The Clinical Analysis Of Thoracolumbar Burst Fractures Treated By Percutaneous Pedicle Screw Fixation Based On The Theory Of "Attaching Equal Importance To Both Muscles And Bones"

Objective:To explore the clinical effect of traditional Chinese medicine manipulative reduction combined withMinimally invasivepercutaneous pedicle screw fixation in the treatment of thoracolumbar burst fracture without neurological symptoms under the guidance of the theory of "attaching equal importance to both muscles and bones".Research methods:Sixty-four patients with thoracolumbar burst fracture admitted to the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from October 2016 to October 2018 were studied.All patients were diagnosed as thoracolumbar burst fracture by clinical examination,without symptoms of spinal cord and nerve root injury.They were divided into control group and observation group according to different treatment methods.Thirty patients underwent traditional open surgery as the control group,and 34 patients underwent minimally invasive percutaneous nailing operation as the observation group.The sex,age,perioperative observation indexes(operation time,intraoperative bleeding volume,knife length,hospitalization time,vertebral height of injured vertebrae after manipulative reduction in traditional Chinese medicine,post-operative correction rate of vertebral height and Cobb angle correction rate)were compared between the two groups.The pain score(VAS score)and the loss rate of vertebral height correction and the loss rate of Cobb angle correction were compared during the last follow-up.The clinical data of the two groups were compared,and the data were collected and measured.SPSS 19.0 statistical software was used to analyze the data.Research results:1.Perioperative observation indicators:the operation time,intraoperative bleeding volume,knife length and hospitalization time of the two groups were compared and comparison of vertebral height before and after manipulative reduction in traditional Chinese medicine,P<0.05,there was statistical difference;post-operative correction rate of vertebral height and Cobb angle correction rate of the two groups were compared,P>0.05,there was no statistical difference.2.VAS score:Two groups of data were repeated measurement of variance analysis,multivariate analysis of variance showed that the time was P<0.001,indicating that both the observation group and the control group after 1 week and the last follow-up and preoperative comparison had statistical differences.At each time point,the thematic effects were compared between the two groups,P>0.05,indicating that there was no statistical difference between the observation group and the control group in the first week and the last follow-up.3.Loss rate of vertebral height correction and Cobb angle correction at the last follow-up:Independent sample t-test was used to test the data of the two groups.At the last follow-up,there was no significant difference in the loss rate of correction of vertebral height and Cobb angle between the two groups(P>0.05).Research conclusion:Both are combined with traditional Chinese medicine manual reduction minimally invasive percutaneous screw reduction and internal fixation compared with with traditional posterior open reduction and pedicle screw internal fixation both can achieve good clinical efficacy,but the minimally invasive operation has smaller wounds and faster recovery,which is more advantageous than traditional open reduction and internal fixation.Based on the theory of "attaching equal importance to both muscles and bones",minimally invasive percutaneous screw reduction and internal fixation for thoracolumbar burst fracture without neurological symptoms is worthy of clinical promotion.