The Clinical Research Of Different Surgical Procedures On The Posterior Reduction And Fixation For The Thoracolumbar Burst Fractures

ObjectiveTo compare the effect of different posterior surgical procedure and bone graft material for the thoracolumbar verterbal burst fracture.MethodsCompare the Cobb’s angel between two surgical methods, the fusion rate of different bone graft materials was analyzed.ResultsA total of36patients included in the study, including22males and14females, aged from21to60(44.22+10.619) years old. All of them are single vertebral burst fractures.32patients with vary degrees of neurological deficiency. Fracture location:6in Til,10in T12,14in LI,6inL2. Dennis typing: IB6cases, ID2case,2A2case,2B14cases,2E4cases,3A4cases,3C2case,4A2case.Two fixation methods comparison:Bone grafted through pedicle group (group1):10cases, fractured vertebral pedicle screw inserted group (group2):26cases. Patients were followed up for six months, fixation displacement or failure is not founded. Group1(45.6+9.20) years old while group2(43.69±11.42) years old, no significant difference between two groups (P=0.744). Cobb angle of Group1:postoperative (4.80±4.658), three months after (9.20±6.943), half a year after (9.40±8.649). The change of vertebral body height in three months was significant (p=0.017), but not significant in half a year (p=0.071). Cobb angle of Group2:postoperative (4.77±5.904), three months after (8.46±6.346), six months after (9.15±6.743). The change of vertebral body height in three months was signi f icant (p=0.000), and six months as well (p=0.000). The three types of graft material comparison:Autogenous iliac bone group (group A):8cases, autogenous bone and nano-hydroxyapatite/collagen (nHAC) mixed group (group B):18cases, nano-hydroxyapatite/collagen (nHAC) group (group C):10cases. Average age:group A (42.25±10.935), group B (43.11±11.581), group C (47.80±9.935), no significant statistically difference among three groups (P=0.695). The patients were followed up for six months. Three months fusion rate:group A75%, group B22.2%, group C0%, with a significant difference among them (p=0.039). Six months fusion rate: group A100%, group B55.6%, group C60%, and no significant difference (p=0.273).Conclusion1. In the long run, bone grafted through pedicle group maintained vertebral height better than fractured vertebral pedicle screw inserted group.2. The nano-hydroxyapatite/collagen (nHAC) can be used as an alternative to the autologous bone.