Efficacy study of thoracolumbar fracture combined spinal cord compression with pedicle screw fixation and injured vertebral bone graft and facet joint grafting in the treatment of percutaneous multinuclear interspace approach / 国际外科学杂志

ABSTRACT

Objective To investigate the clinical efficacy of pedicle screw fixation and injured vertebral bone graft and facet joint grafting in the treatment of thoracolumbar fractures with spinal cord compression.Methods A prospective controlled study was conducted to analyze the clinical data of 60 patients with thoracolumbar fractures complicated with spinal cord compression from January 2015 to April 2017 in Shenzhen Pingle Orthopedic Hospital.The patients were divided into two groups in random number table method.Each group of 30 cases.The patients in the observation group were treated with pedicle screw fixation and injured vertebral bone graft and facet joint grafting in the observation group.The patients in the control group were treated with traditional posterior approach root screw fixation and transverse bone graft was performed.Tactile,vertebral height,motion and Cobb's angle of the two groups were evaluated preoperatively and one month after operation.The patients were followed up by phone for six months.The ASIA score of the American Spinal Injury Association was used to evaluate the neurological function recovery of the two groups to observe the curative effect.Using SPSS 13.0 statistical software analysis,count data were expressed as percentage,measurement data were expressed by ((x) ± s),the two groups were compared using t test.Results The tactile sensation,vertebral height,motion and Cobb's angle in observation group were significantly higher than those before operation (59.4 ± 17.3) scores,(58.8 ± 16.6) scores,(55.8 ± 23.6) scores and (54.5° ± 21.4°) scores respectively],in the control group [(75.6 ± 14.9) scores,(72.4 ± 14.5) scores,(76.8 ± 23.3) scores,(76.2° ± 23.5 °)],with statistical differences (P ＜ 0.05).After the observation group was followed up for one month,the neurological function recovery was better than that of the control group (P ＜ 0.05).Conclutions Pedicle screw fixation and injured vertebral bone grafting via percutaneous multifidus muscle interspace can play an important role in the treatment of thoracolumbar fractures with compression of the spinal cord.It can significantly relieve spinal cord compression in patients.