Clinical Effect of Minimally Invasive Percutaneous Pedicle Screw Internal Fixation Combined with Injured Vertebrae Bone Grafting in the Treatment of Thoracolumbar Fractures in Orthopedic Surgery.

Abstract

Objective To observe the clinical effect of minimally invasive percutaneous pedicle screw internal fixation combined with injured vertebrae bone grafting in the treatment of thoracolumbar fractures in orthopedic surgery. Methods A total of 132 patients with thoracolumbar fractures admitted to the hospital were enrolled between January 2020 and April 2021. Both groups underwent minimally invasive percutaneous pedicle screw internal fixation. According to the presence or absence of intraoperative injured vertebrae bone grafting, they were divided into the grafting group (73 cases) and the injured vertebrae ungrafted group (59 cases). The perioperative indexes, pain at 2 weeks after surgery, surgical stress, recovery of an injured vertebra, self-care ability, quality of life, and postoperative complications were compared between the two groups. Result There was no significant difference in intraoperative blood loss, operation time, or hospitalization time between the grafting group and the nongrafting group (P > 0.05).2 weeks after surgery, scores of the Visual Analogue Scale (VAS) in the grafting group were lower than those in the nongrafting group (P < 0.05).At 3d after surgery, levels of serum cortisol (COR), epinephrine (E), and norepinephrine (NE) in both groups were higher than those before surgery, which were lower in the grafting group than in the nongrafting group (P < 0.05).At 3 months after surgery, the anterior edge height of the injured vertebra in both groups was increased, which was higher in the grafting group than in the nongrafting group (P < 0.05). At 3 months after surgery, the Cobb angle of sagittal kyphosis in both groups was decreased, which was lower in the grafting group than that in the nongrafting group (P < 0.05). At 3 months after surgery, the scores of activity of daily living (ADL) and the MOS item-short form health survey (SF-36) in both groups were higher than those before surgery, which were higher in the grafting group than in the nongrafting group (P < 0.05). The difference in the incidence rate of injured vertebrae collapse, internal fixation breakage, or kyphosis between the grafting group and the nongrafting group was not statistically significant (1.37% vs 6.78%) (P > 0.05). Conclusion Minimally invasive percutaneous pedicle screw internal fixation combined with injured vertebrae bone grafting in orthopedic surgery can improve postoperative pain and surgical stress in patients with thoracolumbar fractures, which is conducive to the recovery of injured vertebrae and improvement in the quality of life.