Clinical Efficacy Of Posterior Short Segment Internal Fixation With Or Without Screws In The Treatment Of Thoracolumbar Burst Fractures

Objective:To investigate the clinical effect of posterior short segment internal fixation with and without screws in the treatment of thoracolumbar burst fractures.Methods:98 patients with thoracolumbar burst fractures in our hospital from March 2020 to October 2021 were retrospectively selected and randomly divided into group A(trans injured vertebra group)and group B(trans injured vertebra group)according to the mode of internal fixation.There were 48 cases in group A and 50 cases in group B.the general conditions,imaging indexes,perioperative indexes,curative effect evaluation indexes and complications of the two groups were statistically analyzed.Results:(1)Comparison of general conditions:there was no significant difference in gender,age,injury factors,injury segments,fracture types and body mass index between the two groups(P>0.05).(2)Comparison of the compression rate of the anterior height of the injured vertebrae:there was no significant difference between the two groups before operation(P>0.05);There were significant differences between the two groups at 1 week,3 months,6 months and 1 year after operation.The improvement of group B was better than that of group A(P<0.05).(3)Comparison of local Cobb angle of injured vertebrae:there was no significant difference between the two groups before operation(P>0.05);There were significant differences between the two groups at 1 week,3 months,6 months and 1 year after operation.The improvement of group B was better than that of group A(P<0.05).(3)Comparison of perioperative indexes:there was no significant difference in operation time,intraoperative bleeding and hospital stay between the two groups(P>0.05).(4)Comparison of efficacy evaluation indexes:①comparison of VAS score:there was no significant difference between the two groups before operation(P>0.05);There were significant differences between the two groups at 1 week,3 months and 1 year after operation.The pain relief in group B was significantly better than that in group A(P<0.05).② Comparison of ODI index:there was no significant difference between the two groups before operation,1 week and 3 months after operation(P>0.05);There was significant difference between 6 months and 1 year after operation(P<0.05).(5)Comparison of postoperative complications:there was no significant difference between the two groups(P>0.05).Conclusion:The results of this study show that nail placement in injured vertebrae can more effectively restore the height of vertebral body,correct kyphosis,promote functional recovery,improve postoperative low back pain,improve patients’ satisfaction with surgery,and provide clinicians with certain basis and suggestions.It is a safe and effective surgical method for thoracolumbar burst fracture,which is worthy of clinicians’ study and use.