Comparison Of Two Percutaneous Pedicle Screw Placement In The Injured Vertebra For Thoraclumbar Fractures

Objective : For patients with single-segment thoracolumbar fractures without nerve injury,minimally invasive percutaneous combined injury polyaxial and monoaxial pedicle screw internal fixation was used to compare and study the recent clinical efficacy of the two nailing placement methods.Methods: Patients with single-segment thoracolumbar fractures without nerve injury admitted to the Second People’s Hospital of Hefei from May 2020 to March 2022 were retrospectively studied.42 patients were included according to the inclusion criteria,of whom 22 patients were treated with percutaneous pedicle screw internal fixation,and polyaxial nailing was used in both the injured and monoplanar pedicle screw in adjacent spine(control group);20 patients were treated with monoaxial screw in the injured spine and monoplanar pedicle screw in the adjacent spine(experimental group).The operative time,intraoperative bleeding,hospital stay,the ratio of the height of the anterior margin of the injured vertebra,the posterior convexity angle of the injured vertebra,the sagittal plane posterior convexity cobb angle and the change in the amount of loss at the end of the three were compared between the two groups,and the postoperative improvement of the patients was also evaluated using the pain level(pain visualization simulation score VAS)before,3 d after surgery and at the end of the follow-up.Results: A total of 42 cases meeting the inclusion criteria were followed up for 8 to 12 months with a mean of(11.2±2.1)months.None of the patients had any postoperative infection or fracture of the internal fixation device.(1)The general data such as age,sex,weight,fracture segment,and perioperative data such as operation time,intraoperative bleeding,and hospitalization time were not statistically significant between the two groups(P > 0.05)(2)There were no statistical differences in the postoperative anterior margin height ratio of the injured vertebrae,posterior convexity angle of the injured vertebrae,and posterior convex cobb angle imaging indexes between the two groups(P >0.05)(3)The final injured vertebrae of the two groups(3)There was a statistically significant difference between the anterior margin height ratio and the amount of loss of the posterior convex cobb angle in the two groups(P < 0.05).Conclusion: Both minimally invasive percutaneous combined with monoaxial pedicle screw and polyaxial pedicle screw in injured vertebrae for thoracolumbar fractures can correct kyphosis and relieve low back pain,but monoaxial pedicle screw is superior to polyaxial pedicle screw for long-term maintenance of the corrective effect.