Analysing The Recovery Of Lumbar Physiological Curvature And Clinical Efficacy By Placing Pedicle Screw At The Fracture Level After Lower Lumbar Fracture

Purpose:To explore whether there are differences in the recovery of lumbar curvature and clinical efficacy of patients with lower lumbar spine fracture after placing pedicle screw at the fracture evel,and thus further give a reference for clinicians.Materials and methods:Sixty patients hospitalized with lower lumbar vertebral fracture from January 2013 to October 2017 were investigated in our hospital,including 35 males and 25 females.They were divided into two groups according to the operation methods: fixation cross the fracture level group(control group)and fixation at the fracture level group(observation group).Among them,25 were in the control group and 35 were in the observation group.The lumbar lordosis angle(LLA),lumbar curve index(LCI),the ratio of anterior height of injured vertebrae,visual analogue scale(VAS)and Oswestry dysfunction index(ODI)were used as related evaluation indexes.Whether the recovery of lumbar curvature and the clinical efficacy correlate with the fixation at the fracture level by analyzing each parameter index.Result:All of the sixty cases recovered after receiving the two surgical methods.No important difference in lumbar lordosis angle(LLA)、lumbar curve index(LCI)and the ratio of anterior height of injured vertebrae can be found between the two groups before surgery(P>0.05).However,There were significant differences in the correction of lumbar lordosis angle(LLA),lumbar curve index(LCI)and the ratio of anterior height of injured vertebrae at the time of operation,6 months and 1 year after operation(P<0.05).Specifically,in terms of VAS and ODI scores,the relief from lower lumbar spine fracture pain by placing pedicle screw cross the fracture level is not different from that by placing pedicle screw at the fracture level between the two groups in an early phase(P>0.05),but VAS between the two groups over 12-month follow-up period and ODI index between them over 6-and 12-month follow-up periods are significantly different(P<0.05).Moreover,there were big differences between the two groups at the last follow-up period: 1 case failed in the control group(fixation cross the fracture level group);while no internal fixation failure occurred in the observation group(fixation at the fracture level group).Conclusion:1.Compared with fixation cross the fracture,fixation at the fracture level can better correct lumbar lordosis angle(LLA),and restore lumbar curve index(LCI)as well as anterior height ratio of injured vertebrae.2.Fixation at the fracture level was better than fixation cross the fracture level for keeping lumbar curvature.3.Compared with fixation cross the fracture level,fixation at the fracture level can significantly relieve the lower-back pain and improve function in the long term.