Trungu Sokol, Forcato Stefano, Bruzzaniti Placido, Fraschetti Flavia, Miscusi Massimo, Cimatti Marco, Raco Antonino
N.E.S.M.O.S Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome.
Neurosurgery Unit, Card. G. Panico Hospital, Tricase, Italy.
Clin Spine Surg. 2019 May;32(4):E171-E176. doi: 10.1097/BSD.0000000000000791.
This was a retrospective study of the clinical and radiologic outcomes of traumatic thoracolumbar (TL) burst fractures.
We aimed to evaluate the clinical and radiologic outcomes after 6 years of follow-up of 144 patients with monosegmental TL burst fractures treated with percutaneous short-segment pedicle screw fixation, comparing two groups with versus without placement of an intermediate screw at the fractured vertebra.
Traumatic TL fractures are the most common vertebral fractures, especially at the TL junction (T10-L2). Minimally invasive surgery (MIS) is a valuable treatment option for traumatic TL burst fractures.
The clinical outcomes and radiologic parameters (Cobb angle, midsagittal index, and sagittal index) of 144 patients with traumatic monosegmental TL fractures treated with MIS were evaluated preoperatively, postoperatively, and after 3 and 6 years of follow-up. Patients were categorized into a nonintermediate screw group (nISG) and an intermediate screw group (ISG), and the groups were compared.
There were 71 patients (49.3%) in the nISG and 73 patients (50.7%) in the ISG. The radiologic parameters improved significantly more from the preoperative evaluation to the 6-year follow-up in the ISG than in the nISG (P<0.025). There were no significant differences in the mean Oswestry Disability Index (ODI) and Visual Analog Scale scores at the 6-year follow-up between the ISG and the nISG: 15.6% (ISG) versus 16.8% (nISG) for ODI (P<0.1) and 2.2 (ISG) versus 2.4 (nISG) for Visual Analog Scale score (P<0.85) (P<0.73).
MIS showed good clinical outcomes 6 years after surgery in both the ISG and the nISG. The additional intermediate screw significantly improved radiologic parameters but not clinical outcomes.
这是一项关于创伤性胸腰椎爆裂骨折临床和影像学结果的回顾性研究。
我们旨在评估144例接受经皮短节段椎弓根螺钉固定治疗的单节段胸腰椎爆裂骨折患者随访6年后的临床和影像学结果，比较两组在骨折椎体是否置入中间螺钉的情况。
创伤性胸腰椎骨折是最常见的椎体骨折，尤其是在胸腰段交界处（T10-L2）。微创手术（MIS）是治疗创伤性胸腰椎爆裂骨折的一种有价值的选择。
对144例接受MIS治疗的创伤性单节段胸腰椎骨折患者的临床结果和影像学参数（Cobb角、矢状面中部指数和矢状面指数）在术前、术后以及随访3年和6年后进行评估。患者被分为非中间螺钉组（nISG）和中间螺钉组（ISG），并对两组进行比较。
nISG组有71例患者（49.3%），ISG组有73例患者（50.7%）。从术前评估到6年随访，ISG组的影像学参数改善明显大于nISG组（P<0.025）。ISG组和nISG组在6年随访时的平均Oswestry功能障碍指数（ODI）和视觉模拟量表评分无显著差异：ODI分别为15.6%（ISG）和16.8%（nISG）（P<0.1），视觉模拟量表评分为2.2（ISG）和2.4（nISG）（P<0.85）（P<0.73）。
MIS在ISG组和nISG组术后6年均显示出良好的临床结果。额外的中间螺钉显著改善了影像学参数，但未改善临床结果。
