Posterior Pedicle Screw Fixation In The Treatment Of Multiple-level Thoracolumbar Fracture

[Objective]To explore the surgical treatment method of multiple-level thoracolumbar fracture by pedicle screw fixation and to evaluate its clinical effect and to analyze the surgery indication and methods as well as their correlation factors.[Methods]From January2007to January2011,25patients with multiple-level thoracolumbar fracture underwent the pedicle screw fixation, all of the cases were checked in radiographies pre-and post-operation, the complications like infection> screw loose or broken were also observed, the vertabral body height and the kyphosis deformity were analyzed to evaluate the surgery effect according to the pre-and post-operation X ray, the ASIA grade was used to evaluate the healing of neuro-function.[Results]All cases were followed up for12～65(27.7)months, no loosening or breakage of the pedicle screw occurred. The anterior vertebral body height of fracture vertebra was restored from preoperative66.4±9.8%(41%～85%) to91.5±8.3%(70%～100%)(p<0.01). The kyphosis deformity angle was corrected from preoperation17.0±7.8(6～43)°to follow-up5.1±4.2(0～14)°(p<0.01).4cases with ASIA grade A preoperation remained unchanged. In2cases of ASIA grade B,1were improved to C,1to D.3cases of grade C improved to D,1case to E. In7cases of grade D,6cases improved to grade E, another case remained grade D.7cases of ASIA grade E got no change.[Conclusion]The posterior surgery with pedicle screw instrumentation is a full-grown technique, in which there is less complications after operation. The pedicle screw instrumentation system can rebuild spinal stability and restore spinal alignment in the treatment of multiple-level thoracolumbar fractures, and the surgical treatment of multiple-level thoracolumbar fractures should be individualized according to the patients’actual conditions.