CLINICAL SIGNIFICANCE OF POSTERIOR INTERNAL FIXATION FOR REGULATION OF SPINAL CURVATURE IN THORACOLUMBAR COMPRESSION FRACTURES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LI Pengfei ¹ , FANG Genqiang ¹ , LI Hua ¹ , JIN Xianhui ¹ , ZHANG Qingsheng ¹ , DING Wenyuan ² , ZHANG Wei ² , CUI Shengjie ¹

1Department of Orthopaedics, Harrison International Peace Hospital, Hengshui Hebei, 053000, P.R.China;;
2Department of Spinal Surgery, the Third Hospital of Hebei Medical University. Corresponding author: JIN Xianhui, E-mail: jianxianhui@yahoo.com.cn;

Corresponding author：

Keywords：

Thoracolumbar compression fracture; Spinal curvature; Internal fixation; Low back pain

DOI：

10.7507/1002-1892.20130031

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Objective To investigate the clinical significance of applicating posterior internal fixation for regulating spinal curvature in thoracolumbar compression fractures. Methods Between May 2006 and May 2009, 63 patients with thoracolumbar compression fractures were treated, and the clinical data were retrospectively analyzed. Among them, 33 patients received traditional posterior internal fixation in control group; 30 patients underwent posterior internal fixation with spinal curvature correction under C-arm X-ray device in trial group. There was no significant difference in age, gender, cause of injury, injured segment, grade of fracture, and time from injury to operation between 2 groups (P gt; 0.05). The Cobb angle, height of injured vertebral body, and disc height were measured by X-ray examination; loosening and breakage of internal fixation were observed and compared between 2 groups. The recovery rate was calculated according to pre- and post-operative visual analogue scale (VAS) and Oswestry disability index (ODI) scores for each patient. Results All cases were followed up 20-45 months (mean, 31 months). The postoperative VAS score, ODI, Cobb angle, height of injured vertebral body, and disc height were improved significantly when compared with preoperative values in 2 groups (P lt; 0.05). At last follow-up, VAS and ODI scores of trial group were significantly better than those of control group (P lt; 0.05); loss of Cobb angle was (2.1 ± 1.7)° in trial group and (4.2 ± 3.2)° in control group, showing significant difference (t=1.457, P=0.000); loss of disc height was (1.4 ± 1.2) mm in trial group and (3.4 ± 2.3) mm in control group, showing significant difference (t=9.336, P= 0.000); loss of height of injured vertebral body was 1.8% ± 0.6% in trial group and 5.4% ± 2.1% in control group, showing significant difference (t=3.435, P=0.000). Broken screw and loosening screw occurred in 1 case of control group, respectively (6.1%), but no broken or loosening screw in trial group, showing significant difference (P=0.000). Conclusion Application of posterior internal fixation for regulating spinal curvature has a good clinical effectiveness. The postoperative spinal curvature, the height of injured vertebral body, and disc height can be improved significantly and low back pain can be recovered satisfactorily. The modified technique is also effective in reducing broken and loosening incidence of the fixation system.

Citation： LI Pengfei,FANG Genqiang,LI Hua,JIN Xianhui,ZHANG Qingsheng,DING Wenyuan,ZHANG Wei,CUI Shengjie. CLINICAL SIGNIFICANCE OF POSTERIOR INTERNAL FIXATION FOR REGULATION OF SPINAL CURVATURE IN THORACOLUMBAR COMPRESSION FRACTURES. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(2): 135-139. doi: 10.7507/1002-1892.20130031 Copy

1.	田耘, 周方, 陈仲强, 等. 复杂胸腰椎骨折的伤椎形态特点与伤椎置钉技术. 中华外科杂志, 2010, 48(16): 1238-1242.
2.	吕豪珍, 林红, 张绍昆, 等. 经伤椎椎弓根置钉技术在胸腰段骨折中的应用. 中国组织工程研究, 2012, 16(9): 1680-1683.
3.	王雷, 夏天, 田纪伟, 等. 后路短节段固定联合伤椎置钉治疗胸腰段单椎体骨折. 中华医学杂志, 2010, 90(13): 886-889.
4.	陈坚, 龙厚清, 温干军, 等. 后路伤椎置钉短节段椎弓根钉内固定治疗胸腰椎爆裂骨折. 生物骨科材料与临床研究, 2011, 8(5): 45-48.
5.	董双海, 田纪伟, 王雷, 等. 后路短节段固定联合伤椎置钉在胸腰段脊柱骨折中的应用. 中华医学杂志, 2009, 89(11): 740-743.
6.	曾至立, 程黎明, 钱列, 等. 单侧伤椎置钉联合短节段椎弓根螺钉内固定治疗轻中度不稳定性胸腰椎骨折. 中华外科杂志, 2012, 50(3): 234-237.
7.	Chow DH, Leung KT, Holmes AD, et al. Changes in spinal curvature and proprioception of schoolboys carrying different weights of backpack. Ergonomics, 2007, 50(12): 2148-2156.
8.	Norton BJ, Sahrmann SA, Van Dillen FL, et al. Differences in measurements of lumbar curvature related to gender and low back pain. J Orthop Sports Phys Ther, 2004, 34(9): 524-534.
9.	昌耘冰, 夏虹, 王义生, 等. 伤椎置钉技术在治疗胸腰椎骨折中的即时复位作用. 中华创伤杂志, 2009, 25(10): 894-897.
10.	朱荣芳, 黄小和, 郭新宇, 等. 经伤椎置钉固定技术治疗胸腰椎骨折. 实用骨科杂志, 2011, 17(7): 626-628.
11.	曾忠友, 张建乔, 金才益, 等. 经伤椎置钉椎弓根螺钉系统固定治疗胸腰椎骨折2年以上随访结果. 中国骨伤, 2012, 25(2): 128-132.
12.	何大川, 张治军, 彭鹏, 等. 经伤椎置钉椎弓根螺钉系统治疗下腰椎爆裂性骨折. 中华创伤骨科杂志, 2011, 13(4): 383-385.
13.	黎明华, 谢文伟, 姚汉刚, 等. 经伤椎置钉技术治疗胸腰椎骨折的疗效分析. 中华创伤骨科杂志, 2012, 14(5): 456-458.
14.	吴卫平, 吴水生, 李会荣, 等. 伤椎置钉后路钉棒系统复位治疗胸腰椎爆裂性骨折. 中国骨与关节杂志, 2012, 1(1): 28-32, 67.
15.	魏思奇, 孙永建, 王建民, 等. 伤椎置钉单节段内固定治疗胸腰椎骨折. 中华创伤骨科杂志, 2011, 13(7): 695-696.
16.	向乾彬, 范海泉, 黄海讯, 等. 伤椎置钉治疗胸腰椎骨折. 颈腰痛杂志, 2012, 33(2): 111-113.
17.	曾忠友, 黄伟, 张建乔, 等. 椎弓根螺钉系统同时经伤椎置钉固定治疗胸腰椎骨折. 中国脊柱脊髓杂志, 2009, 19(8): 609-613.
18.	王洪伟, 李长青, 周跃, 等. 脊柱骨折经伤椎椎弓根置钉附加横连短节段固定的稳定性测试. 中国脊柱脊髓杂志, 2010, 20(9): 745-748.

