A Retrospective Study Of Thoracolumbar Fractures Treated With Fixation And Non-fusion Surgery Of Intra-vertebral Bone Graft Assisted With Balloon Kyphoplasty

Introduction Currently for patients with severe thoracolumbar fractures most of the surgeons choose posterior fixation and fusion,in order to restore spinal stability and ensure spinal bearing capacity.The existing surgical methods are to maintain the stability of the spine as the main goal,the spinal movement function is not considered in the surgical treatment.Whether it is short or long segment fixation,the bone graft and fusion were necessary,and postoperative the surgical segment Range of Motion(ROM)was lost.Thoracolumbar spine is one of the main movement of the spine,the loss of its motor function is bound to affect the non-surgical segment lumbar motion function,so that the stress increases,leading to accelerate the degeneration of the lumbar.There are a class of fractures in the limbs are very special,that is,intra-articular fractures,such fractures in accordance with the principles of fracture reduction need to reset the fracture,but also to retain the joint motion function.So we think that the concept of treatment of limb fractures can be introduced into the treatment of spinal fractures to cure the fracture while retaining its function,so we try to use the balloon to restore the vertebral body,the fracture vertebral body to anatomical reduction,Through the pedicle bone graft bone injury in the postoperative to achieve bone healing,while the injured pedicle into the universal spine to increase the stability of the spine.Postoperative confirmed fracture area bone repair,the removal of internal fixation to restore the spinal movement function.This article compared with the traditional thoracolumbar fractures of a single segment fixation fusion surgery to evaluate the the advantages and disadvantages of the novel surgical approach in the treatment of thoracolumbar fractures.Objective To evaluate the clinical efficacy of the novel non-fusion surgery and fusion surgery.To evaluate the effect of balloon kyphoplasty with pedicle screw fixation in treatment of thoracolumbar fractures.Methods This retrospective study included 61 consecutive patients with thoracic or lumbar fractures treated from October 2010 to May 2014.Patients were divided into one of two groups: group A,intra-vertebral bone graft with balloon kyphoplasty(non-fusion surgery);and group B,traditional posterior fixation and fusion surgery.The total number of patients was 61,and Group A of 31 patients,including 23 males and 8 females,the average age of 48.28 years old.Group B of 30 patients,including 18 males and 12 females,the average age of 50.10 years old.The Visual Analog Scale(VAS)was done preoperatively as well as at three months,one year,and two years.X-ray,CT,and MRI were done preoperatively.X-rays were done postoperatively at three months and two years.Postoperatively at 3 months,CT was used to confirm healing of the vertebral fracture.Results There was no significant difference in sex,mean age,BMI and follow-up time between the two groups.Group A of postoperative X-ray observation,vertebral bone graft after surgery to restore a good height,postoperative follow-up vertebral height was no significant compression;group B,the lateral fusion segment Has reached bone fusion postoperative 4-6 months by CT scan.The injury of the anteroposterior vertebral compression rate,injury sagittal index,vertebral wedge angle,vertebral scoliosis angle,surgical segment kyphosis angle were no significant difference between group A and group B at preoperatively and postoperative follow-up.There was significant difference of surgical segment ROM before and after movel the fixation in group A(P <0.05).After the internal fixation moved,the ROM of surgical segment was well recovered.Conclusion Non-fusion treatment of intra-vertebral bone graft assisted with balloon kyphoplasty demonstrated good fracture reduction,deformity correction,fracture healing,and ROM maintenance.