Comparison of the efficacy of vertebroplasty and pedicle screw fixation for thoracolumbar vertebral fractures

ZHANG Zhao; QI Pengfei; FU Dongwei

doi:10.13919/j.issn.2095-6274.ZHJY202509030

Abstract：Objective To analyze the comparison of the efficacy of two surgical methods,percutaneous verte-broplasty(PKP)and pedicle screw fixation,in patients with thoracolumbar vertebral fractures.Methods Through a retrospective analysis of the clinical data of 204 cases of thoracolumbar spinal fractures admitted to hospitals in Heilong-jiang Province from January 2021 to December 2024,the patients were divided into the PKP group(106 cases,undergoing percutaneous kyphoplasty)and the screw rod group(98 cases,undergoing screw rod system internal fixation)based on the actual surgical treatment plan adopted.The advantages and disadvantages of the two surgical methods,namely PKP and screw rod system internal fixation,were compared in terms of operation time,intraoperative blood loss,postoperative func-tional scores,and postoperative pain.Results The average surgical time in the PKP group was(76.11±23.69)minutes,significantly shorter than that of the pedicle screw fixation group(182.67±42.32)minutes,with a statistically significant difference(P<0.001).The intraoperative blood loss in the PKP group was less than that in the pedicle screw fixation group(15.58±5.28)vs.(214.29±115.92)mL,with a statistically significant difference(P<0.001).Postoperative pain scores:The VAS score at 24 hours post-operation in the PKP group was significantly lower than that in the pedicle screw fixation group,(2.85±0.76)vs.(4.62±0.89),with a statistical-ly significant difference(P<0.001).However,at 72 hours post-operation and at discharge,the VAS scores in the PKP group were slightly lower than those in the pedicle screw fixation group,but the differences were not statistical-ly significant(P>0.05),indicating that PKP caused less pain perception in the early postoperative period,while in the later postoperative period,the pain effects of the two methods were similar.Postoperative functional recovery scores:The ODI improvement rate in the PKP group at 3 days post-operation was(80.25±7.32)%,while in the pedicle screw fixation group it was(75.18±8.15)%,with no statistically significant difference(P=0.15).The satisfaction rate after PKP was 89.62%,and the satisfaction rate after pedicle screw fixation was also 84.69)%,with no statistically significant difference(P=0.250).The complication rate in the PKP group was 4.72%,while in the pedicle screw fixation group it was 8.16%,with no statistically significant difference(P=0.321).Conclusion Both surgical methods have certain advantages in the treatment of thora-columbar fractures,and both can effectively improve postoperative pain and functional status in patients with thoracolum-bar fractures.However,the PKP(Percutaneous Kyphoplasty)group has better short-term effects than the pedicle screw-rod system internal fixation group,characterized by shorter operation time,less intraoperative blood loss,faster pain relief,and quicker postoperative functional recovery.