To investigate the effect of short-segment reduction and internal fixation with percutaneous minimally invasive pedicle screw for the treatment of thoracolumbar fractures without decompression.

From March 2016 to June 2019, 58 patients with thoracolumbar compression fractures who did not need decompression were treated in our department retrospectively. A total of 32 cases were fixed by short-segment reduction and fixation with cross-injury vertebrae (uninjured vertebrae group). 26 cases were fixed by short-segment reduction and fixation with injury vertebrae (injured vertebrae group), including 24 males and 8 females, with an average age of (45±10) years. Twenty-six cases of short-segment reduction and internal fixation (traumatic vertebral screw placement group) were used, including 20 males and 6 females, with an average age of (44±10) years. The length of the incision, intraoperative, the blood loss, the number of intraoperative fluoroscopy, operation time, hospitalization expenses, VAS (Visual Analogue Scale Score for Pain) scores before and after the operation, imaging parameters, and postoperative complications were compared and analyzed.

All the enrolled cases were followed up for 12-18 months, with an average follow-up time of 15.6±1.7 months. Compared with the injured vertebra without nail placement group, the surgical incision was smaller and the hospitalization cost was lower (P<0.05), but there was no statistical difference in intraoperative blood loss, X-ray exposure times, and operation time (P>0.05). There was no statistically significant difference in pain VAS score and ODI score between the two groups before operation and during postoperative follow-up (P>0.05), but the comparison between the two groups was significantly lower after operation than before operation (P<0.05). There was no significant difference in the compression ratio of the anterior edge of the injured vertebrae and the cobb's angle of the kyphosis at the 3 days and 1 year follow-up between the two groups (P>0.05). Compared with the pre-operation, all improved significantly afterwards (P<0.05). There was no significant difference between the two groups in the correction rate of anterior vertebral body height and the correction rate of Cobb angle at 1 year after operation (P>0.05). There were no complications such as intraoperative nail placement resulting in nerve damage, postoperative infection, loosening of internal fixation, or rupture in both groups.

The short-segment reduction and internal fixation of the percutaneous minimally invasive pedicle screw for the treatment of thoracolumbar fractures without decompression has a satisfactory clinical effect. Whether the injured vertebrae is inserted or not has no significant effect on the effect. However, compared with the injured vertebrae without nail placement group, the surgical incision was smaller and the hospitalization cost was lower.