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首页> 外文期刊>Archives of orthopaedic and trauma surgery. >Conservative management of thoracolumbar and lumbar spine compression and burst fractures: functional and radiographic outcomes in 136 cases treated by closed reduction and casting.
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Conservative management of thoracolumbar and lumbar spine compression and burst fractures: functional and radiographic outcomes in 136 cases treated by closed reduction and casting.

机译：胸腰椎和腰椎压缩和爆裂性骨折的保守治疗：136例行闭合复位复位铸造的功能和影像学结果。

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INTRODUCTION: Both fractures of the lumbar spine and at the thoracolumbar junction are quite common. The treatment of these fracture types is discussed controversially. Some authors advocate surgical treatment even in fractures without neurologic compromise while other series report good results after non-operative treatment. MATERIALS AND METHODS: Between January 1997 and April 2004, 324 patients with spinal fractures were admitted to our institution. Hundred and thirty-six patients with compression and burst type fractures treated by closed reduction and casting were available for follow-up. Their medical records, radiographs and computer tomography scans were reviewed and their functional status was assessed. RESULTS: 94 male (69.1%) and 42 female (30.9%) patients with a mean age of 48.6 years (range 17-81) at time of injury were included. The thoracolumbar junction (T11-L1) was affected in 104 patients (76.5%). 23.5% had lumbar fractures. All of the burst type fractures with involvement of the posterior column affection were type A3.3. fractures according to the Magerl classification. Significant correction of radiographic parameters was achieved in the early postreduction period (P < 0.0001). Reduction could not be maintained at the final follow-up but still showed slight improvement compared to the initial presentation. Reduction could be maintained better in the thoracolumbar region than in the lumbar spine. Neurologic function was restored in all patients with unilateral radicular pain but only one patient recovered fully after cauda equina-syndrome. Patients after lumbar spine indicated a higher level of pain when compared to patients with fractures at the thoracolumbar junction. DISCUSSION: Closed reduction and casting is a safe and effective method for treatment of compression and burst type fractures at the thoracolumbar junction and can restore neurologic function in patients with unilateral radicular pain. It is of limited value in lumbar fractures and in burst type fractures with posterior column involvement.
机译：简介：腰椎和胸腰椎交界处的骨折都很常见。这些骨折类型的治疗方法存在争议。一些作者主张即使在没有神经系统损害的骨折中也要进行手术治疗，而另一些系列则在非手术治疗后报告了良好的效果。材料与方法：1997年1月至2004年4月，我院收治324例脊柱骨折患者。闭合性复位和铸造治疗的压缩性和爆裂型骨折的一百三十六例患者可以进行随访。他们的病历，X光片和计算机X线断层扫描已得到审查，并对其功能状态进行了评估。结果：包括94例男性（69.1％）和42例女性（30.9％）患者，受伤时平均年龄为48.6岁（范围17-81）。胸腰椎交界处（T11-L1）受累104例（76.5％）。 23.5％有腰椎骨折。与后柱牵连的所有爆裂型骨折均为A3.3型。根据Magerl分类的骨折。在缩小后早期，放射学参数得到了显着校正（P <0.0001）。在最后的随访中无法保持减少，但与最初的表现相比仍显示出轻微的改善。胸腰椎区域的复位比腰椎更好。所有患有单侧神经根痛的患者的神经功能均得到恢复，但只有一名患者在马尾综合征后完全康复。与胸腰椎交界处骨折的患者相比，腰椎术后的患者表现出更高的疼痛水平。讨论：闭合复位铸造是治疗胸腰椎交界处压缩性和爆裂型骨折的一种安全有效的方法，可以使单侧放射状疼痛的患者恢复神经功能。它在腰椎骨折和后柱累及的爆裂型骨折中价值有限。

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