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| 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 |
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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.
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2021, Vol. 27 
