Observation on the efficacy of vertebral canal decompression,prying reduction,bone grafting,and internal fixation in the treatment of thoracolumbar burst fractures with nerve injury
Wu Yahong
Huang Fang
Pei Xiaopeng
Zhou Xiaoguang
Li Yili
Abstract：Objective To investigate the clinical efficacy of vertebral canal decompression,prying reduction,bone grafting,and internal fixation in the treatment of thoracolumbar burst fractures with nerve injury.Methods Ninety patients with thoracolumbar burst fractures and nerve injury were randomly divided into a control group(n=45,treated with conventional posterior pedicle screw internal fixation)and an observation group(n=45,treated with vertebral canal decompression,prying reduction,bone grafting,and internal fixation)using a random number table.The ratios of the anterior height of the injured vertebra,Cobb angle of the injured vertebra,proportion of the mid-sagittal diameter of the spinal canal at the injured level,the Visual Analogue Scale(VAS)score,and the Japanese Orthopaedic Association(JOA)lumbar score were compared between the two groups before surgery and at 3 months postoperatively.Additionally,the American Spinal Injury Association(ASIA)nerve injury grades were compared before surgery and at 6 months postoperatively.Continuous follow-up was conducted for 12 months,and the bone graft fusion rate and internal fixation failure rate were calculated for both groups.Results Compared with preoperative values,at 3 months postoperatively,both groups showed an increase in the ratio of the anterior height of the injured vertebra and the proportion of the mid-sagittal diameter of the spinal canal at the injured level,along with a decrease in the Cobb angle of the injured vertebra.The magnitude of change in these indicators was greater in the observation group than in the control group,with statistically significant differences(all P<0.05).Compared with preoperative values,at 3 months postoperatively,both groups exhibited a decrease in VAS scores and an increase in JOA scores,with the observation group showing lower VAS scores and higher JOA scores than the control group,the differences were statistically significant(both P<0.05).Compared with preoperative values,at 6 months postoperatively,both groups demonstrated significant improvement in ASIA neural injury grading,with the observation group showing superior ASIA grading to the control group at this time point,a difference that was statistically significant(P<0.05).The bone graft fusion rate in the observation group was 95.56%,higher than that in the control group(86.67%),while the internal fixation failure rate in the observation group was 6.67%,lower than that in the control group(13.33%),although these differences between groups were not statistically significant(both P>0.05).Conclusions Vertebral canal decompression,prying reduction,bone grafting,and internal fixation exhibit favorable clinical efficacy in treating thoracolumbar burst fractures with nerve injury,effectively restoring local anatomical structures,alleviating postoperative pain,and promoting the recovery of nerve and lumbar functions.
Keywords：spinal fracturesburstvertebral canal decompression pry reductionbone graft internal fixationlumbar function
Publication Date：2025-07-20
Online Publishing Date：2025-08-21(First online date of this platform, not the publication date of the document)
Pages：5( 397-401 )