Treatment of thoracolumbar burst fracture with dilator-kyphoplasty combined with autologous bone graft in fractured vertebra

Abstract

Objective To investigate the effect of the self-designed dilator-kyphoplasty combined with autologous bone graft in fractured vertebra for treatment of thoracolumbar burst fractures. Methods From August 2007 to March 2008, 16 patients with thoracolumbar burst fracture were treated by our self-designed dilator-kyphoplasty combined with autologous bone graft in fractured vertebra. Based on AO classification, 10 patients were of A2 and 6 of A3. According to the ASIA (American Spinal Injury Associ-ation) neurological function grading system, there were 2 cases of grade A, 2 grade B, 2 grade C, 3 grade D and 7 grade E. Results On average, the anterior height of fractured vertebrae increased from 18.3±2.5 mm before operation to (25.1±2.8) mm after operation. Their mean Cobb' s angle was restored from 36.33°±2.14°before operation to 2.77°±0.41°after operation. The average amount of bone graft was (10.53±3.62) cm3. There was no perioperative or postoperative vessel or nerve injury. A follow-up of 6 months re-vealed fine fusion of grafts and no implant rupture or loosening. For patients with incomplete neurological injuries, improvement of 1 to 2 grades was made in neurological functions. Conclusion Because the self-designed dilator-kyphoplasty may effectively restore the height of fractured vertebrae, reconstruct the sta-bility of anterior and middle columns of the fractured vertebrae and avoid the complications caused by simple pedicle screw fixation, it should be used widely in clinic for thoracolumbar burst fractures. Key words: Thoracic vertebrae; Lumbar vertebrae; Fracture; Bone transplantation; Dila-tor-kyphoplasty