Non-surgical And Surgical Treatment Of TLICS 4 Points Of Thoracolumbar Vertebral Burst Fractures

Background Currently thoracolumbar burst fractures spinal fractures in the largest proportion, for no neurological disorders such fracture treatment remains to be determined, the conservative and surgical treatment have advantages and disadvantages, in this context, it should be how to choose treatment programs are essential.Objective To compare surgical and non-surgical treatment without neurological dysfunction of thoracolumbar burst fracture clinical efficacy and research thoracolumbar fractures TLICS (Thoraolumbar Injury Classification and Severity Score) classification system score of 4 cases of treatment chosen Guiding significance.Methods A retrospective analysis from October 2013 to October 2015 during a visit to the Affiliated Hospital of Chengdu University of Traditional Chinese orthopedics 52 patients met the inclusion criteria TLICS score 4 points of thoracolumbar burst fractures were, in accordance with its random number table divided into two groups, namely traction hyperextension pressing method with cushions Act (26 cases of non-surgical group) and non-vertebral decompression without a top cross-segment pedicle screw reduction surgery (4 nails) (26 cases surgery group) were collected were observed in the treatment or surgical operation time, bed time, hospital stay, the leading edge of vertebral compression height, kyphosis angle (Cobb angle), visual analog pain scoring system (VAS), spinal Oswestry Disability index questionnaire (ODI index) difference, and the data were statistically analyzed.Result Selected patients were followed up, no loss cases were followed up for 9-12 months, mean 10.3±1. June. Two groups in gender, age, injury way affected vertebral segment, the leading edge of the vertebral height compression ratio before treatment, comparisons Cobb angle, VAS score, ODI index, was not statistically significant, comparable (P> 0.05); two groups of patients after treatment in different ways, in operation time, bed time, hospital stay, vertebral compression ratio and anterior height of vertebral kyphosis Cobb angle before treatment and 1 week after treatment and last follow-up and other indicators, we can draw two research programs were statistically significant (P<0.05). Operation group at bed time, hospital stay, improved Cobb angle instantly restore vertebral height aspect better than the leading edge non-surgical group, and the difference was statistically significant (P <0.05). But in the long-term observation found that the leading edge of vertebral compression height and Cobb angle are present corresponding loss between the two groups was not statistically significant (P> 0.05). Both groups VAS score, ODI index improving aspects than before treatment decreased significantly improved, the difference was statistically significant (P<0.05), especially at the beginning of treatment or after (within the first 3 months) in the surgery group improved VAS ratings and ODI advantage indices (P<0.05), but in the late (after 6 months) and the last follow-up, compared to no clear difference between the two groups, the difference was not statistically significant (P> 0.05).Conclusions Two treatment programs can be effective in restoring vertebral height of the leading edge, correct kyphosis, relieve pain, improve lower back dysfunction. In the surgery group fixed immediately restore vertebral height of the leading edge, improved Cobb angle, VAS and ODI score early, shortening the bed and non-surgical group compared with more advantages on length of stay, but the cost of treatment is relatively expensive and have to take a second within surgical trauma and risk. Non-surgical treatment group, the operation time is shorter, lower cost, non-invasive surgical bleeding, avoiding the use of antibiotics and the risk of anesthesia, reduce scar adhesions and other issues. Two long-term treatment (after six months) the efficacy, the leading edge of the vertebral height loss, Cobb angle loss, improve patients’pain and corresponding spinal dysfunction, no significant difference. Should choose a relatively reasonable solution according to the actual situation of the disease in patients with clinically.