Curative effect of mini-incision common vertebral pedicle screw internal fixation on thoracoclumbar fractures without neurological injury_West China Medical Journal

Authors：

 PENG Chaohua , ZHAO Xiangjie , YANG Bin

Department of Orthopedics, the People’s Hospital of Meishan City, Meishan, Sichuan 620010, P. R. China;

Corresponding?author：

PENG Chaohua, Email: 1581082822@qq.com

Keywords：

Mini-incision; Spinal fractures; Internal fixation; Minimally invasive

DOI：

10.7507/1002-0179.201610063

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the short-term therapeutic effect of mini-incision common vertebral pedicle screw internal fixation on thoracoclumbar fractures without neurological injury. Methods The data of 61 patients with thoracolumbar fractures without neurological injury treated with mini-incision common vertebral pedicle screw internal fixation (the mini-incision group, n=32) or percutaneous pedicle screw fixation (the percutaneous group, n=29) from February 2014 to January 2016 was retrospectively collected and analyzed. Total incision length, operation time, blood loss, fluoroscopy times, postoperative bed rest time, hospitalization costs, Visual Analogue Scale (VAS) score, Oswestry Disability Index (ODI), vertebral Cobb angle of correction, and accuracy rate of screw placement were compared between the two groups. Results All the patients were followed up for 6 to 24 months with a mean of 13.4 months. There were no complications such as incision infection and neurovascular injury except for 2 screws breakage in one patient in the percutaneous group. In the mini-incision group, the average total incision length was longer than that in the percutaneous group [(7.33±0.53) vs. (6.38±0.44) cm], while the average operation time was shorter than that in the percutaneous group [(62.66±4.75) vs. (72.93±5.09) minutes]; the differences were statistically significant (P<0.001). In the mini-incision group, the average frequency of fluoroscopy was fewer [(5.63±0.61)vs. (19.07±1.60) times] and the average hospitalization costs was lower [(23.3±1.5) thousand yuan vs. (39.5±1.6) thousand yuan] than those in the than that in the percutaneous group; the differences were statistically significant (P<0.001). No significant difference was found in blood loss, postoperative bed rest time, VAS score, ODI, vertebral Cobb angle of correction, and accuracy rate of screw placement between the two groups (P>0.05). Conclusions Mini-incision common vertebral pedicle screw internal fixation for thoracoclumbar fractures without neurological injury has the advantages of short operation time, less fluoroscopy times, low hospitalization costs and high fixation strength. It may obtain a good short-term effectiveness.

Citation： PENG Chaohua, ZHAO Xiangjie, YANG Bin. Curative effect of mini-incision common vertebral pedicle screw internal fixation on thoracoclumbar fractures without neurological injury. West China Medical Journal, 2017, 32(12): 1854-1858. doi: 10.7507/1002-0179.201610063 Copy

1.	Li H, Yang L, Xie H, et al. Surgical outcomes of mini-open Wiltse approach and conventional open approach in patients with single-segment thoracolumbar fractures without neurologic injury. J Biomed Res, 2015, 29(1): 76-82.
2.	李長青, 羅剛, 周躍. 新型微創經皮椎弓根螺釘內固定治療胸腰椎骨折. 中華創傷雜志, 2009, 25(6): 522-525.
3.	龐正寶, 龐幫鐳, 湯優民, 等. Wiltse 入路治療單節段胸腰椎骨折對多裂肌影響的研究. 中華骨科雜志, 2016, 36(2): 72-80.
4.	Fan Y, Zhang J, He X, et al. A comparison of the mini-open wiltse approach with pedicle screw fixation and the percutaneous pedicle screw fixation for neurologically intact thoracolumbar fractures. Med Sci Monit, 2017, 23: 5515-5521.
5.	茍永勝, 李海波. 國產微創椎弓根釘系統治療胸腰椎骨折的近中期療效評估. 華西醫學, 2015, 30(4): 652-655.
6.	Court C, Vincent C. Percutaneous fixation of thoracolumbar fractures: current concepts. Orthop Traumatol Surg Res, 2012, 98(8): 900-909.
7.	張文志, 尚希福, 段麗群, 等. 微創經皮與傳統開放椎弓根螺釘內固定治療胸腰椎骨折的臨床對比研究. 中國骨與關節外科, 2012, 5(2): 106-111.
8.	De Iure F, Cappuccio M, Paderni S, et al. Minimal invasive percutaneous fixation of thoracic and lumbar spine fractures. Minim Invasive Surg, 2012, 2012: 141032.
9.	文天林, 孟浩, 王飛, 等. 經皮與開放椎弓根螺釘內固定術治療無神經損傷胸腰段骨折的療效對比. 中國脊柱脊髓雜志, 2016, 26(5): 401-407.
10.	Joaquim AF, de Almeida Bastos DC, Jorge Torres HH, et al. Thoracolumbar injury classification and injury severity score system: a literature review of its safety. Global Spine J, 2016, 6(1): 80-85.
11.	Aebi M. Classification of thoracolumbar fractures and dislocations. Eur Spine J, 2010, 19(1): 2-7.
12.	Huskisson EC. Measurement of pain. Lancet, 1974, 2(7889): 1127-1131.
13.	Fairbank JC, Couper J, Davies JB, et al. The oswestry low back pain disability questionnaire. Physiotherapy, 1980, 66(8): 271-273.
14.	Modi HN, Suh SW, Fernandez H, et al. Accuracy and safety of pedicle screw placement in neuromuscular scoliosis with free-hand technique. Eur Spine J, 2008, 17(12): 1686-1696.
15.	Yu E, Khan SN. Does less invasive spine surgery result in increased radiation exposure? A systematic review. Clin Orthop Relat Res, 2014, 472(6): 1738-1748.
16.	Fransen P. Fluoroscopic exposure in modern spinal surgery. Acta Orthop Belg, 2011, 77(3): 386-389.
17.	方向前, 胡志軍, 范順武, 等. 胸腰段骨折經肌間隙入路與傳統入路內固定的比較研究. 中華骨科雜志, 2009, 29(4): 315-319.

