Journal of Musculoskeletal Trauma

Comparison of Surgical Outcomes in Thoracolumbar Fractures Having 6 or Less Scored by Load-Sharing Classification Based on Posterior Fusion Level: Jung Hoon Kim, Sung Soo Kim, Jin Ho Cho, Bo Hoon Jang, Jin Hwan Kim; J Korean Fract Soc 2013;26(1):21-26. Published online January 31, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.1.21

Abstract PDF: PURPOSE
The aim of this study is to decide the optimal level of fusion with comparing the results between the short segment fusion and long segment fusion treated with pedicle screw instrumentation, including fractured vertebra in thoracolumbar junctional fractures.
MATERIALS AND METHODS
From February 2000 to November 2009, fifty three patients with junctional fracture of thoracolumbar spine were treated with pedicle screws and posterior fusion at our hospital. They were divided into two groups, the short segment group and long segment group. Preoperatively, immediate postoperative and last follow-up lateral radiological evaluation was done by measuring the correction and loss of segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle. In addition, operation time and amount of intraoperative bleeding were measured.
RESULTS
There were no significant differences of statistical analysis regarding the radiological variables between the two groups, especially the loss of corrected segmental kyphosis, wedge angle, body compression rate and instrumented vertebra angle (p>0.05). However, operative time in the short segment group (234 minutes) was shorter than the long segment group (284 minutes), and there was statistical significance (p=0.002).
CONCLUSION
We recommend the short segment transpediculr instrumentation one level above and one level below, including the fractured vertebra for thoracolumbar junctional fracture with 6 points or less of the load-sharing score.

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Multiple Non-contiguous Spine Fractures with Concomitant Injuries: A Case Report: Soo Uk Chae, Yeung Jin Kim, Jung Hwan Yang, Ji Wan Lee, Jae In Park; J Korean Fract Soc 2011;24(3):267-270. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.267

Abstract PDF: Multiple non-contiguous spinal fracture is a special type of multi-level spinal injury, which is rare but most frequently occur in motor vehicle accident or a falling from a height. We report five patients of multiple non-contiguous spinal fractures. All patients underwent segmental pedicle screws fixation without fusion for preserving facet joints and minimizing blood loss and operation time. We performed necessary operation for any concomitant injuries at the same day.

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Biomechanical Efficacy of Various Anterior Spinal Fixation in Treatment of Thoraco-lumbar Spine Fracture: Ye Soo Park, Hyoung Jin Kim, Choong Hyeok Choi, Won Man Park, Yoon Hyuk Kim; J Korean Fract Soc 2007;20(1):70-75. Published online January 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.1.70

PURPOSE
To evaluate the biomechanical results according to various anterior spinal fixation methodology in the treatment of thoracolumbar spine fracture.
MATERIALS AND METHODS
The comparative analysis of fixation method was evaluated by three dimensional finite element model using the 1 mm reconstruction image of CT. Authors evaluated the flexion, extension, lateral bending, torsional stresses with 12 fixation methods for the compression and burst fracture.
RESULTS
In biomechanical analysis, stiffness of body-fixation device was more stable in two-rod system in compression fracture and was stable in one-rod, two-rod system in burst fracture, but two-rod system was showed over-increase of stiffness.
CONCLUSION
Authors recommend the usage of two-rod system in anterior fixation only and anterior one-rod system in anterior-posterior fixation.

