Percutaneous screw fixation combined with articular process bone grafting for the treatment of thoracolumbar fractures: constructing long-term stability / 中国组织工程研究

ABSTRACT

BACKGROUND:It has been a hotspot in the treatment of spinal fracture by minimaly invasive approach.Compare with open operation,minimaly invasive surgery has less trauma,less bleeding,less tissue damage and shorter hospital stay.But no clinical study focuses on the reduction effect of minimaly invasive percutaneous screw fixation and maintenance of vertebral height.OBJECTIVE:To compare the difference of minimaly invasive percutaneous screw combined with articular process bone grafting and simple screw fixation in the treatment of thoracolumbar fracture on maintaining vertebral height.METHODS:Clinical data of 79 patients with T11-L2 thoracolumbar fractures (AO type A1,A2,A3,B1) wereretrospectively analyzed.Among them,41 cases were treated by percutaneous pedicle screw fixation combined with articular process bone grafting,while 38 cases were treated by percutaneous pedicle screw fixation,from January 2010 to September 2013.Perioperative indicators in the two groups,visual analogue scale scores,and Oswestry Disability Index before and after surgery,as wel as at final folow-up were compared between the two groups.The anterior and posterior of vertebral height,the recovery of Cobb's angle were evaluated.RESULTS AND CONCLUSION:The patients in the grafting group were folowed up for 4-36 months and those in the non-grafting group were folowed up for 5-30 months,there was no significant difference in the folow-up time between the two groups (P=0.25).The operation time,intraoperative blood loss,postoperative ambulation time and hospital stay showed no significant difference between the two groups (P＞0.05).The folow-up results showed that,no significant difference was found in visual analogue scale scores and Oswestry Disability Index between the two groups (P＞0.05).However,the anterior and posterior of vertebral height,the recovery of Cobb's angle in the grafting group were significantly better than that in the non-grafting group (P＜ 0.05).The short-term efficacy and security are similar between the two surgery methods in the treatment of thoracolumbar fracture.However,minimaly invasive percutaneous screw combined with articular process bone grafting shows great advantages in recovering and maintaining the long-term stability.