The Applied Research Of AO Classification, Load Sharing And IG Grade Rules In The Treatment Of Unstable Thoracolubar Fractures

BackgroundBecause thoracolumbar vertebrae is between the relatively moving thoracic vertebrae and the relatively stiff lumbar vertebrae ,this kind of anatomic specificity causes that the most frequent fracture is the thoracolumbar fracture in spine. Because the complex specificity of the thoracolumbar anatomy and wounding mechanism ,though there were several classifications or grade rules about thoracolumbar fracture , when depended on one kind of classification or grade rule , some fractures in clinical practice can not be rightly evaluated before operation , thus surgical approaches and choices of instrumentation of these patients can not be selected correctly and failures of internal fixations often happen when passed a period of time after operation, the effective evaluating standard about the combination of classification and grade rule is still absentobjectiveThe objective of this study was to investigate the clinical value about the combination of AO classification, Load- Sharing and Instability grade(IG) rules in guiding the proper surgical approach. Methods95 cases with unstable thoracolumbar vertebral fractures were accepted in our hospital, the surgery and choice of instrumentation of these patients were guided by the combination of AO classification, Load- Sharing and IG grade rules. 79 cases of them were followed up, the clinical value about the combination of AO classification, Load- Sharing and IG rules can be evaluated by observing the clinical effects. Results1.16 cases of them with incomplete injury of nerve were recovered at least 1 Frankel grade and waist pain was evaluated according to Denis's Pain Scale, the results showed P1 56 cases, P2 17 cases, P3 6cases. 2. After the surgery of posterior approach of internal fixation and reduction , the average reduction of anterior body height is 6.59 mm and the average reduction of sagittal index is 15.68;After the surgery of anterior approach , the reduction of the anterior body height is 12.9mm and the average reduction of sagittal index is 20.75°; After the anterior-posterior combined internal fixation , the reduction of anterior body height is 15.07mm and the average reduction of sagittal index is23.8 °.There were significant difference between the radiological index of the preoperative and the postoperative(P<0.05).3. No failure of internal fixation was observed in the fixation. ConclusionThe combination of AO classification , Load Sharing and IG grade rules is a perfect assessment in guiding proper surgical approach and the choice of instrumentation in thoracolumbar fractures.