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Acta Neurochirurgica

, Volume 116, Issue 1, pp 53–59 | Cite as

Near-anatomical reduction and stabilization of burst fractures of the lower thoracic or lumbar spine

  • C. Silvestro
  • N. Francaviglia
  • R. Bragazzi
  • G. L. Viale
Clinical Articles

Summary

Thirty-one consecutive symptomatic patients with burst fractures of the lower thoracic or lumbar spine (T11-L4) were treated by early surgery in a 36-month period, with near-anatomical reduction being achieved via the postero-lateral route. Fusion and reconstruction of the vertebral body was done by using autologous or processed bovine bone. Correction of the kyphotic deformity was obtained by using distraction rods or transpedicular devices. The post-operative mean degree of kyphosis, percent vertebral height, and percent canal stenosis showed statistically significant differences, compared with the corresponding pre-operative mean values. All but one of the 25 patiens with incomplete paraplegia exhibited neurological improvement, with complete recovery occurring in 20 cases (median followup: 16 months) irrespective of the location of the lesion at the thoraco-lumbar junction (T11-L1) or the lower lumbar segment (L2-L4). Out of the 6 patients with pre-operative complete paraplegia, useful motor power returned in one case with a lesion below L1.

The results confirm the suitability of the postero-lateral route and are consistent with the assumption that early near-anatomical reduction and stabilization favours maximum neurological recovery in symptomatic patients.

Keywords

Spine injuries burst fractures surgical treatment surgical outcome 

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Copyright information

© Springer-Verlag 1992

Authors and Affiliations

  • C. Silvestro
    • 1
  • N. Francaviglia
    • 1
  • R. Bragazzi
    • 1
  • G. L. Viale
    • 1
  1. 1.Department of NeurosurgeryUniversity of Genoa Medical SchoolGenoaItaly

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