Posterior indirect reduction and internal fixation and laminectomy in the treatment of thoracolumbar vertebrae burst fracture complicated with spinal cord injury / 局解手术学杂志

ABSTRACT

Objective To explore the clinical effect of posterior indirect reduction and internal fixation and laminectomy in the treatment of thoracolumbar vertebrae burst fracture complicated with spinal cord injury.Methods Eighty patients with thoracolumbar vertebrae burst fracture and spinal cord injury treated in our hospital from March 2014 to March 2015 were selected as the objects,and they were divided into reset group and laminectomy group with forty cases in each group according to surgical method.All the patients were followed up for 1 year,the lumbar function of two groups at 1 week and 1 year after operation were observed respectively,and the pain degree was observed in 1month,3 months and 6 months after operation.The amount of bleeding,operation time,hospitalization time and fracture healing time were observed.Neurological function was assessed by classification criteria of the American Spinal Cord Injury Association(ASIA),and incidence of complications was figured in the two groups.Results The anterior heights of the injured vertebra were higher than those before the operation,and the Cobb's angles were lower than those before the operation,the differences were significant(P ＜ 0.05);while there was no significant differences in the anterior heights of the injured vertebra between the two groups at 1 week and 1 year after operation(P ＞ 0.05).VAS scores of the two groups after 1 month,3 months and 6 months decreased significantly when compared with the preoperative scores(P ＜ 0.05),and VAS scores of each time in the reset group were significantly lower than those in the laminectomy group(P ＜ 0.05).The amount of bleeding,operation time,hospitalization time and fracture healing time in the reset group were less than those in the laminectomy group (P ＜ 0.05).The neurological function recovery of the two groups were significantly improved when compared with that before the operation(P ＜0.05).There was no significant difference in recovery of neurological function between the two groups(P ＞ 0.05).The complication rate was 7.50％ in the reset group,lower than 12.50％ of the laminectomy group,the difference was significant (P ＜ 0.05).Conclusion Posterior indirect reduction and internal fixation of lamina both have a certain effect in the treatment of thoracolumbar vertebrae burst fracture complicated with spinal cord injury.But posterior indirect reduction has less complications and less amount of bleeding,which is beneficial to postoperative recovery.