单节段经伤椎固定治疗AOA3.1型胸腰椎爆裂骨折的基础及临床研究
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摘要
第一部分经骨折椎单节段与短节段椎弓根螺钉固定治疗胸腰椎爆裂骨折(A0A3.1)的离体生物力学研究
目的：研究单节段经伤椎固定治疗胸腰椎爆裂性骨折(AO A3.1)的稳定性。
方法：选取新鲜脊柱标本胸10-腰2节段6具。通过落锤实验机建立AO分型A3.1型胸12爆裂骨折的模型,在与骨折椎相邻的上、下椎体打入椎弓根螺钉建立短节段椎弓根螺钉固定(short segment pedicle instrumentation, SSPI)的模型；随后在骨折椎及其相邻的椎体上植入椎弓根钉,建立单节段椎弓根螺钉固定(monosegment pedicle instrumentation,MSPI)的模型。每具标本均进行完整、骨折、SSPI和MSPI固定四种状态的生物力学测试。分析MSPI固定与完整、骨折标本,SSPI固定与完整、骨折标本,SSPI固定与MSPI固定的稳定性差异。
结果：MSPI固定组的前屈、后伸、左右侧弯的ROM(range of motion,活动范围)为0.14±0.02°、0.07±0.02°、0.74±0.13°和0.73±0.22°明显小于骨折组0.84±0.10°、1.94±0.30°、2.54±0.44°和2.33±0.56°及完整组0.46±0.05°、1.01±0.23°、1.30±0.31。和1.34±0.24°(p<0.05)。轴向旋转,当扭转角相同时,MSPI固定组所需的扭力3103.00±213.11N与完整标本2654.75±122.90N相当(p>0.05),大于骨折标本1519.60±100.82N(p<0.05)。SSPI固定的脊柱标本(胸11-腰1)前屈、后伸、左侧弯和右侧弯的ROM分别为0.32±0.07°、1.55±0.31。、1.27±0.33°和1.61±0.43°明显小于骨折组的1.23±0.24°、4.34±0.68°、3.39±0.77°和3.70±0.98°及完整组0.65±0.15°、2.31±0.22°、2.45±0.44°和2.70±0.54°(p<0.05),轴向旋转,当扭转角相同时,SSPI固定组所需的扭力3184.00±250.40的与完整标本2654.75±122.90N相当(p>0.05),大于骨折标本1519.60±100.82N(p<0.05)。SSPI固定的标本在前屈、后伸、左侧弯和右侧弯稳定指数(SPI,stable potential index)分别为0.50±0.01。、0.45±0.03°、0.52±0.02°和0.70±0.0°3。MSPI固定的标本在前屈、后伸、庄侧弯和右侧弯SPI(稳定指数)分别为0.88±0.05。、0.94±0.02。、0.81±0.19°和0.92±0.01。。MSPI固定的标本在前屈、后伸、左侧弯和右侧弯时的稳定指数明显高于SSPI固定的标本(p<0.05)。当扭转角度相同时,MSPI固定的脊柱标本所需的扭力与SSPI的脊柱标本相比,p>0.05,统计学上无显著差异。
结论：MSPI及SSPI治疗A03.1型胸腰椎爆裂骨折,均能重建脊柱的稳定性,MSPI在前屈后伸和左右侧弯时脊柱的初始稳定性优于SSPI固定,轴向扭转时的稳定性与SSPI固定相似。
第二部分用三维有限元方法评价经骨折椎单节段与短节段椎弓根螺钉固定治疗胸腰椎爆裂骨折(AO A3.1)的生物力学效果
目的：用三维有限元方法比较胸腰椎爆裂骨折(AO A3.1)MSPI及SSPI固定时脊柱稳定性,内固定的应力及力矩。
方法：基于尸体冰冻切片建立T11-L1脊柱三维有限元模型,包括完整模型,胸12骨折模型,MSPI固定的模型,SSPI固定的模型。计算前屈,后伸,侧弯及轴向旋转4种条件下脊柱的ROM,螺钉与棒所受的应力峰值,计算SSPI及MSPI在各种条件下的螺钉及棒力矩。
结果：SSPI组固定模型T11相对于L1的ROM前屈、后伸、侧弯和轴向旋转状况下由完整状态时的0.768°、1.375°、0.905°和0.630°减小为0.762°、0.458°、0.688°和0.601。,均小于完整状态模型。MSPI组固定模型时T11对于T12的ROM前屈、后伸、侧弯和轴向旋转状况下由完整状态时的0.516°0.515°、0.332°和0.120°减小为0.51°、0.114°、0.140°和0.114°,均小完整状态模型。各个活动方向SSPI固定模型椎弓根钉应力峰值较MSPI固定模型的相应椎弓根钉应力峰值明显增高。MSPI固定模型作用于钉和棒上力矩小于SSPI固定模型。
结论：MSPI与SSPI能重建胸腰椎爆裂骨折脊柱的稳定性。MSPI模型中作用于椎弓根螺钉及棒的力矩小于SSPI固定。MSPI内固定断裂的可能性小于SSPI固定。
第三部分单节段与短节段椎弓根螺钉固定治疗脊柱胸腰椎爆裂骨折的回顾性对照研究
目的：探讨后路单节段经伤椎固定治疗胸腰椎爆裂性骨折(AO A3.1和A3.2)的可行性、安全性和疗效。
方法：回顾分析2005年4月至2010年2月胸腰椎不完全爆裂骨折资料共60例,其中单节段固定组30例,短节段固定组30例。比较两组患者手术时间,出血量,术前术后视觉模拟量表(VAS)评分和伤椎后凸角等。
结果：单节段固定组手术平均时间(90±25)min；平均术中出血量(180±62)ml；伤椎后凸角术前17.3°±9.3。,术后1周6.5°±6.5°,末次随访时9.5。±6.4°；VAS评分术前7.5±1.4,术后1周2.5±0.7,末次随访1.4±0.8；术后未发现相邻节段退变征象。短节段固定组手术平均时间(101±28)min；平均术中出血量(203±88)ml；伤椎后凸角术前16.5。±9.1°,术后1周7.1°±6.9°,末次随访7.5。±5.2。；VAS评分术前6.7±1.5,术后1周3.0±0.4,末次随访1.1±0.6：1例患者术后36个月随访时出现固定相邻节段的退变。两组间手术时间,出血量,术前、术后1周及末次随访时伤椎后凸角和VAS评分相比差异均无统计学意义(P>0.05)。两组术后1周及末次随访时VAS评分较术前均有明显改善,伤椎后凸角度术后1周及末次随访时较术前明显减小,差异均有统计学意义(P<0.05)。
