RESUMO
OBJECTIVE: To explore efficacy of modified funnel method for transpedicular bone grafting in treating thoracolumbar vertebras fracture. METHODS: From May 2006 to November 2011, 35 patients (19 males and 16 females, ranged in age from 21 to 66 years with an average of 34.6 years) with thoracolumbar vertebras fracture were treated by posterior pedicle screw fixation, reduction and modified funnel method for transpedicular autogenous iliac bone grafting. Of the 35 cases, 9 cases were severe compression fracture and 26 cases were burst fracture. The anterior body height and Cobb's angle of injured vertebral were measured by X-ray; the effect of implantation bone and CT value were assessed by radiograph CT scan; Nerve function were evaluated according to Frankel's neurological function classification and back pain were evaluated by visual analogue scale (VAS). RESULTS: Thirty-two patients were followed up from 18 to 37 months with an average of 19.7 months. No nerve injuries aggravated, and 11 patients with partial nerve injuires preoperatively were improved at least 1 level recovery postoperatively; Breakage or loosen of screws were not found. Vertebral bone grafting filled well, bone fusion were got after 6 months' treatment and without cavity gap in grafting bone area. The anterior vertebral height was improved respectively from preoperative (50.17 +/- 8.26)% to postoperative (90.79 +/- 4.85)%, and (90.34 +/- 4.03)% at the final follow-up. The Cobb's angle improved from preoperative (28.7 +/- 6.24) degrees to postoperative (7.26 +/- 3.79) degrees, with (7.34 +/- 4.05) degrees at the final follow-up. CT value of injured vertebras at the final follow-up were significantly higher than adjacent vertebras'. The average VAS was 1.06. CONCLUSION: Posterior pedicle screw fixation, reduction and modified funnel method for transpedicular autogenous iliac bone grafting is a feasible and safe method for the treatment of thoracolumbar vertebras fracture. It can effectively prevent bone loss of injured vertebral height, progressive deformity of kyphosis, and keep spinal movement function at the maximum.
