| Objective Through the study of patients with lumbar type A fractures treated by posterior short segmental fixation,to study the effect of different internal fixation time on fixed unfused segments.Methods Retrospective study 80 cases of lumbar fracture of the orthopaedics of general hospital of Ningxia Medical University treated by posterior short segment pedicle screw fixation fusion during 2013.9 to 2016.9,Including 45 males and 35 females,The age was from 32 to 55 years,the average was 38 years;the follow-up time was from 12 to 24 months,the average was 18 months;The cause of injury: high fall injury:30 cases(37.5%),traffic accident injury: 35 cases(43.8%),falling down injury: 5 cases(6.2%),heavy object injury: 10 cases(12.5%);Fracture segments: all of single-segment fractures,Among them,there were 32 cases(32%)fractured in L1,25 cases(31.3%)fractured in L2,18 cases(22.5%)fractured in L3,5 cases(6.2%)fractured in L4,fractures and 0 cases(0%)fractured in L5;Type of fracture: According to AO classification,all fractured type were A fractures,including A1 type 49 cases(61.2%),A2 type 26 cases(32.5%),A3 type 5 cases(6.3%);All patients had no spinal cord,nerve injury.According to postoperative fixation time,divided into two groups: Group A: 1 year after removal of internal fixation,a total of 40 cases;B group: 2 years after removal of internal fixation,a total of 40 cases.80 patients all do lumbar X-ray film,CT,MRI examination before fracture surgery and after internal fixation.Before the fracture surgery and after removal of internal fixation,to measure Anterior vertebral height,middle vertebral height,posterior vertebral height,vertebral wedge angle On the X-ray film.To observe CT and MRI images of lumbar vertebrae fractures before the fracture surgery and after removal of internal fixation,The Weishaup image grading criteria were used to evaluate the fixation of unfixed segments,the degeneration of the end plate and the intervertebral disc of the fixed unfused segments were evaluated by the Modic degeneration standard and the Pfirrmann grading system.Use the SPSS17.0 software to analyze the degenerative differences of fixed and unfused segments between the two groups.Results 1.The loss of vertebral wedge angle correction in group A and group B were 1.42 ± 1.26 and 2.83 ± 2.09,Comparison internal fixation after fracture with Fracture before surgery,The difference of the datas of AVH,MVH,PVH and vertebral wedge angle between group A and group B were statistically significant(P <0.05),except for preoperative MVH(P = 0.095)and the correction loss of MVH(P = 0.057),there was no significant difference between the two groups.2.Comparisoning the two groups of patients of the fixed and untreated segments degeneration before surgery And after internal fixation,there was significant difference(P <0.05);Comparisoning the two groups of patients of the fixed unfinished segmental disc degeneration before surgery And after internal fixation,there was significant difference(P <0.05);Comparisoning the two groups of patients of the Fixed unfinished segment end plate degeneration before surgery And after internal fixation,there was significant difference(P <0.05);3.One-year internal fixation of short-segmental fixation of lumbar type A fractures had different degrees of degeneration compared with those who had internal fixation for 2 years,but 1 year after operation Removal of internal fixation can effectively slow down the immobilized segmental degeneration.Conclusion To use the Posterior short segmental fixation to treat the lumbar type A fractures were satisfactory clinical efficacy;1 year after removal of internal fixation can effectively slow down the fixed unfused segment degeneration. |
PDF Full Text Request