[Minimal invasive internal fixation with U-shaped break-off pedicle screws for treatent of thoracolumbar fractures].

OBJECTIVE

To investigate the clinical outcome of minimal invasive internal fixation with U-shaped break-off pedicle screws through paraspinal muscle sparing approach to treat thoracolumbar fractures, and to discuss its advantages.

METHODS

From August 2010 to June 2012, we had 40 thoracolumber fractures patients (27 males and 13 females). Their ages ranged from 22 to 60 years. Of the 40 cases, 4 were T11 fractures, 13 T12 fractures ,17 L1 fractures,6 L2 fractures. According to Denis classification,all of them were burst fractures, with vertebral canal compromise less than 1/3. According to AO classification they were type A or type B1 injuries. All the cases had no nerve injury. The patients were randomly divided into two groups. With Group A (20 cases) we took the method of minimal invasive internal fixation with U-shaped break-off pedicle screws to fix one level above and below the injured vertebra through the parespinal muscle sparing approach. With Group B (20 cases), we took the traditional posterior midline approach and open procedure. Then we compared the two groups by operation time, blood loss, drainage, Visual Analogue Scales and X-ray exposure.

RESULTS

Minimal invasive group had obvious advatages in operation time, bleeding control and early pain relief of post-operation. The X-ray exposure and long-term follow-up outcome were almost the same.

CONCLUSION

Through paraspinal muscle sparing approach minimal invasive internal fixtation with U-shaped break-off pedicle screws to treat thoracolumber has more advantages than traditional procedure in blood control and quick recovery. The method needs no special instruments and don't increase X-ray exposure.