结论：单节段经伤椎固定治疗胸腰椎爆裂骨折(AO A3.1和A3.2)安全、有效,在术中出血量、手术时间,术后VAS评分改善和伤椎后凸角恢复方面与短节固定组无显著差异。
PART I Biomechanical comparison of monosegmental versus short-segmental fixation by pedicle instrumentation in the management of thoracolumbar fracture (AO A3.1)
Objective:To testify the biomechanical properties of thoracolumbar burst fracture (AO classification A3.1) treated with monosegmental pedicle instrumentation (MSPI).
Methods:Six T10-L2thoracolumbar spine segments were harvested from human donors ranging in age from27to46years (mean39y). Incomplete burst fracture (AO classification A3.1) was made at the level of T12. Monosegmental pedicle instrumentation and short segmental pedicle instrumentation were applied to the specimens sequentially to restore spinal stability. Segmental instability tests were performed on specimens in condition of intact, fractured and MSPI. Range of motions (ROM) in flexion-extension, lateral bending were recorded by a2-camera VICON motion measurement system. The rotational stability was testified by a computer-torsional testing machine.
Results:The ROM of MSPI in flexion-extension, lateral bending was0.14±0.02°,0.07±0.020°,0.74±0.13°and0.73±0.22°. The ROM of intact specimen in flexion-extension, lateral bending was0.46±0.05°,1.01±0.23°,1.30±0.31°and1.34±0.24°.The ROM of MSPI was significantly higher than that of intact in flexion-extension, lateral bending (p<0.05). MSPI group was more stable than intact group in flexion-extension, lateral bending. The torsional force of MSPI was3103.00±213.11N and that of intact was2654.75±122.90N. MSPI group was as stable as intact group in axial rotation (p>0.05). The ROM of SSPI in flexion-extension, lateral bending was0.32±0.07°,1.55±0.31°,1.27±0.33°and1.61±0.43°. The ROM of intact specimen in flexion-extension, lateral bending was0.65±0.15°,2.31±0.22°,2.45±0.44°and2.70±0.54°.The ROM of SSPI was significantly higher than that of intact in flexion-extension, lateral bending(p<0.05). SSPI group was more stable than intact group in flexion-extension, lateral bending. The torsional force of MSPI was3184.00±250.40N and that of intact was2654.75±122.90N. SSPI group was as stable as intact group in axial rotation (p>0.05). The SPI of MSPI in flexion-extension and lateral bending was0.94°,0.88°,0.81°and0.92°, respectively. The SPI of SSPI in flexion-extension and lateral bending was0.50°,0.45°,0.52°and0.70°, respectively. The SPI of MSPI was significantly higher than that of SSPI in both flexion-extension and lateral bending (p<0.05). MSPI was more stable than SSPI in both flexion-extension and lateral bending. The torsional force was3103N for MSPI and3184N for SSPI. SSPI was as stable as MSPI in axial rotation (p>0.05).
