Analysis of the causes of complications after internal fixation for thoracolumbar burst fracture

HAN Heng; XIONG Min; HE Ning; WANG Zhi-yong; ZENG Yun; TANG Bing; ZHANG Jun

doi:10.3969/j.issn.1009-4237.2018.05.004

Abstract：Objective To investigate the effect and complication of different surgical methods in the treat -ment of thoracolumbar burst fracture.Methods A total of 94 patients with thoracolumbar burst fractures who were treated in our hospital from Jul.2014 to Feb.2016 were divided into observation group and control group according to different treatment methods,with 47 cases in each group.In the control group, there were 27 males and 20 fe-males,with an average age of(56.33 ±2.94)years;in the observation group there were 25 males and 22 females, with an average age of(56.13 ±3.24)years.The control group was treated with posterior short -segment pedicle screw fixation;and the observation group was fixed with screw rod system.+bone grafting +posterolateral bone grafting.The postoperative complications and prognosis of the two groups were recorded.Results All patients had completed the surgery,and there was no significant difference in the operation time between the two groups.Howev-er,in the hospitalization time and intraoperative blood loss, the observation group was significantly less than the control group.At 1 month after surgery, the incidence of complications such as incision infection, implant break-age,lung infection,and implant loosening was 4.3% in the observation group and 21.3% in the control group. The observation group was significantly less than the control group(χ2=2.781,P<0.05).All complications im-proved after symptomatic treatment.The neurological function scores of the observation group and control group at one month after operation were(6.13 ±0.78)points and(5.09 ±0.71)points,respectively,which were signifi-cantly higher than preoperatively((2.87 ±0.67)points and(2.81 ±0.71)points)(P<0.05).The neurologi-cal function score in the observation group was significantly higher than that in the control group at 1 month after sur-gery(P<0.05).The Cobb angles of the injured vertebral body in the observation group and the control group at vertebral body in the observation group at 1 month after the operation was also significantly lower than that in the control group.(P<0.05).Conclusion The complications of internal fixation in treating thoracolumbar burst frac-ture are common.The application of internal fixation with screw system,bone grafting and posterolateral bone graft can reduce the occurrence of complications, and promote recovery of postoperative neurological function and Cobb angle of the injured vertebral body,thus promoting the recovery of patients.