Efficacy Of The Preloading Lordotic Rod On The Internal Fixation Of Thoracolumbar Fractures

Background and purpose:To compare the feasibility and clinical efficacy of the preloading lordotic rod on the treatment of thoracolumbar fractures with the posterior pedicle-screw internal fixation.Methods: a retrospective analysis of 52 cases of thoracolumbar fracture surgery from Shengjing Hospital,the second affiliated hospital of China Medical University from January 2010 to October 2017.These patients with clinical data,including 25 cases recieved the preloading lordotic rod fixation surgery are chosed as the observation group(A group),27 cases recieved the reducting straight rod fixation,as the control group(group B).Measurements and calculation of fractured vertebral segment angle and height as well as the Cobb angle,statistical comparison of the reducting rate of the fractured vertebrae,the rate of correction loss,change of Cobb angle and the failure rate of the internal fixation.were taken relatively in the two groups before and after operations and the last follow-up with the coronal and sagital digital X-ray(DR)or 3D thoracolumbar CT.Results: The average follow-up time are 15.52 months(3 ~ 51 months),and there is no statistically significant difference between the two groups in general clinical data.By the statistical analysis,results can be seen respectively that in group A and group B,injuried vertebral anterior height percentage: preoperative values are0.622±0.156 ? 0.647 ±0.165.postoperative values are0.889 ±0.129?0.900 ±0.138,the values of the last follow-up are0.824 ±0.870,0.647 ±0.165,respectively,with no significant statistical difference(P > 0.05).Cobb Angle: 1 week after surgery,-1.60 ±-3.00?-4.67 ±6.872,no statistically significant difference(P < 0.05).At the end of the follow-up,there is a statistically significant difference(P < 0.05),which is-3.56 ± 7.578?-8.93 ±8.348.The correction degree of Cobb Angle in group A and group B are 11.44 ± 10.348?6.44 ±3.886,respectively,and there is a significant difference(P < 0.05).The loss of Cobb Angle was2.04 ±1.369?8.19 ±4.740,respectively,with statistically significant difference(P < 0.05).Cobb Angle,Cobb Angle correction degree,postoperative follow-up Cobb Angle loss degree,internal fixation failure of group A in the last follow-up are significantly superior to group B,with statistically significant difference(P < 0.05).Conclusion: compared with the reducting fixation technology using the straight rod,prebending the connecting rod to make a 15°~25 ° lordosis in the preloading internal fixation of thoracolumbar vertebral fracture is favorable for correction of kyphotic deformity and can reduce the postoperative correction loss in the long time.