Treatment of thoracolumbar burst fractures with transpedicular fixation through the pedicle of fractured vertebra: a prospective randomized trial

Abstract

Objective To compare the therapeutic results of transpedicular fixation through the pedicle of fractured vertebra and of the traditional transpedicular fixation for treatment of thoracolumbar burst fractures. Methods Between May 2004 and June 2007,48 consecutive patients seeking medical treat-ment for one level thoracolumbar burst fracture in our department were included in this study. Their average age was 40. 1 yeas old. They were randomly and evenly assigned into an experimental group of transpedicular fixation through the pediele of fractured vertebra and a control group of traditional transpedicular fixation. All patients underwent X-ray and spiral CT scan preoperatively and postoperatively. The Cobb's angle,anterior vertebral body compression percentage (AVCP),sagittal canal diameter (SCD) and vertebral body translation percentage (VBTP) were recorded for all patients. Their fusion results and neurological functions were ob-served. Results All patients were followed up for 10.6 months averagely. The shape of injured ver-tebrae was maintained and fusion of the grafted bone was observed in all patients. All parameters were improved after operation. Follow-ups revealed that the mean Cobb's angle and AVCP in the experimental group were 6.99°±6.81°and 18.60%±9.96% respectively,significantly lower than those in the con-trol group (P 0.05) . No com-plications were observed in either group. The preoperative incomplete neurological injuries obtained postop-erative improvement of one or two grades. Conclusion Transpedicular fixation through the pedicle of fractured vertebra is a better treatment for thoracolumbar vertebral fractures than the traditional transpedicular fixation,because its safer fixation and better stability help restore the shape of injured vertebra and reduce the Cobb's angle. Key words: Thoracic vertebrae; Lumbar vertebrae; Fractures; Fracture fixation,internal; Fractured vertebra