THORACOLOMBAR BURST FRACTURES: SHORT FIXATION, WITHOUT ARTHRODESIS AND WITHOUT REMOVAL OF THE IMPLANT.

IF 0.5 4区 医学 Q4 ORTHOPEDICS Acta Ortopedica Brasileira Pub Date : 2023-01-01 DOI:10.1590/1413-785220233101e253655
Carlos Humberto Targa Moreira, Walter Krause, Robert Meves
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Abstract

Objectives: To present the functional outcomes, through the first case series in our country, of patients with thoracolumbar burst fractures (A3,A4), submitted to short posterior fixation, without arthrodesis and without removal of the implants, until the end of the minimum follow-up of one year.

Methods: Fifty five patients consecutively treated between January/2010 and January/2019 were evaluated through medical records and imaging exams. Radiographic analysis was performed by mea suring local and segmental kyphosis using the Cobb method. Functional assessment was analyzed using the non-specific SF-36 questionnaire and the 1983 Denis pain and work-specific questionnaire, applied after 12 months of follow-up.

Results: With a loss of five patients (9%), 22 (44%) patients reported having minimal and occasional pain and 8 (16%) patients reported having no pain. Three (6%) patients responded that they were completely incapacitated. Patients had a mean score of 73.16 points in the SF-36 domains. There was a significant reduction in kyphosis in 12 months (9.1±5.2 [min-max 0-22]) compared to the preoperative period (14.9±7.8 [min-max 0-32]) ( p≤0.01). One patient required implant removal due to the symptomatic prominence of the implant.

Conclusion: This case series suggests that the technique leads to satisfactory functional results, without implant failure or significant kyphosis after a minimum follow-up of 12 months of treatment. Evidence Level IV; Case series.

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胸腰椎爆裂性骨折:短时间内固定,不进行关节融合术,不取出内固定物。
目的:通过我国的第一个病例系列,介绍胸腰椎爆裂性骨折(A3,A4)患者的功能结果,这些患者在不进行关节融合术和不取出植入物的情况下进行短时间后路固定,直到最短随访一年结束。方法:对2010年1月至2019年1月期间连续治疗的55例患者进行病历和影像学检查。采用Cobb法对局部和节段性后凸进行影像学分析。随访12个月后,采用非特异性SF-36问卷和1983年Denis疼痛和工作特异性问卷进行功能评估。结果:丢失5例患者(9%),22例(44%)患者报告有轻微和偶尔疼痛,8例(16%)患者报告无疼痛。3名(6%)患者回答说他们完全丧失行为能力。患者SF-36域平均得分为73.16分。与术前(14.9±7.8例[min-max 0-32])相比,术后12个月后凸明显减少(9.1±5.2例[min-max 0-22]) (p≤0.01)。一名患者因种植体症状突出而需要移除种植体。结论:本病例系列表明,在至少12个月的随访治疗后,该技术可获得令人满意的功能结果,没有植入物失败或明显的后凸。证据等级IV;病例系列。
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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
67
审稿时长
25 weeks
期刊介绍: A Revista Acta Ortopédica Brasileira, órgão oficial do Departamento de Ortopedia e Traumatologia da Faculdade de Medicina da Universidade de São Paulo (DOT/FMUSP), é publicada bimestralmente em seis edições ao ano (jan/fev, mar/abr, maio/jun, jul/ago, set/out e nov/dez) com versão em inglês disponível nos principais indexadores nacionais e internacionais e instituições de ensino do Brasil. Sendo hoje reconhecidamente uma importante contribuição para os especialistas da área com sua seriedade e árduo trabalho para as indexações já conquistadas.
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