Chinese Journal of Tissue Engineering Research ›› 2015, Vol. 19 ›› Issue (35): 5636-5640.doi: 10.3969/j.issn.2095-4344.2015.35.012

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Design and application of screw-assisted reduction of fractured vertebrae 

Li Guo-hua1, Wu Wei-ping2, He Shi-sheng2, Li Shan-zhu1, Zeng Zhi-li3, Yu Yan3, Cai Xiao-bing2, Yilihamu•Tuoheti1   

  1. 1Department of Orthopeadic Surgery, the Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830063, Xinjiang Uygur Autonomous Region, China; 2Department of Orthopedics, Tenth People’s Hospital of Tongji University, Shanghai 200072, China; 3Department of Orthopedics, Tongji Hospital Affiliated to Tongji University, Shanghai 200065, China
  • Received:2015-08-01 Online:2015-08-27 Published:2015-08-27
  • About author:Li Guo-hua, Master, Associate chief physician, Department of Orthopeadic Surgery, the Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830063, Xinjiang Uygur Autonomous Region, China
  • Supported by:

    the Science and Technology Support Project of Xinjiang Uygur Autonomous Region, No. 201233148

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Abstract:

BACKGROUND: Screw fixation of the fractured vertebral body can share the stress of implant, increase fixing strength, and help to maintain the stability of late fracture. However, whether it can assist reduction using fracture vertebral screw, but no relevant clinical reports were found at present.
OBJECTIVE: To explore the effectiveness of self-designed screw-assisted reduction of fractured vertebrae. 
METHODS: 161 cases of thoracolumbar fracture who had been hospitalized between June 2001 and June 2009 were enrolled in this study, including 101 males and 60 females, at the age of 22-67 years, averagely 36 years. By Denis classification, 64 cases affected burst fractures and 97 flexion-compression fractures. Fracture levels involved T11 (9 cases), T12 (63 cases), L1 (74 cases) and L2 (15 cases). The self-designed method of reduction assisted with screw insertion was used. The efficacy of this reduction method was evaluated by operation time, intraoperative bleeding, fracture union time, height ratio of anterior borders of injured and normal vertebrae, 
sagittal Cobb’s angle, and reduction of fragments. 
RESULTS AND CONCLUSION: The operation time ranged from 60 to 150 minutes, averaging 80 minutes. The intraoperative bleeding ranged from 67 to 750 mL, averaging 98 mL. The follow-up time ranged from 16 to 42 months in 161 patients. Fracture union time ranged from 10 to 18 weeks, averaging 12.6 weeks. The ratio of anterior heights and sagittal Cobb’s angle of fractured vertebrae were significantly improved from (54.39±9.60)% and (22.55±7.90)° respectively preoperatiion to (82.80±6.63)% and (8.91°±5.85)° 12 months postoperation (P < 0.05). The size of spinal canal was increased by (46.5±2.6)% postoperatively. CT scan revealed satisfactory fragment reduction and no deep infection appeared. These findings suggest that our self-designed screw-assisted reduction of the fractured vertebrae can improve the reduction quality in the treatment of thoracolumbar fractures. 

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, Fracture Healing

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