[Treatment for thoracolumbar spinal burst fracture in youth and middle-aged adults by bone cement filling].
OBJECTIVE
To verify whether the procedure of posterior instrumentation and vertebroplasty for treatment of thoracolumbar burst fracture in youth and middle-aged patients is safe, practical and effective in short- and long-term.


METHODS
A total of 50 patients aged 30-55 years old who suffered from thoracolumbar burst fracture complicated with incomplete paralysis or without neurologic symptom received surgery by using pedicle-screw implantation, reduction and bone cement filling through the unilateral or bilateral pedicles. The bone cement injection was conducted slowly and cautiously under monitor of fluoroscopy. Spinal canal exploration or decompression was performed regularly in follow-ups by X-ray films and CT scans.


RESULTS
Cement leakage occurred in 5 cases without relevant symptom, including 1 case with leak from anterior aspect, 2 cases from lateral aspect, and 2 cases through ruptured end-plate into disc space. No spinal canal leakage or introvascular leakage was detected. The following-up duration was 5 to 10 years. There was no vertebral body height loss and regional kyphosis. The gaps within fractured vertebral body prior to surgery were disappeared completely. There was also no cement-bone interface detected. In 15 out of 50 cases, there were newly-formed bone bridges between fractured vertebral body and upper or lower adjacent vertebral body. There was no hardware failure occurred up to final follow-up.


CONCLUSIONS
Bone cement filling combined with posterior instrumentation through pedicle-screw technique is a safe, practical and effective method for treatment of non-osteoporotic thoracolumbar spinal burst fractures without severe neurologic injury. The gaps among fracture fragments can be filled evenly and completely. Therefore, instant and permanent spinal stability can be achieved with excellent long-term result.
Operation Room of Minimally Invasive Center, Second Xiangya Hospital, Central South University, Changsha 410011, China.
Jing
J
Xiao
Department of Spine Surgery,  Second Xiangya Hospital, Central South University, Changsha 410011, China.
Xiaobin
X
Wang
Department of Spine Surgery,  Second Xiangya Hospital, Central South University, Changsha 410011, China.
Xiaoju
X
Tan
D000328:Adult; D001843:Bone Cements; D001860:Bone Plates; D019299:Decompression, Surgical; D050723:Fractures, Bone; D006801:Humans; D007738:Kyphosis; D008875:Middle Aged; D016103:Spinal Fractures; D014057:Tomography, X-Ray Computed; D054854:Vertebroplasty
D001843:Bone Cements