Acta Ortopédica Mexicana

de la Torre GD, Góngora LJ, Huerta OVM, Gómez-Llata GS
Treatment of thoraco-lumbar vertebral instability by transpedicular instrumentation system “Hospital Juárez de México
Acta Ortop Mex 2000; 14 (1)

Language: Español
References: 19
Page: 41-43
PDF: 65.42 Kb.

[Fulltext - PDF]

ABSTRACT

This is a series of 189 patients who had thoraco-lumbar instability produced either by: spondylolysis, spondylolysthesis, postoperative instability, fractures, vertebral infection or primary or methastatic vertebral tumors and who were treated by the HJM (Hospital Juárez de México) low-cost spine fusion transpedicular system from January 1994 through December 1998. This technique allows specific fusion of short segments, including one level above and below of the unstable level in cases of bone tumors or Pott’s disease when 2 or more vertebral bodies are involved. Two extra levels instead of one must be taken in cases of osteoporotic bone. Surgical exposition is limited and greater mobility segments can remain untouched. Average follow-up was 26 months (10 to 36). Postoperative spinal stability was achieved in the 100% of the cases. Immediate complications were 4 cases of infection and one of thromboembolism. Late complications were, 7 removals if instrumentation because of breaking or loosening and 5 of late infection.


Key words: stability, spine, thorax, lumbar spine, surgery, technique.


REFERENCES

  1. Akbarnia VA, Fogarty JP, Smith KR Jr. New trends in surgical stabilization of thoraco-lumbar spinal fracture with emphasis for sublaminar wiring paraplegia. 1985; 23: 27-33.

  2. Denis F. Spinal unstability as defined by the three-column spine concept in acute trauma. Clin Orthop. 1984; 189: 65-76.

  3. Dove J. Internal fixation of the lumbar spine. The Hartshil rectangle. Clin Orthop 1986; 203: 135-40.

  4. Farcy JP, Weidenbaum M, Micheisen CB et al. A comparative biomechanical study fixation using Cotrel-Dubousset instrumentation. Spine 1987; 12: 877-81.

  5. Flatley TJ, Derderian H. Closed loop instrumentation of the lumbar spine. Clin Orthop 1985; 196: 273-6.

  6. Hamilton A. The role of anterior surgery for vertebral fractures with and without card compression. Clin Orthop Rel Res 1994; 300: 79-89.

  7. Harri Pihlajamaki. Posterolateral lumbosacral fusion with transpedicular fixation. Acta Orthop Scand 1996; 67(1): 63-8.

  8. Harrington PR. The history and development of Harrington instrumentation. Clin Orthop 1975; 112: 4-8.

  9. Henry HB. Anterior decompression for lates pain and paralysis after fractures of the thoracolumbar spine. Clin Orthop Rel Res 1994; 24: 29.

  10. Journal of the Southern Orthopaedic Association. Pedicle screw instrumentation for unstable thoracolumbar fractures. 1996.

  11. Kinnard P, Chibely A, Gordon D et al. Roy-Camille plates in unstable spinal conditions: a preliminary report. Spine 1986; 11: 131-5.

  12. Luque ER. Interpeduncular segmental fixation. Clin Orthop 1986; 203: 54-7.

  13. Luque ER. Segmental spinal instrumentation of the lumbar spine. Clin Orthop 1986; 203: 126-34.

  14. Luque ER. The anatomic basis and development of segmental spine instrumentation. Spine 1982; 7: 256-9.

  15. Maind DJ, Pintar FA. Anatomy and clinical biomechanics of the thoracic spine. Clin Neurosurg 1992; 38: 296-324.

  16. Maind DJ, Sances A Jr, Myclebust JB et al. Experimental trauma of the human thoracolumbar spine. In: Sances A Jr, Thomas DJ, Ewing CL et al. (Eds). Mechanisms of head and spine trauma. Goshen NY: Aloray 1986: 489-504.

  17. McAfee PC, Werner FW, Glisson RR. A biochemical analysis of spinal instrumentation systems in thoracolumbar fractures. Spine 1985; 10: 204-417.

  18. Ogilvie JW, Schendel M. Comparison of lumbosacral fixation device. Clin Orthop 1986; 203: 120-5.

  19. Roy-Camille R, Saillant G, Mazel C. Internal fixation of the lumbar spine with pedicle screw plating. Clin Orthop 1986; 203: 7-17.