The Official journal of the China Association of Rehabilitation of Disabled Persons and the 88th Hospital of PLA

Composite Impact Factor:

0. 948 (2015)

Total citation frequency: 3868 (2015)


ISSN 1005-8478

CN 37-1247/R

Bonegraftversuscementforpediclescrewaugmentationintreatmentofthoracolumbar fracture in patients with ankylosing spondylitis

Author : MIAO Hong-zhan, WANG Xiang-shan.     
Working unit : The Third Department of Spinal Surgery, Zhengzhou Ortho⁃ paedicsHospital Affiliated to Henan University, Zhengzhou 450000,China
Page : 1958-1962
Key words : ankylosing spondylitisAS, thoracolumbar fracture, pedicle screw, bone graft augmentation, cement augmentation

Abstract:

Objective

To compare the outcomes of increasing trace abduction combined with bone graft versus cement for

pedicle screw augmentation in fixation of thoracolumbar facture in patients with ankylosing spondylitis AS.

Methods

From April 2009 to July 2015, 52 AS adults with thoracolumbar fracture were surgically treated in our department. In term of pedicle screw augmentation, 30 patients had the pedicle screw enhanced by increasing trace abduction and intra-tunnel bone graftingthe bone graft group, while the remaining 22 patients got the screw augmented by intra-tunnel cementingthe cement groupduring fracture fixation with a pedicle screw-rod system. The perioperative situation, including operation time, blood loss, drainage volume, hospital stay, bed rest and complications, such as wound infection, pulmonary or urinary system infection, deep venous thrombosis, bed sore and implant loosing were recorded, additionally visual analog scale VAS, Japanese Orthopaedic Association JOAscore and Oswestry Disability Index ODIwere used for evaluation.

Results

There are no statistical differences between the two groups in operation time, blood loss, drainage volume, hospital stay, and bed rest P>0.05, in addition, no a statistical difference was noted between them in complication rate P>0.05. All the patients were followed up for 10 to 18 months with an average of 14.2 months. The VAS and ODI significantly decreased after operation in both the bone graft and cement groups with statistical differences at 6 months postoperatively and the lasted follow up compared to those before operation P<0.05, on other hand the JOA scores considerably increased after operation in the both groupP<0.05. However, there were no significant differences in VAS, ODI and JOA score at any time point between the two groups P>0.05.

Conclusion

Both increasing trace abduction combined with intra-tunnel bone grafting and intratunnel cementing do effectively enhance the pedicle screw stability in treatment of thoracolumbar fracture in patients with AS, however there are no differences between the two waysin clinical outcomes.


summary:
Bonegraftversuscementforpediclescrewaugmentationintreatmentofthoracolumbar fracture in patients with ankylosing spondylitis   
MIAO Hong-zhan, WANG Xiang-shan.
Orthop J Chin,2017,25(21):   1958-1962