Effects of minimally invasive percutaneous and trans-spatium intermuscular short-segment pedicle instrumentation on thoracolumbar mono-segmental vertebral fractures without neurological compromise - 06/06/13
, L. Wang a, Q.H. Zhao a, C.Y. Liu a
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Summary |
Objective |
To compare the outcomes of minimally invasive percutaneous short-segment pedicle instrumentation (SSPI) with that of trans-spatium intermuscular SSPI on thoracolumbar mono-segmental vertebral fracture without neurological compromise.
Methods |
A total of 39 patients with thoracolumbar mono-segmental vertebral fracture without neurological deficit receiving treatment between January 2009 and July 2011 were enrolled. Percutaneous SSPI was performed for 18 patients (the percutaneous group), and trans-spatium intermuscular SSPI was performed for 21 patients (the trans-spatium intermuscular group). Peroperative indices, intraoperative radiation exposure time, postoperative and follow-up lumbodorsal pain, function scores, and radiological data were compared.
Results |
The percutaneous group had significantly less intraoperative blood loss and less severe postoperative pains, but suffered significantly longer fluoroscopy time and higher hospitalization costs compared with the trans-spatium intermuscular group. No significant difference was observed in operating time. All patients were followed up for 17.3±9.2 months (ranging from 5 to 35 months). No significant differences were observed between the two groups in terms of postoperative relative vertebral height (RVH) and regional kyphotic angle (RKA), as well as last follow-up RVH, RKA, lumbodorsal pain, and Oswestry disability index.
Conclusion |
Percutaneous SSPI has the virtues of less intraoperative blood loss and less severe pains in the treatment of thoracolumbar mono-segmental vertebral fracture without neurological deficit. When compared with trans-spatium intermuscular SSPI, it results in longer intraoperative radiation exposure time and a higher surgery cost. To us, percutaneous SSPI has no advantage over trans-spatium intermuscular SSPI in therapeutic outcomes.
Level of evidence |
Level IV. Retrospective study.
El texto completo de este artículo está disponible en PDF.Keywords : Spinal fractures, Pedicle screws, Minimally invasive surgery Trans-muscular spatium approach
Esquema
Vol 99 - N° 4
P. 405-411 - juin 2013 Regresar al número
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