Comparability of unilateral versus bilateral pedicle screw fixation on the stage 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 stage of fracture utilizing posterior short-segment pedicle instrumentation (SSPI). There was rising help for unilateral pedicle screw fixation (UPSF) in an try to scale back issues and prices. The intention of this research was to match the medical and radiologic outcomes of UPSF versus BPSF on the stage of fracture utilizing SSPI within the remedy of extreme TBFs.
METHODS: The data of 42 consecutive sufferers with extreme TBFs who underwent SSPI have been divided into 2 teams in accordance with the variety of screws within the fracture stage, together with 20 sufferers (5 screws) in UPSF group and 22 sufferers (six screws) in BPSF. Completely different medical and radiological parameters have been recorded earlier than surgical procedure, after surgical procedure, and 1.5 years after operation. The sufferers’medical outcomes have 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 top (AVH) have 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 important variations within the age, gender, fracture sort and web site in each teams. Radiologically, no statistically distinction was noticed between the 2 teams in corrected fee of LKA, VWA, or AVH(all P > zero.05). With respect to medical variants together with VAS and ODI scores, there have been additionally no important variations. Nonetheless, the united states 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% larger than the united states group. No severe issues occurred in our research. 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 research is the primary to show that sufferers present process SSPI with UPSF as in contrast with BPSF for the remedy of extreme TBFs had comparable medical and radiologic outcomes.
PMID: 28343026 [PubMed – indexed for MEDLINE]