Case-Control Studies ; Child ; Female ; Humans ; Male ; Otitis Media with Effusion ; etiology ; Risk Factors

BACKGROUND:Open reduction pedicle screw fixation for thoracolumbar fracture could obtain satisfactory effects, and has been extensively used. However, it has potential risk during and after repair. Minimaly invasive percutaneous pedicle screw technique minimizes the trauma and complications of soft tissue. It remains poorly understood which is better minimaly invasive percutaneous or conventional open pedicle screw fixation for the repair of thoracolumbar fracture. OBJECTIVE:To perform quality evaluation and meta-analysis on curative effect and postoperative complications of minimaly invasive percutaneous and conventional open pedicle screw fixation in the treatment of thoracolumbar fractures. METHODS:A detailed search of several electronic databases, including Cochrane Library, PubMed, WanFang, CNKI, VIP and CBM, was undertaken. Simultaneously,Chinese Journal of Orthopaedics, Chinese Journal of Orthopaedic Trauma, and Chinese Journal of Trauma were checked by hand to identify controled trials regarding minimaly invasive percutaneous and conventional open pedicle screw fixation in the treatment of thoracolumbar fractures published from inception to 2015, and the references of the included studies were checked. According to inclusion and exclusion criteria, references were screened, data were extracted and quality was evaluated by four investigators independently. Meta-analysis was conducted using RevMan 5.2 software. The quality of references of the included controled trials was assessed with CONSORT statement and some surgery clinical evaluation indexes. RESULTS AND CONCLUSION: We included 28 studies, including 25 randomized controled trials/quasi-randomized controled trials and 3 retrospective comparative studies, with 1 285 patients. Meta-analysis results demonstrated that compared with the conventional open pedicle screw, minimaly invasive percutaneous pedicle screw fixation could significantly reduce operation time, blood loss, hospital stays, postoperative complication rate and height loss (P < 0.05). No significant difference in postoperative pain grade was detected between them (P > 0.05). These results indicate that minimaly invasive percutaneous pedicle screw fixation for thoracolumbar fracture was safe and reliable, had smal trauma, less blood loss, rapid recovery, short hospital stay, and less postoperative complications. Nevertheless, methods and results of most studies are not detailed enough. We suggested reporting randomized controled trials according to related standards in order to improve the report quality and authenticity of randomized controled trials.

【Objective】 To evaluate the accuracy and safety of self-made iliac puncture guide in severe and rigid scoliosis （SRS） with Halo pelvic traction. 【Methods】 From January 2015 to May 2021， 22 patients with SRS were treated by the Halo pelvic traction. There were 9 males and 13 females， aged 14 to 28 years with an average of 17.6 years； cobb angle was 90° to 140° with an average of （108.80±13.42）°. According to the different methods of iliac puncture， they were divided into guide group （10 patients） in which the self-made guide device was used for iliac puncture and unarmed group （12 patients） in which the needle was punctured through the iliac bone with bare hands. One iliac needle was inserted into each iliac bone of each patient， and the total number of needles in this study was 44. The puncture times， deviation distance， operation time， degree of soft tissue injury， postoperative hospital stay and complications were compared and analyzed. 【Results】 There was no significant difference in age， gender， body mass， or cobb angle between the two groups. In the guide group the average puncture times was （2.50±0.55）， the offset distance was （0.50±0.07） cm， the operation time was （30.50±4.46） min， soft tissue injury was grade （1.83±0.75）， and postoperative hospital stay was （4.33±0.82） d. In the unarmed group the average puncture times was （4.00±0.76）， the offset distance was （2.30±1.20） cm， the operation time was （60.13±26.35） min， soft tissue injury was grade （3.38±1.19）， and postoperative hospital stay was （8.88±3.14）d. There were 2 cases of needle tract infection in both groups respectively. In the unarmed group， there were 2 cases of skin necrosis and 1 case of neurovascular injury. 【Conclusion】 The self-made iliac puncture guide in SRS with Halo pelvic traction can reduce the number of punctures， offset distance， shorten operation time， postoperative hospital stay and complications.