Citations

Citations to this article as recorded by

Lumbar Spine Fracture
Seung-Wook Back, Hyun-Joong Cho, Ye-Soo Park
Journal of the Korean Fracture Society.2011; 24(3): 277. CrossRef

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Cervical Spine Fractures in Ankylosing Spondylitis : A case Report: Jae Yoon Chung, Jung Pil Heo, Hyong Yeon Seo; J Korean Soc Fract 1997;10(1):175-179. Published online January 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.1.175

Abstract PDF: The patient with ankylosing spondylitis is easily apt to be fractured in spine regions, even by minor trauma due to severe limitation of spinal motion and progressive osteoporosis. In those patients, accurate reduction and rigid internal or external immobilization and postoperative early mobilization is very important to treat or prevent the spinal cord injury. Untill now halo-vest immobilization or posterior fusion is widely accepted method of treatment and there was no report about anterior plate fixation. Authors fused the patient anterorily with tricortical iliac graft and plate with compression mechanism to get early solid bony union, to increase the immediate rigid stability, to correct the deformity and to mobilize the patient early as possible. We have experienced a 54-year-old male patient with ankylosing spondylitis complicating traumatic fracture of the cervical spine at C6-7 and follow up study of 9 years was possible. The patient was injured by minor pedestrian motor vehicle accident. Pre-injury activity was normal, and neurological status was Frankel grade D just after trauma however, it was aggrevated to Frankel grade C paraplegia during position change before operation. The patient was anesthesized with aid of the tracheostomy. Anterior plate fixation was performed with tricortical iliac suut bone graft and plate. And then early mobilization was encouraged with SOMI brace. Neurological status was improved and there was no peri- and post-operative complications. Systemic complications was not occured also. Re-displacement at fracture site with minimal screw loosening during follow up period was observed however, solid bony union was obtained at post-operative 3 months without further displacement or loosening. We report this case with review of literatures for good clinical result of anterior fusion with plate during long term follow up period of 9 years.

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Nonoperative Management of Stable Thoracolumbar Fracture with Bracing in Old Age: Jong Oh Kim; J Korean Soc Fract 1996;9(3):750-758. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.750

Abstract PDF: Fourteen neurologically intact patients with stable fractures at the thoracolumbar junction above 60yrs old age were treated with early ambulation in a total contact orthosis, Jewett Brace, Knight-Taylor Brace and had followed up greater than one year. Spinal orthosis have been traditionally used in the management of thoracolumbar junction treated with or without surgical stabilization However, the orthotic treatment modality in the management of spinal fractures remain subjective, especially old age. since few objective data are available on the effectiveness of orthosis in stabilizing injuried segments. At minimum follow up of one year, an overall outcome evaluation involved verbal numerical scale ( VNS ) and radilogical assessment. Approxiamately 80% of the patient had under 3 points in the verbal numerical scale, serial roentgenograms documented significant progressing in body collapse which averaged 9.6% compression,5.2 in Cobbs angle, not correlate with type of brace. Mainly body collapse and increasing Cobbs angle at the fracture site developed within posttraumatic 3 months. Degree of osteoporosis did not correlate with change in deformity. Initial radiographic severity of injury or residual deformity following closed management did not correlate with symptoms at follow-up. This pattern of results suggested comportable brace treatment such as Jewett and Knight-Taylor Brace, as the preferred treatment in stable thoracolumbar fracture in old age.

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Treatment of Unstable Thoracic and Lumbar Spine Fracture with Harrington SSI(Segmental Spinal Instrumentation): Se IL Suk, Choon Ki Lee, Chong Suh Lee; J Korean Soc Fract 1988;1(1):54-63. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.54

Abstract PDF: This is a retrospective clinical and roentgenographic study to measure the correction of deformity and rigidity of Harrington SSI in the stabilization of unstable thoracic and lumbar spine fractures. 35 patients with unstable thoracic and lumbar spine fracture were treated with Harrington SSI from Feb. 1985 to Mar. 1987 in SNUH and 29 patients were followed up for more than 1 year, average 15.6 months. At final follow up of these 29 patients, 73.1% of patents gained neurologic improvment. Measurement of correction of anterior, middle and posterior coumn height, local kyphosis and anteroposterior offset were 29.7%, 5.2%, 31.2%, 12.8Â° and 5.3mm and loss of correction of these were 6.5%, 0.1%, 5.8%, 3.1Â° and 1.1m.

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