Vertebral and inter-vertebral screw fixation for treating thoracolumbar compression fracture：a long-term follow-up of spinal stability / 中国组织工程研究

ABSTRACT

BACKGROUND: Posterior pedicle screw fixation is a common method for treatment of thoracolumbar compression fractures. The fixation method contains long-segment fixation, short-segment fixation and vertebral fixation. Clinical effects of vertebral fixation and inter-vertebral short-segment fixation for treating thoracolumbar fractures remain unclear. OBJECTIVE: To compare the stability of posterior vertebral fixation and inter-vertebral pedicle screw fixation for treating thoracolumbar compression fractures. METHODS: Clinical data of 46 patients with thoracolumbar compression fractures were retrospectively analyzed. According to the fixation methods, they were divided into the vertebral fixation group (n=21) and inter-vertebral fixation group (n=25). The operation time, intraoperative bleeding, intraoperative blood transfusion, the time of lying in bed, vertebral Cobb angle, anterior vertebral height and visual analog scores were evaluated for a long time. RESULTS AND CONCLUSION: (1) During repair, in both groups, operation time, intraoperative bleeding and intraoperative blood transfusion were better in the inter-vertebral fixation group than in the vertebral fixation group (P < 0.05-0.01). The time of lying in bed was better in the vertebral fixation group than in inter-vertebral fixation group (P < 0.01). (2) No significant difference in Cobb angle and anterior vertebral height was detected before and after treatment and during repair in both groups, but final fol ow-up and fol ow-up loss were better in the vertebral fixation group than in inter-vertebral fixation group (P < 0.05-0.01). (3) No significant difference in visual analog scores was detected before and after treatment in both groups. Visual analog scores were better in the vertebral fixation group than in the inter-vertebral fixation group (P <0.01). (4) These results suggested that the two fixation methods obtained satisfactory repair effects in long-term fol ow-up. The dominance in maintaining the height and curvature of the spine was more obvious in the vertebral fixation group than in the inter-vertebral fixation group. The vertebral fixation can be more effective to reconstruct the spinal physiological sequence and restore its stability. After repair, low back pain can also be effectively control ed.