胸腰椎損傷に対するInstrumentation Surgery

概要

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The authors conducted a retrospective analysis of patients with thoracolumbar fractures who underwent instrumentation surgery via anterior or posterior approach. The study group was composed of 25 men and 7 women with the mean age being 40.5 (range 15-69 years). The affected level was midthoracic in 5 patients, thoracolumbar in 23, and lumbar in four. The type of injury was classified as burst fracture in 22 patients, compression-distraction in two, and fracture dislocation in eight. The instrumentation was placed posteriorly in 21 patients and anteriorly in 11. Most of the patients with burst fracture were treated by anterior approach; however compression-distraction and fracture dislocation patients were treated by posterior approach. Solid bony fusion was achieved in all patients. Good neurological outcome was obtained in 26 of 32 patients independently of whether the fixation was by anterior or posterior instrumentation. The five patients who had sustained complete spinal cord injury didn't recover neurologically. The initial and at follow-up kyphotic angle averaged 17.7 and 13.1 degrees in the anterior instrumentation group. They averaged 18.3 and 12.8 degrees in the posterior group.
日本脊髄外科学会の論文