| Objective: To explore the clinical features and epidemiological trends of thoracicand lumbar fractures and to provide clues for clinical prevention, diagnosis andtreatment, as well as prospective studies of thoracic and lumbar fractures.Methods: Data comes from the case of the patients who were diagnosed withthoraco and lumbar fractures and accepted hospitalization treatment in the first hospitalaffiliated to dalian medical university from January2003to January2013.According to the inclusion criteria, confirmed cases all have clear inducing factors,obvious clinical symptoms and signs, and combined with relevant clinical imagingdata;Exclusion criteria removes the false positives cases of the medical recordsystem,and those of not clear diagnosis.Pathological fracture is beyond the scope of thisstudy statistics. The retrospective research about thoracic and lumbar fractures is basedon the1436cases of patients screened out from the bove standard.Patient’s age, gender,injury factors, the distribution of fracture segments, the number of fracture segments,fracture classification and the selection of surgery way were analyzed in this reseach.Results: In1436cases,852are male,584are female, respectively,59.3%and40.7%. Age groups ranging from30to59patients was significantly more than the restof the group;Age groups in terms of gender has significant differences.The femalepatients over60years old group (13.4%) than male (5.5%) and other groups were moremale patients than female patients (P <0.05); In185cases of simple compressionfracture,59patients are male, female patients are126cases, the male to female ratio is 1:2.1;The patients aged over60,40patients are male,99patients are female and themale to female ratio is about1:2.5. Thoracic and lumbar fractures injury factors weremade up with traffic accident injury (35.6%), high falling injury (29.6%), the bruiseinjury caused by heavy object (17.9%), the injury of life and other causes damage(16.9%); Men and women injured by heavy object were no significant difference (P>0.05);Traffic accident injury and high falling injury contribute to the male patients morethan female (P <0.05), while the number of female patients caused by other causesdamage and hurt in life is more than male patients (P <0.05).T11~L2segmentsfracture account for67.8%of the Thoracic and lumbar fractures, T1~T10and L3~L5account for19.0%and13.2%respectively; The most common thoracic and lumbarfracture segment is the single one (65.5%), followed by the double segment (25.9%),multiple segment (8.6%);No matter the thoracolumbar body damage is a single segment,two segment or segments of more than two, T11~L2vertebral body lesions were above65%. Thoracic and lumbar burst fracture in body fracture accounted for the majority(84.2%), including the stability of burst fractures (52.0%), unstable burst fractures(32.2%).Simple compression fractures accounted for12.9%, only2.9%fracturedislocation.The posterior surgery tends to be selected for the treatment of the thoracicand lumbar fractures.The patients suffering from the compression thoracic and lumbarfractures caused by senile osteoporosis or postmenopausal osteoporosis tends to betreated by percutaneous kyphoplasty (PKP), unstable burst fractures tend to chooseposterior vertebral lamina decompression, bone graft fusion and internal fixationstability burst fractures tend to choose posterior decompression and internal fixation.Conclusion:1. High falling injury and traffic accident injury is the major injury factors ofthoracic and lumbar fractures.2. thoracic and lumbar fractures occur in T11~L2vertebral bodies, fracture type isgiven priority to with blowout fracture.3. We currently adopt posterior decompression and internal fixation for thetreatment of unstable thoracic and lumbar burst fracture. 4. Short posterior segmental pedicle screw internal fixation combined with TLIF asa new surgical option for unstable thoracolumbar burst fracture and still needs a largenumber of cases were followed up. |
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