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

BackgroundShort-segment transpedicular screw fixation is a common method for the treatment of thoracolumbar burst fractures (TBFs). When it is used, the anterior middle columns of the fractured vertebral body lack good support, resulting in fractured vertebral bodies decreased height and difficult to reduct.Therefore,the purpose of this study was to evaluate the clinical effect of a new type of transpedicular reducer that we designed for fractured vertebral body reduction and bone grafting in the treatment of TBFs.MethodsA total of 9 patients with TBFs who agreed to be treated with the new transpedicular reducer for fracture reduction via pedicle and bone grafting combined with pedicle screw fixation were retrospectively analysed. We measured the anterior and middlel heights of the injured vertebrae, the ratios of the anterior and middlel 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 at different stages before and after surgery, and evaluated the distribution of bone grafts and bone healing 3 days and 12 months after the operation.ResultsThe anterior height of the injured vertebrae before the operation; after application of the transpedicular reducer; and 3 days, 3 months, 6 months and 12 months after the operation were 17.56±3.74 mm; 27.70±2.53 mm; and 29.08±2.52 mm, 28.36±1.93 mm, 28.12±1.42 mm, and 27.96±0.72 mm, respectively. The mid-heights of the injured vertebrae were 21.36±4.20 mm; 26.74±1.00 mm; and 27.70±2.01 mm, 27.05±2.45 mm, 26.94±1.84 mm, and 26.83 ±2.45 mm, respectively. The Cobb angles of the injured vertebrae were 3.80±1.44°; 1.26±1.00°; and 0.72±0.70°, 1.03±0.65°, 1.12±0.63°, and 1.34±0.56°, respectively. The allogeneic bones were distributed in the anterior and middle columns 3 days after the operation, and the bone had healed well 12 months after the operation.ConclusionThe new transpedicular reducer has a good reduction, allogeneic bone support, and clinical treatment effect for TBFs through pedicle fracture reduction and bone grafting combined with pedicle screw fixation.