后路减压椎体成形短节段融合治疗骨质疏松椎体骨折合并神经损害

[目的]探讨后路减压开放椎体成形结合短节段椎弓根螺钉骨水泥强化治疗骨质疏松椎体压缩骨折(osteoporotic vertebral fractures,OVFs)合并神经损伤的临床疗效。[方法]对2008年8月~2012年3月本科手术治疗的23例OVFs合并神经损伤病例进行回顾性分析。术前,术后3、12个月及末次随访时记录手术并发症、VAS评分、ODI评分、SF-36及ASIA分级;X线片测量后凸Cobb角、椎体前缘压缩率,CT矢状面重建测量椎管侵占率。[结果]患者均获随访,平均随访时间47个月(26~69个月)。手术均顺利完成,无死亡及神经损伤加重等并发症,术中3例出现骨水泥渗漏,术后2例切口延迟愈合、1例切口浅表感染、1例脑脊液漏。术后随访VAS评分、ODI评分及SF-36均比术前改善,差异有统计学意义(P0.05);9例脊髓损伤者术后ASIA分级均至少改善1级;术后后凸Cobb角、椎体前缘压缩率、椎管侵占率均比术前降低,差异有统计学意义(P0.05)。[结论]后路减压短节段椎弓根螺钉骨水泥强化固定结合开放椎体成形是治疗骨质疏松性椎体压缩骨折合并神经损害安全有效的手术方法。     

内固定联合椎体成形治疗Ⅲ型Kummell病疗效观察

目的探讨椎弓根螺钉内固定联合经皮椎体成形术治疗Ⅲ型骨质疏松性骨折不愈合的可行性和有效性。方法回顾性分析2012年3月至2014年6月我院收治的13例Ⅲ型骨质疏松性骨折不愈合患者,本组男性5例,女性8例;年龄61~82岁,平均72.6岁。Frankle分级:C级3例,D级7例,E级3例。患者均行X线片、CT和MRI检查。所有患者全身麻醉后先行体位复位,再行椎弓根螺钉复位内固定结合经皮椎体成形术。对患者进行疼痛视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(oswestry disability index,ODI)评分,同时测评伤椎椎体前缘高度、受累节段矢状面Cobb角。结果全部病例均顺利完成手术,平均手术时间为(80±16)min,出血量为(110±30)m L,平均住院时间为(6.1±2.2)d,无严重并发症发生。所有患者均获随访,随访时间6~24个月,平均15.6个月。VAS评分、ODI评分、伤椎前缘高度、Cobb角术后较术前均有明显改善(P0.05),术后末次随访患者Frankel分级,E级11例,D级2例。患者神经功能改善,生活质量明显提高。结论结合手法复位,行椎弓根螺钉复位内固定联合经皮椎体成形术治疗Ⅲ型骨质疏松性骨折不愈合安全有效,是可行的手术方式。     

改良经椎弓根椎间盘截骨术治疗胸腰椎后凸畸形

目的探讨改良经椎弓根椎间盘截骨术治疗胸腰椎后凸畸形的临床效果。方法采用经椎弓根椎间盘截骨手术治疗36例胸腰椎后凸畸形患者。通过疼痛VAS评分、Oswestry功能障碍指数(ODI)以及测量Cobb角对患者手术的临床效果进行评估,并按ASIA分级评价术后脊髓功能恢复情况。结果患者均获得随访,时间12~44个月。2例术中发生硬膜撕裂,经修补后未出现脑脊液漏;1例术后出现胸腔积液,术后1个月完全吸收;无神经血管损伤及感染患者。骨折均骨性愈合,无明显矫正丢失,无内固定松动、断裂等并发症出现。术后12个月和末次随访的VAS评分、ODI评分以及Cobb角均较术前改善,差异均有统计学意义(P0.05)。末次随访时ASIA分级:B级1例恢复至C级;C级28例中24例恢复至D级,4例无恢复;D级7例中2例恢复至E级,5例无恢复。结论改良经椎弓根椎体截骨手术可实现对胸腰椎后凸畸形的有效矫正,截骨面融合率高。     

