THERAPEUTIC EFFECT OF OSTEOTOMY WITHIN THE CORTICAL SHELL IN TREATMENT OF THORACOLUMBAR BURST FRACTURE WITH INCOMPLETE PARALYSIS
Objective To investigate the therapeutic effect of osteotomy within the cortical shell via the posterior approach to preserve the cortex of the vertebral body in the treatment of thoracolumbar burst fracture with incomplete paralysis.Methods From March 2011 to March 2015,30 patients who suffered from severe thoracolumbar burst fracture with incomplete paralysis underwent subtotal cortical resection via the vertebral pedicle combined with titanium mesh supporting and internal fixation with pedicle screw.The recovery of neurological function was observed during postoperative follow-up,and the change in occupation rate of the spinal canal after surgery was observed to evaluate the surgical outcome.Results All patients were followed up for 7-24 months (mean 17.2 months).The occupation rate of the spinal canal was reduced from (72.48±3.48)％ before surgery to (14.46±1.62)％ after surgery (t =82.754,P＜0.01),and the ASIA score was increased from 265.43±21.80 before surgery to 308.83±16.84 after surgery (t=8.629,P＜0.01).Conclusion In addition to effectively restoring spinal sequence and correcting spinal deformity,osteotomy within the cortical shell can fully reduce the pressure of the spinal canal,restore its volume,remove compression of the spinal cord and the nerve root,and thus create conditions for the recovery of neurological function.Therefore,it is a good method for the treatment of severe thoracolumbar burst fracture.
NETL
NSTL
万方数据
维普
