Posterior short-segment instrumentation without fusion for treatment of thoracolumbar compression fractures

Abstract

Objective To investigate the clinical effect of posterior short-segment pedicle screw reduction and fixation without fusion in treatment of thoracolumbar mono-segmental compression fractures.Methods Thirty cases of thoracolumbar mono-segmental compression fractures admitted from January 2009 to February 2010 were assigned to single posterior pedicle screw fixation (screw group,n =15) and posterior pedicle screw fixation with posterolateral fusion (fusion group,n =15) according to random number table.Clinical results in the two groups were assessed based on Cobb' s angle,anterior vertebral body height ratio (％) and Oswestry disability index (ODI) before operation,after operation,prior to the removal of implant and at the latest follow-up.Results All the cases were followed up for average 24 months.Both operation time and blood loss were less in screw group than in fusion group [(76.58 ±12.67) min vs (116.29 ± 17.45) min,P ＜ 0.01 ; (287.54 ± 30.76) ml vs (480.34 ± 100.54) ml,P ＜0.01],whereas there were no statistical differences between the two groups in aspects of Cobb' s angle and anterior vertebral body height ratio before and after operation,prior to the removal of implant as well as at the latest follow-up.Moreover,no statistical difference of ODI was noted between the two groups prior to the removal of implant and at the latest follow-up.Conclusion Posterior pedicle screw fixation without bone grafting achieves similar effects with pedicle screw fixation with bone grafting. Key words: Thoracic vertebrae ; Lumbar vertebrae; Internal fixators