Surgical treatment for fracture and dislocation of thoracolumbar vertebra in children

Abstract

Objective To describe the traumatic characteristic of fracture and dislocation of thoracolumbar vertebra in children and to investigate method and the effect of pedicle screw fixation in thoracolumbar of children. Methods Fifteen patients with fracture and dislocation of thoracolumhar and with different degree of neurological injury were administered from Jan. of 2000 to Dec. of 2007, including 11 male, 4 female, aged from 5 to 12 years (average, 7 years and 8 months). They underwent posterior surgery in thoracolumbar with positioning, decompression and with pedicle screw fixation. Results The follow up was obtained for 10-48 months (average, 32months). X ray showed that the altitude of traumatic vertebral bodies recover to 50%-80% post-operation. Dislocation in vertebral bodies was retrieved completely. The positions of all pedicle screws were good. The pedicle screws were not loosened or collapsed. There was no spinal cord or vessel injury or infection- The spinal cord injuries improved after operation except tow cases which were complete paralysis. Conclusions Fracture-dislocation of thoracolumbar in children is serious injury, and always companied with the spinal cord injuries and severe complications. It is safe and feasible to perform thoracic and lumbar pedicle screw placement in children with fracture-dislocation of thoracolumbar. This surgery can restitute stabilization of thoracic and lumbar vertebra, decompress of spinal cord, and improve life quality of patients. Key words: Thoracic vertebrae; Lumbar vertebrae; Bone fracture; Dislocation