Jehanzeb Muhammad, Khizar Ahtesham, Shabbir Muhammad Asif, Shakir Muhammad, Anwar Khawar, Bashir Asif
Dr. Muhammad Jehanzeb, MBBS, MS Senior Registrar Neurosurgery, Department of Neurosurgery Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan.
Dr. Ahtesham Khizar, MBBS, FCPS Senior Registrar Neurosurgery, Department of Neurosurgery Unit-I, Punjab Institute of Neurosciences, Lahore, Pakistan.
Pak J Med Sci. 2024 Dec;40(12PINS Suppl):S47-S54. doi: 10.12669/pjms.40.12(PINS).11110.
To compare correction of kyphotic deformity (KD) and implant failure (IF) in percutaneous short-segment pedicle screws fixation (SSPF) with index level versus long-segment pedicle screws fixation (LSPF) without index level for traumatic thoracolumbar (TL) fractures.
This prospective study comprised 56 patients who met the study's inclusion criteria from the Department of Neurosurgery at the Punjab Institute of Neurosciences in Lahore, Pakistan presented between June 2022 and May 2023. We separated them into two groups: Group-A and Group-B, each with 28 patients. Group-A consisted of percutaneous SSPF with incorporated screws in the fractured vertebra, whereas Group-B consisted of percutaneous LSPF without index level involvement for traumatic TL fractures. We reviewed the patient's preoperative, postoperative, and follow-up radiographs. The quantitative factors such as Cobb's angle and implant stability were investigated.
The study comprised individuals with a mean age of 31.5 ± 10.6 SD years. Out of 56 patients, 38 (67.85%) were male and 18 (32.14%) were female. The fracture level distribution was 37 (67.07%) patients with L1 fracture, 15 (26.78%) with D12 fracture, 2 (3.57%) with D11 fracture, and 2 (3.57%) with L2 fracture. Group-A had a preoperative Cobb's angle of 18.8° ± 5.0° SD, whereas Group-B had 19.8° ± 6.3° SD (P-value=0.23). Immediate postoperative Cobb's angle was 6.4° ± 3.4° SD in Group-A and 7.3° ± 3.7° SD in Group-B (P-value 0.66). After three months, Group-A had a Cobb's angle of 7.1° ± 3.6° SD, whereas Group-B had 7.8° ± 3.7° SD (P-value = 0.78). Six-month follow-up Cobb's angle was 7.9° ± 3.6° SD in Group-A and 8.4° ± 3.8° SD in Group-B (P-value=0.502). There were no implant failures in any group.
For a single level traumatic TL fracture, SSPF with index level can preserve Cobb's angle better than LSPF without index level, and it has high IF stability.
比较经皮短节段椎弓根螺钉固定术（SSPF）（针对创伤性胸腰椎（TL）骨折且累及骨折节段）与非累及骨折节段的长节段椎弓根螺钉固定术（LSPF）在矫正后凸畸形（KD）及植入物失败（IF）方面的效果。
这项前瞻性研究纳入了2022年6月至2023年5月期间来自巴基斯坦拉合尔旁遮普神经科学研究所神经外科的56例符合研究纳入标准的患者。我们将他们分为两组：A组和B组，每组28例患者。A组采用经皮SSPF并在骨折椎体置入螺钉，而B组采用经皮LSPF治疗创伤性TL骨折且不涉及骨折节段。我们回顾了患者术前、术后及随访时的X线片。研究了诸如Cobb角和植入物稳定性等定量因素。
该研究纳入的个体平均年龄为31.5±10.6标准差岁。56例患者中，38例（67.85%）为男性，18例（32.14%）为女性。骨折节段分布为：L1骨折37例（67.07%），D12骨折15例（26.78%），D11骨折2例（3.57%），L2骨折2例（3.57%）。A组术前Cobb角为18.8°±5.0°标准差，而B组为19.8°±6.3°标准差（P值=0.23）。A组术后即刻Cobb角为6.4°±3.4°标准差，B组为7.3°±3.7°标准差（P值0.66）。三个月后，A组Cobb角为7.1°±3.6°标准差，B组为7.8°±3.7°标准差（P值 = 0.78）。六个月随访时，A组Cobb角为7.9°±3.6°标准差，B组为8.4°±3.8°标准差（P值=0.502）。两组均未出现植入物失败情况。
对于单节段创伤性TL骨折，累及骨折节段的SSPF在维持Cobb角方面优于非累及骨折节段的LSPF，且具有较高的植入物稳定性。
