{"title":"Open Muscle-Preserving Pedicle Screws Fixation Versus Conventional Open Posterior Approach in Thoracolumbar Burst Fracture without Neurologic Injury","authors":"Urawit Piyapromdee, MD, Chanthong Budsayavilaimas, MD, Kongtush Choovongkomol, MD, Terdpong Tanaviriyachai, MD, Weera Sudprasert, MD","doi":"10.56929/jseaortho.v46i1.20","DOIUrl":null,"url":null,"abstract":"Introduction: Patients who sustained thoracolumbar spine fracture without neurological deficit often require surgical treatment. The conventional open posterior approach had some disadvantages including post-operative pain, blood loss, and duration of the operation. The minimally invasive approach, open muscle-preserving pedicle screw fixation, was proposed to have more benefit than the conventional approach. This study evaluated the clinical and perioperative outcomes of thoracolumbar burst fracture fixation using the open muscle-preserving approach and the conventional open posterior approach.\nMethods: A prospective cohort study from June 2016 to June 2017 of the open muscle-preserving pedicle screw fixation approach was done compared to the historical control of the conventional open posterior approach from May 2015 to May 2016. The post-operative pain score, blood loss, duration of operation and clinical outcome were analyzed.\nResults: Twenty-three patients were enrolled in the muscle-preserving approach group, and 27 patients treated with the conventional open posterior approach were the control group. Post-operative VAS was significantly better in the muscle-preserving group (P<0.001). The mean operating time was significantly shorter in the muscle-preserving group (60.4±17.3 min. vs. 90.9±18.9 min., p<0.001). Moreover, the mean intra-operative blood loss of the muscle-preserving group was also significantly lower (156.96±96.3ml. vs. 269.26±147.6ml., p=0.003).\nConclusion: Our study results indicate a superiority of the open muscle-preserving approach over the conventional open posterior approach for a thoracolumbar burst fracture without neurologic injury in terms of post-operative pain score, blood loss and duration of operation. The open muscle-preserving approach is an alternative treatment for thoracolumbar burst fractures.","PeriodicalId":333749,"journal":{"name":"Journal of Southeast Asian Orthopaedics","volume":"2015 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2022-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Southeast Asian Orthopaedics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.56929/jseaortho.v46i1.20","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
Abstract
Introduction: Patients who sustained thoracolumbar spine fracture without neurological deficit often require surgical treatment. The conventional open posterior approach had some disadvantages including post-operative pain, blood loss, and duration of the operation. The minimally invasive approach, open muscle-preserving pedicle screw fixation, was proposed to have more benefit than the conventional approach. This study evaluated the clinical and perioperative outcomes of thoracolumbar burst fracture fixation using the open muscle-preserving approach and the conventional open posterior approach.
Methods: A prospective cohort study from June 2016 to June 2017 of the open muscle-preserving pedicle screw fixation approach was done compared to the historical control of the conventional open posterior approach from May 2015 to May 2016. The post-operative pain score, blood loss, duration of operation and clinical outcome were analyzed.
Results: Twenty-three patients were enrolled in the muscle-preserving approach group, and 27 patients treated with the conventional open posterior approach were the control group. Post-operative VAS was significantly better in the muscle-preserving group (P<0.001). The mean operating time was significantly shorter in the muscle-preserving group (60.4±17.3 min. vs. 90.9±18.9 min., p<0.001). Moreover, the mean intra-operative blood loss of the muscle-preserving group was also significantly lower (156.96±96.3ml. vs. 269.26±147.6ml., p=0.003).
Conclusion: Our study results indicate a superiority of the open muscle-preserving approach over the conventional open posterior approach for a thoracolumbar burst fracture without neurologic injury in terms of post-operative pain score, blood loss and duration of operation. The open muscle-preserving approach is an alternative treatment for thoracolumbar burst fractures.
无神经功能缺损的胸腰椎骨折患者通常需要手术治疗。传统的后路开放入路存在术后疼痛、失血和手术时间等缺点。微创入路,开放保肌椎弓根螺钉固定,被认为比传统入路有更多的益处。本研究评估开放性保肌入路与传统开放性后路固定胸腰椎爆裂性骨折的临床及围手术期疗效。方法:2016年6月至2017年6月对开放性保肌椎弓根螺钉固定入路与2015年5月至2016年5月传统开放性后路的历史对照进行前瞻性队列研究。分析两组术后疼痛评分、出血量、手术时间及临床结果。结果:保肌入路组23例,常规后路开放入路组27例为对照组。保肌组术后VAS明显优于对照组(P<0.001)。保肌组的平均手术时间明显缩短(60.4±17.3 min vs. 90.9±18.9 min, p<0.001)。保肌组术中平均失血量(156.96±96.3ml)明显低于保肌组。和269.26±147.6毫升。, p = 0.003)。结论:我们的研究结果表明,对于无神经损伤的胸腰椎爆裂性骨折,在术后疼痛评分、出血量和手术时间方面,开放性肌肉保留入路优于传统的开放性后路入路。开放性保肌入路是胸腰椎爆裂性骨折的另一种治疗方法。