title: [Results of operative treatment thoraco-lumbar fractures by posterior lumbar interbody fusion, Daniaux reconstruction or combination of both methods].
abstract: The aim of the study was to compare clinical and radiological results of treatment thoraco-lumbar spine fractures by short segment transpedicular stabilization accompanied by three techniques of reconstruction: posterior lumbar interbody fusion, vertebral body Daniaux reconstruction and combination of both methods. AO system was used to classify the fractures. Frankel's grade system was used for assessment of neurological deficit on admission and subsequently in the postoperative and follow-up period. The height of the fractured vertebral body and angle of segmental kyphotic deformation was measured on lateral X-ray pre- and post-operatively and at last follow-up. To the retrospective analysis we included 167 patients operated in the Orthopaedic and Traumatology Department, Medical University of Lublin in years 1998-2007. Posterior lumbar interbody fusion was performed in 69 patients (41%), isolated vertebral body Daniaux reconstruction in 82 patients (49%) and combination of both methods was performed in 16 patients (10%). The follow-up period has ranged from 3 to 13 years (mean 6.9 years). The most common type of the fracture was a B type (104 patients -62%), followed by type A (43 patients--26%), and type C (20--patients 12%). The neurological deficit was present in 80 patients. The postoperative neurological improvement was noticed in 37 patients (46%), whereas in 46 patients (54%) neurological status has not changed after the treatment. From 87 patients without neurological symptoms, we observed postoperatively contemporary neurological complications in 11 (12.6%) cases. The biggest correction of fractured vertebral height (mean 0.15) and correction of segmental kyphotic deformity (mean 6.3 degrees) we have noticed in the group of isolated vertebralbody Daniaux reconstruction with use of bone grafts. However in every group of patients we observed significant loss of correction during follow-up period. At the latest follow-up assessment there were no differences in vertebral body height of segmental kyphotic deformation between the analyzed groups of patients. None of analyzed methods of treatment: posterior lumbar interbody fusion, vertebral body Daniaux reconstruction or combination of these methods did not protect from recurrence of kyphotic deformity.
authors.affiliation: Samodzielny Publiczny Szpital Kliniczny nr 4, Klinika Ortopedii i Traumatologii, Uniwersytet Medyczny w Lublinie. r.weglowski@wp.pl
authors.forename: Robert
authors.initials: R
authors.lastname: Wegłowski
authors.forename: Piotr
authors.initials: P
authors.lastname: Godlewski
authors.forename: Jan
authors.initials: J
authors.lastname: Blacha
authors.forename: Robert
authors.initials: R
authors.lastname: Kołodziej
authors.forename: Tomasz
authors.initials: T
authors.lastname: Mazurkiewicz
mesh_terms: D000293:Adolescent; D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D010147:Pain Measurement; D011044:Poland; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult