The Changing Factor In The Disc Height Of Thoracolumbar Fracture Patients After Posterior Fixation And It's Clinical Significance

Thoracolumbar fractures is the most common injury of the spine,and it often leads to neurological deficits,which increase the importance and complicacy of the therapy.What's more,adjcent intervertebral disc often get hurt when thoracolumbar fracture,which leads to kyphosis.The therapy of the thoracolumbar has improved a lot in these years because of the improvement in radiology?biomechanics?inter fixator and operative skills.However,controversy is still remaining.Intervertebral disc is an important component as maintaining spinal stability and height.Thoracolumbar fractures usually accompanies with traumatic adjcent disc lesions,the Morphologic changes and the outcome of disc lesions have an effect on the stability of the spine.Traditional posterior lumbar short-segment fixation does not deal with the intervertebral disc lesions which may cause kyphosis after surgery.Twenty patients with thoracolumbar non-osteoporotic compression compression fractures were retrospectively reviewed,with the average age of 33.5 years old.All were cured by posterior lumbar short-segment fixation.They were followed-up at preoperation,after operation and before internal fixation removal,after internal fixation removal and 6 months after internal fixation removal.Data were from MRI,CT,and X-ray.We use MRI to evaluate the injury degrees of the anterior intervertebral discs and endplates,use CT to evaluate the severity of vertebrae fracture at preoperation.And Intervertebral disc height were measure at X-ray at each follow-up time point(average 14.1 months).There were 16 A1 Thoracolumbar fractures,4 A3 Thoracolumbar fractures.There were 2 T11 Thoracolumbar fractures,10 T12 Thoracolumbar fractures,3 L1 Thoracolumbar fractures,5 L2 Thoracolumbar fractures.Nowadays,relieving compress by fracture,Recover the vertebral height by operation is more and more common.But there are controversial on operative or non-operative on burst horacolumbar fractures,fusion or non-fusion.After doing the observation on patients imaging files,we discovered that the Intervertebral disc height are no differences between type I?II intervertebral disc lesion at preoperation.However,there is an obvious decrease at the Intervertebral disc height of type III?IV Intervertebral disc lesion.Patients who got Intervertebral disc lesion,the loss of intervertebral altitude is higher than patients who don't have an intervertebral disc lesion.And the loss of intervertebral altitude is related to the injury degrees of the anterior intervertebral discs.The loss of intervertebral altitude is higher at type III?IV intervertebral disc lesion than the type I?II intervertebral disc lesion.Above all,we can discovered that intervertebral disc lesion accompanied by Thoracolumbar fractures have problems of collapse of disc height and loss of motion segment height.Therefore,in order to prevent the problems caused by intervertebral disc lesion,which may finally influence spinal instability,we have to remove the intervertebral disc,and resort to intervertebral fusion during the operation.