Modified minimally invasive percutaneous pedicle screws osteosynthesis for the treatment of thoracolumbar fracture without neural impairment

Abstract

To explore the feasibility and efficacy of modified minimally invasive percutaneous pedicle screws osteosynthesis for the treatment of thoracolumbar vertebral compression fracture. Twenty cases of thoracolumbar fracture without neural impairment were enrolled. None needed laminotomy decompression. With the aid of C-arm image intensifier, the GSS II pedicle screws were inserted through four small longitudinal incisions and modified surgical instruments. Perioperative parameters and postoperative imaging indices were compared with those undergoing conventional open pedicle screws osteosynthesis in other 20 cases. There was no significant difference in operative time between minimal invasive group and conventional group (P > 0.05); but the length of incisions, length of hospital stay, the volume of operative hemorrhage and post-operative drainage in minimal invasive group were significantly shorter than those in conventional group (P < 0.05); in each group, the comparisons of Cobb's angle, anterior vertebral height and disc height between pre and post-operation were all significantly different (P > 0.05); The incidence rate of chronic lower back pain in minimal invasive group was obviously lower than conventional group during the follow-up visit. The percutaneous internal pedicle screw fixation using modified instruments has the advantages of simple manipulation, less trauma and hemorrhage, quicker recovery, less pain, shorter hospital stay and a lower incidence rate of chronic lower back pain.