The role of the posterior elements of the spine in the classification of th oraco-lumbar burst fractures and spinal cord injuries / 中华骨科杂志

ABSTRACT

Objective To observe the role of the posterior e lements of the spine in the spinal cord injuries and to provide the basic evidence for proper evaluation of the se verity of spinal cord injuries and th e possibilities of functional recove ry.Methods Experimental studyThe experiment al model of spinal burst fracture was established in the thoraco-lumbar column section which subjected high velocity vertical loadi ng in static pattern.The pressure changes in the vertebral canal and the severity of posterior elements of the spin e were observed,and then their relationship was studied.Clinical StudyThe data were obtained from 127consecutive cases of thoraco-lumbar burst fracture associated with paraplegia.The relationship between t he severity of spinal cord injury,functional recovery and the posterior elements injuries was studied retrosp ec-tively.Results The experimental study showed that g reat pressure changes appeared in th e vertebral spec-imens without posterior elements in juries.On the contrary,the peak value of pressure was low in cases with posterior elements injuries.Clini cal results:Of 38cases(69.09%)with spinal cord injuries in 55patie nts without posterior elements injurie s,functional recovery was found in 24cases(63.16%).In another group,of 52cases(72.22%)with spinal cord injuries in 72patie nts with posterior elements injurie s,functional recovery was found in 20cases(38.46%).The statistic difference between t he two groups indicated that the severity of spinal cord injuries in t he patients without posterior eleme nts injuries was more severe than that with posterior elements injuries.Conclusion The spinal posterior elements play a n important role in spinal cord injuries.The severity of posterior elements injuries can be used as a sca le in the evaluation of the severity o f spinal cord injuries,functional re covery and improvement of Denis classification.[