Effect of posterior decompression and bone grafting combined with minimally invasive percutaneous pedicle screw fixation on pain and functional recovery in patients with thoracolumbar spinal fractures.

Abstract

Objective: This study aimed to investigate the effects of posterior decompression and bone grafting combined with minimally invasive percutaneous pedicle screw fixation (MIPSF) on pain relief and functional recovery in patients with thoracolumbar spinal fractures.

Methods: This prospective, randomized controlled trial included 68 patients with thoracolumbar spinal fractures, who were divided into control and observation groups. Perioperative outcomes, visual analogue scale (VAS), Oswestry Disability Index (ODI), American Spinal Injury Association Impairment Scale, vertebral anterior height, vertebral sagittal index, Cobb's Angle, serum substance P (SP), serum cortisol (Cor), and C-reactive protein (CRP) levels, were evaluated. Postoperative complications were also recorded.

Results: The observation group exhibited reduced operation time, intraoperative blood loss, drainage volume, and hospital stay, lower VAS and ODI scores, higher sensory and motor scores, improved injured vertebral anterior height and sagittal index, decreased kyphotic Cobb's angle, and lower serum SP, Cor, and CRP levels versus the control group (p < 0.05). The postoperative complication rate was 5.88% in the control group and 2.94% in the observation group (p > 0.05).

Conclusion: The combination of posterior decompression, bone grafting, and MIPSF for thoracolumbar spine fractures results in less traumatic stress, improved postoperative pain management, and better recovery of spinal function.