Open vertebreplasty for unstabilized thoracic-lumbar fracture / 中国基层医药

ABSTRACT

Objective To investigate the treatment of open vertebreplasty for unstabilized thoracic-lumbar fracture. Methods From September 2003 to May 2007, there were 31 patients of thoracic-lumbar burst fracture who had undergone operation and had been followed. According to the Denis classification, all the patient were burst fracture with the involvement of middle column. All of them were undergone posterior short segment transforminal interbody fusion and vertebreplasty filled with phosphate calcium bone cement. Results All of 31 patients had undergone operation successfully. The interbody were removed when fracture healed. There was no loss of vertebral height, no degenerative change of adjacent segment. They were followed for 9～35 months, the average was 24.2 month. 2 of 31(6.4%) were found collapse of the fracture vertebrae, 1 was found kyphosis and failure fusion, which led another operation. The reason may be the severe burst of vertebrae, insufficient filling of phosphate calcium bone cement or bearing weight early stage. Of all other patients, CT scan showed sufficient decompression of fracture vertebraes, retained height of fracture vertebraes and no collapse. There was no obvious difference between height of fracture vertebrae and normal vertebrae (P0.05). The loss of correction of kyphosis was not obvious. Conclusion posterior short segment transforminal interbody fusion and vertebreplasty filled with phosphate calcium bone cement is a effective treatment for unstabilized thoracic-lumbar fracture. The pain is relieved after operation, patient can exercise on the ground in the early stage, and the quality of life is improved.