1. 田耘, 周方, 陈仲强, 等. 复杂胸腰椎骨折的伤椎形态特点与伤椎置钉技术. 中华外科杂志, 2010, 48(16): 1238-1242.
2. 吕豪珍, 林红, 张绍昆, 等. 经伤椎椎弓根置钉技术在胸腰段骨折中的应用. 中国组织工程研究, 2012, 16(9): 1680-1683.
3. 王雷, 夏天, 田纪伟, 等. 后路短节段固定联合伤椎置钉治疗胸腰段单椎体骨折. 中华医学杂志, 2010, 90(13): 886-889.
4. 陈坚, 龙厚清, 温干军, 等. 后路伤椎置钉短节段椎弓根钉内固定治疗胸腰椎爆裂骨折. 生物骨科材料与临床研究, 2011, 8(5): 45-48.
5. 董双海, 田纪伟, 王雷, 等. 后路短节段固定联合伤椎置钉在胸腰段脊柱骨折中的应用. 中华医学杂志, 2009, 89(11): 740-743.
6. 曾至立, 程黎明, 钱列, 等. 单侧伤椎置钉联合短节段椎弓根螺钉内固定治疗轻中度不稳定性胸腰椎骨折. 中华外科杂志, 2012, 50(3): 234-237.
7. Chow DH, Leung KT, Holmes AD, et al. Changes in spinal curvature and proprioception of schoolboys carrying different weights of backpack. Ergonomics, 2007, 50(12): 2148-2156.
8. Norton BJ, Sahrmann SA, Van Dillen FL, et al. Differences in measurements of lumbar curvature related to gender and low back pain. J Orthop Sports Phys Ther, 2004, 34(9): 524-534.
9. 昌耘冰, 夏虹, 王义生, 等. 伤椎置钉技术在治疗胸腰椎骨折中的即时复位作用. 中华创伤杂志, 2009, 25(10): 894-897.
10. 朱荣芳, 黄小和, 郭新宇, 等. 经伤椎置钉固定技术治疗胸腰椎骨折. 实用骨科杂志, 2011, 17(7): 626-628.
11. 曾忠友, 张建乔, 金才益, 等. 经伤椎置钉椎弓根螺钉系统固定治疗胸腰椎骨折2年以上随访结果. 中国骨伤, 2012, 25(2): 128-132.
12. 何大川, 张治军, 彭鹏, 等. 经伤椎置钉椎弓根螺钉系统治疗下腰椎爆裂性骨折. 中华创伤骨科杂志, 2011, 13(4): 383-385.
13. 黎明华, 谢文伟, 姚汉刚, 等. 经伤椎置钉技术治疗胸腰椎骨折的疗效分析. 中华创伤骨科杂志, 2012, 14(5): 456-458.
14. 吴卫平, 吴水生, 李会荣, 等. 伤椎置钉后路钉棒系统复位治疗胸腰椎爆裂性骨折. 中国骨与关节杂志, 2012, 1(1): 28-32, 67.
15. 魏思奇, 孙永建, 王建民, 等. 伤椎置钉单节段内固定治疗胸腰椎骨折. 中华创伤骨科杂志, 2011, 13(7): 695-696.
16. 向乾彬, 范海泉, 黄海讯, 等. 伤椎置钉治疗胸腰椎骨折. 颈腰痛杂志, 2012, 33(2): 111-113.
17. 曾忠友, 黄伟, 张建乔, 等. 椎弓根螺钉系统同时经伤椎置钉固定治疗胸腰椎骨折. 中国脊柱脊髓杂志, 2009, 19(8): 609-613.
18. 王洪伟, 李长青, 周跃, 等. 脊柱骨折经伤椎椎弓根置钉附加横连短节段固定的稳定性测试. 中国脊柱脊髓杂志, 2010, 20(9): 745-748.

Chinese Journal of Reparative and Reconstructive Surgery

CLINICAL SIGNIFICANCE OF POSTERIOR INTERNAL FIXATION FOR REGULATION OF SPINAL CURVATURE IN THORACOLUMBAR COMPRESSION FRACTURES

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