Monosegmental fixation for the treatment of single thoracolumbar vertebral fractures:a report of 18 cases

Objective:To evaluate the efficacy of monosegment fixation in the treatment of thoracolumbar fractures.Methods:A total of 18 patients with thoracolumbar fractures were treated with monosegmental pedicle instrumentation and bone graft fusion.The Cobb angle of the injured vertebral segment, percentage of the vertebral compression and the spinal canal sagittal diameter stenosis rate were compared before and after the operation.Neurological function was evaluated by the Frankel scale.Results:All the 18 patients were followed up.All the cases achieved bone fusion with no significant lose of the vertebrae body height or implant failure.X-ray film showed that the cobb angle of the injured vertebral segment, percentage of the vertebral compression and the spinal canal sagittal diameter stenosis rate improved significantly after operation(P<0.01).As to the Frankel scale, there were 2 patients at Grade B, 5 at Grade C, 7 at Grade D and 4 at Grade D before operation;and there were 3 patients at Grade C, 8 at Grade D and 7 at Grade E after operation.Conclusions:The transpedicular fixation through posterior approach combined with bony graft is an effective and reliable procedure for specific types of thoracolumbar vertebral fractures, but strict indication is the key to this procedure.