[Surgical treatment of type-C thoracolumbar fractures]

To explore the operative approach and method of internal fixation for the treatment of type-C thoracolumbar fractures.

T wenty-eight patients (male 20, female 8, ranging in age from 20 to 54 years, with an average of 38.5 years) with type-C thoracolumbar fractures were invovled in the study. Distributed segments involved T11 in 2 patients, T12 in 3 patients, L1 in 11 patients, L2 in 8 patient, L3 in 3 patients and L4 in 1 patient. Twenty-six patients were followed up (range from 12 to 20 months). According to the analysis of X-ray and CT image,height of vertebral body, Cobb angle on sagittal and coronal plane and the percentage of occupancy of vertebral canal were measured. The recovery of nerve, happening of back pain and the failure of internal fixation were observed.

The preoperative averaging height-loss decreased from 37.4% to 6.8% and the deformation of coronal plane was completely rectified. The preoperative averaging Cobb angle on sagittal plane recovered from 22.3 degrees to 5.6 degrees and the preoperative occupancy of vertebral canal averaging recovered from 33.7% to 5.9%. The difference was statistically significant (P < 0.05). Moreover, after 1 year follow-up, the changes of the above-mentioned index was no statistically significant (P > 0.05). Except for 8 patients with complete nerve damage losing the possibility of recovery, the others with incomplete nerve damage obtained 1 to 3 degree's improvement. The ratio of back pain occurrence was 19.2%. There was no failure of internal fixation.

The treatment of thoracolumbar type-C fractures with simple posterior long-segment internal fixation or posterior long-segmental fixation added by anterior autograft fusion is a reliable and effective method. The short-term therapeutic effect is satisfactory and the long-term therapeutic effect is to be further observed.