Analysis Of Thoracolumbar Fractures Treated By Posterior Pedicle Screw Fixation With Transdermal And Posterior Transection

Objective:Thoracic lumbar fractures are the most common spinal injuries in the clinic,and the thoracic lumbar segment often incorporates varying degrees of spinal cord injury and neurological impairment,and the disability rate is higher.With the rapid progress of medical technology,surgical treatment of thoracolumbar fractures have also made great progress.In this study,we compared the treatment of thoracolumbar vertebrae fractures by comparing the curative effect of vertebral and pedicle screw fixation.Methods: The clinical data of 52 patients with thoracic lumbar fractures from June 2012 to June 2015 were retrospectively divided into the control group and the treatment group,with 26 cases in each group.Patients were included in the standard:(1)a clear history of trauma,X-ray or CT examination showed a single segment of the chest,lumbar fractures;(2)injury in the T10-L3;(3)Denis thoracolumbar fractures were thoracolumbar burst Type fractures or compression fractures;(4)were followed up for more than 1 year.Exclusion criteria:(1)old fractures,multiple stages of injury and unexplained fracture type;(2)combined with severe heart and kidney and other underlying diseases;(3)the presence of signifiGcant infection.The treatment group was treated with the treatment of vertebral pedicle screw fixation and fixed treatment.The control group was treated with cross-posterior pedicle screw fixation.The improvement of spinal cord function in patients before and after operation was evaluated by Frankel classification.The improvement of low back pain was evaluated by Denis grading,and compare the two groups of patients with operation time,intraoperative blood loss,and before the operation,after surgery,postoperative 1 year after injury vertebral fanterior flange height ratio and Cobb’s Angle.Results:(1)Comparison of operation time,intraoperative blood loss and bedtime comparison.The mean operative time was(179.2 ± 22.5)min and(162.5 ± 27.8)min in the treatment group and the control group respectively.The mean intraoperative blood loss was(320.6 ± 55.2)mL and(258.3 ± 49.7)mL respectively.(P<0.05).The time of bed rest was(4.6 ± 0.5)days and(5.4 ± 0.5)days in the treatment group and the control group,respectively.The time of bed rest was significantly improved in the treatment group and the control group(P<0.05).(2)Frankel grading and Denis grading comparison.After operation,the pain degree and function recovery of the two groups were significantly better than those before treatment(P<0.05).The postoperative treatment of patients with lower back pain and neurological function were significantly better than those of the control group.Significant(P<0.05).(3)the height of the anterior and posterior margin of the vertebral body and the Cobb’s angle.(P<0.05).There was no significant difference between the two groups(P>0.05).There was no significant difference between the two groups(P>0.05).There was no significant difference between the two groups(P>0.05)(P<0.05),and the difference was statistically significant(P<0.05).The difference between the anteroposterior height and the Cobb’s angle was significantly higher in the treatment group than in the control group(P<0.05).Conclusion:The treatment of thoracolumbar fractures with vertebral pedicle screw reduction is effective,can effectively relieve the pain of patients and promote the recovery of patients,and the long-term effect is better than the traditional transected pedicle screw replacement treatment,it is worth promoting application.