scholarly journals Open vs. Percutaneous Pedicle Screw Insertion for Thoracolumbar Traumatic A3 and A4 AO Fractures - 18-Months Follow-Up

2017 ◽  
Vol 36 (04) ◽  
pp. 207-212
Author(s):  
Flávio Romero ◽  
Rodolfo Vieira ◽  
Bruno Ancheschi
Keyword(s):  
Blood Loss ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Statistical Significance ◽  
Column Height ◽  
Intraoperative Blood Loss ◽  
Percutaneous Screw Fixation ◽  
Significant Difference ◽  
The Mean

Purpose To compare the efficacy and safety of the percutaneous screw fixation (PSF) and the open pedicle screw fixation (OPSF) on thoracolumbar (TL) fracture. Methods Sixty-four adult patients with TL vertebral fractures who underwent open or percutaneous posterior short-segment transpedicular screw fixation between January of 2013 and September of 2015 were retrospectively reviewed. All patients underwent clinical, radiological and quality of life follow-up for at least 18 months. Results There was no significant difference in age, gender, time between injury and surgery, and preoperative percentage of anterior column height, preoperative sagittal regional Cobb angle, or kyphotic angle of fractured vertebra between these two groups (p > 0.05). There was significantly less intraoperative blood loss in the PSF (87.6 ± 24.6 mL) than in the OPSF group (271.4 ± 142.6 mL) (p < 0.05). The mean surgery time was 62 minutes (range 42–130 minutes) for open and 58 minutes (range 35 to 128 minutes) for percutaneous screw fixation. The surgery time was shorter in the PSF group, but with no statistical significance (p > 0.05). The mean Oswestry disability index (ODI) scores after 18-months were 23.12 ± 8.2 for the PSF and 24.12 ± 9.2 for the OPSF group, without any statistical significance (p > 0.05). Conclusion Both open and percutaneous screw fixations are safe and effective. The percutaneous techniques significantly reduced the intraoperative blood loss compared with the open techniques.

Minimum 5-year follow-up results of skipped pedicle screw fixation for flexible idiopathic scoliosis

2011 ◽  
Vol 15 (2) ◽  
pp. 146-150 ◽  
Author(s):  
Chang Ju Hwang ◽  
Choon-Ki Lee ◽  
Bong-Soon Chang ◽  
Min-Seok Kim ◽  
Jin S. Yeom ◽  
...  
Keyword(s):  
Blood Loss ◽  
Idiopathic Scoliosis ◽  
Pedicle Screw ◽  
Sagittal Balance ◽  
Screw Fixation ◽  
Operation Time ◽  
Pedicle Screw Fixation ◽  
Correction Loss ◽  
The Mean

Object The aim of this study was to evaluate after more than 5 years the outcome of surgical treatment for flexible idiopathic scoliosis using skipped pedicle screw fixation. Methods For patients with spine curves < 90° and flexibility > 20%, pedicle screws had been inserted into every other segment on the corrective side and 2–4 screws per curve had been inserted on the supportive side. The authors analyzed the results in 57 patients, including the correction rate of coronal curvature and rotational deformity, correction loss, sagittal balance, complications, blood loss, operation time, and implant costs. Results The mean Cobb angle was 54° preoperatively and 17° immediately after surgery (69% correction). At the last follow-up, the mean Cobb angle was 18° (2% correction loss). Rotation of the apical vertebra was corrected by 50% on average and showed only a 6% correction loss at the last follow-up. None of the patients had problems in maintaining sagittal balance. An adding-on phenomenon was detected in 4 patients (7%). Twelve of 14 patients with coronal decompensation showed improvement after surgery, whereas postoperative decompensation developed in 3 patients. Four patients had implant failures, and 4 had postoperative infections. The mean blood loss during surgery was 832 ml, and the mean operation time was 167 minutes. Compared with conventional methods, the authors' method used up to 48% fewer screws. Conclusions Skipped pedicle screw fixation of flexible idiopathic scoliosis showed satisfactory results. This method has several advantages, including reduced blood loss, shorter operation time, and reduced cost.

scholarly journals Percutaneous vertebroplasty versus kyphoplasty for the treatment of neurologically intact osteoporotic Kümmell’s disease

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shou-qian Dai ◽  
Rong-qing Qin ◽  
Xiu Shi ◽  
Hui-lin Yang
Keyword(s):  
Blood Loss ◽  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Intraoperative Blood Loss ◽  
Surgical Time ◽  
Significant Difference ◽  
Neurologically Intact ◽  
Operation Cost

