• World Neurosurg · Jun 2020

    Comparative Study

    Comparison of poly-axial or poly-/mono-axial mixed screw fixation for treatment of thoracolumbar fractures with O-arm navigation: a case control study.

    • Wanjin Qin, Kangwu Chen, Hao Chen, Peng Yang, Huilin Yang, and Haiqing Mao.
    • Department of Orthopedic Surgery, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China.
    • World Neurosurg. 2020 Jun 1; 138: e10-e16.

    BackgroundNavigation and minimally invasive techniques have revolutionized spinal surgery. There are different types of pedicle screws for navigation-assisted percutaneous internal fixation for thoracolumbar burst fractures, resulting in 2 different types of internal fixation approaches: the PPP method (polyaxial screw fixation for all 3 vertebrae) and the MPM method (polyaxial screw fixation for the injured vertebra and monoaxial screw fixation for the adjacent vertebrae). This study aims to compare these 2 different methods for treatment of thoracolumbar fractures via O-arm navigation.MethodsFrom January 2017 to January 2018, 45 patients were enrolled according to the criteria with a minimal follow-up of 1 year; there were 21 patients in the PPP group, and 24 patients in the MPM group. For follow-up, the demographic features and clinical outcomes were collected and evaluated.ResultsWith regard to preoperative indices and demographic features, no significant difference was observed between these 2 groups (P > 0.05). For operation time, intraoperative bleeding, and length of hospitalization, no significant difference was observed either between the 2 groups (P > 0.05). The Cobb angle and anterior vertebrae body height (AVBH) of the injured vertebra were significantly restored in both groups 1 day after surgery (P < 0.05). However, the Cobb angle and AVBH in the MPM group was better corrected than that in the PPP group 1 day, 3 months, and 12 months after surgery, respectively (P < 0.05). In contrast, loss of Cobb angle and AVBH in the PPP group were significantly larger than the MPM group (P < 0.05). Meanwhile, no difference in the Visual Analog Scale and the Oswestry Disability Index were found between the 2 groups (P > 0.05).ConclusionsBoth MPM and PPP systems are good for treatment of single-segment thoracolumbar fracture. However, MPM showed better restoration effect and postoperative maintained Cobb angle than PPP.Copyright © 2020 Elsevier Inc. All rights reserved.

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