Objective To study the effectiveness of transpedicular intervertebral bone graft and pedicle screws fixation in injured vertebrae for the treatment of thoracolumbar fractures. Methods Between February 2007 and January 2009, 25 patients with thoracolumbar fractures were treated by posterior short-segment fixation combined with transpedicular intervertabral bone graft and pedicle screw fixation in injured vertebrae. There were 18 males and 7 females with a mean age
of 46 years (range, 28-63 years). The injured vertebrae were located at T10 in 1 case, T11 in 2 cases, T12 in 8 cases, L1 in 6 cases, L2 in 6 cases, L3 in 1 case, and L4 in 1 case. According to Denis classification, there were 14 cases of burst fractures and 11 cases of compression fractures. Based on Frankel classifications, 2 cases were rated as grade A, 4 cases as grade B, 8 cases as grade C, 7 cases as grade D, and 4 cases as grade E. The time between injury and operation was 6 hours to 7 days (mean, 4.6 days). The X-ray film was taken to measure the relative height of fractured vertebrae and Cobb angle, and Frankel classification was conducted to evaluate the function recovery of the spinal cord. Results The operations were performed successfully, and incisions healed primarily. All the patients were followed up 12-25 months (mean, 16 months). CT and X-ray films showed good bone graft heal ing and no loosening or breakage of screws and rods. The relative height of fractured vertebrae were 56.8% ± 15.6% at preoperation, 91.2% ± 10.7% immediately after operation, and 89.6% ± 10.3% at 1 year after operation, showing significant differences between preoperation and postoperation (P lt; 0.01), while no significant difference between immediately after operation and 1 year after operation. The Cobb angles were (18.2 ± 2.6), (7.5 ± 1.4), and (8.7 ± 1.1)°, respectively, showing significant differences between preoperation and postoperation (P lt; 0.01), while no significant difference between immediately and 1 year after operation. At 1 year after operation, the neural function in 16 cases was improved 1-3 grades. Conclusion
Treatment of thoracolumbar fractures with transpedicular intervertebral bone graft and pedicle screw fixation in injured
vertebrae has satisfactory effectiveness, which can reconstruct vertebral body height, increase the stabil ity of anterior and middle
Citation： LI Qinliang,LIU Yi,CHU Zhaoming,CHEN Jinchuan,CHEN Ming.. TREATMENT OF THORACOLUMBAR FRACTURES WITH TRANSPEDICULAR INTERVERTEBRAL BONE GRAFT AND PEDICLE SCREWS FIXATION IN INJURED VERTEBRAE. Chinese Journal of Reparative and Reconstructive Surgery, 2011, 25(8): 956-959. doi: Copy