Abstract:

Objective　 To explore the clinical efficacy of transpedicular intracorporeal grafting combined with posterior short-segment pedicle screw via the injured vertebra for thoracolumbar fractures treatment.　Methods　A total of 52 patients of thoracolumbar fractures were treated with transpedicular intracorporeal grafting combined with posterior short-segment pedicle screw via the injured vertebra from June 2006 to December 2009. According to the AO classification, all of them are type A fracture. Preoperative, postoperative and follow-up X-ray were performed for evaluating anterior heights of the injured vertebra(AHIV) and Cobb's  angle, as well, preoperative and postoperative CT scans were taken to measure the sagittal canal diameter(SCD). Postoperative complications and neurofunctional recovery of the spinal cord were evaluated. Results　All cases were followed up about 12 to 30 months, averagely 16.5±7.8 months. There was no infection of incision and no aggravation of spinal cord function. There was no implant failure and no loss of spinal curvatures. After surgery and at final follow-up, anterior heights of the injured vertebra showed good recovery, and Cobb's angel appeared smaller. The sagittal canal diameter significantly reduced compared to that before surgery. In patients with incomplete injury, neurofunctions showed 1 to 2 grade improvement compared with the findings before operation.　Conclusions　Transpedicular intracorporeal grafting is effective to repair fractured vertebrae in the vertebral body defects, posterior short-segment pedicle screw via the injured vertebra can reconstruct the stability of thoracolumbar fractures, stable reconstruction of the anterior and middle columns and secured fixation of the posterior column. This technique is an effective method for treatment of A type thoracolumbar fractures.

Key words: Thoracolumbar fractures, Pedicle screw, internal fixation, Injured vertebra, Bone grafting