One stage posterior-anterior correction for thoracolumbar kyphosis due to chronic spine fracture

English Keywords:Thracolumbar fracture  Chronic  Kyphosis  Correction  Anterior-posterior approach

English Abstract:

  【Abstract】　Objectives: To evaluate the feasibility of one stage posterior-anterior correction for thoracolumbar kyphosis due to chronic spine fracture. Methods:　Between June 2005 and October 2010,　21 cases suffering from thoracolumbar kyphosis due to chronic spine fracture were treated surgically.　There were 13 males and 8 females with an average age of 37.6 years(range, 23-61 years). All cases had single segmental fractures, with the affected levels of T11 in 1 case,　T12 in 7 cases,　L1 in 8 cases, and L2 in 5 cases.　The kyphotic Cobb angle averaged 38.6°(range,　23°-59°). All the patients presented serious low back pain. The preoperative VAS score of back pain averaged 7.6(range, 7.1-10). 9 cases were complicated with neurological deficits. According to preoperative Frankel grading system, there were 2 grade B,　2 grade C and 5 grade D. Four patients were complicated with sphincter dysfunction. The preoperative CT showed osseous fusion of articular process joint in 14 cases, osteophyte and bone bridge formation in 16 cases.　The kyphotic Cobb angle,　neural function and VAS of back pain were reviewed and compared. Results:　All patients underwent surgery safely and no severe complications were noted. The operation time was 150-310min(average, 200min), and the perioperative blood loss was 400-1200ml(average, 650ml).　All cases were followed up for 12-60 months(average, 21.3 months). Postoperative low back pain alleviated in all cases, with the VAS score averaging 2.1（range, 1.5-2.6） at 1 year after operation.　The Cobb angle of kyphosis averaged 11.1°(range, 5°-23°) at final follow-up, which improved significantly compared with the preoperative ones(P<0.05). The correction rate was 71.3%. Solid fusion was obtained with the fusion duration of 4.3 months in average.　Eight patients had neurofunction improved, while sphincter function improved in 3 cases. Conclusions: One stage posterior-anterior release and correction is effective and reliable for thoracolumbar kyphosis due to chronic spine fracture.