Clinical efficacy analysis of thoracolumbar fracture with nerve injury treated by trans-traumatic screw placement and micro-decompression

doi:10.3877/cma.j.issn.2095-9141.2021.04.003

Abstract

Abstract:

Objective

To investigate the effect of trans-traumatic screw placement and micro-decompression in the treatment of thoracolumbar fractures with nerve injury.

Methods

From April 2017 to February 2019, 65 cases of thoracolumbar fractures with nerve injury were treated with short segment fixation in in Neurosurgery Department of the 900^th Hospital of Joint Logistics Team. The improvement of anterior height ratio and sagittal Cobb angle were observed before the operation and 1 week, 6 months and 12 months after the operation. Visual analogue scale (VAS) and Oswestry disability index (ODI) of lumbar spine were observed to evaluate the effect of operation. Follow-up for 12 months to check the grading improvement of American Spinal Injury Association (ASIA).

Results

In 65 patients, the anterior height of the injured vertebral body gradually increased and the Cobb angle gradually decreased (P<0.05), the scores of VAS and ODI after operation were significantly improved compared with those before operation, the differences were statistically significant (P<0.05). All patients were followed up for 12 months. There were no broken nails and short rods. Fracture healing were good, and no new neurological dysfunction. The ASIA grade was improved in varying degrees compared with that before operation.

Conclusion

The technique of pedicle screw fixation combined with micro-decompression can improve the stability of thoracolumbar fracture complicated with nerve injury and promote the recovery of nerve function.

Key words: Thoracic and lumbar vertebrae fracture, Pedicle screws, Micro-decompression, Neurosurgery

Liang Xue, Liangfeng Wei, Zhaocong Zheng, Yehuang Chen, Lianjie Li, Shousen Wang. Clinical efficacy analysis of thoracolumbar fracture with nerve injury treated by trans-traumatic screw placement and micro-decompression[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2021, 07(04): 203-206.

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References 19

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指标	伤椎前缘高度比(%)	Cobb角
术前	47.8±8.5	27.6°±6.4°
术后1周	73.5±7.2^a	13.7°±4.5°^a
术后6个月	85.6±8.4^ab	12.5°±4.8°^ab
术后12个月	91.9±5.7^abc	8.4°±2.7°^abc
F值	126.403	856.306
P值	<0.001	<0.001

指标	伤椎前缘高度比(%)	Cobb角
术前	47.8±8.5	27.6°±6.4°
术后1周	73.5±7.2^a	13.7°±4.5°^a
术后6个月	85.6±8.4^ab	12.5°±4.8°^ab
术后12个月	91.9±5.7^abc	8.4°±2.7°^abc
F值	126.403	856.306
P值	<0.001	<0.001

指标	VAS	ODI
术前	5.93±0.86	58.24±20.76
术后1周	1.85±0.63^a	40.81±5.88^a
术后6个月	0.73±0.42^ab	25.66±4.72^ab
术后12个月	0.52±0.38^abc	24.65±3.59^abc
F值	879.302	116.508
P值	<0.001	<0.001

指标	VAS	ODI
术前	5.93±0.86	58.24±20.76
术后1周	1.85±0.63^a	40.81±5.88^a
术后6个月	0.73±0.42^ab	25.66±4.72^ab
术后12个月	0.52±0.38^abc	24.65±3.59^abc
F值	879.302	116.508
P值	<0.001	<0.001

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