Clinical observation of percutaneous pedicle screw fixation for thoracolumbar fractures

MENG Tai-hui; LIU Zhan-li; LIU Yun; XU Xiao-ping; XU Ze-chuan

doi:10.3969/j.issn.1009-4237.2017.03.009

Abstract：Objective To observe the clinical efficacy of minimally invasive incision therapy for single thoracolumbar fractures without spinal cord/nerve injury by long arm universal pedicle screw internal fixation technique through paraspinal muscle gap approach.Methods Totally 60 up-to-standard patients from Jun.2011 to May 2015 were selected and divided to 2 groups.The observation group (n=30) used the minimally invasive incision therapy for single thoracolumbar fractures without spinal cord/nerve injury by long arm universal pedicle screw internal fixation technique through paraspinal muscle gap approach.The control group (n=30) used traditional median incision.Height recovery of the injured vertebra,recovery of the Cobb's angle,operation time,hospitalization time,operative blood loss,postoperative drainage volume and exposure times were compared between the two groups.Results The postoperative X-ray of the two groups showed that the vertebral body height recovery percentage was (48.0±9.5)% and (50.2±9.4)%,respectively.The Cobb's angle recovery percentage was (78.8±10.8)% and (80.2±8.9)%,respectively.There was no difference between the two groups in the above two indexes(P>0.05).But the operation time was (68.4±11.5) and (131.2±45.1) min,respectively,and the hospitalization time was (12.7±2.4) and (20.5±5.3) days,respectively.The blood loss during the operation were (41.2±12.5) and (227.6±56.4)mL,the postoperative wound drainage were (31.9±10.4) and (247.4±48.4)mL,and the intraoperative X-ray exposure were (4.0±0.5) and (7.5±2.0) times, respectively.The observation group was better than the control group in those indexes(P<0.05).Conclusion The technique of minimally invasive incision through paraspinal muscle gap approach has a better recovery of vertebral body height and Cobb's angle as well as less trauma and less blood loss.It is effective for the treatment of thoracolumbar fractures without spinal cord injury and worth application.