title: [Treatment of thoracolumbar kyphosis caused by old fracture using pedical screw at the fracture level, intervertebral distraction, and Cage insertion by posterior approach].
abstract: OBJECTIVE
  To evaluate the effectiveness of using pedical screw at the fracture level, intervertebral distraction, and Cage insertion by posterior approach to treat thoracolumbar kyphosis caused by old fracture.
  
  
  METHODS
  Between June 2008 and June 2010, 15 cases of thoracolumbar kyphosis caused by old fracture were treated with pedical screw at the fracture level, intervertebral distraction, and Cage insertion by posterior approach. There were 9 males and 6 females with a mean age of 54.6 years (range, 39-65 years). The disease duration was 5 months to 3 years with an average of 1.5 years. Fractured segments included T11 in 1 case, T12 in 4 cases, L1 in 5 cases, and L2 in 5 cases. Ten patients had nerve symptom, according to American Spinal Injury Association (ASIA) grading, 3 cases were classified as grade B, 4 cases as grade C, and 3 cases as grade D, of which 3 cases had sexual and sphincter dysfunction. At preoperation, the Cobb angle was (47.4 +/- 10.2) degrees; the Oswestry disability index (ODI) score was 67.9% +/- 6.9%; and the visual analogue scale (VSA) was 8.6 +/- 1.4.
  
  
  RESULTS
  The wounds obtained primary healing. The mean follow-up time was 28 months (range, 13-60 months). X-ray films showed intervertebral bone fusion was obtained within 6-11 months (mean, 10.2 months). No fixation loosening or breaking occurred during follow-up. Kyphosis was corrected, and lumbar back pain was relieved. At 1 year after operation, Cobb angle was significantly corrected to (13.3 +/- 7.7) degrees (t = 72.80, P = 0.00); ODI score was significantly improved to 25.2% +/- 4.6% (t = 48.04, P = 0.00); VAS score was significantly decreased to 2.3 +/- 0.6 (t = 26.52, P = 0.00). According to ASIA grading in 10 patients with spinal cord injury, the spinal cord function was improved by 1 grade in 8 cases (3 cases from grade B to C, 3 cases from grade C to D, and 2 cases from grade D to E); 3 patients with sexual and sphincter dysfunction recovered in different degrees.
  
  
  CONCLUSIONS
  Using pedical screw at the fracture level, intervertebral distraction, and Cage insertion by posterior approach is an effective method to treat thoracolumbar kyphosis caused by old fracture.
authors.affiliation: Department of Spine and Spinal Cord, Wendeng Orthopeadic Hospital, Wendeng Shandong, 264400, PR China.
authors.forename: Song
authors.initials: S
authors.lastname: Fu
authors.affiliation: Department of Spine and Spinal Cord, Wendeng Orthopeadic Hospital, Wendeng Shandong, 264400, PR China.
authors.forename: Shize
authors.initials: S
authors.lastname: Shao
authors.affiliation: Department of Spine and Spinal Cord, Wendeng Orthopeadic Hospital, Wendeng Shandong, 264400, PR China.
authors.forename: Xiuchen
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Spine and Spinal Cord, Wendeng Orthopeadic Hospital, Wendeng Shandong, 264400, PR China.
authors.forename: Haitao
authors.initials: H
authors.lastname: Hou
authors.affiliation: Department of Spine and Spinal Cord, Wendeng Orthopeadic Hospital, Wendeng Shandong, 264400, PR China.
authors.forename: Haijun
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Spine and Spinal Cord, Wendeng Orthopeadic Hospital, Wendeng Shandong, 264400, PR China.
authors.forename: Longqiang
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Spine and Spinal Cord, Wendeng Orthopeadic Hospital, Wendeng Shandong, 264400, PR China.
authors.forename: Huan
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Spine and Spinal Cord, Wendeng Orthopeadic Hospital, Wendeng Shandong, 264400, PR China.
authors.forename: Xiangpeng
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Neurology, Wendeng Central Hospital of Weihai, PR China.
authors.forename: Renhua
authors.initials: R
authors.lastname: Lü
mesh_terms: D000328:Adult; D000368:Aged; D001416:Back Pain / Q000209:etiology / Q000601:surgery; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods; D010147:Pain Measurement; D011859:Radiography; D020127:Recovery of Function; D013116:Spinal Cord / Q000503:physiopathology / Q000601:surgery; D016103:Spinal Fractures / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D016896:Treatment Outcome