Clinical Comparison of Percutaneous Pedicle Nail Fixation and Posterior Median Intermuscular Space Approach Pedicle Fixation in the Treatment of Thoracolumbar Fractures

HAN Jianhua; QI Yongjian; GUO Yongsheng; ZHENG Sheng'an

doi:10.14033/j.cnki.cfmr.2025.16.003

Abstract：Objective:To compare and analyze the clinical effects of percutaneous pedicle nail fixation and posterior median intermuscular space approach pedicle fixation in the treatment of thoracolumbar fractures,and to provide a favorable reference for future clinical treatment options.Method:A total of 76 patients with thoracolumbar fractures who admitted to Beijing Royal Hospital of Integrated Traditional Chinese and Western Medicine from March 2021 to January 2024 were selected,and they were divided into percutaneous group 40 cases and posterior median intermuscular approach group 36 cases according to the fixation method.The percutaneous group was treated with percutaneous pedicle nail fixation,and the posterior median intermuscular approach group was treated with posterior median intermuscular space approach pedicle fixation.The clinical effects of two groups were compared.Result:The operation time of the percutaneous group was longer than that of the posterior median intermuscular approach group,the hospitalization time was shorter than that of the posterior median intermuscular approach group,and the intraoperative blood loss was less than that of the posterior median intermuscular approach group,the differences were statistically significant(P<0.05).At 1 month after operation,the scores of visual analogue scale(VAS)and Oswestry dysfunction index(ODI)in two groups were lower than those before operation,and those in the percutaneous group were lower than those in the posterior median intermuscular approach group,the differences were statistically significant(P<0.05).At 1 month after operation,the Cobb angle of two groups were smaller than those before operation,and the differences were statistically significant(P<0.05).The incidence of postoperative complications in the percutaneous group was 2.50%,compared with 5.56%in the posterior median intermuscular approach group,the difference was not statistically significant(P>0.05).Conclusion:The clinical effect of percutaneous pedicle nail fixation in the treatment of thoracolumbar fractures is significant,the intraoperative blood loss is less,the hospitalization time is shortened,and the postoperative recovery is faster.Compared with the posterior median intermuscular space approach pedicle fixation for the treatment of thoracolumbar fractures,the safety of both are better,but the operation time is longer,the pain degree is lighter at 1 month after operation,and the living ability and action ability are stronger.