Balloon vertebroplasty reinforced by injectable calcium sulfate cement versus posterolateral fusion for treatment of thoracolumbar burst fractures

Abstract

Objective To compare the clinical curative effects of balloon vertebroplasty reinforced by injectable calcium sulfate cement(CSC) and posterolateral fusion after short-segment pedicle screw fixation through the fractured vertebra in treatment of thoracolumbar bumt fractures. Methods From February 2012 to May 2015, 68 cases patients with single thoracolumbar burst fracture were admitted in Orthopaedics and Traumatology Department of Traditional Chinese Medicine Hospital of Gaozhou, and were randomly divided into two observation group and control group, each group with 34 cases.Observation group were treated by short-segment pedicle screw fixation through the fractured vertebra followed by transpedicular balloon reduction of the endplate and CSC injection, the control group were underwent posterolateral fusion in addition to short-segment pedicle screw fixation through the fractured vertebra.The 2 groups were compared at preoperation, and the last follow-up in terms of visual analog pain score(VAS), Oswestry disability index(ODI), anterior height ratio of the injured vertebra, middle height ratio of the injured vertebra, the vertebral wedge angle and the sagittal Cobb angle. Results The patients were followed up from 12 to 54 months.All the measure indexes at the last follow-up were significantly improved than those at preoperation in all the patients(P 0.05). At the last follow-up, the observation group showed a significantly less loss than the control group regarding the corrections of anterior height ratio of the injured vertebra((93.6±3.4) vs.(81.8±4.8)), middle height ratio of the injured vertebra((90.7±3.8) vs.(78.9±5.1)), the veaebral wedge angle((5.7±1.9) ° vs.(8.8±3.0) °) and the sagittal Cobb angle((5.2±2.1) ° vs.(7.9±2.4) °)(t=4.143, 5.786, 4.819, 4.465, P<0.05). Conclusion In treatment of thoracolumbar burst fractures, compared with posterolateral fusion, balloon vertebroplasty reinforced by injectable CSC can better restore the shape of injured vertebral body and stability of the anterior and middle columns in the early period, can also reduce losses of corrections, and keep the function of the spinal motion segment. Key words: Spinal Fractures; Fracture fixation; Calcium sulfate; Bone cement