Department of Neurosurgery, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore.
Singapore Med J. 2012 Sep;53(9):577-81.
This study aimed to evaluate the clinical and radiological outcomes, and safety and efficacy of percutaneous pedicle screw fixation (PPSF) in the treatment of thoracolumbar burst fractures.
This was a retrospective review of patients with thoracolumbar burst fractures treated with PPSF in a single hospital from 2010 to 2011. Baseline data included patient demographics, mechanism of injuries, fracture level, neurologic status and the number of percutaneous screws inserted. Kyphotic angle correction, vertebral body height restoration and mid-sagittal canal diameter improvement were used to assess radiological outcome. Screw misplacement, operative complications, functional improvement (ASIA score) and pain score on visual analogue scale were used to assess safety and clinical outcomes.
21 patients with 25 thoracolumbar burst fractures were treated with 134 percutaneous screws. There was significant improvement in kyphotic angle correction (mean difference 6.1 degrees, p = 0.006), restoration of anterior and posterior vertebral height (mean difference 19.7%, p < 0.01 and mean difference 6.6%, p = 0.007, respectively) and mid-sagittal canal diameter (mean difference 15.6%, p = 0.007) on discharge. These improvements remained statistically significant at six months post operation for restoration of anterior vertebral body height (mean difference 9.8%, p = 0.05) and mid-sagittal diameter (mean difference 30.0%, p < 0.01).
In this first local review, we have shown that PPSF is a relatively safe and effective technique for treating selected thoracolumbar burst fractures, and that it yields satisfactory results. However, its long-term outcome and efficacy need to be further evaluated.
本研究旨在评估经皮椎弓根螺钉固定（PPSF）治疗胸腰椎爆裂骨折的临床和影像学结果、安全性和有效性。
这是对 2010 年至 2011 年在一家医院接受 PPSF 治疗的胸腰椎爆裂骨折患者进行的回顾性研究。基线数据包括患者人口统计学资料、损伤机制、骨折水平、神经状态和置入的经皮螺钉数量。后凸角矫正、椎体高度恢复和正中矢状径改善用于评估影像学结果。螺钉位置不当、手术并发症、功能改善（ASIA 评分）和视觉模拟评分疼痛评分用于评估安全性和临床结果。
21 例 25 节胸腰椎爆裂骨折患者采用 134 枚经皮螺钉治疗。术后出院时，后凸角矫正（平均差异 6.1 度，p = 0.006）、前后位椎体高度恢复（平均差异 19.7%，p < 0.01 和平均差异 6.6%，p = 0.007）和正中矢状径改善（平均差异 15.6%，p = 0.007）均有显著改善。术后 6 个月，前位椎体高度恢复（平均差异 9.8%，p = 0.05）和正中矢状径（平均差异 30.0%，p < 0.01）仍有统计学意义。
在这项首次的本地研究中，我们已经表明，PPSF 是治疗特定胸腰椎爆裂骨折相对安全有效的技术，且结果令人满意。然而，其长期结果和疗效需要进一步评估。