Conclusion:Monosegmental pedicle instrumentation can provide more instant stability than SSPI with respect to the reconstruction of unstable spine (AO classification A3.1) in both flexion-extension and lateral bending. Monosegmental pedicle instrumentation can provide same instant stability as SSPI with respect to the reconstruction of unstable spine (AO classification A3.1) in axial rotation.
PART II Biomechanical Comparison of MSPI and SSPI for thoracolumbar burst fractures (AO A3.1) using Finite Element Method
Object:This study was designed to compare the biomechanical effects of two posterior fixations for thoracolumbar burst fractures using the finite element (FE) method.
Methods:Four T11-L1FE models, including the intact, the fractured at T12, the monosegment pedicle intrumentation at the level of the fracture and the short-segment pedicle intrumentation with four pedicle screws were created. And four loading condi tions (flexion, extension, lateral bending and torsion) were imposed on these models and deformations in these models under different loading conditions were calculated by finite element method. The biomechanical effects of the two different pedicle screw fixations for thoracolumbar burst fractures were compared and analyzed. Results:The ROM of SSPI (T11-L1) in flexion-extension, lateral bending and was0.762°,0.458°,0.688°,0.601°. The ROM of intact specimen(T11-L1) in flexion-extension, lateral bending and axial rotation was0.768°,1.375°,0.905°,0.630°. The ROM of SSPI group was less than that of intact group in flexion-extension, lateral bending. The ROM of MSPI (T11-T12) in flexion-extension, lateral bending and axial rotation was0.51°,0.114°,0.140°,0.114°. The ROM of intact specimen (T11-T12) in flexion-extension, lateral bending and axial rotation was0.516°,0.515°,0.332°,0.120°. The ROM of MSPI (T11-T12) was less than that of intact(T11-T12) in flexion-extension, lateral bending and axial rotation. Conclusion:MSPI and SSPI could provide desirable stability for the fractured spine. The moment of force loaded onto the pedicle screw and rod of MSPI model was smaller than that of SSPI model.
PART Ⅲ Management of thoracolumbar burst fracture:monosegmental fixation versus short-segment fixation-a retrospective controlled study.
Objective:To investigate the safety and therapeutic effects of mono-segmental pedicle instrumentation in treating thoracolumbar burst fracture (AO classification:A3.1and A3.2).
Methods:A retrospective analysis was conducted on60cases with thoracolumbar burst fracture (AO classification:A3.1and A3.2) between April2005and February2010. Half of the60inpatients were treated with mono-segment pedicle instrumentation (MSPI), and the other half were treated with short-segment pedicle instrumentation (SSPI). The mean operation time, blood loss, visual analog scale (VAS) and vertebral kyphotic angle before and after surgery were compared.
Results:In the MSPI group, the mean operation time was90±25min, and the blood loss at operation was180±62ml. The vertebral kyphotic angles were17.3°±9.3°before surgery,6.5°±6.5°one week after surgery, and9.5°±6.4°for the latest follow-up. The VAS scores were7.5±1.4before surgery,2.5±0.7one week after surgery, and1.4±0.8for the latest follow-up. In the SSPI group, the mean operation time was101±28min, and the blood loss at operation was203±88ml. The follow-up duration was12-64months. The vertebral kyphotic angles were16.5°±9.1°before surgery,7.1°±6.9°one week after surgery, and7.5°±5.2°for the latest follow-up. The VAS scores were6.7±1.5before surgery,3.0±0.4one week after surgery, and1.1±0.6for the latest follow-up. There were no statistically significant differences between these two groups in the operation time, blood loss at operation, VAS score and vertebral kyphotic angle before and after surgery (P>0.05). The post-surgical VAS scores and vertebral kyphotic angles were significantly decreased in both groups, compared to before surgery (P＜0.05).
