Analysis on surgicaltreatment of thoracolumbar burst fractures combined with dislocation

Abstract

：Objective To investigatethe effect of posterior operation for thoracolumbar burst fractures combined withdislocation. Methods The study involved 22 patients with thoracolumbar burst fracturescombined with dislocation admitted into our hospital from October 2005 to March 2008.There were 17 males and 5 females at age range of 18-56 years. The fractures were locatedat T12-L2. The fractured vertebrae lost its height by 1/4 to 3/4 of the normal height. Theupper vertebral dislocation ex-tent was from 25% to 50%. All operations were accomplishedwithin two weeks after injury. The patients were randomly divided into two groups, ie,Group Ⅰ (implanted with 4 pediclescrews in upper and lower vertebrae adjacent to the fractured vertebrae) and Group Ⅱ (implanted with 6 pedicle screws in 2 upper and 1 lower vertebraeadjacent to the fractured vertebrae). The operation time, volume of blood loss, ky-photicangle, neurological function and Low Back Outcome Score (LBOS) were compared between twogroups. Results All patients were followed up for 12-36 months. The duration of operationin Group Ⅱ was longer than Group Ⅰ (P < 0.05), with no increase of intraoperative blood loss. GroupⅡI was su-perior to Group Ⅰ in aspects of correction rate, correction loss and implantfailure rate (P < 0.05). There was no statistical difference in aspects of neurologicalfunction recovery and low back outcome score be-tween two groups. Conclusion Fixation withthree vertebrae and six pedicle screws through posterior approach is an effective,feasible and safe procedure for treatment of thoracolumbar burst fractures com-bined withdislocation. Key words: Spinal fractures; Thoracic vertebrae; Lumbar vertebrae; Fracture fixation, internal