| Objective: To analyze the curative efficacy of additional injured vertebral augmentation versus that of additional injured vertebral nail in posterior short segment internal fixation fortraumatic type A thoracolumbar fracture,so as to provide reference for clinical selection.Methods:A total of 74 patients with traumatic type A thoracolumbar fractures admitted to Department of Orthopedics,the Third Affiliated Hospital of Anhui Medical University(the First People’s Hospital of Hefei)from January 2019 to June 2021 were retrospectively analyzed,including 35 males and 39 females,aged from 18 to 60 years old.There were 15 cases of falling injury,20 cases of traffic accident injury and 39 cases of falling injury.The patients were divided into two groups according to whether the fractured vertebra was augmented with liquid artificial bone or inserted with screws.They were the injured vertebra augmentation group and the injured vertebra insertion group.There were 33 cases in the injured vertebral augmentation group,including 16 males and 17 females,aged from 18 to 60 years,with an average age of(45.42 ± 11.19)years.There were 9 cases of traffic accident injury,17 cases of falling injury,and 7cases of falling from height injury.There were 6 cases of thoracic 11 vertebral fractures,6 cases of thoracic 12 vertebral fractures,16 cases of lumbar 1 vertebral fractures,and 5cases of lumbar 2 vertebral fractures.There were 41 cases in the injured vertebral screw placement group,including 19 males and 22 females,aged from 18 to 60 years,with an average age of(44.27 ± 13.04)years.There were 11 cases of traffic accident injury,22 cases of falling injury,and 8 cases of falling from height injury.There were 6 cases of thoracic 11 vertebral fractures,7 cases of thoracic 12 vertebral fractures,19 cases of lumbar 1 vertebral fractures,and 9 cases of lumbar 2 vertebral fractures.The operation time,intraoperative blood loss,weight-bearing time,vertebral compression ratio,Cobb Angle of injured vertebra,Cobb Angle increase Angle of injured vertebra,visual analogue scale(VAS)score,Chinese Oswestry disability index questionnaire(ODI)score and postoperative complications were compared between the two groups.The clinical efficacy of two additional surgical methods was analyzed.Results:The average follow-up time was 17.7 months(13-24 months).The baseline data such as gender(χ2 = 0.034,P = 0.854),age(t = 0.403,P = 0.688),injury cause(χ2= 0.430,P = 0.979),fractured vertebral body(χ2 = 0.619,P = 0.892)were compared between the two groups.The differences were not statistically significant(P > 0.05).The weight-bearing time was(1.81 ± 0.41)months in injured vertebral augmentation group and(1.99 ± 0.41)months in injured vertebral augmentation group,and the difference was statistically significant(P < 0.05).The weight-bearing time of injured vertebral augmentation group was better than that of injured vertebral augmentation group.The operation time was(1.81 ± 0.41)h and(1.99 ± 0.41)h,and the intraoperative blood loss was(132.73 ± 34.49)ml and(143.41 ± 52.61)ml in the injured vertebral augmentation group and the injured vertebral screw placement group,respectively.There was no significant difference(P > 0.05).There was no significant difference in VAS score and ODI score between the two groups at each stage(P > 0.05).At the same time,VAS score at 1 week after operation,VAS score at 1 year after operation and ODI score at 6 months after operation were significantly lower than those before operation(P < 0.05).There was no significant difference between the two groups in the vertebral compression ratio and the Cobb Angle of the injured vertebrae before operation at each stage and the increasing Angle of the injured vertebrae Cobb Angle at1 year after operation(P > 0.05).The vertebral compression ratio and Cobb Angle of the injured vertebrae were significantly improved at 1 week and 1 year after operation,but there was no significant difference between the two groups(P > 0.05).In terms of postoperative complications,there was 1 case of tail cap falling off in the injured vertebral augmentation group,and the fracture was found to have healed at 1 year after operation,and the internal fixation was removed.During the follow-up,the fractures of the two groups healed in one stage,and no infection,nonunion,kyphosis,and other complications were found.Conclusion:According to the results of this study,in the treatment of traumatic type A thoracolumbar fracture,the clinical efficacy of posterior short segment internal fixation plus injured vertebra screw insertion and additional injured vertebra augmentation is equivalent.However,the weight-bearing time is better than that of additional vertebral augmentation,and the former is more suitable for clinical promotion because of its simple operation and maturity. |
PDF Full Text Request