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Thoracolumbar burst fractures requiring instrumented fusion: Should reducted bone fragments be removed? A retrospective study
Affiliations- Department of Neurosurgery, Sakarya University Training and Research Hospital, Sakarya, Türkiye
- Alanya Government Hospital, Clinic of Neurosurgery, Alanya, Türkiye
open access
Abstract
Thoracolumbar burst fractures are common clinical entity encountered in neurosurgical practice, accounting for 10–20% of all spinal fractures. Clinical picture could be devastating due to severe neurological deficits which lead the patients dependent both socially and emotionally.
Materials and methodsThis study compared two groups of patients who were operated because of thoracolumbar burst fracture secondary to spinal trauma in terms of neurologic deficits, degree of improvement, and radiologic measurements at one-year follow-up. The first group (group I) included the patients who underwent posterior total laminectomy, peroperative reduction of intracanal bone fragments, and posterior spinal instrumentation and the second group (group II) included the patients who underwent total laminectomy, and spinal instrumentation without reduction of free bone fragments.
ResultsNeither group showed significant correlation with any measurement parameter. Radiological assessments and clinical improvements did not disclosed significant difference between the two groups at one-year follow-up.
ConclusionRetropulsion of free bone fragments extend the time of surgery and causes complications. This study found that there is no need to retropulse the bone fragments in the spinal canal in patients with unstable burst fractures who underwent total laminectomy and posterior long segment stabilization.
Abstract
Thoracolumbar burst fractures are common clinical entity encountered in neurosurgical practice, accounting for 10–20% of all spinal fractures. Clinical picture could be devastating due to severe neurological deficits which lead the patients dependent both socially and emotionally.
Materials and methodsThis study compared two groups of patients who were operated because of thoracolumbar burst fracture secondary to spinal trauma in terms of neurologic deficits, degree of improvement, and radiologic measurements at one-year follow-up. The first group (group I) included the patients who underwent posterior total laminectomy, peroperative reduction of intracanal bone fragments, and posterior spinal instrumentation and the second group (group II) included the patients who underwent total laminectomy, and spinal instrumentation without reduction of free bone fragments.
ResultsNeither group showed significant correlation with any measurement parameter. Radiological assessments and clinical improvements did not disclosed significant difference between the two groups at one-year follow-up.
ConclusionRetropulsion of free bone fragments extend the time of surgery and causes complications. This study found that there is no need to retropulse the bone fragments in the spinal canal in patients with unstable burst fractures who underwent total laminectomy and posterior long segment stabilization.
Keywords
Bone fragment, Posterior spinal instrumentation, Thoracolumbar burst fracture
About this articleTitle
Thoracolumbar burst fractures requiring instrumented fusion: Should reducted bone fragments be removed? A retrospective study
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
358-366
Page views
295
Article views/downloads
735
DOI
10.1016/j.pjnns.2015.08.005
Bibliographic record
Neurol Neurochir Pol 2015;49(6):358-366.
Keywords
Bone fragment
Posterior spinal instrumentation
Thoracolumbar burst fracture
Authors
Can Yaldiz
Kıyasettin Asil
Birol Özkal
Davut Ceylan
Tibet Kacira
