Treatment of thoracolumbar burst fractures of Denis type B by posterior bisegmental stabilization plus monosegmental fusion

Abstract

Objective To investigate the efficacy of posterior bisegmental stabilization plus monosegmental fusion in the treatment of thoracolumbar burst fractures of Denis type B.Methods From July 2009 to January 2011, 8 patients with vertebral body burst fracture of Denis type B were treated with posterior bisegmental stabilization plus monosegmental fusion.The upper interspace of the injured vertebra was fused posteriorly.They were 5 men and 3 women, aged from 20 to 68 years (average, 42 years).The neurological status was evaluated by Frank grading system.The ratio of the anterior margin height of the injured vertebral body to the normal height (RAH), the ratio of the posterior margin height of the injured vertebral body to the normal height (RPH), the Cobb angle and the volume ratio of spinal canal were compared respectively between preoperation and postoperation to evaluate the clinical efficacy.Results The 8 patients were followed up for 7 to 18 months (average, 13.I months).Fracture dislocation was completely reset.No vascular or nerve damage, or other complications, such as loosening of internal fixation, was found.All patients had neuro-functional improvement by at least one Frank grade.The postoperative RAH (0.97±0.02), RPH (0.97 + 0.03), Cobb angle ( - 0.25° + 1.82°), and the spinal canal volume ratio (93.40 ±5.30) were improved significantly compared with the preoperative data (P ＜ 0.05), but had no significant differences compared with the last follow-up data ( P ＞ 0.05) .Conclusion In treatment of thoracolumbar burst fractures of Denis B-type, posterior bisegmental stabilization plus monosegmental fusion can effectively restore the spinal curvature, decompress the spinal canal, reconstruct spinal stability, and preserve the intact disc under the injured vertebra. Key words: Intervertebral disk; Spinal fusion; Throacolumbar burst fractures