کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4096230 1268555 2015 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Modified closing-opening wedge osteotomy for the treatment of sagittal malalignment in thoracolumbar fractures malunion
ترجمه فارسی عنوان
استئوتومی گوه ای باز شدن بسته شدن-باز برای درمان کمرنگ شدن ساجیتال در شکستگی های توراخالولار
کلمات کلیدی
بلند شدن آئورت، کیفوز، مقیاس سنجش ساجیتال، کوتاه کردن نخاع، استئوتومی ستون فقرات، شکستگی تورا کالولار
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی ارتوپدی، پزشکی ورزشی و توانبخشی
چکیده انگلیسی

Background ContextMany techniques have been described for the surgical treatment of rigid posttraumatic thoracolumbar kyphosis, but none is well adapted to the modified shape of the wedged vertebra.PurposeThe study aimed to describe the modified closing-opening wedge osteotomy (MCOWO), a new osteotomy technique that adapts to the triangular shape of the wedged apical vertebra of the deformity.Study DesignA retrospective assessment of the degree of correction before and after the MCOWO was carried out.Patient SampleTen patients presenting rigid posttraumatic thoracolumbar kyphosis were enrolled in this study.Outcome MeasuresWe used preoperative and postoperative whole spine radiographs to assess the sagittal plane parameters, and computed tomography scan for measurement of the vertebral segment height at the osteotomy level, spinal cord length, aorta length, and fusion rate.MethodsTen patients underwent the MCOWO at T12 or L1. The procedure involves removing the postero-superior triangular corner of the wedged vertebra and transforming it to a shape similar to a trapezoid.ResultsThe patients' mean age was 36.6±7.5 years, the mean time between the fracture and the surgery was 12.2±5.6 months, and the mean follow-up was 30.6±5 months. In all patients, statistically significant improvement was observed in the sagittal plane after surgery. The thoracolumbar angle improved from 52±6° preoperatively to 7.1±5.7° at the last follow-up. Mean osteotomy angle was 38.1±2.6°, mean spinal cord shortening was 1.2±0.2 cm, and mean aorta lengthening was 2.3±0.4 cm. All the patients showed complete fusion at 2 years, and none required revision surgery. Two patients presented a temporary unilateral weakness that recovered completely within 3 months after the surgery.ConclusionsThe MCOWO is an interesting procedure for patients with posttraumatic thoracolumbar kyphosis. The modified osteotomy is adapted to the modified shape of the compressed vertebra. Spinal cord shortening and aorta lengthening were well tolerated in all patients.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Spine Journal - Volume 15, Issue 12, 1 December 2015, Pages 2574–2582
نویسندگان
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