Comparison of outcome between percutaneous pedicle screw fixation and the Mini-Open Wiltse Approach with pedicle screw fixation for neurologically intact thoracolumbar fractures: A retrospective study

Sheng, Wenbo; Jiang, Haitao; Hong, Chenglin; Hong-kui, HU; Yuan, Hantao; Gu, Xiang; Li, Sibo

doi:10.1016/j.jos.2021.03.012

Cited by 6 publications

(7 citation statements)

References 25 publications

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“…Currently, there are two main minimally invasive treatment techniques: PPSF and MWPSF. Minimally invasive surgery has the advantages of less blood loss, shorter operation time, better soft tissue protection, shorter postoperative hospital stay, and faster functional recovery [ 6 – 9 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Hidden blood loss between percutaneous pedicle screw fixation and the mini-open Wiltse approach with pedicle screw fixation for neurologically intact thoracolumbar fractures: a retrospective study

et al. 2023

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Background The aim of this study was to determine the proportion of hidden blood loss (HBL) in patients treated with minimally invasive surgery, and to compare the HBL between patients treated with percutaneous pedicle screw fixation (PPSF) and the mini-open Wiltse approach with pedicle screw fixation (MWPSF). Methods From January 2017 to January 2019, a total of 119 patients with thoracolumbar fractures were included in the analysis, of which 58 cases received PPSF and 61 cases received MWPSF. The clinical information and demographic results were collected and compared. And the HBL of the patients is calculated by the combination formulas of Nadler, Gross and Sehat. Results Compared with the PPSF group, operation time of MWPSF is shorter. The fluoroscopy times are 13.6 ± 3.0 in PPSF group and 5.6 ± 1.6 in MWPSF group (p < 0.001). As shown in Table 3, the intraoperative blood loss in PPSF group is 31.9 ± 9.6 ml, which is significantly less than that in the MWPSF group (44.0 ± 14.9 ml). The HBL (445.7 ± 228.9 ml), and HBL% (91.2 ± 7.7%) of the PPSF group are significantly higher than that in the MWPSF group (P < 0.05). And the total blood loss (TBL) of the PPSF group (477.6 ± 228.8 ml) is also more than that in the MWPSF group (401.0 ± 171.3 ml). Conclusions Our results suggest that in the minimally invasive surgical treatment of thoracolumbar fractures, the perioperative HBL is much higher than visible blood loss (VBL). Although PPSF has less intraoperative blood loss, it has higher TBL and HBL than those of MWPSF. Compared with MWPSF, we should pay more attention to the postoperative anemia status of patients with thoracolumbar fractures undergoing PPSF surgery.

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Section: Discussionmentioning

confidence: 99%

Hidden blood loss between percutaneous pedicle screw fixation and the mini-open Wiltse approach with pedicle screw fixation for neurologically intact thoracolumbar fractures: a retrospective study

et al. 2023

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“…The screws placed in the injured vertebral body are polyaxial screws, which do not adequately reposition the endplate of the injured vertebral body, and the soft tissue obstruction also has an impact on the operation of indirect repositioning. 35,36 The percutaneous screw technique is more suitable for patients with peripheral endplate injuries, where effective repositioning can be achieved by indirect repositioning, but satisfactory repositioning cannot be achieved for vertebrae with central endplate injuries.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of the Endplate Reduction Technique Combined With Bone Grafting for the Treatment of Thoracolumbar Fractures by Using Posterior Short-Segment Fixation

