Application Of The Pedicle Screw With Adjustable Angle In Minimally Invasive Treatment Of Thoracolumbar Fractures

Objective:To research the clinical effect of the pedicle screw with adjustable angle for thoracolumbar fractures without neural injury.Methods:74 cases of single segment thoracolumbar fracture without neural injury were collected and treated in our hospital from January 2010 to December 2013.There were 41 males and 33 females with an average age of 35.6±9.1 years(ranging from 24 to 56 years).22 cases were treated by traditional treatment of open reduction and internal fixation,20 cases were treated by minimally invasive percutaneous pedicle screw internal fixation of Sextant internal fixation system,34 cases were treated by minimally invasive percutaneous pedicle screw with adjustable angle internal fixation of RTS internal fixation system(Ruizhi, Shanghai).Intraoperative blood loss,operation time,postoperation hospital stay,and visual analogue scale scores were observed in all patients.Imaging results were used to observe anterior vertebral height recovery and kyposis Cobb angle changes between preoperation,one week after operation and final follow-up.Results:The average follow-up period was(2.5±1.1)years.No patients appear neural injury due to poor pedicle screw position,loose screw、screw withdrawal and breakage. Intraoperative blood loss,operation time,postoperation hospital stay of Sextant group and RTS group had significant difference with the open reduction group(P<0.05).Anterior vertebral height recovery and kyposis Cobb angle changes of preoperation,one week after operation and final follow-up had no significant difference between the open reduction group, Sextant group and RTS group(P>0.05).VAS scores of preoperation and final follow-up had no significant difference between the open reduction group, Sextant group and RTS group(P>0.05),but VAS scores had significant difference between the open reduction group, Sextant group and RTS group during one week after operation(P<0.05).In the three group,VAS scores,anterior vertebral height recovery and kyposis Cobb angle changes had significant difference between preoperation,one week after operation and final follow-up(P<0.05).Conclusion:Compared with traditional open fixation approach,minimally invasive percutaneous pedicle screw with adjustable angle internal fixation not only has merits of fewer traumas,less intraoperative blood loss,shorter operation time and hospital stay,but also has a satisfied efficacy.It is an safe and reliable way for the treatment of thoracolumbar fractures.