Comparison of minimally invasive self-dilating pedicle screw-rod system and conventional pedicle screw-rod system for treatment of thoracolumbar fractures

Abstract

Objective To compare the midterm clinical outcomes of minimally invasive percutaneous self-dilating pedicle screw-rod system and conventional open pedicle screw-rod system in the treatment of thoracolumbar fractures.Methods Enrolled in this research were 46 patients who had received surgery in our department from January 2012 to March 2013 for thoracolumbar fracture without neurological symptoms.Of them,24 were treated with minimally invasive percutaneous fixation by self-dilating pedicle screw-rod system and 22 with open fixation by conventional pedicle screw-rod system.There were no significant differences between the 2 groups in general data preoperation (P ＞ 0.05).The 2 groups were compared in terms of perioperative indexes,follow-up radiographic indexes and Oswestry disability index (ODI).Results All patients were followed up for 10 to 14 months (average,12 months).Compared with the open group,the minimally invasive group had smaller incisions,less intraoperative blood loss,less postoperative drainage,lower visual analogue scale (VAS) scores for incision one day postoperative,but longer operation time and intraoperative radiation exposure,with statistical significances in all the above differences (P ＜ 0.05).Compared with preoperation,significant improvements were observed at the last follow-up in all the patients regarding cobb angle,sagittal index and anterior height of the fractured vertebral body (P ＜ 0.05),but there were no significant differences between the 2 groups regarding cobb angle,sagittal index and anterior height of the fractured vertebral body at the last follow-up (P ＞ 0.05).There was no significant difference between the 2 groups either regarding ODI at the last follow-up (P ＞ 0.05).Conclusion Minimally invasive percutaneous self-dilating pedicle screw-rod system is an effective and safe treatment of thoracolumbar fractures,because it may lead to more limited invasion,less bleeding,and quicker recovery than the conventional pedicle screw-rod system. Key words: Thoracic vertebrae; Lumbar vertebrae; Fracture, bone; Surgical procedures,minimally invasive