Biomechanical properties of hyperextension traction-elastic compression combined with percutaneous pedicle screw fixation for thoracolumbar fractures / 中国组织工程研究

ABSTRACT

BACKGROUND:The traditional percutaneous pedicle screw fixation for thoracolumbar fractures has a lot of shortcomings,such as restoring the vertebral height.The combination of hyperextension traction-elastic compression and internal percutaneous pedicle screw fixation provides a new treatment strategy.OBJECTIVE:To observe and compare the biomechanical properties of the traditional percutaneous transpedicular screw fixation and hyperextension traction-elastic compression combined with percutaneous pedicle screw fixation in the treatment of thoracolumbar fractures.METHODS:Clinical data of 40 patients with simple vertebral compression fractures undergoing traditional percutaneous pedicle screw fixation (control group) or hyperextension traction-elastic compression combined with percutaneous pedicle screw fixation (treatment group) were analyzed retrospectively,and none had neurologic signs or symptoms.The operation time,intraoperative radiant volume,intraoperative blood loss,hospitalization time or complications were compared between two groups.The sagittal Cobb angle and percentage of anterior height in vertebral body were measured at baseline and different time points after internal fixation.The pain and symptom improvement were evaluated by Visual Analogue Scale and Oswestry Disability Index.RESULTS AND CONCLUSION:All patients were followed up for 12 months.(1) There were no significant differences in the operation time,intraoperative radiation volume,intraoperative blood loss,hospitalization time and complications between two groups (P ＞ 0.05).(2) The sagittal Cobb angle,percentage of anterior height in vertebral body,Visual Analogue Scale and Oswestry Disability Index scores after internal fixation were significantly superior to those before internal fixation in both two groups (P ＜ 0.05).(3) The sagittal Cobb angle and percentage of anterior height in vertebral body in the treatment group were significantly superior to those in the control group at 24 hours,6 and 12 months postoperatively (P ＜ 0.05).(4) The Visual Analogue Scale and Oswestry Disability Index scores in the treatment group were significantly superior to those in the control group at 12 months postoperatively (P ＜ 0.05).(5) These results indicate that hyperextension traction-elastic compression combined with percutaneous pedicle screw fixation exerts remarkable effect on restoring the vertebral height and effectiveness compared with the traditional percutaneous pedicle screw fixation.