Effects of different types of bone cement augmentation of pedicle screws on prognosis of osteoporotic thoraco-lumbar fractures in elderly patients / 局解手术学杂志

ABSTRACT

Objective To compare the effects of different types of bone cement augmentation of pedicle screws on the prognosis of osteo -porotic thoracolumbar fractures in elderly patients.Methods From August 2013 to November 2016,184 elderly patients with osteoporotic thoracolumbar fractures in our hospital were selected as the research object,all the patients were randomly divided into observation group and control group,94 cases in each group.Two groups were treated with pedicle screw fixation,the control group received conventional pedicle screw combined with PMMA bone cement augmentation,and the observation group were treated by cannulated pedicle screws combined with PMMA bone cement augmentation,the prognosis of the two groups were recorded.Results All patients were successfully completed the oper-ation without serious complications occurred.There was no significant difference in operation time,intraoperative blood loss,the amount of sin-gle vertebral bone cement,hospitalization time between the two groups(P>0.05).The postoperative 1 month incidence rate of cerebrospinal fluid leakage,bone cement leakage,wound infection,loosening of internal fixation was 4.3% in the observation group,which was lower than 21.3%in the control group,the difference was significant(P<0.05).The postoperative 1 month of vertebral height in the observation group and the control group were respectively(4.53 ±1.11)mm and(5.09 ±1.42)mm that were lower than the preoperative(6.41 ±1.39)mm and(6.38 ±1.31)mm(P<0.05),meanwhile the vertebral height at postoperative 1 month of the observation group was lower than that of the control group,the differences were significant(P<0.05).There were 0 case of Frankle grade A,0 case of grade B,10 cases of grade C, 18 cases of grade D,66 cases of grade E in the observation group at postoperative 1 month,and there were 6 cases,14 cases,20 cases,20 ca-ses and 34 cases of corresponding Frankle grade in the control group,the observation group was significantly better than the control group,the differences were significant(P<0.05).Conclusion The application of cannulated pedicle screw combined with PMMA bone cement in the osteoporotic thoracolumbar fractures does not increase the difficulty of operation,and it can reduce the complications and reduce vertebral height,which is conducive to the recovery of nerve function.