감입기 (Impactor)를 이용한 흉추 및 요추부 방출성골절의 치료

Abstract

The goals of surgical treatment of spine fractures are : (1) to correct the deformity ; (2) to reduce displaced bone fragments endangering the neural elements ; and (3) to stabilize the spine which became unstable due to the fracture or rupture of ligaments. The correction of deformity or the fixation of spine fractures are now easily accomplished through the use of one of the many fixation devices, but the reduction of posteriorly displaced fragments in burst fractures is highly debated. In the case of a burst fracture with retropulsed fragments, sufficient decompression can not be achieved by laminectomy alone. Anterior surgical decompression followed by posterior stabilization and fusion can achieve ideal results, but is too aggressive for us to accept. We have successfully treated burst fractures by laminectomy, reduction of retropulsed fragments by using specially, designed impactors, posterior instrumentation and fusion via a posterior approach. From January 1988 to December 1989, we treated burst fractures of the thoracic and lumbar spine using the above mentioned method with success. We wish to share our method and results through a review of documented studies.