Abstract Background Percutaneous vertebroplasty (PVP) and kyphoplasty (PKP) have been widely used to treat neurologically intact osteoporotic Kümmell’s disease (KD), but it is still unclear which treatment is more advantageous. Our study aimed to compare and investigate the safety and clinical efficacy of PVP and PKP in the treatment of KD. Methods The relevant data that 64 patients of neurologically intact osteoporotic KD receiving PVP (30 patients) or PKP (34 patients) were analyzed. Surgical time, operation costs, intraoperative blood loss, volume of bone cement injection, and fluoroscopy times were compared. Occurrence of cement leakage, transient fever and re-fracture were recorded. Universal indicators of visual analogue scale (VAS) and Oswestry disability index (ODI) were evaluated separately before surgery and at 1 day, 6 months, 1 year, 2 years and the final follow-up after operation. The height of anterior edge of the affected vertebra and the Cobb’s angle were assessed by imaging. Results All patients were followed up for at least 24 months. The volume of bone cement injection, intraoperative blood loss, occurrence of bone cement leakage, transient fever and re-fracture between two groups showed no significant difference. The surgical time, the operation cost and fluoroscopy times of the PKP group was significantly higher than that of the PVP group. The post-operative VAS, ODI scores, the height of the anterior edge of the injured vertebrae and kyphosis deformity were significantly improved in both groups compared with the pre-operation. The improvement of vertebral height and kyphosis deformity in PKP group was significantly better than that in the PVP group at every same time point during the follow-up periods, but the VAS and ODI scores between the two groups showed no significant difference. Conclusion PVP and PKP can both significantly alleviate the pain of patients with KD and obtain good clinical efficacy and safety. By contrast, PKP can achieve better imaging height and kyphosis correction, while PVP has the advantages of shorter operation time, less radiation volume and operation cost.

scholarly journals Comparison Between With Kirschner-wires Only And Combined Screw Fixation in Proximal Reverse Chevron osteotomy(PCMO) For Hallux Valgus Deformity

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Hwa Jun Kang ◽  
Hong-Geun Jung ◽  
Jong-Soo Lee ◽  
Sungwook Kim ◽  
Mao Yuan Sun
Keyword(s):  
Hallux Valgus ◽  
Screw Fixation ◽  
Fixation Method ◽  
Kirschner Wires ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Severe Hallux Valgus

Category: Bunion Introduction/Purpose: Kirschner-wires fixation, sometimes we have encountered pin irritation or pull-out. This is the reason why we consider additional fixation. Moreover, there are few reports according to comparison of fixation method, and Most of them focused on comparison K-wires or screw fixation only. Purpose of study is to compare clinical and radiographic outcome between Kirschner-wires only and combined screw fixation. Methods: The study included two different groups according to fixation methods. One with Kirschner-wires fixation (KW group) included 117 feet(of 98 patients), the other with combined screw fixation (KWS group) 56 feet (of 40 patients) with moderate to severe hallux valgus. Clinically, the preoperative and final follow-up visual analog scale (VAS) pain scores, the preoperative and final follow-up American Orthopaedic Foot & Ankle Society (AOFAS) hallux metatarsophalangeal (MTP)-interphalangeal (IP) scores, and patient satisfaction after the surgery were evaluated. Radiographically, the hallux valgus angle (HVA), intermetatarsal angle (IMA), medial sesamoid position (MSP), and first to fifth metatarsal width (1-5MTW) were analyzed before and after surgery. Results: The mean AOFAS score improved preoperative 65.5 to 95.3 at final follow up in group A, while preoperative 56.5 to 88.6 at final follow up. Pain VAS decreased from 5.7 to 0.5 in group A, whereas from 6.2 to 1.6 in group B. The mean HVA all improved from preoperative 38.5 to 9.3 at final follow up in group A and 34.7 to 9.1 in group B. The mean IMA and MSP also improved significantly at final follow up. In comparative analysis, the IMA did not show significant difference between postoperative and final state in group A, while showed significant increase in group B. Conclusion: We achieved favorable clinical and radiographic outcomes with minimal complications in patient with moderate to severe hallux valgus in both groups. However, this study shows no statistically significant difference in IMA during follow-up period and lower recurrence rate. Therefore we need to consider combined fixation method to provide better stability and can expect lower recurrence rate.

