Relationship Between Clinical Factors And The Volume Change Of Vertebral "Shell" After Thoracolumbar Burst Fractures After Surgery

Objective:To analyze the relationship between the volume change of vertebral "shell" the clinical factors in the treatment of thoracolumbar burst fractures with posterior open reduction and indirect decompression and internal fixation.Methods:This study included 52 patients with thoracolumbar single-segment burst fractures who underwent open reduction and indirect decompression and internal fixation in our department from January 2016 to January 2018.3D-computed to-mography scan was performed on these patients before surgery,within 3 days after surgery,and at 6 months after surgery.The volume of vertebral "shell" of each period was calculated by 3D-CT data.The ratio of the change of bone volume in the spinal canal to the immediate postoperative volume at 6 months after surgery is called the resorption rate.The ratio of the change of the volume of the vertebral "shell" to the immediate postoperative volume at 6 months after surgery is called the volume change rate.Factors potentially affecting the rate of volume change of vertebral "shell" include: age,gender,BMI,smoking,fracture segment,fracture type,preoperative compression rate of vertebral,resorption rate,recovery rate of the anterior height of vertebral body after operation,recovery rate of Cobb angle and intervertebral disc injury or not.Single factor analysis and multiple factor analysis were used to study the correlation between these factors and the rate of volume change of vertebral "shell".Results:The rate of volume change of vertebral "shell" had no correlation with age,gender,BMI,smoking,fracture type,recovery rate of Cobb angle,intervertebral disc injury or not(P>0.05).Single factor analysis showed that the rate of volume change of vertebral "shell" was significantly correlated with preoperative compression rate of vertebral body,resorption rate and recovery rate of the anterior height of vertebral body after operation(P<0.05).Multiple factor analysis showed that preoperative compression rate(t=-2.47)of vertebral body and resorption rate(t=5.06)were the main influencing factors for the rate of volume change of vertebral "shell".Preoperative compression rate of vertebral body has a negative influence on the rate of volume change of vertebral "shell" while the resorption rate has a positive effect on the rate of volume change of vertebral "shell"(P< 0.05).Conclusion:The volume change of vertebral "shell" after thoracolumbar burst fracture after open reduction and indirect decompression and internal fixation is influenced by many factors,The preoperative vertebral compression rate and resorption rate are the main factors.Influencing factors.