Objective: To observe the effects of expansive pedicle screws fixation combined Wright artificial bone implantation in treating thoracolumbar burst fracture of the elderly.
Methods: From March 2007 to July 2009, 12 patients with thoracolumbar burst fractures were treated with surgery in the study. There were 7 males and 5 females, with an average age of 62.3 years (from 56 to 71 years). Nerve functions of all patients were ASIA classified grade E. According to TLICS score system, 6 points were in 5 cases and 7 points were in 7 cases. Expansive pedicle screw system was used and Wright artificial bone was injected into the injuried vertebrae. The anterior border height of vertebral body and Cobb angle were observed at the preoperation, postoperation and final follow-up.
Results: All patients were followed up from 10 to 15 months with an average of 12 months. Wounds healed well, pain in the chest-back abated, no the expansive pedicle screws loosened or broke down. The anterior border height of vertebral body increased from (32.3 +/- 9.1)% preoperatively to (95.3 +/- 3.2)% postoperatively; and the Cobb angle decreased from (31.6 +/- 6.8) degrees preoperatively to (4.5 +/- 3.2) degrees postoperatively. There was significant difference between two groups (P<0.01). After 3 months, the anterior border height of vertebral body was (94.7 +/- 3.3)% and the Cobb angle was (4.6 +/- 3.4) degrees; at the final follow-up, the anterior border height of vertebral body was (93.2 +/- 3.6)% and the Cobb angle was (5.3 +/- 3.7) degrees. There was no significant difference between the two data (P>0.05).
Conclusion: The combination of expansive pedicle screws fixation and Wright artificial bone injection is a good treatment for thoracolumbar burst fracture, with advantages such as easy operation and good effect, which mainly applied to patients with no obvious nerve injuries.
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