González RyGA, Amaya HDC

Language: Spanish
References: 17
Page: 273-278
PDF size: 178.04 Kb.

ABSTRACT

Background: Thoraco-lumbar fractures of the spine are serious injuries that endanger patient's life and produce severe sequelae, with the highest incidence in young people. The objective of surgical treatment of vertebral fractures is to restore the stability of the spine and preserve neurological function for an early mobilization of the patient to maintain the maximum number of mobile segments. Transpedicular osteosynthesis of two or more functional segments with the inclusion of the fractured vertebra is a common and recommended practice in the treatment of vertebral fractures.
Objective: To compare the percentage of vertebral collapse postsurgery and the evolution of patients with unstable thoraco-lumbar fractures using the method of vertebral re-expand (Rebatu technique) and posterior instrumentation.
Patients and method: There were two groups of patients; in the first was performed posterior instrumentation with traditional technique in patients with thoraco-lumbar fractures; in the other group the same procedure was performed, in addition to re-expansion of vertebra with intracorporeus autologous graft, through fluoroscopic visualization. We got antero-posterior and lateral radiographs of thoracolumbar spine, measurements of thoracic kyphosis, and percentage of fractured vertebra compression of all patients. At the end of the procedure, and then at 2, 4, 6 and 12 months same measurements were made. Vertebral re-expansion technique was created by Alejandro Gonzalez Rebatu y Gonzalez, spinal surgeon and orthopedist at Regional Hospital 1° de Octubre, ISSSTE.
Results: Twelve patients treated only with posterior instrumentation suffered a vertebral collapse in 10 to 25% of the vertebral body, clinically manifested with pain in thoraco-lumbar region, normal curvature changes and, in some cases, radicular involvement. This collapse did not decrease at all despite rehabilitation, analgesic and relaxing muscle. One of the 12 patients treated with posterior instrumentation showed fatigue of osteosynthesis material nine months after the treatment, and other patient rejected osteosynthesis material, so it was necessary to remove it.

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