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Posterior instrumentation with transpedicular calcium sulphate graft for thoracolumbar burst fracture

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Abstract

From October 2005 to September 2006, 20 patients with an acute thoracolumbar burst fracture underwent posterior instrumentation with transpedicular intracorporeal calcium sulphate grafting. The mean age of the patients at surgery was 41.8 years; 14 were men and six were women. The mean follow-up period was 28.5 months. Pre-operative computed tomography showed that the mean canal compromise was 53.5%. The Cobb angle was improved from 21.70 to 2.40°, and the final loss of correction was 4.60°. The anterior body height was corrected from 50.3% to 86.6%, and the average loss of anterior body height was 7.7% at final follow-up. All six patients with partial neurological deficit initially had improvement. According to the Denis criteria, the average pain score was 1.8, and the final mean work score was 2.5. Only one case had implant failure. Analysis of the results indicated that this technique can restore and maintain sagittal alignment and anterior body height, providing satisfactory short-term clinical results.

Résumé

D’octobre 2005 à septembre 2006, 20 patients ayant présenté une fracture thoraco lombaire ont bénéficié d’une instrumentation postérieure avec greffe transpédiculaire intercorporéale. Les patients étaient âgés de 41,8 ans au moment de l’intervention, 14 étaient de sexe masculin et 6 de sexe féminin. Le suivi moyen a été de 28,5 mois. L’angle de Cobb s’est amélioré de 20,80° à 2,40° et la perte de correction n’a été, au suivi final, que de 4,60°. La hauteur du mur vertébral antérieur s’est corrigé de 50,3% à 86,6%, la perte de hauteur n’a été de que 7,7% au dernier suivi. Les six patients ayant présenté un déficit neurologique partiel initial ont été améliorés. Selon les critères de Denis, la valeur moyenne du score était de 1,8 et le score travail de 2,5 au suivi final. Un seul cas présentait un débricolage des implants. L’analyse de ces résultats permet de penser que cette technique peut restaurer un bon alignement sagittal et la hauteur des corps vertébraux avec des résultats satisfaisants à court terme.

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Authors and Affiliations

  1. Orthopedics Department, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan

    Jen-Chung Liao, Kuo-Fong Fan, Wen-Jer Chen & Lih-Huei Chen

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  1. Jen-Chung Liao
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  2. Kuo-Fong Fan
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  3. Wen-Jer Chen
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  4. Lih-Huei Chen
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Correspondence to Kuo-Fong Fan.

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Liao, JC., Fan, KF., Chen, WJ. et al. Posterior instrumentation with transpedicular calcium sulphate graft for thoracolumbar burst fracture. International Orthopaedics (SICOT) 33, 1669–1675 (2009). https://doi.org/10.1007/s00264-008-0677-x

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  • DOI: https://doi.org/10.1007/s00264-008-0677-x

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