Abstract:

BACKGROUND: Most scholars believed that injured vertebral body needs to be fixed in the open surgery of thoracolumbar vertebral fractures; however, it is unclear whether injured vertebra needs to be fixed in the minimally invasive surgery.
OBJECTIVE: To investigate the clinical outcomes of minimally invasive percutaneous self-dilating pedicle in repair of injured vertebral fixation in thoracolumbar vertebral fractures. 
METHODS: Totally 36 patients with thoracolumbar vertebral fractures without nervous system injury who received treatment in Honghui Hospital, Xi’an Jiaotong University Health Science Center from February 2013 
to February 2014 were enrolled and divided into injured vertebral fixation and cross-injured vertebral fixation groups (n=18/group). Patients in these two groups were all subjected to minimally invasive percutaneous self-dilating pedicle treatment. The injured vertebral body, upper, and lower vertebrae of injured vertebral body were fixed in injured vertebral fixation group, and the upper and lower vertebrae of injured vertebral body was fixed in cross-injured vertebral fixation group.
RESULTS AND CONCLUSION: Compared with the injured vertebral fixation group, the cross-injured vertebral fixation group had smaller incisions, less intraoperative blood loss, less operation tine and intraoperative X-ray fluoroscopy time (P < 0.05). After one year of internal fixation, the anterior vertebral height, anterior vertebral height percentage and kyphotic Cobb angle of patients in these two groups improved compared with those before internal fixation (P < 0.05), but there were no significant differences in anterior vertebral height percentage, kyphotic Cobb angle and Oswestry disability index between these two groups (P > 0.05). These results demonstrate that anterior vertebral height cross-injured vertebral fixation has the similar clinical effect with injured vertebral fixation, but cross-injured vertebral fixation had more advantage in the operation. Therefore, there is little significance of conducting injured vertebral fixation in the surgery of minimally invasive percutaneous self-dilating pedicle in repair of thoracolumbar vertebral fractures.