Effects of pedicle screw number and insertion depth on radiographic and functional outcomes in lumbar vertebral fracture
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(2020) 15:572
RESEARCH ARTICLE
Open Access
Effects of pedicle screw number and insertion depth on radiographic and functional outcomes in lumbar vertebral fracture Hao Liu1†, Weikai Chen1†, Junxin Zhang1†, Xiaomin Jiang2†, Huilin Yang1, Rui Qu3* and Tao Liu1*
Abstract Background: The influence of pedicle screw number and insertion depth on outcomes of lumbar fixation remains uncertain. The purpose of this study was to compare the imaging balance stability and clinical functional improvement of lumbar fracture patients with different pedicle screw numbers and insertion depths. Methods: Sixty-five patients undergoing lumbar pedicle screw fixation from January 2016 to January 2018 were enrolled. They were included in long screw (LS) group and short screw (SS) group or 6 screw (6S) group and 4 screw (4S) group. The radiographic outcomes were assessed with lumbar lordosis (LL), segmental lordosis (SL), fractured vertebral lordosis (FL), sacral slope (SS), pelvic incidence (PL), and pelvic tilt (PT). The visual analog scale (VAS) and the Oswestry Disability Index (ODI) score were used for functional assessment. Multiple linear regression was performed to identify the risk factors of FL, SL, and LL correction at the final follow-up. Results: FL, SL, and LL were significantly different in all matching subgroups to compare long and short screws and in most matching subgroups to compare 6 and 4 screws. The SS, PT, and PI seem to be similar in all subgroups in different periods. Significant differences of VAS and ODI were found between LS and SS in the 4S group and between 4S and 6S in the SS group. Insertion depth, screw number, BMD, age, and preoperative imaging data were significant factors for imaging balance stability correction at the final follow-up. Conclusions: Long screws and 6 screws showed better fracture vertebral restoration and lumbar spinal sagittal stabilities. The surgery type, age, and BMD are important focus points for the treatment of lumbar vertebral fractures. Keywords: Vertebral fracture, Sagittal balance, Lumbar pedicle screw fixation, Insertion depth, Screw number
* Correspondence: [email protected]; [email protected] † Hao Liu, Weikai Chen, Junxin Zhang and Xiaomin Jiang contributed equally to this work. 3 The Affiliated Suzhou Hospital of Nanjing Medical University, 26 Daoqian Street, Suzhou 215006, Jiangsu, China 1 Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, 899 Pinghai Road, Suzhou 215006, Jiangsu, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commo
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