Impact of endplate fracture on clinical efficacy of minimally invasive percutaneous pedicle screwing for thoracolumbar vertebra burst fractures / 中华创伤骨科杂志

ABSTRACT

Objective To investigate the impact of endplate fracture on the clinical efficacy of minimally invasive percutaneous pedicle screwing for thoracolumbar burst fractures.Methods From September 2012 to June 2016,35 patients with thoracolumbar burst fracture underwent minimally invasive percutaneous pedicle screwing at Department of Orthopaedics,The First Affiliated Hospital to Nanjing Medical University.They were divided into 2 groups according to the severity of endplate fracture:a mild fracture group of 17 cases and a severe fracture group of 18 cases.Their clinical data were recorded and compared between the 2 groups before surgery,before discharge,6 months after surgery and at the last follow-up with respects to kyphosis cobb angle and height compression rate of the injured vertebra,and visual analogue scale (VAS),Oswestry disability index (ODI) and the MOS 36-item Short Form Health Survey (SF-36) scores.Results The kyphosis cobb angle and height compression rate of the injured vertebra,and VAS,ODI and SF-36 scores before discharge,6 months after surgery and at the last follow-up were all significantly improved in all the patients compared to the values before surgery (P ＜ 0.05).There were no significant differences between the 2 groups in the kyphosis cobb angle of the injured vertebra before surgery,before discharge,6 months after surgery or at the last follow-up (P ＞ 0.05).At the last follow-up,the height compression rate of the injured vertebra,and VAS,ODI and SF-36 scores in the mild fracture group were significantly lower than in the severe fracture group (P ＜ 0.05),and the height compression rate of the injured vertebra,and VAS,ODI and SF-36 scores of the severe fracture group were significantly higher than the values 6 months before (P ＜ 0.05).Conclusions The severity of endplate fracture may have no significant impact on the recovery of vertebral height in the early-to-mid stage after minimally invasive percutaneous pedicle screwing for thoracolumbar burst fractures.However,the patients complicated with severe endplate fracture are likely to suffer a height loss of the injured vertebral body and decreased quality of life in the long run.