KẾT QUẢ PHẪU THUẬT CỘT SỐNG BẰNG VÍT NỞ CHO BỆNH NHÂN CHẤN THƯƠNG CỘT SỐNG NGỰC – THẮT LƯNG CÓ LOÃNG XƯƠNG TẠI BỆNH VIỆN VIỆT ĐỨC

Abstract

Objectives: Evaluate the outcomes of expandable pedicle screw fixation for patient with osteoporotic thoracolumbar fracture. Objects and Methods: A longitudinal descriptive and prospective study on 31 patients underwent expandable pedicle screw fixation surgery due to osteoporotic thoracolumbar fracture Viet Duc Hospital from 01/2021 to 06/2022. Results: Among the 31 patients, female/male ratio = 1,8/1; with an average age of 65,6±7,2. All patients had symptoms of thoracolumbar pain (100%), mild to moderate neurological damage, mean preoperative VAS score of 7,1 ± 1,8  and ODI index of 70,8 ± 10,2 %. The average T-score for the sample patients were -3,2±0,7. The average vertebral Cobb angle (V-Cobb) was 27,2° ± 4,2°, and the preoperative fixed segment Cobb angle (S-Cobb) was 28,5° ± 5,5°. The mean surgical time was 69,7 ± 10,8 minutes, with an average blood loss of 300,5 ± 50,1 ml and the average hospital stay of 6,5 ± 2,8 days. Intraoperatively, dural tears accounted for 3,2%, Postoperative complications included surgical site infection in 3,2%. VAS and ODI scores at 1 and 6 months postoperatively significantly decreased with p<0.05. V-Cobb and S-Cobb postoperatively significantly decreased with p<0,05. Macnab quality of life scores at 6 months postoperatively showed good to excellent improvement in 90,4% of cases. Screw loosening rate was low at 1,6% and screw breakage rate was at 0,8%,  no cases of rod fracture, pull-out screw postoperatively. Conclusion: The result of expandaple pedicle screw fixtation surgery for patient with osteoporotic thoracolumbar fracture achives good results and significant clinical improvement and spine alignment correction. The incidence of intraoperative complications and postoperative complications is low