Analysis Of The Classification And Treatment About Muti-level Noncontiguous Spinal Fractures

Discontinuity more segmental spinal fracture in clinical(multilevel non-contiguous spinal fractures,MNSF)increase in the number of cases,the healer to further improve the classification for the choice of treatment requirements,and in the clinical treatment just rely on single segment or experience,and there is no perfect classification can guide treatment,many scholars put forward and improve the related parting,but does not have a type can be summarized to guide the treatment of all points.This paper consists of four chapters,and presents the classification and treatment analysis of multi-segment discontinuous spinal fractures.By analyzing the existing typing,collecting the existing cases,studying the fracture types,distribution and treatment methods,the classification of multi-segment discontinuous spinal fractures and the treatment of the type should be classified to help spinal surgeons better understand and treat the disease.Chapter1 Previous classification of muti-level non-contiguous spinal fracturesObjectives The deficiency of previous classification was analyzed to provide theoretical basis for the classification of new multi-segment discontinuous spinal fractures.Methods A retrospective analysis was conducted on 221 cases of multi-segment discontinuous spinal fractures,which were divided according to the latest Kanna method in foreign countries.The unclassifiable fractures were found by using imaging data,and the reasons for unclassifiable fractures were summarized.Results 69 cases(31.2%)could not be classified.Among the 38 cases,at least 1 fracture segment crossed the segment defined in the definition,25 cases had segmental fracture plus segmental external fracture,and 6 cases had more than 3 discontinuous fracture segments.Conclusions 1.As the latest classification abroad,Kanna method cannot classify all fractures.2.Too many fracture segments and not enough flexible definition are the reasons for the unclassification.Chapter2 An exploratory study on the classification of new muti-level non-contiguous spinal fracturesObjectives To present the new muti-level non-contiguous spinal fracturesMethods Using the reasons of unclassification in chapter 1.Meantime,on the basis of domestic classification,a new multi-segment discontinuous spinal fracture was proposed by combining the length of the severely injured segment and the normal interval segment,and 221 cases were classified again.Results 221 cases of multi-segment discontinuous spinal fractures(497 fractures)were divided into five types: IA119 cases,IB62 cases,IIA22 cases,IIB4 cases,and IIIA14 cases,with the classification rate of 100%.Compared with Kanna method,the proportion of nonclassification decreased to 0(p < 0.001).There was statistical significance between type II and type I and type III,but no significant statistical significance between type I and type III.Conclusions 1.The new classification can classify all fractures.2.When the fracture is type II,the external force may damage each fracture segment more evenly,resulting in less type II surgery than type I and type III.Chapter3 Clinical application of new muti-level non-contiguous spinal fractures classificationObjectives To verify the role of new multi-segment discontinuous spinal fracture classification in guiding the treatment of this type of spinal fracture.Methods The new classification was used to classify 221 cases of fracture,and the relationship between AB type and operative fixed segment was analyzed.The fixed range of single segment and less than 4 segments is called short segment fixation,and the fixed range longer than or equal to 4 segments is called long segment fixation.Results Long segment fixation in multiple fractures of IA(59/88),single segment fixation in IB(35/45),long segment fixation in IIA(4/5),short segment fixation in IIB(0 cases),and long segment fixation in IIIA(8/14).There was A statistical difference between A and B in the selection of long and short segment fixation.Conclusions1.The majority of type A fractures are fixed in long segment during multiple fracture operations,while the majority of type B fractures are fixed in short segment.2.New typing contains more clinical information and is a more complete typing system.