Abstract:

BACKGROUND: Following burst fractures, the vertebral posterior wall is not complete, and cannot stop bone cement perfusion. Therefore, thoracolumbar burst fracture has become contraindication of kyphoplasty. However, the patients with thoracolumbar burst fracture are always complicated with severe internal diseases, and cannot undergo conventional open reduction and internal fixation. Minimally invasive kyphoplasty may be the only choice for them. Currently, there are few reports regarding kyphoplasty and pedical screw fixation for treatment of thoracolumbar burst fractures.
OBJECTIVE: To compare the effectiveness between kyphoplasty and pedical screw fixation for treatment of thoracolumbar burst fractures. 
METHODS: A total of 27 patients with thoracolumbar burst fractures were selected from Department of Orthopedics, Peking University First Hospital between September 2005 and October 2008, including 12 cases treated with kyphoplasty and 15 treated with pedical screw fixation. The operating time, the effect and time of pain relief, the complication in operation and postoperation were evaluated.
RESULTS AND CONCLUSION: The mean operating time of pedical screw fixation group was 55 minutes, pain relief was detected on the 5th-7th days postoperatively with a mean relief rate of 69.3%; there was no neural complication in pedical screw fixation group. The mean operating time of kyphoplasty group was 37 minutes, pain was relieved on the first day postoperatively with a mean relief rate of 86.2%; 3 cases developed bone cement leakage but no neural complication in kyphoplasty group. The purpose of pain relief can all be obtained by kyphoplasty and pedical screw fixation for treatment of thoracolumbar burst fractures, the mean operating time of pedical screw fixation group is longer than that of kyphoplasty group, but bone cement leakage in kyphoplasty group should be considered. Kyphoplasty may be a new choice for thoracolumbar burst fractures.