Comparative Analysis Of Clinical Efficacy In Posteriorsurgical Decompression Of Different Treatment Of Thoracolumbar Burst Fracture

Objective:Retrospective study of therapeutic effects after different methods of treatment with posterior approach of thoracolumbar burst fracture, therapeutic effects and the factors are analyzed here.Methods:Select 40 patients with thoracolumbar burst fracture who were treated in Department of Orthopaedics Affiliated Hospital of Shandong University of TCM infirmary from June 2006 to DEC.2009, divide them into two groups according to the different ways of decompression with method of decompression treatment with posterior approach transpedicular screw fixation. Each group includes 20 patients. One group is the direct decompression which means to remove one or two vertebral canals of the spinal canal that with posterior approach transpedicular screw-rod system,20 patients; the other group is indirect decompression with pure transpedicular screw-rod system,20 patients. According to the statistical analysis, datum from the two groups obtained great comparability. Arrange 6 to 24 months'follow-up of patients in the two groups. Judge the effects based on the observation of intraoperative and postoperative complications, fractured vertebral body's prevertebral height recovery, reclamation of Cobb angle, placeholder of the bones in spinal canal and the recovery conditions of the spinal cord function.Results:1. There are great significances when compared the fractured vertebral body's prevertebral height recovery, reclamation of Cobb angle and recovery of spinal canal capacity before and after the operation of the two groups (P< 0.01), while there are no significances between the two groups after the operation(P>0.05).2. During the moderate and advanced period (1-2 years) of direct and indirect decompression, there are no significances between the neural function resume situation (P>0.05).3. During the moderate and advanced period (1-2 years) of direct and indirect decompression, there are great significances between complication occurrences and the independent living (P<0.05).Conclusion:The pedicle screw fixation for the treatment of thoracolumbar fractures is a kind of safe, reliable and effective method. Taking direct and indirect decompression of the nerve function recovery after surgery for advanced can achieve the desired therapeutic effect. However, comparing indirect decompression and direct decompression, direct decompression after surgery for advanced is easy to cause pedicle screw loosening, spinal instability and secondary spinalcord, cauda equina injury and a series of complications associating with the surgery.