Repair Of Thoracolumbar Burst Fracture With Cross Injured Vertebra Pedicle Screw Fixation And Posterolateral Allograft Bone Graft

Objective:To investigate the effect of the posterior lateral allograft bone grafting in the treatment of thoracolumbar burst fracture.Method:From January 2011 to June 2015,80 patients with thoracolumbar burst fracture were treated.All patients were randomly divided into bone graft group and non-bone graft group with 40 cases in each group.The bone graft group was treated with pedicle screw fixation combined with posterolateral bone graft fusion,the non bone graft group was treated with crossing injury vertebra pedicle screw fixation.The clinical efficacy of patients was evaluated according to patients with an average operative time,intra-operation blood loss and postoperative drainage volume,wound local condition score,imaging follow up of the changes of vertebral height and Cobb angle in the preoperative and postoperative patients,Steinman spinal fusion score standard,American Spinal Injury Association(ASIA)neurological function rating of spinal cord injury and Oswestry dysfunction index.Result:A total of 80 cases were followed up for 3 to 24 months(with average duration of 6.7 months).The average time of operation,average amount of bleeding during the operation and the average volume of bleeding after operation in bone graft group were higher than those in non-bone graft group(P<0.05).Two groups of patients both revealed significant improvement(P<0.01)in vertebral height and Cobb angle before operation and after operation.However,slight loss of vertebral height and Cobb angle were exhibited in both bone graft group and non graft group during follow-up,and no statistical difference between the two group was found(P>0.05).Patients in two groups also showed comparable melioration in ASIA neurological function rating of spinal cord injury after surgery(P>0.05).Similarly the Oswestry dysfunction index of the two groups approach were significantly improved after operation,but there was no statistical significance between the two groups(P>0.05).Conclusion:Short segment pedicle screw internal fixation system is an effective and safe method for the treatment of thoracolumbar burst fractures,allograft bone has good compatibility with tissue.However,it is not effective to prevent postoperative correction loss,and it is may not need to be posterolateral vertebral body bone graft fusion for patients with vertebral burst fracture.