骨水泥强化椎体技术在骨质疏松性脊柱后凸畸形手术治疗中的应用(16例报告)

[目的]探讨骨水泥强化椎体椎弓根钉棒系统治疗骨质疏松性脊柱后凸畸形的手术效果.[方法]应用骨水泥强化椎后椎弓根钉棒系统后路矫形内固定治疗骨质疏松性脊柱后凸畸形病人16例,观察后凸Cobb角矫正角度、内固定稳定情况及临床症状改善程度.[结果]椎弓根钉内固定系统无松动、脱落、断裂.后凸畸形Cobb角平均矫正22.1°,疼痛VAS评分由术前平均7.8分降至术后平均2.1分,ODI评分由术前平均86.5％改善至术后平均31.2％.[结论]应用骨水泥强化椎体椎弓根钉棒系统治疗骨质疏松性脊柱后凸畸形可获得满意的临床疗效.     

椎弓根钉内固定结合椎体成形术治疗胸腰椎压缩性骨折

目的 探讨椎弓根钉内固定结合椎体成形术治疗胸腰椎压缩性骨折的临床疗效.方法 对39例胸腰椎压缩性骨折应用经椎弓根内固定系统结合椎体成形术治疗.术中通过椎弓根钉复位骨折椎体,经伤椎的椎弓根将骨水泥注入椎体的前中柱,观察其治疗效果.结果 所有患者均获得随访,随访时间12～30个月.后凸Cobb角由术前平均24.0°矫正到术后平均3.50;椎体前缘高度由术前平均18.5mm矫正到术后平均35.0mm.术后12个月所有患者元内固定物断裂、松动等现象.结论 椎弓根钉内固定系统结合椎体成形术是治疗胸腰椎压缩性骨折的安全有效方法.     

中年骨质疏松性胸腰椎爆裂骨折的外科治疗

目的探索中年骨质疏松性胸腰椎爆裂骨折的治疗方法。方法对17例无神经损伤的中年骨质疏松性胸腰椎爆裂骨折采用骨水泥强化椎弓根钉固定结合椎体后凸成形术治疗,比较手术前后Cobb角和疼痛视觉模拟评分（VAS）。结果手术时间75-100 min,平均85 min;术中出血量50-150 ml,平均80 ml;术后X线片示Cobb角平均矫正23.2°,术后VAS评分为（1.7±0.6）分。随访12个月后显示Cobb角平均丢失约2.2°,随访期间未发现内固定松动、断裂或邻椎骨折。结论骨水泥强化椎弓根钉固定结合椎体后凸成形术是治疗中年骨质疏松性胸腰椎爆裂骨折的一种较好方法。     

骨水泥强化椎弓根钉内固定治疗陈旧性骨质疏松性胸腰椎压缩骨折并后凸畸形

目的探讨骨水泥强化椎弓根钉内固定治疗陈旧性骨质疏松性胸腰椎压缩骨折并后凸畸形的疗效。方法自2006-06—2013-08采用骨水泥强化椎弓根钉内固定治疗陈旧性胸腰椎骨质疏松性椎体压缩骨折并后凸畸形30例。观察术后后凸Cobb角、疼痛视觉模拟评分(VAS)的改善程度。结果本组手术时间115~178 min,平均145 min;术中出血量660~1 240 ml,平均810 ml。30例均获得随访7~48个月,平均21.5个月。植骨骨性愈合,后凸矫正角度无明显丢失,固定相邻节段无明显椎间不稳征象。末次随访胸腰段后凸Cobb角、VAS评分较术前明显改善。结论骨水泥强化椎弓根钉内固定治疗陈旧性骨质疏松性胸腰椎压缩骨折并后凸畸形既增强了椎弓根钉的固定强度,又矫正了脊柱后凸畸形。     

骨质疏松性椎体骨折伴脊柱后凸畸形的手术治疗

[目的]探讨一种治疗重度骨质疏松性椎体骨折伴脊柱后凸畸形简单而有效的方法。[方法]随访12例重度骨质疏松性骨折伴后凸畸形行短节段椎弓根螺钉固定加伤椎椎体成形术的患者,用PACS阅片软件测量伤椎中部高度与正常椎体高度的比值(压缩比)、脊柱后凸Cobb角,VAS评分评价腰痛程度。[结果]压缩比由术前的(40.50±4.20)%增加至术后的(67.70±7.28)%;Cobb角由术前的(23.41±4.85)°减少为术后3个月的(7.39±3.72)°;VAS评分由术前的(8.56±0.73)分减少为术后3个月的(1.33±0.21)分。[结论]后路短节段椎弓根螺钉固定加伤椎椎体成形术是治疗重度骨质疏松性椎体骨折伴后凸畸形简单而有效的方法。     

