Treatment of Thoracolumbar Fractures with Different Pedicle Screw Internal Fixations
LI Qing
Orthopedics Department, the Third People' s Hospital of Datong, Datong (037000), China
Abstract:
Objective To compare the curative effect of two different internal fixations with pedicle screws in the treatment of thoracolumbar fractures without nerve injury. Methods The data of 80 patients with thoracolumbar fracture without nerve injury were analyzed retrospectively. Patients were divided into two groups according to different internal ?xation methods. Forty-three patients in routine group were treated with open pedicle screw ?xation, and 37 patients in minimally invasive group were treated with pedicle screw ?xation under minimally invasive channels. The volume of intraoperative bleeding, operation time, postoperative drainage and time of leaving bed with braces, Cobb angle and sagittal index of lateral position of injured vertebrae before and after operation, oswestry dysfunction index (ODI) and visual analogue score of pain (VAS) before and after operation were compared between the two groups. Results The average follow-up time of the two groups was 14 . 25 months. The amount of intraoperative bleeding [( 67 . 9± 7 . 4 ) mL], operation time [( 65 . 0 ± 7.1) min], postoperative drainage volume [(46. 9± 9. 5) mL] and the time of leaving bed with braces [(2. 8± 1.2) d] in the minimally invasive group were significantly lower than those in the routine group [( 108 . 5± 18.5) mL, (84.9±12.0) min, (123.1±21.9) mL and (4.6±1.4) d, respectively, P<0.05]. There was no signi?cant difference in Cobb angle and sagittal index between the two groups before and after operation. The VAS score of minimally invasive group was 3.4±0.2 on day 1 after operation, which was signi?cantly lower than that of the routine group. The ODI score of minimally invasive group was at the 3rd month after operation, which was signi?cantly lower than that of the routine group. Conclusion Pedicle screw ?xation under minimally invasive channels has good therapeutic effects on single segment thoracolumbar fractures without nerve injury, which can shorten the operation time, reduce intraoperative bleeding and relieve pain.
