Posterior mini-open technique combined with percutaneous pedicle screw instrumentation for thora?鄄columbar fracture complicated with neurological deficits

English Keywords:Thoracic and lumbar fracture  Neurological deficit  Mini-open  Percutaneous pedicle screw system  Neural decompression

English Abstract:

  【Abstract】 Objectives: To determine the safety and efficacy of posterior mini-open technique combined with percutaneous pedicle screw instrumentation for thoracolumbar fracture complicated with neurological deficits. Methods: A retrospective review was performed on 18 patients(12 males and 6 females) with thoracolumbar fracture complicated with neurological deficits between December 2010 and October 2013. The patients were from 30 years to 58 years with an average of 42.8 years. After general anesthesia, ZINATM percutaneous pedicle screws were implanted above and below the injured segment, neural tissue decompression, interbody fusion with autograft, and reduction was performed under posterior mini-open approach(MISS group). Compared with the other 20 cases undergoing traditional open surgery(TOS group), the length of soft tissue dissection, the blood loss during surgery, the drainages, the visual analog score(VAS) of incision and analgesics usage after surgery were evaluated separately. Results: Compared with TOS group, the length of soft tissue dissection was 6.9±1.2cm vs. 18.6±2.8cm, the blood loss during surgery was 538.3±188.7ml vs. 735.8±252.2ml, the drainage was 116.4±55.0ml vs. 233.5±95.8ml, the visual analog score（VAS） of incision was 2.5±1.4 vs. 4.4±1.8 and analgesics usage after surgery was 16.7% vs. 70.0%. All showed significant differences between two groups(P<0.05 or P<0.01). No surgery related complains were found. All patients achieved effective decompression. In two groups, more than 6 months were followed up, and more than one grade of neurofunction recovery was observed at final follow-up. Conclusions: Posterior mini-open technique combined with percutaneous pedicle screw instrumentation provides a safe, effective and less invasive alternative for dealing thoracolumbar fracture complicated with neurological deficits.