Treatment of osteoporotic thoracolumbar fractures with transpedicular graft of biological artificial material-induced artificial bone plus internal fixation / 中华创伤杂志

ABSTRACT

Objective To investigate the clinical effects of transpedicular graft of biological artificial material (BAM) -induced artificial bone and posterior pedicle screw fixation in the treatment of osteoporotic thoracolumbar fractures.Methods A total of 72 patients with osteoporotic thoracolumbar fractures treated by transpedicular reduction by leverage,BMA-induced artificial bone grafting and posterior pedicle screw fixation from 2005 to 2010 were reviewed and followed up.The frontal and lateral X-ray radiograph of the spine was performed before and after operation and during the follow-up.The anterior and posterior height of the injured vertebrae,thoracolumbar kyphotic angle ( Cobb' s angle),ratio of anterior to posterior vertebral height were determined.Also,the America Spinal Injury Association (ASIA) scale was used to evaluate the neurological recovery and the visual analog scale (VAS) was applied to assess the back and waist pain.Results All patients were followed up for a mean period of 18.3 months,ranging from 12 to 28 months.Meanwhile,all the patients obtained bone union,with no rejection of artificial bone graft,breakage or loosening of screws,or obvious loss of both vertebrae height and deformity correction angle.Notable improvement of neurological function was achieved in all patients except for two patients with Frankel A nerve injury.The VAS score descended from pre-operative ( 8.4 ± 2.5 ) points to (2.2 ± 1.6 ) points at latest follow-up,which showed obvious alleviation of back and waist pain.Conclusions Transpedicular bone graft plus internal fixation is an effective,reasonable and easy method for managing osteoporotic thoracolumbar fractures.In addition,the implanted BAM-induced artificial bone is of good biological and mechanical properties.