Posterior percutaneous pedicle screw fixation of injured vertebra for thoracolumbar fractures which need no vertebral canal decompression

Abstract

Objective To study the feasibility of posterior pereutaneous pedicle screw fixation of injured vertebra, in comparison of open pedicle screw fixation, for the treatment of thoracolumbar fractures which need no vertebral canal decompression. Methods From November 2004 to August 2005, 34 pa-tients with thoracolumbar fractures were prospectively assigned into two even groups. Group A was treated with the posterior percutaneous pedicle screw fixation of the injured vertebra and Group B with open pedicle screw fixation. The two groups were compared in operation time, bleeding volume, anterior border height of the injured vertebra, Cobb angle of kyphosis, late loss of correction, and complications. Results All the patients were followed up for a mean of 18 months (13 to 21 months). The mean time of operation for Group A was 130 minutes, with no significant difference from that for Group B (t=0.171, P=0.870). In Group A, the mean anterior height of the compressed vertebral body was restored from 52.1%±5.8% to 95.5%±2.2% of the normal height, and the mean Cobb angle was corrected from 16.2°± 1.7°to 5.7°±0.8°, and the mean late loss of correction was 11.2% ± 1.2%, with significant differences from those in Group B (P < 0.05) . There was significant difference in the mean bleeding volume between Group A (120±37) mL and group B (287±31) mL (P<0.05). Conclusion Compared with the open method, posterior pereu-taneous pedicle screw fixation of the injured vertebra is more effective for thoraeolumbar fractures which need no vertebral canal decompression, because it leads to quicker recovery and less invasion. Key words: Spinal fractures; Thoracic vertebrae; Lumbar vertebrae; Fracture fixation; in-ternal