Effects of Orthokeratology Lens On Axial Length Elongation in Myopia With Anisometropia Children

2021 ◽  
Author(s):  
Ziyang Chen ◽  
Kai-Ming Chen ◽  
Ying Shi ◽  
Zhao-Da Ye ◽  
Sheng Chen ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Axial Length ◽  
Statistical Significance ◽  
Spherical Equivalent ◽  
Significant Difference ◽  
The Mean ◽  
The Difference ◽  
Better Than ◽  
Group 1

Abstract AimTo investigate the effect of orthokeratology (OK) lens on axial length (AL) elongation in myopia with anisometropia children.MethodsThirty-seven unilateral myopia (group 1) and fifty-nine bilateral myopia with anisometropia children were involved in this 1-year retrospective study. And bilateral myopia with anisometropia children were divided into group 2A (diopter of the lower SER eye under − 2.00D) and group 2B(diopter of the lower SER eye is equal or greater than − 2.00D). The change in AL were observed.The datas were analysed using SPSS 21.0.Results(1) In group 1, the mean baseline AL of the H eyes and L eye were 24.70 ± 0.89 mm and 23.55 ± 0.69 mm, respectively. In group 2A, the mean baseline AL of the H eyes and L eyes were 24.61 ± 0.84 mm and 24.00 ± 0.70 mm respectively. In group 2B, the mean baseline AL of the H eyes and L eyes were 25.28 ± 0.72 mm and 24.70 ± 0.74 mm. After 1 year, the change in AL of the L eyes was faster than the H eyes in group 1 and group 2A (all P<0.001).While the AL of the H eyes and L eyes had the same increased rate in group 2B. (2) The effect of controlling AL elongation of H eyes is consistent in three groups (P = 0.559).The effect of controlling AL elongation of L eyes in group 2B was better than that in group 1 and group 2A (P < 0.001). And the difference between group 1 and group 2A has no statistical significance. (3) The AL difference in H eyes and L eyes decreased from baseline 1.16 ± 0.55mm to 0.88 ± 0.68mm after 1 year in group 1.And in group 2A, the AL difference in H eyes and L eyes decreased from baseline 0.61 ± 0.34mm to 0.48 ± 0.28mm. There was statistically significant difference (all P<0.001). In group 2B, the baseline AL difference in H eyes and L eyes has no significant difference from that after 1 year (P = 0.069).ConclusionsMonocular OK lens is effective on suppression AL growth of the myopic eyes and reduce anisometropia value in unilateral myopic children. Binocular OK lenses only reduce anisometropia with the diopter of the low eye under − 2.00D. Binocular OK lenses cannot reduce anisometropia with the diopter of the low eye equal or greater than − 2.00D. Whether OK lens can reduce refractive anisometropia value is related to the spherical equivalent refractive of low refractive eye in bilateral myopia with anisometropia children after 1-year follow-up.

scholarly journals Posterior monoaxial screw fixation combined with distraction-compression technology assisted endplate reduction for thoracolumbar burst fractures: a retrospective study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Xuhong Xue ◽  
Sheng Zhao
Keyword(s):  
Retrospective Study ◽  
Pedicle Screw ◽  
Screw Fixation ◽  
Pedicle Screws ◽  
Pedicle Screw Fixation ◽  
Thoracolumbar Burst Fractures ◽  
Correction Rate ◽  
Burst Fractures ◽  
The Mean

Abstract Background The management of thoracolumbar burst fractures traditionally involves posterior pedicle screw fixation, but it has some drawbacks. The aim of this study is to evaluate the clinical and radiological outcomes of patients with thoracolumbar burst fractures. They were treated by a modified technique that monoaxial pedicle screws instrumentation and distraction-compression technology assisted end plate reduction. Methods From March 2014 to February 2016, a retrospective study including 42 consecutive patients with thoracolumbar burst fractures was performed. The patients had undergone posterior reduction and instrumentation with monoaxial pedicle screws. The fractured vertebrae were also inserted screws as a push point. The distraction -compression technology was used as assisting end plate reduction. All patients were followed up at a minimum of 2 years. These parameters including segmental kyphosis, severity of fracture, neurological function, canal compromise and back pain were evaluated in preoperatively, postoperatively and at the final follow-up. Results The average follow-up period was 28.9 ± 4.3 months (range, 24-39mo). No patients had postoperative implant failure at recent follow-up. The mean Cobb angle of the kyphosis was improved from 14.2°to 1.1° (correction rate 92.1%). At final follow-up there was 1.5% loss of correction. The mean preoperative wedge angle was improved from 17.1 ± 7.9°to 4.4 ± 3.7°(correction rate 74.3%). The mean anterior and posterior vertebral height also showed significant improvements postoperatively, which were maintained at the final follow-up(P < 0.05). The mean visual analogue scale (VAS) scores was 8 and 1.6 in preoperation and at the last follow-up, and there was significant difference (p < 0.05). Conclusion Based on our experience, distraction-compression technology can assist reduction of collapsed endplate directly. Satisfactory fracture reduction and correction of segmental kyphosis can be achieved and maintained with the use of monoaxial pedicle screw fixation including the fractured vertebra. It may be a good treatment approach for thoracolumbar burst fractures.

