The comparision of minimally invasive and traditional open treatment for thoracolumbar fractures with fixation using Sextant system

English Keywords:Spinal fracture  Ｆixation of the fractured vertebra  Percutaneous  Pedicle screw  Ｆixation

English Abstract:

  【Abstract】　Objective：To assess the surgical therapeutic result of thoracolumbar fracture by percutaneous pedicle screw fixation with fixation through the pedicle of fractured vertebra or by traditional open fixation technique using Sextant system.Method：42 thoracolumbar fracture patients were divided into two groups：18 cases were included in the Sextant percutaneous pedicle screw fixation group（SPPSF） and 24 cases were in the open pedicle screw fixation group（OPSF）.The perioperative index including correction of kyphosis，recovery of neurological function and relief of the low back pain was compared.Result：There were significant differences in the incision size，surgical blood loss，surgical draining loss，surgical time，hospital stay，postoperative blood transfusion，the proportion of antalgic supplemented and VAS score between the two groups（P<0.01 or P<0.05）.The Cobb′s angle，sagittal index，local angle and anterior height of the fracture vertebral body were all significantly different between pre-operation and post-operation in each group（P<0.01）.There was no significant difference in postoperative improvement of Cobb′s angle，sagittal index，the local angle of fracture vertebral body and the loss of the correction in SPPSF group compared with OPSF group in the follow-up but there was significant difference in postoperative improvement of anterior height（P<0.05） of fractured vertebral body in the two groups.Conclusion：Percutaneous pedicle screw fixation using Sextant system is a good minimally-invasive surgical therapeutic choice for patients with thoracolumbar fracture，this method is simple，safe，with less complication and blood loss，and can provide quick recovery and short stay in hospital and comparable result of the traditional open operation.