Application Value of Minimally Invasive Percutaneous Spinal Pedicle Screw and Rod System Internal Fixation in Treatment of Thoracolumbar Fracture

2021 ◽  
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Pedicle Screw ◽  
Thoracolumbar Fracture ◽  
Rod System

scholarly journals Effect of percutaneous minimally invasive pedicle screw internal fixation in the treatment of thoracolumbar vertebral fractures and its impact on quality of life

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Pengfa Tu ◽  
Chong-chao Yan ◽  
Jian-xue Hao ◽  
Shuo Cao ◽  
Chenyang Jiang
Keyword(s):  
Quality Of Life ◽  
Minimally Invasive ◽  
Internal Fixation ◽  
Pedicle Screw ◽  
Vertebral Fractures ◽  
Sagittal Plane ◽  
Control Group ◽  
Observation Group ◽  
Postoperative Drainage

Objectives: To investigate and analyze the effect of percutaneous minimally invasive pedicle screw internal fixation in the treatment of thoracolumbar vertebral fractures and its impact on quality of life. Methods: Fifty patients with thoracolumbar vertebral fracture admitted to our hospital from January 2015 to December 2018 were selected and divided into two groups according to different treatment regimens. The observation group was treated with minimally invasive percutaneous pedicle screw internal fixation, while the control group was treated with traditional posterior approach open pedicle screw internal fixation. The surgery time, incision length, intraoperative blood loss, postoperative drainage, hospitalization time, ambulation time, fracture healing time and postoperative VAS scores were compared between the two groups. In addition, the cobb angle, the sagittal plane index, and the anterior vertebral height were compared between the two groups before and after surgery, as were the Oswestry Disability Index (ODI) at 1d, 3 months, and 6 months postoperatively. Results: The surgery time, incision length, postoperative pain level, postoperative drainage and intraoperative blood loss of the observation group were less than those of the control group (P<0.05). The postoperative Cobb angle of the two groups decreased, the sagittal plane index as well as the anterior vertebral height increased (P<0.05). The Oswestry index of the observation group was better than that of the control group at one day and three months postoperatively, with a statistical significance between the two groups (P<0.05). The complication rate of the observation group was significantly lower than that of the control group (P<0.05). Conclusion: Percutaneous minimally invasive pedicle screw internal fixation is safer than the traditional open pedicle screw internal fixation, and it is more worthy of clinical promotion. doi: https://doi.org/10.12669/pjms.38.1.4329 How to cite this:Tu P, Yan C, Hao J, Cao S, Jiang C. Effect of percutaneous minimally invasive pedicle screw internal fixation in the treatment of thoracolumbar vertebral fractures and its impact on quality of life. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4329 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Comparison of the clinical efficacy of the Wiltse paraspinal approach and O-arm navigation for the treatment of thoracolumbar fractures

2020 ◽  
Author(s):  
Yingjie Lu ◽  
Tianfeng Zhu ◽  
Xu Shen ◽  
Yuepeng Fang ◽  
Dongdong Lu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screw ◽  
Clinical Efficacy ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Thoracolumbar Fracture ◽  
Screw Placement ◽  
Pedicle Screw Placement ◽  
Percutaneous Pedicle Screw ◽  
Paraspinal Approach

Abstract Background: To evaluate the clinical efficacy of the Wiltse paraspinal approach and percutaneous pedicle screw placement under O-arm navigation for the treatment of thoracolumbar fracture.Methods: We enrolled a total of 54 patients with neurologically intact thoracolumbar fracture who received minimally invasive treatment. Among these, 28 patients were treated with pedicle screw fixation through the Wiltse paraspinal approach (WPSF), and another 26 were received percutaneous pedicle screw fixation under O-arm navigation (OPSF). Statistical methods were used to perform a detailed comparison of clinical outcomes, radiologic findings and complications between the two groups obtained preoperatively, postoperatively and at last follow-up.Results: There were no significant differences between the two groups in terms of the intraoperative bleeding, length of incision, postoperative hospitalization durations or accuracy rate of pedicle screw placement (p>0.05). Visual analog scale (VAS) scores, Oswestry disability in­dex (ODI) scores, local Cobb angle (LCA), vertebral wedge angle (VWA) and R value were notably improved after surgery, though no clear discrepancy between the groups at each time point (p>0.05). However, the OPSF group had a longer operation time and greater surgical expenditure than the WPSF group (p<0.05).Conclusions: Both WPSF and OPSF were safe and effective for the treatment of thoracolumbar fracture. Although the two groups showed favorable clinical and radiologic outcomes through the final follow-up, we recommended the minimally invasive WPSF given its lower duration of surgery and medical costs. A randomized controlled study of high-quality and with a larger sample size is required to comfirm our findings in the future.

