Clinical effect of posterior approach for spine reconstruction with subtotal vertebrectomy for thoracolumbar vertebra burst fracture in 22 cases

LIU Deng-jun; LI Ke-jian; HE Xiao-bing; WANG Ming-gui; YIN Hao; WANG Hai; LI Zheng-yan

doi:10.3969/j.issn.1009-4237.2017.03.008

Abstract：Objective To evaluate the early clinical outcomes of subtotal corpectomy and intervertebral bone grafting via posterior approach in the treatment of thoracolumbar burst fracture and dislocation.Methods Between Jan.2012 and Dec.2014,22 patients with thoracolumbar burst fracture and dislocation were treated with subtotal corpectomy and intervertebral bone grafting via posterior approach.Among them 15 were males and 7 were females with an average of 38.3(22-53) years.The Cobb's angle,vertebral canal volume,intervertebral height before and after surgery and spinal nerve function recovery of all patients were observed.Results All incisions healed well.The operative time was 180-300 min and the hemorrhage volume was 800-2800 mL.The follow-up period was 6-22 months (average,12 months).The bone grafting healed during 6-9 (average,7) months.There was no serious complication related to internal fixation,and recovered vertebral body height was achieved in all cases.No internal fixation loosening or breakage occurred.No vertebral height,curve or volume was lost.During the last follow-up,Frankel nerve function recovery was good.The Cobb's angle was rectified from (24.2±2.8)°preoperatively to [(5.8±0.6)°,P<0.01] postoperatively,and the spinal canal volume increased from (47.05±5.47)% preoperatively to (98.09±0.98)% (P<0.01) postoperatively.Conclusion Posterior approach for spine reconstruction with subtotal vertebrectomy,decompression and internal fixation is an excellent method for thoracolumbar vertebra burst fractures and good for the recovery of canal volume and Cobb angle and spinal cord function.Though this surgical technique has a relatively large amount of blood loss and high requirements for surgeons,it is a safe and effective method.