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新型经皮椎弓根螺钉固定及椎体重建与传统开放椎弓根螺钉固定治疗无神经功能缺损的单节段胸腰椎骨折的疗效比较

Efficacy of a novel percutaneous pedicle screw fixation and vertebral reconstruction versus the traditional open pedicle screw fixation in the treatment of single-level thoracolumbar fracture without neurologic deficit.

作者信息

Rui Lining, Li Fudong, Chen Cao, E Yuan, Wang Yuchen, Yuan Yanhong, Li Yunfeng, Lu Jian, Huang Shengchang

机构信息

Department of Spinal Surgery, Wujin Hospital of Traditional Chinese Medicine, Changzhou, China.

Department of Orthopaedic Surgery, Spine Center, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China.

出版信息

Front Surg. 2023 Jan 6;9:1039054. doi: 10.3389/fsurg.2022.1039054. eCollection 2022.

DOI:10.3389/fsurg.2022.1039054
PMID:36684284
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9852511/
Abstract

OBJECTIVE

The aim of this study was to compare the efficacy and safety of a novel percutaneous pedicle screw fixation and vertebral reconstruction (PPSR) vs. that of open pedicle screw fixation (OPSF) in the treatment of thoracolumbar fractures.

METHODS

This retrospective study enrolled 153 patients who underwent PPSR and 176 patients who received OPSF. Periprocedural characteristics, radiographic parameters, and clinical outcomes were compared between the two groups.

RESULTS

The operation duration was 93.843 ± 20.611 in PPSR group and 109.432 ± 11.903 in OPSF group; blood loss was 131.118 ± 23.673 in PPSR group and 442.163 ± 149.701 in OPSF group, incision length was 7.280 ± 1.289 in PPSR group and 14.527 ± 2.893 in OPSF group, postoperative stay was 8.732 ± 1.864 in PPSR group and 15.102 ± 2.117 in OPSF group, and total hospitalization costs were 59027.196 ± 8687.447 in PPSR group and 73144.432 ± 11747.567 in OPSF group. These results indicated that these parameters were significantly lower in PPSR compared with those in OPSF group. No significant difference was observed in the incidence of complications between the two groups. The radiographic parameters including height of the anterior vertebra, Cobb angle, and vertebral wedge angle were better in PPSR group than in OPSF group. Recovery rate of AVH was 0.449 ± 0.079 in PPSR group and 0.279 ± 0.088 in OPSF group. Analysis of clinical results revealed that during postoperative period, the VAS and ODI scores in PPSR group were lower than those in OPSF group.

CONCLUSIONS

Collectively, these results indicated that PPSR more effectively restored the height of anterior vertebra and alleviated local kyphosis compared with OPSF. Moreover, the VAS and ODI scores in PPSR group were better than those of OPSF group.

摘要

目的

本研究旨在比较新型经皮椎弓根螺钉固定与椎体重建术(PPSR)和开放椎弓根螺钉固定术(OPSF)治疗胸腰椎骨折的疗效和安全性。

方法

本回顾性研究纳入了153例行PPSR的患者和176例行OPSF的患者。比较两组患者围手术期特征、影像学参数和临床结果。

结果

PPSR组手术时间为93.843±20.611分钟,OPSF组为109.432±11.903分钟;PPSR组失血量为131.118±23.673毫升,OPSF组为442.163±149.701毫升;PPSR组切口长度为7.280±1.289厘米,OPSF组为14.527±2.893厘米;PPSR组术后住院时间为8.732±1.864天,OPSF组为15.102±2.117天;PPSR组总住院费用为59027.196±8687.447元,OPSF组为73144.432±11747.567元。这些结果表明,与OPSF组相比,PPSR组的这些参数显著更低。两组并发症发生率无显著差异。PPSR组的影像学参数,包括椎体前缘高度、Cobb角和椎体楔角,均优于OPSF组。PPSR组的AVH恢复率为0.449±0.079,OPSF组为0.279±0.088。临床结果分析显示,术后期间,PPSR组的VAS和ODI评分低于OPSF组。

结论

总体而言,这些结果表明,与OPSF相比,PPSR能更有效地恢复椎体前缘高度并减轻局部后凸畸形。此外,PPSR组的VAS和ODI评分优于OPSF组。

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本文引用的文献

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Neurospine. 2021 Dec;18(4):713-724. doi: 10.14245/ns.2142390.195. Epub 2021 Dec 31.
2
Early loss of angular kyphosis correction in patients with thoracolumbar vertebral burst (A3-A4) fractures who underwent percutaneous pedicle screws fixation.接受经皮椎弓根螺钉固定术的胸腰椎爆裂性(A3-A4型)骨折患者早期矫正的角状后凸丢失情况。
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Effects of pedicle screw number and insertion depth on radiographic and functional outcomes in lumbar vertebral fracture.
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Effect of RTS versus percutaneous conventional pedicle screw fixation on type A thoracolumbar fractures: a retrospective cohort study.后路经皮与传统经皮椎弓根螺钉固定治疗 A 型胸腰椎骨折的效果:一项回顾性队列研究。
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