Conclusions:It is safe and effective to treat thoracolumbar burst fracture (AO3.1and AO3.2) with MSPI. The mean operation time, blood loss at operation, post-surgical VAS and vertebral kyphotic angle of the MSPI group are similar compared to the SSPI group.
目的：研究单节段经伤椎固定治疗胸腰椎爆裂性骨折(AO A3.1)的稳定性。
方法：选取新鲜脊柱标本胸10-腰2节段6具。通过落锤实验机建立AO分型A3.1型胸12爆裂骨折的模型,在与骨折椎相邻的上、下椎体打入椎弓根螺钉建立短节段椎弓根螺钉固定(short segment pedicle instrumentation, SSPI)的模型；随后在骨折椎及其相邻的椎体上植入椎弓根钉,建立单节段椎弓根螺钉固定(monosegment pedicle instrumentation,MSPI)的模型。每具标本均进行完整、骨折、SSPI和MSPI固定四种状态的生物力学测试。分析MSPI固定与完整、骨折标本,SSPI固定与完整、骨折标本,SSPI固定与MSPI固定的稳定性差异。
结果：MSPI固定组的前屈、后伸、左右侧弯的ROM(range of motion,活动范围)为0.14±0.02°、0.07±0.02°、0.74±0.13°和0.73±0.22°明显小于骨折组0.84±0.10°、1.94±0.30°、2.54±0.44°和2.33±0.56°及完整组0.46±0.05°、1.01±0.23°、1.30±0.31。和1.34±0.24°(p<0.05)。轴向旋转,当扭转角相同时,MSPI固定组所需的扭力3103.00±213.11N与完整标本2654.75±122.90N相当(p>0.05),大于骨折标本1519.60±100.82N(p<0.05)。SSPI固定的脊柱标本(胸11-腰1)前屈、后伸、左侧弯和右侧弯的ROM分别为0.32±0.07°、1.55±0.31。、1.27±0.33°和1.61±0.43°明显小于骨折组的1.23±0.24°、4.34±0.68°、3.39±0.77°和3.70±0.98°及完整组0.65±0.15°、2.31±0.22°、2.45±0.44°和2.70±0.54°(p<0.05),轴向旋转,当扭转角相同时,SSPI固定组所需的扭力3184.00±250.40的与完整标本2654.75±122.90N相当(p>0.05),大于骨折标本1519.60±100.82N(p<0.05)。SSPI固定的标本在前屈、后伸、左侧弯和右侧弯稳定指数(SPI,stable potential index)分别为0.50±0.01。、0.45±0.03°、0.52±0.02°和0.70±0.0°3。MSPI固定的标本在前屈、后伸、庄侧弯和右侧弯SPI(稳定指数)分别为0.88±0.05。、0.94±0.02。、0.81±0.19°和0.92±0.01。。MSPI固定的标本在前屈、后伸、左侧弯和右侧弯时的稳定指数明显高于SSPI固定的标本(p<0.05)。当扭转角度相同时,MSPI固定的脊柱标本所需的扭力与SSPI的脊柱标本相比,p>0.05,统计学上无显著差异。
结论：MSPI及SSPI治疗A03.1型胸腰椎爆裂骨折,均能重建脊柱的稳定性,MSPI在前屈后伸和左右侧弯时脊柱的初始稳定性优于SSPI固定,轴向扭转时的稳定性与SSPI固定相似。
第二部分用三维有限元方法评价经骨折椎单节段与短节段椎弓根螺钉固定治疗胸腰椎爆裂骨折(AO A3.1)的生物力学效果
目的：用三维有限元方法比较胸腰椎爆裂骨折(AO A3.1)MSPI及SSPI固定时脊柱稳定性,内固定的应力及力矩。
方法：基于尸体冰冻切片建立T11-L1脊柱三维有限元模型,包括完整模型,胸12骨折模型,MSPI固定的模型,SSPI固定的模型。计算前屈,后伸,侧弯及轴向旋转4种条件下脊柱的ROM,螺钉与棒所受的应力峰值,计算SSPI及MSPI在各种条件下的螺钉及棒力矩。
结果：SSPI组固定模型T11相对于L1的ROM前屈、后伸、侧弯和轴向旋转状况下由完整状态时的0.768°、1.375°、0.905°和0.630°减小为0.762°、0.458°、0.688°和0.601。,均小于完整状态模型。MSPI组固定模型时T11对于T12的ROM前屈、后伸、侧弯和轴向旋转状况下由完整状态时的0.516°0.515°、0.332°和0.120°减小为0.51°、0.114°、0.140°和0.114°,均小完整状态模型。各个活动方向SSPI固定模型椎弓根钉应力峰值较MSPI固定模型的相应椎弓根钉应力峰值明显增高。MSPI固定模型作用于钉和棒上力矩小于SSPI固定模型。
结论：MSPI与SSPI能重建胸腰椎爆裂骨折脊柱的稳定性。MSPI模型中作用于椎弓根螺钉及棒的力矩小于SSPI固定。MSPI内固定断裂的可能性小于SSPI固定。
第三部分单节段与短节段椎弓根螺钉固定治疗脊柱胸腰椎爆裂骨折的回顾性对照研究
目的：探讨后路单节段经伤椎固定治疗胸腰椎爆裂性骨折(AO A3.1和A3.2)的可行性、安全性和疗效。
方法：回顾分析2005年4月至2010年2月胸腰椎不完全爆裂骨折资料共60例,其中单节段固定组30例,短节段固定组30例。比较两组患者手术时间,出血量,术前术后视觉模拟量表(VAS)评分和伤椎后凸角等。
结果：单节段固定组手术平均时间(90±25)min；平均术中出血量(180±62)ml；伤椎后凸角术前17.3°±9.3。,术后1周6.5°±6.5°,末次随访时9.5。±6.4°；VAS评分术前7.5±1.4,术后1周2.5±0.7,末次随访1.4±0.8；术后未发现相邻节段退变征象。短节段固定组手术平均时间(101±28)min；平均术中出血量(203±88)ml；伤椎后凸角术前16.5。±9.1°,术后1周7.1°±6.9°,末次随访7.5。±5.2。；VAS评分术前6.7±1.5,术后1周3.0±0.4,末次随访1.1±0.6：1例患者术后36个月随访时出现固定相邻节段的退变。两组间手术时间,出血量,术前、术后1周及末次随访时伤椎后凸角和VAS评分相比差异均无统计学意义(P>0.05)。两组术后1周及末次随访时VAS评分较术前均有明显改善,伤椎后凸角度术后1周及末次随访时较术前明显减小,差异均有统计学意义(P<0.05)。
