Relative Study Of Fracture Healing And Grafting Distribution Via Literal Pedicular Or Spinal Canal

Objective: To explore the differences and correlation of the fracture union in thoracolumbar fracture via transpedicular allograft or unilateral spinal. Methods: To analyse the clinical materials of 40 cases with thoracolumbar fracture from January 2013 to June 2014. A total of 40 cases were divided into two groups evenly, including group A and Group B, both were grafted either transpedicular or unilateral spinal. Compare the Cobb’s angle of kyphosis, vertebral sagittal index(SI), distribution and percentages of bone graft respectively pre- and postoperative. Results: All the cases were followed-up successfully. Fracture, loosing and dislocation of the pedicle screw were not found. The recovery of neurological function was good. And there were no other complications for any patient. Statistical significance of the ratio of the area of graft(A%) was obtained through the compare of transpedicular and spinal. And the graft transpedicular is better than spinal. Comparing the SI and Cobb’s angle pre-operative with the instantly post-operative or the final follow-up respectively in both methods, statistical significance was obtained(SI: P<0.05, and Cobb’s angle: P<0.01). And there were no statistical significance about SI and Cobb’s angle compared instantly post-operative with the final follow up in Group A or Group B respectively(both, P>0.05). So, the differences about the reconstruction of vertebral height between the two methods still could not be affirmed. The reconstruction of vertebral height was satisfactory in all patients. Nevertheless, certain loss in vertebral height had been observed on the final follow-up(range: 1-4mm). And the distribution of cases with loss more than 2mm in vertebral height was 4 cases in Group A and 2 in Group B, respectively. Conclusion: As the grafting areas, the access of unilateral spinal is better than transpedicular way. But there are no significant differences about the two methods. Both methods have acquired excellent clinical results on the therapy for thoracolumbar vertebral fracture. The reconstruction of the height and the loss rate in impaired vertebraes are desirable. Both methods are good procedures for thoracolumbar vertebral fracture.