[Surgical treatment of thoracolumbar fractures using reduction and short-segment pedicle screw at the fracture level with the approach through para-vertebral muscles].
OBJECTIVE
To evaluate the efficacy and clinical outcome of reduction and pedicle screws fixation at the fracture level with the approach through para-vertebral muscles in treating thoraeolumbar fractures.


METHODS
From January 2007 to March 2010,27 patients with thoracolumbar fractures were treated with posterior open reduction and internal fixation with the approach through para-vertebral muscles. There were 19 males and 8 females with the mean age of 36.3 years old (ranged,21 to 57). According to Magerl type, type A2 was in 5 cases, A3 in 14, B1 in 3, B2 in 5. According to Frankel classification of spinal cord injury: grade D was in 6 cases and grade E in 21 cases. X-rays and CT scans were performed after operation. Cobb angle of the injured vertebral segment,the percentage of vertebral compression,and sagittal diameter stenosis rate of the injured spinal canal were observed by radiographic data. Neurological function was evaluated by the Frankel grade.


RESULTS
All patients were followed up from 12 to 28 months with an average of 19.6 months. The percentage of vertebral compression, Cobb angle of the injured vertebral segment, spinal canal sagittal diameter stenosis rate were respectively corrected from (46.6 +/- 10.5)%, (18.3 +/- 7.2) degrees, (30.2 +/- 7.2)% to postoperative (5.2 +/- 3.7)%, (5.3 +/- 5.1) degrees, (6.3 +/- 4.2)% and (6.7 +/- 4.6)%, (7.1 +/- 3.1), (7.2 +/- 4.5)% at last follow-up. There were significant difference in above items between preoperation and postoperation (P < 0.05); and there was no significant difference in above items between postoperation and last follow-up (P > 0.05). In aspect of nerve function, 3 cases with Frankel grade D recovered to grade E.


CONCLUSIONS
Using reduction and short-segment pedicle screws fixation at the fracture level through para-vertebral muscles approach is an effective method in treating thoracolumbar fractures. The method has advantages of simple operation,easy establishing screw, short operative time, less blood loss, which can obtain good reduction and stable, reliable fixation after operation.
Department of Orthopaedics, the Third Affiliated Hospital of Wenzhou Medical College, Rui'an 325200, Zhejiang, China. dongyilongdel@sina.com
Yi-Long
YL
Dong
Mao-Xiu
MX
Peng
Yi-Jiang
YJ
Huang
Li-Xing
LX
Lin
Cheng-Xuan
CX
Tang
Guo-Jing
GJ
Yang
D000328:Adult; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D016103:Spinal Fractures / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery