Tomczyk-Warunek Agnieszka, Kłapeć Michał, Blicharski Rudolf, Dresler Sławomir, Sowa Ireneusz, Gieleta Andrea Weronika, Skrzypek Tomasz, Lis Magdalena, Kazimierczak Waldemar, Blicharski Tomasz
Laboratory of Locomotor Systems Research, Department of Traumatology, Orthopedics and Rehabilitation, Medical University of Lublin, 20-954 Lublin, Poland.
Clinic of Rehabilitation, Department of Traumatology, Orthopedics and Rehabilitation, Medical University of Lublin, 20-954 Lublin, Poland.
J Clin Med. 2024 Dec 2;13(23):7318. doi: 10.3390/jcm13237318.
: Thoracolumbar and lumbar spine injuries account for 30-60% of spinal fractures, especially at the thoracolumbar junction. Conservative treatment is recommended for stable fractures without neurological symptoms, but studies suggest surgical intervention may offer better outcomes. However, there is no consensus on the best stabilization method. : This non-randomized, prospective study was conducted on 114 patients divided into groups based on the surgical technique selected: pedicle stabilization using Schanz screw constructs (Group One, n = 37) stabilization above and below the fractured vertebra using pedicle screws (Group Two, n = 32), and intermediate fixation with a pedicle screw additionally inserted into the fractured vertebra (Group Three, n = 45). Outcomes were assessed using the Cobb angle, anterior and posterior vertebral wall height, and patient quality of life via the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). X-ray imaging was performed before, during, and after surgery in the control group. : This statistical study showed that the location and type of injury significantly influenced the choice of short-segment stabilization method. In the case of measuring the Cobb angle and the high anterior wall, the statistical analysis showed that the best result was observed in the Schanz Group. Patients from this study group had the lowest pain and the highest efficiency. Schanz screw stabilization may offer superior outcomes for thoracolumbar spine injuries, providing better clinical and quality of life results compared to other methods.
胸腰椎和腰椎损伤占脊柱骨折的30%-60%，尤其在胸腰段交界处。对于无神经症状的稳定骨折，建议采用保守治疗，但研究表明手术干预可能会带来更好的结果。然而，对于最佳的稳定方法尚无共识。：本非随机前瞻性研究对114例患者进行，根据所选手术技术分组：使用斯氏针结构进行椎弓根稳定（第一组，n = 37），使用椎弓根螺钉在骨折椎体上下进行稳定（第二组，n = 32），以及额外在骨折椎体中插入椎弓根螺钉进行中间固定（第三组，n = 45）。通过Cobb角、椎体前后壁高度以及通过视觉模拟量表（VAS）和Oswestry功能障碍指数（ODI）评估患者生活质量来评估结果。对照组在手术前、手术中和手术后进行X线成像。：这项统计研究表明，损伤的部位和类型显著影响短节段稳定方法的选择。在测量Cobb角和前壁高度时，统计分析表明斯氏针组观察到的结果最佳。该研究组的患者疼痛最低且效率最高。与其他方法相比，斯氏针稳定术可能为胸腰椎损伤提供更好的结果，在临床和生活质量方面产生更好的效果。
