Change of spinal canal morphology after pedicle screw rod system fixation and reduction for thoracolumbar burst fracture

doi:10.3969/j.issn.2095-4344.2013.22.009

Abstract

Abstract:

BACKGROUND: At present, the observation index of the thoracolumbar burst fracture after pedicle instrument reset is the imaging examination of vertebral body basic form, and the reports on the changes of morphology of spinal canal after reduction are rare.
OBJECTIVE: To analyze the changes of morphology of spinal canal after thoracolumbar fractures treated with pedicle screw rod system fixation and reduction.
METHODS: Twenty-eight cases of thoracolumbar burst fracture treated with pedicle screw rod system fixation and reduction were followed-up after operation, and all patients took the thoracolumbar anteroposterior and lateral X-ray film before treatment, 1 week, 1 and 2 years after operation. All the patients underwent CT scans of the upper and lower vertebral body, of which 26 patients obtained the image data of CT scan before treatment, 1 week, 1 and 2 years after operation, and partial image information of two patients lost. Whether the fracture block of the posterior margin of vertebral body went into the spinal canal or not was identified on the thoracic and lumbar spine lateral X-ray film firstly, and the changes of spinal canal morphology were observed; the spinal median sagittal diameter measured based on the CT scanning image data represented the spinal space-occupying degree.
RESULTS AND CONCLUSION: Lateral X-ray films of the 28 cases showed the fracture block of the posterior margin of vertebral body of 18 cases (64.2%) went into the spinal canal before operation, fracture block of six cases (21.4%) went into the spinal canal after operation, two cases (7.1%) at 1 year after operation, one cases (3.5%) at 2 years after operation; the average spinal median sagittal diameter was 42.6% (n=28) before operation. The spinal median sagittal diameter of the 26 cases with complete follow-up imaging data was 75.2% (P < 0.05), and the median sagittal diameter at 1 year after operation was 91.2% (n=26). The occupying reduction effect of spinal canal is obvious after thoracolumbar burst fracture treated with pedicle screw rod system fixation and reduction, the postoperative long-term observation shows the spinal canal morphology can be restored to normal.

Key words: bone and joint implants, spinal implants, thoracolumbar fractures, vertebral body, pedicle screw rod system, pedicle screw, spinal canal, morphology, internal fixation, median sagittal diameter, X-ray, CT

CLC Number:

R318

Song Sheng, Sun Zhen-zhong, Rui Yong-jun, Cai Fu-jin, Yin Qu-dong, Wei Xu-ming, Wang Jian-bing, Ma Yun-hong. Change of spinal canal morphology after pedicle screw rod system fixation and reduction for thoracolumbar burst fracture[J]. Chinese Journal of Tissue Engineering Research, 2013, 17(22): 4047-4054.

Figures/Tables 3

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