[Clinical characteristic and surgical treatments for the fresh thoracolumbar fracture-dislocation combined with paraspinal muscles, ligaments and intervertebral disc ruptures].

OBJECTIVE

To analyze the clinical characteristics of fresh thoracolumbar fracture-dislocation combined with paraspinal muscles, ligaments and intervertebral disc ruptures and to discuss the surgical procedure for the fracture.

METHODS

The clinical materials of 15 patients who suffered from the disease mentioned above were retrospectively analyzed.

RESULTS

The common physical examination findings were local bump in the dorsal or lumbar spine area and palpation of rupture ends of paraspinal muscles and ligaments. The common MRI manifestations were ruptures of anterior longitudinal ligament, intervertebral disc, paraspinal muscles, and spinous process ligaments. The common operative findings were similar to MRI findings. The fractured vertebrae in 5 patients who underwent posterior reduction and fixation with two-segments pedicle screw did not restore their shape, but 10 patients who underwent posterior three-segments pedicle screw reduction and fixation restored the shape of fractured vertebrae.

CONCLUSION

The fresh thoracolumbar fracture-dislocation combined with paraspinal muscles, ligaments and intervertebral disc ruptures is a severe spine injury. Clinical physical examination and MRI appearance and intraoperative observation are important for the selection of operation procedure. The open reduction and internal fixation with pedicle screw-rod system, and intervertebral resection and fusion via posterior approach is a good procedure for the special thoracolumbar fracture.