Clinical Observation of the Treatment of Thoracolumbar Burst Fractures with Posterior Unilateral Approach
LEI Jian-fei1，LEI Li-li1，QIN Wei-chang1，CHEN Huan-shi2，REN Zhong-liang3
1.Department of Spinal Surgery,Rong'an People's Hospital of Guangxi,Liuzhou545400,Guangxi,China; 2.Department of Orthopedics,Liuzhou Municipal Liutie Central Hospital,Liuzhou545007,Guangxi,China; 3.Department of Burn and Plastic Surgery,the Second Hospital of Yulin,Yulin719000,Shaanxi,China
Abstract: ObjectiveTo explore the clinical effects of posterior unilateral approach in subtotal vertebrectomy, bone graft fusion and pedicle screw fixation for the treatment of thoracolumbar burst fractures.MethodsFrom January 2014 to March 2016, 41 cases of Denis B thoracolumbar burst fractures were selected. According to the different surgical methods, the patients were divided into two groups. The posterior unilateral approach group (group A, n=23) was treated by the posterior unilateral approach, subtotal vertebrectomy, bone graft fusion and pedicle screw fixation. The lateral anterior approach group (group B, n=18) was treated with the lateral anterior approach. The clinical results of the two groups were compared retrospectively.Results①There was no significant difference in operative time, the amount of bleeding and postoperative drainage between the two groups (P>0.05). ② Both the two groups after 1 week got the Cobb angle improved significantly comparing with preoperative one (P<0.05)， and the 1- year postoperative Cobb angle of group A was lower than that of group B (P<0.05). ③In both groups, the postoperative ASIA grading was better than before (P<0.05); But there was no significant difference between the two groups (P>0.05). ④The clinical total effective rate was 95.65% of group A, which was significantly better than 72.22% of group B (P<0.05).ConclusionIn the treatment of thoracolumbar burst fractures, it is proved to be efficacy of the posterior unilateral approach in the treatment of vertebral subtotal resection, bone fusion and pedicle screw fixation, with better postoperative Cobb angle improvement. It is worthy of clinical promotion.
雷剑飞1，雷黎力1，覃卫常1，陈焕诗2，任忠亮3. 经后外单侧入路手术治疗胸腰椎爆裂性骨折的临床疗效观察[J]. 中国现代手术学杂志, 2017, 21(6): 423-427.
LEI Jian-fei. Clinical Observation of the Treatment of Thoracolumbar Burst Fractures with Posterior Unilateral Approach. Chinese Journal of Modern Operative Surgery, 2017, 21(6): 423-427.
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2017, Vol. 21 
