흉 요추부 골절에 대한 수술적 치료 = Operative Treatment of the Thoracolumbar Spinal Fractures

다국어 초록 (Multilingual Abstract)

Since the suggestion of the three column theory about thoracolumbar spinal injury and the definition of instability by Denis, this concept as a guideline of our treatment. With the advancement in diagnostic method, C-T is a very valuable and effective method especially in the confirmation of fracture pattern, neural canal involvement and evaluation the shape of stenotic apinal canal.
We noticed clinical significance in the relation between neural canal involvement(NCI) with neurologic deficit, andbetween the shape of patent spinal canal with neurologic deficit in the cases defined as bursting fractures.
For the unstable thoracolumbar spinal injuries, operative reduction and spinal fusion is considered to be an established good procedure as a treatment.
We analyzed the clinical results of 32 cases performed open reduction and spinal fusion among 54 cases since May 1982 to Oct. 1990.
The results were as follows:
1. According to the type of mechanism by Denis, Burst fracture was the most common(21 cases, 66%).
2. Among 32 cases 20 cases showed neurologic deficit.
3. The most frequent fracture level were T12 and L1(20 cases, 63%).
4. According to the 3 column theory, the anterior plus middle column injury was most common(19 cases, 59%).
5. In the NCI measured by mid-sagittal diameter, we noticed significant risk at cord with 30%, at conus medullaris with 45%, at cauda equina with 75% in Bursting fractures.
6. There was significant risk of neurologic deficit in the patent canal shape of cresent and horese-shoe type than oval and semicircle type in Bursting fractures.
7. Open reduction and spinal fusion is an established good procedure as a treatment for the unstable thoracolumbar spinal injuries.