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SURGICAL TREATMENT of THORACOLUMBAR BURST FRACTURES with NEUROLOGIC DEFICIT

  • Erol YALNIZ
  • Kenan SARIDOĞAN
  • Aziz KURTULUŞ

J Turk Spinal Surg 1995;6(1):41-44

Betvveen 1992 and 1995, eleven patients with neurologic deficits secondary to a thoracolumbar burst fracture were treated surgically. There were 9 men and 2 women. The mean age was 35 years (range, 16-68 years). Mean follow-up was 18.4 months (range, 6-31 months). İn 6 patients (54.5%), fractures occured at thoracolumbar (T12-L1) region, in 2 thoracic and 3 lumbar. Fractures were classı'fied according to Deniş classification. The aver-age local kyphosis angle was 21° preoperatively and 11.3° at the end of follow-up period. The average cana! compromise ıvas 38% at the time of injury and 12.6% after decompression. Indirect decompression by posterior reduction was performed for four patients, anterior decompression forfour, posterolateral decompression fortvjo, and posterior decompression two. Alıcı spinal instrumentation were applied for three patients, CD instrumentation for four, AO fixateur interne for three, and Zplate for one.

Ten patients improved postoperatively at least one Frankel level. One patient with complete paraplegia re-mained unchanged. This small series demostrated that, the surgery improved the neurologı'cal outcome, after suf-ficent decompression of the spinal cord and nerve roots. The improvement rate was much better in patients with incomplete lesions than among those with complete lesions.

Keywords: Burst fractures, neurologic deficit, thoracolumbar.