KẾT QUẢ PHẪU THUẬT CỐ ĐỊNH CỘT SỐNG BẰNG VÍT BƠM XI MĂNG SINH HỌC CHO BỆNH NHÂN CHẤN THƯƠNG CỘT SỐNG NGỰC – THẮT LƯNG CÓ LOÃNG XƯƠNG TẠI BỆNH VIỆN VIỆT ĐỨC

Abstract

Objectives: Evaluate the outcomes of fenestrated pedicle screw fixtation with cement augmentation for patient with osteoporotic thoracolumbar fracture. Objects and Methods: A longitudinal descriptive and prospective study on 45 patients with osteoporotic thoracolumbar fracture who underwent fenestrated pedicle screw fixtation with cement augmentation surgery Viet Duc Hospital from 06/2021 to 06/2023. Results: Among the 45 patients, male/female ratio = 1/1,5; with an average age of 66,4 ± 9,2. All patients had symptoms of thoracolumbar pain (100%), predominantly mild to moderate neurological damage, with a mean preoperative VAS score of 8.1 ± 1.0 and ODI index of 72.6 ± 5.9%. The average T-score for the sample patients were -3,6 ± 0,4. The average vertebral Cobb angle (V-Cobb) was 26,8° ± 4,1°, and the preoperative fixed segment Cobb angle (S-Cobb) was 26,5° ± 4,3°. The mean surgical time was 89.3 ± 11.9 minutes, with an average blood loss of 310.0 ± 68.9 ml and the average hospital stay of 7.2 ± 2.1 days. Intraoperatively, dural tears accounted for 4.4%, cement leakage around vertebrae 4.4%, and cement overflow into discs 8.8%. Postoperative complications included surgical site infection in 2.2% and urinary tract infection in 4.4% of patients. VAS and ODI scores at 1 and 6 months postoperatively significantly decreased with p<0.001. 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 95.6% of cases. Screw loosening rate was low at 1.4%, with no cases of screw breakage, pull-out screw, or rod fracture postoperatively. Conclusion: The result of fenestrated pedicle screw fixtation with cement augmentation surgery for patient with osteoporotic thoracolumbar fracture yields relatively good results, achieving significant clinical improvement and spine alignment correction. The incidence of intraoperative complications and postoperative complications is low.