Pedicle screw fixation with bone cementversus pedicle screw fixation alone for L1 compression fractures

Yalikun?Yasen

doi:10.3969/j.issn.2095-4344.2015.39.012

Abstract：BACKGROUND:Vertebroplasty and edicle screw fixation are effective repair methods for thoracolumbar fractures. Spine angle loss is a more common complication after removal of implant for thoracolumbar compression fractures. Percutaneous vertebroplasty may be a better choice for preventing spine angle loss. <br> OBJECTIVE:To investigate the clinical curative effect and complication of pedicle screw fixation with bone cement for repair of L1 compression fractures, and to compare with pedicle screw fixation alone. <br> METHODS: A total of 76 cases of L1 compression fractures were enroled and assigned to two groups according to fixation repair method. 40 patients in the vertebroplasty group received bone cement and pedicle screw fixation. 36 patients in the pedicle screw fixation group received pedicle screw fixation alone. Repair effects were compared between the two groups. MRI examination was conducted immediately, 3 and 6 months after surgery taking injured vertebral body as a center to measure Cobb angle and the height of anterior border of the injured vertebral body. Simultaneously, visual analogue scale score was recorded. Loosing and breakage of the fixator were seen. <br> RESULTS AND CONCLUSION:Bone union was detected within 6 months of folow-up in the two groups, no screw loosing or breakage. Kyphosis Cobb angle and the height of anterior border of the vertebral body were significantly improved at 6 months after surgery in both groups (P < 0.01). Above indexes were better in the vertebroplasty group than in the pedicle screw fixation group (P < 0.05). Visual analogue scale score was significantly improved at 6 months post surgery in both groups (P< 0.01), but no significant difference was found between the two groups (P > 0.05). These findings suggested that pedicle screw fixation with bone cement and pedicle screw fixation alone for L1 compression fracture obtained satisfactory reduction, and reconstructed the height of the vertebral body. However, results of compressive stability indicated that the fixation effect of pedicle screw fixation with bone cement was better than that of pedicle screw fixation alone. No short-term screw breakage and correction loss occurred. Perfusion with bone cement could elevate the stability of pedicle screw implantation.