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Posterior Percutaneous Pedicle Screw Fixation for Acute Thoracolumbar Vertebral Fractures

2016-11-16 12:08:21 | BioPortfolio

Summary

To validate the safety and effectiveness of minimally invasive posterior percutaneous pedicle screw fixation in acute thoracolumbar vertebral fractures with simple anterior spinal column injury.

Description

History and current related studies Thoracolumbar spinal fractures are frequently seen after trauma because of the biomechanical transitional junction of this structure. The primary treatment method used for traumatic thoracolumbar spinal fracture is posterior pedicle screw fixation, but this method has some disadvantages including severe trauma, extensive bleeding, long rehabilitation time, and long postoperative duration of intractable lumbar stiffness and low back pain. These complications occur mainly because of wide stripping and injury of the paraspinal muscles and peri-articular denervation. Percutaneous pedicle screw external fixation of spine fracture can reduce injury caused by screw insertion into the paraspinal muscles, particularly in the treatment of acute thoracolumbar vertebral compression fracture with simple anterior spinal column injury.

Adverse events We recorded possible adverse events, including wound pain, infection, back muscle pain, spinal cord/nerve injury, screw pull-out, or screw loosening. If severe adverse events occurred, details including the data of occurrence and measures taken to treat the adverse events were reported to the principle investigator and the institutional review board within 24 hours.

Possible biases and management measures Possible biases

- Diagnosis bias

- Admission rate bias (hospitalized patients were preferred to reduce loss to follow-up and to increase compliance)

- No response bias (subjects not responding to the questionnaire or not responding truthfully)

- Mixed bias (sex and age) Measures taken to control possible biases

- Formulation of strict inclusion and exclusion criteria

- Ensuring sample independence

- Discussion of the mixed factors that may potentially influence the curative effects, such as pathological factors, course of disease, and sex

Statistical analysis Statistical analysis was performed by a statistician using SPSS 19.0 software (IBM, Amrok, USA), and was conducted following the intention-to-treat principle. Normally distributed measurement data were expressed as the mean ± SD, and minimums and maximums. Non-normally distributed measurement data were expressed as lower quartile (q1), and median and upper quartile (q3). The Wilcoxon matched-pairs signed-ranks test was performed for comparison of the Cobb angle before surgery with the Cobb angle 3 years after surgery, and the McNemar's chi-squared test was used to compare the incidence of adverse reactions. The significance level was α = 0.05.

Study Design

Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment

Conditions

Vertebral Fracture

Intervention

posterior percutaneous pedicle screw internal fixation

Status

Completed

Source

153rd Hospital of Chinese People's Liberation Army

Results (where available)

View Results

Links

Published on BioPortfolio: 2016-11-16T12:08:21-0500

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PubMed Articles [6906 Associated PubMed Articles listed on BioPortfolio]

Minimally invasive fixation techniques for thoracolumbar fractures: comparison between percutaneous pedicle screw with intermediate screw (PPSIS) and percutaneous pedicle screw with kyphoplasty (PPSK).

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Percutaneous pedicle screw fixation (PPSF) has been a popular approach for treating thoracolumbar and lumbar fracture, and its relevant complications have been gradually recognized. This study aimed t...

Medical and Biotech [MESH] Definitions

The use of internal devices (metal plates, nails, rods, etc.) to hold the position of a fracture in proper alignment.

BONE SCREWS to be used in the pedicle of the vertebral arch.

Implantable fracture fixation devices attached to bone fragments with screws to bridge the fracture gap and shield the fracture site from stress as bone heals. (UMDNS, 1999)

The use of metallic devices inserted into or through bone to hold a fracture in a set position and alignment while it heals.

Two extensive fibrous bands running the length of the vertebral column. The anterior longitudinal ligament (ligamentum longitudinale anterius; lacertus medius) interconnects the anterior surfaces of the vertebral bodies; the posterior longitudinal ligament (ligamentum longitudinale posterius) interconnects the posterior surfaces. The commonest clinical consideration is OSSIFICATION OF POSTERIOR LONGITUDINAL LIGAMENT. (From Stedman, 25th ed)

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