Ocampo RRI, Jiménez ÁJM

Language: Spanish
References: 21
Page: 25-31
PDF size: 235.51 Kb.

ABSTRACT

Objective: Compare both short instrumentation in traumatic not pathological fractures thoracolumbar; union methods implemented backbone it fractured with full pedicle. Methods: In the period covered between January 2008 to July 2010 reviewed 22 cases divided into 2 groups: 8 (36.40%) with screw in the vertebrae fractured with full pedicle associated with transpedicular grafting and posterolateral. Fourteen (63.60%) treated without screw in the fractured vertebra, associated with transpedicular graft. Included: vertebral fracture in the stab-lumbar (T11-L4). Sixteen patients (72.7%) were male and 6 (27.3%) female, average age was 37.27 d.s. 10.5 years. Results: The probability of fusion (pain ‹ 6 months + absence of neurologic injury without progressive deformity): 2.75 more times with autologous graft that combined with heterologous with an IC 95% = 0. 15-93. 1.91 more times if it implements backbone it fractured with an IC 95% = 0.12 - 58.54. Probability in neurologic improvement (2 or more levels of Frankel follow-up): 30 more times if you corrected the diameter of the spinal canal in less than 30% of invasion (% DC +) with an IC 95% = 1.54-1358. 7.5 most times if you corrected the transverse diameter of the spinal canal in less than 15% of invasion (% DT +) with an IC 95% = 0.36-258.58. 2.17 more times if successfully corrected kyphosis regional to ≪ 5th postsurgery as (CBC + Cr1) with a 95% CI = 0.17-28.35. 1.29 more times if successfully corrected vertebral kyphosis at ‹ 5th post surgery as (CBC + HP) with a CI = 0.14-12.19. With screw in the fractured vertebra there is 1.91 times more likely to fix the spinal canal in less than 15% of invasion with an IC = 0.12 - transverse diameter 38.54. 1.17 more probability of correcting the CR1 with an IC 95% = 0.06-39.62. 12.6 times more likely to fix the CV with an IC 95% = 0.95-366.02. 1.67 times more likely to have a proper functionality (ambulation without limitation or assistance of a second person for minimum activities + fusion) with an IC 95% = 0.17-18.04. Conclusions: When correcting the diameter of the spinal canal, we have 30 times more probability in neurologic improvement 7.5 more times if we increase the spinal transverse diameter, achieving 1.91 more often implemented the fractured vertebra, achieving at the same time 12 times more likely to successfully correct surgical pre radiographic kyphosis at less than 5 degrees. There was no difference between decompression laminectomy or hemilaminectomy on neurological development, functionality, and fusion. The instrumentation of backbone it fractured is an option in not pathological thoracolumbar union fractures with full; pedicle more high rate of melting, neurologic improvement, functionality and radiographic satisfactory correction.

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