Comparison of the efficacy of percutaneous and open pedicle screw internal fixation for the restoration of vertebral morphology in thoracolumbar fractures
Objective:To investigate the clinical efficacy of percutaneous pedicle screw internal fixation and open pedicle screw internal fixation in the treatment of thoracolumbar fractures by analyzing postoperative changes in injury vertebral morphology in patients with thoracolumbar fractures. Methods:A retrospective analysis was conducted on 53 patients with single-segment thoracolumbar fractures who underwent surgery at the First Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2019 to December 2023. Patients were divided into two groups based on the surgical approach:the percutaneous pedicle screw internal fixation group (minimally invasive group,n=26) and the open pedicle screw internal fixation group (open group,n=27). Data on surgical time,intraoperative blood loss,and hospital stay of two groups were collected. The Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) score for pain were assessed preoperatively,at 1 week and 3 months postoperatively,and at the final follow-up. Computed tomography (CT) was used to measure the mid-sagittal area,sagittal Cobb angle,and anterior height of the injured vertebra preoperatively and at the time of screw removal. Results:All patients successfully underwent screw insertion and removal surgeries and were followed up for 6 to 18 months,with a mean follow-up of 11.2±3.3 months. Both groups showed significant postoperative improvement in the mid-sagittal area of the injured vertebra compared to preoperative values (all P<0.05),with no statistically significant difference between the two groups either preoperatively or at the time of screw removal (all P>0.05). Both groups also showed significant improvements in the sagittal Cobb angle and the anterior vertebral height compared to preoperative values (all P<0.05),with no statistically significant differences between the two groups either preoperatively or at the time of screw removal (all P<0.05). The minimally invasive group had significantly better ODI and VAS score at 1 week and 3 months postoperatively compared to the open group (all P<0.05). There was no statistically significant difference in surgical time between the two groups (P>0.05),while the minimally invasive group had significantly less intraoperative blood loss and shorter hospital stays compared to the open group (all P<0.05). Conclusions:Percutaneous pedicle screw fixation demonstrates significant advantages over open surgery in terms of blood loss、length of hospital stay and short-term improvement of ODI and VAS score. In the aspect of restoring the morphology of fractured vertebrae,percutaneous minimally invasive techniques achieve comparable clinical efficacy to traditional open pedicle screw fixation.
万方数据
维普
