Clinical Study On Thoracolumbar Fracture Treated With Percutaneous Long U-shaped Hollow Pedicle Screw Systems Internal Fixation

Purpose:evaluate the clinical effect that percutaneous long U-shaped hollow pedicle screw systems internal fixation for treating thoracolumbar fractures, and provide the theory basis for further promoting this surgery method.Methods:Collected 80 cases which were diagnosed unstable thoracolumbar fractures without obvious neurologic deficits, metted inclusion criteria and treated in the Min Dong hospital of Fu Jian from November 2009 to August 2010.According to the following up order and the treated method, the cases were divided into two groups:40 cases in the first group that was treated with Percutaneous long U-shaped hollow pedicle screw systems internal fixation (A group),40 cases in the second group that was treated with traditional incised transpedicular pedicle screw systems internal fixation (B group).In A and B groups, respectively recorded operative time, intraoperative blood loss, total incision length, postoperative blood loss from incision, time of activity away from the bed after operation, pain relief (VAS) and the ratio of fine screw's position, measured Cobb angle and vertebral anterior margin height of Before and after operation.After 3 months,6 months,9 months follow-up, measured infection of incision, screw breakage and withdrawing, and Cobb angle and vertebral anterior margin height, etc.Then, compared A with B group and done statistical analysis, to evaluate the clinical effect of this surgery method.Results:Via test, the postoperative recovery of Cobb angle and vertebral anterior margin height in A and B groups are all prominently improved, significant difference (p<0.01), but the recovery and the ratio of fine screw's position between two groups have no obvious difference (p>0.05). The average of operative time, intraoperative blood loss, total incision length, postoperative blood loss from incision, time of activity away from the bed after operation and pain relief (VAS) in A group are superior to that of B group, significantly difference (p<0.01). After mean follow-up of 6-16 months, the loss of postoperative Cobb angle and vertebral anterior margin height in A and B groups are not apparent, and without infection, screws loosening, breakage and withdrawing.Conclusion:Percutaneous long U-shaped hollow pedicle screw systems fixation is an ideal surgery therapeutics method for unstable thoracolumbar fractures without obvious neurologic deficits, which maintains minimally invasive techniques characteristic of minimal incision, small trauma, less bleeding, less damage for back muscle, but also reflects its own advantages of simple safe convenient operation, good resetted and fixed effect, benefit to patients with early recovery, cheap price and less X-ray fluoroscopy time and frequency for patients and medical personnel in operation.Its application prospect is magnificent.