Comparison of pedicle screw fixation by four different posterior approaches for the treatment of type A thoracolumbar fractures without neurologic injury
PurposeThis study was designed to compare the pedicle screw fixation by four different posterior approaches for the treatment of type A thoracolumbar fractures without neurologic injury.MethodsA total of 165 patients with type A thoracolumbar fractures without neurologic injury who received pedicle...
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1036255/full |
| _version_ | 1828071150769405952 |
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| author | Xu Zhu Yijie Shao Yun Lu Yun Lu Jiajia Sun Jie Chen |
| author_facet | Xu Zhu Yijie Shao Yun Lu Yun Lu Jiajia Sun Jie Chen |
| author_sort | Xu Zhu |
| collection | DOAJ |
| description | PurposeThis study was designed to compare the pedicle screw fixation by four different posterior approaches for the treatment of type A thoracolumbar fractures without neurologic injury.MethodsA total of 165 patients with type A thoracolumbar fractures without neurologic injury who received pedicle screw fixation by posterior approaches from February 2017 to August 2018 were enrolled in this study. They were further divided into the following four groups according to different posterior approaches: Open-C group (conventional open approach), Open-W group (Wiltse approach), MIS-F group (percutaneous approach with fluoroscopy guidance), and MIS-O group (percutaneous approach with O-arm navigation). The demographic data, clinical outcomes, and radiologic parameters were evaluated and compared among the four groups.ResultsThere were no significant differences in age, gender, fracture segment, and follow-up time. The incision length, blood loss, hospital stay time, and VAS (Visual Analog Scale) and ODI (Oswestry Disability Index) scores at the early stage of post-operation were the worst in the Open-C group. The MIS-O group showed significantly higher accuracy rate of pedicle position than other groups. The preoperative and postoperative AVH (anterior vertebral height) and VWA (vertebral wedge angle) obtain obvious correction in all patients immediately after and 1 year post-operation. No difference was found among the four groups at the final radiographic follow-up.ConclusionsThe four different posterior approaches are effective in treating type A thoracolumbar fractures in our study. Each approach has its own individual strengths and weaknesses and therefore requires comprehensive consideration prior to use. Proper approaches selection is critical to patients. |
| first_indexed | 2024-04-11T00:49:01Z |
| format | Article |
| id | doaj.art-6cbb40ba6a024d48a7f7f2c0c1b0c331 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-11T00:49:01Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-6cbb40ba6a024d48a7f7f2c0c1b0c3312023-01-05T10:16:34ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-01-01910.3389/fsurg.2022.10362551036255Comparison of pedicle screw fixation by four different posterior approaches for the treatment of type A thoracolumbar fractures without neurologic injuryXu Zhu0Yijie Shao1Yun Lu2Yun Lu3Jiajia Sun4Jie Chen5Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, ChinaOrthopedic Institute, Soochow University, Suzhou, ChinaDepartment of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, ChinaPurposeThis study was designed to compare the pedicle screw fixation by four different posterior approaches for the treatment of type A thoracolumbar fractures without neurologic injury.MethodsA total of 165 patients with type A thoracolumbar fractures without neurologic injury who received pedicle screw fixation by posterior approaches from February 2017 to August 2018 were enrolled in this study. They were further divided into the following four groups according to different posterior approaches: Open-C group (conventional open approach), Open-W group (Wiltse approach), MIS-F group (percutaneous approach with fluoroscopy guidance), and MIS-O group (percutaneous approach with O-arm navigation). The demographic data, clinical outcomes, and radiologic parameters were evaluated and compared among the four groups.ResultsThere were no significant differences in age, gender, fracture segment, and follow-up time. The incision length, blood loss, hospital stay time, and VAS (Visual Analog Scale) and ODI (Oswestry Disability Index) scores at the early stage of post-operation were the worst in the Open-C group. The MIS-O group showed significantly higher accuracy rate of pedicle position than other groups. The preoperative and postoperative AVH (anterior vertebral height) and VWA (vertebral wedge angle) obtain obvious correction in all patients immediately after and 1 year post-operation. No difference was found among the four groups at the final radiographic follow-up.ConclusionsThe four different posterior approaches are effective in treating type A thoracolumbar fractures in our study. Each approach has its own individual strengths and weaknesses and therefore requires comprehensive consideration prior to use. Proper approaches selection is critical to patients.https://www.frontiersin.org/articles/10.3389/fsurg.2022.1036255/fullthoracolumbar fractureswiltse approachpedicle screwo-arm navigationminimally invasive surgeryposterior approach |
| spellingShingle | Xu Zhu Yijie Shao Yun Lu Yun Lu Jiajia Sun Jie Chen Comparison of pedicle screw fixation by four different posterior approaches for the treatment of type A thoracolumbar fractures without neurologic injury Frontiers in Surgery thoracolumbar fractures wiltse approach pedicle screw o-arm navigation minimally invasive surgery posterior approach |
| title | Comparison of pedicle screw fixation by four different posterior approaches for the treatment of type A thoracolumbar fractures without neurologic injury |
| title_full | Comparison of pedicle screw fixation by four different posterior approaches for the treatment of type A thoracolumbar fractures without neurologic injury |
| title_fullStr | Comparison of pedicle screw fixation by four different posterior approaches for the treatment of type A thoracolumbar fractures without neurologic injury |
| title_full_unstemmed | Comparison of pedicle screw fixation by four different posterior approaches for the treatment of type A thoracolumbar fractures without neurologic injury |
| title_short | Comparison of pedicle screw fixation by four different posterior approaches for the treatment of type A thoracolumbar fractures without neurologic injury |
| title_sort | comparison of pedicle screw fixation by four different posterior approaches for the treatment of type a thoracolumbar fractures without neurologic injury |
| topic | thoracolumbar fractures wiltse approach pedicle screw o-arm navigation minimally invasive surgery posterior approach |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.1036255/full |
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