Adjacent dis degenerative changes following the pedicle screw fixation using nonfusion method in thoracolumbar fracture
LIN Zi-feng
LIU Tan-shu
YU Zhi-song
WANG Wan-ming
QIU Han-min
Abstract：Objective To evaluate the efficacy and disc degeneratoin of the pedicle screw fixation using nonfusion method in the treatment of thoracolumbar fracture.Methods Thirty-seven patients were treated by pos-terior pedicle screw internal fixation with fusion method(fusion group)and twenty-four patients were treated with nonfusion method(nonfusion group)from Jun.2015 to Jun.2016 in Longyan First Hospital Affiliated to Fujian Medical University.There were 38 males and 23 females,aged from 33 to 65(mean,49.92).All cases met the fol-lowing conditions:TLICS≥4,type A accrording to AO classification,single segment fracture and grade E neurologi-cal function according to ASIA.The therapeutic effect between the two groups was compared and the adjacent dis degenerative changes in the groups at 1 year after surgery were assessed using nonfusion method according to Pearce classification.Results The nonfusion treatment could shorten the surgical time as well as reduce the amount of surgical blood and incision draining loss; it could also effectively recover the height of injured vertebral body and rectify the posterior salient.There was no significant difference between two groups in the loss of height and posterior salient of injured vertebral body after restoration(P>0.05).In the nonfusion group,after removal of the internal fixation at 1 year after operation,there were 3 cases of intervertebral discs with different degrees of degeneration,but no difference with the preoperative ones(P>0.05).Two new high intensity zones were discovered in the annulus fi-brosus,both of whom suffered backache at varying degrees.One high intensity zone disappeared after removing fixa-tion.The fusion rate of the fusion group was 67.57%(25/37).Conclusion Nonfusion treatment could not only shorten the surgical time and reduce the amount of surgical blood and incision draining loss,but also could effectively recover the height of injured vertebral body and rectify the posterior salient.One year after operation,the adjacent in-tervertebral discs did not degenerate significantly in comparison with the preoperative ones.There was no significant degeneration in the adjacent intervertebral discs at 1 year after surgery.
Keywords：thoracolumbar fracturesnon-fusionpedicle screwintemal fixationdisc degeneration
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 253-257 )