Classificação de McCormack e colapso sagital na fratura toracolombar explosão

Abstract

O aumento da cifose toracolombar após tratamento conservador da fratura tipo explosão é complicação constatada por vários autores. Realizamos estudo retrospectivo com 33 portadores de fratura toracolombar do tipo explosão submetidos ao tratamento conservador entre 1992 a 2004 para verificar a correlação entre a cifose toracolombar e a Classificação de McCormack, que pontua a gravidade da fratura conforme a cominuição do corpo, o deslocamento dos fragmentos no corpo vertebral e a quantidade de correção da deformidade em cifose após o tratamento. Após 30 meses de seguimento médio, verificamos correlação entre a pontuação da Classificação de McCormack, conhecida na literatura como load sharing classification, e o colapso vertebral sagital nestes pacientes (p<0,05;r=0,65). A despeito de ser descrita para avaliação do colapso sagital após o tratamento cirúrgico, a aplicabilidade desta Classificação pode ser considerada para os portadores de fratura toracolombar explosão submetidos ao tratamento conservador.

Thoracolumbar Burst Fracture: McCormack Load-sharing Classification

“…Although McCormack's classification also received some criticism, such as not considering the neurologic status and the integrity of the posterior ligament complex, 13,21,23,28 taking our findings into account, the load-sharing theory proved to be a parameter to guide the treatment of TBF 2–5,11,13,21,22 …”

“…Although McCormack's classification also received some criticism, such as not considering the neurologic status and the integrity of the posterior ligament complex, 13,21,23,28 taking our findings into account, the load-sharing theory proved to be a parameter to guide the treatment of TBF. [2][3][4][5]11,13,21,22 After an extensive review of the literature, we did not find any article that studies the efficacy of LSC as a guide for TBF treatment. After the whole selection previously described, we selected nine RCTs on the subject.…”

“…T horacolumbar burst fracture (TBF) is defined as a fracture involving the anterior and middle spinal columns. [1][2][3][4][5] The main characteristics of this lesion are comminution of the vertebral body, kyphotic deformity, and presence of bone fragments in the spinal canal. [2][3][4] The treatment of TBF remains quite controversial in the literature.…”

“…[1][2][3][4][5] The main characteristics of this lesion are comminution of the vertebral body, kyphotic deformity, and presence of bone fragments in the spinal canal. [2][3][4] The treatment of TBF remains quite controversial in the literature. Several approaches have been proposed, ranging from conservative to surgical treatment.…”

Percutaneous Instrumentation Without Arthrodesis for Thoracolumbar Burst Fractures (A3/A4, B): A Retrospective Study

“…Therefore, the disturbance of these structures is key to the instability of injuries, with the main signs being high degrees of axial compression (>50%) or more than 25° of angulation. 1,6,28 Having defined the surgical treatment for injury stabilization, advocates of the percutaneous technique report the reduction of operative time and blood loss, as well as less soft tissue trauma, as the main advantages. Conversely, those who oppose minimally invasive techniques cite the long learning curve required by the surgeon and the possibility of inadequate restoration of the kyphosis.…”