Treatment of Thoracolumbar Fractures by Percutaneous Pedicle Screw Fixation Technique Combined with Three-step Reduction.

Abstract

Purpose To evaluate the efficacy of percutaneous pedicle screw fixation technique combined with three-step reduction in the treatment of thoracolumbar fracture. Methods This is a retrospective study, based on medical records from the archives of the Fifth People's Hospital of Fudan University, from January 2012 to January 2015. The 49 patients with thoracolumbar fracture were treated with percutaneous pedicle screw fixation technique combined with three-step reduction. The treatment plan was determined by the AO classification and the Thoracolumbar Injury Classification and Severity classification. Baseline data included patient demographics, mechanism of injuries, fracture level, and neurologic status. Kyphotic angle correction and vertebral body height (VBH) restoration were used to assess radiologic outcome. Blood loss, operative complications, hospital stay, and pain score on the visual analog scale (VAS) were used to assess safety and clinical outcomes. Result A total of 49 patients with 51 thoracolumbar burst fractures were treated with percutaneous pedicle screw fixation technique combined with three-step reduction. There was significant improvement in kyphotic angle correction (p < 0.05) and restoration of anterior vertebral height (p < 0.05) after each reduction procedure. These improvements remained statistically significant at the latest follow-up for restoration of anterior VBH (p < 0.05) and kyphotic angle correction (p < 0.05). The preoperative VAS score was 8.2 ± 1.3, and the postoperative VAS score (3 days after the operation) was 3.5 ± 0.7. Conclusion Percutaneous pedicle screw internal fixation technique combined with three-step reduction is a relatively safe and effective technique for treating selected thoracolumbar burst fractures, and it yields satisfactory results.