Clinical efficacy of semi-laminectomy and posterior stabilization for treatment of thoracolumbar burst fracture

Abstract

ObjectiveThe purpose of the present study was to investigate the efficacy of posterior semi-laminectomy, restoration of bony fragments and short-segment pedicle screw fixation for treatment of thoracolumbar burst fractures. MethodsFrom January 2008 to April 2011, 21 patients (19 males and 2 females) who suffered single-level thoracolumbar burst fractures were enrolled in this study. Fractures at T11, T12, L1, L2 and L3 level occurred in 3, 5, 8, 4 cases and 1 case, respectively. The patients enrolled were presented with 30%–50% encroachment of spinal canal, partial neurological function deficits and intact pedicles, and underwent semi-laminectomy on the fractured thoracolumbar spine, restoration of the fractured bony fragments with special bone punch beneath dural sac, as well as pedicle screw fixation of the fractured thoracolumbar spine and the two vertical neighboring segments. ResultsAll patients were followed up for 12–48 months, with a mean of 17 months. The mean kyphotic deformity was reduced from (17.3 ± 5.3)° preoperatively to (9.2 ± 4.1)° at follow-up within 12 months. The mean spinal canal diameter increased from (9.7 ± 2.7) mm before surgery to (13.3 ± 1.4) mm at follow-up. Neurological improvement occurred in all subjects after average 2.5 months (range, 1–7 months). Only postoperative wound dehiscence was observed in 1 case, which was caused by implant reaction of calcium phosphate and healed after debridement. ConclusionSemi-laminectomy and restoration of bony fragments is a safe and effective therapeutic measure for thoracolumbar burst factures with spinal canal encroachment of less than 50%.