1. Li H, Yang L, Xie H, et al. Surgical outcomes of mini-open Wiltse approach and conventional open approach in patients with single-segment thoracolumbar fractures without neurologic injury. J Biomed Res, 2015, 29(1): 76-82.
2. 李長青, 羅剛, 周躍. 新型微創經皮椎弓根螺釘內固定治療胸腰椎骨折. 中華創傷雜志, 2009, 25(6): 522-525.
3. 龐正寶, 龐幫鐳, 湯優民, 等. Wiltse 入路治療單節段胸腰椎骨折對多裂肌影響的研究. 中華骨科雜志, 2016, 36(2): 72-80.
4. Fan Y, Zhang J, He X, et al. A comparison of the mini-open wiltse approach with pedicle screw fixation and the percutaneous pedicle screw fixation for neurologically intact thoracolumbar fractures. Med Sci Monit, 2017, 23: 5515-5521.
5. 茍永勝, 李海波. 國產微創椎弓根釘系統治療胸腰椎骨折的近中期療效評估. 華西醫學, 2015, 30(4): 652-655.
6. Court C, Vincent C. Percutaneous fixation of thoracolumbar fractures: current concepts. Orthop Traumatol Surg Res, 2012, 98(8): 900-909.
7. 張文志, 尚希福, 段麗群, 等. 微創經皮與傳統開放椎弓根螺釘內固定治療胸腰椎骨折的臨床對比研究. 中國骨與關節外科, 2012, 5(2): 106-111.
8. De Iure F, Cappuccio M, Paderni S, et al. Minimal invasive percutaneous fixation of thoracic and lumbar spine fractures. Minim Invasive Surg, 2012, 2012: 141032.
9. 文天林, 孟浩, 王飛, 等. 經皮與開放椎弓根螺釘內固定術治療無神經損傷胸腰段骨折的療效對比. 中國脊柱脊髓雜志, 2016, 26(5): 401-407.
10. Joaquim AF, de Almeida Bastos DC, Jorge Torres HH, et al. Thoracolumbar injury classification and injury severity score system: a literature review of its safety. Global Spine J, 2016, 6(1): 80-85.
11. Aebi M. Classification of thoracolumbar fractures and dislocations. Eur Spine J, 2010, 19(1): 2-7.
12. Huskisson EC. Measurement of pain. Lancet, 1974, 2(7889): 1127-1131.
13. Fairbank JC, Couper J, Davies JB, et al. The oswestry low back pain disability questionnaire. Physiotherapy, 1980, 66(8): 271-273.
14. Modi HN, Suh SW, Fernandez H, et al. Accuracy and safety of pedicle screw placement in neuromuscular scoliosis with free-hand technique. Eur Spine J, 2008, 17(12): 1686-1696.
15. Yu E, Khan SN. Does less invasive spine surgery result in increased radiation exposure? A systematic review. Clin Orthop Relat Res, 2014, 472(6): 1738-1748.
16. Fransen P. Fluoroscopic exposure in modern spinal surgery. Acta Orthop Belg, 2011, 77(3): 386-389.
17. 方向前, 胡志軍, 范順武, 等. 胸腰段骨折經肌間隙入路與傳統入路內固定的比較研究. 中華骨科雜志, 2009, 29(4): 315-319.

West China Medical Journal

Curative effect of mini-incision common vertebral pedicle screw internal fixation on thoracoclumbar fractures without neurological injury

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content