Posterior Pedicle Screw Fixation At Injured Level Combined With Vertebroplasty For Treatment Of Severe Osteoporotic Thoracolumber Fractures: Analysis Of Curative Effect

Objective:To investigate the curative effect of posterior pedicle screw fixation at the injured level combined with vertebroplasty for treatment of severe osteoporotic thoracolumber fractures in the elderly,provides the reference for clinical treatment.Methods:Totally 21 patients with severe osteoporotic thoracolumber fractures in our hospital from July 2012 to May 2015 were analyzed retrospectively. All the patients were underwent posterior pedicle screw fixation at the injured level combined with vertebroplasty.Visual analogue pain scale(VAS) were used for evaluate the lower back pain postoperatively,Oswestry disability index( ODI) were used for evaluate function of the back postoperatively,the Cobb angle and high compression ratio of anterior traumatic vertebras on the lumbar film were used for efficacy assessment,at last,the ASIA were used for evaluate the spinal cord nerve function and complication postoperatively.Results:All patients were followed up for 12~21 months, averaged (15.71±2.85)months. Mean preoperative VAS score, ODI score and Cobb angle were(7.57±0.94)points,(72.00±8.30)%and(32.00±10.11))degrees respectively.while those at the postoperation were(2.90±1.14) points,(30.76±7.50)% and(21.48±7.25)degrees,with significant differences between preoperative and postoperative results(P<0.05). However,there were no statistical significance between postoperative1 week and last follow-up results(>0.05).Postoperative X-ray found that 7cases of asymptomatic bone cement leakage.No case of internal fixations breakage was observed at the last follow-up.Conclusions:Posterior pedicle screw fixation at the injured level combined with vertebroplasty is an safe,reliable and effective surgical treatment for severe osteoporotic thoracolumbar fractures in the elderly.It can not only restore the height and strength of the injured vertebral body,rebuild the spine physiological sequence,and correct kyphotic deformity effectively,but also can relieve lower back pain,improve the function of the spine,and increase of life quality,clinical curative effect is better.