Veraltete thorakolumbale Frakturen mit Gibbusbildung View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

1996-09-01

AUTHORS

Archibald von Strempel

ABSTRACT

IndicationsRemote thoracolumbar gibbosity with painful functional disturbances.ContraindicationsSevere osteoporosis.Poor general health.Positioning and AnaesthesiaInitially prone, using a supporting frame, followed by right lateral decubitus.General anaesthesia.Surgical TechniqueStraightening of gibbosity in one sitting using a posterior and an anterior incision. After resection of the involved vertebrae and the neighbouring intervertebral discs wedge-shaped interlaminar resection of the respective neural arches, transection of the partes interarticulares, correction of the malposition with a bone spreader, and posterior fixation with pedicle screws and rods. Completion of surgery by anterior autogenous fibula graft.Postoperative ManagementTwo-hourly control of motoricity and sensitivity.Prevention of intestinal atony and urinary retention by i. v. administration of Prostigmin.Removal of urinary catheter after 2 days.Initially daily chest radiographs.Patient allowed out of bed after removal of the thorax drain within the first week, and without a brace.No routine implant removal.Possible ComplicationsInjury of lung, intestine, ureter, major vessels, lumbar plexus, dura and sympathetic trunk.Haemo-or/and chylothorax.Infection.ResultsTwelve patients were operated between 1990 and 1995. In 4 patients a rigid rodscrew system was used which led to 2 fatigue fractures of the implant. Despite this bony consolidation was achieved in all patients. 6 patients were symptomfree and 4 were markedly improved, increase of symptoms in 1 patient who suffered the initial fracture during a suicide attempt.Mean duration of surgery: 4 1/2 h.Complications: 1 severe blood loss (3600 ml): 1 haemothorax requiring aspiration, 2 implant fractures, 1 transient loss of sensitivity in the distribution of the fibularis nerve, and 1 dura leak.Implant removal was performed 4 times. More... »

PAGES

202-211

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/bf02510281

DOI

http://dx.doi.org/10.1007/bf02510281

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1046185820


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