A Randomised Controlled Trail of Plasma Exchange in Rapidly Progressive Renal Failure of Myeloma.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4899-4899
Author(s):  
William F. Clark ◽  
A. Keith Stewart ◽  
Gail A. Rock ◽  
Marion Sternbach ◽  
David M. Sutton ◽  
...  
Keyword(s):  
Serum Creatinine ◽  
Sample Size ◽  
Plasma Exchange ◽  
Kidney Failure ◽  
Statistical Significance ◽  
Control Group ◽  
Significant Difference ◽  
The Mean ◽  
Baseline Characteristics

Abstract In myeloma, plasma exchange (PE) has been suggested to prevent rapidly progressive kidney failure by reducing exposure to nephrotoxic light chains. We carried out a randomized controlled multi-centre trial comparing PE or no PE in 104 patients of whom 101 met the inclusion, exclusion criteria and 4 were lost to follow-up. We compared baseline characteristics as well as renal outcomes and performed a futility analysis to determine the sample size necessary for potential statistical significance for the changes noted. Thirty-nine patients were randomized to the control group and 58 to the PE group with a 6-month follow-up. The baseline characteristics of these 2 groups were similar including serum creatinine, dialysis dependence, age, gender, serum calcium, serum albumin, 24 -hour urine for protein levels and Durie-Salmon myeloma staging. Thirteen (33.3%) of the control group and 19 (33.3%) of the PE group died within 6 months of follow up. Ten patients (31%) in the control and 10 patients (21%) in the PE arm were dialysis dependent at 6 months. Seven patients (47%) came off dialysis in the control and 13 patients (59%) in the PE arm with the mean number of dialysis days from 0–6 months being 45.7±67.6 in the control versus 29.2±56.1 in the PE arm at 6 months. The mean serum creatinine in the control group was 314.6±256.1 μmol/L versus 215.4±215.3 μmol/L in the PE group and the composite end point of death, dialysis or serum creatinine >254 μmol/L occurred in 12 (30.8%) in the control and 11 (19.3%) in the PE arm. The futility analysis to indicate the per group sample size necessary to achieve statistical significance at 6 months for the difference we observed was infinite for cumulative mortality, 805 for dialysis dependence, 2418 for coming off dialysis, 321 for number of dialysis days, 132 for creatinine difference of 100 μmol/L and for the composite outcome of death, dialysis or creatinine>354 μmol/L, 737. We did not observe a statistically significant difference in mortality or renal morbidity for PE versus no PE in patients with myeloma and rapidly progressive kidney failure.

Clinical and radiographic comparison of mini–open transforaminal lumbar interbody fusion with open transforaminal lumbar interbody fusion in 42 patients with long-term follow-up

2008 ◽  
Vol 9 (6) ◽  
pp. 560-565 ◽  
Author(s):  
Sanjay S. Dhall ◽  
Michael Y. Wang ◽  
Praveen V. Mummaneni
Keyword(s):  
Blood Loss ◽  
Interbody Fusion ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Open Group ◽  
Lumbar Interbody Fusion ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
The Mean ◽  
Mini Open

