Outcomes for standalone anterolateral corpectomy for thoracolumbar burst fractures.

IF 2.5 3区 医学 Q2 CLINICAL NEUROLOGY Neurosurgical Review Pub Date : 2024-10-24 DOI:10.1007/s10143-024-03049-w
Michael J Ortiz Torres, Kaushik Ravipati, Farhan Siddiq, Caitlyn J Smith, Kiersten Norby, Jamir Pleitez, Walter Galicich, Thomas Bergman, Christopher Roark
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Abstract

There is a paucity of data available on the context preceding anterior fusion failure or the need for a posterior fusion, the timing of the second operation, or any correlation between the different instrumentation and failure rates. A retrospective chart review was performed of 131 identified patients who underwent anterolateral corpectomy and fusion for a thoracolumbar burst fracture from 2000 to 2012 in a single institution. 96 patients had clinical and radiographic follow up of greater than two months. Mean kyphosis correction from preoperative (14.1°) to postoperative kyphosis (6.3°) was 7.7° and 37% had loss of kyphotic correction at follow-up. In a univariate analysis, use of a bone strut graft (OR 3.2, p = 0.01), point-loaded graft position (OR 4.9, p = 0.005), end plate damage/subsidence (OR 6.7, p < 0.0001), and graft to endplate width ratio of ≤ 45% on AP x-ray (OR 3.0, p = 0.02) were associated with loss of kyphotic correction. 41% demonstrated scoliosis of ≥ 5° at follow-up. Graft location towards the left of midline (OR 8.6, p < 0.0001), point-loaded graft position (OR 3.8, p = 0.01), and end plate damage/subsidence (OR 5.5, p = 0.0001) were also associated with scoliosis at the time of final follow-up. Five patients required posterior fusion and fifteen patients continued to have daily pain, only one of which was determined to be related to kyphosis. Use of a bone strut graft versus expandable cage, graft location, graft position, presence of early or late subsidence and width of the graft may be associated with loss of kyphotic correction and scoliosis.

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胸腰椎爆裂性骨折独立前外侧椎体后凸切除术的疗效。
关于前路融合失败或需要后路融合的前因后果、第二次手术的时机或不同器械与失败率之间的相关性,目前可获得的数据很少。2000年至2012年期间,一家医疗机构对131名因胸腰椎爆裂性骨折接受前外侧椎体切除术和融合术的患者进行了回顾性病历审查。96名患者的临床和影像学随访时间超过两个月。从术前(14.1°)到术后(6.3°)的平均椎体后凸矫正度为7.7°,37%的患者在随访时丧失了椎体后凸矫正。
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来源期刊
Neurosurgical Review
Neurosurgical Review 医学-临床神经学
CiteScore
5.60
自引率
7.10%
发文量
191
审稿时长
6-12 weeks
期刊介绍: The goal of Neurosurgical Review is to provide a forum for comprehensive reviews on current issues in neurosurgery. Each issue contains up to three reviews, reflecting all important aspects of one topic (a disease or a surgical approach). Comments by a panel of experts within the same issue complete the topic. By providing comprehensive coverage of one topic per issue, Neurosurgical Review combines the topicality of professional journals with the indepth treatment of a monograph. Original papers of high quality are also welcome.
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