Abstract:Objective To discuss effectiveness of different diagnostic methods diagnosis and treatment outcome of thoraco1umbar spine and spina1 cord injury combined with thoracoabdomina1 injury,in order to provide reference for c1inica1 research.Methods 120 cases from January 2010 to January 2012 admitted to our hospita1 thoraco1umbar spine and spina1 cord injuries patients combined with thoracoabdomina1 injuries were se1ected,of which 46 cases with thoracoabdomina1 injury were set as concurrent group,the other 74 cases of unconso1idated thoracoabdomina1 injury as nonconcurrent group.38 cases were treated by spina1 externa1 fixation apparatus combined with percutaneous vertebra1 body bone graft surgery,posterior transpedicu1ar interna1 fixation combined with vertebra1 p1asty in the treatment of 27 cases,and posterior vertebra1 arch fixation in treatment of 9 cases in nonconcurrent group.Spina1 externa1 fixation apparatus combined with percutaneous vertebra1 body bone graft surgery was used in the treatment of 16 cases,posterior transpedicu1ar interna1 fixation combined with vertebra1 p1asty in the treatment of 23 cases,and posterior transpedicu1ar interna1 fixation surgery in the treatment of 7 cases in concurrent group.The operation,hospita1ization time,diagnosis of B u1trasound and CT fau1t,the inf1uence of surgery on neura1 function and prognosis of two groups were observed.Results Un1ess 2 cases died (of which 1 cases sp1enic rupture and 1 case hemopneumothorax),operations on other cases were comp1eted smooth1y in concurrent group;nobody died in nonconcurrent group.Operation time,intraoperative b1eeding and hospita1ization time in concurrent group were higher than those in nonconcurrent group(a11 P<0.05);Operation resu1ts were the go1d standard,diagnostic accordance rate of B u1trasound was 71.74%1ower than that of CT(95.65%)(P<0.05);Sensory and motor nerve function score in concurrent group at the end of fo11ow_up were higher than those before operation(P<0.05);Compared with the same index in conconcurrent group at the same period,the difference was no statistica1 significance;exce11ent rate of 95.95%in nonconcurrent group was higher than 72.73%in concurrent group(P<0.05).Conclusion For patients with thoraco1umbar spine and spina1 cord injury,shou1d take a variety of inspection methods,in order to reduce the misdiagnosis and missed diagnosis,and give preferentia1 treatment to endanger the 1ife of thoracoabdomina1 injury,regard1ess of whether the associated organ injury,different spina1 fixation for patients on 1ong_ term movement,sensory nerve has no affect.
Offiah C,Twigg S.Imaging assessment of penetrating eran_ iocerebra1 and spina1 trauma[J].C1in Radio1,2009,64(12):1146_1157.
[2]
Rajasekaran S.Thoraco1umbar burst fractures without neur_ o1ogica1 deficit:the ro1e for conservative treatment[J].Eur Spine J,2010,19(1):40_47.
[4]
Ender SA,Esch1er A,Ender M,et al.Fracture care using percutaneous1y app1ied titanium mesh cages(OsseoFixR)for unstab1e osteoporotic thoraco1umbar burst fractures is ab1e to reduce cement_associated comp1ications——resu1ts after 12 months[J].J Orthop Surg Res,2015,10(1):175_ 181.
[5]
Tumia1ánLM,Wa1kupRR,GuptaSK,etal.Minima11yinvasive retrieva1 of a bu11et from the L5_S1 neura1 foramina after transperitonea1 gunshot wound[J].Spine J,2008,9(2):169_ 173.
Weninger P,Schu1tz A,Hertz H.Conservative management of thoraco1umbar and 1umbar spine compression and burst fractures:functiona1 and radiographic outcomes in 136 cases treatedbyc1osedreductionandcasting[J].ArchOrthopTrauma Surg,2009,129(6):207_219.
Robert Morrison,Schnake KJ.Correction of a mobi1e post_ traumatic kyphosis in the thoraco1umbar spine with a combined posterior_anterior approach[J].Eur Spine J,2015,24(Supp1 8):955_956.
[15]
LiaoJC,FanKF,ChenWJ,etal.Transpedicu1arbonegrafting fo11owing short_segment posterior instrumentation for acute thoraco1umbar burst fracture[J].Orthopedics,2009,32(5):493.