Clinical value of posterior transpedicular fixation combined with vertebroplasty in the treatment of thoracolumbar spine fractures in elderly patients

Abstract

Objective To investigate the clinical value of posterior transpedicular fixation combined with vertebroplasty in the treatment of thoracolumbar spine fractures in elderly patients. Methods Forty-eight patients with thoracolumbar spine fractures were included in the study.All the patients received posterior transpedicular fixation combined with vertebroplasty.Posterior spinal Cobb's angles, vertebral compression rates, spinal stenosis, Frankel classification and VAS scores before and after operation were compared. Results The mean operative time was (125.9±58.3) min, the average intraoperative fluoroscopy time was (14.0±3.8) min, and the average intraoperative blood loss was (408.7±62.3) ml.There was no internal fixation loosening, fracture, wound infection, swelling and nonunion in 48 cases on average follow-up (19.1±3.6) months.2 cased experienced bone cement leakage but no neurological symptoms.After the treatment, Cobb 's angles changed significantly (F=168.51, P<0.05). Cobb’s angles at 1 months and 6 months after operation were significantly lower than that before the operation ( (2.8±0.8)°vs.(4.3±1.1)°vs.(24.1±6.8)°, P<0.05). Vertebral compression rates changed significantly (F=95.16, P<0.05). Vertebral compression rates at 1 months and 6 months after operation were significantly lower than the preoperative vertebral compression rate ( (10.1±3.7)% vs.(14.5±3.9)% vs.(40.2±8.8)%, F=74.62, 62.68, P<0.05). The spinal stenosis rates changed significantly (F=254.85, P<0.05), the spinal stenosis rates at 1 months and 6 months after operation were significantly lower than the preoperative one ( (7.2±2.4)% vs.(10.3±3.6)% vs.(43.2±5.4)%, F=48.83, 36.26, P<0.05). VAS scores changed significantly (F=56.84, P<0.05). VAS scores at 1 months and 6 months after operation were significantly lower than preoperative VAS score ( (3.5±1.7) vs.(2.6±1.5) vs.(6.8±2.8), F=10.88, 9.59, P<0.05). As paired rank test showed, the Frankel classification were significantly improved after operation (Z=5.64, P<0.05). Conclusion Posterior transpedicular fixation combined with vertebroplasty has a significant curative effect on the treatment of thoracolumbar spine fractures in elderly patients. Key words: Posterior transpedicular fixation; Vertebroplasty; Thoracolumbar spine fractures