Long-Segment or Bone Cement–Augmented Short-Segment Fixation for Kummell Disease with Neurologic Deficits? A Comparative Cohort Study
| Autor: | Xiao-Dong Wang, Hong-Hui Sun, Yan-Sheng Huang, Jun-Song Yang, Peng Xue, Dingjun Hao, Jin-Peng Du, Jie Gao |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Tomography Scanners X-Ray Computed Visual analogue scale Radiography Cohort Studies Disability Evaluation Fracture Fixation Internal 03 medical and health sciences 0302 clinical medicine Humans Medicine Aged Pain Measurement Fixation (histology) 030222 orthopedics Cobb angle business.industry Standard treatment Bone Cements Middle Aged Bone cement Oswestry Disability Index Surgery Spinal Fractures Female Neurology (clinical) Nervous System Diseases business Osteoporotic Fractures 030217 neurology & neurosurgery Cohort study |
| Zdroj: | World Neurosurgery. 116:e1079-e1086 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2018.05.171 |
| Popis: | Background The standard treatment for Kummell disease with neurologic deficit remains controversial. Traditional posterior long-segment fixation (LSF) has been widely used, but the procedure results in significant trauma and carries the risk of multiple complications. Therefore, bone cement–augmented short-segment fixation (BCASSF) has been recommended for this condition. Methods The study included 36 patients treated with LSF or BCASSF between January 2012 and June 2015. The visual analog scale (VAS), Oswestry Disability Index (ODI) score, anterior height of fractured vertebrae, kyphotic Cobb angle, and neurologic function by the Frankel classification were evaluated and compared, and duration of operation, blood loss, length of hospital stay, and complications were recorded. Results Significant differences were observed in the VAS, ODI, anterior height of affected vertebrae, and kyphotic Cobb angle between preoperatively and 7 days postoperatively and between preoperatively and at the final follow-up, whereas no significant differences were observed between 7 days postoperatively and at final follow-up. No significant differences in the aforementioned parameters were observed between the groups at 7 days postoperatively and at the final follow-up. Neurologic function was improved in both groups; however, no significant differences were observed between the 2 groups either preoperatively or postoperatively. Blood loss and length of hospital stay were significantly lower in the BCASSF group compared with the LSF group, but no significant between-group differences were observed in operation time and complications. Conclusions Lower blood loss and shorter hospital stay were associated with BCASSF compared with LSF; the 2 techniques had similar clinical outcomes and radiographic findings. Therefore, we recommend BCASSF for treating patients with Kummell disease with neurologic deficits. |
| Databáze: | OpenAIRE |
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