Minimally invasive percutaneous pedicle screw fixation combined with bone grafting versus simple percutaneous internal fixation in the treatment of single segmental thoracolumbar compression fracture / 中华创伤骨科杂志

ABSTRACT

Objective:To compare the efficacy of minimally invasive percutaneous pedicle screw fixation combined with injured vertebra bone grafting (PPSF+BG) and simple percutaneous pedicle screw fixation (PPSF) in the treatment of single segmental thoracolumbar compression fracture.Methods:The data were analyzed retrospectively of the 56 patients who had undergone PPSE at Department of Spine Surgery, Wuhan Puren Hospital from February 2017 to May 2019. Of them, 29 were treated by PPSF+BG [17 males and 12 females with an age of (50.6±8.4) years] and 27 by simple PPSF [13 males and 14 females with an age of (49.3±8.2) years]. The 2 groups were compared in terms of operation time, intraoperative blood loss, hospital stay and incidence of complications. The height of anterior edge of injured vertebra, cobb angle of injured kyphosis, visual analogue scale (VAS) and Oswestry disability index (ODI) at postoperative 1, 6 and 12 months were also compared between the 2 groups.Results:There was no significant difference in the preoperative general data between the 2 groups, showing they were comparable ( P>0.05). All of them were followed up for more than 12 months. There was no significant difference between the 2 groups in operation time, intraoperative blood loss, hospital stay or incidence of complications ( P>0.05). There was no significant difference between the 2 groups either in the height of anterior edge of injured vertebra, cobb angle of injured kyphosis or ODI score at 1 or 6 months after operation ( P>0.05). At 12 months after operation, PPSF+BG group had a significantly greater height of injured vertebra [(19.5±0.9) mm], a significantly smaller cobb angle of kyphosis (7.1°±0.5°) and a significantly lower ODI score (11.1±2.9) than PPSF group [(18.2±1.3) mm, 8.1°±0.5° and 19.5±1.6] ( P<0.05). At postoperative 6 and 12 months, the VAS scores in PPSF+BG group were significantly lower than those in PPSF group ( P<0.05). In all the patients, the postoperative height of anterior edge of injured vertebra, cobb angle of injured kyphosis, VAS and ODI scores were significantly improved than the preoperative values ( P<0.05). Conclusion:Although both minimally invasive percutaneous pedicle screw fixation combined with bone grafting and simple percutaneous pedicle screw fixation can achieve good therapeutic outcomes for single segmental thoracolumbar compression fractures, the former may be superior in effectively promoting rapid recovery of the patients and improving the quality of life of the patients after operation.