Percutaneous Pedicle Screw Rod Combined With Minimally Invasive Internal Fixation System Injured Vertebral Bone Graft In The Treatment Of Thoracolumbar Fractures

Objective: Explore the percutaneous pedicle screw rod system combined with minimally invasive internal fixation by pedicle injury vertebral vertebral body bone graft clinical curative effect for the treatment of thoracolumbar fractures.Methods: In February 2015 to January 2017,the data of 62 patients with thoracolumbar fractures without decompression were collected: 42 cases of male,female 20 cases,aged 39 to 54 years old,the average age of 46.65±5.14 years old;According to Denis classification: Denis type I(compression type),45 cases of type II(burst)in 17 cases;TLICS grade 4 to 6 points,an average of 4.40 ± 0.59;Preoperative injured vertebral fanterior flange height(18 mm to 24 mm)the average 20.85±2.16 mm;After injured vertebral local convex Cobb’s Angle(17°-22°)to an average of 19.40°±1.67°.The load-sharing classification scored 6 to 8,an average of 6.3±1.6.Randomly divided into 2 groups,31 cases of percutaneous minimally invasive group under "C" arm fluoroscopy guided by application of minimally invasive internal fixation system in combination with injured vertebral vertebral body bone graft treatment,31 cases of open surgery group Open reduction and internal fixation take iliac bone graft pedicle internal fixation treatment.Comparison of two groups of patients with clinical and radiographic parameters index.Results: 2 groups of patients were successfully completed surgery,13~24 months follow-up,an average of 18.00 ± 3.83 months,minimally invasive group of postoperative wound vertebral Cobb Angle(4°~7°),an average of 5.60° ± 1.17° significantly lower than before(P<0.05),postoperative wound open group job Cobb Angle(3°~7°),an average of 5.10° ± 1.20° was significantly lower than that of preoperative(P<0.05);Minimally invasive group began fanterior flange height(25mm ~ 33mm)the average 28.80 mm±3.26 mm is significantly higher than the preoperative(P<0.05),the open group postoperative fanterior flange height(26mm~34mm),an average of 30.00 mm±2.40 mm is significantly higher than the preoperative(P<0.05).Bleeding amount of minimally invasive group(10ml~30ml),an average of 20.50ml±7.98 ml,significantly better than the open group(100ml~150ml),an average of 132.00 ml ± 17.51ml(P<0.05);Minimally invasive group operating time(90min~150min),an average of 113.50min±16.34 min,significantly better than the open group(110min~150min),an average of 135.00 min ± 15.81min(P<0.05);Minimally invasive group had the traffic(15ml~30ml),an average of 23.50ml±6.26 ml,significantly better than the open group(180ml~280ml),an average of 233.00ml±34.33ml(P<0.05);Postoperative thoracic lumbar segment Cobb Angle of the minimally invasive group(a flexor/with a)ratio(1.81~2.69),an average of 2.16±0.30(1.04~1.07)significantly better than the open group,an average of 1.05±0.01(P<0.05),and postoperative wound vertebral minimally invasive group were not present "eggshell" effect.Conclusion: For the strictly selected thoracolumbar fractures of Denis I and II,two groups after surgery in the recovery of injured vertebral height,correct local convex side effect is good,but the percutaneous pedicle screw rod system combined with minimally invasive injury vertebral bone graft in the treatment of thoracolumbar fractures small surgical trauma,less bleeding,safe and reliable,corrective effect is satisfied,quicker recovery,retain thoracic lumbar segment activity,and effectively prevent injury vertebral appear "eggshell" effect,can immediately increase the injury of the vertebral body bone volume and pressure stability of the anterior column,worth clinical promotion.