A Retrospective Study of Thoracolumbar Fractures Treated with Fixation and Nonfusion Surgery of Intravertebral Bone Graft Assisted with Balloon Kyphoplasty.
BACKGROUND
Posterior fixation and fusion is the primary treatment for thoracolumbar fractures, although this treatment may sacrifice range of motion (ROM) to achieve stability, rather than treating the fracture itself. Two issues addressed when treating thoracolumbar fractures are 1) replacing the fractured vertebrae, especially the upper end plate of the injured vertebrae and 2) providing strong fixation with biomechanical stability and flexibility.


METHODS
This retrospective study included 61 consecutive patients with thoracic or lumbar fractures treated from October 2010 to May 2014. Patients were divided into 1 of 2 groups: group A, intravertebral bone graft with balloon kyphoplasty (nonfusion surgery), and group B, traditional posterior fixation and fusion surgery. The visual analog scale was used preoperatively and at 3 months, 1 year, and 2 years. Radiography, computed tomography, and magnetic resonance imaging were performed preoperatively. Radiography was performed postoperatively at 3 months and 2 years. At 3 months after surgery, computed tomography was used to confirm healing of the vertebral fracture.


RESULTS
All fractures in both groups were reduced successfully, and deformities were improved. After the removal of hardware in group A, ROM at the injury level recovered, and at 2 years, there was no loss of vertebral height or recurrence of deformity. There was no hardware failure in group A, but there was evidence of screw loosening in 3 screws in group B.


CONCLUSIONS
Nonfusion treatment of intravertebral bone graft assisted with balloon kyphoplasty showed good fracture reduction, deformity correction, fracture healing, and ROM maintenance. There were no complications associated with the implant.
['Zhang|Chengmin|C|', 'Ouyang|Bin|B|', 'Li|Pei|P|', 'Wang|Liyuan|L|', 'Luo|Lei|L|', 'Zhao|Chen|C|', 'Liu|Liehua|L|', 'Tu|Bing|B|', 'Hou|Tianyong|T|', 'Arnold|Paul|P|', 'Zhou|Qiang|Q|']
D001863:Bone Screws D016025:Bone Transplantation D005260:Female D005500:Follow-Up Studies D005593:Fracture Fixation, Internal D006801:Humans D058498:Kyphoplasty D008159:Lumbar Vertebrae D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D011859:Radiography D016059:Range of Motion, Articular D012189:Retrospective Studies D016103:Spinal Fractures D013123:Spinal Fusion D013904:Thoracic Vertebrae D014057:Tomography, X-Ray Computed
Thoracolumbar Fracture Nonfusion surgery Intravertebral bone graft Kyphoplasty