The treatment of monosegmental fixation and short-segment fixation on thoracolumbar burst fracture a retrospective controlled study / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the safety and therapeutic effects of monosegment pedicle instrumentation in treating incomplete thoracolumbar burst fracture.</p><p><b>METHODS</b>A retrospective analysis was conducted on 56 inpatients with incomplete thoracolumbar burst fracture (AO classification A3.1 and A3.2) from April 2005 to January 2010. There were 28 cases were fixed with monosegment pedicle instrumentation (MSPI), 28 cases were fixed with short segment pedicle instrumentation (SSPI). The operative time, blood loss, visual analogue scale (VAS) and vertebral kyphotic angle (VK) before and after surgery were evaluated.</p><p><b>RESULTS</b>In the group of MSPI, the mean operative time was (93 ± 20) min; the intraoperative blood loss was (184 ± 64) ml; the VK angle was 17° ± 10° before operation, 7° ± 7° at one week after operation, and 10° ± 7° at latest follow-up; VAS score was 7.6 ± 1.5 before operation, 2.4 ± 0.8 at one week after operation, and 1.5 ± 0.9 at latest follow-up; no adjacent segment degeneration was found. In the group of SSPI, the operative time was (102 ± 30) min; the intraoperative blood loss was (203 ± 88) ml; the VK angle was 17° ± 9° before operation, 7° ± 7° at one week after operation, and 8° ± 5° at latest follow-up; VAS score was 6.8 ± 1.3 before operation, 3.1 ± 0.5 at one week after operation, and 1.2 ± 0.7 at latest follow-up. One case of adjacent segment degeneration was found in 36 months after operation. There were no significantly statistical differences between two groups in operative time, blood loss, VAS score and VK angle before and after surgery (P > 0.05). The VAS score and VK angle at one week after surgery and latest follow-up all decreased obviously than preoperative ones in both groups (P < 0.05).</p><p><b>CONCLUSIONS</b>MSPI for incomplete thoracolumbar burst fracture is effective and safe. The operative blood loss, the mean operative time, the improvement of VAS score and the VK angle in group MSPI are equal to those in group SSPI.</p>