| Objective: To compare the clinical effect between multi-segment small incision from thoracolumbar vertebra-side muscle clearance surgery and conventional posterior midline approach in the treatment of Thoracolaric vertebral compressibility fracture.Methods: 40 cases of thoracolaric vertebra l compressibility fracture patients treated in the second people's hospital of FuYang City during April 2015~January 2017 were recruited in this study,all the patients were random ly divided into observation group and control group,each group with 20 cases.There including 12 cases of male and 8 cases of female in observation group,age from 29 to 53 years old,average(39.5±10.4)years old,injury types: 7 cases with simple compression fracture and 13 cases of b urst fracture;While there were 1 1cases of male and 9 cases of fe male in control group,age from 32 to 51 years old,average(38.1±9.9)years old,injury types: 10 cases with simple compression fracture and 10 cases of burst fracture.Observation group patients were given multi-segment small incision from thoracolumbar vertebra-side muscle clearance surgery and control group patients were tr eated with conventional posterior m idline approach surgery.Record the intraoperative blood loss,volume of drainage and operation time in all the patients,and draw the m orning fasting venous blood to detect the serum creatine kinase level at pr eoperative and postoperative 1 d,3 d respectively;Also conduct the X-ray exam ination respectively before sur gery and postoperative 3 days,measure the Cobb Angle,calculate th e Cobb Angle correction rate,com pare the difference of Cobb Angle correction rate between two groups.Evalute the feeling of pain respectively at the preoperative and 1 and 2 postoperative days Using the Visual analog pain score(Visual analogue scale,VAS),compare the difference of pain feeling between two groups.Results: There w ere no statistical d ifference of gen der,age,fracture dam age types,damage section,serum creatine kinase,Cobb Angle,and VAS score between two groups before treatment(P>0.05).Operation situation,the intraoperative blood loss,volume of drainage and operation time in observation group were lower than that of control group,with st atistically significant dif ference(P<0.05).Serum creatine kinase level,the Serum creatine kinase was raised with different extent at postoperative 1 day in both two groups patients,with no tatistica lly significant dif ference between two groups;While the Serum creatine kinase le vel was decreased obviously in observation group postoperative 3 days,lower than the sam e period in the control group(P < 0.05),the decrease range in observation gr oup were higher than that of control group,with statistically si gnificant difference(P<0.05).Cobb Angle correction situation,the postoperative Cobb Angle were both significantly decreased in two groups,there were statistically si gnificant difference in both tw o groups between preoperative and postoperative period,W hile There were no statistically significant difference of postoperative Cobb Angle a nd Cobb Angle correction ra te between two groups(P> 0.05).The VAS score were decreased obvious ly in both control group and observation group postoperative,with statistically significant difference comparing with preoperative period(P<0.05),at the sam e time,The 1 and 2 days postoperative V AS scores in observation group were lower than that of control group(P<0.05).Conclusion: The multi-segment small incision from thoracolumbar vertebra-side muscle clearance sur gery and con ventional posterior midline approach can bo th significantly improve the function of the lumbar spine and relieve pain,but the multi-segment small incision f rom thoracolumbar vertebra-side muscle c learance surgery with the advantage of small trauma,quick operation,less intraoperative blood loss,faster recovery,and rapidly pain relief,we need to grasp the operation indication in clinical and select the right surgical method. |
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