[Treatment of thoracolumbar burst fractures using a self-designed device for intracorporeal autografting combined with osteoinductive materials].

OBJECTIVE

To investigate the clinical significance and efficacy of using a self-designed bone graft device for transpedicular intracorporeal autografting combined with osteoinductive materials in the treatment of thoracolumbar fractures.

METHODS

A retrospective analysis was conducted on 40 patients diagnosed with single-level thoracolumbar burst fractures between May 2016 and March 2020. Patients were divided into two groups based on surgical technique:the conventional surgery group (n=20) underwent open reduction and pedicle screw fixation alone, including 12 males and 8 females with an age of (41.71±8.25) years old;the self-designed device group (n=20) received additional intracorporeal autografting combined with osteoinductive materials using the self-designed device, including 15 males and 5 females with an age of (40.09±7.59) years old. Preoperative and postoperative follow-up assessments included X-ray and CT scans to measure vertebral compression rate, kyphosis angle (Cobb angle), and correction loss. Clinical outcomes were evaluated using the visual analogue scale (VAS) and Oswestry disability index (ODI).

RESULTS

All patients were followed up, and the duration ranged from 12 to 24 months with a mean of (15.51±4.98) months. Both groups began ambulation with brace protection at 2 to 3 weeks postoperatively, with no complications such as infection, implant failure, or neurological deterioration. Postoperative Cobb angles improved significantly in both groups(P<0.05). At the final follow-up, the Cobb angle in the self-designed device group was (4.1±2.9)°, significantly lower than that in the conventional surgery group (8.2±9.6)°, with a statistically significant difference (P<0.05). The correction degree loss in the self-designed device group was (1.8±1.5)°, significantly lower than that in the conventional surgery group (7.6±8.4)°, with a statistically significant difference (P<0.05). Vertebral height restoration was significantly improved in both groups postoperatively (P<0.05). At the final follow-up, the vertebral height reduction in the self-designed device group was (7.4±1.5)%, significantly lower than that in the conventional surgery group (12.8±6.0)%, with a statistically significant difference (P<0.05). The loss of corrective height in the self-designed device group was (1.6±0.7)%, also significantly lower than that in the conventional surgery group (7.9±5.4)%, with a statistically significant difference (P<0.05). Both groups showed significant reductions in VAS and ODI scores at final follow-up (P<0.05). CT scans in the self-designed device group confirmed complete incorporation of all grafts.

CONCLUSION

The use of a self-designed intracorporeal bone graft device for transpedicular autografting combined with osteoinductive materials and pedicle screw fixation effectively restores vertebral height, reconstructs anterior and middle column stability, prevents postoperative correction loss, and preserves spinal mobility in patients with fresh thoracolumbar burst fractures, yielding satisfactory clinical outcomes.