et al. 2023

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Objective: This study aimed to examine the effect of the endplate reduction (EPR) technique combined with bone grafting for treating thoracolumbar burst fractures using posterior short-segmental fixation.Methods: Patients with thoracolumbar fractures admitted between January 2018 and October 2021 were retrospectively analyzed, and those meeting the criteria were assigned to the EPR group and the intermediate screws (IS) group. The vertebral wedge angle (VWA), Cobb angle (CA), anterior vertebral body height (AVBH), middle vertebral body height (MVBH), upper endplate line (UEPL), upper intervertebral angle (UIVA), and upper intervertebral disc height (UIDH) indices were examined and compared preoperatively, first day postoperatively, as well as at 12 months postoperatively.Results: The result indicated that the EPR group achieved better MVBH reduction (p < 0.001), UEPL reduction (p < 0.001), vertebral body fracture healing (p = 0.006), as well as implant breakage (p = 0.04) than the IS group; VWA (p < 0.001), CA (p = 0.005), AVBH (p < 0.001), MVBH (p < 0.001), UEPL (p < 0.001), and UIDH (p < 0.001) were lost after reduction less than those in the IS group. There was no significant difference in operative time (p = 0.315) and intraoperative bleeding (p = 0.274) between the 2 groups.Conclusion: The EPR group achieved better results in repositioning and maintaining MVBH and endplate morphology, with less correction loss after the reduction of the VWA, CA, AVBH, and endplate morphology. The EPR group exhibited a better healing pattern after vertebral fracture and disc degeneration was better relieved.

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“…e Japanese Orthopedic Association (J0A) criteria were applied to assess patients' lumbar spine function, which contains four components: bladder function (0-6 points), degree of life limitation (0-14 points), subjective symptoms (0-9 points), and clinical signs (0-6 points), and the scores were positively correlated with lumbar spine function. [10].…”

Section: Joamentioning

confidence: 99%

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

Zhou

Chen

Gao

et al. 2022

Contrast Media & Molecular Imaging

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Objective. To analyze the influence of minimally invasive arch root nailing internal fixation surgery on tissue traumatic stress response in patients with vertebral fractures and explore the advantages of this treatment. Methods. One hundred and thirty-six patients with vertebral fractures admitted to our hospital from January 2020 to January 2022 were selected and divided into two groups based on the treatment method: the control group was treated with open arch root nail internal fixation surgery and the study group was treated with minimally invasive arch root nail internal fixation. The lumbar spine function, ODI, VAS, JOA score, complications, inflammation, and stress response were compared between the two groups. Results. After the operation, the ratio of intervertebral space and anterior edge height increased, and the Cobb angle decreased in both groups; the surgical incision, hospital stay, and operation time in the study group were shorter than those in the control group, and the intraoperative drainage volume and intraoperative blood loss were smaller than those in the control group ( P < 0.05 ); before surgery, there was no significant difference in ODI and VAS scores between the two groups ( P > 0.05 ). After surgery, the ODI and VAS scores in the two groups were significantly decreased, and the JOA score was significantly increased; complications occurred in the control group and the study. The incidence of complications in the study group was lower than that in the control group ( P < 0.05 ); after surgery, compared with the control group, the serum TNF-α, CRP levels, and stress response indexes of the study group decreased more significantly ( P < 0.05 ). Conclusion. Minimally invasive pedicle screw fixation has high safety and obvious advantages. The patient’s stress response index and pain level are low, and it will not cause obvious damage to the patient. The postoperative lumbar spine function is significantly improved, which is beneficial to the patient’s postoperative recovery. It is easy to operate, will not damage the thoracic and lumbar vertebrae significantly, and the fluoroscopy time is relatively short, and it has a good recovery effect. Therefore, minimally invasive internal arch nailing surgery can be used as the preferred treatment for patients with vertebral fractures.

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Comparison of outcome between percutaneous pedicle screw fixation and the Mini-Open Wiltse Approach with pedicle screw fixation for neurologically intact thoracolumbar fractures: A retrospective study

Cited by 6 publications

References 25 publications

Hidden blood loss between percutaneous pedicle screw fixation and the mini-open Wiltse approach with pedicle screw fixation for neurologically intact thoracolumbar fractures: a retrospective study

Hidden blood loss between percutaneous pedicle screw fixation and the mini-open Wiltse approach with pedicle screw fixation for neurologically intact thoracolumbar fractures: a retrospective study

Effectiveness of the Endplate Reduction Technique Combined With Bone Grafting for the Treatment of Thoracolumbar Fractures by Using Posterior Short-Segment Fixation

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

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