ABSTRACT
Objective To explore the effect of paraspinal approach and posterior median approach for one -stage decompression recon-struction in the treatment of thoracolumbar spine fracture and dislocation .Methods From January 2012 to January 2014, 60 patients with thoracolumbar spine fracture and dislocation who were admitted and treated in our hospital were selected as the research objects .All patients received one-stage decompression reconstruction for treatment .According to the methods of approach , the patients were divided into the ob-servation group and the control group .The 30 cases in observation group were treated by paraspinal approach while the other 30 cases in con-trol group were treated by posterior median approach .Visual analogue score ( VAS) was applied .The status of surgery , recovery of centrum height, changes of Cobb angle as well as the occurrence rate of postoperative complications in the two groups were recorded .Results In the observation group, the operative time, time in bed and length of stay were (89.16 ±11.63) min, (39.75 ±8.69) h and (3.96 ±1.04) d respectively, which were shorter than those in the control group .The intraoperative blood loss was (89.64 ±13.62) mL which was lower than that in the control group and the difference was significant (P<0.05).One week after operation, the anterior and posterior height of centrum in the observation group increased significantly while Cobb angle significantly reduced .Compared with those before the treatment , the difference was significant (P<0.05).The maximum coronary diameter and maximum sagittal diameter of paraspinal muscles in the ob -servation group after the treatment were (48.96 ±5.34)mm and (18.16 ±6.74)mm respectively, which were significantly higher than those in the control group and the difference was significant (P<0.05).The incidence of lumbar and back pain in the observation group was 3.33%which was lower than 23.33%in the control group and the difference was statistically significant (P<0.05).Conclusion To carry out decompression reconstruction through paraspinal approach can reduce the the pain degree of patients and the incidence of lumbar and back pain after operation .
ABSTRACT
Objective To study the clinical effect of transpedicular vertebral osteotomy spine shortening in treating spinal kyphosis com-plicated with spinal cord nerve dysfunction. Methods A total of 80 patients with spinal kyphosis complicated with spinal cord nerve dys-function in our hospital from May 2013 to June 2014 were enrolled and randomly divided into observation group(n=40) and control group (n=40). The observation group received transpedicular vertebral osteotomy,and the control group received lamina and facet osteotomy. The situation of surgery,vertebral healing and spinal cord function condition,treatment effect between two groups were compared. Results The operation time and postoperative ambulation time of observation group were shorter than those of control group [(76. 52 ± 9. 1) vs (113. 46 ± 13. 44) min,(3. 28 ± 0. 43) vs (5. 67 ± 0. 68) d]. The postoperative bleeding volume,postoperative drainage volume of observation group were less than those of control group [(36. 14 ± 4. 28) vs (55. 23 ± 7. 15) mL,(17. 92 ± 2. 12) vs (29. 64 ± 4. 28) mL]. The Cobb angle and residual urine volume,initial and strong urinary bladder capacity,maximum urinary output of observation group were significantly less than those of control group [(6. 12 ± 0. 68) vs(9. 78 ± 1. 21) mL,(241. 45 ± 28. 56) vs(335. 54 ± 36. 86) mL,(456. 56 ± 51. 78) vs (586. 35 ± 63. 12) mL,(63. 78 ± 7. 24) vs (96. 32 ± 10. 22) mL]. The intervertebral height of observation group was higher than that of control group [(12. 62 ± 2. 81) vs (8. 41 ± 1. 32) mm]. The excellent rate of observation group was significantly higher than that of control group(97. 50%vs 82. 50%). Conclusion Transpedicular vertebral osteotomy spine shortening is helpful to reduce operation wound, pro-mote postoperative recovery,correct kyphotic deformity and improve neurological functionin,improve therapeutic effect.