Percutaneous Pedicle Screw Fixation Combined With Traumatic Vertebral Bone Graft For Thoracolumbar Fractures

Objective:To investigate the effect of percutaneous posterior pedicle screw fixation and calcium sulfate implantation in vertebral body for fresh traumatic thoracolumbar fractures.Methods:The clinical data of 42 patients with thoracolumbar fractures from March2014 to March 2016 were retrospectively analyzed.There were 30 males and 12females,at age of 23-58 years（mean,38.9years）.Cause of injury:25 cases of falling from high ground,11 cases of car accident,6 cases of heavy object injuries;The involved segments included T₁₁in 4 patients,T₁₂in 12,L_lin 20 and L₂in 6.Postural reduction,posterior vertebral body implantation of calcium sulfate,unilateral injured vertebrae screw and short segment percutaneous pedicle screw fixation were used to observe the operation time,intraoperative bleeding volume,postoperative pain and imaging indexes（vertebral Cobb angles and anterior vertebral height）.Results:The operative time ranged 105 minutes to 140 minutes,with an average of125 minutes.Intraoperative blood loss was 50～90ml（70ml on average）,and no blood transfusion was performed.The postoperative pain symptoms were significantly alleviated.42 cases were followed up for 24～32 months.There were no spinal cord,nerve injury and wound infection,no loosening and breaking of internal fixation.The height of injured vertebrae and the angle of Cobb had satisfactory recovery,and there was no significant loss of Cobb angle and height of vertebral body in the last follow-up.Conclusions:Percutaneous posterior injured vertebrae implanted with calcium sulfate,unilateral pedicle screw fixation and short-segment pedicle screw fixation for the treatment of thoracolumbar fractures are less invasive and can effectively prevent the loss of vertebral body height,reduce the rate of surgical failures.It conforms to the principle of load sharing and minimally invasive concept,the curative effect is satisfactory.it’s worth of clinical application and promotion,but need to master the operative indications strictly and operation skills.