经椎旁肌间隙内固定椎体成形治疗骨质疏松椎体骨折

目的探讨后路经椎旁肌间隙椎弓根内固定结合椎体成形术治疗骨质疏松椎体爆裂性骨折的可行性及其疗效。方法后路经椎旁肌间隙椎弓根内固定结合椎体成形术治疗15例无神经症状的骨质疏松性胸腰椎爆裂性骨折。术前、术后及术后12个月时采用疼痛视觉模拟评分（visual analog score,VAS）评估疼痛程度、Oswsetry功能障碍指数（oswsetry disability index,ODI）评估患者日常生活功能,并测量术前、术后及12个月时伤椎椎体前缘高度及椎体Cobb角。结果术后患者疼痛症状迅速缓解,无神经损伤的并发症发生。2例患者少量骨水泥渗漏但无症状性并发症。患者VAS评分由术前8.4分降为术后2.6分（P〈0.05）,术后12个月随访时维持在2.8分;ODI评分由术前的（70.2±12.8）分改善为术后的（34.3±2.8）分,术后12个月随访时仍能维持;椎体前缘高度从（33.83±11.52）%纠正为术后的（78.83±8.26）%（P〈0.05）;Cobb角由术前的（28.46±4.86）°改善为（6.56±4.25）°,随访时椎体高度及Cobb角未见明显丢失。结论经椎旁肌间隙椎弓根内固定结合椎体成形术治疗无神经症状的骨质疏松性胸腰段爆裂性骨折具有复位满意、手术创伤小、允许患者早期下床活动等优点,是治疗骨质疏松椎体爆裂性骨折有效方法之一。     

椎弓根内固定椎体后凸成形术治疗骨质疏松性胸腰椎骨折

目的探讨椎弓根内固定结合椎体后凸成形术治疗骨质疏松性胸腰椎骨折的方法及临床效果。方法自2010年2月至2012年1月本院采用后路切开椎弓根内固定结合椎体后凸成形术治疗13例骨质疏松性胸腰椎压缩性骨折患者。术后随访30个月,术后复查胸腰椎正侧位片。分别于术前、术后3d、末次随访用Oswestry功能障碍指数评分（oswestry disability index,ODD,X线片上测量椎体矢状面指数（sagittal index,SI）及Cobb角（SI＝椎体前缘高度／椎体后缘高度）,观察内固定及伤椎稳定情况及功能恢复情况。结果所有患者均未发生骨水泥渗漏,无神经症状缺失。13例患者其中1例失访,12例获平均18个月随访,末次随访时患者功能恢复良好,未发现椎弓根钉松动、断裂。结论椎弓根内固定结合椎体后凸成形术为骨质疏松性胸腰椎压缩性骨折的手术治疗提供了一种比较安全、可靠的方法,能改善功能,防止后期内固定松动、断裂和矫正度丢失,提高患者生活质量。     

椎体成形术辅助短节段椎弓钉内固定治疗胸腰段椎体爆裂骨折

目的　探讨预防胸腰段骨折术后出现继发性后凸畸形、避免椎弓钉断裂的手术方式。方法　对 2 0例胸腰段椎体不稳定爆裂骨折采取短节段椎弓钉固定结合钙磷骨水泥灌注椎体成形术。结果　本组术后 1周离床负重行走 ,3个月后腰背疼痛VAS评分平均减少 6分 ,术后X线摄片显示后凸Cobb角平均矫正 14° ,椎体高度丢失恢复 4 0 % ,随访 12个月后显示Cobb角只丢失0 4° ,椎体高度平均改变 0 15 % ,过伸过屈动力摄片显示固定段无异常活动 ,未发现有椎弓钉松动、断裂病例。结论　短节段椎弓钉固定结合钙磷骨水泥灌注椎体成形术可以使胸腰段爆裂骨折的稳定重建 ,提高手术疗效 ,避免术后内固定失败 ,预防继发后凸畸形。     

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压缩骨折

目的分析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压缩骨折的效果。方法对36例(38个椎体)老年骨质疏松性椎体压缩骨折患者实施单侧椎弓根穿刺椎体后凸成形术。观察术后患者的疼痛VAS评分、椎体前缘高度和Cobb角改善效果。结果 36例患者均顺利完成手术,仅1例(1个椎体)骨水泥渗漏至椎体侧方,但未出现神经损伤症状。术后腰部疼痛均显著缓解。平均随访12个月,患者VAS评分、椎体前缘高度及Cobb角均较术前显著改善,差异有统计学意义(P0.05)。结论单侧椎弓根穿刺椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折,可迅速缓解疼痛,并发症少,并能显著改善椎体前缘高度及Cobb角,疗效肯定。     

