Treatment of serious burst thoracolumbar fracture with posterior pedicle screw fixation, transpedicular bone grafting and vertebral canaloplasty / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To study the clinical results of posterior pedicle screw fixation, transpedicular bone grafting and vertebral canaloplasty with ilium autografting in treating serious burst thoracolumbar fracture.</p><p><b>METHODS</b>From March 2004 to March 2008,10 patients with serious burst thoracolumbar fracture, including 7 males and 3 females with age for 24-58 years (mean 41 years)were treated by posterior pedicle screw fixation, transpedicular bone grafting and total laminectomy with preservation of spinal process and vertebral canaloplasty with ilium autografting. The operative effects were assessed according to Frankel classification and radiologic results.</p><p><b>RESULTS</b>All patients were followed up from 1 to 4 years. There was no loosening or broken in instrumentation. The anterior edge height of the fractured vertebrae body was restored from (21.00 +/- 12.00)% to (95.00 +/- 4.20)%, and the posterior edge height of the fractured vertebrae body was restored from (70.00 +/- 15.00)% to (96.00 +/- 3.20)% postoperatively, which both demonstrated improvement compared with preoperative instance (P < 0.01). The Cobb angle was restored from (32.80 +/- 8.20) degrees to (4.20 +/- 1.60) degrees which also demonstrated improvement compared with the preoperative Cobb angle (P < 0.01). At least one grade recovery was observed in all cases except one patient with preoperative Frankel A degree. The result of Denis classification, P1, had 4 cases, P2 had 4, P3 had 1, P4 had 1.</p><p><b>CONCLUSION</b>Posterior pedicle screw fixation, transpedicular bone grafting and vertebral canaloplasty can obtain satisfactory results treating serious burst thoracolumbar fractures. It is a feasible method with advantages of simple operation, good efficacy, preservation of structure of posterior column which should be applied clinically.</p>