Abstract：Objective To explore the clinical efficacy of pedicle screw fixation combined with transpedicular bone grafting in the treatment of thoracolumbar fractures.Methods Clinical data of 109 cases with thoracolumbar fracture from September 2011 to August 2015 in our hospital were retrospectively analyzed,all patients were divided into group A(49 cases)and group B (60 cases)according to different treatment methods.Group A was treated with simple pedicle screw fixation,and group B was treated with the pedicle screw fixation of the fractured vertebra combined with transpedicular bone grafting of the injured vertebra.All patients were followed up for 8-29 months,the mean follow-up was 15.1 months.The compression ratio of the leading edge height of the injured vertebra,the adjacent vertebral Cobb angle in digital radiography (DR)preoperative,postoperative and final follow-up in the two groups were compared.Operation time,blood loss and complications in the two groups were recorded.Results The operation time of group B was longer than that of group A,and the amount of bleeding of group B was more than that of group A,with significant difference(P＜0.05).The compression ratio of the leading edge height of the injured vertebra after operation and final follow-up of the two groups was greater than that before operation,and the angle of Cobb after operation and final follow-up of the two groups was smaller than that before operation,with significant difference(P＜0.05).The compression ratio of the leading edge height of the injured vertebra final follow-up of group A was smaller than that after operation,and the angle of Cobb final follow-up of group A was greater than that after operation,with significant difference (P＜0.05).There was no significant difference in the compression ratio of the leading edge height of the injured vertebra and the angle of Cobb of group B between final follow-up and after operation (P＞0.05).There was no significant difference in the compression ratio of the leading edge height of the injured vertebra and the angle of Cobb before operation and after operation between the two groups(P＞0.05).The compression ratio of the leading edge height of the injured vertebra final follow-up in group B was greater than that in group A,and the angle of Cobb final follow-up in group B was smaller than that of group A,with significant difference(P＜0.05).1 case nail was broken in group A,and 1 case loss of height of the vertebral column in group A,with symptoms of nerve compression and needed reoperation.There is no broken nail and loss of height of the vertebral column in group B.Conclusion In pedicle screw fixation combined with transpedicular bone grafting,the pedicle screw can effectively restore vertebral height,correct kyphosis angle;at the same time,combined with transpedicular bone grafting can reduce the complications such as long-term screw loosening,broken nail and vertebral height,Cobb angle loss and so on.
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