| Objective: to compare the injured vertebral and without injured vertebral pedicle inthe clinical effect of screw fixation in the treatment of thoracolumbar fractures.Methods A retrospective study in March2012in our hospital in February2013-the single lumbar vertebral fractures in patients with surgical treatment of48cases,parallel and25cases with job placement of pedicle screws (group A),23cases withtraditional hurting job placement of pedicle screws (group B). A group of17cases ofmale, female8cases, with an average age of43(25~56); Group B (15male, female8cases, with an average age of42(23-61). All of the patients are all fresh fractures andfracture vertebra complete unilateral or bilateral pedicle. All patients in anesthesiadownward position reset, posterior routine group B injured vertebral upper and lowervertebral pedicle screw placement reduction and fixation; Based on the method of groupB with group A injured vertebral side pedicle screw placement reduction and fixation.All cases were followed up for more than1year, group A (17.5±4.1) months, group B(18.3±4.3) months on average, there was no statistically significant difference betweentwo groups (P>0.05). Analysis and comparison of two groups of cases of postoperativecorrection rate, postoperative wound vertebral vertebral height loss, Cobb Angle, visualanalogue scale (VAS) pain, ODI (dysfunction index), the postoperative complications oftwo groups of data for statistical analysis and comparison and comprehensive evaluationof the clinical curative effect.Results (1) two groups of patients with gender, age, injury segment operation time,operation time, group B (109.2±30.7) for rain, and the operation time of group Ableeding amount of rain (110.0±32.1) and group B (376.0±303.1) for ml, group A ml(409.5±361.1), no statistical significance (P>0.05).(2) A set of bed time, length ofhospital stay, postoperative nerve function recovery time was significantly less than group B, the difference was statistically significant (P <0.05).(3) A set of postoperativeVAS score change from (7.6±2.5) points preoperatively to postoperative average (1.8-1.5)and group B VAS score change from (7.3±2.8) points preoperatively to postoperativeaverage (3.8-1.6), the difference was statistically significant (P <0.05).(4) two groups ofCobb Angle changes: preoperative group A (23.96±3.96).,(1.91-1.13) after surgery.And the last follow-up (1.96±1.21). Preoperative group B (23.41±3.50).,(5.42-2.35)after surgery. The last follow-up (8.66±2.48). The difference was statistically significant(P <0.05).(5) two groups of injured vertebral height of vertebral body changes: A groupof injured vertebral fanterior flange height percentage (AVHC): preoperative(73.31%±4.54%), postoperative (97.61%±1.44%), the last follow-up (97.58%plus orminus1.45%). A group of injured vertebral height of vertebral rear percentage (AVHC):preoperative (94.94%±2.04%), postoperative (97.91%±1.34%), the last follow-up(97.88%plus or minus1.35%). Group B injury margin of vertebral fanterior highpercentage (AVHC): preoperative (73.82%±3.91%), postoperative (93.94%±2.69%), thelast follow-up (90.58%plus or minus2.85%). A group of injured vertebral height ofvertebral rear percentage (AVHC): preoperative (94.80%±3.14%), postoperative(96.60%±3.14%), the last follow-up (95.50%plus or minus3.23%). Injured vertebralgroup A leading edge height postoperative recovery of A ’more significantly than groupB, the difference was statistically significant (P <0.05). Injured vertebral rear e ’changesin differences between the two groups have statistical significance (P>0.05).Conclusion the two operation modes of single segment thoracolumbar vertebralfracture curative effect are more apparent, the injured vertebral pedicle screw placementreduction and fixation surgery way and the cross injured vertebral pedicle screwplacement reset compared to fixed operation method, is more advantageous to fracture.And in vertebral injury recovery of vertebral body height and section of the protrudingafter Angle after correction by the injured vertebral pedicle screw placement comparedreduction and fixation surgery way across injured vertebral pedicle screw placement resetfixed operation method has obvious advantages. At the same time and down time,promote the recovery after surgery, postoperative complications and so on, by the injured vertebral pedicle screw placement compared reduction and fixation surgery way acrossinjured vertebral pedicle screw placement reduction and fixation surgery way also hasobvious advantages. |