CT引导下经皮椎体成形术治疗胸椎转移性肿瘤

目的:探讨CT引导下经皮椎体成形术治疗胸椎转移性肿瘤的安全性及疗效.方法:2004年4月～2006年2月共治疗胸椎转移性肿瘤患者18例.共30个椎体,患者均有顽固性胸背痛,术前VAS评分平均8.6分,伴脊髓压迫者6例,术前Frankel分级C级2例,D级4例,均应用CT引导下经皮椎体成形术行病变椎体内骨水泥注射治疗.随访观察并发症发生情况及治疗效果.结果:30个椎体存CT引导下均一次穿刺成功.单侧注射骨水泥12例,平均注入量2.75ml;双侧注射6例,平均注入量4.7ml,无骨水泥渗漏及神经损害加重情况发生.15例局麻药效消失后疼痛明显缓解,2例72h后疼痛缓解,1例无效.随访6～24个月,平均11.4个月.术后1周时VAS评分平均2.62分,末次随访时VAS评分平均2.94分,与术前比较均有显著改善(P<0.01).末次随访时6例脊髓压迫者神经功能2例C级恢复至D级,其余均恢复至E级.2例原发灶为肝痛及1例肺癌患者死亡,其余患者手术椎体未发生新的病理性骨折及脊髓压迫加重.结论:CT引导下经皮椎体成形术具有良好的止痛及预防病理性骨折作用,是治疗胸椎转移性肿瘤安全、有效的方法.     

经皮椎体成形术和经皮椎体后凸成形术再手术原因分析

目的分析经皮椎体成形术(PVP)和经皮椎体后凸成形术(PKP)再手术原因,提出再手术要点及预防措施。方法收集2012年6月至2017年12月河南省洛阳正骨医院收治的465例行PVP和PKP患者资料,其中41例行再手术治疗。男8例,女33例;年龄56～89岁,平均75岁;骨质疏松性骨折37例,椎体转移瘤2例,浆细胞骨髓瘤2例。病变节段:T92例,T103例,T116例,T126例,L111例,L25例,L33例,L43例,L52例。5例脊髓损伤患者美国脊柱损伤协会(ASIA)分级为A级1例,B级1例,C级2例,D级1例;2例神经根损伤患者出现持续性神经根疼痛、麻木,肌力2～3级。34例未合并脊髓和神经根损伤患者的疼痛视觉模拟评分(VAS)平均7.8分。7例脊髓和神经根损伤患者行后路开放性手术,其余34例患者行骨水泥强化治疗(14例行PKP,20例行PVP)。所有患者再手术时间为初次手术后2 h～1年。结果 41例患者均获得随访,随访时间为6～29个月,平均18个月。再手术原因有椎体内形成假关节(3/41,7.32%)、椎管内骨水泥渗漏(7/41,17.07%)、非手术椎体再骨折(31/41,75.61%)。末次随访时,2例神经根损伤患者疼痛完全消失,残留皮肤感觉麻木症状,肌力完全恢复正常;5例脊髓损伤患者中1例ASIA分级恢复至C级,1例恢复至D级,2例恢复至E级,1例A级患者无恢复;3例形成假关节患者术后VAS评分平均2.3分;31例非手术椎体再骨折患者VAS评分平均1.8分。结论 PVP、PKP术后再手术的主要原因包括椎管内骨水泥渗漏、椎体内假关节形成、非手术椎体再骨折等,序贯的骨水泥注入、PVP与PKP合理选择、常规病理组织检查、预防跌倒教育及康复功能锻炼能降低再手术率。     

单侧椎弓根穿刺椎体后凸成形术治疗老年骨质疏松性椎体爆裂骨折

目的探讨单侧椎弓根穿刺椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗老年骨质疏松性椎体爆裂骨折的临床疗效及安全性。方法对11例老年骨质疏松性椎体爆裂骨折患者采用经皮单侧椎弓根穿刺,球囊扩张,填充骨水泥治疗。通过观察患者术前及术后1周及末次随访时的视觉模拟疼痛评分(visual analogue scale,VAS)、骨折椎体高度的恢复,Cobb较的测量以及测量后柱骨折块在椎管内占位率以评估治疗效果,通过观察骨水泥向椎体外渗漏情况及对神经功能是否影响,来评估该术式的安全性。结果 11例手术均顺利完成,2例出现骨水泥渗漏,1例通过椎体下方终板渗漏至椎间隙,1例通过椎体前侧骨折线向前渗漏,均未产生神经症状。所有患者均获得随访,随访时间为6~24个月。VAS术前与术后、末次随访评分比较,Cobb角术前与术后、末次随访比较,椎体高度术前与术后、末次随访比较,椎管内骨块占位率术前与术后、末次随访时比较,测量指标差异均有统计学意义(P0.05)。结论单侧椎弓根穿刺椎体后凸成形术治疗无神经症状的老年骨质疏松性椎体爆裂骨折,能有效缓解疼痛,矫正后凸畸形并恢复椎体高度,扩大椎管容积,减少了骨折并发症,是一种安全、有效的微创治疗方式。     

