Abstract
Objectives
Percutaneous pedicle screw fixation (PPSF) has been a common surgery for treating
thoracolumbar and lumbar fractures. Many studies have reported PPSF is associated
with poor reduction. We present a reliable method by using short-segment monoaxial
percutaneous screws and instrumentational maneuvers to reduce the spine. This study
aimed to evaluate radiological and clinical results of this method of reduction compared
to traditional polyaxial screws method in treating thoracolumbar and lumbar fractures.
Methods
From February 2015 to February 2021, 64 patients with thoracolumbar and lumbar fractures
in our department were retrospectively reviewed and divided into experimental group
and control group according to different treatment methods. The experimental group
was treated with short-segment monoaxial percutaneous screws (which were inserted
at the adjacent vertebrae one level above, one level below the fracture, and the fractured
vertebra) and instrumentational maneuvers method, while the control group was treated
with traditional polyaxial screws method. The operation time was recorded. Visual
analogue scale (VAS) and Oswestry disability index (ODI) were assessed as the clinical
outcomes. The anterior height of the injured vertebra (AVH), the kyphosis cobb angle
and the vertebral wedge angle were used to evaluate the fracture radiological reduction.
Results
A total of 64 patients were enrolled including 31 in the experimental group and 33
in the control group. There were no significant difference in operation time, AVH,
the kyphosis cobb angle,the wedge angle of injured vertebra,VAS and ODI score between
the two groups in preoperation. In each group, there were significant differences
in the AVH, the kyphosis cobb angle and wedge angle of injured vertebra between preoperation
and immediate postoperation. In each group, there were significant differences in
VAS and ODI score between the preoperation and last follow-up. The total correction
rates of AVH,the kyphosis cobb angle and the wedge angle of injured vertebra were
significantly higher in the experimental group than those in the control group, while
the loss of correction was significantly lower than the control.
Conclusions
The reduction technique using monoaxial percutaneous screws and instrumentational
maneuvers for thoracolumbar and lumbar fractures exhibited better radiological results
and satisfying functional outcomes when compared to traditional polyaxial screws.
Keywords
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Article info
Publication history
Published online: September 21, 2022
Accepted:
September 16,
2022
Identification
Copyright
© 2022 Published by Elsevier Ltd.
