Clinical analysis of anterior and posterior decompressions for treating thoracolumbar spine fractures combined with spinal cord injury

LI Su-ming; HANG Bo-ya

doi:10.3969/j.issn.1009-4237.2016.07.011

Abstract：Objective To compare and analyze the surgical methods and clinical effects of anterior and posterior decompressions for treating thoracolumbar fractures with spinal cord injury .Methods The clinical data of 60 patients with thoracolumbar fractures combined with spinal cord injury in our hospital from May 2013 to Feb. 2015 was retrospectively analyzed .According to the surgical method ,the 60 cases were divided into anterior and posterior groups,with 30 cases in each group .The anterior group was treated with anterior decompression , and the posterior group was treated with posterior decompression .The operation time, bleeding volume,tactile score,motor score,vertebral height,and Cobb’s angle were compared between the two groups .Results The mean blood loss in the anterior group was (598.3 ±46.1)mL, and was (358.2 ±34.1)mL in the posterior group,which was more in the anterior group than that in the posterior group (P<0.05).The average operation time was (201.6 ±21.5)min in the posterior group,and was (243.8 ±16.8)min in the anterior group, which was longer in the anterior group than in the posterior group(P<0.05).There was no difference between the two groups before treatment in tactile and motor score ( P>0.05 ) . After treatment , the average tactile score was ( 56.4 ±12.2 ) points and the motor score was (54.4 ±14.8) points in the posterior group,and was (76.0 ±14.5),(76.5 ±18.3) points,respectively in the anterior group.The two groups were significantly improved after treatment ,and the anterior group improved more significantly than the posterior group (P<0.05).After treatment,the mean anterior Cobb’s angle was (44 ± 5) °,the vertebral height was (3.8 ±0.5) cm in the anterior group,and was (31 ±2) °,(2.5 ±0.4) cm,respec-tively in the posterior group .The two groups were significantly improved after treatment ,and the anterior group im-proved more significantly(P<0.05).Conclusion Anterior decompression in the treatment of thoracolumbar frac-ture with spinal cord injury patients can significantly relieve spinal cord compression and improve tactile and motor function as well as vertebral height and Cobb ’ s angle.It is worthy promoting in clinical practice .