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Effect of the intermediate pedicle screws and their insertion depth on sagittal balance and functional outcomes of lumbar fracture

OBJECTIVE: This study aimed to examine the effect of the intermediate pedicle screws and their insertion depth on sagittal balance and functional outcomes of lumbar fracture. METHODS: This study reviewed 1,123 patients with lumbar fractures between January 2015 and June 2019, and 97 patients were ul...

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Autores principales: Deng, Lei, Zhang, Junxin, Zhou, Quan, Zheng, Yifei, Hua, Xi, Hu, Xiayu, Liu, Hao, Qian, Zhonglai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9684323/
https://www.ncbi.nlm.nih.gov/pubmed/36439544
http://dx.doi.org/10.3389/fsurg.2022.905946
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author Deng, Lei
Zhang, Junxin
Zhou, Quan
Zheng, Yifei
Hua, Xi
Hu, Xiayu
Liu, Hao
Qian, Zhonglai
author_facet Deng, Lei
Zhang, Junxin
Zhou, Quan
Zheng, Yifei
Hua, Xi
Hu, Xiayu
Liu, Hao
Qian, Zhonglai
author_sort Deng, Lei
collection PubMed
description OBJECTIVE: This study aimed to examine the effect of the intermediate pedicle screws and their insertion depth on sagittal balance and functional outcomes of lumbar fracture. METHODS: This study reviewed 1,123 patients with lumbar fractures between January 2015 and June 2019, and 97 patients were ultimately enrolled in this study: Group A: 32 patients in the four-pedicle screws fixation group; Group B: 28 patients in the six-pedicle screws fixation with long intermediate pedicle screws group; Group C: 37 patients in the six-pedicle screws fixation with short intermediate pedicle screws group. The radiographic outcomes were assessed with lumbar lordosis (LL), segmental lordosis (SL), fractured vertebral lordosis (FL), sacral slope (SS), pelvic incidence (PI), and pelvic tilt (PT). The visual analog scale (VAS) and the Oswestry disability index (ODI) scores were used for assessing functional outcomes. RESULTS: The PI, PT, and SS showed no significant differences between the three groups (P > 0.05). Compared with Group A, Groups B and C showed better FL, SL, and LL 1 month after operation (5.96 ± 1.67/4.81 ± 1.49 vs. 8.78 ± 2.90, 24.39 ± 3.80/23.70 ± 4.10 vs. 20.09 ± 3.33, 39.07 ± 3.61/39.51 ± 3.23 vs. 36.41 ± 3.11, P < 0.05) and at final follow-up (8.75 ± 1.40/6.78 ± 1.70 vs. 11.31 ± 2.61, 22.11 ± 3.39/23.70 ± 4.10 vs. 17.66 ± 2.60, 38.04 ± 3.49/39.51 ± 3.23 vs. 35.41 ± 3.11, P < 0.05). The FL of Group C were significantly better than those of Group B 1 month after operation (4.81 ± 1.49 vs. 5.96 ± 1.67, P < 0.05) and at final follow-up (6.78 ± 1.70 vs. 8.75 ± 1.40, P < 0.05). No significant differences in VAS and ODI were found between Group A and Group B (P > 0.05). There were also no significant differences in VAS and ODI between Group A and Group C (P > 0.05). However, The VAS and ODI of Group C showed better than Group B 1 month after operation (3.05 ± 0.70 vs. 3.54 ± 0.79, 17.65 ± 3.41 vs. 19.71 ± 2.35, P < 0.05) and at final follow-up (2.19 ± 0.46 vs. 2.57 ± 0.57, 13.81 ± 2.20 vs. 15.57 ± 1.73, P < 0.05). CONCLUSIONS: Both four-pedicle screw fixation and six-pedicle screw fixation were effective in treating lumbar fracture. However, six-pedicle screw fixation with short intermediate pedicle screws showed better radiographic and functional outcomes after surgery. Therefore, we recommend six-pedicle screws fixation with short intermediate pedicle screws for the long-term recovery of sagittal balance and function.
