• Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi · Oct 2013

    [Treatment of thoracolumbar kyphosis caused by old fracture using pedical screw at the fracture level, intervertebral distraction, and Cage insertion by posterior approach].

    • Song Fu, Shize Shao, Xiuchen Sun, Haitao Hou, Haijun Liu, Longqiang Wang, Huan Wang, Xiangpeng Huang, and Renhua Lü.
    • Department of Spine and Spinal Cord, Wendeng Orthopeadic Hospital, Wendeng Shandong, 264400, PR China.
    • Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2013 Oct 1; 27 (10): 1221-4.

    ObjectiveTo 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.MethodsBetween 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.ResultsThe 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.ConclusionUsing 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.

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