Minimally Invasive Pedicle Screw Fixation Combined with Vertebroplasty with Calcium Phosphate Bone Cement in the Treatment of Thoracolumbar Burst Fracture
- VernacularTitle:微创椎弓根钉内固定联合磷酸钙骨水泥椎体成形术治疗胸腰椎爆裂性骨折
- Author:
Yutong GU
1
;
Chaoge LIANG
;
Liang ZHANG
;
Hong LIN
;
Jian ZHOU
Author Information
1. 复旦大学附属中山医院骨科
- Keywords:
Thoracolumbar burst fracture;
Pedicle screw fixation;
Vertebroplasty
- From:
Chinese Journal of Clinical Medicine
2015;(2):181-185
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty(PVP) with calcium phosphate bone cement in the treatment of acute thoracolumbar burst fracture . Methods:Twenty‐three patients ,who suffered from single fresh thoracolumbar burst fracture without neurologic deficits and were classified as A3 fracture located between T11~L2 ,underwent the procedure of minimally invasive pedicle screw fixation combined with PVP with calcium phosphate bone cement .Duration of operation and blood loss ,injected volume of bone cement and length of stay ,were recorded .Lumbago and backache scores assessed by visual analogue scale (VAS) were recorded before surgery ,immediately after surgery ,as well as 1 month ,2 months ,3 months ,6 months ,1 year and 2 years after surgery . Vertebral compression rate and restoring rate ,Cobb angle and correction rate of vertebral kyphosis ,were measured at each time point and compared among the time points .Results:The average injected volume of calcium phosphate bone cement was 4 .9(3 .8~6 .4)mL .The mean duration of operation was 92(75~120)min .The average blood loss was 52(40~75)mL .The mean length of stay was 5 .6(4~ 7) d and the average follow‐up period was 26 months (24 ~ 29) .The VAS significantly decreased from 8 .8 ± 1 .2 before surgery to 1 .8 ± 0 .6 immediately after surgery and 0 .4 ± 0 .5 at 2 years after surgery ,and the differences were statistically significant(P< 0 .001) .The compression rate of vertebral body height decreased from(50 .4 ± 7 .2)% before surgery to (6 .2 ± 1 .5)% immediately after surgery and(6 .9 ± 1 .4)% at 2 years after surgery ,and the differences were statistically significant(P<0 .001) .The Cobb angle decreased from (22 .6 ± 1 .8)° before surgery to (3 .2 ± 1 .7)° immediately after surgery and (5 .1 ± 1 .5)° at 2 years after surgery ,and the differences were statistically significant(P<0 .001) .No significant decrease in both kyphosis correction and vertebral body height restoration was observed during the follow‐up .There was no loosen screw or broken screw .Conclusions:Minimally invasive pedicle screw fixation combined with PVP with calcium phosphate bone cement is a safe and efficacious method for the treatment of thoracolumbar vertebral burst fracture .
