Efficacy of computed tomography-assisted limited decompression in the surgical management of thoracolumbar fractures with neurological deficit

计算机断层扫描引导下有限减压术治疗伴有神经功能障碍的胸腰椎骨折的疗效

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Abstract

OBJECTIVE: To investigate the effect of CT-assisted limited decompression in managing single segment A3 lumbar burst fracture. METHOD: A retrospective study (January 2015-June, 2019). One hundred six cases with single-level Magerl type A3 lumbar burst fractures treated with short-segment posterior internal fixation and limited decompression. Patients were divided into two groups: CT-assisted group and non-CT-assisted group. Perioperative factors, clinical outcomes, post-operative complications, imaging parameters, and health-related quality of life (HRQoL) were evaluated. RESULTS: Kyphosis, loss of anterior and posterior vertebral body heights, operative time, and post-operative complications were not significantly different between the two groups. The visual analog score (VAS) and spinal canal encroachment in the CT-assisted group were lower compared with the non-CT-assisted group (p < 0.05). The Japanese Orthopaedic Association (JOA) score, the simplified HRQoL scale, and the American Spinal Injury Association (ASIA) Spinal Cord Injury Grade in the CT-assisted group were significantly higher compared with the non-CT-assisted group (p < 0.05). CONCLUSION: CT-assisted limited decompression in the treatment of single-segment A3 lumbar burst fracture can achieve better fracture reduction and surgical results and improve the long-term recovery of the patients' neurological function and quality of life.

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