Objectives: To study the morphological feature of complicated thoracolumbar fractures and the fixation technology of injured vertebra.
Methods: From January 2005 to December 2007, 61 patients with type B and C thoracolumbar fractures according to AO classification were treated. There were 53 males and 8 females, with a mean age of 33.2 years (range, 9 to 65 years). Based on ASIA grading system of neurologic deficit, Grade A was found in 41 cases, grade B in 5 cases, Grade C in 5 cases, Grade D in 6 cases and Grade E in 4 cases. The injured vertebra located at thoracic region in 13, thoracolumbar in 39 and lumbar in 9 cases. The patients were divided into two groups: 32 cases with pedicle screws in the injured vertebra and 29 cases without pedicle screw in the injured vertebra. The analyses on the morphological features of injured vertebra were performed, and comparisons were carried out on the outcome regarding the reduction and correction of the injured vertebra, and the difference of Denis scale in pain domain and work status domain, between the two groups.
Results: All the patients were followed up for an average of 3 years (range, 1.5 to 4.5 years). There were significance statistical difference in the correction loss of Cobb angle, sagittal index, correction of dislocation index, and the Denis pain scale between the two groups (P < 0.05). A better outcome was observed in the injured vertebra fixation group than the injured vertebra non-fixation group.
Conclusions: Inserting pedicle screws in the injured vertebra is effective and useful in the correction of complicated thoracolumbar fractures. It improves biomechanical stability of the spine after the operation.