Object As minimally invasive approaches gain popularity in spine surgery, clinical outcomes and effectiveness of mini–open transforaminal lumbar interbody fusion (TLIF) compared with traditional open TLIF have yet to be established. The authors retrospectively compared the outcomes of patients who underwent mini–open TLIF with those who underwent open TLIF. Methods Between 2003 and 2006, 42 patients underwent TLIF for degenerative disc disease or spondylolisthesis; 21 patients underwent mini–open TLIF and 21 patients underwent open TLIF. The mean age in each group was 53 years, and there was no statistically significant difference in age between the groups (p = 0.98). Data were collected perioperatively. In addition, complications, length of stay (LOS), fusion rate, and modified Prolo Scale (mPS) scores were recorded at routine intervals. Results No patient was lost to follow-up. The mean follow-up was 24 months for the mini-open group and 34 months for the open group. The mean estimated blood loss was 194 ml for the mini-open group and 505 ml for the open group (p < 0.01). The mean LOS was 3 days for the mini-open group and 5.5 days for the open group (p < 0.01). The mean mPS score improved from 11 to 19 in the mini-open group and from 10 to 18 in the open group; there was no statistically significant difference in mPS score improvement between the groups (p = 0.19). In the mini-open group there were 2 cases of transient L-5 sensory loss, 1 case of a misplaced screw that required revision, and 1 case of cage migration that required revision. In the open group there was 1 case of radiculitis as well as 1 case of a misplaced screw that required revision. One patient in the mini-open group developed a pseudarthrosis that required reoperation, and all patients in the open group exhibited fusion. Conclusions Mini–open TLIF is a viable alternative to traditional open TLIF with significantly reduced estimated blood loss and LOS. However, the authors found a higher incidence of hardware-associated complications with the mini–open TLIF.

Minimally invasive lateral retroperitoneal transpsoas interbody fusion for L4–5 spondylolisthesis: clinical outcomes

2013 ◽  
Vol 19 (3) ◽  
pp. 314-320 ◽  
Author(s):  
Amir Ahmadian ◽  
Sean Verma ◽  
Gregory M. Mundis ◽  
Rod J. Oskouian ◽  
Donald A. Smith ◽  
...  
Keyword(s):  
Blood Loss ◽  
Interbody Fusion ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Disc Space ◽  
Percutaneous Pedicle Screw ◽  
Sf 36 ◽  
The Mean ◽  
Percutaneous Pedicle Screw Fixation

Object In this study the authors report on the clinical outcomes, safety, and efficacy of lateral retroperitoneal transpsoas minimally invasive surgery–lumbar interbody fusion (MIS-LIF) at the L4–5 disc space in patients with spondylolisthesis. This approach has become an increasingly popular means of fusion. Its most frequent complication is lumbar plexus injury. Reported complication rates at the L4–5 disc space vary widely in the literature, bringing into question the safety of MIS-LIF for the L4–5 region, especially in patients with spondylolisthesis. Methods The authors retrospectively reviewed prospectively acquired multicenter databases of patients with Grade I and II L4–5 spondylolisthesis who had undergone elective MIS-LIF between 2008 and 2011. Clinical follow-up had been scheduled for 1, 3, 6, 12, and 24 months postoperatively. Outcome measures included estimated blood loss, operative time, length of hospital stay, integrity of construct, complications, fusion rates, visual analog scale (VAS), Oswestry Disability Index (ODI), and 36-Item Short Form Health Survey (SF-36). Results Eighty-four patients with L4–5 MIS-LIF were identified, 31 of whom met the study inclusion criteria: 26 adults with Grade I and 5 adults with Grade II L4–5 spondylolisthesis who had undergone elective MIS-LIF and subsequent posterior percutaneous pedicle screw fixation without surgical manipulation of the posterior elements (laminectomy, foraminotomy, facetectomy). The study cohort consisted of 9 males (29%) and 22 females (71%) with an average age of 61.5 years. The mean total blood loss was 94 ml (range 20–250 ml). The mean hospital stay and follow-up were 3.5 days and 18.2 months, respectively. The average score on the ODI improved from 50.4 preoperatively to 30.9 at the last follow-up (p < 0.0001). The SF-36 score improved from 38.1 preoperatively to 59.5 at the last follow-up (p < 0.0001). The VAS score improved from 69.9 preoperatively to 38.7 at the last follow-up (p < 0.0001). No motor weakness or permanent deficits were documented in any patient. Correction of deformity did not have any neurological complications. All patients had improvement in anterolisthesis. Residual postoperative listhesis across cases was noted in 4 patients (12.9%). Transient anterior thigh numbness (Sensory Dermal Zone III) was noted in 22.5% of patients. Conclusions With its established surgical corridors through the retroperitoneum and psoas muscle, the MIS-LIF combined with posterior percutaneous pedicle screw fixation/reduction is a safe, reproducible, and effective technique for patients with symptomatic degenerative spondylolisthesis at the L4–5 vertebral segment.

