Clinical Comparison Of Posterior Approach Short-segmental Fixation With Or Without Fusion Technique For Thoracolumber Spine Fracture

[Objective]To observe the long-dated biomechanical conformation of thoracolumber spine fracture cured by posterior approach short-segmental fixation with fusion or non-fusion technique,and compare lang-dated clinical outcomes of two methods.[Methods]From February 2004 to December 2006,79 patients with one level thoracolumber vertebral fracture(TVF), were treated with two operation methods:posterior approach short-segmental fixation (non-fusion group) and posterior approach short-segmental fixation combined with grafting bone for fusion (fusion group).All patients'operative time and perioperative blood loss were recorded to be compared. All patients took the pre-operation examinations of X-ray,CT and MRI to measure the height of anterior and posterior vertebral body,and cobb's angle.All cases were followed up 1 week,3 months,1 year post-operation and 3 months after the fixations being removed out. Two groups'subsequent low back pain and the degeneration of adjacent segments(ASD) were evaluated 3 months,1 year post-operation to be compared. Statistical analyses were performed by software package SPSS 13.0.[Results]There were no statistical significance between two group on the height of the anterior and posterior vertebral body,the cobb's angle before operation (P>0.05). The operative time and perioperative blood loss of the two teams were statistically significant (P<0.05).The height of the anterior and posterior vertebral body,the cobb's angle of the two teams 1 week after operation and 3 months after operation were not statistically significant (P>0.05). The height of the posterior vertebral body of the two teams 1 year after operation was not statistically significant (P>0.05). The height of the anterior vertebral body,the cobb's angle of the two teams 1 year after operation were statistically significant (P<0.05). The height of the posterior vertebral body of the two teams 3 months after the fixations were removed out was not statistically significant (P>0.05). The height of the anterior vertebral body,the cobb's angle of the two teams 3 months after the fixations were removed out were statistically significant (P<0.05). There were no statistical significance between two teams on the subsequent low back pain and the degeneration of adjacent segments(ASD) were evaluated 3 months,1 year post-operation (P>0.05)[Conclusion]l.The operative time and perioperative blood loss of nonfusion team is obviously superior to that of posterior approach short-segmental fixation (non-fusion team).2. The biomechanical conformation of thoracolumber spine fracture cured by posterior approach short-segmental fixation with fusion is superior to that cured by posterior approach short-segmental fixation with non-fusion,especially on preventing internal fixation failure.3.There were no oberviously clinical significance between two teams on the subsequent low back pain and the degeneration of adjacent segments(ASD).