Remodeling of the spinal canal after circum decompression of burst vertebral fractures

Abstract

Objective To observe the time and pattern of remodeling of the spinal canal after circum decompression of burst vertebral fractures. Methods A total of 76 patients with thoracolumbar burst fracture were treated with circum decompression and pedicle screw fixation. Of them, 53 cases were followed up for 24.2 (12 to 60) months averagely. By the ASIA evaluation system, the severity of spinal cord injury was rated as grade A in 27 cases, grade B in 7, grade C in 6, grade D in 2 and grade E in 11. The initial stenosis ratios of the injured spinal canals were calculated. The sngittal diameters of the injured canals were measured pre- and post-operatively and analyzed by paired Student's t test at the follow-up time of remodeling. Results The ASIA evaluation improved 1 to 3 grades in the 15 patients with incomplete injury to the spinal cord, while the nerve root recovered partial function in 8 of the 27 patients with complete injury to the spinal cord. CT scans demonstrated a complete decompression of the canal. Remodeling of the spinal canal developed 12 months after operation. There were no significant differences (P > 0.05) in the sagittal diam-eter between the remodeling and normal canals 24 months postoperatively. Conclusions Significant spontaneous remodeling of the spinal canal can develop 12 months after circum decompression of thoracolumbar burst fracture. This process may not be affected by the fracture location or the severity of neurological deficits. The canal shape after remodeling is close to the normal. Key words: Thoracic vertebrae;  Lumbar vertebrae;  Spinal canal;  Decompression, surgical; Remodeling