BACKGROUND:Pedicle screw fixation in the treatment of thoracolumbar fracture can effectively restore vertebral body height and physiological radian, and are widely used in the clinic. In the clinic, we found that different surgical methods on restoration of vertebral height are different. Simultaneously, there are differences in relevant factors before repair, which causes that the recovery of vertebral body height is not consistent. OBJECTIVE:To explore the related factors influencing the recovery of vertebral height of pedicle screw fixation system for treating thoracolumbar fracture. METHODS:Clinical data of 63 patients with thoracolumbar fracture, who were treated by posterior pedicle screw fixation system from September 2012 to March 2015, were summarized. The fracture types were A3 or A4 type in the AO spine thoracolumbar injury classification system, including 32 cases of transpedicular screw fixation (group A) and 31 cases of beyond-injured-vertebral fixation (group B). The related factors including age, course of disease (within 3 weeks), bone mineral density, preoperative degree of vertebral compression and preoperative sagittal Cobb’s angle were recorded. The degree of vertebral height restoration was also observed. Intergroup analysis was conducted using independent samplet-test. Intragroup analysis was performed using bivariate regression analysis in single factor analysis. Multivariate linear regression analysis was applied for multivariate analysis so as to explore the factors related to vertebral height restoration. RESULTS AND CONCLUSION:No significant difference in preoperative rate of vertebral compression or Cobb’s angle was detected between the two groups (P > 0.05). Postoperative rate of vertebral height restoration of group A was significantly greater than group B (P < 0.05). Univariate analysis within the group showed that course of disease, preoperative degree of vertebral compression and bone mineral density were strongly associated with the restoration of vertebral height (P < 0.05). In contrast, there was no significant correlation between age, preoperative sagittal Cobb’s angle and the restoration of vertebral height (P > 0.05). Multiple linear regression analysis showed that the preoperative degree of vertebral compression and the course of disease were the predominant factors affecting the vertebral height restoration. The standardized partial regression coefficients were 0.225, -0.621, respectively. These results demonstrate that transpedicular screw fixation can more effectively restore vertebral height than traditional beyond-injured-vertebral internal fixation. The preoperative vertebral compression and course of diseases are the predominant factors affecting the vertebral height restoration, which can predict postoperative vertebral height restoration.%背景：应用椎弓根钉内固定系统修复胸腰椎骨折能有效地恢复椎体的高度及生理弧度，被广泛运用于临床。临床工作中发现不同修复方式对椎体高度恢复存在差异，同时患者在修复前的各种相关因素存在差异,导致修复后椎体高度恢复的程度亦不一致。 目的：探讨应用椎弓根螺钉内固定系统修复胸腰椎骨折影响椎体高度恢复的相关因素。 方法：总结2012年9月至2015年3月应用后路复位椎弓根螺钉内固定系统修复胸腰椎骨折63例患者的临床资料，骨折类型均为AO Spine胸腰椎损伤分类系统中的A3、A4型，根据修复方式将患者分为两组，经伤椎固定组32例，跨伤椎固定组31例。分别记录两组患者的年龄、病程(3周以内)、骨密度、治疗前椎体压缩程度、治疗前矢状面Cobb角等指标，观察患者治疗后压缩椎体高度恢复情况，应用独立样本t检验行组间分析，组内应用双变量回归分析行单因素分析，应用多元线性回归分析行多因素分析，探讨影响椎体高度恢复的相关因素。 结果与结论：两组患者治疗前椎体压缩率及Cobb角比较差异无显著性意义(P >0.05)，治疗后经伤椎固定组椎体高度恢复率明显大于跨伤椎固定组，差异有显著性意义(P <0.05)。组内单因素分析结果显示患者的病程、治疗前椎体压缩程度、骨密度与治疗后椎体高度恢复情况有一定的相关性(P <0.05)，而患者的年龄、治疗前矢状面Cobb角与治疗后椎体高度恢复情况无相关性(P >0.05)。多因素分析结果显示，患者治疗前椎体压缩程度、病程是影响治疗后椎体高度恢复情况的主要因素，其标准化偏回归系数分别为0.225，-0.621。提示经伤椎置钉椎弓根内固定较传统的跨伤椎固定能更有效的恢复压缩椎体的高度。患者治疗前椎体压缩程度、病程是影响椎体高度恢复的主要因素，观察这些指标有助于预测修复后椎体高度恢复情况。
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