Abstract
BackgroundThe objective of this study was to evaluate the feasibility, safety, efficacy, and indications of percutaneous pedicle screw fixation (PPSF) combined with selective transforaminal endoscopic decompression (TED) in the treatment of thoracolumbar burst fracture (TBLF).MethodsFrom August 2015 to October 2018, a total of 41 patients with single-segment TLBF (28 men and 13 women) were enrolled in this study. X-ray and computed tomography were obtained before surgery, 1 week after surgery, and 1 year after surgery to evaluate spinal recovery. In addition, we used the visual analog scale (VAS), the Oswestry Disability Index (ODI), the Japanese Orthopedic Association score (JOA), and the Frankel classification of neurological deficits to evaluate the effectiveness of the treatments.ResultsThe average follow-up time was 22.02 ± 8.28 months. The postoperative Cobb angle, vertebral body compression ratio, vertebral wedge angle, mid-sagittal canal diameter compression ratio, and Frankel grade were significantly improved. There were also significant improvements in the VAS (7.61 ± 1.41 vs. 1.17 ± 0.80, P < 0.001), ODI (89.82 ± 7.44 vs. 15.71 ± 13.50, P < 0.001), and JOA (6.90 ± 2.91 vs. 24.90 ± 3.03, P < 0.001).ConclusionsOur results showed that PPSF combined with selective TED in the treatment of TLBF had excellent efficacy, high safety, less secondary injury than other treatments, and a wide range of indications and that it could accurately distinguish patients who did not need spinal canal decompression after posterior fixation. PPSF combined with selective TED is therefore a good choice for the treatment of TLBF.
Highlights
To solve the abovementioned complication that accur-Thoracolumbar fractures are the most common spine ate decompression cannot be achieved, we propose the fractures, with burst fractures accounting for 10–20% of concept of percutaneous pedicle screw fixation (PPSF) combined with selective transforaminal these fractures [1,2,3]
Our results showed that PPSF combined with selective Thoracolumbar burst fracture endoscopic decompression (TED) in the treatment of Thoracolumbar burst fracture (TLBF) had excellent
PPSF combined with selective TED is a good choice for the treatment of TLBF
Summary
Thoracolumbar fractures are the most common spine ate decompression cannot be achieved, we propose the fractures, with burst fractures accounting for 10–20% of concept of PPSF combined with selective transforaminal these fractures [1,2,3]. Thoracolumbar burst fracture endoscopic decompression (TED) for the treatment of (TLBF) often leads to neurological dysfunction and ky- TLBF. After PPSF is performed at cal treatment is preferred for burst fractures with neurological damage [5]. With the development of percutaneous pedicle screw fixation (PPSF) technology, PPSF has gained increasing recognition for thoracolumbar fractures. Its efficacy is similar to open posterior fixation, but related complications have been significantly reduced [7, 8]. T percutaneous pedicle screw fixation (PPSF) combined with selective transforaminal endoscopic decompression (TED) in the treatment of thoracolumbar burst fracture (TBLF)
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