Objectives: To investigate and analyze the effect of percutaneous minimally invasive pedicle screw internal fixation in the treatment of thoracolumbar vertebral fractures and its impact on quality of life. Methods: Fifty patients with thoracolumbar vertebral fracture admitted to our hospital from January 2015 to December 2018 were selected and divided into two groups according to different treatment regimens. The observation group was treated with minimally invasive percutaneous pedicle screw internal fixation, while the control group was treated with traditional posterior approach open pedicle screw internal fixation. The surgery time, incision length, intraoperative blood loss, postoperative drainage, hospitalization time, ambulation time, fracture healing time and postoperative VAS scores were compared between the two groups. In addition, the cobb angle, the sagittal plane index, and the anterior vertebral height were compared between the two groups before and after surgery, as were the Oswestry Disability Index (ODI) at 1d, 3 months, and 6 months postoperatively. Results: The surgery time, incision length, postoperative pain level, postoperative drainage and intraoperative blood loss of the observation group were less than those of the control group (P<0.05). The postoperative Cobb angle of the two groups decreased, the sagittal plane index as well as the anterior vertebral height increased (P<0.05). The Oswestry index of the observation group was better than that of the control group at one day and three months postoperatively, with a statistical significance between the two groups (P<0.05). The complication rate of the observation group was significantly lower than that of the control group (P<0.05). Conclusion: Percutaneous minimally invasive pedicle screw internal fixation is safer than the traditional open pedicle screw internal fixation, and it is more worthy of clinical promotion. doi: https://doi.org/10.12669/pjms.38.1.4329 How to cite this:Tu P, Yan C, Hao J, Cao S, Jiang C. Effect of percutaneous minimally invasive pedicle screw internal fixation in the treatment of thoracolumbar vertebral fractures and its impact on quality of life. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4329 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective: To investigate and compare the effect of decompression and fusion with internal fixation vs. simple decompression in the treatment of elderly patients with two-segment lumbar spinal stenosis (LSS) in perioperative and postoperative follow-up periods. Methods: Twenty-eight elderly patients with two-segment LSS admitted in Baoding First Hospital between Mar. 2017 and Jan. 2018 were retrospectively analyzed. Fifteen patients who underwent simple decompression were included in the simple decompression group, and 13 who underwent decompression and fusion with internal fixation were included in the decompression-fixation group. The general data and perioperative conditions including wound complications, operation time, blood loss, and VAS (legs) and JOA score were analyzed and compared between the two groups. Results: There was no significant difference in postoperative leg pain (VAS) between the two groups, and a statistically significant difference in JOA score was found between the two groups one month after the operation. The operation time, length of stay, and blood loss in the decompression-fixation group were significantly different from those in the simple decompression group and no significant difference in wound complications was observed between the two groups. Conclusion: There is no significant difference in leg pain relief in elderly patients with two-segment LSS when treated with decompression and fusion with internal fixation or simple decompression. Simple decompression is associated with less intraoperative injuries, better postoperative functional recovery, and reduced hospital stay. doi: https://doi.org/10.12669/pjms.37.1.2287 How to cite this:Tu P, Cao S, Jiang C, Yan CC. A comparative study of Lumbar Decompression and Fusion with Internal Fixation versus Simple Decompression in elderly patients with two-segment Lumbar Spinal Stenosis. Pak J Med Sci. 2021;37(1):256-260. doi: https://doi.org/10.12669/pjms.37.1.2287 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective:To investigate the effect of bone graft volume on postoperative fusion and symptom improvement in lumbar posterior lumbar fusion and internal fixation.Methods:A total of 82 patients receiving pedicle screw rod system internal fixation with Cage bone graft fusion in the First Hospital of Baoding City, Hebei Province were selected and randomly divided into three groups. The excised autologous laminar bones were bitten into different sizes of bone fragments. And different sizes of bone grafts were implanted during the operation. Group-A (n=28) was implanted by bone graft granule with the average volume of 0.2 cm3, Group-B (n=27) was implanted by bone graft granule with the average volume of 0.1 cm3, and Group-C (n=27) was implanted by bone graft granule with the average volume of 0.05 cm3. The bone graft granule volume, clinical effect, bone graft fusion rate and intervertebral space height were compared.Results:The three groups had significantly different bone graft granule volumes (P<0.05), but similar intervertebral bone graft total volumes and Cage heights (P>0.05). In the final follow-up, VAS and ODI of low back pain and two lower limbs pain significantly reduced compared with those before surgery (P<0.05), but the three groups had similar results (P>0.05). The bone graft fusions of Group-B one and two years after surgery were significantly higher than those of Group-A and Group-C, and the values of Group-A exceeded those of Group-C (P<0.05). In the final follow-up, the intervertebral space height change of Group-B was significantly smaller than those of Group-A and Group-C (P<0.05).Conclusion:Size of bone graft granule has no significant effect on postoperative symptoms. However, middle-sized volume bone graft granule (0.1 cm3/granule) showed increased postoperative intervertebral fusion rate and reduced intervertebral space height loss in our study.
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