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2012 2 4 1 Chin J Clin Basic Orthop Res, Feb 2012 Vol.4, No.

11


2004 7 2007 7
186
100 86
2430 28.4
2438 28.0 18
38.2 16.1%
2.4 1.7%3.7 1.6%3
P 0.05 18 37.3 13.8%
9.8
5.3%18.4 8.7%3 P 0.05
P 0.05 18
P 0.05 18
2 CT
4

R683.2
R687.34

1674-666X(2012)01-0011-07

A comparative study on the treatment of thoracolumbar fractures between transpedicular


intracorporeal grafting and transposterolateral grafting
SUN Lishan, FENG Yanhong, WANG Liguo, PENG Ningning. The First Department of Orthopaedics,
Cangzhou Central Hospital, Hebei 061001, China
Abstract Objective To compare the clinical effects of two methods of transpedicular intracorporeal
grafting and transposterolateral grafting in the treatment of thoracolumbar fractures with pedicle screw fixation

DOI10.3969/j.issn.1674-666X.2012.01.002
061001
E-mail
15903175126@139.com

12

2012 2 4 1 Chin J Clin Basic Orthop Res, Feb 2012, Vol.4, No.1

system. Methods From July 2004 to July 2007, 186 patients of thoracolumbar fractures were underwent open
reduction and pedicle screw fixation at Cangzhou Central Hospital. Among them, 100 patients treated with
transpedicular intracorporeal grafting (A group), and 86 treated with transposterolateral grafting (B group). The
vertebral compression rate, the improvement of clinical symptoms and postoperative complications were
compared between two groups. Results In A group, patients were followed up from 24 to 30 months, with the
average of 28.4 months; in B group, patients were followed up from 24 to 38 months with the average of 28.0
months. The vertebral compression rate at preoperation, postoperation and 18 months after operation was (38.2
16.1)% , (2.4 1.7)% , and (3.7 1.6)% respectively in A group, the differences among them had statistical
significance (P 0.05); the vertebral compression rate at preoperation, postoperation and 18 months after
operation was (37.3 13.8)%, (9. 8 5.3)% and (18.4 8.7)% respectively in B group, the differences among
them had statistical significance (P 0.05). Between A and B groups, the preoperative vertebral compression rate
was similar (P 0.05), while the vertebral compression rate at postoperation as well as 18 months after the
surgery in A group were lower than those in B group (P 0.05). During the follow-up, all patients who had
neurological symptoms before the surgery got relieved obviously. At 18 months after the surgery, there was no
screw or rod broken, and no fixation loosening in A group, while in B group, there had internal fixation broken
in 2 cases. At the same time, CT scan results showed that intracorporeal graft had stuffed completely, and not
been absorbed in A group, with 4 cases of pedicular broken and thicken but none of them had obvious radicular
symptoms; In B group, we could see vertebral cavity in all patients. Conclusion For thoracolumbar fractures,
transpedicular intracoporeal grafting based on pedicle fixation can get ideal clinical effects because it can restore
vertebral height instantly and maintain the height during a long term, and it also can decrease the incidence of
complications such as internal fixation loosening or rupture.
Key words Spinal fractures; Thoracic vertebrae; Lumbar vertebrae; Bone transplantation; Fracture
fixation, internal

100

[1-2]

86

[3]

1.1

1
2

atlas fixationAF

[4]

[5]

33 d

186

2004 7 2007 7

1 100 54

2012 2 4 1 Chin J Clin Basic Orthop Res, Feb 2012 Vol.4, No.1

46 1748 31.3 8.2

13

2430 28.4
2

86 50 36 18

50 31.1 7.9

46 36

2438 28.0 1

1.4
X

P 0.05
1.2

18 H1H2a

H2b

CT

HA HB[H=HA +

HB/2] [ = (H H1) / H

1.3

100%][ 1= (HH2a) / H

100%] 18 [ 2=

Weinstein [6]

(HH2b) / H100%]

CT 18

1.5

SPSS 13.0
x- s t

0.3 cm 0.3 cm

18

410 cm

LSD

6 cm CT

P 0.05

18

P 0.05 2
1 x s

T11

T12

L1

L2

L3

L4

100

31.3 8.2

54

46

11

13

22

21

18

15

56

44

59

41

37 17

86

31.1 7.9

50

36

10

14

21

22

10

48

38

51

35

30 18

0.167

0.321

2.879

0.001

0.002

0.680

0.868

0.571

0.719

0.980

0.967

0.498

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2012 2 4 1 Chin J Clin Basic Orthop Res, Feb 2012, Vol.4, No.1

18

P 0.05

t = -35.770-34.500P = 0.000

41

18

t = -1.270P = 0.339

18

18

CT 4

P 0.05 2

18

35

18

12

t = -27.628-19.000
-8.628P = 0.000

2 18 CT

2
P 0.05

12

18
2 x s
%

18

100

38.2 16.1

2.4 1.7

3.7 1.6

468.594

0.000

86

37.3 13.8

9.8 5.3

18.4 8.7

173.097

0.000

0.385

-10.900

-14.929

0.701

0.000

0.000

1A

1B

1D

1E

1C

1F

1 + L1 34 1A X 1B X 1C
CT 1D CT 3D 1E 18 X
1F 18 CT

2012 2 4 1 Chin J Clin Basic Orthop Res, Feb 2012 Vol.4, No.1

2A

2B

15

2C

2 +
L1 32 2A
X 2B X
2C CT3D
2D 18 X
2E 18

2E

2D

CT

[11-12]

3.1

[7]

80% 20%

[8-9]

Toyone [13]

[10]

Van-Herck [14]
30

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2012 2 4 1 Chin J Clin Basic Orthop Res, Feb 2012, Vol.4, No.1

D12L5 Cobbs 7.16

3.3

SD 12.44-5.48SD 11.44

4 18

2 Cobbs 1.00SD

CT

3.04

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2012
2012 2012 6 29
30 DLIF/XLIF

William Smith DLIF/XLIF

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2
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2.

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Emailgzzyy_gk@126.com

020-36655321
020-36654551

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