Pedicle screw fixation combined with implantation of artificial bone composite for thoracolumbar fractures：vertebral height and Cobb angle
10.3969/j.issn.2095-4344.2015.26.013
- VernacularTitle:经伤椎置钉并人工骨复合物修复胸腰椎骨折：伤椎高度及Cobb角评价
- Author:
Jianhang WANG
;
Tao SUN
;
Haiping JIANG
- Publication Type:Journal Article
- Keywords:
Thoracic Vertebrae;
Lumbar Vertebrae;
Fractures,Bone;
Bone Nails;
Fracture Fixation
- From:
Chinese Journal of Tissue Engineering Research
2015;(26):4164-4168
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:The traditional treatment for thoracolumbar vertebral fractures is posterior short-segment pedicle screw fixation. This method uses vertebral soft tissue stretch through distraction reduction mechanism, makes shift bone reset, and restores shape and height of vertebral body. Long-term folow-up found that part of cases experience complications such as vertebral height loss, loss of spinal correction of Cobb angle, the pedicle screw breakage and loosening. OBJECTIVE:To explore clinical effects of pedicle screw fixation combined with the implantation of artificial bone composite for the treatment of thoracolumbar fractures, and to compare with conventional pedicle screw. METHODS: A total of 80 patients with thoracolumbar fractures, who were treated in the Yantaishan Hospital from March 2011 to May 2014, were randomly divided into two groups. In the experimental group, patients received pedicle screw fixation combined with the implantation of artificial bone composite. In the control group, patients received routine pedicle fixation. Pain visual analog scale score was evaluated before treatment and at 6 months after treatment in patients of both groups, and easement of pain was evaluated after treatment. Vertebral body height (normal anterior flange height and up and down the front cone height and the ratio of the average multiplied by 100%) and sagittal Cobb angle (sagittal measurements of X-ray film) were measured in patients of both groups before treatment and at 1 and 12 months after treatment. According to conventional hierarchical evaluation criteria used al over the world, prognosis was assessed at 6 months after treatment, including basic cure, powerfuly, effectively, and invalid. RESULTS AND CONCLUSION: At 6 months after treatment, significant differences in pain visual analog scale scores were detected in the experimental group (2.4 points) and control group (3.7 points) (P < 0.05). No significant difference in height of the injured vertebra and Cobb angle was detected between the two groups before treatment (P> 0.05). The height of the injured vertebra and Cobb angle were better in the experimental group compared with the control group at 1 and 12 months after treatment (P < 0.05). Significant differences in treatment efficiency were detectable between the experimental group (90%) and the control group (73%) at 6 months after treatment (P < 0.05). These data indicate that pedicle screw fixation combined with the implantation of artificial bone composite in the treatment of thoracolumbar fractures can be used to fix fracture reduction, effectively restore height of injured vertebral body, prevent postoperative Cobb angle loss, and improve the treatment efficiency.
