Transpedicular osteotomy and internal fixation in the treatment of old thoracolumbar vertebral fracture with kyphosis clinical study with spinal stenosis / 中国综合临床

ABSTRACT

Objective To investigate the clinical effect of old thoracolumbar vertebral fracturekyphosis with spinal stenosis by pedicle of vertebral archosteotomy and internal fixation.Methods Twenty patients with old thoracolumbar fracture with kyphosis,and associated with spinal stenosis,were treated by using transpedicular osteotomy and internal fixation treatment in the First People's Hospital of Shangqiu from June 2012 to May 2014.Radiographical assessments including localized kyphosis,thoracic kyphosis,lumber lordosis,sacral tilt angle,sagittal vertical axis,bony fusion and the relative height of the ifiterbody fusion vertebra.Visual analogue scale(VAS),and ASIA were evaluated before and after surgery,and the operative duration,blood loss were recorded.Results The operation carried out in 120-200 min,800-1600 ml of bleeding statistics through operation process.Localized kyphosis was reduced from an average of (42.6±4.2) ° to (8.2± 1.6) °,the difference was statistically significant (P =0.012).All patients were followed up for 10.0 -26.0 months,average (18.0±6.2) months.The average VAS score was 6.88±0.82 before operation and 2.10 ±0.84 at final follow-up,the difference was statistically significant(P=0.023).The bone healed well,no false joints.Neurological function improved from C to D in 2 patients,from C to E in 4 patients,and from D to E in 14 patients.Conclusion Old thoracolumbar vertebral fracture kyphosis with spinal stenosis by transpedicularosteotomy and internal fixation in the treatment of simple operation,definite effect,less complications and can effectively improve the prognosis.