Department of Orthopaedic, Haikou Hospital of Traditional Chinese Medicine, 2 Poxiang Road, Longhua District, Haikou, Hainan Province, People's Republic of China.
J Orthop Surg Res. 2020 Nov 13;15(1):532. doi: 10.1186/s13018-020-02075-w.
To evaluate the effect of manual reduction and indirect decompression on thoracolumbar burst fracture.
Sixty patients with thoracolumbar burst fracture who were hospitalized from January 2018 to October 2019 were selected and divided into an experimental group (33 cases) and control group (27 cases) according to different treatment methods. The experimental group was treated with manual reduction and indirect decompression, while the control group was not treated with manual reduction. The operation time and intraoperative blood loss were recorded. VAS score was used to evaluate the improvement of pain. The anterior height of the injured vertebra, wedge angle of the injured vertebral body, and encroachment ratio of the injured vertebral canal were used to evaluate the spinal canal decompression and fracture reduction. JOA score was used to evaluate the improvement of spinal function.
There was no significant difference in operation time and intraoperative blood loss between the two groups. Compared with the control group, the VAS score and the wedge angle of the injured vertebral body of the experimental group 3 days after the operation and the last follow-up were significantly lower than that of the control group, and the difference was statistically significant. The ratio of the anterior height of the injured vertebra of the experimental group 3 days after the operation and the last follow-up was significantly higher than that of the control group, and the difference was statistically significant. The difference of the encroachment ratio of the injured vertebral canal between preoperation and 3 days after operation was significantly higher than that of the control group, and the difference was statistically significant. The bladder function of JOA 3 days after the operation of the experimental group was significantly higher than that of the control group, and the difference was statistically significant. And the rest aspect of JOA on 3 days after the operation and last follow-up of the experimental group has no significant difference compared with the control group.
Manipulative reduction and indirect decompression can obtain a better clinical effect in the treatment of thoracolumbar burst fractures.
评价手法复位联合间接减压治疗胸腰椎爆裂骨折的效果。
选取 2018 年 1 月至 2019 年 10 月期间收治的 60 例胸腰椎爆裂骨折患者，按治疗方法不同分为实验组（33 例）和对照组（27 例）。实验组采用手法复位联合间接减压治疗，对照组未采用手法复位。记录两组手术时间、术中出血量。采用视觉模拟评分（VAS）评估疼痛改善情况，采用伤椎前缘高度、伤椎楔变角、椎管侵占率评估椎管减压和骨折复位情况，采用日本骨科协会（JOA）评分评估脊柱功能改善情况。
两组手术时间、术中出血量比较，差异无统计学意义（P＞0.05）。与对照组比较，实验组术后 3d 及末次随访时 VAS 评分、伤椎楔变角均较低，差异有统计学意义（P＜0.05）；实验组术后 3d 及末次随访时伤椎前缘高度比值均较高，差异有统计学意义（P＜0.05）。实验组术后 3d 及末次随访时椎管侵占率差值均大于对照组，差异有统计学意义（P＜0.05）。实验组术后 3d 时膀胱功能 JOA 评分高于对照组，差异有统计学意义（P＜0.05）。术后 3d 及末次随访时 JOA 其余方面评分与对照组比较，差异均无统计学意义（P＞0.05）。
手法复位联合间接减压治疗胸腰椎爆裂骨折可获得较好的临床效果。
