Early- and mid-term effects of trans-injured and cross-injured vertebra pedicle screw fixation in the treatment of thoracolumbar fractures / 中国组织工程研究

ABSTRACT

BACKGROUND: The bone trabecula of the vertebral body cannot be fully recovered, and the mechanical stability of the sagittal position of the spinal column Is affected. The antl-bendlng force and the anti-torsion force of the short-segment fixation of fractured vertebra are obviously Increased. The bearing load of various activities such as flexion, extension, and rotation of the vertebral body is increased. The stability of the injured vertebra is better maintained, and favorable conditions are created for fracture healing. OBJECTIVE: To compare the early- and mid-term follow-up results of trans-injured and cross-injured vertebra pedicle screw fixation in the treatment of thoracolumbar fractures. METHODS: Eighty-eight patients with thoracolumbar vertebrae fracture treated in Affiliated Hospital of Qinghai University from April 2017 to April 2018 were divided into trans-injured vertebra group and cross-injured vertebra group according to the treatment plan. All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. Intraoperative blood loss, operation time, postoperative bed rest time, postoperative site infection, and subcutaneous hematoma were analyzed in both groups. Visual analogue scale score, Oswestry Disability Index, anterior edge height ratio and kyphosis Cobb angle were compared before surgery, 6 and 12 months after surgery between the two groups. RESULTS AND CONCLUSION: (1) The operation time was longer and intraoperative blood loss was higher in the trans-injured group than those in the cross-injured group, but the postoperative bed rest time was shorter in the trans-injured group than that in the cross-injured group (P 0.05). (3) At 6 and 12 months after surgery, visual analogue scale score and Oswestry Disability Index were lower in the trans-injured group than in the cross-injured group; anterior edge height ratio was larger in the trans-injured group than in the cross-injured group; kyphosis Cobb angle was smaller in the trans-injured group than in the cross-injured group (all P < 0.05). (4) Incidence of complications was higher in the cross-injured group (30%) than in the trans-injured group (7%) (P=0.001). (5) The treatment of thoracolumbar fracture with trans-injured pedicle screw can not only effectively restore and maintain the injured vertebral height and kyphosis Cobb angle, restore the physiological height and curvature of vertebral body, but also the incidence of postoperative complications is low, which can effectively improve the prognosis of patients and improve the quality of life of patients.