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| Treatment of severe thoracolumbar burst fractures with modified anterior and posterior combined operation |
| Xiang Qiang, Tian Jun, Chen Xiang-yu, Wang Wei, Tian Zhu, Ren Hong, Liu Ming-hua |
| Emergency department, the First Affiliated Hospital of Army Medical University, Chongging 400038, China |
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Abstract Objective In view of the existing problems and shortcomings in the operation of severe thoracolumbar burst fracture, a new simple, safe and minimally invasive method was developed for the surgical treatment of thoracolumbar burst fracture. Methods From January 2015 to December 2017, 18 cases of severe thoracolumbar burst fractures were treated with posterior percutaneous pedicle screw implantation combined with anterior small incision for artificial vertebral body implantation(Modified operation group). Compared with 15 patients who underwent traditional combined surgery (traditional operation group) in the same period. Results Compared with traditional operation group, the modified operation group showed less operative time［(2.9±0.7) h vs.(4.1±1.2) h］, less blood loss during surgery［(340.0±162.6) mL vs.(562.0±190.6) mL］, shorter incision ［(10.9±1.2) cm vs.(24.8±6.7) cm］, less amount of drainage ［(168.5±49.6) mL vs.(512.0±184.2) mL, and shorter hospitalization time ［(9.1±3.5) day vs.(15.8±3.4) day］. All showed significant differences between two groups(P<0.01). There were no postoperative complications in both groups. The two groups were followed up for 9～27 months with an average of 18.2 months without any failure of internal fixation. Among them, there was no significant difference in intervertebral fusion rate, spinal sequence, spinal canal volume recovery and ASIA nerve function recovery in patients with incomplete paralysis. Conclusion The posterior percutaneous pedicle screw implantation combined with anterior small incision for artificial vertebral body implantationis a feasible and effective method for the treatment of severe thoracolumbar burst fractures. It has the advantages of small trauma, less bleeding and easy operation.
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Corresponding Authors:
Liu Ming-hua, E-mail: mhliu4cq@aliyun.com
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