Posterior monosegment pedicle screw versus short segment pedicle screw instrumentation for type B thoracolumbar vertebral fracture

Cui Shang-bin; Wei Fu-xin; Liu Shao-yu; Wang Le; Han Guo-wei; Huang Yang-liang

doi:10.3969/j.issn.2095-4344.2014.17.015

Abstract：BACKGROUND:Both the posterior monosegment pedicle screw instrumentation and the traditional posterior short segment pedicle screw instrumentation are common surgical methods for treating type B thoracolumbar fractures. However, their advantages, short-term and long-term surgical outcomes are stil unclear. <br> OBJECTIVE:To evaluate the stability of vertebra after posterior monosegment pedicle screw instrumentation and traditional posterior short segment pedicle screw instrumentation in the management of type B thoracolumbar fractures and the effects on intervertebral disc degeneration of adjacent segments. <br> METHODS:We retrospectively analyzed 80 patients suffered from type B thoracolumbar fractures according to AO classification. The patients were divided into two groups according to the surgery they received. One was the traditional posterior short segment pedicle screw instrumentation group (n=45), and the other was posterior monosegment pedicle screw instrumentation group (n=40). The clinical therapeutic results were evaluated by measuring visual analogue scale score, ASIA classification, vertebral body compression rate, the index of vertebral canal occlusion, Cobb angle and UCLA arthritic grade respectively. <br> RESULTS AND CONCLUSION:There were no statistical differences between the two groups in the ASIA neurological function classification, the occlusion index and the Cobb angle. However, operation time, bleeding amount, visual analogue scale scores, vertebral body compression rate and UCLA arthritic grade were better in the posterior monosegment pedicle screw instrumentation group than those in the traditional posterior short segment pedicle screw instrumentation group. Both the posterior monosegment pedicle screw instrumentation and traditional posterior short segment pedicle screw instrumentation showed great therapeutic results in the treatment of type B thoracolumbar fracture. The improvements in vertebral body compression rate and visual analogue scale scores were better in the posterior monosegment pedicle screw instrumentation group than those in the traditional posterior short segment pedicle screw instrumentation group. The posterior monosegment pedicle screw instrumentation also has many advantages such as less operation time, little trauma, preserving normal vertebrae segment and reducing intervertebral disc degeneration of adjacent segments.