The Analysis Of Prognostic Relative Factors Of Conservative And Surgical Treatment Of TLICS4Thoracolumbar Fractures

Objective：To compare the clinical efficacy of Conservative and Surgical Treatment ofTLICS4thoracolumbar fractures.Methods: A prospective randomized controlled study wasperformed in63patients with thoracolumbar fracture who were assigned into2groupsfrom December2010through June2012.Group A（n=32）received Conservative treatmentand group B （n=31） received treatment with shortsegment pedicle screwinstrumentation.The assessments included ambulation time，the cost，the failure offixation，the sagital Cobb angle， anterior vertebral body height，VAS and JOA scores.Results: A total of63cases,61cases received followed-up,follow-up time was12-31months,an average of21.2months.Group A was later than Group B in ambulation time, butGroup A was sinificantly lower than Group B in the cos（tP<0.05）.Group B was better thangroup A in correcting Cobb angle and tanterior vertebral body height （P<0.05）.There wasno significant differences in JOA and VAS scores. Conclusions: Although SurgicalTreatment made for correcting Cobb angle and tanterior vertebral bodyheight,Conservative and Surgical Treatment of TLICS4thoracolumbar fractures bothcould improve JOA and VAS scores.They both could be used to treating TLICS4thoracolumbar fractures.But in clinical decisions,it should be combined with the situationof patients and their demands,then make a resonable choice. Objective：To investigate and compare the reliability and reproducibility of TLICS、AO、Denis and LSC classification systems in the diagnosis of thoracolumbar fracture．Method：Thirty-nine thoracolumbar fracture patients with complete clinical data and radiologicdata(including X-ray， CT and MRI)were enrolled． Six observers determined theclassifications according to TLICS、 AO、 Denis and LSC systerns respectively.Theclassification was repeated three months later.The Cohen Kappa test was used to determineintra-observer reliability and inter-observer reproducibility.Result:The averageinter-observer Kappa values for TLICS、AO、Denis and LSC Systems were0.763、0.491、0.649、0.681. The intra-observer agree． ments were0.827、0.715、0.811、0.803．Conclusion：Among the four classification systems,TLICS system has the greatestreliability and reproducibility，and has more value in clinical practice．...