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Denis의 분류에 의한 척추골절에서의 신경손상과 신경회복

Other Titles
 Neurological injury and recovery patterns in the spinal fractures by Denis classification 
Authors
 김남현  ;  박문수  ;  문성환  ;  강용호  ;  성창훈  ;  이환모 
Citation
 Journal of Korean Society of Spine Surgery (대한척추외과학회지), Vol.7(4) : 579-585, 2000 
Journal Title
 Journal of Korean Society of Spine Surgery (대한척추외과학회지) 
ISSN
 1229-5701 
Issue Date
2000
Keywords
Spine ; Fracture ; Denis classification ; Neurologic recovery
Abstract
Purpose : To determine whether there was a preponderance of a fracture type associated with early and late neurologic deterioration. Materials and Methods : The review of all the surgically managed spinal fractures from October 1989 to July 1999 was performed. Of the 83 surgically managed patients, 39 had spinal cord injury. The other 44 patients in this consecutive series had no spinal cord injury. Charts, operative notes, preoperative and postoperative plain radiographs, computed tomography scans, and follow-up records of all patients were reviewed carefully from the time of surgery until last follow-up assessment. The classification of Denis had been used prospectively for all patients before their surgery to determine the fracture morphology. Frankel Scale and American Spinal Injury Association Spinal Cord Injury Assessment Form(ASIA) were obtained during follow-up evaluation for all patients. Results : All patients were observed over mean 57.4 months except 1 patient who died of pulmonary thromboembolism 1 week after surgery. In Denis classification, the most common injuries were burst fracture and fracture-dislocation. The degree of neurologic injury when first seen and at the latest follow-up was different between burst fracture and fracturedislocation. The extent of neurologic recovery was not different between burst fracture and fracture-dislocation. The fracturedislocation was common in thoracic spine and the degree of neurologic injury was most severe in thoracic spine. Instead, the burst fracture was more common in lumbar spine and the degree of neurologic injury was relatively mild in lumbar spine. Conclusions : The severity of initial posttraumatic and the last follow-up neurologic injuries were correlated with the fracture patterns by Denis classification, but the extent of neurologic recovery was not correlated with the fracture patterns by Denis classification. The lumbar fracture, injuring the cauda equina and the sacral nerve roots, shows greater recovery patterns than thoracic spine fractures.
Files in This Item:
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Moon, Seong Hwan(문성환)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/172340
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