Study On The Curative Of Two Different Minimally Invasive Surgeries In The Treatment Of Thoracolumbar Fractures

Objective: By comparing the two surgical methods of transmuscular space pedicle screw internal fixation and percutaneous pedicle screw internal fixation,the postoperative paraspinal muscle damage of the two groups of patients was observed,and the advantages and disadvantages of the two operations were discussed.Methods: Collected data of 50 patients who were hospitalized in the People’s Hospital of Ningxia Hui Autonomous Region from March 2019 to March 2020 due to thoracolumbar spine and completed surgical treatment.Among them,24 patients in group A underwent percutaneous pedicle screw fixation;B There were 26 patients in the group who underwent Wiltse paraspinal pedicle screw internal fixation.Record the visual analogue scale(VAS)of pain before and three months after the operation,the ODI score of low back pain,the height of the anterior and posterior edge of the injured vertebra,and the Cobb angle;compare A and B before and 3 days after the operation of CK and LDH;12 months after the operation Multifidus muscle scar formation,fat infiltration,measuring the net cross-sectional area of multifidus muscle under MRI T2 signal,and fat infiltration percentage.Results: There was no significant difference in hospitalization time and operation time between the two groups of patients,and was not statistically significant(p>0.05);the blood loss of group B was increased than that of group A,and the difference was significant and statistically significant(p<0.05);Group A and B The postoperative anterior height,posterior height,Cobb angle,VAS score,and ODI score of the group were significantly different from those before the operation(p<0.05);the CK and LDH values of group B were significantly lower than those of group A at 3 days after operation The difference was statistically significant(p<0.05);there was no significant difference in the net cross-sectional area of the multifidus muscle in group A before the operation and the group B,and the difference was not statistically significant(p>0.05);The percentage of fat infiltration in group A was greater than that in group B,and the difference was statistically significant(p<0.05).Conclusion: Traditional posterior incision pedicle screw internal fixation surgery for the treatment of thoracolumbar fractures on the paraspinal muscles,especially the damage of the multifidus muscle,has gradually attracted attention;transmuscular pedicle screw internal fixation and percutaneous vertebral arch Root screw internal fixation is the current mainstream surgical method for the treatment of thoracolumbar fractures.However,the intraoperative bleeding in the percutaneous pedicle screw internal fixation group is less,and the degree of fat infiltration in the transmuscular pedicle screw internal fixation group is small.Percutaneous pedicle screw internal fixation requires higher surgical instruments.It cannot be widely promoted in primary hospitals.