Percutaneous short segment pedicle screw fixation with vertebral augmentation for the treatment of single level thoracolumbar osteoporosis fracture

Abstract

To explore clinical outcomes of percutaneous short segment pedical screw fixation with bone cement augmentation in treating single level thoracolumbar osteoporotic fracture. From January 2009 to January 2013, 48 single level thoracolumbar osteoporotic fracture patients without neurological symptoms were treated with percutaneous short segment pedicle screw fixation with bone cement augmentation. Among them, including 22 males and 26 females aged from 55 to 72 years old with an average of 62.2 years old. The time from injury to operation varied from 8 h to 9 d(mean 4.5 d). According to Denis fracture classification, 35 cases were compression fractures and 13 cases were burst fractures. Nine vertebrae located on T₁₁, 15 vertebrae on T₁₂, 14 vertebrae on L₁, 7 vertebrae on L₂, and ₃ vertebrae on L₃. Anterior vertebral body height, sagittal Cobb angle, sagittal index(SI), failure of internal fixation and recurrence of kyphosis were observed before and after operation. All patients were followed up from 24 to 48 months with an average of 32.5 months. Operative time ranged from 60 to 140 min with an average of 85 min;blood loss ranged from 50 to 100 ml with an average of 75 ml. Before operation, at 3 d and 1 year after operation, anterior vertebral body height respectively was (56.4±2.6)%, (91.2±1.6)% and (86.9±3.2)%; sagittal Cobb angle respectively was(26.6±3.2)°, (6.2±1.0)° and (6.8±1.5)°; SI respectively was(51.6±4.2)%, (90.2±5.9)% and (88.7±4.2)%; VAS respectively was(7.6±1.2), (2.8±1.9), (1.1±0.4) points. There were significant differences above items between before operation and at 3 d after operation, while no significance between 1 year and 3 d after operation. No neurologic damage, internal fixation failure and recurrence of kyphosis occurred. Percutaneous short segment pedicle screw fixation with bone cement augmentation in treating single level thoracolumbar osteoporotic fracture has advantages of less trauma, and could effectively restore normal physiological load transmission of spinal, avoid failure of internal fixation and recurrence of kyphosis.