Minimally invasive technique for direct repair of pars interarticularis defects in adults using a percutaneous pedicle screw and hook-rod system

2009 ◽  
Vol 10 (5) ◽  
pp. 492-495 ◽  
Author(s):  
Koichi Sairyo ◽  
Toshinori Sakai ◽  
Natsuo Yasui
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screw ◽  
Skin Incision ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Tubular Retractor ◽  
Percutaneous Pedicle Screw ◽  
Pars Interarticularis ◽  
Rod System ◽  
Sports Activities

In this report, the authors described a new minimally invasive technique to repair pars interarticularis defects in adults. The well-established technique using the pedicle screw (PS) and hook-rod system was modified. First, bilateral PSs were inserted percutaneuosly using the Sextant system. Then, through a small skin incision (3–4 cm), an illuminated tubular retractor (Quadrant system; Medtronic Sofamore Danek) was inserted into the pars defect. When this system is used, it is not necessary to detach all the back muscles to access the lytic part. The bursa and fibrocartilaginous mass near the defects were removed. After decortication of the pseudarthrosis at the spondylolytic level, bone grafts were implanted. Finally, the hook part of a hook-rod system was attached to the lamina and the rod was secured at the tulip head of the PSs. The authors performed this procedure in 2 adult patients, 32 and 24 years of age. Immediately after surgery both patients' low-back pain disappeared, and by 3 months postoperatively both had returned to their original work or sports activities.

scholarly journals Comparison of the clinical efficacy of Wiltse paraspinal approach and O-arm navigation for the treatment of thoracolumbar fractures

2020 ◽  
Author(s):  
Yingjie Lu ◽  
Tianfeng Zhu ◽  
Xu Shen ◽  
Yuepeng Fang ◽  
Dongdong Lu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screw ◽  
Clinical Efficacy ◽  
Wedge Angle ◽  
Thoracolumbar Fracture ◽  
Screw Placement ◽  
Controlled Study ◽  
Pedicle Screw Placement ◽  
Paraspinal Approach ◽  
Duration Of Surgery

Abstract Background To evaluate the clinical efficacy of Wiltse paraspinal approach and percutaneous pedicle screw placement under O-arm navigation for the treatment of thoracolumbar fracture.Methods We enrolled a total of 54 patients with neurologically intact thoracolumbar fracture that received minimally invasive technology. Among these, 28 cases were treated with pedicle screw fixation through Wiltse paraspinal approach (WPSF), and another 26 cases were received percutaneous pedicle screws fixation under O-arm navigation (OPSF). The statistical methods were used to performing a detailed comparison of clinical outcomes, radiologic findings and complications between the two groups at pre-op, post-op and last follow-up.Results There were no significant differences between the two groups among intraoperative bleeding, length of incision, postoperative hospitalization times and accuracy rate of pedicle screw placement (p>0.05). Visual analog scale (VAS) scores, Oswestry disability in­dex (ODI) scores, local Cobb angle (LCA), vertebral wedge angle (VWA) and R value were obviously improved after surgery, though no clear discrepancy between the groups at each time point (p>0.05). However, the OPSF group had longer operation time and higher surgical expenditure than the WPSF group (p<0.05).Conclusions Both WPSF and OPSF were safe and effective for the treatment of thoracolumbar fracture. Although the two groups showed favorable clinical and radiologic outcomes till the final follow-up, we recommended the minimally invasive technology of WPSF considering the lower duration of surgery and medical costs. A randomized controlled study of high-quality and large sample required to prove our findings in the future.

