41 research outputs found
Classification of thoracolumbar fractures and dislocations
A classification of injuries is necessary in order to develop a common language for treatment indications and outcomes. Several classification systems have been proposed, the most frequently used is the Denis classification. The problem of this classification system is that it is based on an assumption, which is anatomically unidentifiable: the so-called middle column. For this reason, few years ago, a group of spine surgeons has developed a new classification system, which is based on the severity of the injury. The severity is defined by the pathomorphological findings, the prognosis in terms of healing and potential of neurological damage. This classification is based on three major groups: AÂ =Â isolated anterior column injuries by axial compression, BÂ =Â disruption of the posterior ligament complex by distraction posteriorly, and group CÂ =Â corresponding to group B but with rotation. There is an increasing severity from A to C, and within each group, the severity usually increases within the subgroups from .1, .2, .3. All these pathomorphologies are supported by a mechanism of injury, which is responsible for the extent of the injury. The type of injury with its groups and subgroups is able to suggest the treatment modality
RETROSPECTIVE COMPARATIVE ANALYSIS OF SURGICAL TREATMENT OF THORACOLUMBAR BURST FRACTURE: SHORT VERSUS LONG FIXATION
Acesso anterior para pacientes com fraturas traumĂĄticas do tipo compressĂŁo do segmento toracolombar (T11 a L2) da coluna vertebral Anterior approach in patients with traumatic compression fracture type of thoracolumbar spine (T11-L2)
OBJETIVO: Relatar a experiĂȘncia com o acesso anterior em fraturas traumĂĄticas do tipo compressĂŁo no segmento toracolombar (T11 a L2) que foram submetidos Ă cirurgia pelo acesso anterior. MĂTODO: Estudo prospectivo de janeiro de 1994 a janeiro de 2004 envolvendo 32 pacientes. A presença da fusĂŁo Ăłssea e do alinhamento foram analisadas 6 e 12 meses apĂłs a cirurgia. RESULTADOS: A idade mĂ©dia foi 36,53 anos, sendo 23 do sexo masculino. A vĂ©rtebra mais atingida foi L1 (n=12). A maioria dos casos que internaram em ASIA/IMSOP C (n=10) e D (n=13) evoluiram para ASIA/IMSOP E. A mĂ©dia da deformidade angular prĂ©-operatĂłria foi 14,9°±7,5°, com diferença estatĂstica (p<0,0001) na comparação com o valor encontrado no pĂłs-operatĂłrio de 30 dias. CONCLUSĂO: A via anterior permite melhor descompressĂŁo do canal e uma correção da deformidade angular superior Ă observada pela via posterior isolada.<br>OBJECTIVE: To describe experience with anterior access in compression fractures of thoracolumbar segment (T11 to L2) traumatic fractures that undergone anterior access surgery. METHOD: A prospective study was conducted between January 1994 and January 2004 with 32 patients. The bone fusion and thoracolumbar alignment were analyzed 6 months and 12 months after the surgery. RESULTS:The average age was 36.53 years old with 23 male patients. The most compromised vertebrae was L1 (n=12). The 23 patients that was ASIA/IMSOP C and ASIA/IMSOP D turned to ASIA/IMSOP E after 1 month (n=12) and 12 months (n=5) of surgery. The preoperative angular deformity average was 14.9°±7.5°. Statistical significance was found (p<0.0001) when compared to the 30 days postoperative value. CONCLUSION: The anterior access permits a better spinal canal decompression and angular deformity correction when compared with the posterior access alone