Clinical study of percutaneous short-segment injured vertebra pedicle screw fixation combined with bone grafting in treatment of thoracolumbar fractures.
10.7507/1002-1892.202505009
- Author:
Long JIA
1
;
Xiangqian LI
1
;
Yadong QIAN
1
;
Mingji CHEN
1
Author Information
1. Department of Orthopaedics, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, 201700, P. R. China.
- Publication Type:Journal Article
- Keywords:
Thoracolumbar fracture;
injured vertebra bone grafting;
injured vertebra pedicle screw fixation
- MeSH:
Humans;
Thoracic Vertebrae/surgery*;
Pedicle Screws;
Lumbar Vertebrae/surgery*;
Spinal Fractures/surgery*;
Bone Transplantation/methods*;
Fracture Fixation, Internal/instrumentation*;
Male;
Female;
Retrospective Studies;
Adult;
Middle Aged;
Treatment Outcome;
Minimally Invasive Surgical Procedures/methods*;
Operative Time;
Aged
- From:
Chinese Journal of Reparative and Reconstructive Surgery
2025;39(10):1310-1317
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To compare the effectiveness of percutaneous short-segment injured vertebra pedicle screw fixation combined with bone grafting versus percutaneous short-segment injured vertebra pedicle screw fixation alone for the treatment of thoracolumbar fractures.
METHODS:The clinical data of 54 patients with single-level thoracolumbar fractures who met the selection criteria between January 2023 and February 2024 were retrospectively analysed. Based on whether bone grafting was performed on the injured vertebra, the patients were divided into a control group (28 cases, percutaneous short-segment injured vertebra pedicle screw fixation alone) and a study group (26 cases, percutaneous short-segment injured vertebra pedicle screw fixation combined with bone grafting using a self-made minimally invasive bone grafting funnel). No significant difference was observed between the two groups ( P>0.05) in baseline data, including age, gender, surgical segment, cause of injury, AO classification, and preoperative anterior-vertebral height compression ratio, mid-vertebral height compression ratio, Cobb angle, visual analogue scale (VAS) score, and Oswestry Disability Index (ODI). The operation time, intraoperative blood loss, fracture healing status, removal time of internal fixator, and complications were recorded and compared between the two groups. Effectiveness was assessed using anterior-vertebral height compression ratio, mid-vertebral height compression ratio, Cobb angle, VAS scores, and ODI taken preoperatively, at 1 week postoperatively, and at last follow-up.
RESULTS:All patients in both groups successfully underwent surgery. The operation time and intraoperative blood loss in the control group were significantly less than those in the study group ( P<0.05). No significant difference was observed in the follow-up time between the study group [(14.46±2.00) months] and control group [(14.36±1.83) months] ( P>0.05). The fracture healing time of the study group was significantly shorter than that of the control group ( P<0.05). One patient in the study group was found to have bilateral titanium rod breakage by X-ray reexamination at 8 months after operation, and there was no subsequent vertebral height collapse occurred, and the internal fixator was removed following complete fracture healing. The other patients had no complication such as spinal cord injury, internal fixator loosening and breakage. There was no significant difference in the removal time of internal fixator between the two groups ( P<0.05). The anterior-vertebral height compression ratio, mid-vertebral height compression ratio, Cobb angle, VAS score, and ODI significantly improved in both groups at 1 week after operation and at last follow-up ( P<0.05). Among them, the VAS score, and ODI further improved at last follow-up when compared with at 1 week after operation, Cobb angle lost a little at 1 week after operation, while anterior-vertebral height compression ratio and mid-vertebral height compression ratio slightly increased when compared with 1 week after operation, and the differences were significant ( P<0.05). There was no significant difference between the two groups in Cobb angle at last follow-up, VAS score and ODI at 1 week after operation ( P>0.05), while the other indicators in the study group were significantly better than those in the control group at all time points ( P<0.05).
CONCLUSION:Compared to percutaneous short-segment injured vertebra pedicle screw fixation alone, the technique combined with intravertebral bone grafting can shorten fracture healing time, effectively restore and maintain vertebral body height, correct kyphotic deformity, and improve clinical outcomes for patients with thoracolumbar fractures.
