Transpedicular corpectomy with Meshcage and pedicle screw fixation in treatment of thoracolumbar/lumbar burst fractures

Abstract

Objective To investigate the feasibility and clinical outcome of transpedicular corpec-tomy with Meshcage and pedicle screw fixation in the treatment of thoracolumbar/lumbar burst fractures.Methods Twenty-seven patients with thoracolumbar/lumbar burst fracture were treated by posterior pedicle screw reduction and corpectomy with titanic Meshcage implantation from April 2006 to June 2007.This group included 21 males and 6 females, with an average age of 33.6(22 to 53)years.There were 3 cases of T11 fracture, 7 T12 fracture, 9 L1 fracture, 6 L2 fracture, 1 L3 fracture, and 1 L4 fracture.Pre- and post-operative data were recorded in detail.According to the preoperative X-ray images, the average spinal canal occupational ratio was 70.5% and average segmental Cobb angle was 32.2°.Neurological functions were evaluated by Frankel Grading system.Results All patients were followed up for 3 to 12 months, with a mean period of 8.2 months.After the blocks compressing the nerve were removed, the postoperative Cobb angle averaged 3.2° and the spinal curve was restored.Of the 8 patients with complete neural lesion, 2 had 2-grade improvement, 1 had 3-grade improvement but the other 5 had none.The other 19 patients who had suffered incomplete nerve injury showed improvement to different extents.There were no other complications in this group.Conclusions Transpedicular corpectomy, Meshcage and pedicle screw internal fixation and autogenous bone graft can be a very good treatment for thoracolumbar/lumbar burst fractures, because it can spare the trouble of surgery through combined anterior and posterior approaches, resulting in satisfactory reduction, complete decompression, little operative invasion and few complications. Key words: Thoracic vertebrae; Lumbar vertebrae; Orbital fracture; Spinal cord injury; Fracture fixation, internal