Wang Jiangtao, Yang Huiming, Ganau Mario, Wang Yuhang, Miao Junxian, Yan Liang, Wang Biao
Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710054, Shaanxi, China.
Shaanxi University of Chinese Medicine, Xianyang, 712046, Shaanxi, China.
J Orthop Surg Res. 2025 Sep 26;20(1):856. doi: 10.1186/s13018-025-06262-5.
Comparing the efficacy of conservative treatment, percutaneous pedicle screw fixation and percutaneous balloon kyphoplasty with calcium sulphate particles in the treatment of AO Spine type A1 traumatic thoracolumbar fractures.
The 220 patients with type A1 thoracolumbar fractures were divided into group A (n = 63, conservative treatment), group B (n = 85, percutaneous pedicle screw fixation), and group C (n = 72, percutaneous balloon kyphoplasty with calcium sulphate particle). Before treatment, 1 months and 2 years after treatment, and at the final follow-up, the efficacy was measured and compared between the three groups. Calcium sulphate particles ossification was assessed in patients from group C at 9 and 12 months postoperatively using computed tomography scans.
At the corresponding time points, the anterior vertebral body height ratio and Cobb angle were significantly better in groups B and C than in group A (all P < 0.05). At 1-month follow-up, visual analogue scale and oswestry disability index scores were significantly lower in groups B and C than in group A (P < 0.05), but the difference was not significant between the three groups at the subsequent follow-up (P > 0.05). Group C had significantly shorter operation time, less intraoperative blood loss, and shorter incision length compared to group B (all P < 0.05). At 12 months after surgery, computed tomography scan showed that the calcium sulphate particle disappeared and was replaced by autologous newly formed bone in patients of group C.
For the management of type A1 thoracolumbar fractures, all three treatment methods demonstrated satisfactory clinical efficacy. After interim follow-up, similar levels of pain relief and functional improvement were observed across the three methods. Both percutaneous pedicle screw fixation and kyphoplasty with calcium sulphate particle exhibited similar efficacy in correcting kyphotic Cobb angle and restoring vertebral body height, with both being superior to conservative treatment. Notably, percutaneous balloon kyphoplasty with calcium sulphate particle exhibited a more minimally invasive profile compared with percutaneous pedicle screw fixation.
比较保守治疗、经皮椎弓根螺钉固定术以及经皮球囊后凸成形术联合硫酸钙颗粒治疗AO脊柱分型A1型创伤性胸腰椎骨折的疗效。
将220例A1型胸腰椎骨折患者分为A组（n = 63，保守治疗）、B组（n = 85，经皮椎弓根螺钉固定术）和C组（n = 72，经皮球囊后凸成形术联合硫酸钙颗粒）。在治疗前、治疗后1个月和2年以及末次随访时，测量并比较三组的疗效。使用计算机断层扫描对C组患者术后9个月和12个月的硫酸钙颗粒骨化情况进行评估。
在相应时间点，B组和C组的椎体前缘高度比值和Cobb角均显著优于A组（均P < 0.05）。在1个月随访时，B组和C组的视觉模拟评分和奥斯维斯特残疾指数评分均显著低于A组（P < 0.05），但在随后的随访中三组之间差异无统计学意义（P > 0.05）。与B组相比，C组的手术时间显著更短、术中出血量更少且切口长度更短（均P < 0.05）。术后12个月，计算机断层扫描显示C组患者体内硫酸钙颗粒消失，被自体新形成的骨替代。
对于A1型胸腰椎骨折的治疗，三种治疗方法均显示出令人满意的临床疗效。中期随访后，三种方法在疼痛缓解和功能改善方面的水平相似。经皮椎弓根螺钉固定术和硫酸钙颗粒后凸成形术在矫正后凸Cobb角和恢复椎体高度方面疗效相似，均优于保守治疗。值得注意的是，与经皮椎弓根螺钉固定术相比，经皮球囊后凸成形术联合硫酸钙颗粒的微创性更强。
