Clinical Characteristics and Intraoperative Reduction Technique of Thoracolumbar Fractures Combined with Posterior Column Injury.

OBJECTIVE: To analyse the clinical characteristics of thoracolumbar fractures combined with posterior column injury, and explore its intraoperative reduction technique with clinical efficacy. STUDY DESIGN: Descriptive study.                                   Place and Duration of the Study: Department of Orthopaedics, Fuyang People's Hospital, Anhui, China, from December 2017 to 2021. METHODOLOGY: A total of 60 patients met the inclusion criteria, they were divided into two categories according to injury mechanism and imaging characteristics: flexion-distraction injury (FDI) and burst fracture with lamina fracture (BFLF), and their clinical characteristics were analysed. All patients were treated with posterior pedicle screw internal fixation, and different intraoperative reduction methods were adopted for reduction. Measurements of anterior vertebral heights (AVH), local kyphotic angles (LKA), visual analog scale (VAS) and oswestry disability index (ODI) were evaluated preoperative, after operation, and the last follow-up. RESULTS: The two groups of thoracolumbar fractures combined with posterior column injury had different clinical characteristics, and there were significant differences in preoperative imaging related parameters (p<0.05). All patients in the two groups successfully completed the operation, and there were no direct complications related to the operation. The patients were followed up for 12-24 months. Compared with those before the operation, the AVH, LKA, VAS, and ODI immediately after the operation and at the last follow-up were significantly improved (p<0.05). Bone fusion was achieved in all patients. CONCLUSION: Careful and comprehensive preoperative clinical data analysis is the key to diagnosis of thoracolumbar fractures combined with posterior column injury. According to the type of fracture, reasonable selection of intraoperative reduction technique can obtain satisfactory clinical results. KEY WORDS: Burst fracture, Pedicle screw, Internal fixation, Thoracic, Lumbar.