[Objective]To compare the clinical efficacy of"stretching soft tissue and distracting bone"reduction combined with per-cutaneous pedicle screw fixation(PSF)versus PSF only for single-segment thoracolumbar fracture.[Methods]A retrospective study was done on 47 patients who received surgical treatment for type A single-segment thoracolumbar fracture without neurological symptoms in our hospital from January 2019 to June 2021.According to the preoperative doctor-patient discussion,24 patients received"stretching soft tissue and distracting bone"reduction combined with PSF(the reduction group),while other 23 patients had PSF performed only(the con-ventional group).The documents regarding perioperative period,follow-up and images were compared between the two groups.[Results]Al-though there were no significant differences in total incision length,intraoperative blood loss,success rate of one-time screw placement,postoperative walking time,grade of incision healing,hospital stay and incidence of early complications between the two groups(P＞0.05),the reduction group was significantly greater than the conventional group in terms of operation time[(74.0±4.6)min vs(58.8±7.4)min,P＜0.001]and intraoperative fluoroscopy times[(32.3±2.8)times vs(26.1±3.2)times,P＜0.001].All the patients in both group were followed up for a mean of(15.2±2.5)months.The VAS and ODI scores in both groups were significantly improved over time after surgery(P＜0.05),and the reduction group proved significantly better than the conventional group in term of ODI scores at the last follow-up[(1.4±0.9)vs(3.1± 1.6),P＜0.001].Radiographically,the local kyphotic angle(LKA),vertebral wedge angle(VWA)and anterior vertebral height(AVH)were significantly improved in both group after surgery(P＜0.05).By comparison,the reduction group was significantly superior to the convention-al group in terms of LKA[(2.3±2.1)° vs(6.2±3.6)°,P＜0.001],VWA[(2.8±0.7)° vs(6.7±2.0)°,P＜0.001]and AVH[(94.1±2.5)％vs(85.7± 4.9)％,P＜0.001]at the latest follow-up.[Conclusion]This"stretching soft tissue and distracting bone"reduction combined with percuta-neous pedicle screw fixation(PSF)does restore the height of the injured vertebra better to correct the wedge-shaped vertebral deformity,avoid the occurrence of kyphosis,and maintain the long-term clinical effect for single-segment thoracolumbar fracture.
thoracolumbar fracturemanual reductionpercutaneous pedicle screw fixationminimally invasive surgery
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