Surgical Management of Lumbar and Thoracolumbar Spinal Fractures: Indications, Surgical Technique and Evaluation on a Series of 64 Patients Treated with Percutaneous Posterior Osteosynthesis Combined with Kyphoplasty or Anterior Arthrodesis
Introduction: Fractures of the lumbar spine and thoracolumbar junction are common in
spinal trauma. The aim of this work is to analyze the nature of the
indications, the morbidity as well as the results of these treatment regimens. Patients and Methods: A
retrospective, single-center study, based on a review of 64 patients with
lumbar spine and thoracolumbar junction fractures (T10-L2) without neurological
disorders, was collected in the neurosurgery department of the North Hospital
and University Hospital (CHU), Marseille over a period of 2 years from January
2015 to December 2016. Posterior percutaneous osteosynthesis were more or less
associated with kyphoplasty preceded anterior arthrodesis. Clinical and
radiological endpoints were collected at least 6 months later. Results: The mean follow-up was 9.5
months (6 - 24). The clinical evaluation found a mean VAS at last follow-up at
14/100 (0 - 30) and an average Oswestry score at the last follow-up at 88%. The
initial average vertebral kyphosis went from 13° to 4° at the
last follow-up with a correction loss of 1°, an absolute gain of 8°.
No postoperative neurological complications were noted in our series. Conclusion: The implementation of a
two-step therapeutic strategy with anterior reconstruction in Magerl’s lumbar
spine or A3.3 thoracolumbar junction fractures allows effective and
long-lasting correction of lumbar lordosis and thoracic kyphosis, and obtaining
a balanced spine in the sagittal plane. Our functional results are close to
normal, with low morbidity and a low complication rate.
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