长臂单轴椎弓根螺钉与单平面椎弓根螺钉内固定治疗创伤性胸腰椎骨折 复位力度比较.

BACKGROUND: Percutaneous long-arm single-axis pedicle screw fixation and minimally invasive percutaneous single-plane pedicle screw internal fixation are both classical minimally invasive surgical options commonly used in clinical practice, but the two surgical methods in the treatment of thoracolumbar fractures are still controversial. OBJECTIVE: To compare the advantages and limitations of two procedures, long-arm single-axis pedicle screw percutaneous approach and minimally invasive percutaneous single-plane pedicle screw internal fixation, in the treatment of thoracolumbar fractures. METHODS: Ninety patients with thoracolumbar fractures admitted to Shenzhen Hospital of Guangzhou University of Chinese Medicine from March 2017 to June 2021 were included and assigned to the control group (n=45) and the trial group (n=45). The control group received minimally invasive percutaneous single-plane pedicle screw internal fixation. The trial group received long-arm single-axis pedicle screw percutaneous approach. The indexes related to perioperative general condition, pain level, and recovery were compared between the two groups. RESULTS AND CONCLUSION: (1) Compared with the control group, the trial group had less intraoperative blood loss, shorter operative time and hospital stay (P < 0.05). (2) At 2 weeks and 1 month after operation, Oswestry dysfunction index score and Cobb angle in the trial group were lower than those in the control group (P < 0.05). The anterior and posterior heights of the injured vertebra were higher in the trial group than those of the control group (P < 0.05). At 2 months after operation, the Oswestry dysfunction index score and Cobb angle in the trial group were lower than those in the control group (P < 0.05). There was no significant difference in the anterior and posterior heights of the injured vertebra between the two groups (P > 0.05). At 2 weeks after operation, the visual analog scale score was lower in the trial group than that in the control group (P < 0.05). (3) Among the 45 cases in the control group, there were 2 cases of incision infection, 2 cases of dyskinesia, and 1 case of implant-related adverse reactions, with a total incidence rate of 11%. Among the 45 cases in the trial group, there were 2 cases of dyskinesia, and the total incidence was 4%. There was no significant difference in the total incidence of complications between the two groups (P > 0.05). (4) Both long-arm single-axis pedicle screw percutaneous approach and minimally invasive percutaneous single-plane pedicle screw internal fixation can achieve better results in the treatment of thoracolumbar fractures. However, the former has shorter operative time and less intraoperative blood loss, so the former is the ideal surgical option for obtaining the same benefit. [ABSTRACT FROM AUTHOR]