Ding Yan, Wang Banqin, Liu Yongjun, Dong Shengjie, Sun Xuri, Cao Zhilin, Wang Leisheng
Department of Orthopedics, Yantaishan Hospital, Yantai, People's Republic of China.
Department of Blood Transfusion, Shandong Provincial Qianfoshan Hospital Affiliated with Shandong First Medical University, Jinan, People's Republic of China.
J Pain Res. 2024 Jan 9;17:219-226. doi: 10.2147/JPR.S443879. eCollection 2024.
Percutaneous pedicle screw fixation is a common minimally invasive treatment for traumatic thoracolumbar and lumbar fractures; however, research on hardware removal after successful healing is limited. We aimed to introduce a rapid, safe, minimally invasive, and cost-effective method for percutaneous pedicle screw removal.
We conducted a retrospective analysis of demographic (age, sex, body mass index, alcohol use, and current smoking), clinical (hypertension and diabetes mellitus), surgical (affected levels, number of screws, time of surgery, and blood loss), and treatment cost characteristics of 92 patients who had undergone percutaneous pedicle screw removal between May 2016 and February 2023. The first 57 patients underwent the conventional method, and the remaining 35 underwent the modified method. Independent-sample -tests and chi-square tests were used to compare continuous and categorical variables, respectively, between the two groups.
No significant differences were observed in the demographic parameters, complications, or affected levels between the groups. However, the average surgical time (=0.000) was significantly shorter, and the average blood loss volume (=0.002) and total cost (=0.000) were significantly lower in the modified group than in the conventional group.
Compared with the conventional method, our modified method can shorten the surgical time, reduce blood loss, and reduce the total cost of treatment. It is a quick and safe minimally invasive method that does not require additional surgical instruments and is suitable for implementation in primary hospitals.
经皮椎弓根螺钉固定术是治疗胸腰椎和腰椎创伤性骨折的一种常见微创手术；然而，关于骨折成功愈合后取出内固定装置的研究有限。我们旨在介绍一种快速、安全、微创且经济高效的经皮椎弓根螺钉取出方法。
我们对2016年5月至2023年2月间接受经皮椎弓根螺钉取出术的92例患者的人口统计学特征（年龄、性别、体重指数、饮酒情况和当前吸烟情况）、临床特征（高血压和糖尿病）、手术特征（受累节段、螺钉数量、手术时间和失血量）以及治疗费用特征进行了回顾性分析。前57例患者采用传统方法，其余35例采用改良方法。分别使用独立样本t检验和卡方检验比较两组之间的连续变量和分类变量。
两组在人口统计学参数、并发症或受累节段方面未观察到显著差异。然而，改良组的平均手术时间（P = 0.000）显著更短，平均失血量（P = 0.002）和总费用（P = 0.000）显著低于传统组。
与传统方法相比，我们的改良方法可缩短手术时间、减少失血量并降低治疗总成本。它是一种快速且安全的微创方法，无需额外的手术器械，适合在基层医院实施。
