Posterior decompression screw fixation for treatment of thoracolumbar burst fracture combined with spinal cord injury: evaluation of neurological function / 中国组织工程研究

ABSTRACT

BACKGROUND:The surgical treatment of thoracolumbar burst fracture combined with spinal cord injury is to relieve mechanical compression on the spinal cord and reconstruct spinal stability through internal fixation.This theory is derived from a lot of animal experiments and important biomechanical principles,but the available clinical data are stil scarce.OBJECTIVE:To investigate the efficacy of posterior decompression and screw internal fixation for the treatment of thoracolumbar fractures combined spinal cord compression,and to evaluate vertebral body height,kyphosis angle and neurological function.METHODS:A retrospective study was performed among 75 patients with thoracolumbar fractures combined spinal cord compression,who were recruited from Department of Orthopedics,the First People's Hospital of Shunde District of Foshan City,from January 2010 to February 2013.They underwent posterior decompression and internal fixation.The preoperative and postoperative kyphosis angle,vertebral height and neurological function were compared.RESULTS AND CONCLUSION:The preoperative kyphotic angle was (25.2±2.1)° and postoperative kyphotic angle was (8.8±2.3)°,with significant differences (P ＜0.05).Preoperative vertebral body height was (58.4±14.2)％and postoperative vertebral body height was (92.3±6.8)％.According to ASIA score,48 cases had slight impairment of neurological function,scores more than 40 points,and 45 of them had completely recovered walking ability,the recovery rate was 94％; the remaining 27 cases had moderate or severe neurological function impairment,scoring less than 40 points,and 15 of them appeared obvious recovery of neurological function,therecovery rate was 56％.Posterior decompression and internal fixation for treatment of thoracolumbar burst fracture combined with spinal cord injury can effectively restore the vertebral height and kyphosis,and improve significantly neurological function.