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| Clinical study on the treatment of thoracolumbar burst fracture with spinal cord injury by modified limited decompression surgery with reserved posterior ligament complex |
| CHEN Feng GUAN Zhong▲ |
| Department of Spine Surgery, Qinghai University Affiliated Hospital, Qinghai Province, Xining 810000, China |
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Abstract Objective To investigate the clinical application of modified limited decompression surgery with reserved posterior ligament complex to treat thoracolumbar burst fracture with spinal cord injury. Methods A total of 90 patients with thoracolumbar burst fractures with spinal cord injury who were admitted to Qinghai University Affiliated Hospital from June 2017 to June 2019 were selected as the research subjects and they were divided into observation group and control group according to the random number table method, with 45 patients in each group. The observation group was treated with posterior approach modified limited decompression internal fixation surgery on the basis of reserving the posterior ligament complex, while the control group was treated with conventional posterior approach decompression surgery. The operation situation and bone graft fusion situation of the two groups were collected and compared. The height of injured vertebrae and cobb angle before and seven days after operation of the two groups were observed and compared. At the same time, follow-up was conducted 12 months after operation to observe the average degree of loss of spinal correction angle and the incidence of complications in the two groups. Results The operation time of the observation group was longer than that of the control group, and the difference was statistically significant (P ＜ 0.05). However, both intraoperative blood loss and intraoperative blood transfusion in the observation group were lower than those in the control group, and the differences were statistically significant (all P ＜ 0.05). The bone graft fusion time in the observation group was shorter than that in the control group, with statistically significant difference (P ＜ 0.05). Within 12 months, the rate of bone graft fusion in the observation group was higher than that in the control group, with statistically significant difference (P ＜ 0.05). After treatment, the height of the anterior and posterior margins of the injured vertebra in both groups was higher than that before treatment, and the cobb angle was lower than that before treatment, with statistically significant differences (all P ＜ 0.05). The average degree of spinal correction angle loss 12 months after treatment in the observation group was lower than that in the control group, and the difference was statistically significant (P < 0.05). Within 12 months after treatment, the incidence of complications in the observation group was lower than that in the control group, with statistically significant difference (P ＜ 0.05). Conclusion The modified limited decompression surgery with reserved the posterior ligament complex has a more significant effect on patients with thoracolumbar burst fractures and spinal cord injury, it can maximize the improvement on the basis of retaining the joint capsule, ligament complex and some spinous processes of patients, and it can maintain the stability of the patient’s spine, reduce the incidence of other complications, which has a good clinical application value.
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