Posterior short-segment pedicle screw fixation and bone grafting in the treatment of thoracic and lumbar fracture:follow-up evaluation

Ding Hao; Shen Qiang; Zhu Liang; Wei Xiao-kang

doi:10.3969/j.issn.2095-4344.2015.09.009

Abstract：BACKGROUND:Traditional internal fixation for treating the thoracic and lumbar vertebral fracture is prone to induce poor reduction and loss of vertebral height. While the use of posterior short-segment pedicle screw internal fixation can effectively correct the kyphosis and maintain the correcting effect in the treatment of thoracolumbar fracture. <br> OBJECTIVE:To explore the clinical effect of posterior short-segment pedicle screw fixation and posterolateral bone graft fusion in treatment of thoracolumbar fracture. <br> METHODS:A retrospective analysis was performed on the clinical data of 41 patients who underwent thoracic and lumbar posterior open reduction, internal fixation of short-segment pedicle screw system and posterolateral bone graft fusion for the treatment of thoracolumbar fractures in the First People’s Hospital Affiliated to Shanghai Jiaotong University from March 2009 to November 2013. Patients were detected by X-ray and CT examination, to observe internal fixation effect. In addition, lumbar function improvement (Japanese Orthopaedic Association Scores, Visual Analog Score, scoliosis, vertebral edge height ratio, and spinal nerve function) was also assessed. <br> RESULTS AND CONCLUSION:Patients were fol owed up for 5 months to 4 years and 1 month after internal fixation. Al patients achieved fracture healing and the internal fixators were removed 1 year after surgery. Fol ow-up results showed that, 1 case appeared the loosening and 2 cases appeared the fracture (fracture ends were not effectively fused during operation), no cases appeared secondary spinal kyphotic deformity aggravation. Height of injured vertebra was significantly recovered and the spinal nerve function was obviously improved at 5 months after surgery. Posterior short-segment pedicle screw fixation and posterolateral bone graft fusion can obtain good clinical curative effect in treatment of thoracolumbar fracture.