A retrospective comparative study of clinical efficacy of percutaneous short segment pedicle screw fixation with or without screwing of the fractured vertebra with O-arm navigation

Xiaofeng Shao,Peng Peng,Peng Yang,Zhonglai Qian,Haiqing Mao,Xiaoyu Zhu,Xi Hua,Kangwu Chen,Tian Xu,Huilin Yang,Zixiang Liu

doi:10.1186/s12891-022-05069-3

Abstract

ObjectiveTo retrospectively analyze the short and long-term efficacies of O-arm-navigated percutaneous short segment pedicle screw fixation, with or without screwing of the fractured vertebra.MethodsA total of 42 patients who underwent O-arm-navigated percutaneous short segment pedicle screw fixation for the treatment of thoracolumbar fractures from February 2015 to December 2018 were selected for analysis. The patients were divided into two groups according to the surgical intervention they received: Group A received percutaneous short segment pedicle screw fixation with screwing of the fractured vertebra and Group B received percutaneous short segment pedicle screw fixation without screwing of the fractured vertebra. Radiographic analysis included Cobb angles and percentage of anterior vertebral height (AVH%). Clinical functional outcomes were assessed using the visual analog scale (VAS) for back pain and the oswestry disability index (ODI) scores.ResultsNo significant differences were observed in the operation time and intraoperative blood loss between the two groups (P > 0.05). The length of incision was statistically significantly different between the two groups (P < 0.05). There was no significant difference in Cobb angle and AVH% between the two groups before and after the surgery (P > 0.05). However, the Cobb angle and AVH% were both significantly larger in Group A than Group B at the final follow-up (P < 0.05). In terms of clinical outcomes, there were no statistically significant differences in VAS and ODI scores between the two groups (P > 0.05).ConclusionIn the short term, both minimally invasive treatments were safe and effective in treating thoracolumbar fracture. Although there was significant difference between the two groups in Cobb angle and vertebral body height at the last follow-up, the difference was small. Therefore, these specific parameters will be an important outcome measure in further investigations.

Highlights

With the rapid development of industry and extensive popularization of high-speed vehicles, the frequency of thoracolumbar fractures is greatly increased
Thoracolumbar fractures result in spinal instability and nerve damage and often require surgery to achieve sufficient decompression, vertebral height restoration and stability, while avoiding kyphosis, nerve damage, and have accelerated recovery
Since Dick et al [5] proposed the concept of adding intermediate screws to the injured vertebrae, this has become a widely used method of correcting thoracolumbar fractures

Summary

Introduction

With the rapid development of industry and extensive popularization of high-speed vehicles, the frequency of thoracolumbar fractures is greatly increased. People suffering from this type of fracture may incur large medical costs and long-time recovery, which vastly. Pedicle screws were only inserted above and below the injured vertebral body This surgical procedure is shown to save the segmental motion of the vertebral body, poor surgical outcomes, such as, spinal nonunion, implant failure, and increased kyphosis are commonly reported [3, 4]. Since Dick et al [5] proposed the concept of adding intermediate screws to the injured vertebrae, this has become a widely used method of correcting thoracolumbar fractures

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Discussion

Conclusion