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spelling pubmed-96843232022-11-25 Effect of the intermediate pedicle screws and their insertion depth on sagittal balance and functional outcomes of lumbar fracture Deng, Lei Zhang, Junxin Zhou, Quan Zheng, Yifei Hua, Xi Hu, Xiayu Liu, Hao Qian, Zhonglai Front Surg Surgery OBJECTIVE: This study aimed to examine the effect of the intermediate pedicle screws and their insertion depth on sagittal balance and functional outcomes of lumbar fracture. METHODS: This study reviewed 1,123 patients with lumbar fractures between January 2015 and June 2019, and 97 patients were ultimately enrolled in this study: Group A: 32 patients in the four-pedicle screws fixation group; Group B: 28 patients in the six-pedicle screws fixation with long intermediate pedicle screws group; Group C: 37 patients in the six-pedicle screws fixation with short intermediate pedicle screws group. The radiographic outcomes were assessed with lumbar lordosis (LL), segmental lordosis (SL), fractured vertebral lordosis (FL), sacral slope (SS), pelvic incidence (PI), and pelvic tilt (PT). The visual analog scale (VAS) and the Oswestry disability index (ODI) scores were used for assessing functional outcomes. RESULTS: The PI, PT, and SS showed no significant differences between the three groups (P > 0.05). Compared with Group A, Groups B and C showed better FL, SL, and LL 1 month after operation (5.96 ± 1.67/4.81 ± 1.49 vs. 8.78 ± 2.90, 24.39 ± 3.80/23.70 ± 4.10 vs. 20.09 ± 3.33, 39.07 ± 3.61/39.51 ± 3.23 vs. 36.41 ± 3.11, P < 0.05) and at final follow-up (8.75 ± 1.40/6.78 ± 1.70 vs. 11.31 ± 2.61, 22.11 ± 3.39/23.70 ± 4.10 vs. 17.66 ± 2.60, 38.04 ± 3.49/39.51 ± 3.23 vs. 35.41 ± 3.11, P < 0.05). The FL of Group C were significantly better than those of Group B 1 month after operation (4.81 ± 1.49 vs. 5.96 ± 1.67, P < 0.05) and at final follow-up (6.78 ± 1.70 vs. 8.75 ± 1.40, P < 0.05). No significant differences in VAS and ODI were found between Group A and Group B (P > 0.05). There were also no significant differences in VAS and ODI between Group A and Group C (P > 0.05). However, The VAS and ODI of Group C showed better than Group B 1 month after operation (3.05 ± 0.70 vs. 3.54 ± 0.79, 17.65 ± 3.41 vs. 19.71 ± 2.35, P < 0.05) and at final follow-up (2.19 ± 0.46 vs. 2.57 ± 0.57, 13.81 ± 2.20 vs. 15.57 ± 1.73, P < 0.05). CONCLUSIONS: Both four-pedicle screw fixation and six-pedicle screw fixation were effective in treating lumbar fracture. However, six-pedicle screw fixation with short intermediate pedicle screws showed better radiographic and functional outcomes after surgery. Therefore, we recommend six-pedicle screws fixation with short intermediate pedicle screws for the long-term recovery of sagittal balance and function. Frontiers Media S.A. 2022-11-10 /pmc/articles/PMC9684323/ /pubmed/36439544 http://dx.doi.org/10.3389/fsurg.2022.905946 Text en © 2022 Deng, Zhang, Zhou, Zheng, Hua, Hu, Liu and Qian. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Deng, Lei
Zhang, Junxin
Zhou, Quan
Zheng, Yifei
Hua, Xi
Hu, Xiayu
Liu, Hao
Qian, Zhonglai
Effect of the intermediate pedicle screws and their insertion depth on sagittal balance and functional outcomes of lumbar fracture
title Effect of the intermediate pedicle screws and their insertion depth on sagittal balance and functional outcomes of lumbar fracture
title_full Effect of the intermediate pedicle screws and their insertion depth on sagittal balance and functional outcomes of lumbar fracture
title_fullStr Effect of the intermediate pedicle screws and their insertion depth on sagittal balance and functional outcomes of lumbar fracture
title_full_unstemmed Effect of the intermediate pedicle screws and their insertion depth on sagittal balance and functional outcomes of lumbar fracture
title_short Effect of the intermediate pedicle screws and their insertion depth on sagittal balance and functional outcomes of lumbar fracture
title_sort effect of the intermediate pedicle screws and their insertion depth on sagittal balance and functional outcomes of lumbar fracture
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9684323/
https://www.ncbi.nlm.nih.gov/pubmed/36439544
http://dx.doi.org/10.3389/fsurg.2022.905946
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