Abstract
Purpose To evaluate the efficacy of percutaneous pedicle screw fixation technique combined
with three-step reduction in the treatment of thoracolumbar fracture.
Methods This is a retrospective study, based on medical records from the archives of the
Fifth People's Hospital of Fudan University, from January 2012 to January 2015. The
49 patients with thoracolumbar fracture were treated with percutaneous pedicle screw
fixation technique combined with three-step reduction. The treatment plan was determined
by the AO classification and the Thoracolumbar Injury Classification and Severity
classification. Baseline data included patient demographics, mechanism of injuries,
fracture level, and neurologic status. Kyphotic angle correction and vertebral body
height (VBH) restoration were used to assess radiologic outcome. Blood loss, operative
complications, hospital stay, and pain score on the visual analog scale (VAS) were
used to assess safety and clinical outcomes.
Result A total of 49 patients with 51 thoracolumbar burst fractures were treated with percutaneous
pedicle screw fixation technique combined with three-step reduction. There was significant
improvement in kyphotic angle correction (p < 0.05) and restoration of anterior vertebral height (p < 0.05) after each reduction procedure. These improvements remained statistically
significant at the latest follow-up for restoration of anterior VBH (p < 0.05) and kyphotic angle correction (p < 0.05). The preoperative VAS score was 8.2 ± 1.3, and the postoperative VAS score
(3 days after the operation) was 3.5 ± 0.7.
Conclusion Percutaneous pedicle screw internal fixation technique combined with three-step reduction
is a relatively safe and effective technique for treating selected thoracolumbar burst
fractures, and it yields satisfactory results.
Keywords
thoracolumbar fracture - percutaneous pedicle screw fixation - three-step reduction
