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| LIU Xiaolan,LI Yunhua,LIU Sheting.The traditional anterior surgery versus thoracoscope-assisted minimal incision surgery for thoracolum?鄄bar burst fracture[J].Chinese Journal of Spine and Spinal Cord,2010,20(1):24-28. |
| The traditional anterior surgery versus thoracoscope-assisted minimal incision surgery for thoracolum?鄄bar burst fracture |
| Received:July 15, 2009 Revised:October 27, 2009 |
| English Keywords:Thorocolumbar vertebra Fracture Thoracoscopy Surgical operation Clinical efficacy |
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| English Abstract: |
| 【Abstract】 Objective：To compare the clinical efficacy of the traditional anterior surgical method and the thoracoscope-assisted minimal incision surgery for thorocolumbar burst fracture.Method：62 patients with thorocolumbar burst fracture were treated either by traditional anterior surgery，or by thoracoscope -assisted minimal incision anterior surgery between January 2005 and December 2008.There were 35 patients in traditional group，with 19 males and 15 females，the average age was 42 years，the segements were involved as follows，T11 in 2 cases，T12 in 12 cases，L1 in 18 cases，L2 in 3 cases，and the average kyphotic angle was 19.5°. 33 cases suffered incomplete paraplegia.There were 27 patients in thoracoscope-assisted minimal group，with 15 males and 12 females，the average age was 39 years，the involved segements were T11 in 2 cases，T12 in 9 cases，L1 in 14 cases，L2 in 2 cases，and the average kyphotic angle was 18.8°，23 cases suffered incomplete paraplegia.The early therapeutic efficacy of all patients in both groups was observed by follow-up.Result：All operations were successful，no complication related to blood vessels or spinal injury occurred.In traditional group，the average operation time was 190min，the mean blood loss was 1000ml，the mean drainage volume within the first two days was 450ml，while in thoracoscope-assisted minimal incision group，operation time was 230min，the blood loss was 600ml，the drainage volume within the first two days was 275ml.There were significant difference in these data between the two groups（P<0.05），but no difference in the correction rate of kyphotic angle（P＞0.05） as mean correction angle of the kyphosis was 18.1° by traditional method，18.5° by the minimal incision group.The fellow-up time was 16.5 months（range，from 8~24 months）.There was no failure of internal fixation and no loss of corrective kyphotic angle in two groups，all patients had successfully bony fusion.Postoperative neurological fuction was improved at least Ⅰ degree for all incomplete paraplegia patients.In traditional group，the complications included 5 cases with dynamic ileus，9 cases with iliohypogastric and ilioinguinal nerve injury，3 cases with pulmonary atelectasis，and 1 case with wound healing problem. There were 2 cases with dynamic ileus，3 cases with iliohypogastric and ilioinguinal nerve injury，1 case with pulmonary in thoracoscope-assisted minimal group.All above complications were cured by symptomatic treatment.Conclusion：Both traditional anterior surgery and thorascope-assisted minimal incision surgery for thoracolumbar burst fracture may obtain a satisfactory outcome at early clinical stage，but the thoraco-scope-assisted minimal incision surgery can provide less complication and tissue invasion. |
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