[Transpedicular reconstruction of vertebral body height with simultaneous interbody spondylodesis].
OBJECTIVE
Surgical treatment of traumatic spinal injury should include fast and complete decompression of spinal cord and radices wits reduction of broken vertebral body, restoration of physiological spinal curvatures and spondylodesis of injured segments. Restoration of natural spinal curvatures is only possible when the height of broken vertebral body is reconstructed.


METHODS
Between 1992 and 2001, 75 patients were operated on because of traumatic injuries of thoracolumbar spine in the Ortopaedic and Traumatology Department Skubiszewski Medical University of Lublin. 48 patients had broken vertebral body reduction with simultaneous filling of bone loss with autogenic bone grafts inserted through pediculum. Only in 4 cases posterior spondylodesis was carried out on arches and spinous processes. Transpedicular plasty of 44 broken vertebral bodies was connected with posterior interbody fusion with PLIF technique using graft application to interbody space.


RESULTS
The operative protocol presented above allowed for the height of the anterior vertebral wall to be restored on average to 81.5% of the original height. We did not observe either fatigue breakage of the screws or screws loosening with kyphosis recurrence. We did not note serious postoperative complications, including neurological compromise. The operative procedure did not significantly change the neurological status of the patients. In 9 cases we noted neurological improvement: usually by 1 or 2 grades in Frankel's score.


CONCLUSIONS
Restoration of the fractured vertebral body with bone grafts combined with posterior interbody spondylodesis effectively prevents the recurrence of the kyphotic deformation.
Godlewski
Piotr
P
Katedra i Klinika Ortopedii i Traumatologii, Akademia Medyczna im. Prof. Feliksa Skubiszewskiego w Lublinie, Lublin, Poland.
Mazurkiweicz
Tomasz
T
Wegłowski
Robert
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D007403:Intervertebral Disc / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D013123:Spinal Fusion / Q000295:instrumentation*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*