结论：单节段经伤椎固定治疗胸腰椎爆裂骨折(AO A3.1和A3.2)安全、有效,在术中出血量、手术时间,术后VAS评分改善和伤椎后凸角恢复方面与短节固定组无显著差异。
PART I Biomechanical comparison of monosegmental versus short-segmental fixation by pedicle instrumentation in the management of thoracolumbar fracture (AO A3.1)
Objective:To testify the biomechanical properties of thoracolumbar burst fracture (AO classification A3.1) treated with monosegmental pedicle instrumentation (MSPI).
Methods:Six T10-L2thoracolumbar spine segments were harvested from human donors ranging in age from27to46years (mean39y). Incomplete burst fracture (AO classification A3.1) was made at the level of T12. Monosegmental pedicle instrumentation and short segmental pedicle instrumentation were applied to the specimens sequentially to restore spinal stability. Segmental instability tests were performed on specimens in condition of intact, fractured and MSPI. Range of motions (ROM) in flexion-extension, lateral bending were recorded by a2-camera VICON motion measurement system. The rotational stability was testified by a computer-torsional testing machine.
Results:The ROM of MSPI in flexion-extension, lateral bending was0.14±0.02°,0.07±0.020°,0.74±0.13°and0.73±0.22°. The ROM of intact specimen in flexion-extension, lateral bending was0.46±0.05°,1.01±0.23°,1.30±0.31°and1.34±0.24°.The ROM of MSPI was significantly higher than that of intact in flexion-extension, lateral bending (p<0.05). MSPI group was more stable than intact group in flexion-extension, lateral bending. The torsional force of MSPI was3103.00±213.11N and that of intact was2654.75±122.90N. MSPI group was as stable as intact group in axial rotation (p>0.05). The ROM of SSPI in flexion-extension, lateral bending was0.32±0.07°,1.55±0.31°,1.27±0.33°and1.61±0.43°. The ROM of intact specimen in flexion-extension, lateral bending was0.65±0.15°,2.31±0.22°,2.45±0.44°and2.70±0.54°.The ROM of SSPI was significantly higher than that of intact in flexion-extension, lateral bending(p<0.05). SSPI group was more stable than intact group in flexion-extension, lateral bending. The torsional force of MSPI was3184.00±250.40N and that of intact was2654.75±122.90N. SSPI group was as stable as intact group in axial rotation (p>0.05). The SPI of MSPI in flexion-extension and lateral bending was0.94°,0.88°,0.81°and0.92°, respectively. The SPI of SSPI in flexion-extension and lateral bending was0.50°,0.45°,0.52°and0.70°, respectively. The SPI of MSPI was significantly higher than that of SSPI in both flexion-extension and lateral bending (p<0.05). MSPI was more stable than SSPI in both flexion-extension and lateral bending. The torsional force was3103N for MSPI and3184N for SSPI. SSPI was as stable as MSPI in axial rotation (p>0.05).
