中医手法复位联合后路椎弓根钉撑开复位内固定治疗胸腰椎爆裂性骨折的临床研究

Clinical study on treatment of thoracolumbar burst fracture by traditional Chinese medicine manipulation reduction combined with posterior pedicle screw distraction reduction and internal fixation

目的 探讨胸腰椎爆裂性骨折的治疗中采用中医手法复位联合后路椎弓根钉撑开复位内固定手术后,患者相关指标的改变。方法 对郑州市骨科医院骨科在2021年12月30日—2022年12月30日期间收治的胸腰椎爆裂性骨折患者治疗进行分析,从中选取62例进行此次研究,随机分成两组,分别是对照组和研究组,两组患者例数相同均为31例。对照组患者采取后路椎弓根钉撑开复位内固定手术治疗,研究组患者采用中医手法复位联合后路椎弓根钉撑开复位内固定手术进行治疗,后对比两组患者的伤椎Cobb角、疼痛程度[视觉模拟(VAS)评分]、并发症发生率。结果 研究组治疗后1年其伤椎Cobb角小于对照组(P<0.05);研究组并发症发生情况低于对照组(P<0.05);研究组的疼痛程度低于对照组(P<0.05)。结论 对胸腰椎爆裂性骨折患者实施中医手法复位联合后路椎弓根钉撑开复位内固定手术治疗,能改善患者疼痛情况,改善伤椎Cobb角,降低并发症发生率可长期推广。

Objective This article is about the treatment of thoracolumbar burst fracture,the use of traditional Chinese medicine manipulation reduction combined with posterior pedicle screw distraction reduction internal fixation surgery,the patient's related indicators change.Methods Analysis was conducted on the treatment of thoracolumbar burst fracture patients admitted to the Department of Orthopedics of Zhengzhou Orthopaedic Hospital during December 30,2021 to December 30,2022.Sixty-two cases were selected for this study,and were divided into two groups according to the computer lottery,namely the comparison group and the research group.The number of patients in both groups was the same,31 cases.Patients in the control group were treated with posterior pedicle screw distraction and reduction and internal fixation,while patients in the study group were treated with traditional Chinese medicine manipulation and combined with posterior pedicle screw distraction and reduction and internal fixation.Cobb Angle,pain degree visual analog scale(VAS) score and incidence of complications of the injured vertebra were compared between the two groups.Results One year after treatment,the Cobb Angle of the injured vertebra in the study group was smaller than that of the control group(P<0.05).The incidence of complications in the study group was lower than that of the control group(P<0.05).The pain degree of the study group was lower than that of the control group(P<0.05).Conclusion The surgical treatment of traditional Chinese medicine manipulation reduction combined with posterior pedicle screw distraction reduction and internal fixation for patients with thoracolumbar burst fracture can improve the common pain situation of patients,improve the Cobb Angle of the injured vertebra,and reduce the incidence of complications.The effect is recognized by patients and doctors,and can be extended in the long term.