Objective To evaluate the clinical efficacy and feasibility of minimally invasive percutaneous pedicle screw fixation with UPASS II spinal system for the treatment of thoracolumbar Magerl type A fractures without neurological deficits. Methods 18 cases of single thoracolumbar fracture without neurological deficits were treated with the percutaneous pedicle screw fixation with UPASS II spinal system. Perioperative indices were recorded and radio-logic parameters including kyphotic angle and vertebral height were assessed before and after surgery. Results The operative time was 54 ~95 ( 64 ±8. 2 ) min, with the intraoperative blood loss of 37 ~ 90( 45 ± 16 ) ml. There were no new neurological deficits and other surgery related complications. All patients were followed up for 6 ~ 15 ( 8. 4 ± 2. 1 ) months. The preoperative Cobb's angle was 6. 9 ~ 19. 5° ( 13. 5° ± 3. 9° ) , and the angle was immediately improved to 2. 0° ~ 8. 7° ( 5. 1° ± 2. 8° ) postoperatively. At the final follow-up, the Cobb's angle was 7. 2° ± 2. 4° ( range 3. 6° to 10. 1° ), and the average loss of the angle was 2. 1° ±0. 9°. The preoperative percentage of vertebral height was 37% -72% ( 57. 8% ± 10. 9% ), and the percentage increased to 76. 5% ~ 100% ( 91. 7% ±6. 9% ) immediately after the surgery. At the final follow-up, the percentage of vertebral height was 88. 2% ± 7. 4% ( range 68% to 97% ). The mean preoperative pain intensity level was 8. 9 on the VAS ( range 7 ~ 10 ), and the level decreased to 1 -5(2.5 ±1.7) one week after surgery. At the final follow-up, the pain intensity level was 0 ~ 3( 1. 8 ± 1. 0 ). Conclusions The minimally invasive percutaneous pedicle screw fixation with the UPASS II spinal system can be an alternative in treating thoracolumbar Magerl type A fractures with the load-sharing score of 6 or less and without neurological deficits. This technique is proved as a satisfactory surgical intervention with the advantages of minimal invasion, relative safety and simple manipulation for the management of thoracolumbar fracture without neurological deficits.%目的 探讨UPASSⅡ脊柱微创内固定系统治疗Magerl A型胸腰椎骨折的临床疗效及可行性.方法 选择18例单纯性胸腰椎骨折(无神经功能损害)患者进行UPASSⅡ脊柱微创内固定系统治疗.记录围手术期参数(指标),对术前和术后的脊柱后凸角度和椎体高度等影像学指标进行评估.结果 手术时间为54～95 (64±8.2) min,术中出血为37～90(45±16) ml.无神经损伤及其它并发症发生.患者均获随访,时间6～15(8.4±2.1)个月.术前Cobb角度为6.9°～19.5° (13.5°±3.9°),术后为2.0°～8.7° (5.1°±2.8°),末次随访时为3.6°～10.1°(7.2°±2.4°),平均丢失2.1°±0.9°,脊柱后凸畸形平均纠正6.3°±2.2°.术前椎体高度为37%～72 %(57.8%±10.9%),术后即刻为76.5%～100%(91.7%±6.9%),末次随访时为68%～97% (88.2%±7.4%).VAS评分:术前为7～10(8.9±0.9)分,术后1周为1～5(2.5±1.7)分,末次随访时为0～3(1.8±1.0)分.结论 UPASSⅡ脊柱微创椎弓根钉内固定系统可用于治疗Magerl A型、脊柱载荷评分≤6分无神经损伤的胸腰椎骨折,具有手术创伤小,安全性好,操作相对简单,手术效果满意等特点.
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