Pedicle screw fixation through Wiltse approach combined with injectable calcium sulfate bone cement for single-level thoracolumbar fracture

doi:10.3969/j.issn.2095-4344.2017.19.006

Abstract

Abstract:

BACKGROUND: Thoracolumbar fracture is most common seen in spinal fractures. The paraspinal muscle

is subjected to extensive detachment and traction in traditional posterior approach, so the muscular ischemia and denervation lead to muscle atrophy further inducing intractable low back pain. Thereafter, minimally invasive spinal surgery becomes more and more popular.

OBJECTIVE: To investigate the clinical efficacy of pedicle screw fixation through Wiltse approach combined with injectable calcium sulfate bone cement for single-level thoracolumbar fracture.

METHODS: Clinical data of 52 patients with single-level thoracolumbar fracture without nerve injury were analyzed retrospectively, and were then assigned to observation (n=28) and control groups (n=24) according to the treatment method. The patients in the observation group were treated with pedicle screw fixation through Wiltse approach plus implanted with injectable calcium sulfate bone cement, and those in the control group were subjected to pedicle screw fixation through posterior approach plus implanted with injectable calcium sulfate bone cement. The operation time, blood loss and hospitalization time were compared between two groups. The low back pain was observed at baseline, 1 week and 3 months postoperatively, and the percentage of anterior vertebral height revealed on X-ray was observed at baseline, before ambulation, and during last follow-up. Moreover, the complications, loosening and rupture of the screws were recorded.

RESULTS AND CONCLUSION: (1) All patients were followed up, and the follow-up time was 16-24 months. (2) The operation time, blood loss and hospitalization time in the observation group were significantly less than those in the control group (P < 0.05). (3) The postoperative visual analogue scale scores in the two groups were significantly lower than those before surgery, and the scores showed significant differences between two groups (P < 0.05). (4) The percentage of anterior vertebral height before ambulation and during last follow-up in the two groups was significantly improved, and the percentage showed significant difference between two groups at each time point (P < 0.05). (5) These findings suggest that based on strict indications, the pedicle screw fixation through Wiltse approach combined with injectable calcium sulfate bone cement is safe for single-level thoracolumbar fracture, which restores the anterior vertebral height rapidly, alleviates pain and exhibits satisfactory long-term efficacy. Furthermore, it holds shorter operation time and less blood loss than the traditional approach.

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, Calcium Sulfate, Fracture Healing, Tissue Engineering

CLC Number:

R318

Zhan Fang-biao, Wang Shi-jun, Cheng Jun, Feng Shi-long, Xie Li-zhong, Li Bo, Zhang You. Pedicle screw fixation through Wiltse approach combined with injectable calcium sulfate bone cement for single-level thoracolumbar fracture [J]. Chinese Journal of Tissue Engineering Research, 2017, 21(19): 2986-2992.

Figures/Tables 5

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