Abstract: ObjectiveTo investigate the clinical effect of monosegmental fixation for the treatment of single thoracolumbar vertebral fracture.Methods80 cases with single thoracolumbar vertebral fracture were selected from January 2012 to July 2015 in our hospital. All the single thoracolumbar fracture patients were randomly divided into two groups, with 40 patients in each. The patients in the observation group received pedicle screw fixation via the monosegmental vertebra and the patients in the control group were treated with posterior short segment pedicle screw fixation across the injured vertebra. The surgical parameters, such as the Cobb angle, the percentage of vertebral compression, the sagittal diameter of vertebral canal and the recovery of neurological deficits were compared between the two groups. The rate of fixation failure in one year after operation was compared as well.ResultsOperation time, length of hospital stay and intraoperative blood loss of the two groups were compared, and the difference was not statistically significant (P>0.05). The Cobb angle vertebral compression percentage and sagittal diameter of spinal canal occupying rate of the observation group was significantly lower than that of control group, which was (4.56°±0.78°, 12.45±1.02, 4.58±0.23) VS (6.78°±1.02°, 16.47±2.98, 6.85±0.49). The differences were statistically significant (P<0.05). The neurological function of the patients improved, and there was no significant difference between the two groups (P>0.05). The total failure rate of the observation group within one year was 2.5%, which was lower than 17.5% of the control group, and the difference was statistically significant (P<0.05).Conclusion It can improve longterm fixation effect, reduce vertebral collapse and the internal fixation failure rate, and promote early postoperative rehabilitation of the pedicle screw fixation via the injured vertebra for the treatment of single thoracolumbar vertebral fracture.
秦卫,胡丹,司卫兵,焦健. 经伤椎置钉手术治疗单节段胸腰椎骨折的临床研究[J]. 中国现代手术学杂志, 2017, 21(5): 387-390.
QIN Wei, HU Dan, SI Weibing, JIAO Jian. Clinical Study on 40 Cases of Monosegmental Fixation for the Treatment of Single Thoracolumbar Vertebral Fracture. Chinese Journal of Modern Operative Surgery, 2017, 21(5): 387-390.
Cappuccio M, De Iure F, Amendola L, et al. Vertebral body compression fracture after percutaneous pedicle screw removal in a young man[J]. J Orthop Traumatol, 2015,16(4):343345. doi: 10.1007/s1019501403285.
Samdani AF, Asghar J, Miyanji F, et al. Recurrence of rib prominence following surgery for adolescent idiopathic scoliosis with pediclescrews and direct vertebral body derotation[J]. Eur Spine J, 2015,24(7):15471554. doi: 10.1007/s005860143716x.
Lefranc M, Peltier J. Accuracy of thoracolumbar transpedicular and vertebral body percutaneous screw placement: coupling the Rosa? Spine robot with intraoperative flatpanel CT guidancea cadaver study[J]. J Robot Surg, 2015,9(4):331338. doi: 10.1007/s117010150536x.