OBJECTIVETo explore the effect of self-made L-shaped reductors combined with pedicle screw internal fixation for the treatment of thoracolumbar bursting fractures.

METHODSFrom Mar. 2003 to Oct. 2006, a total of 34 patients with thoracolumbar bursting fractures were treated. Among the patients, 26 patients were male and 8 patients were female, with an average age of 42 years (ranged from 18 to 67 years). The course of injury ranged from 6 hours to 7 days. The site of fractures: 3 patients in T11, 9 patients in T12, 15 patients in L1, 7 patients in L2. Preoperative CT showed that posterior wall of the fractured vertebral body were incomplete, bone broke into the spinal canal and compressed epithet dural sac. All the patients had symptoms of varying degrees of nerve injury. The posterior median approach was adopted, and self-made L-shaped reductors were used to press and restore the fractured bones that intruding to vertebral canal through the anterior of vertebral canal, then posterolateral fusion was made. Based on postoperative X-ray and CT inspection the effects were observed by injured vertebral height, cobbs angle, spinal canal stenosis, and symptoms of recovery.

RESULTSAll the patients were followed-up with an average of 2 years. The mean anterior and posterior vertebral height increased to normal as (95.23 +/- 1.90)% and (98.37 +/- 1.45)% respectively, which were higher than those of per-operation. The post-operative average Cobb angle was (4.93 +/- 1.41) degrees, which was smaller than that of pre-operation. Postoperative CT showed that the average ratio of protruded bones to the spinal canal anteroposterior diameter was (6.77 +/- 1.57)%, which was smaller than that of pre-operation. All of neurological functions were improved over one grade.

CONCLUSIONL-shaped reductors combined with pedicle screw internal fixation for the treatment of thoracolumbar bursting fractures has many advantages of simple works, good reduction, fixed securely and better results, and so on.