| BackgroundSevere thoracolumbar burst fracture is familiar in clinical practice and it has kinds of treatment methods. The goals of surgical treatment of thoracolumbar spinal fractures include (1) decompression of the spinal canal and nerve roots to facilitate neurologic recovery, (2) restoration and maintenance of vertebral body height and alignment,obtaining a rigid fixation to facilitate nursing care and to allow early ambulation and rehabilitation There have three surgey methods for thoracolumbar burst fracture, Posterior surgery ,anterior surgery , and combined anteroposterior surgery. anterior surgery has a good results in spinal cord decompression, and its especially suitable for patients whose posterior longitudinal ligament is intact. But it has many disadvantages such as too difficcult for operation,long time on operation, cause great traumas and suffering, and postoperative complications are serious. In contrast, Posterior surgery is more popular. Posterior surgery use pedicle screw syeterm to reconstruction the stabilty of the spine, avoid injuring peritoneal aorta and its operative procedure is so simple.Though traditional posterior surgery has a adventage in spinal canal decompression,but it take the continuity and integrity of the spinal as the cost and it has a uncertain effect on making the bone fragment reduce. Seek a more sutiable methods which can do good in decompression and maintain the stability of the spine is very important. ObjectivesThe study made animal model building with calf spine. A microchannel was drilled inside of the pedicle by medical drill. Though this hole we make the fractured bone segments reducted directly and put pedicle screws syeterm. All posterior structures were preserved in operation. Compared the stability indexes in experimental group with them in control group,and found how different between two groups and whether the microchannel would impact the stability of the spine, then provide experimental basis and clinical guiding for clinical application of this method.Materials and Methods1 Choose 12 healthy adult calf, separated the thoracolumbar vertebrae. randomly divided these specimens into two groups after excluded bone disease, microchannel posterior approach decompression and internal fixation group(experimental group) and traditional posterior approach decompression and internal fixation group (control group).each group have 6 specimens.2 All specimens were made for animal thoracolumbar burst fructure model by incremental trauma approach. experimental group use microchannel posterior approach decompression and internal fixation,control group use traditional posterior approach decompression and internal fixation。The 3-dimensional motion of specimens were tested in intacted state,fractured state,fixed state and unloaded state. analysis the data with Spss 10.0 software.3 All specimens were scaned by X-ray machine and CT machine in intacted state,fractured state and fixed state.Results1 There was no significant difference in all stability index between two groups in intact state and fixed state.when the pedicle screws were unloaded, The statistical data of the stability index in experimental group were significantly lower than that of control group (P<0.05).2 All specimens were typical thoracolumbar brust fractures after incremental trauma approach impact. There was no significant difference in Cobb's angle, AVP(anterior vertebral body percentage) and SCD(the sagittal cannal diameter)between two groups in intact state and fixed state. The statistical data of the SCD in experimental group were significantly lower than that of control group (P<0.05).Conclusions1 Microchannel posterior approach decompression and internal fixation give a more stability after operation compared with traditional posterior approach decompression and internal fixation.2 Microchannel posterior approach decompression and internal fixation have a complete decompression effect and give a enough reduction of the fractured bone fragments.
|
PDF Full Text Request