deformity in average 8.4º ± 6.5º and provide stable osteosynthesis. In patients of II group the magnitude of kyphotic deformity after trauma was 16.4º ± 6.9º, the average magnitude of its correction was 12.6º ± 7.0º. In the III group of patients this index was 18.3º ± 9.7º, and in the IV — 18.67º ± 2.08º.

Conclusions: The choice of method of fixation depends on the morphology of injury. Totally surgical treatment of burst fractures can provide preservation of sagittal vertical axis. Usage of eight screws fixation and combined anterior and posterior spine 360° fusion is the most effective for deformity correction.

Keywords


vertebrae segment trauma; local kyphotic deformity; spine-pelvic balance; surgical treatment

References


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DOI: https://doi.org/10.15674/0030-5987201825-12

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