Treatment of Posterior Facet Fracture-Dislocation in Lumbar Spine

Park Heui-Jeon; Kim In-Gu; Kim Wan-Ki

doi:10.4184/jkss.2002.9.3.204

Journal List > J Korean Soc Spine Surg > v.9(3) > 1036018

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Heui-Jeon, In-Gu, and Wan-Ki: Treatment of Posterior Facet Fracture-Dislocation in Lumbar Spine

Original Article

Journal of Korean Spine Surg 2002;9(3):204-210.

Published online: 21 February 2002

DOI: https://doi.org/10.4184/jkss.2002.9.3.204

Treatment of Posterior Facet Fracture-Dislocation in Lumbar Spine

Park Heui-Jeon, M.D., Kim In-Gu, M.D., Kim Wan-Ki, M.D.

Department of Orthopaedic Surgery, Wonju College of Medicine, Yonsei University, Wonju, Korea

Address reprint requests to Heui-Jeon, M.D. Department of Orthopaedic Surgery, College of Medicine, Wonju Yonsei University #162 Ilsan-dong Wonju, Kangwon-do 220-701, Korea Tel : 82-33-741-1352, Fax : 82-33-741-1538, E-mail : par73@wonju.yonsei.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

Retrospective study.

Objectives

The purpose of this study is to compare the outcomes of short segment fusion and long segment fusion in posterior facet fracture dislocation in the lumbar spine.

Summary of Literature Review

There are many controversies exist about the treatment of fracture dislocation in lumbar spine.

Material and Methods

Sixteen patients with lumbar fracture dislocation were studied retrospectively. The patients divided two groups; group one treated with one level above and below the fracture segment fixation, group two treated with two level above and below the fracture segment fixation. Two groups were compared with neurologic recovery, bladder function recovery and radiologic changes of deformities.

Results

The neurologic deficit in two groups was improved more than one Frankel grade at last follow up. Patients who showed intact dura were neurologically improved significantly than the patients whose dura was ruptured. Radiologic changes were not a sinificant difference in two groups.

Conclusion

In lumbar fracture dislocation treatment, one level above and below the fracture segment fixed with pedicle screw fixation system was an effective treatment method which preserved the mobile segment lumbar spine.

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Keywords: Lumbar spine, Fracture- dislocation, Posterior fixation, Fusion level

REFERENCES

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12). Frankel HL, Hancock DO, Hyslop G. The value of postural reduction in the initial management of closed injuries of the spine with paraplegia and tetraplegia. Paraplegia. 7:179–192. 1969.

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Figures and Tables%

Fig. 1-A

Initial lateral radiograph shows L4-5 fracture dislocation. Fig. 1-B : Immediate postoperative radiograph, treated posterolateral fusion with above and below 1 level fixation, shows satisfactory reduction. Fig. 1-C : Twelve months after operation, lateral radiograph shows 3° loss of sagittal angle

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Fig. 2-A

B. Initial anteroposterior(A) and lateral(B) radiographs show L5-S1 fracture dislocation. Fig. 2-C. Immediate postoperative radiograph, treated posterolateral fusion with above and below 2 level fixation, shows satisfactory reduction. Fig. 2-D. 5 years after operation, lateral radiograph shows 5° loss of sagittal angle.

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Table 1.

Level of Fracture-Dislocation

Level	No (%)
L2/L3	3(18.75)
L3/L4	4(25.00)
L4/L5	6(37.50)
L5/S1	3(18.75)

Table 2.

Neurologic deficit (Frankel grade system)

		Initial	F/U
Group 1*	A	2	2
	B	2	1
	C	1	1
	D	3	2
	E	2	4
Group 2^†	A	1	1
	B	0	0
	C	2	0
	D	2	1
	E	1	4

Table 3.

Neurologic recovery compared dura tear and non-dur tear

		Initial	F/U
Tear(6) ^∗	A	1	0
	B	0	1
	C	2	0
	D	3	3
	E	0	2
Non-Tear(10)^†	A	2	0
	B	1	0
	C	0	1
	D	4	3
	E	3	6

^∗ P=0.099 > 0.05

^† P=0.008 < 0.05

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