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Eur Spine J (2011) 20:395402 DOI 10.1007/s00586-010-1615-3
ORIGINAL ARTICLE
Mid-term results of PLIF/TLIF in trauma
Rene Schmid Dietmar Krappinger
Michael Blauth Anton Kathrein
Received: 26 April 2010 / Revised: 19 August 2010 / Accepted: 20 October 2010 / Published online: 31 October 2010 Springer-Verlag 2010
Abstract Treatment of thoracolumbar fractures is still controversial. Several treatment options are reported to yield satisfactory results. There is no evidence indicating superiority of any treatment option. We have already presented radiological results of the use of PLIF/TLIF in trauma, which showed satisfactory results concerning intervertebral fusion and acceptable loss of correction. We examined 50 patients regarding loss of correction after implant removal and clinical outcome using a validated visual analogue score. The average time of follow-up (FU) was 35 months. We observed a total loss of correction of 4. The pre-injury mean
VAS score was 92. At FU, there was an average reduction of17.2 points. Owing to the presented results, we suggest this method as an alternative to combined procedures.
Keywords Thoracolumbar trauma PLIF/TLIF
Intervertebral fusion Single posterior approach
Introduction
Treatment of thoracolumbar fractures is still controversial.
Several treatment options, such as posterior reduction and stabilization with or without posterolateral fusion, combined procedures using bony strut grafts or titanium implants with or without additional anterior plating for anterior reconstruction, isolated anterior procedures and
conservative treatment with or without bracing are reported to yield satisfactory outcomes, typically in A3-type fractures [1, 7, 9, 13, 23, 28, 32, 34, 35, 49, 57, 61]. There is no evidence indicating superiority of any treatment option [4, 11, 14, 17, 19, 21, 26, 31, 45, 5153, 56, 60, 61].
Combined procedures produce the best radiological results; however, the clinical results measured with different scores were not superior to posterior xations alone and may, therefore, not be justied in many cases [26, 31, 45]. Guidelines based on the level 1 studies of when and how the anterior column should be additionally reconstructed surgically do not exist up to date [10, 19, 21, 36, 5356, 59]. 360 fusions are considered to be necessary in cases with unstable burst fractures and more severe bony destruction [5, 11, 25, 26, 28, 3133, 45, 47, 53, 58].
Regardless of an additional treatment of the anterior column, short segmented posterior...