Paraspinal muscle approach of short-segment pedicle screw fixation for thoracolumbar fracture:change of Cobb’s angle at the injured segment

Shicheng WANG; Biliu HUANG; Lei PAN; Houjun XUE; Qinghua LIU

ABSTRACT

BACKGROUND:

Short-segment pedicle screw technology has been extensively used in the treatment and repair of thoracolumbar burst fractures. The technique of operative treatment through the paraspinal muscle approach has advantages such as less trauma and bleeding, and rapid recovery. However, it requires further investigations to verify the superiority of the paraspinal muscle approach of two lateral incisions near the posterior median line.

OBJECTIVE:

To evaluate the clinical efficacy and Cobb’s angle of short-segment pedicle screw fixation through paraspinal muscle approach of two lateral incisions near the posterior median line in the treatment of thoracic and lumbar fractures.

METHODS:

From September 2010 to June 2012, 56 patients with thoracic and lumbar fractures were included in the retrospective study, including 42 males and14 females, with an average of 45 years (range 18-59 years). According to the surgical approach, patients were divided into two groups, traditional approach (n=25) and paraspinal muscle approach (n=31). The operative time, intraoperative blood loss, postoperative drainage and postoperative ambulant time in the two groups were observed and compared. The visual analog scale scores at 7 days, 1 month and 6 months postoperatively were recorded. The Cobb’s angles of suffered vertebra were measured preoperatively and at 7 days and 6 months postoperatively. RESULTS AND

CONCLUSION:

Al patients were fol owed up after internal fixation. The paraspinal muscle approach was superior to traditional approach in the operation time, intraoperative blood loss, postoperative drainage and postoperative ambulant time, and visual analog scale scores at 7 days and 1 month postoperatively (P0.05). The short-segment pedicle screw fixation through paraspinal muscle approach of two lateral incisions near the posterior median line in the treatment of thoracic and lumbar fractures, is an effective and minimal y invasive treatment, with less trauma, less bleeding, rapid recovery, and simple operations. Similar to open surgery, this treatment can recover the anatomical morphology and reconstruct spinal stability, and had good biocompatibility to the host.