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首页> 外文期刊>Medicine. >Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation: Case report and literature review
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Clinical outcome and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation: Case report and literature review

机译：胸腰椎骨折手术失败后创伤性后凸畸形的临床疗效和手术策略：病例报告和文献复习

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Rationale: Thoracic-lumbar vertebral fracture is very common in clinic, and late post-traumatic kyphosis is the main cause closely related to the patients’ life quality, which has evocated extensive concern for the surgical treatment of the disease. This study aimed to analyze the clinical outcomes and surgical strategies for late post-traumatic kyphosis after failed thoracolumbar fracture operation. Patient concerns: All patients presented back pain with kyphotic apex vertebrae between T12 and L3. According to Frankel classification grading system, among them, 3 patients were classified as grade D, with the ability to live independently. Diagnoses: A systematic review of 12 case series of post-traumatic kyphosis after failed thoracolumbar fracture operation was involved. Interventions: Wedge osteotomy was performed as indicated—posterior closing osteotomy correction in 5 patients and anterior open-posterior close correction in 7 patients.Postoperatively, thoracolumbar x-rays were obtained to evaluate the correction of kyphotic deformity, visual analog scales (VAS) and Frankel grading system were used for access the clinical outcomes. Outcomes: All the patients were followed up, with the average period of 38.5 months (range 24–56 months). The Kyphotic Cobb angle was improved from preoperative (28.65 ± 11.41) to postoperative (1.14 ± 2.79), with the correction rate of 96.02%. There was 1 case of intraoperative dural tear, without complications such as death, neurological injury, and wound infection. According to Frankel grading system, no patient suffered deteriorated neurological symptoms after surgery, and 2 patients (2/3) experienced significant relief after surgery. The main VAS score of back pain was improved from preoperative (4.41 ± 1.08) to postoperative (1.5 ± 0.91) at final follow-up, with an improvement rate of 65.89%. Lessons: Surgical treatment of late post-traumatic kyphosis after failed thoracolumbar fracture operation can obtain good radiologic and clinical outcomes by kyphosis correction, decompression, and posterior stability.
机译：理由：胸腰椎骨折在临床上很常见，创伤后后凸畸形的晚期是与患者生活质量密切相关的主要原因，这引起了对该病的外科治疗的广泛关注。本研究旨在分析胸腰椎骨折手术失败后创伤后后凸畸形的临床结果和手术策略。患者关注：所有患者均在T12和L3之间出现腰背脊柱后凸椎骨疼痛。根据Frankel分类分级系统，其中3例具有独立生活能力的患者被分类为D级。诊断：回顾性分析了胸腰椎骨折手术失败后创伤后凸畸形的12例病例。干预措施：按照指示进行楔形截骨术-5例行后闭合截骨矫正，7例行前开放-后闭合矫正。术后，获得胸腰X线片以评估后凸畸形，视觉模拟量表（VAS）和使用Frankel评分系统获取临床结果。结果：所有患者均获随访，平均38.5个月（24-56个月）。 Kyphotic Cobb角从术前（28.65±11.41）改善为术后（1.14±2.79），矫正率为96.02％。术中硬脑膜撕裂1例，无死亡，神经损伤，伤口感染等并发症。根据Frankel评分系统，没有患者在手术后出现恶化的神经系统症状，并且2名患者（2/3）在手术后明显缓解。最终随访时，背痛的主要VAS评分从术前（4.41±1.08）改善为术后（1.5±0.91），改善率为65.89％。经验教训：胸腰椎骨折手术失败后的创伤后后凸畸形的手术治疗可通过后凸畸形矫正，减压和后稳定性获得良好的放射学和临床效果。

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