Pedicle screw fixation for treating thoracolumbar fracture：related factors influencing vertebral height restoration / 中国组织工程研究

ABSTRACT

BACKGROUND:Pedicle screw fixation in the treatment of thoracolumbar fracture can effectively restore vertebral body height and physiological radian, and are widely used in the clinic. In the clinic, we found that different surgical methods on restoration of vertebral height are different. Simultaneously, there are differences in relevant factors before repair, which causes that the recovery of vertebral body height is not consistent. OBJECTIVE:To explore the related factors influencing the recovery of vertebral height of pedicle screw fixation system for treating thoracolumbar fracture. METHODS:Clinical data of 63 patients with thoracolumbar fracture, who were treated by posterior pedicle screw fixation system from September 2012 to March 2015, were summarized. The fracture types were A3 or A4 type in the AO spine thoracolumbar injury classification system, including 32 cases of transpedicular screw fixation (group A) and 31 cases of beyond-injured-vertebral fixation (group B). The related factors including age, course of disease (within 3 weeks), bone mineral density, preoperative degree of vertebral compression and preoperative sagittal Cobb’s angle were recorded. The degree of vertebral height restoration was also observed. Intergroup analysis was conducted using independent samplet-test. Intragroup analysis was performed using bivariate regression analysis in single factor analysis. Multivariate linear regression analysis was applied for multivariate analysis so as to explore the factors related to vertebral height restoration. RESULTS AND CONCLUSION:No significant difference in preoperative rate of vertebral compression or Cobb’s angle was detected between the two groups (P > 0.05). Postoperative rate of vertebral height restoration of group A was significantly greater than group B (P 0.05). Multiple linear regression analysis showed that the preoperative degree of vertebral compression and the course of disease were the predominant factors affecting the vertebral height restoration. The standardized partial regression coefficients were 0.225, -0.621, respectively. These results demonstrate that transpedicular screw fixation can more effectively restore vertebral height than traditional beyond-injured-vertebral internal fixation. The preoperative vertebral compression and course of diseases are the predominant factors affecting the vertebral height restoration, which can predict postoperative vertebral height restoration.