Abstract
BackgroundComplications in posterior pedicle screw fixation using a conventional posterior approach for thoracolumbar fractures include vertebral height loss, kyphosis relapse and breakage, or loosening of instrumentation. The purpose of this study was to evaluate the clinical effects of transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach for thoracolumbar fractures.MethodsWe retrospectively analyzed 50 patients with thoracolumbar fractures treated with transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach. Operative time, blood loss, visual analog scale (VAS) scores for back pain, and the relative height and Cobb angle of the fractured vertebrae were measured.ResultsThe average operative time was 71.8 min, and the blood loss was 155 ml. Postoperative VAS scores were significantly lower than preoperative scores (P = 0.08), but there was no difference between 1 week and 1 year postoperatively (P = 0.18). The postoperative relative heights of the fractured vertebrae were higher than the preoperative heights (P = 0.001, 0.005, 0.001), but there were no differences between 1 week and 1 or 2 years postoperatively (P = 0.24/0.16). The postoperative Cobb angles were larger than the preoperative angles (P = 0.002, 0.007, 0.001), but there were no differences between 1 week and 1 or 2 years postoperatively (P = 0.19/0.23).ConclusionsTranspedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach for thoracolumbar fractures achieved satisfactory results and can restore vertebral height, increase the stability of the anterior and middle columns of injured vertebrae, and decrease the risk of back pain.
Highlights
Complications in posterior pedicle screw fixation using a conventional posterior approach for thoracolumbar fractures include vertebral height loss, kyphosis relapse and breakage, or loosening of instrumentation
The patients were treated with posterior short-segment fixation combined with transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach, including 34 cases with bilateral and 16 with unilateral screw implantation
visual analog scale (VAS) scores decreased over time, but there was no significant difference between 1 week and 1 year postoperatively (P = 1.15)
Summary
Complications in posterior pedicle screw fixation using a conventional posterior approach for thoracolumbar fractures include vertebral height loss, kyphosis relapse and breakage, or loosening of instrumentation. The purpose of this study was to evaluate the clinical effects of transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach for thoracolumbar fractures. The incidence of vertebral height loss, kyphosis relapse and breakage, or loosening of instrumentation is high [3, 4]. Studies have shown that screw implantation in the injured vertebra exhibits stronger fixation, and more effectively prevents loosening or breakage of instrumentation, compared with traditional four-screw cross-segmental fixation [8, 9]. On the basis of the preceding information, we conducted a retrospective study on 50 patients with thoracolumbar fractures without neurological deficits treated with short-
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