Percutaneous pedicle screw fixation combined with transpedicular interbody bone grafting for the treatment of thoracolumbar fractures

Abstract

Objective To investigate the efficacy of percutaneous pedicle screw fixation combined with transpedicular interbody bone grafting for the treatment of thoracolumbar fractures.Methods A total of 20 patients with thoracolumbar fractures (type A,load sharing ≥7,without neurological deficit) underwent percutaneous pedicle screw fixation of Sextant systems combined with transpedicular interbody bone grafting were retrospectively studied.The perioperative parameters,radiographic and clinical outcomes were compared with another 20 patients underwent traditional short-segment pedicle screw fixation combined with transpedicular interbody bone grafting.All patients were followed up for at least 2 years after surgery.Results There were no significant differences between the two groups in sex,age,injury to operation interval,and load sharing scores.However,there were significant differences between the two groups in operating time and blood loss (P＜0.05).The vertebral body height and kyphosis angle were corrected significantly after surgery (P＜O.05),however,the recovery of the vertebral body height and kypbosis angle were reduced significantly one year after surgery in both groups (P＜0.05).At the final follow-up,there were no significant progressive losses of the recovery of the vertebral body height and kyphosis angle,as compared with that of one year after surgery in two groups.There were no significant differences in radiographic parameters and the clinical outcomes between the two groups,even though less radiographic correction and better clinical outcomes were found in percutaneous techniques.Conclusion Short-segment pedicle screw fixation with transpedicular grafting remains a reliable surgical method for the treatment of severe thoracolumbar fractures without neurological deficit.Percutaneous pedicle screw fixation proved to be an effective method with the advantages of minimal invasiveness and less blood loss. Key words: Spinal fractures; Fracture fixation, internal; Surgical procedures, minimally invasive; Bone screws