Short segment pedicle screw fixation without bone fusion for the repair of thoracolumbar burst fracture:mid-term follow-up / 中国组织工程研究

ABSTRACT

BACKGROUND:Many present studies have reported the early clinical therapeutic effects of short-segment non-fusion fixation for the repair of thoracolumbar burst fracture. The results are satisfactory. However, the mid-and long-term fol ow-up results of this scheme for treating thoracolumbar burst fracture are seldom reported. ＜br> OBJECTIVE:To evaluate the mid-term results of short segment pedicle screw fixation without bone fusion for unstable thoracolumbar burst fracture. ＜br> METHODS:Data of 12 patients with unstable thoracolumbar burst fractures undergoing short segment pedicle screw fixation without bone fusion were retrospectively analyzed. Al patients experienced severe intraspinal occupying and neurological dysfunction, and al of them affected single segment thoracolumbar injuries. The surgical procedure included postural reduction for 2 days and screw fixations at one level above, one level below and at the fractured level itself. The patients underwent removal of implants at 12 months after the initial operation. Imaging and clinical findings, including canal encroachment, percentage of vertebral body height loss, Cobb angle, American Spinal Injury Association motor score, Frankel grade and adjacent segment degenemtion, were evaluated. ＜br> RESULTS AND CONCLUSION:Al patients were fol owed up for at least 5 years. Significant differences in canal encroachment, percentage of vertebral body height loss and Cobb angle were detectable between post-fixation and pre-fixation (P＜0.05). Evaluation results were significantly better after fixation than that before fixation, but no significant difference in evaluation results after fixation was detected (P>0.05). After implantation and removal of fixator, none cases affected aggravated symptoms of neurological impairment. American Spinal Injury Association motor score was 34.2±6.3 before fixation, and 47.7±9.5 during the final fol ow-up, showing significant differences (t=-4.103, P=0.000). During the final fol ow-up, adjacent segments in damage levels did not suffer from degeneration in al patients. Neurological function showed the recovery of Frankel grades 1 or 2. These data indicated that a good mid-term result of short segment pedicle screw fixation without bone fusion for unstable thoracolumbar burst fracture with neurological deficit can be achieved. The improved saggital alignment was effectively constructed and maintained. Adjacent segment degeneration was not found at the injury level.