Short-segment pedicle screw fixation combined with vertebral plasty for treatment of OF type 5 osteoporotic thoracolumbar vertebral fractures
Objective To observe the efficacy of short-segment pedicle screw fixation combined with vertebral plasty for the treatment of OF type 5 osteoporotic thoracolumbar vertebral fractures.Methods A retrospective analysis was conducted on 24 cases of OF type 5 osteoporotic thoracolumbar vertebral fractures with posterior ligament complex injury,or posterior column bone structure injury,or anterior tension band injury treated with posterior short-segment pedicle screw fixation combined with vertebral plasty from May 2013 to December 2020.The differences in VAS scores for back pain,ratio of anterior body height of injured vertebra,and Cobb angle were compared before and after surgery.Results All 24 cases were followed up for 24 to 50 months,29 months on average.All fractures healed well without any internal fixation extraction,fracture,or bending,and there was no vertebral collapse.There were statistically significant differences in VAS scores for back pain,ratio of anterior body height of injured vertebra,and Cobb angle before surgery,1 week after surgery,and at the last follow-up(P＜0.05).The VAS score decreased one week after surgery compared with that before surgery(P＜0.05).At the last follow-up,the VAS score also significantly improved compared with that one week after surgery(P＜0.05).The ratio of anterior body height of injured vertebra increased one week after surgery compared with that before surgery(P＜0.05).At the last follow-up,the ratio of anterior body height of injured vertebra decreased,but there was no statistically significant difference compared with that one week after sur-gery(P＞0.05).The Cobb angle decreased one week after surgery compared with that before surgery(P＜0.05),and there was some loss of Cobb angle at the last follow-up,but there was no statistically significant difference compared with that one week after surgery(P＞0.05).Conclusion Short-segment pedicle screw fixation combined with vertebral plasty for the treatment of OF type 5 osteoporotic thoracolumbar vertebral fractures can enhance spinal stability in the early stage,avoid loss of vertebral height and Cobb angle,and enable patients to move early to prevent the complication of long-term bed rest.
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