Pedicle screw reduction and fixation for thoracolumbar fractures via or not the injured vertebra:a comparative study
10.3760/cma.j.issn.1001-8050.2009.08.222
- VernacularTitle:经伤椎与不经伤椎椎弓根螺钉复位固定治疗胸腰椎骨折的临床对比研究
- Author:
Yong PAN
;
Tongwei CHU
;
Yong HAO
;
Yue ZHOU
;
Weidong WANG
;
Jian WANG
;
Zhengfeng ZHANG
;
Nianchun ZHANG
- Publication Type:Journal Article
- Keywords:
Spinal fractures;
Thoracic vertebrae;
Lumbar vertebrae;
Screws
- From:
Chinese Journal of Trauma
2009;25(8):694-697
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the clinical curative effect of pedicle screw reduction and fix-ation via or not the injured vertebra in treatment of thoracolumbar fractures. Methods A retrospective study was performed on 27 patients with single thoracolumbar fractures admitted from March 2006 to Feb-ruary 2008. There were 12 patients treated with pedicle screw fixation (Group A) and 15 with traditional two-level fixation (Group B). Group A involved 11 males and 5 females, aged average 43 years (25-56 years); Group B included 10 males and 5 females, aged from 23 to 61 years (mean 42 years). All pa-tients had fresh fractures with intact pedicles on either unilateral or bilateral sides. With body position re-duction under anesthesia, the patients in Group B were treated with posterior routine distraction and lordo-sis restoration, while those in Group A were treated with the methods used in Group B as well as pedicle screw reduction and fixation. The kyphosis (Cobb angle) and recovery of injured vertebral height were observed. Results The mean follow-up period was 9 months (6-22 months). After operation, the op-timal Cobb angle and anterior column restoration were achieved through the ventral reduction from the in-jured vertebral body. The degree in anterior movement of injured vertebrae pre- and post-operatively was (0.089±0.036)° in Group A and (0.023±0.048)° in Group B, with statistical difference (P < 0.01). Cobb angle was (9.88±7.69)° in Group A and (5.19±3.24)° in Group B (P < 0.05). Changes of distance between the anterior- upper edge of the cephalad vertebrae to the anterior - lower edge of the caudal vertebral body was (39.3±5.2) % in Group A and (20.6±6.5)% in Group B (P < 0.05). Over distraction of the contiguous discs was also avoided efficiently. Conclusions Selective pedicle screw fixation into the injured vertebrae can help correct the kyphosis and maintain the reduction and en-hance the stiffness of the posterior short-segment instrumentation in single thoracolumbar fractures.
