Clinical Efficacy Of Open Pedicle Screw Fixation And Percutaneous Screw Fixation In The Treatment Of Thoracolumbar Fractures And Comparative Analysis Of Postoperative Lumbar Back Pain

Objective:Discuss and analyze the difference between two different surgical methods for the treatment of patients with thoracolumbar fractures and the causes of residual low back pain after surgery.Methods:A retrospective analysis of 82 patients who underwent thoracolumbar vertebral fractures in our hospital from January 1,2012 to February 28,2019.Among them,42 cases were treated with percutaneous screw fixation(percutaneous fixation group);40 cases were treated with open pedicle screw fixation(conventional incision group).Comparison and analysis of incision length,intraoperative blood loss,operation time,postoperative drainage volume,length of hospitalization,percentage of anterior vertebral height,Cobb angle,Visual Analogue Scale(VAS)scores And the Oswestry disability index(ODI)score and other indicators;Using x ± s to represent measurement data,normal data using independent sample T test,non-normal distribution data using Mann-Whitney U test to compare measurement data between groups,counting data using 2 test,using SPSS 22.0 statistical software for data Treatment,by comparing the differences between the two groups of patients after surgery,analyze the clinical efficacy of the two procedures and the difference in low back pain.Results:Compared between groups,the incision length,total operation time,intraoperative blood loss,postoperative drainage volume,and total hospitalization time of the percutaneous internal fixation group were lower than those of the conventional incision group(P <0.05).Imaging indicators(Cobb angle and percentage of anterior vertebral body height),before and after surgery,the percentage of anterior vertebral body height was significantly increased,Cobb angle was significantly reduced,the difference was statistically significant(P <0.05);There was no statistically significant difference between the two groups(P> 0.05),proving that both procedures have good clinical effects on the correction of vertebral force lines and the improvement of vertebral deformities.For the VAS score,the postoperative rate is lower than that before the operation,and as the time after the operation continues to increase,the score value of the two groups of patients is also continuously decreasing;,The Z value is-4.580,-0.582,7.697,the difference is statistically significant(P <0.05);when comparing between groups in other time periods,the difference is not statistically significant(P> 0.05).When comparing the ODI scores of the two groups of patients,the scores of the two groups of patients continued to decrease with the increase of postoperative time,and the value of the percutaneous internal fixation group at any follow-up period was lower than that of the conventional incision group.The difference was statistically significant when comparing between groups at 1 year after operation and at the last follow-up(P <0.05).When comparing between groups during the rest of the period,the difference was not statistically significant(p> 0.05).Conclusion:Percutaneous screw fixation has the advantages of low trauma,low bleeding,small surgical incision,long-term postoperative low back muscle injury,rapid recovery,and low postoperative low back pain symptoms for the treatment of single-segment thoracolumbar fractures,and the long-term clinical effect is reliable,Worthy of widespread promotion.