A Retrospective Of Longzhong Orthopedic Manipulation Combined With Pedicle Screw Internal Fixation For The Treatment Of Thoracolumbar Fractures (AO Classification A1)

Objective: To analyze and compare the clinical effects of Longzhong orthopedic manipulation combined with pedicle screw internal fixation and simple pedicle screw internal fixation in the treatment of thoracolumbar fractures(AO classification A1).To evaluate the clinical efficacy of Longzhong orthopedic manipulation combined with pedicle screw internal fixation in the treatment of thoracolumbar fractures(AO classification A1).The purpose of this study is to provide a certain reference value for the clinical application of Longzhong orthopedic manipulation combined with pedicle screw internal fixation in the treatment ofthoracolumbar fractures(AO classification A1).Methods: According to the inclusion and exclusion criteria set by this study,the medical records of 78 patients with thoracolumbar fractures(AO classification A1)from 6 orthopedic clinical departments were screened by Donghua HIS medical record system of Gansu Provincial Hospital of Traditional Chinese Medicine from January 1,2018 to December 31,2020.They were divided into group A(n=40)and group B(n=38)according to the different treatment methods.Among them,group A was treated with Longzhong orthopedic manipulationcombined with pedicle screw fixation,group B was treated with simple pedicle screw fixation,and the imaging data of all patients before and after operation were analyzed retrospectively.By comparing the height ratio of the anterior edge of the injured vertebral body,the compression ratio of the anterior edge of the injured vertebral body and the angle of kyphosis(Cobb angle)between pre-operation and 3 days,3 months and 6 months after operation,all the included cases were interviewed by telephone according to the diagnostic and curative effect criteria of Traditional Chinese Medicine,and the clinical effects of the two groups were evaluated 6 months after operation according to the functional description of low back and imaging data.SPSS22.0 statistical software was used to analyze the data,and the curative effects of the two treatments on thoracolumbar fractures(AO classification A1)were compared.Results: The general data of the two groups and the observation indexes at different times before and after operation were statistically analyzed as follows:1.Comparability of general data: the sex,age,distribution of fracture vertebrae,causes of injury and other general data of the two groups were compared.The results showed that there was no statistical difference between the two groups(P>0.05).It was considered that the general data of the two groups were comparable.2.The comparability of the preoperative observation indexes: the ratio of the height of the anterior edge of the injured vertebral body,the compression ratio of the anterior edge of the injured vertebral body and the angle of kyphosis(Cobb angle)were compared,the results showed that P>0.05,there was no statistical difference,it was considered that the preoperative observation indexes of the two groups were comparable.3.Comparison of the height ratio of the anterior edge of the injured vertebral body: the paired sample t-test was used in the two groups before and after treatment,and the results showed that the height of the anterior edge of the injured vertebral body was effectively restored,and the difference was statistically significant(P<0.05).The height of the anterior edge of the injured vertebral body in group A was 89.46 ±2.37 on the 3rd day after operation,and the height of the anterior edge of the injured vertebral body in group B was 87.85 ±3.84 on the 3rd day after operation,the data of the two groups were tested by independent sample t-test,and the difference was statistically significant(P<0.05);Three months after operation,the height of the anterior edge of injured vertebrae in group A was 88.70±2.36,and the height of injured vertebrae in group B was 86.62±3.40,the data of the two groups were tested by independent sample t-test,and the difference was statistically significant(P<0.05);The height of the anterior edge of the injured vertebral body was 87.48±2.37 in group A and 85.55±3.85 in group B six months after operation,the data of the two groups were tested by independent sample t-test,and the difference was statistically significant(P<0.05).4.Comparison of compression ratio of anterior edge of injured vertebral body:comparison of paired sample t-test between the two groups before and after treatment,the results showed that the compression ratio of the anterior edge of the injured vertebral body was effectively reduced,and the difference was statistically significant(P<0.05).The compression ratio of the anterior edge of the injured vertebral body was 7.37±2.20 in group A and 8.57±1.36 in group B at 3 days after operation,the data of the two groups were tested by independent sample t-test,and the difference was statistically significant(P<0.05);Three months after operation,the compression ratio of the anterior edge of injured vertebrae in group A was 7.51±1.64,and that of group B was 8.89±2.04,the data of the two groups were tested by independent sample t-test,and the difference was statistically significant(P<0.05);At six months after operation,the compression ratio of the anterior edge of injured vertebral body in group A was 8.37±1.40,in group B,the compression ratio at the anterior edge of injured vertebral body was 9.21±1.75,the data of the two groups were tested by independent sample t-test,and the difference was statistically significant(P<0.05).5.Comparison of kyphosis angle(Cobb angle): the paired sample t-test was used in the two groups before and after treatment,the results showed that the Cobb angle was effectively corrected,and the difference was statistically significant(P<0.05);The Cobb angle was7.74±3.26 in group A and 8.47±2.86 in B group at 3 days after operation,there was no significant difference between the two groups by independent sample t-test(P>0.05);Three months after operation,the Cobb angle of group A was 9.35±2.25,and the Cobb angle of group B was 11.17±3.99,there was significant difference between the two groups using independent sample t-test(P<0.05);The Cobb angle was 10.51±1.83 in group A and12.21±2.41 in group B at six months after operation,the difference between the two groups was statistically significant by independent sample t-test(P<0.05).6.Evaluation of clinical efficacy six months after operation: the results of this study show that the effective rate of Longzhong orthopedic manipulation combined with pedicle screw internal fixation is 97.50%,and that of simple pedicle screw internal fixation is 92.11%.After chi-square test,the difference is statistically significant(P<0.05).Conclusion:1.Both treatment methods can effectively restore the height of the anterior edge of the injured vertebral body and correct the angle of kyphosis(Cobb angle)on thoracolumbar fractures(AO classification A1),but the treatment group with Longzhong orthopedic manipulation combined with pedicle screw internal fixation had the better effect.2.With the patients’ movements after operation,both the anterior height of the injured vertebral body and the kyphosis angle(Cobb angle)were lost to a certain extent in both groups,but the loss in the Longzhong orthopedic manipulation combined with pedicle screw internal fixation group was less.3.Longzhong orthopedic manipulation combined with pedicle screw internal fixation is effective in the treatment of thoracolumbar fractures(AO classification A1),which is more effective than simple pedicle screw internal fixation,so it is worth popularizing in clinic.