보존적 치료를 시행한 흉요추 이행부 골다공증성 압박골절에서의 척추 시상면상 정렬
The Sagittal Alignment of Spine in Conservatively Treated Osteoporotic Compression Fractures of Thoracolumbar Junction
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Objectives: To evaluate the radiological outcomes of conservative treatment for osteoporotic compression fractures in thoracolumbar junctionMaterials and Methods: 20 osteoporotic compression fracture cases of thoracolumbar junction (group I) which were treated conservatively using TLSO brace were evaluated compared with 20 osteoporotic spine cases (group II), between August 2010 and March 2012. The mean age was 65.3, ranging from 57 to 71 years old. The average follow up period was 27.4, ranging from 17 to 35 months. The bone marrow density (BMD) was recorded at the initial assessment. The lumbar lordotic angles with compression ratios on the initial and the last follow-up plain lateral radiograph were measured, and the sagittal alignments of spine were evaluated. Results: In group I, the average compression ratios initially and at the last follow up were 23.5% and 33.7% respectively, and the average lumbar lordotic angles initially and at the last follow up were 30.8° and 22.6° respectively. In group II, the average lumbar lordotic angles initially and at the last follow up were 40.3° and 39.9° respectively. In group I, the compression ratio was significantly increased, and the lumbar lordotic angle was decreased at the final follow up. In group II, the difference of lumbar lordotic angles was not significant statistically. Conclusions: In most, the osteoporotic compression fractures can be successfully managed conservatively. But, in some cases of thoracolumbar junction, the further collapse of vertebral body and the change of lumbar lordotic angle can be developed, and then sagittal alignment of spine can be disrupted.
Abstract
Objectives: To evaluate the radiological outcomes of conservative treatment for osteoporotic compression fractures in thoracolumbar junctionMaterials and Methods: 20 osteoporotic compression fracture cases of thoracolumbar junction (group I) which were treated conservatively using TLSO brace were evaluated compared with 20 osteoporotic spine cases (group II), between August 2010 and March 2012. The mean age was 65.3, ranging from 57 to 71 years old. The average follow up period was 27.4, ranging from 17 to 35 months. The bone marrow density (BMD) was recorded at the initial assessment. The lumbar lordotic angles with compression ratios on the initial and the last follow-up plain lateral radiograph were measured, and the sagittal alignments of spine were evaluated. Results: In group I, the average compression ratios initially and at the last follow up were 23.5% and 33.7% respectively, and the average lumbar lordotic angles initially and at the last follow up were 30.8° and 22.6° respectively. In group II, the average lumbar lordotic angles initially and at the last follow up were 40.3° and 39.9° respectively. In group I, the compression ratio was significantly increased, and the lumbar lordotic angle was decreased at the final follow up. In group II, the difference of lumbar lordotic angles was not significant statistically. Conclusions: In most, the osteoporotic compression fractures can be successfully managed conservatively. But, in some cases of thoracolumbar junction, the further collapse of vertebral body and the change of lumbar lordotic angle can be developed, and then sagittal alignment of spine can be disrupted.
참고문헌 (17)
- Mumford J, "Thoracolumbar burst fractures. The clinical efficacy and outcome of nonoperative management", Spine, 18, pp.955~970 (1993)
- Reid DC, "The nonoperative treatment of burst fractures of the thoracolumbar junction", J Trauma, 28, pp.1188~1194 (1988)
- Weinstein JN, "Thoracolumbar burst fractures treated conservatively a long-term follow up", Spine, 13, pp.33~38 (1988)
- Sutherland CJ, "Early progressive kyphosis following compression fractures. Two case reports from a series of “stable” thoracolumbar compression fractures", Clin Orthop Relat Res, 173, pp.216~220 (1983)
- Krompinger WJ, "Conservative treatment of fractures of thoracic and lumbar spine", Orthop Clin North Am, 17, pp.161~170 (1986)
- Heggeness MH., "Spine fracture with neurological deficit in osteoporosis", Osteoporosis Int, 3, pp.215~221 (1993)
- Roberson JR., "Surgical reconstruction of late post-traumatic thoracolumbar kyphosis", Spine, 10, pp.307~312 (1985)
- Park BC, "Correction of thoraco-lumbar kyhotic deformity using a posterior interbody fusion", J Kor Spine Surg, 7, pp.639~646 (2000)
- Spivak JM, "Thoracolumbar spine trauma: II. Principle of management", J Am Acad Orthop Surg, 3, pp.353~360 (1995)
- Lee JW, "Comparative study of radiologic changes after conservative treatment in compression fractures and stable bursting fracture of thoracolumbar spine", J Korean Fracture Soc, 8, pp.667~674 (1995)
- Koh YD, "Risk factors in progression of deformity in compression fracture of thoracolumbar junction", J Korean Society Fractures, 12, pp.372~378 (1999)
- Kaufer H, "Lumbar fracture-dislocation. A study of 21 cases", J Bone Joint Surg, 48, pp.712~730 (1966)
- Daniaux H, "Fractures of the thoracolumbar junction. The conservative treatment", Orthopade, 28, pp.682~691 (1999)
- Ha KY, "The surgical treatment of osteoporotic vertebral collapse caused by minor trauma", J of Korean Orthop Assoc, 33, pp.105~112 (1998)
- Benli TI, "Minimum 5-year follow-up surgical results of post-traumatic thoracic and lumbar kyphosis treated with anterior instrumentation", Spine, 32, pp.986~994 (2007)
- Buchowski JM, "Surgical management of posttraumatic thoracolumbar kyphosis", Spine J, 8, pp.666~677 (2008)
- Stagnara P, "Reciprocal angulation of vertebral bodies in a sagittal plane: approach of references or the evaluation of kyphosis and lordosis", Spine, 7, pp.335~342 (1982)