球囊复位终板椎体增强结合经皮椎弓根螺钉固定治疗胸腰椎爆裂性骨折北大核心CSCD

Objective: To investigate the clinical results of percutaneous balloon-assisted endplate reduction reinforced by injectable calcium sulfate cement (CSC) after fixation with percutaneous pedicle screws in the treatment of thoracolumbar burst fractures. Methods: From January 2016 to December 2018, 23 patients were treated at Department of Orthopaedics, The Second People's Hospital of Hefei for thoracolumbar burst fractures without neural impairment (LSC>6). They were 14 males and 9 females, aged from 20 to 60 years (average, 43 years). After reduction and fixation of the injured vertebrae with percutaneous pedicle screws, the collapsed endplates were reset by transpedicular balloon and reinforced by injectable CSC. Recorded were operation time, bleeding volume, fracture healing, visual analogue scale (VAS), anterior height ratio of the injured vertebra, central height ratio of the injured vertebra, sagittal cobb angle, absorption of CSC and complications. Results: The operation time averaged 110 min and the bleeding volume 75 mL. This group of patients obtained follow-up for 12 to 48 months (average, 24 months). The mean time for CSC complete absorption was 3 months postoperatively. The VAS scores for back pain at 3 days postoperation and the last follow-up (2.1±0.9 and 1.1±0.3) were significantly improved than the preoperative value (7.8±1.3);the anterior height ratios of the injured vertebra (93.22%±6.39%, 92.79%±6.41% and 92.38%±6.60%), the central height ratios of the injured vertebra (90.66%±6.28%, 89.92%±6.05% and 86.54%±6.96%) and the sagittal cobb angles (4.88°±2.35°, 5.32°±2.34° and 5.84°±2.43°) at postoperative 1 week, 3 months and the last follow-up were significantly improved than the preoperative values (51.68%±8.32%, 63.37%±9.24% and 20.77°±7.35°, respectively) (P<0.05), but there was no significant difference between the 3 time points (P>0.05). Internal fixation failure or loss of cobb angle greater than 10° was found in none of the patients. Conclusions: Percutaneous balloon-assisted endplate reduction reinforced by injectable CSC combined with percutaneous pedicle screwing is a safe and minimally invasive treatment of thoracolumbar burst fractures with LSC>6, leading to effective reduction of the collapsed endplate and restoration of vertebral mechanical performance. © 2020 Chinese Medical Association

Balloon-assisted endplate reduction reinforced by injectable calcium sulfate cement combined with percutaneous pedicle screwing for thoracolumbar burst fractures