Percutaneous screw fixation combined with articular process bone grafting for the treatment of thoracolumbar fractures: constructing long-term stability

doi:10.3969/j.issn.2095-4344.2015.17.012

Abstract

Abstract:

BACKGROUND: It has been a hotspot in the treatment of spinal fracture by minimally invasive approach. Compare with open operation, minimally invasive surgery has less trauma, less bleeding, less tissue damage and shorter hospital stay. But no clinical study focuses on the reduction effect of minimally invasive percutaneous screw fixation and maintenance of vertebral height.

OBJECTIVE: To compare the difference of minimally invasive percutaneous screw combined with articular process bone grafting and simple screw fixation in the treatment of thoracolumbar fracture on maintaining vertebral height.

METHODS: Clinical data of 79 patients with T₁₁-L₂ thoracolumbar fractures (AO type: A1, A2, A3, B1) were retrospectively analyzed. Among them, 41 cases were treated by percutaneous pedicle screw fixation combined with articular process bone grafting, while 38 cases were treated by percutaneous pedicle screw fixation, from January 2010 to September 2013. Perioperative indicators in the two groups, visual analogue scale scores, and Oswestry Disability Index before and after surgery, as well as at final follow-up were compared between the two groups. The anterior and posterior of vertebral height, the recovery of Cobb’s angle were evaluated.

RESULTS AND CONCLUSION: The patients in the grafting group were followed up for 4-36 months and those in the non-grafting group were followed up for 5-30 months, there was no significant difference in the follow-up time between the two groups (P=0.25). The operation time, intraoperative blood loss, postoperative ambulation time and hospital stay showed no significant difference between the two groups (P > 0.05). The follow-up results showed that, no significant difference was found in visual analogue scale scores and Oswestry Disability Index between the two groups (P > 0.05). However, the anterior and posterior of vertebral height, the recovery of Cobb's angle in the grafting group were significantly better than that in the non-grafting group (P < 0.05). The short-term efficacy and security are similar between the two surgery methods in the treatment of thoracolumbar fracture. However, minimally invasive percutaneous screw combined with articular process bone grafting shows great advantages in recovering and maintaining the long-term stability.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: Thoracic Vertebrae, Lumbar Vertebrae, Fractures, Bone, Internal Fixators, Bone Nails

CLC Number:

R318

Gao Hao-ran, Zhao Hai-en, Qian Shu, Guo Shi-kong, Li Hong, Qian Ji-xian. Percutaneous screw fixation combined with articular process bone grafting for the treatment of thoracolumbar fractures: constructing long-term stability[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(17): 2688-2693.

Figures/Tables 5

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