Clinical studies of pedicle screw rod fixation of thoracolumbar burst fractures through posterior unilateral ap-proach after vertebrae corpectomy fusion
10.3969/j.issn.1003-0034.2016.01.007
- VernacularTitle:后外单侧入路椎体次全切融合钉棒固定治疗胸腰椎爆裂性骨折
- Author:
Jun Yong HUA
1
;
Yan Ren WANG
;
Hui Zhi GUO
;
Hong Cun SHU
;
Hua Chao LI
Author Information
1. 富阳市中医骨伤医院
- Keywords:
Thoracic vertebrae;
Lumbar vertebrae;
Spinal fractures;
Spinal fusion
- From:
China Journal of Orthopaedics and Traumatology
2016;(1):27-32
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical curative effect of thoracolumbar burst fracture treated by the posterior uni-lateral approach corpectomy fusion screw rod fixation and anterior corpectomy bone fusion screw plate fixation. Methods:From January 2008 to May 2014,36 cases of thoracolumbar burst fracture underwent operation of decompression,fusion,and internal fixation was retrospective analyzed. Among them ,16 patients were treated through posterior approach as posterior group,including 13 males and 3 females aged from 37 to 62 years old;9 cases caused by falling injury,3 cases by traffic acci-dent injury,4 cases by heavy aboved;the injury segment was on T12 in 2 cases,L1 in 5 cases,L2 in 7 cases,L3 in 2 cases;ac-cording ASIA grade,3 cases were grade A,2 cases were grade B,2 cases were grade C,5 cases were grade D,4 cases were grade E;the time between injury and operation ranged from 5 to 15 days. Other 20 patients were treated through anterior later-al approach as anterior lateral group,including 15 males and 5 females with age from 27 to 62 years old;12 cases caused by falling injury,4 cases by traffic accident injury,4 cases by heavy aboved;the injury segment was on T12 in 2 cases,L1 in 7 cas-es,L2 in 9 cases,L3 in 2 cases;for ASIA grade:4 cases were grade A,2 cases were grade B,4 cases were grade C,6 cases were grade D,4 cases were grade E;the time between injury and operation ranged from 4 to 12 days. The operation time ,bleeding during operation and postoperative drainage volume were observed in two groups ,and the changes of nerve function of ASIA grade,clinical efficacy,improved degree of thoracic and lumbar lordosis,and bony fusion were compared between two groups. Results:All patients were followed up from 12 to 24 months with an average of (15.8±3.3) months. The operation time,bleed-ing during operation,and postoperative drainage volume had no significant different between two groups (P>0.05). As com-pared with preoperative,ASIA grade of two groups at last follow up had statistically significantly different (P<0.01),the neural function of two groups after operation was recovered for different extent. The JOA score of two groups was compared between last follow-up and preoperative,the difference had statistically significant (P<0.01),the two groups showed good clinical ef-fect. The clinical results of ASIA grade,JOA score and RIS had no significant differences between two groups. All patients of two groups were obtained fusion. Thoracic and lumbar lordosis angle improvement degree had no significant difference between two groups,it had significant difference had statistical significance compared with preoperative ,the two approaches could ef-fectively restore the spinal sequence. Conclusion:For patients with thoracolumbar burst fracture just treated by anterior de-compression and reconstruction of anterior column ,according to the degree of operation performer'skill proficiency and the pa-tient'condition to choose,but for patients must performed the spinal canal decompression anterior and posterior,the three col-umn reconstruction to required anterior posterior approach,the posterior unilateral approach corpectomy fusion screw-rod fixa-tion obviously shorten operation time,reduce the operation wound,it is worth the clinical promotion.