后路半椎体切除椎弓根钉内固定治疗先天性脊柱侧凸畸形的中期疗效分析

目的探讨后路半椎体切除椎弓根钉内固定治疗非嵌顿型半椎体导致的先天性脊柱侧凸畸形的矫形效果、安全性及并发症情况。方法回顾性分析自2010-01—2015-01采用后路半椎体切除椎弓根钉内固定治疗的16例先天性脊柱侧凸畸形。结果 16例均获得随访,随访时间平均55(39~76)个月。术后即刻主侧凸Cobb角、上代偿性侧凸Cobb角、下代偿性侧凸Cobb角、节段后凸Cobb角较术前明显改善,但末次随访时主侧凸Cobb角、下代偿性侧凸Cobb角、节段后凸Cobb角矫正度数较术后即刻出现丢失,差异有统计学意义(P0.05)。手术前后胸椎后凸Cobb角、腰椎前凸Cobb角比较差异无统计学意义(P0.05)。结论后路半椎体切除椎弓根钉内固定治疗先天性脊柱侧凸畸形安全有效,能直接去除致畸因素,获得牢靠的固定、良好的畸形矫正及脊柱平衡,而且手术时机越早,矫形效果越好。     

椎弓根钉固定及高压分步注射椎体成形术治疗老年胸腰椎爆裂骨折并神经损伤

目的探讨椎弓根螺钉内固定结合高压注射椎体成形术治疗老年胸腰椎爆裂性骨折并神经损伤的疗效。方法回顾分析椎弓根螺钉内固定结合经椎弓根高压分步注射骨水泥治疗老年胸腰椎爆裂性骨折并神经损伤患者22例,随访平均19月。术后观察骨折椎体前缘压缩率、椎管侵占率、Cobb角、神经功能改善情况及并发症。结果椎体前缘压缩率由术前的58.7%恢复为术后7.0%,后凸Cobb角由术前平均24.0°矫正至6.6°,椎管侵占率由术前52.6%恢复为术后11.8%,术后与术前比较差异均有统计学意义(P0.01)。VAS术前平均8.7分,术后2.2分。脊髓功能恢复按Frankel分级,除1例A级病例术后截瘫症状无明显恢复外,其他病例均达到1级或1级以上的恢复。有2椎体发生椎体外骨水泥渗漏,无肺栓塞、感染和神经损伤等并发症发生。未发现内固定松动、断裂现象。结论椎弓根螺钉内固定结合椎体成形术有利于同时解决胸腰椎骨折对神经的压迫、脊柱的不稳定及骨质疏松椎体压缩骨折造成的顽固性胸腰背疼痛等问题。高压分步注射可降低骨水泥渗漏的风险。     

直入式注入聚甲基丙烯酸甲酯骨水泥强化椎弓根钉内固定治疗骨质疏松性胸腰椎骨折

目的 探讨应用直入式注入聚甲基丙烯酸甲酯(PMMA)骨水泥强化椎弓根钉内固定治疗骨质疏松性胸腰椎骨折的疗效.方法 2009年1月至2010年2月应用直入式注入PMMA骨水泥强化椎弓根钉内固定治疗14例骨质疏松性胸腰椎骨折患者,男9例,女5例;年龄50～72岁,平均61岁.临床疗效采用视觉模拟(VAS)疼痛评分、Frankel分级方法进行评定,应用X线片评估术后内固定效果.结果 14例患者中13例术后获6～22个月(平均18.4个月)随访,1例失访.VAS评分由术前平均7.9分降至术后平均1.2分,7例合并有神经损伤的患者Frankel分级术后平均改善1.2级,58枚椎弓根钉中54枚行直入式注入PMMA骨水泥强化,术后所有患者均未出现与骨水泥渗漏相关的神经损伤症状和体征.X线片示椎弓根螺钉未发生松动及脱出,周围无透亮线出现.后凸角由术前平均21.8°改善至术后平均10.3°,末次随访后凸角平均为14.3°,平均后凸角矫正丢失40°.结论 应用直入式注入PMMA骨水泥强化椎弓根钉内固定治疗骨质疏松性胸腰椎骨折可获得满意的临床疗效.

Abstract：

Objective To explore clinical outcomes of direct injection of polymethylmethacrylate (PMMA) to augment pedicle screw fixation for osteoporotic thoracolumbar fractures. Methods From January 2009 to February 2010, 14 patients with osteoporotic thoracolumbar fracture underwent spinal decompression and instrumentation with PMMA augmentation of pedicle screw by direct injection. They were 9 men and 5 women, aged from SO to 72 years (average, 61 years). The clinical outcomes were evaluated by the visual analog scale (VAS) and the Frankel scale. Radiologic findings were documented to assess postoperative internal fixation. Results All but one of the patients obtained a mean follow-up of 18. 4 months (from 6 to 22 months). The mean VAS scores of the patients improved from 7. 9 to 1. 2 points (P < 0. 01). Postoperatively, Frankel grading for the 7 patients with neurologic deficit improved by 1. 2 grades. Totally 54 of the 58 screws were augmented with PMMA. There was neither neurologic deterioration nor symptomatic cement leakage after surgery. X-ray plain films revealed no screw loosening, pullout or bright lines around screws. On average,kyphotic deformity was improved from 21. 8° preoperatively to 10. 3° postoperatively (P <0. 01), and returned to 14. 3° at the final follow-up. The average loss of kyphosis correction was 4°. Conclusion Pedicle screw fixation after vertebral augmentation with PMMA by direct injection can gain a satisfactory clinical outcome for patients with osteoporotic thoracolumbar fracture.     

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.