Posterior short-segment instrumentation and limited segmental decompression supplemented with vertebroplasty with calcium sulphate and intermediate screws for thoracolumbar burst fractures

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• 作者：Changbao Chen (1)
  Gongyi Lv (1)
  Baoshan Xu (1)
  Xiaolin Zhang (1)
  Xinlong Ma (1)
  
• 关键词：Thoracolumbar burst fractures ; Short ; segment fixation ; Vertebroplasty ; Calcium phosphate ; Limited segmental decompression
• 刊名：European Spine Journal
• 出版年：2014
• 出版时间：July 2014
• 年：2014
• 卷：23
• 期：7
• 页码：1548-1557
• 全文大小：835 KB
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• 作者单位：Changbao Chen (1)
  Gongyi Lv (1)
  Baoshan Xu (1)
  Xiaolin Zhang (1)
  Xinlong Ma (1)
  
  1. Department of Spinal Surgery, Tianjin Hospital, 406 Jiefang South Road, Tianjin, 300211, China
  
• ISSN：1432-0932

文摘

Purpose Thoracolumbar burst fractures treated with short-segment posterior instrumentation without anterior column support is associated with a high incidence of implant failure and correction loss. This study was designed to evaluate the clinical and radiographic results following posterior short-segment instrumentation and limited segmental decompression supplemented with vertebroplasty with calcium sulphate and intermediate screws for patients with severe thoracolumbar burst fractures. Methods Twenty-eight patients with thoracolumbar burst fractures of LSC point 7 or more underwent this procedure. The average follow-up was 27.5 months. Demographic data, radiographic parameters, neurologic function, clinical outcomes and treatment-related complications were prospectively evaluated. Results Loss of vertebral body height and segmental kyphosis was 55.3?% and 20.2° before surgery, which significantly improved to 12.2?% and 5.4° at the final follow-up, respectively. Loss of kyphosis correction was 2.2°. The preoperative canal encroachment was 49?% that significantly improved to 8.8?%. The preoperative pain and function level showed a mean VAS score of 9.2 and ODI of 89.9?% that improved to 1.4 and 12.9?% at the final follow-up, respectively. No implant failure was observed in this series, and cement leakage occurred in two cases without clinical implications. Conclusions Excellent reduction and maintenance of thoracolumbar burst fractures can be achieved with short-segment pedicle instrumentation supplemented with anterior column reconstruction and intermediate screws. The resultant circumferential stabilization combined with a limited segmental decompression resulted in improved neurologic function and satisfactory clinical outcomes, with a low incidence of implant failure and progressive deformity.