| Objective To study the effect of minimally invasive percutaneous single uniplanar screw internal fixation in the treatment of thoracolumbar fractures by comparing the preoperative and postoperative related indexes of minimally invasive percutaneous single uniplanar screw combined with vertebra universal screw internal fixation surgery,minimally invasive percutaneous universal screw internal fixation surgery and traditional posterior open surgery.Methods According to the inclusion and exclusion criteria,patients with thoracolumbar fractures admitted to our hospital from August 2015 to June 2017 were screened,and their clinical data were analyzed.After screening,97 patients who met the criterias,including 34 patients fixed with percutaneous universal screw implantation in the injured vertebrae,while percutaneous single-uniplanar screws were used in the adjacent vertebrae of the injured vertebrae,30 patients fixed with percutaneous universal screws in the injured vertebrae and adjacent vertebrae,and 33 patients treated with traditional posterior open surgery.We divided these patients into group A,group B and group C respectively,recording and analyzing the operation-related indexes,such as operation time,intraoperative blood loss,and preoperative and postoperative pain status of the patients among the three groups(evaluated by the visual analogue scale of pain((VAS)).In addition,further statistical analysis was made on the imaging indicators of the patients(including the preoperative,immediately postoperative and the final percentage of anterior edge height of injured vertebrae,kyphosis Cobb angle,sagittal plane index,and postoperative efficacy loss of these imaging indicators).Results There were no postoperative complications among the three group and the follow-up time showed no significant difference among the three groups(Group A vs Group B vs Group C: 27.62 ±2.41,vs 29.23 ±3.61,vs: 29.06 ±5.83,P > 0.05).However,when it comes to introperative blood loss and operation time,there were significant differences among the three groups(50.49 ±11.32 vs 49.53 ±10.37 vs 63.84 ±12.58,P <0.01;53.21 ± 4.87 vs 52.6 ± 5.09 vs 181.37 ± 33.42,P<0.01),but no significant difference between Group A and Group B(P > 0.05).The immediately postoperative and final results of VAS scores were similar,which had significantly differences among the three groups(2.53 ±1.11 vs 2.90 ±1.52 vs 4.27 ±0.57,P < 0.05;1.29 ±0.46 vs 1.33 ±0.48 vs 2.30 ±0.98,P < 0.05).In terms of imaging indexes,compared with those before operation,the relevant imaging indexes of the three groups were significantly improved(P < 0.05).There was no significant difference in immediately postoperative and final imaging indexes between group A and group C(P > 0.05),but the related indexes of group A and group C were better than those of group B(P < 0.05).In terms of postoperative efficacy loss,group A and group C had the same related indexes as group B,but there was no significant difference between group A and group C(the percentage of anterior edge height of vertebral body(AEH),kyphosis Cobb angle and sagittal plane index(SPI)in group A,B and C were 4.76 ±4.40 vs 8.03 ±3.71 vs 3.91 ± 3.19;1.68 ±0.84 vs 2.90 ±1.54 vs 1.76 ± 1.04 respectively.3.23 ± 6.94 vs 7.12 ± 6.15 vs 2.48 ± 6.75(P > 0.05).In addition,through the X-ray reexamination,there was no screw nut displacement,good screw position,no nail break and nail withdrawal in the three groups.Conclusion For the surgery of thoracolumbar fracture,in terms of intraoperative blood loss,postoperative VAS score,AEH,kyphosis Cobb angle and SPI,the curative effect of minimally invasive percutaneous single plane screw combined with universal screw was significantly better than that of conventional percutaneous universal screw,but equivalent to that of traditional open operation. |
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