Comparability of unilateral versus bilateral pedicle screw fixation on the degree of fracture utilizing posterior short-segment pedicle instrumentation within the remedy of extreme thoracolumbar burst fractures.
Int J Surg. 2017 Might;41:50-55
Authors: Solar C, Liu X, Tian J, Guan G, Zhang H
BACKGROUND: Thoracolumbar burst fractures (TBFs) are sometimes adopted by bilateral pedicle screw fixation (BPSF) on the degree of fracture utilizing posterior short-segment pedicle instrumentation (SSPI). There was growing assist for unilateral pedicle screw fixation (UPSF) in an try to cut back problems and prices. The goal of this examine was to match the scientific and radiologic outcomes of UPSF versus BPSF on the degree of fracture utilizing SSPI within the remedy of extreme TBFs.
METHODS: The information of 42 consecutive sufferers with extreme TBFs who underwent SSPI had been divided into 2 teams based on the variety of screws within the fracture degree, together with 20 sufferers (5 screws) in UPSF group and 22 sufferers (six screws) in BPSF. Totally different scientific and radiological parameters had been recorded earlier than surgical procedure, after surgical procedure, and 1.5 years after operation. The sufferers’scientific outcomes had been assessed utilizing visible analog scale (VAS), and Oswestry Incapacity Index (ODI). For radiological analysis, adjustments in native kyphosis angle (LKA), vertebral wedge angle (VWA), and anterior vertebral peak (AVH) had been investigated utilizing plain radiographs.
RESULTS: Imply follow-up was 18.three months for UPSF group and 19.zero months for BPSF group (P > zero.05). There have been no vital variations within the age, gender, fracture kind and web site in each teams. Radiologically, no statistically distinction was noticed between the 2 teams in corrected charge of LKA, VWA, or AVH(all P > zero.05). With respect to scientific variants together with VAS and ODI scores, there have been additionally no vital variations. Nevertheless, the us group appeared to have benefits over BPSF group in operative time, blood loss, postoperative drainage, hospitalization time (P > zero.05). Particularly, implant value for the BPSF group was 22% better than the us group. No severe problems occurred in our examine. In all circumstances, fusions healed properly and no revision surgical procedure was carried out for lack of correction or failure of instrumentation throughout follow-up.
CONCLUSIONS: The current examine is the primary to show that sufferers present process SSPI with UPSF as in contrast with BPSF for the remedy of extreme TBFs had related scientific and radiologic outcomes.
PMID: 28343026 [PubMed – indexed for MEDLINE]