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Abstract
Introduction. le but de cette étude était de décrire la prise en charge chirurgicale des traumatismes du rachis thoracique au Centre Hospitalier Universitaire Sylvanus Olympio (CHU SO) de Lomé. Patients et méthodes. Il s’agit d’une étude descriptive monocentrique de novembre 2017 à Juin 2019, rétrospective et analytique des dossiers des patients hospitalisés pour traumatisme du rachis thoracique dans le service de Neurochirurgie du CHU SO de Lomé. Résultats. Quinze patients ont répondu aux critères d’inclusion. L’âge moyen des patients était de 37,29 ± 15,36 ans. Le traitement chirurgical a consisté en une ostéosynthèse par voie postérieure, avec un montage long chez 12 patients. Le délai moyen de prise en charge entre l’admission et la chirurgie était de 18,35 jours. Conclusion. Le traitement chirurgical des traumatismes du rachis thoracique est réalisé dans des délais qui pourraient être raccourcis. L’ostéosynthèse postérieure par visée pédiculaire semble donner de bons résultats.
ABSTRACT
Introduction. The aim of the study was to describe the management of thoracic spine trauma in the Sylvanus Olympio’s Teaching Hospital of Lomé. Patients and Methods. We studied characteristics of 15 patients admitted for thoracic spine fractures between November 2017 and June 2019, in our neurosurgery unit. Results. 12 patients underwent an extensive posterior arthrodesis. The mean age was 37.29 ± 15.36. The median time between diagnosis and surgery was 18.35 days. Conclusion. Surgical management of thoracic trauma is impaired by long delay time before surgery. Good results could be observed by improving timing of surgery.
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References
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- Kawu K, Adebule GT, Gbadegesin AA, Alimi MF, Salami AO. Outcome of conservative treatment of spinal cord injuries in Lagos, Nigeria. Niger J Orthop Trauma 2010 ; 9 (1) :21-3.
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- Rajasekaran S, Rishi Mugesh Kanna and Ajoy Prasad Shetty. Management of thoracolumbar spine trauma :An overview. Indian J Orthop, 2015 ; 49 (1) : 72-82.
- Loembe P, Bouger D, Dukuly L, Ndong-Launay M. Traumatismes vertébro-médullaires. Attitudes thérapeutiques au Gabon. Acta Orthopædica Belgica,1991 ; 57 (1) : 31-43.
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- Liljenqvist URU, Halm HFH, Link TMT. Pedicle screw instrumentation of thethoracic spine in idiopathic scoliosis. Spine 1997;22: 2239–45.
- Verma R, Krishan S, Haendlmayer K, Mohsen A. Functional outcome of computer-assisted spinal pedicle screw placement: a systematic review andmeta-analysis of 23 studies including 5992 pedicle screws. Eur Spine J 2010;19:370–5.
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References
Emejulu JKC, Ekweogwu OC. Outcome of spinal cord injuries managed in centre without modern imaging facilities. West Afr J Med 2009 ; 28 (6) :376-9.
Kawu K, Adebule GT, Gbadegesin AA, Alimi MF, Salami AO. Outcome of conservative treatment of spinal cord injuries in Lagos, Nigeria. Niger J Orthop Trauma 2010 ; 9 (1) :21-3.
Ekouele Mbaki HB, Kinata Bambino SB, Ngackosso OB, Mbola Oyaly Olouassely, Boukassa L. Prise en charge chirurgicale des traumatismes du rachis thoraco-lombo-sacré à Brazzaville. Health Science and Disease 2018 ; 19(3) : 73-7.
Vassal M, Lonjon G, Knafo S, Thouvenin Y, Segnarbieux F, Lonjon N. Surgical treatment of thoracic spine fractures. Outcomes on 50 patients at 23 months follow-up.Orthopaedics & Traumatology ; Surgery & Research 2014 ;100 :475-480.
Masry El WSW, Tsubo MM, Katoh SS, Miligui El YHY, Khan AA. Validation of theAmerican Spinal Injury Association (ASIA) motor score and the National AcuteSpinal Cord Injury Study (NASCIS) motor score. Spine 1996;21:614–9.
Youkilis AS, Quint DJ, McGillicuddy JE, Papadopoulos SM. Stereotactic navi-gation for placement of pedicle screws in the thoracic spine. Neurosurgery2001;48:771–9.
Magerl FF, Aebi MM, Gertzbein SDS, Harms JJ, Nazarian SS. A comprehensiveclassification of thoracic and lumbar injuries. Eur Spine J 1993;3:184–201.
Rajasekaran S, Rishi Mugesh Kanna and Ajoy Prasad Shetty. Management of thoracolumbar spine trauma :An overview. Indian J Orthop, 2015 ; 49 (1) : 72-82.
Loembe P, Bouger D, Dukuly L, Ndong-Launay M. Traumatismes vertébro-médullaires. Attitudes thérapeutiques au Gabon. Acta Orthopædica Belgica,1991 ; 57 (1) : 31-43.
Guigui P, Lassale B et Deburge A. Fractures et luxations récentes du rachis dorsal et lombaire de l’adulte. Encycl Méd Chir (Elsevier, Paris), Appareil locomoteur, 15-829-A-10, 1998, 10p.
WHO | Road traffic injuries: WHO:2020. Available:http://www.who.int/mediacentre/factsheets/fs358/en/. Accessed 5 january 2020.
Prabhakar MM, Rao BS, Patel L. Thoracolumbar burst fracture withcomplete paraplegia: rationale for second-stage anterior decompressionand fusion regarding functional outcome. J Orthop Trauma 2009;10:83–90.
Liljenqvist URU, Halm HFH, Link TMT. Pedicle screw instrumentation of thethoracic spine in idiopathic scoliosis. Spine 1997;22: 2239–45.
Verma R, Krishan S, Haendlmayer K, Mohsen A. Functional outcome of computer-assisted spinal pedicle screw placement: a systematic review andmeta-analysis of 23 studies including 5992 pedicle screws. Eur Spine J 2010;19:370–5.
Fairbank JCT, Pynsent PB. The Oswestry disability index. Spine2000;25:2940–52.