摘要
Objective:To evaluate the efficacy and significance of posterolateral fusion in preventing failure of short-segment stabilization for the treatment of thoracolumbar burst fractures. Methods:Sixty patients with thoracolumbar burst fractures were included in the study. The patients were classified into two groups (n =30 in each group). In Group A, patients were treated in our hospital with short-segment instrumentation via posterolateral fusion with iliac bone. In Group B, patients were treated in other hospital with short-segment fixation without fusion. All cases came to our hospital for reexamination. There were 18 males and 12 females in Group A with a mean age of 42.3 years (range, 24 to 52 years) and 16 males and 14 females in Group B with a mean age of 41.5 years (range, 19 to 54 years). Radiographic (Cobb angle, kyphosis of the vertebral body, and sagittal index) and clinical outcomes (Low Back Outcome Score) were analyzed after an average follow-up of 16 months. Results:After operation, Cobb angle was reduced from 19.3°to 3.1°in Group A and from 19. 1°to 3. 3°in Group B (P>0.05).It was 5.9°in Group A and 11. 9°in Group B at the final follow-up (P < 0.01). Its average loss of correction was 2. 8°in Group A and 8. 6°in Group B. Average kyphosis of the vertebral body was reduced from 21.3°to 6.2°in Group A and from 21.7°to 7.4°in Group B (P > 0.05). It was decreased to 7.9°in Group A and 13.5°in Group B at the final follow-up (P < 0. 01). Its average loss of correction was 1.7°in Group A and 6.1°in Group B. Sagittal index was reduced from 21.3°to 3.6°in Group A and from 20. 5°to 3. 8°in Group B (P < 0.05). It was decreased to 5. 1°in Group A and 9. 8°in Group B at the final follow-up (P < 0. 01). Its average loss was 1.5°in Group A and 6.0°in Group B. In Group A, 73.3% of patients had an excellent result based on Low Back Outcome Score system, while that in Group B was only 43.3%. Conclusions:Posterolateral fusion is an effective measure to prevent implant failure, and decrease loss of correction, posttraumatic kyphosis and neurogical deficit during the treatment of thoracolumbar burst fractures. Short-segment fixation of thoracolumbar burst fractures without fusion obviously increases failure rate and it is not an optional procedure.
