Effect of transpedicular screw fixation on bone metabolism and clinical efficacy in thoracolumbar fractures

Objective To explore the impact of transpedicular screw fixation on bone metabolism and clinical efficacy in thoracolumbar fractures. Methods Totally 77 patients with thoracolumbar fractures (T11-L2) treated at the Spinal Surgery Department of Xinxiang Central Hospital from December 2020 to June 2022 were selected as subjects. According to different surgical screw placement methods, the patients were divided into the cross-pedicle screw group (group A, n=41) and the transpedicular screw group (group B, n=36). The two groups were compared for surgical indicators (operation time, intraoperative blood loss, postoperative drainage volume, hospital stay), hematological indicators[serum alkaline phosphatase (ALP), serum bone glaprotein (BGP)], radiological indicators (anterior vertebral height ratio, correction rate of vertebral Cobb angle), and clinical efficacy indicators (Oswestry Disability Index ODI score, lumbar spine JOA score). Results The operation time of group A was longer than that of group B (P＜0.05). There was no significant differences in intra-operative blood loss, post-operative drainage volume, and hospital stay between the two groups (P＞0.05). At 3 days after surgery, the hematological indicators of both groups were higher than those of before surgery and the data of group A were higher than those of group B (P＜0.05). At 3 months after surgery, the hematological indicators of Group B were higher than those before surgery and those of group A (P＜0.05). The anterior vertebral height ratio of both groups were better than those before surgery at 3 days, 3 months, and 1 year after surgery (P＜0.05). At 1 year after surgery, the anterior vertebral height ratio and Cobb angle correction rate of group A were better than those of group B(P＜0.05). The clinical efficacy indicators of both groups were better than those before surgery at 3 days, 3 months, and 1 year after surgery (P＜0.05). At one year after surgery, the clinical efficacy indicators of group A were better than those of group B, and the differences were statistically significant (P＜0.05). Conclusions In the treatment of thoracolumbar fractures, compared with the cross-pedicle screw fixation method, the transpedicular screw fixation method has an early stimulating effect on bone metabolism indicators, speeds up healing of fractures and has more advantages in maintaining spinal correction and improving spinal function.