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Navigation-guided posterior fixation plus transpedicular vertebroplasty for thoracolumbar frac-tures

2011-08-15ZhouWeiDeptOrthop6thPeopHospShanghaiShanghaiJiaotongUnivShanghai200233ChinOrthopTrauma201113101105

外科研究与新技术 2011年2期

周 蔚(Zhou Wei,Dept Orthop,6th Peop Hosp Shanghai,Shanghai Jiaotong Univ,Shanghai 200233)…∥Chin J Orthop Trauma.-2011,13(2).-101~105

Navigation-guided posterior fixation plus transpedicular vertebroplasty for thoracolumbar frac-tures

周 蔚(Zhou Wei,Dept Orthop,6th Peop Hosp Shanghai,Shanghai Jiaotong Univ,Shanghai 200233)…∥Chin J Orthop Trauma.-2011,13(2).-101~105

ObjectiveTo assess the outcomes of navigationguided posterior fixation plus transpedicular vertebroplasty for thoracolumbar fractures.MethodsFrom June,2005 through March,2009,30 patients with thoracolumbar fracture underwent navigation-guided posterior fixation with transpedicular vertebroplasty in our department.They were 18 men and 12 women,aged from 21 to 57 years(mean,35.5 years).Three fractures occurred on T11,11 on T12,14 on L1,and 2 on L2.ResultsThe follow-ups averaged 18 months(12 to 36 months).Of the 129 pedicle screws inserted,110 were of degree 0,8 of degreeⅠ,2 of degreeⅡ,0 of degreeⅢ.The total good to excellent rate was 98.3%for the screw insertion.Before operation,the average canal compromise was 37.5%(5%to 70%),the average vertebrae compression was 54.5%(40%to 70%),and the average Cobb angle was 29.5°(15.5°to 41.5°).Postoperatively the average canal compromise was 14.3%(0 to 20%),the average height of vertebrae was 91.3%(80%to 100%)and the average Cobb angle was 4.9°(1.3°to 9.1°).The long-term follow-ups showed an average Cobb angle loss of<1°and an average vertebral height loss of <2 mm.ConclusionThe navigation-guided posterior fixation plus transpedicular vertebroplasty is an effective treatment for thoracolumbar fractures.Computer-assisted navigation system enhances accuracy and further improves the safety of spine surgery,compared with just the anterior or posterior fixation.10 refs,1 fig,1 tab.

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