Pedicle screw instrumentation plus augmentation vertebroplasty using calcium sulfate for thoracolumbar burst fractures without neurologic deficits.
OBJECTIVE
To evaluate the efficacy of posterior instrumentation plus vertebroplasty and posterolateral fusion using calcium sulfate for thoracolumbar burst fractures without neurologic deficits.


METHODS
Between July 2005 and January 2008, a total of 45 patients who had been diagnosed as having thoracolumbar burst fractures without neurologic deficits were treated with pedicle screw instrumentation plus vertebroplasty using calcium sulfate in our unit. The Cobb angles and loss rates of anterior-middle columns height at different time intervals were measured on lateral radiographs, and the preoperative and postoperative functional outcomes were evaluated using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI).


RESULTS
The Cobb angles and loss rates of anterior-middle columns height postoperatively period were restored significantly compared with those noted preoperatively. The angles and heights were well maintained for at least two years using this technique. The mean postoperative VAS (back pain) score was 2.1 ± 0.8, which was significantly better (P < 0.001) than the mean preoperative VAS score 7.9 ± 1.1. The average preoperative ODI was 66.6 ± 8.1% and this had improved significantly to 15.5 ± 4.5% by the latest follow-up (P < 0.001). No instrumentation failure was detected in this study. The calcium sulfate had been absorbed completely by 3-6 months postoperatively.


CONCLUSIONS
Pedicle screw instrumentation plus augmentation vertebroplasty with calcium sulfate is an economic, efficient and reliable technique for treating unstable thoracolumbar fractures without neurologic deficits.
Department of Orthopaedics and Spinal Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China. soochowspine@yahoo.cn
Yi-xin
YX
Shen
Peng
P
Zhang
Jia-guo
JG
Zhao
Wei
W
Xu
Zhi-hai
ZH
Fan
Zheng-feng
ZF
Lu
Liu-bing
LB
Li
D000328:Adult; D001843:Bone Cements / Q000627:therapeutic use; D001863:Bone Screws; D002133:Calcium Sulfate / Q000627:therapeutic use; D004185:Disability Evaluation; D005240:Feasibility Studies; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D054854:Vertebroplasty / Q000379:methods*
D001843:Bone Cements; D002133:Calcium Sulfate