Abstract
Background:
Recent studies demonstrated the importance of the Posterior Longitudinal Ligament (PLL) and posterior annulus in the decompression of the medullary canal by reducing intracanal fragment.
Aim:
Purpose of this study is to demonstrate the effects of canal compromise amount to the canal clearance by posterior distraction and ligamentotaxis.
Material and Method:
There were 16 patients (7 vjomen and 9 men) with average age of 37.2 years (range 15-56). Ali patients had preoperative and postoperative CT seans which revealed narrowing of the medullary canal less than 30% in 1; 30-50% in 4 and more than 50% in 11 cases preoperatively. Postoperative narrovving of the medullary canal revealed 0-15% in 6, 15-30% in 3 and more than 30% in 7 patients. The patients were oper-ated with in 4 hours to 18 days (av. 1.8 days) of the injury. 9 patients undervvent posterior, and 7 patients, com-bined anterior and posterior surgery. The average follow-up was 30.4 months. At follow-up examination 3 patinets Frankei A remained unehanged, 1 of 2 Frankel C patients remained unehanged and one improved to grade D, 2 of 6 grade D patients improved to grade E; 2 remained unehanged, and one deteriorated to grade C; 5 patients did not have neurological deficits postoperatively.
Conclusion:
Our results demonstrated that iigamentotaxis achieved by distraction was successful in cases which medullary canal compromise was less than 35%, vvhereas in cases vvhich medullary canal compromise was more than 35%, it was not successful and residual bone fragments stili remained in the canal leading to vari-ous degrees of canal compromise. The possible cause forthis may be that posterior longitudinal ligament 1 (PLL) and posterior annulus could have been ruptured in cases with more than 30% canal compromise.
We think that preoperative MRI might be helpful to evaluate PLL and posterior annulus. If this is not possible, anterior surgery should be chosen.
Keywords: Burst fraetures, canal compromise
