Unilateral placement combined with short-segment five-screw fixation for unstable thoracolumbar fractures

doi:10.3969/j.issn.2095-4344.0349

Abstract

Abstract:

BACKGROUND: Thoracolumbar fractures are the most common spinal fractures. Young and middle-aged thoracolumbar fractures are mostly caused by violent force. Traditional long-segment fixation has been replaced by short-segment transcranial vertebral fixation, but short-segment fixation is easy to cause the loss of the height of the injured vertebra. The fixation method using five nails and three vertebral bodies has gradually become the main surgical method.

OBJECTIVE: To investigate the surgical outcomes of posterior approach unilateral placement combined with short-segment five-screw fixation for unstable thoracolumbar fractures.

METHODS: Data of forty-three patients with single-segment thoracolumbar fractures undergoing posterior approach unilateral placement combined with short-segment five-screw fixation at the Affiliated Hospital of Xuzhou Medical University from January 2012 to December 2015, and followed up for more than 1 year were analyzed retrospectively. The Cobb angle and vertebral anterior height were measured according to the X-ray of the preoperative, postoperative and last follow-up. The ratio of vertebral anterior height was calculated. The fixation and dissection of the internal fixators were observed, the operation time and blood loss were recorded, and the Visual Analogue Scale scores were used to evaluate the preoperative and postoperative pain.

RESULTS AND CONCLUSION: (1) All 43 patients underwent surgery successfully. The operation time was 60-125 minutes (80 minutes on average). The intraoperative blood loss was (50-400) mL (160 mL on average). (2) The preoperative vertebral body height ratio was significantly increased at postoperative 2 weeks and last follow-up compared with the baseline (t=10.15, 9.57, P < 0.05), and the ratio showed no significant difference between postoperative 2 weeks and last follow-up (t=0.42, P > 0.05). (3) Compared with the baseline, the Cobb angle at postoperative 2 weeks and last follow-up was significantly decreased (t=8.46, 7.81, P < 0.05). There was no significant difference in the Cobb angle between postoperative 2 weeks and last follow-up (t=0.93, P > 0.05). (4) The Visual Analogue Scale scores at postoperative 2 weeks were significantly lower than those at baseline (P < 0.05). (5) All patients had no complications such as fracture or prolapse of internal fixators. (6) In summary, unilateral placement combined with short-segment five-screw fixation for unstable thoracolumbar fractures can reduce the Cobb angle, and reconstruct the vertebral body height with few complications. The clinical outcomes are satisfactory.

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: Spinal Fractures, Fracture Fixation, Thoracic Vertebrae, Lumbar Vertebrae, Tissue Engineering

CLC Number:

R318

Chang Bu-qing, Feng Hu, Yu Chao-jiang, Shan Hong-jian, Hu Meng-zi, Li Zi-ang, Bu Xiang-bo, Gao Xiao, Jiang Yun-chang. Unilateral placement combined with short-segment five-screw fixation for unstable thoracolumbar fractures [J]. Chinese Journal of Tissue Engineering Research, 2018, 22(27): 4337-4341.

Figures/Tables 1

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