Minimally invasive bone graft in anterior column through pedicle for thoracolumbar vertebral compression fractures

English Keywords:Thoracolumbar compression fracture  Pillar block  Internal fixation  Outcome

English Abstract:

  【Abstract】 Objective：To study the clinical outcome of minimally invasive bone graft in anterior column through pedicle for thoracolumbar vertebral compression fractures.Method：From May 2009 to April 2010，21 patients undergoing bone graft in anterior column through pedicle ｆｏｒ thoracolumbar vertebral compression fractures were enrolled in this study.There were 12 males and 9 females with the average age of 59.7 years（range，48-76 years）.All patients had single vertebra involved，which included 2 T11，5 T12，9 L1，4 L2 and 1 L3.Preoperative evaluation included nature history，physical examination and imaging，which detailed as the wedge angle of 16.67°±1.70°，the Cobb angle of 23.43°±1.73°，the anterior height of the fracture vertebral body of （61.85±４.３４）%，the sagittal index（SI：the anterior height of the fracture vertebral body/the posterior height of the fracture vertebral body×100%） of（59.48±4.15）%．Ｔhe visual analogue scale（VAS） score was 8.3±1.0.The operative time and blood loss were recorded.The radiographs of 1 week，3 months，6 months and 12 months at follow-up were reviewed retrospectively，and the wedge angle of involved vertebra，kyphosis correction，the anterior vertebral height restoration，sagittal index（SI），and graft location as well as VAS score were reviewed.Result：All the patients underwent surgery successfully．Ｔhe average operation time was 51.2min， and blood loss was 26.4ml.Postoperative CT scan revealed breakout of pedicle cortex in 11 patients，with 10 laterally and 1 medially，however no neurological deficit wａｓ noted.All the patients were followed up for a mean of 21.3 months（range，15-26 months）.There were significant difference with respect to the wedge angle，kyphosis Cobb angle，SI，VAS score and anterior height of involved vertebral body between pre and post-operation（P＜0.05）.The ruptured pedicle cortex healed after 3 months.At final follow-up，no loss of correction and graft displacement were noted.Concluｓion：Minimally invasive bone graft in anterior column through pedicle for thoracolumbar vertebral compression fractures is of less surgical time，less blood loss and maintaining of correction, which is reliable for short term outcome.