A comparative study on the long-term effect of pedicle screw fixation in different directions of injured vertebrae in the treatment of lumbar fractures
Objective To compare the long-term effect of pedicle screw fixation in different directions of injured vertebrae in the treatment of lumbar fractures.Methods 62 patients with lumbar fracture were divided into group A(32 cases)and group B(30 cases)according to different surgical methods.Group A received unilateral pedicle screw fixation,and group B received bilateral pedicle screw fixation.Comparison was made on operative time,intraoperative blood loss,Oswestry disability index(ODI),anterior vertebral body height(AVBH%),sagittal Cobb's angle(SCA)and postoperative complications between the two groups.Results The ODI scores of the two groups at 1 week and 6 months after surgery were lower than those before surgery,and the difference was statistically significant(P<0.05).There was no significant difference in ODI scores between the two groups before surgery,at 1 week and 6 months after surgery(F=0.339,P=0.561>0.05);there was a time effect(F=4050.000,P=0.000<0.05);and there was no interaction effect between time and group(F=2.036,P=0.132>0.05).The operative time and intraoperative blood loss in group A were(98.42±14.61)min and(184.55±22.12)ml,which were less than(252.24±32.15)min and(325.02±35.42)ml in group B(t=24.510,18.857;P=0.000,0.000<0.05).At 1 week,1 month,3 months and 6 months after surgery,the AVBH%in the two groups increased and SCA decreased compared with this group before surgery;AVBH%in group A was higher than that in group B,and SCA was lower than that in group B(P<0.05).There was no significant difference in AVBH%between the two groups before surgery and at 1 week,1 month,3 months and 6 months after surgery(F=1.202,P=0.274>0.05);there was a time effect(F=280.400,P=0.000<0.05);and there was an interaction effect between time and group(F=14.420,P=0.000<0.05).The difference between the two groups of SCA before surgery and at 1 week,1 month,3 months and 6 months after surgery was statistically significant(F=65.410,P=0.000<0.05);there was a time effect(F=484.300,P=0.000<0.05);and there was an interaction effect between time and group(F=9.940,P=0.000<0.05).The incidence of postoperative complications was 3.13%(1/32)in group A,which was significantly lower than 20.00%(6/30)in group B(χ2=4.402,P=0.036<0.05).Conclusion The effect of unilateral and bilateral pedicle screw placement on the recovery of lumbar function in patients with lumbar fracture is similar,but the effect of unilateral pedicle screw placement on the reduction of the injured vertebra and long-term maintenance of the vertebral height is more significant,and the incidence of complications is lower,which is worthy of popularization and application.
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