title: [Short-segment fixation of thoracolumbar burst fractures using pedicle fixation at the level of fracture in patients with osteoporosis].
abstract: OBJECTIVE
  To evaluate the curative effect of short-segment transpedicular fixation plus vertebra fracture fixation for thoracolumbar burst fractures in patients with osteoporosis.
  
  
  METHODS
  The clinical data of thoracolumbar burst fractures in 46 patients with osteoporosis, single segment fracture and neurological intactness were analyzed retrospectively from January 2008 to January 2012. There were 20 males and 26 females with a mean age of 64.5 (56-78) years. The mechanisms of injury were fall (n = 20), traffic accident (n = 12), high falling injury (n = 8) and heavy pound injury (n = 4). The involved vertebrae included T11 (n = 5); T12 (n = 17); L1 (n = 21); L2 (n = 3). Pedicle screw was inserted into injured vertebra and the height of collapsed vertebra fractures reduced with position and instrument. Visual analogue scale (VAS) and short form-36 scoring systems were used to evaluate pain level and quality of life. The height restoration and kyphotic correction rates of fracture level were measured radiologically.
  
  
  RESULTS
  All patients underwent surgery safely without severe complications. The average follow-up period was 20.5 (9-48) months. There was significant difference (t = 20.057, P = 0.000; t = 24.287, P = 0.000) in VAS score between last follow-up (3.09 ± 1.01) and post-operation (2.35 ± 1.02) versus pre-operation (7.22 ± 1.05) respectively. And also there was significant difference (P < 0.05) in SF-36 score between last follow-up (126.5 ± 22.3) and post-operation (96.7 ± 17.5). The Cobb angle was corrected to (5.6 ± 1.9)° of post-operation and (7.8 ± 3.3)° of last follow-up. The loss rate of vertebral was (4.8 ± 5.2)% of post-operation and (7.6 ± 2.9) % of last follow-up. There was no loosening or breakage of internal fixations.
  
  
  CONCLUSIONS
  The approach of short-segment transpedicular fixation plus vertebra fracture fixation is both safe and effective to maintain reduction and reduce the rate of correction loss and instrument failure.
authors.affiliation: Department of Orthopedics, First People's Hospital, Shanghai Jiao Tong University, Shanghai 200080, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Liu
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.forename: Ji-wei
authors.initials: JW
authors.lastname: Tian
mesh_terms: D000368:Aged; D001863:Bone Screws; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000293:injuries; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications* / Q000601:surgery; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000209:etiology* / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries; D016896:Treatment Outcome