Spinal stability of intervertebral grafting reinforced by five or six augmenting screws versus transvertebral grafting reinforced by four augmenting screws for thoracolumbar vertebral fractures

doi:10.3969/j.issn.2095-4344.1030

Abstract

Abstract:

BACKGROUND: Lost of reduction and broken nails usually occur following traditional transvertebral fixation. Intervertebral pedicle fixation can obtain satisfactory curative effectiveness, but its medium- and long-term outcomes still need to be testified by abundant clinical trials.

OBJECTIVE: To compare the stability between intervertebral grafting reinforced by five or six augmenting screws and transvertebral grafting reinforced by four augmenting screws in the treatment of single-segment thoracolumbar fractures.

METHODS: Fifty-six patients with single-segment thoracolumbar fractures were divided into intervertebral fixation group (n=29, intervertebral grafting reinforced by five or six augmenting screws) and transvertebral fixation group (n=27, transvertebral grafting reinforced by four augmenting screws). The operation time, intraoperative blood loss, hospitalization time, anterior vertebral height, Cobb angle, pain degree and daily life function were compared between two groups.

RESULTS AND CONCLUSION: (1) All patients were followed up for more than 3 years. (2) The operation time in the intervertebral fixation group was significantly longer than that in the transvertebral fixation group (P < 0.05). (3) The anterior vertebral height and kyphosis at 1 week, 3 months and last follow-up were significantly improved compared with the baseline. The degree of vertebral compression and loss of sagittal Cobb angle in the intervertebral fixation group were significantly superior to those in the transvertebral fixation group at the last follow-up (P < 0.05). (4) The symptoms of low back pain and daily living function in the two groups were significantly relieved after surgery. The Visual Analogue Scale and Oswestry Disability Index scores in the intervertebral fixation group were significantly better than those in the transvertebral fixation group at the last follow-up (P < 0.05). (5) During follow-up, no nerve root injury, or rod loosening, broking or dropping occurred. Only one case in the transvertebral fixation group suffered from adjacent vertebral fracture. (6) Our findings indicate that both the fixation methods can well restore the height of the injured vertebra and the Cobb angle, but intervertebral fixation can effectively reconstruct the spinal physiological sequence and restore its stability.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Thoracic Vertebrae, Lumbar Vertebrae, Fractures, Bone, Internal Fixators, Tissue Engineering

CLC Number:

R459.9

Zhou Yu, Liu Yuehong, Liu Shuping, Chen Xi, Qin Wei, Li Qifeng. Spinal stability of intervertebral grafting reinforced by five or six augmenting screws versus transvertebral grafting reinforced by four augmenting screws for thoracolumbar vertebral fractures[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(4): 505-511.

Figures/Tables 7

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