Analysis Of Related Factors Of Vertebral Bone Nonunion After Thoracolumbar Fracture Reduction

Aim: To explore the related risk factors of vertebral body nonunion after thoracolumbar fracture reduction.Methods: A retrospective analysis of 119 patients with thoracolumbar vertebral single-segment fractures treated with posterior short-segment pedicle screw rod reduction and internal fixation from January 2016 to March 2019 in our hospital,followed up for 12-19 months The CT examination was perfected 1 year after operation.A total of 74 patients with complete preoperative and postoperative follow-up imaging data were finally included in the sample size.The incidence of vertebral bone nonunion was observed by CT images of injured vertebral horizontal or sagittal at 1 year after operation.The age,gender,BMI index,preoperative vertebral compression degree,and sagittal plane before operation were recorded.Cobb angle,intervertebral disc integrity before surgery,vertebral nailing after trauma,postoperative fracture reduction and reduction,and other related factors.Univariate analysis and multivariate logistic regression analysis were used to study the relationship between each factor and the occurrence of nonunion in the vertebral body after surgery.The correlation was finally verified by the ROC curve.Results: The vertebral bone nonunion was found in 40 of 74 patients after surgery,with an incidence of 54.05%;35 patients had no clinical symptoms.Univariate analysis showed that the integrity of the intervertebral disc,the degree of compression of the vertebral body,the expansion and reduction of fractures,and the placement of injured vertebral nails were closely related to the occurrence of vertebral bone nonunion(P <0.05).There was no correlation between the BMI index,gender,age,and preoperative sagittal Cobb angle and the occurrence of vertebral bone nonunion(P> 0.05).Multivariate analysis showed that the patient's fracture expansion and reduction,the degree of vertebral compression before operation,and the integrity of the intervertebral disc before operation were independent risk factors that affected the occurrence of nonunion of the vertebral body after surgery.The areas under the ROC curve were: 0.660,0.706,0.646(P <0.05).Conclusion: Preoperative disc integrity,preoperative vertebral compression,and fracture reduction were caused by posterior short-segment pedicle screw system reduction and internal fixation for vertebral bone nonunion after thoracolumbar fracture Independent risk factors.