Effect of RTS versus percutaneous conventional pedicle screw fixation on type A thoracolumbar fractures: a retrospective
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ORIGINAL ARTICLE
Effect of RTS versus percutaneous conventional pedicle screw fixation on type A thoracolumbar fractures: a retrospective cohort study Wei qian Jiang1 · Zhen yong Ke1 · Kevin Wu1 · Xiao lin Chen1 · Zhen qi Lou2 Received: 27 October 2019 / Revised: 29 February 2020 / Accepted: 11 April 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose This study aims at evaluating the effects of RTS (rotation softened trauma fixation system) compared with PCPSF (percutaneous conventional pedicle screw fixation) on type A thoracolumbar fractures. Methods In this retrospective cohort study, 116 patients with type A thoracolumbar fractures from March 2014 to June 2018 were enrolled. PCPSF was performed in 60 patients, meanwhile the other 56 patients accepted RTS. VAS scores, Cobb angle, anterior vertebral height (AVH) and perioperative data were compared between the two groups. Results Both groups were consistent with baseline on demographic and clinical characteristics. No significant difference was observed in VAS score between-group before and after operation. One year after surgery, the VAS score of RTS group was lower than that of PCPSF group (0.7 ± 0.3 vs. 1.5 ± 0.4). The postoperative AVH (%) in PCPSF was 82.3% (95%CI, 81.7–84.6), and 91.78% (95% CI, 91.1–92.4) in RTS. The postoperative improvement rate of AVH (%) in RTS was higher than that in PCPSF (30.6 ± 5.0 [95% CI, 29.2–32.0] vs. 22.0 ± 7.3 [95% CI, 20.2–24.2]). The postoperative Cobb angle (°) in PCPSF was 2.6 ± 3.4 (95%CI,11.7–13.5), and 7.5 ± 2.0 (95%CI,7.0–8.0) in RTS. The postoperative correction of Cobb angle (°) in RTS was higher than that in PCPSF (16.1 ± 3.8 95%CI,15.1–17.1] vs. 11.6 ± 5.2 95%CI,10.3–13.1]). Conclusions Compared with PCPSF, RTS has advantages in restoring the anterior vertebral height and reducing local kyphosis. Keywords Thoracolumbar fracture · RTS · Percutaneous pedicle screw fixation · Vertebral height
Introduction With the development of society, the spinal injury caused by high-energy trauma is increasing year by year, mostly in the thoracolumbar region [1]. At present, the surgery indications of type A thoracolumbar fracture without neurological injury are as follows: (1) kyphotic deformity of > 15–20° (compared to normal position); (2) greater than 50% loss of vertebral body height [2, 3]. The objective of surgery is to restore the height of vertebral body, correct Cobb angle and reduce local kyphosis deformity [4]. Kocis et al. [5] found that compared with OPSF (open pedicle screw fixation) * Zhen yong Ke [email protected] 1
Department of Spinal Surgery, The Second Affiliated Hospital of Chongqing Medical University, Yuzhong District, 74 Linjiang Road, Chongqing, China
Department of Spinal Surgery, Ningbo No. 6 Hospital, No.1059 Zhongshan East Road, Ningbo, China
2
group, PCPSF (percutaneous conventional pedicle screw fixation) group has the advantages of less bleeding, shorter operation time and lower VAS score after surgery. However, whether OPSF or PCPSF is used, the post
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