[Effect observation of percutaneous pedicle screw fixation combined with percutaneous vertebroplasty for the treatment of osteoporotic thoracolumbar fractures].

Vertebroplasty

[Effect observation of percutaneous pedicle screw fixation combined with percutaneous vertebroplasty for the treatment of osteoporotic thoracolumbar fractures].

Zhongguo Gu Shang. 2018 Apr 25;31(four):339-346

Authors: Wang N, Xu JZ, Chen EL, Zhao SJ, Quan RF

Summary
OBJECTIVE: To guage the scientific results of percutaneous pedicle screw fixation(PPSF) mixed with percutaneous vertebroplasty(PVP) for the remedy of osteoporotic thoracolumbar fractures.
METHODS: The scientific information of 94 sufferers with osteoporotic thoracolumbar fractures handled from January 2014 to December 2015 have been retrospectively analyzed. There have been 31 males and 63 females, aged from 65 to 70 years previous with a mean of 67.2 years. Fracture stage was T?? on 15 circumstances, T?? on 32 circumstances, L? on 29 circumstances and L? on 18 circumstances. The sufferers have been divided into two teams in accordance with completely different therapeutic strategies. Percutaneous pedicle screw fixation mixed with percutaneous vertebroplasty have been utilized in 43 sufferers(group A) and percutaneous vertebroplasty was utilized to 51 sufferers(group B). Operation time, intraoperative blood loss, bone cement quantity, postoperative in-bed time have been recorded; preoperatively, three d, 1 yr after the operation, the ratios of anterior border heights, sagittal Cobb angles, visible analogue scale(VAS) scores have been in contrast between two teams. The situation of postoperative complication in two teams was analyzed.
RESULTS: All of the sufferers have been adopted up for 12 to 24 months with a mean of 18.5 months. Operation time of group A [(96.2±28.7) min] was longer than that of group B [(31.8±10.6) min]. Intraoperative blood lack of group A[(62.2±25.5) ml] was greater than that of group B [(25.4±10.9) ml]. Bone cement quantity of group A [(5.5±0.5) ml] was bigger than that of group B [(4.9±1.1) ml]. Postoperative in-bed time of group A[(5.1±1.8) d] was longer than that of group B[(1.8±0.7) d]. There have been important variations in operation time, intraoperative blood loss, bone cement quantity, postoperative in-bed time between two teams(P<zero.05). Three days, 12 months after the operation, the ratios of anterior border heights and Cobb angles in two teams have been considerably improved. At remaining follow-up, the ratio of anterior border peak and Cobb angle of group A[(85.6±3.5)%, (11.9±5.3)°] have been higher than of group B[(84.2±4.5)%, (15.3±3.4)°](P<zero.05). Three circumstances in group B had re-collapse of cemented vertebral our bodies. Postoperative at three d, 1 yr, VAS rating of all sufferers had considerably decreased(P<zero.05), and there was no important distinction between two teams(P>zero.05).
CONCLUSIONS: In comparison with easy PVP, PPSF mixed with PVP in treating osteoporotic thoracolumbar fracture can receive stronger vertebral energy and stiffness, moreover to enhance vertebral lowered impact, holding vertebral heights, and stopping vertebral re-collapse.

PMID: 29772860 [PubMed – in process]

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Effect observation of percutaneous pedicle screw fixation combined with percutaneous vertebroplasty for the treatment of osteoporotic thoracolumbar fractures | Nerve root block injection cost