Posterior monosegmental pedicle screw fixation and transforaminal lumbar interbody fusion for type A3 thoracolumbar burst fracture

English Keywords:Thoracic vertebra  Lumbar vertebra  Burst fracture  Pedicle screw  Transforaminal lumbar interbody fusion

English Abstract:

  【Abstract】 Objective：To assess the efficacy and feasibility of posterior monosegmental pedicle screw fixation combined with transforaminal lumbar interbody fusion（TLIF） for traumatic Type A3 thoracolumbar burst fracture.Method：16 patients with isolated type A3（according to the AO classification） thoracolumbar burst fracture undergoing posterior monosegmental pedicle screw fixation and TLIF between March 2005 and October 2007 were reviewed retrospectively.The involved levels included T11（2），T12（2），L1（5），L2（5），L3（1） and L4（1）.Five patients had incomplete neurological deficit including 1 grade C，4 grade D evaluated by Frankel grading system.The anterior vertebral body height and segmental Cobb angle of pre- and post-operative immediate and final follow-up were assessed under radiographs.Result：All operations were completed successfully，no instrument failure and neurovascular complication were noted.The mean operation time was 125min（range，90-180min），the mean blood loss was 330ml（range，200-600ml），all patients were followed-up for 10-38 months（mean，14.6 months）.All patients had solid bony fusion at final follow-up.The post-operative radiographs demonstrated good reduction without loss until the bony fusion.Neurological improvement was noted in all five patients with partial neurological deficit.Conclusion：Posterior monosegmental pedicle fixation combined with TLIF is feasible and reliable for isolated type A3 thoracolumbar burst fractures，which provides time efficient，less blood loss and short segment fusion.