Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2013; 80(1):34-42 | DOI: 10.55095/achot2013/005

Mid-term Radiographic Results in Th12 and L1 Fractures after Anterior Column Reconstruction with Tibial Shaft Bone AllograftOriginal papers

P. Wendsche^1,*, J. Kočiš¹, J. Chmelová², M. Kelbl¹, V. Stursa¹

¹ Úrazová nemocnice v Brně

² Oddělení radiologie a zobrazovací metody Městské nemocnice Ostrava

PURPOSE OF THE STUDY:
Frozen tibial shaft bone allografts filled with autologous cancellous bone chips were used for anterior column reconstruction in Th12 and L1 fractures. The aim of this retrospective study was to evaluate the five-year results of the treatment on the basis of radiographic findings.

MATERIAL AND METHODS:
Twenty-six patients treated in 2005 and 2006 for isolated Th12 or L1 fractures, with no neurological deficit, were evaluated. In all patients, the spine was stabilised from an isolated anterior approach or through a combined posterior and anterior approach, and angle-stable implants were used. On radiographic examination the loss of correction and lateral compression of the segment involved were measured on standard X-ray views. Data on bone union at graft-bone interfaces were obtained from spiral CT scans. For assessment of the stage of bone healing, a scale of 0-25-50-75-100 % was established, and each patient was evaluated by two independent radiologists. Based on the average results, bone union was defined as non-union, 0-24 %; incomplete union, 25-74 %; complete union, 75-100 %.

RESULTS:
The average loss of correction measured by Beck's method was 0.77 degree. In four patients, the lateral compression angle deteriorated on the average by 1.1 degree (range, 0.7°-1.8°) during the treatment. The proximal graft-bone interface showed complete union in 19 patients (73 %), and the distal interface was completely healed in 20 patients (77 %). Incomplete bone union at the proximal and the distal interface was found in seven (27 %) and six (23 %) patients, respectively. Non-union was not recorded. No complications occurred.

CONCLUSIONS:
The use of tibial shaft bone allografts filled with autologous cancellous bone chips resulted in stable reconstruction of the anterior column of the thoracolumbar spine which showed a low loss of correction and good bone union.

Keywords: transpedicular spinal stabilisation, video-assisted thoracoscopic approach, loss of correction, spinal fusion surgery, combined approach for thoracolumbar fractures

Published: February 1, 2013  Show citation