[Minimal invasive internal fixation with U-shaped break-off pedicle screws for treatent of thoracolumbar fractures].
摘要
OBJECTIVE: To investigate the clinical outcome of minimal invasive internal fixation with U-shaped break-off pedicle screws through paraspinal muscle sparing approach to treat thoracolumbar fractures, and to discuss its advantages. METHODS: From August 2010 to June 2012, we had 40 thoracolumber fractures patients (27 males and 13 females). Their ages ranged from 22 to 60 years. Of the 40 cases, 4 were T11 fractures, 13 T12 fractures ,17 L1 fractures,6 L2 fractures. According to Denis classification,all of them were burst fractures, with vertebral canal compromise less than 1/3. According to AO classification they were type A or type B1 injuries. All the cases had no nerve injury. The patients were randomly divided into two groups. With Group A (20 cases) we took the method of minimal invasive internal fixation with U-shaped break-off pedicle screws to fix one level above and below the injured vertebra through the parespinal muscle sparing approach. With Group B (20 cases), we took the traditional posterior midline approach and open procedure. Then we compared the two groups by operation time, blood loss, drainage, Visual Analogue Scales and X-ray exposure. RESULTS: Minimal invasive group had obvious advatages in operation time, bleeding control and early pain relief of post-operation. The X-ray exposure and long-term follow-up outcome were almost the same. CONCLUSION: Through paraspinal muscle sparing approach minimal invasive internal fixtation with U-shaped break-off pedicle screws to treat thoracolumber has more advantages than traditional procedure in blood control and quick recovery. The method needs no special instruments and don't increase X-ray exposure.