Minimally invasive versus open pedicle screw fixation for repair of thoracolumbar fractures
10.3969/j.issn.2095-4344.2014.26.021
- VernacularTitle:微创与开放方案置入椎弓根螺钉内固定修复胸腰椎骨折
- Author:
Xiaozhong PENG
;
Kankan XIAO
- Publication Type:Journal Article
- Keywords:
spinal fractures;
surgical procedures,minimally invasive;
internal fixators;
pain measurement
- From:
Chinese Journal of Tissue Engineering Research
2014;(26):4212-4218
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND:Recently, minimal y invasive techniques obtained more attention. Some new minimal y invasive methods have been used in the treatment of spine fracture and provide new chal enges for conventional open surgery. OBJECTIVE:To discuss the clinical efficacy of conventional posterior open pedicle screw fixation versus minimal y invasive operation (using Mast Quadrant System and Sextant percutaneous pedicle screw fixation) for treating single-segment thoracolumbar fractures without neurological damages. METHODS:A total of 94 cases of single-segment thoracolumbar fracture without neurological damages, who were treated in Department of Spine Surgery, Liuzhou Worker’s Hospital in China from January 2012 to January 2013, were enrol ed in this study. According to patients’ conditions and wil ing, they were divided into open fixation group, Quadrant fixation group and percutaneous Sextant fixation group. Perioperative index, clinical efficacy, and imaging results were observed and compared among different groups. RESULTS AND CONCLUSION:Intraoperative blood loss, incision length and length of stay were better in the Quadrant fixation group and percutaneous Sextant fixation group than in the posterior open fixation group (P<0.05). A total of 94 patients were fol owed up for 6 months. No cases of nerve damage, slippage or breakage of implants were found. The anterior vertebral body height, Cobb’s angle, and sagittal index were significantly improved postoperatively compared to pre-operation in al three groups (P<0.05), but there was no significant difference in the three groups (P>0.05). Postoperative Visual Analog Scale scores and Oswestry Disability Index were better in the two minimal y invasive groups than in the conventional open fixation group (P<0.05). These results suggested that compared with conventional open operation, minimal y invasive operation (Mast Quadrant System and Sextant percutaneous pedicle screw fixation) in the treatment of thoracolumbar fractures not only can achieve similar imaging result, but has smal incision, less blood loss, quick recovery, high safety, and obtains good clinical therapeutic outcomes. In the case of strict surgical indications, minimal y invasive method is an ideal choice in treating thoracolumbar fractures without neurological damages.
