[New external spinal skeletal fixation combined with percutaneous injury vertebra bone grafting for the treatment of two-segment thoracolumbar fractures]

Abstract

Objective: To investigate the clinical results of new external spinal skeletal fixation combined with percutaneous injury vertebra bone grafting in the treatment of two-segment thoracolumbar fractures without neural dysfunction.

Methods: The clinical data of 28 patients with two-segment thoracolumbar fractures without neural dysfunction treated from January 2013 to August 2015 were retrospectively analyzed. There were 17 males and 11 females, with a mean age of(37.5±10.3) years (ranging from 19 to 55 years). According to fracture AO classification, all 28 cases were type A, including 2 cases of T₁₀,₁₁, 3 cases of T₁₁,₁₂, 9 cases of T₁₂-L₁, 4 cases of L₁,₂, 5 cases of L₂,₃, 4 cases of L₃,₄, 1 case of L₄,₅. All 28 patients received treatment of new external spinal skeletal fixation and percutaneous injury vertebra bone grafting. Operation time, intraoperative bleeding and related complications were recorded. The informations of vertebral anterior border height percentage and bone fusion were observed by radiography before and after operation, before removed external fixation and final follow-up. Visual analogue scale(VAS) was used to evaluate the clinical effects.

Results: All the patients were followed up for 13 to 32 months with an average of (24.5±3.5) months. There was significant difference by the time of 3 days postoperatively, before removed external fixation, final follow-up comparing with the preoperative in vertebral anterior border height percentage and VAS score(P<0.05). There was no significant difference in vertebral anterior border height percentage by the time of 3 days postoperatively, before removed external fixation comparing with final follow-up(P>0.05). While the VAS score showed a gradually declining trend, screw lossening ocurred in 2 cases and nail tracker infection occurred in 1 case after operation, and no other complications were found.

Conclusions: New external spinal skeletal fixation and percutaneous injury vertebra bone grafting can got satisfactory clinical effect in treating two-segment thoracolumbar fractures without neural dysfunction, which is an effective method of minimally invasive surgery.

Keywords: Bone transplantation; External spinal skeletal fixation; Lumbar vertebrae; Spinal fractures; Surgical procedures, minimally invasive; Thoracic vertebrae.