Posterior pedicle screw fixation for repair of multi-segmental thoracic fractures: restoration of vertebral height at follow-up

doi:10.3969/j.issn.2095-4344.2014.48.010

Abstract

Abstract:

BACKGROUND: The incidence of multi-segmental thoracic fractures gradually increased. How to restore normal vertebral morphology and neurological injury is the main direction of the present study.
OBJECTIVE: To observe the clinical therapeutic effects of posterior pedicle screw fixation for repair of multi-segmental thoracic fractures in 24 cases.
METHODS: A total of 28 patients with multi-segmental thoracic fractures, who were treated from January 2009 to December 2013, were enrolled in this study. Of them, 24 were followed up, including 19 males and 5 females, with an age of 20-64 years old. They all had a history of trauma. The time taking for transporting to the hospital was between 1 hour and 4 days. All the patients had taken CT plain scan and coronal and sagittal reconstruction and whole-spine lateral X-ray examination in emergency. Whole-spine MRI examination was conducted within 4 days after hospitalization. There were 19 cases of 2-levels thoracic fractures, 3 cases of 3-levels thoracic fractures, 1 case of 4-levels thoracic fractures and 1 case of 6-levels thoracic fractures. There were 10 cases of Grade A, 9 cases of Grade B, 2 cases of Grade C, 2 cases of Grade D and 1 case of Grade E according to ASIA
system. Three cases combined with brain injury, four cases with rib fractures, three cases with hemopneumothorax, four cases of pulmonary contusion, two cases of rupture of spleen, and four cases of limb fractures.
RESULTS AND CONCLUSION: 24 patients were followed up for 9 to 37 months. No implant failure, nonunion, or neurological deterioration were noted during the follow up. No significant loss of vertebral height was found during the final follow-up, and the vertebrae were healed well. There were 10 cases of Grade A, 5 cases of Grade B, 2 cases of Grade C, 5 cases of Grade D and 2 cases of Grade E according to ASIA system at final follow-up. The Cobb angle improved from 26.8° preoperatively to 5.5° postoperatively, and 5.9° at final follow-up. These data suggested that it is very important to clarify the key injury site and the level of spinal cord during multi-segmental thoracic fractures. The pedicle screw fixation by posterior approach can restore the height of thoracic spine effectively, get full decompression and reliable fixation, finally obtained good curative effects.

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

全文链接：

Key words: thoracic vertebrae, fractures, bone, internal fixators, follow-up studies

CLC Number:

R318

Wang Yi-meng, Pi Bin, Zhu Xiao-yu, Qian Zhong-lai, Yang Hui-lin. Posterior pedicle screw fixation for repair of multi-segmental thoracic fractures: restoration of vertebral height at follow-up[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(48): 7763-7768.

Figures/Tables 2

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