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Year : 2006  |  Volume : 40  |  Issue : 3  |  Page : 164-167

Correction of post-traumatic kyphosis using intermediate facet joints as fulcrum in dorso-lumbar spine injuries

KS Hegde Medical Academy, Mangalore, India

Correspondence Address:
Amit Agrawal
Department of Neurosurgery, K.S.Hegde Medical Academy, Deralakatte-575018, Mangalore
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0019-5413.34484

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Background : Post traumatic kyphotic deformity are managed by different methods. Posterior stabilization of dorso-lumbar fractures with transpedicular screws and rods using intermediate facets as fulcrum can restore body height. Methods and material : In a retrospective clinical study 6 consecutive patients with complete or incomplete neurological deficits as a result of the dorso-lumbar fractures were included. Local kyphosis was measured as the angle between the upper and lower end plates of the collapsed vertebrae preoperatively, postoperatively and at the last follow-up visit. The neurological condition of the patients was recorded in the pre-op and follow up period according to Frankel grading systems. Stabilization with pedicle screw fixation and posterior fusion with autogenous bone chips were done after decompression in all 6 patients included in this study. The outcome of the study was evaluated with regard to the correction of kyphotic deformity and increase in vertebral body height after adequate neural canal decompression and fusion. Results : Of the 6 patients 4 were Frankel A and 2 Frankel C pre-operatively. Three patients sustained wedge fracture and three sustained burst fracture. The most commonly affected vertebra was L 1 with 4 cases followed by L 2 . The preoperative mean kyphotic angle was 23.3° (17°-28°), and was corrected to 15.8 (12° - 22°) with a correction rate of 32.3% (21.4 - 43.5 %) in the post-operative period and this correction was improved at three months follow up and the final correction was measured to be 46.3% (22.7-59.0 %). Serial postoperative radiographic follow­up assessment showed maintenance of kyphotic correction. Minimum correction of body height was .05 cm (correction rate­1.8%) and maximum correction was .65 cm (correction rate­28.9%) in post-operative period with a mean of 0.29 cm (correction rate-13.1%). Conclusions : Preserved the intermediate articular processes can be used as fulcrum to reduce the kyphosis that can be maintained as they provides continuous support and traction.

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