脊椎および脳神経外科ジャーナル

Protection of Paravertebral Muscles and Short Segment Stabilization in Surgical Treatment of Thoracic and Lumbar Compression Fractures

Sukru Oral, Atilla Yilmaz, Ahmet Kucuk, Halil Ulutabanca and Ahmet Selcuklu

Objective: In this study, patients with thoracolumbar and lumbar fracture fractures were treated with preservation of the paravertebral muscles, unfused posterior short-segment pedicle instrumentation technique. Methods: Between the years 2009-2015, 24 patients were applied short-segment posterior instrumentation surgery for thoracolumbar and lumbar compression fractures in our clinic included in the study. On radiological evaluation, loss of height in spinal anterior corpus (LHSAC) and local angle of kyphosis (LAK) were used. In the operation, the thoracolumbar fascia opened linearly, fascia was excised laterally and finger-dislocated between the multifidus and longissimus muscles. The transversal processes of vertebrates and manufactured objects were found. The transpedicular screws were placed with the C-arm. Results: The mean local angle of kyphosis measured preoperatively was 11.03 degrees and this angle 7.24 degrees at the end of the first year. Before the operation, loss of height in the spinal anterior corpus (LHSAC) was determined as 27.21% on average. At the end of the 1st year, the mean LHSAC was measured as 22.83%. Mean duration of the operation was 103.75 min and mean blood loss was 123.12 ml. Conclusion: In this surgical procedure, preservation of the paravertebral muscles contributes to vertebral column stabilization in cases of short segment instrumentation. For this reason, short segment instrumentation in thoracic and lumbar locations provides a significant kyphotic improvement in patients with compression fractures.

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