Comparison of the effects of minimally invasive percutaneous pedicle screws osteosynthesis and open surgery on repairing the pain, inflammation and recovery of thoracolumbar vertebra fracture

Gong,Yahui; Fu,Guangmin; Li,Bo; Li,Yinan; Yang,Xiaoning

doi:10.3892/etm.2017.5036

Comparison of the effects of minimally invasive percutaneous pedicle screws osteosynthesis and open surgery on repairing the pain, inflammation and recovery of thoracolumbar vertebra fracture

Authors:
- Yahui Gong
- Guangmin Fu
- Bo Li
- Yinan Li
- Xiaoning Yang
View Affiliations

Affiliations: Department of Orthopedics, The First People's Hospital Xuzhou, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221000, P.R. China
Published online on: August 25, 2017 https://doi.org/10.3892/etm.2017.5036
Pages: 4091-4096
Copyright: © Gong et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

We compared the clinical effects of minimally invasive percutaneous pedicle screws osteosynthesis (MIPPSO) and open surgery on the repair of thoracolumbar vertebra fracture. Seventy patients, who suffered from thoracolumbar vertebra fracture and received treatment at our hospital, were selected and randomly divided into either the minimally invasive percutaneous pedicle screws osteosynthesis group (MIPPSO group) and the traditional open pedicle screws osteosynthesis group (TOPSO group) with 35 cases in each group. The perioperative parameters including length of incision, duration of operation, bleeding during operation, length of hospital stay, the changes of pre-operative and post-operative VAS pain scores, inflammatory indexes including serum C-reactive protein (CRP) and creatine kinase (CK), and imaging indexes including Cobb's angle and anterior margin height of vertebral body of both groups were compared. The length of incision, duration of operation, bleeding volume during operation and length of hospital stay in the MIPPSO group were significantly lower than those in the TOPSO group (P<0.05). Both minimally invasive surgery and traditional surgery effectively alleviated the pain (P<0.05), which was more significant in MIPPSO group (P<0.05). The post-operative inflammatory indexes, CRP and CK levels, of both groups were higher compared to the pre-operation (P<0.05), which was more significant in TOPSO group (P<0.05). The differences of imaging indexes, including Cobb's angle and anterior margin height of injured vertebra, were statistically significant between pre-operation and post-operation for each group (P<0.05); however, there were no statistically significant differences between two groups at either pre-operation or post-operation (P>0.05). The effect of minimally invasive percutaneous pedicle screws osteosynthesis is similar to the traditional open surgery, however, the MIPPSO technique has the advantages of small trauma, less bleeding, short duration of operation, rapid post-operative recovery, light pain, less economic cost, and better aesthetic effect and is therefore worthy of clinical promotion.

