Department of Orthopedics, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou, China; Department of Graduate School, Dalian Medical University, Dalian, China.
Department of Orthopedics, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou, China.
World Neurosurg. 2021 Dec;156:e130-e138. doi: 10.1016/j.wneu.2021.09.008. Epub 2021 Sep 8.
The ideal management of thoracolumbar burst fracture (TLBF) remains controversial. We conducted this study to compare the effectiveness and safety of trans-Kambin triangle versus transpedicular bone grafting combined with posterior internal fixation (PIF) for TLBF.
Fifty-four patients were retrospectively analyzed and divided into 2 groups: the observation group (PIF combined with bone grafting via the Kambin triangle, n = 28) and the control group (PIF combined with bone grafting via transpedicular, n = 26). The anterior vertebral height ratio, sagittal Cobb angle, visual analog scale score, Oswestry Disability Index, bone healing rate, and neurologic complications were measured.
All patients were followed up regularly for a mean period of 17.94 months (12 - 24 months). The anterior vertebral height ratio in the observation group was higher than that in the control group (93.93 ± 2.92 vs. 89.90 ± 5.54%, P = 0.006), and the loss of correction was lower (1.59 ± 1.20 vs. 3.00 ± 1.98%, P = 0.008). The observation group had lower sagittal Cobb angle at final follow-up (8.68 ± 3.75 vs. 11.33 ± 4.77 degrees, P = 0.046) and less correction loss (1.96 ± 1.32 ± 1.15 vs. 3.90 ± 2.39 degrees, P = 0.002). The visual analog scale score and Oswestry Disability Index in the observation group were lower (0.61 ± 0.43 vs. 0.92 ± 0.38, P = 0.016; 15.86 ± 4.11 vs. 19.18 ± 4.04, P = 0.010), while the fracture healing rate showed no significant difference (P > 0.05). No internal fixation failure or neurologic complications occurred in both groups during the follow-up.
Bone grafting via the Kambin triangle combined with PIF is a safe and effective technology for thoracolumbar burst fracture.
胸腰椎爆裂骨折（TLBF）的理想治疗方法仍存在争议。本研究旨在比较经 Kambin 三角与经皮椎弓根骨移植联合后路内固定（PIF）治疗 TLBF 的效果和安全性。
回顾性分析 54 例患者，分为观察组（PIF 联合 Kambin 三角植骨，n=28）和对照组（PIF 联合经皮椎弓根植骨，n=26）。测量两组患者的伤椎前缘高度比、矢状 Cobb 角、视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）、骨愈合率和神经并发症。
所有患者均获定期随访，平均随访时间 17.94 个月（12~24 个月）。观察组患者伤椎前缘高度比高于对照组（93.93±2.92%比 89.90±5.54%，P=0.006），校正丢失率更低（1.59±1.20%比 3.00±1.98%，P=0.008）。观察组末次随访时矢状 Cobb 角更小（8.68±3.75°比 11.33±4.77°，P=0.046），校正丢失更少（1.96±1.32°比 3.90±2.39°，P=0.002）。观察组患者的 VAS 评分和 ODI 均更低（0.61±0.43 比 0.92±0.38，P=0.016；15.86±4.11 比 19.18±4.04，P=0.010），而骨折愈合率无显著差异（P>0.05）。两组患者随访期间均未发生内固定失败或神经并发症。
经 Kambin 三角植骨联合 PIF 治疗胸腰椎爆裂骨折安全有效。
