Pedicle screw instrumentation plus augmentation vertebroplasty using calcium sulfate for thoracolumbar burst fractures without neurologic deficits

Abstract

To evaluate the efficacy of posterior instrumentation plus vertebroplasty and posterolateral fusion using calcium sulfate for thoracolumbar burst fractures without neurologic deficits. Between July 2005 and January 2008, a total of 45 patients who had been diagnosed as having thoracolumbar burst fractures without neurologic deficits were treated with pedicle screw instrumentation plus vertebroplasty using calcium sulfate in our unit. The Cobb angles and loss rates of anterior-middle columns height at different time intervals were measured on lateral radiographs, and the preoperative and postoperative functional outcomes were evaluated using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI). The Cobb angles and loss rates of anterior-middle columns height postoperatively period were restored significantly compared with those noted preoperatively. The angles and heights were well maintained for at least two years using this technique. The mean postoperative VAS (back pain) score was 2.1 ± 0.8, which was significantly better (P < 0.001) than the mean preoperative VAS score 7.9 ± 1.1. The average preoperative ODI was 66.6 ± 8.1% and this had improved significantly to 15.5 ± 4.5% by the latest follow-up (P < 0.001). No instrumentation failure was detected in this study. The calcium sulfate had been absorbed completely by 3-6 months postoperatively. Pedicle screw instrumentation plus augmentation vertebroplasty with calcium sulfate is an economic, efficient and reliable technique for treating unstable thoracolumbar fractures without neurologic deficits.