The Clinical Research On The Treatment Of Thoracolumbar Fracture:Combined Jiegudan Tablet With Pedicle Screw Fixation Through The Pedicle Of Fractured Vertebra

ObjectiveTo explore the efficacy of adding unilateral pedicle screw fixation through the pedicle of fractured vertebra to the short segment of pedicle screw in combination with Jiegudan Tablet in the treatment of thoracolumbar fracture and its underlying mechanisms.MethodsFrom July 2013 to June 2014,52 cases of unilateral pedicle screw fixation through the pedicle of fractured vertebra in combination with the short segment of pedicle screw in the treatment of thoracolumbar fracture were randomly divided into two groups,26 patients per group according to the order of admission.All patients were in the understanding of the purpose and process of the research situation and voluntary participation.Both two groups were treated by the same group of doctors for vertebral unilateral placement of short segment pedicle screw internal fixation.The Chinese traditional medicine group was treated with Jiegudan Tablet, while the contorl group was treated with edible tablet(placebo).in each single case the course of treatment were set into 6 weeks.Separately recorded the level of ALP before and after A 6-week-course of treatment.Separately recorded the preoperative and postoperative percentage of vertebral compression, kyphosis degree, VAS Rating and Oswestry Rating.record if internal fixation was loosen、extracted or fractureed to explore the mechanism and clinical effect of unilateral pedicle screw fixation through the pedicle of fractured vertebra in combination with the short segment of pedicle screw in the treatment of thoracolumbar fracture with Jiegudan Tablet.Data was analyzed statistically by using the SPSS 18.0 statistical software package.ResultsThere’s no significant difference(P> 0.05) in age, gender, fracture type,and the preoperative kyphosis degree, percentage of vertebral compression, ALP, VAS Rating and Oswestry Rating among two groups. Compared with the percentage of vertebral compression,kyphosis degree of the contorl group after operation in the same period,the Chinese traditional medicine group didn’t see significant difference (P> 0.05).Each group the percentage of vertebral compression and kyphosis degree improves obviously comparing to that before operation(P<0.05).There’s significant difference(P<0.05) in the percentage of vertebral compression and kyphosis degree among 3days with 6months after operation in each group.The ALP,VAS and Oswestry Rating in Chinese traditional medicine group improves obviously comparing to in contorl group, P<0.05,which reveal marked discrepancy in the follow-up 6 months.Conclusion:1. Significant improvement were found in ALP,which meant improving the numbers of Osteoblasts and promoting fracture healing,after the treatment of combining Jiegudan Tablet with unilateral pedicle screw fixation through the pedicle of fractured vertebra.2. Significant improvement were found in VAS and Oswestry Rating,after the treatment of combining Jiegudan Tablet with unilateral pedicle screw fixation through the pedicle of fractured vertebra.3.Unilateral pedicle screw fixation through the pedicle of fractured vertebra combined with the short segment of pediele screw is effective for thoraclumbar fracture without spinal cord injuried. Jiegudan Tablet does not definite effect on the prevention of thoracolumbar burst fracture vertebral malformation of the protruding after in the follow-up 6 months.