Chinese Journal of Tissue Engineering Research ›› 2016, Vol. 20 ›› Issue (4): 522-528.doi: 10.3969/j.issn.2095-4344.2016.04.012

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Vertebral and inter-vertebral screw fixation for treating thoracolumbar compression fracture: a long-term follow-up of spinal stability

Xie Shen1, Zhu Shao-bo2   

  1. 1Department of Orthopedics, Ezhou Central Hospital, Ezhou 436000, Hubei Province, China; 2Department of Orthopedics, Zhongnan Hospital of Wuhan University, Wuhan 430071, Hubei Province, China
  • Received:2015-12-09 Online:2016-01-22 Published:2016-01-22
  • About author:Xie Shen, Associate chief physician, Department of Orthopedics, Ezhou Central Hospital, Ezhou 436000, Hubei Province, China
  • Supported by:

     the Natural Science Foundation of Hubei Province in 2013, No. 2013CFB269

Abstract:

BACKGROUND: Posterior pedicle screw fixation is a common method for treatment of thoracolumbar compression fractures. The fixation method contains long-segment fixation, short-segment fixation and vertebral fixation. Clinical effects of vertebral fixation and inter-vertebral short-segment fixation for treating thoracolumbar fractures remain unclear. 
OBJECTIVE: To compare the stability of posterior vertebral fixation and inter-vertebral pedicle screw fixation for treating thoracolumbar compression fractures. 
METHODS: Clinical data of 46 patients with thoracolumbar compression fractures were retrospectively analyzed. According to the fixation methods, they were divided into the vertebral fixation group (n=21) and inter-vertebral fixation group (n=25). The operation time, intraoperative bleeding, intraoperative blood transfusion, the time of lying in bed, vertebral Cobb angle, anterior vertebral height and visual analog scores were evaluated for a long time.
RESULTS AND CONCLUSION: (1) During repair, in both groups, operation time, intraoperative bleeding and intraoperative blood transfusion were better in the inter-vertebral fixation group than in the vertebral fixation group (P < 0.05-0.01). The time of lying in bed was better in the vertebral fixation group than in inter-vertebral fixation group (P < 0.01). (2) No significant difference in Cobb angle and anterior vertebral height was detected before and after treatment and during repair in both groups, but final follow-up and follow-up loss were better in the vertebral fixation group than in inter-vertebral fixation group (P < 0.05-0.01). (3) No significant difference in visual analog scores was detected before and after treatment in both groups. Visual analog scores were better in the vertebral fixation group than in the inter-vertebral fixation group (P < 0.01). (4) These results suggested that the two fixation methods obtained satisfactory repair effects in long-term follow-up. The dominance in maintaining the height and curvature of the spine was more obvious in the vertebral fixation group than in the inter-vertebral fixation group. The vertebral fixation can be more effective to reconstruct the spinal physiological sequence and restore its stability. After repair, low back pain can also be effectively controlled.