Retrospectively Analysis Of Removal Of Internal Fixation In Thoracolumbar Vertebral Fracture Patients Cured By Unilateral Spinal Bone Graft

Objective: To investigate the clinical efficacy of internal fixation in thoracolumbar vertebral fracture patients cured by unilateral spinal bone graft, used to guide the operation of thoracolumbar vertebral fracture.Methods: During the 2013 September to 2014 October,60 patients with thoracolumbar fracture internal fixations removed by our hospital,who were all cured by the unilateral spinal bone graft and segmental pedicle screw fixation at their previously operation in our hospital,Measured the loss rate of anterior height of facture vertebral, height of intervertebral space,spinal sagittal Cobb angle respectively in preoperative and postoperative in the first operation and postoperative of internal fixation removal by the X-ray and spiral CT scanner,and collecting all the data for the statistical analysis, To collect the data of pain visual analog scale(Visual Analogue Score, VAS) of patients in preoperative,postoperative and final follow–up, and observe the JOA score respectively in preoperative and final follow-up, Those with neurologic damage evaluated by Frankel classification method of neural function assessment,in preoperative and final follow-up.Results: 60 patients were followed up, 32 cases of male patients, 28 female patients with, ranged from 14 months to 24 months follow-up, average duration of time is 18.2 months. Evaluated items of in-patient between preoperative and postoperative: spinal sagittal Cobb angle from(31.22±9.00)°declined to(4.13±1.33)°, loss rate of anterior height of facture vertebral from( 50.23±11.01)% sharply declined to(4.78±1.97)%,The VAS score also have significantly declined from(6.39±1.50)to(2.30±0.89),and the JOA sore was 10.33±2.94.The final follow-up of observed items: spinal sagittal Cobb angle was(4.42±1.33)°.loss rate of anterior height of facture vertebral:(4.79±1.74)%,VAS score was 1.71± 0.77,JOA score was 21.92±3.56..Among the 19 cases with nerve function impaired recovered to be :Grade A:0,Grade B:1,Grade C :2,Grade D:2,GradeE(normal):55,There are no aggravating spinal nerve injury,internal fixation loosening and fracture again.Conclusion: The application of unilateral spinal bone graft and segmental pedicle screw fixation in thoracolumbar vertebral fracture can lead to reconstruction of height of injured vertebral, achieve the satisfactory result of nerve function, kyphosis correction,enhance the stability of the spine.