| Objective:To evaluate the efficacy,indication and clinical outcome of the treatment of thoracolumbar fractures with monosegment pedicle instrumentation and bone graft fusion.Methods:A total of18 patients with thoracolumbar fractures were treated with monosegmental pedicle instrumentation and bone graft fusion in our department between May2007 and June2010,including16 male patients and2 female patients.The age of patients is from22 to55(average age38.8).There were5 patients in T12,7 patients in L1,5 patients in L2,1 patients in L3.The Cobb angle of the injured vertebral segment,percentage of vertebral compression and spinal canal sagittal diameter stenosis rate were recorded.Neurological function was evaluated by the Frankel scale.Results:All patients were followed up for 12-32 months with the average time of 18 months.The blood loss was 900 mL in average(88~230)mL,and the incision length was 6 cm in average(5~8)cm.All cases achieved bone fusion,without significant lose of the vertebrae body height and implant failure.The cobb angle of the injured vertebral segment,percentage of vertebral compression and spinal canal sagittal diameter stenosis rate at preoperation,1 week and last follow-up postoperation was(20.5±8.6)°,(4.8±4.2)°,(5.3±4.4)°;(43.2±11.1)%,(5.6±5.4)%,(6.1±5.5)%;(29.9±9.7)%,(4.2±2.4)%,(4.5±2.3)%.There was statistically significant differences at1 week and last follow-up postoperation compared with preoperation(P[0.05).There were no statistically significant differences at1 week and last follow-up postoperation(P]0.05).Conclusion:The monosegment pediele instrumentation through posterior approach and bony graft is an effective and reliable procedure to be used in specific types of thoracolumbar vertebral fractures,but strict indication is the key to this procedure. |
