Characteristics of pedicle screw fixation for thoracolumbar burst fractures among middle and old aged patients
- VernacularTitle:中老年人脊柱胸腰段爆裂型骨折采用椎弓根系统治疗的特点
- Author:
Guilin ZHANG
;
Nan LI
;
Maoqi GONG
- Publication Type:Journal Article
- Keywords:
Thoracic vertebrae;
Lumbar vertebrae;
Spinal fractures;
Osteoporosis
- From:
Chinese Journal of Orthopaedics
1998;0(12):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss methods of pedicle screw fixation for thoracolumbar burst fractures among middle and old aged patients with different degree of osteoporosis, and to improve the clinical result by individualized treatment according to fracture characteristics. Methods There were totally 25 patients, 17 males, and 8 females. These patients with a mean age of 52 years (range, 43-63 years), had suffered from thoracolumbar burst fractures consisted of 1 T11 fracture, 6 T12 fractures, 8 L1 fractures, 7 L2 fractures, 3 L3 fractures. According to Jikeis osteoporosis grading system, 5 patients were of early stage, 7 of stage Ⅰ, 13 of stageⅡ. Posterior stabilization with the short-segment pedicle screw system were given to all the patients, among which 6 RF, 8 AF, 5 USS, 6 Socon were performed. Fifteen patients received anterolateral decompression, and ten patients accepted no decompression at all. Some measures were taken in order to enhance the fixation stiffness for pedicle screw system, such as increasing the screws diameter, using the vertebral body reducer to reduce the depressed vertebral body and so on. To enhance vertebral body strength after fracture union, transpedicular bone graft was also performed. Results All the patients achieved fracture union during the follow-up with a mean period of 28 months (range, 9-48 months). All of the fractures were reduced satisfactorily, SI (sagittal index) was improved from 53% to 89% after operation. No fracture of screws or rods occurred, also no screw loosened. No reduction loss was found. Conclusion In order to decrease failure rate of pedicle screw fixation for thoracolumbar fractures among middle and old aged patients, osteoporosis of vertebral body should never be neglected and, of course, treatment should be given with individualized fixation.
