Posterior Subtotal Vertebraectomy,Titanium Cage Reconstruction And Internal Fixation Of Spine In The Treatment Of Thoracolumbar Burst Fractures

Objective To evaluate the efficacy and prognosis of treating thoracolumbar burst fractures by subtotal vertebreectomy, titanium cage reconstruction and fixation with pedicle screw through posterior approach.Methods From June 2010 to June 2014,35 patients (21 males and 14 females) with thoracolumbar burst fractures who were sleceted by thoracolumbar injury classification and severity score system and loading sharing classification system, were treated by posterior subtotal resection of vertebral body with implantation of titaium cage and distraction reduction fixation at one stage. Neurological status at preoperative, postoperative and final follow-up were reviewed by ASIA scoring system. The distraction, redution and were reviewed by radiologically.Results All of operation procedures were carried out successfully. Cerebrosinal fluid leakage occurred in 6 patients, the others had no postoperative complications. All patients were followed up with an average of 15.3±6.8 months. Nervous function improved in different degree in all patients excpet 5 patients who had the nervous function of grade A. Satisfactory reduction were observed radiologically postoperative. All patients had complete bony fusion at final follow-up without pseudathrosis.Conclusion It is an ideal operation method for the treatment of thoracolumbar burst fractures by subtotal resection of vertebral body, reconstruction the anterior and middle columns with titanium cage and fixation with pedicle screw through posterior approach. It has the advantages of convenient operation, less complications, thoroughly decompression and sufficinet resume vertebral body height.