| 【Objective】To observe the operation time,intraoperative blood loss and length of stay of the two surgical methods for thoracolumbar burst fracture,as well as the changes of Cobb angle,Anterior Heights of the Injured Vertebra(AHIV),median heights of the injured vertebra(MHIV),posterior heights of the injured vertebra(PHIV)and visual analog scale(VAS)pain grade at different time points.To explore the relationship between the treatment of thoracolumbar burst fracture with Bisphasic Calcium Phosphate(BCP)bone graft combined with screw fixation on the injured vertebra and postoperative vertebral height loss,kyphosis angle loss after correction and pain in chest,lower back and back.【Method】The case data of 71 patients with single-level thoracolumbar burst fractures(T11 ～L2)who underwent surgical treatment in the Department of Spinal Surgery of the First Affiliated Hospital of Dali University from January 2018 to December 2019 were retrospectively analyzed.All patients were performed by the same medical team with clear diagnosis and complete case data,and were followed up for 13-20 months.No adverse complications occurred during the operation,postoperative and follow-up.The patients were divided into two groups: study group(n=35): BCP bone grafting via posterior vertebra combined with screw fixation via injured vertebra;the control group(n=36): treated with posterior vertebra screw fixation alone.General data,such as gender,age,preoperative preparation time,postoperative follow-up time,fracture segment and fracture cause,were collected from patients in both groups.Time spent during the operation,the amount of blood loss during the operation and the total length of hospital stay of the patients were also recorded.The changes of AHIV,MHIV,PHIV,Cobb Angle and VAS pain scores in two groups were collected before surgery,one week after surgery and at the last follow-up.Changes of AHIV,MHIV,PHIV,Cobb Angle in postoperative improvement and last loss were compared between the two groups.All data were processed using SPSS 26.0 software.The measurement data were expressed as((?)±s),and t test was used.The counting data were tested by X~2?test(Chi-square test).All P <0.05,the difference was statistically significant.【Results】1.Comparison of general informationComparison of gender,age,preoperative injury time,follow-up time,injury cause and injury segment between the two groups was P>0.05,the difference was not statistically significant.2.Comparison of operative time,intraoperative blood loss and length of hospital stay between the two groupsComparison of operative time,intraoperative blood loss and length of hospital stay between two groups was P>0.05,the difference was not statistically significant.3.Comparison of vertebral body height at different time points between the two groups3.1 Comparison of AHIV at different time points,postoperative improvement and last loss between the two groupsPreoperative AHIV was 56.82±3.84% in the study group and 57.60±5.27% in the control group,P>0.05,the difference was not statistically significant;one week after operation,the AHIV in the study group and the control group were 98.10±1.08% and97.62±0.98%,respectively,P>0.05,the difference was not statistically significant;AHIV was 95.56±1.01% in the study group and 88.89±3.89% in the control group,P<0.001,the difference was statistically significant.The postoperative improvement of AHIV in the study group and the control group was 41.28±3.68% and 40.01±5.46%,respectively,P>0.05,the difference was not statistically significant;the last loss of AHIV in the study group and the control group was 2.54±1.32% and 8.73±3.74%,respectively.P<0.001,difference was statistically significant.3.2 Comparison of MHIV at different time points,postoperative improvement and last loss between the two groupsPreoperative MHIV was 69.17±1.53% in the study group and 68.74±1.50% in the control group,P>0.05,the difference was not statistically significant;one week after surgery,the MHIV in the study group and the control group were 96.10±1.46% and95.71±1.90%,respectively,P>0.05,the difference was not statistically significant;at the last time,MHIV was 94.27±1.66% in the study group and 86.48±1.66% in the control group,respectively.P<0.001,the difference was statistically significant.The postoperative improvement of MHIV in the study group and the control group was 26.93±1.95% and 26.97±2.36%,respectively,P>0.05,the difference was not statistically significant;the last loss of MHIV was 1.83±0.80% in the study group and9.22±2.36% in the control group,P<0.001,the difference was statistically significant.3.3 Comparison of PHIV at different time points,postoperative improvement and last loss between the two groupsPreoperative PHIV was 91.26±1.76% in the study group and 90.59±1.68% in the control group,P>0.05,the difference was not statistically significant;one week after operation,PHIV in the study group and the control group was 99.25±0.69%,98.89±1.27%,P>0.05,the difference was not statistically significant;PHIV in the study group and control group was 98.30±0.71% and 97.87±1.41%,respectively,P>0.05,the difference was not statistically significant.Postoperative improvement in PHIV was 7.99±1.77% in the study group and8.29±2.28% in the control group,P>0.05,the difference was not statistically significant;the last loss of PHIV was 0.96±0.21% in the study group and 1.00±0.57% in the control group,P>0.05,the difference was not statistically significant.4.Comparison of Cobb Angle,postoperative improvement and last loss between two groups at different time pointsPreoperative Cobb Angle was 21.09±1.50°in the study group and 20.78±2.02°in the control group,P>0.05,the difference was not statistically significant;Cobb Angle was 7.14±1.24°and 7.08±1.59°in the study group and the control group one week after surgery,P>0.05,no statistical significance;Cobb Angle was 11.09±1.52°in the study group and 15.00±1.55 ° in the control group,P<0.001,the difference was statistically significant.Postoperative improvement of Cobb Angle in study group and control group was13.94±1.92°,13.69±2.33°,P>0.05,no statistical significance;the last loss of CobbAngle was 3.94±1.39°in the study group and 7.92±1.71°in the control group,P<0.001,the difference was statistically significant.5.Comparison of VAS pain scores in two groups at different time pointsPreoperative VAS was 7.97±1.10 in the study group and 7.72±1.37 in the control group,P>0.05,the difference was not statistically significant;1 week after surgery,the VAS was 5.11±0.80 in the study group and 4.72±0.94 in the control group,P>0.05,the difference was not statistically significant;the final VAS was 1.20±0.41 in the study group and 2.25±0.60 in the control group,P<0.001,the difference was statistically significant.【Conclusion】1.BCP bone grafting via posterior vertebra combined with screw fixation via injured vertebra can better reduce the loss of the injured prevertebral body and the middle body,the loss of correction of the kyphosis Angle and the pain of the chest,waist and back during the last follow-up.2.The recovery of vertebral height and correction of kyphosis Angle after thoracolumbar burst fracture treated by BCP bone grafting via posterior vertebra combined with screw fixation via injured vertebra is consistent with that of treated with posterior vertebra screw fixation alone.3.There was no difference in operative time,amount of blood loss during operation,and length of hospitalization between BCP grafting and non-BCP grafting. |
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