Observation On Clinical Effects Of Early Weight-bearing Walk Combined Lumbar Muscles Exercises On Functional Recovery After Surgical Treatment Of Thoraco Lumbar Fracture

Objective:The purpose of this study was to compare the different time points by comparing the weight-bearing walk combined lumbar muscle exercise on functional recovery after surgical treatment of thoraco lumbar fracture, to clear the best time of thoraco lumbar fracture surgery early ambulation, and explore early rapid recovery feasibility.Methods:To choose 60 cases of thoraco lumbar fracture patients from September 2014 to March 2015 hospitalized in our hospital,that were treated by posterior paraspinal muscle approach pedicle screw fixation. Among of them were 39 cases of male and 21 cases of female, the average age were 40.2±12.7, were diagnosed with T12-L2 segment single vertebral body fracture. According to the order of admission to hospital, the patients were divided into A,B,C three groups and 20 cases in each group.Three groups of patients start early lumbar muscle exercise after operation, and weight-bearing activities respectively under the protection of orthosis on three days, three weeks, six weeks.Compared three groups at different time points after injury vertebral front high compression rate, sagittal Cobb angle change situation, internal fixation failure rate, VAS score, ODI score and short-term complications after operation.Results:There was no significant difference between three groups of patients with gender, age, body mass index, TLICS, Load sharing, fracture section.The postoperative follow-up time injured vertebral front high compression rate, Cobb angle were significantly improved compared with preoperative, the difference was statistically significant (P< 0.05),but the comparison between the postoperative follow-up time points, there was no statistically significant difference (P>0.05),compared between groups, there was no statistically significant difference between the three groups (P>0.05). Three groups of oreoperative and postoperative 1 day VAS and ODI score comparison difference has no statistical significance (P> 0.05), but after 3 months,1 year VAS and ODI scores were significantly lower compared with preoperative and postoperative 1 day, comparative differences are statistically significant (P< 0.05), and the score of group A reduced the most obviously. The postoperative complications of short-term situation between three groups has statistically significant, and the group A was lowest (P< 0.05).There was no statistical significance compared differences between three groups of patients in internal fixation failure rate(P> 0.05). Among of them, one of group A,sagittal collapse of injured vertebral> 10°when postoperative follow-up of 3 months, vertebral height loss, protrusion deformity after aggravating, but it was stablly after postoperative follow-up of 1 year, there were no found breakage of internal fixation in three groups.Conclusion:There was no obvious effect on effect of operation and internal fixation for thoraco lumbar fracture by Early weight-bearing walk combined lumbar muscle functional exercise, it can effectively improve the postoperative patients with lower back pain, reduce the postoperative complications in the short term, and beneficial to the recovery of spine function.