Conclusion:Monosegmental pedicle instrumentation can provide more instant stability than SSPI with respect to the reconstruction of unstable spine (AO classification A3.1) in both flexion-extension and lateral bending. Monosegmental pedicle instrumentation can provide same instant stability as SSPI with respect to the reconstruction of unstable spine (AO classification A3.1) in axial rotation.
PART II Biomechanical Comparison of MSPI and SSPI for thoracolumbar burst fractures (AO A3.1) using Finite Element Method
Object:This study was designed to compare the biomechanical effects of two posterior fixations for thoracolumbar burst fractures using the finite element (FE) method.
Methods:Four T11-L1FE models, including the intact, the fractured at T12, the monosegment pedicle intrumentation at the level of the fracture and the short-segment pedicle intrumentation with four pedicle screws were created. And four loading condi tions (flexion, extension, lateral bending and torsion) were imposed on these models and deformations in these models under different loading conditions were calculated by finite element method. The biomechanical effects of the two different pedicle screw fixations for thoracolumbar burst fractures were compared and analyzed. Results:The ROM of SSPI (T11-L1) in flexion-extension, lateral bending and was0.762°,0.458°,0.688°,0.601°. The ROM of intact specimen(T11-L1) in flexion-extension, lateral bending and axial rotation was0.768°,1.375°,0.905°,0.630°. The ROM of SSPI group was less than that of intact group in flexion-extension, lateral bending. The ROM of MSPI (T11-T12) in flexion-extension, lateral bending and axial rotation was0.51°,0.114°,0.140°,0.114°. The ROM of intact specimen (T11-T12) in flexion-extension, lateral bending and axial rotation was0.516°,0.515°,0.332°,0.120°. The ROM of MSPI (T11-T12) was less than that of intact(T11-T12) in flexion-extension, lateral bending and axial rotation. Conclusion:MSPI and SSPI could provide desirable stability for the fractured spine. The moment of force loaded onto the pedicle screw and rod of MSPI model was smaller than that of SSPI model.
PART Ⅲ Management of thoracolumbar burst fracture:monosegmental fixation versus short-segment fixation-a retrospective controlled study.
Objective:To investigate the safety and therapeutic effects of mono-segmental pedicle instrumentation in treating thoracolumbar burst fracture (AO classification:A3.1and A3.2).
Methods:A retrospective analysis was conducted on60cases with thoracolumbar burst fracture (AO classification:A3.1and A3.2) between April2005and February2010. Half of the60inpatients were treated with mono-segment pedicle instrumentation (MSPI), and the other half were treated with short-segment pedicle instrumentation (SSPI). The mean operation time, blood loss, visual analog scale (VAS) and vertebral kyphotic angle before and after surgery were compared.
Results:In the MSPI group, the mean operation time was90±25min, and the blood loss at operation was180±62ml. The vertebral kyphotic angles were17.3°±9.3°before surgery,6.5°±6.5°one week after surgery, and9.5°±6.4°for the latest follow-up. The VAS scores were7.5±1.4before surgery,2.5±0.7one week after surgery, and1.4±0.8for the latest follow-up. In the SSPI group, the mean operation time was101±28min, and the blood loss at operation was203±88ml. The follow-up duration was12-64months. The vertebral kyphotic angles were16.5°±9.1°before surgery,7.1°±6.9°one week after surgery, and7.5°±5.2°for the latest follow-up. The VAS scores were6.7±1.5before surgery,3.0±0.4one week after surgery, and1.1±0.6for the latest follow-up. There were no statistically significant differences between these two groups in the operation time, blood loss at operation, VAS score and vertebral kyphotic angle before and after surgery (P>0.05). The post-surgical VAS scores and vertebral kyphotic angles were significantly decreased in both groups, compared to before surgery (P＜0.05).
Conclusions:It is safe and effective to treat thoracolumbar burst fracture (AO3.1and AO3.2) with MSPI. The mean operation time, blood loss at operation, post-surgical VAS and vertebral kyphotic angle of the MSPI group are similar compared to the SSPI group.
引文
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