下腰椎爆裂性骨折不同手术方案的选择

doi:10.3969/j.issn.2095-378X.2017.02.001

Abstract

Abstract: Objective To analyze the characteristics of low lumbar burst fractures and the choice of surgery plans.Methods Twenty-two patients with low lumbar burst fractures were included in the study and classified into two groups.Specifically,12 patients who had bone fragment in canal were treated with posterior decompression and short segmental pedicle screw fixation,in which 4 patients were treated in combination with vertebral augmentation; 10 patients had simple vertebral fracture,in which 6 patients received percutaneous pedicle screw fixation and other 4 patients received open surgery with pedicle screw fixation.Average height of anterior vertebral border,average height of injured vertebral body,and Cobb’s angle were evaluated before and after operation with X-ray.Intraspinal mass rate was evaluated on CT scan,neurofunction with American Spinal Injury (ASIA) Association impairment scale (AIS),and clinical outcomes using visual analogue score (VAS) and oswestry disability index (ODI).Results All patients were followed up for 24-56 months after successful operations,with an average of (32.9±11.4) months.The average height of anterior vertebral border changed from preoperative (23.8±5.3) mm to (31.9±3.4) mm two weeks after operation and (30.2±4.0) mm in the last follow-up (P<0.05).The average height of injured vertebral body changed from preoperative (24.3±4.6) mm to (30.3±2.9) mm two weeks after operation and (29.7±3.1) mm in the last follow-up (P<0.05).The Cobb’s angle increased from preoperative (9.2°±9.6°) to (18.5°±7.0°) two weeks after operation and (16.3°±7.3°) in the last follow-up (P<0.05).The intraspinal mass rate decreased from preoperative 43.6% (30%-70%) to postoperative 7.72% (0%-15%).AISA scores increased 0-1 grade.VAS score and ODI score of low back pain showed significant improvement after operation (P<0.01).Conclusion Low lumbar burst fractures,which are unstable,should be treated with surgeries as early as possible.The best choice of surgery depends on the stability of spine,nerve injury,intraspinal mass,and complications.

Key words: Low lumbar, Burst fracture, Surgery

CLC Number:

R683.2

HU Xiao, ZENG Zhili, JIA Yongwei, XU Wei, WANG Jianjie, ZHAN Xinhua, ZHAO Jingwei, CHENG Liming. Choice of surgeries for low lumbar burst fractures[J]. Surgical Research and New Technique, 2017, 6(2): 73-77.

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Choice of surgeries for low lumbar burst fractures

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