Clinical Outcomes of Thoracolumbar Burst Fracture Treated by Trans-Kambin triangle versus Transpedicular Bone Grafting Combined with Posterior Internal Fixation

Abstract

The ideal management of thoracolumbar burst fracture (TLBF) remains controversial. We conducted this study to compare the effectiveness and safety of trans-Kambin triangle versus transpedicular bone grafting combined with posterior internal fixation (PIF) for TLBF. Fifty-four patients were retrospectively analyzed and divided into 2 groups: the observation group (PIF combined with bone grafting via the Kambin triangle, n= 28) and the control group (PIF combined with bone grafting via transpedicular, n= 26). The anterior vertebral height ratio, sagittal Cobb angle, visual analog scale score, Oswestry Disability Index, bone healing rate, and neurologic complications were measured. All patients were followed up regularly for a mean period of 17.94 months (12- 24 months). The anterior vertebral height ratio in the observation group was higher than that in the control group (93.93 ± 2.92 vs. 89.90 ± 5.54%, P= 0.006), and the loss of correction was lower (1.59 ± 1.20 vs. 3.00 ± 1.98%, P= 0.008). The observation group had lower sagittal Cobb angle at final follow-up (8.68 ± 3.75 vs. 11.33 ± 4.77 degrees, P= 0.046) and less correction loss (1.96 ± 1.32 ± 1.15 vs. 3.90 ± 2.39 degrees, P= 0.002). The visual analog scale score and Oswestry Disability Index in the observation group were lower (0.61 ± 0.43 vs. 0.92 ± 0.38, P= 0.016; 15.86 ± 4.11 vs. 19.18 ± 4.04, P= 0.010), while the fracture healing rate showed no significant difference (P>0.05). No internal fixation failure or neurologic complications occurred in both groups during the follow-up. Bone grafting via the Kambin triangle combined with PIF is a safe and effective technology for thoracolumbar burst fracture.