Radiographic and Neurological End result After Surgical Remedy of Traumatic Fractures of the Ankylotic Thoracic Backbone: A Retrospective Case Collection.
Oper Neurosurg (Hagerstown). 2018 Mar 01;14(three):224-230
Authors: Dru AB, Kubilis PS, Murad GA, Carney T, Hoh DJ
Summary
BACKGROUND: Spontaneous thoracic ankylosis is a progressive degenerative course of that predisposes sufferers to doubtlessly extremely unstable traumatic accidents. Acute hyperextension fractures lead to dynamic instability placing the spinal wire in danger.
OBJECTIVE: To explain preoperative radiographic traits of fractures of the ankylotic thoracic backbone and relate findings to early postoperative radiographic and medical outcomes.
METHODS: A single heart, retrospective evaluate was carried out of 28 surgically handled sufferers with fractures of the ankylotic thoracic backbone. Radiographic evaluation included preoperative fracture angulation (FA) and fracture displacement (FD), and postoperative change in sagittal alignment. Early medical outcomes included preoperative and postoperative American Spinal Harm Affiliation (ASIA) grade and perioperative problems.
RESULTS: Seven sufferers (25%) offered with poor neurological grade (ASIA A-C) in comparison with 21 (75%) with good grade (ASIA D, E). At presentation, poor grade sufferers had a imply FA of 16.four° (vary Zero°-34.5°), and FD of seven.76 mm (vary Zero.Eight-9.2). Good grade sufferers had a imply FA of 18.2° (vary Zero°-43.three°), and FD of four.77 mm (vary Zero-25.1). There was no statistically vital distinction in FA or FD between teams (P = .70 and .20 respectively). All underwent posterior pedicle screw fixation for stabilization. Fifty per cent of sufferers presenting with ASIA C or D spinal wire damage improved 1 or extra ASIA grades. There have been no perioperative problems. Early postoperative sagittal alignment was maintained with a imply change of -2.6°.
CONCLUSION: Presenting fracture alignment doesn’t considerably correlate with pre- or postoperative neurological standing. Early posterior stabilization preserved neurological operate, with neurological restoration occurring in a portion of people.
PMID: 29462447 [PubMed – in process]