Effect Of Endplate Rupture Of Thoracolumbar Fracture In Young Adults On Prognosis Of Operation

Objective:This study explored whether there is a correlation between the degree of endplate rupture and the patient’s surgical prognosis.Objective To objectively evaluate the effect of endplate injury on the postoperative curative effect of thoracolumbar spine fractures,and to guide physicians to evaluate the patient’s condition reasonably.Methods:According to the established inclusion and exclusion criteria,40 patients who were diagnosed as single-segment thoracolumbar fractures with upper endplate injury during the period of January 2018 to January2020 in the our hospital were screened and reviewed.Sexual analysis.According to the CT sagittal reconstruction of the cross-sectional area of the endplate rupture or the height of the lowest point of the endplate rupture <50%,≥50%,they were divided into a mild endplate rupture group(23 cases)and a severe endplate rupture group(17 cases).The general data of the two groups of patients,such as age,gender,injury segment,and cause of trauma,were statistically analyzed.There was no statistical difference in general data of the two groups of patients(P>0.05),which was comparable.Both groups were treated with open posterior short-segment pedicle screw fixation.The injuries of the two groups were compared before operation,1 week after operation,3 months after operation,1 year after operation,and the last follow-up.Loss rate of anterior vertebral height,Cobb angle of injured vertebra,VAS score and ODI index,calculated the loss rate of anterior edge of injured vertebra and the degree of change of Cobb angle of injured vertebra at the last follow-up,and counted the intervertebral disc through the CT image data at the last follow-up" The occurrence of the "vacuum" phenomenon.The results were statistically analyzed to evaluate the impact of the degree of endplate rupture on the prognosis of surgery.Results:There was no significant difference in VAS score and ODI score between the two groups of patients before operation,1 week after operation and 3 months after operation(P value>0.05),but the difference between the two groups was statistically significant at 1 year after operation and at the last follow-up(P value <0.05).There was no significant difference in the loss rate of the front edge height and the Cobb angle of the injured vertebrae between the two groups in a short period of time(P value>0.05),but the difference between the two groups was statistically significant(P value<0.05)at 1 year postoperatively and at the last follow-up.According to the CT images of the last follow-up,it was found that of 23 people in the mild endplate rupture group,only 6people had a "vacuum" in the intervertebral disc,while 10 of the 17 people in the vacuum endplate rupture group had a "vacuum" in the intervertebral disc.The chi-square test was performed(P value <0.05),and it was considered that there was a significant difference in the occurrence of "vacuum" in the intervertebral disc between the mild endplate rupture group and the severe endplate rupture group(P value<0.05).Conclusion:1.Compared with the mild endplate rupture group,the severe endplate rupture group has a poorer prognosis of pain relief.2.Compared with the mild endplate rupture group,the severe endplate rupture group was relatively poor in maintaining the height of the vertebral body and maintaining the corrective angle.3.Compared with the mild endplate rupture group,the severe endplate rupture group is more prone to degeneration of the intervertebral disc adjacent to the injured endplate.