Comparison of different pedicle screw fixation schemes in the treatment of neurosurgical spinal fractures: systematic review and meta-analysis

Liang, Dan; Deng, Xiaopeng; Qian, Jiacai; Feng, Hanping; Zhou, Kun

doi:10.21037/apm-21-3533

Cited by 7 publications

(8 citation statements)

References 14 publications

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“…Patients' vertebral fractures have limited mobility and severe pain, which affects their life functions and is treated mainly by surgical means [ 13 ]. The application of traditional surgical treatment can effectively correct and reset the fracture end, but it has more complications and can cause significant damage to the patient with high bleeding, which affects the patient's postoperative recovery [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

Zhou

Chen

Gao

et al. 2022

Contrast Media & Molecular Imaging

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Objective. To analyze the influence of minimally invasive arch root nailing internal fixation surgery on tissue traumatic stress response in patients with vertebral fractures and explore the advantages of this treatment. Methods. One hundred and thirty-six patients with vertebral fractures admitted to our hospital from January 2020 to January 2022 were selected and divided into two groups based on the treatment method: the control group was treated with open arch root nail internal fixation surgery and the study group was treated with minimally invasive arch root nail internal fixation. The lumbar spine function, ODI, VAS, JOA score, complications, inflammation, and stress response were compared between the two groups. Results. After the operation, the ratio of intervertebral space and anterior edge height increased, and the Cobb angle decreased in both groups; the surgical incision, hospital stay, and operation time in the study group were shorter than those in the control group, and the intraoperative drainage volume and intraoperative blood loss were smaller than those in the control group ( P < 0.05 ); before surgery, there was no significant difference in ODI and VAS scores between the two groups ( P > 0.05 ). After surgery, the ODI and VAS scores in the two groups were significantly decreased, and the JOA score was significantly increased; complications occurred in the control group and the study. The incidence of complications in the study group was lower than that in the control group ( P < 0.05 ); after surgery, compared with the control group, the serum TNF-α, CRP levels, and stress response indexes of the study group decreased more significantly ( P < 0.05 ). Conclusion. Minimally invasive pedicle screw fixation has high safety and obvious advantages. The patient’s stress response index and pain level are low, and it will not cause obvious damage to the patient. The postoperative lumbar spine function is significantly improved, which is beneficial to the patient’s postoperative recovery. It is easy to operate, will not damage the thoracic and lumbar vertebrae significantly, and the fluoroscopy time is relatively short, and it has a good recovery effect. Therefore, minimally invasive internal arch nailing surgery can be used as the preferred treatment for patients with vertebral fractures.

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Section: Discussionmentioning

confidence: 99%

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

Zhou

Chen

Gao

et al. 2022

Contrast Media & Molecular Imaging

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“…PS fixation is the method of choice for surgical implantation in spine‐related diseases. 2 However, it also has some shortcomings: screw placement often requires the dissection of more muscles; visual field is poor, especially in the lower lumbar spine or sacrum; tendency to invade the surrounding facet joints; and the nerve is prone to injury. 3 , 4 Moreover, PS loosens easily in older patients with osteoporosis because the screw insertion channel is encased in the cancellous bone.…”

Section: Introductionmentioning

confidence: 99%

“…The traditional pedicle screw (PS) fixation has been used in clinical practice for several years with excellent correction, spinal stability, and fusion results. PS fixation is the method of choice for surgical implantation in spine‐related diseases 2 . However, it also has some shortcomings: screw placement often requires the dissection of more muscles; visual field is poor, especially in the lower lumbar spine or sacrum; tendency to invade the surrounding facet joints; and the nerve is prone to injury 3,4 .…”

Section: Introductionmentioning

confidence: 99%

The Fusion Rate of Cortical Bone Trajectory Screw Fixation and Pedicle Screw Fixations in L4‐5 Interbody Fusion: A Retrospective Cohort Study

