Clinieal Study Of Operative Treatment Of Thoracolumbar Burst Fractures Without Neurological Deficit

Objective To compare the thoracolumbar burst fracture posterior surgical decompressionor not decompression effectiveness，discuss the selection of treatment，explore the methods oftreatment of such fractures.Methods From Department of Orthopaedics,Hospital Affliliated to Ning Xia MedicalUniversity, posterior-instrumentation operations thoracolumbar burst fracture in49cases,decom pression29cases, not decompression20cases from Desember2010to Desember2012reviewed retrospectively. Preoperative Frankel grade is E-Class, Fracture segmentsT_ll-L2,（the T119cases, T1215cases, L113cases L212cases）Preoperative film lateralradiographs of the thoracolumbar vertebral CT scan plus reconstruction and MRI plain scan,to assess fracture stability. After surgery, respectively, the two groups of patients withoperative time, blood loss, pedicle spacing, postoperative vertebral body to restore height, andafter review of fractures to satisfactory level and sagittal change the situation for statisticalanalysis.Conclusion Decompression operation time was120±20min, intraoperative blood losswas500±91ml, vertebral height ratio of preoperative59.58disabilities12.92%immediatelyafter87.33±76%at follow-up,85.53±18%of the Cobb s’ angle before surgery19.67persons11°immediately after6.77±82°, and follow-up,7.65±82°, the sagittal diameter of the casepreoperative34.55±71%, postoperative7.62±35%. Operative time was75±15min,intraoperative blood loss was200±96ml, not decompression of vertebral height ratio ofpreoperative63.13disabilities13.65%, a postoperative instantly90.62±09%, followed up for87.41±37%of Cobb s’ corner17.21Guests of the preoperative52°immediately after6.63 ±15°, the follow-up7.01disabilities22°, the sagittal diameter of the case preoperative26.39±24%, postoperative23.72±51%. the symptoms without neurological symptoms aggravateafter orthodontic protrusion deformity. No internal fixation looseness and complications suchas screw breakage. Decompression group and the non-decompression group compared by t testbetween the two groups come to decompression surgery time, blood loss, and follow-up ofvertebral height loss of the larger, the spinal canal sagittal diameter recoverygood, butimmediately after the vertebral body to restore height of Cobb s’ angle of the two groups wasno significant difference.Results1.No neurological symptoms of thoracolumbar burst fractures,50%of the criticalvalue of the fracture fragments broke into the spinal canal, it is not necessary to open thespinal canal, not decompression;2.the critical value of fracture fragments broke into the spinalcanal should be held more than50%decompression;3. thoracolumbar burst fractures brokeinto the spinal canal, but no symptoms of nerve compression, decompression is not moreconducive to the vertebral height and the Cobb s’ angle recovery;4. without neurologicalsymptoms of thoracolumbar burst fractures of the posterior internal fixationThe surgery is notdecompression surgery with the patient time is short, less blood loss, trauma, cost, etc.