Effects of endplate healing morphology on intervertebral disc degeneration after pedicle screw fixation for thoracolumbar fractures

Intervertebral disc degeneration-Current therapeutic options and challenges

Degeneration of the intervertebral disc (IVD) is a normal part of aging. Due to the spine's declining function and the development of pain, it may affect one's physical health, mental health, and socioeconomic status. Most of the intervertebral disc degeneration (IVDD) therapies today focus on the symptoms of low back pain rather than the underlying etiology or mechanical function of the disc. The deteriorated disc is typically not restored by conservative or surgical therapies that largely focus on correcting symptoms and structural abnormalities. To enhance the clinical outcome and the quality of life of a patient, several therapeutic modalities have been created. In this review, we discuss genetic and environmental causes of IVDD and describe promising modern endogenous and exogenous therapeutic approaches including their applicability and relevance to the degeneration process.

Effect of Minimally Invasive Internal Arch Nailing Surgery on Tissue Traumatic Stress Response in Patients with Vertebral Fractures

Objective

To analyze the influence of minimally invasive arch root nailing internal fixation surgery on tissue traumatic stress response in patients with vertebral fractures and explore the advantages of this treatment.

Methods

One hundred and thirty-six patients with vertebral fractures admitted to our hospital from January 2020 to January 2022 were selected and divided into two groups based on the treatment method: the control group was treated with open arch root nail internal fixation surgery and the study group was treated with minimally invasive arch root nail internal fixation. The lumbar spine function, ODI, VAS, JOA score, complications, inflammation, and stress response were compared between the two groups.

Results

After the operation, the ratio of intervertebral space and anterior edge height increased, and the Cobb angle decreased in both groups; the surgical incision, hospital stay, and operation time in the study group were shorter than those in the control group, and the intraoperative drainage volume and intraoperative blood loss were smaller than those in the control group (P < 0.05); before surgery, there was no significant difference in ODI and VAS scores between the two groups (P > 0.05). After surgery, the ODI and VAS scores in the two groups were significantly decreased, and the JOA score was significantly increased; complications occurred in the control group and the study. The incidence of complications in the study group was lower than that in the control group (P < 0.05); after surgery, compared with the control group, the serum TNF-α, CRP levels, and stress response indexes of the study group decreased more significantly (P < 0.05).

Conclusion

Minimally invasive pedicle screw fixation has high safety and obvious advantages. The patient's stress response index and pain level are low, and it will not cause obvious damage to the patient. The postoperative lumbar spine function is significantly improved, which is beneficial to the patient's postoperative recovery. It is easy to operate, will not damage the thoracic and lumbar vertebrae significantly, and the fluoroscopy time is relatively short, and it has a good recovery effect. Therefore, minimally invasive internal arch nailing surgery can be used as the preferred treatment for patients with vertebral fractures.