| Objective:To analyze features of spiral CT reconstruction image of thoracolumbar compression fracture; to investigate the value of diagnosis and different treatments of64-slice spiral CT and reconstruction technique in thoracolumbar compression fracture; to study correlation between kyphotic Cobb angel after thoracolumbar compression fracture in different stages and the distance and the degree of compression of intraspinal retroposition fracture fragments, to study correlation between the compressed degree of the first lumbar (L1) vertebrae and zygapophyseal vertebrae joints to provide theoretic basis for clinical medicine.Methods:A retrospective Image and reconstruction image data from167vertebra compression fracture cases among140patients were collected which examined by MSCT in Gansu Province Traditional Medicine Hospital between2011and2013; diagnosis value of various reconstruction techniques was analyzed on spinal and accessories fracture. MPR reconstruction image on sagittal section was used to examine kyphotic Cobb angel, the degree of compression of vertebrae, and the distance of retroposition fracture fragments. L1vertebrae zygapophyseal vertebrae joints angel and space were all measured. Compression rate of injured vertebrae, kyphotic Cobb angel, and spinal stenosis rate were measured pre-and post-surgery. Changes of lower limb myodynamia were compared under surgery and none surgery circumstances, kyphotic Cobb angel of vertebrae compression fracture in different stages, the distance and degree of compression of intraspinal retroposition fracture fragments, compression rate of injured vertebrae pre-and post-surgery, kyphotic Cobb angel, spinal stenosis rate, Changes of lower limb myodynamia treated by surgery and none surgery were statistically analyzed by SPSS15.0statistic software.Results:1. Thoracic12(T12) and L1vertebrae were mostly fractured; transverse section of MPR reconstruction image showed142vertebrae fracture and several fracture lines in them. Diagnosis of18vertebrae fracture were confirmed by combining sagittal section and7by sagittal and coronal section; sagittal section showed different spinal stenosis among which96cases were severely stenosis and fracture fragments were founded. Among112vertebrae accessories fracture, MRP coronal section showed75 cases accessories fracture and sagittal section showed96cases. VR image had advantages in showing overall and three-dimensional fracture; inner vertebrae fracture lines, spinal and intervertebral space deformation, spinal fracture fragments, and post-fracture internal fixators with no metal artifact.2. T12, L1, and L2vertebrae kyphotic Cobb angel and the compressive degree of vertebrae had significant difference (P<0.05); L3, L4, and L5vertebrae kyphotic Cobb angel had no correlation with the compressive degree of vertebrae (P>0.05) The distance of intraspinal retroposition fracture fragments in different phases had no correlation with the compressive degree of vertebrae (P>0.05)3. The compressive degree of L1vertebrae was correlated with pedicle angel.4. Comparing the compressive degree of vertebrae, kyphotic Cobb angel, and spinal stenosis rate before and1week after surgery, the difference was statistically significant (P<0.01), however, the difference was not statistically significant comparing them6months and1week after surgery (P>0.05)5. The difference of lower limb myodynamia treated by surgery and none surgery was statistically significant (P<0.01)Conclusion:1.64-slice spiral CT and image reconstruction technique showed important value in diagnosing thoracolumbar compression fracture, in confirmation of spinal stenosis rate, in the range of intraspinal retroposition fracture fragments, and in accurate measurement of compressive degree of vertebrae.2. The degree of vertebrae compression fracture of T12, L1, L2had significant correlation with changes of spine kyphotic curvation (P<0.05)。3. The compressive degree of L1vertebrae was positively correlated with sagittal-section pedicle angel.4. Transpedicular vertebrae bone graft combining short segmental pedicle screw internal fixator to treat thoracolumbar burst fracture not only rebuilt the stability of thoracolumbar vertebrae, but also recovered the height of injured vertebrae and rebuilt the force line of spine. The long-term follow-up achieved satisfied efficacy.5. Lower limb myodynamia and spinal-nerve function were improved significantly after the surgery comparing with pre-surgery; comparing with no surgery treatment, lower limb myodynamia improved noticeably after the surgery. |
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