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Journal of Neurology and Neurorehabilitation Research | Volume 3
November 26-27, 2018 | Dubai, UAE
Spine and Spine Disorders
Addiction Research and Therapy
3rd International Conference on
International Conference on
Joint Event
&
Comparative study of percutaneous pedicle screw fixation after direct decompression with anterior column
reconstruction for Thoraco-lumbar burst fracture
Seul-Kee Lee, Ju-Hui Kim
and
Jung-Kil Lee
Chonnam National University Hospital &Medical School, South Korea
Background:
Thoracolumbar Burst Fractures (TLBFs) are
among the most common spinal traumas, and its appropriate
management remains undetermined. This study aimed
to compare the clinical and radiological results between
anterior corpectomy and fusion technique versus posterior
decompression with percutaneous pedicle screw fixation
technique in the treatment of TLBFs.
Methods:
A total of 46 patients (from 2002 to 2015) with
TLBFs were included in this study. The inclusion criteria were
single-level Magerl type A3 burst fracture of the thoracolumbar
spine (T12–L2). These patients were divided into two groups:
Group A (22 patients) was treated by Anterior Corpectomy
with fusion, while Group B (24 patients) was treated by
posterior decompression with Percutaneous Pedicle Screw
Fixation (PPSF). For the radiologic parameters, Kyphosis angle
was measured preoperatively, early postoperatively, and at
the last follow-up using Cobb angle. The average correction in
degrees and loss of correction were calculated accordingly. All
neurological deficits were identified on the initial evaluation
and graded using the ASIA grading system. Operation time and
intraoperative blood loss were also measured.
Results:
The patients consisted of 17 males and 5 females in
Group A and 13 males and 11 females in Group B. The involved
levels were three T12, twelve L1, and seven L2 in Group A and
one T12, thirteen L1, and ten L2 in Group B. The average follow-
up period was 44.9 months in Group A and 14.7 months in
Group B. The corrections of kyphotic change were 6.4 degrees
in Group A and 9.2 degrees in Group B. Among the patient
with neurologic deficit, 11 of 15 patients in Group A and 20 of
23 patients in Group B demonstrated at least one ASIA grade
improvement on the final observation. However, there was no
significant differencebetween twogroups (p=0.13). Inaddition,
a shorter mean operating time and less mean perioperative
blood loss were observed in Group B than in Group A (p < 0.01
and p < 0.01, respectively; 167.3minutes and 305.9mL inGroup
A; 365 minutes and 1566.7 mL in Group B).
Conclusions:
Spinal Canal Decompression via a small
Laminotomy followed by PPSF in the treatment of TLBFs with
neurological deficits offers excellent biomechanical stability
with clinical and radiological improvement. Furthermore, it can
be a safe and effective surgical option with the advantages of
less invasiveness for the treatment of TLBFs.
e:
winnerlsk@hanmail.net