Transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach for thoracolumbar fractures: a retrospective study

Background: Complications in posterior pedicle screw fixation using a conventional posterior approach for thoracolumbar fractures include vertebral height loss, kyphosis relapse and breakage, or loosening of instrumentation. The purpose of this study was to evaluate the clinical effects of transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach for thoracolumbar fractures. Methods: We retrospectively analyzed 50 patients with thoracolumbar fractures treated with transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach. Operative time, blood loss, visual analog scale (VAS) scores for back pain, and the relative height and Cobb angle of the fractured vertebrae were measured. Results: The average operative time was 71.8 min, and the blood loss was 155 ml. Postoperative VAS scores were significantly lower than preoperative scores (P = 0.08), but there was no difference between 1 week and 1 year postoperatively (P = 0.18). The postoperative relative heights of the fractured vertebrae were higher than the preoperative heights (P = 0.001, 0.005, 0.001), but there were no differences between 1 week and 1 or 2 years postoperatively (P = 0.24/0.16). The postoperative Cobb angles were larger than the preoperative angles (P = 0.002, 0.007, 0.001), but there were no differences between 1 week and 1 or 2 years postoperatively (P = 0.19/0.23). Conclusions: Transpedicular bone grafting and pedicle screw fixation in injured vertebrae using a paraspinal approach for thoracolumbar fractures achieved satisfactory results and can restore vertebral height, increase the stability of the anterior and middle columns of injured vertebrae, and decrease the risk of back pain.