Experimental Study Of Thoracolumbar Spine Fracture Reconstruction Of The Three Columns

Objective: This paper systematically describes the geometric positioningtranspedicular decompression of vertebral bone grafting pedicle reconstruction intreatment of thoracolumbar fracture in clinical application effect, and recovery;Tofurther clarify in the geometric positioning transpedicular decompression of vertebralbone grafting pedicle reconstruction and method of positioning with laminectomy andfixation compared which advantage to have; and also provide a theoretical basis andpractical basis for new treatment of thoracolumbar spine fractures.Method: There were allegedly operation of thoracolumbar spine fractures in40cases from Bone one department of affiliated hospital of Yan’an Univer sity. Divided intotwo groups. Take the geometric positioning transpedicular decompression of vertebralbone grafting pedicle reconstruction fixation and method of positioning withlaminectomy and fixation respectively. After recording two groups of operation time,bleeding volume in operation, C arm fluoroscopy times, to evaluate the two groups ofpatients with nerve function recovery through preoperative, postoperative andfollow-up X-ray and CT scan comparison of vertebral height restoration, Cobb anglecorrection and loss. According to postoperative anteroposterior and lateral position X andCT axial scan observation of pedicle screw placement, assessment of the spinal canaldecompression, bone graft and healing.Result: After6-13months follow-up (average of10.56+/-1.45months), foundthat the two postoperative cases without neurological injury and other complications. Group A bleeding volume and X fluoroscopic times were significantly less in group B.Group A and group B operation time without obvious difference. After2weeks of twogroups of vertebral height and Cobb angle have no significant differences; the two groupsafter3months of vertebral height and Cobb angle have significant differences, A groupof orthopaedic loss rate is lower in group B, group A operation effect is better than that ofgroup B. After3months of A, B two groups,CT showed the volume of vertebral canalwere returned to normal80%above. After3months,6months follow-up of two cases ofnerve function improvement, there is no significant differences. Observe the pediclescrew placement through postoperative anteroposterior and lateral position X and CTaxial scan, the accuracy rate of93%in group A, group B accuracy rate of81%, therewere significant differences, the accuracy rate of group A is higher than that in group B.Group A without internal fixation failure, group B appearance of1case of internalfixation loosening. A and B two groups of patients were no broken bone pieces fromphenomenon, there were no wound infection and don’t heal the wound.Conclusion: The geometric positioning transpedicular decompression of vertebralbone grafting pedicle reconstruction fixation is a more ideal spinal surgery method. Ithas small trauma, less bleeding during operation, accurate screw placement,intraoperative fluoroscopy times, less postoperative vertebral injury of vertebral heightand Cobb angle lost less postoperative fixation, etc, and has good application prospect.But this topic sample number less, surgical technique is still not perfect, must havefurther study the clinical effect.