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Original Articles
- Related Factors of Ligamentotaxis with Posterior Instrumentation for the Surgical Treatment of Thoracolumbar Bursting Fracture
- Sang Bum Kim, Taek Soo Jeon, Seung Hwan Kim, Han Chang, Cheol Mog Hwang
- J Korean Fract Soc 2010;23(2):213-219. Published online April 30, 2010
- DOI: https://doi.org/10.12671/jkfs.2010.23.2.213
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Abstract
PDF - PURPOSE
To investigate factors influencing the amount of indirect reduction by ligamentotaxis according to timing of surgery, extent of surgery, and characteristics of fractures.
MATERIALS AND METHODS
We reviewed 22 cases of thoracolumbar fracture which had been performed posterior instrumentation and fusion using pedicle screw system. We divided patients into each group according to timing of surgery, number of fusion segment, insertion of screw on fractured vertebra, and rupture of posterior ligament complex, and Denis type. We measured changes of kyphotic angle, anterior vertebral height and wedge angle on plain radiographs, and we compared spinal canal area before and after operation using computed tomographic scans.
RESULTS
Kyphotic angle, anterior vertebral height, wedge angle, and area of spinal canal showed significant improvement postoperatively. The wedge angle improved significantly operated within 3 days after injury, however, kyphotic angle and anterior vertebral height had no correlation with variable factors except the rupture of posterior ligament complex. The amount of restoration of spinal canal also affected only by rupture of posterior ligament complex.
CONCLUSION
There is little relationship between timing of surgery and canal restoration, so we cannot conclude that prompt operation helps reduction of narrowed spinal canal. Otherwise narrowed spinal canal had much less restored by ligamentotaxis when there were rupture of posterior ligament complexes.
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- Change of Canal Compromise After Ligamentotaxis in Thoracolumbar Burst Fracture
- Kyu Jung Cho, Min Suk Yang
- J Korean Soc Fract 1996;9(3):759-766. Published online July 31, 1996
- DOI: https://doi.org/10.12671/jksf.1996.9.3.759
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Abstract
PDF
- Twenty-one patients with burst fracture of the thoracolumbar spine were treated by posterior pedicle screw instrumentation and fusion. We assessed canal compromise using CT fcan preoperatively and its restoration shortly after instrunientation lot confirmation of effect of lisamentotafis. The amount of neurologic recovery in each patient was compared to the final area of the spinal canal. The mean initial canal compromise was 42.6% and this was reduced to 16.2% postoperatively. The mean sagittal diameter was 10.2mm preoperatively & 12.9mm postoperatively. We achieved a mean reduction of canal compromise of 62%. A significant correlation between preoperative canal compromise and amount of restoration, or severity of neurologic deficit could not be established. Ligamentotaxis by pedicle screw instrumentation could effectively decompress the canal in thoracolumbar burst fracture.
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