[Short-segment fixation of thoracolumbar burst fractures using pedicle fixation at the level of fracture in patients with osteoporosis].

Objective: To evaluate the curative effect of short-segment transpedicular fixation plus vertebra fracture fixation for thoracolumbar burst fractures in patients with osteoporosis.

Methods: The clinical data of thoracolumbar burst fractures in 46 patients with osteoporosis, single segment fracture and neurological intactness were analyzed retrospectively from January 2008 to January 2012. There were 20 males and 26 females with a mean age of 64.5 (56-78) years. The mechanisms of injury were fall (n = 20), traffic accident (n = 12), high falling injury (n = 8) and heavy pound injury (n = 4). The involved vertebrae included T11 (n = 5); T12 (n = 17); L1 (n = 21); L2 (n = 3). Pedicle screw was inserted into injured vertebra and the height of collapsed vertebra fractures reduced with position and instrument. Visual analogue scale (VAS) and short form-36 scoring systems were used to evaluate pain level and quality of life. The height restoration and kyphotic correction rates of fracture level were measured radiologically.

Results: All patients underwent surgery safely without severe complications. The average follow-up period was 20.5 (9-48) months. There was significant difference (t = 20.057, P = 0.000; t = 24.287, P = 0.000) in VAS score between last follow-up (3.09 ± 1.01) and post-operation (2.35 ± 1.02) versus pre-operation (7.22 ± 1.05) respectively. And also there was significant difference (P < 0.05) in SF-36 score between last follow-up (126.5 ± 22.3) and post-operation (96.7 ± 17.5). The Cobb angle was corrected to (5.6 ± 1.9)° of post-operation and (7.8 ± 3.3)° of last follow-up. The loss rate of vertebral was (4.8 ± 5.2)% of post-operation and (7.6 ± 2.9) % of last follow-up. There was no loosening or breakage of internal fixations.

Conclusions: The approach of short-segment transpedicular fixation plus vertebra fracture fixation is both safe and effective to maintain reduction and reduce the rate of correction loss and instrument failure.