Lin

Zheng

2023

Orthopaedic Surgery

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Objective Although cortical bone trajectory (CBT) screw fixation has been used for several years, the number of studies on its fusion effects is limited. Furthermore, several studies report conflicting outcomes. We aimed to compare the fusion rates and clinical efficacy of CBT screw fixation and pedicle screw (PS) fixation for L4‐L5 interbody fusion. Methods This study was a retrospective cohort control study. Patients with lumbar degenerative disease who underwent L4‐L5 oblique lumbar interbody fusion (OLIF) or posterior decompression using CBT screws between February 2016 and February 2019 were included. Patients in whom PS was used were matched for age, sex, height, weight, and BMI. Record the operation time, blood loss. All enrolled patients underwent lumbar CT imaging at one‐year follow‐up to evaluate the fusion rate. At the two‐year follow‐up the visual analogue scale (VAS), Oswestry disability index (ODI), and Japanese Orthopaedic Association scores (JOA) were used to identify symptom improvement. Independent t ‐test was used for the comparison, and score data were analyzed using the χ 2 and exact probability tests. Results A total of 144 patients with were included. All patients were followed‐up postoperatively for 25–36 months (average 32.42 ± 10.55 months). Twenty‐eight patients underwent OLIF and CBT screw fixation, 36 underwent OLIF and PS fixation, 32 underwent posterior decompression and CBT screw fixation, and 48 underwent posterior decompression and PS fixation. The fusion rates following CBT screw and PS fixations in OLIF were 92.86% (26/28) and 91.67% (33/36), respectively ( P = 1). The fusion rates following CBT screw and PS fixations in posterior decompression were 93.75% (30/32) and 93.75% (45/48), respectively ( P > 0.05). Regardless of OLIF or posterior decompression, there were no significant differences in the VAS, ODI, and JOA scores between patients treated with CBT and PS ( P > 0.05). Conclusion CBT screw fixation can achieve a satisfactory interbody fusion rate with a clinical efficacy similar to that of PS in patients with lumbar degenerative disease, regardless of whether OLIF or posterior decompression was performed.

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“…[3,4] While certain types of fractures still pose a treatment controversy, treatment of TLF often involves the use of posterior segment fixation. [5,6] In the past, posterior internal fixation (PIF) was typically performed using a 4-screw configuration in a short segment (SS), with 2 pedicle screws inserted into the upper and lower adjacent vertebrae of the fractured vertebral body. [7] Studies have demonstrated that the SS technique may not be adequate for adequately realigning the fractured vertebral body and resolving kyphosis.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of different segments fixation for treatment thoracolumbar fractures: A Bayesian network meta-analysis

He,

Zhong,

Zhou

et al. 2023

Medicine

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Background: We did this network meta-analysis to comprehensively compare the efficacy of different segments [intermediate segment (IS), short segment (SS) and long segment (LS)] in the fixation of thoracolumbar fractures. Methods: We searched studies from inception until January 20, 2023 through PubMed, Embase, Web of Science, and the Cochrane Library. All studies comparing different segments in the fixation of thoracolumbar fractures were included in this meta-analysis. Outcomes were anterior vertebral height ratio (AVHR), sagittal Cobb angle (SCA), visual analogue scale score, and implant failure rate. This network meta-analysis was performed by R software with gemtc package. Results: Finally, a total of 22 studies were finally included in this network meta-analysis. IS (WMD 2.43, 95% CrI 2.04–2.91) was more effective than SS in terms of the AVHR, and the difference was statistically significant. IS was more effective than LS in reducing SCA (WMD −2.87, 95% CrI −3.79 to −1.96) with statistically significant. Compared with SS, IS significantly reduced the SCA with statistically significant (WMD −2.52, 95% CrI −3.31 to −1.72). IS (WMD −2.87, 95% CrI −3.78 to −1.96) was more effective than LS, and the difference was statistically significant. Moreover, IS (WMD −2.52, 95% CrI −3.31 to −1.72) was more effective than SS, and the difference was statistically significant. Conclusion: IS was associated with a significant reduction in SCA, implant failure rate, and visual analogue scale compared to SS and LS, while having the most favorable impact on AVHR among all the treatments assessed.

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Comparison of different pedicle screw fixation schemes in the treatment of neurosurgical spinal fractures: systematic review and meta-analysis

Cited by 7 publications

References 14 publications

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

The Fusion Rate of Cortical Bone Trajectory Screw Fixation and Pedicle Screw Fixations in L4‐5 Interbody Fusion: A Retrospective Cohort Study

The efficacy of different segments fixation for treatment thoracolumbar fractures: A Bayesian network meta-analysis

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