Comparison Of Percutaneous And Open Pedicle Screw Fixation For Treatment Of Type A Thoracolumbar Fractures

Objective :To compare the clinical efficacy of percutaneous pedicle screw fixation and traditional open surgury for type A thoracolumbar fracture without neurolodical deficit.Methods:A retrospective analysis was made of 49 patients with thoracolumbar fractures who were treated in our hospital from September 2015 to September 2017.26 cases were treated with open pedicle screw fixation and 23 cases were treated with percutaneous pedicle screw fixation.Clinica and surgical evalution including Perioperative indicators,anterior height ratio of fracture vertebral,kyphosis angle of injured vertebra,visual Analogue Score(VAS score),the Oswestry Disability Index(ODI score).Results:(1)The intraoperative blood loss,length of hospital stay and VAS score 2 days after surgery of the percutaneous group were significantly lower than the open group(p<0.05),which suggest percutaneous group Will suffer less trauma.(2)There were differences between the two groups in the anterior height ratio of fracture vertebral of postoperative(both >80%)and the correction rate of kyphosis angle of injured vertebra(p<0.05);there was no significant difference between the two groups in the loss of anterior height ratio of fracture vertebral at the last follow-up(p>0.05),which suggest the two surgical can provide good correction and reduction for the fractured,but the open group has a slight advantage,and both of the two surgical can provide strong internal fixation support for the fracture in the long-term follow-up.(3)There was no statistically significant difference between the two groups in VAS score at the last follow-up(p>0.05),and there was significant difference between the two groups in ODI score(p<0.05),which indicate that the percutaneous group had a higher quality of life.Conclusion:Although percutaneous pedicle screw internal fixation is slightly worse than open surgery for fracture reduction,it has the advantages of smaller intraoperative blood loss,smaller incision,shorter hospitalization time,lower pain,better lumbar and dorsal muscle function.Patients are beneficial in the early postoperative period and have good clinical efficacy in the long term.It can be regarded as one of the excellent options for the treatment of thoracolumbar type A fracture.