LAUSR

PURPOSE The ideal management of thoracolumbar burst fracture (TLBF) remains controversial. We conducted this study to compare the effectiveness and safety of trans-Kambin's triangle versus transpedicular bone grafting combined with posterior internal fixation (PIF) for TLBF. METHODS 54 patients were retrospectively analyzed and divided into two groups: the observation group (PIF combined with bone grafting via Kambin's triangle, n=28) and the control group (PIF combined with bone grafting via transpedicular, n=26). The anterior vertebral height ratio (AVHR), sagittal Cobb's angle (SCA), visual analogue scale (VAS) score, Oswestry disability index (ODI), bone healing rate, and neurological complications were measured. RESULTS All patients were followed up regularly for a mean period of 17.94 months (12-24months). The AVHR in the observation group was higher than that in the control group (93.93±2.92 vs. 89.90±5.54%, p=0.006), and the loss of correction was lower (1.59±1.20 vs. 3.00±1.98%, p=0.008). The observation group had lower SCA at final follow-up (8.68±3.75 vs. 11.33±4.77°, p=0.046) and less correction loss (1.96±1.32±1.15 vs. 3.90±2.39°, p=0.002). The VAS score and ODI in the observation group were lower (0.61±0.43 vs. 0.92±0.38, p=0.016; 15.86±4.11 vs. 19.18±4.04, p=0.010), while the fracture healing rate showed no significant difference (P>0.05). No internal fixation failure or neurological complications occurred in both groups during the follow-up. CONCLUSION Bone grafting via Kambin's triangle combined with PIF is a safe and effective technology for thoracolumbar burst fracture.