Minimally invasive percutaneous pedicle screw fixation in the treatment of single vertebra magerl type A thoracolumbar fracture / 中国医师杂志

ABSTRACT

Objective:To explore the effect of minimally invasive percutaneous pedicle screw internal fixation on the anterior height and Cobb angle of injured vertebra in patients with single vertebra magerl type A thoracolumbar fracture.Methods:71 cases of single vertebra magerl type A thoracolumbar fracture admitted in our hospital from January 2015 to January 2017 were reviewed. Among them, 31 patients who received minimally invasive percutaneous pedicle screw internal fixation were as the observation group, and 40 patients receiving open pedicle internal fixation were as control group. All the patients were followed up for one year, and the preoperative and postoperative indexes, the height of the anterior edge of the injured vertebra and Cobb angle, as well as the score of Oswestry dysfunction were compared between the two groups.Results:The length of incision and the time of descending were shorter in the observation group than in the control group, and the amount of bleeding during operation was less than in the control group ( P<0.05); there was no significant difference in operation time between the two groups ( P>0.05). There was no significant difference in serum creatine kinase (CK) and C-reaction protein (CRP) levels between the two groups ( P>0.05); the levels of serum CK and CRP in the two groups increased significantly after operation, and those in the control group were significantly higher than those in the observation group ( P<0.01). There was no significant difference in the height of anterior edge and Cobb angle between the two groups ( P>0.05); 7 days and 1 year after operation, the height of the anterior edge of the two groups was significantly higher than that before operation ( P<0.01), and the Cobb angle was significantly lower than that before operation ( P<0.01), but there was no significant difference between the two groups ( P>0.05). There was no significant difference in Oswestry dysfunction score between the two groups ( P>0.05); the scores of Oswestry dysfunction were significantly reduced in both groups 7 days and 1 year ater operation, and the observation group was significantly lower than the control group ( P<0.01). Conclusions:Minimally invasive percutaneous pedicle screw fixation can effectively improve the anterior height and Cobb angle of the injured vertebra in patients with single vertebra magerl A thoracolumbar fracture, and the perioperative indexes, serum inflammatory factors and Oswestry dysfunction scores are better than those of open pedicle internal fixation, which is worthy of clinical application.