Effect of posterior column stability and decompression on the treatment of lumbar burst fracture with nerve injury and its influence on vertebral body and neurological function
10.3760/cma.j.issn.1008-6315.2016
- VernacularTitle:经后路保留后柱稳定结构减压法治疗腰椎爆裂骨折伴神经损伤患者的效果及其对椎体和神经功能指标的影响
- Author:
Huadeng BAN
;
Qunqiang LUO
;
Xiongge MO
;
Wenwu RUAN
- Keywords:
Lumbar burst fracture;
Nerve injury;
Vertebral body;
Posterior column stability and decompression
- From:
Clinical Medicine of China
2017;33(4):312-316
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the effect of posterior column stability and decompression on the treatment of lumbar burst fracture with nerve injury and its effect on vertebral body and neurological function.Methods Fifty-two cases patients of lumbar burst fracture with nerve injury from February 2005 to July 2014 in Affiliated Hospital of Youjiang Medical College For Nationalities were selected as the research objects and divided into retention group(28 cases) and non-retention group(24 cases) according to the choice of operation method.The surgical clinical efficacy,the changes of the vertebral body and nerve function were compared between two groups.Results At 3 months,6 months and 12 months after operation,the fusion rate,sagittal diameter and the height of the injured vertebral body,pre-vertebral body,and intervertebral space were all significantly increased,while the Cobb angle,the pressure area and the sagittal displacement rate were markedly decreased(F of inner grouP=10.492,8.858,7.432,16.311,19.491,10.329,21.587;P<0.05),and the improvement range of Cobb angle,intervertebral space,the pressure area and sagittal displacement rate of retention group were significant better than non-retention group.There was no significant difference on the fusion rate,the volume of bleeding,the incidence of postoperative complications,Denis pain score,the height of injured vertebral body,pre-vertebral body,and sagittal displacement between the two groups(P>0.05).After operation,the ASIA grade gradually improved,neurological function of the retention group recovered at 6 months after surgery,while non-retention group presented this effect at 12 months after surgery,moreover,at 12 months after operation,the proportion of E grade in retention group was 64.29%,higher than that of non-retention group(45.83%,F=12.758,P<0.001).The levels of neuron-specific enolase(NSE),S100B protein and myelin basic protein(MBP) in retention group were significantly lower than those of the non-retention group at 3 months after surgery(P<0.05).The improvement of S100B and MBP in the reservation group at 6 months after surgery were better than those of non-retention group,while at 12 months after surgery,only the improvement of MBP in retention group showed the better effects than non-retention group.Conclusion Posterior column stability and decompression show a high clinical efficacy on the treatment of lumbar burst fracture with nerve injury and it can significantly improve the vertebral body and neurological function.
