Clinical Analysis Of Lumbar Burst Fractures Rear Fenestration Retentionrear Complexus And Posterior Vertebral Stability

Background: lumbar fractures is a relatively common injury, cause of injury in the trafficaccident, falling injury, sports injury, other parts of the head, chest and abdomen with theinjury. Mechanism of injury is buckling, stretching, rotation, compression force, but mainlyin composite force. Damage stability depends on the clinical symptoms and imagingexamination. In clinical, imaging data of lumbar burst fracture patients often have clear orspecific performance, including X-ray kyphosis angle, abnormal, vertebral bone fragmentsand trailing edge CT bone fragments into the spinal canal, the performance is often used asthe indication for operation, think they exist cause damage or affect the nerve functionrecovery. Although lumbar burst fractures are common, in the clinical treatment of extensive,considerable controversy still exists for adapting to the specific operation method and thestability of the treatment of fractures of the lumbar burst fracture operation.Objective: To investigate the effect of lumbar burst fractures rear fenestration retention rearcomplex and traditional incision decompression laminectomy of two different surgicaloperation treatment for thoracolumbar burst fractures.Methods: retrospective analysis by selective76lumbar burst fracture cases from2009~2013years, including36cases of burst fracture of lumbar laminotomy retains rear rear complexoperation treatment, the other40cases by traditional laminotomy decompression in thetreatment by clinical examination. X ray and CT performance evaluation to determine theindex. Evaluation of spinal cord function to admission first examination (non operationtreatment) or preoperative last medical examination (operation treatment) as the standard,as far as possible to eliminate the transient spinal cord dysfunction caused by spinal cordconcussion. At the same time, according to the different parts of the fracture plane ismeasured and the corresponding CT kyphosis angle (Cobb angle) and spinal bonesoccupying degree, analysis of two kinds of surgical treatment. By statistical analysis, theburst fracture of lumbar laminotomy retains rear rear complex and traditional laminotomydecompression in two kinds of stability and traumatic for comparison; and discuss theadvantages and disadvantages of two kinds of operations, including the relief of symptoms iscomplete, exploration of myelinated nerve oppression, if injury is fully, completely. Results: the burst fracture of lumbar laminotomy retains rear rear complex surgery thantraditional laminotomy decompression in the rigid internal fixation on only one side of thevertebral lamina under the protection of removing a small part of the lamina of bone, similarto open a window on the vertebral lamina, the greatest degree of preservation of the posteriormatch fit, also retained the vertebral spine structure, its stability is preserved to the maximumextent, and avail functional recovery. Two patients recovered after operation removed spinalscrew-rod system after the vertebral segment activity function of lumbar vertebrae is almostnot affected. The excision of spinal posterior complexus of severe damage to the longitudinalspinal stability, postoperative lumbar activity decreased significantly in patients withexcessive, the intervertebral joint almost lose activity, multiple injury patients with lumbarstiffness is obvious. After statistical analysis, the vertebral height, Cobb angle and the nervefunction score were significantly different between two kinds of methods followingoperation.Conclusion:1. Compared with the traditional laminotomy decompression, the new operation method hadless damage on the posterior character body, the maximum retained the posterior vertebralstructure and stability, and the spinal nerve function sequence and nerve effect of patientswere significant recovery.2. The vertebral segment activity function of lumbar vertebrae is almost not affected beforesecond operation after the new operation method.3. The new operation method of posterior laminectomy of preserving the posterior complexafter lumbar burst fractures, suitable for patients with no spinal nerve damage or injuryminor.