Surgical treatment of thoracic and lumbar spine fractures using transpedicular vertebroplasty and fixation

Abstract

Objective. To analyze treatment results in patients with fractures of thoracic and lumbar vertebal bodies after transpedicular vertebroplasty and fixation through minimally invasive percutaneous and open approaches. Material and Methods. A total of 154 patients with uncomplicated type A2, A3 fractures of the thoracic and lumbar vertebral bodies were operated on. All patients were examined with X-ray densitometry, spondylog- raphy, and CT. Group 1 included 53 patients who underwent vertebroplasty with deproteinized bone graft and percutaneous transpedicular fix- ation. Patients of Group 2 (n = 41), Group 3 (n = 43) and Group 4 (n = 17) underwent open transpedicular fixation and vertebroplasty with deproteinized bone graft (Group 2) and titanium nikilide granules (Groups 3 and 4). Results. Intraoperative blood loss during open vertebro- plasty combined with short-segment transpedicular fixation exceeded that during percutaneous vertebroplasty. Parameters of kyphotic defor- mity, the wedge index and the loss of correction did not differ significantly except for Group 4. Significant improvement in ODI and VAS scores was noted after percutaneous vertebroplasty as compared with control groups. Conclusion. Transpedicular verteboplasty and transpedicular fixation, both open and percutaneous, performed for the treatment of type A2 and A3 spinal fractures provide reliable stabilization of the injured spinal segments, allow vertebral body height restoration to a greater extent and correction of the kyphotic deformity.

Keywords

• spinal fractures
• transpedicular fixation
• percutaneous vertebroplasty
• open transpedicular vertebroplasty