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Abstract
Objectives
To evaluate the canal encroachment of fractured bony fragments and neurological deficits of pedicle screw instrumentation for the treatment of unstable thoracolumbar burst fractures with pedicle screws inserted into the fractured vertebrae.
Materials and Methods
The authors evaluated 18 patients treated surgically with posterior fusions using pedicle screws for unstable thoracolumbar burst fractures, from March 2000 to September 2004. The ratios of the areas occupied by the fractured bony fragments in the canals were analyzed, before and after pedicle screw insertion, by computed tomography scans of the fractured vertebrae. The kyphotic angles, anterior vertebral heights, and neurological deficits were evaluated.
Results
The areas occupied by the fractured fragments in the canals were improved significantly after surgery and there were no neurological complications resulting from the placement of pedicle screws or fragment displacements. The kyphotic angles and anterior vertebral heights at the last follow- up visits were improved significantly compared with the preoperative radiographs. The neurological deficits were not aggravated after pedicle screw insertion.
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Fig. 1.
CT scan images of fractured vertebra. The area occupied by the fractured fragment in the canal was analyzed before and after pedicle screw insertion by the computed tomography scan in the fractured vertebra. (A) preoperative (B) postoperative
Fig. 2.
(A) Radiograph of measurement methods for anterior vertebral height(AVH) and kyphotic angle(α). AVH = c/(a+b)/2 (B) Postoperative radiograph shows improved anterior vertebral height and kyphotic angle compared with preoperative radiograph.
Table 1.
Results of percentage of area occupied by the fractured fragment in the canal by computed tomography
| percentage of area (°) | |
|---|---|
| preop | 57.8± 11.0 |
| postop | 44.4± 11.2 |
| p-value | <0.001 |
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