Evaluation of Reduction Accuracy of Suture-Button and Screw Fixation Techniques for Syndesmotic Injuries

2016 ◽  
Vol 37 (12) ◽  
pp. 1317-1325 ◽  
Author(s):  
Onur Kocadal ◽  
Mehmet Yucel ◽  
Murad Pepe ◽  
Ertugrul Aksahin ◽  
Cem Nuri Aktekin
Keyword(s):  
Screw Fixation ◽  
Ct Scans ◽  
Functional Evaluation ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Suture Button ◽  
Fixation Group ◽  
Significant Difference ◽  
The Mean

Background: Among the most important predictors of functional results of treatment of syndesmotic injuries is the accurate restoration of the syndesmotic space. The purpose of this study was to investigate the reduction performance of screw fixation and suture-button techniques using images obtained from computed tomography (CT) scans. Methods: Patients at or below 65 years who were treated with screw or suture-button fixation for syndesmotic injuries accompanying ankle fractures between January 2012 and March 2015 were retrospectively reviewed in our regional trauma unit. A total of 52 patients were included in the present study. Fixation was performed with syndesmotic screws in 26 patients and suture-button fixation in 26 patients. The patients were divided into 2 groups according to the fixation methods. Postoperative CT scans were used for radiologic evaluation. Four parameters (anteroposterior reduction, rotational reduction, the cross-sectional syndesmotic area, and the distal tibiofibular volumes) were taken into consideration for the radiologic assessment. Functional evaluation of patients was done using the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale at the final follow-up. The mean follow-up period was 16.7 ± 11.0 months, and the mean age was 44.1 ± 13.2. Results: There was a statistically significant decrease in the degree of fibular rotation ( P = .03) and an increase in the upper syndesmotic area ( P = .006) compared with the contralateral limb in the screw fixation group. In the suture-button fixation group, there was a statistically significant increase in the lower syndesmotic area ( P = .02) and distal tibiofibular volumes ( P = .04) compared with the contralateral limbs. The mean AOFAS scores were 88.4 ± 9.2 and 86.1 ± 14.0 in the suture-button fixation and screw fixation group, respectively. There was no statistically significant difference in the functional ankle joint scores between the groups. Conclusion: Although the functional outcomes were similar, the restoration of the fibular rotation in the treatment of syndesmotic injuries by screw fixation was troublesome and the volume of the distal tibiofibular space increased with the suture-button fixation technique. Level of Evidence: Level III, retrospective comparative study.

scholarly journals Comparison of Percutaneous Kyphoplasty with or without Pedicle Screw Fixation in Osteoporotic Thoracolumbar Vertebral Fractures: A Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Dichao Huang ◽  
Jichong Ying ◽  
Dingli Xu ◽  
Jianming Chen ◽  
Jianlei Liu ◽  
...  
Keyword(s):  
Back Pain ◽  
Retrospective Study ◽  
Pedicle Screw ◽  
Vertebral Fractures ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Fixation Failure ◽  
Percutaneous Kyphoplasty ◽  
Significant Difference

Background. Osteoporotic thoracolumbar compression fractures have become a great social burden due to the aging tendency of population. This study is aimed at comparing the clinical and radiological outcomes of percutaneous kyphoplasty with or without pedicle screw fixation in patients with osteoporotic thoracolumbar fractures. Hypothesis. There is a difference in clinical outcomes between percutaneous kyphoplasty with pedicle screw fixation and percutaneous kyphoplasty. Methods. This retrospective study included 87 patients who received percutaneous kyphoplasty with or without pedicle screw fixation between October 2015 and October 2017 at Ningbo No.6 Hospital and were followed for 2 years. A total of 40 patients received percutaneous kyphoplasty with pedicle screw fixation (PKPF group), and the other 47 patients had percutaneous kyphoplasty only (PKP group). The outcomes were measured using the visual analogue scale (VAS), Oswestry Disability Index (ODI), Cobb angle (CA), and anterior vertebra height rate (AVHr), which were calculated at preoperative admission and each follow-up visit. Complications including postoperative back pain, refracture, and fixation failure were collected from medical records. Results. There was no significant difference in baseline characteristics or preoperative data between the two groups ( p < 0.05 ) but significantly better improvements in VAS, ODI, CA, and AVHr at 12- and 24-month follow-up visits in the PKPF group compared with those of the PKP group. 23 (48.9%) patients in the PKP group had complications, whereas only 5 (12.5%) patients in the PKPF group presented complications including 2 postoperative back pain and 1 fixation failure ( p = 0.04 ). Conclusions. PKPF obtained longer correction and better improvement in VAS, ODI, and CA in patients with osteoporotic thoracolumbar vertebral fractures than PKP.

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