Rezvani Majid, Asadi Jamalodin, Sourani Arman, Foroughi Mina, Tehrani Donya Sheibani
Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Isfahan Medical Students' Research Committee (IMSRC), Isfahan University of Medical Sciences, Isfahan, Iran.
Korean J Neurotrauma. 2023 Mar 13;19(1):90-102. doi: 10.13004/kjnt.2023.19.e9. eCollection 2023 Mar.
To investigate the efficacy and safety of two different techniques for spinal ligamentotaxis. Spine ligamentotaxis reduces the number of retropulsed bone fragments in the fractured vertebrae. Two different ligamentotaxis techniques require clinical evaluation.
This was a randomized clinical trial. The case group was defined as one pedicular screw insertion into a fractured vertebra, and the control group as a no-pedicular screw in the index vertebra. Spine biomechanical values were defined as primary outcomes and complications as secondary outcomes.
A total of 105 patients were enrolled; 23 were excluded for multiple reasons, and the remaining were randomly allocated into the case (n=40) and control (n=42) groups. The patients were followed up and analyzed (n=56). The postoperative mid-sagittal diameter of the vertebral canal (MSD), kyphotic deformity correction, and restoration of the anterior height of the fractured vertebrae showed equal results in both groups. Postoperative retropulsion percentage and pain were significantly lower in the case group than in the control group (=0.003 and =0.004, respectively). There were no group preferences for early or long-term postoperative complications.
Regarding clinical and imaging properties, inserting one extra pedicular screw in a fractured vertebra during ligamentotaxis results in better retropulsion reduction and lower postoperative pain.
探讨两种不同的脊柱韧带整复技术的疗效和安全性。脊柱韧带整复可减少骨折椎体中后凸移位骨块的数量。两种不同的韧带整复技术需要进行临床评估。
这是一项随机临床试验。病例组定义为在骨折椎体中置入一枚椎弓根螺钉,对照组定义为在索引椎体中不置入椎弓根螺钉。将脊柱生物力学值定义为主要结局,并发症定义为次要结局。
共纳入105例患者;23例因多种原因被排除,其余患者被随机分为病例组(n = 40)和对照组(n = 42)。对患者进行随访并分析(n = 56)。两组术后椎管矢状径(MSD)、后凸畸形矫正及骨折椎体前缘高度恢复情况相当。病例组术后后凸移位百分比和疼痛程度均显著低于对照组(分别为P = 0.003和P = 0.004)。术后早期或长期并发症在两组间无明显差异。
就临床和影像学特征而言,在韧带整复过程中在骨折椎体中额外置入一枚椎弓根螺钉可更好地减少后凸移位并降低术后疼痛。