Type AO-C1 thoracolumbar vertebral fracture-dislocations: four-screw two-rod single-segment reduction fixation

doi:10.3969/j.issn.2095-4344.2015.22.016

Abstract

Abstract:

BACKGROUND: The type AO-C1 thoracolumbar acute spine injury is a kind of high-energy instable injury, can cause thoracolumbar fracture-dislocation, and mainly associated with spinal nerve injury. Generally, all needs to posterior open reduction, decompression, bone graft fusion and multiple-segmental internal fixation of pedicle screw rod system, which causes excessive loss of spinal movement segment and a large number of application of internal fixators.
OBJECTIVE: To evaluate the treatment effect of posterior pedicle screw mono-segmental internal fixation for treatment of the type AO-C1 thoracolumbar vertebrae fracture-dislocations.
METHODS: From January 2008 to December 2013, 17 cases of type AO-C1 thoracolumbar fracture-dislocation were followed up. All patients were treated with one-stage posterior open reduction and pedicle screw-rod fixation.
Of them, eight cases received four screws and two rods for single-segment fixation in upper and lower vertebrae adjacent to intervertebral space after dislocation (4-screw 2-rod group). Nine cases received eight screws and two rods for multiple-segment fixation in the upper and lower vertebrae adjacent to intervertebral space after dislocation (8-screw 2-rod group). Operative time and intraoperative blood loss were compared between the two groups. The Cobb’s angle was measured on lateral X-ray film of two groups preoperatively and 1 week postoperatively and during the final follow-up. The neurological function was evaluated by Frankel classification. The visual analogue scale was adopted to assess the degree of low back pain.
RESULTS AND CONCLUSION: Patients were followed up for 1 to 5 years. Significant differences were detected in the operative time between the two groups, and operative time was better in the 4-screw 2-rod group than in the 8-screw 2-rod group (P < 0.05). No significant difference was found in intraoperative blood loss between the two groups. The deformity of fracture-dislocation had been corrected, and the pain of low back had significantly relieved in all patients after fixation. According to Frankel classification, two cases at Grade A were improved to Grade E, but eight cases at Grade A got no improvement after treatment. Two cases at Grade B were also improved to Grade E at the final follow-up. Significant differences in Cobb’s angle and visual analogue scale were detectable at 1 week postoperatively and during final follow-up as compared with preoperatively (P < 0.05), but no significant difference was visible between final follow-up and 1 week postoperatively. No significant difference in Cobb’s angle and visual analogue scale was observed between the 4-screw 2-rod group and 8-screw 2-rod group. Results indicate that there was no significant difference in the clinical efficacy between 4-screw 2-rod single-segment and 8-screw 2-rod multiple-segment fixation for treating type C1 thoracolumbar vertebrae fracture-dislocation. Therefore, AO-C1 thoracolumbar vertebrae fracture-dislocation could be treated with 4-screw 2-rod single-segment reduction fixation.

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, Follow-Up Studies

CLC Number:

R318

Tang Huan-zhang, Xu Hao, Dong Liang, Zhao Xiao-ming. Type AO-C1 thoracolumbar vertebral fracture-dislocations: four-screw two-rod single-segment reduction fixation [J]. Chinese Journal of Tissue Engineering Research, 2015, 19(22): 3525-3530.

Figures/Tables 5

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