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Abstract Objective]To observe clinical efficacy of posterior pedicle screw fixation in the treatment of unstable upper thoracic fractures .[Methods]Clinical data of 21 patients with unstable upper thoracic fractures from March 2010 to April 2013 were analyzed retrospectively .T3 ~ T8 segmental fractures were high‐energy injury .All patients underwent posterior open reduction ,spinal decompression ,pedicle screw fixation ,pos‐terolateral fusion and bone graft .Conventional treatment and early rehabilitation intervention were given after operation .General condition ,radiographic evaluation(including pedicle screw position ,vertebral compression ratio and vertebral kyphosis angle) ,spinal nerve function classification(ASIA) and daily living activity(ADL) before and after operation were evaluated .[Results] All 21 patients successfully completed surgery ,and no postoperative complication occurred .The 20 patients got effective follow up ,and the follow up time was 12~49 months ,and the mean follow up time was (28 .78 ± 6 .25) months .Compared with before operation ,verte‐bral compression rate and vertebral kyphosis angle at 48h after operation and follow‐up were decreased( P <0 .01) .Compared with 24h after operation ,vertebral compression rate and vertebral kyphosis angle at follow‐up were increased( P<0 .05) .Spinal cord injury ASIA classification at 48h after operation had no change .At follow up ,spinal cord injury ASIA classification of 50 .0% of patients was recovered ,and ADL score was sig‐nificantly improved at follow up( P <0 .05) ,and increased by average (22 .11 ± 9 .64) points .[Conclusion]Posterior pedicle screw fixation is an effective method for the treatment of unstable thoracic fractures .The op‐eration combined with early postoperative rehabilitation intervention is the key of spinal function recovery .
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2014, Vol. 31 
