Effect of percutaneous minimally invasive pedicle screw internal fixation in the treatment of thoracolumbar vertebral fractures and its impact on quality of life

Effects of minimally invasive surgery combined with specialized pain management nursing care on postoperativepain improvement and life quality after spinal injury

Objective

To determine the impacts to research the impacts of pain's Specialized Pain Management Nursing Care in the perioperative period on pain symptoms and life quality of patients experiencing minimally invasive surgery for spinal injury.

Method

Eighty patients with a spinal injury who underwent minimally invasive surgery in the Department of Orthopedics of Baoding No.1 Hospital from January 2018 to December 2021 were retrospectively analyzed. They were split into two groups following different nursing methods (n=40 each group). Specialized Pain Management Nursing Care were given to patients in the observation group. Those in the control group were given treated with routine care. Their pain score and nursing effect were compared, after which their quality of life, daily living ability and complication rate compared and analyzed.

Results

The pain degree in the control group was considerably more than that in the observation group in the 1st postoperative period. The pain degree, which decreased in both groups, slumped more significantly in the observation group on the 2nd and 3rd postoperative days. The postoperative hospital stays and pain duration in the observation group were shorter than those in the control group (P<0.05), and the nursing effect was significantly better than that in the control group (P<0.05). After postoperative nursing intervention.

Conclusion

Minimally invasive surgery integrated with the Specialized Pain Management Nursing Care can remarkably ameliorate pain after spinal injury surgery, reducing complications' incidence, and improving the life quality for patients.

Comparative Outcomes of Percutaneous and Conventional Open Pedicle Screw Fixation for Single-level Thoracolumbar Spine Injury: Randomised Controlled Trial

Introduction

To compare post-operative outcomes of percutaneous pedicle screw fixation (PPSF) vs open pedicle screw fixation (OPSF) in patients with thoracolumbar spine fractures with no neurological deficits.

Materials and methods

In a randomised controlled trial, patients received short-segment fixation with intermediate screws. We assessed post-operative back pain (Visual Analog Scale or VAS), blood loss, operative/fluoroscopy times, radiographic parameters, and oswestry disability index (ODI) scores at 1, 2, 3, 6, 9, and 12 months.

Results

Between January 2018 and October 2019, 31 patients received PPSF and 30 OPSF. Mean intra-operative blood loss was 66.45 (±44.29) ml for PPSF vs 184.83 (±128.36) ml for OPSF (p<0.001). Fluoroscopy time averaged 2.36 (±0.76) minutes for PPSF vs 0.58 (±0.51) minutes for OPSF (p<0.001). No significant differences existed in operative time or post-operative VAS scores. Radiographic parameters (kyphosis angle and vertebral height ratios) didn't significantly differ post-operatively or at 12 months. However, ODI scores differed significantly at 6 months (p=0.025), with no difference at 12 months.

Conclusion

In this trial, PPSF was comparable to OPSF in improving ODI scores at 12 months but showed earlier improvement at 6 months and reduced blood loss. Radiographic outcomes remained similar between groups over 12 months.

Study on the clinical effect of percutaneous transforaminal endoscopic discectomy combined with annulus fibrosus repair in the treatment of single-segment lumbar disc herniation in young and middle-aged patients

Objective

To explore the clinical effect of percutaneous transforaminal endoscopic discectomy (PTED) combined with annulus fibrosus repair in the treatment of single-segment lumber disc herniation (LDH) in young and middle-aged patients.

Methods

Ninty-six patients with single-segment LDH admitted to Baoding First Central Hospital from March 2021 to November 2022 were selected in the retrospective study. The patients were divided into endoscopic group and combined group according to different surgical methods. The surgical conditions, VAS score and ODI score the two groups of patients were compared, as well as the postoperative review results.

Results

There were 50 patients in the endoscopic group the average operation time was 43.68 ± 10.77 minutes, the average intraoperative blood loss was 35.38 ± 10.02 ml, there were seven cases of surgical segment recurrence and 10 cases of postoperative intervertebral instability at the surgical segment. There were 46 patients in the combined group, the average operation time was 52.26 ± 8.39 minutes, the average intraoperative blood loss was 39.23 ± 9.02ml, there was one case of surgical segment recurrence and two cases of surgical segment intervertebral instability. The operation time (t=-4.328, P<0.01), postoperative recurrence cases (χ2=4.386, P<0.05) and intervertebral instability cases (χ2=5.366, P<0.05) of the two groups of patients). The difference was statistically significant. There was no significant difference in intraoperative blood loss between the two groups (t=-1.965, P>0.05). For six months after surgery, the differences in VAS and ODI scores between the two groups were statistically significant. In addition, there were statistically significant differences in the VAS scores and ODI scores of the two groups of patients at each time point after surgery compared with those before surgery (P<0.05).

Conclusion

The clinical efficacy of PTED combined with annulus fibrosus repair showed better clinical efficacy than PTED alone, and it can reduce the occurrence of surgical segment recurrence and intervertebral instability, suggesting that PTED combined with annulus fibrosus repair may be worthy of promotion in clinical practice.