| Objective: To compare the clinical effect of percutaneous and intermuscular pedicle screw fixation in the treatment of single segment thoracolumbar fracture type A.Methods:From June 2014 to June 2016 in the first affiliated Hospital of Xinjiang Medical University,60 patients with type A(AO classification)fracture of thoracic and lumbar vertebrae were treated with percutaneous pedicle screw reduction and internal fixation(30 cases,respectively).Percutaneous)and transpedicular screw reduction and internal fixation(30 cases,transmuscular space group).The operative time,the amount of bleeding during operation,the length of incision,the times of fluoroscopy and the visual analogue score(visual analogue scale,)of postoperative incision pain in the two groups were retrospectively analyzed.What’s more,the preoperative,postoperative,and the last follow-up cobb angle were compared.And the percentage of anterior vertebral height recovery(RVH)of preoperative,postoperative and the last follow-up were analyzed.VAS and other general data were compared and analyzed in comparison with those preoperative,postoperative and the last follow-up.Result:The amount of intraoperative bleeding,the length of incision and the length of hospital stay in the percutaneous group were significantly lower than those in the intermuscular space group,and the pain in the percutaneous group was significantly less than that in the transmuscular space group,but there was no significant difference at one week after operation.The times of fluoroscopy and operation time in the percutaneous group were significantly higher than those in the transmuscular space group.The follow-up time of percutaneous group and transmuscular space group were 17.3 ±9.2 months and 18.1 ±6.5 months,respectively.There was no statistic difference in RVH and cob angle of the injured vertebrae between the twogroups.Conclusion: For patients with thoracolumbar type A fracture,although percutaneous pedicle screw fixation and transpedicular approach pedicle screw fixation are effective treatments.Percutaneous method has the advantages of less surgical trauma,short surgery time,quick recovery,and mild pain.However,there is a increasing risk of radiation exposure through the percutaneous approach.Considering that samples included in this study are limited and it is a retrospective study,large randomized controlled trials are still needed to further validate the results of this study. |
