Minimally invasive percutaneous pedicle screw fixation in the treatment of single vertebra magerl type A thoracolumbar fracture

W. Feng, Jin Chen, W. Cui
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Abstract

Objective To explore the effect of minimally invasive percutaneous pedicle screw internal fixation on the anterior height and Cobb angle of injured vertebra in patients with single vertebra magerl type A thoracolumbar fracture. Methods 71 cases of single vertebra magerl type A thoracolumbar fracture admitted in our hospital from January 2015 to January 2017 were reviewed. Among them, 31 patients who received minimally invasive percutaneous pedicle screw internal fixation were as the observation group, and 40 patients receiving open pedicle internal fixation were as control group. All the patients were followed up for one year, and the preoperative and postoperative indexes, the height of the anterior edge of the injured vertebra and Cobb angle, as well as the score of Oswestry dysfunction were compared between the two groups. Results The length of incision and the time of descending were shorter in the observation group than in the control group, and the amount of bleeding during operation was less than in the control group (P 0.05). There was no significant difference in serum creatine kinase (CK) and C-reaction protein (CRP) levels between the two groups (P>0.05); the levels of serum CK and CRP in the two groups increased significantly after operation, and those in the control group were significantly higher than those in the observation group (P 0.05); 7 days and 1 year after operation, the height of the anterior edge of the two groups was significantly higher than that before operation (P 0.05). There was no significant difference in Oswestry dysfunction score between the two groups (P>0.05); the scores of Oswestry dysfunction were significantly reduced in both groups 7 days and 1 year ater operation, and the observation group was significantly lower than the control group (P<0.01). Conclusions Minimally invasive percutaneous pedicle screw fixation can effectively improve the anterior height and Cobb angle of the injured vertebra in patients with single vertebra magerl A thoracolumbar fracture, and the perioperative indexes, serum inflammatory factors and Oswestry dysfunction scores are better than those of open pedicle internal fixation, which is worthy of clinical application. Key words: Pedicle screws; Thoracolumbar fracture; Fracture fixation, internal
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微创经皮椎弓根螺钉内固定治疗单椎体A型胸腰椎骨折
目的探讨经皮微创椎弓根螺钉内固定对单椎体magerl型A型胸腰椎骨折伤椎前高度和Cobb角的影响。方法回顾性分析我院2015年1月至2017年1月收治的单椎体A型胸腰椎骨折71例。其中31例采用微创经皮椎弓根螺钉内固定作为观察组,40例采用开放式椎弓根内固定作为对照组。随访1年,比较两组患者术前、术后各项指标、损伤椎体前缘高度、Cobb角、Oswestry功能障碍评分。结果观察组切口长度、下降时间均短于对照组,术中出血量少于对照组(P < 0.05)。两组血清肌酸激酶(CK)、c反应蛋白(CRP)水平差异无统计学意义(P>0.05);两组患者术后血清CK、CRP水平均显著升高,且对照组显著高于观察组(P < 0.05);术后7天和1年,两组患者的前缘高度均显著高于术前(P < 0.05)。两组患者Oswestry功能障碍评分差异无统计学意义(P>0.05);两组患者术后7 d、1年Oswestry功能障碍评分均显著降低,且观察组显著低于对照组(P<0.01)。结论经皮微创椎弓根螺钉内固定可有效改善单椎体magerl A胸腰椎骨折患者损伤椎体前高度和Cobb角,围手术期指标、血清炎症因子及Oswestry功能障碍评分均优于开放式椎弓根内固定,值得临床推广应用。关键词:椎弓根螺钉;胸腰椎骨折;骨折内固定
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中国医师杂志
中国医师杂志 Medicine-Medicine (all)
CiteScore
0.10
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20937
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