title: Posterior indirect reduction and pedicle screw fixation without laminectomy for Denis type B thoracolumbar burst fractures with incomplete neurologic deficit.
abstract: OBJECTIVE
  The aim of this study is to evaluate the efficacy of posterior indirect reduction and pedicle screw fixation without laminectomy for the treatment of Denis type B thoracolumbar burst fractures with incomplete neurologic deficit.
  
  
  METHODS
  From March 2008 to May 2012, 36 consecutive patients of Denis type B thoracolumbar burst with incomplete neurologic deficit were enrolled. All of the patients accepted the treatments of posterior indirect reduction and pedicle screw fixation without laminectomy. Clinical and radiologic outcomes were assessed preoperatively and postoperatively.
  
  
  RESULTS
  Operations were performed in a relatively short time without massive hemorrhage. Their neurologic functions were improved by at least one Frankel grade. The average score of American Spinal Injury Association (ASIA) motor increased from 25.4 ± 10.8 to 42.1 ± 10.5, and the recovery rate of the ASIA score was also increased. The pain level was relieved for all the patients. The local kyphosis angle was reduced from 25.9° ± 3.4° to 6.9° ± 2.2° (P <0.05) and remained 7.9° ± 2.0° (P > 0.05) at the latest follow-up. After the operation, the mean vertebral canal diameter increased from 5.5 ± 1.3 to 11.1 ± 2.2 mm (P < 0.05) and the mean canal stenosis index increased from 32.9 ± 7.8 to 84.8 ± 7.3% (P < 0.05). There were no serious complications and fixation failures during follow-up.
  
  
  CONCLUSIONS
  Denis type B thoracolumbar burst fractures with incomplete neurologic deficit can be effectively treated by posterior indirect reduction and pedicle screw fixation without laminectomy.
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China.
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China.
authors.forename: Guangdong
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China.
authors.forename: Jiajia
authors.initials: J
authors.lastname: Sun
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China.
authors.forename: Genlin
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China.
authors.forename: Huilin
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China. zongping_luo@yahoo.com.
authors.forename: Zongping
authors.initials: Z
authors.lastname: Luo
authors.affiliation: Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215006, China. jzou@suda.edu.cn.
authors.forename: Jun
authors.initials: J
authors.lastname: Zou
mesh_terms: D000328:Adult; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D065289:Pedicle Screws; D013119:Spinal Cord Injuries / Q000209:etiology / Q000601:surgery*; D016103:Spinal Fractures / Q000150:complications / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries* / Q000601:surgery; D055815:Young Adult