Observation On Clinical Effect Of Hyperextension Reduction Combined With Pedicle Screw Fixation For Treatment Of Simple Thoracolumbar Fractures

Objective:The purpose of this study is to observe and analyze the clinical effect of hyperextension reduction combined with pedicle screw fixation for treatment of thoracolumbar fractures.By comparing with conventional posterior incision reduction and internal fixation,to evaluate the applied value of hyperextending combined with pedicle screw fixation on clinical treatment.Method:In this study,we selected 60 patients with T12-L2 thoracolumbar fractures who were admitted to the Spinal Surgery Ward of Xiamen University Affiliated Fuzhou Second Hospital and consistent with the inclusion and exclusion criteria from January 2016 to January 2017.According to hospital sequence code in accordance with random number table,the cases were randomly divided into treatment group and control group,every groups 30 cases.The treatment group was treated with the mothod of hyperextension reduction combined with pedicle screw fixation under general anesthesia;The control group was treated with the mothod of conventional posterior incision reduction and internal fixation under general anesthesia.By choosing the the numeric rating scales before and after treatment,the Cobb angle change,the height recovery rate and the height loss rate of the anterior and posterior of the wounded vertebrae,the operation time and the bleeding volume as the clinical observation observing,to compare the difference between the two groups before and after treatment in different periods,and record the postoperative adverse reactions.Results:The 60 patients in two group were followed up for 3 months,all patients were able to cooperate with the treatment.The operation time of the treatment group was shorter than the control group for about 26.5 minutes(<0.01),and there was no significant difference in bleeding volume between the two groups(P>0.05).The numeric rating scales of the patients in two groups were significantly improved after treatment(P<0.01),but two groups without significant difference in statistics(P>0.05).The two treatments can both effectively improve the Cobb angle and the height of anterior and posterior of the wounded vertebrae after the operation;During the follow-up period,the Cobb angle of two groups patients were lost to some extent(P<0.01).The anterior height of the wounded vertebrae was significantly decreased at 6 weeks after operation(P<0.01),but there was no significant difference after 6 weeks to 12 weeks(P>0.05).The contrast between two groups have no significant difference in Cobb angle and the anterior height of the wounded vertebrae in each period.Only 1 patients had poor wound healing,without other serious complications and accidents in 60 patients.Conclusion:To comparing with conventional posterior incision reduction and internal fixation,hyperextension reduction combined with pedicle screw fixation can also effectively relieve the painful feeling of patients,and the Cobb angle and the height of the wounded vertebrae were both significantly improved after operation.hyperextension reduction combined with pedicle screw fixation can effectively shorten the operation time and reduce the difficulty of operation.The safe and effective method,which are combind the traditional Chinese manual reduction and surgery,is a useful supplement to the treatment of thoracolumbar fractures.