Percutaneous one-way solid pedicle screw fixationversus pedicle screw fixation in treating patients with thoracolumbar fracture

  Objective  To compare the effect of percutaneous one-way solid pedicle screw fixation and pedicle screw fixation in the treatment of patients with thoracolumbar fracture.

  Methods  Totally 67 patients with thoracolumbar fracture were divided into minimally invasive group (n=35) and conventional group (n=32). Minimally invasive group was treated with percutaneous one-way solid pedicle screw fixation, while conventional group was treated with pedicle screw fixation. The operation time, intra-operative bleeding volume, drainage volume, creatine kinase level and time of getting out of bed were compared between the two groups. Visual analogue scale (VAS) and dysfunction index (ODI) scores at different time points were compared between the two groups, and the comparison value of anterior vertebral height and Cobb angle were compared between the two groups.

  Results  The operation time, intra-operative bleeding volume, postoperative drainage volume, time to get out of bed and the level of creatine kinase at 1^st day after operation in the minimally invasive group were significantly better than those in the conventional group (P < 0.05). There was no significant difference in preoperative VAS score between the two groups (P>0.05). At 1 week after operation, the VAS score of conventional group was significantly higher than that of minimally invasive group (P < 0.05). At 1 month after operation, the VAS score of conventional group was slightly higher than that of minimally invasive group (P>0.05). There was no significant difference in ODI score between the two groups (P>0.05). Three months after operation, the ODI score of the minimally invasive group was significantly lower than that of the conventional group (P < 0.05). Six months after operation, patients in both groups had recovered with behavioral ability, and there was no significant difference in ODI score (P>0.05). There was no significant difference in the comparison value of anterior vertebral height and Cobb angle between the two groups before and 6 months after operation (P>0.05). At 3 months after operation, there was no significant difference in the comparison value of anterior vertebral height between the two groups (P>0.05), but the Cobb angle in the minimally invasive group was significantly higher than that in the conventional group (P < 0.05).

  Conclusion  Compared with the pedicle screw fixation, the percutaneous one-way solid pedicle screw fixation has the advantages of shorter operation time, less bleeding and faster recovery, but there is no significant difference in the final efficacy between the two types of operation.