Objective To observe the effect of trans-Kambin's triangle bone grafting of injured vertebrae combined with posterior internal fixation in the treatment of patients with thoracolumbar burst fracture.
Methods Clinical materials of 41 patients with thoracolumbar burst fractures in the Department of Spinal Surgery from January 2017 to December 2019 were analyzed retrospectively, and they were divided into study group (20 cases, treated with trans-Kambin's triangle bone grafting of injured vertebrae combined with posterior internal fixation) and control group (21 cases, only treated with posterior internal fixation) according to different operation methods. The operation time, intraoperative bleeding, hospital stay, fracture healing time, preoperative and postoperative height ratio of the anterior edge of the injured vertebra, Cobb angle of the injured vertebra, Visual Analogue Scale (VAS), Oswestry Dysfunction Index (ODI) of waist and back as well as complications were compared between the two groups.
Results The operation time in the study group was significantly longer than that in the control group, while the fracture healing time was significantly shorter than that in the control group (P < 0.05). At 1 week after operation, the height ratio of the anterior edge of the injured vertebrae in the study group was greater than that in the control group; at 12 months after operation and 1 month after removal of internal fixation, the height ratios of the anterior edge of the injured vertebrae in the study group were greater than that in the control group, and the Cobb angle was smaller than that in the control group; the correct degree losses in the height ratio of the anterior edge of the injured vertebrae and the Cobb angle in the study group were smaller than those in the control group; the between-group differences mentioned above were statistically significant (P < 0.05). At 12 months after operation and 1 month after removal of internal fixation, the VAS scores and ODI scores of the study group were significantly lower than those of the control group (P < 0.05). The incision in both groups achieved primary healing after operation. During the follow-up, there were no fractures of screws and connecting rods and other complications, and all the patients scored grade E of Frankel rating at the last follow-up.
Conclusion Trans-Kambin's triangle bone grafting of injured vertebrae combined with posterior internal fixation is effective in the treatment of patients with thoracolumbar burst fracture, which can maintain the height ratio of the anterior edge of the injured vertebra and Cobb angle with a high safety, so it is worthy of clinical application.
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