The Clinical Observations Of Burst Fracture Of Thoracolumbar Treated By Vertebral Body Bone Grafting Plus Pedicle Screw Fixation

Objective:Evaluation the clinical effect of unstable and burst fractures of thoracolumbar treated by injured vertebral body bone brafting plus pedicle screw fixation, in order to provide scientific evidence for clinical use.Methods:42unstable and burst thoracolumbar fracture patients were treated by the intraspinal vertebral body autologous and homoplastic bone graft plus pedicle screw fixation. Use X-line and CT at preoperative,1week after operation and follow-up time to measuring anterior vertebral body, cobb angle, spinal stenosis rate of injured vertebral and so on. The date was collected to do statistics processing. Furthermore, observing morphological change and growth of grafted bone. Assess the neuromechanism as AS1A2000grading standard for standard and the clinical effect as Charles standard for standard.Results:All of42patients were received follow-up. There was none bending and loosening of pedicle screws. Preoperative,1week after operation and follow-up time of the anterior vertebral height restoration, sagittal spinal cobb angle and spinal stenosis rate were (48.79±15.58)%,(35.5±4.1°),(35.81±13.68)%at preoperative,(5.10±2.12)%,(7.1°±2.1°),(3.64±1.18)%at1week after the operation,(6.98±3.52)%,(7.8°±2.2°),(4.23±1.78)%at the follow-up time. The difference between preoperative and1week after the operation was statistically significant (P<0.01). The difference between1week after the operation and the follow-up time wasn’t statistically. The grafted bone was grown well. The vertebra canal was fully decompressed. The ASIA2000grading standard improved1-4grade. The fine rate of the clinical effect was 88%.Conclusions:The horacolumbar unstable and burst fracture patients were treated by grafting autologous and homoplastic bone though the injured vertebra canal and pedicle screw fixation. The characteristics were as follows:1.The injured vertebral height was recovered; the kyphotic deformity was corrected;3. the spinal decompression was sufficient;4. the vertebra bone grafted zone integrated with bone tissues around and the fracture was healed;5. the neuromechanism was improved1-4grade;6. the complications of lumbar pain, feature limited and bending and loosening of pedicle screws had low incidence rate. Clinical popularizing can be considered.