Short segmental pedicle screw fixation in repair of thoracolumbar burst fractures:1-year follow-up of vertebral stability

Wang Lai-jie

doi:10.3969/j.issn.2095-4344.2014.44.010

Abstract：BACKGROUND:Pedicle screw system has been extensively used in treatment of thoracolumbar fractures. The effects of pedicle screw system in restoring vertebral height in patients and indirect spinal decompression are affirmative. However, fixator bending, loosing or nail breakage, rod breakage and vertebral height loss and kyphosis are common problems in the clinic. <br> OBJECTIVE:To retrospectively analyze the clinical effects of short segmental pedicle internal fixation in the treatment of severe thoracolumbar burst fractures. <br> METHODS:Clinical data of 51 cases of thoracolumbar burst fractures, who were treated with short segmental pedicle internal fixation in Department of Orthopedics of Hongze County People’s Hospital from February 2009 to January 2014, were retrospectively analyzed. Vertebral height, changes in kyphosis Cobb angle and spinal nerve symptoms before and after fixation were observed during fol ow up. Complications after fixation were recorded. <br> RESULTS AND CONCLUSION:A total of 51 patients were successful y treated with internal fixation. After fixation, no secondary infection was observed in the wound. Frankel nerve function grading results showed that spinal nerve symptoms were relieved. Operation time was between 45 and 70 minutes, mean (60.9±3.7) minutes. The amount of intraoperative blood loss was between 150 and 700 mL, mean (330±130) mL. After fixation, fol ow-up time was more than 12 months. After 6 months of fol ow-up, neural function grade A symptom was not obviously improved in two cases. GradesⅠtoⅢwas restored to different degrees in the remaining patients. At 12 months of fol ow-up, low back pain visual analogue scale scores were between 2 and 5. Dynamic radiographs revealed that no abnormal activities were visible in the fixed segment. Simultaneously, no screw loosening or breakage was detected. Results suggested that thoracolumbar burst fractures treated with short segment pedicle screw fixation can achieve ideal clinical curative effect. This is an effective method gathering decompression, reduction and internal fixation completed once, can significantly improve the quality of life of patients, but due to large surgical trauma, we should be strictly grasp the surgical indications.