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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Seo, Dong Kwang (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine) Kim, Chung Hwan (Department of Orthopaedic Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine) Jung, Sang Ku (Department of Emergency Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine) Kim, Moon Kyu (Spine Center, Gangneung Asan Hospital, University of Ulsan College of Medicine) Choi, Soo Jung (Spine Center, Gangneung Asan Hospital, University of Ulsan College of Medicine) Park, Jin Hoon (Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine)
저널정보
대한신경외과학회 대한신경외과학회지 대한신경외과학회지 제62권 제1호
발행연도
2019.1
수록면
96 - 105 (10page)

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Objective : The aims in the management of thoracolumbar spinal fractures are not only to restore vertebral column stability, but also to obtain acceptable alignment of the thoracolumbar junction (T-L junction) to prevent complications. However, insufficient surgical correction of the thoracolumbar spine would be likely to cause late progression of abnormal kyphosis. Therefore, we identified the surgical factors that affected unfavorable radiologic outcomes of the thoracolumbar spine after surgery. Methods : This study was conducted in a single institution from January 2007 to December 2013. A total of 98 patients with unstable thoracolumbar spine fracture were included. In these patients, fixation was done through transpedicular screws with rods by three surgical patterns. We reviewed digital radiographs and analyzed the images preoperatively and postoperatively during follow-up visits to compare the change of the thoracolumbar Cobb angle with radiologic parameters and clinical outcomes. The unfavorable radiologic group was defined as the patients who were measured as having greater than 20 degrees of thoracolumbar Cobb angle on the last follow-up, or who underwent kyphotic progression of thoracolumbar Cobb angle greater than 10 degrees from the immediate postoperative state to final follow-up, or who had overt instrument failure with/without additional surgery. We assessed the risk factors that affected the unfavorable radiologic outcomes. Results : We had 43 patients with unfavorable radiologic outcomes, including 35 abnormal thoracolumbar alignments and 14 instrumental failures with/without additional surgery. The multivariate logistic regression test showed that immediate postoperative T-L junction Cobb angle less than 10.5 degrees was a statistically significant risk factor, as well as the presence of osteoporosis (p=0.017 and 0.049, respectively). Conclusion : Insufficient correction of thoracolumbar kyphosis was considered to be a major factor of an unfavorable radiological outcome. The spinal surgeon should consider that having a T-L junction Cobb angle larger than 10.5 degrees immediately after surgery could result in an unfavorable radiological outcome, which is related to a poor clinical outcome.
#Spinal injuries #Thoracic vertebrae #Kyphosis #Risk factors

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참고문헌 (44)

참고문헌 신청
Akbarnia BA / 1994 / Use of long rods and a short arthrodesis for burst fractures of the thoracolumbar spine. a long-term follow-up study / J Bone Joint Surg Am 76:1629~1635 google schola Alanay A / 2001 / Short-segment pedicle instrumentation of thoracolumbar burst fractures: does transpedicular intracorporeal grafting prevent early failure? / Spine (Phila Pa 1976) 26:213~217 google schola Albayrak A / 2016 / Preoperative and postoperative photographs and surgical outcomes of patients with kyphosis / Spine (Phila Pa 1976) 41:E1185~E1190 google schola Been HD / 1999 / Comparison of two types of surgery for thoracolumbar burst fractures: combined anterior and posterior stabilisation vs. posterior instrumentation only / Acta Neurochir (Wien) 141:349~357 google schola Briggs AM / 2007 / Thoracic kyphosis affects spinal loads and trunk muscle force / Phys Ther 87:595~607 google schola

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