Clinical Comparative Study On Injured Vertebrae Screw Placement And Vertebrae Calcium Phosphate Cement Reinforcement Combined With Percutaneous Short Segment Pedicle Screw Fixation In The Treatment Of Thoracolumbar Fracture

Objective:To analyze and compare the clinical efficacy of injured vertebrae screw placement combined with percutaneous short segment pedicle screw fixation and vertebrae calcium phosphate cement reinforcement combined with percutaneous short segment pedicle screw fixation in the treatment of thoracolumbar fractures and to provide reference for the selection of treatment methods for thoracolumbar fractures.Methods:Retrospective analysis of 71 patients with thoracolumbar fractures admitted to our hospital between January 2017 and December 2021,divided into two groups: 35 cases in the injured vertebrae screw placement group,treated with injured vertebrae screw placement combined with percutaneous short segment pedicle screw fixation;and 36 cases in the vertebrae reinforcement group,treated with vertebrae calcium phosphate cement reinforcement combined with percutaneous short segment pedicle screw fixation.To compare the perioperative conditions of the two groups: incision length,intraoperative bleeding,operative time and hospitalization time.To follow up and compared VAS score,ODI score,the sagittal Cobb’s angle,anterior fractured vertebral compression rate,and the loss of correction(Cobb’s angle loss,anterior fractured vertebral height loss rate)and complications at the terminal follow-up.The data collected at follow-up were statistically analyzed to compare the clinical efficacy of the two procedures for the treatment of thoracolumbar fractures.Results:All 71 cases received 15-20 months follow-up,with a mean of(16.74±1.51)months.There was no significant difference in intraoperative bleeding,hospital stay,and complication rates between the two groups(P >0.05).The incision length and the operation time in the vertebrae reinforcement group was lower than that in the vertebrae screw placement group and the difference was statistically significant(P < 0.05).The differences in sagittal Cobb angle,anterior fractured vertebral compression rate,VAS scores,and ODI scores within the two groups were statistically significant at different follow-up points(P<0.05).At the preoperative,1 week postoperative,and 6-month postoperative follow-up points,the differences in sagittal Cobb angle and anterior fractured vertebral compression rate between the two groups were not statistically significant(P>0.05).The Cobb’s angle in the vertebrae reinforcement group at the last follow-up was lower than that in the vertebrae screw placement group and the anterior fractured vertebral compression rate was higher than that in the vertebrae screw placement group the difference was statistically significant(P<0.05).The loss of correction in the vertebrae reinforcement group,i.e.,the Cobb’s angle loss and the anterior fractured vertebral height loss rate were lower than those in the vertebrae screw placement group,and the difference was statistically significant(P <0.05).At the preoperative and1-week postoperative follow-up points,the differences in VAS scores and ODI scores between the two groups were not statistically significant(P>0.05).The VAS scores and ODI scores in the vertebrae reinforcement group at 6 months postoperative and the last follow-up were lower than that in the vertebrae screw placement group and the difference was statistically significant(P<0.05).By the time of the final follow-up,the difference in complication rates between the two groups was not statistically significant(P>0.05).Conclusions:Both surgical methods can achieve excellent repositioning of thoracolumbar fractures in the early postoperative period.In comparison,vertebrae calcium phosphate cement reinforcement combined with percutaneous short segment pedicle screw fixation has a smaller incision and shorter operative time,and the follow-up found that vertebrae calcium phosphate cement reinforcement combined with percutaneous short segment pedicle screw fixation is more advantageous in reducing the loss of height and correction of the injured vertebrae in the long term,thus providing better pain relief,restoring the function and improving the quality of life,which is an effective and safe surgical method.