Effect of vertebroplasty combined with pedicle screw internal fixation on functional recovery of patients with thoracolumbar fractures of the spine

doi:10.3877/cma.j.issn.2096-0263.2021.01.006

Abstract

Abstract:

Objective

To investigate the effect of vertebroplasty combined with pedicle screw fixation on functional recovery in patients with thoracolumbar fracture.

Methods

A total of 96 patients with thoracolumbar spine fractures admitted to our hospital from January 2016 to December 2018 were selected and randomly divided into a single group (48 cases) and a combined group (48 cases). The single group was treated with pedicle screw fixation, while the combined group was treated with vertebra plasty. The recovery, pain and dysfunction indexes of the injured vertebrae in the two groups before and after surgery were observed and compared. The indexes related to serum nerve function in the two groups before and after surgery were detected and compared, and the incidence of postoperative adverse events in the two groups were recorded.

Results

Three days after surgery, there was no significant difference in the recovery of injured vertebrae between the two groups (P>0.05). On postoperative 3 d, there was no significant difference in Visual Analogue Scale/Score (VAS) and Oswestry Dability Index (ODI) scores between the two groups (P>0.05). Three months after surgery, VAS and ODI scores of the combined group were significantly lower than those of the single group (P<0.05). On postoperative day 3, there was no significant difference in the levels of neuron specific enolase (NSE), brain derived neurotrophic factor (BDNF), S100 and Nerve growth factor (NGF) between the two groups (P>0.05). NSE, S100 beta and NGF levels were significantly lower in the single group (P<0.05). The incidence of adverse events in the combined group was significantly lower than that in the single group (P<0.05).

Conclusion

vertebroplasty combined with pedicle screw internal fixation to thoracolumbar fracture of spine can effectively improve the recovery of vertebral body after surgery, reduce postoperative pain and dysfunction, improve postoperative neurological function, and reduce the incidence of adverse events.

Key words: Vertebroplasty, Pedicle screw internal fixation, Spine, Recovery of function

Zhonghui Li, Tao Yu, Xiaoyan Zhang. Effect of vertebroplasty combined with pedicle screw internal fixation on functional recovery of patients with thoracolumbar fractures of the spine[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2021, 07(01): 27-33.

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Figures/Tables 6

References 20

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组别	例数	年龄（岁，±s）	性别（例，男/女）	椎体压缩率（%）	椎体后壁破裂（例）	手术距受伤时间（d，±s）
单一组	48	74±5	26/22	36±5	8	3.16±0.22
联合组	48	75±5	25/23	36±4	7	3.18±0.23
χ²/t值		0.998	0.042	0.126	0.079	0.435
P值		0.321	0.838	0.900	0.779	0.664
组别	例数	致伤原因（例）			骨折类型（例）		骨折节段（例）		Frankel分（例）
组别	例数	跌落	交通	压伤	压缩	爆裂	L₁	L₂	D	E
单一组	48	21	20	7	29	19	30	18	17	31
联合组	48	22	20	6	31	17	32	16	19	29
χ²/t值		0.042	0.000	0.089	0.178		0.182		0.178
P值		0.838	1.000	0.765	0.673		0.670		0.673

组别	例数	年龄（岁，±s）	性别（例，男/女）	椎体压缩率（%）	椎体后壁破裂（例）	手术距受伤时间（d，±s）
单一组	48	74±5	26/22	36±5	8	3.16±0.22
联合组	48	75±5	25/23	36±4	7	3.18±0.23
χ²/t值		0.998	0.042	0.126	0.079	0.435
P值		0.321	0.838	0.900	0.779	0.664
组别	例数	致伤原因（例）			骨折类型（例）		骨折节段（例）		Frankel分（例）
组别	例数	跌落	交通	压伤	压缩	爆裂	L₁	L₂	D	E
单一组	48	21	20	7	29	19	30	18	17	31
联合组	48	22	20	6	31	17	32	16	19	29
χ²/t值		0.042	0.000	0.089	0.178		0.182		0.178
P值		0.838	1.000	0.765	0.673		0.670		0.673

组别	例数	前缘压缩率（%）		椎管狭窄率（%）		Cobb角（°）
组别	例数	术后3 d	术后3个月	术后3 d	术后3个月	术后3 d	术后3个月
单一组	48	43±4	41±4^*	33±5	32±4^*	21.4±5.3	12.2±2.4^*
联合组	48	42±4	39±4^*	33±5	30±4^*	21.6±5.3	11.1±2.2^*
t值		0.987	2.085	0.116	2.103	0.166	2.341
P值		0.326	0.040	0.908	0.038	0.868	0.021

组别	例数	前缘压缩率（%）		椎管狭窄率（%）		Cobb角（°）
组别	例数	术后3 d	术后3个月	术后3 d	术后3个月	术后3 d	术后3个月
单一组	48	43±4	41±4^*	33±5	32±4^*	21.4±5.3	12.2±2.4^*
联合组	48	42±4	39±4^*	33±5	30±4^*	21.6±5.3	11.1±2.2^*
t值		0.987	2.085	0.116	2.103	0.166	2.341
P值		0.326	0.040	0.908	0.038	0.868	0.021

组别	例数	VAS		ODI
组别	例数	术后3 d	术后3个月	术后3 d	术后3个月
单一组	48	7.2±0.7	5.9±0.6^*	72±7	65±6^*
联合组	48	7.0±0.7	4.5±0.5^*	70±7	58±6^*
t值		0.959	12.978	1.192	5.236
P值		0.340	0.000	0.236	0.000

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