The Clinical Effectiveness Of Different Pedicle Screw Fixation For The Treatment Of Thoracolumbar Fractures

Objective: To discuss the clinical effectiveness of thoracolumbar fractures treated with three different pedicle screw fixation.Methods: A total of 55 cases of single thoracolumbar fractures were selected in the hospital between January 2013 and December 2016.According to the different fixation methods,they were divided into three groups,control group:traditional short-segment 4 pedicle fixation in 20 cases(36.36%,20/55);bilateral group: intermediate bilateral pedicle screw fixation in 22 cases(40%,22/55);unilateral group:intermediate unilateral pedicle screw fixation in 13 cases(40%,22/55).The three groups were compared by operation time,intra operative blood loss,VAS and ODI scores,the correction of the fractured vertebrae height and kyphosis angle postoperatively and the losing rate of the fractured vertebrae height and kyphosis angle at the final follow-up and so on.Results: There was no significant difference in operation time,intra operative blood loss,VAS score,ODI score,the correction of the fractured vertebrae height and kyphosis angle postoperatively among the three groups(P>0.05).No complications such as loosening of internal fixation and fracture occurred after operation.However,for the losing rate of the fractured vertebrae height and kyphosis angle at the final follow-up,the unilateral and bilateral group were significantly better than the control group(P<0.05),but there was no statistical difference between the unilateral and bilateral group(P>0.05).Conclusion:All the three different methods are suitable for the thoracolumbar fractures and the short-term clinical effects are consistent.Compared with traditional short-segment 4 pedicle screw fixation,intermediate bilateral or unilateral pedicle screw fixation were more effective in maintaining the height of the fractured vertebrae and preventing the occurrence of kyphosis.The intermediate unilateral pedicle screw fixation was comparable to that of bilateral fixation at clinical outcomes,but the unilateral fixed hospitalization cost was lower,which was worthy of clinical promotion.