Evaluation of shortsegment pedicle instrumentation combined with decompression in the treatment of thoracolumbar fracture with neurologic deficits
10.3760/cma.j.issn.1673-4904.2013.32.003
- VernacularTitle:后路减压短节段椎弓根内固定治疗胸腰椎骨折伴神经功能不全损伤
- Author:
Xuanxi DING
;
Weihua HOU
;
Jianmin WANG
- Publication Type:Journal Article
- Keywords:
Spinal fractures;
Internal fixators;
Deampression,surgical;
Heurologic deficits
- From:
Chinese Journal of Postgraduates of Medicine
2013;36(32):8-11
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the chnical effect of posterior decompression and shortsegment pedicle instrumentation treating for thoracolumbar fracture with neurologic deficits in different time intervals.Methods Seventy-nine cases of thoracolumbar fracture with neurologic deficits were treated with shortsegment pedicle instrumentation combined with decompression according to the injury and surgery patients with injury of different time interval were divided into ≤24 h group (41 cases) and ＞ 24 h group (38 cases),the curative effect was evaluated by imaging and nerve function recovery.Results Postoperative hospital stay were performed X-ray check,10-14 d after hospital discharge,were primary healing of incision.A total of 79 patients with thoracolumbar fracture combined with neurologic deficits were followed up for 23.5 (15-32) months averagely.Did not appear in the source sex procedure for postoperative infection,nerve injury and postoperative spinal cord injury aggravated phenomenon,not implants rupture,bending and screw loose phenomenon.There was significant difference at 3 d postoperative and the last follow-up in the rate of vertebral compression,cobb' s angle and spinal canal stenosis rate in two groups [≤ 24 h group:(7.9 ± 4.2)％,(8.5 ± 5.0)％ vs.(40.8 ± 8.4)％ and (3.9 ± 2.5)°,(4.2 ± 2.6)° vs.(28.1 ± 13.1)° ; ＞ 24 h group:(8.8 ± 4.8)％,(9.2 ± 4.8)％ vs.(41.7 ± 7.6)％ and (5.3 ± 2.6)°,(5.7 ± 2.7)° vs.(27.6 ± 12.1)°] (P ＜ 0.05),but there was no statistically significant difference between two groups (P ＞ 0.05).The stenosis rate in two groups at 3 d postoperative was obviously better than preoperative[≤24 h group:(5.3 ± 1.5)％ vs.(41.4 ± 6.1)％; ＞ 24 h group:(6.8 ± 1.1)％ vs.(40.5 ± 5.4)％] (P ＜ 0.05),and ≤ 24 h group was superior to ＞ 24 h group,there was significant difference (P ＜ 0.05).At the last follow-up,the neurological function with ASIA grade 1-2 level recovery,≤24 h group mean improved 1.4 level,and ＞ 24 h group mean improved 1.2 level.Conclusion The opertion of pedicle instrumentation combined with decompression with nerve function damage can rebuild spinal stability,favorable neural functional recovery.
