Retrospective analysis of treatment of thoracolumbar burst fracture using mono-segment pedicle instrumentation compared with short-segment pedicle instrumentation

To investigate the safety and therapeutic effects of mono-segmental pedicle instrumentation (MSPI) in treating thoracolumbar burst fracture (AO classification: A3.1 and A3.2). A retrospective analysis was conducted on 60 cases with thoracolumbar burst fracture (AO classification: A3.1 and A3.2) between April 2005 and February 2010. Half of the 60 inpatients were treated with MSPI, and the other half was treated with short-segment pedicle instrumentation (SSPI). The mean operation time, blood loss, visual analog scale (VAS) and vertebral kyphotic angle before and after surgery were compared. In the MSPI group, the mean operation time was 90 +/- A 25 min, and the blood loss at operation was 180 +/- A 62 ml. The vertebral kyphotic angles were 17.3A degrees A A +/- A 9.3A degrees before surgery, 6.5A degrees A A +/- A 6.5A degrees one week after surgery, and 9.5A degrees A A +/- A 6.4A degrees for the latest follow-up. The VAS scores were 7.5 +/- A 1.4 before surgery, 2.5 +/- A 0.7 one week after surgery, and 1.4 +/- A 0.8 for the latest follow-up. In the SSPI group, the mean operation time was 101 +/- A 28 min, and the blood loss at operation was 203 +/- A 88 ml. The follow-up duration was 12-64 months. The vertebral kyphotic angles were 16.5A degrees A A +/- A 9.1A degrees before surgery, 7.1A degrees A A +/- A 6.9A degrees one week after surgery, and 7.5A degrees A A +/- A 5.2A degrees for the latest follow-up. The VAS scores were 6.7 +/- A 1.5 before surgery, 3.0 +/- A 0.4 one week after surgery, and 1.1 +/- A 0.6 for the latest follow-up. There were no statistically significant differences between these two groups in the operation time, blood loss at operation, VAS score and vertebral kyphotic angle before and after surgery (p > 0.05). The post-surgical VAS scores and vertebral kyphotic angles were significantly decreased in both groups, compared to before surgery (p < 0.05). It is safe and effective to treat thoracolumbar burst fractures (AO 3.1 and AO 3.2) with MSPI. The mean operation time, blood loss at operation, post-surgical VAS and vertebral kyphotic angle of the MSPI group are similar, compared to the SSPI group. Further research is needed to find out whether therapeutic effects of MSPI are better than those of conservative treatment in these cases.