局部麻醉侧卧位下经皮椎体成形术治疗骨质疏松性椎体压缩骨折

目的 探讨局部麻醉侧卧位下经皮椎体成形术治疗骨质疏松性椎体压缩骨折的疗效。方法 采用局部麻醉侧卧位下经皮椎体成形术治疗15例骨质疏松性椎体压缩骨折患者。记录双侧椎弓根穿刺成功率、手术时间、术中透视次数、骨水泥注入量、骨水泥渗漏情况，比较手术前后疼痛VAS评分、伤椎后凸角、伤椎前缘高度比，采用MacNab评定标准评估疗效。结果 手术均顺利完成，无术中血管神经损伤、术后谵妄及认知障碍等并发症发生。双侧椎弓根穿刺成功率13/15,手术时间35～65(45.7±8.8)min,术中透视20～38(28.9±5.3)次，骨水泥注入量3.0～6.0(4.0±0.8)ml/椎。骨水泥渗漏4例。患者均获得随访，时间6～18个月。术后6个月采用MacNab评定标准评价疗效：优10例，良4例，可1例，优良率14/15。疼痛VAS评分、伤椎后凸角、伤椎前缘高度比：术后2 d及末次随访时均较术前改善(P<0.05),末次随访与术后2 d比较差异均无统计学意义(P>0.05)。结论 局部麻醉侧卧位下经皮椎体成形术治疗骨质疏松性椎体压缩骨折能显著改善患者疼痛，疗效明确。     

椎弓根螺钉联合经皮椎体后凸成形术治疗陈旧性椎体骨折不愈合

目的 探讨椎弓根螺钉联合经皮椎体后凸成形术(PKP)治疗陈旧性椎体骨折不愈合(Kummell病)的手术疗效.方法 采用椎弓根螺钉联合PKP治疗25例Ⅱ、Ⅲ期Kummell病患者.采用疼痛VAS评分评估患者疼痛程度及ODI评价脊柱功能改善情况,比较手术前后脊柱后凸Cobb角、椎体前缘及中线高度.结果 患者均获得随访,时间...     

CT引导骨填充网袋成形术治疗老年骨质疏松性椎体压缩骨折的疗效

目的 探讨CT引导骨填充网袋成形术治疗老年骨质疏松性椎体压缩骨折(OVCF)的疗效。方法 采用CT引导骨填充网袋成形术治疗29例老年OVCF患者(33椎)。记录手术时间、骨水泥注入量、骨水泥渗漏情况、术后并发症发生情况。比较手术前后疼痛VAS评分、Cobb角、ODI、伤椎前缘高度比。结果 患者均获得随访，时间12～15个月。手术时间38～54 min/椎，骨水泥注入量：胸椎2～2.5 ml/椎，腰椎3～4 ml/椎。围手术期均未发生死亡、穿刺针孔感染等情况；2例骨水泥向椎体前方少量渗漏，但无临床症状。伤椎前缘高度比、疼痛VAS评分、Cobb角、ODI:术后3 d及末次随访均较术前明显改善(P<0.05),末次随访与术后3 d比较差异均无统计学意义(P>0.05)。末次随访时，患者正常负重行走时下肢肌力正常，未出现脊髓神经压迫症状。结论 CT引导骨填充网袋成形术治疗OVCF,具有提高手术操作精准度、提高椎体稳定性、有效避免骨水泥渗漏的优势。     

