Clinical effect of a new type of transpedicular reducer for fracture reduction via pedicle and bone grafting combined with pedicle screw fixation for thoracolumbar burst fractures

Abstract

Background: Short-segment transpedicular screw fixation is a common method for the treatment of thoracolumbar burst fractures (TBFs),but this technique has many problems.Therefore,the purpose of this article is to observe and evaluate the clinical efficacy of a new type of transpedicular reducer that we designed for fractured vertebral body reduction and bone grafting in the treatment of TBFs.Methods:From July 2018 to November 2020, 70 cases of TBFs were included. 35 cases were treated with the new transpedicular reducer for fracture reduction via pedicle and bone grafting combined with pedicle screw fixation (observation group), 35 cases were treated with short-segment transpedicular screw fixation (control group).Before operation, after application of the transpedicular reducer(not needed in the control group),3 days after operation, 3 months after operation, 6 months after operation, and 12 months after operation, the two groups were recorded and compared respectively: the anterior and middle heights of the injured vertebrae, the ratios of the anterior and middle heights of the injured vertebral body to the respective heights of the adjacent uninjured vertebral bodies (AVBHr and MVBHr, respectively), and the Cobb angle of patients.And we compared the pain VAS score and quality of life GQOL-74 score at the last follow-up.At last,we evaluated the distribution of bone grafts and bone healing 12 months after the operation.Results:All 70 cases were followed up for at least 12 months.The observation group's anterior and middle heights of the injured vertebral, AVBHr and MVBHr were higher than those of the control group at 3 days,3 months,6 months and 12 months after operation, the cobb angle was smaller than that in control group, the pain VAS score and the quality of life GQOL-74 score at the last follow-up were better than those of the control group, and these difference were statistically significant (P <0.05). The observation group showed no obvious defects on CT at 12 months after operation, and the bone healing was good. Conclusion: The new type of transpedicular reducer for fracture reduction via pedicle and bone grafting combined with pedicle screw fixation for TBFs has a good clinical efficacy.