Journal of Hebei Medical University

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Clinical study of anterior and posterior surgical treatment for thoracolumbar burst fractures#br#

  

  1. Department of Orthopedics, Jianguo Hospital of Zhangjiakou, Hebei Province, Zhangjiakou 075000, China
  • Online:2018-05-25 Published:2018-05-30

Abstract: [Abstract]〓Objective〖HTSS〗〓To explore the clinical effect of the anterior and posterior surgical approach in the treatment of thoracolumbar burst fracture.
〖HTH〗〖WTHZ〗Methods〖HTSS〗〓A total of 60 patients with thoracolumbar burst fracture who were admitted in our hospital from March, 2015 to February, 2016 were included in the study and divided into the anterior group and posterior group with 30 cases in each group according to different surgical methods. The patients in the anterior group were given internal fixation, while the patients in the posterior group were given pedicle screw system treatment. The operation time, blood loss, drainage volume, and total fusion time were recorded. CT was used to measure the anteroposterior diameter and crosssectional area of spinal canal before operation, 1 week and 1 year after operation. Cobb′s angle change value before operation, immediately after operation, and 1 year after operation was observed. American Spinal Injury Association(ASIA) was used to evaluate the neurological function recovery 1 year after operation.
〖HTH〗〖WTHZ〗Results〖HTSS〗〓The intraoperative blood loss and postoperative drainage volume in the anterior group were significantly greater than those in the posterior group, while the operation time and fusion time were significantly longer than those in the posterior group(P<005). The spinal canal stenosis degree 1 week and 1 year after operation in the two groups was significantly improved when compared with before operation(P<005). The comparison of spinal canal stenosis 1 week after operation between the two groups was not statistically significant(P>005). The recovery of spinal canal stenosis 1 year after operation in the anterior group was significantly superior to that in the posterior group(P<005),there was a statistically significant in the interactions between groups, time points, groups and time points. Cobb′s angle after opeation in the two groups was significantly reduced when compared with before operation(P<005), there was a statistically significant in the interactions between groups, time points, groups and time points. Cobb′s angle loss 1 year after operation in the anterior group was significantly superior to that in the posterior group(P<005). ASIA grading 1 year after operation in the two groups was significantly superior to that before operation(P<005).
〖HTH〗〖WTHZ〗Conclusion〖HTSS〗〓The great Cobb′s angle loss is the disadvantage of pedicle screw system therapy, while the internal fixation has a long operation time and large trauma, but the postoperative spinal canal stenosis degree is small, and Cobb′s angle loss is less. Due to the advantages and disadvantages for the two surgical methods, the patients should select the appropriate surgical methods according to the specific circumstance.

Key words: spinal fractures; anterior and posterior surgical, comparative study