scholarly journals Treatment of thoracolumbar fracture-dislocation with a trauma limitation strategy: a technical report and 2-year follow-up

2020 ◽  
Author(s):  
fujun wu ◽  
genyi hou ◽  
nijiao huang ◽  
songli ju ◽  
xin wang(New Corresponding Author) ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Pedicle Screw ◽  
Spinal Canal ◽  
Screw Fixation ◽  
Operation Time ◽  
Pedicle Screw Fixation ◽  
Thoracolumbar Fracture ◽  
Fracture Dislocation ◽  
Group B

Abstract Background: To investigate the curative effect of limited traumatic surgical strategy for thoracolumbar fracture-dislocation. Methods : Twenty-two patients with thoracolumbar fracture-dislocation who were admitted to our department from May 2013 to January 2016 were 16 males and 6 females, aged 21-53 years. All patients were associated with varying degrees of spinal nerve injury. Twenty-two patients were randomly assigned to the percutaneous minimally invasive group (group A) and the intermuscular approach group (group B). Among them, 11 patients in group A underwent percutaneous minimally invasive pedicle screw fixation combined with small incision for spinal canal reduction. Pressure and interbody fusion: 11 patients in group B underwent transpedicular space fixation with pedicle screw fixation combined with partial decompression and bone graft fusion. The operation time and intraoperative blood loss were recorded in the two groups. Visual analog scale (VAS) was recorded at 3 days and terminal follow-up. The fracture healing and spinal cord invasion rate were evaluated by imaging examination before and after the final follow-up. The neurological recovery was assessed according to the ASIA grading criteria. Result : There was a statistically significant difference between the two groups in the operation time and intraoperative blood loss (P<0.05). The VAS scores of the lumbar dorsal incision were compared between the two groups at the same time point, and the difference was statistically significant (P<0.05). Imaging examination showed that the fracture healed well and there was no internal fixation fracture. The rate of spinal canal invasion in the fracture and dislocation segments of the two groups was compared at the final follow-up, and the difference was statistically significant. Neurological recovery at the last follow-up (ASIA classification): 6 patients with grade A, 6 patients with grade B, 7 patients with grade C, 2 patients with grade D, and 1 patient with grade E, with significant improvement compared with preoperative. Conclusion : Percutaneous minimally invasive pedicle screw fixation combined with small incision decompression of the spinal canal and interbody fusion can also achieve the effect of posterior open surgery, and the trauma is smaller, which is more conducive to postoperative rehabilitation and reduce surgical complications.

scholarly journals Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis and Open Reduction Internal Fixation on Proximal Humeral Fracture in Elder Patients: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Zhao ◽  
Yuhui Zhang ◽  
Dongni Johansson ◽  
Xingyu Chen ◽  
Fang Zheng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Humeral Fracture ◽  
Plate Osteosynthesis ◽  
Meta Analysis ◽  
Humeral Fracture ◽  
Open Reduction Internal Fixation ◽  
Elder Patients

Objective. The study aims to compare minimally invasive percutaneous plate osteosynthesis (MIPO) and open reduction internal fixation (ORIF) in the treatment of proximal humeral fracture in elder patients. Method. PubMed, Medline, EMbase, Ovid, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wangfang, and VIP Database for Chinese Technical Periodicals were searched to identify all relevant studies from inception to October 2016. Data were analyzed with Cochrane Collaboration’s Review Manage 5.2. Results. A total of 630 patients from 8 publications were included in the systematic review and meta-analysis. The pooled results showed that MIPO was superior to ORIF in the treatment of proximal humeral fracture in elder patients. It was reflected in reducing blood loss, operation time, postoperative pain, or fracture healing time of the surgery and in improving recovery of muscle strength. Concerning complications, no significant difference was seen between MIPO and ORIF. Conclusion. The MIPO was more suitable than ORIF for treating proximal humeral fracture in elder patients.

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