A Comparative Study on Functional Recovery, Complications, and Changes in Inflammatory Factors in Patients with Thoracolumbar Spinal Fracture Complicated with Nerve Injury Treated by Anterior and Posterior Decompression.

ABSTRACT

BACKGROUND The aim of this study was to evaluate 2 methods to treat patients with thoracic lumbar spine fracture with merging spinal cord injury, including complications of surgery and the influence of inflammatory factors. MATERIAL AND METHODS Eighty patients were randomly divided into an anterior decompression group (study group) or a posterior decompression group (control group) to observe perioperative complications, evaluate preoperative and postoperative nerve function, and evaluate the 6-month injured vertebral height and Cobb angle of the vertebral bodies. The expression level of TGF-ß2 on day 1, day 7, day 15, and day 30 after treatment was detected by enzyme-linked immunosorbent assay (ELISA). RESULTS The nerve function sensation score, the height of the vertebral body, and the recovery of Cobb angle were better for the anterior decompression group than the posterior decompression group and the effect was significant (P<0.05). The complication rate for the posterior decompression group was lower than the anterior decompression group. The level of TGF-ß2 in the anterior decompression group was higher than in the posterior decompression group for the same times after day 1, day 7, day 15, and day 30 after treatment (P<0.05). CONCLUSIONS Patients who had thoracic lumbar spine fracture with merging spinal cord injury and who had anterior fixation achieved a good fixation effect; their neurologic and vertebral injury recovery was better. However, this relatively complex and traumatic surgery must consider the clinical manifestations and fractures of the patients and select the appropriate surgical approach.