显微镜下脊髓髓内外减压、灌洗疗法在慢性颈髓损伤中的疗效及机制

Evaluation of Vertebral Function and Long-Term Quality of Life after Percutaneous Minimally Invasive Surgery in Patients with Thoracolumbar Spine Fractures

OBJECTIVE

To investigate the changes in vertebral function after minimally invasive surgery in patients with thoracolumbar spinal fractures and investigate the impact of percutaneous minimally invasive surgery on patients' quality of life by following up the patients in the long term.

METHODS

A retrospective analysis was performed to select 80 patients with thoracolumbar spinal fractures treated in our hospital from April 2013 to October 2018, and the patients were divided into a study group and a control group according to the difference in their choice of procedure. The two groups were compared in terms of perioperative wound pain, serum creatine kinase (CK) activity, and C-reactive protein (CRP) levels, and the two groups were followed up for 2 years to compare the changes in anterior vertebral body height and Cobb's angle during the follow-up period and to compare the differences in quality of life between the two groups.

RESULTS

(1) The pain level of patients in the study group was significantly lower than that of the control group at the 1st and 3rd postoperative days (p < 0.05). (2) The CK activity and CPR level of patients in the study group were significantly lower than that of the control group at the 1st and 3rd postoperative days (p < 0.05). (3) Compared with the preoperative period, the height of the anterior border of the vertebral body and the Cobb's angle in both groups showed significant changes at 7 d, 6 months, one year, and two years after surgery (p < 0.05), suggesting that both procedures can significantly restore the height of the injured vertebra and improve the function of the vertebral body. (4) The somatic, physical, and psychological functions of patients in the study group were significantly greater than those in the control group at 6 months postoperatively (p > 0.05).

CONCLUSION

Compared to traditional open surgery, minimally invasive percutaneous surgery for thoracolumbar fractures can significantly reduce perioperative pain and improve perioperative stress in patients, while achieving better surgical outcomes and a significantly improved quality of life in patients at long-term follow-up.

A feasibility study of modified self-efficacy for the improvement of adverse emotions and quality of life in traumatic fracture patients

OBJECTIVE

To investigate the changes in the adverse psychologies and psychological coping at the late stage of self-efficacy intervention in traumatic fracture patients.

METHODS

A total of 80 traumatic fracture patients admitted to our hospital were recruited as the study cohort and randomly divided into two groups. The control group (n=40) underwent conventional post-fracture nursing, and the study group (n=40) underwent self-efficacy intervention combined with conventional post-fracture nursing. After the intervention, the changes in the anxiety and depression, self-efficacy, quality of life, and the psychological coping scores were assessed and compared between the two groups. Finally, the correlations among the self-efficacy, adverse emotions, and psychological coping scores were analyzed.

RESULTS

Before the intervention, there was no marked difference in the anxiety and depression, self-efficacy, life satisfaction, and psychological coping scale scores between the two groups (P > 0.05). At 1, 3, and 6 months after the intervention, the study group had remarkably lower hospital anxiety and depression scale (HADS) scores and significantly higher self-efficacy, quality of life and psychological coping scale scores than the control group (P < 0.05). The correlation analysis showed that the general self-efficacy scale (GSES) scores were negatively correlated with the self-rating anxiety scale (SAS) and the self-rating depression scale (SDS) scores (r=-0.8623, r=-0.6895, P < 0.05) and were positively correlated with the psychological coping scale scores (r=0.7196, P < 0.05).

CONCLUSION

Self-efficacy intervention can markedly improve the adverse emotions and the self-efficacy and quality of life scores in traumatic fracture patients. The patients' self-efficacy is significantly positively correlated with the psychological coping scores. Therefore, self-efficacy intervention can be implemented to improve the traumatic coping abilities of traumatic fracture patients.