Comparison of effects of pedicle internal fixation through multifidus intermuscular approach and posterior median approach in treatment of patients with thoracolumbar fractures
Objective:To compare effects of pedicle internal fixation through multifidus intermuscular approach and posterior median approach in treatment of patients with thoracolumbar fractures.Methods:A prospective study was conducted on 89 patients with thoracolumbar fractures admitted to this hospital from April 2021 to April 2023.They were divided into control group(44 cases)and observation group(45 cases)according to the random number table method.The control group was treated with pedicle internal fixation through posterior median approach,while the observation group was treated with pedicle internal fixation through multifidus intermuscular approach.The levels of surgery-related indicators,the lumbar function[Oswestry dysfunction index(ODI)]scores,the reduction indicators(anterior vertebral height ratio,Cobb angle)levels,and the trauma factor indicators[creatine kinase(CK),myoglobin(Myo),lactate dehydrogenase(LDH)]levels before and after the surgery,and the incidence of complications were compared between the two groups.Results:The operation time,the incision length in the observation group were were shorter than those in the control group,the intraoperative blood loss and the intraoperative fluoroscopy times were less than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the postoperative drainage volume between the two groups(P>0.05).6 months after the surgery,the ODI score of the two groups were lower than those before the surgery,the Cobb angle of the two groups were smaller than those before the surgery,and the anterior vertebral height ratio levels were higher than those before the surgery;however,there were no significant differences between the two groups(P>0.05).3 days after the surgery,the levels of serum CK,Myo and LDH in the two groups were higher than those before the treatment,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The incidence of low back muscle pain in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusions:The pedicle internal fixation through multifidus intermuscular approach and posterior median approach in the treatment of the patients with thoracolumbar fractures is similar,but the former can reduce the operation time,the incision length,the intraoperative blood loss,the intraoperative fluoroscopy times,the trauma factor index levels and the incidence of low back muscle pain.Moreover,it is superior to pedicle internal fixation through posterior median approach.
万方数据
维普
