Application of minimally invasive poking reduction technique in the treatment of thoracolumbar fractures

Abstract

Objective To investigate the clinical effects of minimally invasive poking reduction technique in the treatment of single segment thoracolumbar fractures without neural impairment. Methods From February 2011 to June 2015, 83 cases of thoracolumbar fractures without neural impairment underwent minimally invasive pedicle screw fixation in Linyi Central Hospital were selected and randomly divided into two groups.Group A (40 cases) was treated with poking reduction technique by percutaneous polyaxial pedical screw fixation, 43 patients in group B were treated with only percutaneous polyaxial pedicle screw fixation.The perioperative index, pre-and postoperative radiography, relief of the low back pain and general health status of the two groups were recorded and compared. Results There were no statistically significant differences in the operation time, operative blood loss, hospitalization time.All patients were followed up for 20-27months (average 24 months), the scores of visual analogue scale(VAS) and Oswestry disablity index(ODI) had no statistically significant differences between the two groups in the same period(all P>0.05). Before operation, the Cobb angle, sagittal index and anterior height of the fracture vertebral body in group A were (66.3±14.2)%, (20.4±6.5) °, (21.9±6.6) °, respectively, which in group B were (64.8±13.5)%, (14.5±7.7) °, (15.6±5.9) °, respectively, the differences were not statistically significant (all P>0.05). After operation, the Cobb angle, sagittal index and anterior height of the fracture vertebral body in group A were (93.8±9.8)%, (5.3±3.3)°, (5.4±2.0)°, respectively, which in group B were (88.0±10.6)%, (4.1±2.8)°, (8.1±4.7)°, respectively , the differences were statistically significant (t=8.893, 2.345, 3.351, all P<0.01). Conclusion The effect of poking reduction technique by percutaneous polyaxial pedical screw fixation is better than simply polyaxial pedicle screw in the treatment of thoracolumbar fracture, which is a safe and effective operation method. Key words: Spinal fractures; Fracture fixation, internal; Bone wires; Comparative effectiveness research