Posterior short-segment instrumentation and limited segmental decompression supplemented with vertebroplasty with calcium sulphate and intermediate screws for thoracolumbar burst fractures.

Abstract

PURPOSE:

Thoracolumbar burst fractures treated with short-segment posterior instrumentation without anterior column support is associated with a high incidence of implant failure and correction loss. This study was designed to evaluate the clinical and radiographic results following posterior short-segment instrumentation and limited segmental decompression supplemented with vertebroplasty with calcium sulphate and intermediate screws for patients with severe thoracolumbar burst fractures.

METHODS:

Twenty-eight patients with thoracolumbar burst fractures of LSC point 7 or more underwent this procedure. The average follow-up was 27.5 months. Demographic data, radiographic parameters, neurologic function, clinical outcomes and treatment-related complications were prospectively evaluated.

RESULTS:

Loss of vertebral body height and segmental kyphosis was 55.3 % and 20.2° before surgery, which significantly improved to 12.2 % and 5.4° at the final follow-up, respectively. Loss of kyphosis correction was 2.2°. The preoperative canal encroachment was 49 % that significantly improved to 8.8 %. The preoperative pain and function level showed a mean VAS score of 9.2 and ODI of 89.9 % that improved to 1.4 and 12.9 % at the final follow-up, respectively. No implant failure was observed in this series, and cement leakage occurred in two cases without clinical implications.

CONCLUSIONS:

Excellent reduction and maintenance of thoracolumbar burst fractures can be achieved with short-segment pedicle instrumentation supplemented with anterior column reconstruction and intermediate screws. The resultant circumferential stabilization combined with a limited segmental decompression resulted in improved neurologic function and satisfactory clinical outcomes, with a low incidence of implant failure and progressive deformity.

• Authors: Changbao Chen, Gongyi Lv, Baoshan Xu, Xiaolin Zhang, Xinlong Ma
• Journal: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society (Eur Spine J) Vol. 23 Issue 7 Pg. 1548-57 (Jul 2014) ISSN: 1432-0932 [Electronic] Germany
• PMID: 24848703 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Bone Cements
• Calcium Sulfate

Topics

• Adult
• Bone Cements
• Calcium Sulfate
• Decompression, Surgical (instrumentation, methods)
• Female
• Follow-Up Studies
• Humans
• Kyphosis (diagnostic imaging, surgery)
• Lumbar Vertebrae (diagnostic imaging, injuries)
• Male
• Middle Aged
• Pedicle Screws
• Prospective Studies
• Radiography
• Recovery of Function
• Spinal Fractures (diagnostic imaging, surgery)
• Thoracic Vertebrae (diagnostic imaging, injuries)
• Vertebroplasty
• Visual Analog Scale
• Young Adult