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Influence of Spinal Immobilization on Consolidation of Posterolateral Lumbosacral FusionA Roentgen Stereophotogrammetric and Radiographic Analysis

 

作者: RAGNAR JOHNSSON,   BJÖRN STRÖMQVIST,   PAUL AXELSSON,   GÖRAN SELVIK,  

 

期刊: Spine  (OVID Available online 1992)
卷期: Volume 17, issue 1  

页码: 16-21

 

ISSN:0362-2436

 

年代: 1992

 

出版商: OVID

 

关键词: posterolateral lumbosacral fusion;postoperative orthotic immobilization;roentgen stereophotogrammetric analysis;intervertebral translations

 

数据来源: OVID

 

摘要:

To determine the influence of the duration of postoperative lumbar immobilization with the aid of a rigid lumbar orthosis on the consolidation of posterolateral lumbosacral fusions, 22 patients with no previous osseous spinal surgery and with fusion without osteosynthesis due to spondylolysis-olisthesis Grade 1 to 2 or intervertebral disc or facet joint disorder were examined by roentgen stereophotogrammetric analysis in supine and erect positions and by conventional radiography for 1 year after surgery. In Series 1, patients (n = 11) were instructed to keep the trunk straight with the aid of a molded, rigid lumbar orthosis for 5 months after surgery; and in Series 2 (n = 1), the same instructions were given, but for 3 months. In Series 1, osseous fusion was seen on radiographs in eight patients. In these patients, the intervertebral translations between the fused vertebrae began to decrease 3–6 months after surgery, and within 1 year, the fusions became rigid, as defined by roentgen stereophotogrammetric analysis, or intervertebral translations of mostly less than 1 mm persisted. In three patients with poor fusion still seen on radiographs 1 year after surgery, no rigid fusion was obtained and intervertebral translations of up to 10 mm persisted. In Series 2, a similar roentgen stereophotogrammetric analysis pattern was noted in two patients with osseous fusion and in seven with poor fusion seen on radiographs. The fusion was radiographically doubtful in two patients. In these patients, the intervertebral translations decreased, but translations of 1.5 mm persisted 1 year after surgery. The rate of fusion healing according to roentgen stereophotogrammetric analysis or radiography was significantly higher (P< 0.05, Fisher exact test) in Series 1 than in Series 2. This seems consistent with the roentgen stereophotogrammetric analysis finding of rather late onset (3–6 months after surgery) of decreasing translatory mobility between the fused vertebrae in successful fusions. The study illustrates the value of roentgen stereophotogrammetric analysis in prospective comparative studies of spinal disorders.

 

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