Application of transforaminal interbody fusion in thoracolumbar fracture / 中华骨科杂志

ABSTRACT

Objective To explore effect of transforaminal interbody fusion (TIF) in the treatment of thoracolumbar fracture.Methods From January 2009 to June 2010,11 patients with thoracolumbar fracture underwent TIF in our hospital.There were 7 males and 4 females,aged from 22 to 54 years (average,37.8±9.5 years).Fracture occurred at T11,12 in 2 cases,T12L1 in 5 cases,L1,2 in 2 cases,L2,3 in 1 case,and L3,4 in 1 case.According to AO classification,all 11 cases were rated as type B.The thoracolumbar injury classification and severity score (TLICS) ranged from 7 to 10 (average,9.2±0.87).According to Frankel grading system,there were 3 cases of grade B,4 cases of grade C,3 cases of grade D,and 1 case of grade E.The operative time,blood loss,and complications were evaluated.Functional recovery was evaluated by Frankel grading system.Radiographic results were obtained before surgery and during follow-up,and Cobb angle was measured.Results The operative time ranged from 130 to 170 minutes (average,147.3±11.9 minutes).The blood loss ranged from 180 to 650 ml (average,369.1±110.2 ml).All patients were followed up for 13 to 26 months (average,20.2±4.3 months).There was no complication during operation and follow-up.X-rays at final follow-up showed that there was no internal fixation failure such as screws break and cages shift.The improvement in Frankel grade was observed in 9 cases.The average Cobb angle improved from preoperative -10.3°±7.8° (range,-21.2° to 3.2°) to 1.2°±7.4° (range,-7.9° to 17.2°) at final follow-up.Conclusion The TIF is an effective method for treating thoracolumbar fracture,which shows good results in deformity correction,improvement of neurological function,bone fusion and stability of internal fixation.