Pedicle screw fixation combined with posterior-lateral fusion with autogenous bone for thoracolumbar burst fractures / 中国组织工程研究

ABSTRACT

BACKGROUND: Spinal reconstruction plays an important role in the treatment of thoracolumbar burst fractures, but wherther the vertebral fusion can effectively reduce the loss of correction still remains controversial. OBJECTIVE: To investigate the repair effect of pedicle screw fixation combined with posterior-lateral fusion with autogenous bone for thoracolumbar burst fractures.METHODS: Eighty patients with thoracolumbar burst fractures undergoing pedicle screw fixation from January 2011 to June 2015 were enrolled, and were then randomly divided into experimental (posterior-lateral fusion with autogenous bone) and control groups (n=40 per group). The clinical efficacy was assessed according to the operation time, intraoperative blood loss and postoperative drainage volume, wound scale scores, anterior vertebral height and Cobb angle, American Spinal Injury Association impairment scale, and Oswestry dysfunction index.RESULTS AND CONCLUSION: (1) All patients were followed up for 24 months. The operation time, intraoperative blood loss and postoperative drainage volum in the experimental group were significantly more than those in the control group (P 0.05). (3) The American Spinal Injury Association impairment scale and Oswestry dysfunction index scores were significantly improved in the two groups, but had no significant difference between two groups (P > 0.05). (4) These results suggest that pedicle screw internal fixation is effective and safe for thoracolumbar burst fractures. Posterior-lateral fusion with autogenous bone allograft holds a good histocompatibility, but cannot reduce postoperative correction loss, therefore, it is not recommended for vertebral burst fractures.