The Efficacies Of Pedicle Screw Fixation Through The Pedicle Of Fractured Vertebra Plus Short-Segment Pedicle Instrumentation In The Treatment Of Thoracolumbar Fractures

Objective: To evaluate the efficacies of pedicle screw fixation through thepedicle of fractured vertebra plus short-segment pedicle instrumentation in thetreatment of thoracolumbar fractures.Methods: A total of63patients with thoracolumbar fractures treated at ourdepartment between January2009and December2012were retrospectivelystudied. They were divided into two groups. Group A consisted of32patientstreated by pedicle screw fixation through the pedicle of fractured vertebra plusshort-segment pedicle instrumentation. Group B consisted of31patients treatedby traditional short-segment pedicle instrumentation. All patients were followedup till at least3months after extraction of the internal fixation devices. The dataof anterior body height compression, the sagittal Cobb’s angle and theoccupation ratio of spinal canal in each group were separately measuredpreoperatively,1week after surgery,3months after surgery,6months aftersurgery,1year after surgery and at least3months after extraction of the internal fixation devices. These datas were analyzed and compared within each groupand between groups.Results: The follow-up period was36months on average, from17to46months.All the three indicators observed, including anterior body height compression,Cobb’s angle and occupation ratio of spinal canal, were improvedpostoperatively (P＜0.05) in both groups. With regards to anterior body heightcompression and Cobb’s angle, there was not significant difference (P＞0.05)between the two groups at1week or3months after surgery, while the differencewas significant (P＜0.05)at6months after surgery,1year after surgery and3months after extraction of the internal fixation devices. The difference ofoccupation ratio of spinal canal between the two groups was significant (P＜0.05) postoperatively. In each group, both anterior body height compression andCobb’s angle were significantly improved (P＜0.05) at6months after surgery,1year after surgery and3months after extraction of the internal fixation devices,compared to those at1week after surgery. Similar differences were observedbetween6months after surgery and3months after extraction of the internalfixation devices, though the differences between6months after surgery and1year after surgery were not significant (P＞0.05). In each group, there was notsignificant difference (P＞0.05) for occupation ratio of spinal canalpostoperatively.Conclusion Pedicle screw fixation through the pedicle of fractured vertebra plusshort-segment pedicle instrumentation is an effective method for the treatmentof thoracolumbar fractures. It can effectively correct the deformity, restore theanterior body height and spinal canal, enhance the stability of the spine andreduce the risk of correction loss, making up the deficiency of traditionalshort-segment pedicle instrumentation.