Comparison of posterior 1/3 corpectomy reconstruction versus subtotal corpectomy reconstruction for thoracolumbar burst fractures

Objective To compare posterior 1/3 corpectomy versus subtotal corpectomy in recon-struction of thoracolumbar burst fractures. Methods A prospective study was conducted in the patients who were admitted into our department for treatment of thoracolumbar burst fracture between January 2010 and December 2012. Eligible patients were randomized into an experimental group (28 cases) and a control group (34 cases). The experimental group accepted posterior 1/3 corpectomy followed by reconstruction of the in-jured vertebrae using our self-designed gate-like cage while the control group subtotal corpectomy followed by cylinder mesh cage reconstruction. Surgery time, intraoperative blood loss, neurological function improvement according to American Spinal Injury Association (ASIA) grading, visual analogue scale (VAS) score, verte-bral height, kyphosis angle and fusion time were recorded before surgery, after surgery and at the final fol-low-up in both groups. Vertebral height loss was measured to evaluate endplate subsidence at the final fol-low-up. Results All the patients were available for 24-month follow-up. All the incisions healed by one intention, and no incision infection, aggravation of neural impairment symptoms or implant breakage oc-curred. The experimental group achieved significantly less surgery time and blood loss, significantly better fusion rates at 3, 6, and 9 months after surgery, and significantly lower VAS score at the final follow-up than the control group(P 0.05), but the VAS score and vertebral height loss were significantly lower in the experimental group than in the control group(P 0.05). Conclusions Posterior 1/3 corpectomy followed by gate-like cage reconstruction is an innovative technique for thoracolumbar fractures which can promote early fusion and reduce endplate subsidence. It is as fine as traditional subtotal corpectomy plus cylinder cage reconstruction in neurological function improvement and kyphosis correction. Key words: Thoracic vertebrae; Lumber vertebrae; Fracture fixation, internal; Posterior 1/3 corpectomy and reconstruction