| objectiveTo discuss the related problems and effect of treatment to thoracolumbar fracture by AF system, back bone decompression and bone grafting.MethodsIt collect and summarize the treatment of 23 cases with thoracolumbar fracture and compound injury of spinal cord. 16 men, 7 women. 18-54 years old, average 32 years old. Reason of causing injury: Fall 11 cases of wound , 9 cases of wound of traffic accident , weighing 3 wounded directly. Damage segments: T112 example , T129 example , L18 example , L23 example , L31 example. The fracture is according to Denis dividing type: Burst 12 of fracture , bucking lead piece 9 of fracture , fracture dislocate 2. The neural function damages the degree according to Frnakel hierarchical standard: Complete a pair of low limbs paraplegia is A grade, 6; Only feel that has not moved as B grade at will, 8; The complete paraplegia existing in non- functional sport is C grade, 6; Is the D grade that functional sports exist but the movement function with limitation can not belong to completely paralysedly, 2; Is it store in to feel, sports are normal basically, unusually reflect (bladder function obstacle ) as E grade, one. The operation time distance is injured time ld-12d, average 5d..Being admitted to hospital ,the patients were given regular treatment(including lying on flat bed with a soft pillow under thoracolumbar. being treating with Hormone , dehydrate , resist inflammation to the symptom). undergo an operation treatment , do way of fiaing AF system, back bone decompression and bone grafting.The patients lie face down with general anesthesia or continue extradural anesthesia, underlaywith rectangle sea body posture cushion patient both shoulders , upper chest and pelvis under anaesthetizing in general anesthesia, the belly is unsettled .Making the center of injury vertebra ,opening the extensor muscle. lay every one segment sour jujube of backbone dash for ward , vertebra board , upper and lower joint and plant into AF system according to method that recommend by DeWei Zou . Wound is it pigeonhole drainage to shoulder, is it happen to pull out after the one hour , poach the hard plank bed behind the skill, use heavy to measure antibiotic , hormone and dehydrate the medicine. Pay attention to preventing the bedsore.ResultsAfter the operation the Injure vertebra foreordained affinity highly by 49 .8±10. 6 (% ) resumes to 94. 6±3. 2 (%), the vertebra body trailing edge is highly by 82. 3±3. 6 (% ) resumes to97.8± 0.7(%),cobb angle is by 25. 2 + 2. 4 (%) resumes to 5. 2± 1.4(%), the vertebra is in charge of the area by 43. 6±13. 1 (% ) resumes to 95. 3± 3. 2 (%), relatively there are extraordinary significance differences before every index and skill(p<0. 01). The fracture healing time after the operation: 8-12 weeks, average 9 weeks are regular while removing one year later. Following up a case by regular visits after the operation is 0. 5-2years, an average is 1. 2years, felt the level drops or resumes. The neural function is evaluated according to Frankel: 20 patients have improvement in various degree , improve by 1-3 grades , no case of aggravating , 3 do not have obvious result.ConclusionAF system contribute to height , cobb corner , vertebra of body in charge of the area after resuming thoracolumbar roll over, offer a good environment for recovery of the spinalnerve function. The vertebra is in charge of reducing pressure and benifitting the recovery of the spinal nerve function. bone grafting regular to fail in preventing from , it is continue person who send backbone become horn deformity later period key to the nervous lesion to avoid. |
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