Abstract：Objective To investigate the methods,choices and effects of strengthened posterior pedicle screw fixation plus bone grafting for thoracolumbar vertebral body fractures.Methods A retrospective study was made on 202 patients with single thoracolumbar vertebral body fractures treated between March 2008 and March 2013.Totally,89 out of the patients at age ranging from 21-71 years (mean,39.2 year) undergone transvertebral pedicle screw fixation were allocated to Group A (including 16 patients as five screw group and 73 patients as six screw group).While other 113 patients at age of 19-67 years (mean,40.4 years) undergone traditional surgery were set as Group B (four screw group).Surgeries were performed within 10 days postinjury.Patients in Group A presented with intact pedicles on either unilateral or bilateral sides,with five screws placed for only single side of intact pedicle and six screws for bilateral intact pedicles.Fractured vertebra was recovered by percutaneous leverage reduction and bone grafting.Kyphosis was corrected by transpedicular pushing the fractured vertebra to the ventral side.Follow-up of the patients lasted for 6 to 30 months (mean,16 months).Results Transvertebral pedicle screw fixation reduced the probability of correction loss of vertebral height.At postoperative one week and one year,height restoration of vertebral body in five screw group [(136.1 ± 10.3) ％,(135.9-±9.5) ％] and six screw group [(135.2 ± 10.6) ％,(134.6 ± 9.9) ％] improved significantly from that in four screw group [(133.8 ±9.8)％,(132.5 ± 9.1)％] ; Cobb's angle also achieved significant improvement in five screw group [(2.2 ± 2.4) °,(2.5 ± 1.8) °] and six screw group [(2.0 ± 1.2) °,(2.1 ± 1.6) °] as compared with that in four screw group [(5.8 ± 3.4) °,(6.7 ± 5.5) °].Conclusions Selective use of transvertebral pedicle screw fixation plus bone grafting provides valid correction of the compressed vertebral body and kyphotic deformity and preservation of orthopedic effect.Bone strength almost returns to normal after fracture healing and short-term result is satisfactory.
. Strengthened transvertebral pedicle screw fixation plus bone grafting for treatment of thoracolumbar vertebral body fractures[J]. CHINESE JOURNAL OF TRAUMA, 2013, 29(12): 1190-1194.
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