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2 "Unstable burst fracture"
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The Impact on Clinical Results by Sagittal Imbalance in Posterior Fixation for Thoraco-lumbar Burst Fractures
Seung Wook Baek, Kyu Dong Shim, Ye Soo Park
J Korean Fract Soc 2011;24(4):354-360.   Published online October 31, 2011
DOI: https://doi.org/10.12671/jkfs.2011.24.4.354
AbstractAbstract PDF
PURPOSE
Evaluate the effects of sagittal imbalance on the clinical outcomes in thoracolumbar burst fractures.
MATERIALS AND METHODS
We evaluated 11 patients who had received posterior fixation for unstable burst fractures. Radiologic assessment including the compression ratio, focal kyphotic angle and sagittal balance were obtained. The clinical outcomes were assessed by ODI, VAS and SF-36. We subdivided the patients into sagittal balance and imbalance group, and compared with clinical outcomes. The relationship between radiologic and clinical outcomes was examined using correlation analysis.
RESULTS
The radiologic assessment were changed on preoperative and postoperative as follows: mean compression ratio: 15.2%, 4.9%, mean focal kyphotic angle: 43.2degrees, 20.9degrees. The mean sagittal balance was 11.5 cm. The mean score of VAS, ODI, Physical and Mental Component Summary of SF-36 were 3.7, 45.8, 43.3 and 39.8, respectively. The ODI was significantly higher in sagittal imbalance group, and SF-36 was significantly higher in sagittal balance group (p<0.05). The VAS was correlated with compression ratio and focal kyphotic angle. The ODI and Mental Component Summary of SF-36 were correlated with sagittal imbalance.
CONCLUSION
Sagittal balance effects on the functions of spine, surgical treatment should be carefully considered with unstable burst fractures.
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Relevancy of Posterior Column Injury and Dural Tear in Unstable Burst Fracture
Ye Soo Park, Kee Hun Son, Ki Chul Park, Il Hoon Sung, Jae Lim Cho
J Korean Fract Soc 2005;18(1):65-68.   Published online January 31, 2005
DOI: https://doi.org/10.12671/jkfs.2005.18.1.65
AbstractAbstract PDF
PURPOSE
To analyze the pattern of posterior column injury in unstable burst fractures and to predict the possibility of dural injury.
MATERIALS AND METHODS
Retrospective review was carried out on 22 patients of unstable burst fracture from Nov. 1996 to Sep. 2003. The pattern posterior column injury was analyzed by simple x-ray, CT and MRI findings. In simple x-ray, authors analyzed laminar fracture, posterior facet injury, inter-spinous widening and inter-spinous malalignment, posterior bony injury by CT, posterior inter-spinous ligament injury and dural tear by MRI. The statistical analysis was performed using Mann-Whitney test and Chi-square test.
RESULTS
There were 13 men and 9 women, and mean age was 41 years-old (18~65). The level of injury showed 15 cases in T12-L2, 6 in L3, 3 L4. In simple x-ray, findings were showed 13 cases (59.1%) in laminar fracture, 7 (31.8%) in posterior facet injury, 16 (72.7%) in inter-spinous widening and 8 (36.4%) in inter-spinous malalignment. In CT, findings were showed 13 (59.1%) in laminar fracture, 10 (45.5%) in posterior facet injury, 9 (40.9%) in transverse process fracture. In MRI, findings were showed 18 (81.8%) in posterior inter-spinous ligament injury and were not showed dural tear. The combined cases of posterior bony and ligamentous injury was 6 (27%) and 5 of 6 showed dural tear and the analysis of dural tear and radiologic findings was showed positive correlation (p=0.004).
CONCLUSION
Posterior ligament injury was more frequent than bony injury in unstable burst fracture. Among the posterior bony injuries, dural tear was more frequent in facet injury. Authors confirmed all dural tear with operation. In cases of posterior bony injury combined with ligamentous injuries, the possibility of dural tear was significantly higher than that of single structural injury (p=0.004).

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
  • Relationship between Lamina Fractures and Dural Tear in Low Lumbar Burst Fractures
    Ki-Chan An, Dae Hyun Park, Yong-Wook Kwon
    Journal of the Korean Fracture Society.2011; 24(3): 256.     CrossRef
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