Screw placement selection of minimally invasive percutaneous pedicle screw fixation for thoracolumbar fractures

doi:10.3969/j.issn.2095-4344.2017.03.006

Abstract

Abstract:

BACKGROUND: Monoaxial pedicle screws are not conducive to the installation during percutaneous pedicle screw technique, but it has better mechanical conductivity and stability than polyaxial pedicle screws. How to select and use these two kinds of screws in the clinic to exert their advantages and to further elevate efficacy has become a subject worthy of reflection.

OBJECTIVE: To compare the clinical efficacy of percutaneous pedicle screw placement for thoracolumbar fracture using monoaxial and polyaxial pedicle screws at different placement selections.

METHODS: A total of 46 cases of thoracolumbar fracture without neurological symptoms underwent minimally invasive percutaneous pedicle screw fixation. 25 patients (monoaxial screw group) were treated with monoaxial pedicle screws and the other 21 ones (polyaxial screw group) with polyaxial pedicle screws. Kyphotic angle, correction rate, correction loss rate and height of injury vertebrae were compared before and after fixation in both groups. The therapeutic effects of monoaxial and polyaxial percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures were evaluated.

RESULTS AND CONCLUSION: (1) Fixation time, blood loss, complication and hospital stay were not significantly different in both groups (P > 0.05). (2) Kyphotic angle and height of the fractured vertebra body were significantly different between the two groups (P < 0.05). (3) The restoration of anterior height of injured vertebrae, kyphotic angle and correction rate were better in the monoaxial screw group than in the polyaxial screw group after treatment (P < 0.05). The correction loss rate was significantly better in the monoaxial screw group than in the polyaxial screw group during last follow-up (P < 0.05). However, there was no significant difference in the posterior height of injured vertebraeafter fixation (P > 0.05). (4) These findings indicate that compared with the polyaxial percutaneous pedicle screw fixation, the monoaxial pedicle screw may be preferable in percutaneous pedicle screw fixation for thoracolumbar fractures, has more satisfactory fracture distraction reduction, and has less postoperative correction loss rate.

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

Key words: Spinal Fractures, Diskectomy, Percutaneous, Internal Fixators, Tissue Engineering

CLC Number:

R318

Zou Wei, Xiao Jie, Long Hao, Zhang Yang, Wu Chen, Du Yu-hui, Feng Ming-xing, Zhou Chang-jun. Screw placement selection of minimally invasive percutaneous pedicle screw fixation for thoracolumbar fractures[J]. Chinese Journal of Tissue Engineering Research, 2017, 21(3): 356-361.

Figures/Tables 4

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