Analysis of the clinical effect of posterio decompression and reduction in hyperextension body position and internal fixation with pedicle of vertebral arch screw system on burst thoracolumbar fracture

Objective:To study the clinical effect of posterio decompression and reduction in hyperextension body position and internal fixation with pedicle of vertebral arch screw system on burst thoracolumbar fracture.Method:48 patients with burst thoracolumbar fracture were treated with posterio decompression and reduction in hyperextension body position and internal fixation with pedicle of vertebral arch screw system.The heights of anterior and posterior border and kyphosis Cobb's angle of compressed vertebral bodies were measured before and after surgery.All patients were followed up regularly and the state of neurofunctional recovery was evaluatd.Results:The heights of anterior border and kyphosis Cobb's angle of compressed vertebral bodies restored obviously after surgery(t=9.26,P0.01;t=7.35,P0.01) and the heights of posterior border presented no obvious change after surgery (t=8.32,P0.05). The average follow-up period was 25 months(7-36 months) and the value of loss of mean height of anterior border and kyphosis Cobb's angle of compressed vertebral bodies were 5% and 8%,respectively. The neurofunction of 5 patients(Frankel A grade) didn't recover,while improvement of neurofunction at least 1 Frankel grade was found in 21 patients(Frankel A-D grade).Break of screw occurred in one case and loose of screw occurred in another case and damage of neurofunction aggravated in one case due to excess drawing.Conclusion:The method of posterio decompression and reduction in hyperextension body position and internal fixation with pedicle of vertebral arch screw system is effective for burst thoracolumbar fracture.It provides satisfactory restoration of height of vertebral bodies and physiologic postural contour and it facilitates recovery of neurofunction.However,it is associated with troubles of break of screw and loose of screw and loss of height and kyphosis Cobb's angle of compressed vertebral bodies.