Pedicle screw fixation for treating thoracolumbar fracture：related factors influencing vertebral height restoration
10.3969/j.issn.2095-4344.2015.39.015
- VernacularTitle:椎弓根螺钉置入修复胸腰椎骨折：影响椎体高度恢复的相关因素分析
- Author:
Zhongshan GUI
;
Xiaofeng XU
- Publication Type:Journal Article
- Keywords:
Thoracic Vertebrae;
Lumbar Vertebrae;
Fractures,Bone;
Bone Nails;
Internal Fixators
- From:
Chinese Journal of Tissue Engineering Research
2015;(39):6315-6320
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Pedicle screw fixation in the treatment of thoracolumbar fracture can effectively restore vertebral body height and physiological radian, and are widely used in the clinic. In the clinic, we found that different surgical methods on restoration of vertebral height are different. Simultaneously, there are differences in relevant factors before repair, which causes that the recovery of vertebral body height is not consistent.
OBJECTIVE:To explore the related factors influencing the recovery of vertebral height of pedicle screw fixation system for treating thoracolumbar fracture.
METHODS:Clinical data of 63 patients with thoracolumbar fracture, who were treated by posterior pedicle screw fixation system from September 2012 to March 2015, were summarized. The fracture types were A3 or A4 type in the AO spine thoracolumbar injury classification system, including 32 cases of transpedicular screw fixation (group A) and 31 cases of beyond-injured-vertebral fixation (group B). The related factors including age, course of disease (within 3 weeks), bone mineral density, preoperative degree of vertebral compression and preoperative sagittal Cobb’s angle were recorded. The degree of vertebral height restoration was also observed. Intergroup analysis was conducted using independent samplet-test. Intragroup analysis was performed using bivariate regression analysis in single factor analysis. Multivariate linear regression analysis was applied for multivariate analysis so as to explore the factors related to vertebral height restoration.
RESULTS AND CONCLUSION:No significant difference in preoperative rate of vertebral compression or Cobb’s angle was detected between the two groups (P > 0.05). Postoperative rate of vertebral height restoration of group A was significantly greater than group B (P < 0.05). Univariate analysis within the group showed that course of disease, preoperative degree of vertebral compression and bone mineral density were strongly associated with the restoration of vertebral height (P < 0.05). In contrast, there was no significant correlation between age, preoperative sagittal Cobb’s angle and the restoration of vertebral height (P > 0.05). Multiple linear regression analysis showed that the preoperative degree of vertebral compression and the course of disease were the predominant factors affecting the vertebral height restoration. The standardized partial regression coefficients were 0.225, -0.621, respectively. These results demonstrate that transpedicular screw fixation can more effectively restore vertebral height than traditional beyond-injured-vertebral internal fixation. The preoperative vertebral compression and course of diseases are the predominant factors affecting the vertebral height restoration, which can predict postoperative vertebral height restoration.
