STUDY ON THE EFFİCACY OF PERCUTANEOUS PEDİCLE SCREW FİXATİON AND TRANSMUSCULAR İNTERSTİTİAL PEDİCLE SCREW FİXATİON WHEN TREATİNG THORACOLUMBAR FRACTURES

Abstract

Objective: To evaluate the efficacy of percutaneous pedicle screw fixation and intermuscular pedicle screw fixation in the treatment of thoracolumbar fractures. Methods: The clinical data of 72 patients with thoracolumbar fracture from March 2020 to March 2021 were analyzed retrospectively. According to the mode of treatment, they were divided into percutaneous pedicle screw fixation group (percutaneous pedicle screw fixation group) and transmuscular interstitial pedicle screw fixation group (transmuscular space fixation group), with 36 cases in each group. The sagittal index of injured vertebra, Cobb angle, perioperative parameters, serum index, degree of multiple laceration, visual analogue score (VAS) and oswestry disability index (ODI) score were compared before and after treatment.Results: The sagittal plane index of injured vertebral body at 3 days, 3 months and 12 months after treatment was higher than that before treatment, and the Cobb angle was lower than that before treatment. The incision length and intraoperative blood loss in the percutaneous group were lower than those in the intermuscular space group, while the operation time and the number of intraoperative fluoroscopy in the percutaneous group were significantly higher than those in the intermuscular space group (P < 0.05). After 3 days of treatment, the levels of creatine kinase (CK) and lactate dehydrogenase (LDH) in the intermuscular space permeation group were significantly lower than those in the percutaneous permeation group. After 12 months of treatment, the fat infiltration rate in the Intermuscular space group was lower than that in the percutaneous group (P < 0.05). Compared with those before treatment, VAS score and ODI score decreased significantly at 1 week, 3 months and 12 months after treatment.Conclusion: Percutaneous puncture has the advantages of less trauma and short operation time, but it also has the risk of increasing radiation exposure. The intermuscular space pedicle screw fixation group had less fat infiltration.