The Study Of Minimally Invasive Treatment Of Thoracolumbar Fracture With Non-nerve Injury Fixation With New Modified Techniques

Objective:Implant pedicle screw through a small incision in the paravertebral muscle to treat thoracolumbar fracture with non-nerve injury under the navigation of C-arm machine.Materials and Methods:There are 30 cases of unstable thoracolumbar fracture patients,with fracture segment from T11to L2.The pre-operative standard positive and lateral X-chip and CT scan of vertebral body and pedicle were taken,to measure the length of upper and lower vertebral body and pedicle,as well as e angle.Under the navigation of C-arm machine,positioning upper and lower vertebral body and bilateral pedicle.Taken the middle longitudinal incision,down to the thoracolumbar fascia,dissection along the fascial layer sneak and pull out.Take thoracolumbar fascia incision about 1.5 cm at the level of upper and lower pedicle,revealed paravertebral muscle and then longitudinal separate with hemostatic forceps reach to small articular process and sub-mastoid.Take the outer edge of the pedicle on X ray film as a screw point,drilling in accordance with the angle e.When the outer edge of the pedicle screw reach the inside edge,on the lateral film, just by the screw into the pedicle from the posterior edge to the front.After the pedicle screw implantation is completed,pre-bent rod will be fixed on screw nail bed along the muscle tunnel,and then locking screw caps.Both simultaneously,finally have the vertebral fracture reducted and fixed.Results:The height of the anterior vertebral body had been recovered from 57.4%to 92.4%in 30 cases.The height of intervertebral space had been recovered from 5.2mm to 24.4mm.And the cobbs angle decreased from 14.5 to 8.5.The obstruct index of the vertebral canal decreased from 2.8 to 0.6.After 12 month follow-up,the Oswestry index number showed the function rehabilitation well.Conclusion: This surgery is minimally invasive approach,and preoperative measurement of e angle improved the safety of surgery.Using this technique in the treatment of thoracolumbar fracture with non-nerve injury,not only significantly reduced injury and bleeding,reduced time and cost of hospitalization,but also Low back pain in patients was mild,exercise can be carried out earlier,it is worth promoting.