Comparison And Analysis Of The Clinical Effect Of Percutaneous Transpasal Nailing And Intervertebral Screw Fixation In The Treatment Of Thoracolumbar Burst Fracture

Objective: The clinical effect of percutaneous transpasal screw placement and intervertebral screw placement for thoracolumbar burst fractures was retrospectively analyzed.In order to guide the choice of clinical treatment.Methods: Methods a randomized controlled clinical trial was conducted to collect and analyze data from 36 patients who underwent percutaneous reduction and internal fixation from September 2015 to May 2017 in our hospital.According to the difference of the form of operation,the operation group(group A)and the operation group(group B)were divided into 18 cases.By comparing the two groups of patients before and after operation of vertebral sagittal Cobb angle,anterior vertebral height ratio,occupying rate of the imaging difference,at the same time were compared between the two groups of patients with VAS visual analogue scale and Oswestry disability index and lumbar JOA score,Operation time,length of incision and amount of intraoperative bleeding.Objective to analyze the differences,advantages and disadvantages of combined spinal injury and intervertebral pedicle screw fixation in the short-term and long-term maintenance of kyphotic deformity correction rate and neurological function recovery.Results:(1)group comparison: two groups of patients with vertebral Cobb postoperative angle,anterior vertebral height,occupying rate,VAS index,ODI score,lumbar JOA score were significantly improved compared with the preoperative(P<0.05,P<0.01);the two group of long-term postoperative vertebral Cobb angle and vertebral the height of the front part was lost.(2)The comparison between the two groups:After the surgery of vertebral pedicle screw group in Cobb angle and anterior height,occupying rate of recovery was significantly better than the trans vertebral pedicle screw group,the differences were statistically significant(P < 0.05,P < 0.01);and after the two groups of VAS score,ODI index and lumbar JOA score,comparison there were no significant differences(P>0.05).Conclusion:(1)Percutaneous pedicle screw fixation has advantages of less trauma and quicker recovery than traditional open surgery.It is the best minimally invasive treatment for both burst and fractured vertebrae.(2)Because of the good mechanical and biomechanical advantages,combined with vertebral pedicle screw surgery compared with trans vertebral pedicle screw surgery,can better restore the vertebral height and physiological curvature of vertebral body height and spinal effectively maintain the nerve recovery after reset,for providing more long protect.(3)The vertebral pedicle screw surgery has increased the damage(two holes),prolonged operation time,a corresponding increase in cost,but compared with the clinical efficacy,the advantages outweigh the disadvantages.(4)Trans vertebral pedicle screw has the necessity of its existence,according to the injury situation with respect to discretionary application,anti stress less because the emphasis should be placed on a longer time in bed.