Pedicle screw instrumentation plus augmentation vertebroplasty using calcium sulfate for thoracolumbar burst fractures without neurologic deficits

Oct 20, 2011Orthopaedic surgery

Using pedicle screws and calcium sulfate bone filler to treat spine burst fractures without nerve damage

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Abstract

The mean postoperative back pain score was 2.1 ± 0.8, significantly improved from a preoperative score of 7.9 ± 1.1.

Postoperative Cobb angles and anterior-middle column height loss rates were significantly restored compared to preoperative measurements.
The angles and heights remained well maintained for at least two years following the procedure.
The average preoperative Oswestry Disability Index (ODI) score of 66.6 ± 8.1% decreased significantly to 15.5 ± 4.5% at the latest follow-up.
No cases of instrumentation failure were detected during the study.
Calcium sulfate used in the procedure was completely absorbed within 3-6 months postoperatively.

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OBJECTIVE: To evaluate the efficacy of posterior instrumentation plus vertebroplasty and posterolateral fusion using calcium sulfate for thoracolumbar burst fractures without neurologic deficits.

METHODS: Between July 2005 and January 2008, a total of 45 patients who had been diagnosed as having thoracolumbar burst fractures without neurologic deficits were treated with pedicle screw instrumentation plus vertebroplasty using calcium sulfate in our unit. The Cobb angles and loss rates of anterior-middle columns height at different time intervals were measured on lateral radiographs, and the preoperative and postoperative functional outcomes were evaluated using the Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI).

RESULTS: The Cobb angles and loss rates of anterior-middle columns height postoperatively period were restored significantly compared with those noted preoperatively. The angles and heights were well maintained for at least two years using this technique. The mean postoperative VAS (back pain) score was 2.1 ± 0.8, which was significantly better (P < 0.001) than the mean preoperative VAS score 7.9 ± 1.1. The average preoperative ODI was 66.6 ± 8.1% and this had improved significantly to 15.5 ± 4.5% by the latest follow-up (P < 0.001). No instrumentation failure was detected in this study. The calcium sulfate had been absorbed completely by 3-6 months postoperatively.

CONCLUSION: Pedicle screw instrumentation plus augmentation vertebroplasty with calcium sulfate is an economic, efficient and reliable technique for treating unstable thoracolumbar fractures without neurologic deficits.

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Pedicle screw instrumentation plus augmentation vertebroplasty using calcium sulfate for thoracolumbar burst fractures without neurologic deficits

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