Percutaneous short segmental pedicle screw fixation of the injured vertebra with self-designed device for treatment of thoracolumbar fractures

Abstract

Objective To compare clinical effects of percutaneous short segmental pedicle screw fixation of the injured vertebra with self-designed device and conventional posterior open surgery for treatment of thoracolumbar fractures. Methods The clinical data of 38 patients with thoracolumbar fractures were included in this study.From November 2005 to December 2006,they were treated with the posterior percutaneous pedicle screw fixation of the injured vertebra with our self-designed minimally invasive device (19cases) and conventional posterior open pedicle screw fixation (19 cases),respectively.The 2 operative methods were compared in terms of operation time,bleeding volume,anterior height of the injured vertebra,Cobb angles of kyphosis,loss of correction and complications. Results All the patients were followed up from 13 to 28 months (mean,24 months) .The mean operation time for the minimally invasive group was 108.2 minutes which was not significantly different from that for the open group( 106.5 mintes) (P ＞0.05 ).The mean bleeding volume for the minimally invasive group was 110 mL which was significantly smaller than that for the open group (287 mL) ( P ＜ 0.05) .For the minimally invasive group,the mean anterior height of the compressed vertebral bodies was restored from 51.9％ to 95.4％ of the normal height,the mean Cobb angle was corrected from 15.8° to 5.7°,and the mean late loss of correction was 11.1％.All these indexes were significantly better than those for the open group (P＜0.05 ). Conclusion In treatment of thoracolumbar fractures,compared with conventional posterior open surgery,the posterior percutaneous pedicle screw fixation of the injured vertebra with our self-designed minimally invasive device can lead to less damage,more effective reduction,more reliable fixation and better outcomes. Key words: Spinal fractures; Internal fixator; Surgical procedures,minimally invasive; pedicle