不同入路法联合小针刀术在胸腰椎创伤性骨折微创椎弓根钉内固定术中的临床疗效研究OACSTPCD

Objective To analyze therapeutic effects of different approaches combined with small needle knife surgery in minimally invasive pedicle screw fixation of thoracolumbar traumatic fractures.Methods 120 patients with thoracolumbar traumatic fractures who underwent minimally invasive pedicle screw internal fixation combined with needle knife intervention treatment in our hospital from January 2020 to June 2022 were selected as the research subjects,All patients received minimally invasive pedicle screw internal fixation.Randomly divide into three groups.Group A(40 cases)chose percutaneous approach,group B(40 cases)via Wiltse approach,and group C(40 cases)via posterior median approach.Observe and record the three groups of injury vertebral effectiveness indexes[Oswestry disability index(ODI),kyphotic Cobb angle and front edge height ratio],visual analogue scale(VAS)score,serum BALP and β-CTX level and perioperative indicators(operation time,intraoperative blood loss and postoperative drainage),and then perform statistical analysis.Results The three groups of injured vertebra ODI,kyphotic Cobb angle and front edge height ratio were significantly optimized(P＜0.05),but there was no statistical difference between the three groups of injured vertebra ODI,kyphotic Cobb angle and front edge height ratio significance(P＞0.05).The postoperative VAS scores of the three groups all decreased significantly(P＜0.05),and the difference in the VAS scores of the three groups at 1 and 7 days after surgery was statistically significant(P＜0.05).The levels of serum BALP and β-CTX in the three groups were significantly increased(P＜0.05),and the serum levels of β-CTX were significantly decreased(P＜0.05),and there were statistically significant differences in serum BALP and β-CTX levels among the three groups on the 7th day after operation(P＜0.05).The operation time,intraoperative blood loss and postoperative drainage volume of the three groups of patients showed obvious signs of group A＜group B＜group C,and the difference was statistically significant(P＜0.05).Conclusion Percutaneous and Wiltse minimally invasive pedicle screw fixation combined with small needle knife intervention can effectively improve the effectiveness and bone metabolism level of thoracic and lumbar spine traumatic fractures in patients.However,the effectiveness and improvement of bone metabolism level of traditional posterior median approach are relatively poor.In clinical practice,the combination of percutaneous and Wiltse approaches can be chosen according to the patient's situation,and the combination of small needle knife intervention and treatment can be chosen according to the patient's situation.