Clinical Research Of Unstable Sacral Fracture With Cauda Equina Nerve Injury

objective By summarizing and analyzing the clinical data of patients with unstable sacral fracture and cauda equina nerve injury,this paper explores the optimal operation time,mode and effect of unstable sacral fracture with cauda equina nerve injury.Methods The clinical data of Eighteen patients with unstable sacral fracture and cauda equina nerve injury treated in our hospital from November 2011 to November 2017 were retrospectively analyzed.Eighteen patients were treated with posterior nerve decompression and internal fixation by the same treatment group.Through statistical analysis of clinical data of patients,the most appropriate internal fixation operation method was selected.Comparing and analysing the Preoperative and Postoperative date of Majeed score,Visual analogue scale(VAS),Matta standard,Lindahl standard,International Index of Erectile Function 5 to evaluate the effect of surgical treatment on nerve function recovery and fracture healing.Results There are many internal fixation methods for unstable sacral fractures,but the lumbosacral-pelvic internal fixation is the most choice in this group.All patients were followed up for more than 12 months.Eighteen patients received surgical treatment within 2 to 14 days after injury,with an average of 7.1 days.The operation time ranged from 80 to 180 minutes,with an average of 125 minutes.Intraoperative bleeding ranged from 200 ml to 1400 ml,with an average of 660 ml.At 12 months after operation,all patients in this group showed bone healing according to Lindahl imaging score.Postoperative Majeed scores of 18 patients were excellent in 5 cases,good in 3 cases,moderate in 7 cases and poor in 3 cases.The excellent and good rate was 44.44%.No patients had progressive exacerbation of symptoms.Preoperative International Index of Erectile Function 5(IIEF-5)for male patients showed that there were 1 cases of mild erectile dysfunction,5 cases had moderate penile erectile dysfunction and ten cases had 7 penile erectile dysfunction.12 months after operation,IIEF-5 showed that there were 7 cases of mild erectile dysfunction,5 cases of moderate erectile dysfunction and 4 cases of severe erectile dysfunction.The scores of Visual analogue scale(VAS)at the last follow-up decreased from 8.56(+0.78)to 2.44(+1.15)on average,and the difference was statistically significant(P<0.05).Conclusion This group of patients with unstable sacral fracture and cauda equina nerve injury is mainly suitable for lumbosacral-pelvic internal fixation.If there is no operative contraindication for patients with unstable sacral fracture and cauda equina nerve injury,early surgical treatment is recommended.The cauda equina nerve should be repaired as far as possible during operation to create conditions for the recovery of nerve function.Posterior surgery is relatively simple,safe and popular.Early rigid internal fixation can make patients walk with load as soon as possible,as well as significantly reduce the incidence of fracture complications.