Observation of Inflammatory Response and Bone Metabolism in the Treatment of Thoracolumbar Fractures with Traditional Posterior Median Approach, Paraspinal Space Approach and Minimally Invasive Percutaneous Approach
HOU Jiangye, ZHANG Ning, CAI Fei, et al
The First Orthopedic Ward, Yulin First Hospital, Shaanxi Yulin 719000, China
Abstract：Objective: To explore the clinical effects of traditional posterior median approach, paraspinal muscle approach and minimally invasive percutaneous approach in the treatment of thoracolumbar fractures. Methods: The selected study subjects were 150 cases of thoracolumbar fractures from January 2017 to December 2019, and they were divided into group A (the paraspinal muscle space approach group received surgical treatment, n=60), Group B (surgery with minimally invasive percutaneous approach, n=30), and group C (surgery with traditional posterior median approach, n=60) according to the random number table. The study compared the three groups of TNF-α, MCP-1, HMGB- 1. CRP, IL-1β, OC, OPG, PICP, PINP, TRACPsb, RANKL, β-CTx, NTX indicators, as well as evaluation of operation time, intraoperative blood loss, hospital stay, and incision length. Results: Repeated measures analysis of variance showed significant difference between the three groups of TNF-α, MCP-1, HMGB-1, CRP, IL-1β, OC, OPG, PCP, PINP, TRACPsb, RANKL, β-CTx, NTX time point. (P<0.05). One-way variance showed that there was no significant difference between the three groups of TNF-α, MCP-1, HMGB-1, CRP, IL-1β, OC, OPG, PICP, PINP, TRACPsb, RANKL, β-CTx, NTX before surgery ( P>0.05); 48h after operation, TNF-α, MCP-1, HMGB-1, CRP, IL-1β, TRACPsb, RANKL, β-CTx, NTX in group A were lower than those in groups B and C, while OC and OPG , PICP and PINP were higher than those in groups B and C , but lower than those of B and C groups (P<0.05). The operation time of group A was shorter than that of group B and C (P<0.05); the blood loss of group A was lower than group C (P<0.05); the blood loss of group A was not significantly different from group B (P>0.05). Comparison of the length of hospital stay of the three groups showed no significant difference (P>0.05). Conclusion: Comparison of the three surgical approaches revealed the paraspinal space approach is more effective, that is, the operation time is short and the inflammation is small.
侯江业, 张宁, 蔡飞, 杨振邦, 李耀章, 董建彬, 贺耀耀. 传统后正中入路椎旁肌间隙入路与微创经皮入路治疗胸腰椎骨折的炎症反应及骨代谢观察[J]. 河北医学, 2021, 27(6): 980-985.
HOU Jiangye, ZHANG Ning, CAI Fei, et al. Observation of Inflammatory Response and Bone Metabolism in the Treatment of Thoracolumbar Fractures with Traditional Posterior Median Approach, Paraspinal Space Approach and Minimally Invasive Percutaneous Approach. HeBei Med, 2021, 27(6): 980-985.
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2021, Vol. 27 
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