Comparison of Different Surgical Methods in Single Level Thoracolumbar Burst Fracture

A burst fracture of the thoracolumbar junction is an unstable spinal fracture caused by high-energy trauma. There are many surgical methods available to manage thoracolumbar burst fractures, but the method of choice remains controversial. Purpose. To evaluate the results of surgically treated thoracolumbar burst fractures. From March 1997 through December 2000, 25 patients with single-level thoracolumbar fracture treated surgically were selected. The twelfth thoracic level was involved in 3 cases, the first lumbar level in 13 cases, and the second lumbar level in 9 cases. Sixteen patients underwent posterior pedicle instrumentation alone (group I), while 9 patients underwent posterior pedicle instrumentation with anterior strut bone graft (group II). The preoperative, postoperative, and the latest follow-up angle of deformity were 22.6∘± 9.7∘, 6.4∘± 7.1∘, and 14.1∘± 9.1∘in group I and 23.1∘± 9.8∘, 8.0∘± 11.2∘, and 8.7∘± 13.6∘in group II, respectively. The average initial corrections of angle deformity were 15.6∘± 6.0∘in group I and 15.7∘± 9.4∘in group II, but the progression angle deformities at the latest follow up were 7.8∘± 5.9∘and 1.6∘± 1.7∘, respectively. There was significant difference of progression angle deformity between group I and group II (P=0.001). If the implant was removed, the progression angle deformities in loss of reduction were 9.1∘± 5.8∘and 2.7∘±2.5∘in group I and group II, and the corresponding values in those with retained implants were 6.0∘± 5.9∘and 1.0∘±1.1∘. Posterior pedicle instrumentation with anterior strut bone grafting is superior to posterior pedicle instrumentation alone in maintaining surgical restoration and preventing progression of kyphosis deformity in patients with single-level thoracolumbar burst fracture.

並列關鍵字

thoracolumbar fracture ； burst fracture ； kyphosis deformity ； progression deformity ； anterior strut bone graft ； posterior pedicle instrumentation

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