View Figures

View References

1	Zairi F, Aboukais R, Marinho P, Allaoui M and Assaker R: Minimally invasive percutaneous stabilization plus balloon kyphoplasty for the treatment of type A thoraco lumbar spine fractures: Minimum 4 year's follow-up. J Neurosurg Sci. 58:169–175. 2014.PubMed/NCBI
2	Alizadeh M, Kadir MR, Fadhli MM, Fallahiarezoodar A, Azmi B, Murali MR and Kamarul T: The use of X-shaped cross-link in posterior spinal constructs improves stability in thoracolumbar burst fracture: A finite element analysis. J Orthop Res. 31:1447–1454. 2013. View Article : Google Scholar : PubMed/NCBI
3	Kim DY, Lee SH, Chung SK and Lee HY: Comparison of multifidus muscle atrophy and trunk extension muscle strength: Percutaneous versus open pedicle screw fixation. Spine. 30:123–129. 2005. View Article : Google Scholar : PubMed/NCBI
4	Magerl F: External skeletal fixation of the lower thoracic and the lumbar spineCurrent Concepts of External Fixation of Fractuers. Unthoff HK and Stahl E: Spring Verlag; New York, NY: pp. 353–366. 1982, View Article : Google Scholar
5	Grossbach AJ, Dahdaleh NS, Abel TJ, Woods GD, Dlouhy BJ and Hitchon PW: Flexion-distraction injuries of the thoracolumbar spine: Open fusion versus percutaneous pedicle screw fixation. Neurosurg Focus. 35:E22013. View Article : Google Scholar : PubMed/NCBI
6	Huskisson EC: Measurement of pain. Lancet. 2:1127–1131. 1974. View Article : Google Scholar : PubMed/NCBI
7	Huang QS, Chi YL, Wang XY, Mao FM, Lin Y, Ni WF and Xu HZ: Comparative percutaneous with open pedicle screw fixation in the treatment of thoracolumbar burst fractures without neurological deficit. Zhonghua Wai Ke Za Zhi. 46:112–114. 2008.(In Chinese). PubMed/NCBI
8	Smith HE, Anderson DG, Vaccaro AR, Albert TJ, Hilibrand AS, Harrop JS and Ratliff JK: Anatomy, biomechanics, and classification of thoracolumbar injuries. Semin Spine Surg. 22:2–7. 2010. View Article : Google Scholar
9	Gu Y, Zhang F, Jiang X, Jia L and McGuire R: Minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty in the surgical treatment of thoracolumbar osteoporosis fracture. J Neurosurg Spine. 18:634–640. 2013. View Article : Google Scholar : PubMed/NCBI
10	Gu YT, Zhu DH, Liu HF, Zhang F and McGuire R: Minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty for preventing secondary fracture after vertebroplasty. J Orthop Surg. 10:312015. View Article : Google Scholar
11	Park HY, Lee SH, Park SJ, Kim ES, Lee CS and Eoh W: Minimally invasive option using percutaneous pedicle screw for instability of metastasis involving thoracolumbar and lumbar spine : A case series in a single center. J Korean Neurosurg Soc. 57:100–107. 2015. View Article : Google Scholar : PubMed/NCBI
12	Palmisani M, Gasbarrini A, Brodano GB, De Iure F, Cappuccio M, Boriani L, Amendola L and Boriani S: Minimally invasive percutaneous fixation in the treatment of thoracic and lumbar spine fractures. Eur Spine J. 18 Suppl 1:71–74. 2009. View Article : Google Scholar : PubMed/NCBI
13	Gaines RW Jr: The use of pedicle-screw internal fixation for the operative treatment of spinal disorders. J Bone Joint Surg Am. 82:1458–1476. 2000. View Article : Google Scholar : PubMed/NCBI
14	Ni WF, Huang YX, Chi YL, Xu HZ, Lin Y, Wang XY, Huang QS and Mao FM: Percutaneous pedicle screw fixation for neurologic intact thoracolumbar burst fractures. J Spinal Disord Tech. 23:530–537. 2010. View Article : Google Scholar : PubMed/NCBI
15	Hildebrand F, Pape HC and Krettek C: The importance of cytokines in the posttraumatic inflammatory reaction. Unfallchirurg. 108:793–794, 796–803. 2005.(In German). View Article : Google Scholar : PubMed/NCBI
16	Baez Laporta Y, Rodriguez Palomero MA, De Vicente Sánchez JC, Carretero Sanabria P, Al Kassam Martínez D, Ferrer Pérez A, Villoria Muriel C and Rodríguez Gilsanz F: C-reactive protein in the diagnosis of postoperative infection in pediatric patients: A prospective observational study of 103 patients. J Pediatr Surg. 46:1726–1731. 2011. View Article : Google Scholar : PubMed/NCBI
17	Kragsbjerg P, Holmberg H and Vikerfors T: Serum concentrations of interleukin-6, tumour necrosis factor-alpha, and C-reactive protein in patients undergoing major operations. Eur J Surg. 161:17–22. 1995.PubMed/NCBI
18	Pokora I, Kempa K, Chrapusta SJ and Langfort J: Effects of downhill and uphill exercises of equivalent submaximal intensities on selected blood cytokine levels and blood creatine kinase activity. Biol Sport. 31:173–178. 2014. View Article : Google Scholar : PubMed/NCBI
19	Bagai A, Schulte PJ, Granger CB, Mahaffey KW, Christenson RH, Bell G, Lopes RD, Green CL, Lincoff AM, Armstrong PW, et al: Prognostic implications of creatine kinase-MB measurements in ST-segment elevation myocardial infarction patients treated with primary percutaneous coronary intervention. Am Heart J. 168:503–511. 2014. View Article : Google Scholar : PubMed/NCBI
20	Kim S, Um TH, Cho CR and Jeon JS: False-positive elevation of creatine kinase MB mass concentrations caused by macromolecules in a patient who underwent nephrectomy for renal cell carcinoma. Ann Lab Med. 34:405–407. 2014. View Article : Google Scholar : PubMed/NCBI
21	Nnadi E, Manafa P, Okocha E, Chukwuma G and Aneke J: Evaluation of creatine kinase activity and inorganic phosphate concentration in adult nigerian homozygous and heterozygous hemoglobin phenotypes. Ann Med Health Sci Res. 4:697–700. 2014. View Article : Google Scholar : PubMed/NCBI
22	Johnsen SH, Lilleng H and Bekkelund SI: Creatine kinase as predictor of blood pressure and hypertension. Is it all about body mass index? A follow-up study of 250 patients. J Clin Hypertens (Greenwich). 16:820–826. 2014. View Article : Google Scholar : PubMed/NCBI
23	Laoutidis ZG and Kioulos KT: Antipsychotic-induced elevation of creatine kinase: A systematic review of the literature and recommendations for the clinical practice. Psychopharmacology (Berl). 231:4255–4270. 2014. View Article : Google Scholar : PubMed/NCBI
24	Behringer M, Montag J, Kilian Y, Mccourt M and Mester J: The repeated bout effect: Is the blunted creatine kinase response an effect of an altered enzyme inactivation kinetic? J Sports Med Phys Fitness. 55:1431–1437. 2015.PubMed/NCBI