Clinical Effect Observation Of Percutaneous Pedicle Screw Internal Fixation Combined With Congrong Niuxi Decoction Plus And Minus In Treating Thoracolumbar Burst Fracture

Objective:Through clinical comparison,this study explored the clinical effect of percutaneous pedicle screw internal fixation combined with Congrong Niuxi Decoction plus and minus in the treatment of thoracolumbar burst fracture after manipulative reduction,and analyzed the role of manipulative reduction and Congrong Niuxi Decoction in the treatment of thoracolumbar burst fracture,to further developed the treatment of thoracolumbar burst fracture.Methods:From June 2018 to November 2019,57 patients with thoracolumbar fractures who were admitted by the spine surgery department of Suzhou Hospital of traditional Chinese Medicine Affiliated to Nanjing University of traditional Chinese medicine were randomly divided into three groups according to the time of admission:17 cases of manipulative reduction combined with percutaneous pedicle screw internal fixation,Congrong Niuxi Decoction group(treatment group),20 cases of percutaneous pedicle screw internal fixation group(control group 1)and 20 cases of manipulative reduction combined with percutaneous pedicle screw fixation treatment group(control group 2).To observe and compare the effect of manipulative reduction on the vertebral height ratio,operation time and kyphosis angle before and after treatment,to compare and analyze the improvement of abdominal distension before operation and clinical efficacy of the three groups,and to track the changes of ODI index and VAS score of lumbago in the three groups before treatment,3 days after treatment,4 weeks after treatment,2 months after treatment and 4 months after treatment.Results:There was no statistical significance in gender,age,cause of injury,fracture segment,VAS score before treatment and ODI index before treatment in the three groups(P>0.05),which was comparable.The VAS score and ODI index of the three groups were statistically significant(P<0.01).There was statistical significance in the improvement of abdominal distension before operation in the three groups(P<0.05).There was no statistical significance in the clinical efficacy of the three groups(P>0.05).There was no significant difference between control group 1 and control group 2 in vertebral height ratio and kyphosis angle before and after treatment(P>0.05),but there was significant difference in operation duration(P<0.05).There was significant difference in VAS score between control group 1 and control group 2 at 3 days and 2 weeks after treatment(P<0.05),but there was no significant difference in VAS score at 4 weeks,2 months and 4 months after treatment(P>0.05).There was significant difference in VAS score between treatment group and control group 2 at 2 weeks after treatment(P<0.05),but there was no significant difference in VAS score between treatment group and control group 2 at 3 days,4 weeks,2 months and 4 months after treatment(P>0.05).In the aspect of ODI index,there was significant difference between treatment group and control group 2 at 2 weeks after treatment(P<0.05),but there was no significant difference at 3 days,4 weeks,2 months and 4 months after treatment(P>0.05).Conclusion:The traditional Chinese medicine manipulative reduction before percutaneous pedicle screw internal fixation can shorten the operation time and reduce the patients' low back pain score.And Congrong Niuxi decoction has a certain effect on the control of thoracolumbar burst fracture pain,the improvement of lumbar dysfunction and the relief of abdominal distention,which has a certain promotion value.