Posterior Segmental Pedicle Instrumentation And Augmentation Using Calcium Sulphate Cement For Denis B Type Of Thoracolumbar Fractures

Objectives:To evaluate the clinical efficacy of Denis B type of thoracolumbar fractures treated with posterior segmental pedicle instrumentation and augmentation using calcium sulphate cement.Methods:Forty patients with a single-level Denis B type of thoracolumbar fractures for treatment with short-segment pedicle screw fixation were enrolled in this retrospective study through Jan2011to Dec2012. Twenty patients in the treatment group were augmented with transpedicular calcium sulphate cement and pedicle screw at the level of fracture, whereas twenty patients in control group were received with traditional short-segment pedicle fixation. All patients received X-rays and CT at the preoperative, postoperative and follow-up periods. Radiographic parameters such as local kyphotic angle, anterior fractured vertebral height and canal encroachment, and clinical outcomes including the Visual Analog Scale (VAS) for back pain, the Oswestry Disability Index (ODI) for function, and neurologic status based upon ASIA2000were compared between the two groups.Results:The mean follow-up period was15months (range12-21months). At the immediately postoperative periods, the reduction of anterior vertebral body height was similar in both groups, whereas significant difference in correction of segmental kyphosis was observed in treatment group as compared with control group (P<0.05). At the final follow-up periods, the anterior vertebral body height and segmental kyphosis at the treatment group were significantly improved compared with control group(P<0.05). Clinical outcome and neurologic recovery were similar in both groups (P>0.05). Implant failure were not found during the follow-up periods.Conclusions:The clinical efficacy of posterior segmental instrumentation combined with augmentation using caciumsulphate cement was satisfactory. The operative strategy can effectively decrease loss of correction and implant failure as compared with traditional short-segment fixation, representing one of the most effective methods of the treatment of Denis B type of thoracolumbar fractures.