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Posterior
decompression and fusion with instrumentation provides better surgical outcomes
in treatment of burst fracture patients but it may increase the incidence of
postoperative complications.
According to recent findings of a retrospective study in the Neurologia medico-chirurgica Journal, each type of burst fracture exhibit different clinical & radiological characteristics, and can be managed by approaches like short-segment instrument & fusion with some augmentation methods with strong osteoporotic medicines.
A total of 38 participants who went through posterior-instrumented fusion were selected for the analysis. The burst fractures affected the middle-low lumbar vertebrae. Patients were assessed as per the fractures types: superior incomplete, inferior incomplete, and complete burst fractures. The assessment of postoperative complexities like instrumentation failure or vertebral collapse (PVC) were done following a mean follow-up period of 3.1 years.
Excluding for one
patient who exhibited equina syndrome (superior-type fracture), all other
patients suffered from leg pain. Out of 27 participants with superior- or inferior-type
fracture, 19 found to have spondylolisthesis because of segmental instability.
Neurological status improved significantly after the treatment. Whereas,
segmental and lumbar lordosis at the fused level declined from the
postoperative stage to the final follow-up because of postoperative
complications. A good clinical outcome was found regarding the
posterior-instrumented fusion; although due to bone fragility, a higher
incidence of postoperative complications was inevitable. Therefore, surgical strategy,
careful postoperative management and strong osteoporotic medications may be
essential for these patients.
Neurologia medico-chirurgica
Surgical Intervention for Osteoporotic Vertebral Burst Fractures in Middle-low Lumbar Spine with Special Reference to Postoperative Complications Affecting Surgical Outcomes.
Motonori KOHNO et al.
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