Paper Information

Journal:   TEHRAN UNIVERSITY MEDICAL JOURNAL (TUMJ)   2004 , Volume 62 , Number 6; Page(s) 442 To 448.
 
Paper: 

USING "REZAIAN" FIXATOR IN VERTEBRAL PATHOLOGIES IMAM HOSPITAL, 1988-2001

 
 
Author(s):  SHEIKH REZAEI A., SABERI H., NIAZI B., EGHTESADI ARAGHI P.
 
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Abstract: 

Background: The aim of successful treatment of spinal injuries is to result in a stable and painless spine throughout the normal lifespan without any deformities, and with the utmost neurological recovery in the least possible hospitalization period. This study has been designed to compare spinal stability indicators and improvement using "Rezaian" vertebral fixtures before and after operation.
Materials and Methods: In a prospective case-series study, one hundred patients with spinal injuries who underwent Rezaian vertebral fixator in Tehran Imam Khomeini Hospital from the first of the 1988 to the end of 2001 were studied. After patient approval for enrollment in the study, all patients underwent the surgery in appropriate time after accurate history and physical examination and neurological deficit estimation, anterior and lateral x-ray and CT-scan with axial views of the injured segment and the other sections that were doubted to be injured. The patients were discharged when they were able to sit being assisted by brace, after control radiographies. Then they were examined in one, three, six month and finally ten year intervals.
Results: The mean age of patients was 42.8+/-16.3 (min=17 and max=84). 56% of the patients were male. The etiologies of vertebral fracture were trauma (77%), infection (13%) and tumor (10%) respectively. The fractures were mostly compression Fractures (63%) and burst fractures (32%) and fracture dislocations (5%) came next. The majority of the injuries was at L1 level and was mostly confined to only one vertebra. Surgical approach was extra-peritoneal in 78% of the patients and TLSO brace was used to support the spine in 73% of the patients. The pain of patients was significantly reduced after surgery [7.11 vs. 2.11 (P<0.05)]. The severity of neurological deficits (according to Frankle classification) was significantly decreased after operation, at discharge time, and at the last follow-up visit as well. 8 patients (8%) experienced the complications (mal-positioning in 50%, dislocation in 25%, angulation Increase in 12.5% and pain-instability in 12.5%).
Conclusion: This study showed that the complication rate was only 8% though we can possibly decrease the complication rate to the minimum possible rate by utilizing this instrument correctly. It was also illustrated that this instrument is very effective in pain reduction, reduction of neurological problems and early rehabilitation of the patients. Considering the fact that this fixture is not technologically complicated and comparing to the similar instruments is not expensive either, it can be regarded as a successful therapeutic choice.

 
Keyword(s): SPINAL STABILITY, VERTEBRAL FIXATOR, REZAIAN
 
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