Relationship between fracture-relevant parameters of thoracolumbar burst fractures and the reduction of intra-canal fracture fragment

Journal of Orthopaedic Surgery and Research

Peifu Tang¹  Lihai Zhang¹  Houchen Lv¹  Tao Shi¹  Licheng Zhang¹  Ye Peng¹ 

[1] Department of Orthopedics, Chinese PLA General Hospital, No. 28 Fuxing Road, Beijing 100853, People’s Republic of China

关键词: Intra-canal fracture fragment;    Fracture reduction;    Posterior longitudinal ligament;    Single thoracolumbar burst fracture;   

Others  :  1227828
DOI  :  10.1186/s13018-015-0260-2

 received in 2015-05-19, accepted in 2015-07-12,  发布年份 2015

【 摘 要 】

Objective

Posterior longitudinal ligament reduction (PLLR) has been widely used for treatment of thoracolumbar burst fractures. However, there are no systemic studies assessing the influence of position parameters of intra-canal fracture fragment (IFF) itself on outcome of reduction. The aim of this study was to analyze the relationship between position parameters of IFF and the reduction efficacy of PLLR.

Methods

Sixty-two patients (average age, 36.9 years) with single thoracolumbar burst fractures and intact posterior longitudinal ligaments were recruited. Patients were divided into reduced and unreduced groups based on IFF reduction situations by PLLR. Preoperative and intraoperative computed tomography (CT) were used to evaluate reduction and location parameters of IFF, such as position, width, height, inversion, and horizontal angle, ratio of width of IFF to the transverse diameter of vertebral canal (R₁ ), and ratio of height of IFF to height of injured vertebrae (R₂ ) before and after PLLR.

Results

There were significant differences in width (P < 0.001), height (P = 0.0141; R₁ , P < 0.001), and R₂(P = 0.0045) between the two groups. When width of IFF was more than 75 % of transverse diameter of vertebral canal and height of IFF was more than 47 % of height of injured vertebrae, the IFF could not be reduced by PLLR.

Conclusions

In patients with thoracolumbar burst fractures, IFF in apterium of the posterior longitudinal ligament cannot be reduced by PLLR. For thoracolumbar burst fractures that cover the posterior longitudinal ligament, the width and height of IFF are important parameters that influence reduction quality.

【 授权许可】

   
2015 Peng et al.

【 图 表 】

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