后路经椎弓根椎体楔形截骨治疗胸腰段创伤性后凸畸形

目的探讨后入路经椎弓根椎体楔形截骨治疗胸腰段创伤性后凸畸形的临床疗效。方法对我院脊柱外科2011-03-2015-05收治的26例脊柱胸腰段创伤性后凸畸形患者,全部采用后路经椎弓根椎体截骨矫形、神经减压,结合椎弓根螺钉系统固定和植骨融合手术治疗,并进行回顾性分析,观测术前、术后初期(3天内)、末次随访(术后1年左右)时胸腰段Cobb角、腰背痛VAS评分、下腰痛JOA评分以及脊髓神经损伤ASIA分级情况。结果 26例患者均获得随访,随访时间10~24个月,平均13.8个月,术后下腰痛JOA评分、腰背痛VAS评分及后凸畸形均有明显改善。术前胸腰段后凸畸形Cobb角为28~58°、平均(40.28±5.66)°,术后2~10°、平均(6.12±3.76)°,平均畸形矫正率86.2%,下腰痛JOA评分标准术前评定为(10.38±1.56)分,术后评定为(22.76±2.23)分,腰背痛VAS评分术前5~8分,平均(6.72±0.33)分,术后2~4分,平均(2.93±0.64)分,以上指标与术前相比较差异均有显著性意义(P0.05);术后神经功能ASIA分级:6例C级5例改善至E级,1例为D级,16例D级15例改善至E级,1例仍为D级;至末次随访,Cobb角矫正丢失角度不明显(1~3°),平均(1.85±0.68)°,平均矫正丢失率3.8%,与术后初期检查比较,差异无统计学意义(P0.05);截骨面均于术后6个月左右骨性愈合,无内固定松动、断裂、假关节形成、感染等并发症。结论后路经椎弓根椎体楔形截骨治疗脊柱胸腰段创伤性后凸畸形,可重建胸腰段矢状面生理曲度,获得满意的后凸畸形矫正和神经减压,改善临床症状。     

Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures

To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with per-cutaneous vertebroplasty in treatment of nonadjacent tho-racolumbar fractures. Methods: Twenty patients who suffered from nonadja-cent thoracolumbar fractures were treated by short segmental pedicle screw fixation for burst fracture and by percutane-ous vertebroplasty for compression fracture. X-rays, CT and MRI scans were conducted using the same protocol before and after surgery and during follow-up. Pre- and post-operative American Spinal Injury Association (ASIA) grades, fusion of fracture sites, visual analog scale (VAS) of back pain, and Oswestry disability index (ODI) were accessed. Results: All patients were followed up for an average period of 12 months. The sagittal profile of the thoracolum-bar spine was restored satisfactorily. No patient had neuro-logic deterioration after surgery, and 9 patients with incom-plete lesions improved postoperatively by at least one ASIA grade. The fusion rate was 100%. The average VAS of back pain was 7.6 preoperatively and 3.2 postoperatively. The average ODI was 72.5 preoperatively and 35.5 postoperatively. Conclusions: Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures exhibits such advan-tages as preserving functional segment units, reliable fixation, good neurologic recovery and early mobilization and, therefore, is suitable for treating nonadjacent thora-columbar fractures.     

Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures

To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with per-cutaneous vertebroplasty in treatment of nonadjacent tho-racolumbar fractures. Methods: Twenty patients who suffered from nonadja-cent thoracolumbar fractures were treated by short segmental pedicle screw fixation for burst fracture and by percutane-ous vertebroplasty for compression fracture. X-rays, CT and MRI scans were conducted using the same protocol before and after surgery and during follow-up. Pre- and post-operative American Spinal Injury Association (ASIA) grades, fusion of fracture sites, visual analog scale (VAS) of back pain, and Oswestry disability index (ODI) were accessed. Results: All patients were followed up for an average period of 12 months. The sagittal profile of the thoracolum-bar spine was restored satisfactorily. No patient had neuro-logic deterioration after surgery, and 9 patients with incom-plete lesions improved postoperatively by at least one ASIA grade. The fusion rate was 100%. The average VAS of back pain was 7.6 preoperatively and 3.2 postoperatively. The average ODI was 72.5 preoperatively and 35.5 postoperatively. Conclusions: Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures exhibits such advan-tages as preserving functional segment units, reliable fixation, good neurologic recovery and early mobilization and, therefore, is suitable for treating nonadjacent thora-columbar fractures.     

Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures

To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with per-cutaneous vertebroplasty in treatment of nonadjacent tho-racolumbar fractures. Methods: Twenty patients who suffered from nonadja-cent thoracolumbar fractures were treated by short segmental pedicle screw fixation for burst fracture and by percutane-ous vertebroplasty for compression fracture. X-rays, CT and MRI scans were conducted using the same protocol before and after surgery and during follow-up. Pre- and post-operative American Spinal Injury Association (ASIA) grades, fusion of fracture sites, visual analog scale (VAS) of back pain, and Oswestry disability index (ODI) were accessed. Results: All patients were followed up for an average period of 12 months. The sagittal profile of the thoracolum-bar spine was restored satisfactorily. No patient had neuro-logic deterioration after surgery, and 9 patients with incom-plete lesions improved postoperatively by at least one ASIA grade. The fusion rate was 100%. The average VAS of back pain was 7.6 preoperatively and 3.2 postoperatively. The average ODI was 72.5 preoperatively and 35.5 postoperatively. Conclusions: Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures exhibits such advan-tages as preserving functional segment units, reliable fixation, good neurologic recovery and early mobilization and, therefore, is suitable for treating nonadjacent thora-columbar fractures.     

Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures

To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with per-cutaneous vertebroplasty in treatment of nonadjacent tho-racolumbar fractures. Methods: Twenty patients who suffered from nonadja-cent thoracolumbar fractures were treated by short segmental pedicle screw fixation for burst fracture and by percutane-ous vertebroplasty for compression fracture. X-rays, CT and MRI scans were conducted using the same protocol before and after surgery and during follow-up. Pre- and post-operative American Spinal Injury Association (ASIA) grades, fusion of fracture sites, visual analog scale (VAS) of back pain, and Oswestry disability index (ODI) were accessed. Results: All patients were followed up for an average period of 12 months. The sagittal profile of the thoracolum-bar spine was restored satisfactorily. No patient had neuro-logic deterioration after surgery, and 9 patients with incom-plete lesions improved postoperatively by at least one ASIA grade. The fusion rate was 100%. The average VAS of back pain was 7.6 preoperatively and 3.2 postoperatively. The average ODI was 72.5 preoperatively and 35.5 postoperatively. Conclusions: Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures exhibits such advan-tages as preserving functional segment units, reliable fixation, good neurologic recovery and early mobilization and, therefore, is suitable for treating nonadjacent thora-columbar fractures.     

Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures

To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with per-cutaneous vertebroplasty in treatment of nonadjacent tho-racolumbar fractures. Methods: Twenty patients who suffered from nonadja-cent thoracolumbar fractures were treated by short segmental pedicle screw fixation for burst fracture and by percutane-ous vertebroplasty for compression fracture. X-rays, CT and MRI scans were conducted using the same protocol before and after surgery and during follow-up. Pre- and post-operative American Spinal Injury Association (ASIA) grades, fusion of fracture sites, visual analog scale (VAS) of back pain, and Oswestry disability index (ODI) were accessed. Results: All patients were followed up for an average period of 12 months. The sagittal profile of the thoracolum-bar spine was restored satisfactorily. No patient had neuro-logic deterioration after surgery, and 9 patients with incom-plete lesions improved postoperatively by at least one ASIA grade. The fusion rate was 100%. The average VAS of back pain was 7.6 preoperatively and 3.2 postoperatively. The average ODI was 72.5 preoperatively and 35.5 postoperatively. Conclusions: Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures exhibits such advan-tages as preserving functional segment units, reliable fixation, good neurologic recovery and early mobilization and, therefore, is suitable for treating nonadjacent thora-columbar fractures.     

Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures

To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with per-cutaneous vertebroplasty in treatment of nonadjacent tho-racolumbar fractures. Methods: Twenty patients who suffered from nonadja-cent thoracolumbar fractures were treated by short segmental pedicle screw fixation for burst fracture and by percutane-ous vertebroplasty for compression fracture. X-rays, CT and MRI scans were conducted using the same protocol before and after surgery and during follow-up. Pre- and post-operative American Spinal Injury Association (ASIA) grades, fusion of fracture sites, visual analog scale (VAS) of back pain, and Oswestry disability index (ODI) were accessed. Results: All patients were followed up for an average period of 12 months. The sagittal profile of the thoracolum-bar spine was restored satisfactorily. No patient had neuro-logic deterioration after surgery, and 9 patients with incom-plete lesions improved postoperatively by at least one ASIA grade. The fusion rate was 100%. The average VAS of back pain was 7.6 preoperatively and 3.2 postoperatively. The average ODI was 72.5 preoperatively and 35.5 postoperatively. Conclusions: Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures exhibits such advan-tages as preserving functional segment units, reliable fixation, good neurologic recovery and early mobilization and, therefore, is suitable for treating nonadjacent thora-columbar fractures.     

Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures

To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with per-cutaneous vertebroplasty in treatment of nonadjacent tho-racolumbar fractures. Methods: Twenty patients who suffered from nonadja-cent thoracolumbar fractures were treated by short segmental pedicle screw fixation for burst fracture and by percutane-ous vertebroplasty for compression fracture. X-rays, CT and MRI scans were conducted using the same protocol before and after surgery and during follow-up. Pre- and post-operative American Spinal Injury Association (ASIA) grades, fusion of fracture sites, visual analog scale (VAS) of back pain, and Oswestry disability index (ODI) were accessed. Results: All patients were followed up for an average period of 12 months. The sagittal profile of the thoracolum-bar spine was restored satisfactorily. No patient had neuro-logic deterioration after surgery, and 9 patients with incom-plete lesions improved postoperatively by at least one ASIA grade. The fusion rate was 100%. The average VAS of back pain was 7.6 preoperatively and 3.2 postoperatively. The average ODI was 72.5 preoperatively and 35.5 postoperatively. Conclusions: Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures exhibits such advan-tages as preserving functional segment units, reliable fixation, good neurologic recovery and early mobilization and, therefore, is suitable for treating nonadjacent thora-columbar fractures.     

Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures

To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with per-cutaneous vertebroplasty in treatment of nonadjacent tho-racolumbar fractures. Methods: Twenty patients who suffered from nonadja-cent thoracolumbar fractures were treated by short segmental pedicle screw fixation for burst fracture and by percutane-ous vertebroplasty for compression fracture. X-rays, CT and MRI scans were conducted using the same protocol before and after surgery and during follow-up. Pre- and post-operative American Spinal Injury Association (ASIA) grades, fusion of fracture sites, visual analog scale (VAS) of back pain, and Oswestry disability index (ODI) were accessed. Results: All patients were followed up for an average period of 12 months. The sagittal profile of the thoracolum-bar spine was restored satisfactorily. No patient had neuro-logic deterioration after surgery, and 9 patients with incom-plete lesions improved postoperatively by at least one ASIA grade. The fusion rate was 100%. The average VAS of back pain was 7.6 preoperatively and 3.2 postoperatively. The average ODI was 72.5 preoperatively and 35.5 postoperatively. Conclusions: Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures exhibits such advan-tages as preserving functional segment units, reliable fixation, good neurologic recovery and early mobilization and, therefore, is suitable for treating nonadjacent thora-columbar fractures.     

Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures

To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with per-cutaneous vertebroplasty in treatment of nonadjacent tho-racolumbar fractures. Methods: Twenty patients who suffered from nonadja-cent thoracolumbar fractures were treated by short segmental pedicle screw fixation for burst fracture and by percutane-ous vertebroplasty for compression fracture. X-rays, CT and MRI scans were conducted using the same protocol before and after surgery and during follow-up. Pre- and post-operative American Spinal Injury Association (ASIA) grades, fusion of fracture sites, visual analog scale (VAS) of back pain, and Oswestry disability index (ODI) were accessed. Results: All patients were followed up for an average period of 12 months. The sagittal profile of the thoracolum-bar spine was restored satisfactorily. No patient had neuro-logic deterioration after surgery, and 9 patients with incom-plete lesions improved postoperatively by at least one ASIA grade. The fusion rate was 100%. The average VAS of back pain was 7.6 preoperatively and 3.2 postoperatively. The average ODI was 72.5 preoperatively and 35.5 postoperatively. Conclusions: Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures exhibits such advan-tages as preserving functional segment units, reliable fixation, good neurologic recovery and early mobilization and, therefore, is suitable for treating nonadjacent thora-columbar fractures.     

Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures

To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with per-cutaneous vertebroplasty in treatment of nonadjacent tho-racolumbar fractures. Methods: Twenty patients who suffered from nonadja-cent thoracolumbar fractures were treated by short segmental pedicle screw fixation for burst fracture and by percutane-ous vertebroplasty for compression fracture. X-rays, CT and MRI scans were conducted using the same protocol before and after surgery and during follow-up. Pre- and post-operative American Spinal Injury Association (ASIA) grades, fusion of fracture sites, visual analog scale (VAS) of back pain, and Oswestry disability index (ODI) were accessed. Results: All patients were followed up for an average period of 12 months. The sagittal profile of the thoracolum-bar spine was restored satisfactorily. No patient had neuro-logic deterioration after surgery, and 9 patients with incom-plete lesions improved postoperatively by at least one ASIA grade. The fusion rate was 100%. The average VAS of back pain was 7.6 preoperatively and 3.2 postoperatively. The average ODI was 72.5 preoperatively and 35.5 postoperatively. Conclusions: Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures exhibits such advan-tages as preserving functional segment units, reliable fixation, good neurologic recovery and early mobilization and, therefore, is suitable for treating nonadjacent thora-columbar fractures.