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Combined posterior-anterior stabilisation of thoracolumbar injuries utilising a vertebral body replacing implant.
- Source :
-
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society [Eur Spine J] 2009 Jul; Vol. 18 (7), pp. 949-63. Date of Electronic Publication: 2009 Apr 09. - Publication Year :
- 2009
-
Abstract
- The authors report on a prospectively followed series of 35 patients with injuries of the thoracolumbar spine from T7 to L3. The radiological course after combined posterior-anterior surgery with anterior column reconstruction with a distractible vertebral body replacing implant demonstrated a stable reconstruction technique with almost no re-kyphosing. In 18/18 patients with CT follow-up intervertebral fusion was observed as bony bridging lateral to the VBR implant. The functional/clinical outcome of the patients was analysed with a set of eight validated outcome scales. After an average follow-up period of 2(1/2) years encouraging results were noticed. The neurological improvement rate (> or =1 Frankel/ASIA grade) was 8/12 patients (67%) with a complete recovery in 6 cases. 17/29 patients returned to former occupation; 20/29 patients returned to former leisure activities; 24/28 patients rated their general outcome as "unlimited and pain free" or "occasionally and/or mild complaints" with a VAS score of >80 (scale 0-100). The psychometric questionnaires revealed good results with strong correlation comparing the different scoring systems statistically: mean McGill Pain Questionnaire 12.5 (0-40); mean Oswestry Disability Index 20% (0-51). 13/29 patients scored <4 in the Roland and Morris Disability Questionnaire. The German back pain questionnaire (Funktionsfragebogen Hannover Rücken) showed a mean "functional capacity" of 75%, corresponding with moderate restriction. We concluded the presented method as highly effective to completely reduce and maintain an anatomic spinal alignment. The outcome tended to be better in comparison with non-operatively treated patients as well as with norm populations with low back pain.
- Subjects :
- Adult
Aged
Disability Evaluation
Female
Humans
Internal Fixators statistics & numerical data
Kyphosis etiology
Kyphosis pathology
Kyphosis prevention & control
Lumbar Vertebrae pathology
Male
Middle Aged
Outcome Assessment, Health Care methods
Pain Measurement
Prospective Studies
Radiography
Recovery of Function physiology
Self-Evaluation Programs
Spinal Cord Compression physiopathology
Spinal Cord Compression prevention & control
Spinal Cord Compression surgery
Spinal Fractures diagnostic imaging
Spinal Fractures pathology
Spinal Injuries diagnostic imaging
Spinal Injuries pathology
Surveys and Questionnaires
Thoracic Vertebrae diagnostic imaging
Thoracic Vertebrae pathology
Treatment Outcome
Young Adult
Lumbar Vertebrae surgery
Prostheses and Implants statistics & numerical data
Spinal Fractures surgery
Spinal Fusion instrumentation
Spinal Fusion methods
Spinal Injuries surgery
Thoracic Vertebrae surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0932
- Volume :
- 18
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
- Publication Type :
- Academic Journal
- Accession number :
- 19357875
- Full Text :
- https://doi.org/10.1007/s00586-009-0970-4