Comparative Study Of Treatment Of Thoracolumbar Fractures With TCM Therapy By Percutaneous With Open Pedicle Screw Fixation System

Objective: Research and analysis in the absence of nerve injury single thoracolumbar fracture treatment, CD HORIZONSTM SEXTANTTM II minimally invasive percutaneous pedicle screw fixation system with TCM therapy and traditional open pedicle screw internal fixation system with TCM therapy in treating effect and advantages and disadvantages.Methods: Retrospective analysis of patients in spine surgery department of Renmin Hospital of Wuhan University in 2013 February-2014 August for the treatment of 33 cases of single thoracolumbar fracture, including 15 cases with SEXTANT II minimally invasive operation, 18 cases were treated by open reduction and internal fixation. And preoperative combined with traditional Chinese medicine treatment, using method of traditional Chinese medicine manipulative reduction of traction extension pressing,after the operation, each group were treated with oral Chinese medicine : shangke jiegu tablet. And we used five point support function exercise after the operation. Select the operation in patients with total amount of bleeding(ml), operation time(min), intraoperative fluoroscopy times, first time standing time after operation(d), and the percentage of anterior vertebral body height before and afteroperation and degrees of side position piece on sagittal Cobb angle before and after operation and the loss of follow-up degree of Cobb angle as a standard of comparison of minimally invasive operation group and the open operation group efficacy. And by the same doctor records of 33 patients before and after operation and during follow-up VAS and ODI score. We used two independent samplest test to compare and analysize curative effect on minimally invasive group and open group patients after operation.Results: The total amount of bleeding(ml) of patients in operation, first time standing time after operation(d) of SEXTANT II minimally invasive operation are less than the open,P<0.05, indicates that the difference of results are statistically significant. Comparing with the operation time(min) of two groups, intraoperative fluoroscopy times, the minimally invasive operation group is more longer than the open, P<0.05, indicates that the difference of results are statistically significant. In contrast imaging on two groups of patients before and after operation of vertebral Cobb angle and anterior height ratio, and compared the changes of follow-up of these two indicators, P>0.05,The result shows that two groups of patients with fracture reduction and fixation effect is quite. Statistics of two groups of patients with preoperative VAS score and ODI score, P>0.05.shows that difference in score of two group patients before without statistical significance. But the VAS score of two group after operation for a week, P<0.05.The ODI score of two group after operation for two weeks, P<0.05, indicates that the results are statistically significant difference. And the comparison of 6 months after surgery, VAS score and ODI score:P>0.05 shows that the result without statistical significance. SEXTANT II minimally invasive system has good effect on short-term pain relief after operation, and there is no difference between the treatment of postoperative mid-term review. They can also effectively fix the fracture and relieve back pain. The open operation group there were two cases of patients with delayed wound healing and a case of wound hematoma, but the remaining patients with wound healing by first intention.And the wound hematoma was healed after pressure pad pressure. Morever,the open operation group a patient at one side of the connecting rod slipping. Two groups of patients were followed up for not found broken nails and nail retreat, vertebral fractures and other phenomena. The open group a patients had anterior cortical bone of vertebral pedicle screw break. At the same time, SEXTANTTM II minimally invasive system group and traditional open operation group were 2 patients had a partial vertebral pedicle screws outside outer cortex breakthrough. But there was no obvious adverse symptoms, and no one screw penetrated into the spinal canal. Comprehensive analysis, show that in the peri-operation period, the indexs of minimally invasive operation group is better than traditional open operation group.But fluoroscopy times are more than open group. In the short-term postoperative pain relief and functional recovery,minimally invasive group had obvious advantage than the open group.In the postoperative reduction on fixation of injured vertebra is maintained, there is no difference between the two groups.Conclusion: CD HORIZONSTM SEXTANTTMII minimally invasive percutaneous pedicle screw fixation system and traditional openpedicle screw internal fixation system combined with preoperative manipulative reduction of traction extension pressing method and traditional Chinese medicine of shangke jiegu tablet and five point support function exercise of treatment are all effective for reduction and fixation for thoracolumbar fractures. While the SEXTANT II system has the advantages of small trauma, small wound, less bleeding, less interference on the paraspinal muscle trauma, vertebral fixation and reduction effect is satisfactory etc. But the deficiency is the operators and patients are receiving more radiographic exposure and the time of operation is longer than open traditional open pedicle screw internal fixation system.