Comparison of effects of transpedicular grafting of vertebral pedicle screw and strode over fractured vertebra of vertebral pedicle screw in the treatment of thoracolumbar fractures
10.3760/cma.j.issn.1008-6706.2019.10.021
- VernacularTitle: 经椎弓根伤椎植骨置钉固定与跨伤椎椎弓根置钉固定治疗胸腰椎骨折的疗效比较
- Author:
Hua CONG
1
;
Feng JIANG
Author Information
1. Department of Orthopaedics, Weihai Central Hospital, Weihai, Shandong 264400, China
- Publication Type:Journal Article
- Keywords:
Spinal fractures;
Thoracic vertebrae;
Lumbar vertebrae;
Fracture fixation, internal;
Bone nails;
Traumatic vertebral reduction;
Posterior process deformity;
Convex Cobb angle
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(10):1238-1241
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the effects of transpedicular grafting of vertebral pedicle screw and strode over fractured vertebra of vertebral pedicle screw in the treatment of thoracolumbar fractures.
Methods:From January 2015 to December 2016, 84 cases of thoracolumbar fractures in Weihai Central Hospital were randomly divided into two groups according to the digital table, with 42 cases in each group.The control group received strode over fractured vertebra of vertebral pedicle screw, and the study group received transpedicular grafting of vertebral pedicle screw.The patients were followed up for 12 months.The bleeding loss, operation time, postoperative drainage, fracture healing time, hospitalization days and anterior compression ratio of vertebral body, kyphosis Cobb angle before and after treatment and postoperative complications were compared between the two groups.
Results:There were no statistically significant differences in postoperative drainage volume, fracture healing time and hospitalization days between the two groups (t=1.38, 1.79, 1.20, all P>0.05), but the intraoperative bleeding volume[(183.85±13.88)mL]and operation time[(119.74±14.85)min]in the study group were significantly higher than those in the control group[(137.97±14.24)mL, (99.46±13.42)min](t=14.95, 6.57, all P<0.01). Compared with the control group, the compression ratio of the anterior vertebral body in the study group was significantly increased after operation[(92.15±8.70)% vs.(83.75±7.04)%](t=4.86, P<0.01), and the kyphotic Cobb angle in the study group and the control group were significantly decreased compared with those before operation[(10.15±2.47)°, (14.53±4.85)°], and the postoperative kyphotic Cobb angle in the study group was significantly lower than that in the control group (t=5.21, P<0.01). The incidence rate of postoperative complications in the study group was 4.76%, which showed no statistically significant difference compared with the control group (14.29%, χ2=2.21, P=0.14).
Conclusion:Transpedicular grafting of vertebral pedicle screw is superior to strode over fractured vertebra of vertebral pedicle screw in promoting reduction, correcting posterior process deformity and reconstructing vertebral height in patients with thoracolumbar fractures, and it does not cause serious complications, so it has good clinical value.
