Analysis Of Curative Effect Of Posterior And Combined Anterior And Posterior Approaches For Thoracolumbar Fracture With PLC Injury Combined With Spinal Cord Injury

Objective:To analyze and discuss the clinical effect of posterior surgery combined with anterior and posterior surgery for thoracolumbar fracture with posterior lignment complexus(PLC)injury and spinal cord injury,in order to maximize the contact with spinal cord compression,restore the stability of the patient's spine and the height of the injured vertebral body,and effectively restore the biology of the spine.Method:From February 2017 to August 2018,66 patients with thoracolumbar spine fracture accompanied by PLV injury and spinal cord injury were randomly selected.According to the different surgical methods,they were divided into posterior surgery group(posterior group)and combined anterior and posterior surgery group(combined group).Cobb's,the height of the injured vertebrae,the degree of vertebral compression and the space occupancy of the spinal canal were evaluated before and after operation.Then,before and 1 month after the operation,the tactile score and motor score of the two groups were evaluated,and the clinical effects of the two groups were compared.Result:?The mean operative time was 179.37(+20.37)min in the posterior approach group,the intraoperative bleeding volume was 311.82(+48.28 ml),and the average operative time was 257.28(+31.37 min)in the combined anterior and posterior approach group,and the average intraoperative bleeding volume was 572.37(+43.82 ml).There were significant differences in operation duration and average bleeding volume between the two groups(P<0.05).?After 6-24 months of follow-up,the ASIA neurological function scores of the two groups were improved to a certain extent.The effect of the combined group was better than that of the posterior group(P<0.05),and the difference was statistically significant.?Compared with the posterior approach group,the improvement of tactile score and motor score,Cobb's angle and vertebral height,vertebral compression degree and spinal canal occupancy in the combined group were significantly improved,P<0.05,with statistical significance.?After operation,the VAS scores of both groups were improved,but the VAS scores of the combined group were better than those of the posterior approach group,P<0.05,the difference was statistically significant.?The total effective rate of 30 patients treated by posterior approach surgery was the same as that of 36 patients treated by anterior and posterior approach.The total effective rate of the two groups was almost the same,P>0.05.There was no significant difference between the two groups.However,the treatment efficiency of the combined group was significantly higher than that of the posterior group(P<0.05),and the difference was statistically significant.Conclusion:In the treatment of thoracolumbar fracture with PLC injury and spinal cord injury,anterior and posterior combined therapy can effectively relieve pressure,make the spinal cord function of patients recover effectively,which is conducive to the correction of kyphosis deformity,help patients recover the height of the injured spine and spinal canal dissolution,and achieve mechanical stability.