Transpedicular intracorporeal grafting for patients with thoracolumbar burst fractures

OBJECTIVE: To evaluate the efficacy of reinforcing short-segment fixation with transpedicular intracorporeal grafting in restoring vertebral body height and preventing loss of correction in patients with thoracolumbar burst fractures.

METHODS: This retrospective study was carried out from the Affiliated Hospital of Jiangsu University, Jiangsu, China. Forty-six patients with thoracolumbar burst fractures without neurological deficit were operatively treated between July 2008 and June 2011. Patients in group A (n=21) were treated by short-segment fixation with transpedicular intracorporeal grafting, whereas patients in group B (n=25) were treated by short-segment fixation without bone grafting. The preoperative, postoperative, and follow-up radiographs (anterior, middle, posterior vertebral height, and local kyphosis angle) were evaluated.

RESULTS: All 46 patients in both groups obtained satisfactory reduction of fractured vertebrae. There were no significant differences between the 2 groups according to the improvement of body height and local kyphosis angle. However, correction losses were observed in both groups. Less losses of anterior body height (p=0.0007), middle body height (p<0.0001), and local kyphosis angle (p=0.0447) were detected in group A than group B. The rate of failure in group A (4.8%) was significantly lower than that in group B (28.0%) (p=0.0383).

CONCLUSION: Reinforcement of short-segment fixation with transpedicular intracorporeal grafting can effectively restore vertebral body height and prevent loss of correction for patients with thoracolumbar burst fractures.