Treatment Tactics for Patients with Isolated Injuries of the Fifth Lumbar Vertebra.

Unlabelled: The major management technique for lumbar burst fractures is transpedicular fixation (TPF). However, in relation to fractures of the L vertebra, this tactic often has no advantages over conservative treatment, and, therefore, it is expected to be supplemented with anterior decompression and reconstruction of the anterior column of the L vertebra. was to determine the most optimal treatment tactics for patients with isolated burst fractures of the fifth lumbar vertebra.

Materials And Methods: We performed a retrospective study of 58 patients treated for isolated burst L fractures. 12 patients refused to undergo surgery and received conservative outpatient treatment. TPF was performed in 27 patients; circular spondylosynthesis (TPF + anterior column support with a Mesh implant) - in 19 patients. The effectiveness of the treatment was assessed by clinical and introscopic research methods.

Results: The radiological and functional outcomes of surgery with conventional TPF for isolated L burst fractures are generally comparable with the outcomes of conservative treatment. In 26% of the patients, the instability of the metal construction developed within 12 months after surgical intervention. Supplementing the transpedicular system with wedging anterior column support with a Mesh implant ensures preservation in 21%, and improves the parameters of the sagittal profile of the lumbosacral transition in 79% of cases.