POSTERIOR FIXATION OF THE THORACIC AND LUMBAR SPINE COMPRESSION FRACTURES

Abstract

Objective. To analyze outcomes of surgical treatment of patients with compression fracture of lower thoracic and lumbar vertebra by posterior spine fixation with shape-memory / super-elastic alloy constructs. Material and Methods. The bench tests of 30 tightening clamps (lamellar, spiral, and biplanar) with shapememory property were performed. Results of clinical trial of 183 patients with uncomplicated thoracic and lumbar compression fractures have been summarized. Patients of the study group (n = 116) underwent posterior spine fixation with shape-memory clamps, while patients from the control group (n = 67) were treated conservatively with gradual reclination in a hummock according to A.V. Kuplan’s method followed by a subsequent brace treatment. Results. Long-term outcomes in study group patients (good in 85.2 %, satisfactory in 14.8 % of cases) were markedly better than those in patients after conservative treatment (unsatisfactory results in 13.4 %, satisfactory — in 52.3 %, and good — in 34.3 % of cases). Posterior fixation of the injured motion segment with tightening biplanar clamps appeared to provide stability and significant decrease in the rate of posttraumatic deformity. Conclusion. Posterior fixation with tightening shapememory clamps essentially enhances the efficacy of multimodal treatment of patients with lower thoracic and lumbar spine compression fractures.