Objective To study the clinical efficacy of unilateral pedicle screw fixation combined with transforam-inal lumbar interbody fusion in treating osteoporotic thoracolumbar vertebral fractures.Methods 96 patients with osteopo-rotic thoracolumbar vertebral fractures,admitted to Zhumadian Weidaode Orthopedics Hospital between January 2020 and January 2022,were enrolled as research subjects,and divided into study group(n=45)and control group(n=51)based on the treatments they received.Patients in the study group received a combined treatment of unilateral pedicle screw fixation and transforaminal lumbar interbody fusion,whereas patients in the control group underwent unilateral pedicle screw fixation alone.Analyses were conducted to compare the following factors,surgery-related indicators,anatomic structures and functions of the vertebral body,pain intensity,complication rate,and re-fracture rate between the two groups.Results Intraoperative blood loss in the study group was markedly more than that in the control group(t= 39.581,P＜0.001).Additionally,postoperative ambulation time and length of stay were significantly longer in the study group(t=36.312 and 19.972,both P＜0.001).12 months after surgery,patients had higher anterior vertebral body height in the study group than the control group(t=4.914,P＜0.001),but lower vertebral compression ratio and Cobb angle and smaller compressed area as opposed to the control group(t=8.922,16.056 and 8.483,all P＜0.001),and both Oswestry disability index(ODI)score and visual analogue scale(VAS)score were significantly lower in the study group(t=10.633 and 12.680,both P＜0.001).During the 12-month follow-up after surgery,the complication rate of patients in the study group was 2.22%,which showed no significant difference compared with the corresponding 9.80%in the control group(χ2 = 2.345,P = 0.126).However,the re-fracture rate of patients was 0%in the study group,being significantly lower than the correspond-ing 11.76%in the control group(χ2 =5.647,P=0.017).Conclusion Unilateral pedicle screw fixation combined with transforaminal lumbar interbody fusion in the treatment of osteoporotic thoracolumbar fractures,though may lead to longer postoperative ambulation time and length of stay,can effectively restore the anatomic structures of the injured vertebra and enhance its function,alleviate patients'pain and significantly reduce the re-fracture rate,deserving to be promoted in clinical practice given its definite therapeutic effects.
关键词
经椎间孔椎间融合/椎弓根螺钉内固定/骨质疏松/椎体骨折/椎体功能
Key words
Transforaminal lumbar interbody fusion/Pedicle screw fixation/Osteoporosis/Vertebral fracture/Vertebral function
维普
万方数据